Dietary Assessment And Analysis Of Influence Factors Of Polyunsaturated Fatty Acids Levels In Human Breast Milk Of311Lactating Women In Changchun

Objective：Polyunsaturated fatty acids can promote the development of infants’ brain andretinal, most of polyunsaturated fatty acids in baby’s body are obtained from mother’smilk through mother-to-child transmission. Currently, research on fatty acids inmaternal plasma phospholipid and the milk of pregnant women have been doneabroad, but domestic research is very limited. In this study, polyunsaturated fatty acidlevels of311Changchun lactating women’ milk were analyzed to obtain the latestdata, explore the influence factors of polyunsaturated fatty acid composition in humanmilk to guide breastfeeding and ensure adequate level of polyunsaturated fatty acidsin human breast milk.Method：The subjects were311cases of healthy Changchun lactating women. Mothers hadno special diet habit, have a feeling to breastfeeding. They delivered full-term birthbabies with no defect or disease. Rule out women whose gestation age <28weeks or>42weeks, have diabetes, hypertension, coronary heart disease, kidney disease,obesity and other viscera merger disease. In3~7days after delivery, a questionnairewas used to collect the basic information of the research objects, all the subjectssigned informed consent. Dietary investigation were done three days before collectingmilk, and assessed individual5kinds of dietary fatty acid intake, at the same time, werecorded the information of pregnancy intake of polyunsaturated fatty acids (PUFA)nutritional supplements.20mL breast milk samples were collected in the postpartum22to25days and8kinds of fatty acid (LA, ALA, GLA, DGLA, AA, EPA, DTA,DHA) composition of breast milk were detected with gas chromatography. The dataof basic information, dietary fatty acids, and milk fatty acids were digital inputSPSS16.0database by designated persons. General data of the normal quantitativedata was shown with Mean±SD and the non-normal distribution of quantitative data was shown with Median±IQR; The Spearman and Pearson correlation were used toanalyze the correlation between dietary fatty acids and human breast milk’s fatty acids.Fatty acid data of different groups were analyzed with One-Way ANOVA test orKruskal-Wallis H test. Multivariate linear regression analysis was used to analysis theinfluence factors on the levels of the fatty acid content. All statistical tests weretwo-sided test, P <0.05is significant.Results：1. The analysis of basic information350cases of lactating women signed the informed consent.311milk samples werecollected in postpartum22~25days. The average age of the subjects was30and theaverage gestational age was39weeks. The rate of natural birth was30%, male: girlswas close to1:1; Mothers whose educational degree were graduate or aboveaccounted for14.34%, college education accounted for63.80%, high schooleducation accounted for21.86%; Monthly family income of2000~5000yuanaccounted for18.75%,5001~10000yuan accounted for54.17%,5001yuan or aboveaccounted for27.08%.2.3day24hour dietary assessment of lactating womenThe intake of dietary protein and fat were higher than the recommended values fornormal population,130.20g and85.55g, respectively; Carbohydrate364.00g, whichwas lower than the recommended value; The intake of calcium and folic acid wasslightly less than the recommended value, of which the average daily intake of folicacid was only260.09ugDFE, accounts for only52.25%of the recommended value.Iron intake was excessive, the average daily intake was34.85mg, accounting for141.00%of the recommended value; The intake of zinc and vitamin A were muchmore reasonable, the average daily intake of zinc was16.75mg, accounting for78.50%of the recommended value, the average daily intake of vitamin A was1196.50ugRE, accounting for100.00%of the recommended value.3. The levels of polyunsaturated fatty acids in breast milkIn addition to the GLA and EPA which were non-normal distribution, the other6kinds of LC-PUFA were all normality distribution. The highest level of n-6fatty acids was LA,1.520mg/ml, the highest level of n-3fatty acids was ALA,0.646mg/ml, the lowest n-6fatty acids was DTA,0.076mg/ml, minimum content of n-3fatty acids was EPA,0.035mg/ml.4. Analysis of influence factors of fatty acid level in breast milkDiet:Dietary LA was weakly negatively correlated to the eight kinds ofpolyunsaturated fatty acids in milk, dietary ALA showed a weak negative correlationwith DGLA, EPA, DTA and DHA in human milk, and correlation analysis werestatistically significant (P <0.05), while other correlation between dietary fatty acidsand breast milk fatty acids were not statistically significant (P>0.05);DHA supplements: The DHA group had a higher level of DHA concentration inbreast milk than the control group (P=0.01). However, the other7kinds of fatty acidsshowed no differences between the DHA group and the control group.Mothers’ degree of education: The levels of the8kinds of PUFA had significantdifference among the3groups (high school, undergraduate, graduate) except ALAand DTA (P=0.027, P=0.027, P=0.009, P=0.010, P=0.021, P=0.046).Delivery mode: The levels of LA, GLA, DGLA, AA, DTA and ALA had significantdifferences between the cesarean section group and natural birth group (P=0.016, P=0.016, P=0.019, P=0.013, P=0.014, P=0.032), However, the levels of EPA andDHA showed no differences between the two groups (P=0.245, P=0.245).Multiple linear regression：The level of DHA was influenced by mothers’ degreeof education and DHA supplements，Y=0.347-0.01X1+0.049X2，R2=0.063；The levelsof GLA、DTA were influenced by delivery mode, Y=0.136+0.04X1，R2=0.03，Y=0.067+0.012X1，R2=0.02；The levels of ALA、DGLA、AA were influenced bymothers’ degree of education， Y=1.13-0.031X1，R2=0.033； Y=0.382-0.01X1，R2=0.032，Y=0.56-0.015X1，R2=0.036.Conclusion：1. Dietary assessment, the intake of grains, vegetables, oil, beans, meat and poultry,aquatic products, vegetables of the311lactating women were appropriate, but theintake of milk and fruit was slightly lower than the recommended value. The ratio of saturated fatty acids: monounsaturated fatty acids: polyunsaturated fatty acids wasbasically closed to the recommended value.2. Among the311cases of lactating women, the highest level of n-6fatty acid in themilk was LA,1.520mg/ml, the highest level of n-3fatty acids was ALA,0.646mg/ml,the lowest level of n-6fatty acids was DTA,0.076mg/ml, minimum content of n-3fatty acids was EPA,0.035mg/ml.3. The influence factors of the level of breast milk PUFA were DHA supplements,mothers’ degree of education and delivery mode.