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Chen F, Wang P, Wang J, Liao Z, Zong X, Chen Y, Lai J, Zhang T, Liu G, Xie X. Analysis and Comparison of Early Childhood Nutritional Outcomes Among Offspring of Chinese Women Under the Chinese 2021 and US 2009 Gestational Weight Gain Guidelines. JAMA Netw Open 2022; 5:e2233250. [PMID: 36149650 PMCID: PMC9508653 DOI: 10.1001/jamanetworkopen.2022.33250] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
IMPORTANCE In 2009, the US National Academy of Medicine (NAM) released revised gestational weight gain (GWG) guidelines, which were established primarily for White North American women and may be unsuitable for Asian women. In 2021, the Chinese Nutrition Society (CNS) released its GWG guidelines, but their applicability requires re-examination. OBJECTIVE To compare the differences between the CNS and NAM recommendations for GWG in association with health outcomes in the offspring of Chinese women. DESIGN, SETTING, AND PARTICIPANTS In this bidirectional cohort study, children in China were recruited at age 3 years from 2017 to 2018, with 2 follow-up visits over the next 2 years (between September 2017 and September 2020). Information during pregnancy was retrieved from medical records. Data analysis was performed from October 2021 to January 2022. MAIN OUTCOMES AND MEASURES GWG was classified as insufficient, appropriate, or excessive according to the CNS and NAM guidelines separately. Children's height, weight, fat mass, fat-free mass, and percentage of body fat were measured at each visit. Body mass index, fat mass index, fat-free mass index, weighted κ score, risk ratio values, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. RESULTS A total of 3822 children (1996 boys and 1826 girls; mean [SD] age, 3.79 [0.30] years) were enrolled; after exclusions, 3170 term singleton children were recruited and were followed at 4 and 5 years of age. According to the CNS guidelines, the prevalence rates were 14.1% for insufficient GWG, 48.1% for appropriate GWG, and 37.9% for excessive GWG, whereas the rates according to NAM guidelines were 39.7% for insufficient GWG, 37.2% for appropriate GWG, and 23.1% for excessive GWG. The weighted κ value for the classification agreement between the 2 guidelines was 0.530 (95% CI, 0.510-0.550). For the appropriate GWG group, the rates for low nutritional levels did not differ between the 2 guidelines, but the rates for high nutritional levels were significantly lower under CNS guidelines than under NAM guidelines. When the sensitivity, specificity, PPV, and NPV with respect to the mothers who maintained appropriate GWG were used to estimate the nonhigh nutritional status of their offspring, generally higher values based on the CNS guidelines were found compared with those based on the NAM recommendations. CONCLUSIONS AND RELEVANCE These findings suggest that the GWG recommendations promulgated by the NAM are higher than the CNS guidelines, with the latter more suitable for Chinese women.
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Affiliation(s)
| | - Peng Wang
- Tianjin Women’s and Children’s Health Center, Tianjin, China
| | - Jing Wang
- Tianjin Women’s and Children’s Health Center, Tianjin, China
| | - Zijun Liao
- Capital Institute of Pediatrics, Beijing, China
| | - Xinnan Zong
- Capital Institute of Pediatrics, Beijing, China
| | - Yiren Chen
- Capital Institute of Pediatrics, Beijing, China
| | - Jianqiang Lai
- National Institute of Nutrition and Health, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Ting Zhang
- Capital Institute of Pediatrics, Beijing, China
| | - Gongshu Liu
- Tianjin Women’s and Children’s Health Center, Tianjin, China
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Abstract
Introduction: Fatty liver disease, defined by the presence of liver fat infiltration, is part of a cluster of disorders that occur in the context of metabolic syndrome. Epigenetic factors - defined as stable and heritable changes in gene expression without changes in the DNA sequence - may not only play an important role in the disease development in adulthood, but they may start exerting their influence in the prenatal stage.Areas covered: By using systems biology approaches, we review the main epigenetic modifications and highlight their likely roles in the pathogenesis of nonalcoholic fatty liver disease.Expert opinion: Knowledge of the mechanisms by which epigenetic modifications participate in complex disorders would not only help scientists find novel therapeutic strategies but could also aid in implementing preventive care measures at gestation.
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Affiliation(s)
- Carlos Jose Pirola
- School of Medicine, Institute of Medical Research A Lanari, University of Buenos Aires, Buenos Aires, Argentina.,Department of Molecular Genetics and Biology of Complex Diseases, National Scientific and Technical Research Council (Conicet)-university of Buenos Aires. Institute of Medical Research (IDIM)
| | - Silvia Sookoian
- School of Medicine, Institute of Medical Research A Lanari, University of Buenos Aires, Buenos Aires, Argentina.,Department of Clinical and Molecular Hepatology, National Scientific and Technical Research Council (CONICET)-University of Buenos Aires. Institute of Medical Research (IDIM), Buenos Aires, Argentina
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3
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Zhou J, Zhang F, Zhang S, Li P, Qin X, Yang M, Teng Y, Huang K. Maternal pre-pregnancy body mass index, gestational weight gain, and pubertal timing in daughters: A systematic review and meta-analysis of cohort studies. Obes Rev 2022; 23:e13418. [PMID: 35014751 DOI: 10.1111/obr.13418] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/10/2021] [Accepted: 12/18/2021] [Indexed: 11/30/2022]
Abstract
The timing of daughter's puberty onset is constantly earlier. It is still unclear about the maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) as important prenatal factors that may affect offspring's onset of puberty. Thus, we evaluated the association among maternal pre-pregnancy BMI, GWG, and daughters' early pubertal development based on the existing literature. Literature review was conducted in different databases, including Web of Science, Pubmed, Wiley, ScienceDirect, Web of Science, and Chinese National Knowledge Infrastructure databases up to June 2021. We selected random effects model or fixed effects model for meta-analysis according to the I2 statistics value to obtain the summary measurement. A total of 12 cohort studies were included. Compared to maternal pre-pregnancy normal weight, maternal pre-pregnancy overall overweight/obesity (RR = 1.24; 95% CI 1.17 to 1.32), obesity (RR = 1.35; 95% CI 1.23 to 1.48), and overweight (RR = 1.17; 95% CI 1.09 to 1.26) were significantly associated with the increased risk of earlier timing of pubertal onset in daughters. Daughters born of mothers with pre-pregnancy overall overweight/obesity, obesity, and overweight had earlier pubertal onset compared to those born of mothers with normal weight ([mean difference = -3.03, 95% CI: -3.97 to -2.10], [mean difference = -3.50, 95% CI: -5.38 to -1.62], and [mean difference = -2.89, 95% CI: -4.07 to -1.71], respectively). The effects were also significant in the assessed three milestones (menarche, breast development, and pubic hair development). Maternal excessive GWG increased the risk of early pubertal timing in daughters (RR = 1.19; 95% CI 1.09 to 1.30).
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Affiliation(s)
- Jixing Zhou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
| | - Fu Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
| | - Shanshan Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
| | - Peixuan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
| | - Xiaoyun Qin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
| | - Mengting Yang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
| | - Yuzhu Teng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.,Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, China
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The Relationship between Telomere Length and Gestational Weight Gain: Findings from the Mamma & Bambino Cohort. Biomedicines 2021; 10:biomedicines10010067. [PMID: 35052747 PMCID: PMC8773008 DOI: 10.3390/biomedicines10010067] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/22/2021] [Accepted: 12/28/2021] [Indexed: 12/21/2022] Open
Abstract
Inadequate gestational weight gain (GWG) affects a growing number of pregnancies, influencing intrauterine environment and long-term health. Uncovering molecular mechanisms associated with GWG could be helpful to develop public health strategies for tackling this issue. Here, our study aimed to understand the relationship of DNA telomere length with weigh gain during pregnancy, using data and samples from the ongoing prospective “Mamma & Bambino” study (Catania, Italy). GWG was calculated according to the Institute of Medicine (IOM) guidelines. Relative telomere length was assessed by real-time quantitative polymerase chain reaction in 252 samples of maternal leucocyte DNA (mlDNA) and 150 samples of cell-free DNA (cfDNA) from amniotic fluid. We observed that relative telomere length of mlDNA seemed to weakly increase with GWG. In contrast, telomere length of cfDNA exhibited a U-shaped relationship with GWG. Women with adequate GWG showed longer telomere length than those who gained weight inadequately. Accordingly, the logistic regression model confirmed the association between telomere length of cfDNA and adequate GWG, after adjusting for potential confounders. Our findings suggest an early effect of GWG on telomere length of cfDNA, which could represent a molecular mechanism underpinning the effects of maternal behaviours on foetal well-being.
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The Relationship between Body Mass Index, Obesity, and LINE-1 Methylation: A Cross-Sectional Study on Women from Southern Italy. DISEASE MARKERS 2021; 2021:9910878. [PMID: 34900031 PMCID: PMC8664509 DOI: 10.1155/2021/9910878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/18/2021] [Accepted: 11/10/2021] [Indexed: 11/17/2022]
Abstract
Uncovering the relationship between body mass index (BMI) and DNA methylation could be useful to understand molecular mechanisms underpinning the effects of obesity. Here, we presented a cross-sectional study, aiming to evaluate the association of BMI and obesity with long interspersed nuclear elements (LINE-1) methylation, among 488 women from Catania, Italy. LINE-1 methylation was assessed in leukocyte DNA by pyrosequencing. We found a negative association between BMI and LINE-1 methylation level in both the unadjusted and adjusted linear regression models. Accordingly, obese women exhibited lower LINE-1 methylation level than their normal weight counterpart. This association was confirmed after adjusting for the effect of age, educational level, employment status, marital status, parity, menopause, and smoking status. Our findings were in line with previous evidence and encouraged further research to investigate the potential role of DNA methylation markers in the management of obesity.
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Demmelmair H, Koletzko B. Perinatal Polyunsaturated Fatty Acid Status and Obesity Risk. Nutrients 2021; 13:3882. [PMID: 34836138 PMCID: PMC8625539 DOI: 10.3390/nu13113882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/22/2021] [Accepted: 10/27/2021] [Indexed: 11/16/2022] Open
Abstract
High obesity rates in almost all regions of the world prompt an urgent need for effective obesity prevention. Very good scientific evidence from cell culture and rodent studies show that the availability of essential polyunsaturated fatty acids (PUFA) and their long-chain polyunsaturated derivatives, namely, arachidonic acid, eicosapentaenoic acid and docosahexaenoic acid, influence adipogenesis; for this reason, early life status may influence later obesity risk. The respective PUFA effects could be mediated via their eicosanoid derivatives, their influence on cell membrane properties, the browning of white adipose tissue, changes to the offspring gut microbiome, their influence on developing regulatory circuits, and gene expression during critical periods. Randomized clinical trials and observational studies show divergent findings in humans, with mostly null findings but also the positive and negative effects of an increased n-3 to n-6 PUFA ratio on BMI and fat mass development. Hence, animal study findings cannot be directly extrapolated to humans. Even though the mechanistic data basis for the effects of n-3 PUFA on obesity risk appears promising, no recommendations for humans can be derived at present.
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Affiliation(s)
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Department Pediatrics, Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, LMU—Ludwig-Maximilians-Universität Munich, D-80337 Munich, Germany;
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Chuang YC, Huang L, Lee WY, Shaw SW, Chu FL, Hung TH. The association between weight gain at different stages of pregnancy and risk of gestational diabetes mellitus. J Diabetes Investig 2021; 13:359-366. [PMID: 34415679 PMCID: PMC8847131 DOI: 10.1111/jdi.13648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/02/2021] [Accepted: 08/17/2021] [Indexed: 12/14/2022] Open
Abstract
AIMS/INTRODUCTION Women with excessive gestational weight gain (GWG) are at a higher risk for complications during pregnancy, such as preeclampsia. However, the association between excessive GWG and gestational diabetes mellitus (GDM) remains unclear. MATERIALS AND METHODS We retrospectively reviewed 8,352 women from our obstetric database with singleton pregnancies who gave birth after 28 completed weeks of gestation between January 1, 2012, and December 31, 2016, excluding pregnancies complicated by fetal anomalies, fetal death, and overt diabetes. Diagnosis of GDM was based on the criteria recommended by the International Association of Diabetes and Pregnancy Study Groups. We used two classification methods to define excessive GWG: a weight gain above the 90th percentile of the population, or exceeding the upper range recommended by the Institute of Medicine, stratified by pre-pregnancy body mass index. Statistical analysis was performed using multiple logistic regression to determine the association between excessive GWG and the risk of GDM. RESULTS Overall, 1,129 women (13.5%) were diagnosed with GDM. There was no difference in GWG between women with and without GDM in the first trimester and before GDM screening. Women with GDM had significantly less GWG in the second trimester, after GDM screening, and throughout the whole gestation than women without GDM. No correlation was found between excessive GWG in the first and second trimesters, before GDM screening, and the later development of GDM. CONCLUSIONS Our results indicate that excessive GWG prior to GDM screening is not associated with an increased risk of GDM.
