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Xue L, Chen X, Sun J, Fan M, Qian H, Li Y, Wang L. Maternal Dietary Carbohydrate and Pregnancy Outcomes: Quality over Quantity. Nutrients 2024; 16:2269. [PMID: 39064712 PMCID: PMC11280101 DOI: 10.3390/nu16142269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 06/30/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Dietary nutrition plays a crucial role in determining pregnancy outcomes, with poor diet being a major contributor to pregnancy metabolic syndrome and metabolic disorders in offspring. While carbohydrates are essential for fetal development, the excessive consumption of low-quality carbohydrates can increase the risk of pregnancy complications and have lasting negative effects on offspring development. Recent studies not only highlighted the link between carbohydrate intake during pregnancy, maternal health, and offspring well-being, but also suggested that the quality of carbohydrate foods consumed is more critical. This article reviews the impacts of low-carbohydrate and high-carbohydrate diets on pregnancy complications and offspring health, introduces the varied physiological effects of different types of carbohydrate consumption during pregnancy, and emphasizes the importance of both the quantity and quality of carbohydrates in nutritional interventions during pregnancy. These findings may offer valuable insights for guiding dietary interventions during pregnancy and shaping the future development of carbohydrate-rich foods.
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Affiliation(s)
- Lamei Xue
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China; (L.X.); (J.S.); (M.F.); (H.Q.)
| | - Xiaofang Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
| | - Juan Sun
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China; (L.X.); (J.S.); (M.F.); (H.Q.)
| | - Mingcong Fan
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China; (L.X.); (J.S.); (M.F.); (H.Q.)
| | - Haifeng Qian
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China; (L.X.); (J.S.); (M.F.); (H.Q.)
| | - Yan Li
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China; (L.X.); (J.S.); (M.F.); (H.Q.)
| | - Li Wang
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China; (L.X.); (J.S.); (M.F.); (H.Q.)
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Ker CR, Yang HC, Wang SH, Chan TF. Assessing sugar-sweetened beverage consumption in early pregnancy using a substance abuse framework. Sci Rep 2023; 13:18979. [PMID: 37923852 PMCID: PMC10624895 DOI: 10.1038/s41598-023-46265-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 10/30/2023] [Indexed: 11/06/2023] Open
Abstract
Sugar-sweetened beverages (SSB) are previously reported to jeopardize maternal fetal health, most well-known for gestational diabetes, childhood obesity, and cognitive impairment. Although warnings and diet recommendations urge pregnant women to consume less SSB, there is no noticeable difference in their behavior. How and why reproductive women change their SSB consumption patterns were not investigated previously. Our study aims to investigate beverage consumption patterns and how these patterns change in pregnancy in the context of substance use disorder (SUD). We invited all pregnant women visiting the clinic to answer a structured 20-min questionnaire every trimester during the regular antennal visit. At the end of the study, 337 pregnant women aged over 20 participated. A total of 301 responses entered for final analysis, with a response rate of 89.3%. Our finding showed those with high DSM-5-TR scores reduced SSB intake after becoming pregnant, while those with mild or low DSM-5-TR scores increased SSB intake after becoming pregnant. The top 3 factors related to their SSB consumption were "use despite of known health hazard (n = 133)", "increased desire to drink (n = 88)", and "excessive time spent on seeking SSB (n = 85)". The least reported factors were in the domains of social impairment (ranging from n = 3 to n = 26), pharmacologic effects (i.e., tolerance (n = 24) and withdrawal (n = 70). When participants reduced SSB consumption after becoming pregnant, their choice of beverages largely shifted to sugarless beverage but not much plain water. The result provided new insights in deciphering pregnant women's psychomotor factors for SSB intake, which served as useful references for making clinical or even public health recommendations.
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Affiliation(s)
- Chin-Ru Ker
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 80708, Taiwan
| | - Hao-Ching Yang
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 80708, Taiwan
| | - Shih-Han Wang
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 80708, Taiwan
| | - Te-Fu Chan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan.
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 80708, Taiwan.
- Center of Cancer Research, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan.
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Adeoye I. Sugar-sweetened beverage consumption among pregnant women attending general and teaching hospitals in Ibadan, Nigeria : SSB consumption during pregnancy. BMC Public Health 2023; 23:980. [PMID: 37237281 DOI: 10.1186/s12889-023-15828-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Sugar-sweetened beverages (SSBs) have become a global health concern because of their adverse health effects and their association with the obesity pandemic. It has not received much attention in sub-Saharan Africa, including Nigeria, especially among pregnant women. The pattern, frequency and factors associated with SSBs among pregnant women in Ibadan, Nigeria, were investigated. DESIGN Data were from the Ibadan Pregnancy Cohort Study - a prospective cohort study investigating 1745 pregnant women from four comprehensive obstetric facilities in Ibadan. A qualitative food frequency questionnaire (FFQ) was used to assess the pregnant women's intake of food and drinks over the previous months. Sugar-sweetened beverage variable and scores were also generated using the principal component analysis with varimax rotation. Factors associated with high SSB scores were examined using multivariate logistics regression analyses at a 5% significance level. RESULTS The most commonly consumed SSBs were cocoa-sweetened beverages, soft drinks, malt drinks, and fruit juice. A quarter of the women (75th percentile) consumed SSB more than once weekly. The factors associated with high SSB on multivariate analysis were; being employed (AOR: 1.52, 95% CI 1.02-2.26), maternal obesity (AOR: 0.065, 95% CI 0.47-0.89), high fruit intake (AOR:3.62, 95% CI 2.62-4.99), high green vegetable consumption (AOR:1.99, 95% CI 1.06-3.74), high milk intake (AOR: 2.13, 95% CI 1.65- 2.74), frequent fast food outlet visit (AOR: 2.19, 95% CI 1.53-1.70), all of these remained significant after adjusting for confounding variables. CONCLUSION SSBs were common among our study population. Factors associated with high SSBs intake are crucial for implementing locally relevant public health interventions.
