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Hakimi S, Dutta P, Layton AT. Renal calcium and magnesium handling during pregnancy: modeling and analysis. Am J Physiol Renal Physiol 2024; 327:F77-F90. [PMID: 38721663 DOI: 10.1152/ajprenal.00001.2024] [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: 01/09/2024] [Revised: 04/15/2024] [Accepted: 05/05/2024] [Indexed: 06/21/2024] Open
Abstract
Pregnancy is associated with elevated demand of most nutrients, with many trace elements and minerals critical for the development of fetus. In particular, calcium (Ca2+) and magnesium (Mg2+) are essential for cellular function, and their deficiency can lead to impaired fetal growth. A key contributor to the homeostasis of these ions is the kidney, which in a pregnant rat undergoes major changes in morphology, hemodynamics, and molecular structure. The goal of this study is to unravel the functional implications of these pregnancy-induced changes in renal handling of Ca2+ and Mg2+, two cations that are essential in a healthy pregnancy. To achieve that goal, we developed computational models of electrolyte and water transport along the nephrons of a rat in mid and late pregnancy. Model simulations reveal a substantial increase in the reabsorption of Mg2+ along the proximal tubules and thick ascending limbs. In contrast, the reabsorption of Ca2+ is increased in the proximal tubules but decreased in the thick ascending limbs, due to the lower transepithelial concentration gradient of Ca2+ along the latter. Despite the enhanced transport capacity, the marked increase in glomerular filtration rate results in elevated urinary excretions of Ca2+ and Mg2+ in pregnancy. Furthermore, we conducted simulations of hypocalcemia and hypomagnesemia. We found that hypocalcemia lowers Ca2+ excretion substantially more than Mg2+ excretion, with this effect being more pronounced in virgin rats than in pregnant ones. Conversely, hypomagnesemia reduces the excretion of Mg2+ and Ca2+ to more similar degrees. These differences can be explained by the greater sensitivity of the calcium-sensing receptor (CaSR) to Ca2+ compared with Mg2+.NEW & NOTEWORTHY A growing fetus' demands of minerals, notably calcium and magnesium, necessitate adaptations in pregnancy. In particular, the kidney undergoes major changes in morphology, hemodynamics, and molecular structure. This computational modeling study provides insights into how these pregnancy-induced renal adaptation impact calcium and magnesium transport along different nephron segments. Model simulations indicate that, despite the enhanced transport capacity, the marked increase in glomerular filtration rate results in elevated urinary excretions of calcium and magnesium in pregnancy.
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Affiliation(s)
- Shervin Hakimi
- Department of Applied Mathematics, University of Waterloo, Waterloo, Ontario, Canada
| | - Pritha Dutta
- Department of Applied Mathematics, University of Waterloo, Waterloo, Ontario, Canada
| | - Anita T Layton
- Department of Applied Mathematics, University of Waterloo, Waterloo, Ontario, Canada
- Department of Biology, Cheriton School of Computer Science, and School of Pharmacology, University of Waterloo, Waterloo, Ontario, Canada
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Nisar S, Kareem O, Muzaffer U, Tanvir M, Ganaie MA, Ahmed RN. Descriptive spectrum of thiamine deficiency in pregnancy: A potentially preventable condition. Int J Gynaecol Obstet 2024; 164:157-165. [PMID: 37458305 DOI: 10.1002/ijgo.14989] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVE Pregnancy, a nutritionally demanding situation in terms of macro- and micronutrient supply owing to heightened maternal, placental, and fetal needs, significantly affects thiamine reserves. Thiamine deficiency during pregnancy and the postpartum period, presenting with varied manifestations and outcomes, is a relatively common condition in our population. The study aimed to understand the various manifestations and outcomes of acute thiamine deficiency in pregnant and postpartum women, emphasizing the significance of early recognition and thiamine therapy to prevent serious complications during pregnancy and after childbirth. METHODS This prospective study conducted in a tertiary care center in North India enrolled consecutive pregnant and postpartum women presenting with clinical features consistent with thiamine deficiency disorders, such as thiamine deficiency-related neuropathy, high-output heart failure, heart failure with reduced ejection fraction, Wernicke's encephalopathy, gastric beriberi, and thiamine-responsive acute pulmonary hypertension. In addition to capturing medical history including drug intake, dietary consumption, and comorbidities, women underwent brief relevant clinical examinations and laboratory assessments, including whole-blood thiamine levels. Response to intravenous thiamine supplementation was also monitored. RESULTS Data of 31 women (12 pregnant, 19 postpartum) with a diagnosis of acute thiamine deficiency and a mean age of 28.88 ± 2.69 years were analyzed. The mean thiamine level was 1.28 ± 0.44 μg/dL with mean blood lactate of 3.46 ± 3.33. The most common presentation was gastric beriberi (n = 10), followed by paraparesis (n = 6), high-output heart failure (n = 6), acute pulmonary hypertension, heart failure with reduced ejection fraction (n = 3 each), and an acute confusional state (n = 2). All patients responded to thiamine challenge. CONCLUSION In the context of borderline thiamine status, particularly in our population with endemic thiamine deficiency and heightened demand for thiamine during pregnancy and the peripartum period, the deficiency can have varied and serious manifestations of dry and wet beriberi. Early recognition of the clinical features and thiamine therapy can be life-saving. There is a need for validated clinical criteria owing to the non-availability of thiamine testing in resource-limited settings.
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Affiliation(s)
- Sobia Nisar
- Department of Medicine, Government Medical College, Srinagar, India
| | - Ozaifa Kareem
- Department of Pharmaceutical Sciences, University of Kashmir, Srinagar, India
| | - Umar Muzaffer
- Department of Medicine, Government Medical College, Srinagar, India
| | - Masood Tanvir
- Department of Medicine, Government Medical College, Srinagar, India
| | - Mohd Ashraf Ganaie
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
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Sugandhi VV, Pangeni R, Vora LK, Poudel S, Nangare S, Jagwani S, Gadhave D, Qin C, Pandya A, Shah P, Jadhav K, Mahajan HS, Patravale V. Pharmacokinetics of vitamin dosage forms: A complete overview. Food Sci Nutr 2024; 12:48-83. [PMID: 38268871 PMCID: PMC10804103 DOI: 10.1002/fsn3.3787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/07/2023] [Accepted: 10/11/2023] [Indexed: 01/26/2024] Open
Abstract
Vitamins are crucial for sustaining life because they play an essential role in numerous physiological processes. Vitamin deficiencies can lead to a wide range of severe health issues. In this context, there is a need to administer vitamin supplements through appropriate routes, such as the oral route, to ensure effective treatment. Therefore, understanding the pharmacokinetics of vitamins provides critical insights into absorption, distribution, and metabolism, all of which are essential for achieving the desired pharmacological response. In this review paper, we present information on vitamin deficiencies and emphasize the significance of understanding vitamin pharmacokinetics for improved clinical research. The pharmacokinetics of several vitamins face various challenges, and thus, this work briefly outlines the current issues and their potential solutions. We also discuss the feasibility of enhanced nanocarrier-based pharmaceutical formulations for delivering vitamins. Recent studies have shown a preference for nanoformulations, which can address major limitations such as stability, solubility, absorption, and toxicity. Ultimately, the pharmacokinetics of pharmaceutical dosage forms containing vitamins can impede the treatment of diseases and disorders related to vitamin deficiency.
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Affiliation(s)
| | - Rudra Pangeni
- Department of PharmaceuticsVirginia Commonwealth UniversityRichmondVirginiaUSA
| | | | - Sagun Poudel
- Department of PharmaceuticsVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Sopan Nangare
- Department of PharmaceuticsH. R. Patel Institute of Pharmaceutical Education and ResearchShirpurMaharashtraIndia
| | - Satveer Jagwani
- KLE College of PharmacyKLE Academy of Higher Education and ResearchBelagaviKarnatakaIndia
| | - Dnyandev Gadhave
- Department of PharmaceuticsSinhgad Technical Education SocietySinhgad Institute of PharmacyPuneMaharashtraIndia
| | - Chaolong Qin
- Department of PharmaceuticsVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Anjali Pandya
- Department of Pharmaceutical Sciences and TechnologyInstitute of Chemical TechnologyMumbaiIndia
| | - Purav Shah
- Thoroughbred Remedies ManufacturingTRM Industrial EstateNewbridgeIreland
| | - Kiran Jadhav
- KLE College of PharmacyKLE Academy of Higher Education and ResearchBelagaviKarnatakaIndia
| | - Hitendra S. Mahajan
- Department of PharmaceuticsR. C. Patel Institute of Pharmaceutical Education and ResearchShirpurMaharashtraIndia
| | - Vandana Patravale
- Department of Pharmaceutical Sciences and TechnologyInstitute of Chemical TechnologyMumbaiIndia
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Al Mansoori A, Bataineh MF, Al Momani H, Ali HI. Micronutrient Status in Pregnant Women after Metabolic Bariatric Surgery in the United Arab Emirates: A Prospective Study. Nutrients 2023; 16:72. [PMID: 38201902 PMCID: PMC10781104 DOI: 10.3390/nu16010072] [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: 11/21/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
Metabolic bariatric surgery (MBS) helps reduce comorbidities, such as hypertension and gestational diabetes, and is more effective than diet management for women with obesity-related health issues. Vitamin B12, vitamin D, and iron play important roles in ensuring the health of a neonate. However, pregnancies occurring after MBS may face complications related to micronutrient deficiencies, particularly of vitamins B12 and D and iron. This study aimed to investigate the vitamin B12, vitamin D, ferritin, and iron status of pregnant women who underwent MBS compared with women without MBS history. The study included 217 pregnant women (105 with a history of MBS and 112 without a history of MBS) who visited a major maternity hospital in Abu Dhabi, United Arab Emirates (UAE) between July 2021 and November 2022. The maternal vitamin B12, vitamin D, iron, and ferritin levels were measured twice, initially during the first or second trimester and subsequently during the third trimester. The iron was measured once during the pregnancy. Vitamin B12 deficiency was higher among pregnant women with MBS history compared to non-bariatric pregnant women (24.4% vs. 3.9%, p < 0.001). Women with a history of MBS had a higher prevalence of vitamin D deficiency (62.3% vs. 37.7%, p < 0.002). Linear regression analysis indicated that vitamin B12 levels decreased by 55 pg/mL in women with a history of MBS and by 4.6 pg/mL with a unit increase in body mass index (kg/m2). Furthermore, vitamin D levels in women with a history of MBS decreased by 4.9 ng/mL during pregnancy. Metabolic bariatric surgery is associated with vitamin B12, vitamin D, and iron deficiencies during pregnancy.
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Affiliation(s)
- Amna Al Mansoori
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (A.A.M.); (M.F.B.)
| | - Mo’ath F. Bataineh
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (A.A.M.); (M.F.B.)
| | - Hazem Al Momani
- Weight Management Unit, NMC Royal Khalifa Hospital, Abu Dhabi P.O. Box 35233, United Arab Emirates;
| | - Habiba I. Ali
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (A.A.M.); (M.F.B.)
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Morales-Suárez-Varela M, Peraita-Costa I, Perales-Marín A, Marcos Puig B, Llopis-Morales J, Picó Y. Effect of Adherence to the Mediterranean Diet on Maternal Iron Related Biochemical Parameters during Pregnancy and Gestational Weight Gain. Life (Basel) 2023; 13:life13051138. [PMID: 37240783 DOI: 10.3390/life13051138] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
Gestation is a crucial life stage for both women and offspring, and outcomes are affected by many environmental factors, including diet. The Mediterranean dietary pattern (MD) is considered a healthy eating pattern that can provide the nutritional requirements of pregnancy. Meanwhile, iron deficiency anemia is one of the most frequent complications related to pregnancy. This study aimed to evaluate how the level of adherence to the MD influences maternal gestational weight gain and specific iron-related maternal biochemical parameters during the pregnancy. Accordingly, an observational, population-based study using data from pregnant women conducted over the entire course of their pregnancy was carried out. Adherence to the MD was assessed once using the MEDAS score questionnaire. Of the 506 women studied, 116 (22.9%) were classified as demonstrating a high adherence, 277 (54.7%) a medium adherence, and 113 (22.3%) a low adherence to the MD. No differences were observed in gestational weight gain among the MD adherence groups but the adequacy of weight gain did vary among the groups, with the proportions of inadequate (insufficient or excessive) weight gain presenting the most notable differences. Total anemia prevalence was 5.3%, 15.6%, and 12.3%, respectively, during the first, second, and third trimesters. For iron-related biochemical parameters, no differences are observed among the adherence groups during pregnancy. With high adherence to the MD as the reference group, the crude odds of iron deficiency diagnosis are significant in the first trimester for both the medium [OR = 2.99 (1.55-5.75)] and low [OR = 4.39 (2.15-8.96)] adherence groups, with deficient adherence to the Mediterranean dietary pattern being responsible for 66.5% (35.5-82.6) and 77.2% (53.5-88.8) of the risk of iron deficiency diagnosis for medium and low adherence, respectively. However, adjusted odds ratios were not significant, possibly due to the small sample size. Our data suggest that MD adherence could be related to gestational weight gain adequacy and that optimal adherence could reduce iron deficiency and/or anemia during pregnancy in the studied population.
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Affiliation(s)
- María Morales-Suárez-Varela
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot, València, Spain
- Biomedical Research Center in Epidemiology and Public Health Network, Carlos III Health Institute, Av. Monforte de Lemos 3-5 Pabellón 11 Planta 0, 28029 Madrid, Madrid, Spain
| | - Isabel Peraita-Costa
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot, València, Spain
- Biomedical Research Center in Epidemiology and Public Health Network, Carlos III Health Institute, Av. Monforte de Lemos 3-5 Pabellón 11 Planta 0, 28029 Madrid, Madrid, Spain
| | - Alfredo Perales-Marín
- Department of Gynecology and Obstetrics, La Fé University and Polytechnic Hospital, Avda. Fernando Abril Martorell, 106, 46026 València, Valencia, Spain
| | - Beatriz Marcos Puig
- Department of Gynecology and Obstetrics, La Fé University and Polytechnic Hospital, Avda. Fernando Abril Martorell, 106, 46026 València, Valencia, Spain
| | - Juan Llopis-Morales
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot, València, Spain
| | - Yolanda Picó
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot, València, Spain
- Biomedical Research Center in Epidemiology and Public Health Network, Carlos III Health Institute, Av. Monforte de Lemos 3-5 Pabellón 11 Planta 0, 28029 Madrid, Madrid, Spain
- Environmental and Food Safety Research Group (SAMA-UV), Desertification Research Centre, (CIDE, CSIC-UV-GV), Moncada-Naquera Road Km 4.5, 46113 Moncada, Valencia, Spain
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ÇOBANOĞULLARI HAVVA, ERGOREN MAHMUTCERKEZ, DUNDAR MUNIS, BERTELLI MATTEO, TULAY PINAR. Periconceptional Mediterranean diet during pregnancy on children's health. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E65-E73. [PMID: 36479491 PMCID: PMC9710394 DOI: 10.15167/2421-4248/jpmh2022.63.2s3.2748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
During pregnancy, rapid and subtle physiological changes are observed from conception to birth. Nutrition and other lifestyle factors before and during pregnancy have been shown in the literature to influence the health of both mother and child. A healthy and varied diet during pregnancy can provide adequate energy and nutrients for both the mother and the growing fetus. Current research focuses on the periconceptional phase, which includes the early processes of gametogenesis, embryogenesis and placentation. A variety of abnormalities and pregnancy-related problems occur during this period, including congenital defects, fetal loss, miscarriage and preterm birth. A varied and balanced diet during periconception is important to maintain fetal development and growth. To date, numerous studies have been conducted to investigate the effects of consuming different nutrients, foods or food groups during pregnancy on the health of mother and child. For example, the Mediterranean diet is considered as a balanced, nutrient-rich diet due to the low consumption of meat products and fatty foods and the high consumption of vegetables, cheese, olive oil, fish, shellfish and little meat. While many studies have been conducted in the literature to investigate the effects of a Mediterranean diet during pregnancy on fetal health, the results have been inconclusive. The aim of this article is to review the current literature on the Mediterranean diet during pregnancy.
