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Shahabi B, Hernández-Martínez C, Voltas N, Canals J, Arija V. The Maternal Omega-3 Long-Chain Polyunsaturated Fatty Acid Concentration in Early Pregnancy and Infant Neurodevelopment: The ECLIPSES Study. Nutrients 2024; 16:687. [PMID: 38474815 DOI: 10.3390/nu16050687] [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: 01/30/2024] [Revised: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
Omega-3 Long-Chain Polyunsaturated Fatty Acids (n-3 LCPUFAs) play a key role in early neurodevelopment, but evidence from observational and clinical studies remains inconsistent. This study investigates the association between maternal n-3 LCPUFA, Docosahexaenoic Acid (DHA), and eicosapentaenoic acid (EPA) concentrations during pregnancy and infant development functioning at 40 days. This study includes 348 mother-infant pairs. Maternal serum concentrations were assessed in the first and third trimesters alongside sociodemographic, clinical, nutritional, psychological, and obstetrical data. At 40 days, the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) was administered. An adjusted analysis revealed that lower first-trimester n-3 LCPUFA and DHA concentrations are associated with better infant motor development. These results underscore the potential significance of the maternal n-3 LCPUFA status in early pregnancy for influencing fetal neurodevelopment. However, the complexity of these associations necessitates further investigation, emphasizing the urgent need for additional studies to comprehensively elucidate the nuanced interplay between the maternal n-3 LCPUFA status and infant neurodevelopment.
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Affiliation(s)
- Behnaz Shahabi
- Research Group in Nutrition and Mental Health (NUTRISAM), Universitat Rovira i Virgili, 43201 Reus, Spain
- Pere Virgili Institute for Health Research (IISPV), Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Carmen Hernández-Martínez
- Research Group in Nutrition and Mental Health (NUTRISAM), Universitat Rovira i Virgili, 43201 Reus, Spain
- Pere Virgili Institute for Health Research (IISPV), Universitat Rovira i Virgili, 43201 Reus, Spain
- Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, 43003 Tarragona, Spain
| | - Núria Voltas
- Research Group in Nutrition and Mental Health (NUTRISAM), Universitat Rovira i Virgili, 43201 Reus, Spain
- Pere Virgili Institute for Health Research (IISPV), Universitat Rovira i Virgili, 43201 Reus, Spain
- Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, 43003 Tarragona, Spain
- Serra Húnter Fellow, Department of Psychology, Faculty of Education Sciences and Psychology, Universitat Rovira i Virgili, 43007 Tarragona, Spain
| | - Josefa Canals
- Research Group in Nutrition and Mental Health (NUTRISAM), Universitat Rovira i Virgili, 43201 Reus, Spain
- Pere Virgili Institute for Health Research (IISPV), Universitat Rovira i Virgili, 43201 Reus, Spain
- Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, 43003 Tarragona, Spain
| | - Victoria Arija
- Research Group in Nutrition and Mental Health (NUTRISAM), Universitat Rovira i Virgili, 43201 Reus, Spain
- Pere Virgili Institute for Health Research (IISPV), Universitat Rovira i Virgili, 43201 Reus, Spain
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Choedon T, Sethi V, Killeen SL, Ganjekar S, Satyanarayana V, Ghosh S, Jacob CM, McAuliffe FM, Hanson MA, Chandra P. Integrating nutrition and mental health screening, risk identification and management in prenatal health programs in India. Int J Gynaecol Obstet 2023; 162:792-801. [PMID: 36808738 DOI: 10.1002/ijgo.14728] [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: 09/05/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023]
Abstract
Pregnancy is a period of major physiologic, hormonal, and psychological change, increasing the risk of nutritional deficiencies and mental disorders. Mental disorders and malnutrition are associated with adverse pregnancy and child outcomes, with potential long-standing impact. Common mental disorders during pregnancy are more prevalent in low- and middle-income countries (LMICs). In India, studies suggest the prevalence of depression is 9.8%-36.7% and of anxiety is 55.7%. India has seen some promising developments in recent years such as increased coverage of the District Mental Health Program; integration of maternal mental health into the Reproductive and Child Health Program in Kerala; and the Mental Health Care Act 2017. However, mental health screening and management protocols have not yet been established and integrated into routine prenatal care in India. A five-action maternal nutrition algorithm was developed and tested for the Ministry of Health and Family Welfare, aiming to strengthen nutrition services for pregnant women in routine prenatal care facilities. In this paper, we present opportunities and challenges for integration of maternal nutrition and mental health screening and a management protocol at routine prenatal care in India, discuss evidence-based interventions in other LMICs including India, and make recommendations for public healthcare providers.
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Affiliation(s)
| | - Vani Sethi
- UNICEF Regional office for South Asia, Kathmandu, Nepal
| | - Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Sundarnag Ganjekar
- National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | | | | | - Chandni Maria Jacob
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Mark A Hanson
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
| | - Prabha Chandra
- National Institute of Mental Health and Neuro Sciences, Bangalore, India
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3
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Liu N, He Y, Zhao F, Li X, Chen Y, Jiang B, Wei M, Li D, Cai L. Association between maternal erythrocyte PUFAs during pregnancy and neurodevelopment in children at 2 years of age: a birth cohort study. Food Funct 2023; 14:7938-7945. [PMID: 37552113 DOI: 10.1039/d3fo01853a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Background: Previous studies on prenatal polyunsaturated fatty acids (PUFAs) and children's neurodevelopment have shown inconsistent results, and evidence from the Asian population is scarce. Objective: To investigate the association between maternal erythrocyte PUFAs and neurodevelopment in children in the Chinese population. Methods: We included 242 mother-child pairs from the Yuexiu birth cohort. The composition of maternal erythrocyte fatty acids during pregnancy was measured by gas chromatography. Each PUFA was divided into 3 tertiles. Neurodevelopment in children was evaluated with the Ages and Stages Questionnaire at 2 years of age, including 5 domains of development: communication, gross motor, fine motor, problem solving, and personal-social skills. Results: Maternal eicosapentaenoic acid (EPA) [OR (95% CI): 0.34 (0.15, 0.74) for tertile 2, and 0.31 (0.13, 0.70) for tertile 3] was associated with a reduced risk of potential developmental delay in gross motor skills. Conversely, arachidonic acid (AA) [OR (95% CI): 2.54 (1.17, 5.70) for tertile 3] was associated with an increased risk of potential developmental delay in personal-social skills. The ratio of AA/EPA [OR (95% CI): 2.64 (1.18, 6.15) for tertile 3] was associated with an increased risk of potential developmental delay in gross motor skills. No significant association was found between other PUFAs and neurodevelopment. Conclusion: This birth cohort has first shown a beneficial association between maternal EPA and gross motor skills of children. Meanwhile, maternal AA and the ratio of AA/EPA have negative associations with neurodevelopment in children.