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Affiliation(s)
- Ikeola Adeoye
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
- Consortium for Advanced Research Training in Africa (CARTA), Nairobi, Kenya.
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Anagnostopoulos C, Anastassiadou M, Castoldi AF, Cavelier A, Coja T, Crivellente F, Dujardin B, Hart A, Hooghe W, Jarrah S, Machera K, Menegola E, Metruccio F, Sieke C, Mohimont L. Retrospective cumulative dietary risk assessment of craniofacial alterations by residues of pesticides. EFSA J 2022; 20:e07550. [PMID: 36237417 PMCID: PMC9536188 DOI: 10.2903/j.efsa.2022.7550] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
EFSA established cumulative assessment groups and conducted retrospective cumulative risk assessments for two types of craniofacial alterations (alterations due to abnormal skeletal development, head soft tissue alterations and brain neural tube defects) for 14 European populations of women in childbearing age. Cumulative acute exposure calculations were performed by probabilistic modelling using monitoring data collected by Member States in 2017, 2018 and 2019. A rigorous uncertainty analysis was performed using expert knowledge elicitation. Considering all sources of uncertainty, their dependencies and differences between populations, it was concluded with varying degrees of certainty that the MOET resulting from cumulative exposure is above 100 for the two types of craniofacial alterations. The threshold for regulatory consideration established by risk managers is therefore not exceeded. Considering the severity of the effects under consideration, it was also assessed whether the MOET is above 500. This was the case with varying levels of certainty for the head soft tissue alterations and brain neural tube defects. However, for the alterations due to abnormal skeletal development, it was found about as likely as not that the MOET is above 500 in most populations. For two populations, it was even found more likely that the MOET is below 500. These results were discussed in the light of the conservatism of the methodological approach.
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Chen B, Zhang M, He Y, Si Y, Shi Y, Jiang K, Shen J, Hong J, Ni S. The association between caffeine exposure during pregnancy and risk of gestational hypertension/preeclampsia: A meta-analysis and systematical review. J Obstet Gynaecol Res 2022; 48:3045-3055. [PMID: 36156331 PMCID: PMC10087308 DOI: 10.1111/jog.15445] [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: 07/13/2022] [Revised: 08/26/2022] [Accepted: 09/14/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The potential effect of caffeine exposure during pregnancy on gestational hypertension (GH)/preeclampsia has attracted attention but remains unclear. METHODS A systematic literature search of PubMed, Embase, and Cochrane Library databases was performed until March 2022. Observational studies assessing the association between caffeine exposure during pregnancy and the risk of GH/preeclampsia were included. The study protocol was registered in PROSPERO: CRD42022322387. RESULTS Ten studies involving 114 984 pregnant women (2548 diagnosed with GH and 2473 diagnosed with preeclampsia) were included. Comparing caffeine exposure with noncaffeine exposure, no significant association was found between caffeine exposure during pregnancy and the risk of GH (odds ratio [OR] = 0.99, 95% confidence interval [CI]: 0.90-1.08, p = 0.800) and preeclampsia (OR = 1.13, 95% CI: 0.97-1.31, p = 0.114). Subgroup analyses comparing low to moderate doses with no/lowest doses showed that caffeine exposure during pregnancy was not significant associated with GH (OR = 1.00, p = 0.987) or preeclampsia (OR = 1.03, p = 0.648). Besides, subgroup analyses comparing high doses with no/lowest doses showed that caffeine exposure during pregnancy was not significant associated with GH (OR = 1.06, p = 0.623) or preeclampsia (OR = 1.18, p = 0.192). CONCLUSION This study found that caffeine exposure during pregnancy was not significantly associated with the risk of GH/preeclampsia.
