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Wang X, Lan Y, Li N, Gao J, Meng D, Miao S. Associations of education attainment with gestational diabetes mellitus and the mediating effects of obesity: A Mendelian randomization study. Heliyon 2024; 10:e29000. [PMID: 38601611 PMCID: PMC11004574 DOI: 10.1016/j.heliyon.2024.e29000] [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: 10/22/2023] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/12/2024] Open
Abstract
We aim to assess the causal association between educational attainment and gestational diabetes mellitus, and the mediating effect of obesity on this association. We estimated the causal effects of educational attainment on gestational diabetes mellitus using European ancestry genome-wide association study summary data with two-sample univariate Mendelian randomization (UVMR) approach. Two-stage Mendelian randomization analysis was performed to assess the potential mediating role of obesity traits in this association and to calculate the mediating proportion. UVMR analysis demonstrated that higher educational attainment was associated with a reduced risk of GDM (OR 0.76, 95% CI 0.67-0.86; p < 0.01). EA has also been associated with decreased obesity in women. Mediation Mendelian randomization results indicated that body mass index (BMI) was the most significant mediating factor in the relationship between educational attainment and GDM, accounting for 42.52% (95% CI 37.75-55.44%) of the effect, followed by waist-to-hip ratio (WHR) at 34.35% (95% CI 29.82-46.41%), body fat percentage at 28.95% (95% CI 35.99-46.81%), and WHR adjusted for BMI (WHRadjBMI) at 12.51% (95% CI 36.2-58.5%). educational attainment exerts a potential causal protective effect against gestational diabetes mellitus, and obesity-related risk factors play a mediating role. Attention should be paid to the educational attainment of women, and obese women with lower educational attainment may represent a higher risk group for GDM than those with higher educational attainment.
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Affiliation(s)
- Xiaoyan Wang
- Department of Clinical Nutrition, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan Province, China
| | - Ying Lan
- Department of Intensive Care Unit, Affiliated Hospital of Chengdu University &Clinical Medical College, Chengdu, Sichuan Province, China
| | - Na Li
- Department of Maternity, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan Province, China
| | - Jinfeng Gao
- Department of Clinical Nutrition, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan Province, China
| | - Dejiao Meng
- Department of Clinical Nutrition, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan Province, China
| | - Shuchuan Miao
- Department of Neurosurgery, Chengdu Seventh People's Hospital, Sichuan Province, China
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
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Xue H, Qin R, Xi Q, Xiao S, Chen Y, Liu Y, Xu B, Han X, Lv H, Hu H, Hu L, Jiang T, Jiang Y, Ding Y, Du J, Ma H, Lin Y, Hu Z. Maternal Dietary Cholesterol and Egg Intake during Pregnancy and Large-for-Gestational-Age Infants: A Prospective Cohort Study. J Nutr 2024:S0022-3166(24)00180-9. [PMID: 38599384 DOI: 10.1016/j.tjnut.2024.04.011] [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: 12/27/2023] [Revised: 03/25/2024] [Accepted: 04/05/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Cholesterol plays a vital role in fetal growth and development during pregnancy. There remains controversy over whether pregnant females should limit their cholesterol intake. OBJECTIVES The objective of this study was to investigate the association between maternal dietary cholesterol intake during pregnancy and infant birth weight in a Chinese prospective cohort study. METHODS A total of 4146 mother-child pairs were included based on the Jiangsu Birth Cohort study. Maternal dietary information was assessed with a semiquantitative food-frequency questionnaire. Birth weight z-scores and large-for-gestational-age (LGA) infants were converted by the INTERGROWTH-21st neonatal weight-for-gestational-age standard. Poisson regression and generalized estimating equations were employed to examine the relationships between LGA and maternal dietary cholesterol across the entire pregnancy and trimester-specific cholesterol intake, respectively. RESULTS The median intake of maternal total dietary cholesterol during the entire pregnancy was 671.06 mg/d, with eggs being the main source. Maternal total dietary cholesterol and egg-sourced cholesterol were associated with an increase in birth weight z-score, with per standard deviation increase in maternal total and egg-sourced dietary cholesterol being associated with an increase of 0.16 [95% confidence interval (CI): 0.07, 0.25] and 0.06 (95% CI: 0.03, 0.09) in birth weight z-score, respectively. Egg-derived cholesterol intake in the first and third trimesters was positively linked to LGA, with an adjusted relative risk of 1.11 (95% CI: 1.04, 1.18) and 1.09 (95% CI: 1.00, 1.18). Compared with mothers consuming ≤7 eggs/wk in the third trimester, the adjusted relative risk for having an LGA newborn was 1.37 (95% CI: 1.09, 1.72) for consuming 8-10 eggs/wk and 1.45 (95% CI: 1.12, 1.86) for consuming >10 eggs/wk (P-trend = 0.015). CONCLUSIONS Maternal total dietary cholesterol intake, as well as consuming over 7 eggs/wk during pregnancy, displayed significant positive relationships with the incidence of LGA, suggesting that mothers should avoid excessive cholesterol intake during pregnancy to prevent adverse birth outcomes.
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Affiliation(s)
- Huixin Xue
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Rui Qin
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Scientific Research and Education, Changzhou Medical Center, Changzhou Maternity and Child Health Care Hospital, Nanjing Medical University, Changzhou, Jiangsu, China
| | - Qi Xi
- Department of Obstetrics, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Shuxin Xiao
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Maternal, Child, and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yiyuan Chen
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuxin Liu
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Bo Xu
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiumei Han
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hong Lv
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine and Offspring Health (Suzhou Centre), Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Haiting Hu
- Department of Scientific Research and Education, Changzhou Medical Center, Changzhou Maternity and Child Health Care Hospital, Nanjing Medical University, Changzhou, Jiangsu, China
| | - Lingmin Hu
- Department of Reproduction, Changzhou Medical Center, Changzhou Maternity and Child Health Care Hospital, Nanjing Medical University, Changzhou, Jiangsu, China
| | - Tao Jiang
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yangqian Jiang
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Maternal, Child, and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ye Ding
- Department of Maternal, Child, and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jiangbo Du
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine and Offspring Health (Suzhou Centre), Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Hongxia Ma
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine and Offspring Health (Suzhou Centre), Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Yuan Lin
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Maternal, Child, and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine and Offspring Health (Suzhou Centre), Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, China.
| | - Zhibin Hu
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine and Offspring Health (Suzhou Centre), Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, China.
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Scheele J, Smith SM, Wahab RJ, Bais B, Steegers-Theunissen RPM, Gaillard R, Harmsen van der Vliet-Torij HW. Current preconception care practice in the Netherlands - An evaluation study among birth care professionals. Midwifery 2023; 127:103855. [PMID: 37890235 DOI: 10.1016/j.midw.2023.103855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVE To evaluate the current practice of preconception care in the Netherlands and the perceptions of birth care professionals concerning preconception care. METHODS We have developed a digital questionnaire and conducted a cross-sectional study by distributing the questionnaire among 102 organisations: 90 primary care midwifery practices and obstetric departments of 12 hospitals in the Southwest region of the Netherlands between December 2020 and March 2021. One birth care professional per organization was asked to complete the questionnaire. Descriptive statistics were used to present the results. FINDINGS Respondents of eighty-three organisations (81.4 %) filled in the questionnaire, of whom 74 respondents were independent primary care midwives and 9 respondents were obstetricians. Preconception care mostly consisted of an individual consultation in which personalized health and lifestyle advice was given. Among the respondents, 44.4 % reported that the organization had a preconception care protocol. The way in which the consultation was carried out, as well as the health and lifestyle related questions asked, differed between respondents. More than 85 % of the respondents inquire about the following possible risk factors for complications: maternal illnesses, obstetric history, folic acid supplement intake, alcohol intake, smoking, substance abuse, hereditary disease, prescription medication, dietary habits, overweight, and birth defects in the family. The respondents acknowledged that preconception care should be offered to all couples who wish to become pregnant, as opposed to offering preconception care only to those with an increased risk of complications. Still, respondents do not receive many questions regarding the preconception period or requests for preconception care consultations. KEY CONCLUSION Birth care professionals acknowledge the need for preconception care for all couples. In the Netherlands, preconception care consists mostly of an individual consultation with recommendations for health and lifestyle advice. However, the identification of risk factors varies between birth care professionals and less than half of the respondents indicate that they have a protocol available in their practice. Furthermore, the demand of parents-to-be for preconception care is low. More research, that includes more obstetricians, is necessary to investigate if there is a difference between the care provided by primary care midwives and obstetricians. IMPLICATIONS FOR PRACTICE To increase the awareness and uptake of preconception care, it would be prudent to emphasize its importance to parents-to-be and professionals, and actively promote the use of widespread, standardized protocols for birth care professionals.
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Affiliation(s)
- J Scheele
- Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK Rotterdam, the Netherlands.
| | - S M Smith
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam the Netherlands
| | - R J Wahab
- The Generation R Study Group, Erasmus MC, University Medical Center, 3000 CA Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center, 3000 CA Rotterdam, the Netherlands
| | - B Bais
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam the Netherlands
| | - R P M Steegers-Theunissen
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam the Netherlands
| | - R Gaillard
- The Generation R Study Group, Erasmus MC, University Medical Center, 3000 CA Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center, 3000 CA Rotterdam, the Netherlands
| | - H W Harmsen van der Vliet-Torij
- Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK Rotterdam, the Netherlands; Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam the Netherlands
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Harmancıoğlu B, Kabaran S. Maternal high fat diets: impacts on offspring obesity and epigenetic hypothalamic programming. Front Genet 2023; 14:1158089. [PMID: 37252665 PMCID: PMC10211392 DOI: 10.3389/fgene.2023.1158089] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/04/2023] [Indexed: 05/31/2023] Open
Abstract
Maternal high-fat diet (HFD) during pregnancy is associated with rapid weight gain and fetal fat mass increase at an early stage. Also, HFD during pregnancy can cause the activation of proinflammatory cytokines. Maternal insulin resistance and inflammation lead to increased adipose tissue lipolysis, and also increased free fatty acid (FFA) intake during pregnancy (˃35% of energy from fat) cause a significant increase in FFA levels in the fetus. However, both maternal insulin resistance and HFD have detrimental effects on adiposity in early life. As a result of these metabolic alterations, excess fetal lipid exposure may affect fetal growth and development. On the other hand, increase in blood lipids and inflammation can adversely affect the development of the liver, adipose tissue, brain, skeletal muscle, and pancreas in the fetus, increasing the risk for metabolic disorders. In addition, maternal HFD is associated with changes in the hypothalamic regulation of body weight and energy homeostasis by altering the expression of the leptin receptor, POMC, and neuropeptide Y in the offspring, as well as altering methylation and gene expression of dopamine and opioid-related genes which cause changes in eating behavior. All these maternal metabolic and epigenetic changes may contribute to the childhood obesity epidemic through fetal metabolic programming. Dietary interventions, such as limiting dietary fat intake <35% with appropriate fatty acid intake during the gestation period are the most effective type of intervention to improve the maternal metabolic environment during pregnancy. Appropriate nutritional intake during pregnancy should be the principal goal in reducing the risks of obesity and metabolic disorders.
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Song X, Wang C, Wang T, Zhang S, Qin J. Obesity and risk of gestational diabetes mellitus: A two-sample Mendelian randomization study. Diabetes Res Clin Pract 2023; 197:110561. [PMID: 36738839 DOI: 10.1016/j.diabres.2023.110561] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 12/29/2022] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
AIMS To estimate genetically predicted causal associations of general and central obesity with GDM, and to determine the mediating role of circulating lipids. METHODS Summary-level data was obtained from the largest available genome-wide association studies of five obesity traits, five lipid traits and GDM. Two-sample univariate Mendelian randomization (MR), multivariate MR, and MR-based mediation analysis was applied to determine the total effect, direct effect and the mediating effect, respectively. RESULTS Univariate MR showed that the odds of GDM increased per 1-SD increase in body mass index (BMI) (OR = 1.64, P = 5.05 × 10-17), waist-to-hip ratio (WHR) (OR = 1.57, P = 2.27 × 10-14) and WHR adjusted for BMI (OR = 1.42, P = 6.11 × 10-15). The heterogeneous associations of waist circumference (OR = 1.64, P = 5.57 × 10-14) and hip circumference (OR = 1.20, P = 0.002) on GDM further reflected that body fat distribution could influence GDM risk. Mediation analysis suggested that triglycerides, high-density lipoprotein-cholesterol and apolipoprotein A-I each mediated between 5% and 10% of the association between obesity and GDM. CONCLUSION Our findings supported a deleterious causal effect of obesity on GDM risk, where lipid metabolism acted as potential drivers of the relationships between both general and central obesity and GDM.
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Affiliation(s)
- Xinli Song
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Cheng Wang
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Tingting Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Senmao Zhang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Jiabi Qin
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China; National Health Committee Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China; Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China; Hunan Provincial Key Laboratory of clinical epidemiology, Changsha, Hunan, China.
