Rol de fitoquímicos dietarios y factores sociosanitarios en el estado cognitivo y la reactividad láctea de mujeres lactantes de Córdoba, Argentina

Abstract

Introducción: Las modificaciones neurobiológicas que experimentan las mujeres durante el puerperio, junto con los consecuentes cambios psicosociales, determinan variaciones en el funcionamiento cognitivo, las cuales pueden interferir en la vida de las mujeres. Esto podría prevenirse por la ingesta de compuestos dietéticos, como ciertos polifenoles neuroprotectores. Su bioactividad depende de sus efectos sobre la neurofisiología y el metabolismo en diferentes tejidos, como el cerebro, la grasa y la mama. Además, una mejora cognitiva relacionada con los polifenoles podría estar asociada a los cambios químicos en la leche humana, que son clave para un adecuado neurodesarrollo infantil.

Objetivo: Estudiar la asociación de la ingesta de fitoquímicos dietarios y diferentes factores sociosanitarios con el estado cognitivo y composición química de la leche humana en mujeres lactantes durante los primeros seis meses de postparto en Córdoba, Argentina.

Métodos: Se realizó un estudio transversal en 75 mujeres puérperas lactantes de Córdoba (Argentina), que incluyó un conjunto de pruebas neuropsicológicas para evaluar atención, memoria, funciones ejecutivas y lenguaje. Se registró la dieta mediante un cuestionario de frecuencia alimentaria para identificar la ingesta de polifenoles y la adherencia a patrones alimentarios, además de variables sociodemográficas y otras mentales (insomnio, estrés, y quejas cognitivas subjetivas). Además, se analizaron proteínas totales, glucosa, triacilgliceroles, colesterol y sus formas oxidativas como biomarcadores lácteos. Se aplicaron métodos estadísticos multivariantes (p < 0,05).

Resultados: Las quejas cognitivas más prevalentes se relacionaron con problemas de concentración, cambios de humor y olvidos. Además, el 50% de las mujeres reportó la fragmentación del sueño como principal síntoma de insomnio, y casi el 70% refirió que sus problemas de sueño impactan en el funcionamiento diario. Por otra parte, los resultados confirmaron que las mujeres que consumían polifenoles presentaban un mejor rendimiento ejecutivo/atencional (es decir, mayores respuestas correctas, respuestas de nivel conceptual, categorías completas y fluidez verbal; menores interferencias atencionales y errores perseverativos) y de memoria (mejor aprendizaje de palabras con menor interferencia). Los polifenoles se asociaron con concentraciones más altas de proteínas, glucosa y lípidos en la leche, los cuales eran mayores en las mujeres con mejor cognición. Además, las mujeres con un mejor estado cognitivo tenían menos triacilgliceroles oxidados. No se encontraron asociaciones significativas entre las quejas cognitivas subjetivas y las medidas neuropsicológicas objetivas. No obstante, la frecuencia de amamantamiento se asoció con un mejor bienestar mental autopercibido. Finalmente, se logró identificar factores protectores y de riesgo para la salud puerperal. En este sentido, las mujeres con nivel educativo menor a 12 años, solteras y sin empleo formal se asociaron con indicadores antropométricos no saludables, sedentarismo, bajo consumo de polifenoles y menor funcionamiento ejecutivo/atencional y de memoria.

Conclusiones: El consumo de polifenoles provistos por la dieta durante el postparto mejora el funcionamiento ejecutivo/atencional, la memoria y el perfil químico de la leche humana. Además, la mayor carga cognitiva diaria asociada a las tareas de cuidado, el desarrollo del comportamiento materno y las expectativas sociales ligadas a dicho rol hacen que las mujeres puérperas evalúen constantemente su cognición y sean más sensibles a reconocer dificultades, lo cual promueve la autopercepción de un funcionamiento cognitivo disminuido sin estar relacionado con el funcionamiento en pruebas neuropsicológicas objetivas. Sin embargo, la calidad del sueño y el estrés psicológico condicionan el estado cognitivo autopercibido por las mujeres. Finalmente, la salud nutricional, reproductiva y los factores sociodemográficos son condicionantes de la salud mental de las mujeres durante el postparto. En consecuencia, se propone que los modelos integrales de salud perinatal pueden ayudar a identificar a los grupos más vulnerables para implementar intervenciones que promuevan el bienestar físico y mental de las personas puérperas, infantes y familias Introduction: The neurobiological modifications experienced by women during puerperium, together with the consequent psychosocial changes, determine variations in cognitive functioning, which may interfere with women's lives. This could be prevented by the intake of dietary compounds, such as certain neuroprotective polyphenols. Their bioactivity depends on their effects on neurophysiology and metabolism in different tissues, such as brain, fat and breast. Thus, a polyphenol-related cognitive enhancement could be associated with chemical changes in human milk, which are key to proper infant neurodevelopment.