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Affiliation(s)
- Bangsheng Chen
- Emergency Medical Center, Ningbo Yinzhou No. 2 Hospital, Ningbo, Zhejiang, China
| | - Mengting Zhang
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yujing He
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yuexiu Si
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yetan Shi
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Ke Jiang
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jingyi Shen
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jiaze Hong
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Saisai Ni
- Emergency Medical Center, Ningbo Yinzhou No. 2 Hospital, Ningbo, Zhejiang, China
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Eshak ES, Okada C, Kimura T, Baba S, Ikehara S, Iso H, For The Jecs Group. Low Periconceptional Dietary Intakes among Japanese Women: The Japan Environment and Children's Study (JECS). J Nutr Sci Vitaminol (Tokyo) 2022; 68:260-269. [PMID: 36047097 DOI: 10.3177/jnsv.68.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Pregnancy is usually associated with dietary imbalances. We aim to assess the changes in Japanese women's diet and nutritional adequacy before and during pregnancy. In the Japan Environment and Children's Study (JECS), we recruited a large cohort of pregnant women (>100,000) from 15 Japanese communities. We assessed their diet before and during pregnancy by a food frequency questionnaire. The before and during pregnancy intakes of energy, macronutrients, and micronutrients were lower than the recommended level for Japanese women by 1% to 49%. The dietary intakes of pregnant women were lower than their intakes before pregnancy, except for milk, dairy products, and calcium. The daily during pregnancy intake of energy, carbohydrate, fat, protein, folic acid, and iron decreased by 85 kcal, 11.6 g, 2.3 g, 2.8 g, 20 μg, and 0.5 mg than the before pregnancy intake. Pregnant women's declined food and nutrients intakes were moderately correlated to their dietary intakes before pregnancy; the correlation coefficient ranged between 0.47 and 0.67. The inter-individual variability was greater than the intra-individual variability of the dietary intakes. Almost half of the pregnant women remained in the same intake quartile for all nutrients and food groups as before pregnancy. Yet, approximately 10% of pregnant women changed their pregnancy intake by ≥50% (≥2 quartiles up or down) compared to before pregnancy. In conclusion, the study identified low periconceptional dietary intakes among Japanese pregnant women. The low dietary intake of essential nutrients, such as folate, requires revising the Japanese national periconceptional dietary and supplementation guidelines.
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Affiliation(s)
- Ehab S Eshak
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Minia University.,Public Health, Department of Social Medicine, Osaka University, Graduate School of Medicine
| | - Chika Okada
- Public Health, Department of Social Medicine, Osaka University, Graduate School of Medicine
| | - Takashi Kimura
- Department of Public Health, Hokkaido University School of Medicine
| | - Sachiko Baba
- Public Health, Department of Social Medicine, Osaka University, Graduate School of Medicine.,Biomedical Ethics and Public Policy, Department of Social Medicine, Osaka University, Graduate School of Medicine
| | - Satoyo Ikehara
- Public Health, Department of Social Medicine, Osaka University, Graduate School of Medicine
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University, Graduate School of Medicine.,Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba
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Simione M, Moreno-Galarraga L, Perkins M, Price SN, Luo M, Kotelchuck M, Blake-Lamb TL, Taveras EM. Effects of the First 1000 Days Program, a systems-change intervention, on obesity risk factors during pregnancy. BMC Pregnancy Childbirth 2021; 21:729. [PMID: 34706698 PMCID: PMC8549242 DOI: 10.1186/s12884-021-04210-9] [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: 06/07/2021] [Accepted: 10/12/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND First 1000 Days is a systems-oriented program starting in early pregnancy lasting through the first 24 months of infancy focused on preventing obesity and related risk factors among low income, mother-infant pairs. The program was developed in partnership with stakeholders to create an infrastructure for system-wide change. It includes screening for adverse health behaviors and socio-contextual factors, patient navigation and educational materials to support behavior change and social needs, and individualized health coaching for women at highest risk of obesity and has been shown to reduce excess gestational weight gain for women who were overweight at the start of their pregnancy. The purpose of this study was to examine changes from the first to third trimester for women participating in the First 1000 Days Program. METHODS We collected information through self-administered questionnaires during the first and third trimester of gestation and from electronic health records relating to obesity risk factors. Measures collected included behavior (i.e., diet, physical activity and screen time) and psychosocial (i.e., anxiety) outcomes, as well as enrollment in Women, Infant, and Children (WIC) program. We examined the extent to which participation in the program was associated with changes in behaviors and psychosocial outcomes among women during pregnancy. RESULTS Women completed surveys at their initial and third trimester prenatal visits (n = 264). Mean age (SD) was 30.2 (5.51) years and 75% had an annual household income of <$50,000. Mean pre-pregnancy body mass index (BMI) was 27.7 kg/m2 and 64% started pregnancy with a BMI ≥ 25 kg/m2. In multivariable adjusted models, we observed decreases in intake of sugary-drinks (- 0.95 servings/day; 95% CI: - 1.86, - 0.03) and in screen time (- 0.21 h/day; 95% CI: - 0.40, - 0.01), and an increase in physical activity (0.88 days/week; 95% CI: 0.52, 1.23) from the first to third trimester. We also observed a decrease in pregnancy-related anxiety score (- 1.06 units; 95% CI: - 1.32, - 0.79) and higher odds of enrollment in Women, Infant, and Children (WIC) program (OR: 2.58; 95% CI: 1.96, 3.41). CONCLUSIONS Our findings suggest that a systems-oriented prenatal intervention may be associated with improvements in behaviors and psychosocial outcomes during pregnancy among low-income mothers. TRIAL REGISTRATION ClinicalTrials.gov ( NCT03191591 ; Retrospectively registered on June 19, 2017).
