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Schenkelaars N, Schoenmakers S, Rousian M, Willemsen SP, Faas MM, Steegers-Theunissen RPM. Periconceptional maternal supplement intake and human embryonic growth, development, and birth outcomes: the Rotterdam Periconception Cohort. Hum Reprod 2024; 39:1925-1933. [PMID: 39025484 PMCID: PMC11373404 DOI: 10.1093/humrep/deae168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 06/13/2024] [Indexed: 07/20/2024] Open
Abstract
STUDY QUESTION Is periconceptional multiple-micronutrient supplement (MMS) use including folic acid (FA) compared to FA use only associated with increased embryonic growth, development, and birth weight in a high-risk population? SUMMARY ANSWER Women with MMS intake show no significant differences in first-trimester morphological embryo development, but increased first-trimester embryonic growth trajectories and fewer neonates born small for gestational age (SGA), less than the 3rd percentile ( WHAT IS KNOWN ALREADY Periconceptional maternal FA intake in the general population is associated with increased embryonic and fetal growth, and reduced risks of neural tube defects, other congenital malformations, low birth weight, and neonates born SGA. STUDY DESIGN, SIZE, DURATION A prospective tertiary hospital-based cohort study (the Rotterdam Periconceptional Cohort) was conducted from January 2010 to December 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS We included 1076 women from the Rotterdam Periconceptional Cohort, before 10 weeks of pregnancy with follow-up until delivery. Embryonic growth was assessed by measurement of crown-rump length (CRL) and embryonic volume (EV), and embryonic morphology was described by Carnegie stages using longitudinal three-dimensional ultrasound scans and virtual reality techniques. Birth outcomes were extracted from medical records. General characteristics and supplement use were extracted from research questionnaires. MAIN RESULTS AND THE ROLE OF CHANCE This study showed increased embryonic growth trajectories (adjusted models, CRL: β = 0.052, 95% CI 0.012-0.090, EV: β = 0.022, 95% CI 0.002-0.042) in women using MMS compared to those using only FA. Moreover, a 45% reduced risk of a neonate-born SGA ( LIMITATIONS, REASONS FOR CAUTION Following the heterogeneity of the composition and dose of MMS preparations, it is unclear which specific micronutrient, combination, or dose explains the increased embryonic growth trajectory and reduction in risk for SGA. This also hampers the possibility of differentiating between the effects of FA alone or as a component of MMS. WIDER IMPLICATIONS OF THE FINDINGS Our findings emphasize the importance of periconceptional maternal MMS use as a potential preventative intervention against reduced embryonic growth and neonates born SGA. Therefore, we recommend the periconceptional use of MMS in women at risk of inadequate micronutrient intake. However, awareness of potentially harmful side effects of high doses and combinations of micronutrients is essential, therefore the optimal composition and dose need to be investigated, and careful surveillance is recommended. STUDY FUNDING/COMPETING INTEREST(S) This research was funded by the Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands, and the ZonMw grant Open Competition 2018 (09120011910046). The authors declare that they have no conflict of interest. TRIAL REGISTRATION NUMBER NTR4356.
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Affiliation(s)
- N Schenkelaars
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - S Schoenmakers
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M Rousian
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - S P Willemsen
- Department of Biostatistics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M M Faas
- Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - R P M Steegers-Theunissen
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Dasgin H, Hay SM, Rees WD. Diet and deprivation in pregnancy: a rat model to investigate the effects of the maternal diet on the growth of the dam and its offspring. Br J Nutr 2024; 131:630-641. [PMID: 37795821 PMCID: PMC10803821 DOI: 10.1017/s0007114523002210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/23/2023] [Accepted: 10/02/2023] [Indexed: 10/06/2023]
Abstract
The offspring of women in the poorest socio-economic groups in Western societies have an increased risk of developing non-communicable disease in adult life. Deprivation is closely related to the consumption of a diet with an excess of energy (sugar and fat), salt and a shortage of key vitamins. To test the hypothesis that this diet adversely affects the development and long-term health of the offspring, we have formulated two rodent diets, one with a nutrient profile corresponding to the diet of pregnant women in the poorest socio-economic group (DEP) and a second that incorporated current UK recommendations for the diet in pregnancy (REC). Female rats were fed the experimental diets for the duration of gestation and lactation and the offspring compared with those from a reference group fed the AIN-93G diet. The growth trajectory of DEP and REC offspring was reduced compared with the AIN-93G. The REC offspring diet had a transient increase in adipose reserves at weaning, but by 30 weeks of age the body composition of all three groups was similar. The maternal diet had no effect on the homoeostatic model assessment index or the insulin tolerance of the offspring. Changes in hepatic gene expression in the adult REC offspring were consistent with an increased hepatic utilisation of fatty acids and a reduction in de novo lipogenesis. These results show that despite changes in growth and adiposity maternal metabolic adaptation minimises the adverse consequences of the imbalanced maternal diet on the metabolism of the offspring.
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Affiliation(s)
- Halil Dasgin
- The Rowett Institute of Nutrition and Health, The University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Susan M. Hay
- The Rowett Institute of Nutrition and Health, The University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - William D. Rees
- The Rowett Institute of Nutrition and Health, The University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
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Foteva V, Fisher JJ, Qiao Y, Smith R. Does the Micronutrient Molybdenum Have a Role in Gestational Complications and Placental Health? Nutrients 2023; 15:3348. [PMID: 37571285 PMCID: PMC10421405 DOI: 10.3390/nu15153348] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Molybdenum is an essential trace element for human health and survival, with molybdenum-containing enzymes catalysing multiple reactions in the metabolism of purines, aldehydes, and sulfur-containing amino acids. Recommended daily intakes vary globally, with molybdenum primarily sourced through the diet, and supplementation is not common. Although the benefits of molybdenum as an anti-diabetic and antioxidant inducer have been reported in the literature, there are conflicting data on the benefits of molybdenum for chronic diseases. Overexposure and deficiency can result in adverse health outcomes and mortality, although physiological doses remain largely unexplored in relation to human health. The lack of knowledge surrounding molybdenum intake and the role it plays in physiology is compounded during pregnancy. As pregnancy progresses, micronutrient demand increases, and diet is an established factor in programming gestational outcomes and maternal health. This review summarises the current literature concerning varied recommendations on molybdenum intake, the role of molybdenum and molybdoenzymes in physiology, and the contribution these play in gestational outcomes.
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Affiliation(s)
- Vladimira Foteva
- Mothers and Babies Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (J.J.F.); (R.S.)
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Joshua J. Fisher
- Mothers and Babies Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (J.J.F.); (R.S.)
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Yixue Qiao
- Academy of Pharmacy, Xi’an Jiaotong Liverpool University, Suzhou 215000, China;
| | - Roger Smith
- Mothers and Babies Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (J.J.F.); (R.S.)
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
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Rak K, Styczyńska M, Godyla-Jabłoński M, Bronkowska M. Some Immune Parameters of Term Newborns at Birth Are Associated with the Concentration of Iron, Copper and Magnesium in Maternal Serum. Nutrients 2023; 15:nu15081908. [PMID: 37111127 PMCID: PMC10141145 DOI: 10.3390/nu15081908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/06/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
The nutritional status of pregnant women is considered to affect fetal development and the health condition of newborns, including their immune system. We investigated the relationship between the concentrations of magnesium (Mg), calcium (Ca), zinc (Zn), iron (Fe) and copper (Cu) in maternal serum (MS) and the concentrations of IgG antibodies and antineutrophil cytoplasmatic auto-antibodies against lactoferrin (Lf-ANCA) in umbilical cord serum (UCS). IgG was considered as a promoter of immunity, and Lf-ANCA as an inhibitor. The examined group consisted of 98 pregnant women and their healthy term newborn children. The concentrations of mineral elements were measured by FAAS/FAES, while the concentrations of antibodies were determined by ELISA. Excessive MS Fe and insufficient MS Cu were related to insufficient UCS IgG and excessive UCS Lf-ANCA. The correlation analysis showed confirming results. Adequate UCS IgG and Lf-ANCA were related to MS Mg at the strictly lower limit of the reference values. The results obtained seem to suggest that an excess of Fe and a deficiency of Cu in pregnancy may adversely affect some immune parameters of newborns. Reference values for MS Mg are likely to require reconsideration. It would be advisable to monitor the nutritional status of pregnant women with minerals in order to support the immune capacity of newborns.
