1
|
Meloncelli N, Wilkinson SA, Rushton A, Pateman K, Gallaher S, O'Connor H, Kearney L, de Jersey S. Co-designing The Healthy Gut Diet for Preventing Gestational Diabetes: Co-design methods and process outcomes. J Hum Nutr Diet 2024. [PMID: 38894634 DOI: 10.1111/jhn.13341] [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: 02/12/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a common and costly condition of pregnancy. The Healthy Gut Diet for Preventing Gestational Diabetes study is a novel randomised controlled trial that aims to prevent GDM through a diet that modulates the gut microbiota for pregnant women with GDM risk factors. Despite increasing interest in co-designing interventions with consumers (lived experience experts), co-design methods and outcomes are often poorly reported. The present study aims to report on the co-design process used to develop The Healthy Gut Diet intervention. METHODS Co-design occurred across three online workshops with consumer participants (women with a lived experience of GDM, n = 11), researchers (n = 6) and workshop co-facilitators (including a consumer co-facilitator, n = 2). The workshops explored women's preferences for the mode and length of education sessions, as well as the types of information and supportive resources women wanted to receive, and undertook a "behaviour diagnosis" to understand barriers and enablers to the target behaviours (eating for gut health). The final intervention is reported according to the Template for Intervention Description and Replication. RESULTS A co-designed dietary intervention (The Healthy Gut Diet), delivered via telehealth, with a suite of educational and supportive resources that integrates published behaviour change techniques, was developed. Generally, the co-design process was reported as a positive experience based on participant feedback and evidenced by no participant dropouts over the 3-month study period. CONCLUSIONS Co-design is recognised as a process that creates a partnership between lived experience experts and researchers who can engage and empower research recipients and improve health behaviours.
Collapse
Affiliation(s)
- Nina Meloncelli
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Office of the Chief Allied Health Practitioner, Metro North Health, Herston, QLD, Australia
| | - Shelley A Wilkinson
- Department of Obstetric Medicine, Mater Mothers Hospitals, South Brisbane, QLD, Australia
- School of Pharmacy; Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Alita Rushton
- Office of the Chief Allied Health Practitioner, Metro North Health, Herston, QLD, Australia
| | - Kelsey Pateman
- Centre for Allied Health Research, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
- School of Dentistry, The University of Queensland, Herston, QLD, Australia
| | | | - Hannah O'Connor
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Dietetics and Foodservices; Royal Brisbane and Women's Hospital; Metro North Health, Herston, QLD, Australia
| | - Lauren Kearney
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, Australia
- Women's and Newborn Service Group, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Susan de Jersey
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Dietetics and Foodservices; Royal Brisbane and Women's Hospital; Metro North Health, Herston, QLD, Australia
| |
Collapse
|
2
|
Kilpatrick ML, Venn AJ, Barnden KR, Newett K, Harrison CL, Skouteris H, Hills AP, Hill B, Lim SS, Jose KA. Health System and Individual Barriers to Supporting Healthy Gestational Weight Gain and Nutrition: A Qualitative Study of the Experiences of Midwives and Obstetricians in Publicly Funded Antenatal Care in Tasmania, Australia. Nutrients 2024; 16:1251. [PMID: 38732498 PMCID: PMC11085055 DOI: 10.3390/nu16091251] [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: 03/15/2024] [Revised: 04/11/2024] [Accepted: 04/18/2024] [Indexed: 05/13/2024] Open
Abstract
Individual and health system barriers can impede clinicians from supporting weight-related behaviour change for pregnant women, particularly in publicly funded antenatal care accessed by women from diverse socioeconomic backgrounds. The aim was to understand clinicians' experiences of supporting healthy gestational weight gain for pregnant women in a publicly funded antenatal setting. The work was undertaken to guide the implementation of systems changes, resource development, and workforce capacity building related to nutrition, physical activity, and gestational weight gain in the service. The qualitative descriptive study used purposive sampling and semi-structured interviews conducted between October 2019 and February 2020. Nine midwives and five obstetricians from a publicly funded hospital antenatal service in Tasmania, Australia participated. Interview transcripts were analysed using inductive thematic analysis. The three dominant themes were prioritising immediate needs, continuity of care support weight-related conversations, and limited service capacity for weight- and nutrition-related support. The subthemes were different practices for women according to weight and the need for appropriately tailored resources. Improving access to continuity of care and clinician training, and providing resources that appropriately consider women's socioeconomic circumstances and health literacy would enhance the ability and opportunities for clinicians to better support all women.
Collapse
Affiliation(s)
- Michelle L. Kilpatrick
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia; (A.J.V.); (K.A.J.)
- Centre for Mental Health Service Innovation, Advocate House, Hobart, TAS 7000, Australia
| | - Alison J. Venn
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia; (A.J.V.); (K.A.J.)
| | | | - Kristy Newett
- Royal Hobart Hospital, Hobart, TAS 7000, Australia; (K.R.B.)
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3168, Australia;
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (H.S.); (B.H.)
