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Kumari D, Bhatia E, Awasthi L, Banerjee R. Phospholipid and menthol based nanovesicle impregnated transdermal patch for nutraceutical delivery to diminish folate and iron deficiency. Biomed Mater 2022; 17. [PMID: 35168221 DOI: 10.1088/1748-605x/ac5571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 02/15/2022] [Indexed: 11/12/2022]
Abstract
Adequate micronutrient availability is particularly important in women, children and infants. Micronutrient deficiencies are the major cause of maternal and neonatal morbidity. To overcome this, WHO recommends the use of folic acid and iron supplements for reducing anaemia and improving the health of the mother and infants. Oral intake of supplements for nutritional deficiencies are associated with gastric irritation, nausea, constipation and non-patient compliance due to associated taste. In case of absorption deficiency nutrients administered orally pass-through digestive tract unabsorbed. In the present study, we propose transdermal delivery of nutraceuticals to avoid the limitations associated with oral intake. Transdermal delivery has limited use because of the closely packed barrier of the stratum corneum that limits the permeability of molecules across skin. Here, we have used biomimetic nanovesicles impregnated in transdermal patches for delivery of folic acid and iron. Nanovesicles are prepared using an abundant component of cell membrane, phosphatidyl choline and a permeation enhancer. Further these nanovesicles are impregnated onto polyacrylate based transdermal patch.In vitrostudies have shown the ability of nanovesicles to fluidise skin lipids and penetrate into deeper skin.In vivoapplication of transdermal patches gradually increased the systemic concentration of nutraceuticals. Post application of the patch, five-fold increase in plasma folic acid concentration and 1.5-fold increase in plasma iron concertation was achieved in 6 h. Developed nanovesicles were compatible with keratinocytes and fibroblasts as testedin vitroand have the potential to enhance the cellular uptake of molecules. Skin irritation studies on human volunteers have confirmed the safety of nutraceutical loaded nanovesicles. Thus, the developed nutraceutical loaded transdermal patches provide a potential, easy to use platform for micronutrient delivery in infants and mothers.
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Affiliation(s)
- Durga Kumari
- Department of Biosciences and Bioengineering, IIT Bombay, Mumbai, India
| | - Eshant Bhatia
- Department of Biosciences and Bioengineering, IIT Bombay, Mumbai, India
| | - Lisha Awasthi
- Department of Biosciences and Bioengineering, IIT Bombay, Mumbai, India
| | - Rinti Banerjee
- Department of Biosciences and Bioengineering, IIT Bombay, Mumbai, India
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Jin Y, Talegawkar SA, Sedlander E, DiPietro L, Parida M, Ganjoo R, Aluc A, Rimal R. Dietary Diversity and Its Associations with Anemia among Women of Reproductive Age in Rural Odisha, India. Ecol Food Nutr 2022; 61:304-318. [PMID: 34644220 DOI: 10.1080/03670244.2021.1987230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The aim of this study is to examine diet diversity, predictors associated with it, and its associations with anemia among non-pregnant women of reproductive age in rural India. Baseline data from the Reductions in Anemia through Normative Innovations (RANI) project were used and included 980 non-pregnant women aged 15-49 years from Odisha, India. The Food and Agriculture Organization's Minimum Dietary Diversity for Women (MDD-W) was used to assess diet diversity. Anemia was determined by hemoglobin level and categorized as normal (hemoglobin ≥ 12 g/dL), mild (11 ≤ hemoglobin <12 g/dL) and moderate/severe (hemoglobin < 11 g/dL). Multivariable logistic regression was used to examine factors associated with diet diversity, and multinomial logistic regression for associations between diet diversity and anemia. Forty-four percent of women were classified as having a diverse diet (MDD-W ≥5). Women with higher education level, belonging to a scheduled caste (vs. tribe), and higher body mass index had higher odds of a diversified diet (p < .05 for all). A more diverse diet was associated with 30% of lower odds of mild anemia (odds ratio = 0.7, 95% confidence interval: 0.5-0.98, p = .035), however, no statistically significant associations were found for moderate/severe anemia. Diet diversity was inversely associated with prevalence of mild anemia among non-pregnant women of reproductive age in rural India.
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Affiliation(s)
- Yichen Jin
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, the George Washington University, Washington, United States
| | - Sameera A Talegawkar
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, the George Washington University, Washington, United States
| | - Erica Sedlander
- Department of Family and Community Medicine, University of California, San Francisco, United States
| | - Loretta DiPietro
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, the George Washington University, Washington, United States
| | | | - Rohini Ganjoo
- Department of Biomedical Laboratory Sciences, School of Medicine and Health Sciences, the George Washington University, Ashburn, United States
| | - Aika Aluc
- Department of Prevention and Community Health, Milken Institute School of Public Health, the George Washington University, Washington, United States
| | - Rajiv Rimal
- Department of Health Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States
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Framework of Methodology to Assess the Link between A Posteriori Dietary Patterns and Nutritional Adequacy: Application to Pregnancy. Metabolites 2022; 12:metabo12050395. [PMID: 35629899 PMCID: PMC9148035 DOI: 10.3390/metabo12050395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 02/07/2023] Open
Abstract
This study aimed to explore the nutritional profile of 608 women during the second trimester of pregnancy, in terms of nutrient patterns, dietary quality and nutritional adequacy. Dietary data were collected using a validated Mediterranean-oriented, culture-specific FFQ. Principal component analysis was performed on 18 energy-adjusted nutrients. Two main nutrient patterns, “plant-origin” (PLO) and “animal-origin” (ANO), were extracted. Six homogenous clusters (C) relative to nutrient patterns were obtained and analyzed through a multidimensional methodological approach. C1, C5 and C6 scored positively on PLO, while C1, C2 and C3 scored positively on ANO. When dietary quality was mapped on food choices and dietary indexes, C6 unveiled a group with a distinct image resembling the Mediterranean-type diet (MedDiet Score = 33.8). Although C1–C5 shared common dietary characteristics, their diet quality differed as reflected in the HEI-2010 (C1:79.7; C2:73.3; C3:70.9; C4:63.2; C5:76.6). The appraisal of nutritional adequacy mirrored a “nutritional-quality gradient”. A total of 50% of participants in C6 had almost 100% adequate magnesium intake, while 50% of participants in C4 had a probability of adequacy of ≤10%. Our methodological framework is efficient for assessing the link between a posteriori dietary patterns and nutritional adequacy during pregnancy. Given that macro- and micronutrient distributions may induce metabolic modifications of potential relevance to offspring’s health, public health strategies should be implemented.
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Valencia-Naranjo A, Manjarres-Correa LM, Bermúdez-Cardona JA. Pilot study of the effect of EPA + DHA supplementation on the fatty acid profile of erythrocytes and breast milk of lactating women from Sonsón, Colombia. Curr Res Food Sci 2022; 5:789-797. [PMID: 35540308 PMCID: PMC9079638 DOI: 10.1016/j.crfs.2022.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/10/2022] [Accepted: 04/14/2022] [Indexed: 11/25/2022] Open
Abstract
Objective The objective of this study was to evaluate changes in the concentrations of EPA and DHA in the erythrocytes and breast milk of a group of lactating women in the municipality of Sonsón (Antioquia) before and after receiving supplementation with these fatty acids for three months. Design In a quasi-experimental study, 11 lactating women were evaluated before and after EPA (100 mg) and DHA (250 mg) supplementation for three months. The consumption of omega-3 food sources was determined by simple frequency, anthropometry (weight, height) was performed, and the fatty acid profiles of erythrocytes and breast milk were determined with gas chromatography. Environment Sonsón, Colombia. Participants A group of lactating women in the municipality of Sonsón (Antioquia). Results Low consumption of foods that are sources of omega-3 fatty acids was found, as was low EPA and DHA content in erythrocytes and breast milk at the beginning of the study period. After supplementation, there was no significant change for EPA, however, there was a significant increase in DHA in both erythrocytes and breast milk; in addition, there was a decrease in the omega-6/omega-3 ratio. Conclusions Supplementation with 250 mg of DHA increased its concentration in the blood and breast milk to levels approaching the recommended average DHA of 0.3%, where benefits have been seen for the mother. A daily intake of DHA in the amounts recommended increases its concentration. The use of DHA supplements helps reduce the w6/w3 ratio in erythrocytes. DHA supplementation is necessary where its availability and access from food is low.
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Household food insecurity during pregnancy as a predictor of anthropometric indices failures in infants aged less than 6 months: a retrospective longitudinal study. Public Health Nutr 2022; 25:1005-1012. [PMID: 34412726 PMCID: PMC9991822 DOI: 10.1017/s1368980021003591] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the impact of household food insecurity during the third trimester of pregnancy on the growth indicators of infants aged less than 6 months. DESIGN Retrospective longitudinal study. SETTING 137 healthcare centres (15 cities) in Khorasan Razavi province, Iran. Data were extracted from the Sina Electronic Health Record System (SinaEHR®). PARTICIPANTS This study was conducted on 2481 mother and infant dyads during November 2016-March 2019. The Household Food Insecurity Access Scale (nine-item version) was used to measure food insecurity in the third trimester of pregnancy. Women who delivered singleton infants were included in the study, and anthropometric indices of infants were measured throughout the first 6 months of life. RESULTS Approximately 67 % of the participants were food secure, while 33 % had varying degrees of food insecurity. The children born to the mothers in the food-insecure households were, respectively, 2·01, 3·03, and 3·83 times more likely to be stunted at birth (95 % CI 1·17, 3·46), 4 months (95 % CI 1·21, 7·61) and 6 months of age (95 % CI 1·37, 10·68) compared to their counterparts in the food-secure households. However, there were no significant differences in mean birth weight, birth height and head circumference at birth between the two groups. CONCLUSIONS Household food insecurity during pregnancy is a risk factor for stunting in infants aged less than 6 months. Therefore, national nutrition programs could considerably support women in food-insecure households during and before pregnancy.
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Nema J, Joshi N, Sundrani D, Joshi S. Influence of maternal one carbon metabolites on placental programming and long term health. Placenta 2022; 125:20-28. [DOI: 10.1016/j.placenta.2022.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/12/2022] [Accepted: 02/24/2022] [Indexed: 10/18/2022]
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Crouse MS, Caton JS, Claycombe-Larson KJ, Diniz WJS, Lindholm-Perry AK, Reynolds LP, Dahlen CR, Borowicz PP, Ward AK. Epigenetic Modifier Supplementation Improves Mitochondrial Respiration and Growth Rates and Alters DNA Methylation of Bovine Embryonic Fibroblast Cells Cultured in Divergent Energy Supply. Front Genet 2022; 13:812764. [PMID: 35281844 PMCID: PMC8907857 DOI: 10.3389/fgene.2022.812764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/12/2022] [Indexed: 11/13/2022] Open
Abstract
Epigenetic modifiers (EM; methionine, choline, folate, and vitamin B12) are important for early embryonic development due to their roles as methyl donors or cofactors in methylation reactions. Additionally, they are essential for the synthesis of nucleotides, polyamines, redox equivalents, and energy metabolites. Despite their importance, investigation into the supplementation of EM in ruminants has been limited to one or two epigenetic modifiers. Like all biochemical pathways, one-carbon metabolism needs to be stoichiometrically balanced. Thus, we investigated the effects of supplementing four EM encompassing the methionine–folate cycle on bovine embryonic fibroblast growth, mitochondrial function, and DNA methylation. We hypothesized that EM supplemented to embryonic fibroblasts cultured in divergent glucose media would increase mitochondrial respiration and cell growth rate and alter DNA methylation as reflected by changes in the gene expression of enzymes involved in methylation reactions, thereby improving the growth parameters beyond Control treated cells. Bovine embryonic fibroblast cells were cultured in Eagle’s minimum essential medium with 1 g/L glucose (Low) or 4.5 g/L glucose (High). The control medium contained no additional OCM, whereas the treated media contained supplemented EM at 2.5, 5, and 10 times (×2.5, ×5, and ×10, respectively) the control media, except for methionine (limited to ×2). Therefore, the experimental design was a 2 (levels of glucose) × 4 (levels of EM) factorial arrangement of treatments. Cells were passaged three times in their respective treatment media before analysis for growth rate, cell proliferation, mitochondrial respiration, transcript abundance of methionine–folate cycle enzymes, and DNA methylation by reduced-representation bisulfite sequencing. Total cell growth was greatest in High ×10 and mitochondrial maximal respiration, and reserve capacity was greatest (p < 0.01) for High ×2.5 and ×10 compared with all other treatments. In Low cells, the total growth rate, mitochondrial maximal respiration, and reserve capacity increased quadratically to 2.5 and ×5 and decreased to control levels at ×10. The biological processes identified due to differential methylation included the positive regulation of GTPase activity, molecular function, protein modification processes, phosphorylation, and metabolic processes. These data are interpreted to imply that EM increased the growth rate and mitochondrial function beyond Control treated cells in both Low and High cells, which may be due to changes in the methylation of genes involved with growth and energy metabolism.