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Affiliation(s)
- Nan Liu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
- Shenzhen Nanshan Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Yannan He
- Institute of Nutrition & Health, Qingdao University, Qingdao, China
| | - Feng Zhao
- Center of Lipid & Chronic Diseases, Suzhou Industrial Technology Research Institute, Zhejiang University, Hangzhou, China
| | - Xiaoxu Li
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Yujing Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Bibo Jiang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Min Wei
- Shenzhen Nanshan Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Duo Li
- Institute of Nutrition & Health, Qingdao University, Qingdao, China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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4
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Cardino VN, Goeden T, Yakah W, Ezeamama AE, Fenton JI. New Perspectives on the Associations between Blood Fatty Acids, Growth Parameters, and Cognitive Development in Global Child Populations. Nutrients 2023; 15:nu15081933. [PMID: 37111152 PMCID: PMC10143140 DOI: 10.3390/nu15081933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/11/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Malnutrition is prevalent in low-middle-income countries (LMICs), but it is usually clinically diagnosed through abnormal anthropometric parameters characteristic of protein energy malnutrition (PEM). In doing so, other contributors or byproducts of malnutrition, notably essential fatty acid deficiency (EFAD), are overlooked. Previous research performed mainly in high-income countries (HICs) shows that deficiencies in essential fatty acids (EFAs) and their n-3 and n-6 polyunsaturated fatty acid (PUFA) byproducts (also known as highly unsaturated fatty acids or HUFAs) lead to both abnormal linear growth and impaired cognitive development. These adverse developmental outcomes remain an important public health issue in LMICs. To identify EFAD before severe malnutrition develops, clinicians should perform blood fatty acid panels to measure levels of fatty acids associated with EFAD, notably Mead acid and HUFAs. This review demonstrates the importance of measuring endogenous fatty acid levels for measuring fatty acid intake in various child populations in LMICs. Featured topics include a comparison of fatty acid levels between global child populations, the relationships between growth and cognition and PUFAs and the possible mechanisms driving these relationships, and the potential importance of EFAD and HUFA scores as biomarkers of overall health and normal development.
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Affiliation(s)
- Vanessa N Cardino
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA
| | - Travis Goeden
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA
| | - William Yakah
- Department of Pediatrics, Columbia University Medical Center, New York, NY 10032, USA
| | - Amara E Ezeamama
- Department of Psychiatry, Michigan State University, East Lansing, MI 48824, USA
| | - Jenifer I Fenton
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA
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Fernández-Gómez E, Mohatar-Barba M, López-Olivares M, Luque-Vara T, Sánchez-Ojeda MA, Martín-Salvador A, Enrique-Mirón C. Caloric and Lipid Profiles during Pregnancy in a Socio-Culturally Diverse Society. Foods 2023; 12:1111. [PMID: 36900628 PMCID: PMC10000863 DOI: 10.3390/foods12051111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/21/2023] [Accepted: 03/04/2023] [Indexed: 03/08/2023] Open
Abstract
This research analyzes the determining factors in diet quality among the Spanish pregnant population with the aim of promoting healthier eating habits and preventing the development of non-communicable diseases. It is a diagnostic, non-experimental, cross-sectional, and observational study, with correlational descriptive methodology, and 306 participants. The information was collected using the 24 h dietary recall. Various sociodemographic factors that influence diet quality were analyzed. It was found that pregnant women consume too much protein and fat, score high in SFA consumption, and do not achieve the CH recommendations, consuming twice as much sugar. Carbohydrate intake is inversely related to income (β = -0.144, p < 0.005). Likewise, protein intake is linked to marital status (β = -0.114, p < 0.005) and religion (β = 0.110, p < 0.005). Finally, lipid intake appears conditional upon age (β = 0.109, p < 0.005). As regards the lipid profile, a positive association is only observed with age and MFA consumption (β = 0.161, p < 0.01). On the other hand, simple sugars are positively related to education (β = 0.106, p < 0.005). The results of this research show that the diet quality of pregnant women does not meet the nutritional recommendations established for the Spanish population.
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Affiliation(s)
- Elisabet Fernández-Gómez
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
| | - Miriam Mohatar-Barba
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
| | | | - Trinidad Luque-Vara
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
| | - María Angustias Sánchez-Ojeda
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
| | - Adelina Martín-Salvador
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
| | - Carmen Enrique-Mirón
- HUM-613 Research Group, Department of Inorganic Chemistry, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
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6
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Lamarre J, Cheema SK, Robertson GJ, Wilson DR. Foraging on anthropogenic food predicts problem-solving skills in a seabird. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 850:157732. [PMID: 35931163 DOI: 10.1016/j.scitotenv.2022.157732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/05/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Abstract
Species and populations with greater cognitive performance are more successful at adapting to changing habitats. Accordingly, urban species and populations often outperform their rural counterparts on problem-solving tests. Paradoxically, urban foraging also might be detrimental to the development and integrity of animals' brains because anthropogenic foods often lack essential nutrients such as the long-chain omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are important for cognitive performance in mammals and possibly birds. We tested whether urbanization or consumption of EPA and DHA are associated with problem-solving abilities in ring-billed gulls, a seabird that historically exploited marine environments rich in omega-3 fatty acids but now also thrives in urban centres. Using incubating adults nesting across a range of rural to urban colonies with equal access to the ocean, we tested whether urban gulls preferentially consumed anthropogenic food while rural nesters relied on marine organisms. As we expected individual variation in foraging habits within nesting location, we characterized each captured gulls' diet using stable isotope and fatty acid analyses of their red blood cells. To test their problem-solving abilities, we presented the sampled birds with a horizontal rendition of the string-pull test, a foraging puzzle often used in animal cognitive studies. The isotopic and fatty acid profiles of urban nesters indicated a diet comprising primarily anthropogenic food, whereas the profiles of rural nesters indicated a high reliance on marine organisms. Despite the gulls' degree of access to urban foraging habitat not predicting solving success, birds with biochemical profiles reflecting anthropogenic food (less DHA and a higher carbon-13 ratio in their red blood cells) had a greater probability of solving the string-pull test. These results suggest that experience foraging on anthropogenic food is the main explanatory factor leading to successful problem-solving, while regular consumption of omega-3s during incubation appears inconsequential.
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Affiliation(s)
- Jessika Lamarre
- Cognitive and Behavioural Ecology Program, Memorial University of Newfoundland and Labrador, St. John's, Canada.
| | - Sukhinder Kaur Cheema
- Department of Biochemistry, Memorial University of Newfoundland and Labrador, St. John's, Canada
| | - Gregory J Robertson
- Wildlife Research Division, Environment and Climate Change Canada, Mount Pearl, Canada
| | - David R Wilson
- Department of Psychology, Memorial University of Newfoundland and Labrador, St. John's, Canada
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7
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Zheng H, Ge F, Song K, Yang Z, Li J, Yan F, Wu X, Zhang Q, Liu Y, Ruan R. Docosahexaenoic acid production of the marine microalga Isochrysis galbana cultivated on renewable substrates from food processing waste under CO 2 enrichment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 848:157654. [PMID: 35908707 DOI: 10.1016/j.scitotenv.2022.157654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/16/2022] [Accepted: 07/23/2022] [Indexed: 06/15/2023]
Abstract
Leftover dough is a starch-rich food processing waste of Chinese steamed bread. Leftover dough hydrolysates enriched with glucose and amino acids were used to cultivate the marine microalga Isochrysis galbana to produce docosahexaenoic acid (DHA) under CO2 enrichment. Isochrysis galbana could use mixed carbon sources (CO2, glucose, and amino acids) synchronously to grow and accumulate DHA. Cell growth, the uptake of glucose and amino acids, and DHA production were significantly affected by CO2 enrichment. The maximum biomass concentration of 3.85 g L-1 was achieved with 3 % CO2. And the maximum DHA yield was 65.5 mg L-1 d-1. To enhance DHA production, a two-stage cultivation strategy was successfully developed by this work. The maximum DHA yield of the two-stage culture was elevated by 2.3-fold. It is feasible to produce DHA by Isochrysis galbana using leftover dough under CO2 enrichment.