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6
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Shin J, Kwon Y, Kim JH, Jeong SJ. Association between maternal weight gain during pregnancy and child's body mass index at preschool age. Clin Exp Pediatr 2023; 66:76-81. [PMID: 36470280 PMCID: PMC9899551 DOI: 10.3345/cep.2022.01158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/28/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Recent studies reported that prepregnancy body mass index (BMI) and weight gain during pregnancy affect birth weight and contribute to childhood obesity. However, no such data are available in Korea. PURPOSE This study gathered data on weight gain during pregnancy and its impact on birth weight and childhood obesity in Korea. METHODS We reviewed 1,753 singleton full-term babies born at CHA Bundang Medical Center in 2014-2016. We first review each maternal and baby factor based on prepregnancy BMI (underweight, normal, overweight/obese) and then divided them into low, normal, and excess gestational weight gain (GWG) groups based on the American Institute of Medicine (IOM) guidelines. We reviewed the characteristics of each group and analyzed the association between maternal GWG based on IOM guidelines and child BMI after 6 years. RESULTS The maternal prepregnancy BMI group showed a significant difference in birth weight and child BMI at 6 years. As the prepregnancy BMI increased, the birth weight and BMI at 6 years also increased (P<0.001). Mean birth weight and child BMI at 6 years differed significantly among the GWG groups. Furthermore, excess postpartum weight gain increased the risk of childhood overweight and obesity (odds ratio, 2.21; 95% confidence interval, 1.40-3.49). CONCLUSION Excess weight gain during pregnancy should be avoided due to its short- and long-term association with childhood obesity. Owing to the high prevalence of excess GWG and childhood obesity, excess weight gain during pregnancy can have significant public health implications.
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Affiliation(s)
- Jeewon Shin
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Yoowon Kwon
- Department of Pediatrics, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Ju Hee Kim
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Su Jin Jeong
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
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Fetal Risks and Morbidity in Pregnant Individuals with Obesity. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2023. [DOI: 10.1007/s13669-023-00347-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Allman BR, McDonald S, May L, Børsheim E. Resistance Training as a Countermeasure in Women with Gestational Diabetes Mellitus: A Review of Current Literature and Future Directions. Sports Med 2022; 52:2871-2888. [PMID: 35810251 PMCID: PMC10043826 DOI: 10.1007/s40279-022-01724-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2022] [Indexed: 10/17/2022]
Abstract
Gestational diabetes mellitus (GDM) poses a significant health concern for both mother and offspring. Exercise has emerged as a cornerstone of glycemic management in GDM. However, most research regarding this topic examines aerobic training (AT), despite substantial evidence for the effectiveness of resistance training (RT) in improving dysregulated glucose in other groups of people with diabetes, such as in type 2 diabetes mellitus (T2DM). Thus, the purpose of this paper is to review research that examined the impact of RT on markers of glucose management in GDM, and to discuss future research directions to determine the benefits of RT in GDM. Based on the current evidence, RT is effective in reducing insulin requirement, especially in overweight women, reducing fasting glucose concentrations, and improving short-term postprandial glycemic control. However, the number of studies and findings limit conclusions about the impact of RT on risk of GDM, fasting insulin concentrations, insulin resistance, β-cell function, and intra-exercise glucose management. Overall, current evidence is accumulating to suggest that RT is a promising non-pharmacological tool to regulate circulating glucose concentrations in women with GDM, and a potential alternative or supplement to AT.
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Affiliation(s)
- Brittany R Allman
- Arkansas Children's Nutrition Center, Little Rock, AR, USA.
- Arkansas Children's Research Institute, Little Rock, AR, USA.
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Samantha McDonald
- School of Kinesiology and Recreation, Illinois State University, Normal, IL, USA
| | - Linda May
- Department of Obstetrics and Gynecology, East Carolina University (ECU), Greenville, NC, USA
- Department of Kinesiology, ECU, Greenville, NC, USA
- Department of Foundational Sciences and Research, ECU, Greenville, NC, USA
| | - Elisabet Børsheim
- Arkansas Children's Nutrition Center, Little Rock, AR, USA
- Arkansas Children's Research Institute, Little Rock, AR, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Departments of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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9
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Lean SC, Candia AA, Gulacsi E, Lee GCL, Sferruzzi-Perri AN. Obesogenic diet in mice compromises maternal metabolic physiology and lactation ability leading to reductions in neonatal viability. Acta Physiol (Oxf) 2022; 236:e13861. [PMID: 35880402 PMCID: PMC9787084 DOI: 10.1111/apha.13861] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/12/2022] [Accepted: 07/20/2022] [Indexed: 01/29/2023]
Abstract
AIMS Diets containing high-fat and high sugar (HFHS) lead to overweight/obesity. Overweight/obesity increases the risk of infertility, and of the pregnant mother and her child for developing metabolic conditions. Overweight/obesity has been recreated in mice, but most studies focus on the effects of chronic, long-term HFHS diet exposure. Here, we exposed mice to HFHS from 3 weeks prior to pregnancy with the aim of determining impacts on fertility, and gestational and neonatal outcomes. METHODS Time-domain NMR scanning was used to assess adiposity, glucose, and insulin tolerance tests were employed to examine metabolic physiology, and morphological and proteomic analyses conducted to assess structure and nutrient levels of maternal organs and placenta. RESULTS Fertility measures of HFHS dams were largely the same as controls. HFHS dams had increased adiposity pre-pregnancy, however, exhibited exacerbated lipolysis/hyper-mobilization of adipose stores in late pregnancy. While there were no differences in glucose or insulin tolerance, HFHS dams were hyperglycemic and hyperinsulinemic in pregnancy. HFHS dams had fatty livers and altered pancreatic islet morphology. Although fetuses were hyperglycemic and hyperinsulinemic, there was no change in fetal growth in HFHS dams. There were also reductions in placenta formation. Moreover, there was increased offspring loss during lactation, which was related to aberrant mammary gland development and milk protein composition in HFHS dams. CONCLUSIONS These findings are relevant given current dietary habits and the development of maternal and offspring alterations in the absence of an increase in maternal weight and adiposity during pregnancy, which are the current clinical markers to determine risk across gestation.
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Affiliation(s)
- Samantha C Lean
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Alejandro A Candia
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK.,Department for the Woman and Newborn Health Promotion, Universidad de Chile, Santiago, Chile
| | - Edina Gulacsi
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Giselle C L Lee
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Amanda N Sferruzzi-Perri
- Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
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Kondracki AJ, Valente MJ, Ibrahimou B, Bursac Z. Risk of large for gestational age births at early, full and late term in relation to pre-pregnancy body mass index: Mediation by gestational diabetes status. Paediatr Perinat Epidemiol 2022; 36:566-576. [PMID: 34755381 DOI: 10.1111/ppe.12809] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Maternal pre-pregnancy body mass index (BMI) is strongly associated with infant birthweight and the risk differs in pregnancies complicated by gestational diabetes (GDM). OBJECTIVES To examine the risk of large for gestational age (LGA) (≥97th percentile) singleton births at early term, full term and late term in relation to maternal pre-pregnancy BMI status mediated through GDM. METHODS We analysed data from the 2018 U.S. National Vital Statistics Natality File restricted to singleton term births (N = 3,229,783). In counterfactual models for causal inference, we estimated the total effect (TE), natural direct effect (NDE) and natural indirect effect (NIE) for the association of pre-pregnancy BMI with subcategories of LGA births at early, full and late term mediated through GDM, using log-binomial regression and adjusting for race/ethnicity, age, education, parity and infant sex. Proportion mediated was calculated on the risk difference scale and potential unmeasured confounders were assessed using the E-value. RESULTS Overall, 6.4% of women had GDM, and there were 3.6% LGA singleton term births. The highest prevalence of GDM was among pre-gestational overweight/obesity that also had the highest rates of LGA births at term. The TE estimates for the risk of LGA births were the strongest across women with higher pre-pregnancy BMI compared to women with normal pre-pregnancy BMI. The NDE estimates were higher than the NIE estimates for overweight/obese BMI status. The proportion mediated, which answers the causal question to what extent the total effect of the association between pre-pregnancy BMI and LGA births is accounted for through GDM, was the highest (up to 16%) for early term births. CONCLUSIONS Term singleton births make up the largest proportion in a cohort of newborns. While the percentage mediated through GDM was relatively small, health risks arising from pre-pregnancy overweight, and obesity can be substantial to both mothers and their offspring.
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Affiliation(s)
- Anthony J Kondracki
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work Florida, International University, Miami, FL, USA
| | - Matthew J Valente
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Boubakari Ibrahimou
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work Florida, International University, Miami, FL, USA
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work Florida, International University, Miami, FL, USA
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Song X, Shu J, Zhang S, Chen L, Diao J, Li J, Li Y, Wei J, Liu Y, Sun M, Wang T, Qin J. Pre-Pregnancy Body Mass Index and Risk of Macrosomia and Large for Gestational Age Births with Gestational Diabetes Mellitus as a Mediator: A Prospective Cohort Study in Central China. Nutrients 2022; 14:nu14051072. [PMID: 35268050 PMCID: PMC8912482 DOI: 10.3390/nu14051072] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/25/2022] [Accepted: 03/02/2022] [Indexed: 02/07/2023] Open
Abstract
This study aimed to examine the risk of macrosomia and large for gestational age (LGA) births in relation to maternal pre-pregnancy body mass index (BMI) status mediated through gestational diabetes mellitus (GDM). This prospective study included 34,104 singleton pregnancies at 8–14 weeks of gestation. The interesting outcomes were macrosomia (≥4000 g) and LGA (≥90th percentile). Mediation analyses were conducted using log-binomial regression adjusted for age, education, parity, fetal sex, and gestational weight gain. The proportion mediated was estimated based on the risk difference scale, and the E-value was utilized to assess potential confounders. Overall, 15.9% of women had GDM, and there were 4.0% macrosomia and 9.9% LGA births. The proportion mediated by GDM on macrosomia was up to 40% among obese women, and the estimate of the total effect was 6.18 (95% CI: 5.26–7.26), of the natural direct effect was 4.10 (95% CI: 3.35–4.99), and of the natural indirect effect was 1.51 (95% CI: 1.31–1.76). Likewise, among overweight women, the proportion mediated by GDM on macrosomia was up to 40%. Furthermore, consistent findings were evident for the outcome of LGA births. Pre-pregnancy overweight/obesity increased the risk of macrosomia and LGA births independently and partly mediated by GDM.
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Affiliation(s)
- Xinli Song
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (X.S.); (J.S.); (S.Z.); (L.C.); (J.D.); (J.L.); (Y.L.); (J.W.); (Y.L.); (M.S.)
| | - Jing Shu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (X.S.); (J.S.); (S.Z.); (L.C.); (J.D.); (J.L.); (Y.L.); (J.W.); (Y.L.); (M.S.)
| | - Senmao Zhang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (X.S.); (J.S.); (S.Z.); (L.C.); (J.D.); (J.L.); (Y.L.); (J.W.); (Y.L.); (M.S.)
| | - Letao Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (X.S.); (J.S.); (S.Z.); (L.C.); (J.D.); (J.L.); (Y.L.); (J.W.); (Y.L.); (M.S.)
| | - Jingyi Diao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (X.S.); (J.S.); (S.Z.); (L.C.); (J.D.); (J.L.); (Y.L.); (J.W.); (Y.L.); (M.S.)
| | - Jinqi Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (X.S.); (J.S.); (S.Z.); (L.C.); (J.D.); (J.L.); (Y.L.); (J.W.); (Y.L.); (M.S.)
| | - Yihuan Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (X.S.); (J.S.); (S.Z.); (L.C.); (J.D.); (J.L.); (Y.L.); (J.W.); (Y.L.); (M.S.)
| | - Jianhui Wei
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (X.S.); (J.S.); (S.Z.); (L.C.); (J.D.); (J.L.); (Y.L.); (J.W.); (Y.L.); (M.S.)
| | - Yiping Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (X.S.); (J.S.); (S.Z.); (L.C.); (J.D.); (J.L.); (Y.L.); (J.W.); (Y.L.); (M.S.)
| | - Mengting Sun
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (X.S.); (J.S.); (S.Z.); (L.C.); (J.D.); (J.L.); (Y.L.); (J.W.); (Y.L.); (M.S.)
| | - Tingting Wang
- National Health Committee Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, 52 Xiangchun Road, Changsha 410028, China
- Correspondence: (T.W.); (J.Q.); Tel.: +86-15273188582 (T.W.); +86-15974269544 (J.Q.)
| | - Jiabi Qin
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha 410078, China; (X.S.); (J.S.); (S.Z.); (L.C.); (J.D.); (J.L.); (Y.L.); (J.W.); (Y.L.); (M.S.)
- National Health Committee Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, 52 Xiangchun Road, Changsha 410028, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Second Road, Guangzhou 510080, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, 110 Xiangya Road, Changsha 410078, China
- Correspondence: (T.W.); (J.Q.); Tel.: +86-15273188582 (T.W.); +86-15974269544 (J.Q.)
