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Lactation alters the relationship between liver lipid synthesis and hepatic fat stores in the postpartum period. J Lipid Res 2022; 63:100288. [PMID: 36162520 PMCID: PMC9619182 DOI: 10.1016/j.jlr.2022.100288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
In mothers who are nursing their infants, increased clearance of plasma metabolites into the mammary gland may reduce ectopic lipid in the liver. No study to date has investigated the role of lactation on liver lipid synthesis in humans, and we hypothesized that lactation would modify fatty acid and glucose handling to support liver metabolism in a manner synchronized with the demands of milk production. Lactating (n = 18) and formula-feeding women (n = 10) underwent metabolic testing at 6-week postpartum to determine whether lactation modified intrahepatic triacylglycerols (IHTGs), measured by proton magnetic resonance spectroscopy. Subjects ingested oral deuterated water to measure fractional de novo lipogenesis (DNL) in VLDL-TG during fasting and during an isotope-labeled clamp at an insulin infusion rate of 10 mU/m2/min. Compared with formula-feeding women, we found that lactating women exhibited lower plasma VLDL-TG concentrations, similar IHTG content and similar contribution of DNL to total VLDL-TG production. These findings suggest that lactation lowers plasma VLDL-TG concentrations for reasons that are unrelated to IHTG and DNL. Surprisingly, we determined that the rate of appearance of nonesterified fatty acids was not related to IHTG in either group, and the expected positive association between DNL and IHTG was only significant in formula-feeding women. Further, in lactating women only, the higher the prolactin concentration, the lower the IHTG, while greater DNL strongly associated with elevations in VLDL-TG. In conclusion, we suggest that future studies should investigate the role of lactation and prolactin in liver lipid secretion and metabolism.
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Nulty AK, Bovbjerg ML, Herring AH, Siega-Riz AM, Thorp JM, Evenson KR. Meal patterning and the onset of spontaneous labor. Birth 2022; 49:123-131. [PMID: 34453454 PMCID: PMC8810608 DOI: 10.1111/birt.12583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 08/06/2021] [Accepted: 08/17/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is a lack of consensus in the literature about the association between meal patterning during pregnancy and birth outcomes. This study examined whether maternal meal patterning in the week before birth was associated with an increased likelihood of imminent spontaneous labor. METHODS Data came from 607 participants in the third phase of the Pregnancy, Infection, and Nutrition Study (PIN3). Data were collected through an interviewer-administered questionnaire after birth, before hospital discharge. Questions included the typical number of meals and snacks consumed daily, during both the week before labor onset and the 24-hour period before labor onset. A self-matched, case-crossover study design examined the association between skipping one or more meals and the likelihood of spontaneous labor onset within the subsequent 24 hours. RESULTS Among women who experienced spontaneous labor, 87.0% reported routinely eating three daily meals (breakfast, lunch, and dinner) during the week before their labor began, but only 71.2% reported eating three meals during the 24-hour period before their labor began. Compared with the week before their labor, the odds of imminent spontaneous labor were 5.43 times as high (95% CI: 3.41-8.65) within 24 hours of skipping 1 or more meals. The association between skipping 1 or more meals and the onset of spontaneous labor remained elevated for both pregnant individuals who birthed early (37-<39 weeks) and full-term (≥39 weeks). CONCLUSIONS Skipping meals later in pregnancy was associated with an increased likelihood of imminent spontaneous labor, though we are unable to rule out reverse causality.
