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Azcorra H, Dickinson F, Batún JL. The relationship between pre-pregnancy BMI and energy and macronutrients intakes during pregnancy in women from Yucatan, Mexico. J OBSTET GYNAECOL 2024; 44:2143259. [PMID: 36394296 DOI: 10.1080/01443615.2022.2143259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 10/25/2022] [Indexed: 11/19/2022]
Abstract
In this observational study, our aim was to analyse the association between pre-pregnancy BMI and adequacy rates of energy and macronutrient intakes in a sample of pregnant women from Yucatan, Mexico. From September to December 2019, we collected data on socioeconomic, pregnancy, and dietary characteristics, and took anthropometric measurements of women during household visits. Pre-pregnancy BMI was calculated from measured height and self-reported body weight. Energy and macronutrient intakes (obtained from three 24-h dietary recalls) were compared with the estimated trimester-specific requirements to calculate adequacies (%). Multiple linear regression models showed that after accounting for maternal socioeconomic characteristics and perinatal variables, each unit increase in pre-pregnancy BMI was associated with decreases of 2%, 2%, and 2.6% in energy, carbohydrate, and total fat intakes, respectively. These results were significant when under- and over-reporters were excluded from the analyses. Women who enter pregnancy with higher BMI values may voluntarily or involuntarily reduce their food intake.IMPACT STATEMENTWhat is already know about this subject? Some studies have analysed the relationship between pre-pregnancy BMI categories (normal weight, overweight, and obesity) and diet quality during pregnancy, but few studies have focussed on quantitative energy and macronutrient intakes or their adequacies in relation to pre-pregnancy BMI.What do the results of this study contribute? In this sample of Mexican women belonging to a middle socioeconomic status, we found that after excluding under- and over-reporters from the analyses and accounting for maternal socioeconomic characteristics and perinatal variables, BMI was negatively associated with adequacy intake rates of energy, carbohydrates, and total fats during pregnancy.What are the implications of these findings for clinical practice and/or further research? Women who enter pregnancy with higher BMI values may voluntarily or involuntarily reduce their food intake. These results can be used to accordingly plan diet counselling during pregnancy.
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Affiliation(s)
- Hugo Azcorra
- Centro de Investigaciones Silvio Zavala, Universidad Modelo, Mérida, México
| | | | - José Luis Batún
- Facultad de Matemáticas, Universidad Autónoma de Yucatán, Mérida, México
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Yuan X, Ma Y, Wang J, Zhao Y, Zheng W, Yang R, Zhang L, Yan X, Li G. The influence of maternal prepregnancy weight and gestational weight gain on the umbilical cord blood metabolome: a case-control study. BMC Pregnancy Childbirth 2024; 24:297. [PMID: 38649888 PMCID: PMC11034091 DOI: 10.1186/s12884-024-06507-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Maternal overweight/obesity and excessive gestational weight gain (GWG) are frequently reported to be risk factors for obesity and other metabolic disorders in offspring. Cord blood metabolites provide information on fetal nutritional and metabolic health and could provide an early window of detection of potential health issues among newborns. The aim of the study was to explore the impact of maternal prepregnancy overweight/obesity and excessive GWG on cord blood metabolic profiles. METHODS A case control study including 33 pairs of mothers with prepregnancy overweight/obesity and their neonates, 30 pairs of mothers with excessive GWG and their neonates, and 32 control mother-neonate pairs. Untargeted metabolomic profiling of umbilical cord blood samples were performed using UHPLC‒MS/MS. RESULTS Forty-six metabolites exhibited a significant increase and 60 metabolites exhibited a significant reduction in umbilical cord blood from overweight and obese mothers compared with mothers with normal body weight. Steroid hormone biosynthesis and neuroactive ligand‒receptor interactions were the two top-ranking pathways enriched with these metabolites (P = 0.01 and 0.03, respectively). Compared with mothers with normal GWG, in mothers with excessive GWG, the levels of 63 metabolites were increased and those of 46 metabolites were decreased in umbilical cord blood. Biosynthesis of unsaturated fatty acids was the most altered pathway enriched with these metabolites (P < 0.01). CONCLUSIONS Prepregnancy overweight and obesity affected the fetal steroid hormone biosynthesis pathway, while excessive GWG affected fetal fatty acid metabolism. This emphasizes the importance of preconception weight loss and maintaining an appropriate GWG, which are beneficial for the long-term metabolic health of offspring.
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Affiliation(s)
- Xianxian Yuan
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China
| | - Yuru Ma
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China
| | - Jia Wang
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun, 130041, Jilin, China
| | - Yan Zhao
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China
| | - Wei Zheng
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China
| | - Ruihua Yang
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China
| | - Lirui Zhang
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China
| | - Xin Yan
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China
| | - Guanghui Li
- Division of Endocrinology and Metabolism, Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China.
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Mangliar IA, Plante AS, Chabot M, Savard C, Lemieux S, Michaud A, Weisnagel SJ, Camirand Lemyre F, Veilleux A, Morisset AS. GLP-1 response during pregnancy: variations between trimesters and associations with appetite sensations and usual energy intake. Appl Physiol Nutr Metab 2024; 49:428-436. [PMID: 38095168 DOI: 10.1139/apnm-2023-0301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Further research is required to understand hormonal regulation of food intake during pregnancy and its association with energy intake. The objectives are to (i) compare postprandial responses of plasma glucagon-like peptide-1 (GLP-1) between trimesters, (ii) compare postprandial appetite sensations between trimesters, and (iii) examine trimester-specific associations between GLP-1 levels, appetite sensations, and usual energy intake. At each trimester, participants (n = 26) consumed a standard test meal following a 12 h fast. Plasma GLP-1 levels were measured by enzyme-linked immunosorbent assay method at fasting and at 30, 60, 120, and 180 min postprandial. A visual analogue scale assessing appetite sensations was completed at fasting and at 15, 30, 45, 60, 90, 120, 150, and 180 min postprandial. Mean energy intake was assessed using three web-based 24 h dietary recalls at each trimester. Lower postprandial GLP-1 responses were observed in the 2nd (p = 0.004) and 3rd trimesters (p < 0.001) compared to the 1st trimester. Greater postprandial sensations of desire to eat, hunger, and prospective food consumption were noted in the 3rd trimester compared to the 1st trimester (p < 0.04, for all). Fasting GLP-1 was negatively associated with fasting appetite sensations (except fullness) at the 2nd trimester (p < 0.02, for all). Postprandially, significant associations were observed for incremental areas under the curve from 0 to 30 min between GLP-1 and fullness at the 2nd (p = 0.01) and 3rd trimesters (p = 0.03). No associations between fasting or postprandial GLP-1 and usual energy intake were observed. Overall, GLP-1 and appetite sensation responses significantly differ between trimesters, but few associations were observed between GLP-1, appetite sensations, and usual energy intake.
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Affiliation(s)
- Inès Auclair Mangliar
- School of Nutrition, Université Laval, Québec, QC, Canada
- Nutrition, Health and Society (NUTRISS) Research Centre, Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, QC, Canada
- Endocrinology and Nephrology Unit, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Anne-Sophie Plante
- Nutrition, Health and Society (NUTRISS) Research Centre, Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, QC, Canada
- Endocrinology and Nephrology Unit, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Myriam Chabot
- Mathematics Department, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Claudia Savard
- School of Nutrition, Université Laval, Québec, QC, Canada
- Nutrition, Health and Society (NUTRISS) Research Centre, Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, QC, Canada
- Endocrinology and Nephrology Unit, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Simone Lemieux
- School of Nutrition, Université Laval, Québec, QC, Canada
- Nutrition, Health and Society (NUTRISS) Research Centre, Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, QC, Canada
| | - Andréanne Michaud
- School of Nutrition, Université Laval, Québec, QC, Canada
- Nutrition, Health and Society (NUTRISS) Research Centre, Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, QC, Canada
- Quebec Heart and Lung Institute, Université Laval, Québec, QC, Canada
| | - S John Weisnagel
- Endocrinology and Nephrology Unit, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Faculty of Medecine, Université Laval, Québec, QC, Canada
| | - Félix Camirand Lemyre
- Mathematics Department, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Alain Veilleux
- School of Nutrition, Université Laval, Québec, QC, Canada
- Nutrition, Health and Society (NUTRISS) Research Centre, Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, QC, Canada
| | - Anne-Sophie Morisset
- School of Nutrition, Université Laval, Québec, QC, Canada
- Nutrition, Health and Society (NUTRISS) Research Centre, Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, QC, Canada
- Endocrinology and Nephrology Unit, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
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Perumal N, Wang D, Darling AM, Liu E, Wang M, Ahmed T, Christian P, Dewey KG, Kac G, Kennedy SH, Subramoney V, Briggs B, Fawzi WW. Suboptimal gestational weight gain and neonatal outcomes in low and middle income countries: individual participant data meta-analysis. BMJ 2023; 382:e072249. [PMID: 37734757 PMCID: PMC10512803 DOI: 10.1136/bmj-2022-072249] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE To estimate the associations between gestational weight gain (GWG) during pregnancy and neonatal outcomes in low and middle income countries. DESIGN Individual participant data meta-analysis. SETTING Prospective pregnancy studies from 24 low and middle income countries. MAIN OUTCOME MEASURES Nine neonatal outcomes related to timing (preterm birth) and anthropometry (weight, length, and head circumference) at birth, stillbirths, and neonatal death. ANALYSIS METHODS A systematic search was conducted in PubMed, Embase, and Web of Science which identified 53 prospective pregnancy studies published after the year 2000 with data on GWG, timing and anthropometry at birth, and neonatal mortality. GWG adequacy was defined as the ratio of the observed maternal weight gain over the recommended weight gain based on the Institute of Medicine body mass index specific guidelines, which are derived from data in high income settings, and the INTERGROWTH-21st GWG standards. Study specific estimates, adjusted for confounders, were generated and then pooled using random effects meta-analysis models. Maternal age and body mass index before pregnancy were examined as potential modifiers of the associations between GWG adequacy and neonatal outcomes. RESULTS Overall, 55% of participants had severely inadequate (<70%) or moderately inadequate (70% to <90%) GWG, 22% had adequate GWG (90-125%), and 23% had excessive GWG (≥125%). Severely inadequate GWG was associated with a higher risk of low birthweight (adjusted relative risk 1.62, 95% confidence interval 1.51 to 1.72; 48 studies, 93 337 participants; τ2=0.006), small for gestational age (1.44, 1.36 to 1.54; 51 studies, 93 191 participants; τ2=0.016), short for gestational age (1.47, 1.29 to 1.69; 40 studies, 83 827 participants; τ2=0.074), and microcephaly (1.57, 1.31 to 1.88; 31 studies, 80 046 participants; τ2=0.145) compared with adequate GWG. Excessive GWG was associated with a higher risk of preterm birth (1.22, 1.13 to 1.31; 48 studies, 103 762 participants; τ2=0.008), large for gestational age (1.44, 1.33 to 1.57; 47 studies, 90 044 participants; τ2=0.009), and macrosomia (1.52, 1.33 to 1.73; 29 studies, 68 138 participants; τ2=0) compared with adequate GWG. The direction and magnitude of the associations between GWG adequacy and several neonatal outcomes were modified by maternal age and body mass index before pregnancy. CONCLUSIONS Inadequate and excessive GWG are associated with a higher risk of adverse neonatal outcomes across settings. Interventions to promote optimal GWG during pregnancy are likely to reduce the burden of adverse neonatal outcomes, however further research is needed to assess optimal ranges of GWG based on data from low and middle income countries.
