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Baron R, Martin L, Gitsels-van der Wal JT, Noordman J, Heymans MW, Spelten ER, Brug J, Hutton EK. Health behaviour information provided to clients during midwife-led prenatal booking visits: Findings from video analyses. Midwifery 2017; 54:7-17. [PMID: 28780476 DOI: 10.1016/j.midw.2017.07.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 07/09/2017] [Accepted: 07/09/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVE to quantify to what extent evidence-based health behaviour topics relevant for pregnancy are discussed with clients during midwife-led prenatal booking visits and to assess the association of client characteristics with the extent of information provided. DESIGN quantitative video analyses. SETTING AND PARTICIPANTS 173 video recordings of prenatal booking visits with primary care midwives and clients in the Netherlands taking place between August 2010 and April 2011. MEASUREMENTS thirteen topics regarding toxic substances, nutrition, maternal weight, supplements, and health promoting activities were categorized as either 'never mentioned', 'briefly mentioned', 'basically explained' or 'extensively explained'. Rates on the extent of information provided were calculated for each topic and relationships between client characteristics and dichotomous outcomes of the extent of information provided were assessed using Generalized Linear Mixed Modelling. FINDINGS our findings showed that women who did not take folic acid supplementation, who smoked, or had a partner who smoked, were usually provided basic and occasionally extensive explanations about these topics. The majority of clients were provided with no information on recommended weight gain (91.9%), fish promotion (90.8%), caffeine limitation (89.6%), vitamin D supplementation (87.3%), physical activity promotion (81.5%) and antenatal class attendance (75.7%) and only brief mention of alcohol (91.3%), smoking (81.5%), folic acid (58.4) and weight at the start of pregnancy (52.0%). The importance of a nutritious diet was generally either never mentioned (38.2%) or briefly mentioned (45.1%). Nulliparous women were typically given more information on most topics than multiparous women. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE although additional information was generally provided about folic acid and smoking, when relevant for their clients, the majority of women were provided with little or no information about the other health behaviours examined in this study. Midwives may be able to improve prenatal health promotion by providing more extensive health behaviour information to their clients during booking visits.
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Affiliation(s)
- Ruth Baron
- Department of Midwifery Science, Midwifery Academy Amsterdam Groningen (AVAG), Amsterdam Public Health Research Institute, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Linda Martin
- Department of Midwifery Science, Midwifery Academy Amsterdam Groningen (AVAG), Amsterdam Public Health Research Institute, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Janneke T Gitsels-van der Wal
- Department of Midwifery Science, Midwifery Academy Amsterdam Groningen (AVAG), Amsterdam Public Health Research Institute, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Janneke Noordman
- Netherlands Institute for Health Services Research (NIVEL), P.O. Box 1568, 3500 BN Utrecht, The Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands; Department of Methodology and Applied Biostatistics, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Evelien R Spelten
- Department of Midwifery Science, Midwifery Academy Amsterdam Groningen (AVAG), Amsterdam Public Health Research Institute, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands; Department of Public Health, Rural Health School, La Trobe University, Melbourne, VIC 3086, Australia
| | - Johannes Brug
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Eileen K Hutton
- Department of Midwifery Science, Midwifery Academy Amsterdam Groningen (AVAG), Amsterdam Public Health Research Institute, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands; Department of Obstetrics and Gynecology, McMaster University, 1280 Main Street West, MDCL 2210, Hamilton, ON, Canada L8S 4K1
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Hjertholm KG, Iversen PO, Holmboe-Ottesen G, Mdala I, Munthali A, Maleta K, Shi Z, Ferguson E, Kamudoni P. Maternal dietary intake during pregnancy and its association to birth size in rural Malawi: A cross-sectional study. MATERNAL AND CHILD NUTRITION 2017; 14. [PMID: 28217860 DOI: 10.1111/mcn.12433] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 12/20/2016] [Accepted: 01/10/2017] [Indexed: 11/28/2022]
Abstract
In low-resource settings, such as rural Malawi, pregnant women are prone to energy and micronutrient deficiencies with the consequence of delivering low-birth weight infants with higher risks of morbidity and mortality. This study aimed to examine the association between maternal dietary intakes during pregnancy and infant birth size. Dietary intakes of 203 pregnant women were assessed between 28 and 35 weeks of gestation and their infants' (n = 132) birth size measured. Intakes of energy, macronutrients, and 11 micronutrients were estimated using a 3-day interactive 24-hr diet recall. Semiquantitative data on food intakes for four additional days were also collected to assess food patterns. Using multilevel linear regression modeling, maternal intakes of carbohydrate were negatively associated with neonate length (β: -0.1; 95% CI: -0.2, 0.0 cm/E%) and abdominal circumference (β: -0.1, 95% CI: -0.2, 0.0 cm/E%), whereas intakes of fat were positively associated with neonate length (β: 0.1; 95% CI: 0.0, 0.2 cm/E%) and abdominal circumference (β: 0.1; 95% CI: 0.0, 0.2 cm/E%). Vitamin C intakes were positively associated with birth weight (β: 1.4; 95% CI: 0.5, 2.3 g/mg). The frequency of milk intake was positively associated with birth weight (β: 75.3; 95% CI: 13.6, 137.0 g/day). These findings offer practical suggestions for food-based interventions in the study area to promote inclusion of fat, vitamin C-rich foods, and milk in pregnancy.