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Affiliation(s)
- Ya-Chun Chuang
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan.,Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Lulu Huang
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan.,Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Wan-Ying Lee
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Steven W Shaw
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Fu-Ling Chu
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,Department of Medical Nutrition Therapy, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tai-Ho Hung
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan.,Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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8
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Nyasordzi J, Conrad J, Goletzke J, Ludwig-Walz H, Herder C, Roden M, Wudy SA, Hua Y, Remer T, Buyken AE. Early life factors and their relevance for markers of cardiometabolic risk in early adulthood. Nutr Metab Cardiovasc Dis 2021; 31:2109-2121. [PMID: 34023180 DOI: 10.1016/j.numecd.2021.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/09/2021] [Accepted: 03/25/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS Early life exposures could be pertinent risk factors of cardiometabolic diseases in adulthood. We assessed the prospective associations of early life factors with markers of cardiometabolic risk among healthy German adults. METHODS AND RESULTS We examined 348 term-born DONALD Study participants with measurement of fasting blood at the age of 18-24 years to assess metabolic indices: fatty liver index (FLI), hepatic steatosis index (HSI), pro-inflammatory score and insulin sensitivity (HOMA2-%S). Early life factors (maternal weight in early pregnancy, maternal early pregnancy BMI, gestational weight gain (GWG), maternal age, birth weight and full breastfeeding (>17 weeks)) were assessed at enrolment of the offspring into the study. Multivariable linear regression models were used to analyze associations between early life factors and markers of cardiometabolic risk in early adulthood with adjustment for potential confounders. A higher early pregnancy BMI was related to notably higher levels of offspring FLI, HSI, pro-inflammatory score and a lower HOMA2-%S (all p < 0.0001). Similarly, a higher gestational weight gain was associated with a higher FLI (p = 0.044), HSI (p = 0.016), pro-inflammatory score (p = 0.032) and a lower HOMA2-%S among females (p = 0.034). Full breastfeeding was associated with a lower adult FLI (p = 0.037). A casual mediation analysis showed that these associations were mediated by offspring adult waist circumference (WC). CONCLUSION This study suggests that early pregnancy BMI, gestational weight gain, and full breastfeeding are relevant for offspring markers of cardiometabolic risk which seems to be mediated by body composition in young adulthood.
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Affiliation(s)
- Juliana Nyasordzi
- Department of Sports and Health, Institute of Nutrition, Consumption and Health, Paderborn University, Germany; University of Health and Allied Sciences, Ho, Volta Region, Ghana.
| | - Johanna Conrad
- Institute of Nutritional and Food Sciences, Nutritional Epidemiology, University of Bonn, Bonn, Germany.
| | - Janina Goletzke
- Department of Sports and Health, Institute of Nutrition, Consumption and Health, Paderborn University, Germany.
| | - Helena Ludwig-Walz
- DONALD Study Dortmund, Department of Nutrition and Food Sciences (IEL), Nutritional Epidemiology, University of Bonn, Dortmund, Germany; Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Germany.
| | - Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Pediatric Endocrinology and Diabetology, Laboratory for Translational Hormone Analytics, Peptide Hormone Research Unit, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany; Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Pediatric Endocrinology and Diabetology, Laboratory for Translational Hormone Analytics, Peptide Hormone Research Unit, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany; Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | - Stefan A Wudy
- Pediatric Endocrinology and Diabetology, Laboratory for Translational Hormone Analytics, Peptide Hormone Research Unit, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, Germany.
| | - Yifan Hua
- DONALD Study Dortmund, Department of Nutrition and Food Sciences (IEL), Nutritional Epidemiology, University of Bonn, Dortmund, Germany; Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Germany.
| | - Thomas Remer
- DONALD Study Dortmund, Department of Nutrition and Food Sciences (IEL), Nutritional Epidemiology, University of Bonn, Dortmund, Germany; Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Germany.
| | - Anette E Buyken
- Department of Sports and Health, Institute of Nutrition, Consumption and Health, Paderborn University, Germany.
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Kogutt BK, Szymanski LM. Diabesity and Pregnancy: How Do We Get Our Patients Moving? Clin Obstet Gynecol 2021; 64:185-195. [PMID: 33284141 DOI: 10.1097/grf.0000000000000588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Obesity and diabetes are 2 commonly encountered complications in pregnancy that adversely affect pregnancy outcomes, maternal health, and the health of the offspring, both short-term and long-term. It is well established that physical activity provides numerous health benefits, both during and outside of pregnancy. By participating in physical activity, many of the negative consequences of both obesity and diabetes may be mitigated. Physical activity guidelines recommend that all adults, including pregnant women, perform at least 150 minutes of moderate-intensity exercise weekly in order to obtain health benefits. More physical activity may be needed to achieve weight management goals.
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Affiliation(s)
- Benjamin K Kogutt
- Obstetrix Medical Group of Texas & Baylor Medical Center, Fort Worth, Texas
| | - Linda M Szymanski
- Division of Maternal-Fetal Medicine, Mayo Clinic, Rochester, Minnesota
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Garmendia ML, Corvalan C, Araya M, Casanello P, Kusanovic JP, Uauy R. Effectiveness of a normative nutrition intervention in Chilean pregnant women on maternal and neonatal outcomes: the CHiMINCs study. Am J Clin Nutr 2020; 112:991-1001. [PMID: 32692805 DOI: 10.1093/ajcn/nqaa185] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/15/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Some nutritional interventions have shown their efficacy in reducing gestational weight gain (GWG); however, their applicability in routine care is limited. OBJECTIVE We assessed the effectiveness of a low-intensity and high-coverage nutritional intervention on maternal and offspring outcomes; the intervention enhanced existing nutritional health care standards and practices at the primary health care level in Chile. METHODS This study was a cluster-randomized controlled trial of 12 primary health care centers (PHCCs) from Santiago, Chile. PHCCs were randomly allocated to either nutritional intervention [intervention group (IG), n = 5] or routine care [control group (CG), n = 7]. A total of 4631 pregnant women were recruited (IG, n = 2565; and CG, n = 2066). Primary outcomes were adequate GWG and glycemic control in mothers and birth weight, birth length, macrosomia, and large for gestational age in neonates. The intervention consisted of 4 key actions: training of health care professionals on nutritional recommendations, counseling of pregnant women on diet and physical activity recommendations, offering a physical activity program implemented in the participating PHCCs, and adequate referral to dietitians. Women randomly assigned to the CG received routine antenatal care. RESULTS At baseline, the mean age was 26.1 y; 45% of women were primipara and 24% were obese. No differences were found in the percentage of women achieving adequate GWG (IG: 30.3%, compared with CG: 31.3%; OR: 0.94; 95% CI: 0.81, 1.09), but women in the IG had lower GWG than those in the CG (11.3 compared with 11.9 kg; mean difference: -0.63 kg; 95% CI: -1.19, -0.08). Effects of the intervention were significantly higher in women with obesity at the begining of pregnancy (mean difference: -1.24 kg; 95% CI: -2.18, -0.30; P for interaction < 0.05). No differences were found between groups regarding maternal glycemic control or neonatal outcomes. CONCLUSIONS Our findings demonstrate that a low-intensity, high-coverage intervention delivered through the Chilean public health care system under standard operating conditions reduces GWG and has the potential for successful scale-up. This trial was registered at clinicaltrials.gov as NCT01916603.
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Affiliation(s)
- Maria Luisa Garmendia
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Camila Corvalan
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Marcela Araya
- Department of Women and Newborn Health Promotion, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Paola Casanello
- Department of Obstetrics and Gynecology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Department of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan Pedro Kusanovic
- Department of Obstetrics and Gynecology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Center for Research and Innovation in Maternal-Fetal Medicine (CIMAF), Department of Obstetrics and Gynecology, Sótero del Río Hospital, Santiago, Chile
| | - Ricardo Uauy
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile.,Department of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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Roland MCP, Lekva T, Godang K, Bollerslev J, Henriksen T. Changes in maternal blood glucose and lipid concentrations during pregnancy differ by maternal body mass index and are related to birthweight: A prospective, longitudinal study of healthy pregnancies. PLoS One 2020; 15:e0232749. [PMID: 32574162 PMCID: PMC7310681 DOI: 10.1371/journal.pone.0232749] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 04/21/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Maternal obesity is increasing worldwide but the consequences for maternal physiology and fetal growth are not fully understood. OBJECTIVE To study whether changes in glucose and lipid metabolism during pregnancy differ between women with normal weight and overweight/obesity, and investigate which of these metabolic factors are associated with birthweight. DESIGN Prospective, longitudinal study. SETTING Department of Obstetrics, Oslo University Hospital, Rikshospitalet. POPULATION 1031 healthy pregnant women with singleton pregnancies. METHODS Blood samples from early and late pregnancy were analyzed for fasting glucose, insulin and lipids (total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides). Associations between metabolic factors and birthweight (z-scores) were explored by linear regression models. Main Outcome Measures: Group-dependent longitudinal changes in glucose and lipids and their association with birthweight (z-scores). RESULTS Compared to women with normal weight (BMI < 25), women with overweight (BMI 25-29.9) and obesity (BMI > 30) had significantly higher fasting glucose (4.54, 4.68 and 4.84 mmol/l), insulin (23, 33 and 50 pmol/l), total cholesterol (4.85, 4.99 and 5.14 mmol/l), LDL-C (2.49, 2.66 and 2.88 mmol/l) and triglycerides (1.10, 1.28 and 1.57 mmol/l), but lower HDL-C (1.86, 1.75 and 1.55 mmol/l). BMI (B 0.05, 95% CI 0.03-0.06, p<0.001), gestational weight gain (GWG) (B 0.06, 0.05-0.08, p<0.001) and an increase in fasting glucose (B 0.30, 0.16-0.43, p<0.001) were positively associated with birthweight, whereas a decrease in HDL-C (B -0.72, -0.96- -0.53, p<0.001) had a negative association with birthweight. CONCLUSIONS Overweight/obesity was associated with an unfavorable metabolic profile in early pregnancy which was associated with increased birthweight. However, modifiable factors like gestational weight gain and an increase in fasting glucose were identified and can be targeted for interventions.
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Affiliation(s)
- Marie Cecilie Paasche Roland
- Department of Obstetrics, Oslo University Hospital, Oslo, Norway
- National Advisory Unit on Women’s Health, Oslo University Hospital, Oslo, Norway
- * E-mail:
| | - Tove Lekva
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - Kristin Godang
- Department of Endocrinology, Oslo University Hospital, Oslo, Norway
| | - Jens Bollerslev
- Department of Endocrinology, Oslo University Hospital, Oslo, Norway
- Department of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tore Henriksen
- Department of Clinical Medicine, University of Oslo, Oslo, Norway
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Souto TDS, Nakao FSN, Giriko CÁ, Dias CT, Cheberle AIDP, Lambertucci RH, Mendes-da-Silva C. Lard-rich and canola oil-rich high-fat diets during pregnancy promote rats’ offspring neurodevelopmental delay and behavioral disorders. Physiol Behav 2020; 213:112722. [DOI: 10.1016/j.physbeh.2019.112722] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 12/26/2022]
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13
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Pre-pregnancy BMI, gestational weight gain and birth outcomes in Lebanon and Qatar: Results of the MINA cohort. PLoS One 2019; 14:e0219248. [PMID: 31265481 PMCID: PMC6605672 DOI: 10.1371/journal.pone.0219248] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 06/20/2019] [Indexed: 11/19/2022] Open
Abstract
Accumulating evidence has highlighted the role of maternal nutritional status on fetal development, birth outcomes and child health. The Mother and Infant Nutritional Assessment (MINA) cohort is a 3-year follow-up study of pregnant women and their children in Qatar and Lebanon. This study reports on the characteristics and determinants of pre-pregnancy BMI and Gestational Weight Gain (GWG) of MINA particiants, as well as birth outcomes. A total of 272 pregnant women were recruited during their first trimester from primary healthcare centers as well as private clinics in Beirut (n = 194) and Doha (n = 147). During the first visit, data collection included pre-pregnancy weight, sociodemographic and lifestyle characteristics. The weight before delivery and neonatal outcomes were extracted from the medical records. GWG was calculated as the difference between weight before delivery and pre-pregnancy weight and was classified into insufficient, adequate, and excessive, as per the IOM criteria. Overall, 42.1% of women had a pre-pregnancy BMI≥25 Kg/m2 (58% in Qatar vs 30.8% in Lebanon, p<0.001). Only 30.2% of women had adequate GWG, while 25.7% and 44.1% of women had insufficient and excessive GWG, respectively. In the cohort 68.7% of infants had a weight adequate-for-gestational age (AGA), 6.7% were SGA and 24.6% were LGA. The proportions of LGA were higher with greater GWG (p<0.05). After adjustment, Qatari women were 3 times more likely to be overweight or obese before pregnancy while a higher education level was associated with significantly lower odds of pre-pregnancy BMI≥25 Kg/m2. Pre-pregnancy BMI≥25 Kg/m2 and regular breakfast consumption were predictors of excessive GWG (OR: 3.20, CI: 1.48–6.91; OR: 2.84, CI: 1.15–7.02, respectively). The high prevalence of pre-pregnancy overweight and excessive GWG among MINA participants underscores the need for culture-specific intervention programs to promote healthy body weight in women of childbearing age, and prevent excessive weight gain during pregnancy.
