title: A randomized controlled trial on the effects of jujube fruit on the concentrations of some toxic trace elements in human milk.
abstract: BACKGROUND
  This study aims to investigate the concentrations of lead, cadmium, and arsenic in the human milk, and to assess the effect of jujube fruit consumption by lactating mothers in reducing the concentration of these heavy metals in their milk.
  
  
  METHODS
  This randomized controlled trial was conducted in 2014 among forty postpartum mothers in Isfahan, the second largest and polluted city in Iran. Mothers were randomized into two groups; the intervention group received 15 g/day of fresh jujube fruit, and the controls received routine care for 8 weeks.
  
  
  RESULTS
  In the beginning, the concentrations of lead, cadmium, and arsenic were high, without significant difference between groups. The mean (standard deviation) concentrations of lead, cadmium, and arsenic were 29.49 (16.6), 4.65 (3.51), and 1.23 (0.63) μg/L, respectively. The smoothed empirical distribution of environmental pollutants showed that in both groups the mean values and variance of toxic metals decreased after 8 weeks, with a sharper decline in the intervention group. Quantile regression analysis showed that in the intervention group, lead concentration decreased by 2.54 μg/L at the 90thquintile, and cadmium decreased by 0.19 μg/Lat 75thquintile; without significant change in arsenic level. The corresponding figures were not significant in the control group.
  
  
  CONCLUSIONS
  The concentrations of heavy metals were high in human milk, and the consumption of jujube fruit had some beneficial effects in reducing these harmful elements. Pregnant and lactating mothers should be advised to reduce their exposure to environmental pollutants, and consumption of some natural medicinal foods can be useful in reducing the concentration of pollutants in human milk. Because of numerous benefits of breast milk, in spite of the existence of some toxic trace elements, breastfeeding must be encouraged because such contaminants are also found in water and formula. The impact of the current findings on the primary prevention of chronic disease should be determined in future longitudinal studies.
authors.affiliation: Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
authors.affiliation: Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Najmeh
authors.initials: N
authors.lastname: Hasanghaliaei
authors.affiliation: Department of Environmental Health Engineering, Environment Research Center, Research Institute for Primordial Prevention of Non Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Parinaz
authors.initials: P
authors.lastname: Poursafa
authors.affiliation: Department of Epidemiology, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Keikha
authors.affiliation: Department of Pharmacognosy, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Ghannadi
authors.affiliation: Department of Biostatistics, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Yazdi
authors.affiliation: Department of Food Hygiene, Young Researchers Club, Faculty of Veterinary Medicine, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran.
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Rahimi
keywords: Health; jujube fruit; pediatric; prevention