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Affiliation(s)
- Meg Simione
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua Street, Suite 860, Boston, MA, 02114, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Laura Moreno-Galarraga
- Department of Pediatrics, Complejo Hospitalario de Navarra, IdiSNA, Pamplona, Navarre, Spain
| | - Meghan Perkins
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua Street, Suite 860, Boston, MA, 02114, USA
| | - Sarah N Price
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua Street, Suite 860, Boston, MA, 02114, USA
| | - Man Luo
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua Street, Suite 860, Boston, MA, 02114, USA
| | - Milton Kotelchuck
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua Street, Suite 860, Boston, MA, 02114, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Tiffany L Blake-Lamb
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA
- Kraft Center for Community Health Leadership, Massachusetts General Hospital, Boston, MA, USA
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua Street, Suite 860, Boston, MA, 02114, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Kraft Center for Community Health Leadership, Massachusetts General Hospital, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Ni J, Wang P, Zheng T, Lv L, Peng H. Consumption of Coffee and Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Observational Studies. Front Nutr 2021; 8:739359. [PMID: 34616766 PMCID: PMC8488146 DOI: 10.3389/fnut.2021.739359] [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: 07/10/2021] [Accepted: 08/16/2021] [Indexed: 11/25/2022] Open
Abstract
Objective: The results from epidemiologic studies on the relationship between intake of coffee and the risk of gestational diabetes mellitus (GDM) remain inconclusive. A meta-analysis was performed to achieve a comprehensive finding regarding the association between intake of coffee and the risk of GDM. Methods: PubMed, Scopus, ISI Web of Science, and Google Scholar were searched to find articles published up to August 2021. Observational studies that reported risk estimates [risk ratios (RRs), hazard ratios (HRs), and odds ratios (ORs)] for the association of consumption of coffee with the risk of GDM in pregnant women were included. Random effects model was applied to calculate summarized risk estimate and 95% CIs for the highest vs. lowest categories of intake of coffee. Results: Seven observational studies (three cohort, two case-control, and two cross-sectional studies) with 75,607 participants and 1,625 women with GDM met the inclusion criteria. The meta-analysis of comparing the highest vs. lowest intake of coffee categories showed no significant association between intake of coffee and risk of GDM (summarized risk estimate: 0.89; 95% CI: 0.76, 1.05; I2 = 63.4%). Subgroup analysis showed that consumption of coffee had an inverse relationship with GDM in studies conducted in non-Asia countries (summarized risk estimate: 0.75; 95% CI: 0.58, 0.97; I2 = 6%). Conclusion: This study has shown that high consumption of coffee did not decrease the risk of GDM. Furthermore, large-scale cohort studies are required to confirm our findings.
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Affiliation(s)
- Jiaying Ni
- Department of Obstetrics and Gynecology, Xinhua Hospital Affiliated to Shanghai JiaoTong University School Medicine, Shanghai, China
| | - Ping Wang
- Department of Internal Medicine, Nanjing Gaochun People's Hospital, Nanjing, China
| | - Tao Zheng
- Department of Obstetrics and Gynecology, Xinhua Hospital Affiliated to Shanghai JiaoTong University School Medicine, Shanghai, China
| | - Long Lv
- Department of General Surgery, Nanjing Gaochun People's Hospital, Nanjing, China
| | - Hao Peng
- Department of Obstetrics and Gynecology, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, Huangshi, China
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Ker CR, Wu CH, Lee CH, Wang SH, Chan TF. Increased sugar-sweetened beverage use tendency in pregnancy positively associates with peripartum Edinburgh postpartum depression scores. Sci Rep 2021; 11:15324. [PMID: 34321556 PMCID: PMC8319412 DOI: 10.1038/s41598-021-94790-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 07/16/2021] [Indexed: 12/28/2022] Open
Abstract
The association among sugar sweetened beverages (SSB) consumption, addiction and depression in adults, children and adolescents is widely reported. Dieting patterns during pregnancy is complicated by maternal fetal concerns. Specifically, restrained use of SSB might be potentially a source of perinatal distress. The current study modified diagnostic criteria for Substance Use Disorder (SUD) in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), into SSB-specific questions to assess SSB use tendency. Edinburgh Postpartum Depression Scores (EPDS) is used to assess maternal distress during pregnancy. One hundred and ninety-six consecutive pregnant women receiving antenatal care at Kaohsiung Medical University Hospital were invited to participate in this study. In the first trimester, 46.6% of women had none or 1 DSM-5 symptom, 27.0% had 2–3 symptoms, while 26.4% had ≥ 4 symptoms. The mean numbers of DSM-5 symptoms in each trimester were found to be 2.5 ± 2.25, 2.6 ± 2.45, 2.4 ± 2.43 for the first, second and third trimester, respectively, p = 0.750. While EPDS score showed no difference among DSM-5 symptoms 0–1, 2–3 and ≥ 4 groups in the first trimester (8.1 ± 4.59, 8.4 ± 5.00, 8.8 ± 4.82, p = 0.343), women with ≥ 4 DSM-symptoms was found significantly higher EPDS scores than those with < 4 DSM-symptoms in the second (7.2 ± 4.81, 7.7 ± 4.98, 8.8 ± 4.33, p = 0.030) and third trimester (6.8 ± 5.00, 7.2 ± 4.63, 8.7 ± 5.24, p = 0.019). The relationship remained significant after adjusting for covariates including actual SSB amount consumed (adjusted β = 0.25 with 95% confident interval (CI) 0.04–0.45 and 0.21 with 95% CI 0.04–0.38 for the second and third trimesters, respectively). Overall, the study is the first to characterize the positive relationship between SSB use tendency and antenatal distress in pregnancy, independent of actual SSB amount consumed. The observational nature of the study design precludes inferences of its underlying socio-psychomotor mechanisms, although restrained SSB use in pregnancy is suspected to contribute. The novel employment of modified SSB-specific DSM-5 scores and EPDS in this setting is feasible and further validation is promising. With better understanding and awareness, pregnant women with increased SSB use tendency should be properly counseled with special attention to their mental state.