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Affiliation(s)
- Karolina Rak
- Department of Human Nutrition, Faculty of Biotechnology and Food Science, Wroclaw University of Environmental and Life Sciences, 51-630 Wrocław, Poland
| | - Marzena Styczyńska
- Department of Human Nutrition, Faculty of Biotechnology and Food Science, Wroclaw University of Environmental and Life Sciences, 51-630 Wrocław, Poland
| | - Michaela Godyla-Jabłoński
- Department of Human Nutrition, Faculty of Biotechnology and Food Science, Wroclaw University of Environmental and Life Sciences, 51-630 Wrocław, Poland
| | - Monika Bronkowska
- Institute of Health Sciences, Collegium Salutis Humanae, University of Opole, 45-060 Opole, Poland
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Paula WO, Gonçalves VSS, Patriota ESO, Franceschini SCC, Pizato N. Impact of Ultra-Processed Food Consumption on Quality of Diet among Brazilian Pregnant Women Assisted in Primary Health Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1015. [PMID: 36673771 PMCID: PMC9859486 DOI: 10.3390/ijerph20021015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 05/14/2023]
Abstract
The quality of diet and nutritional status during pregnancy are crucial to optimize maternal and fetal health. Ultra-processed foods (UPFs) are increasingly prevalent in pregnancy groups despite being nutritionally unbalanced and associated with adverse perinatal outcomes. This cross-sectional study, conducted with data from 229 pregnant women, aimed to investigate the association between UPFs consumption and dietary nutrient intake of pregnant women assisted by Primary Health Care (PHC) in Federal District (DF), Brazil. Food consumption was assessed through two non-consecutive 24-h food records and categorized by the extent of processing using the NOVA classification. Multivariate linear regression models were used to analyze the association between the quintiles of UPF consumption and the total energy and nutrients intake. Mean daily energy intake was 1741 kcal, with 22.6% derived from UPFs. Greater UPF consumption was associated with reduced intake of unprocessed and minimally processed food. The highest quintile of UPFs was positively associated with higher total energy, trans fat, and sodium intake; and inversely associated with the diet content of protein, fiber, iron, magnesium, potassium, copper, zinc, selenium, and folate. Greater UPFs intake negatively impacts the nutritional quality of the diet and impoverishes the nutrient intake of pregnant women. Reducing UPF consumption may broadly improve dietary guidelines adherence in pregnant women and promote maternal and neonatal health.
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Affiliation(s)
- Walkyria O. Paula
- Graduate Program in Human Nutrition, Faculty of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil
| | - Vivian S. S. Gonçalves
- Graduate Program in Public Health, Faculty of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil
| | - Erika S. O. Patriota
- Graduate Program in Public Health, Faculty of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil
| | | | - Nathalia Pizato
- Graduate Program in Human Nutrition, Faculty of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil
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Parisi F, Coco C, Cetin I. Prospective multicentre Italian pregnancy cohort study (SIMPLE) on the associations of maternal first trimester SIMPLE nutritional score with early placental function markers and pregnancy outcomes. BMJ Open 2022; 12:e062940. [PMID: 36288842 PMCID: PMC9615973 DOI: 10.1136/bmjopen-2022-062940] [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] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Currently, the adherence to nutritional guidelines is low, with alarming rates of obesity worldwide and micronutrient deficiencies documented even in industrialised countries. As a consequence, nutritional screening and counselling represent a critical subject in early pregnancy, aiming to improve pregnancy outcomes and population health. METHODS AND ANALYSIS In this setting, the development of a simple and reproducible nutritional checklist is of utmost importance. The Simple Study is a longitudinal prospective multicentre study aiming to identify the associations between maternal nutritional habits in the first trimester, early markers of placental function and pregnancy outcomes on a large population of singleton pregnancies in Italy.Ongoing healthy singleton pregnancies will be enrolled at the ultrasound scan of the first trimester combined screening test (11+0-13+6 gestational weeks). A nutritional score measuring the adherence to a healthy diet and nutritional deficiencies will be collected at recruitment. Fetal (crown-rump length, nuchal translucency (NT), biparietal diameter, femur length) and utero placental (placental volume, uterine arteries Doppler velocimetry) ultrasound data and biochemical placental markers (pregnancy-associated plasma protein A, free ß-human chorionic gonadotropin) will be collected. Second and third trimester ultrasound records and birth outcomes will be recorded from medical registers. This study will set the stage for introducing a reproducible, time-saving and low-cost nutritional screening in pregnancy. The nutritional score will allow the implementation of specific corrective measures with potential large impact on placentation and pregnancy outcomes. ETHICAL AND DISSEMINATION Ethical approval for this study was obtained from the Milano Area 1 Ethics Committee (No 46091, 7 November 2018) prior to the commencement of the research.The dissemination plan includes the presentation of abstracts and findings at national and international scientific meetings.
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Affiliation(s)
- Francesca Parisi
- Obstetrics and Gynecology, Vittore Buzzi Children's Hospital, Milano, Italy
| | - Chiara Coco
- Obstetrics and Gynecology, Vittore Buzzi Children's Hospital, Milano, Italy
| | - Irene Cetin
- Obstetrics and Gynecology, Vittore Buzzi Children's Hospital, Milano, Italy
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Anelli GM, Parisi F, Sarno L, Fornaciari O, Carlea A, Coco C, Porta MD, Mollo N, Villa PM, Guida M, Cazzola R, Troiano E, Pasotti M, Volpi G, Vetrani L, Maione M, Cetin I. Associations between Maternal Dietary Patterns, Biomarkers and Delivery Outcomes in Healthy Singleton Pregnancies: Multicenter Italian GIFt Study. Nutrients 2022; 14:3631. [PMID: 36079896 PMCID: PMC9460547 DOI: 10.3390/nu14173631] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Maternal nutrition represents a critical risk factor for adverse health outcomes in both mother and offspring. We aimed to investigate associations between maternal nutritional habits, biomarker status, and pregnancy outcome among Italian healthy normal-weight pregnancies. Methods: Multicenter prospective cohort study recruiting Italian healthy normal-weight women with singleton spontaneous pregnancies at 20 ± 2 weeks (T1) in Milan and Naples. All patients underwent nutritional evaluations by our collecting a 7-day weighed dietary record at 25 ± 1 weeks (T2) and a Food Frequency Questionnaire at 29 ± 2 weeks (T3). Maternal venous blood samples were collected at T3 to assess nutritional, inflammatory and oxidative biomarker concentrations (RBCs folate, vitamin D, hepcidin, total antioxidant capacity). Pregnancy outcomes were collected at delivery (T4). General linear models adjusted for confounding factors were estimated to investigate associations between maternal dietary pattern adherence, nutrient intakes, biomarker concentrations and delivery outcomes. Results: 219 healthy normal-weight pregnant women were enrolled. Vitamin D and RBCs folate concentrations, as well as micronutrient intakes, were consistently below the recommended range. In a multi-adjusted model, maternal adherence to the most prevalent 'high meat, animal fats, grains' dietary pattern was positively associated with hepcidin concentrations and negatively associated with gestational age at delivery in pregnancies carrying female fetuses. Hepcidin plasma levels were further negatively associated to placental weight, whereas vitamin D concentrations were positively associated to neonatal weight. Conclusions: A high adherence to an unbalanced 'high meat, animal fats, grains' pattern was detected among Italian normal-weight low-risk pregnancies, further associated with maternal pro-inflammatory status and gestational age at delivery. This evidence underlines the need for a dedicated nutritional counseling even among low-risk pregnancies.
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Affiliation(s)
- Gaia Maria Anelli
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy
| | - Francesca Parisi
- Department of Woman, Mother and Child, Luigi Sacco and Vittore Buzzi Children Hospitals, ASST Fatebenefratelli-Sacco, Università degli Studi di Milano, 20154 Milan, Italy
| | - Laura Sarno
- Department of Neurosciences, Reproductive Sciences and Dentistry, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Ottavia Fornaciari
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy
| | - Annunziata Carlea
- Department of Neurosciences, Reproductive Sciences and Dentistry, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Chiara Coco
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy
| | - Matteo Della Porta
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy
| | - Nunzia Mollo
- Department of Molecular Medicine and Medical Biotechnology, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Paola Maria Villa
- Department of Woman, Mother and Child, Luigi Sacco and Vittore Buzzi Children Hospitals, ASST Fatebenefratelli-Sacco, Università degli Studi di Milano, 20154 Milan, Italy
| | - Maurizio Guida
- Department of Neurosciences, Reproductive Sciences and Dentistry, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Roberta Cazzola
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy
| | - Ersilia Troiano
- Nutrition and Dietetics Technical Scientific Association (ASAND), 95128 Catania, Italy
| | - Monica Pasotti
- Nutrition and Dietetics Technical Scientific Association (ASAND), 95128 Catania, Italy
| | - Graziella Volpi
- Nutrition and Dietetics Technical Scientific Association (ASAND), 95128 Catania, Italy
| | - Laura Vetrani
- Nutrition and Dietetics Technical Scientific Association (ASAND), 95128 Catania, Italy
| | - Manuela Maione
- Nutrition and Dietetics Technical Scientific Association (ASAND), 95128 Catania, Italy
| | - Irene Cetin
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy
- Department of Woman, Mother and Child, Luigi Sacco and Vittore Buzzi Children Hospitals, ASST Fatebenefratelli-Sacco, Università degli Studi di Milano, 20154 Milan, Italy
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Schirmbeck GH, Sizonenko S, Sanches EF. Neuroprotective Role of Lactoferrin during Early Brain Development and Injury through Lifespan. Nutrients 2022; 14:2923. [PMID: 35889882 PMCID: PMC9322498 DOI: 10.3390/nu14142923] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/11/2022] [Accepted: 07/15/2022] [Indexed: 12/04/2022] Open
Abstract
Early adverse fetal environments can significantly disturb central nervous system (CNS) development and subsequently alter brain maturation. Nutritional status is a major variable to be considered during development and increasing evidence links neonate and preterm infant impaired brain growth with neurological and psychiatric diseases in adulthood. Breastfeeding is one of the main components required for healthy newborn development due to the many "constitutive" elements breastmilk contains. Maternal intake of specific nutrients during lactation may alter milk composition, thus affecting newborn nutrition and, potentially, brain development. Lactoferrin (Lf) is a major protein present in colostrum and the main protein in human milk, which plays an important role in the benefits of breastfeeding during postnatal development. It has been demonstrated that Lf has antimicrobial, as well as anti-inflammatory properties, and is potentially able to reduce the incidence of sepsis and necrotizing enterocolitis (NEC), which are particularly frequent in premature births. The anti-inflammatory effects of Lf can reduce birth-related pathologies by decreasing the release of pro-inflammatory factors and inhibiting premature cervix maturation (also related to commensal microbiome abnormalities) that could contribute to disrupting brain development. Pre-clinical evidence shows that Lf protects the developing brain from neuronal injury, enhances brain connectivity and neurotrophin production, and decreases inflammation in models of perinatal inflammatory challenge, intrauterine growth restriction (IUGR) and neonatal hypoxia-ischemia (HI). In this context, Lf can provide nutritional support for brain development and cognition and prevent the origin of neuropsychiatric diseases later in life. In this narrative review, we consider the role of certain nutrients during neurodevelopment linking to the latest research on lactoferrin with respect to neonatology. We also discuss new evidence indicating that early neuroprotective pathways modulated by Lf could prevent neurodegeneration through anti-inflammatory and immunomodulatory processes.