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Affiliation(s)
- Katrine G Hjertholm
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Per Ole Iversen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Gerd Holmboe-Ottesen
- Department of Community Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ibrahimu Mdala
- Department of Community Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Alister Munthali
- School of Public Health and Family Medicine, University of Malawi, Zomba, Malawi
| | - Kenneth Maleta
- School of Public Health and Family Medicine, University of Malawi, Zomba, Malawi
| | - Zumin Shi
- Discipline of Medicine, School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Elaine Ferguson
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Penjani Kamudoni
- Department of Community Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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Dhobale M. Neurotrophic Factors and Maternal Nutrition During Pregnancy. VITAMINS AND HORMONES 2017; 104:343-366. [DOI: 10.1016/bs.vh.2016.10.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Effect of a diet intervention during pregnancy on dietary behavior in the randomized controlled Norwegian Fit for Delivery study. J Dev Orig Health Dis 2016; 7:538-547. [PMID: 27307037 DOI: 10.1017/s2040174416000258] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A mother's diet during pregnancy has the potential to influence both her own and her child's short- and long-term health. This paper reports the effects of a randomized controlled diet intervention during pregnancy on dietary behavior post-intervention as reported in late pregnancy. The diet intervention was part of a lifestyle intervention targeting both diet and physical activity behaviors among nulliparous women participating in the randomized controlled Norwegian Fit for Delivery study (NFFD). Eligible women were enrolled in early pregnancy from eight healthcare clinics in southern Norway between 2009 and 2013. The diet intervention was based on 10 dietary recommendations that were conveyed during two counseling sessions by phone and in a pamphlet describing the recommendations and their simplified rationale. A diet score was constructed from a 43-item food frequency questionnaire (FFQ) and used to assess intervention effect on dietary behavior (score range 0-10). Between-group dietary differences post-intervention were estimated with analysis of covariance, with adjustment for baseline diet. A total of 508 women completed the FFQ both at baseline and post-intervention. There were no between-group differences in diet score and subscales at baseline. Post-intervention, the intervention group had higher overall diet score (control: 4.61, intervention: 5.04, P=0.013) and favorable dietary behavior in seven of the 10 dietary domains: 'consumption of water relative to total beverage consumption' (P=0.002), 'having vegetables with dinner' (P=0.027), 'choosing fruits and vegetables for between-meal snacks' (P=0.023), 'buying small portion sizes of unhealthy foods' (P=0.010), 'limiting sugar intake' (P=0.005), 'avoiding eating beyond satiety' (P=0.009) and 'reading food labels' (P=0.011). The NFFD diet intervention improved dietary behavior. Potential long-term clinical influence in mother and child will be investigated in further studies.