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Affiliation(s)
- Matthew S. Crouse
- USDA, ARS, U.S. Meat Animal Research Center, Clay Center, NE, United States
- *Correspondence: Matthew S. Crouse,
| | - Joel S. Caton
- Department of Animal Sciences, North Dakota State University, Fargo, ND, United States
| | | | | | | | - Lawrence P. Reynolds
- Department of Animal Sciences, North Dakota State University, Fargo, ND, United States
| | - Carl R. Dahlen
- Department of Animal Sciences, North Dakota State University, Fargo, ND, United States
| | - Pawel P. Borowicz
- Department of Animal Sciences, North Dakota State University, Fargo, ND, United States
| | - Alison K. Ward
- Department of Animal Sciences, North Dakota State University, Fargo, ND, United States
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Mohammadi A, Effati-Daryani F, Ghelichkhani F, Zarei S, Mirghafourvand M. Effective factors on nutrition behaviors of pregnant women based on the beliefs, attitudes, subjective norms, and enabling factors model: A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:12. [PMID: 35281378 PMCID: PMC8893070 DOI: 10.4103/jehp.jehp_1609_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/06/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND One of the useful models in health education is the Beliefs, Attitudes, Subjective Norms, and Enabling Factors (BASNEF) model. The model is used to study behavior and to plan for change it and to determine the factors that influence people's decision-making. The aim of this study was to investigate the factors affecting the nutritional behavior of pregnant women based on BASNEF model. MATERIALS AND METHODS This cross-sectional study was performed on 360 pregnant women referring to health centers of Tabriz-Iran by two-stage cluster sampling method from April to December 2016. Data were collected using sociodemographic, nutrition subdomain of Health Promoting Lifestyle-II (HPLP-II), and researcher-made questionnaire based on constructs of BASNEF model. Data were analyzed using the SPSS software version 21 and Pearson correlation test and General Linear Model (GLM). RESULTS Mean ± standard deviation (SD) of nutrition subdomain of HPLP-II was 24.65 ± 4.75 within the range 9-36. Mean ± SD of BASNEF model constructs (score range) was also obtained as 45.30 ± 10.80 (0-100), 17.98 ± 2.40 (8-24), 9.30 ± 2.82 (0-20) and 2.47 ± 1.74 (0-6) for belief, attitude, subjective norms, and enabling factors, respectively. Based on the GLM, there was significant relationships between nutritional behavior and BASNEF model constructs (belief [P < 0.001], attitude [P = 0.043], enabling factors [P < 0.001], and subjective norms [P = 0.038]) as well as the variables of job, husband's education, and job and sufficiency of income for expenses. CONCLUSION The results of the present study showed the impact of BASNEF model constructs and some sociodemographic variables on nutrition behaviors in pregnant women. Therefore, in order to improve nutrition behaviors of pregnant women, designing and implementation of interventions based on the BASNEF model are recommended.
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Affiliation(s)
- Azam Mohammadi
- Department of Midwifery and Reproductive Health, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Effati-Daryani
- Department of Midwifery, Reproductive Health Research Center, Faculty of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Fatemeh Ghelichkhani
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran and Midwifery Department, Emam Sajad Hospital, Iran University of Medical Sciences, Shahriar, Tehran, Iran
| | - Somayeh Zarei
- Department of Midwifery, Shohada Hospital, Qom University of Medical Sciences, Qom, Iran
| | - Mojgan Mirghafourvand
- Department of Midwifery, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Gantenbein KV, Kanaka-Gantenbein C. Highlighting the trajectory from intrauterine growth restriction to future obesity. Front Endocrinol (Lausanne) 2022; 13:1041718. [PMID: 36440208 PMCID: PMC9691665 DOI: 10.3389/fendo.2022.1041718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/25/2022] [Indexed: 11/12/2022] Open
Abstract
During the last decades several lines of evidence reported the association of an adverse intrauterine environment, leading to intrauterine restriction, with future disease, such as obesity and metabolic syndrome, both leading to increased cardiovascular and cancer risk. The underlying explanation for this association has firstly been expressed by the Barker's hypothesis, the "thrifty phenotype hypothesis". According to this hypothesis, a fetus facing an adverse intrauterine environment adapts to this environment through a reprogramming of its endocrine-metabolic status, during the crucial window of developmental plasticity to save energy for survival, providing less energy and nutrients to the organs that are not essential for survival. This theory evolved to the concept of the developmental origin of health and disease (DOHaD). Thus, in the setting of an adverse, f. ex. protein restricted intrauterine environment, while the energy is mainly directed to the brain, the peripheral organs, f.ex. the muscles and the liver undergo an adaptation that is expressed through insulin resistance. The adaptation at the hepatic level predisposes to future dyslipidemia, the modifications at the vascular level to endothelial damage and future hypertension and, overall, through the insulin resistance to the development of metabolic syndrome. All these adaptations are suggested to take place through epigenetic modifications of the expression of genes without change of their amino-acid sequence. The epigenetic modifications leading to future obesity and cardiovascular risk are thought to induce appetite dysregulation, promoting food intake and adipogenesis, facilitating obesity development. The epigenetic modifications may even persist into the next generation even though the subsequent generation has not been exposed to an adverse intrauterine environment, a notion defined as the "transgenerational transfer of environmental information". As a consequence, if the increased public health burden and costs of non-communicable chronic diseases such as obesity, hypertension, metabolic syndrome and type 2 diabetes have to be minimized, special attention should be laid to the healthy lifestyle habits of women of reproductive age, including healthy diet and physical activity to be established long before any pregnancy takes place in order to provide the best conditions for both somatic and mental health of future generations.
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Affiliation(s)
| | - Christina Kanaka-Gantenbein
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, Athens, Greece
- *Correspondence: Christina Kanaka-Gantenbein, ,
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Molla W, Mengistu N, Madoro D, Assefa DG, Zeleke ED, Tilahun R, Bayisa Y, Meshesha MD, Ayele GM, Kabthyme RH, Alemu A, Eshetu MA, Shumye S, Funga ML, Eritero AC, Aregawi S, Wodaynew T, Muche T, Wudneh A. Dietary diversity and associated factors among lactating women in Ethiopia: Cross sectional study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Barbosa CM, Lima TC, Barbosa MA, Rezende A, Carneiro CM, Silva SDQ, Itabaiana YA, Carvalho Alzamora A. Progenitor with cardiometabolic disorders increases food intake, systemic inflammation and gut microbiota alterations in the second generation offspring. Food Funct 2022; 13:8685-8702. [DOI: 10.1039/d1fo02838c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This work presents the effects of the high-fat diet (H) consumed by the progenitor (G0) on cardiometabolic disorders and on intestinal microbiota in the second generation ofspring (F2). Rats submitted...
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Kalita-Kurzyńska K, Mołas A, Kozak K, Dulęba M, Kiersnowska I. Assessment of nutrition knowledge during lactation among postpartum women. MEDICAL SCIENCE PULSE 2021. [DOI: 10.5604/01.3001.0015.6027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Breastfeeding is the most appropriate form of nutrition for newborns and infants. During lactation, milk production is an important function of a new mother’s body. The lack of a healthy, balanced diet carries a high risk of macro- and micronutrient deficiencies in postpartum women.
Aim of the study: The aim of the study was to explore the nutrition knowledge of postpartum mothers during lactation, based on current guidelines.
Material and methods: The study involved 103 postpartum mothers who stayed in the maternity and neonatal ward in a secondary care hospital from April 2019 to January 2020. The diagnostic survey method was used as the research tool, which included an original questionnaire. Participation in the study was voluntary and anonymous. Results were analyzed using Microsoft Excel descriptive statistics. The analysis of Spearman’s R correlation between the variables was performed in the Statistica 13.1 program. Statistical significance was taken at p < 0.05.
Results: The average score among respondents was 4.82/10 points. Most study participants (77%, n = 79) considered breastfeeding women to have greater energy and nutritional requirements. More than half of the study participants (59%, n = 61) declared that some food products should be eliminated from the diet, namely strawberries, citrus fruit and chocolate.
Conclusions: Women’s knowledge about nutrition during lactation is insufficient. There is a need to intensify education in this area by medical professionals including midwives.
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Affiliation(s)
- Kinga Kalita-Kurzyńska
- University Laboratory for Research on Feminine Milk and Lactation at the Regional Milk Bank at the Hospital of St. Families in Warsaw, Department of Medical Biology, Faculty of Health Sciences, Medical University of Warsaw, Poland
| | - Aleksandra Mołas
- University Laboratory for Research on Feminine Milk and Lactation at the Regional Milk Bank at the Hospital of St. Families in Warsaw, Department of Medical Biology, Faculty of Health Sciences, Medical University of Warsaw, Poland
| | | | - Marta Dulęba
- Department of Oncological Prevention, Medical University of Warsaw, Poland
| | - Iwona Kiersnowska
- Department of Obstetrics and Perinatology, Medical University of Warsaw, Poland
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Tian W, Yan W, Liu Y, Zhou F, Wang H, Sun W. The Status and Knowledge of Iodine among Pregnant Women in Shanghai. Biol Trace Elem Res 2021; 199:4489-4497. [PMID: 33462796 DOI: 10.1007/s12011-021-02587-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/10/2021] [Indexed: 11/27/2022]
Abstract
Iodine plays an important role in thyroid function. However, in daily practices, people lack the related details including the knowledge concerned iodine usage, attitudes towards it, and practice among pregnant women. The aim of the present study is to assess the iodine status of pregnant women in Shanghai, and their knowledge regarding iodine, with the goal of investigating the relationship between iodine and thyroid function during pregnancy. This is a cross-sectional study. We recruited 3 groups of participants including 145 pregnant women (12-16 weeks gestation), 101 pregnant women (24-28 weeks gestation), and 108 pregnant women (34-38 weeks gestation). Iodine status and dietary intake were calculated from 24-h urinary iodine concentration (UIC). Knowledge regarding iodine was collected through a questionnaire. We additionally examined TSH, FT3, FT4, and TPOAb of the participants. The median of UIC of the 354 pregnant women was 119.2 μg/L, and 68.9% had urinary iodine levels below 150 μg/L. The proportion of daily iodized salt consumption in pregnant women was only 78.0%. The median UIC of the pregnant women who had consumed iodized salt was significantly higher than that of the pregnant women without iodized salt intake (Z = - 5.087, P < 0.001). Pregnant women in weeks 34-38 with a high level of knowledge had significantly lower TSH levels than those with low knowledge level (P = 0.046). Among the 349 pregnant women, few were aware of the harm to the fetus (8.3%). Significant differences were found in the scores for the knowledge level of women with different educational levels (Z = - 5.413, P < 0.001). Pregnant women in Shanghai have mild iodine deficiency. Approaches to improve iodine status among pregnant women in Shanghai include raising their awareness of iodine intake and changing their dietary habits. Otherwise, the risk of iodine deficiency in pregnant women may continue to increase.
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Affiliation(s)
- Wenxia Tian
- College of Food Science and Technology, Shanghai Ocean University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wenqing Yan
- College of Food Science and Technology, Shanghai Ocean University, Shanghai, China
| | - Yang Liu
- Obstetrics and Gynecology, Shanghai Sixth People's Hospital East Campus, Shanghai, China
| | - Fangfang Zhou
- Obstetrics and Gynecology, Shanghai Sixth People's Hospital East Campus, Shanghai, China
| | - Haixia Wang
- College of Food Science and Technology, Shanghai Ocean University, Shanghai, China
| | - Wenguang Sun
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
- Shanghai Municipal Key Clinical Specialty, Shanghai, China.
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Skoracka K, Ratajczak AE, Rychter AM, Dobrowolska A, Krela-Kaźmierczak I. Female Fertility and the Nutritional Approach: The Most Essential Aspects. Adv Nutr 2021; 12:2372-2386. [PMID: 34139003 PMCID: PMC8634384 DOI: 10.1093/advances/nmab068] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/19/2021] [Accepted: 05/05/2021] [Indexed: 12/17/2022] Open
Abstract
Infertility is an increasing problem that affects couples attempting pregnancy. A growing body of evidence points to a link between diet and female fertility. In fact, data show that a diet high in trans fats, refined carbohydrates, and added sugars can negatively affect fertility. Conversely, a diet based on the Mediterranean dietary patterns, i.e., rich in dietary fiber, omega-3 (ɷ-3) fatty acids, plant-based protein, and vitamins and minerals, has a positive impact on female fertility. An unhealthy diet can disrupt microbiota composition, and it is worth investigating whether the composition of the gut microbiota correlates with the frequency of infertility. There is a lack of evidence to exclude gluten from the diet of every woman trying to become pregnant in the absence of celiac disease. Furthermore, there are no data concerning adverse effects of alcohol on female fertility, and caffeine consumption in the recommended amounts also does not seem to affect fertility. On the other hand, phytoestrogens presumably have a positive influence on female fertility. Nevertheless, there are many unanswered questions with regard to supplementation in order to enhance fertility. It has been established that women of childbearing age should supplement folic acid. Moreover, most people experience vitamin D and iodine deficiency; thus, it is vital to control their blood concentrations and consider supplementation if necessary. Therefore, since diet and lifestyle seem to be significant factors influencing fertility, it is valid to expand knowledge in this area.