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Affiliation(s)
- HAVVA ÇOBANOĞULLARI
- Near East University, Faculty of Medicine, Department of Molecular Medicine, Nicosia, Cyprus
| | - MAHMUT CERKEZ ERGOREN
- Near East University, Faculty of Medicine, Department of Medical Genetics, Nicosia, Cyprus
| | - MUNIS DUNDAR
- Erciyes University, Faculty of Medicine, Department of Medical Genetics, Kayseri, Turkey
| | - MATTEO BERTELLI
- MAGISNAT, Peachtree Corners, USA
- MAGI Euregio, Bolzano, Italy
- MAGI’S LAB, Rovereto, Italy
| | - PINAR TULAY
- Near East University, Faculty of Medicine, Department of Medical Genetics, Nicosia, Cyprus
- Near East University, DESAM Research Institute, Nicosia, Cyprus
- Correspondence: Pınar Tulay, Near East University, Faculty of Medicine, Department of Medical Genetics, 99138 Nicosia, Cyprus. E-mail:
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Xiang C, Luo J, Yang G, Sun M, Liu H, Yang Q, Ouyang Y, Xi Y, Yong C, Khan MJ, Lin Q. Dietary Supplement Use during Pregnancy: Perceptions versus Reality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074063. [PMID: 35409746 PMCID: PMC8998507 DOI: 10.3390/ijerph19074063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 02/01/2023]
Abstract
This study aimed to examine the prevalence, associated factors and perceptions of dietary supplement use among pregnant Chinese women. A cross-sectional study was conducted to collect data about prevalence, purchase channels, perceptions, and related factors of dietary supplement use from 572 pregnant women, through a face-to-face survey, using a self-designed questionnaire. Of the respondents, 94.8% used at least one dietary supplement, whereas 29.8% used more than four supplements in the previous month. The majority of the pregnant women were highly educated (81.2% had a bachelor’s degree or above) and had the perception that dietary supplements could prevent and improve (89.2%), or treat, nutrition-related diseases (78.7%). Multivariate analysis showed that pregnant women who had used multiple (more than four) supplements were more likely to have a larger gestational age, received fertility treatment, more prenatal visits, and hypothyroidism during pregnancy. Furthermore, pregnant women not only purchased dietary supplements through hospitals (72.6%) and pharmacies (45.1%), but overseas Daigou or online purchases (31.8%) were also a major channel of purchase. A high prevalence of dietary supplement use during pregnancy was observed, with extensive and repeated consumption of nutrients. Pregnant women’s craze for dietary supplements calls for more comprehensive guidelines in China.
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Affiliation(s)
- Caihong Xiang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
| | - Jing Luo
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
| | - Guilian Yang
- Department of Women Health, Hunan Maternal and Child Health Care Hospital, 53 Xiangchun Road, Changsha 410008, China;
| | - Minghui Sun
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
| | - Hanmei Liu
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
| | - Qiping Yang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
| | - Yufeng Ouyang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK
| | - Yue Xi
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
| | - Cuiting Yong
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
| | - Muhammad Jamal Khan
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
| | - Qian Lin
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
- Correspondence: ; Tel.: +86-138-7482-0173
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Kumari D, Garg S, Bhawrani P. Zinc homeostasis in immunity and its association with preterm births. Scand J Immunol 2022; 95:e13142. [PMID: 35007353 DOI: 10.1111/sji.13142] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 12/27/2021] [Accepted: 01/06/2022] [Indexed: 11/27/2022]
Abstract
Preterm birth is among the most common adverse pregnancy outcomes and is the leading cause of neonatal mortality and morbidity. While trace elements are essential for humans, their specific roles in the prenatal period remain unexplored. Zinc, a ubiquitous element plays a pivotal role in protein synthesis, cell division, nucleic acid metabolism, apoptosis, ageing, reproduction, immunological as well as antioxidant defense mechanism. Although zinc quantities are very small in body tissue, it is involved in every conceivable biochemical pathway which is critical for the performance of various functions necessary to sustain life. Owing to the multifactorial role of zinc, it is not possible to attribute a certain zinc dependent mechanism in pre-term births. Although the effect of zinc deficiency on immunity, its impact on maternal function and health as well as its role in the developing foetus is well documented, much less attention has been given to the understanding of micronutrient zinc homeostasis in immunity and its association with preterm births. Despite extensive research, the pathway by which zinc regulates pregnancy outcomes as well as the function of immune cells in controlling the delivery status (term/ preterm) is still obscure. The present review aims to focus on the understanding of relationship of micronutrient zinc homeostasis in immunity and its association with preterm births.
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Affiliation(s)
- Deepa Kumari
- Department of Obstetrics and Gynecology, Mahatma Gandhi University of Medical Science & Technology, Jaipur, Rajasthan- 302022
| | - Swati Garg
- Department of Obstetrics and Gynecology, Mahatma Gandhi University of Medical Science & Technology, Jaipur, Rajasthan- 302022
| | - Priyanka Bhawrani
- ICMR Project, Mahatma Gandhi University of Medical Science & Technology, Jaipur, Rajasthan- 302022
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Pyridoxine deficiency modulates benzene inhalation-induced hematotoxicity associated with hepatic CYP2E1 activity in B 6C 3F 1 mice. Toxicol Rep 2021; 8:1607-1615. [PMID: 34522624 PMCID: PMC8426182 DOI: 10.1016/j.toxrep.2021.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 08/25/2021] [Accepted: 08/29/2021] [Indexed: 11/21/2022] Open
Abstract
Modifying effects of pyridoxine deficiency on benzene toxicity were assessed in B6C3F1 mice. The mice were fed either a pyridoxine-deficient diet or control diet. Pyridoxine deficiency was combined with nose-only benzene inhalation exposure (100 ppm). Pyridoxine deficiency and benzene inhalation led to lower body, thymus and spleen weights. The treatment combination also led to higher hepatic CYP2E1 protein expression and activity.
Pyridoxine is a co-factor in many enzymatic reactions and impacts of deficiency have been observed in affected populations. A possible modifying effect of pyridoxine deficiency on benzene toxicity was assessed in male B6C3F1 mice fed either a pyridoxine-deficient diet or a control diet. This treatment was combined with benzene inhalation exposure (100 ppm) or no benzene treatment. Pyridoxine-deficient mice exposed to 100 ppm benzene had significantly lower body, thymus and spleen weights. While total white blood cell counts, percentage of lymphocytes, hematocrit and hemoglobin levels were lower, the percentage of neutrophils was significantly higher in deficient and benzene-exposed mice compared to non-exposed controls. Hepatic CYP2E1 protein expression and activity in the deficient and exposed mice were also significantly higher compared to the non-exposed controls. A significant correlation between CYP2E1 activity and several hematological parameters was observed. These results demonstrated that pyridoxine deficiency significantly impacted benzene-induced hematotoxicity. Moreover, the observed agonistic effect of pyridoxinedeficiency and benzene inhalation exposure on CYP2E1 would seem to indicate an involvement of metabolism, but this needs to be further assessed.
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Kayhan Tetik B, Gedik Tekinemre I, Kurt O. Evaluation of Adolescents' Status of The First-Step Health Services Use and Healthy Nutrition Behaviors. EURASIAN JOURNAL OF FAMILY MEDICINE 2021. [DOI: 10.33880/ejfm.2021100207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: This study aimed to evaluate the status of the first-step health services use, healthy nutrition behaviors in adolescents and investigate their relationships with each other.
Methods: One hundred and forty-six adolescents between the ages of 10 and 18 were included in this descriptive study. A survey of 15 questions about the participants' healthy nutritional behaviors, the status of knowing their family physicians, and going to their family physicians for the examination was applied. The obtained data were analyzed using the SPSS 22 package program, and p
Results: Of the participants, 85.6% went to their family physicians for the examination, the mean age was 16.4±1.6, and 58.9% were girls. Girls' mean scores of healthy nutritional behavior and going to their family physicians for the examination were significantly higher than boys'. In those who were obese and overweight, the rate of knowing their family physicians, the mean score of going to their family physicians for the examination, and healthy nutritional behavior were lower than normal weight.
Conclusion: In our study, lower obesity and overweight rates and having a healthier diet were seen in adolescents using primary health care services more. We believe that to eliminate obesity, which has been a significant public health problem today, increasing the rate of using primary health care services for adolescent individuals needs to be increased. We hope that our comments raised herein will encourage other physicians to be more sensitive about this issue and direct patients to primary care more often to receive such services.
Keywords: adolescents, nutrition behavior, primary health care
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Affiliation(s)
| | | | - Osman Kurt
- Department of Public Health, Firat University Medical Faculty
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11
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Kibr G. A Narrative Review of Nutritional Malpractices, Motivational Drivers, and Consequences in Pregnant Women: Evidence from Recent Literature and Program Implications in Ethiopia. ScientificWorldJournal 2021; 2021:5580039. [PMID: 34248425 PMCID: PMC8236338 DOI: 10.1155/2021/5580039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/27/2021] [Accepted: 06/08/2021] [Indexed: 11/17/2022] Open
Abstract
Maternal nutrition is very important for the wellbeing of pregnant women, childbirth, and lactating women, which are crucial and meant for the wellbeing of a mother and newborn baby. This narrative review discusses nutritional malpractices, motivational drivers, and their consequences typically from Ethiopian pregnant women's context. Different studies (regarding less of study design and type) done among pregnant women (aged 15-49 years) by considering pregnancy-related outcomes and timing of nutritional malpractices were included mostly. Accordingly, taboos of healthy diets, craving for unhealthy foods (sweet, fat, raw, and salty/spicy foods), and nonfood items (soil, coffee residue, stone, and ash) were practiced majorly by the women. The birth difficulty, fetal head plastering, fetus discoloration, fetus burns, abortion, and abdominal cramp are the primary drivers of taboos of healthy diets. Hormonal change and social and nutrient-seeking behavior are the most prevalent drivers to the consumption of unhealthy foods. Additionally, personal interest, flavor, and color of items are important motivators to practice pica. Such pica practice hurts nutrient intake, absorption of iron/zinc, abdominal health, and diarrhea occurrence. Food taboos are high predictors of health disorders, such as intrauterine growth restriction, infection, bleeding, preeclampsia, stillbirth, early birth, low birth weight, retarded development of cognitive, and anemia. Craving and eating unhealthy foods were interconnected with chronic disease development (hypertension, diabetes, heart disease, and cancer), discomforts, preterm labor, preeclampsia, and intrauterine growth restriction in women. Additionally, it is also associated with stillbirth, low birth weight, obesity, birth defect/deficit, hypertension, cancer, diabetes, metabolic syndrome, renal disease, decreased fetal growth, behavioral change, heart failure, and poor cognitive development in the infant. Overall, these nutritional malpractices are significantly associated with many argumentative pregnancies as well as developmental consequences leading to the direction of infant and maternal mortality and morbidity. Therefore, urgent implementation of health and nutrition education programs considering food misconceptions and beliefs regarding pregnancy and use of ground-breaking ways to play down the negative and maximize potential positive dietary effects designed by the government of Ethiopia could also serve as a long-term solution to the problem.
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Affiliation(s)
- Gesessew Kibr
- Department of Food and Nutritional Sciences, Faculty of Agriculture, Shambu Campus, Wollega University, P. O. Box: 38, Shambu, Ethiopia
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12
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Gong L, Yang Q, Liu CWB, Wang X, Zeng HL. Assessment of 12 Essential and Toxic Elements in Whole Blood of Pregnant and Non-pregnant Women Living in Wuhan of China. Biol Trace Elem Res 2021; 199:2121-2130. [PMID: 32780203 DOI: 10.1007/s12011-020-02337-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/06/2020] [Indexed: 12/21/2022]
Abstract
Exposures to toxic trace elements and deficiencies of essential elements during pregnancy are associated to various birth complications. Assessment of the trace elements in pregnant women living in specific areas is important for biomonitoring. A total of 196 healthy pregnant women absent of pregnancy complications living in Wuhan of China and 210 healthy non-pregnant women were enrolled. The whole blood were collected. The toxic element chromium (Cr), arsenic (As), cadmium (Cd), mercury (Hg), thallium (Tl), and lead (Pb) and essential elements magnesium (Mg), calcium (Ca), manganese (Mn), iron (Fe), copper (Cu), and zinc (Zn) were determined by using a inductively coupled plasma mass spectrometry (ICP-MS)-based method. All the metal(loid)s, except for Cd, Hg, and Tl, showed different levels in whole blood of the pregnant women compared with the non-pregnant women (p < 0.05), among which Mg, Fe, As, and Pb were lower while Ca, Cr, Mn, Cu, and Zn were higher. Moreover, whole blood levels of Mg, Mn, Fe, Cu, and Zn showed significant variations among different gestational ages, while As and Cd showed significant variations among different maternal ages. In addition, Fe-Mg, Fe-Zn, Cu-Ca, and Hg-As were found to be correlated positively in whole blood of the pregnant women, while Fe-Ca, Zn-Ca, and Fe-Cu were correlated negatively. The systematic information of toxic and essential elements in whole blood of pregnant women living in Wuhan of China can provide important guidance for the supplementation of essential elements during pregnancy and for biomonitoring of environmental overexposure.
