Human milk fatty acids and growth of infants in Brazzaville (The Congo) and Ouagadougou (Burkina Faso).

OBJECTIVE: To estimate the role of human milk n-6 and n-3 polyunsaturated fatty acids (PUFA) in term infant growth in two African urban populations. DESIGN: Observational study. Weight gains at 5 months of age and dietary habits were compared between Congolese infants (n=102) and Burkinabè infants (n=101). Socio-economic status and anthropometry of the mothers were also recorded. SETTING: One suburban district in Brazzaville (capital of The Congo) and one in Ouagadougou (capital of Burkina Faso). SUBJECTS: Two random samples of nursing mothers and their 5-month-old infants. RESULTS: All infants were born at term and there was no difference in birth weights. At 5 months of age, infants in Ouagadougou were thinner but not shorter than their counterparts in Brazzaville (average weight gain (standard deviation): 614 (168) g month-1 vs. 720 (176) g month-1; P= 0.0001). Drastic differences were found in infant diets with regard to extra fluid intake and n-6 and n-3 PUFA concentrations in breast milk. In Ouagadougou, all infants were given fluids other than milk from birth. Breast milk had highly unbalanced 18:2n-6/18:3n-3 and n-6/n-3 long-chain PUFA ratios (53:1 and 5:1, respectively). In Brazzaville, half of the infants received fluids other than milk, and breast milk showed balanced 18:2n-6/18:3n-3 and n-6/n-3 long-chain PUFA ratios (12:1 and 1:1, respectively). A non-linear relationship between 18:2n-6/18:3n-3 ratio and growth was established in Brazzaville (P= 0.0027). The 18:2n-6/18:3n-3 ratio adjusted with covariates had an even more significant effect on weight gain (P= 0.0011). Applying the same model in Ouagadougou did not show such a relation. CONCLUSION: : Data strongly suggest that a balanced ratio of 18:2n-6/18:3n-3 (between 5:1 and 15:1) in breast milk leads to higher weight gain of infants during the first 5 months of life.

Seasonal and environmental effects on breast milk fatty acids in Burkina Faso and the need to improve the omega 3 PUFA content.

AIM: To determine the Burkinabè breast milk lipid content and fatty acid composition and to compare these values with the recommended adequate intakes. METHODS: The study comprised four cross-sectional surveys conducted in urban and rural Burkina Faso at two different times of the year: during a period of food shortage (lean season) and during a favourable food availability period (post-harvest season). The subjects were apparently healthy mothers nursing 5-mo-old infants. A total of 70 urban and 52 rural mothers and 100 urban and 98 rural mothers, respectively, during the post-harvest season and the lean season, completed the surveys. The surveys were conducted in January-February 2001 (urban) and 2002 (rural) corresponding to the post-harvest season, and in April-May 1998 (urban) and 1999 (rural), which is the lean season, and were carried out during home visits. The families were informed of the objectives of the study and gave their consent to participate. Breast milk samples were collected from each mother and analysed for lipid and fatty acid concentrations. RESULTS: Noticeable breast milk characteristics were: low lipid content (30-35 g/L), high C6:0-C14:0 saturated fatty acids (27%-33% total fatty acids), high linoleic acid (15%-20% total fatty acids) and unbalanced linoleic/alpha-linolenic acid (20:1 to 53:1) and long-chain omega6/long-chain omega3 (3.6:1 to 4.9:1) polyunsaturated fatty acid ratios. In all life conditions and food availability, linoleic acid was in excess of and alpha-linolenic was below the recommended adequate intakes. Over 80% of breast milk samples had linoleic/alpha-linolenic acid and long-chain omega6/omega3 polyunsaturated ratios well above the recommendations. CONCLUSION: Improvement in breast milk omeag3 PUFA seems to be recommendable in Burkina Faso, where breastfeeding is the primary infant feeding practice.

High proportions of n-6 polyunsaturated fatty acids in mature milk of mothers in Ouagadougou, Burkina Faso.

UNLABELLED: Milk from 101 mothers living in Ouagadougou (Burkina Faso) showed a mean lipid content of 33.42 g/l and a fatty acid composition strongly related to the mothers' dietary habits: high proportions of linoleic acid (19.80%), n-6 long-chain polyunsaturated fatty acids (1.90%), and 8:0-14:0 saturated fatty acids (26.94%). CONCLUSION: The proportions of alpha-linolenic acid (0.45%) and n-3 long-chain polyunsaturated fatty acids (0.44%) were low. The 18:2/18:3 and n-6/n-3 long-chain polyunsaturated fatty acids ratios (53:1 and 5:1, respectively) were well above recommendations.

Lipid content and essential fatty acid (EFA) composition of mature Congolese breast milk are influenced by mothers' nutritional status: impact on infants' EFA supply.

