title: 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.
abstract: 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.
  
  
  
  We assessed whether daily consumption of biofortified orange maize would increase the retinol concentration in the breast milk of Zambian women.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD;
authors.forename: Amanda C
authors.identifier: 0000-0002-3212-955X
authors.initials: AC
authors.lastname: Palmer
authors.affiliation: Tropical Diseases Research Centre, Ndola, Zambia; and.
authors.forename: Justin
authors.initials: J
authors.lastname: Chileshe
authors.affiliation: Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Hall
authors.affiliation: Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD;
authors.forename: Maxwell A
authors.initials: MA
authors.lastname: Barffour
authors.affiliation: Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD;
authors.forename: Ngosa
authors.initials: N
authors.lastname: Molobeka
authors.affiliation: Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD;
authors.forename: Keith P
authors.identifier: 0000-0001-9458-362X
authors.initials: KP
authors.lastname: West
authors.affiliation: Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA mjhaskell@ucdavis.edu.
authors.forename: Marjorie J
authors.initials: MJ
authors.lastname: Haskell
mesh_terms: D000328:Adult; D015992:Body Mass Index; D004224:Diterpenes; D005260:Female; D005527:Food, Fortified; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007774:Lactation; D008895:Milk, Human / Q000737:chemistry*; D009752:Nutritional Status; D000072664:Provitamins / Q000008:administration & dosage* / Q000097:blood; D000084562:Retinyl Esters; D016896:Treatment Outcome; D014801:Vitamin A / Q000008:administration & dosage* / Q000031:analogs & derivatives / Q000737:chemistry*; D014802:Vitamin A Deficiency / Q000097:blood / Q000517:prevention & control; D055815:Young Adult; D015024:Zambia; D003313:Zea mays / Q000737:chemistry*
chemical_list: D004224:Diterpenes; D006454:Hemoglobins; D000072664:Provitamins; D000084562:Retinyl Esters; D014801:Vitamin A; C014794:retinol palmitate
keywords: biofortification; milk; provitamin A; retinol; vitamin A