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Affiliation(s)
- Gabriel Henrique Schirmbeck
- Biochemistry Post-Graduate Program, Biochemistry Department, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil;
| | - Stéphane Sizonenko
- Division of Child Development and Growth, Department of Pediatrics, School of Medicine, University of Geneva, 1205 Geneva, Switzerland;
| | - Eduardo Farias Sanches
- Division of Child Development and Growth, Department of Pediatrics, School of Medicine, University of Geneva, 1205 Geneva, Switzerland;
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Lisso F, Massari M, Gentilucci M, Novielli C, Corti S, Nelva Stellio L, Milazzo R, Troiano E, Schaefer E, Cetin I, Mandò C. Longitudinal Nutritional Intakes in Italian Pregnant Women in Comparison with National Nutritional Guidelines. Nutrients 2022; 14:1944. [PMID: 35565911 PMCID: PMC9101748 DOI: 10.3390/nu14091944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Nutritional quality during pregnancy is crucial for mother and child health and their short/long-term outcomes. The aim of this study is to evaluate the adherence to nutritional recommendations in Italy during the three pregnancy trimesters in Normal Weight (NW) and Over Weight (OW) women. METHODS Data from a multicenter randomized controlled trial included 176 women (NW = 133; OW = 43) with healthy singleton pregnancies enrolled within 13 + 6 weeks of gestation. Dietary intake was assessed every trimester by a Food Frequency Questionnaire. RESULTS OW and NW had similar gestational weight gain. However, as Institute of Medicine (IOM) recommend lower gestational weight gain (GWG) for OW, they exceeded the suggested range. In both groups, caloric intake during the three trimesters never met recommendations. Protein intake in first and second trimester was higher than recommendations, as was sugars percentage. Dietary fiber intake was lower in OW. Polyunsaturated fatty acids, calcium, iron and folic acid requirements were never satisfied, while sodium intake exceeded recommendations. CONCLUSIONS NW and OW women in Italy do not adhere to nutritional recommendations during pregnancy, with lower caloric intake, protein and sugars excess and inadequacies in micronutrients intake. Pregnant women in Italy should be provided with an adequate counseling and educational intervention as well as supplementation when indicated.
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Affiliation(s)
- Fabrizia Lisso
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy; (F.L.); (C.N.); (I.C.)
| | - Maddalena Massari
- Department of Woman, Mother and Neonate, “V. Buzzi” Children Hospital, ASST Fatebenefratelli Sacco, 20154 Milan, Italy; (M.M.); (S.C.); (L.N.S.); (R.M.)
| | - Micaela Gentilucci
- Department of Woman, Mother and Neonate, “L. Sacco” Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, Italy;
| | - Chiara Novielli
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy; (F.L.); (C.N.); (I.C.)
| | - Silvia Corti
- Department of Woman, Mother and Neonate, “V. Buzzi” Children Hospital, ASST Fatebenefratelli Sacco, 20154 Milan, Italy; (M.M.); (S.C.); (L.N.S.); (R.M.)
| | - Leonardo Nelva Stellio
- Department of Woman, Mother and Neonate, “V. Buzzi” Children Hospital, ASST Fatebenefratelli Sacco, 20154 Milan, Italy; (M.M.); (S.C.); (L.N.S.); (R.M.)
| | - Roberta Milazzo
- Department of Woman, Mother and Neonate, “V. Buzzi” Children Hospital, ASST Fatebenefratelli Sacco, 20154 Milan, Italy; (M.M.); (S.C.); (L.N.S.); (R.M.)
| | - Ersilia Troiano
- Nutrition and Dietetics Technical Scientific Association-ASAND, 90144 Palermo, Italy;
| | | | - Irene Cetin
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy; (F.L.); (C.N.); (I.C.)
- Department of Woman, Mother and Neonate, “V. Buzzi” Children Hospital, ASST Fatebenefratelli Sacco, 20154 Milan, Italy; (M.M.); (S.C.); (L.N.S.); (R.M.)
| | - Chiara Mandò
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy; (F.L.); (C.N.); (I.C.)
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Framework of Methodology to Assess the Link between A Posteriori Dietary Patterns and Nutritional Adequacy: Application to Pregnancy. Metabolites 2022; 12:metabo12050395. [PMID: 35629899 PMCID: PMC9148035 DOI: 10.3390/metabo12050395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 02/07/2023] Open
Abstract
This study aimed to explore the nutritional profile of 608 women during the second trimester of pregnancy, in terms of nutrient patterns, dietary quality and nutritional adequacy. Dietary data were collected using a validated Mediterranean-oriented, culture-specific FFQ. Principal component analysis was performed on 18 energy-adjusted nutrients. Two main nutrient patterns, “plant-origin” (PLO) and “animal-origin” (ANO), were extracted. Six homogenous clusters (C) relative to nutrient patterns were obtained and analyzed through a multidimensional methodological approach. C1, C5 and C6 scored positively on PLO, while C1, C2 and C3 scored positively on ANO. When dietary quality was mapped on food choices and dietary indexes, C6 unveiled a group with a distinct image resembling the Mediterranean-type diet (MedDiet Score = 33.8). Although C1–C5 shared common dietary characteristics, their diet quality differed as reflected in the HEI-2010 (C1:79.7; C2:73.3; C3:70.9; C4:63.2; C5:76.6). The appraisal of nutritional adequacy mirrored a “nutritional-quality gradient”. A total of 50% of participants in C6 had almost 100% adequate magnesium intake, while 50% of participants in C4 had a probability of adequacy of ≤10%. Our methodological framework is efficient for assessing the link between a posteriori dietary patterns and nutritional adequacy during pregnancy. Given that macro- and micronutrient distributions may induce metabolic modifications of potential relevance to offspring’s health, public health strategies should be implemented.
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Xiang C, Luo J, Yang G, Sun M, Liu H, Yang Q, Ouyang Y, Xi Y, Yong C, Khan MJ, Lin Q. Dietary Supplement Use during Pregnancy: Perceptions versus Reality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074063. [PMID: 35409746 PMCID: PMC8998507 DOI: 10.3390/ijerph19074063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 02/01/2023]
Abstract
This study aimed to examine the prevalence, associated factors and perceptions of dietary supplement use among pregnant Chinese women. A cross-sectional study was conducted to collect data about prevalence, purchase channels, perceptions, and related factors of dietary supplement use from 572 pregnant women, through a face-to-face survey, using a self-designed questionnaire. Of the respondents, 94.8% used at least one dietary supplement, whereas 29.8% used more than four supplements in the previous month. The majority of the pregnant women were highly educated (81.2% had a bachelor’s degree or above) and had the perception that dietary supplements could prevent and improve (89.2%), or treat, nutrition-related diseases (78.7%). Multivariate analysis showed that pregnant women who had used multiple (more than four) supplements were more likely to have a larger gestational age, received fertility treatment, more prenatal visits, and hypothyroidism during pregnancy. Furthermore, pregnant women not only purchased dietary supplements through hospitals (72.6%) and pharmacies (45.1%), but overseas Daigou or online purchases (31.8%) were also a major channel of purchase. A high prevalence of dietary supplement use during pregnancy was observed, with extensive and repeated consumption of nutrients. Pregnant women’s craze for dietary supplements calls for more comprehensive guidelines in China.
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Affiliation(s)
- Caihong Xiang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
| | - Jing Luo
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
| | - Guilian Yang
- Department of Women Health, Hunan Maternal and Child Health Care Hospital, 53 Xiangchun Road, Changsha 410008, China;
| | - Minghui Sun
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
| | - Hanmei Liu
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
| | - Qiping Yang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
| | - Yufeng Ouyang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK
| | - Yue Xi
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
| | - Cuiting Yong
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
| | - Muhammad Jamal Khan
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
| | - Qian Lin
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China; (C.X.); (J.L.); (M.S.); (H.L.); (Q.Y.); (Y.O.); (Y.X.); (C.Y.); (M.J.K.)