- Warwick Business School, University of Warwick, Coventry CV4 7AL, UK
| | - Andrew P. Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia;
| | - Briony Hill
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (H.S.); (B.H.)
| | - Siew S. Lim
- Eastern Health Clinical School, Monash University, Melbourne, VIC 3128, Australia;
| | - Kim A. Jose
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia; (A.J.V.); (K.A.J.)
| |
Collapse
|
3
|
Meloncelli N, O’Connor H, Wilkinson SA, Nitert MD, Kearney L, de Jersey S. Preventing Gestational Diabetes with a Healthy Gut Diet: Protocol for a Pilot, Feasibility Randomized Controlled Trial. Nutrients 2023; 15:4653. [PMID: 37960306 PMCID: PMC10649061 DOI: 10.3390/nu15214653] [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: 09/15/2023] [Revised: 10/18/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
Around 14% of pregnancies globally are affected by gestational diabetes mellitus (GDM), making it one of the most common disorders experienced by women in pregnancy. While dietary, physical activity and supplement interventions have been implemented to prevent GDM, with varying levels of success, altering the gut microbiota through diet is a promising strategy for prevention. Several studies have demonstrated that women with GDM likely have a different gut microbiota to pregnant women without GDM, demonstrating that the gut microbiota may play a part in glycemic control and the development of GDM. To date, there have been no randomized controlled trials using diet to alter the gut microbiota in pregnancy with the aim of preventing GDM. Here, we present the study protocol for a single-blind randomized controlled trial which aims to determine the effectiveness of the Healthy Gut Diet on reducing the diagnosis of GDM in pregnant women with one or more risk factors. Consenting women will be randomized into either the Healthy Gut Diet intervention group or the usual care (control) group after 11 weeks gestation. The women in the intervention group will receive three telehealth counseling appointments with an Accredited Practicing Dietitian with the aim of educating and empowering these women to build a healthy gut microbiota through their diet. The intervention was co-designed with women who have lived experience of GDM and incorporates published behavior change techniques. The control group will receive the usual care and will also be shown a brief (3 min) video on general healthy eating in pregnancy. The primary outcome is the diagnosis of GDM at any stage of the pregnancy. Secondary outcomes include changes to gut microbiota composition and diversity; gestational weight gain; maternal and infant outcomes; management of GDM (where relevant); dietary quality and intake; physical activity; and depression scoring. We aim to recruit 120 women over 16 months. Recruitment commenced in January 2023. The trial has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622001285741).
Collapse
Affiliation(s)
- Nina Meloncelli
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4029, Australia
- Office of the Chief Allied Health Practitioner, Metro North Hospital and Health Service, Brisbane, QLD 4029, Australia
| | - Hannah O’Connor
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4029, Australia
| | - Shelley A. Wilkinson
- Department of Obstetric Medicine, Mater Mothers Hospital, South Brisbane, QLD 4101, Australia;
- Faculty of Health and Behavioural Sciences, School of Pharmacy, The University of Queensland, Brisbane, QLD 4102, Australia
| | - Marloes Dekker Nitert
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD 4072, Australia;
| | - Lauren Kearney
- Women’s and Newborn Service Group, Royal Brisbane and Women’s Hospital, Metro North Health, Brisbane, QLD 4029, Australia;
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD 4102, Australia
| | - Susan de Jersey
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4029, Australia
- Department of Dietetics and Foodservices, Royal Brisbane and Women’s Hospital, Metro North Health, Brisbane, QLD 4029, Australia
| |
Collapse
|
4
|
Knox B, Galera C, Sutter-Dallay AL, Heude B, de Lauzon-Guillain B, van der Waerden J. A network analysis of nutritional markers and maternal perinatal mental health in the French EDEN cohort. BMC Pregnancy Childbirth 2023; 23:603. [PMID: 37612677 PMCID: PMC10463670 DOI: 10.1186/s12884-023-05914-w] [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: 12/05/2022] [Accepted: 08/10/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Perinatal maternal depression and anxiety are associated with adverse maternal outcomes, and nutrition may play an important role in their emergence. Previous research shows that certain micro and macronutrients found in different dietary patterns may associate with perinatal mood disorders. This study aims to explore relationships between nutrition during pregnancy and perinatal maternal depression and anxiety symptoms using network analyses. METHODS Using data from the French EDEN mother-child cohort, the sample consisted of 1438 women with available mental health outcomes (CES-D, STAI and EPDS) and nutritional markers collected from food frequency questionnaires. Four networks were constructed to explore the relationships between prenatal nutrient status, dietary patterns, and perinatal mental health, while accounting for important confounders. RESULTS The Healthy dietary pattern was associated with the presence of vital micronutrients, while the Western dietary pattern was consistently associated with poorer intake of specific micronutrients and contained an excess of certain macronutrients. Western dietary pattern and symptoms of postnatal depression were connected by a positive edge in both the macronutrient and micronutrient networks. Lower education levels were associated with higher Western dietary pattern scores, from which a positive edge linked to postnatal depression symptoms in both models. CONCLUSIONS A Western dietary pattern was associated with increased symptoms of postnatal depression in our adjusted network models; The Healthy dietary pattern was associated with essential micronutrients but not with symptoms of depression or anxiety. Perinatal mental health might be impacted by specific dietary patterns in the context of psychosocial and physical stress associated with pregnancy.
