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Ghorbani‐Kafteroodi S, Ghiasvand M, Saghafi‐Asl M, Kazemi Aski S. Association of dietary patterns of pregnant women with pregnancy outcomes: A hospital-based study. Food Sci Nutr 2023; 11:8072-8081. [PMID: 38107120 PMCID: PMC10724595 DOI: 10.1002/fsn3.3726] [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: 06/25/2023] [Revised: 09/14/2023] [Accepted: 09/20/2023] [Indexed: 12/19/2023] Open
Abstract
Diet is one of the main factors influencing pregnancy outcomes. Maternal and child health both seem to be related to dietary patterns. So far, no study on dietary pattern has been performed on pregnant women and its association with pregnancy outcomes in Rasht. Therefore, the present study aimed to investigate the association between dietary patterns and pregnancy outcomes in Rasht. In this cross-sectional study, 300 healthy pregnant women were included from three public hospitals in Rasht. Data on demographic, dietary intake, physical activity (PA), and anthropometric measurements of mothers were recorded. Outcomes of newborns were also gathered. Dietary patterns were identified using principal component analysis. General linear model was used for data analysis. Prior to pregnancy, only 40% of women had a normal body mass index (BMI). More than half of them (52.3%) had a gestational weight gain in excess of the guidelines. The dominant dietary patterns among pregnant women were traditional, Western, and healthy, respectively. High adherence to the Western pattern had a direct association with gestational weight gain (B = 1.48, p = .046) and inverse association with birth length (B = -0.71, p = .043). However, the results did not remain significant after adjusting for covariates. The present study indicated that several factors can affect the association of the Western diet with pregnancy outcomes. Therefore, making policies for interventional programs to improve maternal lifestyle factors along with their diet quality is recommended.
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Affiliation(s)
| | - Maryam Ghiasvand
- School of Nutrition and Food SciencesTabriz University of Medical SciencesTabrizIran
| | - Maryam Saghafi‐Asl
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food SciencesTabriz University of Medical SciencesTabrizIran
| | - Soudabeh Kazemi Aski
- Reproductive Health Research Center, Department of Obstetrics and Gynecology, Al‐Zahra Hospital, School of MedicineGuilan University of Medical SciencesRashtIran
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Harris HA, Friedman C, Starling AP, Dabelea D, Johnson SL, Fuemmeler BF, Jima D, Murphy SK, Hoyo C, Jansen PW, Felix JF, Mulder RH. An epigenome-wide association study of child appetitive traits and DNA methylation. Appetite 2023; 191:107086. [PMID: 37844693 PMCID: PMC11156223 DOI: 10.1016/j.appet.2023.107086] [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: 06/19/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 10/18/2023]
Abstract
The etiology of childhood appetitive traits is poorly understood. Early-life epigenetic processes may be involved in the developmental programming of appetite regulation in childhood. One such process is DNA methylation (DNAm), whereby a methyl group is added to a specific part of DNA, where a cytosine base is next to a guanine base, a CpG site. We meta-analyzed epigenome-wide association studies (EWASs) of cord blood DNAm and early-childhood appetitive traits. Data were from two independent cohorts: the Generation R Study (n = 1,086, Rotterdam, the Netherlands) and the Healthy Start study (n = 236, Colorado, USA). DNAm at autosomal methylation sites in cord blood was measured using the Illumina Infinium HumanMethylation450 BeadChip. Parents reported on their child's food responsiveness, emotional undereating, satiety responsiveness and food fussiness using the Children's Eating Behaviour Questionnaire at age 4-5 years. Multiple regression models were used to examine the association of DNAm (predictor) at the individual site- and regional-level (using DMRff) with each appetitive trait (outcome), adjusting for covariates. Bonferroni-correction was applied to adjust for multiple testing. There were no associations of DNAm and any appetitive trait when examining individual CpG-sites. However, when examining multiple CpGs jointly in so-called differentially methylated regions, we identified 45 associations of DNAm with food responsiveness, 7 associations of DNAm with emotional undereating, 13 associations of DNAm with satiety responsiveness, and 9 associations of DNAm with food fussiness. This study shows that DNAm in the newborn may partially explain variation in appetitive traits expressed in early childhood and provides preliminary support for early programming of child appetitive traits through DNAm. Investigating differential DNAm associated with appetitive traits could be an important first step in identifying biological pathways underlying the development of these behaviors.
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Affiliation(s)
- Holly A Harris
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Erasmus University Rotterdam, Department of Psychology, Education & Child Studies, Rotterdam, the Netherlands.
| | - Chloe Friedman
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Anne P Starling
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Susan L Johnson
- Department of Pediatrics, Section of Nutrition, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Bernard F Fuemmeler
- Virginia Commonwealth University, Massey Comprehensive Cancer Center, Richmond, VA, USA.
| | - Dereje Jima
- Bioinformatics Research Center, North Carolina State University, Raleigh, NC, USA; Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA.
| | - Susan K Murphy
- Duke University Medical Center, Department of Obstetrics and Gynecology, Reproductive Sciences, Durham, NC, USA.
| | - Cathrine Hoyo
- Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA.
| | - Pauline W Jansen
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Erasmus University Rotterdam, Department of Psychology, Education & Child Studies, Rotterdam, the Netherlands.
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Rosa H Mulder
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
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Harris HA, Friedman C, Starling AP, Dabelea D, Johnson SL, Fuemmeler BF, Jima D, Murphy SK, Hoyo C, Jansen PW, Felix JF, Mulder R. An epigenome-wide association study of child appetitive traits and DNA methylation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.17.549289. [PMID: 37503194 PMCID: PMC10370073 DOI: 10.1101/2023.07.17.549289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Childhood appetitive traits are consistently associated with obesity risk, and yet their etiology is poorly understood. Appetitive traits are complex phenotypes which are hypothesized to be influenced by both genetic and environmental factors, as well as their interactions. Early-life epigenetic processes, such as DNA methylation (DNAm), may be involved in the developmental programming of appetite regulation in childhood. In the current study, we meta-analyzed epigenome-wide association studies (EWASs) of cord blood DNAm and early-childhood appetitive traits. Data were from two independent cohorts: the Generation R Study (n=1,086, Rotterdam, the Netherlands) and the Healthy Start study (n=236, Colorado, USA). DNAm at autosomal methylation sites in cord blood was measured using the Illumina Infinium HumanMethylation450 BeadChip. Parents reported on their child's food responsiveness, emotional undereating, satiety responsiveness and food fussiness using the Children's Eating Behaviour Questionnaire at age 4-5 years. Multiple regression models were used to examine the association of DNAm (predictor) at the individual site- and regional-level (using DMRff) with each appetitive trait (outcome), adjusting for covariates. Bonferroni-correction was applied to adjust for multiple testing. There were no associations of DNAm and any appetitive trait at the individual site-level. However, at the regional level, we identified 45 associations of DNAm with food responsiveness, 7 associations of DNAm with emotional undereating, 13 associations of DNAm with satiety responsiveness, and 9 associations of DNAm with food fussiness. This study shows that DNAm in the newborn may partially explain variation in appetitive traits expressed in early childhood and provides preliminary support for early programming of child appetitive traits through DNAm. Investigating differential DNAm associated with appetitive traits could be an important first step in identifying biological pathways underlying the development of these behaviors.
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Affiliation(s)
- Holly A. Harris
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Erasmus University Rotterdam, Department of Psychology, Education & Child Studies, Rotterdam, the Netherlands
| | - Chloe Friedman
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Anne P. Starling
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Susan L. Johnson
- Department of Pediatrics, Section of Nutrition, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Bernard F. Fuemmeler
- Virginia Commonwealth University, Mase Comprehensive Cancer Center, Richmond, VA, USA
| | - Dereje Jima
- Bioinformatics Research Center, North Carolina State University, Raleigh, NC, USA
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | - Susan K. Murphy
- Duke University Medical Center, Department of Obstetrics and Gynecology, Reproductive Sciences, Durham, NC, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | - Pauline W. Jansen
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Erasmus University Rotterdam, Department of Psychology, Education & Child Studies, Rotterdam, the Netherlands
| | - Janine F. Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Rosa Mulder
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Martin K, Radler DR, Sackey J, Zhang C, Shrestha K, Shrestha A, Shrestha A, Barrett ES, Rawal S. Association between 1 st trimester diet quality & gestational weight gain rate among pregnant women in Dhulikhel, Nepal. BMC Nutr 2022; 8:129. [PMID: 36369060 PMCID: PMC9650875 DOI: 10.1186/s40795-022-00623-7] [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: 07/27/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite promising data from high-income countries, the impact of diet quality on gestational weight gain (GWG) has not been investigated in the context of many low-income countries including Nepal. METHODS We prospectively examined the association between 1st trimester diet quality and GWG rate among a cohort of singleton pregnant women (n = 101; age 25.9 ± 4.1 years) from a community-based periurban hospital in Dhulikhel, Nepal. Diet quality was assessed from the adapted Nepali version of the 21-item PrimeScreen questionnaire in the 1st trimester. The diet quality score is based on consumption frequency of 21 food group components (score ranging 0-42), categorized as healthy (12 groups) versus unhealthy (9 groups), with higher scores indicative of better overall diet quality. The GWG rate was calculated as the measured weight at early-to-mid 3rd trimester (28-35 wks) minus the weight at 2nd trimester (13-25 wks), divided by the number of weeks in between. Linear regression estimated the association between diet quality and GWG rate, adjusting for a priori covariates (i.e. age, education, ethnicity, pre-pregnancy BMI, and nausea/vomiting.) RESULTS: The mean GWG rate in mid-to-late pregnancy was 0.46 ± 0.2 kg/wk and the mean diet quality score was 23.6 ± 2.5. Based on pre-pregnancy BMI, 49.4% of women had excessive GWG rate, while nearly equal numbers had either adequate GWG or inadequate GWG rate. There was no significant association between diet quality and GWG rate [adjusted β (95% CI) = -0.02 (-0.05, 0.01); p = 0.14]. The mean GWG rate was marginally higher (0.57 vs. 0.44 kg/wk; p = 0.06) among those with high versus low (2 + servings vs. 0-1 serving/wk) intake of red meat; similar findings were seen when comparing red meat intake between women with excessive versus adequate GWG (Cramer's V = 0.2; p = 0.06). CONCLUSIONS While 1st trimester diet quality is not related to GWG among Nepali women, a high intake of red meat may be a potential risk factor for excessive GWG in this population.
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Affiliation(s)
- Kelly Martin
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers the State University of New Jersey, 65 Bergen Street. Room 157, Newark, NJ, 07107, USA
- Department of Human Ecology, SUNY Oneonta, Oneonta, NY, USA
| | - Diane Rigassio Radler
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers the State University of New Jersey, 65 Bergen Street. Room 157, Newark, NJ, 07107, USA
| | - Joachim Sackey
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers the State University of New Jersey, 65 Bergen Street. Room 157, Newark, NJ, 07107, USA
| | - Cuilin Zhang
- Eunice Kennedy Shriver National Institute of Child Health and Development, Bethesda, MD, USA
| | - Kusum Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Abha Shrestha
- Department of Obstetrics and Gynecology, Dhulikhel Hospital, Dhulikhel, Nepal
| | - Archana Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
- Department of Chronic Disease and Epidemiology, Center of Methods for Implementation and Prevention Science, Yale School of Public Health, New Haven, CT, USA
- Institute for Implementation Science and Health, Kathmandu, Nepal
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute, Rutgers the State University of New Jersey, Piscataway, NJ, USA
| | - Shristi Rawal
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers the State University of New Jersey, 65 Bergen Street. Room 157, Newark, NJ, 07107, USA.
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Maternal Consumption of Ultra-Processed Foods-Rich Diet and Perinatal Outcomes: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14153242. [PMID: 35956418 PMCID: PMC9370797 DOI: 10.3390/nu14153242] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 11/23/2022] Open
Abstract
The consumption of ultra-processed food (UPF)-rich diets represents a potential threat to human health. Considering maternal diet adequacy during pregnancy is a major determinant for perinatal health outcomes, this study aimed to systematically review and meta-analyze studies investigating the association between maternal consumption of a UPF-rich diet and perinatal outcomes. Conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, five electronic databases and gray literature using Google Scholar and ProQuest Dissertations and Theses Global were searched up to 31 May 2022. No restrictions were applied on language and publication date. Two reviewers independently conducted the study selection and data extraction process. Meta-analysis was conducted according to the random-effects model. In total, 61 studies were included in the systematic review and the overall population comprised 698,803 women from all gestational trimesters. Meta-analysis of cohort studies showed that maternal consumption of UPF-rich diets was associated with an increased risk of gestational diabetes mellitus (odds ratio (OR): 1.48; 95% confidence interval (CI): 1.17, 1.87) and preeclampsia (OR: 1.28; 95% CI: 1.15, 1.42). Neonatal outcomes showed no association. The overall GRADE quality of the evidence for the associations was very low. The findings highlight the need to monitor and reduce UPF consumption, specifically during the gestational period, as a strategy to prevent adverse perinatal outcomes.
