Use of Theoretical Women and Model-Based Compartmental Analysis to Evaluate the Impact of Vitamin A Intake with or without a Daily Vitamin A Supplement on Vitamin A Total Body Stores and Balance During Lactation.
Study Goal
The researchers aimed to simulate the impact of dietary Vitamin A intake and daily supplements on Vitamin A total body stores and balance in lactating women with low/moderate Vitamin A stores.
Results Summary
The study found that increasing Vitamin A intake or adding a daily supplement (2.8 μmol/d) effectively countered negative Vitamin A balance caused by lactation, maintaining or increasing Vitamin A stores and breastmilk concentration. Without supplementation, Vitamin A balance was negative, but supplementation resulted in positive balance.
Population
Theoretical lactating women with low/moderate Vitamin A total body stores.
Effective Dosage
2.8 μmol/d (daily supplement)
Duration
6 months
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
increasing prelactation VA intake to maintain VA balance (LSS) | increase | VA intake | theoretical lactating women with low/moderate TBS | 0.8-1.87 μmol/d | had to increase | #1 |
maintaining prelactation VA intake (NLSS) | decrease | VA balance | theoretical lactating women with low/moderate TBS | -0.77 μmol/d | was negative | #2 |
adding a daily VA supplement (2.8 μmol/d) to maintained prelactation VA intake (NLSS+S) | increase | VA balance | theoretical lactating women with low/moderate TBS | 0.75 μmol/d | was positive | #3 |
adding a daily VA supplement (2.8 μmol/d) to increased VA intake for balance (LSS+S) | increase | VA balance | theoretical lactating women with low/moderate TBS | 1.5 μmol/d | was positive | #4 |
adding a daily VA supplement (2.8 μmol/d) to the diet | increase | VA balance | lactating women with suboptimal VA intake | - | may effectively counterbalance the negative VA balance | #5 |
adding a daily VA supplement (2.8 μmol/d) to the diet | increase | VA stores | lactating women with suboptimal VA intake | - | benefit both mother and infant by maintaining or increasing | #6 |
adding a daily VA supplement (2.8 μmol/d) to the diet | increase | breastmilk VA concentration | lactating women with suboptimal VA intake | - | benefit both mother and infant by maintaining or increasing | #7 |
BACKGROUND: Inadequate vitamin A (VA) intake is common among lactating women in many communities worldwide, but high-dose VA supplementation for postpartum women is not recommended by the World Health Organization as an effective intervention. OBJECTIVES: To simulate the impact of VA intake via diet and daily VA supplements on VA total body stores (TBS) and balance in theoretical lactating women with low/moderate TBS. METHODS: We studied 6 theoretical subjects with assigned values for TBS from 219-624 μmol. Using Simulation, Analysis, and Modeling software and a previously published compartmental model for whole-body VA metabolism, we simulated TBS over 6 mo of established lactation for each subject under 4 conditions: 1) prelactation VA intake was increased to maintain VA balance (LSS); 2) prelactation VA intake was maintained (NLSS); 3) VA intake was the same as 2) but a daily VA supplement (2.8 μmol/d) was added (NLSS+S); and 4) VA intake was as 1) and the daily VA supplement was included (LSS+S). RESULTS: To compensate for the loss of VA via milk while VA balance was maintained (LSS) over 6 mo of lactation, VA intake had to increase by 0.8-1.87 μmol/d (n = 6) compared with NLSS. Over 6 mo of NLSS treatment, VA balance was negative (geometric mean, -0.77 μmol/d) compared with LSS, whereas balance was positive under NLSS+S and LSS+S conditions (0.75 and 1.5 μmol/d, respectively). For LSS, the proportion of total VA disposal was 37% via breastmilk, 32% from VA stores, and 32% from nonstorage tissues. CONCLUSIONS: Adding a daily VA supplement (2.8 μmol/d) to the diet of lactating women with suboptimal VA intake may effectively counterbalance the negative VA balance resulting from the output of VA via breastmilk and thus benefit both mother and infant by maintaining or increasing VA stores and breastmilk VA concentration.