Biofortified, fortified maize ease low milk retinol, do not increase vitamin A stores in infants

Consumption of fortified and biofortified maize results in improved milk retinol concentration, reveals a study. However, this does not lead to greater infant total body stores (TBS), most probably because of adequate TBS at baseline.

“Replacement of conventional staples with biofortified or industrially fortified staples in household diets may increase maternal breast milk retinol content and vitamin A intakes from complementary foods, improving infant TBS of vitamin A,” the authors said.

Lactating women (n=255) and their 9-month-old infants were randomized to a 90-d intervention providing 0 µg retinol equivalents (RE)/d as conventional maize or ∼315 µg RE/d to mothers and ∼55 µg RE/d to infants as provitamin A carotenoid-biofortified maize or retinyl palmitate–fortified maize.

The primary outcome was TBS, measured by retinol isotope dilution in infants, while secondary one was breastmilk retinol, measured by high-performance liquid chromatography in women.

The intervention groups were similar at baseline, with 10-percent loss to follow-up (n=230 mother-infant pairs). Women consumed 92 percent of the intended 287 g/d, while infants consumed 82 percent of the intended 50 g/d maize.

At baseline, the geometric mean (GM) milk retinol concentration was 1.57 μmol/L (95 percent confidence interval [CI], 1.45–1.69); 24 percent of women had milk retinol <1.05 μmol/L.

Mean milk retinol did not change in the biofortified arm (β, 0.11, 95 percent CI, –0.02 to 0.24), but the intervention reduced the prevalence of low milk retinol (relative risk [RR], 0.42, 95 percent CI, 0.21–0.85). Fortified main improved mean milk retinol (β, 0.17, 95 percent CI, 0.04–0.30) and reduced the prevalence of low milk retinol (RR, 0.46, 95 percent CI, 0.25–0.82).

Baseline Gm TBS was 178 μmol (95 percent CI, 166–191). Over the 90-day intervention period, this increased by 24 μmol regardless of treatment group.