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Yang M, Feng Q, Chen C, Chen S, Guo Y, Su D, Chen H, Sun H, Dong H, Zeng G. Healthier diet associated with reduced risk of excessive gestational weight gain: A Chinese prospective cohort study. MATERNAL & CHILD NUTRITION 2022:e13397. [PMID: 35821659 DOI: 10.1111/mcn.13397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/07/2022] [Accepted: 06/12/2022] [Indexed: 11/29/2022]
Abstract
Limited studies have examined the associations between diet quality and gestational weight gain (GWG) among Chinese pregnant women, adopting Chinese GWG guidelines. We prospectively investigate the associations of diet quality, using the Chinese Healthy Diet Index for Pregnancy (CHDI-P), which assessed diet quality from 'Diversity', 'Adequacy' and 'Limitation' dimensions with overall 100 points, with GWG among participants enroled in Southwest China. Food consumption was collected by 24 h dietary recalls for three consecutive days and CHDI-P scores were divided into tertiles. GWG was calculated according to the weight measured before delivery and classified into adequate weight gain (AWG), insufficient weight gain (IWG) and excessive weight gain(EWG) following Chinese GWG guidelines. Multinomial regression analyses and stratified analyses by pre-pregnancy body mass index were performed to estimate the association between CHDI-P and GWG. A total of 1416 participants were recruited in early pregnancy, and 971 and 997 participants were respectively followed up in middle and late pregnancy. The mean CHDI-P score was 56.44 ± 6.74, 57.07 ± 7.44 and 57.38 ± 7.94 points in early, middle and late pregnancy, respectively. Women in the lowest CHDI-P scores group had an increased risk of EWG in middle (OR = 1.53, 95% confidence interval [CI] = 1.08-2.17) and late pregnancy (OR = 1.71, 95% CI = 1.21-2.41) than women in the highest group, while overweight/obese women had a greater risk of EWG in late pregnancy (OR = 4.25, 95% CI = 1.30-13.90). No association was found between the CHDI-P scores and IWG. Poor diet quality in middle and late pregnancy was associated with a higher risk of EWG.
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Affiliation(s)
- Mengtong Yang
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiuyu Feng
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Cong Chen
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Sijia Chen
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yishan Guo
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Danping Su
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hong Chen
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hong Sun
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hongli Dong
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Guo Zeng
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
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Anti-inflammatory diets reduce the risk of excessive gestational weight gain in urban South Africans from the Soweto First 1000-Day Study (S1000). Eur J Nutr 2022; 61:3929-3941. [PMID: 35764725 PMCID: PMC9244370 DOI: 10.1007/s00394-022-02931-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/31/2022] [Indexed: 11/04/2022]
Abstract
Purpose To (i): examine whether maternal dietary inflammation assessed using the dietary inflammatory index (DII) is associated with gestational weight gain (GWG) and delivery outcomes in urban South African women from the Soweto First 1000-Day Study (S1000); and (ii): explore whether serum high-sensitivity c-reactive protein (hs-CRP) levels mediate these associations. Methods Energy-adjusted-DII (E-DII™) scores were calculated for 478 pregnant women using a quantitative food frequency questionnaire. GWG (kg/week) was assessed via anthropometry and hs-CRP concentrations were assessed in a sub-sample at < 14 (n = 263) and at 24–28 (n = 270) weeks gestational age. Multivariable linear and logistic regression models were used to examine associations between maternal E-DII scores, GWG, hs-CRP concentrations, and delivery outcomes. Results Positive vs. negative E-DII scores were associated with an increased odds of excessive weight gain (OR (95% CI): 2.23 (1.20; 4.14); P = 0.01) during pregnancy. Higher hs-CRP concentrations in the first trimester were associated with lower weight-for-length z-score (β (95% CI): −0.06 (−0.11; −0.01) per 1 mg/l hs-CRP; P = 0.02) and a reduction in odds of a large-for-gestational age delivery (OR (95% CI): 0.66 (0.47; 0.94); P = 0.02). Higher hs-CRP concentrations in the second trimester were associated with an increased odds of delivering preterm (OR (95% CI): 1.16 (1.01; 1.32); P = 0.03). Conclusions Consumption of an anti-inflammatory diet during pregnancy reduced the risk of excessive GWG in a rapidly urbanising setting (Soweto, South Africa), where obesity prevalence rates are high. Further research is needed to better understand how maternal diet may ameliorate the effects of maternal adiposity on inflammatory milieu and fetal programming. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-022-02931-x.
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Khanduri S, Chawla H, Khan A, LNU S, Pathak V, Gupta A, Shaikh J, Fatima S, Khan Z, LNU V. Association and Correlation Between Amniotic Fluid Index and Glucose Concentration. Cureus 2022; 14:e25973. [PMID: 35855256 PMCID: PMC9286010 DOI: 10.7759/cureus.25973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose: To study the association and correlation between the amniotic fluid index, random glucose concentration, and serum glucose concentration after avoiding oral intake of sugar in a pregnant female with polyhydramnios. Methods: The research was performed on pregnant women with polyhydramnios (n=104 ) after 28 weeks. USG was performed using a SAMSUNG HS 70A (Samsung Electronics Pvt. Ltd., Seoul, South Korea) and a GE Voluson P8 (GE Healthcare, Little Chalfont, UK). We measured amniotic fluid index and took a blood sample for hemoglobin (Hb)A1C, fasting blood glucose, post-prandial and random blood glucose, and also performed a glucose tolerance test in pregnant women. Results: This is a prospective study, all 104 patients that were recruited in this study were pregnant females with polyhydramnios mainly from the urban and rural zone with different age groups (between 21 and 37 years). In our study, we observed that after avoiding oral intake of sugar in pregnant females with polyhydramnios, it was concluded that the amnionic fluid index lies towards the lower side. Polyhydramnios is more common in the urban zone and among older pregnant females. Out of 104 pregnant females with polyhydramnios, 82 were diagnosed with gestational diabetes after 28 weeks. Conclusion: In this study, we have concluded that the earliest and most sensitive predictor for gestational diabetes is a rise in the amniotic fluid index which could have been prevented by avoiding oral intake of sugar. Early prediction of gestational diabetes can be made by amniotic fluid index even before glucose concentration. We observed that by reducing oral intake of sugar, the amniotic fluid index drops down in pregnant females
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Ferreira LB, Lobo CV, Miranda AEDS, Carvalho BDC, Santos LCD. Dietary Patterns during Pregnancy and Gestational Weight Gain: A Systematic Review. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:540-547. [PMID: 35483873 PMCID: PMC9948295 DOI: 10.1055/s-0042-1744290] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The present systematic review (PROSPERO: CRD42020148630) hypothesizes the association of excessive weight gain during pregnancy with dietary patterns composed of ultraprocessed foods. Thus, the objective was to investigate the association between dietary patterns after analysis and weight gain during pregnancy. The search for articles was performed in nine databases. Two reviewers selected the articles in the databases and extracted from them the data used in the review. Two scales were used to evaluate the quality of the selected studies: New Castle-Ottawa Quality Assessment for cohort-based studies and Appraisal tool for Cross-Sectional Studies (AXIS) for cross-sectional-based studies. In total, 11 studies were identified with sample size variation (n = 173-5,733). Women presenting more adherence to healthy and traditional patterns (fruits, vegetables, salads, nuts, and dairy) recorded less excessive gestational weight gain (GWG). Higher intake of mixed patterns and western patterns rich in ultraprocessed foods were associated with a higher prevalence of excessive GWG (24.48-55.20%). Gestational dietary patterns a posteriori-derived that have presented ultraprocessed components rich in fat and sugars presented association with high GWG; healthy and traditional dietary patterns were related to better mother-child health conditions, such as adequate GWG.
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Affiliation(s)
- Larissa Bueno Ferreira
- Child and Adolescent Health, Federal University of Minas Gerais, Faculdade de Medicina/UFMG, Belo Horizonte, MG, Brazil
| | - Cecília Viana Lobo
- Nutrition Departament, Federal University of Minas Gerais, Escola de Enfermagem/UFMG, Belo Horizonte, MG, Brazil
| | | | - Brenda da Cunha Carvalho
- Nutrition Departament, Federal University of Minas Gerais, Escola de Enfermagem/UFMG, Belo Horizonte, MG, Brazil
| | - Luana Caroline Dos Santos
- Nutrition Departament, Federal University of Minas Gerais, Escola de Enfermagem/UFMG, Belo Horizonte, MG, Brazil
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Yang J, Wang M, Tobias DK, Rich-Edwards JW, Darling AM, Abioye AI, Noor RA, Madzorera I, Fawzi WW. Dietary diversity and diet quality with gestational weight gain and adverse birth outcomes, results from a prospective pregnancy cohort study in urban Tanzania. MATERNAL & CHILD NUTRITION 2022; 18:e13300. [PMID: 34908233 PMCID: PMC8932689 DOI: 10.1111/mcn.13300] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 10/25/2021] [Accepted: 11/06/2021] [Indexed: 12/15/2022]
Abstract
Healthy maternal diets during pregnancy are an important protective factor for pregnancy‐related outcomes, including gestational weight gain (GWG) and birth outcomes. We prospectively examined the associations of maternal dietary diversity and diet quality, using Minimum Dietary Diversity for Women (MDD‐W) and Prime Diet Quality Score (PDQS), with GWG and birth outcomes among women enrolled in a trial in Tanzania (n = 1190). MDD‐W and PDQS were derived from a baseline food frequency questionnaire. Women were monthly followed until delivery, during which weight was measured. GWG was classified based on the 2009 Institute of Medicine guidelines. Adverse birth outcomes were classified as low birth weight (LBW), small for gestational age, large for gestational age, and preterm birth. 46.2% participants had MDD‐W ≥ 5. Mean score of PDQS was 23.3. Maternal intakes of nuts, poultry, and eggs were low, whereas intakes of sugar‐sweetened beverages and refined grains were high. MDD‐W was not associated with GWG or birth outcomes. For PDQS, compared to the lowest tertile, women in the highest tertile had lower risk of inappropriate GWG (risk ratio [RR] = 0.93, 95% confidence interval [CI]: 0.87–1.00). Women in the middle tertile group of PDQS (RR = 0.72, 95% CI: 0.51–1.00) had lower risk of preterm birth. After excluding women with prior complications, higher PDQS was associated with lower risk of LBW (middle tertile: RR = 0.55, 95% CI: 0.31–0.99, highest tertile: RR = 0.52, 95% CI: 0.29–0.94; continuous per SD: RR = 0.77, 95% CI: 0.60–0.99). Our findings support continuing efforts to improve maternal diet quality for optimal GWG and infant outcomes among Tanzanian women. Maternal diets are a key modifiable determinant of gestational weight gain (GWG) and birth outcomes. We observed suboptimal intakes of healthy proteins and fats and high intakes of refined grains and sugar‐containing foods among well‐nourished pregnant women in urban Tanzania. This study found that higher‐quality maternal diets were associated with lower risks of inappropriate GWG, low birth weight, and preterm birth. This study supports the importance of high maternal diet quality and continuing efforts to promote well‐balanced maternal diets with avoiding both under‐ and over‐nutrition for optimal pregnancy outcomes among Tanzanian populations.
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Affiliation(s)
- Jiaxi Yang
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Molin Wang
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.,Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Deirdre K Tobias
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.,Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Janet W Rich-Edwards
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.,Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Anne-Marie Darling
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ajibola I Abioye
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ramadhani A Noor
- United Nations Children's Fund (UNICEF), Dar es Salaam, Tanzania
| | - Isabel Madzorera
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Wafaie W Fawzi
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.,Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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11
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Dietary Patterns During Pregnancy and Their Association with Gestational Weight Gain and Anthropometric Measurements at Birth. Matern Child Health J 2022; 26:1464-1472. [PMID: 35195821 DOI: 10.1007/s10995-022-03392-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Dietary patterns can influence maternal and child health outcomes. The study aims to characterize dietary patterns during pregnancy as well as to identify their associations with gestational weight gain (GWG) and anthropometric measurements at birth. METHODS A minimum sample size of 95 nursing mothers was estimated for this work. Socioeconomic, anthropometric, physical activity, obstetric and food consumption (food frequency questionnaire) data was collected from mothers and their newborns in immediate postpartum (n = 260) at the maternity hospital. Maternal pregestational weight and GWG were self-reported and the neonatal data was obtained from their records. The patterns were derived posteriori by Principal Component Analysis (PCA). Multinomial Logistic Regression and Poisson Regression with Robust Variance were applied. FINDINGS Four dietary patterns were derived: "pattern 1", characterized by the consumption of meat and eggs, processed meat, vegetables and olive oil; "pattern 2", consisting of sweets, snacks and cookies; "pattern 3", which includes cereals and breads, coffee and tea, and processed fats; and "pattern 4", characterized by soft drinks, tubers and instant noodles. Together, the dietary patterns account for 49.16% of the total variance for food intake. Higher adherence to "pattern 3" was associated with inadequate birth weight (low and excessive birth weight); while greater adherence to "pattern 2" was associated with lower chances of inadequate GWG. CONCLUSION The dietary patterns presented mixed composition and predominance of ultra-processed foods. They were associated with the investigated outcomes, denoting the importance of strategies to promote healthy eating habits during pregnancy in order to avoid possible complications.