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Affiliation(s)
- Lu Gong
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qing Yang
- Institute of Food Science and Engineering, Wuhan Polytechnic University, Wuhan, 430023, Hubei, China
| | - Chang-Wen-Bo Liu
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xu Wang
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao-Long Zeng
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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13
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Shao Y, Mao B, Qiu J, Bai Y, Lin R, He X, Lin X, Lv L, Tang Z, Zhou M, Xu X, Yi B, Liu Q. Association between Iron Supplementation, Dietary Iron Intake and Risk of Moderate Preterm Birth: A Birth Cohort Study in China. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:1177-1187. [PMID: 34540738 PMCID: PMC8410969 DOI: 10.18502/ijph.v50i6.6416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/06/2020] [Indexed: 01/15/2023]
Abstract
Background: To evaluate the independent and collective effects of maternal iron supplementation and dietary iron intake upon the risk of moderate preterm birth and its subtypes. Methods: In this birth cohort study, 1019 pregnant women with moderate preterm birth and 9160 women with term birth were recruited at Gansu Provincial Maternity and Child Care Hospital from 2010–2012 in China. Unconditional logistic regression models were utilized to evaluate the association between maternal iron supplementation, dietary iron intake, and the risk of moderate preterm birth and its subtypes. Results: Compared with non-users, iron supplement users exerted a protective effect upon the overall (OR=0.54, 95%CI=0.40–0.72) and spontaneous moderate preterm birth (OR=0.39, 95%CI=0.33–0.83). Compared with the 25th quartiles of dietary iron intake, either before or during pregnancy, it exerted a significantly protective effect upon those who had the highest quartiles of dietary iron intake (OR=0.87, 95%CI=0.82–0.95 for the highest quartiles of dietary iron intake before pregnancy OR=0.85, 95%CI=0.79–0.91). Positive association was observed between the additive scale and multiplicative scale for preterm birth, spontaneous preterm rather than medically indicated preterm. Conclusion: Iron supplements (60 mg/day) and high-iron intake (>25.86 mg/day before pregnancy, >30.46 mg/day during pregnancy) reduced the risk of moderate preterm birth. Positive correlation is found between the additive scale and multiplicative scale for preterm birth, spontaneous preterm birth.
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Affiliation(s)
- Yawen Shao
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Baohong Mao
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Jie Qiu
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Yan Bai
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Ru Lin
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Xiaochun He
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Xiaojuan Lin
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Ling Lv
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Zhongfeng Tang
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Min Zhou
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Xiaoying Xu
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Bin Yi
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Qing Liu
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
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14
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Saronga N, Burrows TL, Collins CE, Mosha IH, Sunguya BF, Rollo ME. Contents of nutrition care services among pregnant women attending antenatal clinic: An Exit interview. J Hum Nutr Diet 2021; 35:265-272. [PMID: 33977578 DOI: 10.1111/jhn.12915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Focused antenatal care currently implemented in Tanzania recommends that women receive nutrition care during routine clinic visits. However, little detail is documented in regard to the nutrition information provided to pregnant women during these visits. The present study aimed to investigate whether pregnant women recalled nutrition information or support provided and, if so, who provided this during routine antenatal clinic visits. The secondary aim was to determine how pregnant women intended to implement the information and what mode of delivery was preferred for receiving nutrition information. METHODS An exploratory cross-sectional study comprising exit interviews was conducted with 50 pregnant women attending antenatal clinics in three regional referral hospitals in Dar es Salaam, Tanzania. RESULTS All participants (n = 50) reported receiving nutrition care from healthcare workers in regard to; haemoglobin checks (79% of participants), iron and folic acid supplementation (70%), weight measurement (70%), eating advice (60%), and dietary intake assessment (38%). However, the information recalled on each category was inconsistent. For 60% of participants, nurses were reported as the source of nutrition care during pregnancy, followed by medical doctors (22%). The most preferable mode for receiving nutrition information was reported as individual face-to-face sessions with health practitioners, followed by mobile phone. All of the participants who received nutrition information indicated that they intended to implement. CONCLUSIONS Nurses were the main source of nutrition information for pregnant women attending antenatal clinics, followed by medical doctors. However, the content of nutrition information recalled by participants was inconsistent. Healthcare facilities need to implement strategies to ensure pregnant women understand and can implement nutrition information provided by healthcare workers during routine antenatal care.
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Affiliation(s)
- Naomi Saronga
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia.,School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia.,Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Tracy L Burrows
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia.,School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Clare E Collins
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia.,School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Idda H Mosha
- Department of Behaviour Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Bruno F Sunguya
- Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Megan E Rollo
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia.,School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
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Rodrigues Amorim Adegboye A, Dias Santana D, Teixeira dos Santos PP, Guedes Cocate P, Benaim C, Trindade de Castro MB, Maia Schlüssel M, Kac G, Lilienthal Heitmann B. Exploratory Efficacy of Calcium-Vitamin D Milk Fortification and Periodontal Therapy on Maternal Oral Health and Metabolic and Inflammatory Profile. Nutrients 2021; 13:783. [PMID: 33673568 PMCID: PMC7997467 DOI: 10.3390/nu13030783] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/21/2021] [Accepted: 02/24/2021] [Indexed: 12/16/2022] Open
Abstract
In this 2 × 2 factorial, outcome-assessor blinded, feasibility randomised trial we explored the effect of a non-pharmaceutical multi-component intervention on periodontal health and metabolic and inflammatory profiles among pregnant women with periodontitis receiving prenatal care in a Brazilian public health centre. 69 pregnant women (gestational age ≤20 weeks, T0) were randomly allocated into four groups: (1) fortified sachet (vitamin D and calcium) and powdered milk plus periodontal therapy during pregnancy (early PT) (n = 17); (2) placebo sachet and powdered milk plus early PT (n = 15); (3) fortified sachet and powdered milk plus late PT (after delivery) (n = 19); (4) placebo sachet and powdered milk plus late PT (n = 18). Third trimester (T1) and 6-8 weeks postpartum (T2) exploratory outcomes included periodontal health (% sites with bleeding on probing (BOP)), glucose, insulin, C-Reactive Protein, serum calcium and vitamin D. The mean BOP was significantly reduced in the early PT groups, while BOP worsened in the late PT groups. No significant effect of fortification on BOP was observed. Changes in glucose levels and variation on birthweight did not differ among groups This feasibility trial provides preliminary evidence for estimating the minimum clinically important differences for selected maternal outcomes. A large-scale trial to evaluate the interventions' clinical benefits and cost-effectiveness is warranted.
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Affiliation(s)
- Amanda Rodrigues Amorim Adegboye
- Faculty of Health and Life Sciences, School of Nursing, Midwifery and Health, Coventry University, Priory Street, Coventry CV1 5FB, UK
| | - Danilo Dias Santana
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (D.D.S.); (P.P.T.d.S.); (C.B.); (M.B.T.d.C.); (G.K.)
| | - Pedro Paulo Teixeira dos Santos
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (D.D.S.); (P.P.T.d.S.); (C.B.); (M.B.T.d.C.); (G.K.)
| | - Paula Guedes Cocate
- Department of Bioscience and Physical Activity, School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro 21941-599, Brazil;
| | - Camila Benaim
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (D.D.S.); (P.P.T.d.S.); (C.B.); (M.B.T.d.C.); (G.K.)
| | - Maria Beatriz Trindade de Castro
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (D.D.S.); (P.P.T.d.S.); (C.B.); (M.B.T.d.C.); (G.K.)
| | - Michael Maia Schlüssel
- The EQUATOR Network—UK Centre, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Old Road, Oxford OX3 7LD, UK;
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (D.D.S.); (P.P.T.d.S.); (C.B.); (M.B.T.d.C.); (G.K.)
| | - Berit Lilienthal Heitmann
- Research Unit for Dietary Studies at the Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2000 Frederiksberg, Denmark;
- Section for General Practice, Institute of Public Health, Copenhagen University, 1014 Copenhagen, Denmark
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16
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Bordeleau M, Fernández de Cossío L, Chakravarty MM, Tremblay MÈ. From Maternal Diet to Neurodevelopmental Disorders: A Story of Neuroinflammation. Front Cell Neurosci 2021; 14:612705. [PMID: 33536875 PMCID: PMC7849357 DOI: 10.3389/fncel.2020.612705] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/07/2020] [Indexed: 12/13/2022] Open
Abstract
Providing the appropriate quantity and quality of food needed for both the mother's well-being and the healthy development of the offspring is crucial during pregnancy. However, the macro- and micronutrient intake also impacts the body's regulatory supersystems of the mother, such as the immune, endocrine, and nervous systems, which ultimately influence the overall development of the offspring. Of particular importance is the association between unhealthy maternal diet and neurodevelopmental disorders in the offspring. Epidemiological studies have linked neurodevelopmental disorders like autism spectrum disorders, attention-deficit-hyperactivity disorder, and schizophrenia, to maternal immune activation (MIA) during gestation. While the deleterious consequences of diet-induced MIA on offspring neurodevelopment are increasingly revealed, neuroinflammation is emerging as a key underlying mechanism. In this review, we compile the evidence available on how the mother and offspring are both impacted by maternal dietary imbalance. We specifically explore the various inflammatory and anti-inflammatory effects of dietary components and discuss how changes in inflammatory status can prime the offspring brain development toward neurodevelopmental disorders. Lastly, we discuss research evidence on the mechanisms that sustain the relationship between maternal dietary imbalance and offspring brain development, involving altered neuroinflammatory status in the offspring, as well as genetic to cellular programming notably of microglia, and the evidence that the gut microbiome may act as a key mediator.
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Affiliation(s)
- Maude Bordeleau
- Integrated Program in Neuroscience, McGill University, Montréal, QC, Canada
- Axe Neurosciences, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | | | - M. Mallar Chakravarty
- Integrated Program in Neuroscience, McGill University, Montréal, QC, Canada
- Cerebral Imaging Centre, Douglas Mental Health University, McGill University, Montréal, QC, Canada
- Department of Psychiatry, McGill University, Montréal, QC, Canada
- Department of Biological and Biomedical Engineering, McGill University, Montréal, QC, Canada
| | - Marie-Ève Tremblay
- Axe Neurosciences, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Département de Médecine Moléculaire, Université Laval, Québec, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Biochemistry and Molecular Biology, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
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Zec M, Roje D, Matovinović M, Antičević V, Librenjak Škare L, Jerončić A, Puljak L, Madunić S, Meštrović Z. Vitamin B12 Supplementation in Addition to Folic Acid and Iron Improves Hematological and Biochemical Markers in Pregnancy: A Randomized Controlled Trial. J Med Food 2020; 23:1054-1059. [DOI: 10.1089/jmf.2019.0233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mirela Zec
- Department of Transfusion Medicine, Split University Hospital, Split, Croatia
| | - Damir Roje
- Department of Obstetrics and Gynecology, Split University Hospital, Split, Croatia
| | - Martina Matovinović
- Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Vesna Antičević
- University Department of Health Studies, University of Split, Split, Croatia
| | | | - Ana Jerončić
- Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
| | - Livia Puljak
- Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Zagreb, Croatia
| | - Sanja Madunić
- Department of Internal Medicine, Split University Hospital, Split, Croatia
| | - Zoran Meštrović
- Department of Obstetrics and Gynecology, Split University Hospital, Split, Croatia
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Salam RA, Das JK, Irfan O, Ahmed W, Sheikh SS, Bhutta ZA. Effects of preventive nutrition interventions among adolescents on health and nutritional status in low- and middle-income countries: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2020; 16:e1085. [PMID: 37131413 PMCID: PMC8356321 DOI: 10.1002/cl2.1085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background Malnutrition is one of the most common causes of morbidity and mortality among children and adolescents and is now considered to be one of the largest risk factors responsible for the global burden of diseases along with poor diet. Objectives The objective of this review was to assess the impact of preventive nutrition interventions (including nutrition education and counselling; micronutrient supplementation/fortification and macronutrient supplementation) to improve the health and nutritional status of adolescents aged 10-19 years in low- and middle-income countries (LMICs). The secondary objective of the review was to assess various contextual factors based on the World Health Organisation (WHO) health system building blocks framework that might potentially impact the effectiveness of these interventions for this age group. Search Methods The search was conducted on Cochrane Controlled Trials Register (CENTRAL), MEDLINE, EMBASE, CINAHL, PsycINFO, the WHO nutrition databases, CAB Global Health, Social Science Citation Index, Scopus, WHO Global Health Index, ADOLEC and EPPI until February 5, 2019. We searched Google Scholar along with key nutrition agencies database such as Nutrition International, the Global Alliance for Improved Nutrition, the World Food Programme and HarvestPlus to search for nonindexed, grey literature to locate relevant programme evaluations and any additional trials. All searches were performed without any restrictions on publication date, language or publication status. Selection Criteria We included randomised controlled trials, quasiexperimental studies, controlled before-after studies and interrupted time series evaluating the effectiveness of preventive nutrition interventions among adolescents between 10 and 19 years of age from LMICs. Data Collection and Analysis Two review authors independently assessed trials for inclusion, assessed risk of bias and extracted data from included studies. Meta-analysis was conducted separately for each outcome and intervention. For dichotomous data, we reported risk ratios (RR) with 95% confidence intervals (CI). For continuous data, we reported the mean difference (MD) or standard mean difference (SMD) with 95% CI. Main Results This review summarises findings from a total of 10 studies from 15 papers including 10,802 participants. All the studies included in this review assessed the impact of micronutrient supplementation/fortification on health and nutritional status among adolescents in LMIC. We did not find any study assessing the impact of nutrition education and counselling or on macronutrient supplementation among adolescents. Micronutrient supplementation/fortification interventions included calcium/vitamin D supplementation/fortification, iron supplementation with or without folic acid, zinc supplementation and multiple micronutrient (MMN) fortification. The majority of the studies (eight out of 10 studies) included adolescent girls aged between 10 and 19 years of age. We did not find any large scale preventive nutrition intervention programmes targeting adolescents in LMICs. We are uncertain of the effect of iron supplementation with or without folic acid on anaemia (daily supplementation; RR: 1.04, 95% CI 0.88, 1.24; one study; 1,160 participants; low quality evidence. Weekly supplementation; RR: 1.07, 95% CI: 0.91, 1.26; one study; 1,247 participants; low quality evidence). We are uncertain of the effect of various micronutrient supplementation/fortification on body mass index (calcium/vitamin D supplementation; (MD: -0.01 kg/m2; 95% CI: -1.20, 1.17; two studies; 730 participants; I 2 94%; very low quality evidence, iron supplementation with or without folic acid; MD: 0.29 kg/m2; 95% CI: -0.25, 0.83; two studies; 652 participants; I 2 69%; very low quality evidence, zinc supplementation; MD: 0.35 kg/m2; 95% CI: -0.15, 0.85; one study; 382 participants; very low quality evidence) and MMN fortification; MD: 0.23 kg/m2, 95% CI: -0.11, 0.57; two studies; 943 participants; I 2 22%; very low quality evidence). None of the included studies reported any other primary outcomes including morbidity or adverse effects. Iron supplementation with or without folic acid may improve haemoglobin concentrations (MD: 0.42 g/dL, 95% CI: 0.13, 0.71; four studies; 1,020 participants; I 2 89%; low quality evidence). Calcium/vitamin D supplementation may improve serum 25(OH) D levels (standardised mean difference [SMD]: 2.85, 95% CI: 0.89, 4.82; two studies; 395 participants; I 2 99%; low quality evidence). We are uncertain of the effect of calcium only supplementation (MD: 0.02 g/cm2, 95% CI: -0.00, 0.04; one study; 233 participants; low quality outcome) and calcium + vitamin D supplementation (MD: 0.02 g/cm2, 95% CI: -0.00, 0.04; one study; 235 participants; low quality evidence) on total bone mineral density (BMD). We are uncertain of the effect of MMN fortification on haemoglobin concentrations (MD: -0.10 g/dL, 95% CI: -0.88, 0.68; two studies; 1102 participants; I 2 100%; very low quality evidence); calcium supplementation on total body bone mineral content (BMC); (MD: 30.20 g, 95% CI: -40.56, 100.96; one study; 233 participants; low quality evidence), calcium + vitamin D supplementation on total body BMC (MD: 21.60 g, 95% CI: -45.32, 88.52; one study; 235 participants; low quality evidence) and zinc supplementation on serum zinc levels (SMD: 6.94, 95% CI: -4.84, 18.71; two studies; 494 participants; very low quality evidence). One study reported the impact of iron supplementation with or without folic acid on cognition of adolescent girls suggesting improved cognition in most of the tests with daily or twice weekly supplementation compared to once weekly or no supplementation. None of the other secondary outcomes were reported including any other development outcomes and all-cause mortality. These findings warrant caution while interpreting due to very few studies and high heterogeneity. Authors' Conclusions There is limited evidence of micronutrient supplementation/fortification among adolescents on health and nutritional status in LMICs, with lack of evidence on nutrition education and counselling and macronutrient supplementation. The findings are generaliseable for adolescent girls since all studies (except one) targeted female adolescents.