- Correspondence: ; Tel.: +86-138-7482-0173
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Tsakoumaki F, Kyrkou C, Athanasiadis AP, Menexes G, Michaelidou AM. Nutritional Inadequacy: Unraveling the Methodological Challenges for the Application of the Probability Approach or the EAR Cut-Point Method-A Pregnancy Perspective. Nutrients 2021; 13:3473. [PMID: 34684473 PMCID: PMC8538604 DOI: 10.3390/nu13103473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/20/2021] [Accepted: 09/28/2021] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to unravel the methodological challenges when exploring nutritional inadequacy, involving 608 healthy pregnant women. The usual intake of twenty-one nutrients was recorded by employing a validated FFQ. Simulated datasets of usual intake were generated, with randomly imposed uncertainty. The comparison between the usual intake and the EAR was accomplished with the probability approach and the EAR cut-point method. Point estimates were accompanied by bootstrap confidence intervals. Bootstrap intervals applied on the risk of inadequacy for raw and simulated data tended in most cases to overlap. A detailed statistical analysis, aiming to predict the level of inadequacy, as well as the application of the EAR cut-point method, along with bootstrap intervals, could effectively be used to assess nutrient inadequacy. However, the final decision for the method used depends on the distribution of nutrient-intake under evaluation. Irrespective of the applied methodology, moderate to high levels of inadequacy, calculated from FFQ were identified for certain nutrients (e.g., vitamins C, B6, magnesium, vitamin A), while the highest were recorded for folate and iron. Considering that micronutrient-poor, obesogenic diets are becoming more common, the underlying rationale may help towards unraveling the complexity characterizing nutritional inadequacies, especially in vulnerable populations.
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Affiliation(s)
- Foteini Tsakoumaki
- Department of Food Science and Technology, School of Agriculture, Faculty of Agriculture, Forestry and Natural Environment, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (F.T.); (C.K.)
| | - Charikleia Kyrkou
- Department of Food Science and Technology, School of Agriculture, Faculty of Agriculture, Forestry and Natural Environment, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (F.T.); (C.K.)
| | - Apostolos P. Athanasiadis
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece;
| | - Georgios Menexes
- Department of Field Crops and Ecology, School of Agriculture, Faculty of Agriculture, Forestry and Natural Environment, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece;
| | - Alexandra-Maria Michaelidou
- Department of Food Science and Technology, School of Agriculture, Faculty of Agriculture, Forestry and Natural Environment, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (F.T.); (C.K.)
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Kibr G. A Narrative Review of Nutritional Malpractices, Motivational Drivers, and Consequences in Pregnant Women: Evidence from Recent Literature and Program Implications in Ethiopia. ScientificWorldJournal 2021; 2021:5580039. [PMID: 34248425 PMCID: PMC8236338 DOI: 10.1155/2021/5580039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/27/2021] [Accepted: 06/08/2021] [Indexed: 11/17/2022] Open
Abstract
Maternal nutrition is very important for the wellbeing of pregnant women, childbirth, and lactating women, which are crucial and meant for the wellbeing of a mother and newborn baby. This narrative review discusses nutritional malpractices, motivational drivers, and their consequences typically from Ethiopian pregnant women's context. Different studies (regarding less of study design and type) done among pregnant women (aged 15-49 years) by considering pregnancy-related outcomes and timing of nutritional malpractices were included mostly. Accordingly, taboos of healthy diets, craving for unhealthy foods (sweet, fat, raw, and salty/spicy foods), and nonfood items (soil, coffee residue, stone, and ash) were practiced majorly by the women. The birth difficulty, fetal head plastering, fetus discoloration, fetus burns, abortion, and abdominal cramp are the primary drivers of taboos of healthy diets. Hormonal change and social and nutrient-seeking behavior are the most prevalent drivers to the consumption of unhealthy foods. Additionally, personal interest, flavor, and color of items are important motivators to practice pica. Such pica practice hurts nutrient intake, absorption of iron/zinc, abdominal health, and diarrhea occurrence. Food taboos are high predictors of health disorders, such as intrauterine growth restriction, infection, bleeding, preeclampsia, stillbirth, early birth, low birth weight, retarded development of cognitive, and anemia. Craving and eating unhealthy foods were interconnected with chronic disease development (hypertension, diabetes, heart disease, and cancer), discomforts, preterm labor, preeclampsia, and intrauterine growth restriction in women. Additionally, it is also associated with stillbirth, low birth weight, obesity, birth defect/deficit, hypertension, cancer, diabetes, metabolic syndrome, renal disease, decreased fetal growth, behavioral change, heart failure, and poor cognitive development in the infant. Overall, these nutritional malpractices are significantly associated with many argumentative pregnancies as well as developmental consequences leading to the direction of infant and maternal mortality and morbidity. Therefore, urgent implementation of health and nutrition education programs considering food misconceptions and beliefs regarding pregnancy and use of ground-breaking ways to play down the negative and maximize potential positive dietary effects designed by the government of Ethiopia could also serve as a long-term solution to the problem.
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Affiliation(s)
- Gesessew Kibr
- Department of Food and Nutritional Sciences, Faculty of Agriculture, Shambu Campus, Wollega University, P. O. Box: 38, Shambu, Ethiopia
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Oxidative Stress at Birth Is Associated with the Concentration of Iron and Copper in Maternal Serum. Nutrients 2021; 13:nu13051491. [PMID: 33924889 PMCID: PMC8145844 DOI: 10.3390/nu13051491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 04/23/2021] [Accepted: 04/25/2021] [Indexed: 11/30/2022] Open
Abstract
Oxidative stress (OS) in the foetal and neonatal periods leads to many disorders in newborns and in later life. The nutritional status of pregnant women is considered to be one of the key factors that triggers OS. We investigated the relationship between the concentration of selected mineral elements in the blood of pregnant women and the concentration of 3′nitrotyrosine (3′NT) as a marker of OS in the umbilical cord blood of newborns. The study group consisted of 57 pregnant women and their newborn children. The concentrations of magnesium (Mg), calcium (Ca), iron (Fe), zinc (Zn) and copper (Cu) in maternal serum (MS) were measured by the flame atomic absorption/emission spectrometry (FAAS/FAES) method. The concentration of 3′NT in umbilical cord serum (UCS) of newborns was determined by the ELISA method. A positive correlation between MS Fe and UCS 3′NT in male newborns was shown (rho = 0.392, p = 0.053). Significantly higher UCS 3′NT was demonstrated in newborns, especially males, whose mothers were characterized by MS Fe higher than 400 μg/dL compared to those of mothers with MS Fe up to 300 μg/dL (p < 0.01). Moreover, a negative correlation between the MS Cu and UCS 3′NT in male newborns was observed (rho = −0.509, p = 0.008). Results of the study showed the need to develop strategies to optimize the nutritional status of pregnant women. Implementation of these strategies could contribute to reducing the risk of pre- and neonatal OS and its adverse health effects in the offspring.
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Paffoni A, Reschini M, Noli SA, Viganò P, Parazzini F, Somigliana E. Folate Levels and Pregnancy Rate in Women Undergoing Assisted Reproductive Techniques: a Systematic Review and Meta-analysis. Reprod Sci 2021; 29:341-356. [DOI: 10.1007/s43032-021-00467-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 01/11/2021] [Indexed: 12/29/2022]
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Bordeleau M, Fernández de Cossío L, Chakravarty MM, Tremblay MÈ. From Maternal Diet to Neurodevelopmental Disorders: A Story of Neuroinflammation. Front Cell Neurosci 2021; 14:612705. [PMID: 33536875 PMCID: PMC7849357 DOI: 10.3389/fncel.2020.612705] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/07/2020] [Indexed: 12/13/2022] Open
Abstract
Providing the appropriate quantity and quality of food needed for both the mother's well-being and the healthy development of the offspring is crucial during pregnancy. However, the macro- and micronutrient intake also impacts the body's regulatory supersystems of the mother, such as the immune, endocrine, and nervous systems, which ultimately influence the overall development of the offspring. Of particular importance is the association between unhealthy maternal diet and neurodevelopmental disorders in the offspring. Epidemiological studies have linked neurodevelopmental disorders like autism spectrum disorders, attention-deficit-hyperactivity disorder, and schizophrenia, to maternal immune activation (MIA) during gestation. While the deleterious consequences of diet-induced MIA on offspring neurodevelopment are increasingly revealed, neuroinflammation is emerging as a key underlying mechanism. In this review, we compile the evidence available on how the mother and offspring are both impacted by maternal dietary imbalance. We specifically explore the various inflammatory and anti-inflammatory effects of dietary components and discuss how changes in inflammatory status can prime the offspring brain development toward neurodevelopmental disorders. Lastly, we discuss research evidence on the mechanisms that sustain the relationship between maternal dietary imbalance and offspring brain development, involving altered neuroinflammatory status in the offspring, as well as genetic to cellular programming notably of microglia, and the evidence that the gut microbiome may act as a key mediator.
