학술논문
Feeding Practice and Delivery Mode Are Determinants of Vitamin K in the Infant Gut: An Exploratory Analysis
ORIGINAL RESEARCH
ORIGINAL RESEARCH
Document Type
Report
Author
Source
Current Developments in Nutrition. March 2022, Vol. 6 Issue 3, p1j, 10 p.
Subject
Language
English
ISSN
2475-2991
Abstract
Introduction Infants have low vitamin K stores due to poor placental transfer of vitamin K, low concentrations of vitamin K in breast milk, and possibly insufficient vitamin K from gut [...]
Background: Infants have low stores of vitamin K at birth. Dietary intake of phylloquinone (PK) differs dramatically by infant feeding practice, but the contribution of microbially produced vitamin K (menaquinones) to infant vitamin K status is not well understood. Objectives: The objective of this study was to investigate determinants of infant fecal vitamin K profiles in mother-infant dyads at 6 wk postpartum. Methods: Fecal and breast milk samples were collected from a subsample of breastfeeding (n = 23) or formula-feeding (n = 23) mother and infant dyads, delivered vaginally (n = 26) or by cesarean section (CS) (n = 20) in the Synergistic Theory and Research on Nutrition and Growth (STRONG) Kids 2 cohort. Vitamin K concentrations in breast milk and feces were analyzed by LC/MS and/or HPLC. Fecal bacterial metagenomes were analyzed to derive taxonomy and vitamin K biosynthetic genes. Multivariate linear modeling was used to assess effects of delivery and feeding modes on infant fecal vitamin K. Results: Breast milk contained 1.3 [+ or -] 0.2 ng/mL PK, and formula was reported to contain 52 ng/mL PK. Fecal PK was 38-times higher (P < 0.001) in formula-fed than breastfed infants. Infant fecal menaquinones (MKn) MK6, MK7, MK12, and MK13 were higher (P < 0.001) in formula-fed than breastfed infants, whereas MK8 predominated in breastfed and was 5-times higher than formula-fed infants. Total MKn were greater (P < 0.001) in vaginally delivered than CS infants. Relative abundances of 33 bacterial species were affected by feeding mode, 2 by delivery mode, and 4 by both (P < 0.05). Bacterial gene content of 5/12 vitamin K biosynthetic genes were greater (P < 0.05) in breastfed compared with formula-fed infants, and 1 differed by delivery mode. Conclusions: Feeding practice and delivery mode influence bacterial vitamin K production in the infant gut. High concentrations of unmetabolized PK in feces of formula-fed infants suggests formula PK content exceeds the absorptive capacity of the infant gut. Curr Dev Nutr2022;6:nzac019. Keywords: vitamin K, phylloquinone, menaquinone, infant gut microbiota, infant nutrition C The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the origina work is properly cited. For commercial re-use, please contact journals.permissions@oup.com Manuscript received January 10, 2022. Initial review completed January 29, 2022. Revision accepted February 2, 2022. Published online February 12, 2022. Supported by the USDA Agricultural Research Service under Cooperative Agreement No. 58-8050-9-004, NIH R01DK107561 (SMD), The National Dairy Council (SMD), and The Gerber Foundation (SMD). The National Dairy Council and the Gerber Foundation had no input into study design or implementation or analysis and interpretation of the data. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily refilect the views of the USDA. Author disclosures: SMD has received grant funding and receives honoraria for service on a Scientific Advisory Board for the National Dairy Council. SLB is a Deputy Editor on Current Developments in Nutrition and played no role in the journal's evaluation of the manuscript. All other authors report no conflicts of interest. Supplemental Figures 1-2 and Supplemental Tables 1-6 are available from the "Supplementary data" link in the online posting of the article and from the same link in the online table of contents at https://academic.oup.com/cdn/. Address correspondence to SLB (e-mail: sarah.booth@tufts.edu). Abbreviations used: CS, cesarean section; LLOD, lower limit of detection; MKn, menaquinone-n; ND, nondetectable; PK, phylloquinone; RDA, redundancy analysis; STRONG, Synergistic Theory and Research on Nutrition and Growth; VKDB, vitamin K deficiency bleeding.
Background: Infants have low stores of vitamin K at birth. Dietary intake of phylloquinone (PK) differs dramatically by infant feeding practice, but the contribution of microbially produced vitamin K (menaquinones) to infant vitamin K status is not well understood. Objectives: The objective of this study was to investigate determinants of infant fecal vitamin K profiles in mother-infant dyads at 6 wk postpartum. Methods: Fecal and breast milk samples were collected from a subsample of breastfeeding (n = 23) or formula-feeding (n = 23) mother and infant dyads, delivered vaginally (n = 26) or by cesarean section (CS) (n = 20) in the Synergistic Theory and Research on Nutrition and Growth (STRONG) Kids 2 cohort. Vitamin K concentrations in breast milk and feces were analyzed by LC/MS and/or HPLC. Fecal bacterial metagenomes were analyzed to derive taxonomy and vitamin K biosynthetic genes. Multivariate linear modeling was used to assess effects of delivery and feeding modes on infant fecal vitamin K. Results: Breast milk contained 1.3 [+ or -] 0.2 ng/mL PK, and formula was reported to contain 52 ng/mL PK. Fecal PK was 38-times higher (P < 0.001) in formula-fed than breastfed infants. Infant fecal menaquinones (MKn) MK6, MK7, MK12, and MK13 were higher (P < 0.001) in formula-fed than breastfed infants, whereas MK8 predominated in breastfed and was 5-times higher than formula-fed infants. Total MKn were greater (P < 0.001) in vaginally delivered than CS infants. Relative abundances of 33 bacterial species were affected by feeding mode, 2 by delivery mode, and 4 by both (P < 0.05). Bacterial gene content of 5/12 vitamin K biosynthetic genes were greater (P < 0.05) in breastfed compared with formula-fed infants, and 1 differed by delivery mode. Conclusions: Feeding practice and delivery mode influence bacterial vitamin K production in the infant gut. High concentrations of unmetabolized PK in feces of formula-fed infants suggests formula PK content exceeds the absorptive capacity of the infant gut. Curr Dev Nutr2022;6:nzac019. Keywords: vitamin K, phylloquinone, menaquinone, infant gut microbiota, infant nutrition C The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the origina work is properly cited. For commercial re-use, please contact journals.permissions@oup.com Manuscript received January 10, 2022. Initial review completed January 29, 2022. Revision accepted February 2, 2022. Published online February 12, 2022. Supported by the USDA Agricultural Research Service under Cooperative Agreement No. 58-8050-9-004, NIH R01DK107561 (SMD), The National Dairy Council (SMD), and The Gerber Foundation (SMD). The National Dairy Council and the Gerber Foundation had no input into study design or implementation or analysis and interpretation of the data. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily refilect the views of the USDA. Author disclosures: SMD has received grant funding and receives honoraria for service on a Scientific Advisory Board for the National Dairy Council. SLB is a Deputy Editor on Current Developments in Nutrition and played no role in the journal's evaluation of the manuscript. All other authors report no conflicts of interest. Supplemental Figures 1-2 and Supplemental Tables 1-6 are available from the "Supplementary data" link in the online posting of the article and from the same link in the online table of contents at https://academic.oup.com/cdn/. Address correspondence to SLB (e-mail: sarah.booth@tufts.edu). Abbreviations used: CS, cesarean section; LLOD, lower limit of detection; MKn, menaquinone-n; ND, nondetectable; PK, phylloquinone; RDA, redundancy analysis; STRONG, Synergistic Theory and Research on Nutrition and Growth; VKDB, vitamin K deficiency bleeding.