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Affiliation(s)
- Nandita Perumal
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Dongqing Wang
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, VA, USA
| | - Anne Marie Darling
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Enju Liu
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, MA, USA
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Molin Wang
- Department of Epidemiology, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Biostatistics, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Tahmeed Ahmed
- Nutrition & Clinical Services, International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Parul Christian
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kathryn G Dewey
- Department of Nutrition, University of California, Davis, CA, USA
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Stephen H Kennedy
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | | | - Brittany Briggs
- Certara USA, on behalf of the Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Epidemiology, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Nutrition, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
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Patro-Golab B, Zalewski BM, Kammermeier M, Schwingshackl L, Koletzko B. Fat Intake and Fat Quality in Pregnant and Lactating Women, Infants, Children, and Adolescents and Related Health Outcomes: A Scoping Review of Systematic Reviews of Prospective Studies. ANNALS OF NUTRITION & METABOLISM 2023; 79:413-422. [PMID: 37611559 DOI: 10.1159/000533757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/21/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION Dietary fat intake during pregnancy and childhood is important for health. However, several health aspects are inconclusive. METHODS We systematically searched Medline, Cochrane Library, and Epistemonikos for systematic reviews (SRs) of randomized controlled trials (RCTs) and/or prospective cohort studies published from January 01, 2015, to December 31, 2019, assessing the association of dietary fat intake (including dietary supplements) during pregnancy and across childhood with pregnancy, perinatal, and child health outcomes. RESULTS Thirty-one SRs, mainly of RCTs, were included. Omega-3 fatty acids supplementation during pregnancy reduced the risk of early preterm birth, and in some SRs also any preterm birth, increased gestation length and birth weight, but mostly was not associated with other pregnancy/perinatal outcomes. Pre- and postnatal polyunsaturated fatty acids (PUFAs) intake was not consistently associated with growth, neurological, visual and cognitive outcomes, allergic diseases, cardiovascular, and metabolic health in childhood. Reduced saturated fatty acids (SFAs) intake and its replacement with PUFA/monounsaturated fatty acids had favourable effects on blood pressure and blood lipids in children. No apparent effects of total or trans fat on health outcomes across target groups were observed. CONCLUSION Omega-3 PUFA supplementation during pregnancy and SFA intake reduction in childhood require further consideration in dietary recommendations targeting these populations.
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Affiliation(s)
- Bernadeta Patro-Golab
- Division of Metabolic and Nutritional Medicine, Department of Paediatrics, Dr. von Hauner Children's Hospital, LMU - Ludwig-Maximilians-Universität Munich, LMU University Hospital, Munich, Germany
| | | | - Michael Kammermeier
- Division of Metabolic and Nutritional Medicine, Department of Paediatrics, Dr. von Hauner Children's Hospital, LMU - Ludwig-Maximilians-Universität Munich, LMU University Hospital, Munich, Germany
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Department of Paediatrics, Dr. von Hauner Children's Hospital, LMU - Ludwig-Maximilians-Universität Munich, LMU University Hospital, Munich, Germany
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Adamo KB, Semeniuk K, da Silva DF, Souza SCS, Baillargeon JP, Redman LM, Piccinini-Vallis H, Shen GX, Nerenberg K. SmartMoms Canada: An evaluation of a mobile app intervention to support a healthy pregnancy. Contemp Clin Trials 2023; 126:107066. [PMID: 36572241 DOI: 10.1016/j.cct.2022.107066] [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: 08/22/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND There is a lack of cost-effective and readily available access to evidence-based information to manage healthy behaviours for pregnant individuals. Mobile health (mHealth) tools offer a cost-effective, interactive, personalized option that can be delivered anywhere at a time most convenient for the user. This study protocol was primarily developed to, i) assess the feasibility of the SmartMoms Canada intervention in supporting participants to achieve gestational weight gain (GWG) guidelines. The secondary objectives are to, ii) assess user experience with the app, measured by adherence to the program via app software metrics and frequency of use, iii) determine the impact of SmartMoms Canada app usage on the adoption of healthful behaviours related to nutrition, physical activity and sleep habits, improvements in health-related quality of life, pregnancy-related complications, and symptoms of depression, and iv) investigate the potential extended effects of the app on postpartum health-related outcomes. METHODS This is a feasibility trial. Pregnant individuals aged 18-40 years with pre-gravid body mass index between 18.5 and 39.9 kg/m2, carrying a singleton fetus, having Wi-Fi access, and at ≤20 weeks' gestation will be recruited. Eligible people will be followed from recruitment until 12 months postpartum. DISCUSSION SmartMoms Canada is the first bilingual Canadian-centric app designed for pregnant people. This mHealth intervention, with its ability to supply frequent interactions, provides pregnancy- related health knowledge to users, potentially leading to an improvement in pregnancy-related outcomes and behaviours, and, ultimately a reduction in the present economic burden related to in-person interventions. TRIAL REGISTRATION ISRCTN, ISRCTN16254958. Registered 20 December 2019, http://www.isrctn.com/ ISRCTN16254958.
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Affiliation(s)
- Kristi B Adamo
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
| | - Kevin Semeniuk
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
| | - Danilo F da Silva
- Sports Studies Department, Faculty of Arts and Science, Bishop's University, Sherbrooke, QC, Canada.
| | - Sara C S Souza
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
| | | | - Leanne M Redman
- Pennington Biomedical Research Center, Baton Rouge, LA, United States.
| | - Helena Piccinini-Vallis
- Department of Family Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
| | - Garry X Shen
- Department of Internal Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
| | - Kara Nerenberg
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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Cliffer I, Darling AM, Madzorera I, Wang D, Perumal N, Wang M, Liu E, Pembe AB, Urassa W, Fawzi WW. Associations of Diet Quality, Socioeconomic Factors, and Nutritional Status with Gestational Weight Gain among Pregnant Women in Dar es Salaam, Tanzania. Curr Dev Nutr 2023; 7:100041. [PMID: 37181931 PMCID: PMC10111583 DOI: 10.1016/j.cdnut.2023.100041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/12/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Background Gestational weight gain (GWG) is a modifiable factor associated with maternal and child health outcomes, but the relationship between diet quality and GWG has not been evaluated using metrics validated for low-income and middle-income countries (LMICs). Objective This study aimed to investigate relationships between diet quality, socioeconomic characteristics, and GWG adequacy using the novel Global Diet Quality Score (GDQS), the first diet quality indicator validated for use across LMIC. Methods Weights of pregnant women enrolled between 12 and 27 wk of gestation (N = 7577) were recorded in Dar es Salaam, Tanzania, from 2001 to 2005 during a prenatal micronutrient supplementation trial. GWG adequacy was the ratio of measured GWG to Institute of Medicine-recommended GWG, categorized into severely inadequate (<70%), inadequate (70 to <90%), adequate (90 to <125%), or excessive (≥125%). Dietary data were collected using 24-h recalls. Multinomial logit models were used to estimate relationships between GDQS tercile, macronutrient intake, nutritional status, and socioeconomic characteristics and GWG. Results GDQS scores in the second [relative risk (RR): 0.82; 95% confidence interval (CI): 0.70, 0.97] tercile were associated with lower risk of inadequate weight gain than those in the first tercile. Increased protein intake was associated with higher risk of severely inadequate GWG (RR: 1.06; 95% CI: 1.02, 1.09). Nutritional status and socioeconomic factors were associated with GWG: underweight prepregnancy BMI (in kg/m2) with a higher risk of severely inadequate GWG (RR: 1.49; 95% CI: 1.12, 1.99), overweight or obese BMI with a higher risk of excessive GWG (RR: 6.80; 95% CI: 5.34, 8.66), and a higher education (RR: 0.61; 95% CI: 0.42, 0.89), wealth (RR: 0.68; 95% CI: 0.48, 0.80), and height (RR: 0.96; 95% CI: 0.95, 0.98) with a lower risk of severely inadequate GWG. Conclusions Dietary indicators showed few associations with GWG. However, stronger relationships were revealed between GWG, nutritional status, and several socioeconomic factors.This trial was registered at clinicaltrials.gov as NCT00197548.
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Affiliation(s)
- Ilana Cliffer
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Anne Marie Darling
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Isabel Madzorera
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Division of Community Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Dongqing Wang
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Nandita Perumal
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Molin Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Enju Liu
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA, USA
| | - Andrea B. Pembe
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Willy Urassa
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Wafaie W. Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
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8
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Jayedi A, Zeraattalab-Motlagh S, Moosavi H, Mirmohammadkhani M, Emadi A, Shab-Bidar S. Association of plant-based dietary patterns in first trimester of pregnancy with gestational weight gain: results from a prospective birth cohort. Eur J Clin Nutr 2023:10.1038/s41430-023-01275-x. [PMID: 36788355 DOI: 10.1038/s41430-023-01275-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND/OBJECTIVES Plant-based dietary patterns are becoming more popular worldwide. We aimed to examine the relationship between plant-based dietary patterns and the risk of inadequate or excessive gestational weight gain (GWG) in Iranian pregnant women. METHODS We prospectively followed 657 pregnant women in Iran. Adherence to the plant-based diet, represented by plant-based (PDI), healthy (hPDI) and unhealthy plant-based (uPDI) dietary indexes was evaluated by applying a 90-item food frequency questionnaire during the first trimester of pregnancy. Multivariable-adjusted Cox proportional-hazards regression model was used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) across quartiles of plant-based diet scores. RESULTS Over 25,562 person-weeks of follow-up, we documented 106 and 294 participants with inadequate and excessive GWG, respectively. We found a strong inverse association between adherence to the PDI and inadequate GWG after adjustment for demographic and confounding variables. Women in the highest quartile of the PDI had 50% lower risk of inadequate GWG than those in the lowest quartile (adjusted HR: 0.50; 95%CI 0.29, 0.89; P = 0.02). No significant association was found between hPDI and uPDI and inadequate GWG. There was no association between PDI, hPDI, and uPDI and the risk of excessive GWG. CONCLUSIONS Greater adherence to a plant-based diet during the first trimester of pregnancy may be associated with a lower risk of inadequate GWG. This finding needs to be confirmed in larger cohort studies, considering other pregnancy outcomes such as birth weight and the potential changes across the trimester in terms of food types and quantity.
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Affiliation(s)
- Ahmad Jayedi
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.,Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sheida Zeraattalab-Motlagh
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh Moosavi
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Mirmohammadkhani
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Alireza Emadi
- Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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9
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Liu EF, Zhu Y, Ferrara A, Hedderson MM. Dietary Quality Indices in Early Pregnancy and Rate of Gestational Weight Gain among a Prospective Multi-Racial and Ethnic Cohort. Nutrients 2023; 15:835. [PMID: 36839193 PMCID: PMC9961419 DOI: 10.3390/nu15040835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/02/2023] [Accepted: 02/02/2023] [Indexed: 02/09/2023] Open
Abstract
Meeting the Institute of Medicine (IOM) gestational weight gain (GWG) guidelines is associated with a reduced risk of adverse perinatal outcomes. Overall diet quality comprehensively assesses dietary components and accounts for interactions between them. While GWG is influenced by maternal diet, its association with overall diet quality-measured by various dietary quality indices-is not well-defined. We prospectively estimated the relationship between four established dietary quality indices and the risk of GWG rate above (excessive) or below (inadequate) IOM guidelines in a multi-racial and ethnic cohort of 2914 pregnant people from the Pregnancy Environment and Lifestyle Study (2014-2019). We assessed diet quality using the Healthy Eating Index 2010 (HEI-2010), alternate Mediterranean Diet (aMED), Dietary Approaches to Stop Hypertension (DASH), and Empirical Dietary Inflammatory Index (EDIP). Following the first trimester, 56% of the cohort had excessive GWG, and 14% had inadequate GWG. Poor diet quality (below the 75th percentile), measured by HEI-2010, was associated with a higher risk of excessive GWG in the second and third trimesters [RR = 1.03 (1.00, 1.06)]. Effect modification of this relationship by race and ethnicity and pre-pregnancy BMI was assessed. We found poor diet quality to be associated with elevated risk of excessive GWG among Black participants [RR = 1.14 (1.02, 1.28)] and White participants [RR 1.07 (1.01, 1.12)]. This was also the case for participants with pre-pregnancy BMI < 25.0 [RR 1.05 (1.00, 1.10)]. These results suggest that diet quality measured by the HEI-2010 is associated with excessive GWG, and the associations appear to be stronger among pregnant people without overweight or obesity and pregnant people who identify as Black or White race and ethnicity.