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12
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Wu Y, Chai X. Effects of maternal sugar intake during pregnancy on allergies in offspring: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e27447. [PMID: 34678875 PMCID: PMC8542120 DOI: 10.1097/md.0000000000027447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND To our knowledge, there is no comprehensive evidence quantifying the plausibility of the association between maternal free sugar intake during pregnancy and the development of offspring's allergic diseases. Thus, this systematic review examines the weight of evidence for causality from cohort studies on the association between maternal free sugar intake during pregnancy and the development of allergies in offspring. METHODS The present meta-analysis is prepared and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. We search PUBMED, Scopus, EMBASE, and Cochrane Library databases through October, 2021. All clinical trials to assess the efficacy of maternal sugar intake during pregnancy on allergies in offspring are considered eligible for analysis. The Comprehensive Meta-Analysis Software 2 program is used for statistical analyses of the pooled data. A P value < .05 is considered statistically significant. The outcome measure is development of allergic disease among offspring assessed by any method (parental history, doctor diagnosed, or questionnaire based). RESULTS It is hypothesized that high free sugar consumption during pregnancy may be associated with the development of allergies in offspring.
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Affiliation(s)
- Yijun Wu
- Department of Obstetrics, Huanggang Central Hospital, Huanggang, Hubei, China
| | - Xiaoli Chai
- Department of Obstetrics and Gynecology, Xishui County People's Hospital, Hubei University of Science and Technology, Huanggang, Hubei, China
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13
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Santana JDM, Pereira M, Carvalho GQ, Dos Santos DB, de Oliveira AM. Polyunsaturated fatty acid consumption and weight gain during pregnancy: NISAMI Cohort study. Am J Hum Biol 2021; 34:e23687. [PMID: 34636455 DOI: 10.1002/ajhb.23687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/18/2021] [Accepted: 09/20/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Few studies have investigated the influence of polyunsaturated fatty acid consumption on excessive weight gain during pregnancy. Thus, we analyzed the association between the intake of polyunsaturated fatty acids (ω-6 and ω-3) and weight gain in women during pregnancy. METHODS This is a cohort study of 250 pregnant women enrolled in municipal pre-natal services. Weight, height, and dietary intake of polyunsaturated fatty acids were evaluated at the baseline. The semi-quantitative food frequency questionnaire was employed to assess the main exposure. Gestational weight was measured in the first, second, and third trimesters. A dietary pattern involving the consumption of fatty acids was identified through factor analysis. A generalized estimating equation was used for the data analysis. RESULTS The prevalence of excessive weight gain at the end of pregnancy was 35.2%. Consumption patterns 1 (salted meats, offal, vegetable oil, snacks, legumes, and oleaginous foods) and 2 (red meat, sausages, butter, margarine, mayonnaise, acarajé, caruru, vatapá, and refined cereals) revealed a risk for the accumulation of excess weight during pregnancy. Women who adhered to consumption patterns 1 (RR: 2.39; 95% CI: 1.44-3.94) and 2 (RR: 2.39; 95% CI: 1.44-3.94) were more susceptible to excess weight gain during pregnancy. CONCLUSIONS Women who adhered to dietary patterns involving foods that are sources of ω-6 fatty acids and saturated fatty acids were more susceptible to gaining weight during pregnancy compared to those who adhered less to these patterns.
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Affiliation(s)
- Jerusa da Mota Santana
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil.,Centro de Ciências de Saúde, Universidade Federal do Recôncavo da Bahia, Santo Antônio de Jesus, Bahia, Brazil
| | - Marcos Pereira
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Gisele Queiroz Carvalho
- Universidade Federal de Juiz de Fora, Campus Avançado de Governador Valadares, Governador Valadares, Minas Gerais, Brazil
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14
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Rugină C, Mărginean CO, Meliţ LE, Giga DV, Modi V, Mărginean C. Relationships between excessive gestational weight gain and energy and macronutrient intake in pregnant women. J Int Med Res 2021; 48:300060520933808. [PMID: 32776838 PMCID: PMC7418251 DOI: 10.1177/0300060520933808] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE This study aimed to compare energy and macronutrient intake, birth weight, and anthropometric parameters (mid-upper arm circumference or tricipital skin-fold thickness) between women who had adequate and excessive gestational weight gain (GWG) during pregnancy. METHODS We studied 115 pregnant women and divided them according to GWG into two groups: adequate GWG (n = 49) and excessive GWG (n = 66). We assessed the medical history, clinical examinations, and dietary habits through a detailed 7-day dietary recall using myfitnesspal software. RESULTS Weight, body mass index, mid-upper arm circumference, and tricipital skin-fold thickness were significantly higher at the time of delivery in women with excessive GWG compared with those with adequate GWG. A lipid-based diet was a risk factor for excessive GWG (relative risk: 1.488, 95% confidence interval: 1.112-1.991), whereas a protein-based diet was a protective factor (relative risk: 0.6723, 95% confidence interval: 0.4431-1.020). We found no significant relationship between a carbohydrate-based diet and GWG. The total energy intake was significantly higher in the excessive GWG group than in the adequate GWG group. CONCLUSIONS Mainly a lipid-based diet in pregnant women might represent a risk factor for excessive GWG. However, a protein-based diet is a protective factor for excessive GWG.
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Affiliation(s)
- Cosmin Rugină
- Department of Obstetrics and Gynecology, "George Emil Palade" University of Medicine, Pharmacy, Sciences and Technology, Târgu Mureș, Romania
| | - Cristina Oana Mărginean
- Department of Pediatrics, "George Emil Palade" University of Medicine, Pharmacy, Sciences and Technology, Târgu Mureș, Romania
| | - Lorena Elena Meliţ
- Department of Pediatrics, "George Emil Palade" University of Medicine, Pharmacy, Sciences and Technology, Târgu Mureș, Romania
| | - Dana Valentina Giga
- Department of Medical Informatics and Biostatistics, "George Emil Palade" University of Medicine, Pharmacy, Sciences and Technology, Târgu Mureș, Romania
| | - Viviana Modi
- Department of Obstetrics and Gynecology, "George Emil Palade" University of Medicine, Pharmacy, Sciences and Technology, Târgu Mureș, Romania
| | - Claudiu Mărginean
- Department of Obstetrics and Gynecology, "George Emil Palade" University of Medicine, Pharmacy, Sciences and Technology, Târgu Mureș, Romania
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15
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A Priori and a Posteriori Dietary Patterns among Pregnant Women in Johannesburg, South Africa: The NuPED Study. Nutrients 2021; 13:nu13020565. [PMID: 33572105 PMCID: PMC7914963 DOI: 10.3390/nu13020565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 01/22/2023] Open
Abstract
Dietary pattern analyses allow assessment of the diet as a whole. Limited studies include both a priori and a posteriori dietary pattern analyses. This study aimed to explore the diet of pregnant women in urban South Africa through both a priori and a posteriori dietary pattern analyses and associated maternal and household factors. Dietary data were collected during early pregnancy using a quantified food frequency questionnaire from 250 pregnant women enrolled in the Nutrition During Pregnancy and Early Development (NuPED) cohort. A priori dietary patterns were determined using the Diet Quality Index-International (DQI-I), and a posteriori nutrient patterns using exploratory factor analysis. Based on the DQI-I, the study population followed a borderline low-quality diet. Three a posteriori nutrient patterns were identified: Pattern 1 “plant protein, iron, thiamine, and folic acid”; pattern 2 “animal protein, copper, vitamin A, and vitamin B12”; pattern 3 “fatty acids and sodium”. Pattern 1 was associated with higher dietary quality (p < 0.001), lower maternal educational level (p = 0.03) and socioeconomic status (p < 0.001). Pattern 3 was significantly associated with lower dietary quality. The low dietary quality among pregnant women residing in urban South Africa should be addressed to ensure optimal maternal and offspring health outcomes.
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16
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Abdollahi S, Soltani S, de Souza RJ, Forbes SC, Toupchian O, Salehi-Abargouei A. Associations between Maternal Dietary Patterns and Perinatal Outcomes: A Systematic Review and Meta-Analysis of Cohort Studies. Adv Nutr 2021; 12:1332-1352. [PMID: 33508080 PMCID: PMC8321866 DOI: 10.1093/advances/nmaa156] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/10/2020] [Accepted: 11/10/2020] [Indexed: 02/06/2023] Open
Abstract
The aim was to systematically review and meta-analyze prospective cohort studies investigating the relation between maternal dietary patterns during pregnancy with pregnancy and birth outcomes. PubMed, Scopus, and ISI Web of Science were searched from inception until October 2019 for eligible studies. Studies reporting relative risk, ORs, or incidences (for binary data) or means ± SDs or B-coefficients (for continuous outcomes) comparing the highest and lowest adherence with maternal dietary patterns were included. Dietary patterns were categorized as "healthy," "unhealthy," or "mixed." No language restrictions were applied. Study-specific effect sizes with SEs for outcomes of interest were pooled using a random-effects model. Quality of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Sixty-six relevant publications were included. A higher maternal adherence to a healthy diet was associated with a reduced risk of gestational hypertension (14%, P < 0.001), maternal depression (40%, P = 0.004), low birth weight (28%, P = 0.001), preterm birth (56%, P < 0.001), higher gestational weight gain (Hedges' g: 0.15; P = 0.01), and birth weight (Hedges' g: 0.19; P = 0.007). Higher maternal adherence to an unhealthy or a mixed diet was associated with higher odds of gestational hypertension (23%, P < 0.001 for unhealthy, and 8%, P = 0.01 for mixed diet). In stratified analyses, a higher healthy eating index was associated with reduced odds of being large based on gestational age (31%, P = 0.02) and a higher head circumference at birth (0.23 cm, P = 0.02). The Mediterranean and "prudent" dietary patterns were related to lower odds of being small based on gestational age (46%, P = 0.04) and preterm birth (52%, P = 0.03), respectively. The overall GRADE quality of the evidence for most associations was low or very low, indicating that future high-quality research is warranted. This study was registered at http://www.crd.york.ac.uk/PROSPERO as CRD42018089756.
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Affiliation(s)
- Shima Abdollahi
- School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Sepideh Soltani
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Russell J de Souza
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada,Population Health Research Institute, Hamilton, Ontario, Canada
| | - Scott C Forbes
- Department of Physical Education, Faculty of Education, Brandon University, Brandon, Manitoba, Canada
| | - Omid Toupchian
- School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
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17
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Casas R, Castro Barquero S, Estruch R. Impact of Sugary Food Consumption on Pregnancy: A Review. Nutrients 2020; 12:E3574. [PMID: 33266375 PMCID: PMC7700555 DOI: 10.3390/nu12113574] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/16/2020] [Accepted: 11/20/2020] [Indexed: 12/16/2022] Open
Abstract
Obesity in pregnancy has been directly associated with an increased risk of almost all pregnancy complications such as gestational hypertension, preeclampsia, gestational diabetes mellitus (GDM), and premature delivery. Thereby, according to current evidence available, life-style interventions to prevent pre-pregnancy overweight and obesity in women of fertile age are necessary to reduce the negative impact of obesity on mother and child health. Unhealthy dietary patterns, together with the increased consumption of processed foods rich in simple sugar and sweeteners are some of the responsible, among others, for the increase in obesity rates during the last years. Nevertheless, how its consumption can affect pregnancy outcomes and long-term children's health is still uncertain. This review aims to collate the available evidence about the consequences of unhealthy dietary patterns and sugary products consumption, including sweeteners, during pregnancy for obesity in childhood and mid-childhood. High simple sugar intake during gestation may contribute to an excessive gestational weight gain (GWG) as well as to develop other pregnancy complications such as GDM, preeclampsia and preterm birth. The heterogeneity of study populations, sample size, different approaches to measure GWG, GMD, preeclampsia, and birth weight, among other conditions, might explain the divergences observed among studies. Therefore, large, well-designed intervention-controlled trials with biological biomarkers to ensure dietary adherence are necessary to evaluate the effectiveness of lifestyle interventions in order to provide effective nutritional advice.
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Affiliation(s)
- Rosa Casas
- Department of Internal Medicine, Hospital Clinic, Institut d’Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel, 170, 08036 Barcelona, Spain; (S.C.B.); (R.E.)
- CIBER 06/03: Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Sara Castro Barquero
- Department of Internal Medicine, Hospital Clinic, Institut d’Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel, 170, 08036 Barcelona, Spain; (S.C.B.); (R.E.)
- CIBER 06/03: Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Ramon Estruch
- Department of Internal Medicine, Hospital Clinic, Institut d’Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel, 170, 08036 Barcelona, Spain; (S.C.B.); (R.E.)