Collapse
Affiliation(s)
- Bethany Knox
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, F75012, France
| | - Cédric Galera
- University of Bordeaux, Bordeaux, France
- INSERM, Bordeaux Population Health Center, UMR1219, Bordeaux, France
- Centre Hospitalier Perrens, Bordeaux, France
| | - Anne-Laure Sutter-Dallay
- University of Bordeaux, Bordeaux, France
- INSERM, Bordeaux Population Health Center, UMR1219, Bordeaux, France
- Centre Hospitalier Perrens, Bordeaux, France
| | - Barbara Heude
- Université Paris Cité and Université Sorbonne Paris Nord, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Inserm, Paris, France
| | - Blandine de Lauzon-Guillain
- Université Paris Cité and Université Sorbonne Paris Nord, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Inserm, Paris, France
| | - Judith van der Waerden
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe de Recherche en Epidémiologie Sociale, 27 Rue Chaligny, Paris Cedex 12, 75571, France.
| |
Collapse
|
5
|
Feasibility of a Food Delivery Intervention during Pregnancy in a Rural US Population: The PEAPOD Pilot Study. Nutrients 2023; 15:nu15040816. [PMID: 36839174 PMCID: PMC9958944 DOI: 10.3390/nu15040816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/28/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
Pregnancy nutrition is important for maternal and child health and may affect the development of the infant gut microbiome. Our objective was to assess the feasibility of implementing a food-based intervention designed to increase fiber intake among pregnant women in a rural setting. Participants were enrolled (N = 27) mid-pregnancy from a prenatal care clinic in rural Michigan, randomized to intervention (N = 13) or usual care (N = 14), and followed to 6 weeks postpartum. The intervention was designed to be easily replicable and scalable by partnering with hospital foodservices and included non-perishable high fiber foods and recipes, as well as weekly delivery of salads, soup, and fresh fruit. Surveys, maternal blood, urine, and stool were collected at 24- and 36-weeks gestation and at 6 weeks postpartum. Infant stool was collected at 6 weeks. Participants were 100% White (7% Hispanic White, 7% Native American and White); 55% with education < 4-year college degree. Data on dietary intake and urinary trace elements are presented as evidence of feasibility of outcome measurement. Retention was high at 93%; 85% reported high satisfaction. The intervention described here can be replicated and used in larger, longer studies designed to assess the effects of pregnancy diet on the establishment of the infant gut microbiome and related health outcomes.
Collapse
|
6
|
Roche D, Rafferty A, Holden S, Killeen SL, Kennelly M, McAuliffe FM. Maternal Well-Being and Stage of Behaviour Change during Pregnancy: A Secondary Analysis of the PEARS Randomised Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:34. [PMID: 36612357 PMCID: PMC9819687 DOI: 10.3390/ijerph20010034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
We aimed to determine whether early pregnancy well-being was associated with the stage of behaviour change during an antenatal lifestyle intervention using a secondary analysis of data from the Pregnancy Exercise and Nutrition Research Study (PEARS). Pregnant women (n = 277) with well-being data in early pregnancy were included. Maternal well-being was measured using the World Health Organisation Five-Item Well-Being Index. The intervention consisted of a mobile health (mHealth) phone application, supported by antenatal education and exercise, to prevent gestational diabetes in a population with overweight. Stage of behaviour change was measured in late pregnancy using a five-stage classification. Ordinal logistic regression was used to examine if well-being, the study group, or their interaction, were related to behaviour change. Maternal well-being (OR 1.03, 95% CI 1.01, 1.04, p < 0.01) and the study group (OR 2.25, 95% CI 1.44, 3.51, p < 0.01) both significantly influenced the positive stage of behaviour change. The probability of being at stage 5 increased from 43 to 92% as well-being increased from 0 to 100% and was higher in the intervention (53%) compared to the control (34%) group (p ≤ 0.01 (8.65, 29.27). This study demonstrates the potential importance of well-being in enabling women to engage with a healthy lifestyle, and the role that mHealth technology has in facilitating beneficial behaviour change.