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Affiliation(s)
- Chin-Ru Ker
- Department of Obstetrics and Gynecology, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan
| | - Chen-Hsuan Wu
- Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan. .,Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Dapi Road, Niaosong District, Kaohsiung, 833, Taiwan.
| | - Chien-Hung Lee
- Department of Public Health, College of Health Science, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Sanmin District, Kaohsiung, 807, Taiwan
| | - Shih-Han Wang
- Department of Obstetrics and Gynecology, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan
| | - Te-Fu Chan
- Department of Obstetrics and Gynecology, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. .,Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan. .,Center of Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
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10
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Beverage Intake and the Risk of Gestational Diabetes Mellitus: The SECOST. Nutrients 2021; 13:nu13072208. [PMID: 34199062 PMCID: PMC8308348 DOI: 10.3390/nu13072208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 12/28/2022] Open
Abstract
The contribution and impact of beverage intake to total nutrient and energy intake may be substantial. Given the link between lifestyle, diet, and the risk of pregnancy complications, this study investigated the association between the quantity and types of beverages with gestational diabetes mellitus (GDM) risk. The study included 452 women from the Seremban Cohort Study (SECOST). The mean energy by beverage intake was 273 ± 23.83 kcal/day (pre-pregnancy), 349 ± 69.46 kcal/day (first trimester) and 361 ± 64.24 kcal/day (second trimester). Women significantly increased intake of maternal milks and malted drinks, but significantly reduced the intake of carbonated drinks and other drinks from before until the second trimester of pregnancy. For chocolate drinks, carbonated drinks, and soy milk, women increased intake from pre-conception to the first trimester, but reduced their intake from the first to the second trimester. While higher intake of cultured-milk drinks was associated with an increased risk of GDM, higher fruit juice intake was associated with a lower risk of GDM. However, these associations were only observed for intake prior to pregnancy and during the first trimester. Further research is needed to corroborate these findings and investigate the contributions of different beverages to overall diet quality as well as adverse health outcomes during pregnancy.
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Ishitsuka K, Sasaki S, Yamamoto-Hanada K, Mezawa H, Konishi M, Ohya Y. Changes in Dietary Intake in Pregnant Women from Periconception to Pregnancy in the Japan Environment and Children's Study: A Nationwide Japanese Birth Cohort Study. Matern Child Health J 2020; 24:389-400. [PMID: 31894508 DOI: 10.1007/s10995-019-02835-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Nutritional requirements increase during pregnancy. However, relatively few studies have examined longitudinal changes in dietary intake from periconception to pregnancy. Here, we investigated changes in the intake of food and nutrients, and compliance with dietary reference intakes (DRIs) in pregnant women. METHODS The Japan Environment and Children's Study, a nationwide multicenter prospective cohort study, included 30,373 pregnant women who answered a validated food frequency questionnaire repeatedly to assess changes in dietary intake in periconception and pregnancy. Energy-adjusted intakes of food groups and nutrients were described using the density method. The percentage of women not meeting DRIs was calculated. RESULTS Of all foods groups examined, intake of food significantly increased from periconception to pregnancy for dairy products (mean difference 23.5 g/1000 kcal, 95% confidence interval [CI] 22.0-25.0 g/1000 kcal), confectionaries (2.0 g/1000 kcal, 1.8-2.2 g/1000 kcal), and soft drinks (1.3 g/1000 kcal, 0.3-2.3 g/1000 kcal). Of all nutrients examined, intake was significantly increased for calcium (mean difference 27 mg/1000 kcal, 95% CI 25-29 mg/1000 kcal), vitamin A (15 μgRE/1000 kcal, 13-18 g/1000 kcal), and saturated fat (0.4% energy, 0.4-0.4% energy). The percentage of women not meeting DRIs increased for vitamin B group, vitamin C, saturated fat and salt. CONCLUSION We found that energy-adjusted intakes of calcium, vitamin A, and saturated fat increased from periconception to pregnancy, while intake of other nutrients did not increase. The percentage of women not meeting DRIs increased for water-soluble vitamins, saturated fat, and salt.
