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Ter Borg S, Koopman N, Verkaik-Kloosterman J. An Evaluation of Food and Nutrient Intake among Pregnant Women in The Netherlands: A Systematic Review. Nutrients 2023; 15:3071. [PMID: 37447397 DOI: 10.3390/nu15133071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Nutritional deficiencies during pregnancy can have serious consequences for the health of the (unborn) child. This systematic review provides an updated overview of the available food and nutrient intake data for pregnant women in The Netherlands and an evaluation based on the current recommendations. Embase, MEDLINE, and national institute databases were used. Articles were selected if they had been published since 2008 and contained data on food consumption, nutrient intake, or the status of healthy pregnant women. A qualitative comparison was made with the 2021 Dutch Health Council recommendations and reference values. A total of 218 reports were included, representing 54 individual studies. Dietary assessments were primarily performed via food frequency questionnaires. Protein, vitamin A, thiamin, riboflavin, vitamin B6, folate, vitamin B12, vitamin C, iron, calcium, and magnesium intakes seemed to be adequate. For folate and vitamin D, supplements were needed to reach the recommended intake. The reasons for concern are the low intakes of fruits, vegetables, and (fatty) fish, and the intakes of alcohol, sugary drinks, and salt. For several foods and nutrients, no or limited intake data were found. High-quality, representative, and recent data are needed to evaluate the nutrient intake of pregnant women in order to make accurate assessments and evaluations, supporting scientific-based advice and national nutritional policies.
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Affiliation(s)
- Sovianne Ter Borg
- National Institute for Public Health and the Environment, 3721 BA Bilthoven, The Netherlands
| | - Nynke Koopman
- National Institute for Public Health and the Environment, 3721 BA Bilthoven, The Netherlands
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Lecorguillé M, Schipper MC, O'Donnell A, Aubert AM, Tafflet M, Gassama M, Douglass A, Hébert JR, de Lauzon-Guillain B, Kelleher C, Charles MA, Phillips CM, Gaillard R, Lioret S, Heude B. Impact of parental lifestyle patterns in the preconception and pregnancy periods on childhood obesity. Front Nutr 2023; 10:1166981. [PMID: 37275643 PMCID: PMC10233059 DOI: 10.3389/fnut.2023.1166981] [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: 02/15/2023] [Accepted: 04/07/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction High prevalence of overweight and obesity already observed in preschool children suggests the involvement of early-life risk factors. Preconception period and pregnancy are crucial windows for the implementation of child obesity prevention interventions with parental lifestyle factors as relevant targets. So far, most studies have evaluated their role separately, with only a few having investigated their potential synergistic effect on childhood obesity. Our objective was to investigate parental lifestyle patterns in the preconception and pregnancy periods and their association with the risk of child overweight after 5 years. Materials and methods We harmonized and interpreted results from four European mother-offspring cohorts participating in the EndObesity Consortium [EDEN, France; Elfe, France; Lifeways, Ireland; and Generation R, Netherlands] with data available for 1,900, 18,000, 1,100, and 9,500 families, respectively. Lifestyle factors were collected using questionnaires and included parental smoking, body mass index (BMI), gestational weight gain, diet, physical activity, and sedentary behavior. We applied principal component analyses to identify parental lifestyle patterns in preconception and pregnancy. Their association with risk of overweight (including obesity; OW-OB) and BMI z-scores between 5 and 12 years were assessed using cohort-specific multivariable logistic and linear and regression models (adjusted for potential confounders including parental age, education level, employment status, geographic origin, parity, and household income). Results Among the various lifestyle patterns derived in all cohorts, the two explaining the most variance were characterized by (1) "high parental smoking, low maternal diet quality (and high maternal sedentary behavior in some cohorts)" and, (2) "high parental BMI and low gestational weight gain." Patterns characterized by high parental BMI, smoking, low diet quality or high sedentary lifestyle before or during pregnancy were associated with higher risk of OW-OB in children, and BMI z-score at any age, with consistent strengths of associations in the main cohorts, except for lifeways. Conclusion This project provides insight into how combined parental lifestyle factors in the preconception and pregnancy periods are associated with the future risk of child obesity. These findings are valuable to inform family-based and multi-behavioural child obesity prevention strategies in early life.