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Gupta V, Saxena R, Walia GK, Agarwal T, Vats H, Dunn W, Relton C, Sovio U, Papageorghiou A, Davey Smith G, Khadgawat R, Sachdeva MP. Gestational route to healthy birth (GaRBH): protocol for an Indian prospective cohort study. BMJ Open 2019; 9:e025395. [PMID: 31048433 PMCID: PMC6501957 DOI: 10.1136/bmjopen-2018-025395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 10/17/2018] [Accepted: 03/12/2019] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Pregnancy is characterised by a high rate of metabolic shifts from early to late phases of gestation in order to meet the raised physiological and metabolic needs. This change in levels of metabolites is influenced by gestational weight gain (GWG), which is an important characteristic of healthy pregnancy. Inadequate/excessive GWG has short-term and long-term implications on maternal and child health. Exploration of gestational metabolism is required for understanding the quantitative changes in metabolite levels during the course of pregnancy. Therefore, our aim is to study trimester-specific variation in levels of metabolites in relation to GWG and its influence on fetal growth and newborn anthropometric traits at birth. METHODS AND ANALYSIS A prospective longitudinal study is planned (start date: February 2018; end date: March 2023) on pregnant women that are being recruited in the first trimester and followed in subsequent trimesters and at the time of delivery (total 3 follow-ups). The study is being conducted in a hospital located in Bikaner district (66% rural population), Rajasthan, India. The estimated sample size is of 1000 mother-offspring pairs. Information on gynaecological and obstetric history, socioeconomic position, diet, physical activity, tobacco and alcohol consumption, depression, anthropometric measurements and blood samples is being collected for metabolic assays in each trimester using standardised methods. Mixed effects regression models will be used to assess the role of gestational weight in influencing metabolite levels in each trimester. The association of maternal levels of metabolites with fetal growth, offspring's weight and body composition at birth will be investigated using regression modelling. ETHICS AND DISSEMINATION The study has been approved by the ethics committees of the Department of Anthropology, University of Delhi and Sardar Patel Medical College, Rajasthan. We are taking written informed consent after discussing the various aspects of the study with the participants in the local language.
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Affiliation(s)
- Vipin Gupta
- Department of Anthropology, University of Delhi, Delhi, India
| | - Ruchi Saxena
- Department of Obstetrics and Gynaecology, Sardar Patel Medical College, Bikaner, Rajasthan, India
| | | | | | - Harsh Vats
- Department of Anthropology, University of Delhi, Delhi, India
| | - Warwick Dunn
- School of Biosciences, Phenome Centre Birmingham and Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Caroline Relton
- MRC Integrative Epidemiology Unit and Bristol Medical School, University of Bristol, Bristol, UK
| | - Ulla Sovio
- Obstetrics and Gyneacology, University of Cambridge, Cambridge, UK
| | - Aris Papageorghiou
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - George Davey Smith
- MRC Integrative Epidemiology Unit and Bristol Medical School, University of Bristol, Bristol, UK
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Attenuation of maternal weight gain impacts infant birthweight: systematic review and meta-analysis. J Dev Orig Health Dis 2018; 10:387-405. [PMID: 30411697 DOI: 10.1017/s2040174418000879] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Despite many interventions aiming to reduce excessive gestational weight gain (GWG), it is currently unclear the impact on infant anthropometric outcomes. The aim of this review was to evaluate offspring anthropometric outcomes in studies designed to reduce GWG. A systematic search of seven international databases, one clinical trial registry and three Chinese databases was conducted without date limits. Studies were categorised by intervention type: diet, physical activity (PA), lifestyle (diet + PA), other, gestational diabetes mellitus (GDM) (diet, PA, lifestyle, metformin and other). Meta-analyses were reported as weighted mean difference (WMD) for birthweight and birth length, and risk ratio (RR) for small for gestational age (SGA), large for gestational age (LGA), macrosomia and low birth weight (LBW). Collectively, interventions reduced birthweight, risk of macrosomia and LGA by 71 g (WMD: -70.67, 95% CI -101.90 to -39.43, P<0.001), 16% (RR: 0.84, 95% CI 0.73-0.98, P=0.026) and 19% (RR: 0.81, 95% CI 0.69-0.96, P=0.015), respectively. Diet interventions decreased birthweight and LGA by 99 g (WMD -98.80, 95% CI -178.85 to -18.76, P=0.016) and 65% (RR: 0.35, 95% CI 0.17-0.72, P=0.004). PA interventions reduced the risk of macrosomia by 51% (RR: 0.49, 95% CI 0.26-0.92, P=0.036). In women with GDM, diet and lifestyle interventions reduced birthweight by 211 and 296 g, respectively (WMD: -210.93, 95% CI -374.77 to -46.71, P=0.012 and WMD:-295.93, 95% CI -501.76 to -90.10, P=0.005, respectively). Interventions designed to reduce excessive GWG lead to a small reduction in infant birthweight and risk of macrosomia and LGA, without influencing the risk of adverse outcomes including LBW and SGA.
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Walker R, Bennett C, Blumfield M, Gwini S, Ma J, Wang F, Wan Y, Truby H. Attenuating Pregnancy Weight Gain-What Works and Why: A Systematic Review and Meta-Analysis. Nutrients 2018; 10:E944. [PMID: 30037126 PMCID: PMC6073617 DOI: 10.3390/nu10070944] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/18/2018] [Accepted: 07/20/2018] [Indexed: 11/26/2022] Open
Abstract
Excessive maternal gestational weight gain (GWG) contributes to generational obesity. Our aim was to explore efficacy and intervention characteristics (trimester, duration, frequency, intensity, and delivery method) of interventions to prevent excessive GWG. CINAHL, Cochrane, EMBASE, LILACS, MEDLINE, PsycINFO, and Scopus were searched up to May 2018 (no date or language restrictions). Keywords and MeSH terms for diet, GWG, intervention, lifestyle, maternal, physical activity, and pregnancy were used to locate randomized-controlled trials (RCTs). The Cochrane Collaboration tool for assessing risk of bias was applied. Eighty-nine RCTs were included. Meta-analysis (60 trials) estimated that women in diet only (WMD: -3.27; 95% CI: -4.96, -1.58, p < 0.01), physical activity (PA) (WMD: -1.02; 95% CI: -1.56, -0.49, p < 0.01), and lifestyle interventions (combining diet and PA) (WMD: -0.84; 95% CI: -1.29, -0.39, p < 0.01) gained significantly less weight than controls. The three eHealth interventions favored neither intervention nor control (WMD: -1.06; 95% CI: -4.13, 2.00, p = 0.50). Meta-regression demonstrated no optimal duration, frequency, intensity, setting, or diet type. Traditional face to face delivery of weight management interventions during pregnancy can be successful. Delivery via eHealth has potential to extend its reach to younger women but needs further evaluation of its success.
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Affiliation(s)
- Ruth Walker
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Clayton VIC 3168, Australia.
| | - Christie Bennett
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Clayton VIC 3168, Australia.
| | - Michelle Blumfield
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Clayton VIC 3168, Australia.
| | - Stella Gwini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne VIC 3004, Australia.
| | - Jianhua Ma
- Institute of Nutrition and Food Hygiene, School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Fenglei Wang
- Department of Food Science and Nutrition, Zhejiang University, Hangzhou 310058, China.
| | - Yi Wan
- Department of Food Science and Nutrition, Zhejiang University, Hangzhou 310058, China.
| | - Helen Truby
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Clayton VIC 3168, Australia.
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Developmental Origins of Disease: Emerging Prenatal Risk Factors and Future Disease Risk. CURR EPIDEMIOL REP 2018; 5:293-302. [PMID: 30687591 DOI: 10.1007/s40471-018-0161-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Purpose of review Many of the diseases and dysfunctions described in the paradigm of the developmental origins of health and disease have been studied in relation to prenatal nutrition or environmental toxicant exposures. Here, we selectively review the current research on four exposures-two nutritional and two environmental-that have recently emerged as prenatal risk factors for long-term health outcomes. Recent findings Recent studies have provided strong evidence that prenatal exposure to (1) excessive intake of sugar-sweetened beverages, (2) unhealthy dietary patterns, (3) perfluoroalkyl substances, and (4) fine particulate matter, may increase risk of adverse health outcomes, such as obesity, cardiometabolic dysfunction, and allergy/asthma. Summary Emerging prenatal nutritional factors and environmental toxicants influence offspring long-term health. More work is needed to identify the role of paternal exposures and maternal exposures during the preconception period and to further elucidate causality through intervention studies. The ubiquity of these emerging nutritional and environmental exposures makes this area of inquiry of considerable public health importance.
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18
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Effects of an antenatal dietary intervention in overweight and obese women on 6 month infant outcomes: follow-up from the LIMIT randomised trial. Int J Obes (Lond) 2018; 42:1326-1335. [PMID: 29568100 PMCID: PMC6054603 DOI: 10.1038/s41366-018-0019-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 11/12/2017] [Accepted: 01/03/2018] [Indexed: 01/20/2023]
Abstract
Background The immediate impact of providing an antenatal dietary intervention during pregnancy has been extensively studied, but little is known of the effects beyond the neonatal period. Our objective was to evaluate the effect of an antenatal dietary intervention in overweight or obese women on infant outcomes 6 months after birth. Methods We conducted a follow up study of infants born to women who participated in the LIMIT trial during pregnancy. Live-born infants at 6-months of age, and whose mother provided consent to ongoing follow-up were eligible. The primary follow-up study endpoint was the incidence of infant BMI z-score ≥90th centile for infant sex and age. Secondary study outcomes included a range of infant anthropometric measures, neurodevelopment, general health, and infant feeding. Analyses used intention to treat principles according to the treatment group allocated in pregnancy. Missing data were imputed and analyses adjusted for maternal early pregnancy BMI, parity, study centre, socioeconomic status, age, and smoking status. Outcome assessors were blinded to the allocated treatment group. Results A total of 1754 infants were assessed at age 6 months (Lifestyle Advice n = 869; Standard Care n = 885), representing 82.1% of the eligible sample (n = 2136). There were no statistically significant differences in the incidence of infant BMI z-score ≥90th centile for infants born to women in the Lifestyle Advice group, compared with the Standard Care group (Lifestyle Advice 233 (21.71%) vs. Standard Care 233 (21.90%); adjusted relative risk (aRR) 0.99; 95% confidence interval 0.82 to 1.18; p = 0.88). There were no other effects on infant growth, adiposity, or neurodevelopment. Conclusion Providing pregnant women who were overweight or obese with an antenatal dietary and lifestyle intervention did not alter 6-month infant growth and adiposity. Trial Registration: Australian and New Zealand Clinical Trials Registry (ACTRN12607000161426).