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Affiliation(s)
- Kazue Ishitsuka
- Medical Research Center for Japan Environment and Children's Study, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan
| | - Kiwako Yamamoto-Hanada
- Medical Research Center for Japan Environment and Children's Study, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Hidetoshi Mezawa
- Medical Research Center for Japan Environment and Children's Study, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Mizuho Konishi
- Medical Research Center for Japan Environment and Children's Study, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Yukihiro Ohya
- Medical Research Center for Japan Environment and Children's Study, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
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12
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Diet and Healthy Lifestyle in the Management of Gestational Diabetes Mellitus. Nutrients 2020; 12:nu12103050. [PMID: 33036170 PMCID: PMC7599681 DOI: 10.3390/nu12103050] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/01/2020] [Accepted: 10/02/2020] [Indexed: 12/16/2022] Open
Abstract
Gestational diabetes mellitus (GDM) among pregnant women increases the risk of both short-term and long-term complications, such as birth complications, babies large for gestational age (LGA), and type 2 diabetes in both mother and offspring. Lifestyle changes are essential in the management of GDM. In this review, we seek to provide an overview of the lifestyle changes which can be recommended in the management of GDM. The diet recommended for women with GDM should contain sufficient macronutrients and micronutrients to support the growth of the foetus and, at the same time, limit postprandial glucose excursions and encourage appropriate maternal gestational weight gain. Blood glucose excursions and hyperglycaemic episodes depend on carbohydrate-intake. Therefore, nutritional counselling should focus on the type, amount, and distribution of carbohydrates in the diet. Further, physical activity has beneficial effects on glucose and insulin levels and it can contribute to a better glycaemic control.
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13
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Consumption of non-nutritive sweeteners during pregnancy. Am J Obstet Gynecol 2020; 223:211-218. [PMID: 32275895 DOI: 10.1016/j.ajog.2020.03.034] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 01/15/2023]
Abstract
In an effort to reduce sugar consumption to prevent diabetes mellitus and cardiovascular diseases, "sugar-free" or "no added sugar" products that substitute sugar with non-nutritive sweeteners (NNSs) (eg, Splenda, Sweet'N Low, and Stevia) have become increasingly popular. The use of these products during pregnancy has also increased, with approximately 30% of pregnant women reporting intentional NNS consumption. In clinical studies with nonpregnant participants and animal models, NNSs were shown to alter gut hormonal secretion, glucose absorption, appetite, kidney function, in vitro insulin secretion, adipogenesis, and microbiome dysbiosis of gut bacteria. In pregnant animal models, NNS consumption has been associated with altered sweet taste preference later in life and metabolic dysregulations in the offspring (eg, elevated body mass index, increased risk of obesity, microbiome dysbiosis, and abnormal liver function tests). Despite the accumulating evidence, no specific guidelines for NNS consumption are available for pregnant women. Furthermore, there are limited clinical studies on the effects of NNS consumption during pregnancy and postpartum and long-term outcomes in the offspring.
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14
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Acehnese Cultural Leaders’ Perspective on Anemia in Pregnant Women: A Qualitative Study. ADVANCES IN PUBLIC HEALTH 2020. [DOI: 10.1155/2020/8710254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Anemia during pregnancy is one of the commonest issues in pregnancy. Cultural belief is among the contributing factors to this problem. This study aims to explore the cultural leaders’ perception on Acehnese culture regarding anemia in pregnancy. Methods. The qualitative study was conducted using three in-depth interviews and a focus group discussion with Acehnese cultural leaders. Data analysis was conducted by the inductive content analysis method. Results. Four themes emerged from interviews and discussion: (1) cultural beliefs about anemia; (2) locally resourced food; (3) husband participation in preventing anemia during pregnancy; (4) do’s and don’ts. Conclusion. Our findings provide insight into how cultural leaders’ perceptions of anemia are in pregnancy and how they are integrated strongly into Acehnese people’s lives. These findings would assist in developing culturally adapted strategic policy to prevent anemia during pregnancy.
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15
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Saunders CM, Rehbinder EM, Carlsen KCL, Gudbrandsgard M, Carlsen KH, Haugen G, Hedlin G, Jonassen CM, Sjøborg KD, Landrø L, Nordlund B, Rudi K, O Skjerven H, Söderhäll C, Staff AC, Vettukattil R, Carlsen MH. Food and nutrient intake and adherence to dietary recommendations during pregnancy: a Nordic mother-child population-based cohort. Food Nutr Res 2019; 63:3676. [PMID: 31920469 PMCID: PMC6939665 DOI: 10.29219/fnr.v63.3676] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 12/21/2022] Open
Abstract
Background A woman's food intake during pregnancy has important implications not only for herself but also for the future health and well-being of her child. Suboptimal dietary quality has been consistently reported in many high-income countries, reflecting poor adherence to dietary guidelines. Objective This study aimed to explore the intake of food and nutrients in a cohort of pregnant women in Norway and their adherence to Nordic Nutrition Recommendations (NNR) and Norwegian food-based guidelines (NFG). Design We investigated the dietary intake in 1,674 pregnant women from the mother-child birth cohort, PreventADALL, recruited at approximately 18-week gestational age. Dietary intake was assessed by an electronic validated food frequency questionnaire (PrevFFQ) in the first half of pregnancy. Results Total fat intake was within the recommended intake (RI) range in most women; however, the contribution of saturated fatty acids to the total energy intake was above RI in the majority (85.2%) of women. Carbohydrate intake was below RI in 43.9% of the women, and 69.5% exceeded the RI of salt. Intakes of fiber, vegetables, and fish were high in a large part of the population. Many women had a high probability of inadequate intakes of the following key micronutrients during pregnancy: folate (54.4%), iron (49.6%), calcium (36.2%), vitamin D (28.7%), iodine (24.4%), and selenium (41.3%). A total of 22.8% women reported an alcohol intake of >1 g/day, and 4.4% reported an alcohol intake of >10 g/day. Women with higher educational levels showed a tendency towards healthier eating habits, except for higher intakes of alcohol and coffee, compared to women with lower educational level. Discussion Excessive saturated fat intake and limited intake of many important micronutrients during pregnancy were common, potentially increasing the risk for adverse pregnancy and birth outcomes. Conclusions This study highlights the need for improved nutritional guidance to pregnant women across all educational levels.