OBJECTIVE: To measure the lipid content and the fatty acid (FA) composition of breast milk as part of a nutritional survey of the essential fatty acid (EFA) status of 5 months old Congolese infants. DESIGN: Cross sectional nutrition survey. SETTING: A suburban district of Brazzaville (capital of the Congo). SUBJECTS: A random sample of nursing mothers and their 5 months old infants (n = 102). Data collection procedures: The mothers were questioned on their socio-economic status, dietary habits, and their body mass index (BMI) was measured. Breast milk samples were collected from each mother. Milk lipid content and fatty acid composition were determined. RESULTS: Compared with milk from various countries, Congolese women's mature breast milk was low in lipid (28.70+/-11.33 g/L) but rich in 8:0-14:0 FAs (25.97+/-8.17% of total FAs) and in polyunsaturated FAs (PUFAs), particularly n-3 PUFAs (2.39+/-0.68% of total FAs, mainly 18:3 and 22:6). This was associated with the frequent consumption of high-carbohydrate foods (processed cassava roots, wheat bread, doughnuts) known to enhance 8:0-14:0 FA biosynthesis, and with that of foods providing n-6 and n-3 EFAs such as freshwater and saltwater fish, vegetable oil, green leafy vegetables, and high-fat fruit (peanuts, avocado, bushbutter). These foods were traditionally and locally produced. Milk lipid content was negatively related with mothers' BMI (P < 0.01) and varied with the frequency of consumption of certain foods corresponding to distinct dietary patterns. CONCLUSIONS: Lipid content and FA composition of Congolese breast milk were dependent on mother's nutritional status. However, despite an adequate EFA composition of breast milk, partially breast-fed 5 months old Congolese infants probably did not get enough n-6 and n-3 EFAs from breast milk to meet their EFA requirements.

PIP: Optimum infant growth and development, especially neurodevelopment and visual acuity, require sufficient n-6 and n-3 essential fatty acid supplies from the placenta or breast milk. The lipid content and fatty acid composition of mature breast milk were measured in samples from 102 randomly selected Congolese mothers of 5-month-old infants, residing in a suburban district of Brazzaville. Mean body mass index (BMI) was 22.3; 14% of mothers were energy-deficient and 22% were overweight. Breast milk samples from these mothers were low in lipids (mean, 28.70 g/l), and 75% had a lipid content below reference values. Adequate lipid content was associated with a maternal diet high in carbohydrates and low in fats. Breast milk was rich in 8:0-14:0 fatty acids (25.97% of total fatty acids) and in polyunsaturated fatty acids, especially n-3. These findings appear related to Congolese mothers' frequent consumption of high-carbohydrate foods such as processed cassava roots, wheat bread, and doughnuts known to enhance 8:0-14:0 fatty acid biosynthesis, as well as locally produced foods such as fish, vegetable oil, leafy green vegetables, and high-fat fruit that provide n-6 and n-3 essential fatty acids. Milk lipid content was inversely associated with the maternal BMI, but was unrelated to maternal age or socioeconomic status. Since the essential fatty acid content of traditional complementary foods is lower than that present in breast milk, Congolese mothers should be encouraged to postpone the introduction of such foods until their infant is 4-6 months old.

Lipid content and fatty acid composition in foods commonly consumed by nursing Congolese women: incidences on their essential fatty acid intakes and breast milk fatty acids.

The fat content and fatty acid (FA) composition of nearly 40 foods, currently consumed by 102 nursing Congolese mothers living in Brazzaville, were determined to assess their impact on mothers' essential fatty acid (EFA) intakes and breast milk FA. Data on mothers' milk FA and dietary habits which allowed food selection were recently published (Rocquelin et al., 1998). Most foods were locally produced. Food samples were collected at local markets, bleached if necessary to avoid microbial degradation, and stored at +4 degrees C or -20 degrees C. They were lyophilized upon their arrival in the laboratory before lipid analyses. FA composition of food lipids was determined by capillary gas chromatography. Staple diets included low-fat, high-carbohydrate foods (processed cassava roots, wheat bread) and high-polyunsaturated fatty acid (PUFA) foods: soybean oil (high in 18 : 2 n-6 and alpha-18 : 3 n-3), bushbutter (dacryodes edulis), peanuts, avocado (high in fat and 18 : 2 n-6), freshwater and salt-water fish (high in LC n-3 and/or n-6 PUFA), and leafy green vegetables (low in fat but very high in alpha-18 : 3 n-3). Their frequent consumption by nursing mothers provided enough EFA to meet requirements due to lactation. It also explains why mothers' breast milk was rich in C8-C14 saturated FA (26% of total FA) and in n-6, n-3 PUFA (respectively 15.0% and 2.4% of total FA) highly profitable for breastfed infants' development. From this point of view, dietary habits of Congolese mothers have to be sustained for they are more adequate than most Western-type diets.