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Affiliation(s)
- Rehana A. Salam
- Division of Women and Child HealthAga Khan University HospitalKarachiPakistan
| | - Jai K. Das
- Division of Women and Child HealthAga Khan University HospitalKarachiPakistan
| | - Omar Irfan
- Division of Women and Child HealthAga Khan University HospitalKarachiPakistan
| | - Wardah Ahmed
- Department of PediatricsAga Khan UniversityKarachiPakistan
| | - Sana S. Sheikh
- Division of Women and Child HealthAga Khan University HospitalKarachiPakistan
| | - Zulfiqar A. Bhutta
- Centre for Global Child HealthThe Hospital for Sick ChildrenTorontoCanada
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19
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Ciangura C, Coupaye M, Deruelle P, Gascoin G, Calabrese D, Cosson E, Ducarme G, Gaborit B, Lelièvre B, Mandelbrot L, Petrucciani N, Quilliot D, Ritz P, Robin G, Sallé A, Gugenheim J, Nizard J. Clinical Practice Guidelines for Childbearing Female Candidates for Bariatric Surgery, Pregnancy, and Post-partum Management After Bariatric Surgery. Obes Surg 2020; 29:3722-3734. [PMID: 31493139 DOI: 10.1007/s11695-019-04093-y] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Emerging evidence suggests that bariatric surgery improves pregnancy outcomes of women with obesity by reducing the rates of gestational diabetes, pregnancy-induced hypertension, and macrosomia. However, it is associated with an increased risk of a small-for-gestational-age fetus and prematurity. Based on the work of a multidisciplinary task force, we propose clinical practice recommendations for pregnancy management following bariatric surgery. They are derived from a comprehensive review of the literature, existing guidelines, and expert opinion covering the preferred type of surgery for women of childbearing age, timing between surgery and pregnancy, contraception, systematic nutritional support and management of nutritional deficiencies, screening and management of gestational diabetes, weight gain during pregnancy, gastric banding management, surgical emergencies, obstetrical management, and specific care in the postpartum period and for newborns.
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Affiliation(s)
- Cécile Ciangura
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Departments of Nutrition and Diabetology, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne University, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Muriel Coupaye
- Assistance Publique-Hôpitaux de Paris, Louis Mourier Hospital, Department of Explorations Fonctionnelles, Colombes, University Paris Diderot, Paris, France.,Association Française d'Etude et de Recherche sur l'Obésité (AFERO), Paris, France
| | - Philippe Deruelle
- Department of Obstetrics and Gynecology, Strasbourg University Hospital, Strasbourg, France.,Collège National des Gynécologues et Obstétriciens Français (CNGOF), Paris, France
| | - Géraldine Gascoin
- Department of Neonatal Medicine, Angers University Hospital, Angers, France.,Société Française de Néonatologie et Société Française de Pédiatrie, Paris, France
| | - Daniela Calabrese
- Assistance Publique-Hôpitaux de Paris, Louis Mourier Hospital, Department of Digestive Surgery, Colombes, University Paris Diderot, Paris, France
| | - Emmanuel Cosson
- Assistance Publique-Hôpitaux de Paris, Jean Verdier Hospital, Department of Endocrinology-Diabetology-Nutrition, Bondy, 10 UMR U557 INSERM/U11125 INRA/CNAM, University Paris13, Bobigny, France.,Société Francophone du Diabète (SFD), Paris, France
| | - Guillaume Ducarme
- Department of Obstetrics and Gynecology, Departemental Hospital, La Roche-sur-Yon, France
| | - Bénédicte Gaborit
- Association Française d'Etude et de Recherche sur l'Obésité (AFERO), Paris, France.,Assistance Publique-Hôpitaux de Marseille, Department of Endocrinology, Metabolic Diseases and Nutrition, Marseille, INSERM, INRA, C2VN, Aix Marseille University, Marseille, France
| | - Bénédicte Lelièvre
- Laboratory of Pharmacology and Toxicology, Angers University Hospital, Angers, France
| | - Laurent Mandelbrot
- Assistance Publique-Hôpitaux de Paris, Louis Mourier Hospital, Department of Gynecology and Obstetrics, Colombes, University Paris Diderot, Paris, France
| | - Niccolo Petrucciani
- Assistance Publique-Hôpitaux de Paris, Henri Mondor Hospital, Division of Digestive Surgery and Liver Transplantation, UPEC University, Créteil, France
| | - Didier Quilliot
- Department of Diabetology-Endocrinology-Nutrition, CHRU Nancy, INSERM 954, University of Lorraine, Nancy, France.,Société Francophone Nutrition Clinique et Métabolisme (SFNCM), Paris, France
| | - Patrick Ritz
- Department of Endocrinology, Metabolic Diseases and Nutrition, Toulouse University Hospital, UMR1027, Paul Sabatier University, Toulouse, France
| | - Geoffroy Robin
- Collège National des Gynécologues et Obstétriciens Français (CNGOF), Paris, France.,Department of Medical Gynecology, and Sexology and Department of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, Lille, EA4308 "gametogenesis and gamete quality", Lille University, Lille, France
| | - Agnès Sallé
- Department of Diabetology-Endocrinology-Nutrition, Angers University Hospital, Angers, France
| | - Jean Gugenheim
- Division of Digestive Surgery and Liver Transplantation, Nice University Hospital, University of Nice, Nice, France.,Société Française et Francophone de Chirurgie de l'Obésité et des Maladies Métaboliques (SOFFCOMM), Porte des Pierres Dorées, France
| | - Jacky Nizard
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Gynecology and Obstetrics, Sorbonne University, Paris, France
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Daniali SS, Shayegh S, Tajaddin MH, Goodarzi-Khoigani M, Kelishadi R. Association of Cord Blood Zinc Level and Birth Weight in a Sample of Iranian Neonates. Int J Prev Med 2020; 11:3. [PMID: 32089803 PMCID: PMC7011459 DOI: 10.4103/ijpvm.ijpvm_160_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 07/11/2019] [Indexed: 12/01/2022] Open
Abstract
Background: In addition to its short-term effects, low birth weight increases the risk of noncommunicable diseases (NCDs) in adult life. The quality of maternal diet including the macronutrient intake is very important in this regard. This study aims to evaluate the possible associations between maternal zinc and neonatal anthropometric measures. Method: This cross-sectional study was conducted on 226 pairs of mothers-neonates in Isfahan, Iran. Maternal characteristics including the history of the disease, age, preconceptional weight, weight gain during pregnancy, as well as, anthropometric characteristics of neonates such as weight, height, length, and circumferences of head, belly, chest, and thigh were documented. Cord blood zinc was measured by atomic absorption spectrophotometer in three groups of neonates depending on their weights. Results: The gestational age of neonates was 35 to 38 weeks with a mean weight of 3.13 ± 0.42 kg. The mean of zinc concentration was 0.81 ± 0.18 and it was higher in neonates with appropriate weight than in those with high or low birth weight (0.82 ± 0.18, 0.75 ± 0.19, and 0.65 ± 0.12 ng/ml, respectively). Bivariate correlation analysis showed significant weak correlation between cord blood zinc and neonatal weight (r = 0.16, P = 0.04). Conclusions: The cord blood zinc concentration of normal-weight neonates was higher than others. Our findings suggest that maternal zinc may influence neonatal birth weight, and it should be considered in the primordial prevention of NCDs.
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Affiliation(s)
- Seyede Shahrbanoo Daniali
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Science, Isfahan, Iran
| | - Sara Shayegh
- Student of Medical Science, Faculty of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | | | - Masoomeh Goodarzi-Khoigani
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Science, Isfahan, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Science, Isfahan, Iran
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21
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Effects of Preventive Nutrition Interventions among Adolescents on Health and Nutritional Status in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Nutrients 2019; 12:nu12010049. [PMID: 31878019 PMCID: PMC7019616 DOI: 10.3390/nu12010049] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/12/2019] [Accepted: 12/17/2019] [Indexed: 12/30/2022] Open
Abstract
The objective of this review was to assess the impact of preventive nutrition interventions on health and nutritional status of adolescents aged 10–19 years in low- and middle-income countries (LMICs). We searched the databases until 5 February 2019 without any restrictions on publication, date, language, or publication status. A total of 10 studies (15 papers) including 10,802 participants assessing the impact of micronutrient supplementation/fortification were included in this review. We did not find any study assessing the impact of nutrition education and counseling or macronutrient supplementation among adolescents. Among primary outcomes, we are uncertain of the effect of iron supplementation with or without folic acid on anemia (daily supplementation; relative risk (RR): 1.04, 95% confidence interval (CI) 0.42, 2.57; one study; 1160 participants; low-quality evidence; weekly supplementation; RR: 1.07, 95% CI: 0.46, 2.52; one study; 1247 participants; low-quality evidence). We are also uncertain of the effect of various micronutrient supplementation/fortification on body mass index (BMI) (calcium/vitamin D supplementation; (MD: −0.01 kg/m2; 95% CI: −1.20, 1.17; two studies; 730 participants; I2 94%; very-low-quality evidence, iron supplementation with or without folic acid; MD: 0.47 kg/m2; 95% CI: −0.17, 1.11; two studies; 652 participants; I2 37%; very-low-quality evidence, zinc supplementation; MD: 0.35 kg/m2; 95% CI: −0.15, 0.85; one study; 382 participants; very-low-quality evidence) and multiple micronutrient (MMN) fortification; MD: 0.23 kg/m2, 95% CI: −0.11, 0.57; two studies; 943 participants; I2 22%; very-low-quality evidence). None of the included studies reported any other primary outcomes including morbidity or adverse effects. Among secondary outcomes, iron supplementation with or without folic acid may improve hemoglobin concentrations, and calcium/vitamin D supplementation may improve serum 25(OH)D levels, while calcium only supplementation and calcium and vitamin D supplementation may marginally improve total body bone mineral density (BMD). We are uncertain of the effect of MMN fortification on hemoglobin concentrations, calcium supplementation on total body bone mineral content (BMC), calcium + vitamin D supplementation on total body BMC, and zinc supplementation on zinc levels. There is limited evidence of micronutrient supplementation/fortification among adolescents, especially adolescent boys, on health and nutritional status in LMICs. These findings should be interpreted with caution due to the low quality and limited number of studies.
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22
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Acute hypocalcaemic tetany with normal serum calcium at the time of emergency caesarean delivery. Int J Obstet Anesth 2019; 42:122-123. [PMID: 31859136 DOI: 10.1016/j.ijoa.2019.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 11/05/2019] [Accepted: 11/08/2019] [Indexed: 11/21/2022]
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Kambunga SN, Candeias C, Hasheela I, Mouri H. Review of the nature of some geophagic materials and their potential health effects on pregnant women: some examples from Africa. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2019; 41:2949-2975. [PMID: 30977022 DOI: 10.1007/s10653-019-00288-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 03/27/2019] [Indexed: 05/25/2023]
Abstract
The voluntary human consumption of soil known as geophagy is a global practice and deep-rooted in many African cultures. The nature of geophagic material varies widely from the types to the composition. Generally, clay and termite mound soils are the main materials consumed by geophagists. Several studies revealed that gestating women across the world consume more soil than other groups for numerous motives. These motivations are related to medicinal, cultural and nutrients supplementation. Although geophagy in pregnancy (GiP) is a universal dynamic habit, the highest prevalence has been reported in African countries such as Kenya, Ghana, Rwanda, Nigeria, Tanzania, and South Africa. Geophagy can be both beneficial and detrimental. Its health effects depend on the amount and composition of the ingested soils, which is subjective to the geology and soil formation processes. In most cases, the negative health effects concomitant with the practice of geophagy eclipse the positive effects. Therefore, knowledge about the nature of geophagic material and the health effects that might arise from their consumption is important.
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Affiliation(s)
- Selma N Kambunga
- Department of Geology, University of Johannesburg, Johannesburg, South Africa
| | - Carla Candeias
- GeoBioTec, Geosciences Department, University of Aveiro, Aveiro, Portugal
- EpiUnit, Public Health Institute, University of Porto, Porto, Portugal
| | - Israel Hasheela
- Environmental and Engineering Geology Division, Geological Survey of Namibia, Windhoek, Namibia
| | - Hassina Mouri
- Department of Geology, University of Johannesburg, Johannesburg, South Africa.