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Affiliation(s)
- Maude Bordeleau
- Integrated Program in Neuroscience, McGill University, Montréal, QC, Canada
- Axe Neurosciences, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | | | - M. Mallar Chakravarty
- Integrated Program in Neuroscience, McGill University, Montréal, QC, Canada
- Cerebral Imaging Centre, Douglas Mental Health University, McGill University, Montréal, QC, Canada
- Department of Psychiatry, McGill University, Montréal, QC, Canada
- Department of Biological and Biomedical Engineering, McGill University, Montréal, QC, Canada
| | - Marie-Ève Tremblay
- Axe Neurosciences, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Département de Médecine Moléculaire, Université Laval, Québec, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Biochemistry and Molecular Biology, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
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Schaefer E, Demmelmair H, Horak J, Holdt L, Grote V, Maar K, Neuhofer C, Teupser D, Thiel N, Goeckeler-Leopold E, Maggini S, Koletzko B. Multiple Micronutrients, Lutein, and Docosahexaenoic Acid Supplementation during Lactation: A Randomized Controlled Trial. Nutrients 2020; 12:E3849. [PMID: 33339438 PMCID: PMC7765837 DOI: 10.3390/nu12123849] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/10/2020] [Accepted: 12/14/2020] [Indexed: 01/28/2023] Open
Abstract
Breastfed infants require an adequate supply of critical nutrients for growth, tissue functions, and health. Recommended intakes for several nutrients are considerably higher in lactating than non-lactating women but are not always met with habitual diets. We report a randomized, double-blind clinical trial in 70 healthy lactating women in Germany evaluating the effects of supplementation with multiple micronutrients, lutein, and docosahexaenoic acid (DHA) compared to placebo on maternal nutrient status and milk composition. The primary endpoint was the effect on the change of human milk DHA content (as a proportion of total milk fatty acids) during 12 weeks of supplementation. Maternal blood and milk biomarkers were measured as secondary endpoints. Supplementation increased maternal milk DHA by 30% compared to a decline in the placebo group. Supplementation also increased maternal blood DHA (17%), eicosapentaenoic acid (4%), 25-OH-vitamin D (24%), vitamin B12 (12%), lutein (4%), and beta carotene (49%), while homocysteine decreased. No significant difference in the number of adverse events was observed between supplementation and placebo groups. In conclusion, multi-micronutrient supplementation was safe and increased maternal blood and milk concentrations of selected nutrients in healthy women.
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Affiliation(s)
- Ella Schaefer
- Bayer Consumer Care AG, Peter-Merian-Straße 84, 4002 Basel, Switzerland;
| | - Hans Demmelmair
- Department Paediatrics, Division Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, LMU University Hospitals, Ludwig-Maximilians-Universität Munich, Lindwurmstraße 4, 80337 Munich, Germany; (H.D.); (J.H.); (V.G.); (B.K.)
| | - Jeannie Horak
- Department Paediatrics, Division Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, LMU University Hospitals, Ludwig-Maximilians-Universität Munich, Lindwurmstraße 4, 80337 Munich, Germany; (H.D.); (J.H.); (V.G.); (B.K.)
| | - Lesca Holdt
- Institute of Laboratory Medicine, LMU University Hospitals, Ludwig-Maximilians-Universität Munich, Marchioninistraße 15, 81377 Munich, Germany; (L.H.); (D.T.)
| | - Veit Grote
- Department Paediatrics, Division Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, LMU University Hospitals, Ludwig-Maximilians-Universität Munich, Lindwurmstraße 4, 80337 Munich, Germany; (H.D.); (J.H.); (V.G.); (B.K.)
| | - Karoline Maar
- Gynecology & Obstetrics Specialist, Schloßstraße 2, 13507 Berlin, Germany;
| | - Christoph Neuhofer
- Gynecology & Obstetrics Specialist, Marienplatz 4, 85354 Freising, Germany; (C.N.); (N.T.)
| | - Daniel Teupser
- Institute of Laboratory Medicine, LMU University Hospitals, Ludwig-Maximilians-Universität Munich, Marchioninistraße 15, 81377 Munich, Germany; (L.H.); (D.T.)
| | - Nadja Thiel
- Gynecology & Obstetrics Specialist, Marienplatz 4, 85354 Freising, Germany; (C.N.); (N.T.)
| | | | - Silvia Maggini
- Bayer Consumer Care AG, Peter-Merian-Straße 84, 4002 Basel, Switzerland;
| | - Berthold Koletzko
- Department Paediatrics, Division Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, LMU University Hospitals, Ludwig-Maximilians-Universität Munich, Lindwurmstraße 4, 80337 Munich, Germany; (H.D.); (J.H.); (V.G.); (B.K.)
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Habibi N, Grieger JA, Bianco-Miotto T. A Review of the Potential Interaction of Selenium and Iodine on Placental and Child Health. Nutrients 2020; 12:nu12092678. [PMID: 32887377 PMCID: PMC7551633 DOI: 10.3390/nu12092678] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/28/2020] [Accepted: 08/28/2020] [Indexed: 12/12/2022] Open
Abstract
A healthy pregnancy is important for the growth and development of a baby. An adverse pregnancy outcome is associated with increased chronic disease risk for the mother and offspring. An optimal diet both before and during pregnancy is essential to support the health of the mother and offspring. A key mediator of the effect of maternal nutrition factors on pregnancy outcomes is the placenta. Complicated pregnancies are characterized by increased oxidative stress in the placenta. Selenium and iodine are micronutrients that are involved in oxidative stress in placental cells. To date, there has been no comprehensive review investigating the potential synergistic effect of iodine and selenium in the placenta and how maternal deficiencies may be associated with increased oxidative stress and hence adverse pregnancy outcomes. We undertook a hypothesis-generating review on selenium and iodine, to look at how they may relate to pregnancy complications through oxidative stress. We propose how they may work together to impact pregnancy and placental health and explore how deficiencies in these micronutrients during pregnancy may impact the future health of offspring.
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Affiliation(s)
- Nahal Habibi
- School of Agriculture, Food and Wine, Waite Research Institute, and Robinson Research Institute, University of Adelaide, Adelaide 5005, Australia;
| | - Jessica A. Grieger
- Adelaide Medical School, and Robinson Research Institute, University of Adelaide, Adelaide 5005, Australia
- Correspondence: (J.A.G.); (T.B.-M.)
| | - Tina Bianco-Miotto
- School of Agriculture, Food and Wine, Waite Research Institute, and Robinson Research Institute, University of Adelaide, Adelaide 5005, Australia;
- Correspondence: (J.A.G.); (T.B.-M.)
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Massari M, Novielli C, Mandò C, Di Francesco S, Della Porta M, Cazzola R, Panteghini M, Savasi V, Maggini S, Schaefer E, Cetin I. Multiple Micronutrients and Docosahexaenoic Acid Supplementation during Pregnancy: A Randomized Controlled Study. Nutrients 2020; 12:E2432. [PMID: 32823606 PMCID: PMC7468952 DOI: 10.3390/nu12082432] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/08/2020] [Accepted: 08/11/2020] [Indexed: 12/15/2022] Open
Abstract
Maternal dietary intake during pregnancy needs to meet increased nutritional demands to maintain metabolism and to support fetal development. Docosahexaenoic acid (DHA) is essential for fetal neuro-/visual development and in immunomodulation, accumulating rapidly within the developing brain and central nervous system. Levels available to the fetus are governed by the maternal diet. In this multicenter, parallel, randomized controlled trial, we evaluated once-daily supplementation with multiple micronutrients and DHA (i.e., multiple micronutrient supplementation, MMS) on maternal biomarkers and infant anthropometric parameters during the second and third trimesters of pregnancy compared with no supplementation. Primary efficacy endpoint: change in maternal red blood cell (RBC) DHA (wt% total fatty acids) during the study. Secondary variables: other biomarkers of fatty acid and oxidative status, vitamin D, and infant anthropometric parameters at delivery. Supplementation significantly increased RBC DHA levels, the omega-3 index, and vitamin D levels. Subscapular skinfold thickness was significantly greater with MMS in infants. Safety outcomes were comparable between groups. This first randomized controlled trial of supplementation with multiple micronutrients and DHA in pregnant women indicated that MMS significantly improved maternal DHA and vitamin D status in an industrialized setting-an important finding considering the essential roles of DHA and vitamin D.
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Affiliation(s)
- Maddalena Massari
- Department of Woman, Mother and Neonate, Buzzi Children Hospital, ASST Fatebenefratelli Sacco, 20154 Milan, Italy; (M.M.); (S.D.F.); (I.C.)
- Department of Woman, Mother and Neonate, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, Italy;
- “Luigi Sacco” Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, 20157 Milan, Italy; (C.N.); (C.M.); (M.D.P.); (R.C.); (M.P.)
| | - Chiara Novielli
- “Luigi Sacco” Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, 20157 Milan, Italy; (C.N.); (C.M.); (M.D.P.); (R.C.); (M.P.)
| | - Chiara Mandò
- “Luigi Sacco” Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, 20157 Milan, Italy; (C.N.); (C.M.); (M.D.P.); (R.C.); (M.P.)
| | - Stefania Di Francesco
- Department of Woman, Mother and Neonate, Buzzi Children Hospital, ASST Fatebenefratelli Sacco, 20154 Milan, Italy; (M.M.); (S.D.F.); (I.C.)
| | - Matteo Della Porta
- “Luigi Sacco” Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, 20157 Milan, Italy; (C.N.); (C.M.); (M.D.P.); (R.C.); (M.P.)
| | - Roberta Cazzola
- “Luigi Sacco” Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, 20157 Milan, Italy; (C.N.); (C.M.); (M.D.P.); (R.C.); (M.P.)
| | - Mauro Panteghini
- “Luigi Sacco” Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, 20157 Milan, Italy; (C.N.); (C.M.); (M.D.P.); (R.C.); (M.P.)
| | - Valeria Savasi
- Department of Woman, Mother and Neonate, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, Italy;
- “Luigi Sacco” Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, 20157 Milan, Italy; (C.N.); (C.M.); (M.D.P.); (R.C.); (M.P.)
| | | | | | - Irene Cetin
- Department of Woman, Mother and Neonate, Buzzi Children Hospital, ASST Fatebenefratelli Sacco, 20154 Milan, Italy; (M.M.); (S.D.F.); (I.C.)
- Department of Woman, Mother and Neonate, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, 20157 Milan, Italy;
- “Luigi Sacco” Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, 20157 Milan, Italy; (C.N.); (C.M.); (M.D.P.); (R.C.); (M.P.)
