Vitamin Information Center

Air Traveling Through Milk Likely Causing Degradation of Nutrients ST. LOUIS, Aug. 25
ST. LOUIS, Aug. 25 /PRNewswire/ — A first-of-its-kind study to measure the level of nutrient loss during simulated baby bottle feedings has found that some bottle types resulted in significant loss of ascorbic acid (vitamin C) during a typical 20-minute feeding. In some cases, there were minimal amounts of detectable vitamin C remaining in the milk after 20 minutes. The results suggest that the amount of air within a bottle, bottle design, and the impact on vitamin C levels warrant closer examination.
The study, “Comparative Analysis of Nutrients in Baby Milk Using Varied Milk Delivery Systems,” was recently published in the International Breastfeeding Journal. The study was conducted by a group of researchers at the University of Nevada-Reno, led by Dr. Jimi Francis, an international board certified lactation consultant and researcher. The study findings were also presented in July 2008 at the International Lactation Consultant Association (ILCA) Annual Conference.
The study was designed to investigate changes in vitamin C levels that might occur during a typical feeding time of 20 minutes, using both expressed human milk and infant formula, in both vented and unvented bottles. The study looked at the amount of vitamin C in the milk when delivered through seven commonly used baby bottles. The purpose was to determine if exposure to air within a bottle during a simulated feeding affected the level of vitamin C, which is known to oxidize when exposed to air. Vitamin C is critical for health and growth in infancy. Medical research shows that children with low intakes of vitamin C are more vulnerable to develop frequent and more severe common day-to-day illness.
As milk is removed from the bottle by the infant, the milk is replaced by ambient air. Nutrient loss is likely caused by the oxidation of nutrients that takes place as air is introduced into the liquid. The amount of air moving through the milk and into the bottle depends on the bottle type, shape, and size. Vitamin C was examined because it is an essential nutrient and is easily degraded by heat, light, and air. Dr. Francis says that previous studies have been conducted to evaluate the loss of vitamin C during the handling and freezing of human milk, but not on what happens during the feeding process itself.
“Handling and storage of breastmilk and formula can impact the levels of vitamin C,” Dr. Francis says. “The ability to maintain vitamin C in bottle feeding appears to be influenced by bottle design.”
She adds that the degradation of the nutrient during a 20-minute feeding does not mean that the infant is getting insufficient vitamin C over the course of a day, but rather that the vitamin level is declining — in some cases quickly — during the duration of the feeding. Mature human milk was donated by anonymous volunteers for the study. The milk was standardized for vitamin C.
In addition to studying effects on human milk, the study also examined two types of infant formula. The milks were delivered through seven different major brand baby bottles with five samples collected from each bottle: baseline, 5 minutes, 10 minutes, 15 minutes, and 20 minutes (see graph). Each sample was analyzed for vitamin C using normal-phase high-performance liquid chromatography, and each collection was completed in triplicate to ensure the consistency of results.
See graph, http://www.nutrientstudy.com. This graph demonstrates the loss of vitamin C. As an example based on the findings, a two-month old child, fed by bottle 10 times per day in 20-minute feedings, would take in approximately 13 mg of vitamin C with one bottle, and approximately 34 mg of vitamin C with a different bottle over a period of one day. The Food and Nutrition Board at the Institute of Medicine recommends a vitamin C intake of 40 mg per day for infants aged up to six months old.
“Maintaining optimal vitamin C levels over the course of a bottle feeding is of clinical significance to practitioners and parents,” says Robin Hollen, a registered nurse, international board certified lactation consultant, and private practice lactation consultant. “For infants at high risk, such as those in neonatal intensive care or with compromised immune systems, vitamin C intake should be evaluated. Bottle shape, size, and venting should be considered.”
The bottles used in the study were different in design in the way that air is replaced in the bottle as milk is removed. Two bottles had removable screw-off bottoms with a diaphragm in the base of the bottles. One bottle had an insert inside the collar of the nipple. One bottle has a vent system that allows air moving into the bottle to bypass movement through the milk, with no bubbles forming as milk is removed from the bottle. Those bottles observed to have more bubbles forming in the milk had lower levels of vitamin C, an expected outcome given that exposure to air causes oxidative loss of vitamin C in many foods.
“Nutrition is an important area of study. Evaluating not only what we eat but how we eat can provide greater understanding of how to achieve optimal nutritional status. This is about looking at bottle design and other factors that can influence maintaining optimal nutrition levels of bottle-fed milk and formula,” Dr. Francis says. “With even a basic understanding of possible differences between bottles, moms are armed with useful knowledge to help them make informed choices for their babies.”
Dr. Francis emphasized that there are many other factors, including length of time and manner of storage, which are thought to impact nutritional levels of key nutrients. She adds that additional research is needed to fully understand how nutrients in breastmilk and infant formula are affected by handling, storage, and the delivery through a bottle. As this data becomes available, changes may need to be made regarding the protocols recommended for the handling of human milk with regard to preserving the integrity of specific nutrients.
Almost two-thirds of women in the Unites States work outside of the home, according to the U.S. Department of Labor. The changes in lifestyle and economic activities of lactating mothers have led to an increase in the expression of human milk for later use in infant feeding. While breastfeeding is consistently recommended as the best choice for feeding infants, many infants are fed with a bottle. The expression, handling, storage and delivery of breastmilk or infant formula to infants through a bottle may diminish nutrient levels.
Recommendations for Moms
So what’s a mom to do? Dr. Francis offers the following tips:
– Select bottles that minimize air traveling through the bottle.
– Look for little to no bubbles forming in the milk as the baby feeds.
– Use breastmilk that is as fresh as possible.
– Use small bottles that minimize the amount of air at the top of the
milk.
– When using infant formula, make it fresh for every feeding.
– Feed babies with small, frequent feedings.