- CIBER 06/03: Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
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18
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Angali KA, Shahri P, Borazjani F. Maternal dietary pattern in early pregnancy is associated with gestational weight gain and hyperglycemia: A cohort study in South West of Iran. Diabetes Metab Syndr 2020; 14:1711-1717. [PMID: 32916554 DOI: 10.1016/j.dsx.2020.08.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 08/06/2020] [Accepted: 08/11/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND AIMS Maternal dietary pattern could influence on fetal health outcome. Thus, this study was conducted to evaluate the relationship between maternal dietary pattern and Gestational Weight Gain (GWG) in each trimester and hyperglycemia amongst Arab pregnant women in south-west of Iran. METHODS This longitudinally study was performed in urban healthcare centers of south-west of Iran. Among 610 candidates, 488 pregnant women were included in the final analysis. Consequently, two diet patterns were determined by principal component analysis and the association between GWG and blood glucose level was determined using quartile regression. Using generalized linear model, a model was adjusted for pre-pregnancy BMI, maternal age, income, and education levels. RESULTS Two dietary patterns were identified as follows: "high fat -fast food" and "vegetable-fruits & protein" pattern. High adherence to "high fat -fast food" pattern was associated with higher GWG and hyperglycemia in 3rd trimester (adjusted β: 0.029 95%CI 0.012; 0.049 P = 0.001) (adjusted β: 0.029 95%CI 0.012; 0.049 P = 0.001) respectively. High tendency to "vegetable-fruits & protein" pattern was inversely associated with development of hyperglycemia in 3rd trimester. Higher SES level was associated with low adherence to "high fat-fast food" pattern. CONCLUSION Findings of the study revealed that, higher adherence to high -fat diet is related to excessive GWG and hyperglycemia in late pregnancy.
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Affiliation(s)
- Kambiz Ahmadi Angali
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Biostatistics, School of Health Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Parvin Shahri
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Public Health, School of Health Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Fatemeh Borazjani
- Nutrition and Metabolic Disease Research Center, Ahvaz Jundishapur University of medical science, Ahvaz, Iran; Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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19
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Souza SCS, da Silva DF, Nagpal TS, Adamo KB. Eating Habits, Advice from Family/Friends, and Limited Personal Effort May Increase the Likelihood of Gaining Outside Gestational Weight Gain Recommendations. Matern Child Health J 2020; 24:1473-1481. [PMID: 32975725 DOI: 10.1007/s10995-020-03007-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The present study analyzed the association between (i) eating habits during pregnancy, (ii) advice from family or friends about gestational weight gain (GWG), and iii) personal effort to stay within weight gain limits, and meeting GWG recommendations. METHODS Participants included pregnant and postpartum women who completed the validated electronic maternal health survey (EMat). Sociodemographic, lifestyle variables, and body mass index were covariates used in the analyses. RESULTS Among all eligible women (1171), and a subset of women receiving a specific GWG target from HCP (365, 31.2%), participants who considered that their eating habits became less healthy, or could not evaluate if habits changed, had a higher likelihood of gaining above (adjusted odds ratio, aOR = 2.62; 95% CI 1.84; 3.73 for the total sample (TS); aOR = 4.79; CI 2.32;9.88 for the subset) GWG guidelines after adjusting for the covariates. Women who received advice from family or friends about how much weight they should gain while pregnant were more likely to experience GWG below (TS: aOR = 1.49; CI 1.02;2.17; subset: aOR = 1.95; CI 1.03;3.68) and above (TS: aOR = 1.42; CI 1.01;1.99; subset: aOR = 1.92; CI 1.06;3.48) guidelines, when compared to women who did not receive family/friends advice. Moreover, lower personal effort to stay within weight gain limits was associated with gaining below (TS: aOR = 1.77; CI 1.07;2.92; subset: aOR = 2.71; CI 1.30; 5.65) GWG guidelines. CONCLUSIONS FOR PRACTICE Women self-reporting less healthy eating habits than before pregnancy, receiving advice from family/friends about GWG, and lower personal effort to stay within guidelines, had an increased odds of weight gain discordant with recommendations.
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Affiliation(s)
- Sara C S Souza
- Faculty of Heath Sciences, School of Human Kinetics, University of Ottawa, Lees Campus, E 250F, 200 Lees Ave., Ottawa, ON, K1N 6N5, Canada
| | - Danilo F da Silva
- Faculty of Heath Sciences, School of Human Kinetics, University of Ottawa, Lees Campus, E 250F, 200 Lees Ave., Ottawa, ON, K1N 6N5, Canada
| | - Taniya S Nagpal
- Faculty of Heath Sciences, School of Human Kinetics, University of Ottawa, Lees Campus, E 250F, 200 Lees Ave., Ottawa, ON, K1N 6N5, Canada
| | - Kristi B Adamo
- Faculty of Heath Sciences, School of Human Kinetics, University of Ottawa, Lees Campus, E 250F, 200 Lees Ave., Ottawa, ON, K1N 6N5, Canada.
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20
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Khaled K, Hundley V, Almilaji O, Koeppen M, Tsofliou F. A Priori and a Posteriori Dietary Patterns in Women of Childbearing Age in the UK. Nutrients 2020; 12:E2921. [PMID: 32987718 PMCID: PMC7598658 DOI: 10.3390/nu12102921] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/19/2020] [Accepted: 09/21/2020] [Indexed: 12/13/2022] Open
Abstract
Poor diet quality is a major cause of maternal obesity. We aimed to investigate a priori and a-posteriori derived dietary patterns in childbearing-aged women in UK. An online survey assessed food intake, physical activity (PA), anthropometry and socio-demographics. An a priori defined diet quality was determined via Mediterranean diet (MD) adherence score and Exploratory Factor Analysis (EFA) derived dietary patterns (DPs). Multiple linear regression explored associations between DPs with anthropometric measures, PA and socio-demographics. Participants (n = 123) had low-to-medium MD adherence (average MD-score: 4.0 (2.0)). Age was positively associated with higher MD adherence (X2 (2) = 13.14, p = 0.01). EFA revealed three DPs: 'fruits, nuts, vegetables and legumes' ("Vegetarian-style" DP); 'sweets, cereals, dairy products and potatoes' ("Dairy, sweets and starchy foods" DP); and 'eggs, seafood and meats' ("Protein-rich" DP). "Vegetarian-style" DP was positively associated with higher maternal educational level (p < 0.01) and PA (p = 0.01), but negatively with white ethnicity (p < 0.01). "Dairy, sweets and starchy foods" DP was positively associated with white ethnicity (p = 0.03) and negatively with age (p = 0.03). "Protein-rich" DP was positively associated with age (p < 0.001) and negatively with PA (p = 0.01). A poor diet quality was found among childbearing-aged women; notably in the younger age category, those of white ethnicity, that were more physically inactive and with a lower socioeconomic background.
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Affiliation(s)
- Karim Khaled
- Department of Rehabilitation & Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK; (K.K.); (M.K.)
| | - Vanora Hundley
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK;
| | - Orouba Almilaji
- Department of Medical Science and Public Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK;
| | - Mareike Koeppen
- Department of Rehabilitation & Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK; (K.K.); (M.K.)
| | - Fotini Tsofliou
- Department of Rehabilitation & Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK; (K.K.); (M.K.)
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK;
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Yan H, Dang S, Zhang Y, Luo S. Dietary patterns of Chinese women of childbearing age during pregnancy and their relationship to the neonatal birth weight. Nutr J 2020; 19:89. [PMID: 32847595 PMCID: PMC7449039 DOI: 10.1186/s12937-020-00607-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/17/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To examine the type of maternal dietary patterns during pregnancy and the distribution characteristics of children's birth weight and the association between dietary patterns and neonatal birth weight in China. METHODS Data were derived from a cross-sectional program named "The prevalence and risk factors of birth defects in Shaanxi Province" in July to November in 2013. A stratified multistage random sampling method was used to select women and their children. The mother's diet during pregnancy was investigated using semi-quantitative food frequency questionnaire (FFQ) to collect the frequency and amount of food consumption, and the newborn birth weight as well as related social demographic information was collected at the same time. In our study, 0-1 year old children and their mothers with complete dietary survey data were selected as research objects. The main dietary patterns were identified according to factor analysis, and latent class analysis (LCA) was used to investigate the social demographic factors affecting dietary patterns. The logistic regression model was used to assess the association between birth weight and maternal dietary patterns during pregnancy by establishing three adjusting models and the data were stratified for further analysis by urban-rural and regions. RESULTS A total of 15,980 participants were involved in this study. Four dietary patterns were identified: "vegetarian pattern", "balance pattern", "traditional pattern" and "processing pattern". Compared with moderate tertile, women in the highest tertile of adherence to vegetarian pattern increased the risk of low birth weight in offspring in rural areas (OR = 1.61, 95%CI:1.06-2.93) and middle region (OR = 1.75, 95%CI:1.18-2.62), and the traditional pattern had greater odds of lower birth weight in the middle region (OR = 1.55, 95%CI:1.05-3.75). The processing pattern was found a protective factor for the occurrence of low birth weight in rural areas (OR = 0.98, 95%CI:0.43-0.99) but was a risk factor for low birth weight in the southern region (OR = 8.83, 95%CI:1.22-15.16). The balance pattern was a protective factor for the occurrence of low birth weight in the northern region(OR = 0.35, 95%CI:0.14-0.83). CONCLUSION The vegetarian and traditional pattern may be positively related to a higher risk of low birth weight while the balanced pattern may keep birth weight of offspring within the appropriate range. Health education of balanced diet and individual nutrition guidance during pregnancy should be strengthened, to make the dietary structure during pregnancy are more reasonable, reduce the occurrence of adverse birth weight of newborns.
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Affiliation(s)
- Hui Yan
- The Children’s Hospital Affiliaten to Zhengzhou University; Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, 450018 China
| | - Shaonong Dang
- School of Public Health, Xi’an Jiaotong University, Xi’an, 710061 China
| | - Yaodong Zhang
- The Children’s Hospital Affiliaten to Zhengzhou University; Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, 450018 China
| | - Shuying Luo
- The Children’s Hospital Affiliaten to Zhengzhou University; Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, 450018 China
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22
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Hirko KA, Comstock SS, Strakovsky RS, Kerver JM. Diet during Pregnancy and Gestational Weight Gain in a Michigan Pregnancy Cohort. Curr Dev Nutr 2020; 4:nzaa121. [PMID: 32793851 PMCID: PMC7413979 DOI: 10.1093/cdn/nzaa121] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/17/2020] [Accepted: 07/09/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Gestational weight gain (GWG) has important health implications for both the mother and offspring. Maternal diet during pregnancy may play an important role in achieving adequate GWG, although its precise role is unclear. OBJECTIVES Associations between maternal dietary components (fruits and vegetables, added sugar, percentage energy from fat, dairy) and GWG were examined in 327 pregnant women from the Archive for Research on Child Health cohort. METHODS Self-reported usual dietary intake was assessed with validated dietary screening tools at the first prenatal visit. GWG was obtained from the birth certificate and was categorized as inadequate, adequate, or excessive according to the Institute of Medicine recommendations. Associations between dietary components and GWG were assessed using multivariable regression models, stratified by maternal prepregnancy BMI category. RESULTS Only 31.5% of women had adequate GWG, with 24.8% gaining insufficient weight and 43.7% gaining excessively. Women who consumed more fruits and vegetables were suggestively less likely to have excessive GWG (OR: 0.86; 95% CI: 0.75, 1.00) in the minimally adjusted model, but the association became nonsignificant after adjusting for covariates (OR: 0.89; 95% CI: 0.77, 1.03). In stratified models, higher fruit and vegetable intake was linked to lower likelihood of excessive GWG among women with obesity (OR: 0.77; 95% CI: 0.60, 0.97), whereas higher added sugar intake was linked to a slight reduction in likelihood of excessive GWG (OR: 0.91; 95% CI: 0.84, 0.99) among women with a prepregnancy BMI in the normal range. Other dietary components were not significantly associated with GWG. CONCLUSIONS These results suggest that consuming fruits and vegetables during pregnancy may reduce risk of excessive GWG among women with obesity. With the rising prevalence of obesity among women of reproductive age, interventions to increase fruit and vegetable intake during pregnancy may have broad public health impact by improving maternal and child health outcomes.
