Journal Articles
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Item Saccharomyces cerevisiae Yeast-Based Supplement and Breast Milk Supply: A Randomised Placebo-Controlled Trial(John Wiley and Sons Ltd, 2025-09-11) Jia L; Brough L; Weber JLSaccharomyces cerevisiae yeast-based supplements (SCYS) are frequently used as galactagogues with limited evidence of their efficacy. This study investigates the effect of SCYS on human milk oligosaccharide (HMO) concentration and indicators of milk supply. Sixty-eight breastfeeding women with a healthy singleton infant aged 1–7 months were randomly assigned to consume a SCYS product (5 g/day) or placebo for 4 weeks. The primary outcome was the change in the total HMO concentration. The secondary outcomes included participants' perceptions of milk supply, intervention effectiveness, postnatal distress, infant feeding patterns, infant anthropometry, and adverse effects. Intention-to-treat analysis was performed. Multivariable linear regression analysis showed no significant effect of SCYS on individual or total HMO concentrations. However, 65% of women in the SCYS group, compared to 35% in the placebo group, perceived an increase in milk production (p < 0.05). No significant differences were found for other secondary outcomes. However, mothers in the SCYS group had a small but significant improvement in perception of their milk quantity and quality (p < 0.05). SCYS use was also associated with significantly lower formula use at 6 months postpartum (4% vs. 27%, p < 0.05). While SCYS does not impact HMO concentration, it may improve women's perceptions of milk supply. A larger randomised controlled trial is needed to assess its potential effects on actual milk production and composition and address issues of perceived insufficient milk. Trial Registration: This trial was registered at the Australian New Zealand Clinical Trials Registry (trial registration number: ACTRN12619000704190).Item Portable X-ray fluorescence of zinc and selenium with nail clippings – visit 3 of the Mother and Infant Nutrition Investigation (MINI)(Elsevier B.V., 2025-10) Fleming DEB; Scott AR; Ouellette JA; Kim JS; Lefsay A; Jin Y; Coad J; Brough LIntroduction: Recent advances in portable X-ray fluorescence (XRF) have opened up the possibility of a rapid and cost-effective method for measuring elemental content in nail clippings. Two elements of particular interest for intake assessment through nail clipping measurement are zinc and selenium. The New Zealand-based Mother and Infant Nutrition Investigation (MINI) provides an ideal testing ground for the application of portable XRF in the measurement of zinc and selenium. Two aspects requiring further study with portable XRF are the optimal time of measurement and the optimal approach to energy spectrum analysis. Methods: A subset of nail clippings from 20 mother-infant pairings were initially selected for analysis over three separate MINI study visits. This paper considers measurements from visit 3 (12 months postpartum). For portable XRF, a mono-energetic X-ray beam was used to excite characteristic X-rays from zinc and selenium. Individual XRF measurements were made for 60 s (real time). In each case, analysis of the elemental signal was performed in four different ways: (1) automated system output concentration; (2) element signal to total signal ratio; (3) element signal to Compton scatter signal; (4) element signal to coherent scatter signal. XRF results were compared against zinc and selenium concentrations obtained from a “gold standard” method of inductively coupled plasma mass spectrometry (ICP-MS). Results: ICP-MS results from the visit 3 nail clippings determined a mean zinc concentration of 104 µg/g and a mean selenium concentration of 0.606 µg/g. Analysis of XRF energy spectra from 60 s measurements showed that zinc was clearly detected in all cases. The selenium signal was more challenging, but was also detected from all spectra. For both zinc and selenium, correlations between XRF results and ICP-MS concentrations were highly significant (p < 0.01) in all cases, with the zinc results more strongly correlated than selenium. Of the four approaches to XRF signal analysis, the three approaches involving an external software package provided superior results relative to the automated system output. Correlations