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Affiliation(s)
- Marion Lecorguillé
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Mireille C Schipper
- The Generation R Study Group (Na 29-15), Erasmus University Medical Center, CA, Rotterdam, Netherlands
| | - Aisling O'Donnell
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Adrien M Aubert
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Muriel Tafflet
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | | | - Alexander Douglass
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - James R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- Department of Nutrition, Connecting Health Innovations, LLC, Columbia, SC, United States
| | - Blandine de Lauzon-Guillain
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Cecily Kelleher
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Marie-Aline Charles
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
- Ined, Inserm, EFS, Joint Unit Elfe, Aubervilliers, France
| | - Catherine M Phillips
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Romy Gaillard
- The Generation R Study Group (Na 29-15), Erasmus University Medical Center, CA, Rotterdam, Netherlands
| | - Sandrine Lioret
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Barbara Heude
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
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Voerman E, Gaillard R, Geurtsen ML, Jaddoe VWV. Maternal First-Trimester Cow-Milk Intake Is Positively Associated with Childhood General and Abdominal Visceral Fat Mass and Lean Mass but Not with Other Cardiometabolic Risk Factors at the Age of 10 Years. J Nutr 2021; 151:1965-1975. [PMID: 33758934 PMCID: PMC8245880 DOI: 10.1093/jn/nxab047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/17/2020] [Accepted: 02/10/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Higher maternal cow-milk intake during pregnancy is associated with higher fetal growth measures and higher birth weight. OBJECTIVE The aim of this study was to assess the associations of maternal milk intake during pregnancy with body fat measures and cardiometabolic risk factors at the age of 10 y. METHODS In a population-based cohort of Dutch mothers and their children (n = 2466) followed from early pregnancy onwards, we assessed maternal first-trimester milk intake (milk and milk drinks) by food-frequency questionnaire. Maternal milk intake was categorized into 0-0.9, 1-1.9, 2-2.9, 3-3.9, 4-4.9, and ≥5 glasses/d, with 1 glass equivalent to 150 mL milk. For children at the age of 10 y, we calculated BMI and obtained detailed measures of body and organ fat by DXA and MRI. We also measured blood pressure and lipid, insulin, and glucose concentrations. Data were analyzed using linear and logistic regression models. RESULTS Compared with children whose mothers consumed 0-0.9 glass of milk/d during their pregnancy, those whose mothers consumed ≥5 glasses of milk/d had a 0.29 SD (95% CI: 0.10, 0.48) higher BMI, 0.27 SD (95% CI: 0.08, 0.47) higher fat mass, 0.26 SD (95% CI: 0.07, 0.46) higher lean mass, 0.30 SD (95% CI: 0.09, 0.50) higher android-to-gynoid fat mass ratio and 0.38 SD (95% CI: 0.09, 0.67) higher abdominal visceral fat mass. After correction for multiple comparisons, groups of maternal milk intake were not associated with pericardial fat mass index, liver fat fraction, blood pressure, or lipid, insulin, or glucose concentrations (P values >0.0125). CONCLUSIONS Our results suggest that maternal first-trimester milk intake is positively associated with childhood general and abdominal visceral fat mass and lean mass, but not with other cardiometabolic risk factors.
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Affiliation(s)
- Ellis Voerman
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Romy Gaillard
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Madelon L Geurtsen
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Ni Y, Szpiro A, Loftus C, Tylavsky F, Kratz M, Bush NR, LeWinn KZ, Sathyanarayana S, Enquobahrie DA, Davis R, Fitzpatrick AL, Sonney J, Zhao Q, Karr CJ. Associations Between Maternal Nutrition in Pregnancy and Child Blood Pressure at 4-6 Years: A Prospective Study in a Community-Based Pregnancy Cohort. J Nutr 2021; 151:949-961. [PMID: 33561258 PMCID: PMC8030724 DOI: 10.1093/jn/nxaa395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/30/2020] [Accepted: 11/16/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The intrauterine environment may influence offspring blood pressure, with effects possibly extending into adulthood. The associations between prenatal nutrition and offspring blood pressure, alone or in combination with other sociodemographic or behavioral factors, are unclear. OBJECTIVES To investigate the associations of maternal dietary patterns and plasma folate concentrations with blood pressure in children aged 4-6 years, and assess the potential effect modifications by child sex, maternal race, pre-pregnancy overweight or obesity, maternal smoking, and breastfeeding. METHODS Participants were 846 mother-child dyads from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study. Maternal nutrition was characterized by the Healthy Eating Index 2010 (HEI) scores and plasma folate concentrations in pregnancy. We calculated the systolic blood pressure (SBP) and diastolic blood pressure percentiles, incorporating sex, age, and height, and categorized children as either having high blood pressure (HBP; ≥90th percentile) or normal blood pressure. Linear regressions were performed to quantify the associations between maternal nutrition and continuous blood pressure percentiles, and Poisson regressions were used to estimate the incidence rate ratio (IRR) of binary HBP. We examined the effect modifications using interaction models. RESULTS Mean HEI scores and folate concentrations were 60.0 (SD, 11.3) and 23.1 ng/mL (SD, 11.1), respectively. Based on measurements at 1 visit, 29.6% of the children were defined as having HBP. Maternal HEI scores and plasma folate concentrations were not associated with child blood pressure percentiles or HBP in the full cohort. Among mothers self-identified as white, there was an inverse relationship between maternal HEI score and child SBP percentile (β, -0.40; 95%CI: -0.75 to -0.06). A maternal HEI score above 59 was associated with a reduced risk of HBP in girls (IRR, 0.53; 95% CI: 0.32-0.88). No modified associations by pre-pregnancy overweight or obesity, maternal smoking, or breastfeeding were indicated. CONCLUSIONS We found little evidence for effects of maternal nutrition during pregnancy on childhood blood pressure, but detected sex- and race-specific associations. The study contributes to the evolving scientific inquiry regarding developmental origins of disease.
