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Prediabetes is associated with an elevated risk for developing type 2 diabetes (T2DM) and associated cardiovascular complications. Lifestyle factors such as physical activity (PA) and dietary intake are strongly implicated in the development of metabolic disease, yet few Americans meet PA and dietary recommendations. Middle-aged and older adults are at increased risk for developing prediabetes and T2DM due to age-related muscle loss, increased fat mass, and alterations in glucose handling. In addition, this segment of the population is least likely to meet PA guidelines, particularly the resistance training (RT) recommendation of completing a whole body routine 2x/week. Ideally, individuals would alter their lifestyle in order to meet PA guidelines and habitually consume a healthy diet, to decrease disease risk. However, behavior change is difficult and optimal strategies to promote and maintain changes have yet to be determined. Furthermore, behavior change interventions tend to be time-, cost-, and resource-intensive, limiting the ability for efficacious programs to be translated into community settings and broadly disseminated. Evidence suggests that health-related behaviors, particularly diet and exercise habits, tend to cluster together. Thus, intervening on one behavior (e.g. PA) may elicit a spillover effect, promoting alterations in other behaviors (e.g. diet), though findings to date are conflicting. The purpose of this dissertation was to determine if participation in a social cognitive theory-based RT program targeting the initiation and maintenance of RT exerts a spillover effect and is associated with alterations in dietary intake and/or non-RT PA in a population at risk for T2DM. Data from the 15-month Resist Diabetes study was analyzed to evaluate this possibility. Sedentary, overweight/obese (BMI 25-39.9 kg/m2 ), middle-aged and older (50 -69 years) adults with prediabetes (impaired fasting glucose and/or impaired glucose tolerance) completed a 3 month initiation phase where they RT 2x/week in a lab-gym with an ACSM-certified personal trainer. Participants then completed a 6-month faded contact maintenance phase, and a 6-month no-contact phase during which they were to continue RT on their own in a public facility. No advice or encouragement was given to participants to alter dietary intake or non-RT PA habits. At baseline, and months 3, 9, and 15, three non-consecutive 24-hour diet recalls were collected to evaluate dietary intake and quality, the Aerobics Institute Longitudinal Study Questionnaire was completed to evaluate non-RT PA, and body mass, body composition, and strength (3 repetition maximum on leg and chest press) were measured. At months 3, 9, and 15 social cognitive theory (SCT) constructs were assessed with a RT Health Beliefs Questionnaire. In the first study, dietary intake was assessed at baseline and after 3 months of RT. Using paired sample t-tests, reductions in intake of energy (1914 ± 40 kcal vs. 1834 ± 427 kcal, p = 0.010), carbohydrate (211.6 ± 4.9 g vs. 201.7 ± 5.2 g, p = 0.015), total sugar (87.4 ± 2.7 g vs. 81.5 ± 3.1 g, p = 0.030), glycemic load (113.4 ± 3.0 vs. 108.1 ±3.2, p= 0.031), fruits and vegetables (4.6±0.2 servings vs. 4.1±0.2 servings, p= 0.018), and sweets and desserts (1.1 ± 0.07 servings vs. 0.89 ± 0.07 servings, p = 0.023) were detected from baseline to month 3. No changes in other dietary intake variables were observed. These findings supported additional investigation in this area. The second study assessed changes in overall diet quality (Healthy Eating Index [HEI]-2010 scores) and non-RT PA over the initiation, maintenance, and no-contact phases using mixed effects models. Demographic, physiological, and psychosocial factors that may predict alterations to diet quality and non-RT PA were also explored. Energy and carbohydrate intake decreased with RT (β= -87.9, p=.015 and β= -16.3, p<.001, respectively). No change in overall dietary quality (HEI-2010 score: β= -0.13, p=.722) occurred, but alterations in HEI-2010 sub-scores were detected. Maintenance of RT was accompanied by an increase in MET-min/week of total non-RT PA (β=153.5, p=0.01), which was predicted by increased self-regulation for RT (β=78.1, p=0.03). RT may be a gateway behavior leading to improvements in other health-related behaviors among adults with prediabetes. These results support the use of singlecomponent vs. multi-component interventions. This may have broad translational potential for the development of time-, resource-, and cost-efficient lifestyle interventions which can improve multiple health-related behaviors and decrease disease risk. / Ph. D.