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Norris T, McCarthy FP, Khashan AS, Murray DM, Kiely M, Hourihane JO, Baker PN, Kenny LC. Do changing levels of maternal exercise during pregnancy affect neonatal adiposity? Secondary analysis of the babies after SCOPE: evaluating the longitudinal impact using neurological and nutritional endpoints (BASELINE) birth cohort (Cork, Ireland). BMJ Open 2017; 7:e017987. [PMID: 29196482 PMCID: PMC5719326 DOI: 10.1136/bmjopen-2017-017987] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To investigate whether changing levels of exercise during pregnancy are related to altered neonatal adiposity. DESIGN Secondary analysis of data from a prospective cohort study. SETTING Cork, Ireland. PARTICIPANTS 1200 mother - infant pairs recruited as part of a prospective birth cohort, Babies After SCOPE: Evaluating the Longitudinal Impact Using Neurological and Nutritional Endpoints (BASELINE). MAIN OUTCOME MEASURES Neonatal adiposity was assessed within several days of birth using air displacement plethysmography (PEAPOD). Per cent body fat (BF%) as a continuous outcome and a pair of dichotomous variables; high or low adiposity, representing BF% >90th or <10th centile, respectively. Multivariable linear and logistic regression models were used to investigate the relationship between exercise and the respective outcomes. RESULTS Crude analysis revealed no association between a changing level of exercise (since becoming pregnant) at 15 weeks' gestation and any of the outcomes (BF%, low adiposity and high adiposity). At 20 weeks' gestation, analyses revealed that relative to women who do not change their exercise level up to 20 weeks, those women who decreased their exercise level were more likely to give birth to a neonate with adiposity above the 90th centile (OR 1.62, 95% CI 1.07 to 2.46). This association was maintained after adjustment for putative confounders (OR 1.62, 95% CI 1.06 to 2.47). CONCLUSIONS We observed a possible critical period for the association between changing exercise levels and neonatal adiposity, with no association observed with exercise recall for the first 15 weeks of gestation, but an association with a decreasing level of exercise between 15 and 20 weeks. These results should be interpreted in line with the limitations of the study and further studies utilising objectively measured estimates of exercise are required in order to replicate these findings. TRIAL REGISTRATION NUMBER NCT01498965.
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Affiliation(s)
- Tom Norris
- Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK
| | - Fergus P McCarthy
- Department of Obstetrics and Gynecology, The Irish Centre for Fetal and Neonatal Translational Research (INFANT), Cork, Ireland
- Division of Women's Health KCL, Women's Health Academic Centre KHP, St Thomas's Hospital, London, UK
| | - Ali S Khashan
- Department of Obstetrics and Gynecology, The Irish Centre for Fetal and Neonatal Translational Research (INFANT), Cork, Ireland
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Deidre M Murray
- Department of Obstetrics and Gynecology, The Irish Centre for Fetal and Neonatal Translational Research (INFANT), Cork, Ireland
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Mairead Kiely
- Department of Obstetrics and Gynecology, The Irish Centre for Fetal and Neonatal Translational Research (INFANT), Cork, Ireland
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Jonathan O'B Hourihane
- Department of Obstetrics and Gynecology, The Irish Centre for Fetal and Neonatal Translational Research (INFANT), Cork, Ireland
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Philip N Baker
- College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Louise C Kenny
- Department of Obstetrics and Gynecology, The Irish Centre for Fetal and Neonatal Translational Research (INFANT), Cork, Ireland
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Vanstone M, Kandasamy S, Giacomini M, DeJean D, McDonald SD. Pregnant women's perceptions of gestational weight gain: A systematic review and meta-synthesis of qualitative research. MATERNAL & CHILD NUTRITION 2017; 13:e12374. [PMID: 27873484 PMCID: PMC6866018 DOI: 10.1111/mcn.12374] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 07/25/2016] [Accepted: 08/10/2016] [Indexed: 01/01/2023]
Abstract
Excess gestational weight gain has numerous negative health outcomes for women and children, including high blood pressure, diabetes, and cesarean section (maternal) and high birth weight, trauma at birth, and asphyxia (infants). Excess weight gain in pregnancy is associated with a higher risk of long-term obesity in both mothers and children. Despite a concerted public health effort, the proportion of pregnant women gaining weight in excess of national guidelines continues to increase. To understand this phenomenon and offer suggestions for improving interventions, we conducted a systematic review of qualitative research on pregnant women's perceptions and experiences of weight gain in pregnancy. We used the methodology of qualitative meta-synthesis to analyze 42 empirical qualitative research studies conducted in high-income countries and published between 2005 and 2015. With this synthesis, we provide an account of the underlying factors and circumstances (barriers, facilitators, and motivators) that pregnant women identify as important for appropriate weight gain. We also offer a description of the strategies identified by pregnant women as acceptable and appropriate ways to promote healthy weight gain. Through our integrative analysis, we identify women's common perception on the struggle to enact health behaviors and physical, social, and environmental factors outside of their control. Effective and sensitive interventions to encourage healthy weight gain in pregnancy must consider the social environment in which decisions about weight take place.
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Affiliation(s)
- Meredith Vanstone
- Department of Family MedicineMcMaster UniversityHamiltonOntarioCanada
- Centre for Health Economics and Policy AnalysisMcMaster UniversityHamiltonOntarioCanada
| | - Sujane Kandasamy
- Department of Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonOntarioCanada
| | - Mita Giacomini
- Centre for Health Economics and Policy AnalysisMcMaster UniversityHamiltonOntarioCanada
- Department of Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonOntarioCanada
| | - Deirdre DeJean
- Centre for Health Economics and Policy AnalysisMcMaster UniversityHamiltonOntarioCanada
- Department of Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonOntarioCanada
| | - Sarah D. McDonald
- Department of Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonOntarioCanada
- Departments of Obstetrics and Gynecology, RadiologyMcMaster UniversityHamiltonOntarioCanada
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Ronnberg AK, Hanson U, Nilsson K. Effects of an antenatal lifestyle intervention on offspring obesity - a 5-year follow-up of a randomized controlled trial. Acta Obstet Gynecol Scand 2017; 96:1093-1099. [PMID: 28498482 DOI: 10.1111/aogs.13168] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 05/05/2017] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Strategies to limit excessive maternal gestational weight gain could also have positive health effects for the offspring. This study informs us on the effect of an antenatal lifestyle intervention on offspring body mass index (BMI) trajectory until age five. MATERIAL AND METHODS A secondary analysis of a randomized controlled trial aimed at reducing gestational weight gain, set in Ørebro, Sweden (Clinical Trials.gov Id NCT00451425). Offspring were followed with standardized measures of weight and height until age five. Mean BMI z-score and proportion (%) of over- and undernutrition (BMI z-score > ± 2 standard deviations) was compared between groups. Risk estimates for obesity at age five were analyzed in relation to maternal gestational weight gain and prepregnancy BMI as a secondary outcome. RESULTS We analyzed 374 children at birth and 300 at age five. No significant difference in mean BMI z-score was seen at birth (0.68 (I) vs 0.56 (C), p = 0.242) or at age five (0.34 (I) vs 0.26 (C), p = 0.510) and no significant difference in proportion of over- or undernutrition was seen. Excessive maternal gestational weight gain was an independent risk factor for offspring obesity at birth (OR = 4.51, p < 0.001) but not at age five. Maternal obesity was an independent risk factor for offspring obesity at age five (OR = 4.81, p = 0.006). CONCLUSIONS Our composite antenatal lifestyle intervention did not significantly reduce the risk of obesity in offspring up until age five.
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Affiliation(s)
| | - Ulf Hanson
- Department of Obstetrics and Gynecology, Örebro University, Örebro
| | - Kerstin Nilsson
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Garmendia ML, Mondschein S, Matus O, Murrugarra R, Uauy R. Predictors of gestational weight gain among Chilean pregnant women: The Chilean Maternal and Infant Nutrition Cohort study. Health Care Women Int 2017; 38:892-904. [DOI: 10.1080/07399332.2017.1332627] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Susana Mondschein
- Facultad de Ingeniería y Ciencias, Universidad Adolfo Ibañez, Santiago, Chile
| | - Omar Matus
- Facultad de Ingeniería y Ciencias, Universidad Adolfo Ibañez, Santiago, Chile
| | - Ruth Murrugarra
- Facultad de Ingeniería y Ciencias, Universidad Adolfo Ibañez, Santiago, Chile
| | - Ricardo Uauy
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
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Zerfu TA, Umeta M, Baye K. Dietary habits, food taboos, and perceptions towards weight gain during pregnancy in Arsi, rural central Ethiopia: a qualitative cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2016; 35:22. [PMID: 27456151 PMCID: PMC5025964 DOI: 10.1186/s41043-016-0059-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 07/19/2016] [Indexed: 05/29/2023]
Abstract
BACKGROUND The nutritional status of women before and during pregnancy can be determined by maternal knowledge, attitudes, and perceptions towards certain foods. The present study aimed to explore maternal dietary habits, food taboos, and cultural beliefs that can affect nutrition during pregnancy in rural Arsi, central Ethiopia. METHODS A qualitative, cross-sectional study, involving 38 key informant in-depth interviews and eight focus group discussions, was conducted among purposefully selected pregnant women and their husbands, elderly people, community leaders, health workers, and agriculture office experts. Participants were selected purposefully from all the major agro-ecologic areas of the study site. Data was analyzed manually using the thematic framework analyses method. RESULTS The pregnant women reported that they did not change the amount and type of foods consumed to take into account their increased nutritional need during pregnancy. The consumption of meat, fish, fruits, and some vegetables during pregnancy remained as low as the pre-pregnancy state, irrespective of the women's income and educational status. Although not practiced by all, a number of taboos related to the intake of certain food items and misconceptions that can adversely affect nutritional status during pregnancy were identified. The most common taboos were related to the consumption of green leafy vegetables, yogurt, cheese, sugar cane, and green pepper. However, the frequency and extent of the practice varied by maternal age, family composition, and literacy level. Older mothers, from rural villages, and those with no formal education were more likely to practice the taboos than younger and educated ones. Almost all of the participants disfavored weight gain during pregnancy in fear of obstetric complications associated with the delivery of a bigger infant. CONCLUSIONS Misconceptions about weight gain during pregnancy and food taboos were widespread, particularly among older and illiterate rural communities. Thus, future nutrition programs should promote diversification of both the agricultural production and consumption.
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Affiliation(s)
- Taddese Alemu Zerfu
- Center for Food Science and Nutrition, Addis Ababa University, College of Natural Sciences, Addis Ababa, Ethiopia.
| | - Melaku Umeta
- Department of Medical Biochemistry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | - Kaleab Baye
- Center for Food Science and Nutrition, Addis Ababa University, College of Natural Sciences, Addis Ababa, Ethiopia
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Ohadike CO, Cheikh-Ismail L, Ohuma EO, Giuliani F, Bishop D, Kac G, Puglia F, Maia-Schlüssel M, Kennedy SH, Villar J, Hirst JE. Systematic Review of the Methodological Quality of Studies Aimed at Creating Gestational Weight Gain Charts. Adv Nutr 2016; 7:313-22. [PMID: 26980814 PMCID: PMC4785472 DOI: 10.3945/an.115.010413] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
A range of adverse outcomes is associated with insufficient and excessive maternal weight gain in pregnancy, but there is no consensus regarding what constitutes optimal gestational weight gain (GWG). Differences in the methodological quality of GWG studies may explain the varying chart recommendations. The goal of this systematic review was to evaluate the methodological quality of studies that aimed to create GWG charts by scoring them against a set of predefined, independently agreed-upon criteria. These criteria were divided into 3 domains: study design (12 criteria), statistical methods (7 criteria), and reporting methods (4 criteria). The criteria were broken down further into items, and studies were assigned a quality score (QS) based on these criteria. For each item, studies were scored as either high (score = 0) or low (score = 1) risk of bias; a high QS correlated with a low risk of bias. The maximum possible QS was 34. The systematic search identified 12 eligible studies involving 2,268,556 women from 9 countries; their QSs ranged from 9 (26%) to 29 (85%) (median, 18; 53%). The most common sources for bias were found in study designs (i.e., not prospective); assessments of prepregnancy weight and gestational age; descriptions of weighing protocols; sample size calculations; and the multiple measurements taken at each visit. There is wide variation in the methodological quality of GWG studies constructing charts. High-quality studies are needed to guide future clinical recommendations. We recommend the following main requirements for future studies: prospective design, reliable evaluation of prepregnancy weight and gestational age, detailed description of measurement procedures and protocols, description of sample-size calculation, and the creation of smooth centile charts or z scores.