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Affiliation(s)
- Hongli Zheng
- College of Food Science and Technology, MOE Biomass Energy Research Center, State Key Laboratory of Food Science and Technology, Nanchang University, 235 East Nanjing Road, Nanchang, Jiangxi 330047, People's Republic of China.
| | - Fengru Ge
- College of Food Science and Technology, MOE Biomass Energy Research Center, State Key Laboratory of Food Science and Technology, Nanchang University, 235 East Nanjing Road, Nanchang, Jiangxi 330047, People's Republic of China
| | - Kunyan Song
- College of Food Science and Technology, MOE Biomass Energy Research Center, State Key Laboratory of Food Science and Technology, Nanchang University, 235 East Nanjing Road, Nanchang, Jiangxi 330047, People's Republic of China
| | - Zixiang Yang
- College of Food Science and Technology, MOE Biomass Energy Research Center, State Key Laboratory of Food Science and Technology, Nanchang University, 235 East Nanjing Road, Nanchang, Jiangxi 330047, People's Republic of China
| | - Jinmeng Li
- College of Food Science and Technology, MOE Biomass Energy Research Center, State Key Laboratory of Food Science and Technology, Nanchang University, 235 East Nanjing Road, Nanchang, Jiangxi 330047, People's Republic of China
| | - Feng Yan
- College of Food Science and Technology, MOE Biomass Energy Research Center, State Key Laboratory of Food Science and Technology, Nanchang University, 235 East Nanjing Road, Nanchang, Jiangxi 330047, People's Republic of China
| | - Xiaodan Wu
- College of Food Science and Technology, MOE Biomass Energy Research Center, State Key Laboratory of Food Science and Technology, Nanchang University, 235 East Nanjing Road, Nanchang, Jiangxi 330047, People's Republic of China
| | - Qi Zhang
- College of Food Science and Technology, MOE Biomass Energy Research Center, State Key Laboratory of Food Science and Technology, Nanchang University, 235 East Nanjing Road, Nanchang, Jiangxi 330047, People's Republic of China
| | - Yuhuan Liu
- College of Food Science and Technology, MOE Biomass Energy Research Center, State Key Laboratory of Food Science and Technology, Nanchang University, 235 East Nanjing Road, Nanchang, Jiangxi 330047, People's Republic of China
| | - Roger Ruan
- Center for Biorefining and Department of Bioproducts and Biosystems Engineering, University of Minnesota, 1390 Eckles Avenue, St. Paul, MN 55108, United States
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8
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Mulder KA, Dyer RA, Elango R, Innis SM. Complexity of understanding the role of dietary and erythrocyte docosahexaenoic acid (DHA) on the cognitive performance of school-age children. Curr Dev Nutr 2022; 6:nzac099. [PMID: 35854937 PMCID: PMC9283108 DOI: 10.1093/cdn/nzac099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Early childhood is a period of rapid brain development, with increases in synapses rich in the omega-3 (ω-3) fatty acid, DHA (22:6ω-3) continuing well beyond infancy. Despite the importance of DHA to neural phospholipids, the requirement of dietary DHA for neurodevelopment remains unclear. Objectives The aim was to assess the dietary DHA and DHA status of young children, and determine the association with cognitive performance. Methods This was a cross-sectional study of healthy children (5-6 y), some of whom were enrolled in a follow-up of a clinical trial (NCT00620672). Dietary intake data (n = 285) were assessed with a food-frequency questionnaire (FFQ) and three 24-h recalls. Family characteristics were collected by questionnaire, and anthropometric data measured. Venous blood was collected, cognitive performance assessed using several age-appropriate tools including the Kaufman Assessment Battery for Children. The relation between dietary DHA, RBC DHA, and child neurodevelopment test scores was determined using Pearson's correlation or Spearman's rho, and quintiles of test scores compared by Mann-Whitney U test. Results Child DHA intakes were highly variable, with a stronger association between RBC DHA and DHA intake assessed by FFQ (rho = 0.383, P < 0.001) compared with one or three 24-h recalls. Observed ethnic differences in DHA intake status as well as neurodevelopmental test scores led to analysis of the association between DHA intake and status with neurodevelopment test scores for White children only (n = 190). Child RBC DHA status was associated with neurodevelopment test scores, including language (rho = 0.211, P = 0.009) and short-term memory (rho = 0.187, P = 0.019), but only short-term memory was associated with dietary DHA (rho = 0.221, P = 0.003). Conclusions Child RBC DHA but not dietary DHA was associated with multiple tests of cognitive performance. In addition, DHA intake was only moderately associated with RBC DHA, raising complex questions on the relation between diet, DHA transfer to membrane lipids, and neural function.
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Affiliation(s)
- Kelly A Mulder
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Roger A Dyer
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Analytical Core for Metabolics and Nutrition (ACMaN), BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Rajavel Elango
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Sheila M Innis
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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9
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Morton SU, Leyshon BJ, Tamilia E, Vyas R, Sisitsky M, Ladha I, Lasekan JB, Kuchan MJ, Grant PE, Ou Y. A Role for Data Science in Precision Nutrition and Early Brain Development. Front Psychiatry 2022; 13:892259. [PMID: 35815018 PMCID: PMC9259898 DOI: 10.3389/fpsyt.2022.892259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
Multimodal brain magnetic resonance imaging (MRI) can provide biomarkers of early influences on neurodevelopment such as nutrition, environmental and genetic factors. As the exposure to early influences can be separated from neurodevelopmental outcomes by many months or years, MRI markers can serve as an important intermediate outcome in multivariate analyses of neurodevelopmental determinants. Key to the success of such work are recent advances in data science as well as the growth of relevant data resources. Multimodal MRI assessment of neurodevelopment can be supplemented with other biomarkers of neurodevelopment such as electroencephalograms, magnetoencephalogram, and non-imaging biomarkers. This review focuses on how maternal nutrition impacts infant brain development, with three purposes: (1) to summarize the current knowledge about how nutrition in stages of pregnancy and breastfeeding impact infant brain development; (2) to discuss multimodal MRI and other measures of early neurodevelopment; and (3) to discuss potential opportunities for data science and artificial intelligence to advance precision nutrition. We hope this review can facilitate the collaborative march toward precision nutrition during pregnancy and the first year of life.
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Affiliation(s)
- Sarah U Morton
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, United States.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, United States.,Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | | | - Eleonora Tamilia
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, United States.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, United States.,Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Rutvi Vyas
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, United States.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, United States
| | - Michaela Sisitsky
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, United States.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, United States
| | - Imran Ladha
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, United States
| | | | | | - P Ellen Grant
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, United States.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, United States.,Department of Pediatrics, Harvard Medical School, Boston, MA, United States.,Department of Radiology, Boston Children's Hospital, Boston, MA, United States
| | - Yangming Ou
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, United States.,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, MA, United States.,Department of Pediatrics, Harvard Medical School, Boston, MA, United States.,Department of Radiology, Boston Children's Hospital, Boston, MA, United States
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10
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Importance of EPA and DHA Blood Levels in Brain Structure and Function. Nutrients 2021; 13:nu13041074. [PMID: 33806218 PMCID: PMC8066148 DOI: 10.3390/nu13041074] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 12/14/2022] Open
Abstract
Brain structure and function depend on a constant and sufficient supply with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) by blood. Blood levels of EPA and DHA reflect dietary intake and other variables and are preferably assessed as percentage in erythrocytes with a well-documented and standardized analytical method (HS-Omega-3 Index®). Every human being has an Omega-3 Index between 2 and 20%, with an optimum of 8–11%. Compared to an optimal Omega-3 Index, a lower Omega-3 Index was associated with increased risk for total mortality and ischemic stroke, reduced brain volume, impaired cognition, accelerated progression to dementia, psychiatric diseases, compromises of complex brain functions, and other brain issues in epidemiologic studies. Most intervention trials, and their meta-analyses considered EPA and DHA as drugs with good bioavailability, a design tending to produce meaningful results in populations characterized by low baseline blood levels (e.g., in major depression), but otherwise responsible for many neutral results and substantial confusion. When trial results were evaluated using blood levels of EPA and DHA measured, effects were larger than comparing EPA and DHA to placebo groups, and paralleled epidemiologic findings. This indicates future trial design, and suggests a targeted use EPA and DHA, based on the Omega-3 Index.