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Affiliation(s)
- Yu Ni
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Adam Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - Christine Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Frances Tylavsky
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Mario Kratz
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Sheela Sathyanarayana
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Daniel A Enquobahrie
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Robert Davis
- Center for Biomedical Informatics, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Annette L Fitzpatrick
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
- Department of Family Medicine, School of Medicine, University of Washington, Seattle, WA, USA
- Department of Global Health, School of Public Health, University of Washington, Seattle, WA, USA
| | - Jennifer Sonney
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WA, USA
| | - Qi Zhao
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Catherine J Karr
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
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Monasso GS, Santos S, Geurtsen ML, Heil SG, Felix JF, Jaddoe VWV. Associations of Early Pregnancy and Neonatal Circulating Folate, Vitamin B-12, and Homocysteine Concentrations with Cardiometabolic Risk Factors in Children at 10 y of Age. J Nutr 2021; 151:1628-1636. [PMID: 33758913 PMCID: PMC8243896 DOI: 10.1093/jn/nxab039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/03/2020] [Accepted: 02/02/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Higher circulating folate and vitamin B-12 concentrations and lower circulating homocysteine concentrations during pregnancy seem to be associated with fetal development. These micronutrients may also be associated with cardiometabolic health. OBJECTIVE We examined the associations of circulating folate, vitamin B-12, and homocysteine concentrations during pregnancy and in neonates with childhood cardiometabolic outcomes. METHODS This study was embedded in the Generation R Study, a population-based prospective cohort study from early pregnancy onward. We sampled blood in early pregnancy and cord blood. We measured cardiometabolic outcomes in the children at school age. Among 4449 children aged 10 y (median: 9.7; 95% range: 9.3, 10.7), we examined associations of plasma folate, serum vitamin B-12, and plasma homocysteine concentrations in early pregnancy and at birth with BMI, body fat distribution, heart rate, blood pressure, and insulin, glucose, and lipid concentrations, using linear regression models. Using logistic models, we examined the associations of these micronutrients with risks of overweight/obesity and clustering of cardiovascular risk factors. RESULTS One standard deviation score (SDS) higher maternal plasma folate concentration was associated with lower BMI (-0.04 SDS; 95% CI: -0.08, -0.01), android-to-gynoid fat ratio (-0.04 SDS; 95% CI: -0.07, -0.01), systolic blood pressure (-0.06 SDS; 95% CI: -0.10, -0.03), risk of overweight (OR: 0.87; 95% CI: 0.78, 0.96), and clustering of cardiovascular risk factors (OR: 0.79; 95% CI: 0.68, 0.91). One SDS higher maternal serum total B-12 concentration was associated with lower glucose (-0.06 SDS; 95% CI: -0.10, -0.02) and higher HDL cholesterol concentrations (0.04 SDS; 95% CI: 0.00, 0.08). Cord blood folate, vitamin B-12, and homocysteine concentrations were not consistently associated with cardiometabolic outcomes. CONCLUSIONS Subtle differences in circulating folate and vitamin B-12 concentrations in early pregnancy may be associated with child cardiometabolic health at age 10 y. The causality and mechanisms underlying these associations need further study.
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Affiliation(s)
- Giulietta S Monasso
- The Generation R Study Group, Erasmus MC, University Medical
Center Rotterdam, Rotterdam, The
Netherlands,Department of Pediatrics, Erasmus MC, University Medical
Center Rotterdam, Rotterdam, The
Netherlands
| | - Susana Santos
- The Generation R Study Group, Erasmus MC, University Medical
Center Rotterdam, Rotterdam, The
Netherlands,Department of Pediatrics, Erasmus MC, University Medical
Center Rotterdam, Rotterdam, The
Netherlands
| | - Madelon L Geurtsen
- The Generation R Study Group, Erasmus MC, University Medical
Center Rotterdam, Rotterdam, The
Netherlands,Department of Pediatrics, Erasmus MC, University Medical
Center Rotterdam, Rotterdam, The
Netherlands
| | - Sandra G Heil
- Department of Clinical Chemistry, Erasmus MC, University
Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical
Center Rotterdam, Rotterdam, The
Netherlands,Department of Pediatrics, Erasmus MC, University Medical
Center Rotterdam, Rotterdam, The
Netherlands
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6
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Dhamo B, Jaddoe VWV, Steegers EAP, Wolvius EB, Ongkosuwito EM. The association of maternal folic acid supplementation and prenatal folate and vitamin B12 concentrations with child dental development. Community Dent Oral Epidemiol 2021; 49:445-453. [PMID: 33486813 PMCID: PMC8518742 DOI: 10.1111/cdoe.12620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 01/05/2021] [Accepted: 01/09/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Low folic acid, folate and vitamin B12 might affect tooth formation and mineralization. The conversion of folic acid into folate is catalysed by the methylenetetrahydrofolate (MTHFR) enzyme which is encoded by the MTHFR gene. Among 3728 mothers and their 10-year-old children from the Generation R Study, we investigated associations of maternal folic acid supplementation and prenatal folate and vitamin B12 concentrations with child dental development. Secondly, we checked the modifying effect of MTHFR-C677T polymorphism. METHODS Information on folic acid supplementation was obtained by questionnaires. Concentrations of folate and vitamin B12 were measured from venous samples taken in early pregnancy. Developmental stages of teeth were defined by the Demirjian method at the age-10 assessment. In addition, dental age of the children was calculated using the Dutch standard. GLM and multivariate linear regression models were built to study the associations. RESULTS Folic acid supplementation started when pregnancy was known (β = -0.09; 95% CI: -0.17, -0.01) and folic acid supplementation started prior to known pregnancy (β = -0.12; 95% CI: -0.20, -0.04) were both associated with decelerated dental development by 1-2 months lower dental age of 10-year-old children. Folate (β = -0.02, 95% CI: -0.05, 0.02) and vitamin B12 (β = 0.03, 95% CI: -0.00, 0.06) were not associated with dental age. MTHFR-C677T did not modify the associations. CONCLUSIONS Maternal folic acid supplementation delays dental development of children by 1-2 months dental age, whereas maternal folate and vitamin B12 concentrations in early pregnancy do not affect the timing of child dental development.