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Affiliation(s)
- Kelly A Hirko
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Sarah S Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA
| | - Rita S Strakovsky
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA
| | - Jean M Kerver
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
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23
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Gherasim A, Arhire LI, Niță O, Popa AD, Graur M, Mihalache L. The relationship between lifestyle components and dietary patterns. Proc Nutr Soc 2020; 79:311-323. [PMID: 32234085 PMCID: PMC7663317 DOI: 10.1017/s0029665120006898] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We conducted a narrative review on the interaction between dietary patterns with demographic and lifestyle variables in relation to health status assessment. The food pattern has the advantage of taking into account the correlations that may exist between foods or groups of foods, but also between nutrients. It is an alternative and complementary approach in analysing the relationship between nutrition and the risk of chronic diseases. For the determination of dietary patterns one can use indices/scores that evaluate the conformity of the diet with the nutrition guidelines or the established patterns (a priori approach). The methods more commonly used are based on exploratory data (a posteriori): cluster analysis and factor analysis. Dietary patterns may vary according to sex, socio-economic status, ethnicity, culture and other factors, but more, they may vary depending on different associations between these factors. The dietary pattern exerts its effects on health in a synergistic way or even in conjunction with other lifestyle factors, and we can therefore refer to a 'pattern of lifestyle'.
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Affiliation(s)
- Andreea Gherasim
- ‘Grigore T. Popa’ University of Medicine and Pharmacy, Faculty of Medicine, 16 Universității street, Iași 700115, Romania
- ‘Sf. Spiridon’ Clinical Emergency Hospital, 1 Independenței boulevard, Iași 700111, Romania
| | - Lidia I. Arhire
- ‘Grigore T. Popa’ University of Medicine and Pharmacy, Faculty of Medicine, 16 Universității street, Iași 700115, Romania
- ‘Sf. Spiridon’ Clinical Emergency Hospital, 1 Independenței boulevard, Iași 700111, Romania
| | - Otilia Niță
- ‘Grigore T. Popa’ University of Medicine and Pharmacy, Faculty of Medicine, 16 Universității street, Iași 700115, Romania
- ‘Sf. Spiridon’ Clinical Emergency Hospital, 1 Independenței boulevard, Iași 700111, Romania
| | - Alina D. Popa
- ‘Grigore T. Popa’ University of Medicine and Pharmacy, Faculty of Medicine, 16 Universității street, Iași 700115, Romania
- ‘Sf. Spiridon’ Clinical Emergency Hospital, 1 Independenței boulevard, Iași 700111, Romania
| | - Mariana Graur
- ‘Grigore T. Popa’ University of Medicine and Pharmacy, Faculty of Medicine, 16 Universității street, Iași 700115, Romania
- ‘Sf. Spiridon’ Clinical Emergency Hospital, 1 Independenței boulevard, Iași 700111, Romania
| | - Laura Mihalache
- ‘Grigore T. Popa’ University of Medicine and Pharmacy, Faculty of Medicine, 16 Universității street, Iași 700115, Romania
- ‘Sf. Spiridon’ Clinical Emergency Hospital, 1 Independenței boulevard, Iași 700111, Romania
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Abstract
Background: Childhood overweight and obesity are recognized as predictors of the risk of obesity in adulthood. The aim of this systematic literature review was to determine the association between dietary pattern and obesity risk among children. Methods: Articles were selected from databases (Cochrane Library, Lilacs, Eric, Livivo, and PubMed/Medline), without limitations regarding language or date. Database-specific search terms included the key words "obesity," "diet," "dietary pattern," "childhood," "children," "adolescents," and relevant synonyms. The review included studies that reported the assessment of the dietary pattern in childhood and that correlated eating patterns with the obesity risk through cluster analysis (CA) and/or factor analysis and/or principal component analysis and presented odds ratios (ORs). The methodology of the selected studies was evaluated using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Owing to the heterogeneity among the assessments of the association of dietary patterns and obesity, the results are described narratively. Results: Using a selection process in two phases, 16 articles were included. Fifteen studies used a cross-sectional design, and one case-control study. The included studies showed variation in sample size (range = 232 to 10,187 children/adolescents) and age (range = 1-19 years old). The studies reported between two and five dietary patterns each. The OR for the relationship between the dietary pattern and the risk of childhood obesity ranged from OR = 1.02; confidence interval (95% CI) (0.91-1.15) to OR = 3.55; 95% CI (1.80-7.03). In this study, the dietary patterns identified by the studies were given different names. The food intake patterns identified could, in most factor or CA studies, be categorized as (1) potentially obesogenic foods that increased risk of becoming overweight (including fatty cheeses, sugary drinks, processed foods, fast food, candies, snacks, cakes, animal products, whole milk, and refined grains) or (2) food classified as healthy with the weakest association with the risk of becoming overweight or obese (including low levels of sugar and fat and high levels of fruits, vegetables, whole grains, fish, nuts, legumes, and yogurt). Conclusion: Overall, the results indicated from most studies that a diet with a lower percentage of obesogenic foods should be effective in reducing the risk of developing obesity.
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Affiliation(s)
- Rafaela Liberali
- Post-Graduation Program in Medical Sciences, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Emil Kupek
- Department of Public Health, Federal University of Santa Catarina, Florianopolis, SC, Brazil
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Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Appannah G, Bindels J, Tee YYS, van der Beek EM. The association between dietary patterns before and in early pregnancy and the risk of gestational diabetes mellitus (GDM): Data from the Malaysian SECOST cohort. PLoS One 2020; 15:e0227246. [PMID: 31923230 PMCID: PMC6953856 DOI: 10.1371/journal.pone.0227246] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/15/2019] [Indexed: 02/07/2023] Open
Abstract
Generally, dietary patterns (DP)s have been linked to the risk of diabetes mellitus, however, only few studies examined the associations between DPs in early pregnancy and the risk of gestational diabetes mellitus (GDM). This study aims to determine the association between DPs before and during pregnancy and risk of GDM in Malaysian pregnant women. DPs were derived using principal component analysis of consumed 126 food and beverage items assessed using a validated semi-quantitative food frequency questionnaire collecting data retrospectively for pre-pregnancy, but prospectively for the first and second trimester. Three different DPs were identified at each time point and labelled as DP 1–3 (pre-pregnancy), DP 4–6 (first trimester), and DP 7–9 (second trimester). About 10.6% (n = 48) of pregnant women were diagnosed with GDM in our cohort. Women with high adherence (HA) to DP 2 (adjusted OR: 0.45, 95% CI: 0.20–0.91) and DP 5 (adjusted OR: 0.28, 95% CI: 0.11–0.68) showed a significantly reduced risk of GDM compared to women with low adherence (LA). Other DPs were not significantly associated with GDM risk. Compared to women with GDM, non-GDM women showed HA scores for all DPs throughout pregnancy. Overall, a relative low percentage of women with GDM was found in this cohort. The risk was lower in women with HA to a relatively unhealthy dietary pattern, i.e. DP 2 and DP 5. The lower body mass index (BMI) status and energy intake of women showing a HA to DP 2 in the first trimester may underlie the observed association with a lower GDM risk. Additionally, genetic variance might explain the less susceptibility to GDM despite HA to unhealthy DPs among non-GDM women.
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Affiliation(s)
- Heng Yaw Yong
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Zalilah Mohd Shariff
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
- * E-mail:
| | - Barakatun-Nisak Mohd Yusof
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Zulida Rejali
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Geeta Appannah
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | | | | | - Eline M. van der Beek
- Danone Nutricia Research, Utrecht, The Netherlands
- Department of Pediatrics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
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Wrottesley SV, Prioreschi A, Kehoe SH, Ward KA, Norris SA. A maternal "mixed, high sugar" dietary pattern is associated with fetal growth. MATERNAL AND CHILD NUTRITION 2019; 16:e12912. [PMID: 31777191 PMCID: PMC7083459 DOI: 10.1111/mcn.12912] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 10/10/2019] [Accepted: 10/18/2019] [Indexed: 01/06/2023]
Abstract
This study examined associations between a maternal "mixed, high sugar" dietary pattern during pregnancy and ultrasound-determined fetal growth in 495 urban African women and explored whether these associations were independent of maternal baseline body mass index (BMI) and gestational weight gain (GWG). Linear mixed effects modelling (LMM) was used to test the associations between maternal mixed, high sugar dietary pattern score, baseline BMI (kg/m2 ), and GWG (kg/week) and the following fetal growth outcomes: (a) biparietal diameter (cm), (b) head circumference (cm), (c) abdominal circumference (cm), and (d) femur length (cm). In the pooled LMM, a +1 standard deviation (SD) increase in the mixed, high sugar dietary pattern score was associated with higher biparietal diameter (0.03 cm/+1 SD; p = .007), head circumference (0.07 cm/+1 SD; p = .026), abdominal circumference (0.08 cm/+1 SD; p = .038), and femur length (0.02 cm/+1 SD; p = .015). Although these associations were independent of maternal BMI and GWG, higher baseline BMI was independently and positively associated with abdominal circumference (0.03 cm/+1 kg/m2 ; p = .011) and femur length (0.01 cm/+1 kg/m2 ; p = .007) and 1 kg/week greater GWG was associated with a 0.82 cm increase in abdominal circumference (p = .007). In urban African settings, where preconception maternal obesity prevalence is high and processed, high sugar diets are common, improving maternal dietary intake and BMI prior to conception should be prioritised for optimising pregnancy and birth outcomes as well as longer-term offspring health. In addition, dietary management strategies during pregnancy may be beneficial in facilitating healthy fetal growth.
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Affiliation(s)
- Stephanie V Wrottesley
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alessandra Prioreschi
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sarah H Kehoe
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Kate A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
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27
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Ancira-Moreno M, Vadillo-Ortega F, Rivera-Dommarco JÁ, Sánchez BN, Pasteris J, Batis C, Castillo-Castrejón M, O'Neill MS. Gestational weight gain trajectories over pregnancy and their association with maternal diet quality: Results from the PRINCESA cohort. Nutrition 2019; 65:158-166. [PMID: 31132630 PMCID: PMC7276248 DOI: 10.1016/j.nut.2019.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 01/08/2019] [Accepted: 02/02/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aims of this study were to characterize, among pregnant Mexican women, gestational weight gain (GWG) trajectories; assess associations of maternal dietary quality score (MDQS) with GWG during early-mid pregnancy, middle pregnancy, late pregnancy, and prolonged pregnancy; and evaluate the association between MDQS and adequacy of GWG, throughout pregnancy. We hypothesized that higher MDQS adherence is protective against insufficient or excessive GWG across pregnancy and that the association between MDQS adherence and GWG would vary by prepregnancy body mass index (BMI) category. METHODS We analyzed data from 660 pregnant women participating in the PRINCESA (Pregnancy Research on Inflammation, Nutrition and City Environments: Systematic Analyses) cohort in Mexico City, 2009 to 2014. Repeated measures of dietary intake and mother's weight were obtained during pregnancy. Individual GWG trajectories were modeled in a multilevel regression framework. Associations between MDQS (low, medium, and high adherence) and GWG were investigated using mixed-effect regression models with linear splines. RESULTS Women with prepregnancy BMI of ≥30 kg/m2 had a slower rate of GWG (RGWG) compared with other categories. A higher adherence to MDQS was protective against an insufficient (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.42-0.95; P = 0.03) and an excessive RGWG (OR, 0.62; 95% CI, 0.41-0.94; P = 0.03) throughout pregnancy, adjusting for prepregnancy BMI, energy intake, maternal age, educational level, parity, fetal sex, marital status, and physical activity. Associations between diet and RGWG differed by gestational period. CONCLUSION A better quality diet, as measured by MDQS, was associated with appropriate GWG during pregnancy in the PRINCESA cohort.
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Affiliation(s)
- Monica Ancira-Moreno
- Health Department, Universidad Iberoamericana, Mexico City, Mexico; UNAM, School of Medicine Branch at Instituto Nacional de Medicina Genómica, México City, México; National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Felipe Vadillo-Ortega
- UNAM, School of Medicine Branch at Instituto Nacional de Medicina Genómica, México City, México
| | | | - Brisa N Sánchez
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Jeremy Pasteris
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Carolina Batis
- CONACYT - Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | - Marie S O'Neill
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
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Goran MI, Plows JF, Ventura EE. Effects of consuming sugars and alternative sweeteners during pregnancy on maternal and child health: evidence for a secondhand sugar effect. Proc Nutr Soc 2019; 78:262-271. [PMID: 30501650 PMCID: PMC7441786 DOI: 10.1017/s002966511800263x] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Consumption of sugar and alternative low- or no-energy sweeteners has increased in recent decades. However, it is still uncertain how consumption of sugar and alternative sweeteners during pregnancy affects pregnancy outcomes and long-term offspring health. This review aims to collate the available evidence surrounding the consequences of sugar and alternative sweetener consumption during pregnancy, a so-called secondhand sugar effect. We found evidence that sugar consumption during pregnancy may contribute to increased gestational weight gain and the development of pregnancy complications, including gestational diabetes, preeclampsia and preterm birth. Further, we found a growing body of the animal and human evidence that maternal sugar intake during pregnancy may impact neonatal and childhood metabolism, taste perception and obesity risk. Emerging evidence also suggests that both maternal and paternal preconception sugar intakes are linked to offspring metabolic outcomes, perhaps via epigenetic alterations to the germline. While there have been fewer studies of the impacts of alternative sweetener consumption before and during pregnancy, there is some evidence to suggest effects on infant outcomes including preterm birth risk, increased infant body composition and offspring preference for sweet foods, although mechanisms are unclear. We conclude that preconception and gestational sugar and alternative sweetener consumption may negatively impact pregnancy outcomes and offspring health and that there is a need for further observational, mechanistic and intervention research in this area.