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24
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Kambunga SN, Candeias C, Hasheela I, Mouri H. The geochemistry of geophagic material consumed in Onangama Village, Northern Namibia: a potential health hazard for pregnant women in the area. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2019; 41:1987-2009. [PMID: 30778788 DOI: 10.1007/s10653-019-00253-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 01/27/2019] [Indexed: 06/09/2023]
Abstract
Ingestion of geophagic materials might affect human health and induce diseases by different ways. The purpose of this study is to determine the geochemical composition of geophagic material consumed especially by pregnant women in Onangama Village, Northern Namibia and to assess its possible health effects. X-ray fluorescence and inductively coupled plasma mass spectrometry were used in order to determine the major, and trace elements as well as anions concentrations of the consumed material. The geochemical analysis revealed high concentrations of aluminium (Al), calcium (Ca), iron (Fe), magnesium (Mg), manganese (Mn), potassium (K), sodium (Na), and silica (Si); and trace elements including arsenic (As), chromium (Cr), mercury (Hg), nickel (Ni) and vanadium (V) as well as sulphate (SO42-), nitrate (NO3-), and nitrite (NO2-) anions comparing to the recommended daily allowance for pregnant women. The pH for some of the studied samples is alkaline, which might increase the gastrointestinal tract pH (pH < 2) and cause a decrease in the bioavailability of elements. The calculated health risk index (HRI > 1) revealed that Al and Mn might be a potential risk for human consumption. Based on the results obtained from the geochemical analysis, the consumption of the studied material might present a potential health risk to pregnant women including concomitant detrimental maternal and foetal effects.
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Affiliation(s)
- Selma N Kambunga
- Department of Geology, University of Johannesburg, Johannesburg, South Africa
| | - Carla Candeias
- GeoBioTec, Geosciences Department, University of Aveiro, Aveiro, Portugal
- EpiUnit, Public Health Institute, University of Porto, Porto, Portugal
| | - Israel Hasheela
- Environmental and Engineering Geology Division, Geological Survey of Namibia, Windhoek, Namibia
| | - Hassina Mouri
- Department of Geology, University of Johannesburg, Johannesburg, South Africa.
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25
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McKee SE, Reyes TM. Effect of supplementation with methyl-donor nutrients on neurodevelopment and cognition: considerations for future research. Nutr Rev 2019; 76:497-511. [PMID: 29701796 DOI: 10.1093/nutrit/nuy007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Pregnancy represents a critical period in fetal development, such that the prenatal environment can, in part, establish a lifelong trajectory of health or disease for the offspring. Poor nutrition (macro- or micronutrient deficiencies) can adversely affect brain development and significantly increase offspring risk for metabolic and neurological disease development. The concentration of dietary methyl-donor nutrients is known to alter DNA methylation in the brain, and alterations in DNA methylation can have long-lasting effects on gene expression and neuronal function. The decreased availability of methyl-donor nutrients to the developing fetus in models of poor maternal nutrition is one mechanism hypothesized to link maternal malnutrition and disease risk in offspring. Animal studies indicate that supplementation of both maternal and postnatal (early- and later-life) diets with methyl-donor nutrients can attenuate disease risk in offspring; however, clinical research is more equivocal. The objective of this review is to summarize how specific methyl-donor nutrient deficiencies and excesses during pre- and postnatal life alter neurodevelopment and cognition. Emphasis is placed on reviewing the current literature, highlighting challenges within nutrient supplementation research, and considering potential strategies to ensure robust findings in future studies.
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Affiliation(s)
- Sarah E McKee
- Department of Pharmacology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Teresa M Reyes
- Department of Psychiatry and Behavioral Neurosciences, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
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26
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Alves C, Saleh A, Alaofè H. Iron-containing cookware for the reduction of iron deficiency anemia among children and females of reproductive age in low- and middle-income countries: A systematic review. PLoS One 2019; 14:e0221094. [PMID: 31479458 PMCID: PMC6719866 DOI: 10.1371/journal.pone.0221094] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 07/30/2019] [Indexed: 12/15/2022] Open
Abstract
Background & objective There is limited evidence regarding the efficacy of iron-containing pots and ingots in reducing iron deficiency (ID) and iron deficiency anemia (IDA) in low- and middle-income countries (LMICs). The objective of this systematic review is to summarize the evidence regarding the effect of iron-containing cookware on ID and IDA among children and females of reproductive age (FRA) in LMICs. Methods Searches were last conducted in May 2019 in PubMed, Embase, Cochrane Library, Web of Science, Scopus, CAB Abstracts, POPLINE, LILACS, ProQuest Dissertations & Theses Global, WHO ICTRP and ClinicalTrials.gov. Hand searching was also conducted. Selection criteria included randomized-controlled trials (RCTs), quasi-experimental studies and observational studies with control groups that studied the effect of iron-containing cookware in children (4 months-11 years) and females of reproductive age (12–51 years). Results Eleven studies were eligible for inclusion in the review. Statistically significant increases in hemoglobin and/or iron indices (p < 0.05) were observed in 50% (4/8) of studies on pots (relative change/mean difference in Hb: -0.4–1.20 g/dL), and 33.3% (1/3) of studies on ingots (relative change/mean difference in Hb: 0.32–1.18 g/dL). Positive outcomes (p < 0.05) were observed among children in 50% (4/8) of studies and among FRA in 28.6% (2/7) of studies. Compliance ranged from 26.7–71.4% daily use of pots to 90–93.9% daily use of ingots. Conclusions There are indications that, with reasonable compliance, iron-containing cookware could serve as a means of reducing IDA, especially among children. The potential advantages of iron-containing cookware include relative cost-effectiveness and complementary combination with other interventions. However, further research is needed regarding both the efficacy and safety of this intervention.
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Affiliation(s)
- Clark Alves
- Abrazo Central Campus Family Medicine Residency Program, Phoenix, Arizona, United States of America
- Office of Global and Border Health, University of Arizona College of Medicine, Tucson, Arizona, United States of America
- * E-mail: ,
| | - Ahlam Saleh
- Arizona Health Sciences Library, University of Arizona, Tucson, Arizona, United States of America
| | - Halimatou Alaofè
- Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, United States of America
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Priliani L, Prado EL, Restuadi R, Waturangi DE, Shankar AH, Malik SG. Maternal Multiple Micronutrient Supplementation Stabilizes Mitochondrial DNA Copy Number in Pregnant Women in Lombok, Indonesia. J Nutr 2019; 149:1309-1316. [PMID: 31177276 PMCID: PMC6686057 DOI: 10.1093/jn/nxz064] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/11/2019] [Accepted: 03/15/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The Supplementation with Multiple Micronutrients Intervention Trial (SUMMIT) in Lombok, Indonesia showed that maternal multiple micronutrients (MMN), as compared with iron and folic acid (IFA), reduced fetal loss, early infant mortality, and low birth weight. Mitochondria play a key role during pregnancy by providing maternal metabolic energy for fetal development, but the effects of maternal supplementation during pregnancy on mitochondria are not fully understood. OBJECTIVE The aim of this study was to assess the impact of MMN supplementation on maternal mitochondrial DNA copy number (mtDNA-CN). METHODS We used archived venous blood specimens from pregnant women enrolled in the SUMMIT study. SUMMIT was a cluster-randomized double-blind controlled trial in which midwives were randomly assigned to distribute MMN or IFA to pregnant women. In this study, we selected 108 sets of paired baseline and postsupplementation samples (MMN = 54 and IFA = 54). Maternal mtDNA-CN was determined by real-time quantitative polymerase chain reaction in baseline and postsupplementation specimens. The association between supplementation type and change in mtDNA-CN was performed using rank-based estimation for linear models. RESULTS In both groups, maternal mtDNA-CN at postsupplementation was significantly elevated compared with baseline (P < 0.001). The regression revealed that the MMN group had lower postsupplementation mtDNA-CN than the IFA group (β = -4.63, P = 0.003), especially for women with mtDNA-CN levels above the median at baseline (β = -7.49, P = 0.007). This effect was rapid, and observed within 33 d of initiation of supplementation (β = -7.39, P = 0.017). CONCLUSION Maternal MMN supplementation rapidly stabilized mtDNA-CN in pregnant women who participated in SUMMIT, indicating improved mitochondrial efficiency. The data provide a mechanistic basis for the beneficial effects of MMN on fetal growth and survival, and support the transition from routine IFA to MMN supplementation.This trial was registered at www.isrctn.com as ISRCTN34151616.
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Affiliation(s)
- Lidwina Priliani
- Eijkman Institute for Molecular Biology, Ministry of Research, Technology and Higher Education and,Faculty of Biotechnology, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Elizabeth L Prado
- Summit Institute of Development, Mataram, West Nusa Tenggara, Indonesia,Department of Nutrition, University of California at Davis, Davis, CA
| | - Restuadi Restuadi
- Eijkman Institute for Molecular Biology, Ministry of Research, Technology and Higher Education and,Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Diana E Waturangi
- Faculty of Biotechnology, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Anuraj H Shankar
- Summit Institute of Development, Mataram, West Nusa Tenggara, Indonesia,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA,Address correspondence to AHS (e-mail: )
| | - Safarina G Malik
- Eijkman Institute for Molecular Biology, Ministry of Research, Technology and Higher Education and,Address correspondence to SGM (e-mail: )
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Abstract
The concept of developmental programming was established using epidemiologic studies that investigated chronic illnesses in humans, such as coronary heart disease and hypertension. In livestock species, the impacts of developmental programming are important for production and welfare reasons and are used as research models for human and other animal species. Dams should be in adequate nutritional status to ensure optimal nutrient supply for fetal growth, including development of their immune system. Beef and dairy cows with insufficient nutrient intake during gestation produce calves with reduced immunity against diseases, such as scours, respiratory disease, and mastitis.
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Affiliation(s)
- Reinaldo F Cooke
- Department of Animal Science, Texas A&M University, 2471 TAMU, College Station, TX 77843, USA.
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29
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Miranda VIA, da Silva Dal Pizzol T, Silveira MPT, Mengue SS, da Silveira MF, Lutz BH, Bertoldi AD. The use of folic acid, iron salts and other vitamins by pregnant women in the 2015 Pelotas birth cohort: is there socioeconomic inequality? BMC Public Health 2019; 19:889. [PMID: 31277638 PMCID: PMC6612145 DOI: 10.1186/s12889-019-7269-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 06/30/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Many low- and middle-income countries recommend micronutrient supplements for pregnant women to improve their nutritional status, prevent possible deficiencies and avoid fetal healgth consequences. This study evaluated the influence of socioeconomic status on the use of folic acid, iron salts and other vitamins and minerals among pregnant women in the 2015 Pelotas Birth Cohort. METHODS This population-based birth cohort study was carried out with 4270 women. Participants were interviewed during pregnancy and at the maternity hospital about the antenatal period; including the use of iron salts, vitamins and other minerals. Descriptive analyses were performed to characterize the sample. The analyses were adjusted according to socioeconomic variables (maternal education, ethnicity, household income). RESULTS The overall prevalence of the use of folic acid, iron salts or other vitamins and minerals was 91.0% (95% CI: 90.1-91.8). Specifically, 70.9% (95% CI: 69.5-72.3) used folic acid, 72.9% (95% CI: 71.5-74.3) used iron compounds, and 31.8% (95% CI: 30.3-33.2) used other vitamins or minerals. In the adjusted analysis, the use of iron salts was associated with nonwhite mothers, with ≤4 years of education and whose family income was less than or equal to the monthly minimum wage. The use of folic acid and other vitamins and minerals was associated with white mothers who were more highly educated and had a higher family income. CONCLUSION Although folic acid and other vitamins and minerals were more frequently used in white, richer and more educated mothers, which indicates inequality, iron supplements were more frequently used in the poorer, less educated nonwhite mothers, suggesting the opposite association for this supplement.
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Affiliation(s)
- Vanessa Iribarrem Avena Miranda
- Post-Graduate Program in Epidemiology, Federal University of Pelotas (UFPel), Rua Marechal Deodoro, 1160, Centro, Pelotas, RS CEP 96020-220 Brazil
| | - Tatiane da Silva Dal Pizzol
- Post-Graduate Program in Epidemiology, Federal University of Porto Alegre, Av. Ipiranga, 2752, sala 203 Porto Alegre, RS – Brasil, Porto Alegre, CEP 90610-000 Brazil
| | - Marysabel Pinto Telis Silveira
- Post-Graduate Program in Epidemiology, Federal University of Pelotas (UFPel), Rua Marechal Deodoro, 1160, Centro, Pelotas, RS CEP 96020-220 Brazil
| | - Sotero Serrate Mengue
- Post-Graduate Program in Epidemiology, Federal University of Porto Alegre, Av. Ipiranga, 2752, sala 203 Porto Alegre, RS – Brasil, Porto Alegre, CEP 90610-000 Brazil
| | - Mariângela Freitas da Silveira
- Faculty of Medicine, Maternal and Child Department, Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, Centro, Pelotas, RS CEP 96020-220 Brazil
| | - Bárbara Heather Lutz
- Post-Graduate Program in Epidemiology, Federal University of Pelotas (UFPel), Rua Marechal Deodoro, 1160, Centro, Pelotas, RS CEP 96020-220 Brazil
| | - Andréa Dâmaso Bertoldi
- Post-Graduate Program in Epidemiology, Federal University of Pelotas (UFPel), Rua Marechal Deodoro, 1160, Centro, Pelotas, RS CEP 96020-220 Brazil
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30
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Minimum Dietary Diversity Score and Associated Factors among Pregnant Women at Alamata General Hospital, Raya Azebo Zone, Tigray Region, Ethiopia. J Nutr Metab 2019; 2019:8314359. [PMID: 31192011 PMCID: PMC6525861 DOI: 10.1155/2019/8314359] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 02/26/2019] [Accepted: 03/26/2019] [Indexed: 12/14/2022] Open
Abstract
Background Consumption of diversified food during pregnancy found very important and critical to determine healthy pregnancy outcome. Low dietary diversity has a major adverse effect on mothers, fetus, and life of new born. Dietary diversity is still low in low-resourced countries. Therefore, this study aims to determine prevalence of minimum dietary diversity score (MDDS) and associated factors among pregnant women. Methods Facility-based cross-sectional study was conducted from April to May, 2017, in Alamata General Hospital (AGH). Data were collected using a pretested and structured self-interview questionnaire. A systematic sampling technique was used to select study participants. Binary logistic regression and odds ratio with 95% confidence interval (CI) were carried out to see the association between variables and the outcomes. Results From a survey of 412 participants, 61.2% had high MDDS and 38.8% had low MDDS. Multivariate analysis revealed that being government employees (AOR = 4.87, CI: 1.70–13.95), merchant (AOR = 4.67, CI: 1.81–12.05), secured food (AOR = 3.85, CI: 2.12–6.97), and eating three meals and above (AOR = 2.66, CI: 1.47–4.82) were significantly associated with high MDDS among pregnant women. Conclusions In our study, minimum dietary diversity shows small increment from previous study. Screening and special emphases should be given by a health-care provider on women diet during antenatal follow-up at health-care settings.
