How the data revolution can benefit farmers

Background: Iodine deficiency occurs in West European countries. Iodine is important for brain development of the foetus and infant. The current iodine status of pregnant and lactating Dutch women is unknown. Methods: In a pilot study we examined the iodine status of 36 women. From 20 gestational weeks (GW) until 4 weeks postpartum, they ingested 150 mu g iodine/day in the form of a multivitamin supplement for pregnant and lactating women. Twenty-four hour urine samples were collected at 20 and 36 GW and at 4 weeks postpartum. A breast milk sample was collected at 4 weeks postpartum. Iodine concentrations were analysed by inductively coupled plasma-mass spectrometry. Cut-off values for the urinary iodine concentration (UIC) for pregnant and lactating women are 150 and 100 mu g/l, respectively. Adequate intakes (AI) of iodine for infants aged 0-6 months are 1.1 mu mol/l (Institute of Medicine recommendations) or 0.5 mu mol/l (Nordic Council recommendations). Results: The median UICs (percentages below cut-off) were 102 mu g/l (83%) at 20 GW, 144 mu g/l (56%) at 36 GW and 112 mu g/l (40%) at 4 weeks postpartum. The median breast milk iodine concentration was 1.2 mu mol/l (range 0.5-3.0); 33% and 0% of the infants had estimated iodine intakes below the IOM-AI and Nordic-AI, respectively. Conclusion: This pilot study suggested a high prevalence of iodine deficiency during pregnancy. Daily supplementation of 150 mu g iodine from 20 GW might be insufficient to reach maternal iodine adequacy. The median breast milk iodine concentration seems adequate. Further studies, using a representative sample of the Dutch population, are needed to establish the current Dutch iodine status of pregnant and lactating women

A maternal erythrocyte DHA content of approximately 6 g% is the DHA status at which intrauterine DHA biomagnifications turns into bioattenuation and postnatal infant DHA equilibrium isreached

PURPOSE: Higher long-chain polyunsaturated fatty acids (LCP) in infant compared with maternal lipids at delivery is named biomagnification. The decline of infant and maternal docosahexaenoic acid (DHA) status during lactation in Western countries suggests maternal depletion. We investigated whether biomagnification persists at lifelong high fish intakes and whether the latter prevents a postpartum decline of infant and/or maternal DHA status. METHODS: We studied 3 Tanzanian tribes with low (Maasai: 0/week), intermediate (Pare: 2–3/week), and high (Sengerema: 4–5/week) fish intakes. DHA and arachidonic acid (AA) were determined in maternal (m) and infant (i) erythrocytes (RBC) during pregnancy (1st trimester n = 14, 2nd = 103, 3rd = 88), and in mother–infant pairs at delivery (n = 63) and at 3 months postpartum (n = 104). RESULTS: At delivery, infants of all tribes had similar iRBC-AA which was higher than, and unrelated to, mRBC-AA. Transplacental DHA biomagnification occurred up to 5.6 g% mRBC-DHA; higher mRBC-DHA was associated with “bioattenuation” (i.e., iRBC-DHA < mRBC-DHA). Compared to delivery, mRBC-AA after 3 months was higher, while iRBC-AA was lower. mRBC-DHA after 3 months was lower, while iRBC-DHA was lower (low fish intake), equal (intermediate fish intake), and higher (high fish intake) compared to delivery. We estimated that postpartum iRBC-DHA equilibrium is reached at 5.9 g%, which corresponds to a mRBC-DHA of 6.1 g% throughout pregnancy. CONCLUSION: Uniform high iRBC-AA at delivery might indicate the importance of intrauterine infant AA status. Biomagnification reflects low maternal DHA status, and bioattenuation may prevent intrauterine competition of DHA with AA. A mRBC-DHA of about 6 g% during pregnancy predicts maternal–fetal equilibrium at delivery, postnatal iRBC-DHA equilibrium, but is unable to prevent a postnatal mRBC-DHA decline

Influence of daily 10-85 mu g vitamin D supplements during pregnancy and lactation on maternal vitamin D status and mature milk antirachitic activity