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Affiliation(s)
- Brunilda Dhamo
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Eric A P Steegers
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Department of Obstetrics & Gynecology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Eppo B Wolvius
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Edwin M Ongkosuwito
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands
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Ter Borg S, Koopman N, Verkaik-Kloosterman J. Food Consumption, Nutrient Intake and Status during the First 1000 days of Life in the Netherlands: a Systematic Review. Nutrients 2019; 11:E860. [PMID: 30995816 PMCID: PMC6520769 DOI: 10.3390/nu11040860] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/04/2019] [Accepted: 04/11/2019] [Indexed: 12/25/2022] Open
Abstract
Adequate nutrition is essential for growth and development in early life. Nutritional data serves as a basis for national nutritional guidelines and policies. Currently, there is no insight into the availability of such data during the first 1000 days of life. Therefore, a systematic review was performed, following the PRISMA reporting guideline, to identify studies on food consumption, nutrient intake or status in the Netherlands. Potential gaps were identified, and the quality of the studies is discussed. The databases Embase and Medline were used, as well as databases from national institutes. Articles published in 2008-2018 were screened by two independent reviewers. In total 601 articles were identified, of which 173 were included. For pregnant women, 32 studies were available with nutritional data, for young children 40 studies were identified. No studies were available for breastfeeding women. A large variety of foods and nutrients were assessed, however certain nutrients were lacking (e.g., vitamin K). Overall, the studies had methodological limitations, making the data unsuitable to assess nutrient inadequacies. There is a need for recent, high quality nutritional research to strengthen the understanding of the nutritional needs and deficiencies during early life, and is fundamental for national guidelines and policies.
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Affiliation(s)
- Sovianne Ter Borg
- National Institute for Public Health and the Environment, 3721 MA, Bilthoven, The Netherlands.
| | - Nynke Koopman
- National Institute for Public Health and the Environment, 3721 MA, Bilthoven, The Netherlands.
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Fernández-Barrés S, Vrijheid M, Manzano-Salgado CB, Valvi D, Martínez D, Iñiguez C, Jimenez-Zabala A, Riaño-Galán I, Navarrete-Muñoz EM, Santa-Marina L, Tardón A, Vioque J, Arija V, Sunyer J, Romaguera D. The Association of Mediterranean Diet during Pregnancy with Longitudinal Body Mass Index Trajectories and Cardiometabolic Risk in Early Childhood. J Pediatr 2019; 206:119-127.e6. [PMID: 30429079 DOI: 10.1016/j.jpeds.2018.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 10/01/2018] [Accepted: 10/03/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate the associations between maternal adherence to the Mediterranean diet during pregnancy and their offspring's longitudinal body mass index (BMI) trajectories and cardiometabolic risk in early childhood. STUDY DESIGN We included mother-child pairs from the Infancia y Medio Ambiente (INMA) longitudinal cohort study in Spain. We measured dietary intake during pregnancy using a validated food frequency questionnaire and calculated the relative Mediterranean diet score (rMED). We estimated offspring's BMI z score trajectories from birth to age 4 years using latent class growth analyses (n = 2195 mother-child pairs). We measured blood pressure, waist circumference, and cardiometabolic biomarkers to construct a cardiometabolic risk score at 4 years (n = 697 mother-child pairs). We used multivariable adjusted linear and multinomial regression models. RESULTS A higher maternal rMED in pregnancy was associated with a lower risk in offspring of larger birth size, followed by accelerated BMI gain (reference trajectory group: children with average birth size and subsequent slower BMI gain) (relative risk of high vs low rMED score, 0.68; 95% CI, 0.47-0.99). rMED score during pregnancy was not associated with the cardiometabolic risk score, its components, or related biomarkers. CONCLUSIONS Higher adherence to the Mediterranean diet in pregnancy was associated with lower risk of having offspring with an accelerated growth pattern. This dietary pattern was not associated with the offspring's cardiometabolic risk at 4 years.
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Affiliation(s)
- Sílvia Fernández-Barrés
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Departament de Ciències Mèdiques Bàsiques, Nutrition and Mental Health Research Group (NUTRISAM), Facultat de Medicina i Ciències de la Salut (FMCS), Universitat Rovira i Virgili (URV), Reus, Spain.