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20
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Suliburska J, Skrypnik K, Chmurzyńska A. Folic Acid Affects Iron Status in Female Rats with Deficiency of These Micronutrients. Biol Trace Elem Res 2020; 195:551-558. [PMID: 31512172 PMCID: PMC7176598 DOI: 10.1007/s12011-019-01888-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 08/27/2019] [Indexed: 02/07/2023]
Abstract
Although simultaneous supplementation with iron and folic acid is justified, the potential interactions between these micronutrients are unknown. The aim of this study was to determine the effects of oral iron and folic acid, administered together or separately, on iron concentration in tissues in rats with a deficiency of both these micronutrients. In the first stage of the experiment (28 days), 150 8-week-old female Wistar rats were randomly assigned to a control group (C; n = 30) fed the standard diet and to a study group (n = 120) fed a diet deficit in iron and folate. The study group was then randomly divided to four groups: D group fed a deficit diet, FE group fed a deficit diet with iron gluconate, the FOL group fed a deficit diet with folate acid, and the FEFOL group fed a deficit diet with iron gluconate and folate acid. After 2, 10, and 21 days of supplementation, ten animals from each group were killed. Morphological parameters were measured in whole blood. Iron concentration was assayed in serum, liver, spleen, pancreas, heart, and kidneys. Folic acid supplementation more significantly decreased iron concentrations in the pancreas and spleen than in the D group after 10 and 21 days of supplementation. Moreover, the combination of iron with folic acid markedly decreased iron levels in the liver and spleen, in comparison with iron alone, after 10 and 21 days of the experiment. In conclusion, folic acid affects iron status in female rats deficient in these micronutrients in moderate and long-term supplementation.
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Affiliation(s)
- Joanna Suliburska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Wojska Polskiego St. 31, 60-624, Poznan, Poland.
| | - Katarzyna Skrypnik
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Wojska Polskiego St. 31, 60-624, Poznan, Poland
| | - Agata Chmurzyńska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Wojska Polskiego St. 31, 60-624, Poznan, Poland
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21
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Saunders CM, Rehbinder EM, Carlsen KCL, Gudbrandsgard M, Carlsen KH, Haugen G, Hedlin G, Jonassen CM, Sjøborg KD, Landrø L, Nordlund B, Rudi K, O Skjerven H, Söderhäll C, Staff AC, Vettukattil R, Carlsen MH. Food and nutrient intake and adherence to dietary recommendations during pregnancy: a Nordic mother-child population-based cohort. Food Nutr Res 2019; 63:3676. [PMID: 31920469 PMCID: PMC6939665 DOI: 10.29219/fnr.v63.3676] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 12/21/2022] Open
Abstract
Background A woman's food intake during pregnancy has important implications not only for herself but also for the future health and well-being of her child. Suboptimal dietary quality has been consistently reported in many high-income countries, reflecting poor adherence to dietary guidelines. Objective This study aimed to explore the intake of food and nutrients in a cohort of pregnant women in Norway and their adherence to Nordic Nutrition Recommendations (NNR) and Norwegian food-based guidelines (NFG). Design We investigated the dietary intake in 1,674 pregnant women from the mother-child birth cohort, PreventADALL, recruited at approximately 18-week gestational age. Dietary intake was assessed by an electronic validated food frequency questionnaire (PrevFFQ) in the first half of pregnancy. Results Total fat intake was within the recommended intake (RI) range in most women; however, the contribution of saturated fatty acids to the total energy intake was above RI in the majority (85.2%) of women. Carbohydrate intake was below RI in 43.9% of the women, and 69.5% exceeded the RI of salt. Intakes of fiber, vegetables, and fish were high in a large part of the population. Many women had a high probability of inadequate intakes of the following key micronutrients during pregnancy: folate (54.4%), iron (49.6%), calcium (36.2%), vitamin D (28.7%), iodine (24.4%), and selenium (41.3%). A total of 22.8% women reported an alcohol intake of >1 g/day, and 4.4% reported an alcohol intake of >10 g/day. Women with higher educational levels showed a tendency towards healthier eating habits, except for higher intakes of alcohol and coffee, compared to women with lower educational level. Discussion Excessive saturated fat intake and limited intake of many important micronutrients during pregnancy were common, potentially increasing the risk for adverse pregnancy and birth outcomes. Conclusions This study highlights the need for improved nutritional guidance to pregnant women across all educational levels.
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Affiliation(s)
- Carina Madelen Saunders
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Eva Maria Rehbinder
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - Karin C Lødrup Carlsen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Malén Gudbrandsgard
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Kai-Håkon Carlsen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Guttorm Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Christine Monceyron Jonassen
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway.,Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | | | - Linn Landrø
- Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Håvard O Skjerven
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Cilla Söderhäll
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Anne Cathrine Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Riyas Vettukattil
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Monica Hauger Carlsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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Computer-based tailored dietary counselling improves the nutrient adequacy of the diet of French pregnant women: a randomised controlled trial. Br J Nutr 2019; 123:220-231. [PMID: 31625483 DOI: 10.1017/s0007114519002617] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
During pregnancy, mothers-to-be should adapt their diet to meet increases in nutrient requirements. Pregnant women appear to be keener to adopt healthier diets, but are not always successful. The objective of the present study was to determine whether a guided, stepwise and tailored dietary counselling programme, designed using an optimisation algorithm, could improve the nutrient adequacy of the diet of pregnant women, beyond generic guidelines. Pregnant women (n 80) who attended Notre-Dame-de-Bon-Secours Maternity Clinic were randomly allocated to the control or intervention arm. Dietary data were obtained twice from an online 3-d dietary record. The nutrient adequacy of the diet was calculated using the PANDiet score, a 100-point diet quality index adapted to the specific nutrient requirements for pregnancy. Women were supplied with generic dietary guidelines in a reference booklet. In the intervention arm, they also received nine sets of tailored dietary advice identified by an optimisation algorithm as best improving their PANDiet score. Pregnant women (n 78) completed the 12-week dietary follow-up. Initial PANDiet scores were similar in the control and intervention arms (60·4 (sd 7·3) v. 60·3 (sd 7·3), P = 0·92). The PANDiet score increased in the intervention arm (+3·6 (sd 9·3), P = 0·02) but not in the control arm (-0·3 (sd 7·3), P = 0·77), and these changes differed between arms (P = 0·04). In the intervention arm, there were improvements in the probabilities of adequacy for α-linolenic acid, thiamin, folate and cholesterol intakes (P < 0·05). Tailored dietary counselling using a computer-based algorithm is more effective than generic dietary counselling alone in improving the nutrient adequacy of the diet of French women in mid-pregnancy.
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23
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Parisi F, di Bartolo I, Savasi VM, Cetin I. Micronutrient supplementation in pregnancy: Who, what and how much? Obstet Med 2019; 12:5-13. [PMID: 30891086 PMCID: PMC6416688 DOI: 10.1177/1753495x18769213] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 03/05/2018] [Indexed: 12/22/2022] Open
Abstract
Pregnancy represents a period of major physiological and metabolic change, aiming to ensure proper fetal growth and development, as well as maternal preservation. This review focuses on maternal nutrition, and particularly on micronutrient deficiencies and supplementation during pregnancy. Nutrient deficiencies and consequences in pregnant women are presented, with an overview of current recommendations for dietary supplementation in pregnancy, even considering the risk of micronutrient overload. Appropriate universal supplementation and prophylaxis/treatment of nutritional needs currently appear to be the most cost-effective goal in low-income countries, thus ensuring adequate intake of key elements including folate, iron, calcium, vitamin D and A. In high-income countries, a proper nutritional assessment and counselling should be mandatory in obstetric care in order to normalize pregestational body mass index, choose a healthy dietary pattern and evaluate the risk of deficiencies.
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Affiliation(s)
- F Parisi
- Center for Fetal Research Giorgio Pardi, Department
of Biomedical and Clinical Sciences, Università degli Studi di Milano, Hospital
Luigi Sacco, Unit of Obstetrics and Gynecology, Milan, Italy
| | - I di Bartolo
- Center for Fetal Research Giorgio Pardi, Department
of Biomedical and Clinical Sciences, Università degli Studi di Milano, Hospital
Luigi Sacco, Unit of Obstetrics and Gynecology, Milan, Italy
| | - VM Savasi
- Center for Fetal Research Giorgio Pardi, Department
of Biomedical and Clinical Sciences, Università degli Studi di Milano, Hospital
Luigi Sacco, Unit of Obstetrics and Gynecology, Milan, Italy
| | - I Cetin
- Center for Fetal Research Giorgio Pardi, Department
of Biomedical and Clinical Sciences, Università degli Studi di Milano, Hospital
Luigi Sacco, Unit of Obstetrics and Gynecology, Milan, Italy
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24
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Supplement Use and Dietary Sources of Folate, Vitamin D, and n-3 Fatty Acids during Preconception: The GLIMP2 Study. Nutrients 2018; 10:nu10080962. [PMID: 30046020 PMCID: PMC6115753 DOI: 10.3390/nu10080962] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 02/06/2023] Open
Abstract
An adequate nutritional status during the preconception period is important, particularly for folate, vitamin D, and n-3 fatty acids (i.e., EPA+DHA). We aimed to determine supplement intake and the main dietary sources of folate, vitamin D, and EPA+DHA using the data of 66 Dutch women aged 18–40 years who wished to become pregnant. Additionally, associations of these intakes with their blood levels were examined. Dietary intake was assessed with a validated food frequency questionnaire, and supplement use with a structured questionnaire. 25-hydroxyvitamin D levels were determined in serum and folate and phospholipid EPA+DHA levels in plasma. Partial Spearman’s correlations, restricted cubic splines and trend analyses over tertiles of nutrient intakes were performed to examine intake-status associations. A large proportion of women did not meet the Dutch recommended intakes of folate (50%), vitamin D (67%), and EPA+DHA (52%). Vegetables were the main contributor to dietary folate intake (25%), oils and fats to dietary vitamin D intake (39%), and fish to dietary EPA+DHA intake (69%). Fourteen percent of the women had an inadequate folate status and 23% an inadequate vitamin D status. Supplemental folate intake, supplemental and dietary vitamin D intake and dietary EPA+DHA intake were significantly associated with their blood levels. In conclusion, even in our highly educated population, a large proportion did not achieve recommended folate, vitamin D and n-3 fatty acid intakes. Promotion of folate and vitamin D supplement use and fish consumption is needed to improve intakes and blood levels of these nutrients in women who wish to become pregnant.