Collapse
Affiliation(s)
- Doireann Roche
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Anthony Rafferty
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Sinead Holden
- UCD School of Mathematics and Statistics, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Maria Kennelly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Fionnuala M. McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| |
Collapse
|
7
|
Yamada P, Paetow A, Chan M, Arslan A, Landberg R, Young BK. Pregnancy outcomes with differences in grain consumption: a randomized controlled trial. J Perinat Med 2022; 50:411-418. [PMID: 34981703 DOI: 10.1515/jpm-2021-0479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/13/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Contemporary obstetrics has begun to appreciate the importance of diet in pregnancy, but guidelines are not based on robust data. The hypothesis that a whole grains diet improves pregnancy outcomes is tested in this study. We compared maternal and neonatal outcomes for a pregnancy diet containing 75% of total carbohydrates as refined grains with outcomes for a diet with 75% of total carbohydrates as whole grains. METHODS This was a randomized interventional study in a clinic population over the last 4-7 months of normal pregnancy with extensive compliance measures. Besides obstetrical and neonatal outcomes, anthropometric measurements were done. In addition to food frequency questionnaires (FFQs), total plasma alkyl resorcinols, a unique quantitative measure of whole grains, were used as a measure of whole grain consumption. RESULTS The data show effective compliance and no difference in outcomes between the diets with regard to maternal weight gain, birth weights, subcutaneous fat and glucose tolerance. CONCLUSIONS Ensuring compliance to a proper pregnancy diet resulted in satisfactory weight gain and normal outcomes even when the proportion of whole grains consumed is only 25% of total carbohydrates.
Collapse
Affiliation(s)
- Pamella Yamada
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, USA
| | - Alexandra Paetow
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, USA
| | - Michael Chan
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, USA
| | - Alan Arslan
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, USA
| | - Rikard Landberg
- Division of Food and Nutrition Science, Department of Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Bruce K Young
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, USA
| |
Collapse
|
8
|
A randomized controlled trial of the effects of whole grains versus refined grains diets on the microbiome in pregnancy. Sci Rep 2022; 12:7509. [PMID: 35525865 PMCID: PMC9079079 DOI: 10.1038/s41598-022-11571-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 04/18/2022] [Indexed: 01/04/2023] Open
Abstract
Dietary whole grain consumption has been postulated to have metabolic benefits. The purpose of this study was to compare a pregnancy diet containing 75% of total carbohydrates as refined grains with a diet of 75% of total carbohydrates as whole grains for pregnancy outcomes and effects on the microbiome. Gestational weight gain, glucose tolerance and newborn outcomes were measured on 248 enrolled compliant women from whom a subset of 103 women consented to give 108 vaginal and 109 anal swabs. The data presented here are limited to the patients from whom the vaginal and anal swabs were obtained in order to study the microbiome. A microbiome—16SrRNA survey—was characterized in these samples. Samples and measurements were obtained at the first obstetrical visit, before beginning a prescribed diet (T1—baseline) and after 17–32 weeks on the prescribed diet (T3). Food frequency questionnaires and total plasma alkylresorcinols were used as a measure of whole grain consumption. There were no dietary differences in maternal weight gain, birth weight, or glucose tolerance test. Mothers consuming the whole grains diet showed a trend of gestational decrease in vaginal bacterial alpha diversity, with increasing Lactobacillus-dominance. No significant difference was observed for the anal microbiome. The results suggest that diet modulations of the vaginal microbiome during gestation may have important implications for maternal and neonatal health and in the intergenerational transfer of maternal microbiome. Trial registration: ClinicalTrials.gov Identifier: NCT03232762.
Collapse
|
9
|
Carbonneau E, Dumas A, Brodeur-Doucet A, Fontaine-Bisson B. A Community Prenatal Intervention in Social Nutrition: Evaluating the Impact on Pregnancy and Birthweight Outcomes. Nutrients 2022; 14:nu14061151. [PMID: 35334807 PMCID: PMC8951613 DOI: 10.3390/nu14061151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 02/04/2023] Open
Abstract
This study aims to assess the associations between structural features of the Montreal Diet Dispensary’s social nutrition intervention and pregnancy (i.e., anemia, gestational diabetes mellitus (GDM), gestational weight gain (GWG), hypertension) and birthweight outcomes (i.e., small- or large-for-gestational-age) among pregnant women, most of them recent immigrants. The study consists of a secondary analysis of the digital client database of the Montreal Diet Dispensary (n = 2925). Logistic regressions were used to estimate the odds of pregnancy and birthweight outcomes, depending on structural features of the intervention. Pregnant women who attended a welcoming group session presented lower odds of GDM and anemia compared to those who did not attend. A longer duration of intervention was also associated with lower odds of GDM and anemia. Each additional appointment with a dietitian was associated with higher odds of excessive GWG and lower odds of insufficient GWG only among women with a pre-pregnancy BMI lower than 25 kg/m2. This study emphasizes the importance of providing nutritional services early in pregnancy to reduce the risk of GDM and anemia. It also stresses the importance of using appropriate nutritional guidelines to avoid increasing the risk of excessive GWG.
