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Loh J, Loy SL, Appannah G, Colega MT, Godfrey KM, Yap F, Chong YS, Eriksson JG, Chan JKY, Chan SY, Chong MFF, Lai JS. Relation of preconception eating behaviours to dietary pattern trajectories and gestational weight gain from preconception to late pregnancy. Appetite 2024; 198:107336. [PMID: 38574819 DOI: 10.1016/j.appet.2024.107336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/26/2024] [Accepted: 04/02/2024] [Indexed: 04/06/2024]
Abstract
Studies examining preconception eating behaviours with longitudinal dietary patterns from preconception to late pregnancy as well as gestational weight gain (GWG) are limited. We derived dietary pattern trajectories from preconception to late-pregnancy, and related preconception eating behaviours to these trajectories and GWG. Preconception eating behaviours were assessed using the Three-Factor Eating Questionnaire measuring cognitive restraint (CR) - conscious restriction of food intake, emotional eating (EE) - overeating in response to negative emotions, and uncontrolled eating (UE) - overeating with a feeling of lack of control. Dietary intakes were measured at preconception, 20-21 and 34-36 weeks' gestation with food frequency questionnaires. Dietary patterns were determined using factor analysis, and trajectories derived using group-based trajectory modelling. Inadequate and excessive GWG were defined according to Institute of Medicine guidelines based on weights at preconception and the last antenatal visit (median: 38 weeks' gestation). Two dietary patterns were derived: 'Fast Food, Fried Snacks and Desserts (FFD)' and 'Soup, Fish and Vegetables (SFV)'. Adherence trajectories from preconception to late-pregnancy were characterised as consistently high ("stable-high") and low ("stable-low"). Women with higher UE scores had higher odds of being in the "stable-high" trajectory (n = 34) of the FFD pattern [Odds Ratio (OR): 1.25, 95% Confidence Interval (CI): 1.03, 1.51], compared to "stable-low" (n = 260). Percentages of women with inadequate, adequate or excessive GWG were 21.7% (n = 70), 25.8% (n = 83), and 52.5% (n = 169), respectively; women with higher EE scores had a higher likelihood of excessive GWG [Relative Risk Ratio (RRR): 1.35, 95% CI: 1.02, 1.80], but this association was attenuated after adjusting for preconception body mass index. Eating behaviour interventions to improve dietary patterns among pregnant women may need to start as early as preconception, incorporating strategies to manage UE.
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Affiliation(s)
- Jason Loh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore
| | - See Ling Loy
- Department of Reproductive Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore; Duke-NUS Medical School, 8 College Road, 169857, Singapore
| | - Geeta Appannah
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, UPM Serdang, Selangor Darul Ehsan, Malaysia
| | - Marjorelee T Colega
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - Fabian Yap
- Duke-NUS Medical School, 8 College Road, 169857, Singapore; Department of Paediatric Endocrinology, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, & Folkhälsan Research Center, University of Helsinki, PO Box 20, 00014, University of Helsinki, Helsinki, Finland; Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore
| | - Jerry K Y Chan
- Department of Reproductive Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore; Duke-NUS Medical School, 8 College Road, 169857, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 16 Medical Drive, 117597, Singapore
| | - Jun S Lai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore.