Controversy surrounds the use of artificial sweeteners (non-nutritive sweeteners [NNS]) as an effective weight-loss and/or maintenance strategy. This controversy is especially important as obesity is an epidemic in the United States. Excessive added sugar intake, primarily from sugar-sweetened beverages, has been linked to increased risk of overweight and obesity, as well as type 2 diabetes and cardiovascular disease. NNS provide minimal to no calories and thus, they have been suggested as a method to reduce added sugar intake, and consequently decrease energy intake, weight, and cardiometabolic risk. However, NNS intake has been associated with various health outcomes in observational studies and randomized controlled trials, including cancer, weight gain and loss, physiological and intestinal changes, cardiovascular disease, and diabetes. The uncertainties around the effect of NNS on health outcomes stem from a variety of limitations, one of which is inadequate dietary assessment methodology. Accuracy of dietary intake assessment methods is limited by the inability to distinguish between different types of NNS and lack of information about consumer use of NNS in a variety of beverages and foods. The purpose of this investigation is to explore NNS consumer characteristics and to characterize NNS intake in a sample of rural Southwest Virginian adults. This characterization is especially important for rural populations, as they are known to be high sugar-sweetened beverage consumers and are at an increased risk of obesity and chronic disease; thus, NNS could serve as a replacement method to facilitate cardiometabolic health. Cross-sectional data from a large randomized controlled trial, Talking Health (n=301), was utilized in this investigation to compare demographic characteristics, anthropometrics, biochemical markers, dietary quality, and dietary factors between NNS consumers and NNS non-consumers. This data was also used to characterize NNS intake (frequency, type, and source of sweetener). Of this rural sample, 33% consumed NNS, with sucralose being the most prevalent type of NNS and diet soda being the most frequently consumed source of NNS. NNS consumers had a higher BMI status than NNS non-consumers. However, NNS consumers had better overall dietary quality than NNS non-consumers. The characteristics of these NNS consumers and their intake patterns can be used to develop well-designed dietary intake assessment tools that accurately measure NNS intake, which can facilitate a better understanding of the associations of NNS with health outcomes. / Master of Science

Background and Purpose: Little is known about influences of obstructive sleep apnea syndrome (OSAS) on dietary intake and body composition. The purpose of this study was to evaluate dietary status, body fat distribution and leptin in overweight young men with and without OSAS in comparison to published values for normal weight counterparts. Methods: Groups were comprised of 24 sedentary overweight young men with and without OSAS, who had a body mass index (BMI) greater than 25 kg/m². Serum leptin concentration was measured in the 24 subjects using radioimmunoassay, while OSAS assessment was done using nighttime home somnography. Analysis of 4-day diet recalls was performed using Nutritionist Pro (First DataBank, Inc., San Bruno, CA). A Healthy Eating Index (HEI) score was calculated for the 24 overweight subjects. Results: There were no differences between the two overweight groups for total fat mass, central abdominal fat, BMI, waist circumference, leptin, or the HEI. The HEI was not predictive of overall OSAS severity; however, BMI was moderately related to OSAS severity (r = 0.39; p=0.05). The normal weight group did have a 50% higher report of carbohydrate intake, and consumed on average, 500 more kilocalories per day. The normal weight group consumed 50% less sodium, and 50% more Vitamin's C and E including a 13% increase in the HEI. Conclusions: Regulation of eating behavior and related influences on diet composition may be affected by a number of neurohormonal disturbances associated with OSAS and/or obesity, itself. Further research is needed to quantify these possible differences on dietary status and the underlying mechanism involved. / Master of Science

Doctor of Philosophy / Department of Human Nutrition / Valentina M. Remig / The frequency of dietary supplement use has increased in recent years, especially among older adults. National studies estimated 60-65% of older adults were using at least one dietary supplement, typically a multi-vitamin, multi-mineral (MVMM) supplement. Dietary supplement use has been reported to improve the micronutrient intakes of older adults. The current research study focused on the use of dietary supplements, dietary intakes, and impact of vitamin/mineral (VM) supplements on the nutrient intakes of older Kansans. Volunteer subjects, 60+ years of age, were recruited from 35 senior centers across Kansas. Subjects completed a questionnaire asking for demographic information, current health status, and dietary supplement use. Dietary supplement use was verified for 319 subjects. Two subsequent 24-hour diet recalls were completed by 312 subjects. The sample population was primarily white, non-Hispanic females. Nearly 86% of participants used at least one dietary supplement; most commonly MVMM, calcium, vitamin D, and fish oil. Dietary intake analyses compared intakes of dietary supplement (DS) users to non-dietary supplement (NDS) users. DS subjects consumed significantly higher dietary intakes of carbohydrate, fiber, vitamin A, and zinc than NDS subjects. The NDS group consumed undesirably higher intakes of total fat, saturated fat, and sodium. These results support previous findings that DS users consume healthier diets. The impact of VM supplement use on micronutrient intake compared only the intakes of subjects using VM supplements (n=263) to the Dietary Reference Intakes (DRI). Subjects were most likely to have inadequate dietary intakes of vitamin D, calcium, vitamin E, and magnesium. All micronutrient intakes were improved with the inclusion of VM supplements; most improved were vitamin E, folic acid, vitamin D, vitamin B6, and calcium. Despite supplementation, nearly half of subjects still exhibited low intakes of vitamin D, calcium, and magnesium. Supplementation did not consistently exceed the Tolerable Upper Limit established by the DRIs for most nutrients. In conclusion, dietary supplement use was very common in the sample population, DS subjects had generally healthier diets, and VM supplement use improved micronutrient intake without contributing to concern for toxicity.