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Affiliation(s)
- Kinga Skoracka
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, the Heliodor Swiecicki Hospital, Poznan, Poland
| | - Alicja Ewa Ratajczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, the Heliodor Swiecicki Hospital, Poznan, Poland
| | - Anna Maria Rychter
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, the Heliodor Swiecicki Hospital, Poznan, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, the Heliodor Swiecicki Hospital, Poznan, Poland
| | - Iwona Krela-Kaźmierczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, the Heliodor Swiecicki Hospital, Poznan, Poland
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Kusrini I, Kristanto Mulyantoro D, Tjandrarini DH, Ashar H. Profile of Double of Undernutrition Problem, Coexistence with Anemia among Pregnant Women Indonesia 2018: A Cross Sectional Survey. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Anemia is the most common type of malnutrition in pregnant women, and when combined with another nutritional problem, it would increase the risk of adverse pregnancy outcomes.
AIM: This study aims to analyze the risk of double undernutrition in pregnant women with anemia.
MATERIALS AND METHODS: We used secondary data from the 2018 National Basic Health Survey as well as biomedical anemia samples. Anthropometric measurements were maternal body height, middle–upper circumference (MUAC) for chronic energy malnutrition (CEM); anemia was predicted using hemoglobin levels. The number of samples is 484, considering the minimum sample size for each undernutrition proportion.
RESULTS: Anemia in pregnant women is not a single malnutrition issue. Almost one–third of pregnant women with anemia also had another form of undenutrition. In this study, the prevalence of anemia among pregnant women (%) is 35.7; stunted is 35.9, and CEM is 16.7. The malnutrition was identified as double nutritional problems coexistence to anemia, such as prevalence stunted–anemia (%) 12.5; anemia–CEM 9.2; and anemia–stunted–CEM 4.4. Overall, CEM is associated with anemia with p < 0.05 and AOR 2.25 (CI; 1.38–3.66), adjusted to height and type of residence, education, and occupation. Urban areas have a similar risk to rural areas with AOR for CEM to anemia, 2.29 (CI; 1.12–4.69); rural areas 2.23 (CI; 1.14–4.33), respectively. Moreover, women with double of undernutrition stunted–CEM in rural areas have a risk of anemia with AOR 2.75 (1.14–6.65).
CONCLUSION: The risk of anemia in pregnant women with chronic energy malnutrition has increased more than twice in rural and urban areas.
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Perfil de diagnósticos de enfermagem CIPE® para pré-natal, por trimestre gestacional. ACTA PAUL ENFERM 2021. [DOI: 10.37689/acta-ape/2021ao00575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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67
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Li J, Chu Y, Yao W, Wu H, Feng J. Differences in Diet and Gut Microbiota Between Lactating and Non-lactating Asian Particolored Bats ( Vespertilio sinensis): Implication for a Connection Between Diet and Gut Microbiota. Front Microbiol 2021; 12:735122. [PMID: 34712210 PMCID: PMC8546350 DOI: 10.3389/fmicb.2021.735122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/15/2021] [Indexed: 12/31/2022] Open
Abstract
In mammals, lactation is considered the most energetically costly phase for females. To meet nutritional and energy demands, lactating females usually change feeding patterns by eating food that is higher in protein and calories. Their gut microbes respond accordingly to help adapt to the changes in diet. In this study, we examined differences in diet and gut microbial composition between lactating and non-lactating Asian particolored bats (Vespertilio sinensis) using COI and 16S amplicon sequencing. When compared with non-lactating bats, we found that the diversity and composition of lactating bats' diets differed; the proportion of Diptera increased and Coleoptera and Orthoptera decreased significantly. This could be attributed to the easy availability and high protein content of Diptera. Comparative analysis of the gut microbiota of lactating and non-lactating females showed that although the diversity of gut microbiota did not change, the relative abundance of specific gut microbiota associated with a particular diet did change. For example, when the consumption of Coleoptera decreased in lactating bats, the relative abundance of Lactobacillaceae was also reduced. Lactobacillaceae are thought to be involved in the digestion of Coleopteran exoskeletons. This study suggests that during lactation, Asian particolored bats eat a diet that yields higher levels of protein, and at the same time, the abundance of specific gut microbes change to help their hosts adapt to these changes in diet.
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Affiliation(s)
- Jingjing Li
- College of Life Science, Jilin Agricultural University, Changchun, China
| | - Yujia Chu
- College of Life Science, Jilin Agricultural University, Changchun, China
| | - Wenwen Yao
- College of Life Science, Jilin Agricultural University, Changchun, China
| | - Hui Wu
- College of Life Science, Jilin Agricultural University, Changchun, China
| | - Jiang Feng
- College of Life Science, Jilin Agricultural University, Changchun, China.,Jilin Provincial Key Laboratory of Animal Resource Conservation and Utilization, Northeast Normal University, Changchun, China
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Sibeko L, Johns T, Cordeiro LS. Traditional plant use during lactation and postpartum recovery: Infant development and maternal health roles. JOURNAL OF ETHNOPHARMACOLOGY 2021; 279:114377. [PMID: 34192598 DOI: 10.1016/j.jep.2021.114377] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/11/2021] [Accepted: 06/25/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Evidence of phytochemical roles in infant development and maternal recovery offers insights into beneficial functions of traditional plant use during lactation and the postpartum period. Ethnopharmacological research has relevance to global priorities on maternal and child health, to understanding origins and determinants of human self-medication, and for reconciling traditional postpartum practices and mainstream healthcare. AIM OF THE STUDY Present emerging evidence, within evolutionary and socio-cultural contexts, on the role of maternal consumption on transfer of phytochemicals into breast milk with impacts on maternal and child health, and on infant development. Establish current state of knowledge and an ethnopharmacological research agenda that is attentive to cross-cultural and regional differences in postpartum plant use. MATERIALS AND METHODS An extensive literature review using Medline, Scopus, and Web of Science focused on traditional and contemporary use and socio-cultural context, as well as physiological, pharmacological, toxicological, and behavioral activities of plants used medicinally by women during postpartum recovery and lactation. RESULTS The most widely reported postpartum plants show antimicrobial, anti-inflammatory, immunological, and neurophysiological activities, with low toxicity. Phytochemicals transfer from maternal consumption into breast milk in physiological concentrations, while animal studies demonstrate immunomodulation and other actions of medicinal plants during lactation. Reporting on the use and diverse traditional knowledge of women about plants during the postpartum period is obscured by the marginal place of obstetric issues and by gender biases in ethnobotanical research. In many contemporary contexts use is prejudiced by precautionary risk warnings in health literature and practice that confound lactation with pregnancy. CONCLUSIONS Although systematic investigation of postpartum plant use is lacking, known pharmacological activities support potential benefits on infant development and maternal health with immediate and long-term consequences in relation to allergic, inflammatory, autoimmune, and other diseases. An ethnopharmacological agenda focused on the perinatal period requires directed methodologies and a regional approach in relation to culturally-specific knowledge and practices, traditional plant use, and local health needs. Testing the hypothesis that phytochemicals transferred from medicinal plants into breast milk impact the human immune system and other aspects of infant development requires extended analysis of phytochemicals in human milk and infant lumen and plasma, as well as effects on gastrointestinal and milk microbiome.
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Affiliation(s)
- Lindiwe Sibeko
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, 01003, USA.
| | - Timothy Johns
- School of Human Nutrition, McGill University, Ste. Anne de Bellevue, QC, H9X 3V9, Canada.
| | - Lorraine S Cordeiro
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, 01003, USA.
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Li P, Chen X, Chen Y, Teng T, Fan X, Tang T, Wang R, Zhao Y, Qi K. DHA-rich n-3 PUFAs intake from the early- and mid-pregnancy decreases the weight gain by affecting the DNA methylation status among Chinese Han infants. Food Nutr Res 2021. [DOI: 10.29219/fnr.v65.7548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Consequences of Paternal Nutrition on Offspring Health and Disease. Nutrients 2021; 13:nu13082818. [PMID: 34444978 PMCID: PMC8400857 DOI: 10.3390/nu13082818] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/10/2021] [Accepted: 08/13/2021] [Indexed: 12/30/2022] Open
Abstract
It is well established that the maternal diet during the periconceptional period affects the progeny’s health. A growing body of evidence suggests that the paternal diet also influences disease onset in offspring. For many years, sperm was considered only to contribute half of the progeny’s genome. It now appears that it also plays a crucial role in health and disease in offspring’s adult life. The nutritional status and environmental exposure of fathers during their childhood and/or the periconceptional period have significant transgenerational consequences. This review aims to describe the effects of various human and rodent paternal feeding patterns on progeny’s metabolism and health, including fasting or intermittent fasting, low-protein and folic acid deficient food, and overnutrition in high-fat and high-sugar diets. The impact on pregnancy outcome, metabolic pathways, and chronic disease onset will be described. The biological and epigenetic mechanisms underlying the transmission from fathers to their progeny will be discussed. All these data provide evidence of the impact of paternal nutrition on progeny health which could lead to preventive diet recommendations for future fathers.
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71
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Karcz K, Lehman I, Królak-Olejnik B. The link between knowledge of the maternal diet and breastfeeding practices in mothers and health workers in Poland. Int Breastfeed J 2021; 16:58. [PMID: 34372889 PMCID: PMC8351426 DOI: 10.1186/s13006-021-00406-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 07/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are multiple misconceptions concerning the breastfeeding mother's diet and its adverse impact on breast milk composition and the breastfed child's health, which might lead to breastfeeding cessation. Although prophylactic maternal dietary restrictions are not recommended, mothers all over the world are often recommended to avoid certain foods, due to cultural beliefs, social pressure and even outdated or ambiguous medical recommendations. In Poland, there is no systematic approach to breastfeeding education in the form of nationwide educational programs for particular social groups. It was estimated that in 2017 only 3-4% of Polish infants were exclusively breastfed at 6 months of age. The aim of this study was to recognize the scale of common dietary misconceptions among lactating mothers in Poland and to compare knowledge and opinions between medical staff and mothers who have ever breastfed a child. In addition, the paper is an attempt to identify factors contributing to the still current practice of recommending prophylactic dietary restrictions to breastfeeding mothers by medical staff. METHODS The study was conducted in Poland, in January - February 2019. The study used a diagnostic poll method and was conducted mainly in an electronic form. A total of 1159 completed questionnaires data were analyzed: 35.1% completed by medical staff and 64.9% by mothers in non-medical professions. Statistical calculations were conducted with Chi-square test, logistic regression and U Mann Whitney test (level of significance set at 0.05). RESULTS The respondents presented a good level of knowledge and predominantly assessed the questioned statements correctly. Duration of breastfeeding was found to be the main factor determining respondents' knowledge (p < 0.05). Concerning medical staff, the parity (p < 0.001) and applying an elimination diet when themselves breastfeeding (p < 0.001) had a significant impact on recommendation of prophylactic dietetic restrictions to the lactating women. CONCLUSIONS Regardless of a resonably good level of knowledge on maternal nutrition in the lactation period, both breastfeeding mothers and medical staff are still convinced of the beneficial effect of preventive dietary restrictions, which affects further lactational counselling and lactational performance.
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Affiliation(s)
- Karolina Karcz
- Department and Clinic of Neonatology, Wroclaw Medical University, Wroclaw, Poland.
| | - Izabela Lehman
- Department and Clinic of Neonatology, Wroclaw Medical University, Wroclaw, Poland
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Madzia J, McKinney D, Kelly E, DeFranco E. Influence of Gestational Weight Gain on the Risk of Preterm Birth for Underweight Women Living in Food Deserts. Am J Perinatol 2021; 38:e77-e83. [PMID: 32131115 DOI: 10.1055/s-0040-1705168] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Preterm birth (PTB) and food insecurity are two of the most significant public health crises in the United States. Effects of being underweight among populations with low food security are not well understood. We assess whether the protective effect of gestational weight gain (GWG) for women with low prepregnancy body mass index (BMI) differs by accessibility to sources of healthy food. STUDY DESIGN Population-based retrospective cohort study using Ohio birth records analyzing all live births, 2006 to 2015. Analyses were stratified by maternal BMI (underweight, normal, overweight, and obese), Institute of Medicine (IOM) recommended GWG (under vs. met), and whether the U.S. Department of Agriculture (USDA) classified the residential census tract for each birth as a food desert. Food access data were retrieved from the USDA's 2018 Food Access Research Atlas. Covariates were selected using least absolute shrinkage and selection operator regression. Logistic regression models estimated the risk ratio (RR) of PTB for each group based on under or exceeded recommended GWG (reference = met), adjusting for coexisting risk factors. RESULTS Analysis was performed on 1,124,299 births. PTB risk was highest for underweight women below GWG recommendations (no food desert: 21.3%, RR = 2.15, 95% confidence interval [CI]: 1.81-2.57; food desert: 21.0%, RR = 1.46, 95% CI: 0.96-2.21). Underweight women living in food deserts who exceeded GWG recommendations had lower PTB risk than those who met GWG recommendations (13.5 vs. 14.3%, RR = 0.85, 95% CI: 0.51-1.41). Factors other than GWG significantly associated with PTB included in the adjusted analysis include maternal age and race, education, marital status, interpregnancy interval, and presence of prepregnancy diabetes or hypertension. CONCLUSION Underweight women who do not meet GWG recommendations are at high risk for PTB. Increasing pregnancy weight gain to a level that exceeds IOM recommendations was not associated with a reduction in PTB risk for underweight women who reside in food deserts compared with women who met GWG recommendations. KEY POINTS · Women with low prepregnancy BMI are at high risk of PTB.. · Food insecurity increases the risk of PTB for underweight women.. · Excessive GWG for underweight women in food deserts does not reduce PTB risk..