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Affiliation(s)
- Emily F. Liu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
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10
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Dietary and Nutrient Intake, Eating Habits, and ItsAssociation with Maternal Gestational Weight Gain and Offspring’s Birth Weight in Pregnant Adolescents. Nutrients 2022; 14:nu14214545. [DOI: 10.3390/nu14214545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 11/17/2022] Open
Abstract
Pregnant adolescents’ diet and eating habits are inadequate; however, their association with gestational weight gain (GWG) is uncertain. We aimed to analyze whether there is an association between dietary and nutrient intake and eating habits with GWG among pregnant adolescents and their offspring’s birth weight. A longitudinal study was performed with 530 participants. We assessed GWG and applied several tools, such as a food frequency questionnaire and 24-h recall, to obtain dietary and nutrient intake and eating habits. The birth weight of adolescents’ offspring was registered. Later, we performed crude and adjusted Poisson models. The mean age was 15.8 ± 1.3 years. Of all food groups, the lowest frequency of adequate intake corresponded to vegetables (7%) and legumes (10.2%). Excessive (36.8%) and insufficient (40.9%) GWG were observed. Pregnant adolescents with inadequate legumes intake increased the probability of excessive GWG: (PR 1.86 95% CI 1.00–3.44). Cereals and grains were positively associated with GWG: (PR 1.65, 95% CI 1.18–2.29). Energy, macronutrient intake, and eating habits were not associated with GWG. Offspring’s small gestational age (SGA) increased when pregnant adolescents had inadequate sugar-sweetened beverages intake: PR (1.58, 95% CI 1.01–2.49) and when pregnant adolescent watched television (TV). In our sample of Mexican adolescents, dietary and nutrient intake and eating habits were inadequate. Excessive dietary intake from cereals, grains, and animal-sourced foods along with insufficient legumes were associated with excessive GWG. Watching TV while adolescents ate was associated with the birth weight of the offspring.
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11
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Saldiva SRDM, De Arruda Neta ADCP, Teixeira JA, Peres SV, Marchioni DML, Carvalho MA, Vieira SE, Francisco RPV. Dietary Pattern Influences Gestational Weight Gain: Results from the ProcriAr Cohort Study-São Paulo, Brazil. Nutrients 2022; 14:nu14204428. [PMID: 36297111 PMCID: PMC9607592 DOI: 10.3390/nu14204428] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/15/2022] [Accepted: 10/18/2022] [Indexed: 11/30/2022] Open
Abstract
The maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) influence maternal and infant outcomes. This study identified patterns of habitual dietary intake in 385 pregnant women in São Paulo and explored their associations with excessive weight gain (EGWG). Weight at the first visit (<14 weeks) was used as a proxy for pre-pregnancy weight. Food consumption was assessed using the 24HR method, administered twice at each gestational trimester, and dietary patterns were identified by principal component analysis. Three dietary patterns were identified: “Vegetables and Fruits,” “Western,” and “Brazilian Traditional.” Descriptive data analysis was performed using absolute and relative frequencies for each independent variable and multilevel mixed-effects logistic regression was used to analyze excessive gestational gain weight (EGWG) and dietary patterns (DP). The Brazilian Traditional dietary pattern showed a protective effect on EGWG (p = 0.04) and age > 35 years (p = 0.03), while subjects overweight at baseline had a higher probability of EGWG (p = 0.02), suggesting that the identification of dietary and weight inadequacies should be observed from the beginning of pregnancy, accompanied by nutritional intervention and weight monitoring throughout the gestational period to reduce risks to the mother and child’s health.
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Affiliation(s)
- Silvia Regina Dias Medici Saldiva
- Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil
- Correspondence: ; Tel.: +55-112661-3185
| | | | - Juliana Araujo Teixeira
- Brazilian Center for Early Child Development, Insper Learning Institution, São Paulo 04546-042, Brazil
| | - Stela Verzinhasse Peres
- Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil
| | | | - Mariana Azevedo Carvalho
- Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil
| | - Sandra Elisabete Vieira
- Department of Pediatrics, Faculty of Medicine, University of São Paulo, São Paulo 05403-000, Brazil
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12
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Hanley-Cook G, Toe LC, Tesfamariam K, de Kok B, Argaw A, Compaoré A, Ouédraogo M, Dailey-Chwalibóg T, Kolsteren P, Lachat C, Huybregts L. Fortified Balanced Energy-Protein Supplementation, Maternal Anemia, and Gestational Weight Gain: A Randomized Controlled Efficacy Trial among Pregnant Women in Rural Burkina Faso. J Nutr 2022; 152:2277-2286. [PMID: 35906874 PMCID: PMC9535447 DOI: 10.1093/jn/nxac171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/22/2022] [Accepted: 07/28/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Anemia and suboptimal gestational weight gain (GWG) are associated with adverse maternal and birth outcomes. Limited research indicates that balanced energy-protein (BEP) supplements reduce the incidence of inadequate GWG. OBJECTIVES We assessed the efficacy of a micronutrient-fortified BEP supplement on the secondary outcomes of anemia, GWG, GWG rate, and GWG in relation to the Institute of Medicine (IOM)'s recommendations, as compared with an iron-folic acid (IFA) tablet. METHODS We conducted a randomized controlled trial in Burkina Faso, among pregnant women (15-40 y old) enrolled at <21 weeks of gestation. Women received either BEP and IFA (intervention) or IFA (control). Hemoglobin (g/dL) concentrations were measured at baseline and the third antenatal care visit (ANC), whereas maternal weight was measured at baseline and all subsequent ∼7-weekly ANCs. GWG (kg) was calculated as a woman's last weight measurement (at ∼36 weeks of gestation) minus weight at enrollment, whereas GWG rate (kg/wk) was GWG divided by the time between the first and last weight measurements. GWG adequacy (%) was computed as GWG divided by the IOM's recommendation. Binary outcomes included severely inadequate, inadequate, and excessive GWG. Statistical analyses followed the intention-to-treat principle. Linear regression and probability models were fitted for the continuous and binary outcomes, respectively, adjusting for baseline measurements. RESULTS Women in the BEP group tended to have higher, but nonsignificantly different, GWG (0.28 kg; 95% CI: -0.05, 0.58 kg; P = 0.099). Furthermore, there were no significant differences in prenatal anemia prevalence, GWG rate, GWG adequacy, or incidence of inadequate or excessive GWG. Findings were robust to model adjustments and complete case and per protocol analyses. CONCLUSIONS This trial does not provide evidence that fortified BEP supplementation reduces maternal anemia or increases GWG, as compared with IFA. In conjunction with the small, but positive, effects of maternal BEP supplementation on birth outcomes, our findings warrant the investigation of additional biochemical and postnatal outcomes.This trial was registered at clinicaltrials.gov as NCT03533712.
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Affiliation(s)
- Giles Hanley-Cook
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Laeticia C Toe
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium.,Nutrition and Metabolic Diseases Unit, Health Sciences Research Institute (IRSS), Bobo-Dioulasso, Burkina Faso
| | - Kokeb Tesfamariam
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Brenda de Kok
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Alemayehu Argaw
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Anderson Compaoré
- AFRICSanté (Health Research and Expertise Training Agency for Africa), Bobo-Dioulasso, Burkina Faso
| | - Moctar Ouédraogo
- AFRICSanté (Health Research and Expertise Training Agency for Africa), Bobo-Dioulasso, Burkina Faso
| | - Trenton Dailey-Chwalibóg
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Patrick Kolsteren
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Lieven Huybregts
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium.,Poverty, Health, and Nutrition Division, International Food Policy Research Institute (IFPRI), Washington, DC, USA
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13
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Martín-Rodríguez A, Bustamante-Sánchez Á, Martínez-Guardado I, Navarro-Jiménez E, Plata-SanJuan E, Tornero-Aguilera JF, Clemente-Suárez VJ. Infancy Dietary Patterns, Development, and Health: An Extensive Narrative Review. CHILDREN 2022; 9:children9071072. [PMID: 35884056 PMCID: PMC9319947 DOI: 10.3390/children9071072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/03/2022] [Accepted: 07/16/2022] [Indexed: 11/27/2022]
Abstract
Correct dietary patterns are important for a child’s health from birth to adulthood. Understanding a child’s health as a state of entire physical, mental, and social well-being is essential. However, reaching adulthood in a complete health proper state is determined by feeding and dietary habits during preconception, pregnancy, or children infancy. Different factors, such as the mother’s lifestyle, culture, or socioeconomic status, are crucial during all these phases. In this review, we aimed to assess the long-term associations between infancy dietary patterns and health and their influence on development and growth. To reach this objective, a consensus critical review was carried out using primary sources such as scientific articles, and secondary bibliographic indexes, databases, and web pages. PubMed, SciELO, and Google Scholar were the tools used to complete this research. We found that high-income countries promote high-calorie foods and, consequently, obesity problems among children are rising. However, undernutrition is a global health issue concerning children in low- and middle-income countries; thus, parental socioeconomic status in early life is essential to children’s health and development, showing that biological, social, and environmental influences are increased risk factors for chronic diseases. This narrative review is aimed to collect evidence for early nutritional intervention and future disease prevention.
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Affiliation(s)
| | - Álvaro Bustamante-Sánchez
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (A.M.-R.); (V.J.C.-S.)
- Correspondence: (Á.B.-S.); (J.F.T.-A.); Fax: +34-911-413-585 (J.F.T.-A.)
| | | | | | | | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (A.M.-R.); (V.J.C.-S.)
- Correspondence: (Á.B.-S.); (J.F.T.-A.); Fax: +34-911-413-585 (J.F.T.-A.)
| | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (A.M.-R.); (V.J.C.-S.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
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14
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The Association between Dietary Patterns and Pre-Pregnancy BMI with Gestational Weight Gain: The "Born in Shenyang" Cohort. Nutrients 2022; 14:nu14122551. [PMID: 35745281 PMCID: PMC9229543 DOI: 10.3390/nu14122551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 12/27/2022] Open
Abstract
The reported associations of maternal dietary patterns during pregnancy with gestational weight gain are inconsistent, especially among the less studied Asian Chinese populations. In a prospective pre-birth cohort study conducted in northern China, we determined the associations between maternal dietary patterns and the probability of excess gestational weight gain (EGWG) among 1026 pregnant women. We used 3-day food diaries to assess maternal diet and performed principal component analysis to identify dietary patterns. Maternal adherence to a traditional pattern, which was characterized by a higher intake of tubers, vegetables, fruits, red meat, and rice, was associated with a higher probability of EGWG (quartile 3 vs. quartile 1, odds ratio [OR] = 1.62, 95% confidence interval [CI] = 1.10−2.38). This risk association was more pronounced among women who were overweight/obese before pregnancy (quartile 4 vs. quartile 1, OR = 5.17, 95% CI = 1.45−18.46; p for interaction < 0.01). Maternal adherence to a high protein pattern, which was characterized by a higher intake of fried foods, beans and bean products, dairy products, and fruits, was associated with a lower risk of EGWG (quartile 3 vs. quartile 1, OR = 0.56, 95% CI, 0.39−0.81). The protective association was more pronounced among non-overweight/obese women (p for interaction < 0.01). These findings may help to develop interventions and better define target populations for EGWG prevention.
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15
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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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16
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Assessment of pregnancy dietary intake and association with maternal and neonatal outcomes. Pediatr Res 2022; 91:1890-1896. [PMID: 34344991 PMCID: PMC9270222 DOI: 10.1038/s41390-021-01665-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 06/19/2021] [Accepted: 06/30/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Maternal dietary habits are contributors of maternal and fetal health; however, available data are heterogeneous and not conclusive. METHODS Nutrient intake during pregnancy was assessed in 503 women with uncomplicated pregnancies, using the validated Food Frequency Questionnaire developed by the European Prospective Investigation into Cancer and Nutrition (EPIC-FFQ). RESULTS In all, 68% of women had a normal body mass index at the beginning of pregnancy, and 83% of newborns had an appropriate weight for gestational age. Maternal pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and placental weight were independently correlated with birth weight. GWG was not related to the pre-pregnancy BMI. EPIC-FFQ evaluation showed that 30% of women adhered to the European Food Safety Authority (EFSA) ranges for macronutrient intake. In most pregnant women (98.1%), consumption of water was below recommendations. Comparing women with intakes within EFSA ranges for macronutrients with those who did not, no differences were found in BMI, GWG, and neonatal or placental weight. Neither maternal nor neonatal parameters were associated with the maternal dietary profiles. CONCLUSIONS In our population, maternal pre-pregnancy BMI, GWG, and placental weight are determinants of birth weight percentile, while no association was found with maternal nutrition. Future studies should explore associations through all infancy. IMPACT Maternal anthropometrics and nutrition status may affect offspring birth weight. In 503 healthy women, maternal pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and placental weight were independently correlated to neonatal birth weight. GWG was not related to the pre-pregnancy BMI. In all, 30% of women respected the EFSA ranges for macronutrients. Neither maternal nor neonatal parameters were associated with maternal dietary profiles considered in this study. Maternal pre-pregnancy BMI, GWG, and placental weight are determinants of neonatal birth weight percentile, while a connection with maternal nutrition profiles was not found.