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Affiliation(s)
- M. I. Goran
- Department of Preventive Medicine, University of Southern California Health Sciences Campus, 2250 Alcazar Street, Los Angeles, CA 90033, USA
| | - J. F. Plows
- Department of Preventive Medicine, University of Southern California Health Sciences Campus, 2250 Alcazar Street, Los Angeles, CA 90033, USA
| | - E. E. Ventura
- Department of Preventive Medicine, University of Southern California Health Sciences Campus, 2250 Alcazar Street, Los Angeles, CA 90033, USA
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Maternal Dietary Patterns Are Associated with Pre-Pregnancy Body Mass Index and Gestational Weight Gain: Results from the "Mamma & Bambino" Cohort. Nutrients 2019; 11:nu11061308. [PMID: 31185656 PMCID: PMC6627583 DOI: 10.3390/nu11061308] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 05/29/2019] [Accepted: 06/05/2019] [Indexed: 12/30/2022] Open
Abstract
The present study investigated the association of maternal dietary patterns with pre-pregnancy body mass index (BMI) and total gestational weight gain (GWG), using data of 232 women from the "Mamma & Bambino" cohort. Dietary patterns were derived by a food frequency questionnaire and principal component analysis. Self-reported pre-pregnancy BMI and GWG were calculated according to the World Health Organization and Institute of Medicine guidelines, respectively. The adherence to the "Western" dietary pattern-characterized by high intake of red meat, fries, dipping sauces, salty snacks and alcoholic drinks-was associated with increased GWG (β = 1.217; standard error [SE] = 0.487; p = 0.013), especially among obese women (β = 7.363; SE = 1.808; p = 0.005). In contrast, the adherence to the "prudent" dietary pattern-characterized by high intake of boiled potatoes, cooked vegetables, legumes, pizza and soup-was associated with reduced pre-pregnancy BMI (β = -0.631; SE = 0.318; p-trend = 0.038). Interestingly, the adherence to this pattern was positively associated with GWG among underweight (β = 4.127; SE = 1.722; p = 0.048), and negatively among overweight and obese individuals (β = -4.209; SE = 1.635; p = 0.016 and β = -7.356; SE = 2.304; p = 0.031, respectively). Our findings point out that the promotion of a healthy diet might represent a potential preventive strategy against inadequate weight gain, even during the periconceptional period.
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30
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Alves-Santos NH, Cocate PG, Benaim C, Farias DR, Emmett PM, Kac G. Prepregnancy Dietary Patterns and Their Association with Perinatal Outcomes: A Prospective Cohort Study. J Acad Nutr Diet 2019; 119:1439-1451. [PMID: 31053516 DOI: 10.1016/j.jand.2019.02.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 02/11/2019] [Accepted: 02/28/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dietary intake may be associated with neonatal outcomes, yet little is known about the influence of prepregnancy dietary pattern (DP). OBJECTIVES To evaluate the association between prepregnancy DPs and perinatal outcomes. DESIGN Prospective cohort study during pregnancy (baseline between 5 and 13 gestational week and three follow-up visits: 20 to 26 gestational weeks, 30 to 36 gestational weeks, and 30 to 40 days postpartum, respectively). Diet was assessed in the first trimester using a food frequency questionnaire and having prepregnancy as the time frame. PARTICIPANTS/SETTING Two hundred fifty-three pregnant women met the following eligibility criteria (20 to 40 years of age, 5 to 13 weeks of gestation at baseline, free of chronic [except obesity] or infectious diseases, and with a singleton pregnancy). The final sample was composed of 193 pregnant women attending a public health care center in Rio de Janeiro, Brazil, from 2009 to 2012. MAIN OUTCOME MEASURES Type of delivery, large for gestational age (LGA), birth length (BL)>90th percentile, Apgar score<7 at 1 minute, and preterm birth. STATISTICAL ANALYSES Reduced rank regression was used to identify prepregnancy DPs that explain the following response variables: fiber density (daily dietary fiber intake in grams, divided by total daily energy intake in kilocalories), dietary energy density, and percent energy from saturated fat. Statistical analyses included multiple logistic regression models. The following covariates were defined as confounders based on a unique Direct Acyclic Graph for each outcome: maternal age, current smoker, alcohol consumption, years of education, and first-trimester leisure physical activity. RESULTS The prevalence of normal delivery was 56.7%. LGA occurred in 16%, BL>90th percentile in 24.3%, Apgar score<7 at 1 minute in 14.2%, and preterm birth in 9.5% of the study population. Three DPs were identified: "fast food and candies" was associated with higher odds of LGA (odds ratio [OR]=4.38, 95% CI: 1.32 to 14.48) and BL>90th percentile (OR=4.81, 95% CI: 1.77 to 13.07); "beans, bread, and fat" was inversely associated with Apgar score<7 at 1 minute (OR=0.14, 95% CI: 0.03 to 0.70); and "vegetables and dairy" was inversely associated with preterm birth (OR=0.24, 95% CI: 0.06 to 0.97). There was no association between adherence to DPs and type of delivery. CONCLUSIONS Higher adherence to fast food and candies prepregnancy DP increased the odds of LGA birth, while a higher adherence to vegetables and dairy DP decreased the odds of preterm birth.
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Suliga E, Rokita W, Adamczyk-Gruszka O, Pazera G, Cieśla E, Głuszek S. Factors associated with gestational weight gain: a cross-sectional survey. BMC Pregnancy Childbirth 2018; 18:465. [PMID: 30509248 PMCID: PMC6276162 DOI: 10.1186/s12884-018-2112-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 11/22/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The aim of this study was to describe the dietary patterns in pregnant women and determine the association between diet factors, pre-pregnancy body mass index, socio-demographic characteristics and gestational weight gain. METHODS The analysis was conducted on a group of 458 women. Cut-off values of gestational weight gain adequacy were based on recommendations published by the US Institute of Medicine and were body mass index-specific. Logistic regression analysis was used to assess the risk of the occurrence of inadequate or excessive gestational weight gain. Dietary patterns were identified by factor analysis. RESULTS Three dietary patterns characteristic of pregnant women in Poland were identified: 'unhealthy', 'varied' and 'prudent'. The factor associated with increased risk of inadequate gestational weight gain was being underweight pre-pregnancy (OR = 2.61; p = 0.018). The factor associated with increased risk of excessive weight gain were being overweight or obese pre-pregnancy (OR = 7.00; p = 0.031) and quitting smoking (OR = 7.32; p = 0.019). The risk of excessive weight gain was decreased by being underweight pre-pregnancy (OR = 0.20; p = 0.041), being in the third or subsequent pregnancy compared to being in the first (OR = 0.37; p = 0.018), and having a high adherence to a prudent dietary pattern (OR = 0.47; p = 0.033). CONCLUSIONS Women who were overweight or obese pre-pregnancy and those who quit smoking at the beginning of pregnancy should be provided with dietary guidance to prevent excessive gestational weight gain.
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Affiliation(s)
- Edyta Suliga
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland.
| | - Wojciech Rokita
- Department of Gynecological and Obstetric Prophylaxis, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Olga Adamczyk-Gruszka
- Department of Gynecological and Obstetric Prophylaxis, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Grażyna Pazera
- Clinic of Neonatology at the Regional Polyclinic Hospital, Kielce, Poland
| | - Elżbieta Cieśla
- Department of Developmental Age Research, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Stanisław Głuszek
- Department of Surgery and Surgical Nursing with the Scientific Research Laboratory, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
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Relationship Between Psychosocial Factors, Dietary Intake and Gestational Weight Gain: A Narrative Review. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2018; 41:495-504. [PMID: 30393057 DOI: 10.1016/j.jogc.2018.02.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/21/2018] [Accepted: 02/23/2018] [Indexed: 12/25/2022]
Abstract
Inadequate gestational weight gain (GWG), which has reached almost two-thirds of Canadian pregnant women, is associated with several adverse effects both in the mother and her child. The aim of this review was to establish how psychosocial factors, diet and GWG are interrelated during pregnancy. More specifically, it aimed to evaluate how psychosocial factors can impact on diet and, thus, influence GWG. Studies published through May 2017 that examined factors related to GWG were included. Of 3268 non-duplicate titles and abstract, 77 articles underwent full-text review. Regarding dietary intakes, the majority of the included studies demonstrated that a higher caloric intake was associated with an elevated GWG. Also, a negative body image and attitude toward weight gain as well as a poor knowledge of GWG recommendations and inadequate prenatal care is associated with an increased GWG. Only few studies examined altogether the factors included and conclusions about how psychosocial factors can impact on diet and, thus, influence GWG cannot be drawn at this point. In the few studies that evaluated the interrelationships between psychosocial factors, diet and GWG, energy intake was not identified as a mediator of the association between psychosocial factors and GWG. This review highlights the scarcity of findings regarding psychosocial and dietary factors in relation to GWG and the need for high quality prospective cohort studies that will include all these factors to provide a better understanding of how they are interrelated to influence short- and long-term health.
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Lee A, Muggli E, Halliday J, Lewis S, Gasparini E, Forster D. What do pregnant women eat, and are they meeting the recommended dietary requirements for pregnancy? Midwifery 2018; 67:70-76. [PMID: 30267936 DOI: 10.1016/j.midw.2018.09.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 08/30/2018] [Accepted: 09/08/2018] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To compare the dietary intake of pregnant women to the 2013 Australian Dietary Guidelines and explore factors associated with inadequate intake. DESIGN Dietary intake data were collected between July 2011 and July 2012 (n = 1570) using a 74-item food frequency questionnaire. SETTING Metropolitan public health hospitals in Melbourne, Australia. PARTICIPANTS Pregnant women, at least 16 years of age, with a singleton pregnancy, and literate in English. MEASUREMENTS AND FINDINGS The highest proportion of women met the recommended daily servings for fruit (65.7%), followed by dairy products (55.2%), meat/meat alternatives (31.1%), vegetables (10.3%), and then grain foods (1.8%). A majority of women (83.8%) regularly consumed up to 2.5 serves of discretionary foods per day. Only one woman met the minimum recommended daily servings for all five food groups. Women who were obese were more likely to consume an inadequate diet (Adj. OR 2.13, 95% CI 1.53, 2.95); and having a university degree was associated with a lower odds of consuming an inadequate diet (Adj. OR 0.63, 95% CI 0.50, 0.78). KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Pregnancy care providers need to be aware of women's low compliance with the national dietary guidelines, particularly regarding the poor intake of vegetables and grain foods; targeted as well as population-based approaches may be required.
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Affiliation(s)
- Amelia Lee
- Royal Women's Hospital, 20 Flemington Road, Parkville, Victoria 3052, Australia.
| | - Evelyne Muggli
- Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia; University of Melbourne, Parkville, Victoria 3052, Australia.
| | - Jane Halliday
- Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia; University of Melbourne, Parkville, Victoria 3052, Australia.
| | - Sharon Lewis
- Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia; University of Melbourne, Parkville, Victoria 3052, Australia.
| | - Elisabeth Gasparini
- Royal Women's Hospital, 20 Flemington Road, Parkville, Victoria 3052, Australia.
| | - Della Forster
- Royal Women's Hospital, 20 Flemington Road, Parkville, Victoria 3052, Australia; Latrobe University, Bundoora, Victoria 3086, Australia.
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Wrottesley SV, Ong KK, Pisa PT, Norris SA. Maternal traditional dietary pattern and antiretroviral treatment exposure are associated with neonatal size and adiposity in urban, black South Africans. Br J Nutr 2018; 120:557-566. [PMID: 30058507 PMCID: PMC6773599 DOI: 10.1017/s0007114518001708] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This study examines the associations between maternal Traditional dietary pattern adherence and HIV/treatment with neonatal size and adiposity in urban, black South Africans, as well as how specific maternal factors - that is BMI and gestational weight gain (GWG) - may influence these associations. Multiple linear regression models were used to examine associations among maternal Traditional diet pattern adherence (pattern score), HIV/treatment status (three groups: HIV negative, HIV positive (antenatal antiretroviral treatment (ART) initiation), HIV positive (pre-pregnancy ART initiation)), BMI and GWG (kg/week), and newborn (1) weight:length ratio (WLR, kg/m) in 393 mother-neonate pairs, and (2) Peapod estimated fat mass index (FMI, kg/m3) in a 171-pair subsample. In fully adjusted models, maternal obesity and GWG were associated with 0·25 kg/m (P=0·008) and 0·48 kg/m (P=0·002) higher newborn WLR, whereas Traditional diet pattern score was associated with lower newborn WLR (-0·04 kg/m per +1 sd; P=0·033). In addition, Traditional diet pattern score was associated with 0·13 kg/m3 (P=0·027) and 0·32 kg/m3 (P=0·005) lower FMI in the total sample and in newborns of normal-weight women, respectively. HIV-positive (pre-pregnancy ART) v. HIV-negative (ref) status was associated with 1·11 kg/m3 (P=0·002) higher newborn FMI. Promotion of a Traditional dietary pattern, alongside a healthy maternal pre-conception weight, in South African women may reduce newborn adiposity and metabolic risk profiles. In HIV-positive women, targeted monitoring and management strategies are necessary to limit treatment-associated effects on in utero fat deposition.