Collapse
Affiliation(s)
- Elise Carbonneau
- School of Nutrition Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
- Centre NUTRISS—Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Quebec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, Quebec, QC G1V 0A6, Canada
- Correspondence:
| | - Alex Dumas
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
- Institut du Savoir Montfort, Montfort Hospital, Ottawa, ON K1K 0T2, Canada
| | | | - Bénédicte Fontaine-Bisson
- School of Nutrition Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
- Institut du Savoir Montfort, Montfort Hospital, Ottawa, ON K1K 0T2, Canada
| |
Collapse
|
10
|
Abstract
The present paper outlines current issues in the nutritional care of women during pregnancy and potential resources to address them. Globally, overnutrition, undernutrition and nutritional imbalances are widespread among women of reproductive age; increasing the risk of pregnancy complications and non-communicable diseases in both mothers and their children. Most women do not meet dietary guidelines for pregnancy. The World Health Organisation (WHO) recommends nutrition and weight counselling during pregnancy for all women. However, clinical practices focusing on nutrition vary and there is no consensus on which outcomes are most important for pregnancy nutrition interventions, with little consideration for the 'patient voice'. The International Federation of Gynaecology and Obstetrics (FIGO) nutrition checklist is a clinical practice tool that is available for healthcare professionals that will address this issue. The pregnancy nutrition core outcome set will also support advancement of antenatal nutrition by identifying the most critical nutrition-related outcomes from the perspective of healthcare professionals, researchers and women with experience of pregnancy. While poor nutrition can result in adverse outcomes across women of all weight categories, those with obesity may require specialist care to reduce their risk. Obesity is a chronic, progressive, relapsing disease that has high individual variability in its prognosis. The use of obesity staging systems, which consider mental, physical and functional health, can stratify individuals into risk categories and aid in treatment prioritisation in pregnancy. As the prevalence of obesity continues to rise, an obesity staging approach may support clinicians, especially those in limited resource settings.
Collapse
|
11
|
Chang MW, Lin CJ, Lee RE, Wegener DT, Hu J, Williams KP. Factors Associated with Beverage Intake in Low-Income, Overweight, or Obese Pregnant Women. Nutrients 2022; 14:nu14040840. [PMID: 35215490 PMCID: PMC8877862 DOI: 10.3390/nu14040840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/06/2022] [Accepted: 02/15/2022] [Indexed: 02/05/2023] Open
Abstract
This study examined consumption proportions and factors associated with sugar-sweetened beverages (SSBs), artificially sweetened beverages (ASBs), and 100% fruit juice (FJ) consumption. We recruited Non-Hispanic Black (n = 136) and White (n = 192) low-income overweight or obese pregnant women aged 18 to 46 years (mean = 25.7 years) from the Special Supplemental Nutrition Program for Women, Infants, and Children clinics in Michigan, USA. Independent variables included weight status, trimester, smoking, stress, education, employment, race, and age. Dependent variables were high (consuming ≥ 1 serving/day) versus low consumptions of SSB, ASB, and 100% FJ. Multivariate logistic regression modeling was performed to examine factors associated with beverage consumption. Out of the sample, 48.2%, 6.7%, and 31.3% reported high SSB, ASB, and 100% FJ consumption, respectively. SSB consumption was associated with smoking (OR: 3.77, p < 0.001), education (OR: 0.57, p = 0.03), and race (OR: 1.69, p = 0.03). Artificially sweetened beverage consumption was not associated with any factors examined. One hundred percent FJ consumption was associated with stress (OR: 0.90, p = 0.03) and race (OR: 4.48, p < 0.001). Clinicians may advocate for reductions in SSB and 100% FJ consumption tailored to client consumption characteristics.
Collapse
Affiliation(s)
- Mei-Wei Chang
- College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH 43210, USA; (C.J.L.); (J.H.); (K.P.W.)
- Correspondence: ; Tel.: +86-614-247-7211; Fax: +1-614-292-4948
| | - Chyongchiou J. Lin
- College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH 43210, USA; (C.J.L.); (J.H.); (K.P.W.)
| | - Rebecca E. Lee
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd St., Phoenix, AZ 85004, USA;
| | - Duane T. Wegener
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH 43210, USA;
| | - Jie Hu
- College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH 43210, USA; (C.J.L.); (J.H.); (K.P.W.)
| | - Karen Patricia Williams
- College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH 43210, USA; (C.J.L.); (J.H.); (K.P.W.)
| |
Collapse
|
12
|
What Works to Improve Nutrition and Food Sustainability across the First 2000 Days of Life: A Rapid Review. Nutrients 2022; 14:nu14040731. [PMID: 35215381 PMCID: PMC8878998 DOI: 10.3390/nu14040731] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 12/12/2022] Open
Abstract
Informed by the Innocenti framework, this rapid review of systematic reviews (n = 60) and sentinel grey literature (n = 27) synthesises the evidence of what works to improve nutrition and food sustainability across the first 2000 days. Most systematic reviews focused on interventions targeting the behaviour of parents and caregivers (n = 49), with fewer reviews focusing on the personal (n = 7) and external (n = 4) food environments. No reviews focused on food supply-chain activities. Most reviews were rated as critically low (n = 28, 47%) or low (n = 21, 35%) quality using AMSTAR 2. Evidence supports the effectiveness of multi-component breastfeeding interventions, interventions delivered in home and child-care settings, particularly when involving parents, interactive skill building and repeated exposure to vegetables. Food vouchers and access to local farmers markets and community gardens have potential for improving access and availability to healthier foods, while evidence supports interventions improving the external food environment, including fiscal strategies such as the SSB tax, restrictions on marketing and advertising of discretionary products and improved food labelling. Overall, this review highlights the importance of action across a range of settings and sectors at the international, national and local levels to improve young children’s diets.