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Affiliation(s)
- Juliana Madzia
- Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - David McKinney
- Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Elizabeth Kelly
- Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Emily DeFranco
- Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Yang M, Yue W, Han X, Hu C, Sun X, Luo J. Postpartum care indications and methodological quality:a systematic review of guidelines. JOURNAL OF PUBLIC HEALTH-HEIDELBERG 2021; 30:2261-2275. [PMID: 34306970 PMCID: PMC8288832 DOI: 10.1007/s10389-021-01629-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/18/2021] [Indexed: 10/25/2022]
Abstract
Background The coverage of postpartum care is not ideal, and has not been used very well due to not enough attention being paid to the puerperal women and newborns, especially in developing countries. Practice guidelines on postpartum care provide beneficial practice guidance and help to reduce maternal mortality. However, little is known about the credibility and consistency of those guidelines. This systematic review was conducted to summarize main postpartum care indications and appraise methodological quality of guidelines. Methods Seven literature databases and guideline development institutions and organizations of obstetrics and maternity care were searched. Two reviewers independently assessed guideline quality using the AGREE II instrument, and synthesized consistent and non-consistent recommendations using the content analysis approach. Results Twenty-nine guidelines were included and a total of eight postpartum care indications were identified. Most guidelines focused on care indications and interventions including exclusive breastfeeding, maternal nutrition, home visit, infant or newborn care and sexuality, contraception, and birth spacing. However, indications such as pain or weight management, pelvic floor muscle training, abdominal rehabilitation, and mental health got less attention. Additionally, the overall quality of all involving postpartum care guidelines is relatively good and acceptable. Conclusions Guidelines developed by NICE, RANO, and WHO indicated higher methodological quality. For postpartum care indications, most guidelines are incomplete. Variation in practice guidelines for postpartum care recommendations exists. In the future, implementation research into shared decision-making, as well as further high-quality research to broaden the evidence base for postpartum care indications is recommended. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-021-01629-4.
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Affiliation(s)
- Ming Yang
- School of Nursing, Guangzhou University of Chinese Medicine, No. 232, Waihuan East Road, Guangzhou University City, Panyu District, Guangzhou, Guangdong China
| | - Wei Yue
- School of Nursing, Guangzhou University of Chinese Medicine, No. 232, Waihuan East Road, Guangzhou University City, Panyu District, Guangzhou, Guangdong China
| | - Xinrui Han
- School of Nursing, Guangzhou University of Chinese Medicine, No. 232, Waihuan East Road, Guangzhou University City, Panyu District, Guangzhou, Guangdong China
| | - Chunhong Hu
- Department of Spleen and Stomach, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China
| | - Xiaoning Sun
- School of Nursing, Guangzhou University of Chinese Medicine, No. 232, Waihuan East Road, Guangzhou University City, Panyu District, Guangzhou, Guangdong China
| | - Jianghe Luo
- School of Nursing, Guangzhou University of Chinese Medicine, No. 232, Waihuan East Road, Guangzhou University City, Panyu District, Guangzhou, Guangdong China
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Deriba BS. Nutritional-Related Predictors of Preterm Birth in North Shewa Hospitals, Central Ethiopia: A Case-Control Study. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2021; 12:315-324. [PMID: 34262390 PMCID: PMC8275143 DOI: 10.2147/phmt.s319867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/27/2021] [Indexed: 11/23/2022]
Abstract
Background Preterm birth (PTB) is the leading cause of newborn death and the second cause of mortality among under-five children. Globally, about 15 million infants are born preterm every year. However, there is a lack of data on the nutritional-related predictors of preterm birth among Ethiopian women. The objective of the study was to identify nutritional-related predictors of preterm birth among women who gave birth at North Shewa public Hospitals in central Ethiopia. Methods A case–control study was undertaken in public hospitals in the North Shewa zone, central Ethiopia. Interviewer-administered questionnaire was used to gather data, which was then entered into EPI INFO version 7 and then exported to SPSS version 23 for analysis. Data were presented using texts, tables, and proportions. To find predictors of preterm birth, researcher used binary and multiple logistic regression models. The presence of a relationship between PTB and predictor factors was determined using the adjusted odds ratio (AOR), 95% confidence interval (CI), and p-value <0.05. Results A total of 161 cases and 322 controls participated in the study making a response rate of 97.6%. Unable to get iron folic acid (IFA) (AOR=2.26, 95% CI: 1.22, 4.18), not eating additional meals (AOR=2.63, 95% CI: 1.1, 4.62), restriction of foods (AOR=2.85, 95% CI: 1.58, 5.12), not taking dark green leafy vegetables (DGLV), (AOR=4.46, 95% CI: 1.72, 11.61), and mid upper arm circumference of mother (MUAC) <23 centimeters (AOR=3.7, 95% CI: 2.25, 6.11) had statistically significant association with premature birth. Conclusion IFA supplementation, additional meals, food taboo, frequency of DGLV, and MUAC were identified predictors of preterm birth. Encouraging such women to eat additional meals, varieties of diets like vegetables, and fruits during pregnancy, and adhering to culturally appropriate nutrition education to reverse food taboo is compulsory.
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Affiliation(s)
- Berhanu Senbeta Deriba
- Department of Public Health, Salale University College of Health Sciences, Fitche, Ethiopia
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75
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Quattrini S, Pampaloni B, Cianferotti L, Fossi C, Ottanelli S, Gronchi G, Duradoni M, Di Tommaso M, Dubini V, Brandi ML. Mediterranean diet adherence and dietary calcium intake in a group of pregnant women: Results of an Italian survey. Food Sci Nutr 2021; 9:3426-3435. [PMID: 34262703 PMCID: PMC8269676 DOI: 10.1002/fsn3.2233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/22/2021] [Accepted: 02/27/2021] [Indexed: 11/17/2022] Open
Abstract
Pregnancy is a delicate phase in woman's life that could become a risk factor for osteoporosis in pregnant women who do not meet recommended nutrient standards, especially for calcium and vitamin D. Mediterranean diet (MD) has been demonstrated to be beneficial for adequate nutrient intake. This article aims to evaluate the MD adherence and dietary calcium intake in a group of pregnant Italian women and to investigate how these are linked to each other and to fast glycemia at first trimester of pregnancy. Two hundred and seventy-nine pregnant women were recruited at the gynecology units of two hospitals in Florence. Socio-demographic, clinical information, and results of the first trimester blood sample analysis were collected. Two questionnaires, validated for evaluation of MD adherence and calcium intake, were administered to the pregnant women. Approximately 60% of the women had a high level of MD adherence, with a mean dietary calcium intake of 870.3 ± 335.3. In women with higher MD adherence level, fast glycemia resulted lower. Calcium intake was lower than Population Rate Intake for the Italian population (1,200 mg/daily) and was positively correlated to MD adherence score. The MD proved to be nutritious, as it was related to a higher calcium intake in this group of Italian women.
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Affiliation(s)
- Sara Quattrini
- Department of Experimental and Clinical biomedical Sciences “Mario Serio”University of FlorenceFlorenceItaly
| | - Barbara Pampaloni
- Department of Experimental and Clinical biomedical Sciences “Mario Serio”University of FlorenceFlorenceItaly
| | - Luisella Cianferotti
- Department of Experimental and Clinical biomedical Sciences “Mario Serio”University of FlorenceFlorenceItaly
| | - Caterina Fossi
- Department of Experimental and Clinical biomedical Sciences “Mario Serio”University of FlorenceFlorenceItaly
| | - Silva Ottanelli
- Department of Experimental and Clinical biomedical Sciences “Mario Serio”University of FlorenceFlorenceItaly
| | - Giorgio Gronchi
- Department of Neurosciences, Psychology, Drug Research, and Child Health (Section of Psychology)University of FlorenceFlorenceItaly
| | - Mirko Duradoni
- Department of Information EngineeringUniversity of FlorenceFlorenceItaly
| | | | - Valeria Dubini
- Direttore Unità Funzionale Complessa – Attività Territoriali e Presidio P. PalagiUSL Toscana CentroFlorenceItaly
| | - Maria Luisa Brandi
- Department of Experimental and Clinical biomedical Sciences “Mario Serio”University of FlorenceFlorenceItaly
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Bukari M, Saaka M, Masahudu A, Ali Z, Abubakari A, Danquah LO, Abdulai AN, Abizari A. Household factors and gestational age predict diet quality of pregnant women. MATERNAL & CHILD NUTRITION 2021; 17:e13145. [PMID: 33528101 PMCID: PMC8189244 DOI: 10.1111/mcn.13145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 12/28/2020] [Accepted: 01/12/2021] [Indexed: 11/28/2022]
Abstract
Adequate diet during pregnancy has positive effects on the mother and pregnancy outcome. Assessment of diet quality during pregnancy is particularly important in areas where household food security is suboptimal, to enable appropriate targeting and intervention. This study assessed diet quality and identified predicting factors among pregnant women in northern Ghana. A cross-sectional study involving 403 pregnant women was conducted in May 2018. Pregnant women attending antenatal care clinics (ANC) were selected using simple random sampling technique. We assessed socio-demographic characteristics, 24-h recall and household food security. The minimum dietary diversity for women (MDD-W) was used as a proxy measure for diet quality based on Food and Agricultural Organization (FAO) guidelines. Logistic regression models were fitted to determine the predictors of diet quality. The mean dietary diversity score (DDS) of 10 food groups was 4.4 ± 1.1 (95% CI: 4.3-4.5). Logistic regression showed that women of high educational level (adjusted odds ratio [AOR] = 2.42; 95% confidence interval [CI] [1.21-4.84]; P = 0.01), women of high household wealth index (AOR = 1.78; 95% CI [1.14-2.77]; P = 0.01], none/mild household hunger (AOR = 2.71; 95% CI [1.26-5.82]; P = 0.01), medium household size (6-15 members) (AOR = 1.66; 95% CI [1.04-2.66]; P = 0.03) and women of gestational age 20-35 weeks (AOR = 1.89; 95% CI [1.05-3.40]; P = 0.03) were more likely to have quality diets after adjusting for potential confounding variables. Diet quality among pregnant women was low and was predicted by educational level, household wealth, gestational age and food security. Women education and improvements in household food security could impact diets of pregnant women in northern Ghana.