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Affiliation(s)
- Corah O Ohadike
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford Maternal and Perinatal Health Institute, Green Templeton College, Oxford, United Kingdom;
| | - Leila Cheikh-Ismail
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital,,Oxford Maternal and Perinatal Health Institute, Green Templeton College, Oxford, United Kingdom
| | - Eric O Ohuma
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital,,Centre for Statistics in Medicine, Botnar Research Centre, and,Oxford Maternal and Perinatal Health Institute, Green Templeton College, Oxford, United Kingdom
| | - Francesca Giuliani
- Neonatal Unit, Department of Paediatrics, Turin University, Regina Margherita, S. Anna Hospital, Turin, Italy; and
| | - Deborah Bishop
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital,,Oxford Maternal and Perinatal Health Institute, Green Templeton College, Oxford, United Kingdom
| | - Gilberto Kac
- Rio de Janeiro Federal University, Josué de Castro Nutrition Institute, Department of Social and Applied Nutrition, Rio de Janeiro, Brazil
| | - Fabien Puglia
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital,,Oxford Maternal and Perinatal Health Institute, Green Templeton College, Oxford, United Kingdom
| | - Michael Maia-Schlüssel
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Stephen H Kennedy
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital,,Oxford Maternal and Perinatal Health Institute, Green Templeton College, Oxford, United Kingdom
| | - José Villar
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital,,Oxford Maternal and Perinatal Health Institute, Green Templeton College, Oxford, United Kingdom
| | - Jane E Hirst
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital,,Oxford Maternal and Perinatal Health Institute, Green Templeton College, Oxford, United Kingdom
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Tsoulis MW, Chang PE, Moore CJ, Chan KA, Gohir W, Petrik JJ, Vickers MH, Connor KL, Sloboda DM. Maternal High-Fat Diet-Induced Loss of Fetal Oocytes Is Associated with Compromised Follicle Growth in Adult Rat Offspring. Biol Reprod 2016; 94:94. [PMID: 26962114 PMCID: PMC4861169 DOI: 10.1095/biolreprod.115.135004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 02/25/2016] [Indexed: 11/12/2022] Open
Abstract
Maternal obesity predisposes offspring to metabolic and reproductive dysfunction. We have shown previously that female rat offspring born to mothers fed a high-fat (HF) diet throughout pregnancy and lactation enter puberty early and display aberrant reproductive cyclicity. The mechanisms driving this reproductive phenotype are currently unknown thus we investigated whether changes in ovarian function were involved. Wistar rats were mated and randomized to: dams fed a control diet (CON) or dams fed a HF diet from conception until the end of lactation (HF). Ovaries were collected from fetuses at Embryonic Day (E) 20, and neonatal ovaries at Day 4 (P4), prepubertal ovaries at P27 and adult ovaries at P120. In a subset of offspring, the effects of a HF diet fed postweaning were evaluated. The present study shows that fetuses of mothers fed a HF diet had significantly fewer oocytes at E20, and in neonates, have reduced AMH signaling that may facilitate an increased number of assembled primordial follicles. Both prepubertally and in adulthood, ovaries show increased follicular atresia. As adults, offspring have reduced FSH responsiveness, low expression levels of estrogen receptor alpha (Eralpha), the oocyte-secreted factor, Gdf9, oocyte-specific RNA binding protein, Dazl, and high expression levels of the granulosa-cell derived factor, AMH, in antral follicles. Together, these data suggest that ovarian compromise in offspring born to HF-fed mothers may arise from changes already observable in the fetus and neonate and in the long term, associated with increased follicular atresia through adulthood.
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Affiliation(s)
- Michael W Tsoulis
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Pauline E Chang
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Caroline J Moore
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Kaitlyn A Chan
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Wajiha Gohir
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - James J Petrik
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada Department of Biomedical Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Mark H Vickers
- Liggins Institute and Gravida, National Centre for Growth and Development, University of Auckland, Aukland, New Zealand
| | - Kristin L Connor
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Deborah M Sloboda
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
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Gaillard R, Welten M, Oddy WH, Beilin LJ, Mori TA, Jaddoe VWV, Huang RC. Associations of maternal prepregnancy body mass index and gestational weight gain with cardio-metabolic risk factors in adolescent offspring: a prospective cohort study. BJOG 2015; 123:207-16. [DOI: 10.1111/1471-0528.13700] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2015] [Indexed: 01/06/2023]
Affiliation(s)
- R Gaillard
- Department of Epidemiology; Erasmus Medical Center; Rotterdam the Netherlands
| | - M Welten
- Department of Epidemiology; Erasmus Medical Center; Rotterdam the Netherlands
| | - WH Oddy
- Telethon Kids Institute; The University of Western Australia; Perth WA Australia
| | - LJ Beilin
- School of Medicine and Pharmacology; UWA; Perth WA Australia
| | - TA Mori
- School of Medicine and Pharmacology; UWA; Perth WA Australia
| | - VWV Jaddoe
- Department of Epidemiology; Erasmus Medical Center; Rotterdam the Netherlands
| | - R-C Huang
- Telethon Kids Institute; The University of Western Australia; Perth WA Australia
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van Rossem L, Wijga AH, Gehring U, Koppelman GH, Smit HA. Maternal Gestational and Postdelivery Weight Gain and Child Weight. Pediatrics 2015; 136:e1294-301. [PMID: 26482665 DOI: 10.1542/peds.2015-0874] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Maternal gestational weight gain (GWG) is a risk factor for the development of overweight in her child. It is unknown whether GWG programs the child's health or whether GWG indicates a shared familial lifestyle during childhood. To disentangle these influences, we studied the association of GWG and postdelivery maternal weight change simultaneously with child's weight development. METHODS We used data from 3367 children participating in a birth cohort that started in 1996 in the Netherlands. Weight and height were self-reported. GWG was categorized as "inadequate," "adequate," and "excessive." Multivariable regression and mixed models were used to study maternal and child weight changes. RESULTS Children of mothers with excessive GWG had a higher BMI z score and overweight prevalence (odds ratio [OR] 1.20; 95% confidence interval [CI], 0.99 to 1.46) throughout childhood. Children of mothers with a high (≥1 kg/year) postdelivery weight gain had a 0.14 (95% CI, -0.08 to 0.36) higher change in BMI z score between age 1 and 14 years than children of mothers with a low (<0.5 kg/year) postdelivery weight gain. Children of mothers with excessive GWG in combination with a high postdelivery weight gain had the highest BMI z score and overweight risk at age 14 years (OR 3.53; 95% CI, 1.70 to 7.33). CONCLUSIONS Maternal GWG and postdelivery weight gain contribute to child's weight development up to adolescence independently.
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Affiliation(s)
- Lenie van Rossem
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands;
| | - Alet H Wijga
- Center for Prevention and Health Services Research, National Institute of Public Health and the Environment, Bilthoven, Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands; and
| | - Gerard H Koppelman
- Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Henriette A Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
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Onubi OJ, Marais D, Aucott L, Okonofua F, Poobalan AS. Maternal obesity in Africa: a systematic review and meta-analysis. J Public Health (Oxf) 2015; 38:e218-e231. [PMID: 26487702 PMCID: PMC5072166 DOI: 10.1093/pubmed/fdv138] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Maternal obesity is emerging as a public health problem, recently highlighted together with maternal under-nutrition as a ‘double burden’, especially in African countries undergoing social and economic transition. This systematic review was conducted to investigate the current evidence on maternal obesity in Africa. Methods MEDLINE, EMBASE, Scopus, CINAHL and PsycINFO were searched (up to August 2014) and identified 29 studies. Prevalence, associations with socio-demographic factors, labour, child and maternal consequences of maternal obesity were assessed. Pooled risk ratios comparing obese and non-obese groups were calculated. Results Prevalence of maternal obesity across Africa ranged from 6.5 to 50.7%, with older and multiparous mothers more likely to be obese. Obese mothers had increased risks of adverse labour, child and maternal outcomes. However, non-obese mothers were more likely to have low-birthweight babies. The differences in measurement and timing of assessment of maternal obesity were found across studies. No studies were identified either on the knowledge or attitudes of pregnant women towards maternal obesity; or on interventions for obese pregnant women. Conclusions These results show that Africa's levels of maternal obesity are already having significant adverse effects. Culturally adaptable/sensitive interventions should be developed while monitoring to avoid undesired side effects.
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Affiliation(s)
- Ojochenemi J Onubi
- Institute of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK
| | - Debbi Marais
- Institute of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK
| | - Lorna Aucott
- Institute of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK
| | - Friday Okonofua
- Department of Obstetrics and Gynaecology, College of Medical Sciences, University of Benin, Benin City, Edo State, Nigeria
| | - Amudha S Poobalan
- Institute of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK
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Garmendia ML, Corvalan C, Araya M, Casanello P, Kusanovic JP, Uauy R. Effectiveness of a normative nutrition intervention (diet, physical activity and breastfeeding) on maternal nutrition and offspring growth: the Chilean maternal and infant nutrition cohort study (CHiMINCs). BMC Pregnancy Childbirth 2015; 15:175. [PMID: 26283529 PMCID: PMC4538752 DOI: 10.1186/s12884-015-0605-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 08/03/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternal obesity before and during pregnancy predicts maternal and infant risks of obesity and its associated metabolic conditions. Dietary and physical activity recommendations during pregnancy as well as weight monitoring are currently available in the Chilean primary health care system. However some of these recommendations are not updated and most of them are poorly implemented. We seek to assess the effectiveness of an intervention that enhances the implementation of updated nutrition health care standards (diet, physical activity, and breastfeeding promotion) during pregnancy on maternal weight gain and infant growth. METHODS DESIGN & SETTING Cluster randomized controlled trial. The cluster units will be 12 primary health care centers from two counties (La Florida and Puente Alto) from the South-East Area of Santiago randomly allocated to: 1) enhanced nutrition health care standards (intervention group) or 2) routine care (control group). PARTICIPANTS Women seeking prenatal care before 15 weeks of gestation, residing within a catchment area of selected health centers, and who express that they are not planning to change residence will be invited to participate in the study. Pregnant women classified as high risk according to the Chilean norms (i.e age <16 or >40 years, multiple gestation, pre-gestational medical conditions, previous pregnancy-related issues) and/or underweight will be excluded. INTERVENTION Pregnant women who attend intervened health care centers starting at their first prenatal visit will receive advice regarding optimal weight gain during pregnancy and diet and physical activity counseling-support. Pregnant women who attend control health clinics will receive routine antenatal care according to national guidelines. We plan to recruit 200 women in each health center. Assuming a 20% loss to follow up, we expect to include 960 women per arm. MAIN OUTCOME MEASURES 1) Achievement of adequate weight gain based on IOM 2009 recommendations and adequate glycaemic control at 24-28 weeks of pregnancy according to ADA 2011, and 2) healthy infant growth during the first year of age based on WHO standards. DISCUSSION We expect that the intervention will benefit the participants in achieving adequate weight gain & metabolic control during pregnancy as well as adequate infant growth as a result of an increased impact of standard nutrition and health care practices. Gathered information should contribute to a better understanding of how to develop effective interventions to halt the maternal obesity epidemic and its associated co-morbidities in the Chilean population. TRIAL REGISTRATION Clinicaltrials.gov Identifier: NCT01916603.