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Diet quality before or during pregnancy and the relationship with pregnancy and birth outcomes: the Australian Longitudinal Study on Women's Health. Public Health Nutr 2016; 19:2975-2983. [PMID: 27238757 DOI: 10.1017/s1368980016001245] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To assess whether diet quality before or during pregnancy predicts adverse pregnancy and birth outcomes in a sample of Australian women. DESIGN The Dietary Questionnaire for Epidemiological Studies was used to calculate diet quality using the Australian Recommended Food Score (ARFS) methodology modified for pregnancy. SETTING A population-based cohort participating in the Australian Longitudinal Study on Women's Health (ALSWH). SUBJECTS A national sample of Australian women, aged 20-25 and 31-36 years, who were classified as preconception or pregnant when completing Survey 3 or Survey 5 of the ALSWH, respectively. The 1907 women with biologically plausible energy intake estimates were included in regression analyses of associations between preconception and pregnancy ARFS and subsequent pregnancy outcomes. RESULTS Preconception and pregnancy groups were combined as no significant differences were detected for total and component ARFS. Women with gestational hypertension, compared with those without, had lower scores for total ARFS, vegetable, fruit, grain and nuts/bean/soya components. Women with gestational diabetes had a higher score for the vegetable component only, and women who had a low-birth-weight infant had lower scores for total ARFS and the grain component, compared with those who did not report these outcomes. Women with the highest ARFS had the lowest odds of developing gestational hypertension (OR=0·4; 95 % CI 0·2, 0·7) or delivering a child of low birth weight (OR=0·4; 95 % CI 0·2, 0·9), which remained significant for gestational hypertension after adjustment for potential confounders. CONCLUSIONS A high-quality diet before and during pregnancy may reduce the risk of gestational hypertension for the mother.
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Macronutrient Balance and Dietary Glycemic Index in Pregnancy Predict Neonatal Body Composition. Nutrients 2016; 8:nu8050270. [PMID: 27164136 PMCID: PMC4882683 DOI: 10.3390/nu8050270] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/28/2016] [Accepted: 04/28/2016] [Indexed: 01/21/2023] Open
Abstract
The influence of maternal macronutrient balance and dietary glycemic index (GI) on neonatal body composition has received little study. We hypothesized that the overall quantity and quality of macronutrients, particularly carbohydrate, in the maternal diet could have trimester-specific effects on neonatal growth and body composition in women at risk of gestational diabetes. Maternal diet was assessed using 3-day food records in mid (n = 96) and late (n = 88) pregnancy as part of the GI Baby 3 study. Neonatal body composition was assessed by air-displacement plethysmography within 48 h of birth, adjusted for length, and expressed as fat mass index (FMI) and fat-free mass index (FFMI). In mid pregnancy, higher maternal intake of carbohydrate energy was negatively correlated with infant FFMI (p = 0.037). In late pregnancy, higher dietary GI was associated with lower FFMI (p = 0.010) and higher carbohydrate energy predicted lower FMI (p = 0.034). Higher fat intake (%E) and saturated fat, but not protein, also predicted neonatal body composition (higher FFMI in mid pregnancy and higher FMI in late pregnancy). Depending on pregnancy stage, a high carbohydrate-low fat diet, particularly from high glycemic sources, may reduce neonatal indices of both lean mass and adiposity.
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Bianchi CM, Mariotti F, Verger EO, Huneau JF. Pregnancy Requires Major Changes in the Quality of the Diet for Nutritional Adequacy: Simulations in the French and the United States Populations. PLoS One 2016; 11:e0149858. [PMID: 26959492 PMCID: PMC4784858 DOI: 10.1371/journal.pone.0149858] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 02/05/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Maternal nutrition is critical to the health of both mother and offspring, but there is a paucity of data on the nutritional adequacy of diets during pregnancy. OBJECTIVE Our objective was to identify to what extent pregnancy reduces the nutritional adequacy of the expecting mother's diet and if this nutritional gap can be resolved by simple quantitative or qualitative changes in the diet. MATERIALS AND METHODS We evaluated the observed overall nutritional adequacy of diets of French and American women of childbearing age participating in ENNS (n = 344) and NHANES (n = 563) using the probabilistic approach of the PANDiet system, resulting in a 100-point score. Then, we simulated the changes in the PANDiet scores of women of childbearing age who would remain on their diet during pregnancy. Finally, by either increasing the quantity of consumed foods or using eleven snacks recommended during pregnancy, we simulated the effect of a 150-kcal increase in the energy intake of French women. RESULTS Observed PANDiet scores were equal to 59.3 ± 7.0 and 58.8 ± 9.3 points respectively in France and in the US. Simulation of pregnancy for women of childbearing age led to a decrease in nutritional adequacy for key nutrients during pregnancy and resulted in reducing PANDiet scores by 3.3 ± 0.1 and 3.7 ± 0.1 points in France and in the US. Simulated 150-kcal increases in energy intake proved to be only partially effective in filling the gap both when the quantity of food consumed was increased and when recommended snacks were used. CONCLUSIONS The decrease in nutritional adequacy induced by pregnancy cannot be addressed by simply following generic dietary guidelines.