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Toh JY, Cai S, Lim SX, Pang WW, Godfrey KM, Shek LP, Tan KH, Yap F, Lee YS, Chong YS, Eriksson JG, Broekman BFP, Rifkin-Graboi A, Chong MFF. Nutrient trajectories during infancy and their associations with childhood neurodevelopment. Eur J Nutr 2023; 62:2429-2439. [PMID: 37118033 DOI: 10.1007/s00394-023-03164-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/21/2023] [Indexed: 04/30/2023]
Abstract
PURPOSE To examine the associations between infants' dietary nutrient trajectories and subsequent neurodevelopment during childhood in the Growing Up in Singapore Towards healthy Outcomes study. METHODS One-day food records were collected at ages 6, 9 and 12 months, whilst Bayley Scales of Infant and Toddler Development-III and Kaufman Brief Intelligence Test-2 were conducted at ages 24 and 54 months respectively. Nutrient trajectories were constructed using multi-level mixed modelling and associations with neurodevelopment (24 months: n = 484; 54 months: n = 444) were examined using adjusted multivariable linear regression. RESULTS At age 24 months, higher protein intake (at 6 months) and increasing rate of intake (from 6 to 12 months) were associated with higher fine motor score [β = 0.17 SD (95% CI 0.03, 0.31) and 0.62 SD (0.10, 1.14) respectively]. Higher fat intake was associated with higher receptive language score [0.04 SD (0.003, 0.07)], but increasing rate of intake was associated with lower expressive language [- 0.20 SD (- 0.39, - 0.01)] and fine motor [- 0.29 SD (- 0.48, - 0.10)] scores. Higher carbohydrate intake was associated with lower gross motor score [- 0.07 SD (- 0.14, - 0.005)], but increasing rate of intake was associated with higher receptive language [0.44 SD (0.08, 0.81)] and fine motor [0.56 SD (0.18, 0.93)] scores. Increasing rate of dietary fibre intake was associated with higher fine motor scores [0.63 SD (0.16, 1.10)]. No significant associations were observed with neurodevelopment at 54 months. CONCLUSION Our findings provide greater understanding of how nutrition over time could have varying effects on child neurodevelopment.
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Affiliation(s)
- Jia Ying Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Shirong Cai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shan Xuan Lim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Wei Wei Pang
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Centre and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital, Southampton National Health Service Foundation Trust, Southampton, UK
| | - Lynette P Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
- Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Fabian Yap
- Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
- Department of Paediatric Endocrinology, KK Women's and Children's Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Paediatric Endocrinology and Diabetes, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Folkhälsan Research Center, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Psychiatry, OLVG and Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - Anne Rifkin-Graboi
- Centre for Research in Child Development, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
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Lai JS, Colega MT, Godfrey KM, Tan KH, Yap F, Chong YS, Lee YS, Eriksson JG, Chan SY, Chong MFF. Changes in Diet Quality from Pregnancy to 6 Years Postpregnancy and Associations with Cardiometabolic Risk Markers. Nutrients 2023; 15:1870. [PMID: 37111088 PMCID: PMC10145322 DOI: 10.3390/nu15081870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/03/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Adopting a healthy diet during and after pregnancy is important for women's cardiometabolic health. We related changes in diet quality from pregnancy to 6 years postpregnancy to cardiometabolic markers 8 years postpregnancy. In 652 women from the GUSTO cohort, we assessed dietary intakes at 26-28 weeks' gestation and 6 years postpregnancy using 24 h recall and a food frequency questionnaire, respectively; diet quality was scored using a modified Healthy Eating Index for Singaporean women. Diet quality quartiles were derived; stable, large/small improvement/decline in diet quality as no change, >1 or 1 quartile increase/decrease. Fasting triglyceride (TG), total-, high- and low-density-lipoprotein cholesterol (TC, HDL- and LDL-C), glucose and insulin were measured 8 years postpregnancy; homeostatic model assessment for insulin resistance (HOMA-IR) and TG: HDL-C ratio were derived. Linear regressions examined changes in diet quality quartiles and cardiometabolic markers. Compared to a stable diet quality, a large improvement was associated with lower postpregnancy TG [-0.17 (-0.32, -0.01) mmol/L], TG: HDL-C ratio [-0.21 (-0.35, -0.07) mmol/L], and HOMA-IR [-0.47 (-0.90, -0.03)]; a large decline was associated with higher postpregnancy TC and LDL-C [0.25 (0.02, 0.49); 0.20 (0.004, 0.40) mmol/L]. Improving or preventing a decline in diet quality postpregnancy may improve lipid profile and insulin resistance.
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Affiliation(s)
- Jun S. Lai
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 117609, Singapore; (M.T.C.); (Y.S.C.); (J.G.E.); (S.-Y.C.); (M.F.F.C.)
| | - Marjorelee T. Colega
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 117609, Singapore; (M.T.C.); (Y.S.C.); (J.G.E.); (S.-Y.C.); (M.F.F.C.)