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Affiliation(s)
- Maria Luisa Garmendia
- Institute of Nutrition and Food Technology (INTA), University of Chile, Avenida El Líbano 5524, Macul, Santiago, Chile.
| | - Camila Corvalan
- Institute of Nutrition and Food Technology (INTA), University of Chile, Avenida El Líbano 5524, Macul, Santiago, Chile
| | - Marcela Araya
- Department of Women and Newborn Health Promotion, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Paola Casanello
- Department of Obstetrics and Gynecology, School of Medicine, Pontifical Catholic University of Chile, Santiago, Chile
| | - Juan Pedro Kusanovic
- Department of Obstetrics and Gynecology, School of Medicine, Pontifical Catholic University of Chile, Santiago, Chile
- Center for Research and Innovation in Maternal-Fetal Medicine (CIMAF), Department of Obstetrics and Gynecology, Sótero del Río Hospital, Santiago, Chile
| | - Ricardo Uauy
- Institute of Nutrition and Food Technology (INTA), University of Chile, Avenida El Líbano 5524, Macul, Santiago, Chile
- Department of Pediatrics, School of Medicine, Pontifical Catholic University of Chile, Santiago, Chile
- London School of Hygiene and Tropical Medicine, London, UK
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Fetal programming of overweight through the microbiome: boys are disproportionately affected. J Dev Orig Health Dis 2015; 7:25-34. [PMID: 26118444 DOI: 10.1017/s2040174415001269] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Maternal and childhood obesity in pregnancy are worrisome public health issues facing our world today. New gene sequencing methods have advanced our knowledge of the disruptive effect of birth interventions and postnatal exposures on the maturation of gut microbiota and immunity during infancy. Yet, little is known about the impact of maternal pregnancy overweight on gut microbes and related processes, and how this may affect overweight risk in offspring. To address this gap in knowledge, we surveyed human studies for evidence in children, infants and pregnant women to piece together the limited literature and generate hypotheses for future investigation. From this literature, we learned that higher Lactobacillus yet lower Bacteroides spp. colonization of gut microbiota within 3 months of birth predicted risk for infant and child overweight. The abundance of bifidobacteria and staphylococci also appeared to play a role in the association with overweight, as did infant fecal immunoglobulin A levels, glycoproteins of the gut immune system that are acquired from breast milk and produced by the infant. We proposed that pregnancy overweight influences the compositional structure of gut microbiota in infants through vertical transfer of microbiota and/or their metabolites during pregnancy, delivery and breastfeeding. Finally, we brought forward emerging evidence on sex dimorphism, as well as ethnic and geographic variation, in reported associations between maternal overweight-induced gut microbiota dysbiosis and overweight risk.
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Daraki V, Georgiou V, Papavasiliou S, Chalkiadaki G, Karahaliou M, Koinaki S, Sarri K, Vassilaki M, Kogevinas M, Chatzi L. Metabolic profile in early pregnancy is associated with offspring adiposity at 4 years of age: the Rhea pregnancy cohort Crete, Greece. PLoS One 2015; 10:e0126327. [PMID: 25970502 PMCID: PMC4430416 DOI: 10.1371/journal.pone.0126327] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 03/19/2015] [Indexed: 12/14/2022] Open
Abstract
Context Maternal pre-pregnancy obesity may increase the risk of childhood obesity but it is unknown whether other metabolic factors in early pregnancy such as lipid profile and hypertension are associated with offspring cardiometabolic traits. Objective Our objective was to investigate whether fasting lipid, glucose, and insulin levels during early pregnancy and maternal pre-pregnancy weight status, are associated with offspring adiposity measures, lipid levels and blood pressure at preschool age. Design and Methods The study included 618 mother-child pairs of the pregnancy cohort “Rhea” study in Crete, Greece. Pregnant women were recruited at the first prenatal visit (mean: 12weeks, SD: 0.7). A subset of 348 women provided fasting serum samples for glucose and lipid measurements. Outcomes measures were body mass index, abdominal circumference, sum of skinfold thickness, and blood pressure measurements at 4 years of age. A subsample of 525 children provided non-fasting blood samples for lipid measurements. Results Pre-pregnancy overweight/obesity was associated with greater risk of offspring overweight/obesity (RR: 1.83, 95%CI: 1.19, 2.81), central adiposity (RR: 1.97, 95%CI: 1.11, 3.49), and greater fat mass by 5.10mm (95%CI: 2.49, 7.71) at 4 years of age. These associations were more pronounced in girls. An increase of 40mg/dl in fasting serum cholesterol levels in early pregnancy was associated with greater skinfold thickness by 3.30mm (95%CI: 1.41, 5.20) at 4 years of age after adjusting for pre-pregnancy BMI and several other confounders. An increase of 10mmHg in diastolic blood pressure in early pregnancy was associated with increased risk of offspring overweight/obesity (RR: 1.22, 95%CI: 1.03, 1.45), and greater skinfold thickness by 1.71mm (95% CI: 0.57, 2.86) at 4 years of age. Conclusions Metabolic dysregulation in early pregnancy may increase the risk of obesity at preschool age.
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Affiliation(s)
- Vasiliki Daraki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece; Clinic of Endocrinology, University Hospital of Crete, Heraklion, Greece
| | - Vaggelis Georgiou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | | | - Georgia Chalkiadaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Marianna Karahaliou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Stella Koinaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Katerina Sarri
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Maria Vassilaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Manolis Kogevinas
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; IMIM (Hospital del Mar Research Institute), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain; National School of Public Health, Athens, Greece
| | - Leda Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
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Karachaliou M, Georgiou V, Roumeliotaki T, Chalkiadaki G, Daraki V, Koinaki S, Dermitzaki E, Sarri K, Vassilaki M, Kogevinas M, Oken E, Chatzi L. Association of trimester-specific gestational weight gain with fetal growth, offspring obesity, and cardiometabolic traits in early childhood. Am J Obstet Gynecol 2015; 212:502.e1-14. [PMID: 25557209 PMCID: PMC5081180 DOI: 10.1016/j.ajog.2014.12.038] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 11/05/2014] [Accepted: 12/18/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the association of trimester-specific gestational weight gain with offspring fetal growth, obesity risk, and cardiometabolic health outcomes from birth to 4 years of age. STUDY DESIGN We conducted the present study with 977 mother-child pairs of the pregnancy cohort "Rhea" study in Crete, Greece. We measured birthweight, body mass index from 6 months to 4 years of age, waist circumference, skinfold thickness, blood pressure, and blood levels of lipids, C-reactive protein, and adipose tissue hormones at 4 years of age. We used multiple linear and log Poisson regression models to examine the association of exposure with continuous or binary outcomes, respectively. RESULTS Greater rate of gestational weight gain in the first trimester of pregnancy (per 200 g/wk) was associated with increased risk of overweight/obesity from 2 years (relative risk [RR], 1.25; 95% confidence interval [CI], 1.09-1.42) to 4 years of age (RR, 1.15; 95% CI, 1.05-1.25), but not with birth size. Each 200 g/wk of weight gain in the first trimester of pregnancy was also associated with greater risk of high waist circumference (RR, 1.13; 95% CI, 1.04-1.23), high sum of skinfold thickness (RR, 1.15; 95% CI, 1.02-1.29), and higher diastolic blood pressure at 4 years of age (β, 0.43 mm Hg; 95% CI, 0.00-0.86). Greater rate of gestational weight gain during the second and third trimesters of pregnancy (per 200 g/wk) was associated with greater risk of large-for-gestational-age neonates (RR, 1.22; 95% CI, 1.02, 1.45) and higher levels of cord blood leptin (ratio of geometric means, 1.08; 95% CI, 1.00-1.17), but not with child anthropometry at later ages. CONCLUSION Timing of gestational weight gain may influence childhood cardiometabolic outcomes differentially.
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Affiliation(s)
- Marianna Karachaliou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece.
| | - Vaggelis Georgiou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
| | - Theano Roumeliotaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
| | - Georgia Chalkiadaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
| | - Vasiliki Daraki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece; Department of Endocrinology, Diabetes Mellitus, and Metabolic Disorders, Faculty of Medicine, University of Crete, Crete, Greece
| | - Stella Koinaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
| | - Eirini Dermitzaki
- Department of Clinical Chemistry and Biochemistry, Faculty of Medicine, University of Crete, Crete, Greece
| | - Katerina Sarri
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
| | - Maria Vassilaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
| | - Manolis Kogevinas
- National School of Public Health, Athens, Greece; Center for Research in Environmental Epidemiology, Municipal Institute of Medical Research, and CIBER Epidemiologia y Salud Pública, Barcelona, Spain
| | - Emily Oken
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Leda Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
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Maftei O, Whitrow MJ, Davies MJ, Giles LC, Owens JA, Moore VM. Maternal body size prior to pregnancy, gestational diabetes and weight gain: associations with insulin resistance in children at 9-10 years. Diabet Med 2015; 32:174-80. [PMID: 25407383 DOI: 10.1111/dme.12637] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/17/2014] [Indexed: 11/29/2022]
Abstract
AIMS To investigate whether maternal body size pre-pregnancy, gestational diabetes and weight gain are independently associated with subsequent insulin resistance in children; and to examine the potential mediating role of child's body size in any associations. METHODS At 9-10 years, 443 children took part in a follow-up of a prospective cohort. Of those, 163 children elected to provide a fasting blood sample and child insulin resistance was estimated by homeostasis model assessment. Generalized linear models with log link function and Gaussian family were used to assess associations with antenatal exposures. Potential confounders were considered as well as the role of the child's size. RESULTS Prior to pregnancy, 23% of mothers were overweight and another 17% obese. All women were screened for gestational diabetes, with 6% diagnosed. On average, women gained an estimated 14 kg during pregnancy. Gestational diabetes was positively associated with child insulin resistance. In addition, maternal pre-pregnancy body mass index (BMI) was associated with child insulin resistance in a non-linear manner: a positive, progressive association was observed until BMI of 30 kg/m² was reached, but not thereafter. Estimated gestational weight gain was not associated with child insulin resistance. These findings were not accounted for by size of the child at birth or at 9-10 years. CONCLUSIONS Maternal body size prior to pregnancy is positively associated with increases in child insulin resistance, at least until the 'obese' category is reached. This is independent of gestational diabetes and not mediated by body size of the child, suggesting genetic and/or developmental programming origins.
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Affiliation(s)
- O Maftei
- Discipline of Public Health, School of Population Health, The University of Adelaide, Australia; Discipline of Obstetrics & Gynaecology, School of Paediatrics & Reproductive Health, The University of Adelaide, Australia; Robinson Research Institute, The University of Adelaide, Australia
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Telomere length in the two extremes of abnormal fetal growth and the programming effect of maternal arterial hypertension. Sci Rep 2015; 5:7869. [PMID: 25598199 PMCID: PMC5379006 DOI: 10.1038/srep07869] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/12/2014] [Indexed: 12/13/2022] Open
Abstract
We tested the hypothesis that leukocyte telomere length (LTL) is associated with birth weight in both extremes of abnormal fetal growth: small (SGA) and large for gestational age newborns (LGA). Clinical and laboratory variables of the mothers and the neonates were explored; 45 newborns with appropriate weight for gestational age (AGA), 12 SGA and 12 LGA were included. Whether the differences might be explained by variation in OBFC1 (rs9419958) and CTC1 (rs3027234) genes associated with LTL was determined. A significant association between birth weight and LTL was observed; LTL was significantly shorter in LGA newborns (1.01 ± 0.12) compared with SGA (1.73 ± 0.19) p < 0.005, mean ± SE. Maternal (Spearman R = −0.6, p = 0.03) and neonatal LTL (R = −0.25, p = 0.03) were significantly and inversely correlated with maternal history of arterial hypertension in previous gestations. Neonatal LTL was not significantly associated with either rs9419950 or rs3027234, suggesting that the association between neonatal LTL and birth weight is not influenced by genetic variation in genes that modify the interindividual LTL. In conclusion, telomere biology seems to be modulated by abnormal fetal growth; modifications in telomere length might be programmed by an adverse environment in utero.
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Increased expression of Hes5 protein in Notch signaling pathway in the hippocampus of mice offspring of dams fed a high-fat diet during pregnancy and suckling. Int J Dev Neurosci 2014; 40:35-42. [PMID: 25450527 DOI: 10.1016/j.ijdevneu.2014.11.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 11/12/2014] [Accepted: 11/12/2014] [Indexed: 12/31/2022] Open
Abstract
Maternal high-fat diet (HFD) impairs hippocampal development of offspring promoting decreased proliferation of neural progenitors, in neuronal differentiation, in dendritic spine density and synaptic plasticity reducing neurogenic capacity. Notch signaling pathway participates in molecular mechanisms of the neurogenesis. The activation of Notch signaling leads to the upregulation of Hes5, which inhibits the proliferation and differentiation of neural progenitors. This study aimed to investigate the Notch/Hes pathway activation in the hippocampus of the offspring of dams fed an HFD. Female Swiss mice were fed a control diet (CD) and an HFD from pre-mating until suckling. The bodyweight and mass of adipose tissue in the mothers and pups were also measured. The mRNA and protein expression of Notch1, Hes5, Mash1, and Delta1 in the hippocampus was assessed by RT-PCR and western blotting, respectively. Dams fed the HFD and their pups had an increased bodyweight and amount of adipose tissue. Furthermore, the offspring of mothers fed the HFD exhibited an increased Hes5 expression in the hippocampus compared with CD offspring. In addition, HFD offspring also expressed increased amounts of Notch1 and Hes5 mRNA, whereas Mash1 expression was decreased. However, the expression of Delta1 did not change significantly. We propose that the overexpression of Hes5, a Notch effector, downregulates the expression of the proneural gene Mash1 in the offspring of obese mothers, delaying cellular differentiation. These results provide further evidence that an offspring's hippocampus is molecularly susceptible to maternal HFD and suggest that Notch1 signaling in this brain region is important for neuronal differentiation.