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Affiliation(s)
- Mohammed Bukari
- Department of Nutritional Sciences, School of Allied Health SciencesUniversity for Development StudiesTamaleGhana
| | - Mahama Saaka
- Department of Nutritional Sciences, School of Allied Health SciencesUniversity for Development StudiesTamaleGhana
| | - Azaratu Masahudu
- Department of Nutritional Sciences, School of Allied Health SciencesUniversity for Development StudiesTamaleGhana
| | - Zakari Ali
- Medical Research Council UnitThe Gambia at the London School of Hygiene and Tropical MedicineBanjulThe Gambia
| | - Abdul‐Latif Abubakari
- Department of Nutritional Sciences, School of Allied Health SciencesUniversity for Development StudiesTamaleGhana
| | - Lillian Owusuwaa Danquah
- Department of Nutritional Sciences, School of Allied Health SciencesUniversity for Development StudiesTamaleGhana
| | - Ayishetu Napari Abdulai
- Department of Nutritional Sciences, School of Allied Health SciencesUniversity for Development StudiesTamaleGhana
| | - Abdul‐Razak Abizari
- Department of Nutritional Sciences, School of Allied Health SciencesUniversity for Development StudiesTamaleGhana
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Amadori R, Aquino CI, Colagiorgio S, Osella E, Surico D, Remorgida V. What may happen if you are pregnant during Covid-19 lockdown? A retrospective study about peripartum outcomes. Minerva Obstet Gynecol 2021; 74:319-324. [PMID: 34137568 DOI: 10.23736/s2724-606x.21.04878-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND One of the provisions implemented to contain the spread of Covid-19 infections in Italy was the lockdown. Effects of the lockdown on childbirth outcomes and on the well-being of both the mother and the child have not yet been defined. An inadequate diet during pregnancy and a reduced physical activity can predispose women to become overweight or obese and trigger the development of various complications and maternal-fetal adverse outcomes. METHODS This is a retrospective study including all consecutive patients who delivered at University Hospital Maggiore della Carità in Novara, Italy, in April-May 2017 (group 1, n=294), a period prior to the pandemic, and during the same months in 2020 (group 2, n=256) during and immediately after lockdown. Clinical data were extracted from The Report "Childbirth Assistance Certificate (CedAP) - Birth Event Analysis". RESULTS Demographic characteristics were similar between the two study groups, except for a decreased number of married couples in group 2 (p-value 0.018) and an increased percentage of patients with clinical checkups at Family Planning facilities in 2020 (p-value 0.04). The number of hospitalizations during pregnancy was 26 (8.9%) vs 10 (3.9%) with a significative reduction during 2020 (p-value 0.004). Regarding obstetric outcomes, we observed a significant increase in induction of labour in 2020 (23.9% vs 35.9%; p-value 0. 002), a reduction of amniorrhexis (11.3% vs 5.5% p-value 0.015), a reduction of supine positions with an increase of vertical and all fours positions in 2020 (49.3% vs 61.9% and 9.5% vs 12.4% respectively, p 0.023), and a reduction of left occipito-anterior presented part (63.2% vs 55.4%) in favor of right occipito-anterior (34.7% vs 41.2%, p-value 0.019). CONCLUSIONS There were no significant differences either for antepartum or intrapartum complications. Long-term studies are needed to evaluate psychological, behavioral, and epigenetic effects of maternal physical inactivity on obstetric outcomes.
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Affiliation(s)
- Roberta Amadori
- Department of Gynecology and Obstetrics, Ospedale Maggiore della Carità, University of Piemonte Orientale, Novara, Italy
| | - Carmen I Aquino
- Department of Gynecology and Obstetrics, Ospedale Maggiore della Carità, University of Piemonte Orientale, Novara, Italy -
| | - Sofia Colagiorgio
- Department of Gynecology and Obstetrics, Ospedale Maggiore della Carità, University of Piemonte Orientale, Novara, Italy
| | - Elena Osella
- Department of Gynecology and Obstetrics, Ospedale Maggiore della Carità, University of Piemonte Orientale, Novara, Italy
| | - Daniela Surico
- Department of Gynecology and Obstetrics, Ospedale Maggiore della Carità, University of Piemonte Orientale, Novara, Italy
| | - Valentino Remorgida
- Department of Gynecology and Obstetrics, Ospedale Maggiore della Carità, University of Piemonte Orientale, Novara, Italy
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Mate A, Reyes-Goya C, Santana-Garrido Á, Vázquez CM. Lifestyle, Maternal Nutrition and Healthy Pregnancy. Curr Vasc Pharmacol 2021; 19:132-140. [PMID: 32234002 DOI: 10.2174/1570161118666200401112955] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 03/12/2020] [Accepted: 03/14/2020] [Indexed: 02/07/2023]
Abstract
Healthy lifestyle habits spanning from preconception to postpartum are considered as a major safeguard for achieving successful pregnancies and for the prevention of gestational diseases. Among preconception priorities established by the World Health Organization (WHO) are healthy diet and nutrition, weight management, physical activity, planned pregnancy and physical, mental and psychosocial health. Most studies covering the topic of healthy pregnancies focus on maternal diet because obesity increases the risks for adverse perinatal outcomes, including gestational diabetes mellitus, large for gestational age newborns, or preeclampsia. Thus, foods rich in vegetables, essential and polyunsaturated fats and fibre-rich carbohydrates should be promoted especially in overweight, obese or diabetic women. An adequate intake of micronutrients (e.g. iron, calcium, folate, vitamin D and carotenoids) is also crucial to support pregnancy and breastfeeding. Moderate physical activity throughout pregnancy improves muscle tone and function, besides decreasing the risk of preeclampsia, gestational diabesity (i.e. diabetes associated with obesity) and postpartum overweight. Intervention studies claim that an average of 30 min of exercise/day contributes to long-term benefits for maternal overall health and wellbeing. Other factors such as microbiome modulation, behavioural strategies (e.g. smoking cessation, anxiety/stress reduction and sleep quality), maternal genetics and age, social class and education might also influence the maternal quality of life. These factors contribute to ensure a healthy pregnancy, or at least to reduce the risk of adverse maternal and foetal outcomes during pregnancy and later in life.
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Affiliation(s)
- Alfonso Mate
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, E-41012 Sevilla, Spain
| | - Claudia Reyes-Goya
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, E-41012 Sevilla, Spain
| | - Álvaro Santana-Garrido
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, E-41012 Sevilla, Spain
| | - Carmen M Vázquez
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, E-41012 Sevilla, Spain
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79
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Poblete JA, Olmos P. Obesity and Gestational Diabetes in Pregnant Care and Clinical Practice. Curr Vasc Pharmacol 2021; 19:154-164. [PMID: 32598260 DOI: 10.2174/1570161118666200628142353] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 04/17/2020] [Accepted: 05/11/2020] [Indexed: 02/07/2023]
Abstract
Obesity and Gestational Diabetes Mellitus (GDM) are the most frequent pathologies affecting mothers and offspring during pregnancy. Both conditions have shown a sustained increase in their prevalence in recent years, and they worsen the outcome of pregnancy and the long-term health of mothers. Obesity increases the risk of GDM and pre-eclampsia during pregnancy and elevates the risk of developing metabolic syndrome in later life. Offspring of obese mothers have an increased risk of obstetric morbidity and mortality and, consistent with the developmental origins of health and disease, a long term risk of childhood obesity and metabolic dysfunction. On the other hand, GDM also increases the risk of pre-eclampsia, caesarean section, and up to 50% of women will develop type 2 diabetes later in life. From a fetal point of view, it increases the risk of macrosomia, large-for-gestational-age fetuses, shoulder dystocia and birth trauma. The insulin resistance and inflammatory mediators released by a hypoxic trophoblast are mainly responsible for the poor pregnancy outcome in obese or GDM patients. The adequate management of both pathologies includes modifications in the diet and physical activity. Drug therapy should be considered when medical nutrition therapy and moderate physical activity fail to achieve treatment goals. The antenatal prediction of macrosomia is a challenge for physicians. The timing and the route of delivery should consider adequate metabolic control, gestational age, and optimal conditions for a vaginal birth. The best management of these pathologies includes pre-conception planning to reduce the risks during pregnancy and improve the quality of life of these patients.
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Affiliation(s)
- José Andrés Poblete
- Division of Obstetrics and Gynaecology, School of Medicine, Pontificia Universidad Catolica de Santiago, Región Metropolitana, Chile
| | - Pablo Olmos
- Department of Nutrition, School of Medicine, Pontificia Universidad Catolica de Santiago, Región Metropolitana, Chile
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Gila-Díaz A, Díaz-Rullo Alcántara N, Herranz Carrillo G, Singh P, Arribas SM, Ramiro-Cortijo D. Multidimensional Approach to Assess Nutrition and Lifestyle in Breastfeeding Women during the First Month of Lactation. Nutrients 2021; 13:1766. [PMID: 34067287 PMCID: PMC8224582 DOI: 10.3390/nu13061766] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/18/2021] [Accepted: 05/21/2021] [Indexed: 02/07/2023] Open
Abstract
The first month of lactation is a vulnerable nutritional period for the mother. Our aims were (1) to evaluate the nutritional status of breastfeeding women in the first month of lactation, and (2) to explore different aspects of nutrition and lifestyle through a multidimensional approach. A total of 30 healthy breastfeeding women were enrolled in this study. Dietary pattern was assessed through a 72-hour dietary recall questionnaire (days 7 and 28 postpartum) and data were compared with Dietary Recommendation Values (DRV), and through the Adherence to Healthy Food Pyramid (HFP) questionnaire (day 28). Anthropometric parameters were evaluated by bioimpedance. Using factor analysis, nutritional dimensions were extracted, and linear regression models were used to analyze the association between anthropometric parameters and dimensions. Compared to the DRV, women showed insufficient energy, water, vitamin D, and potassium intake and excessive proteins, vitamins B1, B2, B3, B6, B12, and iron intake. We observed a moderate adherence to the HFP, with women being high in the fruits, vegetables, and oil categories, and low adherence to the physical activity, dairy products, and hydration categories. The nutritional dimension, including the HFP categories of physical activity, hydration, and animal protein intake together, was negatively associated with body weight (β = -3.7 ± 1.7; p-value = 0.047). In conclusion, during the first month postpartum, breastfeeding women exhibited several nutritional imbalances and poor physical activity negatively influencing anthropometric parameters. We propose a multidimensional approach to assess the nutritional status of breastfeeding women as a tool to detect specific deficiencies, allowing for personalized counseling.
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Affiliation(s)
- Andrea Gila-Díaz
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain; (A.G.-D.); (N.D.-R.A.); (S.M.A.)
| | - Nuria Díaz-Rullo Alcántara
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain; (A.G.-D.); (N.D.-R.A.); (S.M.A.)
| | - Gloria Herranz Carrillo
- Division of Neonatology Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), C/Profesor Martin Lagos s/n, 28040 Madrid, Spain;
| | - Pratibha Singh
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline avenue, Boston, MA 02215, USA;
| | - Silvia M. Arribas
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain; (A.G.-D.); (N.D.-R.A.); (S.M.A.)
| | - David Ramiro-Cortijo
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline avenue, Boston, MA 02215, USA;
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Souza RCVE, Miranda C, Ferreira LB, Dos Santos LC. The Influence of Nutrients Intake during Pregnancy on Baby's Birth Weight: A Systematic Review. J Trop Pediatr 2021; 67:6290306. [PMID: 34059907 DOI: 10.1093/tropej/fmab034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVE Maternal food intake during pregnancy can substantially interfere in the baby's anthropometric measurements at birth. Our objective was to perform a systematic review that investigate the influence of nutrient intake via food during pregnancy on the baby's anthropometric measurements at birth. METHODS A search was performed without time limits on CINAHL, Embase, PubMed, Scopus and Web of Science databases and manual on studies references. All nutrients and baby's anthropometric measurements at birth were included as descriptors. RESULTS Thirty articles were included, the majority of prospective cohort studies, with 15.39 (2.36) quality points (maximum value: 22). Thirty-six results of associations were found, of which 17 studies had direct associations between nutrient intake and birth outcomes. Inverse associations were identified in 8 studies and 11 articles showed no significant associations in all analyses. Maternal food intake of vitamin C, calcium and magnesium during pregnancy seems to have a positive influence on the baby's birth weight, while carbohydrates intake have an inverse association with the same outcome. CONCLUSION It is suggested that vitamin C, calcium, magnesium and carbohydrates influence on baby's birth weight. So, these specific nutrients need more attention to the consumption, in addition to carried out new studies, with robust methodologies for measuring maternal food consumption and considering the several factors that can interfere in this assessment. REGISTRATION This review has been registered to the PROSPERO (International prospective register of systematic reviews) (ID: CRD42020167889).
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Affiliation(s)
| | - Cristianny Miranda
- Department of Nutrition, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Larissa Bueno Ferreira
- Department of Nutrition, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luana Caroline Dos Santos
- Department of Nutrition, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Reski RN, Pebriani R, Azizah SN, Basri H, Hadju V. Food consumption and household income of pregnant and lactating women. ENFERMERIA CLINICA 2021. [PMID: 32545119 DOI: 10.1016/j.enfcli.2019.10.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To look at the relationship between food consumption patterns and household income in pregnant and lactating women, in Malili District, East Luwu Regency, South Sulawesi. METHOD This study was an analytical survey, using a cross-sectional approach with 128 respondents consisting of 42 pregnant women and 86 lactating mothers. Data collection using questionnaires with interview techniques. Data analysis using bivariate analysis using the chi-square test and fisher exact test. RESULTS Of the total respondents there were high-risk age <20 years and >35 years 20%, low education 47%, housewives 84%, and low income 45%, high income 55%. The results showed that nutritional intake obtained a value of p=0.002 (p<0.05) which showed that there were differences in fat intake in pregnant women and breastfeeding mothers, whereas in energy, protein, carbohydrate, vitamin C, and FE intake there were no differences. In the consumption pattern, fruit intake, vegetable intake has no relationship with household income but the chi-square test on staple foods obtained a value of p=0.03 (p<0.05) which indicates that there is a relationship between food consumption and income. CONCLUSION There is a relationship between staple food consumption and household income in pregnant and lactating women.