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Kasture V, Dalvi S, Swamy M, Kale A, Joshi S. Omega-3 fatty acids differentially influences embryotoxicity in subtypes of preeclampsia. Clin Exp Hypertens 2019; 42:205-212. [PMID: 30964712 DOI: 10.1080/10641963.2019.1601208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background: Early (EOP) and late onset (LOP) preeclampsia are two subtypes of preeclampsia. This study examines the effect of maternal omega-3 fatty acids and vitamin E supplementation in a rat model of preeclampsia.Method: Pregnant Wistar rats were assigned to control; EOP; LOP; EOP+omega-3 fatty acid supplementation+vitamin E and LOP+omega-3 fatty acid supplementation+vitamin E. L-Nitroarginine methylester was used to induce preeclampsia. Blood Pressure (BP) was recorded during pregnancy and dams were dissected at d14 and d20 of gestation.Results: Animals from EOP and LOP groups demonstrated higher systolic and diastolic BP, lower weight gain, lower conceptuses size, lower conceptuses weight and fetal weight as compared to control. EOP and LOP groups showed higher percentage of fetal resorptions and embryotoxicity (deformities and hematomas).Conclusion: Supplementation reduced the diastolic BP, percentage of resorptions and embryotoxicity only in the LOP group, suggesting a need for differential supplementation regime for the two subtypes of preeclampsia.
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Affiliation(s)
- Vaishali Kasture
- Department of Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune, India
| | - Surabhi Dalvi
- Department of Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune, India
| | - Mayur Swamy
- Department of Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune, India
| | - Anvita Kale
- Department of Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune, India
| | - Sadhana Joshi
- Department of Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune, India
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Rottenstreich A, Elazary R, Goldenshluger A, Pikarsky AJ, Elchalal U, Ben-Porat T. Maternal nutritional status and related pregnancy outcomes following bariatric surgery: A systematic review. Surg Obes Relat Dis 2019; 15:324-332. [PMID: 30658948 DOI: 10.1016/j.soard.2018.11.018] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/15/2018] [Accepted: 11/12/2018] [Indexed: 02/06/2023]
Abstract
Up to 80% of patients who undergo bariatric surgery are women of childbearing age. Coupled with improved fertility in women with obesity after bariatric surgery, pregnancy postbariatric surgery has become increasingly more common. Although numerous studies have evaluated associations of bariatric surgery with pregnancy outcomes, the effect of maternal nutritional status on maternal and perinatal outcomes is not well established. We used Medline and Embase databases and a manual search of references for articles published until June 2018 to conduct a systematic review on nutritional status after bariatric surgery and its association with maternal and perinatal outcomes. Of the 306 initially identified articles, 27 met the study inclusion criteria, comprising 2056 women with pregnancies after bariatric surgery. Deficiencies were reported in maternal concentrations of vitamins A, B1, B6, B12, C, D, K, iron, calcium, selenium, and phosphorous. The only adverse events documented for these deficiencies encountered during pregnancy were anemia (vitamin B12, iron), night blindness (vitamin A), and urinary tract infections (vitamin A, D). This systematic review suggests that various micronutrient deficiencies are common among pregnant postbariatric surgery patients. Nevertheless, despite the concern that these deficiencies could adversely affect pregnancy outcomes (e.g., lower neonatal birth weight), evidence of such is lacking. Further prospective studies are warranted to confirm our findings and better delineate the optimal supplementation regimen during pregnancy after bariatric surgery.
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Affiliation(s)
- Amihai Rottenstreich
- Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ram Elazary
- Department of Surgery, Hadassah-Hebrew University Medical Center, Ein-Kerem Campus, Jerusalem, Israel.
| | - Ariela Goldenshluger
- Department of Nutrition, Hadassah-Hebrew University Medical Center, Ein-Kerem Campus, Jerusalem, Israel
| | - Alon J Pikarsky
- Department of Surgery, Hadassah-Hebrew University Medical Center, Ein-Kerem Campus, Jerusalem, Israel
| | - Uriel Elchalal
- Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Tair Ben-Porat
- Department of Nutrition, Hadassah-Hebrew University Medical Center, Ein-Kerem Campus, Jerusalem, Israel
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Trimester-Specific Assessment of Diet Quality in a Sample of Canadian Pregnant Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030311. [PMID: 30678329 PMCID: PMC6388152 DOI: 10.3390/ijerph16030311] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 01/09/2019] [Accepted: 01/22/2019] [Indexed: 02/06/2023]
Abstract
The present study aimed to (1) examine changes in diet quality throughout pregnancy and (2) identify maternal characteristics associated with trimester-specific diet quality. Pregnant women (n = 79) were recruited in their 1st trimester of pregnancy and completed, at each trimester, three web-based 24-hour dietary recalls, from which the Canadian Healthy Eating Index (HEI) was calculated. Physical activity, nutrition knowledge, and socio-demographic web-questionnaires were also completed. Although no variation in total HEI scores was observed across trimesters, we found an overall decrease in the following subscores: adequacy, total fruits and vegetables, unsaturated fats and saturated fats (p < 0.05). In the 1st trimester, overweight and obese pregnant women had a lower diet quality in comparison with normal-weight and underweight women (HEI scores: 63.1 ± 11.9 vs. 68.0 ± 9.3; p = 0.04). In the 3rd trimester, women younger than 28 years old, with no university degree, poorer nutrition knowledge and who reside in an urban setting, had a lower diet quality (p < 0.05). In conclusion, less educated, younger women who reside in an urban setting may be at a higher risk of poor diet quality in late pregnancy and could benefit from public health programs.
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Alowais MA, Selim MAEH. Knowledge, attitude, and practices regarding dietary supplements in Saudi Arabia. J Family Med Prim Care 2019; 8:365-372. [PMID: 30984640 PMCID: PMC6436290 DOI: 10.4103/jfmpc.jfmpc_430_18] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective: The study was aimed at determining the characteristics and lifestyle choices of dietary supplement users and to assess knowledge, attitude, and practice related to dietary supplements in the health sciences students versus other individuals in Saudi Arabia. Methods: A descriptive cross-sectional, online questionnaire-based study was conducted on 351 participants (138 were health sciences students and 203 were not). The results were documented and analyzed using SPSS- version 22. Results: More than half of the participants consumed dietary supplements, 53.6% of the health sciences students versus 56.3% of the other individuals. Multivitamins were the most commonly used supplement in all participants (49%). Both groups believed that people might need dietary supplements more during specific times as pregnancy or recovery from diseases, with higher percentage in health sciences students than other people (43% versus 38%). Most of the students were somewhat aware about the facts concerning dietary supplements compared to others. Significant difference (P ≤ 0.05) was found concerning opinion and beliefs related to dietary supplements between the two groups. However, the health sciences students were not highly knowledgeable about the facts regarding supplements. Conclusion: The users of dietary supplements tend to incorporate these products into their lifestyles as part of a broader focus on healthy living. Many of health sciences students do not have accurate information about dietary supplements. It is important to strengthen the health science curriculum concerning this topic, with the aim of producing better-informed future professionals.
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Early Folic Acid Supplement Initiation and Risk of Adverse Early Childhood Respiratory Health: A Population-based Study. Matern Child Health J 2018; 22:111-119. [PMID: 28887720 DOI: 10.1007/s10995-017-2360-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objectives Folate plays a vital role in biologic functions yet women often do not meet the recommended dietary intake in pregnancy. It has been suggested that high folic acid intake during pregnancy may increase the risk of respiratory diseases in offspring. However, findings from observational studies in human populations are inconclusive. Methods In this population-based study, we collected self-reported folic acid and prenatal vitamin supplement use during pregnancy 3-6 months postpartum from mothers in Los Angeles whose children were born in 2003. Supplement initiation was based on whichever supplement, either folic acid or prenatal supplements, the women initiated first. In a 2006 follow-up survey, approximately 50% of women were re-contacted to gather information on the child's respiratory health, including symptoms and diagnoses, at approximately 3.5 years of age. Results Overall, timing of folic acid supplement initiation was not associated with wheeze or lower respiratory tract infection, even after accounting for preterm births and censoring at follow-up. However, children born to mothers with a history of atopy (hay fever, eczema or asthma) who initiate folic acid supplements in late pregnancy, compared to first trimester initiators, have 1.67 (95% CI 1.12, 2.49) times the risk of wheeze in the first 3 years of life and 1.88 (95% CI 1.05, 3.34) times the risk of wheeze in the past year. No association was found among children of non-atopic mothers. Conclusions These findings suggest that early folic acid or prenatal supplementation among atopic women may be important to prevent wheeze among offspring.
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Almaghamsi A, Almalki MH, Buhary BM. Hypocalcemia in Pregnancy: A Clinical Review Update. Oman Med J 2018; 33:453-462. [PMID: 30410686 DOI: 10.5001/omj.2018.85] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Though hypocalcemia in pregnancy is not often reported in the literature, it occurs in cases of hypoparathyroidism and in mothers with severe dietary inadequacy. Hypocalcemia during pregnancy can pose numerous problems to the mother and fetus. It is associated with hypertensive disorders and can increase the risk of numerous problems such as preeclampsia and fetal growth disorders. In this review, we summarize the challenges physicians face diagnosing and managing hypocalcemia during pregnancy. A multidisciplinary team including endocrinologists and obstetricians is warranted to ensure appropriate treatment and optimal outcomes.
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Affiliation(s)
| | - Mussa H Almalki
- Obesity, Endocrine and Metabolism Centre, King Fahad Medical City, Riyadh, Saudi Arabia.,College of Medicine, King Saud bin Abdulaziz University for Health Science, King Fahad Medical City, Riyadh, Saudi Arabia
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Coupaye M, Legardeur H, Sami O, Calabrese D, Mandelbrot L, Ledoux S. Impact of Roux-en-Y gastric bypass and sleeve gastrectomy on fetal growth and relationship with maternal nutritional status. Surg Obes Relat Dis 2018; 14:1488-1494. [PMID: 30146424 DOI: 10.1016/j.soard.2018.07.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/21/2018] [Accepted: 07/15/2018] [Indexed: 12/16/2022]
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Woldetensay YK, Belachew T, Biesalski HK, Ghosh S, Lacruz ME, Scherbaum V, Kantelhardt EJ. The role of nutrition, intimate partner violence and social support in prenatal depressive symptoms in rural Ethiopia: community based birth cohort study. BMC Pregnancy Childbirth 2018; 18:374. [PMID: 30219050 PMCID: PMC6139168 DOI: 10.1186/s12884-018-2009-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 09/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression during pregnancy has far-reaching adverse consequences on mothers, children and the whole family. The magnitude and determinants of prenatal depressive symptoms in low-resource countries are not well established. This study aims to describe the prevalence of prenatal depressive symptoms and whether it is associated with maternal nutrition, intimate partner violence and social support among pregnant women in rural Ethiopia. METHODS This study is based on the baseline data from a large prospective, community-based, birth cohort study conducted in the South Western part of Ethiopia from March 2014 to March 2016. A total of 4680 pregnant women were recruited between 12 and 32 weeks of gestation. Depressed mood was assessed using the Patient Health Questionnaire (PHQ-9) scale and a cut off of ≥8 was taken to define prenatal depressive symptoms. Data collection was conducted electronically on handheld tablets and submitted to a secured server via an internet connection. Bivariate and multivariate logistic regression analyses were computed using IBM SPSS version 20 software. RESULT The community based prevalence of depressive symptoms during pregnancy was 10.8% (95%Confidence Interval (CI): 9.92-11.70). Adjusting for confounding variables, moderate household food insecurity (OR 1.74; 95% CI: 1.31-2.32), severe household food insecurity (OR 7.90; 95% CI: 5.87-10.62), anaemia (OR = 1.30; 95% CI: 1.04-1.61) and intimate partner violence (OR 3.08; 95% CI: 2.23-4.25) were significantly associated with prenatal depressive symptoms. On the other hand, good social support from friends, families and husband reduced the risk of prenatal depressive symptoms by 39% (OR 0.61; 95% CI: 0.50-0.76). CONCLUSION Prenatal depressive symptomatology is rather common during pregnancy in rural Ethiopia. In this community based study, household food insecurity, anaemia and intimate partner violence were significantly associated with prenatal depressive symptoms. Good maternal social support from friends, families and spouse was rather protective. The study highlights the need for targeted screening for depression and intimate partner violence during pregnancy. Policies aimed at reducing household food insecurity, maternal anaemia and intimate partner violence during pregnancy may possibly reduce depression.
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Affiliation(s)
- Yitbarek Kidane Woldetensay
- Institute of Biological Chemistry and Nutrition (140a), University of Hohenheim, Stuttgart, Germany. .,Food Security Center, University of Hohenheim, Stuttgart, Germany. .,Department of Population and Family Health, College of Health Sciences, Jimma University, Jimma, Ethiopia.
| | - Tefera Belachew
- Department of Population and Family Health, College of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Hans Konrad Biesalski
- Institute of Biological Chemistry and Nutrition (140a), University of Hohenheim, Stuttgart, Germany.,Food Security Center, University of Hohenheim, Stuttgart, Germany
| | - Shibani Ghosh
- Tufts University, Freidman School of Nutrition Science and Policy, Boston, USA
| | - Maria Elena Lacruz
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Faculty of Medicine, Martin-Luther University, Halle, Germany
| | - Veronika Scherbaum
- Institute of Biological Chemistry and Nutrition (140a), University of Hohenheim, Stuttgart, Germany.,Food Security Center, University of Hohenheim, Stuttgart, Germany
| | - Eva Johanna Kantelhardt
- Department of Gynecology, Faculty of Medicine, Martin-Luther University, Halle, Germany.,Institute of Medical Epidemiology, Biostatistics, and Informatics, Faculty of Medicine, Martin-Luther University, Halle, Germany
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Akibu M, Tekelab T, Amano A, Besho M, Grutzmacher S, Tadese M, Habtewold TD. Adherence to prenatal iron-folic acid supplementation in low- and middle-income countries (LMIC): a protocol for systematic review and meta-analysis. Syst Rev 2018; 7:107. [PMID: 30045772 PMCID: PMC6060532 DOI: 10.1186/s13643-018-0774-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 07/11/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Daily iron-folic acid supplementation reduces anemia and various adverse obstetric outcomes such as preterm delivery, low birthweight, hemorrhage, and perinatal and maternal morbidity and mortality. However, its supplementation has not been successful that attributed to several determinants including poor adherence. Therefore, we aimed to conduct a systematic review and meta-analysis on the prevalence and determinants of adherence to prenatal iron-folic acid supplementation in low- and middle-income countries. In addition, we will develop a conceptual framework in the context of low- and middle-income countries (LMIC). METHODS/DESIGN We will search PubMed, MEDLINE, EMBASE, EBSCO, Web of Science, SCOPUS, WHO Global Index Medicus, and African Journals Online (AJOL) databases to retrieve relevant literatures. Observational (i.e., case-control, cohort, cross-sectional, survey, and surveillance reports) and quasi-randomized and randomized controlled trial studies conducted in LMIC will be included. The Newcastle-Ottawa Scale (NOS) and Joanna Briggs Institute (JBI) critical appraisal checklist will be used to assess the quality of observational and randomized controlled trial studies respectively. The pooled prevalence and odds ratio of determinants of adherence will be generated using a weighted inverse-variance meta-analysis model. Statistical heterogeneity among studies will be assessed by Cochran's Q χ2 statistics and Higgins (I2 statistics) method. The result will be presented using forest plots and Harvest plots when necessary. Furthermore, we will perform Jackknife sensitivity and subgroup analysis. Data will be analyzed using comprehensive meta-analysis software (version 2). DISCUSSION Contemporary evidence about the prevalence and determinants of adherence in LMIC will be synthesized to generate up-to-date knowledge. To our knowledge, this is the first systematic review. It would have substantial implications for researchers, clinicians, and policymakers for optimizing maternal and child health outcomes in LMIC. SYSTEMATIC REVIEW REGISTRATION The protocol has been registered on International Prospective Register of Systematic Review (PROSPERO), University of York Center for Reviews and Dissemination ( https://www.crd.york.ac.uk/ ), registration number CRD42017080245 .