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Affiliation(s)
- Carina Madelen Saunders
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Eva Maria Rehbinder
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - Karin C Lødrup Carlsen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Malén Gudbrandsgard
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Kai-Håkon Carlsen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Guttorm Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Christine Monceyron Jonassen
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway.,Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | | | - Linn Landrø
- Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Håvard O Skjerven
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Cilla Söderhäll
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Anne Cathrine Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Riyas Vettukattil
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Monica Hauger Carlsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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16
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Tovar A, Kaar JL, McCurdy K, Field AE, Dabelea D, Vadiveloo M. Maternal vegetable intake during and after pregnancy. BMC Pregnancy Childbirth 2019; 19:267. [PMID: 31349808 PMCID: PMC6660649 DOI: 10.1186/s12884-019-2353-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 06/04/2019] [Indexed: 11/10/2022] Open
Abstract
Background Improved understanding of vegetable intake changes between pregnancy and postpartum may inform future intervention targets to establish healthy home food environments. Therefore, the goal of this study was to explore the changes in vegetable intake between pregnancy and the postnatal period and explore maternal and sociodemographic factors that are associated with these changes. Methods We examined sociodemographic, dietary, and health characteristics of healthy mothers 18-43y from the prospective Infant Feeding Practices II cohort (n = 847) (2005–2012). Mothers completed a modified version of the diet history questionnaire, a food-frequency measure, developed by the National Cancer Institute. We created four categories of mothers, those that were: meeting vegetable recommendations post- but not prenatally (n = 121; improved intake), not meeting vegetable recommendations during pregnancy and postnatally (n = 370; stable inadequate), meeting recommendations pre- but not postnatally (n = 123; reduced intake), and meeting recommendations at both time points (n = 233; stable adequate). To make our results more relevant to public health recommendations, we were interested in comparing the improved vegetable intake group vs. stable inadequate vegetable intake group, as well as those that reduced their vegetable intake compared to the stable adequate vegetable intake group. Separate multivariable-adjusted logistic regression were used to examine sociodemographic predictors of improved vs. stable inadequate and reduced vs. stable adequate vegetable intake. Results Women with improved vegetable intake vs. stable inadequate smoked fewer cigarettes while women with reduced vegetable intake vs. stable adequate were more likely to experience less pregnancy weight gain. In adjusted models, employed women had greater odds of reduced vegetable intake (OR = 1.64 95% CI 1.14–2.36). In exploratory analyses, employment was associated with greater odds of reduced vegetable intake among low-income (OR = 1.79; 95% CI 1.03–3.1), but not higher income women (OR = 1.31; 95% CI 0.94–1.84). After further adjustment for paid maternity leave, employment was no longer associated with vegetable intake among lower income women (OR: 1.53; 95% CI: 0.76–3.05). Conclusions More women with reduced vs. stable adequate vegetable intake were lower income and worked full time. Improved access to paid maternity leave may help reduce disparities in vegetable quality between lower and higher income women.
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Affiliation(s)
- Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, 41 Lower College Road, Kingston, RI, 02881, USA.