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Nawabi F, Alayli A, Krebs F, Lorenz L, Shukri A, Bau AM, Stock S. Health literacy among pregnant women in a lifestyle intervention trial: protocol for an explorative study on the role of health literacy in the perinatal health service setting. BMJ Open 2021; 11:e047377. [PMID: 34210730 PMCID: PMC8252873 DOI: 10.1136/bmjopen-2020-047377] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Pregnancy is a vulnerable period that affects long-term health of pregnant women and their unborn infants. Health literacy plays a crucial role in promoting healthy behaviour and thereby maintaining good health. This study explores the role of health literacy in the GeMuKi (acronym for 'Gemeinsam Gesund: Vorsorge plus für Mutter und Kind'-Strengthening health promotion: enhanced check-up visits for mother and child) Project. It will assess the ability of the GeMuKi lifestyle intervention to positively affect health literacy levels through active participation in preventive counselling. The study also explores associations between health literacy, health outcomes, health service use and effectiveness of the intervention. METHODS AND ANALYSIS The GeMuKi trial has a hybrid effectiveness-implementation design and is carried out in routine prenatal health service settings in Germany. Women (n=1860) are recruited by their gynaecologist during routine check-up visits before 12 weeks of gestation. Trained healthcare providers carry out counselling using motivational interviewing techniques to positively affect health literacy and lifestyle-related risk factors. Healthcare providers (gynaecologists and midwives) and women jointly agree on Specific, Measurable, Achievable Reasonable, Time-Bound goals. Women will be invited to fill in questionnaires at two time points (at recruitment and 37th-40th week of gestation) using an app. Health literacy is measured using the German version of the Health Literacy Survey-16 and the Brief Health Literacy Screener. Lifestyle is measured with questions on physical activity, nutrition, alcohol and drug use. Health outcomes of both mother and child, including gestational weight gain (GWG) will be documented at each routine visit. Health service use will be assessed using social health insurance claims data. Data analyses will be conducted using IBM SPSS Statistics, version 26.0. These include descriptive statistics, tests and regression models. A mediation model will be conducted to answer the question whether health behaviour mediates the association between health literacy and GWG. ETHICS AND DISSEMINATION The study was approved by the University Hospital of Cologne Research Ethics Committee (ID: 18-163) and the State Chamber of Physicians in Baden-Wuerttemberg (ID: B-F-2018-100). Study results will be disseminated through (poster) presentations at conferences, publications in peer-reviewed journals and press releases. TRAIL REGISTRATION German Clinical Trials Register (DRKS00013173). Registered pre-results, 3rd of January 2019, https://www.drks.de.
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Affiliation(s)
- Farah Nawabi
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Adrienne Alayli
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Federal Centre for Health Education, Cologne, Germany
| | - Franziska Krebs
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Laura Lorenz
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Arim Shukri
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | | | - Stephanie Stock
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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13
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Ejigu AG, Lambyo SH. Predicting factors of failed induction of labor in three hospitals of Southwest Ethiopia: a cross-sectional study. BMC Pregnancy Childbirth 2021; 21:387. [PMID: 34011318 PMCID: PMC8132374 DOI: 10.1186/s12884-021-03862-x] [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: 02/09/2021] [Accepted: 05/06/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Failed induction of labor affects maternal and neonatal outcomes as well as the cost of healthcare, especially in low-resource setting regions in which the prevalence of failed induction is higher despite the incidence of labor induction is low. This study aimed to assess the prevalence of failed induction of labor in southwest Ethiopia. Method A hospital-based cross-sectional study was conducted among 441 induced women from March 1 to August 30, 2018. A systematic random sampling technique was used to select study participants. Data were collected using a pretested and structured questionnaire. Bivariable and multivariable logistic regression models were done and fitted to identify predictors of failed induction. An adjusted odds ratio with 95% confidence interval (CI) was calculated to determine the level of significance. Result Premature rupture of membrane was the most common cause of labor induction and the commonly used method of labor induction were oxytocin infusion. Cesarean section was done for 28.1% of induced women. Failed induction of labor was found to be 21%. Primiparous [AOR = 2.35 (1.35–4.09)], analgesia/anesthesia [AOR = 4.37 (1.31–14.59)], poor Bishop Score [AOR = 2.37 (1.16–4.84)], Birth weight ≥ 4 k grams [AOR = 2.12 (1.05–4.28)] and body mass index [AOR = 5.71 (3.26–10.01)] were found to be significantly associated with failed induction of labor. Conclusion The prevalence of failed induction of labour was found to be high. Preparation of the cervix before induction in primi-parity women is suggested to improve the success of induction. To achieve the normal weight of women and newborns, proper nutritional interventions should be given for women of reproductive age. It is better to use analgesia/anesthesia for labor induction when it becomes mandatory and there are no other optional methods of no- pharmacologic pain management. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03862-x.
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Affiliation(s)
- Amare Genetu Ejigu
- Department of Midwifery, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Teferi, Ethiopia.
| | - Shewangizaw H/Mariam Lambyo
- Department of Midwifery, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Teferi, Ethiopia
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14
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Abstract
The worldwide rates of obesity have increased significantly in recent decades. In the United States, more than 50% of pregnant women are overweight or obese. Obese gravid women are more prone to adverse pregnancy outcomes, including gestational diabetes, hypertensive disorders, and cardiovascular diseases. The adverse outcomes extend beyond the pregnant obese woman; offspring of obese women are themselves at increased risk of prematurity, fetal death, injury during birth, and transient respiratory problems and metabolic effects (ie, neonatal hypoglycemia). Furthermore, maternal obesity can predispose their offspring to long-term health problems, potentially generating an intergenerational cycle of obesity and insulin resistance.
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Affiliation(s)
- Carmen Paredes
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI.,Department of Obstetrics and Gynecology, Detroit Medical Center, Detroit, MI
| | - Richard C Hsu
- Wayne State University School of Medicine, Detroit, MI
| | - Anna Tong
- Wayne State University School of Medicine, Detroit, MI
| | - Jeffery R Johnson
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI.,Department of Obstetrics and Gynecology, Detroit Medical Center, Detroit, MI
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15
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Worsham W, Dalton S, Bilder DA. The Prenatal Hormone Milieu in Autism Spectrum Disorder. Front Psychiatry 2021; 12:655438. [PMID: 34276434 PMCID: PMC8280339 DOI: 10.3389/fpsyt.2021.655438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/17/2021] [Indexed: 01/03/2023] Open
Abstract
Though the etiology of autism spectrum disorder (ASD) remains largely unknown, recent findings suggest that hormone dysregulation within the prenatal environment, in conjunction with genetic factors, may alter fetal neurodevelopment. Early emphasis has been placed on the potential role of in utero exposure to androgens, particularly testosterone, to theorize ASD as the manifestation of an "extreme male brain." The relationship between autism risk and obstetric conditions associated with inflammation and steroid dysregulation merits a much broader understanding of the in utero steroid environment and its potential influence on fetal neuroendocrine development. The exploration of hormone dysregulation in the prenatal environment and ASD development builds upon prior research publishing associations with obstetric conditions and ASD risk. The insight gained may be applied to the development of chronic adult metabolic diseases that share prenatal risk factors with ASD. Future research directions will also be discussed.
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Affiliation(s)
- Whitney Worsham
- University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Susan Dalton
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, United States
| | - Deborah A Bilder
- Division of Child & Adolescent Psychiatry, Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
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16
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Association of anthropometric measures across the life-course with refractive error and ocular biometry at age 15 years. BMC Ophthalmol 2020; 20:269. [PMID: 32641126 PMCID: PMC7341653 DOI: 10.1186/s12886-020-01480-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/22/2020] [Indexed: 11/10/2022] Open
Abstract
Background A recent Genome-wide association meta-analysis (GWAS) of refractive error reported shared genetics with anthropometric traits such as height, BMI and obesity. To explore a potential relationship with refractive error and ocular structure we performed a life-course analysis including both maternal and child characteristics using data from the Avon Longitudinal Study of Parents and Children cohort. Methods Measures collected across the life-course were analysed to explore the association of height, weight, and BMI with refractive error and ocular biometric measures at age 15 years from 1613children. The outcome measures were the mean spherical equivalent (MSE) of refractive error (dioptres), axial length (AXL; mm), and radius of corneal curvature (RCC; mm). Potential confounding variables; maternal age at conception, maternal education level, parental socio-economic status, gestational age, breast-feeding, and gender were adjusted for within each multi-variable model. Results Maternal height was positively associated with teenage AXL (0.010 mm; 95% CI: 0.003, 0.017) and RCC (0.005 mm; 95% CI: 0.003, 0.007), increased maternal weight was positively associated with AXL (0.004 mm; 95% CI: 0.0001, 0.008). Birth length was associated with an increase in teenage AXL (0.067 mm; 95% CI: 0.032, 0.10) and flatter RCC (0.023 mm; 95% CI: 0.013, 0.034) and increasing birth weight was associated with flatter RCC (0.005 mm; 95% CI: 0.0003, 0.009). An increase in teenage height was associated with a lower MSE (− 0.007 D; 95% CI: − 0.013, − 0.001), an increase in AXL (0.021 mm; 95% CI: 0.015, 0.028) and flatter RCC (0.008 mm; 95% CI: 0.006, 0.010). Weight at 15 years was associated with an increase in AXL (0.005 mm; 95% CI: 0.001, 0.009). Conclusions At each life stage (pre-natal, birth, and teenage) height and weight, but not BMI, demonstrate an association with AXL and RCC measured at age 15 years. However, the negative association between refractive error and an increase in height was only present at the teenage life stage. Further research into the growth pattern of ocular structures and the development of refractive error over the life-course is required, particularly at the time of puberty.
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17
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Allman BR, Diaz EC, Andres A, Børsheim E. Divergent Changes in Serum Branched-Chain Amino Acid Concentrations and Estimates of Insulin Resistance throughout Gestation in Healthy Women. J Nutr 2020; 150:1757-1764. [PMID: 32275314 PMCID: PMC7330471 DOI: 10.1093/jn/nxaa096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/11/2020] [Accepted: 03/17/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Branched-chain amino acid (BCAA) concentrations in the blood have been correlated with insulin resistance, but this relation throughout gestation (period in which insulin resistance typically increases) is unclear. OBJECTIVE The objective of this study was to determine the associations between changes in BCAA concentrations and estimates of insulin resistance throughout gestation. METHODS Serum BCAA (Leu, Ile, Val) concentrations and insulin resistance/sensitivity [i.e., homeostatic model assessment-2 of insulin resistance (HOMA2-IR), estimated metabolic clearance rate (MCR) of glucose, and estimated first- and second-phase insulin responses] were assessed at early (EP; 8.5 ± 0.2 wk) and/or late (LP; 29.2 ± 0.8 wk) pregnancy in 53 healthy women from the Glowing cohort. Adjusted Spearman correlations were used to evaluate the association between BCAA and insulin resistance/sensitivity measures at EP and LP, adjusted for body fat percentage and gestational weight gain (GWG). A multiple linear regression analysis was used to assess the association between changes in HOMA2-IR and BCAAs throughout gestation. Groups were made post hoc based on the mean percentage change (10% decrease) in Leu throughout gestation, creating a group with a ≥10% decrease in LeuLP-EP (BELOW) and a <10% decrease in LeuLP-EP (ABOVE), and Student's t tests were performed to assess differences between groups. RESULTS Leu and Ile concentrations positively correlated with HOMA2-IR at both time points, but these relations at EP disappeared/weakened when adjusted for body fat percentage. From EP to LP, the change in Leu (LeuLP-EP) was negatively associated with the change in HOMA2-IR (HOMA2-IRLP-EP) (β = -0.037, P = 0.006). MCR was lower in the BELOW group compared with the ABOVE group, whereas there was no difference in HOMA2-IR between groups. CONCLUSIONS In this pregnancy cohort, BCAA concentrations decreased throughout gestation, whereas the mean insulin resistance did not change. These data do not support a connection between changes in blood BCAA concentrations and estimates of insulin resistance in pregnant women. This trial is registered at clinicaltrials.gov as NCT01131117.
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Affiliation(s)
| | - Eva C Diaz
- Arkansas Children's Nutrition Center, Little Rock, AR, USA,Arkansas Children's Research Institute, Little Rock, AR, USA,Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Aline Andres
- Arkansas Children's Nutrition Center, Little Rock, AR, USA,Arkansas Children's Research Institute, Little Rock, AR, USA,Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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18
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Gawlińska K, Gawliński D, Filip M, Przegaliński E. Relationship of maternal high-fat diet during pregnancy and lactation to offspring health. Nutr Rev 2020; 79:709-725. [PMID: 32447401 DOI: 10.1093/nutrit/nuaa020] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
A balanced maternal diet is essential for proper fetal development, and the consumption of a nutritionally inadequate diet during intrauterine development and early childhood is associated with a significantly increased risk of metabolic and brain disorders in offspring. The current literature indicates that maternal exposure to a high-fat diet exerts an irreversible influence on the general health of the offspring. This review of preclinical research examines the relationship between a maternal high-fat diet during pregnancy or lactation and metabolic changes, molecular alterations in the brain, and behavioral disorders in offspring. Animal models indicate that offspring exposed to a maternal high-fat diet during pregnancy and lactation manifest increased depressive-like and aggressive behaviors, reduced cognitive development, and symptoms of metabolic syndrome. Recently, epigenetic and molecular studies have shown that maternal nutrition during pregnancy and the suckling period modifies the development of neurotransmitter circuits and many other factors important to central nervous system development. This finding confirms the importance of a balanced maternal diet for the health of offspring.