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Cohen Kadosh K, Muhardi L, Parikh P, Basso M, Jan Mohamed HJ, Prawitasari T, Samuel F, Ma G, Geurts JMW. Nutritional Support of Neurodevelopment and Cognitive Function in Infants and Young Children-An Update and Novel Insights. Nutrients 2021; 13:nu13010199. [PMID: 33435231 PMCID: PMC7828103 DOI: 10.3390/nu13010199] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 12/12/2022] Open
Abstract
Proper nutrition is crucial for normal brain and neurocognitive development. Failure to optimize neurodevelopment early in life can have profound long-term implications for both mental health and quality of life. Although the first 1000 days of life represent the most critical period of neurodevelopment, the central and peripheral nervous systems continue to develop and change throughout life. All this time, development and functioning depend on many factors, including adequate nutrition. In this review, we outline the role of nutrients in cognitive, emotional, and neural development in infants and young children with special attention to the emerging roles of polar lipids and high quality (available) protein. Furthermore, we discuss the dynamic nature of the gut-brain axis and the importance of microbial diversity in relation to a variety of outcomes, including brain maturation/function and behavior are discussed. Finally, the promising therapeutic potential of psychobiotics to modify gut microbial ecology in order to improve mental well-being is presented. Here, we show that the individual contribution of nutrients, their interaction with other micro- and macronutrients and the way in which they are organized in the food matrix are of crucial importance for normal neurocognitive development.
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Affiliation(s)
- Kathrin Cohen Kadosh
- School of Psychology, University of Surrey, Guildford GU2 7XH, UK; (K.C.K.); (M.B.)
| | - Leilani Muhardi
- FrieslandCampina AMEA, Singapore 039190, Singapore; (L.M.); (P.P.)
| | - Panam Parikh
- FrieslandCampina AMEA, Singapore 039190, Singapore; (L.M.); (P.P.)
| | - Melissa Basso
- School of Psychology, University of Surrey, Guildford GU2 7XH, UK; (K.C.K.); (M.B.)
- Department of General Psychology, University of Padova, 35131 Padova, Italy
| | - Hamid Jan Jan Mohamed
- Nutrition and Dietetics Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia;
| | - Titis Prawitasari
- Nutrition and Metabolic Diseases Working Group, Indonesian Pediatric Society, Jakarta 10310, Indonesia;
- Department of Pediatrics, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusomo National Referral Hospital Jakarta, Jakarta 10430, Indonesia
| | - Folake Samuel
- Department of Human Nutrition, University of Ibadan, Ibadan 200284, Nigeria;
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China;
- Laboratory of Toxicological Research and Risk assessment for Food Safety, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Jan M. W. Geurts
- FrieslandCampina, 3818 LE Amersfoort, The Netherlands
- Correspondence: ; Tel.: +31-6-53310499
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12
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[Effect of omega-3 supplementation during pregnancy and lactation on the fatty acid composition of breast milk in the first months of life: a narrative review]. NUTR HOSP 2021; 38:848-870. [PMID: 34082564 DOI: 10.20960/nh.03486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Omega-3 long-chain, polyunsaturated fatty acids are essential, so they must be provided through the diet, as their biological synthesis is limited, making it essential to meet their requirements during physiological stages such as pregnancy and lactation. A narrative review was conducted on the effects of omega-3 supplementation during pregnancy and lactation on the fatty acid composition of breast milk in the first months of life. Eight randomized clinical studies were analyzed, showing a significant increase in docosahexaenoic acid (DHA) concentration in breast milk (BM) post-supplementation, compared to control groups. One study evaluated the dose needed to achieve 8 % DHA in erythrocytes and 1 % DHA in BM, reaching these levels with a supplementation close to 1 g of docosahexaenoic acid + eicosapentaenoic acid (EPA). Finally, a trial was found that used supplementation with small lipid contributions (0,59 g α-linolenic acid (ALA)), without generating significant changes in the DHA composition of LM, but in the ALA content. Therefore, it is inferred that omega-3 supplementation beneficially modifies DHA and EPA levels in the composition of BM in pregnant women and during the lactation stage, although further studies are needed to identify doses, times, beneficial effects on development, and more efficient forms of delivery of omega-3 supplementation.
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13
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van Steenwyk G, Gapp K, Jawaid A, Germain P, Manuella F, Tanwar DK, Zamboni N, Gaur N, Efimova A, Thumfart KM, Miska EA, Mansuy IM. Involvement of circulating factors in the transmission of paternal experiences through the germline. EMBO J 2020; 39:e104579. [PMID: 33034389 PMCID: PMC7705452 DOI: 10.15252/embj.2020104579] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 09/04/2020] [Accepted: 09/16/2020] [Indexed: 12/12/2022] Open
Abstract
Environmental factors can change phenotypes in exposed individuals and offspring and involve the germline, likely via biological signals in the periphery that communicate with germ cells. Here, using a mouse model of paternal exposure to traumatic stress, we identify circulating factors involving peroxisome proliferator-activated receptor (PPAR) pathways in the effects of exposure to the germline. We show that exposure alters metabolic functions and pathways, particularly lipid-derived metabolites, in exposed fathers and their offspring. We collected data in a human cohort exposed to childhood trauma and observed similar metabolic alterations in circulation, suggesting conserved effects. Chronic injection of serum from trauma-exposed males into controls recapitulates metabolic phenotypes in the offspring. We identify lipid-activated nuclear receptors PPARs as potential mediators of the effects from father to offspring. Pharmacological PPAR activation in vivo reproduces metabolic dysfunctions in the offspring and grand-offspring of injected males and affects the sperm transcriptome in fathers and sons. In germ-like cells in vitro, both serum and PPAR agonist induce PPAR activation. Together, these results highlight the role of circulating factors as potential communication vectors between the periphery and the germline.
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Affiliation(s)
- Gretchen van Steenwyk
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
| | - Katharina Gapp
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
- Laboratory of Molecular and Behavioral NeuroscienceETH ZurichZurichSwitzerland
- Gurdon InstituteUniversity of CambridgeCambridgeUK
- Wellcome Trust Sanger InstituteHinxtonUK
- Department of GeneticsUniversity of CambridgeCambridgeUK
| | - Ali Jawaid
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
- Laboratory of Translational Research in Neuropsychiatric DisordersBRAINCITY Nencki‐EMBL Center of Excellence for Neural Plasticity and Brain DisordersWarsawPoland
| | - Pierre‐Luc Germain
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Statistical Bioinformatics GroupSwiss Institute of BioinformaticsZürichSwitzerland
| | - Francesca Manuella
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
| | - Deepak K Tanwar
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
- Statistical Bioinformatics GroupSwiss Institute of BioinformaticsZürichSwitzerland
| | - Nicola Zamboni
- Institute of Molecular Systems BiologyETH ZurichZurichSwitzerland
| | - Niharika Gaur
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
| | - Anastasiia Efimova
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
| | - Kristina M Thumfart
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
| | - Eric A Miska
- Gurdon InstituteUniversity of CambridgeCambridgeUK
- Wellcome Trust Sanger InstituteHinxtonUK
- Department of GeneticsUniversity of CambridgeCambridgeUK
| | - Isabelle M Mansuy
- Laboratory of NeuroepigeneticsBrain Research InstituteMedical Faculty of the University of ZurichZurichSwitzerland
- Institute for NeuroscienceDepartment of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Zurich Neuroscience CenterETH Zurich and University of ZurichZurichSwitzerland
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14
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Maternal Docosahexaenoic Acid Status during Pregnancy and Its Impact on Infant Neurodevelopment. Nutrients 2020; 12:nu12123615. [PMID: 33255561 PMCID: PMC7759779 DOI: 10.3390/nu12123615] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 12/15/2022] Open
Abstract
Dietary components are essential for the structural and functional development of the brain. Among these, docosahexaenoic acid, 22:6n-3 (DHA), is critically necessary for the structure and development of the growing fetal brain in utero. DHA is the major n-3 long-chain polyunsaturated fatty acid in brain gray matter representing about 15% of all fatty acids in the human frontal cortex. DHA affects neurogenesis, neurotransmitter, synaptic plasticity and transmission, and signal transduction in the brain. Data from human and animal studies suggest that adequate levels of DHA in neural membranes are required for maturation of cortical astrocyte, neurovascular coupling, and glucose uptake and metabolism. Besides, some metabolites of DHA protect from oxidative tissue injury and stress in the brain. A low DHA level in the brain results in behavioral changes and is associated with learning difficulties and dementia. In humans, the third trimester-placental supply of maternal DHA to the growing fetus is critically important as the growing brain obligatory requires DHA during this window period. Besides, DHA is also involved in the early placentation process, essential for placental development. This underscores the importance of maternal intake of DHA for the structural and functional development of the brain. This review describes DHA’s multiple roles during gestation, lactation, and the consequences of its lower intake during pregnancy and postnatally on the 2019 brain development and function.