Pregnant and lactating women and breastfed infants are at risk of vitamin D deficiency. The supplemental vitamin D dose that optimises maternal vitamin D status and breast milk antirachitic activity (ARA) is unclear. Healthy pregnant women were randomised to 10 (n 10), 35 (n 11), 60 (n 11) and 85 (n 11) mu g vitamin D-3/d from 20 gestational weeks (GW) to 4 weeks postpartum (PP). The participants also received increasing dosages of fish oil supplements and a multivitamin. Treatment allocation was not blinded. Parent vitamin D and 25-hydroxyvitamin D (25(OH)D) were measured in maternal plasma at 20 GW, 36 GW and 4 weeks PP, and in milk at 4 weeks PP. Median 25(OH)D and parent vitamin D at 20 GW were 85 (range 25-131) nmol/l and 'not detectable (nd)' (range nd-40) nmol/l. Both increased, seemingly dose dependent, from 20 to 36 GW and decreased from 36 GW to 4 weeks PP. In all, 35 mu g vitamin D/d was needed to increase 25(OH)D to adequacy (80-249 nmol/l) in >97 center dot 5 % of participants at 36 GW, while >85 mu g/d was needed to reach this criterion at 4 weeks PP. The 25(OH)D increments from 20 to 36 GW and from 20 GW to 4 weeks PP diminished with supplemental dose and related inversely to 25(OH)D at 20 GW. Milk ARA related to vitamin D-3 dose, but the infant adequate intake of 513 IU/l was not reached. Vitamin D-3 dosages of 35 and >85 mu g/d were needed to reach adequate maternal vitamin D status at 36 GW and 4 weeks PP, respectively

Kinetics of Plasma- and Erythrocyte-Astaxanthin in Healthy Subjects Following a Single and Maintenance Oral Dose

Aim & background: Astaxanthin is a unique carotenoid of predominantly marine origin providing the pink-red color to certain microalgae and accumulating in various animals higher in the food chain. It is an antioxidant without pro-oxidant properties or known side-effects following oral intake. Methods: We investigated astaxanthin kinetics in plasma and erythrocytes (RBC) of four healthy adults after a single oral 40 mg dose. Plasma- and RBC-astaxanthin were measured during 72h. Subsequently, an 8 mg/day dose was given during 17 days. Plasma- and RBC-astaxanthin were measured each morning. Results: Plasmaastaxanthin reached a peak (from 79 to 315 nmol/L) after 8h and then declined (half-life, 18h). Within 72h, plasma-astaxanthin had returned to baseline. RBC-astaxanthin reached a peak (from 63 to 137 nmol/L packed cells) at 12h and subsequently disappeared (half-life, 28h). During the daily dose, plasmaastaxanthin increased until day 10 (187 nmol/L) and then decreased to a steady concentration similar to that reached after 2 days. RBC-astaxanthin appeared to be highly variable (group median concentration, 86 nmol/L packed cells). Conclusion: We found high intra- and inter-individual variations, especially in RBC, possibly due to non-standardized time difference between astaxanthin intake and sampling, fl uctuating background intake from the diet, variable bioavailability, large distribution volume, degradation or others. Oral astaxanthin is rapidly absorbed and incorporated into RBC. The subsequent rapid decline suggests that, for a higher-than-baseline status, astaxanthin should be taken daily, at least in an early phase when total body equilibrium, if any, has not been reached yet