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Affiliation(s)
- Stephanie V. Wrottesley
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ken K. Ong
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Pedro T. Pisa
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A. Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Bédard A, Northstone K, Holloway JW, Henderson AJ, Shaheen SO. Maternal dietary antioxidant intake in pregnancy and childhood respiratory and atopic outcomes: birth cohort study. Eur Respir J 2018; 52:13993003.00507-2018. [PMID: 30093569 PMCID: PMC6383601 DOI: 10.1183/13993003.00507-2018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 07/16/2018] [Indexed: 11/25/2022]
Abstract
Evidence for a possible protective effect of maternal dietary antioxidant intake during pregnancy on childhood asthma and other atopic outcomes is conflicting, and associations with childhood lung function have been little studied. In the Avon Longitudinal Study of Parents and Children, we analysed associations between maternal intake of fruits, vegetables, vitamins C and E, carotene, zinc, and selenium in pregnancy and current doctor-diagnosed asthma, atopy and lung function in 8915 children at age 7–9 years. Potential modification of associations by maternal smoking and common maternal antioxidant gene polymorphisms was explored to strengthen causal inference. After controlling for confounders, positive associations were observed between maternal intake of zinc and childhood forced expiratory volume in 1 s and forced vital capacity (difference in age-, height- and sex-adjusted sd units per quartile increase in maternal dietary zinc intake β 0.05 (95% CI 0.01–0.08); ptrend=0.01 and 0.05 (95% CI 0.02–0.09); ptrend=0.005, respectively). Weak evidence was found for an interaction between maternal zinc intake and maternal glutathione S-transferase GSTM1 genotype on childhood forced vital capacity (pinteraction=0.05); association among the GSTM1 null group β 0.11 (95% CI 0.05–0.17); ptrend=0.001. Our results suggest that a higher maternal intake of zinc during pregnancy may be associated with better lung function in the offspring. A higher maternal intake of zinc during pregnancy may improve lung function, and especially forced vital capacity, in the offspringhttp://ow.ly/oTt030l1rew
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Affiliation(s)
- Annabelle Bédard
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kate Northstone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - A John Henderson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,These authors are joint senior authors
| | - Seif O Shaheen
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,These authors are joint senior authors
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Wei X, He JR, Lin Y, Lu M, Zhou Q, Li S, Lu J, Yuan M, Chen N, Zhang L, Qiu L, Mai W, Pan Y, Yin C, Hu C, Xia H, Qiu X. The influence of maternal dietary patterns on gestational weight gain: A large prospective cohort study in China. Nutrition 2018; 59:90-95. [PMID: 30471529 DOI: 10.1016/j.nut.2018.07.113] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 06/14/2018] [Accepted: 07/17/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The relationship between dietary patterns and gestational weight gain (GWG) in different pregnancy stages has rarely been reported among the Asian population. The aim of this study was to examine the relationship between dietary patterns and GWG in Chinese pregnant women. METHODS Participants were women from the Born in Guangzhou Cohort Study who completed a validated food frequency questionnaire at 24 to 27 wk gestation (N = 5733). Dietary patterns were generated by cluster analysis. Maternal prepregnancy weight was self-reported; weights during pregnancy were extracted from medical records. Regression analyses were performed to test the associations between dietary patterns and total GWG and GWG rates (linear regression), and the adequacy of GWG (logistic regression). RESULTS According to food consumption frequency, six dietary patterns were generated: "richer in cereals," "richer in vegetables," "richer in meats," "richer in fruits," "richer in fish, beans, nuts, and yogurt," and "richer in milk and milk powder." Compared with women following the richer in cereals pattern, those who followed the richer in fruits pattern had a significantly higher GWG (β = 0.592; 95% confidence interval [CI], 0.166-1.018) and total rate of GWG; those who followed the richer in fish, beans, nuts, and yogurt" pattern had a greater GWG rate in the second trimester, and also had a decreased risk for inadequate GWG (odds ratio, 0.797; 95% CI, 0.638-0.997). CONCLUSION Consuming a variety of foods and frequent consumption of fruits during pregnancy contributes to a more rapid increase in GWG among pregnant women in China. Findings may be useful in pregnancy weight monitoring.
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Affiliation(s)
- Xueling Wei
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Jian-Rong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Yan Lin
- Nursing department, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Minshan Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Qianling Zhou
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Shenghui Li
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Jinhua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Mingyang Yuan
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Niannian Chen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Lifang Zhang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Lan Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Weibi Mai
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Yonghong Pan
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Caixin Yin
- Nursing department, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Cuiyue Hu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Huimin Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China.
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37
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Hrolfsdottir L, Halldorsson TI, Birgisdottir BE, Hreidarsdottir IT, Hardardottir H, Gunnarsdottir I. Development of a dietary screening questionnaire to predict excessive weight gain in pregnancy. MATERNAL AND CHILD NUTRITION 2018; 15:e12639. [PMID: 30033533 PMCID: PMC6586038 DOI: 10.1111/mcn.12639] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 05/05/2018] [Accepted: 05/22/2018] [Indexed: 01/13/2023]
Abstract
Excessive gestational weight gain (GWG) is a risk factor for several adverse pregnancy outcomes, including macrosomia. Diet is one of the few modifiable risk factors identified. However, most dietary assessment methods are impractical for use in maternal care. This study evaluated whether a short dietary screening questionnaire could be used as a predictor of excessive GWG in a cohort of Icelandic women. The dietary data were collected in gestational weeks 11–14, using a 40‐item food frequency screening questionnaire. The dietary data were transformed into 13 predefined dietary risk factors for an inadequate diet. Stepwise backward elimination was used to identify a reduced set of factors that best predicted excessive GWG. This set of variables was then used to calculate a combined dietary risk score (range 0–5). Information regarding outcomes, GWG (n = 1,326) and birth weight (n = 1,651), was extracted from maternal hospital records. In total, 36% had excessive GWG (Icelandic criteria), and 5% of infants were macrosomic (≥4,500 g). A high dietary risk score (characterized by a nonvaried diet, nonadequate frequency of consumption of fruits/vegetables, dairy, and whole grain intake, and excessive intake of sugar/artificially sweetened beverages and dairy) was associated with a higher risk of excessive GWG. Women with a high (≥4) versus low (≤2) risk score had higher risk of excessive GWG (relative risk = 1.23, 95% confidence interval, CI [1.002, 1.50]) and higher odds of delivering a macrosomic offspring (odds ratio = 2.20, 95% CI [1.14, 4.25]). The results indicate that asking simple questions about women's dietary intake early in pregnancy could identify women who should be prioritized for further dietary counselling and support.
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Affiliation(s)
- Laufey Hrolfsdottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.,Department of Education, Science and Quality, Akureyri Hospital, Akureyri, Iceland
| | - Thorhallur I Halldorsson
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.,Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Bryndis E Birgisdottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | | | - Hildur Hardardottir
- Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavík, Iceland.,Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Ingibjorg Gunnarsdottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
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Dietary patterns and their association with adiponectin and leptin concentrations throughout pregnancy: a prospective cohort. Br J Nutr 2018; 119:320-329. [PMID: 29345609 DOI: 10.1017/s0007114517003580] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The aim of this study was to evaluate the association of dietary patterns (DP) with maternal adiposity indicators, leptin, adiponectin and insulin concentrations during pregnancy. A prospective cohort of pregnant women followed up at the 5th-13th, 20th -26th and 30th-36th gestational weeks and 30-40 d postpartum was conducted in Rio de Janeiro. A FFQ was administered in the third trimester (30th-36th gestational weeks). The reduced rank regression procedure was used to identify DP that explain response variables (dietary fibre and total fat) related to indicators of maternal adiposity (postpartum weight retention and gestational weight gain (GWG) adequacy), and plasma leptin, adiponectin and insulin concentrations. The associations between tertiles of DP and the outcomes were determined using logistic regression or longitudinal linear mixed-effect regression models. The mean daily energy intake during pregnancy was 10 104 (sd 3234) kJ (2415 (sd 773) kcal), and GWG was 11·9 (sd 4·2) kg. In all, 40 % of women presented pre-gestational overweight/obesity. Excessive GWG occurred in 34·7 % of pregnant women and 56·6 % were overweight/obese at postpartum. The 'common-Brazilian' DP (characterised by higher intake of beans, rice and lower intake of fast food/snacks, candies/table sugar and processed meats/bacon) was positively associated with adiponectin (β=1·07; 95 % CI 0·17, 1·98). The 'Western' DP (characterised by higher intake of fast food/snacks and processed meat/bacon and lower intake of noodles/pasta/roots/tubers and sodas) was negatively associated with adiponectin (β=-1·11; 95 % CI -2·00, -0·22) and positively associated with leptin concentrations (β=64·9; 95 % CI 22·8, 107·0) throughout pregnancy. It may be suggested that the 'common-Brazilian' is a healthy DP and beneficial for serum concentrations of adiponectin and leptin.
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Shin D, Lee KW, Song WO. Dietary Patterns During Pregnancy are Associated with Gestational Weight Gain. Matern Child Health J 2018; 20:2527-2538. [PMID: 27456307 DOI: 10.1007/s10995-016-2078-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective The role of diet during pregnancy on gestational weight gain is unclear. This study aimed to evaluate the hypothesis that dietary patterns during pregnancy are differentially associated with the adequacy of gestational weight gain at different stages of pregnancy. Methods A total of 391 pregnant women in National Health and Nutrition Examination Survey (NHANES) 2003-2006 were included. Dietary intake was obtained using a National Cancer Institute's food-frequency questionnaire. Results Three dietary patterns were identified by factor analysis with 36 food groups among pregnant women, and they were named according to food group factor loadings: 'mixed', 'healthy', and 'western'. The 'mixed' pattern characterized by a high intake of meat, dairy products, fruits, vegetables, potatoes, nuts and seeds and sweets. After adjusting for maternal sociodemographic variables and physical activity level, women in the highest tertile of 'mixed' pattern score had significantly greater odds of being in the inadequate gestational weight gain compared to those in the lowest tertile (adjusted odds ratio (AOR) 4.72; 95 % CI 1.07-20.94). Women in the mid tertile of the 'mixed' pattern had significantly lower odds of being in the excessive gestational weight gain compared to those in the lowest tertile (AOR 0.39; 95 % CI 0.15-0.99). Conclusion These results suggest that a diet high in meat, dairy products, fruits, vegetables, potatoes, and nuts and seeds during pregnancy might be associated with reducing excessive gestational weight gain.
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Affiliation(s)
- Dayeon Shin
- Department of Nutrition and Dietetics, University of North Dakota, 221 Centennial Dr, Stop 8237, Grand Forks, ND, 58202-8237, USA.,Department of Food Science and Human Nutrition, Michigan State University, 469 Wilson Road, G. Malcolm Trout FSHN Building, East Lansing, MI, 48824-1224, USA
| | - Kyung Won Lee
- Department of Food Science and Human Nutrition, Michigan State University, 469 Wilson Road, G. Malcolm Trout FSHN Building, East Lansing, MI, 48824-1224, USA
| | - Won O Song
- Department of Food Science and Human Nutrition, Michigan State University, 469 Wilson Road, G. Malcolm Trout FSHN Building, East Lansing, MI, 48824-1224, USA.
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40
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Erler NS, Rizopoulos D, Jaddoe VW, Franco OH, Lesaffre EM. Bayesian imputation of time-varying covariates in linear mixed models. Stat Methods Med Res 2017; 28:555-568. [PMID: 29069967 PMCID: PMC6344996 DOI: 10.1177/0962280217730851] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Studies involving large observational datasets commonly face the challenge of
dealing with multiple missing values. The most popular approach to overcome this
challenge, multiple imputation using chained equations, however, has been shown
to be sub-optimal in complex settings, specifically in settings with
longitudinal outcomes, which cannot be easily and adequately included in the
imputation models. Bayesian methods avoid this difficulty by specification of a
joint distribution and thus offer an alternative. A popular choice for that
joint distribution is the multivariate normal distribution. In more complicated
settings, as in our two motivating examples that involve time-varying
covariates, additional issues require consideration: the endo- or exogeneity of
the covariate and its functional relation with the outcome. In such situations,
the implied assumptions of standard methods may be violated, resulting in bias.
In this work, we extend and study a more flexible, Bayesian alternative to the
multivariate normal approach, to better handle complex incomplete longitudinal
data. We discuss and compare assumptions of the two Bayesian approaches about
the endo- or exogeneity of the covariates and the functional form of the
association with the outcome, and illustrate and evaluate consequences of
violations of those assumptions using simulation studies and two real data
examples.
