Maternal Nutrition and Lactation in India

印度的孕产妇营养和哺乳

基本信息

批准号：
9129781
负责人：
REYNALDO MARTORELL
金额：
$ 14.54万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-09-01 至 2019-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9129781
关键词：
Address Age-Months Anemia Birth Body Composition Body fat Body mass index Bottle feeding Breast Feeding Carbohydrates Child Child Nutrition Child health care Choline Copper Data Data Collection Deuterium Oxide Diet Dietary Intervention Dietary intake Dose Enrollment Exclusive Breastfeeding Failure Fatty acid glycerol esters Folic Acid Food Frequencies Fright Future Goals Growth Health Height Human Milk IL8 gene Immune Immunoglobulin A Immunoglobulins India Infant Infant Health Infant Malnutrition Inflammation Inflammatory Intake Intervention Intestines Iodine Iron Knowledge Lactation Lactoferrin Life Macronutrients Nutrition Malnutrition Maternal and Child Health Measurement Measures Methodology Methods Micronutrients Milk Milk Substitutes Mothers Nutrient Nutritional Nutritional Requirements Nutritional status Outcome Output Pathway interactions Pattern Performance Permeability Population Prevention Preventive Intervention Proteins Recommendation Reference Values Research Riboflavin Risk Role Route Rural Sample Size Sampling Selenium Serum Source Techniques Testing Thiamine Triceps Brachii Muscle United States National Center for Health Statistics Upper arm Vitamin A Vitamin B 12 Vitamin B6 Vitamin D Weight Woman Work Zinc base cost effective cytokine density design evidence base improved in utero innovation insight meetings mother nutrition novel nutrition prevent programs stable isotope wasting

项目摘要

DESCRIPTION (provided by applicant): Wasting and stunting are common in breastfed infants under six months in India and elsewhere but we know little about the prevention of these conditions. This research will generate critical knowledge about maternal malnutrition and lactation performance that will guide future maternal and child interventions. The mother should be the only nutrition portal to reach the young breastfed infant. Breast milk is undeniably the optimal source of vital nutrients and maternal immunoglobulins required for infant health and survival; however for too long the assumption has been that poor, thin women in India can produce as much high quality milk as the child demands. Fear of opening the door to inappropriate breast milk substitutes has discouraged research about potential effects of maternal malnutrition on breast milk. What little research exists often suffers from methodological limitations (such as small sample sizes and reliance on test weighing). We plan to enroll 232 lactating women with children 2-4 months of age. We propose preliminary work to allow us to assess the feasibility of using deuterium oxide (dose-to-mother technique) to measure milk volume and body composition in rural India. Our hypothesis is that the poor nutritional status of Indian women contributes to suboptimal lactation performance such that the child's high nutrient requirements are not met. In addition, we plan to explore whether maternal malnutrition leads to an altered inflammatory and immune milk profile and impaired infant intestinal permeability; which would further place the child at risk for early growth failure. Our key hypotheses are: Hypothesis 1: Women in rural India produce less milk and of lower energy and micronutrient density than necessary to meet children's optimal intakes. Hypothesis 2: Maternal malnutrition (low BMI, % body fat, mid upper arm circumference, and suboptimal micronutrient status) is associated with decreased breast milk quality (milk fat %, quantity and inadequate micronutrient concentrations) Hypothesis 3: Maternal malnutrition is associated with an inflammatory milk profile (higher Na:K ratios and pro-inflammatory cytokines) and breast milk inflammation is associated with infant intestinal permeability. This innovative research will provide critical information to inform maternal-focused nutrition strategies. The end goal would be to make national recommendations for the improvement of maternal and child health and nutrition outcomes in India and elsewhere.

描述（由申请人提供）：在印度和其他地方，消瘦和发育迟缓在六个月以下母乳喂养的婴儿中很常见，但我们对这些情况的预防知之甚少。这项研究将产生有关孕产妇营养不良和哺乳表现的重要知识，从而指导未来的孕产妇和儿童干预措施。母亲应该是母乳喂养的婴儿获得营养的唯一门户。无可否认，母乳是婴儿健康和生存所需的重要营养素和母体免疫球蛋白的最佳来源；然而，长期以来，人们一直认为印度贫穷、瘦弱的妇女可以生产出满足孩子需求的高质量牛奶。由于担心使用不适当的母乳替代品，有关孕产妇营养不良对母乳潜在影响的研究受到阻碍。现有的研究很少，但往往受到方法学限制（例如样本量小和对测试称重的依赖）。我们计划招募 232 名带着 2-4 个月大孩子的哺乳期妇女。我们建议开展初步工作，以评估使用氧化氘（母亲剂量技术）测量印度农村地区的乳汁量和身体成分的可行性。我们的假设是，印度妇女的营养状况不佳导致哺乳期表现不佳，从而无法满足孩子的高营养需求。此外，我们计划探讨母亲营养不良是否会导致炎症和免疫乳汁谱改变以及婴儿肠道通透性受损；这将进一步使孩子面临早期生长障碍的风险。我们的主要假设是：假设 1：印度农村妇女生产的牛奶较少，能量和微量营养素密度也低于满足儿童最佳摄入量所需的水平。假设 2：母亲营养不良（低 BMI、体脂百分比、中上臂周长和微量营养素状态欠佳）与母乳质量下降（乳脂百分比、数量和微量营养素浓度不足）相关假设 3：母亲营养不良与母乳质量下降相关炎症乳汁特征（较高的 Na:K 比率和促炎细胞因子）和母乳炎症与婴儿肠道通透性相关。这项创新研究将为以孕产妇为中心的营养策略提供重要信息。最终目标是为改善印度和其他地区的孕产妇和儿童健康和营养结果提出国家建议。

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Maternal nutritional status and milk volume and composition in India: an observational study.

DOI：
10.1016/j.ajcnut.2023.02.002
发表时间：
2023-04
期刊：
The American journal of clinical nutrition
影响因子：
0
作者：
通讯作者：

A mixed-methods study of pesticide exposures in Breastmilk and Community & Lactating Women's perspectives from Haryana, India.

DOI：
10.1186/s12889-020-09966-x
发表时间：
2020-12-07
期刊：
BMC public health
影响因子：
4.5
作者：
Mehta RV;Sreenivasa MA;Mathew M;Girard AW;Taneja S;Ranjan S;Ramakrishnan U;Martorell R;Ryan PB;Young MF
通讯作者：
Young MF

Risk of dietary and breastmilk exposure to mycotoxins among lactating women and infants 2-4 months in northern India.

DOI：
10.1111/mcn.13100
发表时间：
2021-04
期刊：
Maternal & child nutrition
影响因子：
3.4
作者：
Mehta RV;Wenndt AJ;Girard AW;Taneja S;Ranjan S;Ramakrishnan U;Martorell R;Ryan PB;Rangiah K;Young MF
通讯作者：
Young MF