27. New echocardiogram index alternatives to MAPSE and TAPSE z-scores in children

BackgroundMitral annular plane systolic excursion (MAPSE), and tricuspid annular plane systolic excursion (TAPSE) are relatively load independent longitudinal left ventricle (LV) and right ventricle (RV) measurement in both adults and children. Normal paediatric values of MAPSE and TAPSE unlike adults are based on inconvenient z-scores. We hypothesize novel indexes of (LSI) LV longitudinal systolic index and (RSI) RV longitudinal systolic index are BSA, age, gender independent and nullifies the need for MAPSE and TAPSE z-scores.MethodsNormal echocardiograms were retrospectively reviewed from 2009 to 2011. Ejection fraction, LV dimensions, MAPSE, and TAPSE were determined. LSI and RSI were calculated using MAPSE and TAPSE divided by LV length. Echocardiogram indices were correlated. Regression analysis was done for BSA, age, and gender.ResultsTwo hundred and one patients had normal ejection fractions (67.3;±5.1%). Mean MAPSE 10.4;±3.3mm, z-score −0.07;±1.2, and LSI 0.20;±0.03; Mean TAPSE 17.4;±5.4mm, z-score 0.74;±1.7, and RSI 0.34;±0.06. LSI and MAPSE z-scores correlated, r=0.73, p<0.001. Age, gender, and BSA did not correlate with LSI. RSI and TAPSE z-scores correlated with r=0.76, p<0.001. Age influences RSI, R2=0.58, p value <0.001, BSA and gender does not. RSI, with age stratification, is significantly decreased less than 2months.ConclusionLSI obviates need for-MAPSE z scores. RSI offers an additional non TAPSE z-score method to evaluate RV function, but does not nullify age effect. RSI, especially in the first two months is decreased

Case study of temporal changes in maternal dietary intake and the association with breast milk mineral contents

Minerals play important roles in infant growth and development, even though they only make up to 0.2 g% of the mature breast milk contents. Limited studies examined the association between maternal dietary intake and breast milk mineral contents in a temporal manner. Twenty Malaysian Malay postpartum mothers were recruited by either convenience or snow balling sampling from the urban lower middle income residential areas. Dietary intake of the subjects was obtained by 24-hour recall during each breast milk collection. Adequacy of maternal mineral intake was compared with the latest Recommended Nutrient Intake for Malaysia. Each of the subject provided breast milk samples for three times (T1, T2, and T3) at consecutive 2-week intervals. Breast milk concentrations of selected macro- and micro-minerals, including Ca, P, K, Na, Mg, Fe, Zn, Cu, Mn, Se, I, Cr and Mo were determined by inductively coupled plasma mass spectrometry (ICP-MS). Subjects were aged 31.4 +/- 6.1 years with a majority (60 %) having post-secondary school/college education. While maternal intake of macro-minerals, Ca, P, K and Mg, did not display a significant temporal changes from T1 to T3, the intake of micro-minerals, Cu, Mn and I decreased significantly over time from T1 to T3. Breast milk K, Fe, Zn and Cu concentrations showed a significant decreased with the progression of lactation from transitional (2-3 weeks) to established stage (>8-12 weeks). Significant correlations were established between maternal intake of K, Na, Fe and Se and their respective concentrations in breast milk in the present study. This case study revealed an inadequate maternal intake of several key micro-minerals (Cu, Mn, I) among the postpartum Malay mothers and a decreasing concentrations of certain essential minerals (K, Fe, Zn and Cu) in breast milk with lactation stage

Folate reference interval estimation in the Dutch general population

Background: Folate functions as an enzyme co-factor within the one-carbon metabolic pathway, providing key metabolites required for DNA synthesis and methylation. Hence, insufficient intake of folate can negatively affect health. As correct interpretation of folate status is dependent on a well-established reference interval, we set out to perform a new estimation following the restandardization of the Roche folate assay against the international folate standard. Materials and methods: The folate reference interval was estimated using samples obtained from the Dutch population-based Lifelines cohort. The reference interval was estimated using two methods: a nonparametric estimation combined with bootstrap resampling and by fitting the data to a gamma distribution. The lower reference limit was verified in a patient cohort by combined measurement of folate and homocysteine. Results: Dependent on the method used for estimation and in- or exclusion of individuals younger than 21 years of age, the lower reference limit ranged from 6.8 to 7.3 nmol/L and the upper reference limit ranged from 26 to 38.5 nmol/L. Applying a lower reference limit of 7.3 nmol/L resulted in the following percentage of folate deficiencies over a period of 12 months: general practitioner 15.5% (IQR 4.0%), general hospital 12.8% (IQR 5.3%), academic hospital 9.6% (IQR 4.3%). Conclusions: We estimated the folate reference interval in the Dutch general population which is not affected by a folic acid fortification program and verified the obtained lower reference limit by homocysteine measurements. Based on our results, we propose a folate reference interval independent of age of 7.3-38.5 nmol/

