Journal article
Antiretroviral therapy provided to HIV-infected Malawian women in a randomized trial diminishes the positive effects of lipid-based nutrient supplements on breast-milk B vitamins
The American journal of clinical nutrition, Vol.102(6), pp.1468-1474
12/01/2015
DOI: 10.3945/ajcn.114.105106
PMCID: 4658457
PMID: 26537941
Abstract
Background: Little information is available on B vitamin concentrations in human milk or on how they are affected by maternal B vitamin deficiencies, antiretroviral therapy, or maternal supplementation.
Objective: The objective was to evaluate the effects of antiretroviral therapy and/or lipid-based nutrient supplements (LNSs) on B vitamin concentrations in breast milk from HIV-infected women in Malawi.
Design: Breast milk was collected from 537 women recruited within the Breastfeeding, Antiretrovirals, and Nutrition study at 2 or 6 wk and 24 wk postpartum. Women were assigned to receive antiretrovirals and LNSs, antiretrovirals only, LNSs only, or a control. Antiretrovirals and LNSs were given to the mothers from weeks 0 to 28. The antiretrovirals were zidovudine/lamivudine and nelfinavir or lopinavir/ritonavir. LNSs provided 93-118% of the Recommended Dietary Allowances of thiamin, riboflavin, niacin, pyridoxine, and vitamin B-12. Infants were exclusively breastfed.
Results: LNSs increased milk concentrations of all vitamins except thiamin, whereas antiretrovirals lowered concentrations of nicotinamide, pyridoxal, and vitamin B-12. Although antiretrovirals alone had no significant effect on riboflavin concentrations, they negatively affected the LNS-induced increase in this vitamin. Thiamin was not influenced by the study interventions. Concentrations of all B vitamins were much lower than usually accepted values.
Conclusions: All B vitamins were low in milk, and all but thiamin were increased by maternal supplementation with LNSs. Antiretrovirals alone decreased concentrations of some B vitamins in milk. When LNS was given in addition to antiretrovirals, the negative effect of antiretrovirals offset the positive effect of LNSs for all vitamins except thiamin.
Details
- Title: Subtitle
- Antiretroviral therapy provided to HIV-infected Malawian women in a randomized trial diminishes the positive effects of lipid-based nutrient supplements on breast-milk B vitamins
- Creators
- Lindsay H. Allen - Western Human Nutrition Research CenterDaniela Hampel - Western Human Nutrition Research CenterSetareh Shahab-Ferdows - Western Human Nutrition Research CenterEmily R. York - Western Human Nutrition Research CenterLinda S. Adair - University of North Carolina at Chapel HillValerie L. Flax - University of North Carolina at Chapel HillGerald Tegha - UNC Project, Lilongwe, MalawiCharles S. Chasela - University of the WitwatersrandDebbie Kamwendo - UNC Project, Lilongwe, MalawiDenise J. Jamieson - CDC FoundationMargaret E. Bentley - University of North Carolina at Chapel Hill
- Resource Type
- Journal article
- Publication Details
- The American journal of clinical nutrition, Vol.102(6), pp.1468-1474
- Publisher
- Oxford Univ Press
- DOI
- 10.3945/ajcn.114.105106
- PMID
- 26537941
- PMCID
- 4658457
- ISSN
- 0002-9165
- eISSN
- 1938-3207
- Number of pages
- 7
- Grant note
- DHHS/NIH/FIC 2-D43 Tw01039-06; R24 Tw00798 / NIH Fogarty AIDS International Training and Research Program US Agency for International Development; United States Agency for International Development (USAID) Elizabeth Glaser Pediatric AIDS Foundation R24 HD050924 / Carolina Population Center SIP 13-01 U48-CCU409660-09; SIP 26-04 U48-DP000059-01; SIP 22-09 U48-DP001944-01 / Prevention Research Centers Special Interest Project of the CDC OPP53107; OPP1061055 / Bill & Melinda Gates Foundation; CGIAR Johnson Johnson; Johnson & Johnson; Johnson & Johnson USA NIH Fogarty AIDS International Training and Research Program (American Recovery and Reinvestment Act) 5306-51000-003-00D / intramural USDA-ARS Project P30-AI50410 / University of North Carolina Center for AIDS Research World Food Program National Institute of Allergy and Infectious Diseases; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) Malawi Ministry of Health and Population United Nations Children's Fund
- Language
- English
- Date published
- 12/01/2015
- Academic Unit
- Obstetrics and Gynecology; VPMA - Administration
- Record Identifier
- 9984446533202771
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