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Affiliation(s)
- Clélia M. Bianchi
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, 75005, Paris, France
| | - François Mariotti
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, 75005, Paris, France
| | - Eric O. Verger
- INSERM, UMR_S U1166, Nutriomics team, F-75013, Paris, France
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Publique des Hôpitaux de Paris, Pitié-Salpêtrière hospital, Nutrition department, F-75013, Paris, France
| | - Jean-François Huneau
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, 75005, Paris, France
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Chiavaroli V, Derraik JGB, Hofman PL, Cutfield WS. Born Large for Gestational Age: Bigger Is Not Always Better. J Pediatr 2016; 170:307-11. [PMID: 26707580 DOI: 10.1016/j.jpeds.2015.11.043] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 10/27/2015] [Accepted: 11/13/2015] [Indexed: 12/22/2022]
Affiliation(s)
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand.
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Geraghty AA, Lindsay KL, Alberdi G, McAuliffe FM, Gibney ER. Nutrition During Pregnancy Impacts Offspring's Epigenetic Status-Evidence from Human and Animal Studies. Nutr Metab Insights 2016; 8:41-7. [PMID: 26917970 PMCID: PMC4758803 DOI: 10.4137/nmi.s29527] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 01/19/2016] [Accepted: 01/21/2016] [Indexed: 12/14/2022] Open
Abstract
Pregnancy is a vital time of growth and development during which maternal nutrition significantly influences the future health of both mother and baby. During pregnancy, the fetus experiences a critical period of plasticity. Epigenetics, specifically DNA methylation, plays an important role here. As nutrition is influential for DNA methylation, this review aims to determine if maternal nutrition during pregnancy can modify the offspring's epigenome at birth. Research focuses on micronutrients and methyl donors such as folate and B vitamins. Evidence suggests that maternal nutrition does not largely influence global methylation patterns, particularly in nutrient-replete populations; however, an important impact on gene-specific methylation is observed. A link is shown between maternal nutrition and the methylome of the offspring; however, there remains a paucity of research. With the potential to use DNA methylation patterns at birth to predict health of the child in later life, it is vital that further research be carried out.
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Affiliation(s)
- Aisling A Geraghty
- Department of Obstetrics & Gynaecology, School of Medicine and Medical Science, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - Karen L Lindsay
- Department of Obstetrics & Gynaecology, School of Medicine and Medical Science, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - Goiuri Alberdi
- Department of Obstetrics & Gynaecology, School of Medicine and Medical Science, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - Fionnuala M McAuliffe
- Department of Obstetrics & Gynaecology, School of Medicine and Medical Science, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - Eileen R Gibney
- UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
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Leermakers ETM, Tielemans MJ, van den Broek M, Jaddoe VWV, Franco OH, Kiefte-de Jong JC. Maternal dietary patterns during pregnancy and offspring cardiometabolic health at age 6 years: The generation R study. Clin Nutr 2016; 36:477-484. [PMID: 26907582 DOI: 10.1016/j.clnu.2015.12.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 12/23/2015] [Accepted: 12/28/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND & AIMS Maternal nutrition during pregnancy might be important in influencing offspring cardiometabolic health. However, research has focused mostly on specific nutrients or total energy, and possible effects of whole diet are unclear. We aimed to assess the associations between different dietary patterns during pregnancy and offspring cardiometabolic health among 2592 mother-child pairs from Generation R, a prospective population-based cohort study from fetal life onwards in Rotterdam, the Netherlands. METHODS Maternal diet was assessed in early pregnancy with a food-frequency questionnaire. We identified three a posteriori-dietary patterns, namely a 'Vegetable, fish and oil', 'Nuts, soy and high-fiber cereals' and 'Margarine, snacks and sugar'-pattern. An a priori-pattern was created based on the 'Dutch Healthy Diet Index'. Cardiometabolic health (pulse wave velocity, blood pressure, insulin, HDL-cholesterol and triglycerides) was measured at the child's age of 6 years. RESULTS In the crude models, the 'Vegetable, fish and oil', 'Nuts, soy and high-fiber cereals' and 'Dutch Healthy Diet Index' seemed beneficial, as higher adherence to these patterns was significantly associated with lower blood pressure and lower pulse wave velocity. After adjustment for other socio-demographic and lifestyle factors, most associations disappeared, except for lower pulse wave velocity with the 'Vegetable, fish and oil'-dietary pattern (-0.19 SD (95% CI -0.33; -0.06), highest quartile of adherence vs. lowest quartile). No associations were found between maternal dietary patterns and offspring blood lipids or insulin levels. CONCLUSIONS Our results suggest that there are no consistent independent associations of maternal dietary patterns with offspring cardiometabolic health at 6 years.