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Affiliation(s)
- Alison K Nulty
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Marit L Bovbjerg
- Epidemiology Program, Oregon State University, Corvallis, Oregon
| | - Amy H Herring
- Department of Statistical Science, Duke University, Durham, North Carolina,Duke Global Health Institute, Duke University, Durham, North Carolina,Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
| | - Anna Maria Siega-Riz
- Department of Nutrition, School of Public Health and Health Services, University of Massachusetts, Amherst, Massachusetts
| | - John M Thorp
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Chrononutrition during Pregnancy: A Review on Maternal Night-Time Eating. Nutrients 2020; 12:nu12092783. [PMID: 32932985 PMCID: PMC7551833 DOI: 10.3390/nu12092783] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 01/20/2023] Open
Abstract
Evidence from women working night shifts during pregnancy indicates that circadian rhythm disruption has the potential to adversely influence pregnancy outcomes. In the general population, chronodisruption with the potential to affect pregnancy outcomes may also be seen in those with high energy intakes in the evening or at night. However, maternal night eating during pregnancy remains understudied. This narrative review provides an overview of the prevalence, contributing factors, nutritional aspects and health implications of night eating during pregnancy. We derived evidence based on cross-sectional studies and longitudinal cohorts. Overall, night eating is common during pregnancy, with the estimated prevalence in different populations ranging from 15% to 45%. The modern lifestyle and the presence of pregnancy symptoms contribute to night eating during pregnancy, which is likely to coexist and may interact with multiple undesirable lifestyle behaviors. Unfavorable nutritional characteristics associated with night eating have the potential to induce aberrant circadian rhythms in pregnant women, resulting in adverse metabolic and pregnancy outcomes. More research, particularly intervention studies, are needed to provide more definite information on the implications of night eating for mother-offspring health.
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McLemore MR, Altman MR, Cooper N, Williams S, Rand L, Franck L. Health care experiences of pregnant, birthing and postnatal women of color at risk for preterm birth. Soc Sci Med 2018; 201:127-135. [PMID: 29494846 DOI: 10.1016/j.socscimed.2018.02.013] [Citation(s) in RCA: 201] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 01/25/2018] [Accepted: 02/15/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Chronic stress is a known risk factor for preterm birth, yet little is known about how healthcare experiences add to or mitigate perceived stress. In this study, we described the pregnancy-related healthcare experiences of 54 women of color from Fresno, Oakland, and San Francisco, California, with social and/or medical risk factors for preterm birth. METHODS This study was a secondary analysis of focus group data generated as part of a larger project focused on patient and community involvement in preterm birth research. English and Spanish speaking women, age 18 or greater with social and/or medical risk factors for preterm birth participated in two focus groups, six weeks apart. Data from the first focus groups are included in this analysis. RESULTS Five themes emerged from thematic analysis of the transcripts. Participants described disrespect during healthcare encounters, including experiences of racism and discrimination; stressful interactions with all levels of staff; unmet information needs; and inconsistent social support. Despite these adverse experiences, women felt confidence in parenting and newborn care. Participant recommendations for healthcare systems improvement included: greater attention to birth plans, better communication among multiple healthcare providers, more careful listening to patients during clinical encounters, increased support for social programs such as California's Black Infant Health, and less reliance on past carceral history and/or child protective services involvement. DISCUSSION The women in this study perceived their prenatal healthcare as a largely disrespectful and stressful experience. Our findings add to the growing literature that women of color experience discrimination, racism and disrespect in healthcare encounters and that they believe this affects their health and that of their infants.
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Affiliation(s)
- Monica R McLemore
- Family Health Care Nursing Department, University of California, 2 Koret Way, N431H, San Francisco, CA, 94143, United States.
| | - Molly R Altman
- UCSF Preterm Birth Initiative, 3333 California Street, Suite 285, San Francisco, CA, 94118, United States.
| | - Norlissa Cooper
- Department of Social and Behavioral Sciences, Health Policy, University of California, 3333 California Street, San Francisco, CA, 94118, United States.
| | - Shanell Williams
- UCSF Preterm Birth Initiative, 3333 California Street, Suite 285, San Francisco, CA, 94118, United States.
| | - Larry Rand
- Marc and Lynne Benioff Endowed Chair in Maternal Fetal Medicine, Director of Perinatal Services, Fetal Treatment Center, University of California, Dept. of Ob/Gyn and Surgery, Divisions of Perinatology and Pediatric Surgery, 550 16th Street, Box #0132, San Francisco, CA, 94143-0132, United States.
| | - Linda Franck
- Department of Family Health Care Nursing, Jack and Elaine Koehn Endowed Chair in Pediatric Nursing, University of California, 2 Koret Way, N411F, Box 0606, San Francisco, CA, 94143, United States.