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Affiliation(s)
| | - Reski Pebriani
- Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - St Nur Azizah
- Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Hasan Basri
- Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Veni Hadju
- Department of Nutrition, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
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83
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Bitew ZW, Alemu A, Ayele EG, Worku T. Dietary diversity and practice of pregnant and lactating women in Ethiopia: A systematic review and meta-analysis. Food Sci Nutr 2021; 9:2686-2702. [PMID: 34026082 PMCID: PMC8116864 DOI: 10.1002/fsn3.2228] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/21/2021] [Accepted: 02/25/2021] [Indexed: 11/17/2022] Open
Abstract
The dietary diversity of pregnant and lactating women remains unacceptably poor in resource-limited countries such as Ethiopia. Despite the presence of inconsistent and inconclusive small-scale studies, it is difficult to portray an actual picture of dietary diversity and dietary practices of women in Ethiopia. This study aimed to identify the prevalence of dietary diversity, dietary practice, and dietary patterns of pregnant and lactating women in Ethiopia. Electronic and gray literature sources were explored. A total of 3,256 articles were found, of which 38 were included in the final analysis. The data were analyzed by using STATA version 15. The pooled estimates were presented using random-effects models due to considerable heterogeneities among studies. In this study, 16,412 pregnant and lactating women were included. The pooled prevalence of low, medium, and high dietary diversity scores of pregnant women was 37.1%, 41.55%, and 39.3%, respectively. Likewise, low, medium, and high dietary diversity scores of lactating women were 50.31%, 41.22%, and 9.1%, respectively. The mean dietary diversity of pregnant and lactating women was 3.99 ± 0.20. Regarding the minimum dietary diversity, 56.6% of pregnant women and 50.21% of lactating women were found to have inadequate dietary diversities. Two-third (65.7%) of pregnant women were found to have poor dietary practice. Starchy foods were the main staple foods of study subjects, whereas organ meats were least consumed food types. The dietary diversity score, minimum dietary diversity, and dietary practices of women are suboptimal and below WHO and FAO recommendations. This could lead to both macro- and micronutrient deficiencies. Policymakers, program managers, healthcare workers, and stakeholders need to redesign nutrition promotion and intervention programs to alleviate this issue.
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Affiliation(s)
- Zebenay Workneh Bitew
- Department of Pediatric NursingSchool of NursingSt. Paul’s Hospital Millennium Medical CollegeAddis AbabaEthiopia
| | | | - Ermias Getaneh Ayele
- Department of Pediatric NursingSchool of NursingSt. Paul’s Hospital Millennium Medical CollegeAddis AbabaEthiopia
| | - Teshager Worku
- College of Health and Medical SciencesSchool of Nursing and MidwiferyHaramaya UniversityHararEthiopia
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Nutrient Intake during Pregnancy and Adherence to Dietary Recommendations: The Mediterranean PHIME Cohort. Nutrients 2021; 13:nu13051434. [PMID: 33923157 PMCID: PMC8146946 DOI: 10.3390/nu13051434] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 12/12/2022] Open
Abstract
Few studies provide a detailed description of dietary habits during pregnancy, despite the central role of nutrition for the health of the mother and offspring. This paper describes the dietary habits, energy and nutrient intake in pregnant women from four countries belonging to the Mediterranean PHIME cohort (Croatia, Greece, Italy and Slovenia) and evaluates their adherence to the European Food Safety Authority (EFSA) recommendations. A total of 1436 women were included in the present analysis. Maternal diet was assessed using a food frequency questionnaire (FFQ). The mean macro and micronutrient intakes were estimated and compared with the dietary reference values (DRVs). The percentage distribution of the 16 food groups in the total intake of each macronutrient was estimated. All women shared a similar diet during pregnancy; almost all the women in the four countries exceeded the DRV for sugars, and the total fat intake was above the DRV in most women in all the countries, as was the contribution of saturated fatty acids (SFAs) to the total energy intake. In all four countries, we observed an increased risk of micronutrient deficiency for iron, folate and vitamin D. Shared guidelines, implemented at both the national and European level, are essential to improve the maternal nutritional status during pregnancy.
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85
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Sun CF, Liu H, Hao YH, Hu HT, Zhou ZY, Zou KX, Liu XM, Sheng JZ, Ding GL, Huang HF. Association between gestational anemia in different trimesters and neonatal outcomes: a retrospective longitudinal cohort study. World J Pediatr 2021; 17:197-204. [PMID: 33625695 DOI: 10.1007/s12519-021-00411-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 01/02/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Previous studies investigated the association between gestational anemia and neonatal outcomes. However, few studies explored whether the effects of gestational anemia could be eliminated by subsequent correction of anemia in the later stages of pregnancy. This study aimed to investigate the relationship between anemia in different trimesters and neonatal outcomes. METHODS The study was conducted in Shanghai, China, with a sample of 46,578 pregnant women who delivered between January 1, 2016 and July 1, 2019. A multivariable logistic regression model was adopted to analyse the associations between maternal anemia and neonatal outcomes. RESULTS The incidence of gestational anemia was 30.2%, including 4.4% in the first trimester, 9.6% in the second trimester, and 16.2% in the third trimester. Only 24.5% (507/2066) of anemia that occurred in the first trimester and 29.6% (1320/4457) that occurred in the second trimester could be corrected in the later stages of pregnancy. Anemia occurring in the first trimester was associated with small for gestational age [odds ratio (OR) 1.46; 95% confidence interval (CI) 1.20-1.78] and with fetal distress (OR 1.23; 95% CI 1.08-1.40). Anemia corrected in the first trimester also was associated with a higher risk of small for gestational age. CONCLUSIONS Gestational anemia is a public health problem in China impacting neonatal health. Anemia in pregnancy could be corrected in only about a quarter of the women. Anemia in the first trimester, whether corrected or not, still led to lower birth weight; therefore, the prevention of anemia prior to pregnancy is important.
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Affiliation(s)
- Chang-Fa Sun
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Han Liu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Yan-Hui Hao
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Hong-Tao Hu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai, 200030, China.,Department of Gynecology and Obstetrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhi-Yang Zhou
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Ke-Xin Zou
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Xin-Mei Liu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Jian-Zhong Sheng
- Department of Pathology and Pathophysiology, School of Medicine, Zhejiang University, Hangzhou, China
| | - Guo-Lian Ding
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai, 200030, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - He-Feng Huang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai, 200030, China. .,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
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The Triad Mother-Breast Milk-Infant as Predictor of Future Health: A Narrative Review. Nutrients 2021; 13:nu13020486. [PMID: 33540672 PMCID: PMC7913039 DOI: 10.3390/nu13020486] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 02/07/2023] Open
Abstract
The benefits of human milk for both mother and infant are widely acknowledged. Human milk could represent a link between maternal and offspring health. The triad mother-breast milk-infant is an interconnected system in which maternal diet and lifestyle might have effects on infant's health outcome. This link could be in part explained by epigenetics, even if the underlining mechanisms have not been fully clarified yet. The aim of this paper is to update the association between maternal diet and human milk, pointing out how maternal diet and lifestyle could be associated with breast-milk composition, hence with offspring's health outcome.
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87
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Lust CAC, Bi X, Henry CJ, Ma DWL. Development of Fatty Acid Reference Ranges and Relationship with Lipid Biomarkers in Middle-Aged Healthy Singaporean Men and Women. Nutrients 2021; 13:nu13020435. [PMID: 33572735 PMCID: PMC7911367 DOI: 10.3390/nu13020435] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/14/2021] [Accepted: 01/26/2021] [Indexed: 12/17/2022] Open
Abstract
Dietary fatty acids (FA) are essential for overall human health, yet individual FA reference ranges have yet to be established. Developing individual FA reference ranges can provide context to reported concentrations and whether an individual displays deficient, or excess amounts of FA. Reference ranges of sixty-seven individual FA (μmol/L) were profiled and analyzed using gas chromatography with a flame ionization detector from serum samples collected from 476 middle-aged Singaporean males (BMI:23.3 ± 2.9) and females (BMI:21.8 ± 3.6). Measures of triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol (TC) (mmol/L) were also collected. The mean FA concentration seen in this cohort (11,458 ± 2478 was similar to that of overweight North American cohorts assessed in past studies. Ten biologically relevant FA were compared between sexes, with females exhibiting significantly higher concentrations in four FA (p < 0.05). A multiple regression model revealed the ten FA contributed significantly to nearly all lipid biomarkers (p < 0.05). A majority of participants who had FA concentrations in the ≥95th percentile also exhibited TG, HDL, LDL, and TC levels in the “high” risk classification of developing cardiovascular disease. Future studies profiling individual FA reference ranges in many unique, global cohorts are necessary to develop cut-off values of individual FA concentrations highly related to disease-risk.
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Affiliation(s)
- Cody A. C. Lust
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada;
| | - Xinyan Bi
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A*STAR), 14 Medical Drive #07-02, MD 6 Building, Singapore 117599, Singapore; (X.B.); (C.J.H.)
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A*STAR), 14 Medical Drive #07-02, MD 6 Building, Singapore 117599, Singapore; (X.B.); (C.J.H.)
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore
| | - David W. L. Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada;
- Correspondence:
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Sharma S, Akhtar F, Kumar Singh R, Mehra S. Dietary Patterns and Determinants of Pregnant and Lactating Women From Marginalized Communities in India: A Community-Based Cross-Sectional Study. Front Nutr 2020; 7:595170. [PMID: 33282903 PMCID: PMC7691489 DOI: 10.3389/fnut.2020.595170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 10/26/2020] [Indexed: 01/30/2023] Open
Abstract
Objective: Dietary pattern analysis has emerged as a balanced and realistic approach that reflects how the food is consumed in real life. However, previous studies have overlooked the two important phases in women's life, pregnancy, and lactation. We aimed to explore dietary patterns and their determinants among pregnant and lactating women from marginalized families in rural areas and urban slums of India. Methods: It was a community-based cross-sectional study conducted across four districts of India, one from each region (North, West, East, and South). We used a structured questionnaire to collect data on socio-demographic characteristics and access to nutrition services. The dietary data were collected using a qualitative food frequency questionnaire having 204 food items, which were clubbed into 16 major food groups. The principal component analysis method was employed to identify dietary patterns (prefixed at 4). We used multinomial logistic regression to explore associations of socio-demographic and access to nutrition services' variables with identified dietary patterns. Results: The data of 476 pregnant and 446 lactating women were assessed. Four patterns explained for 54% of the variation in their food intake. The patterns identified were low-mixed vegetarian (19%), non-vegetarian (15%), high-mixed vegetarian (11%), and calorie-rich (9%). The low-mixed diet was rich in rice, roots and tubers, green leafy vegetables, and other vegetables. The non-vegetarian diet was characterized by high loadings for nuts or seeds, chicken, meat or fish, eggs, beverages (milk-based), and snacks. The high-mixed vegetarian diet was rich in cereals other than rice and wheat, pulses, and fruits. The calorie-rich diet had high factor loadings for wheat, butter and oil, sweets, and milk and milk products. Hindus and women who lived in rural areas had higher odds of consuming a low-mixed vegetarian diet and lower odds of a high-mixed vegetarian diet. Working women and those who received nutrition advice during pregnancy or lactation had 2-3 times higher odds of consuming a high-mixed vegetarian diet. Conclusions: A high prevalence of a low-mixed vegetarian diet among women can have adverse pregnancy and birth outcomes. Healthy dietary patterns during pregnancy and lactation are required to meet the increased micro- and macronutrient requirements for improved maternal and child health.