Collapse
|
13
|
van Lonkhuijzen RMR, Cremers SS, de Vries JHMJ, Feskens EJME, Wagemakers MAEA. Evaluating ‘Power 4 a Healthy Pregnancy’ (P4HP) – protocol for a cluster randomized controlled trial and process evaluation to empower pregnant women towards improved diet quality. BMC Public Health 2022; 22:148. [PMID: 35062921 PMCID: PMC8780817 DOI: 10.1186/s12889-022-12543-z] [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: 12/24/2021] [Accepted: 01/07/2022] [Indexed: 12/19/2022] Open
Abstract
Background In general during pregnancy, women are aware of the importance of good diet quality, interested in nutrition, and receptive to changing dietary intake. However, adherence to dietary guidelines is sub-optimal. A pregnant woman’s first information source regarding nutrition information is her midwife. Healthy nutrition promotion by midwives may therefore be very promising, but midwives face multiple barriers in providing nutritional support. Empowering pregnant women to improve their diet quality is expected to improve their health. Therefore an empowerment intervention has been developed to improve diet quality among pregnant women. The objective of this study is to evaluate the effectiveness and feasibility of Power 4 a Healthy Pregnancy (P4HP). P4HP aims to empower pregnant women to have a healthier diet quality. Methods/design This study applies a mixed methodology consisting of a non-blinded cluster randomized trial with an intervention (P4HP) group and a control group and a process evaluation. Midwifery practices, the clusters, will be randomly allocated to the intervention arm (n = 7) and control arm (n = 7). Participating women are placed in intervention or control conditions based on their midwifery practice. Each midwifery practice includes 25 pregnant women, making 350 participants in total. Health related outcomes, diet quality, empowerment, Sense of Coherence, Quality of Life, and Self-Rated Health of participants will be assessed before (T0) and after (T1) the intervention. The process evaluation focuses on multidisciplinary collaboration, facilitators, and barriers, and consists of in-depth interviews with midwives, dieticians and pregnant women. Discussion This study is the first to evaluate an empowerment intervention to improve diet quality in this target population. This mixed method evaluation will contribute to knowledge about the effectiveness and feasibility regarding diet quality, empowerment, health-related outcomes, multidisciplinary collaboration, facilitators and barriers of the empowerment intervention P4HP. Results will help inform how to empower pregnant women to achieve improved diet quality by midwives and dieticians. If proven effective, P4HP has the potential to be implemented nationally and scaled up to a long-term trajectory from preconception to the postnatal phase. Trial registration The trial is prospectively registered at the Netherlands Trial Register (NL9551). Date registered: 19/05/2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12543-z.
Collapse
|
14
|
Sauder KA, Harte RN, Ringham BM, Guenther PM, Bailey RL, Alshawabkeh A, Cordero JF, Dunlop AL, Ferranti EP, Elliott AJ, Mitchell DC, Hedderson MM, Avalos LA, Zhu Y, Breton CV, Chatzi L, Ran J, Hertz-Picciotto I, Karagas MR, Sayarath V, Hoover J, MacKenzie D, Lyall K, Schmidt RJ, O'Connor TG, Barrett ES, Switkowski KM, Comstock SS, Kerver JM, Trasande L, Tylavsky FA, Wright RJ, Kannan S, Mueller NT, Catellier DJ, Glueck DH, Dabelea D. Disparities in Risks of Inadequate and Excessive Intake of Micronutrients during Pregnancy. J Nutr 2021; 151:3555-3569. [PMID: 34494118 PMCID: PMC8564697 DOI: 10.1093/jn/nxab273] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/29/2021] [Accepted: 07/26/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Inadequate or excessive intake of micronutrients in pregnancy has potential to negatively impact maternal/offspring health outcomes. OBJECTIVE The aim was to compare risks of inadequate or excessive micronutrient intake in diverse females with singleton pregnancies by strata of maternal age, race/ethnicity, education, and prepregnancy BMI. METHODS Fifteen observational cohorts in the US Environmental influences on Child Health Outcomes (ECHO) Consortium assessed participant dietary intake with 24-h dietary recalls (n = 1910) or food-frequency questionnaires (n = 7891) from 1999-2019. We compared the distributions of usual intake of 19 micronutrients from food alone (15 cohorts; n = 9801) and food plus dietary supplements (10 cohorts with supplement data; n = 7082) to estimate the proportion with usual daily intakes below their age-specific daily Estimated Average Requirement (EAR), above their Adequate Intake (AI), and above their Tolerable Upper Intake Level (UL), overall and within sociodemographic and anthropometric subgroups. RESULTS Risk of inadequate intake from food alone ranged from 0% to 87%, depending on the micronutrient and assessment methodology. When dietary supplements were included, some women were below the EAR for vitamin D (20-38%), vitamin E (17-22%), and magnesium (39-41%); some women were above the AI for vitamin K (63-75%), choline (7%), and potassium (37-53%); and some were above the UL for folic acid (32-51%), iron (39-40%), and zinc (19-20%). Highest risks for inadequate intakes were observed among participants with age 14-18 y (6 nutrients), non-White race or Hispanic ethnicity (10 nutrients), less than a high school education (9 nutrients), or obesity (9 nutrients). CONCLUSIONS Improved diet quality is needed for most pregnant females. Even with dietary supplement use, >20% of participants were at risk of inadequate intake of ≥1 micronutrients, especially in some population subgroups. Pregnancy may be a window of opportunity to address disparities in micronutrient intake that could contribute to intergenerational health inequalities.