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Centre & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK;
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore 229899, Singapore;
| | - Fabian Yap
- Duke-NUS Medical School, Singapore 169857, Singapore;
- Department of Paediatric Endocrinology, KK Women’s and Children’s Hospital, Singapore 229899, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 117609, Singapore; (M.T.C.); (Y.S.C.); (J.G.E.); (S.-Y.C.); (M.F.F.C.)
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore
| | - Yung Seng Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore;
| | - Johan G. Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 117609, Singapore; (M.T.C.); (Y.S.C.); (J.G.E.); (S.-Y.C.); (M.F.F.C.)
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore
- Finland and Folkhälsan Research Center, University of Helsinki, Helsinki 00014, Finland
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 117609, Singapore; (M.T.C.); (Y.S.C.); (J.G.E.); (S.-Y.C.); (M.F.F.C.)
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore
| | - Mary F. F. Chong
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 117609, Singapore; (M.T.C.); (Y.S.C.); (J.G.E.); (S.-Y.C.); (M.F.F.C.)
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore
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Lai JS, Yuan WL, Ong CN, Tan KH, Yap F, Chong YS, Gluckman PD, Godfrey KM, Lee YS, Chan JKY, Chan SY, Chong MFF. Perinatal plasma carotenoid and vitamin E concentrations with maternal blood pressure during and after pregnancy. Nutr Metab Cardiovasc Dis 2022; 32:2811-2821. [PMID: 36184364 DOI: 10.1016/j.numecd.2022.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/22/2022] [Accepted: 07/22/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS Few studies examined the influence of carotenoids and vitamin E on blood pressure or hypertension during and after pregnancy. We related perinatal plasma concentrations of carotenoids and vitamin E (in individual forms and in combination) to blood pressure and hypertension at late pregnancy and 4 years post-pregnancy. METHODS AND RESULTS In 684 women of the Growing Up in Singapore Towards Healthy Outcomes cohort, we quantified plasma carotenoids and vitamin E concentrations at delivery. Systolic blood pressure and diastolic blood pressure (SBP and DBP) around 37-39 weeks' gestation were extracted from obstetric records and measured at 4 years post-pregnancy. Principal component analysis derived patterns of carotenoids (CP) and vitamin E. Associations were examined using linear or logistic regressions adjusting for confounders. Two carotenoids (CP1: α-carotene, β-carotene, and lutein; CP2: zeaxanthin, lycopene, and β-cryptoxanthin) and one vitamin E (γ-, δ-, and α-tocopherols) patterns were derived. CP1 (1SD score increment) was associated with lower SBP and DBP [β (95% CI): -2.36 (-3.47, -1.26) and -1.37 (-2.21, -0.53) mmHg] at late pregnancy> and 4 years post-pregnancy [-1.45 (-2.72, -0.18) and -0.99 (-1.98, -0.01) mmHg]. Higher β-cryptoxanthin concentrations were associated with lower SBP and DBP [-1.50 (-2.49, -0.51) and -1.20 (-1.95, -0.46) mmHg] at late pregnancy. Individual vitamin E and their pattern were not associated with blood pressure or hypertension. CONCLUSION Higher perinatal α-carotene, β-carotene, and lutein concentrations are associated with lower blood pressure in women at late pregnancy and post-pregnancy. Foods rich in these carotenoids, such as red-, orange-, and dark-green-colored vegetables, might be beneficial for blood pressure during and after pregnancy.
