Dietary supplementation of lactating Gambian women. II. Effect on maternal health, nutritional status and biochemistry.

The effect of a high-energy dietary supplement provided under carefully controlled conditions to 130 lactating Gambian women was assessed with respect to changes in maternal health, nutritional status and biochemistry. The supplement resulted in a net increase in energy intake of 723 kcal/d (3.03 MJ/d) and corrected deficits in the intake of protein, riboflavin, vitamin A, vitamin C and calcium. Supplemented women complained of fewer health problems when attending postnatal clinics (P less than 0.001). In particular the incidence of gastrointestinal problems was lower (P less than 0.001). The supplement caused a net body weight gain of only 1.8 kg averaged over a year, and women still lost weight during the farming season. Fasting serum levels of non-esterified fatty acids were increased and of glucose were decreased by the supplement. Plasma concentrations of prolactin, cortisol, insulin and T3 were found to be decreased after supplementation at one or more points during lactation, but growth hormone values remained unchanged. It is suggested that these changes reflect a relaxation from a state of high metabolic efficiency and that much of the additional energy derived from the supplement was simply wasted through a decreased efficiency in the women.