Irritable bowel syndrome (IBS) är en sjukdom som leder till en funktionell motorisk störning i mag-tarmkanalen och symtom som förstoppning, diarré, gasbesvär, buksmärta och uppspänd buk är vanligt förekommande. Symtomen leder ofta till stress, depression, ångest vilket kan medföra ett begränsat vardagsliv. Individens livskvalitet påverkas av vad symtomen orsakar för individen i vardagslivet vilket kan leda till lidande. Syftet med litteraturstudien var att granska och sammanställa vårdvetenskaplig forskning som belyser patienters upplevelser av att leva med IBS. Metoden är en litteraturstudie utifrån Fribergs modell. Sex kvalitativa artiklar och tre kvantitativa artiklar har analyserats. Resultatet visade att kroppen var opålitlig då sjukdomen orsakade fysiska symtom och gav oönskade symtom som gasbesvär, smärta i buken, diarré, förstoppning och uppspändhet. Patienter upplevde begränsningar i vardagen i form av symtom som ökade gasbesvär, uppspändhet, diarré. Patienter hade ständigt uppsikt efter toaletter då de gick hemifrån vilket ofta skapade en ökad oro. Symtom som gasbildningar och diarré innebar att patienter ofta behövde gå på toaletten vilket var besvärligt i samband med möte, arbete, skola. Detta upplevde patienter vara skamligt. Sjukdomen bidrog i längden till ökad stress, ångest, depression och isolering hos patienterna. Detta har orsakat minskat förtroende till vården, patienterna upplevde sig missförstådda och välbefinnandet minskade. Strategier och planering bidrog till bekräftelse, medvetenhet, kunskap och förståelse. Patienter upplevde sig ha bättre koll på symtomen och kunde agera tills värken släppte. Sjuksköterskan har en viktig roll där hen kan hjälpa patienten att känna välbefinnande, hopp, livslust och ökad självkänsla genom bekräftelse av att bli sedd och hörd samt ge nyttig kunskap för att patienter ska kunna hantera sin sjukdom med bra planering och strategier.