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15
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Khandelwal S, Kondal D, Chaudhry M, Patil K, Swamy MK, Metgud D, Jogalekar S, Kamate M, Divan G, Gupta R, Prabhakaran D, Tandon N, Ramakrishnan U, Stein AD. Effect of Maternal Docosahexaenoic Acid (DHA) Supplementation on Offspring Neurodevelopment at 12 Months in India: A Randomized Controlled Trial. Nutrients 2020; 12:E3041. [PMID: 33023067 PMCID: PMC7600740 DOI: 10.3390/nu12103041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/11/2022] Open
Abstract
Intake of dietary docosahexaenoic acid (DHA 22:6n-3) is very low among Indian pregnant women. Maternal supplementation during pregnancy and lactation may benefit offspring neurodevelopment. We conducted a double-blind, randomized, placebo-controlled trial to test the effectiveness of supplementing pregnant Indian women (singleton gestation) from ≤20 weeks through 6 months postpartum with 400 mg/d algal DHA compared to placebo on neurodevelopment of their offspring at 12 months. Of 3379 women screened, 1131 were found eligible; 957 were randomized. The primary outcome was infant neurodevelopment at 12 months, assessed using the Development Assessment Scale for Indian Infants (DASII). Both groups were well balanced on sociodemographic variables at baseline. More than 72% of women took >90% of their assigned treatment. Twenty-five serious adverse events (SAEs), none related to the intervention, (DHA group = 16; placebo = 9) were noted. Of 902 live births, 878 were followed up to 12 months; the DASII was administered to 863 infants. At 12 months, the mean development quotient (DQ) scores in the DHA and placebo groups were not statistically significant (96.6 ± 12.2 vs. 97.1 ± 13.0, p = 0.60). Supplementing mothers through pregnancy and lactation with 400 mg/d DHA did not impact offspring neurodevelopment at 12 months of age in this setting.
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Affiliation(s)
- Shweta Khandelwal
- Public Health Foundation of India, 47, Sector 44, Institutional area, Gurugram, Haryana 122003, India; (D.K.); (M.C.); (R.G.); (D.P.)
- Centre for Chronic Disease Control, C-1/52, 2nd Floor, Safdarjung Development Area, New Delhi 110016, India
| | - Dimple Kondal
- Public Health Foundation of India, 47, Sector 44, Institutional area, Gurugram, Haryana 122003, India; (D.K.); (M.C.); (R.G.); (D.P.)
- Centre for Chronic Disease Control, C-1/52, 2nd Floor, Safdarjung Development Area, New Delhi 110016, India
| | - Monica Chaudhry
- Public Health Foundation of India, 47, Sector 44, Institutional area, Gurugram, Haryana 122003, India; (D.K.); (M.C.); (R.G.); (D.P.)
| | - Kamal Patil
- KAHER’s JN Medical College, JNMC KLE University Campus, Nehru Nagar, Belgaum, Karnataka 590010, India; (K.P.); (M.K.S.); (S.J.); (M.K.)
| | - Mallaiah Kenchaveeraiah Swamy
- KAHER’s JN Medical College, JNMC KLE University Campus, Nehru Nagar, Belgaum, Karnataka 590010, India; (K.P.); (M.K.S.); (S.J.); (M.K.)
| | - Deepa Metgud
- KAHER’s Institute of Physiotherapy, JNMC KLE University Campus, Nehru Nagar, Belgaum, Karnataka 590010, India;
| | - Sandesh Jogalekar
- KAHER’s JN Medical College, JNMC KLE University Campus, Nehru Nagar, Belgaum, Karnataka 590010, India; (K.P.); (M.K.S.); (S.J.); (M.K.)
| | - Mahesh Kamate
- KAHER’s JN Medical College, JNMC KLE University Campus, Nehru Nagar, Belgaum, Karnataka 590010, India; (K.P.); (M.K.S.); (S.J.); (M.K.)
| | - Gauri Divan
- Sangath, C-1/52, Block C 1, Bhim Nagri, Hauz Khas, New Delhi 110016, India;
- Sangath Goa, H No 451 (168), Bhatkar Waddo, Socorro, Porvorium, Bardez, Goa 403501, India
| | - Ruby Gupta
- Public Health Foundation of India, 47, Sector 44, Institutional area, Gurugram, Haryana 122003, India; (D.K.); (M.C.); (R.G.); (D.P.)
- Centre for Chronic Disease Control, C-1/52, 2nd Floor, Safdarjung Development Area, New Delhi 110016, India
| | - Dorairaj Prabhakaran
- Public Health Foundation of India, 47, Sector 44, Institutional area, Gurugram, Haryana 122003, India; (D.K.); (M.C.); (R.G.); (D.P.)
- Centre for Chronic Disease Control, C-1/52, 2nd Floor, Safdarjung Development Area, New Delhi 110016, India
| | - Nikhil Tandon
- All India Institute of Medical Sciences, Sri Aurobindo Marg, New Delhi 110029, India;
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; (U.R.); (A.D.S.)
| | - Aryeh D. Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; (U.R.); (A.D.S.)
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16
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Araujo P, Kjellevold M, Nerhus I, Dahl L, Aakre I, Moe V, Smith L, Markhus MW. Fatty Acid Reference Intervals in Red Blood Cells among Pregnant Women in Norway-Cross Sectional Data from the 'Little in Norway' Cohort. Nutrients 2020; 12:nu12102950. [PMID: 32993043 PMCID: PMC7601079 DOI: 10.3390/nu12102950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 12/15/2022] Open
Abstract
There is a growing interest in determining fatty acid reference intervals from pregnancy cohort, especially considering the lack of reference values for pregnant women in the literature and the generalized misconception of equating reference intervals for nonpregnant women as equivalent to pregnant women. Seafood and supplements are important dietary sources for the omega-3 long-chain polyunsaturated fatty acids (ω-3 LCPUFA), such as eicosapentaenoic acid (EPA, 20:5ω-3), docosapentaenoic acid (DPA, 22:55ω-3), and docosahexaenoic acid (DHA, 22:6ω-3). Sufficient intake of EPA and DHA is vital during pregnancy for the development of the fetus, as well as for maintaining adequate levels for the mother. This study describes the fatty acid status and suggests reference values and cut-offs for fatty acids in red blood cells (RBC) from pregnant women (n = 247). An electronic food frequency questionnaire (e-FFQ) mapped the dietary habits of the participants, and gas chromatography was used to determine the fatty acid levels in RBC. The association between e-FFQ variables and fatty acid concentrations was established using a principal component analysis (PCA). Twenty-nine-point-one percent (29.1%) of the participants reported eating seafood as dinner according to the Norwegian recommendations, and they added in their diet as well a high percentage (76.9%) intake of ω-3 supplements. The concentration levels of fatty acids in RBC were in agreement with those reported in similar populations from different countries. The reference interval 2.5/97.5 percentiles for EPA, DPA, DHA were 0.23/2.12, 0.56/2.80, 3.76/10.12 in relative concentration units (%), and 5.99/51.25, 11.08/61.97, 64.25/218.08 in absolute concentration units (µg/g), respectively. The number of participants and their selection from all over Norway vouch for the representativeness of the study and the validity of the proposed reference values, and therefore, the study may be a useful tool when studying associations between fatty acid status and health outcome in future studies. To the best of our knowledge, this is the first PCA study reporting a direct association between ω-3 LCPUFA and intake of seafood and ω-3 supplements in a pregnancy cohort.