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Affiliation(s)
- Nicole S Erler
- 1 Department of Biostatistics, Erasmus MC, Rotterdam, The Netherlands.,2 Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Vincent Wv Jaddoe
- 2 Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,3 Department of Pediatrics, Erasmus MC, Rotterdam, The Netherlands.,4 Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Oscar H Franco
- 2 Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Emmanuel Meh Lesaffre
- 1 Department of Biostatistics, Erasmus MC, Rotterdam, The Netherlands.,5 L-Biostat, KU Leuven, Leuven, Belgium
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The Influence of Maternal Dietary Patterns on Body Mass Index and Gestational Weight Gain in Urban Black South African Women. Nutrients 2017; 9:nu9070732. [PMID: 28696364 PMCID: PMC5537846 DOI: 10.3390/nu9070732] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 06/09/2017] [Accepted: 06/14/2017] [Indexed: 11/18/2022] Open
Abstract
Maternal pre-pregnancy body mass index (BMI) and subsequent gestational weight gain (GWG) are strong predictors of maternal and infant outcomes; however the influence of dietary patterns on BMI-specific GWG is unclear. This study identifies patterns of habitual dietary intake in urban South African women and explores their associations with first trimester BMI and GWG. Habitual dietary intake of 538 pregnant women was assessed using a quantitative food-frequency questionnaire and dietary patterns were depicted via principle component analysis. Associations between dietary patterns and BMI-specific GWG were analyzed using linear and logistic regression. Three dietary patterns were identified: Western, Traditional and Mixed. Western and Mixed diet patterns were associated with 35 g/week (p = 0.021) and 24 g/week (p = 0.041) higher GWG in normal weight and obese women respectively. Additionally, high intakes of a Traditional diet pattern were associated with a reduced odds of excessive weight gain in the total sample (OR: 0.81; p = 0.006) and in normal weight women (OR: 0.68; p = 0.003). Increased intake of a traditional diet pattern—high in whole grains, legumes, vegetables and traditional meats—and decreased intake of refined, high sugar and fat driven diets may reduce GWG (including risk of excessive weight gain) in urban South African women.
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Bédard A, Northstone K, Henderson AJ, Shaheen SO. Maternal intake of sugar during pregnancy and childhood respiratory and atopic outcomes. Eur Respir J 2017; 50:50/1/1700073. [PMID: 28679610 PMCID: PMC5540678 DOI: 10.1183/13993003.00073-2017] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 05/05/2017] [Indexed: 11/17/2022]
Abstract
The possible role of maternal consumption of free sugar during pregnancy in the inception of respiratory and atopic diseases has not been studied. We aimed to study the relationship between maternal intake of free sugar during pregnancy and respiratory and atopic outcomes in the offspring in a population-based birth cohort, the Avon Longitudinal Study of Parents and Children. We analysed associations between maternal intake of free sugar in pregnancy (estimated by a food frequency questionnaire), and current doctor-diagnosed asthma, wheezing, hay fever, eczema, atopy, serum total IgE and lung function in children aged 7–9 years (n=8956 with information on maternal diet in pregnancy and at least one outcome of interest). After controlling for potential confounders, maternal intake of free sugar was positively associated with atopy (OR for highest versus lowest quintile of sugar intake 1.38, 95% CI 1.06–1.78; per quintile p-trend=0.006) and atopic asthma (OR 2.01, 95% CI 1.23–3.29; per quintile p-trend=0.004). These associations were not confounded by intake of sugar in early childhood, which was unrelated to these outcomes. Our results suggest that a higher maternal intake of free sugar during pregnancy is associated with an increased risk of atopy and atopic asthma in the offspring, independently of sugar intake in early childhood. Higher maternal intake of sugar in pregnancy may increase the risk of allergy and allergic asthma in the offspringhttp://ow.ly/zehc30bFswP
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Affiliation(s)
- Annabelle Bédard
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kate Northstone
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - A John Henderson
- School of Social and Community Medicine, University of Bristol, Bristol, UK.,Joint senior authors
| | - Seif O Shaheen
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Joint senior authors
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Bédard A, Northstone K, Henderson AJ, Shaheen SO. Maternal intake of sugar during pregnancy and childhood respiratory and atopic outcomes. Eur Respir J 2017. [PMID: 28679610 DOI: 10.1183/13993003-00073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Abstract
The possible role of maternal consumption of free sugar during pregnancy in the inception of respiratory and atopic diseases has not been studied. We aimed to study the relationship between maternal intake of free sugar during pregnancy and respiratory and atopic outcomes in the offspring in a population-based birth cohort, the Avon Longitudinal Study of Parents and Children.We analysed associations between maternal intake of free sugar in pregnancy (estimated by a food frequency questionnaire), and current doctor-diagnosed asthma, wheezing, hay fever, eczema, atopy, serum total IgE and lung function in children aged 7-9 years (n=8956 with information on maternal diet in pregnancy and at least one outcome of interest).After controlling for potential confounders, maternal intake of free sugar was positively associated with atopy (OR for highest versus lowest quintile of sugar intake 1.38, 95% CI 1.06-1.78; per quintile p-trend=0.006) and atopic asthma (OR 2.01, 95% CI 1.23-3.29; per quintile p-trend=0.004). These associations were not confounded by intake of sugar in early childhood, which was unrelated to these outcomes.Our results suggest that a higher maternal intake of free sugar during pregnancy is associated with an increased risk of atopy and atopic asthma in the offspring, independently of sugar intake in early childhood.
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Affiliation(s)
- Annabelle Bédard
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kate Northstone
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - A John Henderson
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- Joint senior authors
| | - Seif O Shaheen
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Joint senior authors
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Starling AP, Sauder KA, Kaar JL, Shapiro AL, Siega-Riz AM, Dabelea D. Maternal Dietary Patterns during Pregnancy Are Associated with Newborn Body Composition. J Nutr 2017; 147:1334-1339. [PMID: 28539412 DOI: 10.3945/jn.117.248948] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 03/11/2017] [Accepted: 04/26/2017] [Indexed: 01/04/2023] Open
Abstract
Background: Maternal dietary intake during pregnancy may influence offspring growth and adiposity. Specific dietary patterns associated with newborn adiposity have not been identified.Objective: We aimed to identify patterns of maternal dietary intake associated with gestational weight gain (GWG) and fasting glucose during pregnancy and to evaluate whether adherence to these patterns is associated with newborn adiposity.Methods: In the Healthy Start prospective cohort, dietary intake during pregnancy was assessed via 24-h recalls. Reduced-rank regression identified dietary patterns predictive of GWG and fasting glucose. Associations between dietary patterns and newborn fat mass, fat-free mass, and adiposity were estimated by using linear regression models among 764 ethnically diverse mother-infant pairs.Results: Two dietary patterns were identified. Pattern 1, correlated with greater GWG (r = 0.22, P < 0.01), was characterized by a higher consumption of poultry, nuts, cheese, fruits, whole grains, added sugars, and solid fats. Greater adherence to pattern 1 (upper compared with lower tertile) predicted a greater newborn fat-free mass (61 g; 95% CI: 12, 110 g) but no difference in fat mass or adiposity. Pattern 2, correlated with greater maternal fasting glucose (r = 0.16, P < 0.01), was characterized by a higher consumption of eggs, starchy vegetables, solid fats, fruits, and nonwhole grains and a lower consumption of dairy foods, dark-green vegetables, and whole grains. Greater adherence to pattern 2 was associated with a greater newborn birth weight (80 g; 95% CI: 15, 145 g), fat mass (33 g; 95% CI: 8, 59 g), and adiposity (0.9%; 95% CI: 0.3%, 1.6%).Conclusions: Among pregnant women, adherence to a dietary pattern characterized by an intake of poultry, nuts, cheese, and whole grains was associated with greater GWG but not maternal fasting glucose or newborn adiposity. Adherence to a pattern characterized by an intake of eggs, starchy vegetables, and nonwhole grains was associated with higher maternal fasting glucose and greater newborn adiposity. Maternal dietary patterns during pregnancy may influence newborn body composition.
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Affiliation(s)
| | - Katherine A Sauder
- Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO; and
| | - Jill L Kaar
- Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO; and
| | | | - Anna Maria Siega-Riz
- Departments of Public Health Sciences and Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA
| | - Dana Dabelea
- Departments of Epidemiology and.,Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO; and
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Abdolaliyan N, Shahnazi H, Kzemi A, Hasanzadeh A. Determinants of the self-efficacy of physical activity for maintaining weight during pregnancy: The application of the health belief model. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2017; 6:93. [PMID: 29114560 PMCID: PMC5651666 DOI: 10.4103/jehp.jehp_175_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Accepted: 05/23/2017] [Indexed: 05/11/2023]
Abstract
INTRODUCTION Pregnancy is one of the high-risk periods for women's health that the lack of attention to healthy behaviors such as weight control behaviors can lead to adverse consequences on the health of women and also the fetus. Therefore, the aim of this paper was to explore the determinants of weight control self-efficacy among pregnant women using Health Belief Model (HBM). MATERIALS AND METHODS In this cross-sectional study were enrolled 202 pregnant women referring to Health Care Center in Isfahan city, Iran. Sampling method was multistage random. A researcher-made instrument based on HBM structures was used after confirming the valid and reliable. Data were analyzed by software SPSS 21 and descriptive statistics were represented with (frequency, mean and standard deviation) and analytical (Pearson correlation, independent t and liner regression) at the significant level of <0.05. RESULTS The average age of participants was 27.80 ± 5.08. HBM structures were able explained 31% of variance of weight control self-efficacy. Also, of the studied structures, perceived benefits, perceived barriers were statistically significant predictors of weight control self-efficacy, within which perceived barriers (β = 0.391) was the most significant predictor. CONCLUSION The findings of current study showed that the HBM model could be as a suitable framework to identify effective factors for designing educational intervention to improve weight control behaviors among pregnant women.
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Affiliation(s)
- Nafise Abdolaliyan
- Department of Health Education, School of Public Health, Isfahan University of Medical Science, Isfahan, Iran
| | - Hossein Shahnazi
- Department of Health Education, School of Public Health, Isfahan University of Medical Science, Isfahan, Iran
- Address for correspondence: Dr. Hossein Shahnazi, School of Public Health, Isfahan University of Medical Science, Isfahan, Iran. E-mail:
| | - Ashraf Kzemi
- Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Science, Isfahan, Iran
| | - Akbar Hasanzadeh
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Science, Isfahan, Iran
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Nguyen AN, de Barse LM, Tiemeier H, Jaddoe VWV, Franco OH, Jansen PW, Voortman T. Maternal history of eating disorders: Diet quality during pregnancy and infant feeding. Appetite 2016; 109:108-114. [PMID: 27889494 DOI: 10.1016/j.appet.2016.11.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 11/09/2016] [Accepted: 11/22/2016] [Indexed: 02/06/2023]
Abstract
We studied associations of maternal history of eating disorders (EDs) with diet quality of pregnant women and their infants, and breastfeeding practices. We included 6196 mother-child pairs from Generation R, a population-based cohort in the Netherlands. Maternal history of lifetime EDs was assessed during pregnancy with a questionnaire. Dietary intake during pregnancy and in infancy was assessed with food-frequency questionnaires and diet quality scores were calculated, reflecting adherence to dietary guidelines. Breastfeeding practices were assessed with questionnaires at 2, 6, and 12 months. We observed that, after adjustment for socioeconomic and lifestyle factors, women with a history of EDs had a higher diet quality than women without a history of EDs (B = 0.24 SD, 95%CI: 0.15; 0.33). Mothers with a history of EDs were less likely to breastfeed (unadjusted OR = 0.68, 95%CI: 0.51; 0.93), although no longer statistically significant after adjustment (OR = 0.75, 95%CI: 0.55; 1.03). These findings suggest that mothers with a history of EDs seem slightly less likely to initiate breastfeeding, however, this warrants further investigation. At the age of 1 year, infants of mothers with a history of EDs had a higher diet quality (B = 0.15 SD, 95%CI: 0.02; 0.27). We conclude that mothers with a history of EDs and their infants have a relative good diet quality, although follow-up studies are needed to assess long-term associations with diet in later childhood and adolescence.
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Affiliation(s)
- Anh N Nguyen
- Department of Epidemiology, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Lisanne M de Barse
- Department of Epidemiology, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands; The Generation R Study Group, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry / Psychology, Erasmus MC-University Medical Center, PO Box 2060, 3000 CB Rotterdam, The Netherlands; Department of Psychiatry, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- Department of Epidemiology, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands; The Generation R Study Group, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands; Department of Pediatrics, Erasmus MC-University Medical Center, PO Box 2060, 3000 CB Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Pauline W Jansen
- Department of Child and Adolescent Psychiatry / Psychology, Erasmus MC-University Medical Center, PO Box 2060, 3000 CB Rotterdam, The Netherlands; Institute of Psychology, Erasmus University Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands; The Generation R Study Group, Erasmus MC-University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
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