Os ácidos graxos poli-insaturados de cadeia longa são de grande importância para o crescimento e o desenvolvimento infantil. Suas concentrações variam amplamente no leite materno, em partes, devido à variabilidade do teor de ácidos graxos da dieta materna. Entretanto a relação entre os ácidos graxos da dieta, durante a gestação, e seus teores no leite materno maduro ainda não foi elucidada. O presente estudo tem como objetivo avaliar a composição de ácidos graxos poli-insaturados do leite materno maduro de mulheres residentes em área distante da costa litorânea do Brasil (Manuscrito 1) e investigar a associação entre a composição de ácidos graxos poli-insaturados da dieta materna, em distintos períodos da gestação e no período pós-parto, na composição destes no leite humano maduro (Manuscrito 2). A presente pesquisa integra as atividades de um estudo prospectivo, conduzido entre 103 gestantes saudáveis, com idade entre 18 e 35 anos, usuárias do Sistema Único de Saúde do município de Ribeirão Preto, SP. O consumo alimentar materno, durante a gestação e após o parto, foi avaliado por meio de três inquéritos recordatórios de 24 horas, ao longo da gestação, e dois inquéritos recordatórios de 24 horas, no puerpério. As mulheres com dados completos de consumo alimentar durante a gestação, que tiveram parto a termo e praticavam aleitamento materno exclusivo ou predominante a partir da 5ª semana pós-parto, foram convidadas a participar do presente estudo. Amostras de 5-10ml de leite materno maduro foram obtidas por meio de ordenha manual, e a dosagem do teor de ácidos graxos se deu por meio de cromatografia gasosa. Para investigação da influência do consumo alimentar de cada trimestre gestacional e no período pós-parto na composição de ácidos graxos poli-insaturados do leite materno maduro, foram utilizados modelos de regressão linear ajustados pelo IMC pós-parto e deatenuados. O Manuscrito 1 descreve a composição de ácidos graxos poli-insaturados do leite materno maduro de mulheres residentes em área distante da costa litorânea do Brasil. Observaram-se baixo teor de ácido docosa-hexaenoico (0,09%) e alta concentração de ácidos graxos trans (2,05%), no leite humano das mulheres avaliadas. O Manuscrito 2 descreve a associação direta entre o teor dos ácidos eicosapentaenoico [= 1,87 (95% IC: 0,54; 3,28)] e docosa-hexaenoico [= 0,46 (95% IC 0,21; 0,71)] da dieta materna do terceiro trimeste gestacional e o teor destes no leite humano maduro, assim como a relação direta entre a razão n3/n6 da dieta [= 0,09 (95% IC 0,02; 0,17)] do segundo e terceiro trimestres gestacionais e no período pós-parto com a proporção verificada no leite materno. Os resultados indicam um baixo teor de ácido docosa-hexaenoico entre as mulheres avaliadas e uma alta concentração de ácidos graxos trans no leite materno. O teor de DHA e EPA da dieta materna, no final do período gestacional, pode influenciar a composição de ácidos graxos de leite materno maduro. Ainda, a razão n-3/n-6 de ácidos graxos da dieta materna, no final da gestação e no período pós-parto, também pode influenciar na composição de ácidos graxos do leite materno. Os dados sugerem a relevância de medidas de intervenção para promoção do consumo de alimentos ricos em n-3, no terceiro trimestre gestacional. / Long-chain polyunsaturated fatty acids play a relevant role on child development and growth. Their content in breast milk vary widely, partially due to the variability of fatty acids content on maternal dietary intake. However little is known about the relationship between maternal dietary intake during pregnancy and the fatty acids content of breast milk. The aim of the present study was to assess the polyunsaturated fatty acids composition of mature breast milk of women living far from the Brazilian coast (Manuscript 1) and to evaluate the influence of the food intake in different periods of pregnancy and postpartum on the polyunsaturated fatty acids composition of mature breast milk (Manuscript 2). This research integrates the activities of a prospective study conducted among 103 healthy pregnant women, aged 18 to 35 years old, users of the Public Health System in Ribeirão Preto, SP. The maternal dietary intake was evaluated by three 24/hour dietary recalls during pregnacy and two 24/hour dietary recalls at the postpartum period. Women with complete data of the dietary intake during pregnancy, who delivered at term, and were exclusively or predominantly breastfeeding their babies after the 5th week postpartum were invited to participate of the present study. Samples of 5 to 10ml of mature breast milk were obtained by manual expression to determine the fatty acids content by gas chromatography. Linear regression models were applied to assess the influence of dietary intake on fatty acids content of mature breast milk, at each trimester of pregnancy and at postpartum period, adjusted by postpartum BMI and deattenuated. The Manuscript 1 describes the polyunsaturated fatty acids composition of mature breast milk of women living far from the Brazilian coast. Among the samples evaluated, low content of docosahexaenoic acid (0,09%) and high level trans fatty (2,05%) acid were found. The Manuscript 2 describes a positive association between the eicosapentaenoic acid [= 1.87 (95% IC: 0.54, 3.28)] and docosahexaenoic acid [= 0.46 (95% IC 0.21, 0.71)] content of the maternal diet at the third trimester of pregnancy. Moreover, a positive association between the n-3/n-6 dietary ratio [= 0.09 (95% IC 0.02, 0.17)] at the second and third trimesters of pregnancy and at the postpartum period with the content of these fatty acids in human milk. Low docosahexaenoic acid and high trans fatty acid levels in mature breast milk were found. DHA and EPA content of the maternal diet during late pregnancy might influence the content of these fatty acids on mature breast milk. Moreover, the dietary ratio of n- 3/n-6 fatty acids on late pregnancy and post-partum period also influences the fatty acid composition of breast milk. The data suggest the relevance of intervention strategies to promote the intake of food rich in n-3 on late pregnancy.