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Ernährung und Nahrungsergänzungsmittel bei Kinderwunsch. GYNAKOLOGISCHE ENDOKRINOLOGIE 2018. [DOI: 10.1007/s10304-018-0181-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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26
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Singh A, Trumpff C, Genkinger J, Davis A, Spann M, Werner E, Monk C. Micronutrient Dietary Intake in Latina Pregnant Adolescents and Its Association with Level of Depression, Stress, and Social Support. Nutrients 2017; 9:E1212. [PMID: 29113038 PMCID: PMC5707684 DOI: 10.3390/nu9111212] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 10/26/2017] [Accepted: 11/01/2017] [Indexed: 12/03/2022] Open
Abstract
Adolescent pregnant women are at greater risk for nutritional deficits, stress, and depression than their adult counterparts, and these risk factors for adverse pregnancy outcomes are likely interrelated. This study evaluated the prevalence of nutritional deficits in pregnant teenagers and assessed the associations among micronutrient dietary intake, stress, and depression. One hundred and eight pregnant Latina adolescents completed an Automated Self-Administered 24-hour dietary recall (ASA24) in the 2nd trimester. Stress was measured using the Perceived Stress Scale and the Prenatal Distress Questionnaire. Depressive symptoms were evaluated with the Reynolds Adolescent Depression Scale. Social support satisfaction was measured using the Social Support Questionnaire. More than 50% of pregnant teenagers had an inadequate intake (excluding dietary supplement) of folate, vitamin A, vitamin E, iron, zinc, calcium, magnesium, and phosphorous. Additionally, >20% of participants had an inadequate intake of thiamin, riboflavin, niacin, vitamin B6, vitamin B12, vitamin C, copper, and selenium. Prenatal supplement inclusion improved dietary intake for most micronutrients except for calcium, magnesium, and phosphorous, (>50% below the Estimated Average Requirement (EAR)) and for copper and selenium (>20% below the EAR). Higher depressive symptoms were associated with higher energy, carbohydrates, and fats, and lower magnesium intake. Higher social support satisfaction was positively associated with dietary intake of thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, vitamin C, vitamin E, iron, and zinc. The findings suggest that mood and dietary factors are associated and should be considered together for health interventions during adolescent pregnancy for the young woman and her future child.
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Affiliation(s)
- Angelie Singh
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Medical Center, New York, NY 10032, USA.
- Medical School for International Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er Sheva 84105, Israel.
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
| | - Caroline Trumpff
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Medical Center, New York, NY 10032, USA.
| | - Jeanine Genkinger
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY 10032, USA.
| | - Alida Davis
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Medical Center, New York, NY 10032, USA.
| | - Marisa Spann
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Medical Center, New York, NY 10032, USA.
- New York State Psychiatric Institute, New York, NY 10032, USA.
| | - Elizabeth Werner
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Medical Center, New York, NY 10032, USA.
- New York State Psychiatric Institute, New York, NY 10032, USA.
| | - Catherine Monk
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Medical Center, New York, NY 10032, USA.
- New York State Psychiatric Institute, New York, NY 10032, USA.
- Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY 10032, USA.
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Associations among prenatal stress, maternal antioxidant intakes in pregnancy, and child temperament at age 30 months. J Dev Orig Health Dis 2017; 8:638-648. [PMID: 28651674 DOI: 10.1017/s2040174417000411] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Prenatal stress and prenatal nutrition each have demonstrable impact on fetal development, with implications for child neurodevelopment and behavior. However, few studies have examined their joint influences despite evidence of potential interactive effects. We examined associations among prenatal stress, prenatal antioxidant intakes, and child temperament in a sociodemographically diverse pregnancy cohort (N=137 mother-child dyads). In mid-pregnancy, mothers completed an assessment of recent negative life events as a measure of prenatal stress and an assessment of prenatal diet. When the children were 30 months of age, mothers completed the Early Childhood Behavior Questionnaire-Very Short form, which provides scores on child Negative Affectivity, Effortful Control, and Surgency/Extraversion. Linear regressions tested associations between maternal prenatal negative life events and child temperament, and effect modification by maternal prenatal antioxidant intakes (vitamins A, C, and E, magnesium, zinc, selenium, β-carotene). Analyses revealed that increased maternal prenatal negative life events were associated with higher child Negative Affectivity (β=0.08, P=0.009) but not with child Effortful Control (β=-0.03, P=0.39) or Surgency/Extraversion (β=0.04, P=0.14). Prenatal intakes of zinc and selenium modified this effect: Maternal exposure to prenatal negative life events was associated with higher child Negative Affectivity in the presence of lower intakes of zinc and selenium. Modification effects approached significance for vitamins A and C. The results suggest that the combination of elevated stress exposures and lower antioxidant intakes in pregnancy increases the likelihood of heightened child temperamental negative affectivity. Increased antioxidant intakes during pregnancy may protect against influences of prenatal stress on child temperament.
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Abstract
Hypertension and chronic kidney disease (CKD) have a significant impact on global morbidity and mortality. The Low Birth Weight and Nephron Number Working Group has prepared a consensus document aimed to address the relatively neglected issue for the developmental programming of hypertension and CKD. It emerged from a workshop held on April 2, 2016, including eminent internationally recognized experts in the field of obstetrics, neonatology, and nephrology. Through multidisciplinary engagement, the goal of the workshop was to highlight the association between fetal and childhood development and an increased risk of adult diseases, focusing on hypertension and CKD, and to suggest possible practical solutions for the future. The recommendations for action of the consensus workshop are the results of combined clinical experience, shared research expertise, and a review of the literature. They highlight the need to act early to prevent CKD and other related noncommunicable diseases later in life by reducing low birth weight, small for gestational age, prematurity, and low nephron numbers at birth through coordinated interventions. Meeting the current unmet needs would help to define the most cost-effective strategies and to optimize interventions to limit or interrupt the developmental programming cycle of CKD later in life, especially in the poorest part of the world.
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29
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Multiple micronutrient supplementation and birth outcomes: The potential importance of selenium. Placenta 2016; 48 Suppl 1:S61-S65. [DOI: 10.1016/j.placenta.2016.02.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 02/05/2016] [Accepted: 02/10/2016] [Indexed: 11/22/2022]
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30
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Parisi F, Berti C, Mandò C, Martinelli A, Mazzali C, Cetin I. Effects of different regimens of iron prophylaxis on maternal iron status and pregnancy outcome: a randomized control trial. J Matern Fetal Neonatal Med 2016; 30:1787-1792. [PMID: 27588568 DOI: 10.1080/14767058.2016.1224841] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Iron supplementation is associated with side effects and overload risk. We compared different regimens of iron supplementation on maternal hematological status and pregnancy outcome in a cohort of healthy pregnant women. MATERIALS AND METHODS Eighty non-anemic women with a normal singleton pregnancy were recruited at 11-13 weeks and randomized into controls (C; n = 20) and groups supplemented with ferrous iron 30 mg (FI; n = 20), liposomal iron 14 mg (Sideral® Pharmanutra, Pisa PI, Italy) (LI14; n = 20) and liposomal iron 28 mg/daily (LI28; n = 20) up to 6 weeks post-partum. Longitudinal maternal blood samples for iron markers were collected. Data on birth outcome were recorded. The treatment effect was evaluated using a mixed-effect regression model. RESULTS Both LI28 and LI14 groups showed significantly higher hemoglobin and ferritin concentrations compared with controls. Birth weight showed a trend to increase with supplementation, resulting in higher birth weight in the LI28 group compared with controls (3499 ± 464.1 g and 3092 ± 469.5 g, respectively, p < 0.01). CONCLUSIONS Our data show the effectiveness of 28 mg and 14 mg LI on maternal anemia prevention, as previously reported with FI 40 mg. LI has similar effects of higher doses of ferrous iron on maternal hematological parameters, thus allowing to reduce iron doses and side effects.
