Short-Term Daily Consumption of Provitamin A Carotenoid-Biofortified Maize Has Limited Impact on Breast Milk Retinol Concentrations in Zambian Women Enrolled in a Randomized Controlled Feeding Trial

J Nutr. 2016 Sep;146(9):1783-92. doi: 10.3945/jn.116.233700. Epub 2016 Jul 27.

Abstract

Background: Provitamin A carotenoid-biofortified maize is a conventionally bred staple crop designed to help prevent vitamin A deficiency. Lactating women are a potential target group, because regularly eating biofortified maize may increase vitamin A in breast milk-a critical source of vitamin A for breastfeeding infants.

Objective: We assessed whether daily consumption of biofortified orange maize would increase the retinol concentration in the breast milk of Zambian women.

Methods: Lactating women (n = 149) were randomly assigned to receive orange maize delivering 600 μg retinol equivalents (REs)/d as carotenoid plus placebo (OM), low-carotenoid white maize plus 600 μg REs/d as retinyl palmitate (VA), or white maize plus placebo (WM). Boiled maize (287 g dry weight/d) was served as 2 meals/d, 6 d/wk for 3 wk. We measured initial and final breast milk plasma retinol and β-carotene concentrations, and plasma inflammatory protein concentrations.

Results: Groups were comparable at enrollment, with an overall geometric mean milk retinol concentration of 0.95 μmol/L (95% CI: 0.86, 1.05 μmol/L); 56% of samples had milk retinol <1.05 μmol/L. Median capsule and maize intake was 97% and 258 g dry weight/d, respectively. Final milk β-carotene did not vary across groups (P = 0.76). Geometric mean (95% CI) milk retinol concentration tended to be higher in the OM [1.15 μmol/L (0.96, 1.39 μmol/L)] and VA [1.17 μmol/L (0.99, 1.38 μmol/L)] groups than in the WM group [0.91 μmol/L (0.72, 1.14 μmol/L); P = 0.13], and the proportion of women with milk retinol <1.05 μmol/L was 52.1%, 42.9%, and 36.7% in the WM, OM, and VA groups, respectively (P-trend = 0.16).

Conclusions: Daily biofortified maize consumption did not increase mean milk retinol concentration in lactating Zambian women; however, there was a plausible downward trend in the risk of low milk retinol across intervention groups. This trial was registered at clinicaltrials.gov as NCT01922713.

Keywords: biofortification; milk; provitamin A; retinol; vitamin A.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Body Mass Index
  • Diterpenes
  • Female
  • Food, Fortified*
  • Hemoglobins / metabolism
  • Humans
  • Lactation
  • Milk, Human / chemistry*
  • Nutritional Status
  • Provitamins / administration & dosage*
  • Provitamins / blood
  • Retinyl Esters
  • Treatment Outcome
  • Vitamin A / administration & dosage*
  • Vitamin A / analogs & derivatives
  • Vitamin A / chemistry*
  • Vitamin A Deficiency / blood
  • Vitamin A Deficiency / prevention & control
  • Young Adult
  • Zambia
  • Zea mays / chemistry*

Substances

  • Diterpenes
  • Hemoglobins
  • Provitamins
  • Retinyl Esters
  • Vitamin A
  • retinol palmitate

Associated data

  • ClinicalTrials.gov/NCT01922713