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17
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Adesina N, Dogan H, Green S, Tsofliou F. Effectiveness and Usability of Digital Tools to Support Dietary Self-Management of Gestational Diabetes Mellitus: A Systematic Review. Nutrients 2021; 14:10. [PMID: 35010884 PMCID: PMC8746603 DOI: 10.3390/nu14010010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 12/15/2022] Open
Abstract
Advice on dietary intake is an essential first line intervention for the management of gestational diabetes mellitus (GDM). Digital tools such as web-based and smartphone apps have been suggested to provide a novel way of providing information on diet for optimal glucose regulation in women with GDM. This systematic review explores the effectiveness and usability of digital tools designed to support dietary self-management of GDM. A systematic search of Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Scopus using key search terms identified 1476 papers reporting research studies, of which 16 met the specified inclusion criteria. The quality of the included studies was assessed using the ErasmusAGE Quality Score or the Mixed Methods Appraisal Tool (MMAT) version 2018. The findings show that the adoption of digital tools may be an effective approach to support self-management relating to healthy diet, health behaviour, and adherence to therapy in women with GDM as a usable intervention. However, there is a lack of evidence concerning the effectiveness of tools to support the dietary management of GDM. Consideration for ethnic specific dietary advice and evidence-based frameworks in the development of effective digital tools for dietary management of GDM should be considered as these aspects have been limited in the studies reviewed.
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Affiliation(s)
- Nurudeen Adesina
- Department of Rehabilitation and Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK;
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
| | - Huseyin Dogan
- Department of Computing and Informatics, Faculty of Science and Technology, Bournemouth University, Poole BH12 5BB, UK;
| | - Sue Green
- Department of Nursing Science, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK;
| | - Fotini Tsofliou
- Department of Rehabilitation and Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK;
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
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18
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Callahan ML, Schneider-Worthington CR, Martin SL, Gower BA, Catalano PM, Chandler-Laney P. Association of weight status and carbohydrate intake with gestational weight gain. Clin Obes 2021; 11:e12455. [PMID: 33837658 PMCID: PMC10165995 DOI: 10.1111/cob.12455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 02/23/2021] [Accepted: 03/22/2021] [Indexed: 11/29/2022]
Abstract
Test the hypothesis that women with obesity have greater gestation weight gain (GWG) with a moderately higher, vs lower, carbohydrate (CHO) diet, independent of energy intake, whereas GWG for women of normal weight would not differ by CHO group. This was a secondary analysis of data collected from glucose tolerant women with normal weight (NW) or obesity in pregnancy. Women completed a three-day food diary 16 to 20 weeks. A median split for percent kilocalories from CHO (median = 49.6%) categorized women into moderately highCHO vs lowCHO groups (n = 13-15/group). GWG was calculated between consent and the last prenatal care visit. A two-way ANOVA was used to examine whether there was an interaction between weight status and CHO group on GWG, independent of energy intake, time between consent and last prenatal visit, and age. Women in both highCHO groups consumed more sugars and starches compared to women in the lowCHO groups (P < .05). A significant interaction between weight status and CHO content of the diet was found (P < .05), such that, for women with obesity, those consuming a lowCHO diet had less GWG than those consuming a highCHO diet, whereas the pattern was opposite for women with NW. Results suggest that intake of a moderately lower CHO diet may help limit GWG among glucose tolerant women with obesity. Given that women in this study were eligible only if they had normal fasting glucose concentrations in early pregnancy, it is not clear if these results would generalize to all women with obesity during pregnancy.
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Affiliation(s)
- Makenzie L Callahan
- Department of Nutrition, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Samantha L Martin
- Department of Nutrition, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Barbara A Gower
- Department of Nutrition, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Patrick M Catalano
- Mother Infant Research Institute, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Paula Chandler-Laney
- Department of Nutrition, University of Alabama at Birmingham, Birmingham, Alabama, USA
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19
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Awoke MA, Skouteris H, Makama M, Harrison CL, Wycherley TP, Moran LJ. The Relationship of Diet and Physical Activity with Weight Gain and Weight Gain Prevention in Women of Reproductive Age. J Clin Med 2021; 10:2485. [PMID: 34199753 PMCID: PMC8199997 DOI: 10.3390/jcm10112485] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 11/16/2022] Open
Abstract
Reproductive-age women often see increased weight gain, which carries an increased risk of long-term overweight and obesity and adverse maternal and child health outcomes. Supporting women to achieve optimal weight through lifestyle modification (diet and physical activity) is of critical importance to reduce weight gain across key reproductive life-stages (preconception, pregnancy and postpartum). This review comprehensively summarizes the current state of knowledge on the contribution of diet and physical activity to weight gain and weight gain prevention in reproductive-aged women. Suboptimal diets including a higher proportion of discretionary choices or energy intake from fats, added sugars, sweets or processed foods are associated with higher weight gain, whereas increased consumption of core foods including fruits, vegetables and whole grains and engaging in regular physical activity are associated with reduced weight gain in reproductive age women. Diet and physical activity contributing to excessive gestational weight gain are well documented. However, there is limited research assessing diet and physical activity components associated with weight gain during the preconception and postpartum period. This review highlights the need for further research to identify key dietary and physical activity components targeting the critical windows of reproductive life-stages in women to best guide interventions to prevent weight gain.
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Affiliation(s)
- Mamaru Ayenew Awoke
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia; (M.A.A.); (M.M.); (C.L.H.)
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia;
| | - Maureen Makama
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia; (M.A.A.); (M.M.); (C.L.H.)
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia; (M.A.A.); (M.M.); (C.L.H.)
| | - Thomas Philip Wycherley
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, SA 5001, Australia;
| | - Lisa J. Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia; (M.A.A.); (M.M.); (C.L.H.)
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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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Savard C, Lebrun A, O’Connor S, Fontaine-Bisson B, Haman F, Morisset AS. Energy expenditure during pregnancy: a systematic review. Nutr Rev 2021; 79:394-409. [PMID: 32974660 PMCID: PMC7947828 DOI: 10.1093/nutrit/nuaa093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
CONTEXT Contrary to nutritional guidelines, accumulating evidence shows that pregnant women's energy intakes remain stable throughout trimesters. Although pregnant women may eat below their needs or underreport their energy intakes, it is also relevant to question how energy requirements - estimated through measurements of energy expenditure (EE) - change throughout pregnancy. OBJECTIVE This review examined prospective studies that measured EE during pregnancy, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES PubMed/MEDLINE, Web of Science, Embase, and CINAHL databases were searched to identify relevant publications up to November 14, 2019. STUDY SELECTION All studies that measured EE prospectively and objectively during pregnancy were included in this systematic review. Two authors independently screened 4852 references. A total of 32 studies were included in the final analysis. DATA EXTRACTION One author extracted data and assessed the risk of bias and a second author did so for a random sample of studies (n = 7; 22%). DATA ANALYSIS Increases in resting EE ranged from 0.5% to 18.3% (8-239 kcal), from 3.0% to 24.1% (45-327 kcal), and from 6.4% to 29.6% (93-416 kcal) between early and mid-, mid- and late, and early and late pregnancy, respectively. Increases in total EE ranged from 4.0% to 17.7% (84-363 kcal), from 0.2% to 30.2% (5-694 kcal), and from 7.9% to 33.2% (179-682 kcal) between early and mid-, mid- and late, and early and late pregnancy, respectively. Participants were mainly of normal weight, although many studies did not report important covariates such as prepregnancy body mass index and gestational weight gain adequacy. CONCLUSIONS Additional high-quality longitudinal studies (ie, with multiple objective measurements of EE in all periods of pregnancy while considering important confounding variables, like gestational weight gain) are required.
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Affiliation(s)
- Claudia Savard
- School of Nutrition, Laval University, Quebec, Canada; CHU of Quebec-Laval University Research Center, Quebec, Canada
- NUTRISS Research Center, Institute of Nutrition and Functional Foods, Laval University, Quebec, Canada
| | - Audrée Lebrun
- School of Nutrition, Laval University, Quebec, Canada; CHU of Quebec-Laval University Research Center, Quebec, Canada
- NUTRISS Research Center, Institute of Nutrition and Functional Foods, Laval University, Quebec, Canada
| | - Sarah O’Connor
- School of Nutrition, Laval University, Quebec, Canada; CHU of Quebec-Laval University Research Center, Quebec, Canada
- Faculty of Pharmacy, Laval University, Quebec, Canada, and Quebec Cardiology and Respirology University Institute, Quebec, Canada
| | - Bénédicte Fontaine-Bisson
- School of Nutrition, Laval University, Quebec, Canada; CHU of Quebec-Laval University Research Center, Quebec, Canada
- School of Nutrition Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Institut du Savoir Montfort, Montfort Hospital, Ottawa, Ontario, Canada
| | - François Haman
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Anne-Sophie Morisset
- School of Nutrition, Laval University, Quebec, Canada; CHU of Quebec-Laval University Research Center, Quebec, Canada
- NUTRISS Research Center, Institute of Nutrition and Functional Foods, Laval University, Quebec, Canada
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Bernardi JR, da Silva Rocha A, de Matos S, Kretzer DC, Schöffel AC, Goldani MZ, de Azevedo Magalhães JA. Modifiable predictors to maternal visceral adipose tissue during pregnancy: A clinical, demographic, and nutritional study. J Obstet Gynaecol Res 2021; 47:1023-1030. [PMID: 33438351 DOI: 10.1111/jog.14633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/22/2020] [Accepted: 12/17/2020] [Indexed: 11/30/2022]
Abstract
AIM Higher amounts of maternal visceral adipose tissue were related to abnormal outcomes in pregnancy. Our objective was to evaluate the impact of modifiable and nonmodifiable predictors related to abnormal amounts of maternal visceral fat during three trimesters of pregnancy. METHODS Visceral fat thickness was evaluated by ultrasound during three trimesters centered in the maternal epigastrium (preperitoneal m-VAT) and additionally fat thickness evaluation centered at maternal periumbilical region (periumbilical m-VAT) among cases with gestational age below 20 weeks. The fourth quartile was considered abnormal m-VAT and the first three quartiles as normal m-VAT. Nonmodifiable characteristics included maternal age, past term pregnancies, and ethnicity. Modifiable characteristics included pre-pregnancy body mass index (BMI), weight gain, usual macronutrients, and sugar consumption during pregnancy. RESULTS Preperitoneal m-VAT was assessed in 270 pregnant women and m-VAT periumbilical assessment in 154. The fourth quartile measurement was 15 mm and 53 mm, respectively. Nonmodifiable predictors including maternal age and past term pregnancies significantly impacted the primary study outcome of abnormal periumbilical m-VAT. Having a non-Caucasian ethnicity had a significant impact on the amount of normal preperitoneal m-VAT. Among the modifiable characteristics, both pre-pregnancy BMI and pre-pregnancy obesity impacted the amount of abnormal preperitoneal and periumbilical m-VAT. CONCLUSION Abnormal amounts of maternal visceral fat during pregnancy are related to nonmodifiable predictors and those present before pregnancy. No impact was found among weight gain during pregnancy or macronutrients and sugar consumption at pregnancy.
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Affiliation(s)
- Juliana Rombaldi Bernardi
- Department of Nutrition, Graduate Program in Child and Adolescent Health and Graduate Program in Food, Nutrition and Health, Hospital de Clínicas de Porto Alegre; School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alexandre da Silva Rocha
- Graduate Program in Gynecology and Obstetrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Salete de Matos
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Daniela Cortés Kretzer
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alice Carvalhal Schöffel
- Department of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Marcelo Zubaran Goldani
- Department of Pediatrics, Hospital de Clínicas de Porto Alegre; School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - José Antônio de Azevedo Magalhães
- Maternal-Fetal Division (Head), Hospital de Clínicas de Porto Alegre; School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Maugeri A. The Effects of Dietary Interventions on DNA Methylation: Implications for Obesity Management. Int J Mol Sci 2020; 21:ijms21228670. [PMID: 33212948 PMCID: PMC7698434 DOI: 10.3390/ijms21228670] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/28/2020] [Accepted: 11/16/2020] [Indexed: 12/13/2022] Open
Abstract
Previous evidence from in vivo and observational research suggested how dietary factors might affect DNA methylation signatures involved in obesity risk. However, findings from experimental studies are still scarce and, if present, not so clear. The current review summarizes studies investigating the effect of dietary interventions on DNA methylation in the general population and especially in people at risk for or with obesity. Overall, these studies suggest how dietary interventions may induce DNA methylation changes, which in turn are likely related to the risk of obesity and to different response to weight loss programs. These findings might explain the high interindividual variation in weight loss after a dietary intervention, with some people losing a lot of weight while others much less so. However, the interactions between genetic, epigenetic, environmental and lifestyle factors make the whole framework even more complex and further studies are needed to support the hypothesis of personalized interventions against obesity.