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Affiliation(s)
- Francesca Parisi
- a Unit of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences, Center for Fetal Research Giorgio Pardi, Hospital Luigi Sacco, Università degli Studi di Milano , Milan , Italy and
| | - Cristiana Berti
- a Unit of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences, Center for Fetal Research Giorgio Pardi, Hospital Luigi Sacco, Università degli Studi di Milano , Milan , Italy and
| | - Chiara Mandò
- a Unit of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences, Center for Fetal Research Giorgio Pardi, Hospital Luigi Sacco, Università degli Studi di Milano , Milan , Italy and
| | - Anna Martinelli
- a Unit of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences, Center for Fetal Research Giorgio Pardi, Hospital Luigi Sacco, Università degli Studi di Milano , Milan , Italy and
| | - Cristina Mazzali
- b Unit of Statistics and Biometrics, Department of Biomedical and Clinical Sciences, Hospital Luigi Sacco, Università degli Studi di Milano , Milan , Italy
| | - Irene Cetin
- a Unit of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences, Center for Fetal Research Giorgio Pardi, Hospital Luigi Sacco, Università degli Studi di Milano , Milan , Italy and
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Vasilevski V, Carolan-Olah M. Food taboos and nutrition-related pregnancy concerns among Ethiopian women. J Clin Nurs 2016; 25:3069-75. [PMID: 27411855 DOI: 10.1111/jocn.13319] [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] [Accepted: 04/01/2016] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To discuss Ethiopian food taboos during pregnancy and their relation to maternal nutritional status and pregnancy outcomes. BACKGROUND Recent waves of migration have seen large groups of Ethiopian refugees moving to countries around the globe. This is of concern as Ethiopian women are at risk of a number of medical and pregnancy complications. Health is further compromised by poor diet and adherence to cultural food beliefs and taboos. In refugee women, many of these factors correspond with significantly higher rates of pregnancy complications and poor birth outcomes. DESIGN This is a discussion paper informed by a literature review. METHODS A search of the Scopus, PubMed, Web of Science and Academic Search Premier databases for the keywords Ethiopian, pregnancy, food and taboos was conducted in the research literature published from 1998-2015. This time is contingent with Ethiopian migration trends. RESULTS Ethiopian migrant women are at risk of inadequate nutrition during pregnancy. Risks include cultural factors associated with food taboos as well as issues associated with low socioeconomic status. Consequently, Ethiopian women are more likely to have nutritional deficiencies such as anaemia which have been associated with a range of pregnancy complications. CONCLUSIONS There are many serious consequences of poor diet during pregnancy; however, most of these can be avoided by greater awareness about the role of nutrition during pregnancy and by adopting a balanced diet. RELEVANCE TO CLINICAL PRACTICE There is an urgent unmet need for nutrition education among Ethiopian women. Research indicates that Ethiopian women are receptive to nutritional advice during pregnancy and also that pregnant women are generally motivated to act in the baby's interest. These factors suggest that this high-risk group would be amenable to culturally appropriate nutrition education, which would provide much-needed meaningful support in pregnancy.
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Affiliation(s)
- Vidanka Vasilevski
- College of Health and Biomedicine, Victoria University, Melbourne, Vic., Australia.
| | - Mary Carolan-Olah
- College of Health and Biomedicine, Victoria University, Melbourne, Vic., Australia
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32
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Gernand AD, Schulze KJ, Stewart CP, West KP, Christian P. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention. Nat Rev Endocrinol 2016; 12:274-89. [PMID: 27032981 PMCID: PMC4927329 DOI: 10.1038/nrendo.2016.37] [Citation(s) in RCA: 340] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Micronutrients, vitamins and minerals accessible from the diet, are essential for biologic activity. Micronutrient status varies widely throughout pregnancy and across populations. Women in low-income countries often enter pregnancy malnourished, and the demands of gestation can exacerbate micronutrient deficiencies with health consequences for the fetus. Examples of efficacious single micronutrient interventions include folic acid to prevent neural tube defects, iodine to prevent cretinism, zinc to reduce risk of preterm birth, and iron to reduce the risk of low birth weight. Folic acid and vitamin D might also increase birth weight. While extensive mechanistic and association research links multiple antenatal micronutrients with plausible materno-fetal health advantages, hypothesized benefits have often been absent, minimal or unexpected in trials. These findings suggest a role for population context in determining health responses and filling extensive gaps in knowledge. Multiple micronutrient supplements reduce the risks of being born with low birth weight, small for gestational age or stillborn in undernourished settings, and justify micronutrient interventions with antenatal care. Measurable health effects of gestational micronutrient exposure might persist into childhood but few data exists on potential long-term benefits. In this Review, we discuss micronutrient intake recommendations, risks and consequences of deficiencies, and the effects of interventions with a particular emphasis on offspring.
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Affiliation(s)
- Alison D Gernand
- Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, Pennsylvania 16802, USA
| | - Kerry J Schulze
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, Maryland 21205, USA
| | - Christine P Stewart
- Department of Nutrition, One Shields Avenue, University of California, Davis, California 95616, USA
| | - Keith P West
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, Maryland 21205, USA
| | - Parul Christian
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, Maryland 21205, USA
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Barnett MP, Bermingham EN, Young W, Bassett SA, Hesketh JE, Maciel-Dominguez A, McNabb WC, Roy NC. Low folate and selenium in the mouse maternal diet alters liver gene expression patterns in the offspring after weaning. Nutrients 2015; 7:3370-86. [PMID: 26007332 PMCID: PMC4446756 DOI: 10.3390/nu7053370] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 04/22/2015] [Accepted: 04/29/2015] [Indexed: 12/18/2022] Open
Abstract
During pregnancy, selenium (Se) and folate requirements increase, with deficiencies linked to neural tube defects (folate) and DNA oxidation (Se). This study investigated the effect of a high-fat diet either supplemented with (diet H), or marginally deficient in (diet L), Se and folate. Pregnant female mice and their male offspring were assigned to one of four treatments: diet H during gestation, lactation and post-weaning; diet L during gestation, lactation and post-weaning; diet H during gestation and lactation but diet L fed to offspring post-weaning; or diet L during gestation and lactation followed by diet H fed to offspring post-weaning. Microarray and pathway analyses were performed using RNA from colon and liver of 12-week-old male offspring. Gene set enrichment analysis of liver gene expression showed that diet L affected several pathways including regulation of translation (protein biosynthesis), methyl group metabolism, and fatty acid metabolism; this effect was stronger when the diet was fed to mothers, rather than to offspring. No significant differences in individual gene expression were observed in colon but there were significant differences in cell cycle control pathways. In conclusion, a maternal low Se/folate diet during gestation and lactation has more effects on gene expression in offspring than the same diet fed to offspring post-weaning; low Se and folate in utero and during lactation thus has persistent metabolic effects in the offspring.
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Affiliation(s)
- Matthew P.G. Barnett
- Food Nutrition & Health Team, Food & Bio-Based Products Group, AgResearch Limited, Grasslands Research Centre, Tennent Drive, Palmerston North 4442, New Zealand; E-Mails: (E.N.B.); (W.Y.); (S.A.B.); (N.C.R.)
- Nutrigenomics New Zealand; Private Bag 92019, Auckland 1142, New Zealand
- Gravida: National Centre for Growth and Development, Private Bag 92019, Auckland 1142, New Zealand
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +64-21-938-549; Fax: +64-6-351-8032
| | - Emma N. Bermingham
- Food Nutrition & Health Team, Food & Bio-Based Products Group, AgResearch Limited, Grasslands Research Centre, Tennent Drive, Palmerston North 4442, New Zealand; E-Mails: (E.N.B.); (W.Y.); (S.A.B.); (N.C.R.)
- Nutrigenomics New Zealand; Private Bag 92019, Auckland 1142, New Zealand
| | - Wayne Young
- Food Nutrition & Health Team, Food & Bio-Based Products Group, AgResearch Limited, Grasslands Research Centre, Tennent Drive, Palmerston North 4442, New Zealand; E-Mails: (E.N.B.); (W.Y.); (S.A.B.); (N.C.R.)
- Nutrigenomics New Zealand; Private Bag 92019, Auckland 1142, New Zealand
| | - Shalome A. Bassett
- Food Nutrition & Health Team, Food & Bio-Based Products Group, AgResearch Limited, Grasslands Research Centre, Tennent Drive, Palmerston North 4442, New Zealand; E-Mails: (E.N.B.); (W.Y.); (S.A.B.); (N.C.R.)
- Nutrigenomics New Zealand; Private Bag 92019, Auckland 1142, New Zealand
| | - John E. Hesketh
- Institute for Cell and Molecular Biosciences and Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK; E-Mails: (J.E.H.); (A.M.-D.)
| | - Anabel Maciel-Dominguez
- Institute for Cell and Molecular Biosciences and Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK; E-Mails: (J.E.H.); (A.M.-D.)
| | - Warren C. McNabb
- AgResearch Limited, Grasslands Research Centre, Tennent Drive, Palmerston North 4442, New Zealand; E-Mail:
- Riddet Institute, Massey University, Tennent Drive, Palmerston North 4442, New Zealand
| | - Nicole C. Roy
- Food Nutrition & Health Team, Food & Bio-Based Products Group, AgResearch Limited, Grasslands Research Centre, Tennent Drive, Palmerston North 4442, New Zealand; E-Mails: (E.N.B.); (W.Y.); (S.A.B.); (N.C.R.)
- Nutrigenomics New Zealand; Private Bag 92019, Auckland 1142, New Zealand
- Gravida: National Centre for Growth and Development, Private Bag 92019, Auckland 1142, New Zealand
- Riddet Institute, Massey University, Tennent Drive, Palmerston North 4442, New Zealand
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Forsyth S. Meeting nutrient needs in the first 1,000 days of life. ANNALS OF NUTRITION AND METABOLISM 2014; 65:2-3. [PMID: 25227245 DOI: 10.1159/000365791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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