| | - Jill L Kaar
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Karen McCurdy
- Department of Human Development and Family Studies, University of Rhode Island, Kingston, RI, USA
| | - Alison E Field
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Dana Dabelea
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Maya Vadiveloo
- Department of Nutrition and Food Sciences, University of Rhode Island, 41 Lower College Road, Kingston, RI, 02881, USA
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17
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Affiliation(s)
- Favorite Iradukunda
- College of Nursing, University of Massachusetts Amherst, Amherst, Massachusetts, USA
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18
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Hillesund ER, Bere E, Sagedal LR, Vistad I, Seiler HL, Torstveit MK, Øverby NC. Pre-pregnancy and early pregnancy dietary behavior in relation to maternal and newborn health in the Norwegian Fit for Delivery study - a post hoc observational analysis. Food Nutr Res 2018; 62:1273. [PMID: 30108471 PMCID: PMC6085578 DOI: 10.29219/fnr.v62.1273] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 07/18/2018] [Accepted: 07/19/2018] [Indexed: 12/16/2022] Open
Abstract
Background Randomized controlled trials targeting maternal dietary and physical activity behaviors during pregnancy have generally failed to accomplish reductions in the prevalence of adverse maternal and neonatal outcomes. Interventions carried out during pregnancy could thus be missing the mark in maximizing intervention health benefit. Objective To investigate whether pre-pregnancy and early pregnancy dietary behavior as reported at inclusion into the Norwegian Fit for Delivery (NFFD) trial was associated with maternal and neonatal outcomes irrespective of subsequent randomization assignment. Design The study is a post-hoc observational analysis of data from a randomized controlled lifestyle intervention. We constructed two diet scores from participant responses to a 43-item questionnaire that addressed dietary behavior in retrospect (pre-pregnancy diet score) and dietary behavior at inclusion (early pregnancy diet score), respectively. The diet scores ranged from 0 to 10, with higher score reflecting healthier dietary behavior. Associations between diet scores and maternal and neonatal health outcomes were estimated in multivariate logistic regression models. Results A total of 591 women were eligible for analysis. A one-point increase in pre-pregnancy diet score was associated with lower odds of excessive gestational weight gain (GWG) (odds ratio [OR]adj: 0.92; 95% confidence interval [CI]: 0.84-1.00, p = 0.050), preterm delivery (ORadj: 0.81; 95% CI: 0.68-0.97, p = 0.019), and birthweight ≥ 4,000 g (ORadj: 0.88; 95% CI: 0.78-0.99, p = 0.038). A one-point increase in early pregnancy diet score was associated with lower odds of excessive GWG (ORadj: 0.88; 95% CI: 0.79-0.97, p = 0.009), preterm delivery (ORadj: 0.82; 95% CI: 0.67-0.99, p = 0.038), and preeclampsia (ORadj: 0.78; 95% CI: 0.62-0.99, p = 0.038). Discussion Higher diet score either pre-pregnancy or in early pregnancy was protectively associated with excessive GWG and preterm delivery, whereas the protective association with high birthweight was confined to pre-pregnancy diet and with preeclampsia to early pregnancy diet. Conclusions Both pre-pregnancy and early pregnancy dietary behavior was associated with important maternal and neonatal health outcomes in the NFFD dataset.
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Affiliation(s)
- Elisabet R Hillesund
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway
| | - Elling Bere
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway
| | - Linda R Sagedal
- Department of Obstetrics and Gynecology, Sørlandet Hospital HF, Kristiansand, Norway.,Department of Research, Sørlandet Hospital HF, Kristiansand, Norway
| | - Ingvild Vistad
- Department of Obstetrics and Gynecology, Sørlandet Hospital HF, Kristiansand, Norway.,Department of Research, Sørlandet Hospital HF, Kristiansand, Norway
| | - Hilde L Seiler
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway
| | - Monica K Torstveit
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway
| | - Nina C Øverby
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway
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19
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Hillier SE, Olander EK. Women's dietary changes before and during pregnancy: A systematic review. Midwifery 2017; 49:19-31. [DOI: 10.1016/j.midw.2017.01.014] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 01/16/2017] [Accepted: 01/30/2017] [Indexed: 10/20/2022]
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21
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Skreden M, Øverby NC, Sagedal LR, Vistad I, Torstveit MK, Lohne-Seiler H, Bere E. Change in active transportation and weight gain in pregnancy. Int J Behav Nutr Phys Act 2016; 13:10. [PMID: 26818593 PMCID: PMC4730776 DOI: 10.1186/s12966-016-0332-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 01/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pregnancy is characterised by large weight gain over a short period, and often a notable change in mode of transportation. This makes pregnancy suitable for examining the plausible, but in the scientific literature still unclear, association between active transportation and weight gain. We hypothesize that women continuing an active mode of transportation to work or school from pre- to early pregnancy will have a lower gestational weight gain (GWG) than those who change to a less active mode of transportation. METHODS We analysed prospective data from the Norwegian Fit for Delivery (NFFD) trial. Between September 2009 and February 2013 606 women were consecutively enrolled in median gestational week 16 (range; 8-20). Of 219 women who used an active mode of transportation (biking, walking, public transportation) pre-pregnancy, 66 (30%) converted to a less active mode in early pregnancy ("active-less active" group), and 153 (70%) continued with active transportation ("active-active" group). Pre-pregnancy weight was self-reported. Weight at gestational (GA) weeks 16, 30, 36, and at term delivery was objectively measured. Weight gain was compared between the two groups. Linear mixed effects analysis of the repeated weight measures was performed including the group*time interaction. RESULTS A significant overall group effect was observed for the four time points together ("active-active" group: 77.3 kg vs. "active-less active" group: 78.8 kg, p = 0.008). The interaction term group*time was significant indicating different weight gain throughout pregnancy for the two groups; the mean differences between the groups were 0.7 kg at week 16, 1.4 kg at week 30, 2.1 kg at week 36, and 2.2 kg at term delivery, respectively. CONCLUSION The findings indicate that active transportation is one possible approach to prevent excessive weight gain in pregnancy.
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Affiliation(s)
- Marianne Skreden
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway.
| | - Nina C Øverby
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway.
| | - Linda R Sagedal
- Department of Obstetrics and Gynaecology, Sørlandet Hospital, Kristiansand, Norway.
| | - Ingvild Vistad
- Department of Obstetrics and Gynaecology, Sørlandet Hospital, Kristiansand, Norway.
| | - Monica K Torstveit
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway.
| | - Hilde Lohne-Seiler
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway.
| | - Elling Bere
- Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway.
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22
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Selected Literature Watch. JOURNAL OF CAFFEINE RESEARCH 2014. [DOI: 10.1089/jcr.2014.1243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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