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      Calcium and magnesium concentrations in mature human milk: influence of calcium intake, age and socioeconomic level Translated title: Concentrações de cálcio e magnésio em leite humano maduro: Influencia da ingestão de cálcio, idade e nível sócioeconômico da nutriz.

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          Abstract

          SUMMARY. Concentrations of calcium and magnesium were measured in mature milk, collected between 30 and 90 days after childbirth, from a group of 90 mothers between 14 and 39 years of age, exclusively breastfeeding. The group was divided into three sub-groups: low socioeconomic-level adolescents (LSAd), low socioeconomic-level adults (LSA), and high socioeconomic-level adults (HSA). Each mother’s nutritional status was determined using the body-mass index (BMI) and her eating habits, obtained on the basis of a 24-h dietary recall. Adolescent and adult mothers in the low socioeconomic-level group had lower average calcium intake (LSAd = 618.4 ± 555.2 mg and LSA = 679.4 ± 411.4 mg) than adult mothers in the higher socioeconomic-level group (853.6 ± 415.5 mg). The average concentration of calcium in the adolescent mothers’ milk (LSAd) was significantly lower (5.30 ± 1.42 mmol Ca/L, P= 0.01) than that of the two adult groups (LSA = 5.82 ± 1.55 mmol Ca/L and HSA = 6.40 mmol Ca/L). The average magnesium concentrations for all groups did not show significant differences (LSAd = 1.06 ± 0.18, LSA = 1.16 ± 0.23 and HSA = 1.11 ± 0.23 mmol Mg/L, for P= 0.16). These results indicate that magnesium concentrations in mature human milk do not seem to depend on maternal nutritional status. The condition of adolescence, however, associated with lower calcium intake by the mother, resulted in lower calcium concentrations in the milk secreted when compared to that of adult mothers.

          Translated abstract

          RESUMO: Concentrações de cálcio e magnésio foram medidas em leite maduro colhido entre 30 e 90 dias após o parto de 90 mães em regime exclusivo de aleitamento ao peito e com idades entre 14 e 39 anos. O grupo de doadoras foi dividido em três sub-grupos: adolescentes de baixo nível socioeconômico (LSAd), adultas de baixo nível socioeconômico (LSA), e adultas de alto nível socioeconômico (HSA). O estado nutricional de cada doadora foi determinado usando o índice de massa corporal (BMI) e seus hábitos alimentares com base em um inquérito recordatório das últimas 24 horas. Mães adolescentes e adultas dos grupos de baixo nível socioeconômico apresentaram uma ingestão média de cálcio (LSAd = 618.4 ± 555.2 mg e LSA = 679.4 ± 411.4 mg) do que as mães do grupo alto nível (853.6 ± 415.5 mg). A concentração media de cálcio no leite das mães adolescentes (LSAd) foi significativamente mais baixo (5.30 ± 1.42 mmol Ca/L, P= 0.01) que as mães adultas dos dois outros grupos (LSA = 5.82 ± 1.55 mmol Ca/L e HSA = 6.40 mmol Ca/L). A concentração media de magnésio para todos os grupos não mostrou diferença significativa (LSAd = 1.06 ± 0.18, LSA = 1.16 ± 0.23 e HSA = 1.11 ± 0.23 mmol Mg/L, for P= 0.16). Estes resultados indicam que a concentração de magnésio em leite humano maduro não parece depender do estado nutricional materno. No entanto, a condição de adolescência associada a uma ingestão mais baixa de cálcio pela mãe resultou em concentrações mais baixas de cálcio no leite secretado quando comparado ao leite de mães adultas.

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          A longitudinal study of calcium homeostasis during human pregnancy and lactation and after resumption of menses.