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Affiliation(s)
- Jun S Lai
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.
| | - Wen Lun Yuan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore; Université de Paris, CRESS, Inserm, INRAE, F-75004 Paris, France
| | - Choon Nam Ong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Fabian Yap
- Department of Paediatric Endocrinology, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore; Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore; Liggins Institute, University of Auckland, New Zealand
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, UK
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Jerry K Y Chan
- Duke-NUS Medical School, Singapore; Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
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Tan KML, Tint MT, Kothandaraman N, Yap F, Godfrey KM, Lee YS, Tan KH, Gluckman PD, Chong YS, Chong MFF, Eriksson JG, Cameron-Smith D. Association of plasma kynurenine pathway metabolite concentrations with metabolic health risk in prepubertal Asian children. Int J Obes (Lond) 2022; 46:1128-1137. [PMID: 35173282 PMCID: PMC7612806 DOI: 10.1038/s41366-022-01085-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND The tryptophan-kynurenine (KYN) pathway is linked to obesity-related systemic inflammation and metabolic health. The pathway generates multiple metabolites, with little available data on their relationships to early markers of increased metabolic disease risk in children. The aim of this study was to examine the association of multiple KYN pathway metabolites with metabolic risk markers in prepubertal Asian children. METHODS Fasting plasma concentrations of KYN pathway metabolites were measured using liquid chromatography-tandem mass spectrometry in 8-year-old children (n = 552) from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) prospective mother-offspring cohort study. The child's weight and height were used to ascertain overweight and obesity using local body mass index (BMI)-for-age percentile charts. Body fat percentage was measured by quantitative magnetic resonance. Abdominal circumference, systolic and diastolic blood pressure, homeostatic model assessment for insulin resistance (HOMA-IR), triglyceride, and HDL-cholesterol were used for the calculation of Metabolic syndrome scores (MetS). Serum triglyceride, BMI, gamma-glutamyl transferase (GGT), and abdominal circumference were used in the calculation of the Fatty liver index (FLI). Associations were examined using multivariable regression analyses. RESULTS In overweight or obese children (n = 93; 16.9% of the cohort), all KYN pathway metabolites were significantly increased, relative to normal weight children. KYN, kynurenic acid (KA), xanthurenic acid (XA), hydroxyanthranilic acid (HAA) and quinolinic acid (QA) all showed significant positive associations with body fat percentage (B(95% CI) = 0.32 (0.22,0.42) for QA), HOMA-IR (B(95% CI) = 0.25 (0.16,0.34) for QA), and systolic blood pressure (B(95% CI) = 0.14(0.06,0.22) for QA). All KYN metabolites except 3-hydroxykynurenine (HK) significantly correlated with MetS (B (95% CI) = 0.29 (0.21,0.37) for QA), and FLI (B (95% CI) = 0.30 (0.21,0.39) for QA). CONCLUSIONS Higher plasma concentrations of KYN pathway metabolites are associated with obesity and with increased risk for metabolic syndrome and fatty liver in prepubertal Asian children.
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Affiliation(s)
- Karen Mei-Ling Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Laboratory Medicine, National University Hospital, Singapore, Singapore
| | - Mya-Thway Tint
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (YLLSOM), National University of Singapore, Singapore, Singapore
| | - Narasimhan Kothandaraman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Fabian Yap
- Duke-National University of Singapore (NUS) Medical School, Singapore, Singapore
- Department of Pediatric Endocrinology, KK Women's and Children's Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University of Southampton Hospital, Southampton, UK
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat - National University Children's Medical Institute (KTPCMI), National University Health System, Singapore, Singapore
| | - Kok Hian Tan
- Duke-National University of Singapore (NUS) Medical School, Singapore, Singapore
- Perinatal Audit and Epidemiology, Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine (YLLSOM), National University of Singapore, Singapore, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (YLLSOM), National University of Singapore, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine (YLLSOM), National University of Singapore, Singapore, Singapore
- Folkhälsan Research Center, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - David Cameron-Smith