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Affiliation(s)
- Mohammed Akibu
- Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia.
- Department of Midwifery, Institute of Medicine and Health Science, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia.
| | - Tesfalidet Tekelab
- Research Centre for Generational Health and Ageing at the Hunter Medical Research Institute, University of Newcastle, Callaghan, Australia
- College of Medicine and Health Science, Wollaga University, Nekemte, Ethiopia
| | - Abdella Amano
- College of Medicine and Health Science, School of Public Health, Hawassa University, Hawassa, Ethiopia
| | - Merga Besho
- College of Medicine and Health Science, Wollaga University, Nekemte, Ethiopia
| | - Stephanie Grutzmacher
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, USA
| | - Mesfin Tadese
- Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Tesfa Dejenie Habtewold
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Bi WG, Nuyt AM, Weiler H, Leduc L, Santamaria C, Wei SQ. Association Between Vitamin D Supplementation During Pregnancy and Offspring Growth, Morbidity, and Mortality: A Systematic Review and Meta-analysis. JAMA Pediatr 2018; 172:635-645. [PMID: 29813153 PMCID: PMC6137512 DOI: 10.1001/jamapediatrics.2018.0302] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
IMPORTANCE Whether vitamin D supplementation during pregnancy is beneficial and safe for offspring is unclear. OBJECTIVE To systematically review studies of the effects of vitamin D supplementation during pregnancy on offspring growth, morbidity, and mortality. DATA SOURCES Searches of Medline, Embase, and the Cochrane Database of Systematic Reviews were conducted up to October 31, 2017. Key search terms were vitamin D, pregnancy, randomized controlled trials, and offspring outcomes. STUDY SELECTION Randomized clinical trials of vitamin D supplementation during pregnancy and offspring outcomes. DATA EXTRACTION AND SYNTHESIS Two authors independently extracted data, and the quality of the studies was assessed. Summary risk ratio (RR), risk difference (RD) or mean difference (MD), and 95% CI were calculated using fixed-effects or random-effects meta-analysis. MAIN OUTCOMES AND MEASURES Main outcomes were fetal or neonatal mortality, small for gestational age (SGA), congenital malformation, admission to a neonatal intensive care unit, birth weight, Apgar scores, neonatal 25-hydroxyvitamin D (25[OH]D) and calcium concentrations, gestational age, preterm birth, infant anthropometry, and respiratory morbidity during childhood. RESULTS Twenty-four clinical trials involving 5405 participants met inclusion criteria. Vitamin D supplementation during pregnancy was associated with a lower risk of SGA (RR, 0.72; 95% CI, 0.52 to 0.99; RD, -5.60%; 95% CI, -0.86% to -10.34%) without risk of fetal or neonatal mortality (RR, 0.72; 95% CI, 0.47 to 1.11) or congenital abnormality (RR, 0.94; 95% CI, 0.61 to 1.43). Neonates with prenatal vitamin D supplementation had higher 25(OH)D levels (MD, 13.50 ng/mL; 95% CI, 10.12 to 16.87 ng/mL), calcium levels (MD, 0.19 mg/dL; 95% CI, 0.003 to 0.38 mg/dL), and weight at birth (MD, 75.38 g; 95% CI, 22.88 to 127.88 g), 3 months (MD, 0.21 kg; 95% CI, 0.13 to 0.28 kg), 6 months (MD, 0.46 kg; 95% CI, 0.33 to 0.58 kg), 9 months (MD, 0.50 kg; 95% CI, 0.01 to 0.99 kg), and 12 months (MD, 0.32 kg; 95% CI, 0.12 to 0.52 kg). Subgroup analysis by doses showed that low-dose vitamin D supplementation (≤2000 IU/d) was associated with a reduced risk of fetal or neonatal mortality (RR, 0.35; 95% CI, 0.15 to 0.80), but higher doses (>2000 IU/d) did not reduce this risk (RR, 0.95; 95% CI, 0.59 to 1.54). CONCLUSIONS AND RELEVANCE Vitamin D supplementation during pregnancy is associated with a reduced risk of SGA and improved infant growth without risk of fetal or neonatal mortality or congenital abnormality. Vitamin D supplementation with doses of 2000 IU/d or lower during pregnancy may reduce the risk of fetal or neonatal mortality.
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Affiliation(s)
- Wei Guang Bi
- Centre Hospitalier Universitaire Saint-Justine Research Center, University of Montréal, Montréal, Quebec, Canada,Department of Obstetrics and Gynecology, University of Montréal, Montréal, Quebec, Canada
| | - Anne Monique Nuyt
- Centre Hospitalier Universitaire Saint-Justine Research Center, University of Montréal, Montréal, Quebec, Canada,Department of Pediatrics; Faculty of Medicine, University of Montréal, Montréal, Quebec, Canada
| | - Hope Weiler
- School of Human Nutrition, McGill University, Montréal, Quebec, Canada
| | - Line Leduc
- Centre Hospitalier Universitaire Saint-Justine Research Center, University of Montréal, Montréal, Quebec, Canada,Department of Obstetrics and Gynecology, University of Montréal, Montréal, Quebec, Canada
| | - Christina Santamaria
- Centre Hospitalier Universitaire Saint-Justine Research Center, University of Montréal, Montréal, Quebec, Canada
| | - Shu Qin Wei
- Centre Hospitalier Universitaire Saint-Justine Research Center, University of Montréal, Montréal, Quebec, Canada,Department of Obstetrics and Gynecology, University of Montréal, Montréal, Quebec, Canada
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Elliott-Sale KJ, Graham A, Hanley SJ, Blumenthal S, Sale C. Modern dietary guidelines for healthy pregnancy; maximising maternal and foetal outcomes and limiting excessive gestational weight gain. Eur J Sport Sci 2018; 19:62-70. [PMID: 29842836 DOI: 10.1080/17461391.2018.1476591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Maternal dietary habits influence maternal and foetal health, representing a pathway for intervention to maximise pregnancy outcomes. Advice on energy intake is provided on a trimester basis, with no additional calories required in the first trimester and an additional 340 kcal d-1 and 452 kcal d-1 needed for the second and third trimesters. Energy intake depends on pre-gravid body mass index (BMI); underweight women are recommended an increase of 150, 200 and 300 kcal d-1 during the first, second and third trimester, normal weight women an increase of 0, 350 and 500 kcal d-1 and obese women an increase of 0, 450 and 350 kcal day-1. The recommendations for carbohydrate and protein intake are 175 g d-1 and 0.88-1.1 g kgBM d-1, with no change to fat intake. The number of pre-gravid obese women is rising; therefore, we need to regulate weight in women of childbearing age and limit gestational weight gain to within the recommended ranges [overweight women 6.8-11.3 kg and obese women 5.0-9.1 kg]. This can be achieved using nutritional interventions, as dietary changes have been shown to help with gestational weight management. As pregnancy has been identified as a risk factor for the development of obesity, normal weight women should gain 11.5-16.0 kg during pregnancy. While some research has shown that dietary interventions help to regulate gestational weight gain and promote postpartum weight loss to some extent, future research is needed to provide safe and effective guidelines to maximise these effects, while benefitting maternal and foetal health.
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Affiliation(s)
- Kirsty Jayne Elliott-Sale
- a Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology , Nottingham Trent University , Nottingham , UK
| | - Ashley Graham
- a Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology , Nottingham Trent University , Nottingham , UK
| | - Stephanie Jane Hanley
- a Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology , Nottingham Trent University , Nottingham , UK
| | | | - Craig Sale
- a Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology , Nottingham Trent University , Nottingham , UK
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Hofstee P, McKeating DR, Perkins AV, Cuffe JS. Placental adaptations to micronutrient dysregulation in the programming of chronic disease. Clin Exp Pharmacol Physiol 2018; 45:871-884. [PMID: 29679395 DOI: 10.1111/1440-1681.12954] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 03/27/2018] [Accepted: 04/09/2018] [Indexed: 12/19/2022]
Abstract
Poor nutrition during pregnancy is known to impair foetal development and increase the risk of chronic disease in offspring. Both macronutrients and micronutrients are required for a healthy pregnancy although significantly less is understood about the role of micronutrients in the programming of chronic disease. This is despite the fact that modern calorie rich diets are often also deficient in key micronutrients. The importance of micronutrients in gestational disorders is clearly understood but how they impact long term disease in humans requires further investigation. In contrast, animal studies have demonstrated how diets high or low in specific micronutrients influence offspring physiology. Many of these studies highlight the importance of the placenta in determining disease risk. This review will explore the effects of individual vitamins, minerals and trace elements on offspring disease outcomes and discuss several key placental adaptations that are affected by multiple micronutrients. These placental adaptations include micronutrient induced dysregulation of oxidative stress, altered methyl donor availability and its impact on epigenetic mechanisms as well as endocrine dysfunction. Critical gaps in our current knowledge and the relative importance of different micronutrients at different gestational ages will also be highlighted. Finally, this review will discuss the need for further studies to characterise the micronutrient status of Australian women of reproductive age and correlate micronutrient status to placental adaptations, pregnancy complications and offspring disease.
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Affiliation(s)
- Pierre Hofstee
- School of Medical Science, Menzies Health Institute Queensland, Griffith University Gold Coast Campus, Southport, QLD, Australia
| | - Daniel R McKeating
- School of Medical Science, Menzies Health Institute Queensland, Griffith University Gold Coast Campus, Southport, QLD, Australia
| | - Anthony V Perkins
- School of Medical Science, Menzies Health Institute Queensland, Griffith University Gold Coast Campus, Southport, QLD, Australia
| | - James Sm Cuffe
- School of Medical Science, Menzies Health Institute Queensland, Griffith University Gold Coast Campus, Southport, QLD, Australia
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de Boer A, Bast A, Godschalk R. Dietary supplement intake during pregnancy; better safe than sorry? Regul Toxicol Pharmacol 2018; 95:442-447. [PMID: 29567330 DOI: 10.1016/j.yrtph.2018.03.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 03/16/2018] [Accepted: 03/18/2018] [Indexed: 12/31/2022]
Abstract
Consumption of dietary supplements and specifically niche products such as supplements targeting pregnant women is increasing. The advantages of dietary supplementation during pregnancy with folic acid have been established, but health effects of many other supplements have not been confirmed. EU and US legislation on dietary supplements requires the product to be safe for the direct consumer, the mother. Long-term health effects for the fetus due to fetal programming (in utero adaptation of the fetal epigenome due to environmental stimuli such as supplementation) are not taken into account. Such epigenetic alterations can, however, influence the response to health challenges in adulthood. We therefore call for both conducting research in birth cohorts and animal studies to identify potential health effects in progeny of supplement consuming mothers as well as the establishment of a nutrivigilance scheme to identify favorable and adverse effects post-marketing. The acquired knowledge can be used to create more effective legislation on dietary supplement intake during pregnancy for safety of the child. Increasing knowledge on the effects of consuming supplements will create a safer environment for future mothers and their offspring to optimize their health before, during and after pregnancy.
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Affiliation(s)
- Alie de Boer
- Food Claims Centre Venlo, Maastricht University Campus Venlo, Faculty of Humanities and Sciences, Venlo, The Netherlands.
| | - Aalt Bast
- Department of Pharmacology and Toxicology, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; Maastricht University Campus Venlo, Faculty of Humanities and Sciences, Venlo, The Netherlands
| | - Roger Godschalk
- Department of Pharmacology and Toxicology, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Emond JA, Karagas MR, Baker ER, Gilbert-Diamond D. Better Diet Quality during Pregnancy Is Associated with a Reduced Likelihood of an Infant Born Small for Gestational Age: An Analysis of the Prospective New Hampshire Birth Cohort Study. J Nutr 2018; 148:22-30. [PMID: 29378041 PMCID: PMC6251578 DOI: 10.1093/jn/nxx005] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 10/10/2017] [Indexed: 02/06/2023] Open
Abstract
Background Birth weight has a U-shaped relation with chronic disease. Diet quality during pregnancy may impact fetal growth and infant birth weight, yet findings are inconclusive. Objective We examined the relation between maternal diet quality during pregnancy and infant birth size among women enrolled in a prospective birth cohort. Methods Women 18-45 y old with a singleton pregnancy were recruited at 24-28 wk of gestation from prenatal clinics in New Hampshire. Women completed a validated food frequency questionnaire at enrollment. Diet quality was computed as adherence to the Alternative Healthy Eating Index. Infant birth outcomes (sex, head circumference, weight, and length) were extracted from medical records. Weight-for-length z scores, low birth weight, macrosomia, and size for gestational age [small for gestational age (SGA) or large for gestational age (LGA)] were computed. Multivariable regression models fit each outcome on quartiles of diet quality, adjusted for covariates. Models were computed overall and stratified by smoking status. Results Analyses included 862 women and infants with complete data. Lower diet quality was associated with lower maternal education, being a smoker, prepregnancy obesity status, and lack of exercise during pregnancy. Overall, 3.4% of infants were born with a low birth weight, 12.1% with macrosomia, 4.6% were SGA, and 8.7% were LGA. In an adjusted model, increased diet quality appeared linearly associated with a reduced likelihood of SGA (P-trend = 0.03), although each quartile comparison did not reach statistical significance. Specifically, ORs for SGA were 0.89 (95% CI: 0.37, 2.15), 0.73 (95% CI: 0.28, 1.89), and 0.35 (95% CI: 0.11, 1.08) for each increasing quartile of diet quality compared to the lowest quartile. Similar trends for SGA were observed among non-smokers (n = 756; P-trend = 0.07). Also among non-smokers, increased diet quality was associated with lower infant birth weight (P-trend = 0.03) and a suggested reduction in macrosomia (P-trend = 0.07). Conclusions Increased diet quality during pregnancy was related to a reduced risk of SGA in this cohort of pregnant women from New Hampshire. Additional studies are needed to elucidate the relation between maternal diet quality and macrosomia.