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Koenig MD, McFarlin BL, Steffen AD, Tussing-Humphreys L, Giurgescu C, Engeland CG, Kominiarek MA, Ciezczak-Karpiel C, O'Brien WD, White-Traut R. Decreased Nutrient Intake Is Associated With Premature Cervical Remodeling. J Obstet Gynecol Neonatal Nurs 2016; 46:123-134. [PMID: 27836660 DOI: 10.1016/j.jogn.2016.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2016] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To examine the direct relationship between nutrient intake and cervical remodeling. DESIGN Longitudinal descriptive design. SETTING Maternal-fetal medicine clinic in a Midwestern urban city. PARTICIPANTS Forty-seven pregnant African American women. METHODS Participants completed the Block brief food frequency questionnaire at 19 to 24 weeks and 27 to 29 weeks gestation and had quantitative ultrasonic attenuation estimates at 19 to 21 weeks, 23 to 25 weeks, 27 to 29 weeks, 31 to 33 weeks, and 35 to 37 weeks gestation. RESULTS Trajectory mixture models identified two subpopulations within our sample: those at risk (n = 36) and at less risk (n = 11) for premature cervical remodeling. More participants in the less-risk group consumed the dietary reference intake for calcium, vitamin A, folate, vitamin E, zinc, and vitamin D than in the at-risk group. The percentage of participants in the less-risk group who consumed the recommended dietary reference intake for vitamin E was twice the percentage of women in the at-risk group (82% and 44%, respectively; p = .004). Mean intake of calcium was almost 1.3 times more (p = .05) and for zinc was 1.5 times more (p = .04) in the less-risk group than in the at-risk group. CONCLUSION Practitioners can inform women that certain nutrients, particularly zinc, calcium, and vitamin E, could be important to the health of the cervix and inhibit premature cervical remodeling, which in turn may help prevent preterm birth.
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Blumfield ML, Hure AJ, Macdonald-Wicks L, Smith R, Collins CE. Systematic review and meta-analysis of energy and macronutrient intakes during pregnancy in developed countries. Nutr Rev 2012; 70:322-36. [PMID: 22646126 DOI: 10.1111/j.1753-4887.2012.00481.x] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Research reporting diet during pregnancy in nationally representative samples is limited. This review summarizes the dietary intakes of pregnant women in developed countries and compares them with national recommendations. A systematic search without date limits was conducted. All studies reporting the macronutrient intakes of pregnant women were considered, irrespective of design. Two authors independently identified the studies to be included and assessed the methodological quality. Nutritional adequacy was summarized, with confounding factors considered. Meta-analysis data are reported for developed countries collectively, by geographical region, and by dietary methodology. Energy and macronutrient intakes of pregnant women do not match national recommendations. Energy and fiber intakes were consistently below recommendations, while total fat and saturated fat intakes were generally above recommendations and carbohydrate and polyunsaturated fat intakes were below to borderline low compared with recommendations. A mismatch between dietary practices and macronutrient recommendations in pregnant women is widespread and not well quantified. The implications of these practices are unknown until further research compares maternal diet with short-term and long-term maternal and offspring health outcomes.
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Affiliation(s)
- Michelle L Blumfield
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health, University of Newcastle, Australia
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Stringer M, Averbuch T, Brooks PM, Jemmott LS. Response to Homeless Childbearing Women’s Health Care Learning Needs. Clin Nurs Res 2011; 21:195-212. [DOI: 10.1177/1054773811420769] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The study findings showed that homeless childbearing women are at greatest risk for cancer, violence, poor nutrition, sexually transmitted infections, unplanned pregnancy, and adverse pregnancy outcomes. Collaborating with personnel at a women’s shelter, the authors studied homeless childbearing women’s knowledge, attitudes, and beliefs about general health promotion, healthy pregnancy promotion, and preterm labor prevention. Guided by the Integrative Model of Behavioral Prediction and Change, 45 homeless women participated in focus groups. They were 28.7 years old (range 18-44 years), and approximately 87% of these women had custody of their children. Three themes identified included things you do to stay healthy during pregnancy, where you learned about staying healthy, and women’s knowledge about preterm labor and general health promotion. These findings informed an 8-week educational session (1 hr/week). During the past year, four 8-week sessions were conducted with attendance between 8 and 14 participants. Each week a different health topic was discussed incorporating the associated unique challenges of homelessness.
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Affiliation(s)
| | - Tali Averbuch
- University of Pennsylvania School of Nursing, Philadelphia
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