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Cyntia B Manzano-Salgado
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Damaskini Valvi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - David Martínez
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carmen Iñiguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Ana Jimenez-Zabala
- BIODONOSTIA Health Research Institute, San Sebastian, Spain; Public Health Division of Gipuzkoa, Basque Government, San Sebastian, Spain
| | - Isolina Riaño-Galán
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Pediatric Unit, Hospital San Agustin, Aviles, Spain
| | - Eva Maria Navarrete-Muñoz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Public Health, History of Medicine and Gynecology, Universidad Miguel Hernández, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - Loreto Santa-Marina
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; BIODONOSTIA Health Research Institute, San Sebastian, Spain; Public Health Division of Gipuzkoa, Basque Government, San Sebastian, Spain
| | - Adonina Tardón
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; IUOPA and University of Oviedo, Asturias, Spain
| | - Jesús Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Public Health, History of Medicine and Gynecology, Universidad Miguel Hernández, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - Victoria Arija
- Departament de Ciències Mèdiques Bàsiques, Nutrition and Mental Health Research Group (NUTRISAM), Facultat de Medicina i Ciències de la Salut (FMCS), Universitat Rovira i Virgili (URV), Reus, Spain
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Dora Romaguera
- ISGlobal, Barcelona, Spain; Instituto de Investigación Sanitaria Illes Balears, Hospital Universitari Son Espases, Palma de Mallorca, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
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9
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Diet and physical activity in pregnancy and offspring's cardiovascular health: a systematic review. J Dev Orig Health Dis 2018; 10:286-298. [PMID: 30419991 DOI: 10.1017/s204017441800082x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
There is increasing evidence linking maternal diet and physical activity before and during pregnancy with offspring's cardiovascular health. Although many studies examined this association, the evidence has not been reviewed systematically. We therefore undertook a systematic review to synthesize evidence examining the association of maternal diet and physical activity before and during pregnancy with offspring's blood pressure and vascular health. We systematically searched the databases MEDLINE and EMBASE from inception to June 30, 2017. Eligibility screening, data extraction and quality assessment were performed by two independent reviewers. A total of 19 articles were included comprising three randomized controlled trials and 16 observational studies. Of the studies that examined the association of interest, 60% (three out of five studies) showed that high maternal carbohydrate intake was associated with higher offspring's blood pressure. Maternal protein intake during pregnancy was negatively associated with offspring carotid intima-media thickness in two out of two studies. No consistent findings for maternal fatty acid intake were found. There were too few studies to draw conclusions on energy intake, fibre intake, protein/carbohydrate ratio, specific foods, dietary patterns and maternal physical activity. Heterogeneity in exposure and outcome assessment hampered pooling. Also, owing to the observational nature of most studies, causality cannot be established. Harmonization of valid exposure and outcome measurements, and the development of core outcome sets are needed to enable more robust conclusions.
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10
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Wang H, Xu BP, Xu RB, Walker SO, Wang G. Joint effect of maternal plasma homocysteine and prepregnancy obesity on child blood pressure: a prospective birth cohort study. Int J Obes (Lond) 2017; 41:1447-1453. [PMID: 28465603 PMCID: PMC5585041 DOI: 10.1038/ijo.2017.109] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/06/2017] [Accepted: 04/19/2017] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES Elevated homocysteine (Hcy) is a known cardiovascular risk factor. However, its role in intergenerational cardiometabolic risk is unknown. We hypothesized that maternal elevated Hcy can act alone or in combination with maternal prepregnancy obesity to increase child systolic blood pressure (SBP). METHODS This study included 1279 mother-child pairs who were enrolled at birth and followed prospectively up to age 9 years from 2003 to 2014 at the Boston Medical Center. Child SBP percentile was calculated according to US reference data and elevated SBP was defined as SBP⩾75th percentile. RESULTS A U-shaped relationship between maternal Hcy and her child SBP was observed. The risk for child elevated SBP was higher among those in the lowest quartile (Q1, odds ratio (OR): 1.27; 95% confidence interval (CI): 0.94-1.72), and highest quartile (Q4, OR: 1.34; 95% CI: 1.00-1.81) as compared with those in quartiles 2 and 3. The highest risk of child elevated SBP was found among children born to obese mothers with Hcy in Q4 (OR: 2.22; 95%CI: 1.35-3.64), compared with children of non-obese mothers with Hcy in Q2-Q3. This association was independent from maternal folate and vitamin B12 status, and was not mediated by gestational age or size at birth. CONCLUSIONS In this prospective birth cohort, we observed a U-shaped association between maternal Hcy levels and child elevated SBP. Maternal high Hcy (Q4) and prepregnancy obesity jointly increased the risk of child elevated SBP by more than two-fold.