of XRF results with ICP-MS concentrations were similar between these three approaches. Conclusion: ICP-MS concentrations for both zinc and selenium were found to be lower from visit 3 relative to results from visit 1 and visit 2. This may indicate overall dietary changes postpartum. Correlations of XRF results with ICP-MS concentrations suggest that a relatively short 60 s measurement time is adequate for a reliable zinc assessment, but not for selenium. Although correlations of XRF results with ICP-MS concentrations were similar between three different methods of spectra analysis, practical considerations may favor use of the element signal to total signal approach.Item Supplement Use during Pregnancy in Aotearoa, New Zealand(MDPI (Basel, Switzerland), 2023-03-06) Funnell C; Coad J; Brough L; Smith C; Mackay S; Jalili-Moghaddam S; Gibbs MIodine is an essential micronutrient required for thyroid function, and is essential during pregnancy for growth and development. Manatū Hauora (MoH) recommends an iodine supplement of 150 µg/day during pregnancy and breastfeeding. To reduce the risk of brain and spinal cord birth defects, the MoH also recommends a folic acid (FA) supplement of 800 µg/day preconception (four weeks) and during the first trimester of pregnancy. A self-administered Qualtrics XM survey was designed for pregnant women between 20–23 weeks of gestation and advertised on Facebook between March 2021–June 2021 throughout Aotearoa. The aim of the survey was to ascertain supplement usage during pregnancy, with a particular focus on iodine and FA. In total, one hundred and sixty pregnant women completed the online survey. A total of 50% were of New Zealand/European ethnicity, 11% were Māori, and 3.2% of a Pacific Island ethnicity. Furthermore, 43% were educated to university level, and 80% were in either voluntary and/or paid employment. In addition, 66% consumed iodine-only supplements (Neurotab; 150 µg/day), 44% consumed FA-only supplements (800 µg/day), and 34% consumed multiple-micronutrient (MN) supplements containing iodine and FA, predominately Elevit or Blackmore pregnancy supplements. Concerningly, 11% of participants took no supplements, and only 45% of the FA supplement users reported taking the FA prior to conception. Furthermore, 13% took both folic and an MN supplement, putting them at risk of an intake over the upper level of intake (1000 mg/day). Additionally, 18% of the participants consumed both an iodine-only and an MN supplement. Only 37% of those using an iodine supplement planned to stop taking it when breastfeeding ceased, suggesting that many were not aware of the recommendation for continuation of use. Despite the high educational status, many did not adhere to the supplement use recommendations. Public health strategies are required to ensure that women of childbearing age are aware of these recommendations for supplement use pre-, during, and post-pregnancy.Item Effect of Iodine Nutrition During Pregnancy and Lactation on Child Cognitive Outcomes: A Review(MDPI (Basel, Switzerland), 2025-06-16) Ma ZF; Brough L; Marconi AMIodine deficiency remains one of the most serious global public health challenges, recognised as the leading cause of preventable brain damage worldwide. It is widely accepted as the primary aetiological factor underlying iodine deficiency disorders (IDD). Inadequate maternal iodine intake reduces thyroxine synthesis, impairing foetal brain development and leading to long-term deficits in cognitive function across childhood and adulthood. However, emerging evidence also suggests that excessive iodine intake may disrupt thyroid function, particularly in individuals with underlying thyroid autoimmunity, potentially leading to adverse neurodevelopmental outcomes. In this state-of-the-art review, we examine the effects of iodine nutrition during pregnancy and lactation on child cognitive outcomes. We provide an overview of the recent global iodine status, critically appraise the current evidence linking both iodine deficiency and excess to neurodevelopmental outcomes, and offer expert interpretation of the key findings. We further highlight areas of uncertainty, introduce emerging evidence from contemporary studies, and propose directions for future research to inform and optimise public health policies and clinical practice. Our findings