Objective: To study the association of dietary phytochemical intake and different socio-health factors with cognitive status and chemical composition of human milk in lactating women during the first six months postpartum in Córdoba, Argentina.

Results: The most prevalent cognitive complaints were related to concentration problems, mood changes and forgetfulness. In addition, 50% of the women reported sleep fragmentation as the main symptom of insomnia, and almost 70% reported that their sleep problems impacted daily functioning. In addition, the results confirmed that women who consumed polyphenols had better executive/attentional performance (i.e., higher correct responses, conceptual level responses, complete categories, and verbal fluency; lower attentional interference and perseverative errors) and memory (better word learning with less interference). Polyphenols increased milk protein, glucose and lipid concentrations, which were higher in women with better cognition. In addition, women with better cognitive status had fewer oxidized triacylglycerols. No significant associations were found between subjective cognitive complaints and objective neuropsychological measures. However, breastfeeding frequency was associated with better self-perceived mental well-being. Finally, protective and risk factors for puerperal health were identified. In this sense, women with less than 12 years of education, single and without formal employment were associated with unhealthy anthropometric indicators, sedentary lifestyle, low polyphenol intake and lower executive/attentional and memory functioning.

Conclusions: Consumption of dietary polyphenols during postpartum improves executive/attentional functioning, memory, and the chemical profile of human milk. In addition, the increased daily cognitive load linked to caregiving tasks, the development of maternal behavior, and the social expectations linked to that role make postpartum women constantly assess their cognition and be more sensitive to recognize cognitive difficulties, which promotes self-perception of impaired cognition unrelated to functioning on objective neuropsychological tests. However, sleep quality and psychological stress condition women's self-perceived cognitive status. Finally, nutritional, reproductive health and sociodemographic factors are conditioning factors of women's mental health during postpartum. Consequently, it is proposed that comprehensive models of perinatal health based on diversity and equity can help to identify the most vulnerable groups in order to implement interventions that promote the physical and mental wellbeing of postpartum women, infants and families

Introduction: The neurobiological modifications experienced by women during puerperium, together with the consequent psychosocial changes, determine variations in cognitive functioning, which may interfere with women's lives. This could be prevented by the intake of dietary compounds, such as certain neuroprotective polyphenols. Their bioactivity depends on their effects on neurophysiology and metabolism in different tissues, such as brain, fat and breast. Thus, a polyphenol-related cognitive enhancement could be associated with chemical changes in human milk, which are key to proper infant neurodevelopment.

Objective: To study the association of dietary phytochemical intake and different socio-health factors with cognitive status and chemical composition of human milk in lactating women during the first six months postpartum in Córdoba, Argentina.

Results: The most prevalent cognitive complaints were related to concentration problems, mood changes and forgetfulness. In addition, 50% of the women reported sleep fragmentation as the main symptom of insomnia, and almost 70% reported that their sleep problems impacted daily functioning. In addition, the results confirmed that women who consumed polyphenols had better executive/attentional performance (i.e., higher correct responses, conceptual level responses, complete categories, and verbal fluency; lower attentional interference and perseverative errors) and memory (better word learning with less interference). Polyphenols increased milk protein, glucose and lipid concentrations, which were higher in women with better cognition. In addition, women with better cognitive status had fewer oxidized triacylglycerols. No significant associations were found between subjective cognitive complaints and objective neuropsychological measures. However, breastfeeding frequency was associated with better self-perceived mental well-being. Finally, protective and risk factors for puerperal health were identified. In this sense, women with less than 12 years of education, single and without formal employment were associated with unhealthy anthropometric indicators, sedentary lifestyle, low polyphenol intake and lower executive/attentional and memory functioning.

Conclusions: Consumption of dietary polyphenols during postpartum improves executive/attentional functioning, memory, and the chemical profile of human milk. In addition, the increased daily cognitive load linked to caregiving tasks, the development of maternal behavior, and the social expectations linked to that role make postpartum women constantly assess their cognition and be more sensitive to recognize cognitive difficulties, which promotes self-perception of impaired cognition unrelated to functioning on objective neuropsychological tests. However, sleep quality and psychological stress condition women's self-perceived cognitive status. Finally, nutritional, reproductive health and sociodemographic factors are conditioning factors of women's mental health during postpartum. Consequently, it is proposed that comprehensive models of perinatal health based on diversity and equity can help to identify the most vulnerable groups in order to implement interventions that promote the physical and mental wellbeing of postpartum women, infants and families