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Affiliation(s)
- Pedro Araujo
- Institute of Marine Research, 1870 Nordnes, N-5817 Bergen, Norway; (I.N.); (L.D.); (I.A.); (M.W.M.)
- Correspondence: (P.A.); (M.K.); Tel.: +47-47645029 (P.A.); +47-40854582 (M.K.)
| | - Marian Kjellevold
- Institute of Marine Research, 1870 Nordnes, N-5817 Bergen, Norway; (I.N.); (L.D.); (I.A.); (M.W.M.)
- Correspondence: (P.A.); (M.K.); Tel.: +47-47645029 (P.A.); +47-40854582 (M.K.)
| | - Ive Nerhus
- Institute of Marine Research, 1870 Nordnes, N-5817 Bergen, Norway; (I.N.); (L.D.); (I.A.); (M.W.M.)
| | - Lisbeth Dahl
- Institute of Marine Research, 1870 Nordnes, N-5817 Bergen, Norway; (I.N.); (L.D.); (I.A.); (M.W.M.)
| | - Inger Aakre
- Institute of Marine Research, 1870 Nordnes, N-5817 Bergen, Norway; (I.N.); (L.D.); (I.A.); (M.W.M.)
| | - Vibeke Moe
- Department of Psychology, Faculty of Social Sciences, University of Oslo, 0317 Oslo, Norway; (V.M.); (L.S.)
| | - Lars Smith
- Department of Psychology, Faculty of Social Sciences, University of Oslo, 0317 Oslo, Norway; (V.M.); (L.S.)
| | - Maria Wik Markhus
- Institute of Marine Research, 1870 Nordnes, N-5817 Bergen, Norway; (I.N.); (L.D.); (I.A.); (M.W.M.)
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17
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Fang X, Sun W, Jeon J, Azain M, Kinder H, Ahn J, Chung HC, Mote RS, Filipov NM, Zhao Q, Rayalam S, Park HJ. Perinatal Docosahexaenoic Acid Supplementation Improves Cognition and Alters Brain Functional Organization in Piglets. Nutrients 2020; 12:E2090. [PMID: 32679753 PMCID: PMC7400913 DOI: 10.3390/nu12072090] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/10/2020] [Accepted: 07/11/2020] [Indexed: 12/22/2022] Open
Abstract
Epidemiologic studies associate maternal docosahexaenoic acid (DHA)/DHA-containing seafood intake with enhanced cognitive development; although, it should be noted that interventional trials show inconsistent findings. We examined perinatal DHA supplementation on cognitive performance, brain anatomical and functional organization, and the brain monoamine neurotransmitter status of offspring using a piglet model. Sows were fed a control (CON) or a diet containing DHA (DHA) from late gestation throughout lactation. Piglets underwent an open field test (OFT), an object recognition test (ORT), and magnetic resonance imaging (MRI) to acquire anatomical, diffusion tensor imaging (DTI), and resting-state functional MRI (rs-fMRI) at weaning. Piglets from DHA-fed sows spent 95% more time sniffing the walls than CON in OFT and exhibited an elevated interest in the novel object in ORT, while CON piglets demonstrated no preference. Maternal DHA supplementation increased fiber length and tended to increase fractional anisotropy in the hippocampus of offspring than CON. DHA piglets exhibited increased functional connectivity in the cerebellar, visual, and default mode network and decreased activity in executive control and sensorimotor network compared to CON. The brain monoamine neurotransmitter levels did not differ in healthy offspring. Perinatal DHA supplementation may increase exploratory behaviors, improve recognition memory, enhance fiber tract integrity, and alter brain functional organization in offspring at weaning.
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Affiliation(s)
- Xi Fang
- Department of Foods and Nutrition, College of Family and Consumer Sciences, University of Georgia, Athens, GA 30602, USA; (X.F.); (J.J.)
| | - Wenwu Sun
- Department of Physics and Astronomy, Franklin College of Arts and Sciences, University of Georgia, Athens, GA 30602, USA; (W.S.); (Q.Z.)
| | - Julie Jeon
- Department of Foods and Nutrition, College of Family and Consumer Sciences, University of Georgia, Athens, GA 30602, USA; (X.F.); (J.J.)
| | - Michael Azain
- Department of Animal and Dairy Science, College of Agricultural & Environmental Sciences, University of Georgia, Athens, GA 30602, USA; (M.A.); (H.K.)
| | - Holly Kinder
- Department of Animal and Dairy Science, College of Agricultural & Environmental Sciences, University of Georgia, Athens, GA 30602, USA; (M.A.); (H.K.)
| | - Jeongyoun Ahn
- Department of Statistics, Franklin College of Arts and Sciences, University of Georgia, Athens, GA 30602, USA; (J.A.); (H.C.C.)
| | - Hee Cheol Chung
- Department of Statistics, Franklin College of Arts and Sciences, University of Georgia, Athens, GA 30602, USA; (J.A.); (H.C.C.)
| | - Ryan S. Mote
- Department of Physiology and Pharmacology, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA; (R.S.M.); (N.M.F.)
| | - Nikolay M. Filipov
- Department of Physiology and Pharmacology, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA; (R.S.M.); (N.M.F.)
| | - Qun Zhao
- Department of Physics and Astronomy, Franklin College of Arts and Sciences, University of Georgia, Athens, GA 30602, USA; (W.S.); (Q.Z.)
| | - Srujana Rayalam
- Department of Pharmaceutical Sciences, Philadelphia College of Osteopathic Medicine, Suwanee, GA 30024, USA
| | - Hea Jin Park
- Department of Foods and Nutrition, College of Family and Consumer Sciences, University of Georgia, Athens, GA 30602, USA; (X.F.); (J.J.)
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18
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Cheatham CL. Nutritional Factors in Fetal and Infant Brain Development. ANNALS OF NUTRITION AND METABOLISM 2020; 75 Suppl 1:20-32. [PMID: 32564018 DOI: 10.1159/000508052] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 02/12/2020] [Indexed: 11/19/2022]
Abstract
Fetal and infant brain development determine the trajectory of the organism across the lifespan. Optimal maternal and infant nutrition during the period of rapid brain development is vital to the integrity of the neural substrate for subsequent lifelong functions. The goal of this review is to educate the reader on the effects of fetal and infant nutrition on the developing human brain. A review of the literature reveals 6 nutrients that have been studied with respect to maternal nutrition and subsequent offspring brain development: folate, iodine, iron, vitamin D, choline, and docosahexaenoic acid (DHA; 22:6n-3). The research is discussed with a focus on the timing of nutrient needs (preconception, prenatally, and postnatally) as well as potential confounding and unobserved variables.