highlight a U-shaped association, whereby both insufficient and excessive iodine exposure during pregnancy and lactation may impair optimal brain development in the offspring.Item Iodine and selenium intakes and status and thyroid function in midlife women with low bread intakes in New Zealand(John Wiley and Sons Australia, Ltd on behalf of Dietitians Australia, 2025-06-18) Berger J; Finlayson J; Von Hurst PR; Brough LAims: Iodine and selenium are important nutrients for thyroid function; however, the New Zealand food supply is generally low in both minerals. Bread can be a good source of these minerals; although the popularity of lower carbohydrate diets means some people avoid bread. This study aimed to investigate the effect of low bread intakes on iodine and selenium intakes and status, and thyroid function in mid-life women in New Zealand. Methods: Self-selecting women (n = 46), aged 40–63 years, with a mean daily intake of 1.6 ± 1.5 slices of fortified commercial bread, were recruited into a cross-sectional study in Auckland, New Zealand. Assessment of iodine and selenium intake was via a 3-day diet diary. Iodine and selenium concentrations were measured in 24-h urine samples and selenium concentrations in plasma using inductively coupled plasma mass spectrometry. Thyroid hormones including triiodothyronine and thyroxine were also determined. Results: Median urinary iodine concentration was 49 (35, 78; 25, 75 centile) μg/L indicating iodine deficiency. Of plasma samples measured, 32% had selenium concentrations below 110 μg/L, suggesting inadequacy. Data suggested at least 40% of participants had low intakes of both nutrients. Only two participants had impaired thyroid function; however, plasma selenium concentrations predicted the ratio of triiodothyronine to thyroxine (p = 0.038). Conclusions: A high prevalence of inadequate selenium and iodine intake was observed in women with low bread intakes. Those with low bread intakes need to ensure they consume alternative sources such as dairy, fish and seafood, eggs, meat, other grains, and nuts.Item Dietary Patterns and Nutrient Intake in Pregnancy and Lactation(MDPI (Basel, Switzerland), 2025-05) Rees G; Brough L; Brough L; Rees GItem Food Group Consumption and Nutrient Intake by Breastfeeding Women: Comparison to Current Dietary Guidelines and Nutrient Recommendations.(MDPI (Basel, Switzerland), 2025-01-21) Jin Y; Coad J; Brough L; Billeaud C; Asher OBACKGROUND/OBJECTIVES: Optimal nutrition is essential for the health of breastfeeding women and their infants. This study aimed to assess food and nutrient intake and alignment with nutrition guidelines for breastfeeding women living in New Zealand. METHODS: Seventy-six breastfeeding women were enrolled in the longitudinal Mother and Infant Nutrition Investigation study and completed a weighed four-day diet diary including supplement use at three months postpartum. The number of servings consumed for each food group were calculated based on the 2020 Eating and Activity Guidelines for New Zealand Adults. Nutrient intakes were compared to the nutrient reference values for Australia and New Zealand. RESULTS: Overall, the percentages of women who met the recommended number of servings for fruits, vegetables, grain foods, meats and milk/milk products were 25%, 0%, 5%, 34%, and 13%, respectively. None of women met the current recommendations for all food groups. Many participants had intakes below the estimated average requirement or adequate intake and were at risk of nutrient inadequacy for vitamin E (55%), vitamin D (53%), manganese (61%), and selenium (55%). CONCLUSIONS: Breastfeeding women had a low alignment with the current dietary guidelines and were at risk of an inadequate intake of vitamin E, D, manganese, and selenium. Research to investigate the barriers and enablers of healthy food choices is needed.Item Iodine(Elsevier Inc. on behalf of American Society for Nutrition, 2024-01-30) Brough L; Skeaff SThe micronutrient iodine is essential for thyroid function. Iodine is a constituent of the thyroid hormones, thyroxine (tetraiodothyronine, T4), and triiodothyronine (T3) that control metabolism, growth, and development [2].Item Portable X-ray fluorescence of zinc and selenium with nail clippings-Mother and Infant Nutrition Investigation (MINI).