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Affiliation(s)
- Hongjian Wang
- Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Benjamin P. Xu
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Richard B. Xu
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sheila O. Walker
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- School of Education, Johns Hopkins University, Baltimore, MD, USA
- University of California, Irvine, Irvine, USA
| | - Guoying Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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11
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Silva C, Keating E, Pinto E. The impact of folic acid supplementation on gestational and long term health: Critical temporal windows, benefits and risks. Porto Biomed J 2017; 2:315-332. [PMID: 32258789 DOI: 10.1016/j.pbj.2017.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 05/10/2017] [Accepted: 05/31/2017] [Indexed: 01/23/2023] Open
Abstract
Highlights Associations between FA supplementation in pregnancy and effects on offspring's NTDs, allergy/respiratory problems, cancer and behaviour problems as been studied.There is growing concern about the effects of excessive FA supplementation, whether in terms of doses or times of exposure.FA supplementation in the periconceptional period is protective against NTDs while in later periods it could be deleterious.A daily dose of 0.4 mg FA in the periconceptional period seems to be effective and safe. Abstract Maternal folic acid (FA) supplementation is one of the most popular nutritional interventions during pregnancy for its protective effect against neural tube defects (NTDs).The purposes of this review are: (a) to gather the current evidence regarding supplementation of maternal diet with FA and (b) to problematize the available literature in terms of dosages, critical temporal windows, and its potential benefits and risks.The expression (pregnancy OR fetus OR offspring OR mother) AND ("folic acid" AND supplementation) was searched on PubMed database, filtering for articles published from 2005 to 2014. Publications referring to FA supplementation during the periconceptional period or pregnancy in which there was a conclusion about the effects of isolated FA supplementation on pregnant woman, pregnancy or offspring were included. Of the initial 1182 papers, 109 fulfilled the inclusion criteria.The majority of the publications reported FA supplementation outcomes on offspring's health, with emphasis in NTDs, allergy/respiratory problems, cancer and behaviour problems. Some inconsistency is observed on the impact of FA supplementation on different outcomes, except for NTDs. It is also visible an increased concern about the impact of excessive supplementation, either in terms of doses or exposure's duration.In conclusion, there is a growing interest in FA supplementation issues. The protective effect of FA supplementation over NTDs has been confirmed, being the periconceptional period a critical window, and it is frequently suggested that allergy/respiratory outcomes arise from (excessive) FA supplementation particularly later in pregnancy. Further research on critical doses and time of exposure should be conducted.
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Affiliation(s)
- Carla Silva
- Faculty of Medicine of University of Porto, Porto, Portugal
| | - Elisa Keating
- Department of Biomedicine - Biochemistry Unit, Faculty of Medicine of University of Porto, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - Elisabete Pinto
- CBQF - Centre of Biotechnology and Fine Chemistry - School of Biotechnology, Portuguese Catholic University, Porto, Portugal.,Institute of Public Health of the University of Porto, Porto, Portugal
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12
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Wang H, Mueller NT, Li J, Sun N, Huo Y, Ren F, Wang X. Association of Maternal Plasma Folate and Cardiometabolic Risk Factors in Pregnancy with Elevated Blood Pressure of Offspring in Childhood. Am J Hypertens 2017; 30:532-540. [PMID: 28338750 PMCID: PMC5861539 DOI: 10.1093/ajh/hpx003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 12/05/2016] [Accepted: 01/17/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The prevalence of childhood elevated blood pressure (BP) has increased in the United States, particularly among African Americans. The influence of maternal plasma folate levels, alone or in combination with maternal cardiometabolic risk factors (hypertensive disorders, diabetes, and prepregnancy obesity), on child systolic BP (SBP) has not been examined in a prospective birth cohort. We hypothesize that adequate maternal folate levels can reduce the risk of elevated SBP in children born to mothers with cardiometabolic risk factors. METHODS This study included 1,290 mother-child dyads (875 African Americans (67.8%)) recruited at birth and followed prospectively up to age 9 years from 2003 to 2014 at the Boston Medical Center. Child SBP percentile was calculated according to US reference data and elevated SBP was defined as SBP ≥75th percentile. RESULTS Maternal folate levels, overall, were not associated with child SBP. However, we found a significant multiplicative interaction between maternal cardiometabolic risk factors and maternal folate levels (Pinteraction = 0.015) on childhood elevated SBP. Among children born to mothers with any cardiometabolic risk factors, those whose mothers had folate levels above (vs. below) the median had 40% lower odds of elevated childhood SBP (odds ratio = 0.60, 95% confidence interval: 0.40-0.90). The associations did not differ appreciably in analyses restricted to African Americans, and they were not explained by gestational age, size at birth, prenatal folate intake, or breastfeeding. CONCLUSIONS Findings from our urban minority birth cohort suggest that higher levels of maternal folate may help counteract the adverse associations of maternal cardiometabolic risk factors on child SBP.