Footnotes
1) The study did not examine whether the observed differences would have
any effect on infant health, a complex subject that is beyond the scope
of the study.
2) The study did not involve infants, nor did the researchers study any
potential impact on vitamin C intake for infants.
SOURCE Dr. Jimi Francis, Ph.D.

Last week, we reported that high consumption of sugar-sweetened drinks seems to increase the risk for type 2 diabetes among African-American women. In the most recent issue of the Archives of Internal Medicine, investigators from England reported that high levels of vitamin C in the blood are associated with a substantially decreased risk of diabetes.

The researchers studied a population of people, ranging from age 40 to age 75, who completed food questionnaires. The study population was followed for 12 years - in that time, 735 cases of diabetes were identified among 21,831 health individuals. After analyzing the information from the food questionnaires, the researchers found that individuals with high vitamin C levels in the blood were substantially less likely to develop diabetes. They found that higher fruit and vegetable intake was also associated with a significantly decreased risk of diabetes.

These findings highlight a potentially important public health message - promoting a diet rich in fruits and vegetables could help in the prevention of diabetes.

An abundance of vitamin C in the diet may help lower a person’s risk of developing type 2 diabetes, new research suggests.

In a study of middle-aged and older men and women, those with the highest blood levels of vitamin C were significantly less likely to develop diabetes over 12 years than those with the lowest levels, researchers found.

Fruits and vegetables are the main source of vitamin C in Western diets, and blood levels of vitamin C are good markers of fruit and vegetable intake, Dr. Nita G. Forouhi, at the Institute of Metabolic Science at Addenbrooke’s Hospital, Cambridge, England, and colleagues note.

The current findings “re-endorse the public health message of the beneficial effect of increasing total fruit and vegetable intake,” the investigators wrote in Archives of Internal Medicine.

Forouhi’s team followed 21,831 healthy men and women who were 40 to 75 years old for the development of type 2 diabetes. At study entry, all participants provided detailed health and lifestyle information, as well as blood samples, which investigators used to determine vitamin C levels.