Introdução Refeições em família (RF) são consideradas como refeições em que a família se senta junto e concentra sua atenção na experiência comum de aproveitar a refeição, preferencialmente, tendo uma conversação ao mesmo tempo. A alimentação em família desempenha importante papel para aquisição de bons hábitos alimentares. Objetivos - Identificar os fatores que contribuem para a prática de refeições em família, o impacto das mesmas no consumo alimentar e avaliar se a intervenção com múltiplos componentes promoveu mudanças nos hábitos alimentares de adolescentes e no ambiente das refeições em família. Métodos O projeto Hábitos Saudáveis, Meninas Saudáveis Brasil é um ensaio comunitário, randomizado e controlado, com 253 adolescentes do sexo feminino de escolas técnicas de São Paulo. Avalia estratégias de mudanças de comportamentos. Foi estruturado com base na Teoria Social Cognitiva e utilizados múltiplos componentes tais como materiais instrucionais, seminários, oficinas culinárias, envio de mensagens pelo WhatsApp®. Resultados As adolescentes realizavam em média 5,04±ep0,20 RF por semana, a prática de RF regulares foi associado: a atividade física vigorosa ativa (p=0,009), a preparação de refeição conjunta com a família (p=0,024), a oferta de legumes nas refeições (p=0,037) e entre outros a escolha de alimentos com menor teor de gordura (p<0,001). Foram enviadas 26 mensagens motivadoras, que promoveram 503 interações. Conclusões - A prática de RF regulares sofre forte influência do ambiente, e após a intervenção houve alteração na dinâmica das refeições e melhoria no consumo de frutas, legumes e verduras. Expor as adolescentes a diferentes metodologias com abordagem social e cognitiva, foi importante, principalmente, para produzir a mudança de ação. / Introduction Family meals (FM) are considered meals that family are together and focus their attention in a common experience to turn the meal, in special, making a conversation at the same time. Family meals have an important role in the acquision of adequate eating habits. Objective Identify factors that contribute for family meal practices, their impact in dietary intake and assess the intervention with multiple components that promoted changes in eating habits in adolescents and family environment meals. Methods The Healthy Habits, Healthy Girls Brazil is a randomized controlled trial with 253 adolescent girls from technical schools of São Paulo. It was bases on the Social Cognitive Theory and used multiple components such as instructional materials, seminars and nutrition workshops, Whatsapp® messages. Results Adolescents realized on average 5.04±er0.20 FM per week, the practice for regular FM were associated to vigorous physical activity (p=0.024), availability of vegetables during meals (p=0.037) and among others the choices for foods reduced in fats (p<0.001). 26 motivational messages were sent, and promoted 503 interactions. Conclusions - Regular FM presents a great influence on the environment, and after the intervention there was a change on meals and enhanced intake of fruits and vegetables. Exposure the girls to different methodologies with social cognitive approaches, was important, specially, for promoting action chances.

Os ácidos graxos poli-insaturados de cadeia longa são de grande importância para o crescimento e o desenvolvimento infantil. Suas concentrações variam amplamente no leite materno, em partes, devido à variabilidade do teor de ácidos graxos da dieta materna. Entretanto a relação entre os ácidos graxos da dieta, durante a gestação, e seus teores no leite materno maduro ainda não foi elucidada. O presente estudo tem como objetivo avaliar a composição de ácidos graxos poli-insaturados do leite materno maduro de mulheres residentes em área distante da costa litorânea do Brasil (Manuscrito 1) e investigar a associação entre a composição de ácidos graxos poli-insaturados da dieta materna, em distintos períodos da gestação e no período pós-parto, na composição destes no leite humano maduro (Manuscrito 2). A presente pesquisa integra as atividades de um estudo prospectivo, conduzido entre 103 gestantes saudáveis, com idade entre 18 e 35 anos, usuárias do Sistema Único de Saúde do município de Ribeirão Preto, SP. O consumo alimentar materno, durante a gestação e após o parto, foi avaliado por meio de três inquéritos recordatórios de 24 horas, ao longo da gestação, e dois inquéritos recordatórios de 24 horas, no puerpério. As mulheres com dados completos de consumo alimentar durante a gestação, que tiveram parto a termo e praticavam aleitamento materno exclusivo ou predominante a partir da 5ª semana pós-parto, foram convidadas a participar do