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Affiliation(s)
- Shantanu Sharma
- Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden.,Reproductive, Maternal, Newborn, Child and Adolescent Health Division, MAMTA Health Institute for Mother and Child, New Delhi, India
| | - Faiyaz Akhtar
- Reproductive, Maternal, Newborn, Child and Adolescent Health Division, MAMTA Health Institute for Mother and Child, New Delhi, India
| | - Rajesh Kumar Singh
- Reproductive, Maternal, Newborn, Child and Adolescent Health Division, MAMTA Health Institute for Mother and Child, New Delhi, India
| | - Sunil Mehra
- Reproductive, Maternal, Newborn, Child and Adolescent Health Division, MAMTA Health Institute for Mother and Child, New Delhi, India
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89
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Yalewdeg M, Birhane M, Adissu Y. Dietary Practices and Their Determinants Among Pregnant Women in Gedeo Zone, Southern Ethiopia: A Community-Based Cross-Sectional Study . NUTRITION AND DIETARY SUPPLEMENTS 2020. [DOI: 10.2147/nds.s267453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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90
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Beringer M, Schumacher T, Keogh L, Sutherland K, Knox P, Herden J, Brown L, Rae K. Nutritional adequacy and the role of supplements in the diets of Indigenous Australian women during pregnancy. Midwifery 2020; 93:102886. [PMID: 33254096 DOI: 10.1016/j.midw.2020.102886] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/07/2020] [Accepted: 11/09/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine sources of key nutrients contributing towards nutritional adequacy during pregnancy (fibre, calcium, iron, zinc and folate) in a cohort of women carrying an Indigenous child. DESIGN Analysis of cross-sectional data from a prospective longitudinal cohort study that followed Indigenous women through pregnancy. SETTING Women recruited via antenatal clinics in regional and remote locations in NSW, Australia as part of the Gomeroi gaaynggal project. PARTICIPANTS One hundred and fifty-two pregnant Australian women who identified as Indigenous or carrying an Indigenous child. MEASUREMENTS AND FINDINGS Measurement outcomes included demographic information, smoking status, anthropometrics (weight and height,), self-reported pre-pregnancy weight, health conditions and dietary information (24-hour food recall). Findings indicate the inadequate intake of key pregnancy nutrients in this cohort. Supplements contributed to the nutrient adequacy of the cohort with 53% reporting use. As expected, predominant sources of fibre were from core food groups, whereas calcium was attained from a range of sources including food and beverages, with small amounts from supplementation. Importantly, supplements contributed significant amounts of iron, zinc and folate. KEY CONCLUSIONS There is limited literature on Indigenous Australian maternal nutrition. This study highlights the key dietary contributors of nutritional adequacy during pregnancy for the cohort and that supplementation may be considered a viable source of nutrients during pregnancy for these women. Few women met national nutrient recommendations. The findings present an opportunity to optimise nutrient intakes of Indigenous pregnant women. IMPLICATIONS FOR PRACTICE Culturally appropriate targeted interventions to optimise dietary intakes of Indigenous Australian pregnant women is required. Collaborative support of health workers, Indigenous Australian communities, dietitians, and researchers to raise awareness of nutrition during pregnancy is imperative to achieving nutrient targets and optimising pregnancy outcomes. Targeted interventions provide positive opportunities to achieve improvements.
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Affiliation(s)
- Madison Beringer
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Tracy Schumacher
- University of Newcastle Department of Rural Health, Tamworth, Faculty of Health and Medicine, University of Newcastle, Australia; Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | | | | | | | | | - Leanne Brown
- University of Newcastle Department of Rural Health, Tamworth, Faculty of Health and Medicine, University of Newcastle, Australia
| | - Kym Rae
- Mater Research Institute, Aubigny Place, South Brisbane, Australia; University of Queensland, Faculty of Medicine, Brisbane, Australia.
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91
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Song J, Zhang J, Fawzi W, Huang Y. Double Burden of Malnutrition among Chinese Women of Reproductive Age and Their Social Determinants. Nutrients 2020; 12:E3102. [PMID: 33053638 PMCID: PMC7601850 DOI: 10.3390/nu12103102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/30/2020] [Accepted: 10/03/2020] [Indexed: 01/12/2023] Open
Abstract
This study aimed to examine the impact of a wide range of demographic, socioeconomic, and community factors on the double burden of malnutrition among women of reproductive age using longitudinal data. We used data about 11,348 women of reproductive age who participated in the China Health and Nutrition Survey (CHNS), a longitudinal survey, between 1989 and 2015. Nutritional outcomes were categorized into four groups, namely underweight, normal weight, overweight, and obesity, with normal weight as reference. A multinomial logit model was fitted due to geographic clustering and repeated observations of individuals. The prevalence of underweight decreased over time from 1991 but has tended to rise again since 2004, while the prevalence of overweight/obesity continued to rise between 1991 and 2015. Improved individual factors, socioeconomic status, and community urbanization reduced the risk of underweight but elevated the risk of overweight and obesity. The medium levels, rather than the highest levels, of household income and community urbanization are associated with a higher risk of overweight and obesity. The notable increase in underweight prevalence is a cause for concern to be addressed along with efforts to curb the rising tide of overweight. In order to enhance the nutritional status of women of reproductive age, it is essential to improving the community environment, levels of education, and living environment from a wider context. Long-term and targeted plans are urgently needed for nutrition improvements among the different populations.
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Affiliation(s)
- Jingqi Song
- School of Public Health, Peking University Health Science Center, Beijing 100191, China; (J.S.); (J.Z.)
| | - Ji Zhang
- School of Public Health, Peking University Health Science Center, Beijing 100191, China; (J.S.); (J.Z.)
| | - Wafaie Fawzi
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA;
| | - Yangmu Huang
- School of Public Health, Peking University Health Science Center, Beijing 100191, China; (J.S.); (J.Z.)
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92
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Wagner BA, Zork N, Blackett JW, Green PHR, Lebwohl B. Characteristics and Maternal-Fetal Outcomes of Pregnant Women Without Celiac Disease Who Avoid Gluten. Dig Dis Sci 2020; 65:2970-2978. [PMID: 32239378 DOI: 10.1007/s10620-020-06232-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/23/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Gluten avoidance among patients without celiac disease has become increasingly popular, especially among young and female demographics; however, no research has explored gluten avoidance during pregnancy, when nutrition is particularly important. AIMS To determine whether avoiding gluten in pregnancy is associated with any medical, obstetric, or neonatal characteristics. METHODS In this single-center retrospective cohort study, we identified women with singleton pregnancies who avoid gluten based on antenatal intake questionnaire responses and inpatient dietary orders, excluding those with celiac disease. Certain demographic, medical, obstetric, and neonatal characteristics were compared to matched controls who do not avoid gluten. RESULTS From July 1, 2011 to July 1, 2019, 138 pregnant women who avoid gluten were admitted for delivery of singleton gestations. Compared to controls, gluten-avoidant women had fewer prior pregnancies (p = 0.005), deliveries (p < 0.0005), and living children (p < 0.0005), higher rates of hypothyroidism (OR = 3.22; p = 0.001) and irritable bowel syndrome (OR = 6.00; p = 0.019), higher second trimester hemoglobin (p = 0.018), and lower body mass index at delivery (p = 0.045). Groups did not differ in any obstetric or fetal characteristics. CONCLUSIONS Gluten avoidance in pregnancy is common and, in women without celiac disease, is associated with higher rates of hypothyroidism and irritable bowel syndrome, fewer pregnancies, term births, and living children, and lower peripartum BMI, but is not associated with any obstetric or neonatal comorbidities. Avoiding gluten does not appear to adversely affect maternal or fetal health, but reasons for gluten avoidance, as well as long-term maternal and pediatric outcomes after gluten avoidance in pregnancy, warrant further study.
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Affiliation(s)
- Benjamin A Wagner
- Columbia University Vagelos College of Physicians and Surgeons, New York, USA
| | - Noelia Zork
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, USA
| | - John W Blackett
- Division of Digestive and Liver Diseases, Department of Medicine, Celiac Disease Center, Columbia University Vagelos College of Physicians and Surgeons, New York, USA
| | - Peter H R Green
- Division of Digestive and Liver Diseases, Department of Medicine, Celiac Disease Center, Columbia University Vagelos College of Physicians and Surgeons, New York, USA
| | - Benjamin Lebwohl
- Division of Digestive and Liver Diseases, Department of Medicine, Celiac Disease Center, Columbia University Vagelos College of Physicians and Surgeons, New York, USA. .,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA.
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93
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Grammatikopoulou MG, Theodoridis X, Gkiouras K, Lampropoulou M, Petalidou A, Patelida M, Tsirou E, Papoutsakis C, Goulis DG. Methodological quality of clinical practice guidelines for nutrition and weight gain during pregnancy: a systematic review. Nutr Rev 2020; 78:546-562. [PMID: 31755916 DOI: 10.1093/nutrit/nuz065] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
CONTEXT Ensuring a healthy pregnancy and achieving optimal gestational weight gain (GWG) are important for maternal and child health. Nevertheless, the nutritional advice provided during pregnancy is often conflicting, suggesting limited adherence to clinical practice guidelines (CPGs). OBJECTIVE The aim of this review was to identify all CPGs on maternal nutrition and GWG and to critically appraise their methodological quality. DATA SOURCES The MEDLINE/PubMed, Cochrane, Guidelines International Network, and BMJ Best Practice databases, along with gray literature, were searched from inception until February 2019 for CPGs and consensus, position, and practice papers. STUDY SELECTION Clinical practice guidelines published in English and containing advice on maternal nutrition or GWG were eligible. DATA EXTRACTION Two authors independently extracted data on items pertaining to maternal nutrition or GWG, and CPGs were appraised using the AGREE II instrument. RESULTS Twenty-two CPGs were included. All scored adequately in the "scope" domain, but most were considered inadequate with regard to stakeholder involvement, rigor of development, applicability, and editorial independence. Many CPGs lacked patient or dietician involvement, and more than half did not disclose funding sources or conflicts of interest. Guidance on GWG was based mostly on Institute of Medicine thresholds, while nutrition recommendations appeared scattered and heterogeneous. CONCLUSION Despite the importance of maternal nutrition and the plethora of advising bodies publishing relevant guidance, there is room for substantial improvement in terms of development standards and content of nutritional recommendations. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42019120898.
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Affiliation(s)
- Maria G Grammatikopoulou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, Thessaloniki, Greece.,Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Xenophon Theodoridis
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Medical School, Faculty of Health Sciences, University of Thessaly, Larissa, Greece
| | - Konstantinos Gkiouras
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Medical School, Faculty of Health Sciences, University of Thessaly, Larissa, Greece
| | - Maria Lampropoulou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, Thessaloniki, Greece.,Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Fourth Department of Pediatrics, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Arianna Petalidou
- Medical School, Faculty of Health Sciences, University of Thessaly, Larissa, Greece
| | - Maria Patelida
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Efrosini Tsirou
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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94
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Dietary Choices of New Zealand Women during Pregnancy and Lactation. Nutrients 2020; 12:nu12092692. [PMID: 32899261 PMCID: PMC7551142 DOI: 10.3390/nu12092692] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 11/17/2022] Open
Abstract
Dietary recommendations during pregnancy and lactation have become increasingly complex, and sources of information more numerous but not always reliable, potentially causing confusion and unsafe choices. Women were recruited during pregnancy or within six months postpartum and completed questionnaires on dietary choices, food safety, and sources of nutrition information. Women (n = 458) from around New Zealand participated in the study. They consumed a wide range of foods and beverages and reported various dietary changes. In pregnancy, women commonly avoided alcohol (92%), raw milk products (86%), and raw, smoked, or pre-cooked seafood and fish (84%), and made changes due to food safety concerns. Influential advice was acquired from a range of sources including midwives (37%) and the New Zealand pregnancy and breastfeeding guidelines (25%) during pregnancy. Food avoidance was less common in lactation. However, fewer women consumed milk products during lactation (64%) than pregnancy (93%). Potentially unreliable sources were used more frequently in lactation including alternative health practitioners (26%) and family or friends (12%), and dietary changes were often made in response to infant symptoms without supporting evidence. This study highlighted a need for good communication of evidence-based recommendations to women, especially during lactation.
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95
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Spigolon E, Cimolato I, Priante E, Bonadies L, Visentin S, De Terlizzi F, Cavicchiolo ME, Verlato G. Diet in pregnant women that delivered prematurely and preterm newborn's bone status. J Matern Fetal Neonatal Med 2020; 35:2859-2866. [PMID: 32814481 DOI: 10.1080/14767058.2020.1807507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Inadequate maternal dietary pattern has been associated to negative pregnancy and fetal outcomes. With this study, we aimed to evaluate the adequacy of diet in pregnant women that delivered prematurely and its possible correlations with bone status of preterm newborns. STUDY DESIGN We prospectively enrolled women who delivered prematurely (≤than 34 gestational weeks) and their newborns (Neonatal Intensive Care, University Hospital of Padova) from January 2017 to May 2018. Maternal nutritional status and diet supplementations were assessed using a validated questionnaire. The preterm newborns were evaluated with anthropometric measurements and bone status by Quantitative Ultrasound of the second metacarpal bone within 72 h from birth. RESULTS One hundred and eighty mothers and 202 preterm newborns were evaluated. The mothers assumed more calories, proteins, total lipids and simple sugars compared to the revised National Guidelines. The intake of calcium, phosphorus and Vitamin D was inadequate despite the use of multivitamin supplements. The mothers assumption of vitamin D and zinc positively correlated with bone status and mothers with very low intake of vitamin D during gestation (<7 µg/die) had preterm newborns with a worst bone status at birth compared to those with a better intake (>7 µg/die). CONCLUSIONS Nutrition of pregnant women could be improved and maternal intakes of Vitamin D and zinc positively correlated with preterm newborn's bone status.