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Affiliation(s)
- Kinga Gawlińska
- Department of Drug Addiction Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Dawid Gawliński
- Department of Drug Addiction Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Małgorzata Filip
- Department of Drug Addiction Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Edmund Przegaliński
- Department of Drug Addiction Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
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19
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Brown MM, Woolcott CG, Dodds L, Ashley-Martin J, Allen VM, Fahey J, Kuhle S. The 3G Multigenerational Cohort of Nova Scotian women and their mothers and offspring. Paediatr Perinat Epidemiol 2020; 34:214-221. [PMID: 32003903 DOI: 10.1111/ppe.12647] [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: 09/04/2019] [Revised: 11/27/2019] [Accepted: 12/22/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The negative impact of exposures such as maternal obesity, excessive gestational weight gain, and hypertension in pregnancy on the health of the next generation has been well studied. Evidence from animal studies suggests that the effects of in utero exposures may persist into the second generation, but the epidemiological literature on the influence of pregnancy-related exposures across three generations in humans is sparse. OBJECTIVES This cohort was established to investigate associations between antenatal and perinatal exposures and health outcomes in women and their offspring. POPULATION The cohort includes women who were born and subsequently had their own pregnancies in the Canadian province of Nova Scotia from 1980 onward. DESIGN Intergenerational linkage of data in the Nova Scotia Atlee Perinatal Database was used to establish a population-based dynamic retrospective cohort. METHODS The cohort has prospectively collected information on sociodemographics, maternal health and health behaviours, pregnancy health and complications, and obstetrical and neonatal outcomes for two generations of women and their offspring. PRELIMINARY RESULTS As of October 2018, the 3G cohort included 14 978 grandmothers (born 1939-1986), 16 766 mothers or cohort women (born 1981-2003), and 28 638 children (born 1996-2018). The cohort women were generally younger than Nova Scotian women born after 1980, and as a result, characteristics associated with pregnancy at a younger age were more frequently seen in the cohort women; sampling weights will be created to account for this design effect. The cohort will be updated annually to capture future deliveries to women who are already in the cohort and women who become eligible for inclusion when they deliver their first child. CONCLUSIONS The 3G Multigenerational Cohort is a population-based cohort of women and their mothers and offspring, spanning a time period of 38 years, and provides the opportunity to study inter- and transgenerational associations across the maternal line.
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Affiliation(s)
- Mary M Brown
- Perinatal Epidemiology Research Unit, Departments of Pediatrics, and Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
| | - Christy G Woolcott
- Perinatal Epidemiology Research Unit, Departments of Pediatrics, and Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
| | - Linda Dodds
- Perinatal Epidemiology Research Unit, Departments of Pediatrics, and Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
| | - Jillian Ashley-Martin
- Perinatal Epidemiology Research Unit, Departments of Pediatrics, and Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
| | - Victoria M Allen
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
| | - John Fahey
- Reproductive Care Program of Nova Scotia, Halifax, NS, Canada
| | - Stefan Kuhle
- Perinatal Epidemiology Research Unit, Departments of Pediatrics, and Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
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Chattrapiban T, Smit HA, Wijga AH, Brunekreef B, Vonk JM, Gehring U, van Rossem L. The joint effect of maternal smoking during pregnancy and maternal pre-pregnancy overweight on infants' term birth weight. BMC Pregnancy Childbirth 2020; 20:132. [PMID: 32106826 PMCID: PMC7047372 DOI: 10.1186/s12884-020-2816-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 02/17/2020] [Indexed: 11/20/2022] Open
Abstract
Background It is well known that maternal smoking during pregnancy and maternal pre-pregnancy overweight have opposite effects on the infants’ birth weight. We report on the association of the combination between both risk factors and the infants’ birth weight. Methods We studied 3241 infants born at term in the PIAMA birth cohort. Maternal smoking during pregnancy and pre-pregnancy height and weight were self-reported. Multivariable regression analysis was performed to assess the associations between infants of mothers who only smoked during pregnancy, who only had pre-pregnancy overweight and who had both risk factors simultaneously, on term birth weight and the risk of being SGA or LGA. Results Of 3241 infants, 421 infants (13%) were born to smoking, non-overweight mothers, 514 (15.8%) to non-smoking, overweight mothers, 129 (4%) to smoking and overweight mothers and 2177 (67%) to non-smoking, non-overweight mothers (reference group). Infants of mothers who smoked and also had pre-pregnancy overweight had similar term birth weight (− 26.6 g, 95%CI: − 113.0, 59.8), SGA risk (OR = 1.06, 95%CI: 0.56, 2.04), and LGA risk (OR = 1.09, 95%CI: 0.61, 1.96) as the reference group. Conclusions Our findings suggested that the effects of maternal smoking during pregnancy and maternal pre-pregnancy overweight on infants’ birth weight cancel each other out. Therefore, birth weight may not be a good indicator of an infant’s health status in perinatal practice because it may mask potential health risks due to these maternal risk factors when both present together.
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Affiliation(s)
- Thanin Chattrapiban
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, STR 6.118, Utrecht, 3508, GA, The Netherlands
| | - Henriette A Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, STR 6.118, Utrecht, 3508, GA, The Netherlands
| | - Alet H Wijga
- Center for Prevention and Health Services Research, National Institute of Public Health and the Environment, P.O Box 1, 3720, BA, Bilthoven, The Netherlands
| | - Bert Brunekreef
- Institute for Risk Assessment Science (IRAS), Utrecht University, Yalelaan 2, 3584, CM, Utrecht, The Netherlands
| | - Judith M Vonk
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Science (IRAS), Utrecht University, Yalelaan 2, 3584, CM, Utrecht, The Netherlands
| | - Lenie van Rossem
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, STR 6.118, Utrecht, 3508, GA, The Netherlands. .,Department of Obstretrics and Gynecology, Erasmus MC University Medical Center, Dr. Molewaterplein 50, 3015, GD, Rotterdam, the Netherlands.
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Şanlı E, Kabaran S. Maternal Obesity, Maternal Overnutrition and Fetal Programming: Effects of Epigenetic Mechanisms on the Development of Metabolic Disorders. Curr Genomics 2019; 20:419-427. [PMID: 32476999 PMCID: PMC7235386 DOI: 10.2174/1389202920666191030092225] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 10/12/2019] [Accepted: 10/21/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Maternal obesity and maternal overnutrition, can lead to epigenetic alterations during pregnancy and these alterations can influence fetal and neonatal phenotype which increase the risk of metabolic disorders in later stages of life. OBJECTIVE The effects of maternal obesity on fetal programming and potential mechanisms of maternal epigenetic regulation of gene expression which have persistent effects on fetal health and development were investigated. METHODS Review of the literature was carried out in order to discuss the effects of maternal obesity and epigenetic mechanisms in fetal programming of metabolic disorders. All abstracts and full-text articles were examined and the most relevant articles were included in this review. RESULTS Maternal obesity and maternal overnutrition during fetal period has important overall effects on long-term health. Maternal metabolic alterations during early stages of fetal development can lead to permanent changes in organ structures, cell numbers and metabolism. Epigenetic modifications (DNA methylation, histone modifications, microRNAs) play an important role in disease susceptibility in the later stages of human life. Maternal nutrition alter expression of hypothalamic genes which can increase fetal and neonatal energy intake. Epigenetic modifications may affect the increasing rate of obesity and other metabolic disorders worldwide since the impact of these changes can be passed through generations. CONCLUSION Weight management before and during pregnancy, together with healthy nutritional intakes may improve the maternal metabolic environment, which can reduce the risks of fetal programming of metabolic diseases. Further evidence from long-term follow-up studies are needed in order to determine the role of maternal obesity on epigenetic mechanisms.
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Affiliation(s)
- Ezgi Şanlı
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, T.R. North Cyprus via Mersin 10, Turkey
| | - Seray Kabaran
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, T.R. North Cyprus via Mersin 10, Turkey
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Hehir MP, Burke N, Burke G, Turner MJ, Breathnach FM, Mcauliffe FM, Morrison JJ, Dornan S, Higgins J, Cotter A, Geary MP, Mcparland P, Daly S, Cody F, Dicker P, Tully E, Malone FD. Sonographic markers of fetal adiposity and risk of Cesarean delivery. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2019; 54:338-343. [PMID: 30887629 DOI: 10.1002/uog.20263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 03/10/2019] [Accepted: 03/12/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Increased fetal size is associated with shoulder dystocia during labor and subsequent need for assisted delivery. We sought to investigate if increased fetal adiposity diagnosed sonographically in late pregnancy is associated with increased risk of operative delivery. METHODS This secondary analysis of the Genesis Study recruited 2392 nulliparous women with singleton pregnancy in cephalic presentation, in a prospective, multicenter study, to examine prenatal and intrapartum predictors of Cesarean delivery. Participants underwent ultrasound and clinical evaluation between 39 + 0 and 40 + 6 weeks' gestation. Data on fetal biometry were not revealed to patients or to their managing clinicians. A fetal adiposity composite of fetal thigh adiposity and fetal abdominal wall thickness was compiled for each infant in order to determine whether fetal adiposity > 90th centile was associated with an increased risk of Cesarean or operative vaginal delivery. RESULTS After exclusions, data were available for 2330 patients. Patients with a fetal adiposity composite > 90th centile had a higher maternal body mass index (BMI) (25 ± 5 kg/m2 vs 24 ± 4 kg/m2 ; P = 0.005), birth weight (3872 ± 417 g vs 3585 ± 401 g; P < 0.0001) and rate of induction of labor (47% (108/232) vs 40% (834/2098); P = 0.048) than did those with an adiposity composite ≤ 90th centile. Fetuses with adiposity composite > 90th centile were more likely to require Cesarean delivery than were those with adiposity composite ≤ 90th centile (P < 0.0001). After adjusting for birth weight, maternal BMI and need for induction of labor, fetal adiposity > 90th centile remained a risk factor for Cesarean delivery (P < 0.0001). A fetal adiposity composite > 90th centile was more predictive of the need for unplanned Cesarean delivery than was an estimated fetal weight > 90th centile (odds ratio, 2.20 (95% CI, 1.65-2.94; P < 0.001) vs 1.74 (95% CI, 1.29-2.35; P < 0.001). Having an adiposity composite > 90th centile was not associated with an increased likelihood of operative vaginal delivery when compared with having an adiposity composite ≤ 90th centile (P = 0.37). CONCLUSIONS Fetuses with increased adipose deposition are more likely to require Cesarean delivery than are those without increased adiposity. Consideration should, therefore, be given to adding fetal thigh adiposity and abdominal wall thickness to fetal sonographic assessment in late pregnancy. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M P Hehir
- Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
| | - N Burke
- Rotunda Hospital, Dublin, Ireland
| | - G Burke
- Department of Obstetrics and Gynaecology, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - M J Turner
- University College Dublin Centre for Human Reproduction, School of Medicine and Medical Science, Coombe Women and Infants Maternity Hospital, Dublin, Ireland
| | - F M Breathnach
- Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
| | - F M Mcauliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - J J Morrison
- Department of Obstetrics and Gynaecology, National University of Ireland, Galway, Ireland
| | - S Dornan
- Royal Jubilee Maternity Hospital, Belfast, Ireland
| | - J Higgins
- University College Cork, Cork University Maternity Hospital, Cork, Ireland
| | - A Cotter
- Department of Obstetrics and Gynaecology, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | | | - P Mcparland
- National Maternity Hospital, Dublin, Ireland
| | - S Daly
- Coombe Women and Infants Maternity Hospital, Dublin, Ireland
| | - F Cody
- Rotunda Hospital, Dublin, Ireland
| | - P Dicker
- Epidemiology & Public Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - E Tully
- Rotunda Hospital, Dublin, Ireland
| | - F D Malone
- Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
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Virzì G, Clementi A, Battaglia G, Ronco C. Multi-Omics Approach: New Potential Key Mechanisms Implicated in Cardiorenal Syndromes. Cardiorenal Med 2019; 9:201-211. [DOI: 10.1159/000497748] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 01/31/2019] [Indexed: 11/19/2022] Open
Abstract
Cardiorenal syndromes (CRS) include a scenario of clinical interactions characterized by the heart and kidney dysfunction. The crosstalk between cardiac and renal systems is clearly evidenced but not completely understood. Multi-factorial mechanisms leading to CRS do not involve only hemodynamic parameters. In fact, in recent works on organ crosstalk endothelial injury, the alteration of normal immunologic balance, cell death, inflammatory cascades, cell adhesion molecules, cytokine and chemokine overexpression, neutrophil migration, leukocyte trafficking, caspase-mediated induction of apoptotic mechanisms and oxidative stress has been demonstrated to induce distant organ dysfunction. Furthermore, new alternative mechanisms using the multi-omics approach may be implicated in the pathogenesis of cardiorenal crosstalk. The study of “omics” modifications in the setting of cardiovascular and renal disease represents an emerging area of research. Over the last years, indeed, many studies have elucidated the exact mechanisms involved in gene expression and regulation, cellular communication and organ crosstalk. In this review, we analyze epigenetics, gene expression, small non-coding RNAs, extracellular vesicles, proteomics, and metabolomics in the setting of CRS.
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Abstract
PURPOSE OF REVIEW Type 2 diabetes is a growing concern worldwide with increasing incidence in youth. Development of preventive strategies in earlier stages of life is crucial. We aimed to examine epidemiological evidence of early-life exposures and their associations with childhood and later risk of obesity and diabetes, and to discuss potential mechanisms. RECENT FINDINGS Parental obesity and diabetes in the preconception period may influence offspring's obesity risk via epigenetic mechanisms influencing gametogenesis and early development that could have significant transgenerational effects. A more comprehensive understanding of these effects is needed to identify possible avenues for interventions in both fathers and mothers to be. In addition, current evidence suggests that growth and body weight trajectories in infancy and childhood are useful indicators of later obesity and type 2 diabetes. Moreover, the composition and variations in the microbiome in early life are associated with long-term health and could mediate associations between several early-life exposures and later risk of diseases. Altogether, the epidemiological evidence supports the need for preconception and early-life interventions to reduce the obesity and diabetes burden in later life.
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Affiliation(s)
- Véronique Gingras
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Landmark Center, 401 Park Drive Suite 401 East, Boston, MA, 02215, USA.