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Affiliation(s)
- Hongjian Wang
- Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Noel T Mueller
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Ninglin Sun
- Department of Cardiology, Peking University People's Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Fazheng Ren
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Laboratory for Food Quality and Safety, and Key Laboratory of Functional Dairy, College of Food Science & Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xiaobin Wang
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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13
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Colussi G, Catena C, Cogo P, Sechi LA. Elevated Blood Pressure in Children of Cardiovascular Risk Mothers: Could Maternal Folic Acid Be the Link? Am J Hypertens 2017; 30:473-475. [PMID: 28338867 DOI: 10.1093/ajh/hpx036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 02/15/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- GianLuca Colussi
- Division of Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy
| | - Cristiana Catena
- Division of Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy
| | - Paola Cogo
- Division of Pediatrics, Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy
| | - Leonardo Alberto Sechi
- Division of Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy
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Hrolfsdottir L, Halldorsson TI, Rytter D, Bech BH, Birgisdottir BE, Gunnarsdottir I, Granström C, Henriksen TB, Olsen SF, Maslova E. Maternal Macronutrient Intake and Offspring Blood Pressure 20 Years Later. J Am Heart Assoc 2017; 6:e005808. [PMID: 28438741 PMCID: PMC5533044 DOI: 10.1161/jaha.117.005808] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 03/22/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Results from 2 cohort studies in Scotland established in the 1940s and 1950s (Aberdeen and Motherwell) suggested that a high protein diet during pregnancy might adversely influence offspring blood pressure at adult age. Our objective was to examine this association in the Danish Fetal Origins Cohort (DaFO88). METHODS AND RESULTS This was a prospective birth cohort of 965 women who gave birth in 1988-1989 in Aarhus, Denmark, and whose offspring (n=434) participated in a clinical examination ≈20 years later. Macronutrient intake was assessed in gestational week 30. Multivariable adjusted linear regression was used to examine the relation between higher maternal protein intake, at the expense of carbohydrates, and offspring blood pressure (isocaloric substitution). Main analyses were adjusted for mother's age during pregnancy, prepregnancy body mass index, parity, smoking during pregnancy, educational level, and offspring's sex. The mean total energy intake was 8.7 MJ/day (SD 2.3 MJ/day). The mean energy from carbohydrate, fat, and protein intake was 51, 31, and 16 of total energy, respectively. The results showed that after adjustment, higher maternal protein intake was associated with slightly higher offspring diastolic blood pressure (highest compared with the lowest quintile of protein intake: ∆=2.4 mm Hg; 95% CI 0.4-4.4; P=0.03 for trend). Similar differences, although not significant, were found for systolic blood pressure (∆=2.6 mm Hg; 95% CI -0.0 to 5.3; P=0.08 for trend). CONCLUSIONS Higher maternal dietary protein intake at the expense of carbohydrates was associated with a modest increase in offspring blood pressure in young adulthood.
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Affiliation(s)
- Laufey Hrolfsdottir
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Thorhallur I Halldorsson
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Dorte Rytter
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Bodil Hammer Bech
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Bryndis E Birgisdottir
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Ingibjorg Gunnarsdottir
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Charlotta Granström
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Tine Brink Henriksen
- Perinatal Epidemiology Research Unit, Pediatric Department, Aarhus University Hospital, Skejby, Denmark
| | - Sjurdur F Olsen
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Nutrition, Harvard School of Public Health, Boston, MA
| | - Ekaterina Maslova
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Primary Care and Public Health, Imperial College, London, United Kingdom
- Danish Diabetes Academy, Odense, Denmark
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15
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Miliku K, Mesu A, Franco OH, Hofman A, Steegers EAP, Jaddoe VWV. Maternal and Fetal Folate, Vitamin B 12, and Homocysteine Concentrations and Childhood Kidney Outcomes. Am J Kidney Dis 2017; 69:521-530. [PMID: 28143670 PMCID: PMC5408932 DOI: 10.1053/j.ajkd.2016.11.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 11/14/2016] [Indexed: 12/21/2022]
Abstract
Background Folate, vitamin B12 and homocysteine concentrations during pregnancy are important factors for early development and may persistently influence kidney function in the offspring. We examined the associations of folate, vitamin B12, and homocysteine concentrations during pregnancy with kidney outcomes in school-aged children. Study design Population-based prospective cohort study from fetal life onwards. Settings & participants This study was performed among 4,226 pregnant women and their children. Predictors Folate, vitamin B12 and homocysteine blood concentrations measured in early pregnancy (median gestational age 13.2 weeks (25th to 75th percentiles 12.2, 14.8) and at birth (cord blood). Outcomes & measurements At the median age of 6.0 years (25th to 75th percentiles 5.9, 6.3) we measured combined kidney volume with ultrasound, estimated glomerular filtration rate based on creatinine (eGFRcreat) and cystatin C (eGFRcystC) concentrations and microalbuminuria. Results We observed that higher maternal folate concentrations were associated with larger childhood combined kidney volume, whereas higher maternal vitamin B12 concentrations were associated with higher childhood eGFRcystC (p-values <0.05). These associations were independent of homocysteine concentrations. Higher maternal homocysteine concentrations were associated with smaller combined kidney volume and lower childhood eGFRcystC (p-values <0.05). The association of maternal homocysteine concentrations with childhood eGFRcystC was largely explained by combined kidney volume. Higher cord blood homocysteine concentrations were associated with larger combined kidney volume and lower eGFRcystC (p-values <0.05). Folate, vitamin B12 or homocysteine concentrations were not associated microalbuminuria. Limitations Observational study, so causality cannot be established. Conclusion Our findings suggest that folate, vitamin B12 and homocysteine concentrations during fetal life are associated with offspring kidney development. However, the effect sizes are small. Further studies are needed to replicate these findings and assess the causality and consequences for kidney health in later life.
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Affiliation(s)
- Kozeta Miliku
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Anne Mesu
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus University Medical Center, Rotterdam, the Netherlands.