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Affiliation(s)
- Carol L Cheatham
- Department of Psychology and Neuroscience and Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, North Carolina, USA,
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19
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Khaire A, Wadhwani N, Madiwale S, Joshi S. Maternal fats and pregnancy complications: Implications for long-term health. Prostaglandins Leukot Essent Fatty Acids 2020; 157:102098. [PMID: 32380367 DOI: 10.1016/j.plefa.2020.102098] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 03/12/2020] [Accepted: 03/23/2020] [Indexed: 12/19/2022]
Abstract
Pregnancy imposes increased nutritional requirements for the well being of the mother and fetus. Maternal lipid metabolism is critical for fetal development and long-term health of the offspring as it plays a key role in energy storage, tissue growth and cell signaling. Maternal fat composition is considered as a modifiable risk for abnormal lipid metabolism and glucose tolerance during pregnancy. Data derived from observational studies demonstrate that higher intake of saturated fats during pregnancy is associated with pregnancy complications (preeclampsia, gestational diabetes mellitus and preterm delivery) and poor birth outcomes (intra uterine growth retardation and large for gestational age babies). On the other hand, prenatal long chain polyunsaturated fatty acids status is shown to improve birth outome. In this article, we discuss the role of maternal lipids during pregnancy on fetal growth and development and its consequences on the health of the offspring.
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Affiliation(s)
- Amrita Khaire
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be) University, Pune Satara Road, Pune, 411043, India
| | - Nisha Wadhwani
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be) University, Pune Satara Road, Pune, 411043, India
| | - Shweta Madiwale
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be) University, Pune Satara Road, Pune, 411043, India
| | - Sadhana Joshi
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be) University, Pune Satara Road, Pune, 411043, India.
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DELİORMAN ORHAN D, ÖZÜPEK B. Krill Yağı ve Sağlık Faydaları. DÜZCE ÜNIVERSITESI SAĞLIK BILIMLERI ENSTITÜSÜ DERGISI 2020. [DOI: 10.33631/duzcesbed.637714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Harauma A, Sueyasu T, Tokuda H, Yasuda H, Hoshi Y, Kaneda Y, Rogi T, Shibata H, Nakamura MT, Moriguchi T. Changes in behavior and fatty acid composition induced by long-term reduction in murine Δ6-desaturation activity. Prostaglandins Leukot Essent Fatty Acids 2020; 155:102079. [PMID: 32145668 DOI: 10.1016/j.plefa.2020.102079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 11/28/2022]
Abstract
Polyunsaturated fatty acids (PUFAs), especially arachidonic acid (ARA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), play an important role in biological regulation. In our previous study using mice deficient in Δ6 desaturase (D6D), we reported that ARA is required for body growth, while DHA is necessary for functional development. In mammals, ARA and DHA are supplied directly or by synthesis from linoleic acid (LA) and α-linolenic acid (ALA). However, as desaturase enzyme activity is immature or low in newborns, and humans with minor alleles of the gene encoding desaturase, respectively, they require dietary supplementation with ARA and DHA. To investigate how the body reacts to a long-term reduction in fatty acid synthesis, we measured behavioral changes and fatty acid composition in mice heterozygous for the D6D null mutation with reduced D6D activity fed a diet containing only LA and ALA as PUFAs. During the growth-maturity period, heterozygous mice showed a slightly change in interest and curiosity compared with the wild-type group. ARA levels were decreased in the brain and liver in the heterozygous group, especially during the growth-maturity period, whereas DHA levels were decreased in the liver only in the old age period, suggesting that there are differences in the synthesis of and demand for ARA and DHA during life. For newborns, and humans with minor alleles with low desaturase activity, direct ARA intake is particularly important during the growth-maturity period, but they may need to be supplemented with DHA in the old age period. Further research is needed to determine the optimal intake and duration of these fatty acids.
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Affiliation(s)
- Akiko Harauma
- School of Life and Environmental Science, Azabu University, 1-17-71 Fuchinobe, Sagamihara, Kanagawa 252-5201, Japan
| | - Toshiaki Sueyasu
- Institute for Health Care Science, Suntory Wellness Ltd. 8-1-1 Seikadai, Seika-cho, Soraku-gun, Kyoto 619-0284, Japan
| | - Hisanori Tokuda
- Institute for Health Care Science, Suntory Wellness Ltd. 8-1-1 Seikadai, Seika-cho, Soraku-gun, Kyoto 619-0284, Japan
| | - Hidemi Yasuda
- School of Life and Environmental Science, Azabu University, 1-17-71 Fuchinobe, Sagamihara, Kanagawa 252-5201, Japan
| | - Yukino Hoshi
- School of Life and Environmental Science, Azabu University, 1-17-71 Fuchinobe, Sagamihara, Kanagawa 252-5201, Japan
| | - Yoshihisa Kaneda
- Institute for Health Care Science, Suntory Wellness Ltd. 8-1-1 Seikadai, Seika-cho, Soraku-gun, Kyoto 619-0284, Japan
| | - Tomohiro Rogi
- Institute for Health Care Science, Suntory Wellness Ltd. 8-1-1 Seikadai, Seika-cho, Soraku-gun, Kyoto 619-0284, Japan
| | - Hiroshi Shibata
- Institute for Health Care Science, Suntory Wellness Ltd. 8-1-1 Seikadai, Seika-cho, Soraku-gun, Kyoto 619-0284, Japan
| | - Manabu T Nakamura
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, 905 South Goodwin Avenue, Urbana, IL 61801, United States
| | - Toru Moriguchi
- School of Life and Environmental Science, Azabu University, 1-17-71 Fuchinobe, Sagamihara, Kanagawa 252-5201, Japan.
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Comitini F, Peila C, Fanos V, Coscia A. The Docosahexanoic Acid: From the Maternal-Fetal Dyad to Early Life Toward Metabolomics. Front Pediatr 2020; 8:538. [PMID: 33102402 PMCID: PMC7555995 DOI: 10.3389/fped.2020.00538] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/27/2020] [Indexed: 02/05/2023] Open
Abstract
Docosahexaenoic acid (DHA) is an essential ω-3 long-chain polyunsaturated fatty acid (LCPUFA) and represents the dominant structural fatty acid in the retina and in the brain's gray matter. Due to its active participation in the development of the nervous system, DHA is one of the most studied LCPUFA and is currently considered a critical nutrient during pregnancy and breastfeeding. Increasing evidence in literature suggests that an adequate concentration of DHA is required from the fetal stage through to early life to ensure optimal neurological development. Likewise, many studies in literature demonstrated that an adequate supply of DHA during pregnancy and lactation is essential to promote proper brain development in utero and in early life. Daily supplementation of DHA in newborns has potentially stronger effects compared to maternal supplementation during pregnancy. Supplementation initiated in the second year of life in children born preterm did not result in global cognitive development improvements. Preliminary findings arising from metabolomics has reported that mother's milk and infant formula supplementation of Vitamin D associated with DHA results in a higher antioxidant and protective action, with a possible positive influence on renal function and body fat on preterm infants compared to those receiving only vitamin D. Recent applications of metabolomic studies on newborns may lead to a better understanding of the metabolic process linked to early nutrition and, subsequently, to the development of targeted and personalized nutritional strategies.