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Landmark Center, 401 Park Drive Suite 401 East, Boston, MA, 02215, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Landmark Center, 401 Park Drive Suite 401 East, Boston, MA, 02215, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
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Manta-Vogli PD, Schulpis KH, Dotsikas Y, Loukas YL. The significant role of amino acids during pregnancy: nutritional support. J Matern Fetal Neonatal Med 2018; 33:334-340. [PMID: 29909700 DOI: 10.1080/14767058.2018.1489795] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Background: Pregnancy is characterized by a complexity of metabolic processes that may impact fetal development and infant health outcome. Normal fetal growth and development depend on a continuous supply of nutrients via the placenta. The placenta transports, utilizes, produces, and interconverts amino acids (AAs).Findings: Concentrations of both nonessential and essential AAs in maternal plasma decrease in early pregnancy and persist at low concentrations throughout. The decline is greatest for the glucogenic AAs and AAs of the urea cycle. Additionally, there is a large placental utilization of the branched-chain AAs, some of which are transaminated to alpha ketoacids and contribute to placental ammonia production. Both nonessential and essential AAs regulate key metabolic pathways to improve health, survival, growth, development, lactation, and reproduction of organisms. Some of the nonessential AAs (e.g. glutamine, glutamate, and arginine) play also important roles in regulating gene expression, cell signaling, antioxidant responses, immunity, and neurological function.Conclusions: Nutritional support during pregnancy is of great interest focusing not only to common pregnancies but also to those with low socioeconomic status, vegan-vegetarian groups, and pregnant women with metabolic disorders, the most known maternal phenylketonuria. The latter is of great interest because phenylalanine must be within the recommended range throughout pregnancy in addition to other nutrients such as vitamin B12, folate, etc. Loss of the adherence to this specific diet results in congenital malformations of the fetus. In addition to the routine laboratory test, quantitation of plasma AAs may be necessary throughout pregnancy.
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Affiliation(s)
- Penelope D Manta-Vogli
- Department of Clinical Nutrition and Dietetics, Agia Sofia Children's Hospital, Athens, Greece
| | | | - Yannis Dotsikas
- Laboratory of Pharm. Analysis, Department of Pharmacy, National and Kapodestrian University of Athens, Athens, Greece
| | - Yannis L Loukas
- Laboratory of Pharm. Analysis, Department of Pharmacy, National and Kapodestrian University of Athens, Athens, Greece
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26
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Grandy M, Snowden JM, Boone-Heinonen J, Purnell JQ, Thornburg KL, Marshall NE. Poorer maternal diet quality and increased birth weight . J Matern Fetal Neonatal Med 2018; 31:1613-1619. [PMID: 28514885 PMCID: PMC5694379 DOI: 10.1080/14767058.2017.1322949] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 04/14/2017] [Accepted: 04/21/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Maternal diet and gestational weight gain (GWG) influence birth weight and infant adiposity, which are important predictors of lifetime health. To better understand these relationships, we studied associations between maternal diet and GWG, adiposity, and birth weight in a well characterized cohort of pregnant women. STUDY DESIGN Data were obtained from 41 term (>37 weeks), uncomplicated, singleton pregnancies according to pre-pregnancy BMI categories of normal (n = 11), overweight (n = 15), or obese (n = 15). Daily consumption of protein, fat, and carbohydrates and a Healthy Eating Index (HEI-2010) score were determined from 24 h food recall collections. Associations were modeled using multinomial logistic and linear regression. RESULTS Neither the third trimester maternal diet quality nor the macronutrient consumption was associated with GWG after adjusting for pre-pregnancy BMI, maternal age, and parity. A ten-point lower HEI-2010 score was associated with 200 g higher infant birth weight and a 1.0 cm longer length. However, maternal HEI-2010 and macronutrient composition were unrelated to infant percent body fat, ponderal index, or abdominal circumference. CONCLUSIONS Poorer third trimester maternal diet quality was associated with higher birth weight and longer length, but was unrelated to markers of infant adiposity. GWG was independent of third trimester maternal diet composition and quality.
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Affiliation(s)
- Madeline Grandy
- School of Medicine, Oregon Health & Science University, Portland, OR
| | - Jonathan M. Snowden
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR
| | - Janne Boone-Heinonen
- School of Public Health, Oregon Health & Science University/Portland State University, Portland, OR
| | - Jonathan Q. Purnell
- Department of Medicine, Oregon Health & Science University, Portland, OR
- Knight Cardiovascular Institute, Center for Developmental Health, Oregon Health & Science University, Portland, OR
| | - Kent L. Thornburg
- Knight Cardiovascular Institute, Center for Developmental Health, Oregon Health & Science University, Portland, OR
| | - Nicole E. Marshall
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR
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Glastras SJ, Chen H, Pollock CA, Saad S. Maternal obesity increases the risk of metabolic disease and impacts renal health in offspring. Biosci Rep 2018; 38:BSR20180050. [PMID: 29483369 PMCID: PMC5874265 DOI: 10.1042/bsr20180050] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/17/2018] [Accepted: 02/26/2018] [Indexed: 12/16/2022] Open
Abstract
Obesity, together with insulin resistance, promotes multiple metabolic abnormalities and is strongly associated with an increased risk of chronic disease including type 2 diabetes (T2D), hypertension, cardiovascular disease, non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD). The incidence of obesity continues to rise in astronomical proportions throughout the world and affects all the different stages of the lifespan. Importantly, the proportion of women of reproductive age who are overweight or obese is increasing at an alarming rate and has potential ramifications for offspring health and disease risk. Evidence suggests a strong link between the intrauterine environment and disease programming. The current review will describe the importance of the intrauterine environment in the development of metabolic disease, including kidney disease. It will detail the known mechanisms of fetal programming, including the role of epigenetic modulation. The evidence for the role of maternal obesity in the developmental programming of CKD is derived mostly from our rodent models which will be described. The clinical implication of such findings will also be discussed.
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Affiliation(s)
- Sarah J Glastras
- Department of Medicine, Kolling Institute, University of Sydney, Sydney, Australia
- Department of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Hui Chen
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Australia
| | - Carol A Pollock
- Department of Medicine, Kolling Institute, University of Sydney, Sydney, Australia
| | - Sonia Saad
- Department of Medicine, Kolling Institute, University of Sydney, Sydney, Australia
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Farpour-Lambert NJ, Ells LJ, Martinez de Tejada B, Scott C. Obesity and Weight Gain in Pregnancy and Postpartum: an Evidence Review of Lifestyle Interventions to Inform Maternal and Child Health Policies. Front Endocrinol (Lausanne) 2018; 9:546. [PMID: 30319539 PMCID: PMC6168639 DOI: 10.3389/fendo.2018.00546] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 08/28/2018] [Indexed: 12/16/2022] Open
Abstract
Background: Maternal obesity, excessive gestational weight gain (GWG) and post-partum weight retention (PPWR) constitute new public health challenges, due to the association with negative short- and long-term maternal and neonatal outcomes. The aim of this evidence review was to identify effective lifestyle interventions to manage weight and improve maternal and infant outcomes during pregnancy and postpartum. Methods: A review of systematic reviews and meta-analyses investigating the effects of lifestyle interventions on GWG or PPWR was conducted (Jan 2009-2018) via electronic searches in the databases Medline, Pubmed, Web of Science and Cochrane Library using all keywords related to obesity/weight gain/loss, pregnancy or postpartum and lifestyle interventions;15 relevant reviews were selected. Results: In healthy women from all BMI classes, diet and physical activity interventions can decrease: GWG (mean difference -1.8 to -0.7 kg, high to moderate-quality evidence); the risks of GWG above the IOM guidelines (risk ratio [RR] 0.72 to 0.80, high to low-quality evidence); pregnancy-induced hypertension (RR 0.30 to 0.66, low to very low-quality evidence); cesarean section (RR 0.91 to 0.95; high to moderate-quality evidence) and neonatal respiratory distress syndrome (RR 0.56, high-quality evidence); without any maternal/fetal/neonatal adverse effects. In women with overweight/obesity, multi-component interventions can decrease: GWG (-0.91 to -0.63 kg, moderate to very low-quality evidence); pregnancy-induced hypertension (RR 0.30 to 0.66, low-quality evidence); macrosomia (RR 0.85, 0.73 to 1.0, moderate-quality evidence) and neonatal respiratory distress syndrome (RR 0.47, 0.26 to 0.85, moderate-quality evidence). Diet is associated with greater reduction of the risks of GDM, pregnancy-induced hypertension and preterm birth, compared with any other intervention. After delivery, combined diet and physical activity interventions reduce PPWR in women of any BMI (-2.57 to -2.3 kg, very low quality evidence) or with overweight/obesity (-3.6 to -1.22, moderate to very low-quality-evidence), but no other effects were reported. Conclusions: Multi-component approaches including a balanced diet with low glycaemic load and light to moderate intensity physical activity, 30-60 min per day 3-5 days per week, should be recommended from the first trimester of pregnancy and maintained during the postpartum period. This evidence review should help inform recommendations for health care professionals and women of child-bearing age.
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Affiliation(s)
- Nathalie J. Farpour-Lambert
- Obesity Prevention and Care Program “Contrepoids,” Service of Therapeutic Education for Chronic Diseases, Department of Community Medicine, Primary Care and Emergency, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Pediatric Sports Medicine Consultation, Service of General Pediatrics, Department of Child and Adolescent, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- *Correspondence: Nathalie J. Farpour-Lambert
| | - Louisa J. Ells
- School of Health and Social Care, Teesside University, Middlesbrough, United Kingdom
| | - Begoña Martinez de Tejada
- Service of Obstetrics, Department of Gynaecology and Obstetrics, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Courtney Scott
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
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Bellavia A, Hauser R, Seely EW, Meeker JD, Ferguson KK, McElrath TF, James-Todd T. Urinary phthalate metabolite concentrations and maternal weight during early pregnancy. Int J Hyg Environ Health 2017; 220:1347-1355. [PMID: 28939183 DOI: 10.1016/j.ijheh.2017.09.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 08/29/2017] [Accepted: 09/11/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Phthalates are a class of chemicals that may be associated with obesity in non-pregnant populations. Little is known about the association between pregnancy phthalate exposure and maternal obesity. OBJECTIVE We evaluated the association between early-pregnancy urinary concentrations of specific phthalate metabolites and the distribution of body mass index (BMI, cross-sectional), and early gestational weight gain (GWG, prospective). METHODS We measured 1st trimester urinary phthalate metabolite concentrations (median 9.9 weeks gestation) in 347 women from the LIFECODES pregnancy cohort (Boston, MA), who delivered term births. All measures were adjusted for specific-gravity and log-transformed. We used quantile regression to evaluate shifts in the entire outcome distributions, calculating multivariable-adjusted differences in the associations between these phthalate metabolites and BMI and GWG at the 25th, 50th, and 75th percentiles of these anthropometric outcomes. RESULTS Higher concentrations of mono-ethyl phthalate (MEP) were associated with a rightward shift of 2.8kg/m2 at the 75th percentiles of BMI (lowest vs highest quartile, 95% CI: 0.2-5.4) and 1.3kg at the 75th percentiles of early GWG (lowest vs second quartiles, 95% CI: 0.3-2.4). A significant right-shift in the upper tail of BMI was also observed at higher concentrations of mono-benzyl (MBzP), mono-3-carboxypropyl (MCPP), and a summary measure of di-(2-ethylhexyl) phthalate metabolites (∑DEHP). ∑DEHP was also associated with lower GWG. CONCLUSIONS Certain phthalates may be associated with shifts in maternal obesity measures, with MEP, MBzP, MCPP, and ∑DEHP being cross-sectionally associated with 1st trimester BMI and MEP and ∑DEHP being positively and inversely associated with early GWG, respectively.
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Affiliation(s)
- Andrea Bellavia
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, United States
| | - Ellen W Seely
- Division of Endocrine, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, United States
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States
| | - Kelly K Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences,Research Triangle Park, NC 27709, United States
| | - Thomas F McElrath
- Division of Maternal Fetal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, United States
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, United States; Division of Women's Health, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, United States.
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30
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Xu M, Liu B, Wu MF, Chen HT, Cianflone K, Wang ZL. Relationships among acylation-stimulating protein, insulin resistance, lipometabolism, and fetal growth in gestational diabetes mellitus women. J OBSTET GYNAECOL 2016; 35:341-5. [PMID: 26018222 DOI: 10.3109/01443615.2014.960376] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of this study was to investigate the potential relationship between acylation-stimulating protein (ASP), insulin resistance, lipometabolism, the intrauterine metabolic environment and fetal growth in well-controlled gestational diabetes mellitus (GDM) women. A total of 55 well-controlled GDM women, 66 pregnant women with normal glucose tolerance (NGT) and their newborns, were included in this study. Fasting maternal and cord blood ASP, serum lipid profiles, glucose level, insulin level, HOMA-IR, in addition to neonatal anthropometry data, were measured. Maternal blood ASP in GDM is higher than that in NGT. In the GDM group, maternal blood ASP has a positive correlation with TG, FFA and HOMA-IR. Maternal and cord blood ASP levels of LGA fetuses correlate with elevated birth weight and SF4. Similarly, cord blood ASP levels of LGA fetuses also correlate with birth weight and SF4 in the NGT group. The maternal blood ASP level of GDM mothers is associated with lipometabolism, insulin resistance and LGA fetal growth. Nevertheless, the cord blood ASP level correlates with FFA of GDM mothers, LGA fetal growth of GDM and NGT mothers. ASP may be a biomarker for evaluating insulin resistance of GDM and LGA fetal growth.