Collapse
Affiliation(s)
- Katherine A Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Robyn N Harte
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Brandy M Ringham
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Patricia M Guenther
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | | | - José F Cordero
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA
| | - Anne L Dunlop
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Erin P Ferranti
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | | | - Diane C Mitchell
- Department of Nutritional Sciences, Penn State University, University Park, PA, USA
| | - Monique M Hedderson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Lyndsay A Avalos
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Carrie V Breton
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Jin Ran
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
| | | | - Vicki Sayarath
- Department of Epidemiology, Dartmouth College, Hanover, NH, USA
| | - Joseph Hoover
- Community Environmental Health Program, College of Pharmacy at the University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Debra MacKenzie
- Community Environmental Health Program, College of Pharmacy at the University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
| | - Rebecca J Schmidt
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
| | - Thomas G O'Connor
- Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Karen M Switkowski
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Sarah S Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA
| | - Jean M Kerver
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Srimathi Kannan
- Department of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor, MI, USA
| | - Noel T Mueller
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Deborah H Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| |
Collapse
|
15
|
Beulen YH, Super S, Rothoff A, van der Laan NM, de Vries JHM, Koelen MA, Feskens EJM, Wagemakers A. What is needed to facilitate healthy dietary behaviours in pregnant women: A qualitative study of Dutch midwives' perceptions of current versus preferred nutrition communication practices in antenatal care. Midwifery 2021; 103:103159. [PMID: 34628180 DOI: 10.1016/j.midw.2021.103159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 09/14/2021] [Accepted: 09/26/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this paper was to explore midwives' perceptions of current and preferred nutrition communication practices in antenatal care, and to identify what is needed to achieve their preferred practices. DESIGN A qualitative descriptive design was used. Semi-structured interviews were conducted with twenty Dutch midwives working in primary care or secondary care settings across the Netherlands. To create a positive atmosphere, interviews were based on the principles of Appreciative Inquiry. FINDINGS Opportunities identified in current practices included midwives' sense of responsibility, their skills and experience, availability of resources, and group consultations. Barriers were the precarity and lack of prioritization of the topic, and the current focus on food safety (risks). Ideally, midwives envisioned nutrition communication as a continuous trajectory, in which not only reliable and consistent information is provided, but also more personalized and positive communication, to empower pregnant women. KEY CONCLUSIONS Midwives favour nutrition communication practices characterized by continuity of care and woman-centeredness. Opportunities to realize such practices in antenatal care are the use of innovative tools to support nutrition communication, more sustainable collaborations with dietitians, and better nutrition education for midwives. IMPLICATIONS FOR PRACTICE Midwives could act as facilitators and gatekeepers in nutrition communication, requiring limited time and expertise from midwives, and empowering pregnant women.
Collapse
Affiliation(s)
- Yvette H Beulen
- Social Sciences Group, Wageningen University & Research, Wageningen, the Netherlands; Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Sabina Super
- Social Sciences Group, Wageningen University & Research, Wageningen, the Netherlands
| | - Auke Rothoff
- Social Sciences Group, Wageningen University & Research, Wageningen, the Netherlands
| | | | - Jeanne H M de Vries
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Maria A Koelen
- Social Sciences Group, Wageningen University & Research, Wageningen, the Netherlands
| | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Annemarie Wagemakers
- Social Sciences Group, Wageningen University & Research, Wageningen, the Netherlands.
