BACKGROUND Diets rich in fruits and vegetables (F/V) can reduce the inflammatory profile of circulating cytokines and potentially decrease the risk of breast cancer. However, the extent to which a diet rich in F/V alters cytokine levels in breast tissue remains largely unknown. Breast milk provides a means of assessing concentrations of secreted cytokines in the breast microenvironment and is a potential tool for studying the effects of diet on inflammation in breast tissue and breast cancer risk. OBJECTIVE The aim of this pilot randomized trial was to test the feasibility of increasing F/V intake in breastfeeding women and of measuring changes in markers of inflammation in breast milk. DESIGN AND INTERVENTION Participants randomized to the intervention (n=5) were provided weekly boxes of F/V, along with dietary counseling, to increase consumption of F/V to 8 to 10 daily servings for 12 consecutive weeks. Controls (n=5) were directed to the US Department of Agriculture's "ChooseMyPlate" diet for pregnancy and breastfeeding. PARTICIPANTS/SETTING Ten breastfeeding women consuming fewer than five servings of F/V per day, as estimated by the National Institutes of Health "All-Day" Fruit and Vegetable Screener (F/V Screener), were recruited through flyers and a lactation consultant between February and May 2016 in the Western Massachusetts area. MAIN OUTCOME MEASURES Baseline demographic and F/V intake data were collected during enrollment. At week 1 and week 13 (final) home visits, participants provided milk samples and anthropometric measurements were recorded. Participants completed F/V screeners at baseline and at study end. Adiponectin, leptin, C-reactive protein, and 11 additional cytokines were measured in breast milk collected at weeks 1 and 13. STATISTICAL ANALYSES F/V consumption at baseline and after the final visit, and between controls and intervention groups, was compared with dependent and independent t tests, respectively. Differences between cytokine levels at weeks 1 and 13 were assessed with a mixed-effects repeated-measures model. RESULTS All women in the intervention increased F/V intake and were consuming more servings than controls by week 13; daily serving of F/V at baseline and final visit: controls=1.6 and 2.0, diet=2.6 and 9.9. Most cytokines were detected in the majority of milk samples: 12 were detected in 90% to 100% of samples, one was detected in 75% of samples, and one was detected in 7.5% of samples; coefficients of variation were below 14% for 11 of the cytokines. CONCLUSIONS These preliminary findings indicate that it is feasible to significantly increase F/V intake in breastfeeding women and provide support for conducting a larger diet intervention study in breastfeeding women, in which longer-term benefits of the intervention are assessed.

中文翻译：

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增加母乳喂养妇女水果和蔬菜摄入量的饮食干预：一项随机试验测量母乳中的炎症标志物

背景富含水果和蔬菜 (F/V) 的饮食可以减少循环细胞因子的炎症特征，并可能降低患乳腺癌的风险。然而，富含 F/V 的饮食在多大程度上改变了乳腺组织中的细胞因子水平仍然未知。母乳提供了一种评估乳腺微环境中分泌细胞因子浓度的方法，并且是研究饮食对乳腺组织炎症和乳腺癌风险影响的潜在工具。目的 本试验随机试验的目的是测试增加母乳喂养妇女 F/V 摄入量和测量母乳中炎症标志物变化的可行性。设计和干预 随机接受干预的参与者 (n=5) 每周获得一盒 F/V，以及饮食咨询、连续 12 周将 F/V 的消耗量增加到每天 8 到 10 份。对照（n=5）针对美国农业部的“ChooseMyPlate”妊娠和哺乳期饮食。参与者/环境 根据美国国立卫生研究院“全天”水果和蔬菜筛选者 (F/V Screener) 的估计，通过传单和一名哺乳顾问招募了 10 名每天摄入少于 5 份 F/V 的母乳喂养妇女2016 年 2 月至 5 月期间在马萨诸塞州西部地区。主要结局指标 基线人口统计学和 F/V 摄入量数据是在入组期间收集的。在第 1 周和第 13 周（最终）家访时，参与者提供了牛奶样本并记录了人体测量数据。参与者在基线和研究结束时完成了 F/V 筛选。脂联素，在第 1 周和第 13 周收集的母乳中测量了瘦素、C 反应蛋白和 11 种额外的细胞因子。 统计分析 基线和最终访视后以及对照组和干预组之间的 F/V 消耗量与依赖组和独立组进行比较t 检验，分别。使用混合效应重复测量模型评估第 1 周和第 13 周细胞因子水平之间的差异。结果 到第 13 周，所有参与干预的女性都增加了 F/V 摄入量，并且比对照组消耗了更多的份量；基线和最终访视时的每日 F/V 量：对照 = 1.6 和 2.0，饮食 = 2.6 和 9.9。在大多数牛奶样品中检测到大多数细胞因子：12 种在 90% 至 100% 的样品中检测到，1 种在 75% 的样品中检测到，1 种在 7.5% 的样品中检测到；11 种细胞因子的变异系数低于 14%。结论 这些初步结果表明，显着增加母乳喂养妇女的 F/V 摄入量是可行的，并为在母乳喂养妇女中进行更大规模的饮食干预研究提供支持，其中评估干预的长期益处。