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Affiliation(s)
- M Xu
- Department of Obstetrics and Gynaecology, the First Affiliated Hospital of Sun Yat-sen University , Guangdong , China
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Weaver SR, Bohrer JC, Prichard AS, Perez PK, Streckenbach LJ, Olson JM, Cook ME, Hernandez LL. Serotonin Deficiency Rescues Lactation on Day 1 in Mice Fed a High Fat Diet. PLoS One 2016; 11:e0162432. [PMID: 27603698 PMCID: PMC5014414 DOI: 10.1371/journal.pone.0162432] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 08/23/2016] [Indexed: 01/08/2023] Open
Abstract
Obesity is an inflammatory state associated with delayed lactogenesis stage II and altered mammary gland morphology. Serotonin mediates inflammation and mammary gland involution. The objective of this study was to determine if a genetic deficiency of tryptophan hydroxylase 1, the rate-limiting enzyme in peripheral serotonin synthesis, would result in an improved ability to lactate in dams fed a high fat diet. Twenty-six female mice were fed a high (HFD) or low fat (LFD) diet throughout pregnancy and lactation. Fourteen mice were genetically deficient for Tph1 (Tph1-/-), and twelve were wild type. Milk yield, pup mortality, and dam weights were recorded and milk samples were collected. On day 10 of lactation, dams were sacrificed and mammary glands were harvested for RT-PCR and histological evaluation. HFD dams weighed more than LFD dams at the onset of lactation. WT HFD dams were unable to lactate on day 1 of lactation and exhibited increased pup mortality relative to all other treatments, including Tph1-/- HFD dams. mRNA expression of immune markers C-X-C motif chemokine 5 and tumor necrosis factor alpha were elevated in WT HFD mammary glands. Mammary gland histology showed a reduced number of alveoli in WT compared to Tph1-/- dams, regardless of diet, and the alveoli of HFD dams were smaller than those of LFD dams. Finally, fatty acid profile in milk was dynamic in both early and peak lactation, with reduced de novo synthesis of fatty acids on day 10 of lactation in the HFD groups. Administration of a HFD to C57BL/6 dams produced an obese phenotype in the mammary gland, which was alleviated by a genetic deficiency of Tph1. Serotonin may modulate the effects of obesity on the mammary gland, potentially contributing to the delayed onset of lactogenesis seen in obese women.
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Affiliation(s)
- Samantha R. Weaver
- Department of Dairy Science, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Justin C. Bohrer
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Allan S. Prichard
- Department of Dairy Science, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Paola K. Perez
- Department of Dairy Science, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Liana J. Streckenbach
- Department of Dairy Science, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Jake M. Olson
- Department of Animal Sciences, University of Wisconsin-Madison, Madison WI, United States of America
| | - Mark E. Cook
- Department of Animal Sciences, University of Wisconsin-Madison, Madison WI, United States of America
| | - Laura L. Hernandez
- Department of Animal Sciences, University of Wisconsin-Madison, Madison WI, United States of America
- * E-mail:
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Mărginean C, Mărginean CO, Bănescu C, Meliţ L, Tripon F, Iancu M. Impact of demographic, genetic, and bioimpedance factors on gestational weight gain and birth weight in a Romanian population: A cross-sectional study in mothers and their newborns: the Monebo study (STROBE-compliant article). Medicine (Baltimore) 2016; 95:e4098. [PMID: 27399105 PMCID: PMC5058834 DOI: 10.1097/md.0000000000004098] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The present study had 2 objectives, first, to investigate possible relationships between increased gestational weight gain and demographic, clinical, paraclinical, genetic, and bioimpedance (BIA) characteristics of Romanian mothers, and second, to identify the influence of predictors (maternal and newborns characteristics) on our outcome birth weight (BW).We performed a cross-sectional study on 309 mothers and 309 newborns from Romania, divided into 2 groups: Group I-141 mothers with high gestational weight gain (GWG) and Group II-168 mothers with normal GWG, that is, control group.The groups were evaluated regarding demographic, anthropometric (body mass index [BMI], middle upper arm circumference, tricipital skinfold thickness, weight, height [H]), clinical, paraclinical, genetic (interleukin 6 [IL-6]: IL-6 -174G>C and IL-6 -572C>G gene polymorphisms), and BIA parameters.We noticed that fat mass (FM), muscle mass (MM), bone mass (BM), total body water (TBW), basal metabolism rate (BMR) and metabolic age (P < 0.001), anthropometric parameters (middle upper arm circumference, tricipital skinfold thickness; P < 0.001/P = 0.001) and hypertension (odds ratio = 4.65, 95% confidence interval: 1.27-17.03) were higher in mothers with high GWG. BW was positively correlated with mothers' FM (P < 0.001), TBW (P = 0.001), BMR (P = 0.02), while smoking was negatively correlated with BW (P = 0.04). Variant genotype (GG+GC) of the IL-6 -572C>G polymorphism was higher in the control group (P = 0.042).We observed that high GWG may be an important predictor factor for the afterward BW, being positively correlated with FM, TBW, BMR, metabolic age of the mothers, and negatively with the mother's smoking status. Variant genotype (GG+GC) of the IL-6 -572C>G gene polymorphism is a protector factor against obesity in mothers. All the variables considered explained 14.50% of the outcome variance.
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Affiliation(s)
| | | | - Claudia Bănescu
- Department of Genetics, University of Medicine and Pharmacy, Tîrgu Mureţ
- Correspondence: Claudia Bănescu, Department of Medical Genetics, University of Medicine and Pharmacy Tirgu Mures, 38 Gh Marinescu St, 540139, Tirgu Mures, Romania (e-mail: )
| | | | - Florin Tripon
- Department of Genetics, University of Medicine and Pharmacy, Tîrgu Mureţ
| | - Mihaela Iancu
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy, Cluj Napoca, Romania
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Virzì GM, Clementi A, Brocca A, de Cal M, Ronco C. Molecular and Genetic Mechanisms Involved in the Pathogenesis of Cardiorenal Cross Talk. Pathobiology 2016; 83:201-10. [DOI: 10.1159/000444502] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 02/04/2016] [Indexed: 11/19/2022] Open
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Vinturache AE, Chaput KH, Tough SC. Pre-pregnancy body mass index (BMI) and macrosomia in a Canadian birth cohort. J Matern Fetal Neonatal Med 2016; 30:109-116. [PMID: 26955762 DOI: 10.3109/14767058.2016.1163679] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To compare demographic characteristics and maternal, fetal, neonatal, and pregnancy outcomes of term macrosomic infants of obese and non-obese mothers. METHODS A sample of 1996 singleton, term deliveries was drawn from the All Our Babies Cohort, a prospective, community-based pregnancy cohort. Maternal self-reported socio-demographic and anthropometric information was linked to the clinical data on pregnancy and birth events abstracted from electronic health records. Demographic, obstetrical characteristics and maternal, fetal, neonatal, and pregnancy outcomes of macrosomic infants in obese, overweight, and normal weight women were compared. Multinomial regression analysis assessed the risk factors of macrosomia in primiparous and multiparous women stratified by maternal pre-pregnancy BMI, controlling for confounding variables. RESULTS Macrosomia affected 10% of pregnancies in the study. Mothers whose infants were macrosomic were more likely to be Caucasian, obese, have had previous deliveries, undergo induction of labour and delivery by emergency C-section, particularly for labour abnormalities. Macrosomic infants were more likely to be delivered postdates, have meconium stained liquor and require resuscitation at birth. There were no significant differences in birth and neonatal outcomes of macrosomic pregnancies between obese, overweight and normal weight women. Pre-pregnancy BMI and gestational age at delivery were risk factors for macrosomia in all women. Ethnicity and history of delivery of a macrosomic infant were additional independent risk factors in multiparas. CONCLUSIONS Obesity in pregnancy increases the risk of delivery of a macrosomic infant in both primiparous and multiparous women. The maternal, fetal and neonatal outcomes of macrosomic pregnancies are similar in obese and normal weight women.
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Affiliation(s)
- Angela E Vinturache
- a Department of Paediatrics , Cumming School of Medicine, University of Calgary , Calgary , Alberta , Canada and
| | - Kathleen H Chaput
- a Department of Paediatrics , Cumming School of Medicine, University of Calgary , Calgary , Alberta , Canada and
| | - Suzanne C Tough
- b Departments of Pediatrics and Community Health Sciences , Cumming School of Medicine, University of Calgary , Calgary , Alberta , Canada
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Mei H, Guo B, Yin B, Liang X, Adair L, Thompson A, Zhang J. Interactive Effects of Early Exclusive Breastfeeding and Pre-Pregnancy Maternal Weight Status on Young Children's BMI - A Chinese Birth Cohort. PLoS One 2015; 10:e0144357. [PMID: 26641272 PMCID: PMC4671642 DOI: 10.1371/journal.pone.0144357] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 11/17/2015] [Indexed: 11/18/2022] Open
Abstract
Objectives To assess if the maternal pre-pregnancy weight status (MPWS) alters the association of early infant feeding pattern (at one and third months) with infant body mass index (BMI) in the first two years of life. Methods A cohort of 2,220 neonates were recruited in a community-based study conducted in China. Body weight and length were measured at birth, at age one and two, with BMI calculated accordingly. The BMI z-scores (BMI-Z) were computed according to the World Health Organization Growth Standard (2006). Feeding patterns were classified as exclusive breastfeeding (EBF), mixed feeding (MF), and formula feeding (FF). General linear models (GLM) were employed to estimate main and interaction effects of EBF and MPWS on children’s BMI-Z. Results No main effect of MPWS was found on child BMI-Z at ages one and two, nor the feeding patterns. An interaction between MPWS and feeding patterns was detected (p<0.05). For children who were formula fed during the first month, those who were born to overweight/obesity (OW/OB) mothers had a significantly greater BMI-Z at ages one and two, compared with those with underweight/normal weight (UW/NW) mothers. FF children had greater BMI-Z at ages one and two compared with their EBF and MF counterparts, when they were born to OW/OB mothers. Conclusions Maternal pre-pregnancy weight control and early initiation of EBF for children are essential for healthy development in children’s BMI, hence the prevention of early life obesity.
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Affiliation(s)
- Hong Mei
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Bingbing Guo
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Baomin Yin
- The Maternal and Child Health Hospital of Zhuhai City, Zhuhai, Guangdong, China
| | - Xiong Liang
- The People’s Hospital of Zhuhai City, Zhuhai, Guangdong, China
| | - Linda Adair
- Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Amanda Thompson
- Department of Anthropology, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- * E-mail:
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Lin C, Shao B, Huang H, Zhou Y, Lin Y. Maternal high fat diet programs stress-induced behavioral disorder in adult offspring. Physiol Behav 2015; 152:119-27. [DOI: 10.1016/j.physbeh.2015.09.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 09/18/2015] [Accepted: 09/25/2015] [Indexed: 01/28/2023]
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Abstract
Cardiovascular disease continues to be the leading cause of global morbidity and mortality. Traditional risk factors account for only part of the attributable risk. The origins of atherosclerosis are in early life, a potential albeit largely unrecognized window of opportunity for early detection and treatment of subclinical cardiovascular disease. There are robust epidemiological data indicating that poor intrauterine growth and/or prematurity, and perinatal factors such as maternal hypercholesterolaemia, smoking, diabetes and obesity, are associated with adverse cardiovascular intermediate phenotypes in childhood and adulthood. Many of these early-life risk factors result in a heightened inflammatory state. Inflammation is a central mechanism in the development of atherosclerosis and cardiovascular disease, but few studies have investigated the role of overt perinatal infection and inflammation (chorioamnionitis) as a potential contributor to cardiovascular risk. Limited evidence from human and experimental models suggests an association between chorioamnionitis and cardiac and vascular dysfunction. Early life inflammatory events may be an important mechanism in the early development of cardiovascular risk and may provide insights into the associations between perinatal factors and adult cardiovascular disease. This review aims to summarise current data on the early life origins of atherosclerosis and cardiovascular disease, with particular focus on perinatal inflammation.
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Maternal High-fat Diet Accelerates Development of Crohn's Disease-like Ileitis in TNFΔARE/WT Offspring. Inflamm Bowel Dis 2015; 21:2016-25. [PMID: 26284294 DOI: 10.1097/mib.0000000000000465] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Maternal high-fat diet (HFD) and obesity increases the risk of the offspring to develop inflammatory processes in various organs including the gut. We hypothesized that maternal diet-induced obesity programs the fetal gut towards inflammation in a mouse model of genetically-driven Crohn's disease (CD)-like ileitis. METHODS TNF(WT/WT) and TNF(ΔARE/WT) dams were fed an experimental control diet (CTRLD; 13 kJ% fat) or HFD (48 kJ%). Offspring mice were fed CTRLD or HFD at 4 weeks of age. Metabolic characteristics and severity of CD-like ileitis was assessed in 8- and 12-week old WT and ARE offspring measuring tissue histopathology and markers of inflammation in the distal ileum as well as plasma cytokine and LPS levels. To study prenatal effects, we laser microdissected fetal intestinal epithelial cells at 17.5 days postconception and performed microarray-based global gene expression analysis. RESULTS Maternal HFD significantly accelerated the severity of CD-like ileitis in HFD-fed ARE mice at early life stages associated with increased mucosal neutrophil infiltration, Il12p40 expression, and portal vein LPS levels. In contrast to WT mice, metabolic characteristics of ARE offspring were not affected by maternal HFD. Gene expression patterns in fetal intestinal epithelial cells of ARE mice remained largely unchanged under conditions of maternal diet-induced obesity suggesting that the positive association of intestinal inflammation, portal vein endotoxemia, and plasma TNF levels is independent of prenatal conditioning of the gut epithelium. CONCLUSIONS Maternal HFD promotes the early onset of severe CD-like ileitis in genetically susceptible offspring independent of metabolic alterations.