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Affiliation(s)
- Elisabeth T M Leermakers
- Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands; The Generation R Study Group, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Myrte J Tielemans
- Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands; The Generation R Study Group, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Marion van den Broek
- Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands; The Generation R Study Group, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands; Department of Pediatrics, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands; Leiden University College, The Hague, The Netherlands
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Tielemans MJ, Garcia AH, Peralta Santos A, Bramer WM, Luksa N, Luvizotto MJ, Moreira E, Topi G, de Jonge EAL, Visser TL, Voortman T, Felix JF, Steegers EAP, Kiefte-de Jong JC, Franco OH. Macronutrient composition and gestational weight gain: a systematic review. Am J Clin Nutr 2016; 103:83-99. [PMID: 26675773 DOI: 10.3945/ajcn.115.110742] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 10/16/2015] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Abnormal gestational weight gain is associated with unfavorable pregnancy outcomes. Several risk factors have been identified, but the effect of macronutrient intake during pregnancy on gestational weight gain has not been systematically evaluated in both high-income countries and low- and middle-income countries. OBJECTIVE We conducted a systematic review of the literature in 8 different databases (until 12 August 2015) to assess whether energy intake and macronutrient intake (i.e., protein, fat, and carbohydrate) during pregnancy were associated with gestational weight gain (following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines). RESULTS Of 7623 identified references, we included 56 articles (46 observational studies and 10 trials, 28 of which were in high-income countries and 28 of which were in low- and middle-income countries). Eleven of the included articles were of high quality (20%). Results of 5 intervention and 7 high-quality observational studies suggested that higher energy intake during pregnancy is associated with higher gestational weight gain (n = 52). Results from observational studies were inconsistent for protein intake (n = 29) and carbohydrate intake (n = 18). Maternal fat intake (n = 25) might be associated with gestational weight gain as suggested by observational studies, although the direction of this association might depend on specific types of fat (e.g., saturated fat). Macronutrient intake was not consistently associated with the prevalence of inadequate or excessive gestational weight gain. Associations were comparable for high-income countries and low- and middle-income countries. CONCLUSIONS The current literature provides evidence that energy intake is associated with gestational weight gain, but the roles of individual macronutrients are inconsistent. However, there is a need for higher-quality research because the majority of these studies were of low quality.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Pediatrics, Erasmus Medical Center, University Medical Center, Rotterdam, Netherlands; and Department of Global Public Health, Leiden University College the Hague, The Hague, Netherlands
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Walz H, Bohn B, Sander J, Eberle C, Alisch M, Oswald B, Kroke A. Access to Difficult-to-reach Population Subgroups: A Family Midwife Based Home Visiting Service for Implementing Nutrition-related Preventive Activities - A Mixed Methods Explorative Study. AIMS Public Health 2015; 2:516-536. [PMID: 29546123 PMCID: PMC5690248 DOI: 10.3934/publichealth.2015.3.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 08/10/2015] [Indexed: 11/18/2022] Open
Abstract
Health and social inequality are tightly linked and still pose an important public health problem. However, vulnerable and disadvantaged populations are difficult to reach for health-related interventions. Given the long-lasting effects of an adverse, particular nutrition-related, intrauterine and neonatal environment on health development (perinatal programming), an early and easy access is essential for sustainable interventions. The goal of this explorative study was therefore to elucidate whether an existing access of family midwives (FMs) to families in need of support could be an option to implement effective public health and nutrition interventions. To that end three research objectives were formulated: (1) to determine whether a discernible impact of home visits by FMs can be described; (2) to identify subgroups among these families in need of more specific interventions; (3) to determine how relevant nutrition-related topics are for both FMs and the supported families. For addressing these objectives a mixed methods design was used: Routine documentation data from 295 families visited by a family midwife (FM) were analyzed (secondary analysis), and structured expert interviews with FMs were conducted and analyzed. Study reporting followed the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) statement. Based on the FMs reports, a significant improvement (p < 0.001) regarding psycho-social variables could be determined after the home visits. Single mothers, however, seemed to benefit less from the FMs service compared to their counterparts (p = 0.015). Nutritional counseling was demanded by 89% of the families during the home visits. In addition, nutrition-related topics were reported in the interviews to be of high interest to both families and the FMs. Based on the obtained results it is concluded that FMs home visits offer a promising access to vulnerable and disadvantaged families for implementing nutrition-related preventive activities.