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Affiliation(s)
- Jennifer A Emond
- Departments of Biomedical Data Science, Pediatrics, and Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH,Departments of Pediatrics, and Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH,Norris Cotton Cancer Center, Lebanon, NH,Address correspondence to JAE (e-mail: )
| | - Margaret R Karagas
- Departments of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH,Norris Cotton Cancer Center, Lebanon, NH,Children's Environmental Health and Disease Prevention Center at Dartmouth College, Lebanon, NH
| | - Emily R Baker
- Children's Environmental Health and Disease Prevention Center at Dartmouth College, Lebanon, NH,Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Diane Gilbert-Diamond
- Departments of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH,Norris Cotton Cancer Center, Lebanon, NH,Children's Environmental Health and Disease Prevention Center at Dartmouth College, Lebanon, NH
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Salam RA, Das JK, Irfan O, Bhutta ZA. PROTOCOL: Effects of preventive nutrition interventions among adolescents on health and nutritional status in low- and middle-income countries: a systematic review. CAMPBELL SYSTEMATIC REVIEWS 2018; 14:1-27. [PMID: 37131382 PMCID: PMC8427976 DOI: 10.1002/cl2.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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Slater C, Morris L, Ellison J, Syed AA. Nutrition in Pregnancy Following Bariatric Surgery. Nutrients 2017; 9:nu9121338. [PMID: 29292743 PMCID: PMC5748788 DOI: 10.3390/nu9121338] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 11/28/2017] [Accepted: 12/03/2017] [Indexed: 12/13/2022] Open
Abstract
The widespread use of bariatric surgery for the treatment of morbid obesity has led to a dramatic increase in the numbers of women who become pregnant post-surgery. This can present new challenges, including a higher risk of protein and calorie malnutrition and micronutrient deficiencies in pregnancy due to increased maternal and fetal demand. We undertook a focused, narrative review of the literature and present pragmatic recommendations. It is advisable to delay pregnancy for at least 12 months following bariatric surgery. Comprehensive pre-conception and antenatal care is essential to achieving the best outcomes. Nutrition in pregnancy following bariatric surgery requires specialist monitoring and management. A multidisciplinary approach to care is desirable with close monitoring for deficiencies at each trimester.
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Affiliation(s)
- Christopher Slater
- Department of Nutrition and Dietetics, Salford Royal NHS Foundation & University Teaching Trust, Salford, Greater Manchester M6 8HD, UK.
| | - Lauren Morris
- Department of Diabetes & Endocrinology, Salford Royal NHS Foundation & University Teaching Trust, Salford, Greater Manchester M6 8HD, UK.
| | - Jodi Ellison
- Department of Surgery, Salford Royal NHS Foundation & University Teaching Trust, Salford, Greater Manchester M6 8HD, UK.
| | - Akheel A Syed
- Department of Diabetes & Endocrinology, Salford Royal NHS Foundation & University Teaching Trust, Salford, Greater Manchester M6 8HD, UK.
- Faculty of Biology, Medicine & Health, The University of Manchester, Manchester M13 9PL, UK.
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Araban M, Baharzadeh K, Karimy M. Nutrition modification aimed at enhancing dietary iron and folic acid intake: an application of health belief model in practice. Eur J Public Health 2017; 27:287-292. [PMID: 28057694 DOI: 10.1093/eurpub/ckw238] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background The amount of calories and nutrients required for woman increase during pregnancy and Intake adequate amounts of nutrients is essential for the health of mother and foetal. This study was designed to investigate the effect of nutrition education based on the Health Belief Model (HBM) on calories, iron and folic acid intake for pregnant women. Methods This quasi-experimental study was performed on 76 pregnant women referring to four urban health centres of Khuzestan at 2015. Two education sessions were held covering items on nutrition during pregnancy. Data were collected through a demographic questionnaire, HBM questionnaire (CVI= 0.89, CVI = 0.83 and Cronbach's alpha = 0.84) and 3-day food record form. Data collection tool was valid and reliable self-administered questionnaire based on the HBM. Data analysis was done applying Chi-squared t -test, Mann-Whitney U -test and Wilcoxon test using SPSS 15. Results Before the intervention, there was no significant difference between the mean of calories, iron and folic acid intake in both groups. But after intervention, it was significant ( P <0.05). Before the intervention, there was no significant difference between the two groups in terms of health belief model constructs ( P > 0.05), but the difference was significant after intervention ( P < 0.05). Conclusions Educational intervention strategies based on HBM can improve dietary iron and folic acid intake in pregnant women in primary health care setting. Since anaemia is one of the leading indirect causes of maternal mortality and it is easily preventable, our findings have critical public health implications and perhaps might be used in evidence-based decision making by authority bodies.
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Affiliation(s)
- Marzieh Araban
- Social Determinants of Health, Research center, Health Education and Health Promotion Department, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Khadije Baharzadeh
- Health Education and Health Promotion Department, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahmood Karimy
- Department of Public Health, Faculty of Health, Saveh University of Medical Sciences, Saveh, Iran
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Grooten IJ, Koot MH, van der Post JA, Bais JM, Ris-Stalpers C, Naaktgeboren C, Bremer HA, van der Ham DP, Heidema WM, Huisjes A, Kleiverda G, Kuppens S, van Laar JO, Langenveld J, van der Made F, van Pampus MG, Papatsonis D, Pelinck MJ, Pernet PJ, van Rheenen L, Rijnders RJ, Scheepers HC, Vogelvang TE, Mol BW, Roseboom TJ, Painter RC. Early enteral tube feeding in optimizing treatment of hyperemesis gravidarum: the Maternal and Offspring outcomes after Treatment of HyperEmesis by Refeeding (MOTHER) randomized controlled trial. Am J Clin Nutr 2017; 106:812-820. [PMID: 28793989 DOI: 10.3945/ajcn.117.158931] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 06/27/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Hyperemesis gravidarum (HG) leads to dehydration, poor nutritional intake, and weight loss. HG has been associated with adverse pregnancy outcomes such as low birth weight. Information about the potential effectiveness of treatments for HG is limited.Objective: We hypothesized that in women with HG, early enteral tube feeding in addition to standard care improves birth weight.Design: We performed a multicenter, open-label randomized controlled trial [Maternal and Offspring outcomes after Treatment of HyperEmesis by Refeeding (MOTHER)] in 19 hospitals in the Netherlands. A total of 116 women hospitalized for HG between 5 and 20 wk of gestation were randomly allocated to enteral tube feeding for ≥7 d in addition to standard care with intravenous rehydration and antiemetic treatment or to standard care alone. Women were encouraged to continue tube feeding at home. On the basis of our power calculation, a sample size of 120 women was anticipated. Analyses were performed according to the intention-to-treat principle.Results: Between October 2014 and March 2016 we randomly allocated 59 women to enteral tube feeding and 57 women to standard care. The mean ± SD birth weight was 3160 ± 770 g in the enteral tube feeding group compared with 3200 ± 680 g in the standard care group (mean difference: -40 g, 95% CI: -230, 310 g). Secondary outcomes, including maternal weight gain, duration of hospital stay, readmission rate, nausea and vomiting symptoms, decrease in quality of life, psychological distress, prematurity, and small-for-gestational-age, also were comparable. Of the women allocated to enteral tube feeding, 28 (47%) were treated according to protocol. Enteral tube feeding was discontinued within 7 d of placement in the remaining women, primarily because of its adverse effects (34%).Conclusions: In women with HG, early enteral tube feeding does not improve birth weight or secondary outcomes. Many women discontinued tube feeding because of discomfort, suggesting that it is poorly tolerated as an early routine treatment of HG. This trial was registered at www.trialregister.nl as NTR4197.
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Affiliation(s)
- Iris J Grooten
- Departments of Obstetrics and Gynecology and .,Clinical Epidemiology, Biostatistics, and Bioinformatics, and.,Department of Obstetrics and Gynaecology, Northwest Hospital Group, Alkmaar, Netherlands
| | - Marjette H Koot
- Departments of Obstetrics and Gynecology and.,Clinical Epidemiology, Biostatistics, and Bioinformatics, and
| | | | - Joke Mj Bais
- Department of Obstetrics and Gynaecology, Northwest Hospital Group, Alkmaar, Netherlands
| | - Carrie Ris-Stalpers
- Laboratory of Reproductive Biology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | | | - Henk A Bremer
- Department of Obstetrics and Gynecology, Reinier de Graaf Hospital, Delft, Netherlands
| | - David P van der Ham
- Department of Obstetrics and Gynecology, Martini Hospital, Groningen, Netherlands
| | - Wieteke M Heidema
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Anjoke Huisjes
- Department of Obstetrics and Gynecology, Gelre Hospital, Apeldoorn, Netherlands
| | - Gunilla Kleiverda
- Department of Obstetrics and Gynecology, Flevo Hospital, Almere, Netherlands
| | - Simone Kuppens
- Department of Obstetrics and Gynecology, Catharina Hospital, Eindhoven, Netherlands
| | - Judith Oeh van Laar
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, Netherlands
| | - Josje Langenveld
- Department of Obstetrics and Gynecology, Zuyderland Hospital, Heerlen, Netherlands
| | - Flip van der Made
- Department of Obstetrics and Gynecology, Franciscus Hospital, Rotterdam, Netherlands
| | - Mariëlle G van Pampus
- Department of Obstetrics and Gynecology, Onze Lieve Vrouwen Hospital, Amsterdam, Netherlands
| | - Dimitri Papatsonis
- Department of Obstetrics and Gynecology, Amphia Hospital, Breda, Netherlands
| | - Marie-José Pelinck
- Department of Obstetrics and Gynecology, Scheper Hospital, Emmen, Netherlands
| | - Paula J Pernet
- Department of Obstetrics and Gynecology, Spaarne Hospital, Haarlem, Netherlands
| | - Leonie van Rheenen
- Department of Obstetrics and Gynecology, Onze Lieve Vrouwen Hospital, Amsterdam, Netherlands
| | - Robbert J Rijnders
- Department of Obstetrics and Gynecology, Jeroen Bosch Hospital, 's-Hertogenbosch, Netherlands
| | - Hubertina Cj Scheepers
- Department of Obstetrics and Gynecology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Tatjana E Vogelvang
- Department of Obstetrics and Gynecology, Diakonessenhuis, Utrecht, Netherlands
| | - Ben W Mol
- Robinson Institute, School of Pediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia; and.,The South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Tessa J Roseboom
- Departments of Obstetrics and Gynecology and.,Clinical Epidemiology, Biostatistics, and Bioinformatics, and
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Ncube A, Kunguma O, Nyahwo M, Manombe S. Nutritional vulnerability: An assessment of the 2010 feeding food programme in Mbire district, Zimbabwe, and its impact on pregnant women. JAMBA (POTCHEFSTROOM, SOUTH AFRICA) 2017; 9:406. [PMID: 29955343 PMCID: PMC6014120 DOI: 10.4102/jamba.v9i1.406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 06/23/2017] [Indexed: 06/08/2023]
Abstract
Malnutrition contributes significantly to Zimbabwe's high maternal mortality rate. The prevalence of malnutrition among vulnerable pregnant women in the Mbire district of Zimbabwe was studied to establish why they remained vulnerable despite benefiting from the Vulnerable Group Feeding Programme, a subsidiary of the World Food Programme. A case study on the demographic characteristics, nutritional provision of the programme and the vulnerable pregnant women benefiting from the programme was conducted. One hundred women were purposively sampled at health centres in the district. A two-stage sampling procedure was then utilised to select the most food-insecure wards. The two most food-insecure wards, namely Angwa and Chapoto, were chosen because of their proximity to each other. A questionnaire was administered to the pregnant women to collect their demographic information. Practising nurses at the health centres determined the women's nutritional status and anthropometrics, and they also assessed the food baskets. Permission to conduct the study was obtained from the relevant authorities. The results indicated that the food hamper provided by the World Food Programme was complementary food aid given to all vulnerable members of the community regardless of the nutritional demands. The supplements that the pregnant women received were also inadequate to cater for their nutritional needs or those of the foetuses. It was therefore recommended that the government, through the Ministry of Health, should make more provisions available for vulnerable pregnant women in order to reduce the risks facing pregnant women in the country.
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Affiliation(s)
- Alice Ncube
- Disaster Risk Management Training and Education Centre for Africa, University of the Free State, South Africa
| | - Olivia Kunguma
- Disaster Risk Management Training and Education Centre for Africa, University of the Free State, South Africa
| | - Moddie Nyahwo
- Disaster Risk Management Training and Education Centre for Africa, University of the Free State, South Africa
| | - Stella Manombe
- Disaster Risk Management Training and Education Centre for Africa, University of the Free State, South Africa
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50
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Abnormal Biomarkers of Homocysteine Metabolism in Neonates with Conotruncal Heart Defects. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7404397. [PMID: 28819628 PMCID: PMC5551507 DOI: 10.1155/2017/7404397] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 05/04/2017] [Accepted: 06/28/2017] [Indexed: 11/18/2022]
Abstract
Objectives The etiology of conotruncal heart defects (CHD) remains unknown; however relation between homocysteine, folate levels, and congenital heart disease was found. With this perspective in mind, the aim of the study was to investigate biomarkers of homosyteine metabolism pathway in mothers and their neonates with CHD. Material and Methods Forty-three pairs of mothers and their neonates with CHD and forty pairs of mothers and neonates with nonconotruncal heart defects (non-CHD) were enrolled. The control group (CG) consisted of fifty-nine pairs of mothers and their healthy neonates. For estimating the plasma total homocysteine (tHcy), serum folates, and cobalamin levels, mothers' venous blood samples and umbilical cord blood were taken in all groups. Results We observed higher tHcy levels in newborns with CHD in comparison to their mothers and to neonates with non-CHD. Cobalamin levels were significantly lower in neonates with CHD compared to other children. Folates and cobalamin levels were lower in CHD mothers compared to their children. Conclusions Elevated homocysteine levels in neonates with CHD and folate metabolism disturbances in their mothers were noticed. The observed differences in homocysteine and cobalamin levels between neonates with CHD suggest the influence of various agents disturbing homocysteine metabolic pathways.
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