Over the course of the study, 423 men and 312 women developed type 2 diabetes, an overall rate of 3.2 percent.

According to the investigators, the likelihood of developing diabetes was 62 percent lower in men and women with the highest circulating vitamin C levels, relative to men and women with the lowest vitamin C levels.

Factoring out other characteristics associated with diabetes risk, such as older age, gender, family history, alcohol intake, physical activity, smoking status and body weight did not significantly alter these associations.

These data offer “persuasive evidence of a beneficial effect of vitamin C and fruit and vegetable intake on diabetes risk,” Forouhi and colleagues conclude.

etting Botox and spending hundreds of dollar on age-defying skin creams are not the only ways to keep your skin looking healthy and fresh. One of the most effective strategies to have super skin is to nourish your body with plenty of nutrients. Research has shown that consuming specific foods can help prevent wrinkling, sun-damage and keep your skin well-hydrated. Next time you go food shopping have a grocery list for your skin, too.

SATURDAY MARCH 1, 2008 (Foodconsumer.org) — University of Cambridge researchers found those who had the highest level of vitamin C in their blood were much less likely to have a stroke, suggesting that intake of vitamin C ma help reduce the risk.

The study published in the Jan, 2008 issue of American Journal of Clinical Nutrition showed those who had the highest level (greater than 66 micromoles per liter) had a 42 percent reduced risk for stroke compared to those who had the lowest level (less than 41 micromoles per liter).

The study did not mean that increasing vitamin C intake through one’s diet or a supplement would definitely reduce the risk of stroke or increased levels of the vitamin was the cause for the reduced risk although the possibility could not be excluded either.

Phyo Myint and colleagues suggested that vitamin C in the blood may be a good biomarker of lifestyle. A high level of it indicates that one follows a healthy lifestyle, minimizing their risk for stroke.

For the study, the researchers followed 20,649 men and women participating in the European Prospective Investigation into Cancer for 9.5 years to record their health status such as incidence of stroke.

Their dietary habits and other lifestyle parameters were surveyed at the entry of the study using a health and lifestyle questionnaire and vitamin C levels in the blood samples were measured. During the follow-up, 448 stroke cases were identified.

The association between the plasma vitamin C level and the risk of stroke existed after a series of other factors were considered including age, sex, smoking habits, alcohol consumption, blood pressure, cholesterol, BMI, physical activity, and use of supplements.

The researchers said the association was probably not due to the supplemental vitamin C because when those who used vitamin C supplements were excluded, the link still held, suggesting that the possible benefit could come from vitamin C-rich foods such as fruit and vegetables.

The US government recommends in dietary guidelines adults should take at least five servings of fruit and vegetables per day to maintain health. But often vitamin C supplementation is not encouraged.

The researchers said although the study did not mean to say taking vitamin C supplements would render this protective effect and trials of vitamin C supplements in preventing cardiovascular disease unlikely occur, the association was substantial and independent of known major risk factors for stroke.

Sebastian Padayatty and Mark Levine from the National Institutes of Health (NIH) said in their commentary accompanying the study report that “Vitamin C is an attractive marker of fruit and vegetable intake because these foods are the primary sources of dietary vitamin C.” and the take-home message is to use five to nine servings of fruits and vegetables.

Vitamin C has proved controversial. Some experts notably Noble Prize laureate Dr. Linus Pauling had been advocating for years that people should use HIGH doses of vitamin C to prevent a whole spectrum of diseases from colds to cancer. But trials proved that vitamin C at low doses does not help prevent diseases.

Dr. Pauling had worked with a doctor to test how vitamin C affects the survival of cancer patients and they found that cancer patients subject to conventional treatments, but using high doses of vitamin C often lived a few more years than those who received only conventional treatments.

Vitamin C is non-toxic and many people use more than 5 grams per day, according to The Vitamin C Foundation, a not-for-profit organization advocating use of vitamin C.

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