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Affiliation(s)
- Andrea Maugeri
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, 95123 Catania, Italy
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Maternal Dietary Patterns during Pregnancy and Their Association with Gestational Weight Gain and Nutrient Adequacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217908. [PMID: 33126602 PMCID: PMC7662940 DOI: 10.3390/ijerph17217908] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/24/2020] [Accepted: 10/25/2020] [Indexed: 12/16/2022]
Abstract
Several epidemiologic studies have shown an association between Gestational Weight Gain (GWG) and offspring complications. The GWG is directly linked to maternal dietary intake and women’s nutritional status during pregnancy. The aim of this study was (1) to assess, in a sample of Spanish pregnant women, the association between maternal dietary patterns and GWG and (2) to assess maternal dietary patterns and nutrient adequate intake according to GWG. A retrospective study was conducted in a sample of 503 adult pregnant women in five hospitals in Eastern Andalusia (Spain). Data on demographic characteristics, anthropometric values, and dietary intake were collected from clinical records by trained midwives. Usual food intake was gathered through a validated Food Frequency Questionnaire (FFQ), and dietary patterns were obtained by principal component analysis. Nutrient adequacy was defined according to European dietary intake recommendations for pregnant women. Regression models adjusted by confounding factors were constructed to study the association between maternal dietary pattern and GWG, and maternal dietary patterns and nutritional adequacy. A negative association was found between GWG and the Mediterranean dietary pattern (crude β = −0.06, 95% CI: −0.11, −0.04). Independent of maternal dietary pattern, nutrient adequacy of dietary fiber, vitamin B9, D, E, and iodine was related to a Mediterranean dietary pattern (p < 0.05). A Mediterranean dietary pattern is related to lower GWG and better nutrient adequacy. The promotion of healthy dietary behavior consistent with the general advice promoted by the Mediterranean Diet (based on legumes, vegetables, nuts, olive oil, and whole cereals) will offer healthful, sustainable, and practical strategies to control GWG and ensure adequate nutrient intake during pregnancy.
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Paulino DSM, Pinho-Pompeu M, Assumpção D, Kasawara KT, Surita FG. Dietary intake profile in high-risk pregnant women according to the degree of food processing. J Matern Fetal Neonatal Med 2020; 35:3330-3336. [PMID: 32924704 DOI: 10.1080/14767058.2020.1818213] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND/OBJECTIVE Studies that address dietary intake theme during pregnancy are generally centered on specific nutrients or on dietary patterns. However, the maternal dietary profile according to the degree of food processing is poorly understood. The purpose of the present study was to describe the dietary profile of high-risk pregnant women according to the degree of food processing. MATERIALS AND METHODS A prospective cohort study was conducted at Prof. Dr. Jose Aristodemo Pinotti Women's Hospital (CAISM), University of Campinas, Brazil, with high-risk pregnant women in the third trimester of gestation. RESULTS Data from 125 high-risk pregnant women were collected between September 2017 and April 2019. The mean total energy intake (EI) was 1778.3 ± 495.79 kcal/day and the majority of the calories was from unprocessed foods (52.42%), followed by ultra-processed foods (25.46%). The consumption of free sugar and sodium exceeded recommendations, while the consumption of fiber, calcium, folate and iron was below recommendations. The ultra-processed foods intake affects dietary patterns negatively. CONCLUSION More than 50% of the EI of high-risk pregnant women is from unprocessed or minimally processed foods, but it is insufficient for meeting dairy fiber, iron, folate and calcium recommendations.
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Affiliation(s)
| | - Maira Pinho-Pompeu
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
| | - Daniela Assumpção
- Department of Pediatrics, University of Campinas, Campinas, SP, Brazil
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The UK Pregnancies Better Eating and Activity Trial (UPBEAT); Pregnancy Outcomes and Health Behaviours by Obesity Class. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134712. [PMID: 32629997 PMCID: PMC7370059 DOI: 10.3390/ijerph17134712] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/26/2020] [Accepted: 06/28/2020] [Indexed: 11/25/2022]
Abstract
The effectiveness of antenatal intervention in women with increasing obesity is unknown. This study investigated whether there was a differential effect of antenatal intervention on diet, physical activity and pregnancy outcomes in women stratified by obesity class using data from the UK Pregnancies Better Eating and Activity Trial (UPBEAT) (n = 1555). The stratification was by World Health Organization classifications: Class I, II and III (30–34.9 kg/m2, 35–39.9 kg/m2 and ≥40 kg/m2). Using linear and logistic regression, adjusted for confounders, outcomes were assessed post-intervention (27+0–28+6 weeks’ gestation) and in late pregnancy (34+0–36+0 weeks’ gestation). Interactions between obesity class and the intervention were explored. Compared to the standard care arm, class III intervention women had lower gestational weight gain (GWG) (−1.87 kg; 95% CI −3.29 to −0.47, p = 0.009), and the effect of the intervention was greater in class III compared to class I, by −2.01 kg (95% CI −3.45 to −0.57, p = 0.006). Class I and II intervention women reported significantly lower dietary glycaemic load and saturated fat intake across their pregnancy. This differential effect of the intervention suggests antenatal interventions for women with obesity should stratify outcomes by obesity severity. This would inform evidence-based antenatal strategies for high-risk groups, including women with a BMI ≥ 40 kg/m2.
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Voortman T, Steegers-Theunissen RP, Bergen NE, Jaddoe VWV, Looman CWN, Kiefte-de Jong JC, Schalekamp-Timmermans S. Validation of a Semi-Quantitative Food-Frequency Questionnaire for Dutch Pregnant Women from the General Population Using the Method or Triads. Nutrients 2020; 12:nu12051341. [PMID: 32397149 PMCID: PMC7284899 DOI: 10.3390/nu12051341] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/01/2020] [Accepted: 05/04/2020] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE We aimed to validate a food-frequency questionnaire (FFQ) for Dutch pregnant women, against three 24 h-recalls and blood concentrations of B-vitamins and fatty acids, using the method of triads. METHODS We included 83 pregnant women from the general population of Rotterdam, the Netherlands, at a median gestational age of 15.6 weeks. Participants completed three non-consecutive 24 h-recalls, and subsequently filled out the 293-item FFQ. Participants provided blood samples from which we analyzed serum folate and vitamin B12, as well as red blood cell folate, linoleic acid, and total saturated, monounsaturated, and polyunsaturated fatty acids. RESULTS Estimated energy intake did not differ between the FFQ and 24 h-recalls. Deattenuated Pearson's correlation coefficients, between energy-adjusted nutrient intake estimates from the FFQ and the 24 h-recalls, ranged from 0.41 (fat) to 0.88 (fiber) for macronutrients, and were around 0.6 for most micronutrients, except for vitamin E (0.27). Using the triad method, we obtained validity coefficients of 0.86 (95% Confidence Interval (CI) 0.36, 1.00) for serum folate, 0.86 (95% CI 0.18, 1.00) for red blood cell folate, and 1.00 (95% CI 0.42, 1.00) for vitamin B12. Validity coefficients for serum fatty acids ranged from 0.22 to 0.67. CONCLUSION This FFQ is a reliable tool for estimating intake of energy, macronutrients, folate and vitamin B12 among women in mid-pregnancy.
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Affiliation(s)
- Trudy Voortman
- Department of Epidemiology, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (T.V.); (J.C.K.-d.J.)
| | | | - Nienke E. Bergen
- Department of Obstetrics and Gynecology, 3000 CA Erasmus MC, Rotterdam, The Netherlands; (R.P.S.-T.); (N.E.B.)
- The Generation R Study Group, Erasmus MC, 3000 CA Rotterdam, The Netherlands;
| | - Vincent W. V. Jaddoe
- The Generation R Study Group, Erasmus MC, 3000 CA Rotterdam, The Netherlands;
- Department of Pediatrics, Erasmus MC, 3000 CA Rotterdam, The Netherlands
| | - Caspar W. N. Looman
- Department of Public Health, Erasmus MC, 3000 CA Rotterdam, The Netherlands;
| | - Jessica C. Kiefte-de Jong
- Department of Epidemiology, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (T.V.); (J.C.K.-d.J.)
- Department of Public Health and Primary Care, LUMC Campus, 2511 VA The Hague, The Netherlands
| | - Sarah Schalekamp-Timmermans
- Department of Obstetrics and Gynecology, 3000 CA Erasmus MC, Rotterdam, The Netherlands; (R.P.S.-T.); (N.E.B.)
- The Generation R Study Group, Erasmus MC, 3000 CA Rotterdam, The Netherlands;
- Correspondence:
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Itani L, Radwan H, Hashim M, Hasan H, Obaid RS, Ghazal HA, Al Hilali M, Rayess R, Mohamed HJJ, Hamadeh R, Al Rifai H, Naja F. Dietary patterns and their associations with gestational weight gain in the United Arab Emirates: results from the MISC cohort. Nutr J 2020; 19:36. [PMID: 32316972 PMCID: PMC7175557 DOI: 10.1186/s12937-020-00553-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 04/06/2020] [Indexed: 02/06/2023] Open
Abstract
Background Suboptimum weight gain during pregnancy may carry long term health consequences for the infant or mother. Nutritional imbalances are well recognized as a determinant of gestational weight gain. Few studies examined the effect of dietary patterns on gestational weight gain, especially in countries undergoing nutrition transition, such as the United Arab Emirates. Objectives To characterize dietary patterns among pregnant women living in the UAE and examine their associations with gestational weight gain and gestational weight rate. Methodology Data were drawn from the Mother-Infant Study Cohort, a two-year prospective cohort study of pregnant women living in the United Arab Emirates, recruited during their third trimester (n = 242). Weight gain during pregnancy was calculated using data from medical records. The Institute of Medicine’s recommendations were used to categorize gestational weight gain and gestational weight gain rate into insufficient, adequate, and excessive. During face-to-face interviews, dietary intake was assessed using an 89-item culture-specific semi-quantitative food frequency questionnaire that referred to usual intake during pregnancy. Dietary patterns were derived by principal component analysis. Multiple logistic regression analyses were used to evaluate the associations of derived dietary patterns with gestational weight gain/gestational weight gain rate. Results Two dietary patterns were derived, a “Diverse” and a “Western” pattern. The “Diverse” pattern was characterized by higher intake of fruits, vegetables, mixed dishes while the “Western” pattern consisted of sweets and fast food. The “Western” pattern was associated with excessive gestational weight gain (OR:4.04,95% CI:1.07–15.24) and gestational weight gain rate (OR: 4.38, 95% CI:1.28–15.03) while the “Diverse” pattern decreased the risk of inadequate gestational weight gain (OR:0.24, 95% CI:0.06–0.97) and gestational weight gain rate (OR:0.28, 95% CI:0.09–0.90). Conclusion The findings of this study showed that adherence to a “Diverse” pattern reduced the risk of insufficient gestational weight gain/gestational weight gain rate, while higher consumption of the “Western” pattern increased the risk of excessive gestational weight gain/gestational weight gain rate. In view of the established consequences of gestational weight gain on the health of the mother and child, there is a critical need for health policies and interventions to promote a healthy lifestyle eating through a life course approach.
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Affiliation(s)
- Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Mona Hashim
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates.,Nutrition and Dietetics Program, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Hayder Hasan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hessa Al Ghazal
- Sharjah Child Friendly Office, Sharjah, United Arab Emirates
| | - Marwa Al Hilali
- Clinical Nutrition Department, Al Qassimi Hospital-Ministry of Health and Prevention, Sharjah, United Arab Emirates
| | - Rana Rayess
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | | | - Rena Hamadeh
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Hiba Al Rifai
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Farah Naja
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon.