presente estudo. Amostras de 5-10ml de leite materno maduro foram obtidas por meio de ordenha manual, e a dosagem do teor de ácidos graxos se deu por meio de cromatografia gasosa. Para investigação da influência do consumo alimentar de cada trimestre gestacional e no período pós-parto na composição de ácidos graxos poli-insaturados do leite materno maduro, foram utilizados modelos de regressão linear ajustados pelo IMC pós-parto e deatenuados. O Manuscrito 1 descreve a composição de ácidos graxos poli-insaturados do leite materno maduro de mulheres residentes em área distante da costa litorânea do Brasil. Observaram-se baixo teor de ácido docosa-hexaenoico (0,09%) e alta concentração de ácidos graxos trans (2,05%), no leite humano das mulheres avaliadas. O Manuscrito 2 descreve a associação direta entre o teor dos ácidos eicosapentaenoico [= 1,87 (95% IC: 0,54; 3,28)] e docosa-hexaenoico [= 0,46 (95% IC 0,21; 0,71)] da dieta materna do terceiro trimeste gestacional e o teor destes no leite humano maduro, assim como a relação direta entre a razão n3/n6 da dieta [= 0,09 (95% IC 0,02; 0,17)] do segundo e terceiro trimestres gestacionais e no período pós-parto com a proporção verificada no leite materno. Os resultados indicam um baixo teor de ácido docosa-hexaenoico entre as mulheres avaliadas e uma alta concentração de ácidos graxos trans no leite materno. O teor de DHA e EPA da dieta materna, no final do período gestacional, pode influenciar a composição de ácidos graxos de leite materno maduro. Ainda, a razão n-3/n-6 de ácidos graxos da dieta materna, no final da gestação e no período pós-parto, também pode influenciar na composição de ácidos graxos do leite materno. Os dados sugerem a relevância de medidas de intervenção para promoção do consumo de alimentos ricos em n-3, no terceiro trimestre gestacional. / Long-chain polyunsaturated fatty acids play a relevant role on child development and growth. Their content in breast milk vary widely, partially due to the variability of fatty acids content on maternal dietary intake. However little is known about the relationship between maternal dietary intake during pregnancy and the fatty acids content of breast milk. The aim of the present study was to assess the polyunsaturated fatty acids composition of mature breast milk of women living far from the Brazilian coast (Manuscript 1) and to evaluate the influence of the food intake in different periods of pregnancy and postpartum on the polyunsaturated fatty acids composition of mature breast milk (Manuscript 2). This research integrates the activities of a prospective study conducted among 103 healthy pregnant women, aged 18 to 35 years old, users of the Public Health System in Ribeirão Preto, SP. The maternal dietary intake was evaluated by three 24/hour dietary recalls during pregnacy and two 24/hour dietary recalls at the postpartum period. Women with complete data of the dietary intake during pregnancy, who delivered at term, and were exclusively or predominantly breastfeeding their babies after the 5th week postpartum were invited to participate of the present study. Samples of 5 to 10ml of mature breast milk were obtained by manual expression to determine the fatty acids content by gas chromatography. Linear regression models were applied to assess the influence of dietary intake on fatty acids content of mature breast milk, at each trimester of pregnancy and at postpartum period, adjusted by postpartum BMI and deattenuated. The Manuscript 1 describes the polyunsaturated fatty acids composition of mature breast milk of women living far from the Brazilian coast. Among the samples evaluated, low content of docosahexaenoic acid (0,09%) and high level trans fatty (2,05%) acid were found. The Manuscript 2 describes a positive association between the eicosapentaenoic acid [= 1.87 (95% IC: 0.54, 3.28)] and docosahexaenoic acid [= 0.46 (95% IC 0.21, 0.71)] content of the maternal diet at the third trimester of pregnancy. Moreover, a positive association between the n-3/n-6 dietary ratio [= 0.09 (95% IC 0.02, 0.17)] at the second and third trimesters of pregnancy and at the postpartum period with the content of these fatty acids in human milk. Low docosahexaenoic acid and high trans fatty acid levels in mature breast milk were found. DHA and EPA content of the maternal diet during late pregnancy might influence the content of these fatty acids on mature breast milk. Moreover, the dietary ratio of n- 3/n-6 fatty acids on late pregnancy and post-partum period also influences the fatty acid composition of breast milk. The data suggest the relevance of intervention strategies to promote the intake of food rich in n-3 on late pregnancy.