| |
Collapse
|
16
|
Super S, Beulen YH, Koelen MA, Wagemakers A. Opportunities for dietitians to promote a healthy dietary intake in pregnant women with a low socio-economic status within antenatal care practices in the Netherlands: a qualitative study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:35. [PMID: 34332642 PMCID: PMC8325401 DOI: 10.1186/s41043-021-00260-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 07/12/2021] [Indexed: 05/14/2023]
Abstract
Background A healthy dietary intake during pregnancy is important for maternal and child health. However, pregnant women with a low socio-economic status often fail to meet dietary guidelines and requirements for healthy nutrition. Dietitians may play an important role in providing nutritional advice during pregnancy because midwives often experience a lack of nutritional knowledge, time and skills to provide adequate advice. However, there is limited research on the support that dietitians can offer in antenatal care practices for pregnant women. Therefore, this study aims to explore the opportunities for dietitians to support pregnant women with a low socio-economic status in concurrent antenatal care practices in the Netherlands. Methods In-depth interviews were conducted with 14 pregnant women with a low socio-economic status and 13 dietitians to identify barriers for healthy eating for pregnant women and the associated opportunities for dietitians to support these women in making healthy dietary changes. Results Four opportunities for dietitians to support pregnant women in making dietary changes could be discerned: (1) creating awareness of healthy and unhealthy eating patterns, (2) providing reliable and personally relevant information, (3) help identifying barriers and solutions for healthy eating and (4) making healthy eating manageable. Dietitians indicated that supporting pregnant women with a low socio-economic status in consuming a healthy diet requires the investment of sufficient time, effort and money. Conclusions Dietitians are trained and well-equipped to provide extensive support to pregnant women to promote a healthy dietary intake, especially when the complex interplay of barriers that pregnant women with a low socio-economic status experience for healthy eating needs to be addressed. In addition, there is a strong need for strengthening the collaboration between dietitians and midwives because midwives are the primary care provider for pregnant women in the Netherlands, but they often lack sufficient opportunities to provide adequate nutrition support. Strengthening this collaboration could promote that nutrition becomes a recurring and standard topic in antenatal care.
Collapse
Affiliation(s)
- Sabina Super
- Health and Society, Social Sciences Group, Wageningen University & Research, Postbus 8130, 6700 KN Wageningen, the Netherlands
| | - Yvette H. Beulen
- Health and Society, Social Sciences Group, Wageningen University & Research, Postbus 8130, 6700 KN Wageningen, the Netherlands
| | - Maria A. Koelen
- Health and Society, Social Sciences Group, Wageningen University & Research, Postbus 8130, 6700 KN Wageningen, the Netherlands
| | - Annemarie Wagemakers
- Health and Society, Social Sciences Group, Wageningen University & Research, Postbus 8130, 6700 KN Wageningen, the Netherlands
| |
Collapse
|
17
|
BA D, BA S, MD M. What the World Needs Now: Lifestyle Medicine for All Women. Am J Lifestyle Med 2021; 17:97-107. [PMID: 36636386 PMCID: PMC9830235 DOI: 10.1177/15598276211028101] [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: 01/16/2023] Open
Abstract
Over the last several centuries, economic progress has allowed millions of women to move from rural subsistence agriculture to urban, more economically prosperous lifestyles. This trend is set to continue, even accelerate in the next century. Due to changes in diet, activity, and lifestyle, non-communicable diseases, such as cancer and heart disease, will continue to rise for women globally. At this time, we are uniquely positioned to anticipate this impact and empower women in both the developed and the developing world to learn from what has worked. Choosing the best approaches to nutrition, exercise, sleep, connectedness, substances, and stress can optimize women's health span across the globe.
Collapse
Affiliation(s)
| | | | - McHugh MD
- John McHugh, The Keck School of Medicine,
University of Southern California, 3334 E. Coast Highway #708 Corona del Mar, CA
92625, USA; e-mail:
| |
Collapse
|
18
|
Curcumin: Could This Compound Be Useful in Pregnancy and Pregnancy-Related Complications? Nutrients 2020; 12:nu12103179. [PMID: 33080891 PMCID: PMC7603145 DOI: 10.3390/nu12103179] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/08/2020] [Accepted: 10/12/2020] [Indexed: 02/06/2023] Open
Abstract
Curcumin, the main polyphenol contained in turmeric root (Curcuma longa), has played a significant role in medicine for centuries. The growing interest in plant-derived substances has led to increased consumption of them also in pregnancy. The pleiotropic and multi-targeting actions of curcumin have made it very attractive as a health-promoting compound. In spite of the beneficial effects observed in various chronic diseases in humans, limited and fragmentary information is currently available about curcumin’s effects on pregnancy and pregnancy-related complications. It is known that immune-metabolic alterations occurring during pregnancy have consequences on both maternal and fetal tissues, leading to short- and long-term complications. The reported anti-inflammatory, antioxidant, antitoxicant, neuroprotective, immunomodulatory, antiapoptotic, antiangiogenic, anti-hypertensive, and antidiabetic properties of curcumin appear to be encouraging, not only for the management of pregnancy-related disorders, including gestational diabetes mellitus (GDM), preeclampsia (PE), depression, preterm birth, and fetal growth disorders but also to contrast damage induced by natural and chemical toxic agents. The current review summarizes the latest data, mostly obtained from animal models and in vitro studies, on the impact of curcumin on the molecular mechanisms involved in pregnancy pathophysiology, with the aim to shed light on the possible beneficial and/or adverse effects of curcumin on pregnancy outcomes.
Collapse
|