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11-year trends in pregnancy-related health indicators in Maine, 2000-2010. J Pregnancy 2014; 2014:780626. [PMID: 25485153 PMCID: PMC4248427 DOI: 10.1155/2014/780626] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 10/26/2014] [Indexed: 01/14/2023] Open
Abstract
The objective of this study is to understand health and demographic trends among mothers and infants in Maine relative to the goals of Healthy People 2020. Pregnancy risk assessment monitoring system (PRAMS) data from Maine for 2000–2010 were used to determine yearly values of pregnancy-related variables. Means (for continuous variables) and percentages (for categorical variables) were calculated using the survey procedures in SAS. Linear trend analysis was applied with study year as the independent variable. The slope and significance of the trend were then calculated. Over the study period, new mothers in Maine became better educated but the fraction of households with incomes <$20,000/year remained stagnant. Maternal prepregnancy BMI increased. Average pregnancy weight gain decreased but the number of women whose pregnancy weight gain was within the recommended range was unchanged. The rates of smoking and alcohol consumption (before and during pregnancy) increased. The Caesarean section rate rose and the fraction of infants born premature (<37 wks gestation) or underweight (<2500 gms) remained unchanged. The fraction of infants who were breast-fed increased. These results suggest that, despite some positive trends, Maine faces significant challenges in meeting Healthy People 2020 goals.
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Ronnberg AK, Ostlund I, Fadl H, Gottvall T, Nilsson K. Intervention during pregnancy to reduce excessive gestational weight gain-a randomised controlled trial. BJOG 2014; 122:537-44. [DOI: 10.1111/1471-0528.13131] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2014] [Indexed: 11/30/2022]
Affiliation(s)
- AK Ronnberg
- Department of Obstetrics & Gynaecology; School of Health and Medical Sciences; Örebro University; Örebro Sweden
| | - I Ostlund
- Department of Obstetrics & Gynaecology; Örebro University Hospital; Örebro Sweden
| | - H Fadl
- Department of Obstetrics & Gynaecology; School of Health and Medical Sciences; Örebro University; Örebro Sweden
| | - T Gottvall
- Department of Obstetrics & Gynaecology; Linköping University Hospital; Linköping Sweden
| | - K Nilsson
- Department of Obstetrics & Gynaecology; School of Medicine; Örebro University; Örebro Sweden
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Gestational weight gain in normal weight women and offspring cardio-metabolic risk factors at 20 years of age. Int J Obes (Lond) 2014; 39:671-6. [PMID: 25298277 DOI: 10.1038/ijo.2014.179] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 08/07/2014] [Accepted: 09/06/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Limited knowledge exists on the long-term implications of maternal gestational weight gain (GWG) on offspring health. Our objective was to examine whether high GWG in normal weight women is associated with adult offspring cardio-metabolic risk factors. METHODS We used a cohort of 308 Danish women who gave birth in 1988-89 and whose offspring participated in a clinical examination at 20 years of age. Main outcome measures were offspring body mass index (BMI), waist circumference, weight-regulating hormones, blood lipids and glucose metabolism. Associations were assessed using multivariable linear and logistic regression models. RESULTS A weak positive association was observed between GWG during the first 30 weeks and offspring anthropometry. Each 1-kg increase in maternal GWG was associated with 0.1-kg m(-2) higher (95% confidence interval (CI): 0.01, 0.2) offspring BMI and 10% (95% CI: 0.1%, 20%) higher odds of offspring overweight at the age of 20 years, with similar associations observed in both sexes. However, sex differences were observed for the association between maternal GWG and specific cardio-metabolic risk factors. Hence, a 1-kg increase in GWG was associated with 3.4% (95% CI; 0.8, 6.0%) higher homeostasis model assessment-estimated insulin resistance (HOMA-IR), 3.7% (95% CI: 1.4%, 6.2%) higher insulin and 10.7% (95% CI: 5.7%, 15.9%) higher leptin levels in male offspring. These associations were not observed in females, which may partly be explained by more frequent reports of dieting and physical exercise at follow-up among female offspring. CONCLUSIONS In normal-weight women, high GWG may have modest long-term implications on offspring cardio-metabolic risk factors at adult age.
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Gaillard R, Steegers EAP, Franco OH, Hofman A, Jaddoe VWV. Maternal weight gain in different periods of pregnancy and childhood cardio-metabolic outcomes. The Generation R Study. Int J Obes (Lond) 2014; 39:677-85. [PMID: 25287752 DOI: 10.1038/ijo.2014.175] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 09/21/2014] [Accepted: 09/26/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Excessive gestational weight gain seems to be associated with offspring cardio-metabolic risk factors. Little is known about the critical periods of gestational weight gain. We examined the associations of maternal weight gain in different periods of pregnancy with childhood cardio-metabolic risk factors. METHODS In a population-based prospective cohort study from early pregnancy onwards among 5908 mothers and their children, we obtained maternal prepregnancy weight and weight in early, mid and late pregnancy. At the age of 6 years (median: 72.6 months; 95% range: 67.9, 95.8), we measured childhood body mass index (BMI), total body and abdominal fat distribution, blood pressure and blood levels of lipids, insulin and c-peptide. RESULTS Overall, the associations of maternal prepregnancy weight with childhood outcomes were stronger than the associations of maternal gestational weight gain. Independent from maternal prepregnancy weight and weight gain in other periods, higher weight gain in early pregnancy was associated with higher childhood BMI, total fat mass, android/gynoid fat mass ratio, abdominal subcutaneous fat mass and systolic blood pressure (P-values<0.05). Independent associations of maternal weight gain in early pregnancy with childhood abdominal preperitoneal fat mass, insulin and c-peptide were of borderline significance. Higher weight gain in mid pregnancy was independently associated with higher childhood BMI, total and abdominal subcutaneous fat mass and systolic blood pressure (P-values<0.05). The associations for childhood cardio-metabolic outcomes attenuated after adjustment for childhood BMI. Weight gain in late pregnancy was not associated with childhood outcomes. Higher weight gain in early, but not in mid or late pregnancy, was associated with increased risks of childhood overweight and clustering of cardio-metabolic risk factors (odds ratio (OR) 1.19 (95% confidence interval (CI): 1.10, 1.29) and OR 1.20 (95% CI: 1.07, 1.35) per standard deviation increase in early gestational weight gain, respectively). CONCLUSIONS Higher weight gain in early pregnancy is associated with an adverse cardio-metabolic profile in offspring. This association is largely mediated by childhood adiposity.
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Affiliation(s)
- R Gaillard
- 1] The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - E A P Steegers
- Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - V W V Jaddoe
- 1] The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
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Ferrari N, Mallmann P, Brockmeier K, Strüder HK, Graf C. Secular trends in pregnancy weight gain in German women and their influences on foetal outcome: a hospital-based study. BMC Pregnancy Childbirth 2014; 14:228. [PMID: 25027843 PMCID: PMC4223617 DOI: 10.1186/1471-2393-14-228] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 07/09/2014] [Indexed: 11/10/2022] Open
Abstract
Background Increasing rates of overweight have been reported. In Germany, women of childbearing age are especially affected. Those women are at increased risks of several peri- and postnatal complications. The purpose of this study was to carry out Germany’s first study in terms of secular trends of overweight and weight gain during pregnancy related to foetal clinical outcomes (birth weight, Apgar score and umbilical blood pH). Methods A database maintained by a large regional university hospital in Cologne, Germany was used to evaluate clinical routine data from 1996 to 2012. 11771 women (23.5 ± 5.4 years; 18–48 years), who gave birth to a live singleton child (>2000 gram) were included. Recommended weight gain during pregnancy was based on IOM guidelines: Total weight gain range for underweight (initial BMI < 18.5 kg/m2) is 12.5 - 18 kg/ 28–40 lbs respectively, for normal-weight (initial BMI 18.5 -24.9 kg/m2) is 11.5 - 16 kg/ 25–35 lbs respectively, for overweight (initial BMI 25.0-29.9 kg/m2) is 7–11.5 kg/ 15–25 lbs respectively and for obese (initial BMI ≥ 30.0 kg/m2) is 5–9 kg/ 11–20 lbs respectively. A one-way variance analysis was employed to test for differences in particular factors in various groups. Multiple linear regression analysis was used to model impact factors. Results Over the second analysed period (2005–2012), the number of women with high weight gain increased from 33.8% to 42.9% (p <0.001). 54.5% overweight and 57.7% obese women were affected (p <0.001). Women with high weight gain were 54.5% significantly more likely to give birth to an infant ≥ 4000 grams than women with normal (31.7%) or low weight gain (13.8%, p < 0.001). Women with normal weight gain had significantly better foetal outcomes in terms of the Apgar score at 5 min and umbilical cord blood pH. Conclusion These data confirm an increase in maternal weight gain before and during pregnancy. An excessive weight gain is accompanied by macrosomia, lower Apgar scores and pH-value. Women should therefore be advised about the risks of obesity before and during pregnancy as well as excessive maternal weight gain during pregnancy.
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Affiliation(s)
- Nina Ferrari
- Cologne Centre for Prevention in Childhood and Youth/ Heart Centre Cologne, University Hospital of Cologne, Kerpener Str, 62, 50937 Cologne, Germany.
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Abstract
BACKGROUND The increasing incidence of obesity in children is a significant risk factor for nonalcoholic fatty liver disease and obesity-associated morbidity. Vitamin D has a major role in bone mineral metabolism and has antimicrobial, antioxidant properties. In this study we aimed to investigate the role of vitamin D in children with obesity with hepatosteatosis. METHODS A total of 101 children with obesity were included in this study. Hepatosteatosis was diagnosed and graded using ultrasonography. Serum levels of 25-hydroxyvitamin D (25-(OH) vitamin D), calcium, phosphate, alkaline phosphatase, and parathormone were tested. Two-sided t test and Pearson χ tests were used for the relation between vitamin D and hepatosteatosis. RESULTS In our study group, 45.5% were girls (n=46) and the mean age was 11.5 ± 2.8 years (range 3-17 years). Hepatosteatosis was identified in 58 children (57.4%). The diagnosis of grade 1 and grade 2 hepatosteatosis was made in 41 (40.6%) and 17 (16.8%) children, respectively. Median serum 25-(OH) vitamin D levels in children without hepatosteatosis was 16.4 ng/mL (interquartile range 12.4-24.8 ng/mL), whereas children with grade 1 and grade 2 hepatosteatosis had 25-(OH) vitamin D levels of 14.2 ng/mL (interquartile range 9.5-21.2 ng/mL) and 11.5 ng/mL (interquartile range 7.5-16.7 ng/mL), respectively (P=0.005). There was a positive correlation between insulin resistance and the grade of hepatosteatosis (P=0.03). CONCLUSIONS Serum vitamin D levels in children with obesity with hepatosteatosis are significantly lower than vitamin D levels in children with obesity without hepatosteatosis. In this observational study we only refer to the association of vitamin D deficiency/insufficiency with hepatosteatosis.
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Elhddad AS, Fairlie F, Lashen H. Impact of gestational weight gain on fetal growth in obese normoglycemic mothers: a comparative study. Acta Obstet Gynecol Scand 2014; 93:771-7. [DOI: 10.1111/aogs.12427] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 05/07/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Agzail S. Elhddad
- Academic Unit of Reproductive and Developmental Medicine; Human Metabolism Department; Medical School; University of Sheffield; Sheffield UK
| | - Fiona Fairlie
- Royal Hallamshire Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| | - Hany Lashen
- Academic Unit of Reproductive and Developmental Medicine; Human Metabolism Department; Medical School; University of Sheffield; Sheffield UK
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Kelishadi R, Poursafa P. A review on the genetic, environmental, and lifestyle aspects of the early-life origins of cardiovascular disease. Curr Probl Pediatr Adolesc Health Care 2014; 44:54-72. [PMID: 24607261 DOI: 10.1016/j.cppeds.2013.12.005] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 12/04/2013] [Indexed: 12/29/2022]
Abstract
This article is a comprehensive review on developmental origins of health and disease regarding various factors related to the origins of cardiovascular diseases from early life. It presents a summary of the impacts of various factors such as epigenetics; gene-environment interaction; ethnic predisposition to cardiovascular diseases and their underlying risk factors; prenatal factors; fetal programming; maternal weight status and weight gain during pregnancy; type of feeding during infancy; growth pattern during childhood; obesity; stunting; socioeconomic status; dietary and physical activity habits; active, secondhand, and thirdhand smoking, as well as environmental factors including air pollution and global climate change on the development and progress of cardiovascular diseases and their risk factors. The importance of early identification of predisposing factors for cardiovascular diseases for primordial and primary prevention of cardiovascular diseases from early life is highlighted.