          To clarify the role of the intestine, kidney, and bone in maintaining calcium homeostasis during pregnancy and lactation and after the resumption of menses, a longitudinal comparison was undertaken of 14 well-nourished women consuming approximately 1200 mg Ca/d. Measurements were made before conception (prepregnancy), once during each trimester of pregnancy (T1, T2, and T3), early in lactation at 2 mo postpartum (EL), and 5 mo after resumption of menses. Intestinal calcium absorption was determined from the enrichment of the first 24-h urine sample collected after administration of stable calcium isotopes. Bone mineral of the total body and lumbar spine was measured by dual-energy X-ray absorptiometry and quantitative computerized tomography, respectively. Twenty-four-hour urine and fasting serum samples were analyzed for calcium, calcitropic hormones, and biochemical markers of bone turnover. Despite an increase in calcium intake during pregnancy, true percentage absorption of calcium increased from 32.9+/-9.1% at prepregnancy to 49.9+/-10.2% at T2 and 53.8+/-11.3% at T3 (P < 0.001). Urinary calcium increased from 4.32+/-2.20 mmol/d at prepregnancy to 6.21+/-3.72 mmol/d at T3 (P < 0.001), but only minor changes in maternal bone mineral were detected. At EL, dietary calcium and calcium absorption were not significantly different from that at prepregnancy, but urinary calcium decreased to 1.87+/-1.22 mmol/d (P < 0.001) and trabecular bone mineral density of the spine decreased to 147.7+/-21.2 mg/cm3 from 162.9+/-25.0 mg/cm3 at prepregnancy (P < 0.001). Calcium absorption postmenses increased nonsignificantly to 36.0+/-8.1% whereas urinary calcium decreased to 2.72+/-1.52 mmol/d (P < 0.001). We concluded that fetal calcium demand was met by increased maternal intestinal absorption; early breast-milk calcium was provided by maternal renal calcium conservation and loss of spinal trabecular bone, a loss that was recovered postmenses.
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            Calcium requirements of lactating Gambian mothers: effects of a calcium supplement on breast-milk calcium concentration, maternal bone mineral content, and urinary calcium excretion.

            The calcium requirement for prolonged lactation was investigated in a randomized supplementation study of Gambian mothers consuming a low-calcium diet (7.1 mmol/d, or 283 mg/d). Sixty women were studied from 10 d to 78 wk of lactation, receiving calcium or placebo for the first 12 mo. The supplement increased average calcium intake by 17.9 mmol/d (714 mg/d). Supplementation had no effect on breast-milk calcium concentration or on maternal bone mineral content. Urinary calcium output was higher in supplemented than in unsupplemented mothers by 1.18 mmol/d (47 mg/d), P < or = 0.005. Longitudinal changes in urinary calcium output and bone mineral content made a substantial contribution to calcium requirements for lactation. This study suggests that, in women with low calcium intakes, there is no direct benefit from increasing calcium intake during lactation, and that physiological mechanisms operate to furnish calcium for breast-milk production.
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              Breast milk as a source of vitamins, essential minerals and trace elements.

              Human breast milk provides all of the vitamins and essential minerals and trace elements (micronutrients) that are required by the normal term infant, until weaning. With a few exceptions, excessive micronutrient supplies to the mother, or a moderate deficiency in her diet, do not greatly alter the supply to the infant. Thus, the infant is well-protected by maternal homeostatic processes, although the mechanisms of these are not yet well understood. Considerable progressive changes in concentration occur for some of the micronutrients during the course of lactation. Because the concentration of these nutrients, and of other substances that modify their absorption by the infant, such as binding proteins, differs considerably between human milk, animal milk and, hence, commercial milk formulae, there is great interest in the quantitative significance of micronutrient supplies, and their variability in breast milk, in the quest for improvement of commercial formulations. The aim of this review is to summarize the available information about the factors that determine breast milk contents of micronutrients.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                alan
                Archivos Latinoamericanos de Nutrición
                ALAN
                Sociedad Latinoamericana de Nutrición (Caracas )
                0004-0622
                March 2004
                : 54
                : 1
                : 118-122
                Article
                S0004-06222004000100017
                15332365
                9eb0a732-c483-455c-8a2d-b803712e88f5

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0004-0622&lng=en
                Categories
                NUTRITION & DIETETICS

                Nutrition & Dietetics
                Calcium,magnesium,human milk,Cálcio,magnésio,leite humano
                Nutrition & Dietetics
                Calcium, magnesium, human milk, Cálcio, magnésio, leite humano

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