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Affiliation(s)
- Helena Walz
- Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Fulda, Germany
| | - Barbara Bohn
- formerly: Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Fulda, Germany; currently: University of Ulm, Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm, Germany
| | - Jessica Sander
- Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Fulda, Germany
| | - Claudia Eberle
- Fulda University of Applied Sciences, Department of Nursing and Health Sciences, Fulda, Germany
| | - Monika Alisch
- Fulda University of Applied Sciences, Department of Social Work, Fulda, Germany
| | - Bernhard Oswald
- Youth Welfare Office, Quality Management / Early Prevention, Fulda, Germany
| | - Anja Kroke
- Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Fulda, Germany
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Sharma SR, Giri S, Timalsina U, Bhandari SS, Basyal B, Wagle K, Shrestha L. Low birth weight at term and its determinants in a tertiary hospital of Nepal: a case-control study. PLoS One 2015; 10:e0123962. [PMID: 25853813 PMCID: PMC4390309 DOI: 10.1371/journal.pone.0123962] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Accepted: 03/09/2015] [Indexed: 11/21/2022] Open
Abstract
Birth weight of a child is an important indicator of its vulnerability for childhood illness and chances of survival. A large number of infant deaths can be averted by appropriate management of low birth weight babies and prevention of factors associated with low birth weight. The prevalence of low birth weight babies in Nepal is estimated to be about 12-32%.Our study aimed at identifying major determinants of low birth weight among term babies in Nepal. A hospital-based retrospective case control study was conducted in maternity ward of Tribhuvan University Teaching Hospital from February to July 2011. A total of 155 LBW babies and 310 controls were included in the study. Mothers admitted to maternity ward during the study period were interviewed, medical records were assessed and anthropometric measurements were done. Risk factors, broadly classified into proximal and distal factors, were assessed for any association with birth of low-birth weight babies. Regression analysis revealed that a history of premature delivery (adjusted odds ratio; aOR5.24, CI 1.05-26.28), hard physical work during pregnancy (aOR1.48, CI 0.97-2.26), younger age of mother (aOR1.98, CI 1.15-3.41), mothers with haemoglobin level less than 11gm/dl (aOR0.51, CI0.24-1.07) and lack of consumption of nutritious food during pregnancy (aOR1.99, CI 1.28-3.10) were significantly associated with the birth of LBW babies. These factors should be addressed with appropriate measures so as to decrease the prevalence of low birth weight among term babies in Nepal.
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Affiliation(s)
| | - Smith Giri
- The University of Tennessee Health Science Center, Memphis, United States of America
| | - Utsav Timalsina
- Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
| | | | - Bikash Basyal
- Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
| | | | - Laxman Shrestha
- Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
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Robinson S, Baird J, Godfrey KM. Eating for two? The unresolved question of optimal diet in pregnancy. Am J Clin Nutr 2014; 100:1220-1. [PMID: 25332319 PMCID: PMC4878703 DOI: 10.3945/ajcn.114.098293] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Siân Robinson
- From the MRC Lifecourse Epidemiology Unit, University of Southampton, and the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Janis Baird
- From the MRC Lifecourse Epidemiology Unit, University of Southampton, and the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Keith M Godfrey
- From the MRC Lifecourse Epidemiology Unit, University of Southampton, and the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
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