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Morton JS, Cooke CL, Davidge ST. In Utero Origins of Hypertension: Mechanisms and Targets for Therapy. Physiol Rev 2016; 96:549-603. [DOI: 10.1152/physrev.00015.2015] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The developmental origins of health and disease theory is based on evidence that a suboptimal environment during fetal and neonatal development can significantly impact the evolution of adult-onset disease. Abundant evidence exists that a compromised prenatal (and early postnatal) environment leads to an increased risk of hypertension later in life. Hypertension is a silent, chronic, and progressive disease defined by elevated blood pressure (>140/90 mmHg) and is strongly correlated with cardiovascular morbidity/mortality. The pathophysiological mechanisms, however, are complex and poorly understood, and hypertension continues to be one of the most resilient health problems in modern society. Research into the programming of hypertension has proposed pharmacological treatment strategies to reverse and/or prevent disease. In addition, modifications to the lifestyle of pregnant women might impart far-reaching benefits to the health of their children. As more information is discovered, more successful management of hypertension can be expected to follow; however, while pregnancy complications such as fetal growth restriction, preeclampsia, preterm birth, etc., continue to occur, their offspring will be at increased risk for hypertension. This article reviews the current knowledge surrounding the developmental origins of hypertension, with a focus on mechanistic pathways and targets for therapeutic and pharmacologic interventions.
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Affiliation(s)
- Jude S. Morton
- Departments of Obstetrics and Gynaecology and of Physiology, University of Alberta, Edmonton, Canada; Women and Children's Health Research Institute, Edmonton, Canada; and Cardiovascular Research Centre, Edmonton, Canada
| | - Christy-Lynn Cooke
- Departments of Obstetrics and Gynaecology and of Physiology, University of Alberta, Edmonton, Canada; Women and Children's Health Research Institute, Edmonton, Canada; and Cardiovascular Research Centre, Edmonton, Canada
| | - Sandra T. Davidge
- Departments of Obstetrics and Gynaecology and of Physiology, University of Alberta, Edmonton, Canada; Women and Children's Health Research Institute, Edmonton, Canada; and Cardiovascular Research Centre, Edmonton, Canada
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17
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Miliku K, Voortman T, van den Hooven EH, Hofman A, Franco OH, Jaddoe VWV. First-trimester maternal protein intake and childhood kidney outcomes: the Generation R Study. Am J Clin Nutr 2015; 102:123-9. [PMID: 25971715 PMCID: PMC5408936 DOI: 10.3945/ajcn.114.102228] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 03/25/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Nutritional exposures during in utero development may have long-lasting consequences for postnatal renal health. Animal studies suggest that specifically maternal dietary protein intake during pregnancy influences childhood kidney function. OBJECTIVE We examined the associations of total, animal, and vegetable maternal protein intake during pregnancy with kidney volume and function in school-aged children. DESIGN This study was conducted in 3650 pregnant women and their children who were participating in a population-based cohort study from early life onward. First-trimester energy-adjusted maternal protein intake was assessed with a food-frequency questionnaire. At the child's age of 6 y, we assessed kidney volume, estimated glomerular filtration rate (eGFR) using serum creatinine and cystatin C concentrations, and microalbuminuria using urine albumin:creatinine ratios. RESULTS First-trimester maternal total protein intake was associated with a higher childhood creatinine-based eGFR (difference: 0.06 mL × min(-1) × 1.73 m(-2); 95% CI: 0.01, 0.12 mL · min(-1) · 1.73 m(-2) per gram of protein intake). This association was mainly driven by vegetable protein intake (0.22 mL × min(-1) × 1.73 m(-2); 95% CI: 0.10, 0.35 mL · min(-1) · 1.73 m(-2) per gram of vegetable protein intake). These associations were not explained by protein intake in early childhood. First-trimester maternal protein intake was not significantly associated with childhood kidney volume, cystatin C-based eGFR, or the risk of microalbuminuria. CONCLUSIONS Our findings suggest that higher total and vegetable, but not animal, maternal protein intake during the first trimester of pregnancy is associated with a higher eGFR in childhood. Further follow-up studies are needed to investigate whether maternal protein intake in early pregnancy also affects the risk of kidney diseases in later life.
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Affiliation(s)
- Kozeta Miliku
- The Generation R Study Group and the Departments of Epidemiology and Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Trudy Voortman
- The Generation R Study Group and the Departments of Epidemiology and Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Edith H van den Hooven
- The Generation R Study Group and the Departments of Epidemiology and Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | | | - Vincent W V Jaddoe
- The Generation R Study Group and the Departments of Epidemiology and Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Welten M, Gaillard R, Hofman A, de Jonge LL, Jaddoe VWV. Maternal haemoglobin levels and cardio-metabolic risk factors in childhood: the Generation R Study. BJOG 2014; 122:805-815. [DOI: 10.1111/1471-0528.13043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2014] [Indexed: 12/14/2022]
Affiliation(s)
- M Welten
- The Generation R Study Group; Erasmus Medical Center; Rotterdam the Netherlands
| | - R Gaillard
- The Generation R Study Group; Erasmus Medical Center; Rotterdam the Netherlands
- Department of Paediatrics; Erasmus Medical Center; Rotterdam the Netherlands
| | - A Hofman
- Department of Epidemiology; Erasmus Medical Center; Rotterdam the Netherlands
| | - LL de Jonge
- The Generation R Study Group; Erasmus Medical Center; Rotterdam the Netherlands
- Department of Paediatrics; Erasmus Medical Center; Rotterdam the Netherlands
| | - VWV Jaddoe
- The Generation R Study Group; Erasmus Medical Center; Rotterdam the Netherlands
- Department of Paediatrics; Erasmus Medical Center; Rotterdam the Netherlands
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