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Labouesse MA, Langhans W, Meyer U. Long-term pathological consequences of prenatal infection: beyond brain disorders. Am J Physiol Regul Integr Comp Physiol 2015; 309:R1-R12. [DOI: 10.1152/ajpregu.00087.2015] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 04/21/2015] [Indexed: 12/24/2022]
Abstract
Prenatal immunological adversities such as maternal infection have been widely acknowledged to contribute to an increased risk of neurodevelopmental brain disorders. In recent years, epidemiological and experimental evidence has accumulated to suggest that prenatal exposure to immune challenges can also negatively affect various physiological and metabolic functions beyond those typically associated with primary defects in CNS development. These peripheral changes include excessive accumulation of adipose tissue and increased body weight, impaired glycemic regulation and insulin resistance, altered myeloid lineage development, increased gut permeability, hyperpurinergia, and changes in microbiota composition. Experimental work in animal models further suggests that at least some of these peripheral abnormalities could directly contribute to CNS dysfunctions, so that normalization of peripheral pathologies could lead to an amelioration of behavioral deficits. Hence, seemingly unrelated central and peripheral effects of prenatal infection could represent interrelated pathological entities that emerge in response to a common developmental stressor. Targeting peripheral abnormalities may thus represent a valuable strategy to improve the wide spectrum of behavioral abnormalities that can emerge in subjects with prenatal infection histories.
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Affiliation(s)
| | | | - Urs Meyer
- Physiology and Behavior Laboratory, ETH Zurich, Switzerland
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Bolton JL, Bilbo SD. Developmental programming of brain and behavior by perinatal diet: focus on inflammatory mechanisms. DIALOGUES IN CLINICAL NEUROSCIENCE 2015. [PMID: 25364282 PMCID: PMC4214174 DOI: 10.31887/dcns.2014.16.3/jbolton] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Obesity is now epidemic worldwide. Beyond associated diseases such as diabetes, obesity is linked to neuropsychiatric disorders such as depression. Alarmingly maternal obesity and high-fat diet consumption during gestation/lactation may “program” offspring longterm for increased obesity themselves, along with increased vulnerability to mood disorders. We review the evidence that programming of brain and behavior by perinatal diet is propagated by inflammatory mechanisms, as obesity and high-fat diets are independently associated with exaggerated systemic levels of inflammatory mediators. Due to the recognized dual role of these immune molecules (eg, interleukin [IL]-6, 11-1β) in placental function and brain development, any disruption of their delicate balance with growth factors or neurotransmitters (eg, serotonin) by inflammation early in life can permanently alter the trajectory of fetal brain development. Finally, epigenetic regulation of inflammatory pathways is a likely candidate for persistent changes in metabolic and brain function as a consequence of the perinatal environment.
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Affiliation(s)
- Jessica L Bolton
- Department of Psychology and Neuroscience, Duke Institute for Brain Sciences, Duke University, Durham, North Carolina, USA
| | - Staci D Bilbo
- Department of Psychology and Neuroscience, Duke Institute for Brain Sciences, Duke University, Durham, North Carolina, USA
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Hildebrand M, Kolle E, Hansen BH, Collings PJ, Wijndaele K, Kordas K, Cooper AR, Sherar LB, Andersen LB, Sardinha LB, Kriemler S, Hallal P, van Sluijs E, Ekelund U. Association between birth weight and objectively measured sedentary time is mediated by central adiposity: data in 10,793 youth from the International Children's Accelerometry Database. Am J Clin Nutr 2015; 101:983-90. [PMID: 25832337 PMCID: PMC4409689 DOI: 10.3945/ajcn.114.103648] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 03/09/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Birth weight is an early correlate of disease later in life, and animal studies suggest that low birth weight is associated with reduced activity and increased sedentary time. Whether birth weight predicts later sedentary time in humans is uncertain. OBJECTIVES We examined the relation between birth weight and sedentary time in youth and examined whether this association was mediated by central adiposity. DESIGN We used pooled cross-sectional data from 8 observational studies conducted between 1997 and 2007 that consisted of 10,793 youth (boys: 47%) aged 6-18 y from the International Children's Accelerometry Database. Birth weight was measured in hospitals or maternally reported, sedentary time was assessed by using accelerometry (<100 counts/min), and abdominal adiposity (waist circumference) was measured according to WHO procedures. A mediation analysis with bootstrapping was used to analyze data. RESULTS The mean (±SD) time spent sedentary was 370 ± 91 min/d. Birth weight was positively associated with sedentary time (B = 4.04, P = 0.006) and waist circumference (B = 1.59, P < 0.001), whereas waist circumference was positively associated with sedentary time (B = 0.82, P < 0.001). Results of the mediation analysis showed a significant indirect effect of birth weight on sedentary time through waist circumference (B: 1.30; 95% bias-corrected CI: 0.94, 1.72), and when waist circumference was controlled for, the effect of birth weight on sedentary time was attenuated by 32% (B = 2.74, P = 0.06). CONCLUSION The association between birth weight and sedentary time appears partially mediated by central adiposity, suggesting that both birth weight and abdominal adiposity may be correlates of sedentary time in youth.
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Affiliation(s)
- Maria Hildebrand
- From the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway (MH, EK, BHH, LBA, and UE); the Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom (PJC, KW, EvS, and UE); the School of Social and Community Medicine (KK) and the Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies (ARC), University of Bristol, Bristol, United Kingdom; the School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (LB Sherar); the Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (LBA); the Department of Sport and Health, University of Lisbon, Lisbon, Portugal (LB Sardinha); the Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland (SK); and the Department of Physical Education, Federal University of Pelotas, Pelotas, Brazil (PH)
| | - Elin Kolle
- From the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway (MH, EK, BHH, LBA, and UE); the Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom (PJC, KW, EvS, and UE); the School of Social and Community Medicine (KK) and the Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies (ARC), University of Bristol, Bristol, United Kingdom; the School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (LB Sherar); the Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (LBA); the Department of Sport and Health, University of Lisbon, Lisbon, Portugal (LB Sardinha); the Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland (SK); and the Department of Physical Education, Federal University of Pelotas, Pelotas, Brazil (PH)
| | - Bjørge H Hansen
- From the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway (MH, EK, BHH, LBA, and UE); the Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom (PJC, KW, EvS, and UE); the School of Social and Community Medicine (KK) and the Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies (ARC), University of Bristol, Bristol, United Kingdom; the School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (LB Sherar); the Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (LBA); the Department of Sport and Health, University of Lisbon, Lisbon, Portugal (LB Sardinha); the Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland (SK); and the Department of Physical Education, Federal University of Pelotas, Pelotas, Brazil (PH)
| | - Paul J Collings
- From the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway (MH, EK, BHH, LBA, and UE); the Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom (PJC, KW, EvS, and UE); the School of Social and Community Medicine (KK) and the Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies (ARC), University of Bristol, Bristol, United Kingdom; the School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (LB Sherar); the Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (LBA); the Department of Sport and Health, University of Lisbon, Lisbon, Portugal (LB Sardinha); the Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland (SK); and the Department of Physical Education, Federal University of Pelotas, Pelotas, Brazil (PH)
| | - Katrien Wijndaele
- From the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway (MH, EK, BHH, LBA, and UE); the Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom (PJC, KW, EvS, and UE); the School of Social and Community Medicine (KK) and the Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies (ARC), University of Bristol, Bristol, United Kingdom; the School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (LB Sherar); the Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (LBA); the Department of Sport and Health, University of Lisbon, Lisbon, Portugal (LB Sardinha); the Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland (SK); and the Department of Physical Education, Federal University of Pelotas, Pelotas, Brazil (PH)
| | - Katarzyna Kordas
- From the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway (MH, EK, BHH, LBA, and UE); the Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom (PJC, KW, EvS, and UE); the School of Social and Community Medicine (KK) and the Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies (ARC), University of Bristol, Bristol, United Kingdom; the School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (LB Sherar); the Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (LBA); the Department of Sport and Health, University of Lisbon, Lisbon, Portugal (LB Sardinha); the Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland (SK); and the Department of Physical Education, Federal University of Pelotas, Pelotas, Brazil (PH)
| | - Ashley R Cooper
- From the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway (MH, EK, BHH, LBA, and UE); the Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom (PJC, KW, EvS, and UE); the School of Social and Community Medicine (KK) and the Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies (ARC), University of Bristol, Bristol, United Kingdom; the School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (LB Sherar); the Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (LBA); the Department of Sport and Health, University of Lisbon, Lisbon, Portugal (LB Sardinha); the Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland (SK); and the Department of Physical Education, Federal University of Pelotas, Pelotas, Brazil (PH)
| | - Lauren B Sherar
- From the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway (MH, EK, BHH, LBA, and UE); the Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom (PJC, KW, EvS, and UE); the School of Social and Community Medicine (KK) and the Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies (ARC), University of Bristol, Bristol, United Kingdom; the School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (LB Sherar); the Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (LBA); the Department of Sport and Health, University of Lisbon, Lisbon, Portugal (LB Sardinha); the Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland (SK); and the Department of Physical Education, Federal University of Pelotas, Pelotas, Brazil (PH)
| | - Lars Bo Andersen
- From the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway (MH, EK, BHH, LBA, and UE); the Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom (PJC, KW, EvS, and UE); the School of Social and Community Medicine (KK) and the Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies (ARC), University of Bristol, Bristol, United Kingdom; the School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (LB Sherar); the Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (LBA); the Department of Sport and Health, University of Lisbon, Lisbon, Portugal (LB Sardinha); the Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland (SK); and the Department of Physical Education, Federal University of Pelotas, Pelotas, Brazil (PH)
| | - Luis B Sardinha
- From the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway (MH, EK, BHH, LBA, and UE); the Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom (PJC, KW, EvS, and UE); the School of Social and Community Medicine (KK) and the Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies (ARC), University of Bristol, Bristol, United Kingdom; the School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (LB Sherar); the Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (LBA); the Department of Sport and Health, University of Lisbon, Lisbon, Portugal (LB Sardinha); the Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland (SK); and the Department of Physical Education, Federal University of Pelotas, Pelotas, Brazil (PH)
| | - Susi Kriemler
- From the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway (MH, EK, BHH, LBA, and UE); the Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom (PJC, KW, EvS, and UE); the School of Social and Community Medicine (KK) and the Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies (ARC), University of Bristol, Bristol, United Kingdom; the School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (LB Sherar); the Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (LBA); the Department of Sport and Health, University of Lisbon, Lisbon, Portugal (LB Sardinha); the Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland (SK); and the Department of Physical Education, Federal University of Pelotas, Pelotas, Brazil (PH)
| | - Pedro Hallal
- From the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway (MH, EK, BHH, LBA, and UE); the Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom (PJC, KW, EvS, and UE); the School of Social and Community Medicine (KK) and the Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies (ARC), University of Bristol, Bristol, United Kingdom; the School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (LB Sherar); the Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (LBA); the Department of Sport and Health, University of Lisbon, Lisbon, Portugal (LB Sardinha); the Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland (SK); and the Department of Physical Education, Federal University of Pelotas, Pelotas, Brazil (PH)
| | - Esther van Sluijs
- From the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway (MH, EK, BHH, LBA, and UE); the Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom (PJC, KW, EvS, and UE); the School of Social and Community Medicine (KK) and the Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies (ARC), University of Bristol, Bristol, United Kingdom; the School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (LB Sherar); the Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (LBA); the Department of Sport and Health, University of Lisbon, Lisbon, Portugal (LB Sardinha); the Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland (SK); and the Department of Physical Education, Federal University of Pelotas, Pelotas, Brazil (PH)
| | - Ulf Ekelund
- From the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway (MH, EK, BHH, LBA, and UE); the Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom (PJC, KW, EvS, and UE); the School of Social and Community Medicine (KK) and the Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies (ARC), University of Bristol, Bristol, United Kingdom; the School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (LB Sherar); the Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (LBA); the Department of Sport and Health, University of Lisbon, Lisbon, Portugal (LB Sardinha); the Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland (SK); and the Department of Physical Education, Federal University of Pelotas, Pelotas, Brazil (PH)
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Kitsantas P, Gallo S, Palla H, Nguyen V, Gaffney K. Nature and nurture in the development of childhood obesity: early infant feeding practices of overweight/obese mothers differ compared to mothers of normal body mass index. J Matern Fetal Neonatal Med 2015; 29:290-3. [DOI: 10.3109/14767058.2014.999035] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Sina Gallo
- Department of Nutrition and Food Studies, and
| | - Hira Palla
- Department of Health Administration and Policy,
| | - Vi Nguyen
- Department of Health Administration and Policy,
| | - Kathleen Gaffney
- School of Nursing, College of Health and Human Services, George Mason University, Fairfax, VA, USA
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Bispo KP, de Oliveira Rodrigues L, da Silva Soares de Souza É, Mucci D, Tavares do Carmo MDG, de Albuquerque KT, de Carvalho Sardinha FL. Trans and interesterified fat and palm oil during the pregnancy and lactation period inhibit the central anorexigenic action of insulin in adult male rat offspring. J Physiol Sci 2015; 65:131-8. [PMID: 25398547 PMCID: PMC10717077 DOI: 10.1007/s12576-014-0351-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Accepted: 11/03/2014] [Indexed: 11/28/2022]
Abstract
Palm oil and interesterified fat have been used to replace partially hydrogenated fats, rich in trans isomers, in processed foods. This study investigated whether the maternal consumption of normolipidic diets containing these lipids affects the insulin receptor and Akt/protein kinase B (PKB) contents in the hypothalamus and the hypophagic effect of centrally administered insulin in 3-month-old male offspring. At 90 days, the intracerebroventricular injection of insulin decreased 24-h feeding in control rats but not in the palm, interesterified or trans groups. The palm group exhibited increases in the insulin receptor content of 64 and 69 % compared to the control and trans groups, respectively. However, the quantifications of PKB did not differ significantly across groups. We conclude that the intake of trans fatty acid substitutes during the early perinatal period affects food intake regulation in response to centrally administered insulin in the young adult offspring; however, the underlying mechanisms remain unclear.