(PLOS, 2024-10-23) Fleming DEB; Madani N; Kaiser MG; Kim JS; Keltie E; Drage N; Jin Y; Coad J; Brough L; Specht AZinc and selenium are essential minerals for human nutrition. Reliable biomarkers of zinc status and selenium status in humans are therefore important. This work investigates a novel portable X-ray fluorescence (XRF) method with the ability to rapidly assess zinc and selenium in nail clippings. This approach used a mono-energetic X-ray beam to excite characteristic X-rays from the clippings. Nail clippings were obtained from the Mother and Infant Nutrition Investigation (MINI), a study designed to assess nutrition in a population of women and their breastfed children in New Zealand. Twenty mother-infant pairings were selected to provide nail clippings at two time points (visit 1 at 3 months postpartum; visit 2 at 6 months postpartum). Nail clippings from each mother-infant pairing were divided into three groupings of clippings prior to analysis: those obtained from a big toe of the mother, those from the other toes of the mother, and those from the toes and fingers of the infant. Clippings were prepared and mounted prior to XRF measurement, providing four distinct fragments from each clipping grouping. These fragments were assessed by XRF using a measurement time of either 300 s (visit 1) or 180 s (visit 2). XRF results were determined through both an automated system output and an analysis of the X-ray energy spectrum. Following this assessment of zinc and selenium with the non-destructive XRF method, clippings were measured for zinc and selenium concentration using a "gold standard" technique of inductively coupled plasma mass spectrometry (ICP-MS). Mean ICP-MS concentrations ranged from 122 μg/g to 127 μg/g for zinc, and from 0.646 μg/g to 0.659 μg/g for selenium. Precision, assessed by a relative standard deviation of measurement, was superior for ICP-MS relative to XRF. For both zinc and selenium, XRF results were compared with ICP-MS concentrations. Linear equations of best fit were determined for each comparison between XRF and ICP-MS results. Coefficients of determination (r2) were stronger for zinc (from 0.74 to 0.95) than selenium (from 0.53 to 0.70). A decrease in XRF measurement time from 300 s to 180 s did not appear to adversely affect the correlation between XRF and ICP-MS results. Using the mono-energetic portable XRF method, the correlation of XRF zinc results with ICP-MS zinc concentrations was improved over previous findings, and selenium measurement was reported for the first time. The method may prove useful for future applications to trace element analysis using nail clippings as a biomarker.Item Gymnema lactiferum: A Review of Its Traditional Applications, Phytochemical Constituents, and Biological Properties(Wiley Periodicals LLC, 2024-10-16) Weerasinghe DMKP; Brough L; Everett DW; Rashidinejad AHumanity has a longstanding reliance on natural plants for medicinal purposes, and Gymnema lactiferum (G. lactiferum) has emerged as a medicinal plant with deep-rooted traditional usage. Throughout history, this plant has been an integral part of traditional medical systems, demonstrating diverse therapeutic effects. Notably, among these effects is its ability to decrease blood glucose concentration in diabetic patients, impart cooling effects, serve as an anabolic and rehydrating agent, stimulate spermiogenesis, and exhibit wormicidal properties. Furthermore, G. lactiferum has been used in treating conditions such as hemorrhoids cancers, anorexia, and as a cardiac stimulant. The primary objective of this review is to comprehensively gather and critically assess research findings regarding the medicinal properties of G. lactiferum, specifically emphasizing the bioactive compounds responsible for these properties. Previous studies have documented the presence of various phytochemicals in G. lactiferum, which are associated with some biological activities, including antioxidative, anti-hyperglycemic, cholesterol-regulating, and anti-inflammatory properties. Additionally, this review explores potential future applications for this plant. Beyond its medicinal significance, extracts derived from G. lactiferum demonstrate promise for future nutritional applications. This review highlights the potential use of G. lactiferum as an herbal medicine by critically assessing research on its medicinal value.