Dietary share of ultra-processed foods and its association with vitamin E biomarkers in Brazilian lactating women

Abstract

Despite evidence showing that the intake of ultra-processed food has a negative impact on health, diet quality and dietary vitamin E, its impact on vitamin E nutritional status and breast milk remains unknown. This study aimed to assess the influence of the consumption of ultra-processed foods on vitamin E biomarkers of lactating women. A cross-sectional study was performed with 294 lactating women. Food consumption was obtained by 24-hour dietary recall and foods were grouped according to the NOVA classification. Levels of alpha-tocopherol were analyzed by High Performance Liquid Chromatography. Breast milk vitamin E (BMVE) adequacy was based on the quantity of the vitamin in the estimated intake volume. The Kruskal-Wallis test was used to compare the tertiles and linear regression to association between ultra-processed food consumption and biomarkers. Ultra-processed foods accounted for 16% of energy intake and vitamin E intakes by all women were considered low. Serum alpha-tocopherol was 26.55 (SD 7.98) µmol/L, 5% (n=11) showed inadequate vitamin E (<12µmol/L), and 78% had an inadequate BMVE content (< 4mg/780mL). The regression showed that a higher dietary share of ultra-processed foods was associated with lower concentrations of serum alpha-tocopherol (β=−0.168, CI=−0.047–0.010, p=0.003) and inadequate BMVE content (β=−0.144, CI=−0.505–0.063, p=0.012) (adjustment for income and maternal age). Thus, higher dietary shares of ultra-processed foods had an impact on vitamin E biomarkers, suggesting that inadequate dietary intake practices during lactation may reduce the supply of vitamin E to women and breast milk.

Impacts of Consumption of Ultra-Processed Foods on the Maternal-Child Health: A Systematic Review

“…Of the three life cycles studied, the lactation phase is practically invisible to the state of the art between UPF consumption and maternal and child health, with only one study being found addressing UPF consumption by lactating women and the micronutrient status and composition of breast milk. In this study, it was observed that a greater participation of UPF in the diet can negatively impact maternal serum alpha-tocopherol levels and the theoretical supply of vitamin E to the infant via breast milk analyzed (15), which alerts for the development of studies to assess the impact of UPF consumption on the composition of breast milk and on the development of specific nutritional deficiencies during lactation. This downward trend in micronutrients was observed in Brazil's 2008-2009 Household Budget Survey, which found that increased dietary UPF was associated with reduced content of vitamins B12, D, E, niacin and pyridoxine, and copper, iron, phosphorus, magnesium, selenium, and zinc, when compared with fresh and minimally processed foods (64).…”

“…The contribution of UPF in the diet ranged from 15.2 to 76.0%, and higher levels of consumption were reported in children, especially English children (21). Exposure was assessed through UPF total energy contribution in twelve studies (13)(14)(15)(21)(22)(23)(24)(25)(26)(27)(28)(29) and selected studies examined the association between UPF consumption and the following health outcomes: weight gain (n = 4) (13,14,22,26), adiposity measures gain (n = 3) (13, 24, 26), overweight/obesity (n = 2) (24, 26), nutrient intakes (n = 2) (21, 28), breastfeeding exclusive duration (n = 1) (30), alpha-tocopherol serum levels/nutrition composition of human milk (n = 1) (15), glucose levels (n = 1) ( 14), Attention deficit hyperactivity disorder (ADHD) (n = 1) (31), depression or sadness (n = 1) (23), wheeze/asthma (n = 1) (25, 29), caries (n = 1) (32) and urinary biomarkers of phthalates and bisphenol compounds levels (n = 1) (27). In the following topics we developed a narrative synthesis of our findings.…”

“…In lactating women, only one study was found regarding the researched parameters (15), and investigated the relationship between UPF maternal consumption and maternal vitamin E status. A higher dietary share of UPF (% energy) reduced serum concentration of alpha-tocopherol (vitamin E) (β = −0.168, 95% CI = −0.047-0.010) and the trajectories of probable inadequacy of the vitamin E content in breast milk (adjustment for income and maternal age), due to the lower availability of vitamin in the milk samples analyzed, suggesting that a higher dietary share of UPF may cause inadequate vitamin E status in lactating women and, possibly, low values in breast milk.…”

“…During pregnancy, a greater share of UPF in the diet was associated with excessive weight gain during pregnancy (13) and an increased risk of developing gestational diabetes (14). In lactating women, a study showed the relationship between UPF consumption and breast milk composition, when a greater participation of UPF was associated with lower levels of circulating maternal alpha-tocopherol and, hypothetically, lower vitamin E supply to infants via breast milk (15). This consumption was also directly associated with the child's eating practices (16).…”

Molecular Mechanisms Underlying the Therapeutic Role of Vitamin E in Age-Related Macular Degeneration

“…In most newborns, vitamin E is derived from breastmilk and reaches normal levels after a few weeks. Vitamin E is easily found in a balanced diet, however, a diet high in processed foods or low in fat can lead to a deficiency in vitamin E. This was studied in lactating women and those with diets high in processed foods had lower vitamin E levels in their breastmilk ( Amorim et al, 2021 ).…”