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A low intensity dietary intervention for reducing excessive gestational weight gain in an overweight and obese pregnant cohort. Eat Weight Disord 2020; 25:257-263. [PMID: 30155856 DOI: 10.1007/s40519-018-0566-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 08/15/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE Excessive gestational weight gain is associated with detrimental outcomes to both the mother and baby. Currently, the best approach to prevent excessive gestational weight gain in overweight and obese women is undetermined. The present study aimed to evaluate the effectiveness of a group-based outpatient dietary intervention in pregnancy to reduce excessive gestational weight gain. METHODS In this retrospective study, overweight and obese pregnant women who attended a single 90-min group education session were compared to women who received standard care alone. Total gestational weight gain, maternal and neonatal outcomes were compared between the intervention and control groups. Data were analysed using Student t, Mann-Whitney and Chi-squared tests as appropriate. A 24-h dietary recall was analysed and compared to the Australian National Nutrition Survey. RESULTS A significant reduction in gestational weight gain was observed with this intervention (P = 0.010), as well as in the rate of small for gestational age births (P = 0.043). Those who attended the intervention had saturated fat and sodium intake levels that exceeded recommendations. Intake of pregnancy-specific micronutrients including folate, calcium and iron were poor from diet alone. CONCLUSIONS A low-intensity antenatal dietary intervention may be effective in reducing excessive gestational weight gain, although multi-disciplinary interventions yield the best success. Further research is required to identify the optimal modality and frequency to limit excessive gestational weight gain. Dietary interventions tailored to ethnicity should also be explored. LEVEL OF EVIDENCE Level II, controlled trial without randomization.
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Yu Y, Hardy I, Sun W, Fergusson DA, Fraser W, Dubois L. Diet quality during preconception or pregnancy and gestational weight gain: protocol for a systematic review and meta-analysis. BMJ Open 2020; 10:e033130. [PMID: 32114465 PMCID: PMC7050399 DOI: 10.1136/bmjopen-2019-033130] [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] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Inappropriate gestational weight gain (GWG), including inadequate and excessive GWG, has become pandemic across nations and continents. This review aims to synthesise the evidence on the correlation between diet quality and GWG. If this association is confirmed, improving diet quality could become an intervention target in the efforts to reduce inappropriate GWG. METHODS AND ANALYSIS We will conduct a systematic review of all prospective cohort studies on diet quality in preconception or pregnancy and GWG. Our secondary outcomes include gestational diabetes, pre-eclampsia and birth weight. A comprehensive search of all published articles in MEDLINE ALL (Ovid), Embase (Ovid), Food Science and Technology Abstracts (Ovid) and CINAHL (EBSCOHost), from database creation to 20 April 2019, will be conducted. Studies will be screened for eligibility by title, abstract and full text in duplicate by two independent reviewers. Study quality and risk of bias will be assessed using the adapted Newcastle-Ottawa Scale. Results will be reported following the meta-analysis of observational studies in epidemiology guidelines. If sufficient data are available, a meta-analysis will be conducted to synthesise the effect size reported as OR with 95% CI using both fixed-effect and random-effect models. I2 statistics and visual inspection of the forest plots will be used to assess heterogeneity and identify the potential sources of heterogeneity. Publication bias will be assessed by visual inspections of funnel plots and Egger's test. ETHICS AND DISSEMINATION Formal ethical approval is not required as no primary data will be collected. We aim to publish the results of this study in a peer-reviewed journal and present them at conferences and scientific meetings to promote knowledge transfer. PROSPERO REGISTRATION NUMBER CRD42019128732.
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Affiliation(s)
- Yamei Yu
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Isabelle Hardy
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Wenguang Sun
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Dean A Fergusson
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - William Fraser
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Centre de Recherche du Centre hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, Ottawa, Canada
| | - Lise Dubois
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Influences of the perinatal diet on maternal and child health: insights from the GUSTO study. Proc Nutr Soc 2020; 79:253-258. [PMID: 31973784 DOI: 10.1017/s0029665119001526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Maternal and child health are intrinsically linked. With accumulating evidence over the past two decades supporting the developmental origins of health and diseases hypothesis, it is now widely recognised that nutrition in the first 1000 d sets the foundation for long-term health. Maternal diet before, during and after pregnancy can influence the developmental pathways of the fetus and lead to health consequences later in life. While maternal and infant mortality rates have declined significantly in the past two decades, the growing burden of obesity and chronic non-communicable diseases in women of reproductive age and children is on a rapid rise worldwide, in developed and developing countries. A key contributory factor is malnutrition, which is a consequence of consuming poor quality diets. Suboptimal macronutrient balance and micronutrient inadequacies can lead to undesirable maternal body composition and metabolism, in turn influencing the health of the mother and leading to longer-term metabolic and cognitive health consequences in the infant. The GUSTO (Growing Up in Singapore Towards healthy Outcomes) study, a mother-offspring multi-ethnic cohort study in Singapore, has contributed to this body of evidence over the past 10 years. This review will illustrate how nutritional epidemiological research through a birth cohort has illuminated the importance and urgency of maternal and child nutrition and health in a modern, industrialised setting. It underscores the importance of a number of critical nutrients during pregnancy, in combination with healthy dietary patterns and appropriate meal timing, for optimal maternal and child health.
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Effects of timing of food intake on eating patterns, diet quality and weight gain during pregnancy. Br J Nutr 2020; 123:922-933. [PMID: 31902384 DOI: 10.1017/s0007114519003398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Studies have suggested that meal timing plays a role in nutritional health, but this subject has not been sufficiently studied in pregnant women. We analysed the effect that timing of food intake has on eating patterns, diet quality and weight gain in a prospective cohort study with 100 pregnant women. Data were collected once per trimester: 4th-12th, 20th-26th and 30th-37th weeks. Food intake was evaluated using three 24-h dietary recalls, which were used to assess eating patterns and diet quality. Distribution of energy and macronutrient intake throughout the day was considered eating patterns. Diet quality was assessed using the Brazilian Healthy Eating Index-Revised. Weight gain was evaluated during each trimester. Women were classified as early or late timing of the first and last eating episodes if these values were below or above the median of the population, respectively (first eating episode = 08.38 hours; last eating episode = 20.20 hours). Generalised estimating equation models adjusted for confounders were used to determine the effects of timing of the first and last eating episodes (groups) and gestational trimesters (time) (independent variable) on eating patterns, diet quality and weight gain (dependent variables). Early eaters of the first eating episode have a higher percentage of energy and carbohydrate intake in morning and a lower at evening meals. They also have a better diet quality for fruit components when compared with late eaters of the first eating episode. Our results emphasise the importance of considering meal timing in the nutritional antenatal guidelines to promote maternal-fetal health.
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Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Tee YYS, Bindels J, van der Beek EM. Pre-Pregnancy BMI Influences the Association of Dietary Quality and Gestational Weight Gain: The SECOST Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193735. [PMID: 31590213 PMCID: PMC6801791 DOI: 10.3390/ijerph16193735] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/26/2019] [Accepted: 09/30/2019] [Indexed: 11/17/2022]
Abstract
Poor diet quality in pregnancy could impact gestational weight gain (GWG) and consequently fetal growth and development. But today there is limited data available on gestational diet quality. This study investigated the association between diet quality in each pregnancy trimester and GWG in Malaysian women. Diet quality was assessed using the modified Healthy Eating Index for Malaysians (HEI). Total GWG was defined as the difference between measured weight at last prenatal visit and pre-pregnancy weight. About one-fourth of women (23.3%) had excessive total GWG. There were significant differences in the HEI component score across trimesters, except for fruits. Overall, overweight/obese women had lower total HEI score (51.49–55.40) during pregnancy compared to non-overweight/obese women (53.38–56.50). For non-overweight/obese women, higher total HEI scores in the second and third trimesters were significantly associated with lower risk of inadequate GWG (aOR = 0.97, 95% CI = 0.95–0.99, p = 0.01) and higher risk of excessive GWG (aOR = 1.04, 95% CI = 1.01–1.07, p = 0.03), respectively. Overweight/obese women with higher total HEI scores in the second (aOR = 1.04, 95% CI = 1.01–1.07, p = 0.02) and third trimester (aOR = 1.04, 95% CI = 1.01–1.08, p = 0.02) were significantly at higher risk for excessive GWG. Pregnant women had relatively low diet quality throughout pregnancy. Diet quality and GWG association differed according to pre-pregnancy BMI with excessive GWG more likely to be associated with higher total HEI scores in the third trimester.
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Affiliation(s)
- Heng Yaw Yong
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia.
| | - Zalilah Mohd Shariff
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia.
| | - Barakatun Nisak Mohd Yusof
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia.
| | - Zulida Rejali
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia.
| | - Yvonne Yee Siang Tee
- Danone Dumex (M) Sdn Bhd. Lot 759 (B3), Nilai Industrial Estate, Nilai 71800, Malaysia.
| | - Jacques Bindels
- Danone Nutricia Research, Uppsalalaan 12, 3584 CT Utrecht, The Netherlands.
| | - Eline M van der Beek
- Danone Nutricia Research, Uppsalalaan 12, 3584 CT Utrecht, The Netherlands.
- Department of Pediatrics, University Medical Centre Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
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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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Plante AS, Lemieux S, Drouin-Chartier JP, Weisnagel SJ, Robitaille J, Drapeau V, Provencher V, Morisset AS. Changes in Eating Behaviours Throughout Pregnancy: Associations with Gestational Weight Gain and Pre-pregnancy Body Mass Index. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019; 42:54-60. [PMID: 31289011 DOI: 10.1016/j.jogc.2019.04.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/15/2019] [Accepted: 04/18/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Most pregnant women gain weight above recommended levels, and this weight gain affects mothers' and children's health. Factors influencing gestational weight gain (GWG) are numerous and include eating behaviours. The objective of this study was to evaluate the association between eating behaviours and GWG while considering pre-pregnancy body mass index (BMI). METHODS Fifty-three (n = 53) women were recruited at 9.4 ± 0.6 gestational weeks. At each trimester, they completed the Three-Factor Eating Questionnaire, which evaluates disinhibition, dietary restraint, and susceptibility to hunger. Using a weight gain curve, trimester-specific GWG was calculated with interpolated weights. Total GWG was calculated as the difference between maternal weight before delivery and self-reported pre-pregnancy weight (Canadian Task Force Classification II-2). RESULTS Women were aged 31.5 ± 3.5, and 81.1% had a university degree. The proportion of women who gained weight within recommendations was 21%, 28%, and 26%, at each trimester, respectively, and 38% for total pregnancy. Overall, dietary restraint score was lower in the third trimester in comparison with the first (6.1 ± 4.1 vs. 7.2 ± 4.6; P = 0.049), whereas no difference was observed for disinhibition or susceptibility to hunger. Our data suggest that variations in eating behaviours throughout pregnancy were similar among women who exhibited total GWG below, within, or above recommendations (Ptrim × GWG = NS) (NS: not significant; trim: trimester). Similar observations were reported when women were compared according to their pre-pregnancy BMI (Ptrim × BMI = NS). CONCLUSION Maintaining high levels of restraint may be challenging considering the increase in hunger, which could explain the decrease observed in dietary restraint scores. Changes in eating behaviours were not associated with total GWG or pre-pregnancy BMI.
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Affiliation(s)
- Anne-Sophie Plante
- School of Nutrition, Laval University, Québec City, QC; Endocrinology and Nephrology Unit, Centre Hospitalier Universitaire of Québec - Université Laval Research Centre, Québec City, QC; Institute of Nutrition and Functional Foods, Laval University, Québec City, QC
| | - Simone Lemieux
- School of Nutrition, Laval University, Québec City, QC; Institute of Nutrition and Functional Foods, Laval University, Québec City, QC
| | | | - S John Weisnagel
- Endocrinology and Nephrology Unit, Centre Hospitalier Universitaire of Québec - Université Laval Research Centre, Québec City, QC
| | - Julie Robitaille
- School of Nutrition, Laval University, Québec City, QC; Endocrinology and Nephrology Unit, Centre Hospitalier Universitaire of Québec - Université Laval Research Centre, Québec City, QC; Institute of Nutrition and Functional Foods, Laval University, Québec City, QC
| | - Vicky Drapeau
- Institute of Nutrition and Functional Foods, Laval University, Québec City, QC; Department of Physical Education, Laval University, Québec City, QC; Québec Heart and Lung Institute/Research Centre, Québec City, QC
| | - Véronique Provencher
- School of Nutrition, Laval University, Québec City, QC; Institute of Nutrition and Functional Foods, Laval University, Québec City, QC
| | - Anne-Sophie Morisset
- School of Nutrition, Laval University, Québec City, QC; Endocrinology and Nephrology Unit, Centre Hospitalier Universitaire of Québec - Université Laval Research Centre, Québec City, QC; Institute of Nutrition and Functional Foods, Laval University, Québec City, QC.