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Affiliation(s)
- Roya Kelishadi
- Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parinaz Poursafa
- Environment Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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45
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Bammann K, Peplies J, De Henauw S, Hunsberger M, Molnar D, Moreno LA, Tornaritis M, Veidebaum T, Ahrens W, Siani A. Early life course risk factors for childhood obesity: the IDEFICS case-control study. PLoS One 2014; 9:e86914. [PMID: 24551043 PMCID: PMC3923715 DOI: 10.1371/journal.pone.0086914] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 12/16/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The early life course is assumed to be a critical phase for childhood obesity; however the significance of single factors and their interplay is not well studied in childhood populations. OBJECTIVES The investigation of pre-, peri- and postpartum risk factors on the risk of obesity at age 2 to 9. METHODS A case-control study with 1,024 1:1-matched case-control pairs was nested in the baseline survey (09/2007-05/2008) of the IDEFICS study, a population-based intervention study on childhood obesity carried out in 8 European countries in pre- and primary school settings. Conditional logistic regression was used for identification of risk factors. RESULTS For many of the investigated risk factors, we found a raw effect in our study. In multivariate models, we could establish an effect for gestational weight gain (adjusted OR = 1.02; 95%CI 1.00-1.04), smoking during pregnancy (adjusted OR = 1.48; 95%CI 1.08-2.01), Caesarian section (adjusted OR = 1.38; 95%CI 1.10-1.74), and breastfeeding 4 to 11 months (adjusted OR = 0.77; 95%CI 0.62-0.96). Birth weight was related to lean mass rather than to fat mass, the effect of smoking was found only in boys, but not in girls. After additional adjustment for parental BMI and parental educational status, only gestational weight gain remained statistically significant. Both, maternal as well as paternal BMI were the strongest risk factors in our study, and they confounded several of the investigated associations. CONCLUSIONS Key risk factors of childhood obesity in our study are parental BMI and gestational weight gain; consequently prevention approaches should target not only children but also adults. The monitoring of gestational weight seems to be of particular importance for early prevention of childhood obesity.
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Affiliation(s)
- Karin Bammann
- Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
- BIPS Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Jenny Peplies
- BIPS Institute for Prevention Research and Epidemiology, Bremen, Germany
| | | | - Monica Hunsberger
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Denes Molnar
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | | | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Wolfgang Ahrens
- BIPS Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Alfonso Siani
- Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
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Hearn L, Miller M, Lester L. Reaching perinatal women online: the Healthy You, Healthy Baby website and app. J Obes 2014; 2014:573928. [PMID: 24872891 PMCID: PMC4020447 DOI: 10.1155/2014/573928] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 02/09/2014] [Accepted: 03/16/2014] [Indexed: 11/18/2022] Open
Abstract
Overwhelming evidence reveals the close link between unwarranted weight gain among childbearing women and childhood adiposity. Yet current barriers limit the capacity of perinatal health care providers (PHCPs) to offer healthy lifestyle counselling. In response, today's Internet savvy women are turning to online resources to access health information, with the potential of revolutionising health services by enabling PHCPs to guide women to appropriate online resources. This paper presents the findings of a project designed to develop an online resource to promote healthy lifestyles during the perinatal period. The methodology involved focus groups and interviews with perinatal women and PHCPs to determine what online information was needed, in what form, and how best it should be presented. The outcome was the development of the Healthy You, Healthy Baby website and smartphone app. This clinically-endorsed, interactive online resource provides perinatal women with a personalised tool to track their weight, diet, physical activity, emotional wellbeing, and sleep patterns based on the developmental stage of their child with links to quality-assured information. One year since the launch of the online resource, data indicates it provides a low-cost intervention delivered across most geographic and socioeconomic strata without additional demands on health service staff.
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Affiliation(s)
- Lydia Hearn
- School of Dentistry, University of Western Australia, Perth, WA 6009, Australia
- School of Exercise and Health Science, Edith Cowan University, Joondalup, WA 6027, Australia
- *Lydia Hearn:
| | - Margaret Miller
- Child Health Promotion Research Centre, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Leanne Lester
- Health Promotion Evaluation Unit, University of Western Australia, Perth, WA 6009, Australia
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Paslakis G, Buchmann AF, Westphal S, Banaschewski T, Hohm E, Zimmermann US, Laucht M, Deuschle M. Intrauterine exposure to cigarette smoke is associated with increased ghrelin concentrations in adulthood. Neuroendocrinology 2014; 99:123-9. [PMID: 24821310 DOI: 10.1159/000363325] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 04/29/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND The appetite-stimulating hormone ghrelin is a fundamental regulator of human energy metabolism. A series of studies support the notion that long-term appetite and weight regulation may be already programmed in early life and it could be demonstrated that the intrauterine environment affects the ghrelin system of the offspring. Animal studies have also shown that intrauterine programming of orexigenic systems persists even until adolescence/adulthood. METHODS We hypothesized that plasma ghrelin concentrations in adulthood may be associated with the intrauterine exposure to cigarette smoke. We examined this hypothesis in a sample of 19-year-olds followed up since birth in the framework of the Mannheim Study of Children at Risk, an ongoing epidemiological cohort study of the long-term outcome of early risk factors. RESULTS As a main finding, we found that ghrelin plasma concentrations in young adults who had been exposed to cigarette smoke in utero were significantly higher than in those without prenatal smoke exposure. Moreover, individuals with intrauterine nicotine exposure showed a significantly higher prevalence of own smoking habits and lower educational status compared to those in the group without exposure. CONCLUSION Smoking during pregnancy may be considered as an adverse intrauterine influence that may alter the endocrine-metabolic status of the offspring even until early adulthood.
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Affiliation(s)
- Georgios Paslakis
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
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48
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Durmuş B, Arends LR, Ay L, Hokken-Koelega AC, Raat H, Hofman A, Steegers EAP, Jaddoe VWV. Parental anthropometrics, early growth and the risk of overweight in pre-school children: the Generation R Study. Pediatr Obes 2013; 8:339-50. [PMID: 23239588 DOI: 10.1111/j.2047-6310.2012.00114.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 08/30/2012] [Accepted: 09/28/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND There are limited data regarding the associations of both maternal and paternal anthropometrics with longitudinally measured post-natal growth measures in early childhood. OBJECTIVE To assess the associations of maternal and paternal anthropometrics with growth characteristics and the risk of overweight in pre-school children. STUDY DESIGN Population-based prospective cohort study from early foetal life onwards in the Netherlands. METHODS Maternal pre-pregnancy anthropometrics and gestational weight gain, and paternal anthropometrics were related to foetal and post-natal growth measures and the risk of overweight until the age of 4 years. Analyses were based on 5674 mothers, fathers and their children. RESULTS Both pre-pregnancy maternal and paternal height, weight and body mass index were associated with corresponding foetal and post-natal anthropometric measures. Maternal body mass index had a significantly stronger effect on childhood body mass index than paternal body mass index. As compared to children from parents with normal body mass index, children from two obese parents had an increased risk of overweight at the age of 4 years (odds ratio 6.52 (95% confidence interval 3.44, 12.38). Maternal gestational weight gain was only among mothers with normal body mass index associated with body mass index and the risk of overweight in the children. CONCLUSION Maternal and paternal anthropometrics affect early growth in pre-school children differently. Gestational weight gain in mothers without overweight and obesity is related to the risk of overweight in early childhood.
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Affiliation(s)
- B Durmuş
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands
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49
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Giriko CÁ, Andreoli CA, Mennitti LV, Hosoume LF, Souto TDS, Silva AVD, Mendes-da-Silva C. Delayed physical and neurobehavioral development and increased aggressive and depression-like behaviors in the rat offspring of dams fed a high-fat diet. Int J Dev Neurosci 2013; 31:731-9. [PMID: 24071008 DOI: 10.1016/j.ijdevneu.2013.09.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 09/07/2013] [Accepted: 09/07/2013] [Indexed: 12/20/2022] Open
Abstract
Early maternal exposure to a high-fat diet (HFD) may influence the brain development of rat offspring and consequently affect physiology and behavior. Thus, in the present study, we investigated the somatic, physical, sensory-motor and neurobehavioral development of the offspring of dams fed an HFD (52% calories from fat, mainly saturated) and the offspring of dams fed a control diet (CD - 14.7% fat) during lactation from the 1st to the 21st postnatal day (P). Maternal body weights were evaluated during lactation. In the progeny, somatic (body weight, head and lengths axes) and physical (ear unfolding, auditory conduit opening, eruption of the incisors and eye opening) development and the consolidation of reflex responses (palm grasp, righting, vibrissa placing, cliff avoidance, negative geotaxis, auditory startle response and free-fall righting) were determined during suckling. Depressive and aggressive behaviors were tested with the forced swimming test (FST) and the "foot-shock" test on days 60 and 110, respectively. The open field test was used to assess motor function. Compared to controls, the HFD-pups exhibited decreases in body weight (P7-P21) and body length (P4-P18), but by days P71 and P95, these pups were overweight. All indicators of physical maturation and the consolidation of the following reflexes, vibrissa placing, auditory startle responses, free-fall righting and negative geotaxis, were delayed in HFD-progeny. In addition, the pups from HFD dam rats also exhibited reduced swimming and climbing times in the FST and increased aggressive behavior. No changes in locomotion were observed. These findings show developmental and neurobehavioral changes in the rat offspring of dams fed the HFD during lactation and suggest possible disruption of physical and sensory-motor maturation and increased susceptibility to depressive and aggressive-like behavior.
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Affiliation(s)
- Catherine Ássuka Giriko
- Department of Biosciences - Federal University of Sao Paulo/UNIFESP (Campus Baixada Santista), 11060-001 Santos, Brazil; Interdisciplinary Master in Health Sciences/UNIFESP (Campus Baixada Santista), 11060-001 Santos, Brazil
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50
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Samuelsson AM, Clark J, Rudyk O, Shattock MJ, Bae SE, South T, Pombo J, Redington K, Uppal E, Coen CW, Poston L, Taylor PD. Experimental hyperleptinemia in neonatal rats leads to selective leptin responsiveness, hypertension, and altered myocardial function. Hypertension 2013; 62:627-33. [PMID: 23836797 DOI: 10.1161/hypertensionaha.111.00691] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The prevalence of obesity among pregnant women is increasing. Evidence from human cohort studies and experimental animals suggests that offspring cardiovascular and metabolic function is compromised through early life exposure to maternal obesity. Previously, we reported that juvenile offspring of obese rats develop sympathetically mediated hypertension associated with neonatal hyperleptinemia. We have now addressed the hypothesis that neonatal exposure to raised leptin in the immediate postnatal period plays a causal role. Pups from lean Sprague-Dawley rats were treated either with leptin (3 mg/kg IP) or with saline twice daily from postnatal day 9 to 15 to mimic the exaggerated postnatal leptin surge observed in offspring of obese dams. Cardiovascular function was assessed by radiotelemetry at 30 days, and 2 and 12 months. In juvenile (30 days) leptin-treated rats, hearts were heavier and night-time (active period) systolic blood pressure was raised (mm Hg; mean ± SEM: male leptin-treated, 132 ± 1 versus saline-treated, 119 ± 1, n=6, P<0.05; female leptin-treated, 132 ± 2 versus saline-treated, 119 ± 1, n=6, P<0.01), and the pressor response to restraint stress and leptin challenge increased compared with saline-treated rats. Heart rate variability demonstrated an increased low:high frequency ratio in 30-day leptin-treated animals, indicative of heightened sympathetic efferent tone. Echocardiography showed altered left ventricular structure and systolic function in 30-day female leptin versus saline-treated rats. These disorders persisted to adulthood. In isolated hearts, contractile function was impaired at 5 months in male leptin-treated rats. Exogenously imposed hyperleptinemia in neonatal rats permanently influences blood pressure and cardiac structure and function.
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Affiliation(s)
- Anne-Maj Samuelsson
- Division of Women's Health, Women's Health Academic Centre, London SE1 7EH, United Kingdom.
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