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Affiliation(s)
- Federica Comitini
- Neonatal Intensive Care Unit, Department of Surgical Sciences, University Hospital and University of Cagliari, Monserrato, Italy
| | - Chiara Peila
- Complex Structure Neonatology Unit, Department of Public Health and Paediatric, University of Turin, Turin, Italy
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, Department of Surgical Sciences, University Hospital and University of Cagliari, Monserrato, Italy
| | - Alessandra Coscia
- Complex Structure Neonatology Unit, Department of Public Health and Paediatric, University of Turin, Turin, Italy
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Caut C, Leach M, Steel A. Dietary guideline adherence during preconception and pregnancy: A systematic review. MATERNAL AND CHILD NUTRITION 2019; 16:e12916. [PMID: 31793249 PMCID: PMC7083492 DOI: 10.1111/mcn.12916] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 10/25/2019] [Accepted: 10/30/2019] [Indexed: 12/25/2022]
Abstract
The aim of this study is to determine the level of adherence to dietary guidelines among men and women during preconception, and pregnant women, and factors associated with adherence. Searches were conducted in CINAHL, AMED, EMBASE, and Maternity and Infant Care from inception to March 2018. Observational studies assessing the primary outcome (adherence to dietary guidelines and/or nutritional recommendations) and/or secondary outcome (factors associated with adherence) were eligible. Study quality was assessed using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross‐sectional studies. Men or women (aged ≥18 years) who identified as trying/intending to conceive or were pregnant. Eighteen studies were included. The quality of studies was fair (44%) to good (56%). Most studies indicated preconceptual and pregnant women do not meet recommendations for vegetable, cereal grain, or folate intake. Pregnant women did not meet iron or calcium intake requirements in 91% and 55% of included studies, respectively, and also exceeded fat intake recommendations in 55% of included studies. Higher level education was associated with improved guideline adherence in pregnant women, whereas older age and non‐smoking status were associated with greater guideline adherence in preconceptual and pregnant women. The findings of this review suggest that preconceptual and pregnant women may not be meeting the minimum requirements stipulated in dietary guidelines and/or nutritional recommendations. This could have potential adverse consequences for pregnancy and birth outcomes and the health of the offspring. Major knowledge gaps identified in this review, which warrant further investigation, are the dietary intakes of men during preconception, and the predictors of guideline adherence.
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Affiliation(s)
- Cherie Caut
- Office of Research, Endeavour College of Natural Health, Queensland, Australia
| | - Matthew Leach
- Department of Rural Health, Division of Health Sciences, University of South Australia, Whyalla, South Australia, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
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Jackson KH, Harris WS. A Prenatal DHA Test to Help Identify Women at Increased Risk for Early Preterm Birth: A Proposal. Nutrients 2018; 10:E1933. [PMID: 30563193 PMCID: PMC6316227 DOI: 10.3390/nu10121933] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 11/26/2018] [Accepted: 11/30/2018] [Indexed: 12/11/2022] Open
Abstract
Fish intake and docosahexaenoic acid (DHA), a nutrient found in fish, have been favorably linked to several pregnancy outcomes. The risk of early preterm birth (ePT, <34 weeks gestation) is associated with low fish intake and DHA blood levels and can be reduced by supplemental DHA. Here, we summarize the evidence linking blood DHA levels with risk for ePT birth, and based on the available studies, propose that women who are pregnant or trying to become pregnant aim for a red blood cell (RBC) DHA value of at least 5% (of total RBC fatty acids). In the US, ~70% of women of childbearing age are likely below this cut-point, and dietary intake data suggest that this group, including pregnant women, consumes ~60 mg/day DHA and that >90% of this group do not take an omega-3 supplement. Since the recommendations for women to consume fish and to take a 200 mg DHA supplement during pregnancy are not being heeded generally, there is a need to motivate practitioners and pregnant women to attend to these recommendations. Having an objective prenatal blood DHA test could provide such motivation. More research is needed to test the clinical utility of this proposed target prenatal DHA level.
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Affiliation(s)
| | - William S Harris
- OmegaQuant, LLC, 5009 W. 12th St., Suite 8, Sioux Falls, SD 57106, USA.
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Koletzko B, Cremer M, Flothkötter M, Graf C, Hauner H, Hellmers C, Kersting M, Krawinkel M, Przyrembel H, Röbl-Mathieu M, Schiffner U, Vetter K, Weißenborn A, Wöckel A. Diet and Lifestyle Before and During Pregnancy - Practical Recommendations of the Germany-wide Healthy Start - Young Family Network. Geburtshilfe Frauenheilkd 2018; 78:1262-1282. [PMID: 30655650 PMCID: PMC6294644 DOI: 10.1055/a-0713-1058] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 08/22/2018] [Accepted: 08/22/2018] [Indexed: 12/11/2022] Open
Abstract
Diet and exercise before and during pregnancy affect the course of the pregnancy, the child's development and the short- and long-term health of mother and child. The Healthy Start - Young Family Network has updated the recommendations on nutrition in pregnancy that first appeared in 2012 and supplemented them with recommendations on a preconception lifestyle. The recommendations address body weight before conception, weight gain in pregnancy, energy and nutritional requirements and diet (including a vegetarian/vegan diet), the supplements folic acid/folate, iodine, iron and docosahexaenoic acid (DHA), protection against food-borne illnesses, physical activity before and during pregnancy, alcohol, smoking, caffeinated drinks, oral and dental hygiene and the use of medicinal products. Preparation for breast-feeding is recommended already during pregnancy. Vaccination recommendations for women planning a pregnancy are also included. These practical recommendations of the Germany-wide Healthy Start - Young Family Network are intended to assist all professional groups that counsel women and couples wishing to have children and during pregnancy with uniform, scientifically-based and practical information.
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Affiliation(s)
- Berthold Koletzko
- Kinderklinik und Kinderpoliklinik, Dr. von Haunersches Kinderspital, LMU – Ludwig-Maximilians-Universität, München, Germany
- Deutsche Gesellschaft für Kinder- und Jugendheilkunde e. V. (DGKJ), Berlin, Germany
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
| | - Monika Cremer
- Netzwerk Gesund ins Leben/Bundeszentrum für Ernährung (BZfE) in der Bundesanstalt für Landwirtschaft und Ernährung (BLE), Bonn, Germany
| | - Maria Flothkötter
- Netzwerk Gesund ins Leben/Bundeszentrum für Ernährung (BZfE) in der Bundesanstalt für Landwirtschaft und Ernährung (BLE), Bonn, Germany
| | - Christine Graf
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Deutsche Sporthochschule Köln, Köln, Germany
| | - Hans Hauner
- Lehrstuhl für Ernährungsmedizin, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Claudia Hellmers
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Hochschule Osnabrück, Osnabrück, Germany
- Deutsche Gesellschaft für Hebammenwissenschaft e. V. (DGHWi), Münster, Germany
| | - Mathilde Kersting
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Forschungsdepartment Kinderernährung, Klinik für Kinder- und Jugendmedizin, Universitätsklinikum der Ruhr-Universität Bochum, Bochum, Germany
| | - Michael Krawinkel
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Institut für Ernährungswissenschaft, Justus-Liebig-Universität Gießen, Gießen, Germany
- Deutsche Gesellschaft für Ernährung e. V. (DGE), Bonn, Germany
| | - Hildegard Przyrembel
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
| | - Marianne Röbl-Mathieu
- Mitglied der Ständigen Impfkommission am Robert Koch-Institut (STIKO), Berlin, Germany
| | - Ulrich Schiffner
- Poliklinik für Zahnerhaltung und Präventive Zahnheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
- Deutsche Gesellschaft für Kinderzahnheilkunde e. V. (DGKiZ), Würzburg, Germany
| | - Klaus Vetter
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Nationale Stillkommission, Bundesinstitut für Risikobewertung (BfR), Berlin, Germany
| | - Anke Weißenborn
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Bundesinstitut für Risikobewertung (BfR), Berlin, Germany
| | - Achim Wöckel
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Frauenklinik und Poliklinik Universitätsklinikum Würzburg, Würzburg, Germany
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