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Günther J, Hoffmann J, Kunath J, Spies M, Meyer D, Stecher L, Rosenfeld E, Kick L, Rauh K, Hauner H. Effects of a Lifestyle Intervention in Routine Care on Prenatal Dietary Behavior-Findings from the Cluster-Randomized GeliS Trial. J Clin Med 2019; 8:jcm8070960. [PMID: 31269753 PMCID: PMC6678299 DOI: 10.3390/jcm8070960] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/24/2019] [Accepted: 06/27/2019] [Indexed: 11/16/2022] Open
Abstract
The antenatal lifestyle and excessive gestational weight gain (GWG) modify the risk of obstetric complications, maternal weight retention, and the risk of obesity for the next generation. The cluster-randomized controlled "Healthy living in pregnancy" (GeliS) study, recruiting 2286 women, was designed to examine whether a lifestyle intervention reduced the proportion of women with excessive GWG. Trained healthcare providers gave four counseling sessions covering a healthy diet, regular physical activity, and self-monitoring of GWG in the intervention group. In this secondary analysis, the effect on maternal dietary behavior was analyzed. Dietary behavior was assessed by means of a 58-item food frequency questionnaire in early and late pregnancy. The intervention resulted in a significant reduction in soft drink intake (p < 0.001) and an increase in the consumption of fish (p = 0.002) and vegetables (p = 0.023). With the exception of higher percentage energy from protein (p = 0.018), no effects of the intervention on energy and macronutrient intake were observed. There was no evidence for an overall effect on dietary quality measured with a healthy eating index. Some dietary variables were shown to be associated with GWG. In a routine prenatal care setting in Germany, lifestyle advice modified single aspects of dietary behavior, but not energy intake or overall dietary quality.
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Affiliation(s)
- Julia Günther
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, Munich 80992, Bavaria, Germany
| | - Julia Hoffmann
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, Munich 80992, Bavaria, Germany
| | - Julia Kunath
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, Munich 80992, Bavaria, Germany
| | - Monika Spies
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, Munich 80992, Bavaria, Germany
| | - Dorothy Meyer
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, Munich 80992, Bavaria, Germany
| | - Lynne Stecher
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, Munich 80992, Bavaria, Germany
| | - Eva Rosenfeld
- Competence Centre for Nutrition (KErn), Am Gereuth 4, Freising 85354, Bavaria, Germany
| | - Luzia Kick
- Competence Centre for Nutrition (KErn), Am Gereuth 4, Freising 85354, Bavaria, Germany
| | - Kathrin Rauh
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, Munich 80992, Bavaria, Germany
- Competence Centre for Nutrition (KErn), Am Gereuth 4, Freising 85354, Bavaria, Germany
| | - Hans Hauner
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, Munich 80992, Bavaria, Germany.
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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: 49] [Impact Index Per Article: 9.8] [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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Lesser MNR, Mauldin K, Sawrey-Kubicek L, Gildengorin V, King JC. The Type of Dietary Fat in an Isocaloric Breakfast Meal Does Not Modify Postprandial Metabolism in Overweight/Obese Pregnant Women. Nutrients 2019; 11:nu11030490. [PMID: 30813584 PMCID: PMC6471094 DOI: 10.3390/nu11030490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 02/09/2019] [Accepted: 02/21/2019] [Indexed: 12/11/2022] Open
Abstract
Almonds provide a satiating, healthy source of fat and fiber. The postprandial metabolic and satiety response to 2 ounces of nuts or dairy was assessed in 18 overweight/obese women during late pregnancy. Serum glucose, triglycerides, insulin, c-peptide, leptin, ghrelin, and lipoprotein particles were measured prior to and during a 5-h postprandial period following the consumption of an isocaloric breakfast meal with equivalent amounts of fat from either nuts or dairy on two separate mornings. Satiety was assessed by visual analogue scale (VAS) questionnaires and ad libitum food intake at the end of the study. At 33 weeks gestation, the women had gained an average of 7.0 ± 4.4 kg during gestation. Body fat averaged 41.9 ± 5.5% and hemoglobin A1c levels were elevated, (7.2 ± 0.6%). Fasting glucose levels were normal, but hyperinsulinemia was evident. The two test meals did not affect the postprandial metabolic response, but glucose, triglyceride, and ghrelin concentrations changed with time during the postprandial period (p < 0.001, p = 0.0008, p = 0.006). Satiety measures did not differ between the two test meals. Consuming an isocaloric breakfast meal with equivalent amounts of fat from nuts or dairy did not alter postprandial levels of blood lipids, glucose, hormones, or measures of satiety in overweight/obese, pregnant women.
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Affiliation(s)
- Mary N R Lesser
- Children's Hospital Oakland Research Institute, 5700 Martin Luther King Jr. Way, Oakland, CA 94609, USA.
- Department of Nutritional Sciences & Toxicology, 119 Morgan Hall, University of California, Berkeley, CA 94720, USA.
| | - Kasuen Mauldin
- Department of Nutrition, Food Science & Packaging, San Jose State University, One Washington Square, San Jose, CA 95192, USA.
| | - Lisa Sawrey-Kubicek
- Department of Nutrition, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA.
| | - Virginia Gildengorin
- Children's Hospital Oakland Research Institute, 5700 Martin Luther King Jr. Way, Oakland, CA 94609, USA.
| | - Janet C King
- Children's Hospital Oakland Research Institute, 5700 Martin Luther King Jr. Way, Oakland, CA 94609, USA.
- Department of Nutritional Sciences & Toxicology, 119 Morgan Hall, University of California, Berkeley, CA 94720, USA.
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Lin PID, Bromage S, Mostofa MG, Rahman M, Allen J, Oken E, Kile ML, Christiani DC. Mediating role of arsenic in the relationship between diet and pregnancy outcomes: prospective birth cohort in Bangladesh. Environ Health 2019; 18:10. [PMID: 30728020 PMCID: PMC6364468 DOI: 10.1186/s12940-019-0450-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 01/31/2019] [Indexed: 05/29/2023]
Abstract
BACKGROUND Epidemiological evidence suggests that arsenic (As) exposure during pregnancy may reduce infant birth weight. One significant source of As exposure is diet; thus, As may indirectly affect infant growth by mediating the effect of maternal diet on birth weight (BW). This study evaluated the potential mediating effect of As in the relationship between maternal diet and BW, gestational age (GA), and gestational weight gain (GWG). METHOD The study used a prospective birth cohort in Bangladesh that captured the dietary habits of 1057 pregnant women through validated semi-quantitative food frequency questionnaires. We applied a causal mediation model with counterfactual approach and performed analyses with and without adjustment for total energy intake. Other potential confounders captured by self-report questionnaire were exposure to secondhand tobacco smoke, betel nut chewing, maternal age, education level, household income level, physical activity level during pregnancy, and daily hours spent cooking over open fire. RESULT No association was found between maternal toenail As and BW. Higher absolute and energy-adjusted protein, fat and fiber intakes were associated with higher toenail As and lower GA and GWG, while higher absolute and energy-adjusted carbohydrate intake was associated with lower toenail As and greater GA and GWG. Mediation analysis showed significant natural indirect effects by toenail As in the relationships between absolute fat, carbohydrate and fiber intake with GA. Specifically, 3% (95% CI: 1-6%) of the association between carbohydrate intake and GA was mediated by change in toenail As, 6% (95% CI: 1-9%) for absolute fat intake and 10% (95% CI: 4-13%) for absolute fiber intake. After adjusting for total energy, no significant mediating effect was observed, suggesting the mediating effect might be due to measurement error or that absolute amount of As exposure rather than the amount in relationship to total energy intake was a more important factor to consider when understanding the negative implication of As on fetal growth. CONCLUSION The mediating effect of As in the relationship between maternal diet and birth outcome was small and might be due to measurement error.
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Affiliation(s)
- Pi-I D. Lin
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA 02215 USA
- Research Center for Environmental Medicine, Kaohsiung Medical University, No. 100 Shiquan 1st Road, Sanmin District, Kaohsiung City, Taiwan 807 Taiwan
| | - Sabri Bromage
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - Md. Golam Mostofa
- Department of Environmental Research, Dhaka Community Hospital, 190/1 Wireless Railgate Bara Moghbazar, Dhaka, 1217 Bangladesh
| | - Mohammad Rahman
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - Joseph Allen
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA 02215 USA
| | - Molly L. Kile
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
- College of Public Health and Human Science, Oregon State University, 160 SW 26th St, Corvallis, OR 97331 USA
| | - David C. Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
- Research Center for Environmental Medicine, Kaohsiung Medical University, No. 100 Shiquan 1st Road, Sanmin District, Kaohsiung City, Taiwan 807 Taiwan
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Koletzko B, Cremer M, Flothkötter M, Graf C, Hauner H, Hellmers C, Kersting M, Krawinkel M, Przyrembel H, Röbl-Mathieu M, Schiffner U, Vetter K, Weißenborn A, Wöckel A. Diet and Lifestyle Before and During Pregnancy - Practical Recommendations of the Germany-wide Healthy Start - Young Family Network. Geburtshilfe Frauenheilkd 2018; 78:1262-1282. [PMID: 30655650 PMCID: PMC6294644 DOI: 10.1055/a-0713-1058] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 08/22/2018] [Accepted: 08/22/2018] [Indexed: 12/11/2022] Open
Abstract
Diet and exercise before and during pregnancy affect the course of the pregnancy, the child's development and the short- and long-term health of mother and child. The Healthy Start - Young Family Network has updated the recommendations on nutrition in pregnancy that first appeared in 2012 and supplemented them with recommendations on a preconception lifestyle. The recommendations address body weight before conception, weight gain in pregnancy, energy and nutritional requirements and diet (including a vegetarian/vegan diet), the supplements folic acid/folate, iodine, iron and docosahexaenoic acid (DHA), protection against food-borne illnesses, physical activity before and during pregnancy, alcohol, smoking, caffeinated drinks, oral and dental hygiene and the use of medicinal products. Preparation for breast-feeding is recommended already during pregnancy. Vaccination recommendations for women planning a pregnancy are also included. These practical recommendations of the Germany-wide Healthy Start - Young Family Network are intended to assist all professional groups that counsel women and couples wishing to have children and during pregnancy with uniform, scientifically-based and practical information.