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Affiliation(s)
- Kenia Pereira Bispo
- Laboratório de Bioquímica Nutricional, Instituto de Nutrição Josué de Castro da, Universidade Federal do Rio de Janeiro, Centro de Ciências da Saúde, Av. Carlos Chagas, 373, Edificio do Centro de Ciências da Saúde, Bloco J, 2º andar, sala 021, Rio de Janeiro, RJ 219415-902 Brazil
| | - Letícia de Oliveira Rodrigues
- Laboratório de Bioquímica Nutricional, Instituto de Nutrição Josué de Castro da, Universidade Federal do Rio de Janeiro, Centro de Ciências da Saúde, Av. Carlos Chagas, 373, Edificio do Centro de Ciências da Saúde, Bloco J, 2º andar, sala 021, Rio de Janeiro, RJ 219415-902 Brazil
| | - Érica da Silva Soares de Souza
- Laboratório de Bioquímica Nutricional, Instituto de Nutrição Josué de Castro da, Universidade Federal do Rio de Janeiro, Centro de Ciências da Saúde, Av. Carlos Chagas, 373, Edificio do Centro de Ciências da Saúde, Bloco J, 2º andar, sala 021, Rio de Janeiro, RJ 219415-902 Brazil
| | - Daniela Mucci
- Laboratório de Bioquímica Nutricional, Instituto de Nutrição Josué de Castro da, Universidade Federal do Rio de Janeiro, Centro de Ciências da Saúde, Av. Carlos Chagas, 373, Edificio do Centro de Ciências da Saúde, Bloco J, 2º andar, sala 021, Rio de Janeiro, RJ 219415-902 Brazil
| | - Maria das Graças Tavares do Carmo
- Laboratório de Bioquímica Nutricional, Instituto de Nutrição Josué de Castro da, Universidade Federal do Rio de Janeiro, Centro de Ciências da Saúde, Av. Carlos Chagas, 373, Edificio do Centro de Ciências da Saúde, Bloco J, 2º andar, sala 021, Rio de Janeiro, RJ 219415-902 Brazil
| | - Kelse Tibau de Albuquerque
- Laboratório de Bioquímica Nutricional, Instituto de Nutrição Josué de Castro da, Universidade Federal do Rio de Janeiro, Centro de Ciências da Saúde, Av. Carlos Chagas, 373, Edificio do Centro de Ciências da Saúde, Bloco J, 2º andar, sala 021, Rio de Janeiro, RJ 219415-902 Brazil
- Laboratório de Nutrição Experimental, LABNEX, Universidade Federal do Rio de Janeiro, Macaé, RJ Brazil
| | - Fatima Lucia de Carvalho Sardinha
- Laboratório de Bioquímica Nutricional, Instituto de Nutrição Josué de Castro da, Universidade Federal do Rio de Janeiro, Centro de Ciências da Saúde, Av. Carlos Chagas, 373, Edificio do Centro de Ciências da Saúde, Bloco J, 2º andar, sala 021, Rio de Janeiro, RJ 219415-902 Brazil
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45
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Ojha S, Saroha V, Symonds ME, Budge H. Excess nutrient supply in early life and its later metabolic consequences. Clin Exp Pharmacol Physiol 2014; 40:817-23. [PMID: 23350968 DOI: 10.1111/1440-1681.12061] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 01/17/2013] [Accepted: 01/20/2013] [Indexed: 12/20/2022]
Abstract
Suboptimal nutrition in early life, both in utero and during infancy, is linked to increased risk of adult obesity and its associated adverse metabolic health problems. Excess nutrient supply during early life can lead to metabolic programming in the offspring. Such overnutrition can occur in the offspring of obese mothers, the offspring of mothers who gain excess weight during gestation, infants of diabetic mothers and infants who undergo rapid growth, particularly weight gain, during early infancy. Postnatal overnutrition is particularly detrimental for infants who are born small for gestational age, who are overfed to attain 'catch-up growth'. Potential mechanisms underlying metabolic programming that results from excess nutrition during early life include resetting of hypothalamic energy sensing and appetite regulation, altered adipose tissue insulin sensitivity and impaired brown adipose tissue function. More detailed understanding of the mechanisms involved in metabolic programming could enable the development of therapeutic strategies for ameliorating its ill effects. Research in this field could potentially identify optimal and appropriate preventative interventions for a burgeoning population at risk of increased mortality and morbidity from obesity and its concomitant metabolic conditions.
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Affiliation(s)
- Shalini Ojha
- The Early Life Nutrition Research Unit, Academic Division of Child Health, School of Clinical Sciences, University Hospital, The University of Nottingham, Nottingham, UK
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46
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Martin SAL, Jameson CH, Allan SM, Lawrence CB. Maternal high-fat diet worsens memory deficits in the triple-transgenic (3xTgAD) mouse model of Alzheimer's disease. PLoS One 2014; 9:e99226. [PMID: 24918775 PMCID: PMC4053375 DOI: 10.1371/journal.pone.0099226] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 05/12/2014] [Indexed: 11/30/2022] Open
Abstract
Alzheimer’s disease (AD) is not normally diagnosed until later in life, although evidence suggests that the disease starts at a much earlier age. Risk factors for AD, such as diabetes, hypertension and obesity, are known to have their affects during mid-life, though events very early in life, including maternal over-nutrition, can predispose offspring to develop these conditions. This study tested whether over-nutrition during pregnancy and lactation affected the development of AD in offspring, using a transgenic AD mouse model. Female triple-transgenic AD dam mice (3xTgAD) were exposed to a high-fat (60% energy from fat) or control diet during pregnancy and lactation. After weaning (at 3 weeks of age), female offspring were placed on a control diet and monitored up until 12 months of age during which time behavioural tests were performed. A transient increase in body weight was observed in 4-week-old offspring 3xTgAD mice from dams fed a high-fat diet. However, by 5 weeks of age the body weight of 3xTgAD mice from the maternal high-fat fed group was no different when compared to control-fed mice. A maternal high-fat diet led to a significant impairment in memory in 2- and 12-month-old 3xTgAD offspring mice when compared to offspring from control fed dams. These effects of a maternal high-fat diet on memory were accompanied by a significant increase (50%) in the number of tau positive neurones in the hippocampus. These data demonstrate that a high-fat diet during pregnancy and lactation increases memory impairments in female 3xTgAD mice and suggest that early life events during development might influence the onset and progression of AD later in life.
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Affiliation(s)
- Sarah A. L. Martin
- Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom
| | | | - Stuart M. Allan
- Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom
| | - Catherine B. Lawrence
- Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom
- * E-mail:
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Scott C, Andersen CT, Valdez N, Mardones F, Nohr EA, Poston L, Loetscher KCQ, Abrams B. No global consensus: a cross-sectional survey of maternal weight policies. BMC Pregnancy Childbirth 2014; 14:167. [PMID: 24884985 PMCID: PMC4031379 DOI: 10.1186/1471-2393-14-167] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 04/25/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Growing evidence suggests that maternal prepregnancy weight and gestational weight gain are risk factors for perinatal complications and subsequent maternal and child health. Postpartum weight retention is also associated with adverse birth outcomes and maternal obesity. Clinical guidelines addressing healthy weight before, during, and after pregnancy have been introduced in some countries, but at present a systematic accounting for these policies has not been conducted. The objective of the present study was to conduct a cross-national comparison of maternal weight guidelines. METHODS This cross sectional survey administered a questionnaire online to key informants with expertise on the subject of maternal weight to assess the presence and content of preconceptional, pregnancy and postpartum maternal weight guidelines, their rationale and availability. We searched 195 countries, identified potential informants in 80 and received surveys representing 66 countries. We estimated the proportion of countries with guidelines by region, income, and formal or informal policy, and described and compared guideline content, including a rubric to assess presence or absence of 4 guidelines: encourage healthy preconceptional weight, antenatal weighing, encourage appropriate gestational gain, and encourage attainment of healthy postpartum weight. RESULTS Fifty-three countries reported either a formal or informal policy regarding maternal weight. The majority of these policies included guidelines to assess maternal weight at the first prenatal visit (90%), to monitor gestational weight gain during pregnancy (81%), and to provide recommendations to women about healthy gestational weight gain (62%). Guidelines related to preconceptional (42%) and postpartum (13%) weight were less common. Only 8% of countries reported policies that included all 4 fundamental guidelines. Guideline content and rationale varied considerably between countries, and respondents perceived that within their country, policies were not widely known. CONCLUSIONS These results suggest that maternal weight is a concern throughout the world. However, we found a lack of international consensus on the content of guidelines. Further research is needed to understand which recommendations or interventions work best with respect to maternal weight in different country settings, and how pregnancy weight policies impact clinical practices and health outcomes for the mother and child.
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Affiliation(s)
- Courtney Scott
- Berkeley School of Public Health, University of California, Berkeley, CA, USA
| | | | - Natali Valdez
- Department of Anthropology, University of California, Irvine, Irvine, CA, USA
| | - Francisco Mardones
- Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ellen A Nohr
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Lucilla Poston
- Division of Women’s Health, King’s College London, St Thomas’ Hospital, London, UK
| | | | - Barbara Abrams
- Berkeley School of Public Health, University of California, Berkeley, CA, USA
- 103 Haviland Hall, Berkeley, CA 94720, USA
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48
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Rasmussen S, Irgens LM, Espinoza J. Maternal obesity and excess of fetal growth in pre-eclampsia. BJOG 2014; 121:1351-7. [DOI: 10.1111/1471-0528.12677] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2013] [Indexed: 12/01/2022]
Affiliation(s)
- S Rasmussen
- Department of Clinical Science; University of Bergen; Bergen Norway
- Department of Obstetrics and Gynaecology; Haukeland University Hospital; Bergen Norway
| | - LM Irgens
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
| | - J Espinoza
- Department of Obstetrics and Gynecology; Baylor College of Medicine and Texas Children's Hospital Pavilion for Women; Houston TX USA
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49
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Entwistle PA, Webb RJ, Abayomi JC, Johnson B, Sparkes AC, Davies IG. Unconscious agendas in the etiology of refractory obesity and the role of hypnosis in their identification and resolution: a new paradigm for weight-management programs or a paradigm revisited? Int J Clin Exp Hypn 2014; 62:330-59. [PMID: 24837063 DOI: 10.1080/00207144.2014.901085] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Hypnosis has long been recognized as an effective tool for producing behavioral change in the eating disorders anorexia and bulimia. Despite many studies from the latter half of the last century suggesting that hypnosis might also be of value in managing obesity situations, the efficacy of hypnotherapy for weight reduction has received surprisingly little formal research attention since 2000. This review presents a brief history of early clinical studies using hypnosis for weight reduction and describes a hypnotherapeutic approach within which a combination of instructional/pedagogic and exploratory therapeutic sessions can work together synergistically to maximize the potential for sustained weight loss. Hypnotic modulation of appetite- and satiation-associated peptides and hormone levels may yield additional physiological benefits in Type 1 and Type 2 diabetes.
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50
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Musa MG, Torrens C, Clough GF. The microvasculature: a target for nutritional programming and later risk of cardio-metabolic disease. Acta Physiol (Oxf) 2014; 210:31-45. [PMID: 23758932 DOI: 10.1111/apha.12131] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 04/03/2013] [Accepted: 06/03/2013] [Indexed: 12/25/2022]
Abstract
There is compelling evidence that microvascular deficits affecting multiple tissues and organs play an important role in the aetiopathogenesis of cardio-metabolic disease. Furthermore, both in humans and animal models, deficits in small vessel structure and function can be detected early, often before the onset of macrovascular disease and the development of end-organ damage that is common to hypertension and obesity-associated clinical disorders. This article considers the growing evidence for the negative impact of an adverse maternal diet on the long-term health of her child, and how this can result in a disadvantageous vascular phenotype that extends to the microvascular bed. We describe how structural and functional modifications in the offspring microcirculation during development may represent an important and additional risk determinant to increase susceptibility to the development of cardio-metabolic disease in adult life and consider the cell-signalling pathways associated with endothelial dysfunction that may be 'primed' by the maternal environment. Published studies were identified that reported outcomes related to the microcirculation, endothelium, maternal diet and vascular programming using NCBI PubMed.gov, MEDLINE and ISI Web of Science databases from 1980 until April 2013 using pre-specified search terms. Information extracted from over 230 original reports and review articles was critically evaluated by the authors for inclusion in this review.
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Affiliation(s)
- M. G. Musa
- Vascular Research Group; Human Development and Health; Faculty of Medicine; University of Southampton; Southampton UK
| | - C. Torrens
- Vascular Research Group; Human Development and Health; Faculty of Medicine; University of Southampton; Southampton UK
| | - G. F. Clough
- Vascular Research Group; Human Development and Health; Faculty of Medicine; University of Southampton; Southampton UK
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