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Affiliation(s)
- Eleonora Spigolon
- Neonatal Intensive Care Unit, Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | - Irene Cimolato
- Neonatal Intensive Care Unit, Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | - Elena Priante
- Neonatal Intensive Care Unit, Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | - Luca Bonadies
- Neonatal Intensive Care Unit, Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | - Silvia Visentin
- Neonatal Intensive Care Unit, Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | | | - Maria Elena Cavicchiolo
- Neonatal Intensive Care Unit, Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | - Giovanna Verlato
- Neonatal Intensive Care Unit, Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
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96
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Gómez G, Nogueira Previdelli Á, Fisberg RM, Kovalskys I, Fisberg M, Herrera-Cuenca M, Cortés Sanabria LY, Yépez García MC, Rigotti A, Liria-Domínguez MR, Guajardo V, Quesada D, Murillo AG, Brenes JC. Dietary Diversity and Micronutrients Adequacy in Women of Childbearing Age: Results from ELANS Study. Nutrients 2020; 12:E1994. [PMID: 32635544 PMCID: PMC7400493 DOI: 10.3390/nu12071994] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/27/2020] [Accepted: 07/01/2020] [Indexed: 12/18/2022] Open
Abstract
Dietary diversity, an important component of diet quality, is associated with an increased probability of adequate micronutrient intake. Women of childbearing age (WCA) are particularly vulnerable to micronutrient inadequacy. The Minimum Dietary Diversity for Women (MDD-W) has been used widely as a proxy measurement of micronutrient adequacy. This study aimed to assess the association between MDD-W and nutrients adequacy among WCA of eight Latin American countries. Nutrient intakes from 3704 WCA were analyzed with two 24-hour dietary recalls. Dietary diversity was calculated based on ten food groups with a cut-off point of intake ≥5 groups. The mean dietary diversity score was 4.72 points, and 57.7% of WCA achieved MDD-W. Vitamin D and E showed a mean Nutrient Adequacy Ratio (NAR) of 0.03 and 0.38, respectively. WCA with a diverse diet (MDD-W > 5) reported a significantly higher intake of most micronutrients and healthy food groups with less consumption of red and processed meats and sugar-sweetened beverages. MDD-W was significantly associated with the mean adequacy ratio (MAR) of 18 micronutrients evaluated. Nevertheless, even those women with a diverse diet fell short of meeting the Estimated Average Requirements (EAR) for vitamins D and E. MDD-W is an appropriate tool to evaluate micronutrients adequacy in WCA from Latin America, showing that women who achieved the MDD-W reported higher adequacy ratios for most micronutrients and an overall healthier diet.
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Affiliation(s)
- Georgina Gómez
- Departamento de Bioquimica, Escuela de Medicina, Universidad de Costa Rica, San Jose 94088, Costa Rica; (D.Q.); (A.G.M.)
| | | | - Regina Mara Fisberg
- Departamento de Nutriçao, Faculdade de Saude Publica, Universidade de Sao Paulo, Sao Paulo 01000, Brazil;
| | - Irina Kovalskys
- Committee of Nutrition and Wellbeing, International Life Science Institute (ILSI-Argentina), Buenos Aires C1059ABF, Argentina; (I.K.); (V.G.)
- Pontificia Universidad Catolica de Argentina, Facultad de Medicina, Buenos Aires B1675, Argentina
| | - Mauro Fisberg
- Instituto Pensi, Fundaçao Jose Egydio Setubal, Sabara Hospital Infantil, Sao Paulo 01239-040, Brazil;
- Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo 04023-062, Brazil
| | | | | | | | - Attilio Rigotti
- Centro de Nutricion Molecular y Enfermedades Cronicas, Departamento de Nutricion, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Catolica, Santiago 833-0024, Chile;
| | | | - Viviana Guajardo
- Committee of Nutrition and Wellbeing, International Life Science Institute (ILSI-Argentina), Buenos Aires C1059ABF, Argentina; (I.K.); (V.G.)
| | - Dayana Quesada
- Departamento de Bioquimica, Escuela de Medicina, Universidad de Costa Rica, San Jose 94088, Costa Rica; (D.Q.); (A.G.M.)
| | - Ana Gabriela Murillo
- Departamento de Bioquimica, Escuela de Medicina, Universidad de Costa Rica, San Jose 94088, Costa Rica; (D.Q.); (A.G.M.)
| | - Juan Carlos Brenes
- Instituto de Investigaciones Psicologicas & Centro de Investigacion en Neurociencias, Universidad de Costa Rica, San Jose 11501, Costa Rica;
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97
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Balduit A, Mangogna A, Agostinis C, Zito G, Romano F, Ricci G, Bulla R. Zinc Oxide Exerts Anti-Inflammatory Properties on Human Placental Cells. Nutrients 2020; 12:nu12061822. [PMID: 32570911 PMCID: PMC7353449 DOI: 10.3390/nu12061822] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/07/2020] [Accepted: 06/16/2020] [Indexed: 02/07/2023] Open
Abstract
Background: An aberrant and persistent inflammatory state at the fetal-maternal interface is considered as a key contributor in compromised pregnancies. Decidual endothelial cells (DECs) play a pivotal role in the control of the local decidual inflammation. The aim of the current study was to determine whether dietary supplement with zinc oxide (ZnO), due to its very low adverse effects, may be useful for modulating the inflammatory response in the first trimester of pregnancy. Methods: The anti-inflammatory properties of ZnO in pregnancy were evaluated by in vitro tests on endothelial cells isolated from normal deciduas and on a trophoblast cell line (HTR8/Svneo). The effects of this treatment were analyzed in terms of adhesion molecule expression and inflammatory cytokine secretion, by real time-quantitative PCR (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA). Results: Our data showed that ZnO was able to reduce the inflammatory response of DECs, in terms of vascular cell adhesion molecule-1 (VCAM-1), interleukin (IL)-8, IL-6, tumor necrosis factor-α (TNF-α) and monocyte chemoattractant protein-1 (MCP-1) expression induced by TNF-α stimulation. This compound exerted no effect on intracellular adhesion molecule-1 (ICAM-1) exocytosis induced by TNF-α on stimulated trophoblast cells, but significantly reduced their IL-6 expression. Conclusion: According to these results, it can be suggested that the ZnO supplement, through its modulation of the pro-inflammatory response of DECs, can be used in pregnancy for the prevention of local decidual inflammation.
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Affiliation(s)
- Andrea Balduit
- Department of Life Sciences, University of Trieste, 34127 Trieste, Italy; (A.B.); (A.M.); (R.B.)
| | - Alessandro Mangogna
- Department of Life Sciences, University of Trieste, 34127 Trieste, Italy; (A.B.); (A.M.); (R.B.)
| | - Chiara Agostinis
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34134 Trieste, Italy; (G.Z.); (F.R.); (G.R.)
- Correspondence: ; Tel.: +39-04055-88646
| | - Gabriella Zito
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34134 Trieste, Italy; (G.Z.); (F.R.); (G.R.)
| | - Federico Romano
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34134 Trieste, Italy; (G.Z.); (F.R.); (G.R.)
| | - Giuseppe Ricci
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34134 Trieste, Italy; (G.Z.); (F.R.); (G.R.)
- Department of Medical, Surgical and Health Science, University of Trieste, 34129 Trieste, Italy
| | - Roberta Bulla
- Department of Life Sciences, University of Trieste, 34127 Trieste, Italy; (A.B.); (A.M.); (R.B.)
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98
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Kadayifci FZ, Haggard S, Jeon S, Ranard K, Tao D, Pan YX. Early-life Programming of Type 2 Diabetes Mellitus: Understanding the Association between Epigenetics/Genetics and Environmental Factors. Curr Genomics 2020; 20:453-463. [PMID: 32477001 PMCID: PMC7235385 DOI: 10.2174/1389202920666191009110724] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 07/03/2019] [Accepted: 09/06/2019] [Indexed: 11/22/2022] Open
Abstract
Type 2 Diabetes Mellitus is an increasing public health problem that poses a severe social and economic burden affecting both developed and developing countries. Defects in insulin signaling itself are among the earliest indications that an individual is predisposed to the development of insulin resistance and subsequently Type 2 Diabetes Mellitus. To date, however, the underlying molecular mechanisms which result in resistance to the actions of insulin are poorly understood. Furthermore, it has been shown that maternal obesity is associated with an increased risk of obesity and insulin resistance in the offspring. However, the genetic and/or epigenetic modifications within insulin-sensitive tissues such as the liver and skeletal muscle, which contribute to the insulin-resistant phenotype, still remain unknown. More importantly, a lack of in-depth understanding of how the early life environment can have long-lasting effects on health and increased risk of Type 2 Diabetes Mellitus in adulthood poses a major limitation to such efforts. The focus of the current review is thus to discuss recent experimental and human evidence of an epigenetic component associated with components of nutritional programming of Type 2 Diabetes Mellitus, including altered feeding behavior, adipose tissue, and pancreatic beta-cell dysfunction, and transgenerational risk transmission.
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Affiliation(s)
- Fatma Z Kadayifci
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Sage Haggard
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Sookyoung Jeon
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Katie Ranard
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Dandan Tao
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Yuan-Xiang Pan
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Illinois Informatics Institute, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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99
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Karcz K, Lehman I, Królak-Olejnik B. Foods to Avoid While Breastfeeding? Experiences and Opinions of Polish Mothers and Healthcare Providers. Nutrients 2020; 12:nu12061644. [PMID: 32498286 PMCID: PMC7352950 DOI: 10.3390/nu12061644] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/16/2020] [Accepted: 05/28/2020] [Indexed: 12/11/2022] Open
Abstract
Popular beliefs regarding a mother’s diet during lactation have a significant impact on breastfeeding practices among mothers, as well on breastfeeding counseling among healthcare providers worldwide. The objective of this study was to assess mothers’ and medical professionals’ knowledge and opinions on the “lactating mother’s diet”. An electronic survey, prepared in Polish, was administered to healthcare providers, as well as mothers who have breastfed a child. The chi-square test, logistic regression, and Mann Whitney U test were used for statistical calculations. Out of a total of 1180 responses received, 1159 were analyzed, and 21 were excluded because they did not meet the inclusion criteria. The survey was completed by 407 (35%) medical healthcare providers and 752 (65%) lactating mothers in non-medical professions. In total, the study included 1074 mothers who have breastfed a child, and 29.14% of them reported that they eliminated certain foods from their diet when breastfeeding. There was no statistically significant difference in the responses received from mothers and medical staff providing maternal care (for each of 17 products, e.g., steak tartare, sushi, legumes, dairy products, p > 0.05 by the Mann-Whitney test). However, a logistic regression revealed some significant correlations with other variables (e.g., duration of lactation). The respondents revealed an appropriate level of knowledge on nutrition during lactation and the majority of participants neither adhered to nor recommended a prophylactic elimination diet. Among other evaluated factors, the experience of following an elimination diet affected respondents’ knowledge of nutrition during breastfeeding. Both mothers and healthcare providers require good nutritional education.
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100
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Torreggiani M, Fois A, D’Alessandro C, Colucci M, Orozco Guillén AO, Cupisti A, Piccoli GB. Of Mice and Men: The Effect of Maternal Protein Restriction on Offspring's Kidney Health. Are Studies on Rodents Applicable to Chronic Kidney Disease Patients? A Narrative Review. Nutrients 2020; 12:E1614. [PMID: 32486266 PMCID: PMC7352514 DOI: 10.3390/nu12061614] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/19/2020] [Accepted: 05/28/2020] [Indexed: 12/20/2022] Open
Abstract
In the almost 30 years that have passed since the postulation of the "Developmental Origins of Health and Disease" theory, it has been clearly demonstrated that a mother's dietary habits during pregnancy have potential consequences for her offspring that go far beyond in utero development. Protein malnutrition during pregnancy, for instance, can cause severe alterations ranging from intrauterine growth retardation to organ damage and increased susceptibility to hypertension, diabetes mellitus, cardiovascular diseases and chronic kidney disease (CKD) later in life both in experimental animals and humans. Conversely, a balanced mild protein restriction in patients affected by CKD has been shown to mitigate the biochemical derangements associated with kidney disease and even slow its progression. The first reports on the management of pregnant CKD women with a moderately protein-restricted plant-based diet appeared in the literature a few years ago. Today, this approach is still being debated, as is the optimal source of protein during gestation in CKD. The aim of this report is to critically review the available literature on the topic, focusing on the similarities and differences between animal and clinical studies.
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Affiliation(s)
- Massimo Torreggiani
- Nephrology and Dialysis, Centre Hospitalier Le Mans, Avenue Roubillard 194, 72000 Le Mans, France; (A.F.); (G.B.P.)
| | - Antioco Fois
- Nephrology and Dialysis, Centre Hospitalier Le Mans, Avenue Roubillard 194, 72000 Le Mans, France; (A.F.); (G.B.P.)
| | - Claudia D’Alessandro
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.D.); (A.C.)
| | - Marco Colucci
- Unit of Nephrology and Dialysis, ICS Maugeri S.p.A. SB, Via S. Maugeri 10, 27100 Pavia, Italy;
| | | | - Adamasco Cupisti
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (C.D.); (A.C.)
| | - Giorgina Barbara Piccoli
- Nephrology and Dialysis, Centre Hospitalier Le Mans, Avenue Roubillard 194, 72000 Le Mans, France; (A.F.); (G.B.P.)
- Dipartimento di Scienze Cliniche e Biologiche, Università di Torino, 10100 Torino, Italy
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