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Affiliation(s)
- Berthold Koletzko
- Kinderklinik und Kinderpoliklinik, Dr. von Haunersches Kinderspital, LMU – Ludwig-Maximilians-Universität, München, Germany
- Deutsche Gesellschaft für Kinder- und Jugendheilkunde e. V. (DGKJ), Berlin, Germany
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
| | - Monika Cremer
- Netzwerk Gesund ins Leben/Bundeszentrum für Ernährung (BZfE) in der Bundesanstalt für Landwirtschaft und Ernährung (BLE), Bonn, Germany
| | - Maria Flothkötter
- Netzwerk Gesund ins Leben/Bundeszentrum für Ernährung (BZfE) in der Bundesanstalt für Landwirtschaft und Ernährung (BLE), Bonn, Germany
| | - Christine Graf
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Deutsche Sporthochschule Köln, Köln, Germany
| | - Hans Hauner
- Lehrstuhl für Ernährungsmedizin, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Claudia Hellmers
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Hochschule Osnabrück, Osnabrück, Germany
- Deutsche Gesellschaft für Hebammenwissenschaft e. V. (DGHWi), Münster, Germany
| | - Mathilde Kersting
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Forschungsdepartment Kinderernährung, Klinik für Kinder- und Jugendmedizin, Universitätsklinikum der Ruhr-Universität Bochum, Bochum, Germany
| | - Michael Krawinkel
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Institut für Ernährungswissenschaft, Justus-Liebig-Universität Gießen, Gießen, Germany
- Deutsche Gesellschaft für Ernährung e. V. (DGE), Bonn, Germany
| | - Hildegard Przyrembel
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
| | - Marianne Röbl-Mathieu
- Mitglied der Ständigen Impfkommission am Robert Koch-Institut (STIKO), Berlin, Germany
| | - Ulrich Schiffner
- Poliklinik für Zahnerhaltung und Präventive Zahnheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
- Deutsche Gesellschaft für Kinderzahnheilkunde e. V. (DGKiZ), Würzburg, Germany
| | - Klaus Vetter
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Nationale Stillkommission, Bundesinstitut für Risikobewertung (BfR), Berlin, Germany
| | - Anke Weißenborn
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Bundesinstitut für Risikobewertung (BfR), Berlin, Germany
| | - Achim Wöckel
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Frauenklinik und Poliklinik Universitätsklinikum Würzburg, Würzburg, Germany
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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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Pellonperä O, Koivuniemi E, Vahlberg T, Mokkala K, Tertti K, Rönnemaa T, Laitinen K. Dietary quality influences body composition in overweight and obese pregnant women. Clin Nutr 2018; 38:1613-1619. [PMID: 30224302 DOI: 10.1016/j.clnu.2018.08.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 06/26/2018] [Accepted: 08/25/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS Excessive adiposity and gestational weight gain (GWG) have been linked with maternal and offspring morbidity. We investigated the relation of maternal diet, physical activity and GWG on body composition in overweight and obese pregnant women. METHODS Fat mass (FM) and fat free mass (FFM) of 110 overweight and obese pregnant women were measured by air displacement plethysmography in early and late pregnancy (mean 13.5 and 35.3 gestational weeks). At the same time points, the quality of overall diet was assessed by validated index of diet quality (IDQ) questionnaire (score < 10/15 denotes poor dietary quality and score ≥ 10/15 denotes good dietary quality), nutrient intakes by 3-day food diaries, and physical activity by questionnaire. Weight gain between early and late pregnancy was compared to the gestational weight gain guidelines issued by Institute of Medicine. RESULTS Of the women, 77% gained more weight than recommended; this was related to greater dietary fat consumption (80 ± 21 g/day vs. 67 ± 11 g/day, p = 0.010) and greater increase in FM (2.7 ± 3.0 kg vs. -1.0 ± 2.4 kg, p < 0.001) compared to women with ideal GWG. Dietary protein intake (g) correlated positively with FFM at both time points (early pregnancy: r = 0.31, p < 0.002, late pregnancy: r = 0.39, p < 0.001). Women with higher dietary quality index score had more FFM, compared to women with lower dietary quality (early pregnancy FFM: 48.8 ± 5.8 kg vs. 45.8 ± 4.7 kg, p = 0.004, late pregnancy FFM: 56.1 ± 6.4 kg vs. 53.4 ± 5.6 kg, p = 0.025). No correlations were detected between total energy intake or physical activity and FM or FFM at early or late pregnancy. CONCLUSIONS Body composition changes from early to late pregnancy were related to the amount of weight gained and overall dietary quality during pregnancy. Higher dietary quality and protein intake were associated with greater FFM, while dietary fat intake was related to excess weight gain. Identification of these dietary determinants of body composition and weight offers new targets for dietary counseling of pregnant women and thus potential for ensuing health benefits through reduced adiposity.
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Affiliation(s)
- Outi Pellonperä
- University of Turku and Turku University Hospital, Department of Obstetrics and Gynecology, Finland.
| | | | - Tero Vahlberg
- University of Turku and Turku University Hospital, Department of Clinical Medicine, Biostatistics, Finland
| | - Kati Mokkala
- University of Turku, Institute of Biomedicine, Finland
| | - Kristiina Tertti
- University of Turku and Turku University Hospital, Department of Obstetrics and Gynecology, Finland
| | - Tapani Rönnemaa
- University of Turku and Turku University Hospital, Department of Medicine, Finland
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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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Savard C, Lemieux S, Weisnagel SJ, Fontaine-Bisson B, Gagnon C, Robitaille J, Morisset AS. Trimester-Specific Dietary Intakes in a Sample of French-Canadian Pregnant Women in Comparison with National Nutritional Guidelines. Nutrients 2018; 10:E768. [PMID: 29899222 PMCID: PMC6024697 DOI: 10.3390/nu10060768] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 06/06/2018] [Accepted: 06/12/2018] [Indexed: 01/11/2023] Open
Abstract
Diet during pregnancy greatly impacts health outcomes. This study aims to measure changes in dietary intakes throughout trimesters and to assess pregnant women’s dietary intakes in comparison with current Canadian nutritional recommendations. Seventy-nine pregnant women were recruited and completed, within each trimester, three Web-based 24-h dietary recalls and one Web questionnaire on supplement use. Dietary intakes from food, with and without supplements, were compared to nutritional recommendations throughout pregnancy. Energy and macronutrient intakes remained stable throughout pregnancy. A majority of women exceeded their energy and protein requirements in the first trimester, and fat intakes as a percentage of energy intakes were above recommendations for more than half of the women in all trimesters. Supplement use increased dietary intakes of most vitamins and minerals, but 20% of women still had inadequate total vitamin D intakes and most women had excessive folic acid intakes. This study showed that pregnant women did not increase their energy intakes throughout pregnancy as recommended. Furthermore, although prenatal supplementation reduces the risk of inadequate intake for most micronutrients, there is still a risk of excessive folic acid and insufficient vitamin D intake, which needs further investigation.
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Affiliation(s)
- Claudia Savard
- School of Nutrition, Laval University, Québec City, QC G1V 0A6, Canada.
- Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada.
- Institute of Nutrition and Functional Foods, Laval University, Québec City, QC G1V 0A6, Canada.
| | - Simone Lemieux
- School of Nutrition, Laval University, Québec City, QC G1V 0A6, Canada.
- Institute of Nutrition and Functional Foods, Laval University, Québec City, QC G1V 0A6, Canada.
| | - S John Weisnagel
- Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada.
- Department of Medicine, Laval University, Québec City, QC G1V 0A6, Canada.
| | - Bénédicte Fontaine-Bisson
- School of Nutrition Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada.
- Institut du Savoir Montfort, Montfort Hospital, Ottawa, ON K1K 0T2, Canada.
| | - Claudia Gagnon
- Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada.
- Institute of Nutrition and Functional Foods, Laval University, Québec City, QC G1V 0A6, Canada.
- Department of Medicine, Laval University, Québec City, QC G1V 0A6, Canada.
| | - Julie Robitaille
- School of Nutrition, Laval University, Québec City, QC G1V 0A6, Canada.
- Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada.
- Institute of Nutrition and Functional Foods, Laval University, Québec City, QC G1V 0A6, Canada.
| | - Anne-Sophie Morisset
- School of Nutrition, Laval University, Québec City, QC G1V 0A6, Canada.
- Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada.
- Institute of Nutrition and Functional Foods, Laval University, Québec City, QC G1V 0A6, Canada.
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Adequacy of nutritional intake during pregnancy in relation to prepregnancy BMI: results from the 3D Cohort Study. Br J Nutr 2018; 120:335-344. [PMID: 29875026 DOI: 10.1017/s0007114518001393] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Our study compares adequacy of nutritional intakes among pregnant women with different prepregnancy BMI and explores associations between nutritional intakes during pregnancy and both prepregnancy BMI and gestational weight gain (GWG). We collected dietary information from a large cohort of pregnant Canadian women (n 861) using a 3-d food record. We estimated usual dietary intakes of energy (E), macronutrients and micronutrients using the National Cancer Institute method. We also performed Pearson's correlations between nutritional intakes and both prepregnancy BMI and GWG. In all BMI categories, intakes considered suboptimal (by comparison with estimated average requirements) were noted for Fe, vitamin D, folate, vitamin B6, Mg, Zn, Ca and vitamin A. Total fat intakes were above the acceptable macronutrient distribution range (AMDR) for 36 % of the women. A higher proportion of obese women had carbohydrate intakes (as %E) below the AMDR (v. normal-weight and overweight women; 19 v. 9 %) and Na intakes above the tolerable upper intake level (v. other BMI categories; 90 v. 77-78 %). In all BMI categories, median intakes of K and fibre were below adequate intake. Intakes of several nutrients (adjusted for energy) were correlated with BMI. Correlations were detected between energy-adjusted nutrient intakes and total GWG and were, for the most part, specific to certain BMI categories. Overweight and obese pregnant women appear to be the most nutritionally vulnerable. Nutrition interventions are needed to guide pregnant women toward their optimal GWG while also meeting their nutritional requirements.
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Grandy M, Snowden JM, Boone-Heinonen J, Purnell JQ, Thornburg KL, Marshall NE. Poorer maternal diet quality and increased birth weight . J Matern Fetal Neonatal Med 2018; 31:1613-1619. [PMID: 28514885 PMCID: PMC5694379 DOI: 10.1080/14767058.2017.1322949] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 04/14/2017] [Accepted: 04/21/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Maternal diet and gestational weight gain (GWG) influence birth weight and infant adiposity, which are important predictors of lifetime health. To better understand these relationships, we studied associations between maternal diet and GWG, adiposity, and birth weight in a well characterized cohort of pregnant women. STUDY DESIGN Data were obtained from 41 term (>37 weeks), uncomplicated, singleton pregnancies according to pre-pregnancy BMI categories of normal (n = 11), overweight (n = 15), or obese (n = 15). Daily consumption of protein, fat, and carbohydrates and a Healthy Eating Index (HEI-2010) score were determined from 24 h food recall collections. Associations were modeled using multinomial logistic and linear regression. RESULTS Neither the third trimester maternal diet quality nor the macronutrient consumption was associated with GWG after adjusting for pre-pregnancy BMI, maternal age, and parity. A ten-point lower HEI-2010 score was associated with 200 g higher infant birth weight and a 1.0 cm longer length. However, maternal HEI-2010 and macronutrient composition were unrelated to infant percent body fat, ponderal index, or abdominal circumference. CONCLUSIONS Poorer third trimester maternal diet quality was associated with higher birth weight and longer length, but was unrelated to markers of infant adiposity. GWG was independent of third trimester maternal diet composition and quality.
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Affiliation(s)
- Madeline Grandy
- School of Medicine, Oregon Health & Science University, Portland, OR
| | - Jonathan M. Snowden
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR
| | - Janne Boone-Heinonen
- School of Public Health, Oregon Health & Science University/Portland State University, Portland, OR
| | - Jonathan Q. Purnell
- Department of Medicine, Oregon Health & Science University, Portland, OR
- Knight Cardiovascular Institute, Center for Developmental Health, Oregon Health & Science University, Portland, OR
| | - Kent L. Thornburg
- Knight Cardiovascular Institute, Center for Developmental Health, Oregon Health & Science University, Portland, OR
| | - Nicole E. Marshall
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR
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CABRAL M, SICHIERI R, ROCHA CMMD, CASTRO MBTD. Protein intake and weight gain among low-income pregnant women from Mesquita County, Rio de Janeiro, Brazil. REV NUTR 2018. [DOI: 10.1590/1678-98652018000300002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
ABSTRACT Objective To evaluate the effect of protein intake on body weight gain at pregnancy. Methods A cross-sectional study was carried out with 297 women who delivered a child at the maternity ward of Municipal Hospital Leonel de Moura Brizola in Mesquita city in the state of Rio de Janeiro. Sociodemographic and anthropometric data were collected through the use of a structured questionnaire at first week after delivery. Food intake was assessed by a food frequency questionnaire. Protein intake per kilogram of body weight (g/kg per day) during pregnancy was categorized as high or low protein intake according to overall median levels. Hierarchical multiple linear regression was fitted to estimate the effect of protein intake per kg during pregnancy on weight gain. Results Women presented an average weight gain of 12.8kg (SD=6.34) and 26.8kg/m2 (SD=4.78) of Body Mass Index. Those who consumed a diet with high levels of protein content significantly presented less weight at postpartum (p<0.01) lower Early-Pregnancy Body Mass Index (p<0.01). In the hierarchical linear regression, it was found a negative association of protein intake per kg and Weight gain (b=-4.3025; IC95%=-6.0215; -2.5836; p<0.01). In the final model, all others covariates (energy, schooling, family income and gestational age) were significantly associated with the outcome (p<0.05). The additional model showed a negatively association between Early-Pregnancy Body Mass Index and weight gain (b=-0.2951; IC95%= -0.4987; -0.0915; p<0.01). Conclusion Higher levels of protein intake per kg of body weight during pregnancy were associated with lower weight gain.
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