1. Fatty acid composition of diet, cord blood and breast milk in Chinese mothers with different dietary habits Yongmei Peng, MD, MPH Qing Wang, MD Tingting Zhou, MD Peining Liu, MD Children's Hospital, Fudan University, Shanghai Women and Children Health Care Centre of Changzhou Karolinska Hospital, Karolinska Institute, Sweden Sahlgrenska Academy, Göteborg University, Sweden R Zetterström, MD B Strandvik, MD

2. saturated fatty acids polyunsaturated fatty acids (PUFAs) unsaturated fatty acids Monounsaturated fatty acid (MUFAs) fatty acids AA ω-3 PUFAs GLA α-Linolenic Acid (18:3ω3) ALA Eicosapentaenoic Acid (20:5 ω3) EPA Docosahexaenoic Acid(22:6 ω3) DHA ω-6 PUFAs What is Omega-3 What is Omega-3

3. Background Brain development is most active Brain development is most active at the end of pregnancy at the end of pregnancy and during the first postnatal months and during the first postnatal months A surge of EFA, and LCPUFAs, to the fetus over the placenta during the last trimester A surge of EFA, and LCPUFAs, to the fetus over the placenta during the last trimester Postnatally, breast milk(BM) is the source of the LCPUFAs in exclusively breast fed infants Postnatally, breast milk(BM) is the source of the LCPUFAs in exclusively breast fed infants

4. Background In newbaby, sufficient amounts In newbaby, sufficient amounts of DHA are essential for development of neuronal tissue and visual function of DHA are essential for development of neuronal tissue and visual function and of AA for optimal growth and of AA for optimal growth The fatty acid (FA) composition of BM varies with The fatty acid (FA) composition of BM varies with the nutritional intake of the mothers, the nutritional intake of the mothers, especially the quality of the fat. especially the quality of the fat. DHA,22:6  3

5. Background The BM in Hong Kong and Chongqing had different FA profiles due to different dietary habits and life-style The BM in Hong Kong and Chongqing had different FA profiles due to different dietary habits and life-style In rural of northern China ： In rural of northern China ： the intake of linoleic acid (LA, 18:2 ω6) > α-linolenic acid (ALA, 18:3  3) and  ω-3 the intake of linoleic acid (LA, 18:2 ω6) > α-linolenic acid (ALA, 18:3  3) and  ω-3 the ratio of ω-6/ ω-3 (19:1)was higher than other country the ratio of ω-6/ ω-3 (19:1)was higher than other country

6. Background Human and animal studies show that Human and animal studies show that maternal dietary FA intakes may influence the FA profiles of cord blood and fetal tissues maternal dietary FA intakes may influence the FA profiles of cord blood and fetal tissues Amusquivar E, Biol Neonate. 2003;83(2):136-45. De Vriese SR, PLEFA. 2002 ;67(6):389-96. During the first postnatal weeks During the first postnatal weeks neonates do not seem to synthesize sufficient amounts of LC-PUFAs from their precursors (LA and ALA) neonates do not seem to synthesize sufficient amounts of LC-PUFAs from their precursors (LA and ALA) Can not to satisfy their high needs Can not to satisfy their high needs Salem NJ, Proc Natl Acad Sci U S A. 1996;93(1):49-54.

7. Objectives To help untangle the influence of two different dietary patterns on To help untangle the influence of two different dietary patterns on maternal fatty acid intake the composition of umbilical cord blood transitional breast milk To analyze the related factors on the composition of LC-PUFAs in To analyze the related factors on the composition of LC-PUFAs in the BM and the paired infants ’ plasma PLs

8. Subjects mother-term infant pairs 7-day forward dietary record during the last trimester recruited subjects before delivery Follow-up to 42days Day 5, day 42 breast milkDay 0 、 5 、 42 infant’s blood Ocean area (Wenzhou) Traditional chinese food area (Changzhou)

9. Data Collection Breast milk was manually expressed into a plastic vial Breast milk was manually expressed into a plastic vial Cord blood was obtained after the umbilical cord had been cut Cord blood was obtained after the umbilical cord had been cut Blood samples ( infants) were obtained at day 5 and day 42 by venipuncture Blood samples ( infants) were obtained at day 5 and day 42 by venipuncture

10. Fatty acid analysis Extract The lipids were extracted with chloroform-methanol Fractionate The phospholipids(PLs) from plasma were fractionated on a single SEP-PAK aminopropyl cartridge fractionated on a single SEP-PAK aminopropyl cartridge Separate by capillary gas-liquid chromatography

11. Statistical Analysis Mann-Whitney´s U test Mann-Whitney´s U test was used to calculate the differences of FA between dietary, cord blood and breast milk samples. Spearman correlation test Spearman correlation test was used for analyses of associations between dietary intake and FA composition

12. Subjects at Baseline WenzhouChangzhouP Mothers: age(y) weight(kg) height(cm) BMI Babies: gestation age(w) birth wight(g) birth length(cm) 27.80±2.33 55.60±9.36 159.90±3.60 21.71±3.33 39.73±1.03 3422.00±384.89 50.20±0.65 26.96±2.82 56.96±7.55 160.75±4.65 22.02±2.61 39.58±1.04 3374.26±338.79 50.03±0.76 0.22 0.49 0.45 0.66 0.58 0.35

13. Food comparison of the two types of dietary area ＊ ＊＊ Dairy Cereal Comestic Fresh-water food Sea food Oil (g) ＊＊ ＊ Food (g)

14. Fatty acid comparison of food in two types area Fatty acid (g)

15. EPA and DHA in food and milk dietary d5milk d42milk ** Fatty acid (g)

16. The change of blood DHA Cord D5 blood D42 blood Fatty acid %

17. ω-3 Cord D5 blood D42 blood Fatty acid %

18. 脂肪酸类别 ω-6 Cord D5 blood D42 blood Fatty acid %

19. ω-6/ω-3 ratio Cord D5 blood D42 blood Fatty acid %

20. Relation of ALA in BM and in the plasma PLs of the infants at d 5 (r=0.39, p<0.01) and d 42 (r=0.55, p<0.001)

21. Relation of docosahexaenoic acid in BM and in the plasma PLs of the infants at d 5 ( r=0.30, p<0.05) and d 42 (r=0.48, p<0.001).

22. Relation of linolic acid in BM and in the plasma PLs of the infants at d 42(r=0.49, p<0.001)

23. Relation of in arachidonic acid in BM and in the plasma PLs of the infants at d 42 (n=45, r=0.48, p<0.001).

24. Implications There were significant differences in maternal intakes of FA confirming different dietary habits, There were significant differences in maternal intakes of FA confirming different dietary habits, which influenced the FA composition of cord plasma phospholipids and transitional breast milk. which influenced the FA composition of cord plasma phospholipids and transitional breast milk. Since FA influence gene expression, it implies that the long-term follow up of this cohort will be interesting Since FA influence gene expression, it implies that the long-term follow up of this cohort will be interesting Mothers ’ milk in Changzhou, had a ratio of ω-6/ω-3 around 15, similar to rural area, north of Beijing in China, the ratio was 19.3 Mothers ’ milk in Changzhou, had a ratio of ω-6/ω-3 around 15, similar to rural area, north of Beijing in China, the ratio was 19.3 the supply to the foetus and newborn of these FA depends on the dietary intake and the mother ’ s storage the supply to the foetus and newborn of these FA depends on the dietary intake and the mother ’ s storage

25. 谢谢 ! 复旦大学附属儿科医院 ( 新址 ) Thanks