Use of Salivary Iodine Concentrations to Estimate the Iodine Status of Adults in Clinical Practice

BACKGROUND: Measurement of the 24-h urinary iodine concentration or urinary iodine excretion (UIE) is the gold standard to determine iodine status; however, this method is inconvenient. The use of salivary iodine could be a possible alternative since salivary glands express the sodium-iodine symporter. OBJECTIVES: We aimed to establish the correlation between the salivary iodine secretion and UIE, to evaluate the clinical applicability of the iodine saliva measurement. METHODS: We collected 24-h urine and saliva samples from 40 participants ≥18 y: 20 healthy volunteers with no specific diet (group 1), 10 patients with differentiated thyroid cancer with a low dietary intake (<50 μg/d, group 2), and 10 patients with a high iodine status as the result of the use of amiodarone (group 3). Urinary and salivary iodine were measured using a validated inductively coupled plasma MS method. To correct for differences in water content, the salivary iodine concentration (SIC) was corrected for salivary protein and urea concentrations (SI/SP and SI/SU, respectively). The intra- and inter-individual CVs were calculated, and the Kruskal-Wallis test and Spearman's correlation were used. RESULTS: The intra-individual CVs for SIC, SI/SP, and SI/SU were 63.8%, 37.7%, and 26.9%, respectively. The inter-individual CVs for SIC, SI/SP, and SI/SU were 77.5%, 41.6% and 47.0%, respectively. We found significant differences (P < 0.01) in urinary and salivary iodine concentrations between all groups [the 24-h UIE values were 176 μg/d (IQR, 96.1–213 μg/d), 26.0 μg/d (IQR, 22.0–37.0 μg/d), and 10.0*10(3) μg/d (IQR, 7.57*10(3)–11.4*10(3) μg/d) in groups 1–3, respectively; the SIC values were 136 μg/L (IQR, 86.3–308 μg/L), 71.5 μg/L (IQR, 29.5–94.5 μg/L), and 14.3*10(3) μg/L (IQR, 10.6*10(3)–25.6*10(3) μg/L) in groups 1–3, respectively]. Correlations between the 24-h UIE and SIC, SI/SP, and SI/SU values were strong (ρ = 0.80, ρ = 0.90, and ρ = 0.86, respectively; P < 0.01). CONCLUSIONS: Strong correlations were found between salivary and urinary iodine in adults with different daily iodine intakes. A salivary iodine measurement can be performed to assess the total iodine body pool, with the recommendation to correct for salivary protein or urea

Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115 nmol/l

Cutaneous synthesis of vitamin D by exposure to UVB is the principal source of vitamin D in the human body. Our current clothing habits and reduced time spent outdoors put us at risk of many insufficiency-related diseases that are associated with calcaemic and non-calcaemic functions of vitamin D. Populations with traditional lifestyles having lifelong, year-round exposure to tropical sunlight might provide us with information on optimal vitamin D status from an evolutionary perspective. We measured the sum of serum 25-hydroxyvitamin D-2 and D-3 (25(OH) D) concentrations of thirty-five pastoral Maasai (34 (SD 10) years, 43% male) and twenty-five Hadzabe hunter-gatherers (35 (SD 12) years, 84% male) living in Tanzania. They have skin type VI, have a moderate degree of clothing, spend the major part of the day outdoors, but avoid direct exposure to sunlight when possible. Their 25(OH) D concentrations were measured by liquid chromatography-MS/MS. The mean serum 25(OH) D concentrations of Maasai and Hadzabe were 119 (range 58-167) and 109 (range 71-171) nmol/l, respectively. These concentrations were not related to age, sex or BMI. People with traditional lifestyles, living in the cradle of mankind, have a mean circulating 25(OH) D concentration of 115 nmol/l. Whether this concentration is optimal under the conditions of the current Western lifestyle is uncertain, and should as a possible target be investigated with concomitant appreciation of other important factors in Ca homeostasis that we have changed since the agricultural revolution