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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Tan KML, Tint MT, Kothandaraman N, Michael N, Sadananthan SA, Velan SS, Fortier MV, Yap F, Tan KH, Gluckman PD, Chong YS, Chong MFF, Lee YS, Godfrey KM, Eriksson JG, Cameron-Smith D. The Kynurenine Pathway Metabolites in Cord Blood Positively Correlate With Early Childhood Adiposity. J Clin Endocrinol Metab 2022; 107:e2464-e2473. [PMID: 35150259 PMCID: PMC9113811 DOI: 10.1210/clinem/dgac078] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT The kynurenine pathway generates metabolites integral to energy metabolism, neurotransmission, and immune function. Circulating kynurenine metabolites positively correlate with adiposity in children and adults, yet it is not known whether this relationship is present already at birth. OBJECTIVE In this prospective longitudinal study, we investigate the relationship between cord blood kynurenine metabolites and measures of adiposity from birth to 4.5 years. METHODS Liquid chromatography-tandem mass spectrometry was used to quantify cord blood kynurenine metabolites in 812 neonates from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Fat percentage was measured by air displacement plethysmography and abdominal adipose tissue compartment volumes; superficial (sSAT) and deep subcutaneous (dSAT) and internal adipose tissue were quantified by magnetic resonance imaging at early infancy in a smaller subset of neonates, and again at 4 to 4.5 years of age. RESULTS Cord blood kynurenine metabolites appeared to be higher in female newborns, higher in Indian newborns compared with Chinese newborns, and higher in infants born by cesarean section compared with vaginal delivery. Kynurenine, xanthurenic acid, and quinolinic acid were positively associated with birthweight, but not with subsequent weight during infancy and childhood. Quinolinic acid was positively associated with sSAT at birth. Kynurenic acid and quinolinic acid were positively associated with fat percentage at 4 years. CONCLUSION Several cord blood kynurenine metabolite concentrations were positively associated with birthweight, with higher kynurenic acid and quinolinic acid correlating to higher percentage body fat in childhood, suggesting these cord blood metabolites as biomarkers of early childhood adiposity.
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Affiliation(s)
- Karen Mei-Ling Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Department of Laboratory Medicine, National University Hospital, 119074, Singapore
| | - Mya-Thway Tint
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Department of Obstetrics and Gynaecology, Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (YLLSOM), National University of Singapore, 119228, Singapore
| | - Narasimhan Kothandaraman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Institute of Bioengineering and Bioimaging (IBB), Agency for Science Technology and Research, 138669, Singapore
| | - Marielle V Fortier
- Department of Diagnostic and Interventional Imaging, KK Women’s and Children’s Hospital, 229899, Singapore
| | - Fabian Yap
- Duke-National University of Singapore (NUS) Medical School, 169857, Singapore
- Department of Pediatric Endocrinology, KK Women’s and Children’s Hospital, 229899, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore
| | - Kok Hian Tan
- Duke-National University of Singapore (NUS) Medical School, 169857, Singapore
- Perinatal Audit and Epidemiology, Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, 119228, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Liggins Institute, University of Auckland, Auckland 1023, New Zealand
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Department of Obstetrics and Gynaecology, Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (YLLSOM), National University of Singapore, 119228, Singapore
- Yong Loo Lin School of Medicine (YLLSOM), National University of Singapore, 117597, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 117549, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore
- Khoo Teck Puat – National University Children’s Medical Institute, National University Health System, 119074, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton Hospital, Southampton SO16 6YD, United Kingdom
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Department of Obstetrics and Gynaecology, Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (YLLSOM), National University of Singapore, 119228, Singapore
- Folkhälsan Research Center, 00250 Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, 00290 Helsinki, Finland
| | - David Cameron-Smith
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, 117596, Singapore
- Correspondence: Professor David Cameron Smith, Singapore Institute for Clinical Sciences, Brenner Centre for Molecular Medicine, Agency for Science, Technology and Research, 30 Medical Drive 117609, Singapore.
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7
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Sum KK, Tint MT, Aguilera R, Dickens BSL, Choo S, Ang LT, Phua D, Law EC, Ng S, Tan KML, Benmarhnia T, Karnani N, Eriksson JG, Chong YS, Yap F, Tan KH, Lee YS, Chan SY, Chong MFF, Huang J. The socioeconomic landscape of the exposome during pregnancy. Environ Int 2022; 163:107205. [PMID: 35349911 DOI: 10.1016/j.envint.2022.107205] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 03/08/2022] [Accepted: 03/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND While socioeconomic position (SEP) is consistently related to pregnancy and birth outcome disparities, relevant biological mechanisms are manifold, thus necessitating more comprehensive characterization of SEP-exposome associations during pregnancy. OBJECTIVES We implemented an exposomic approach to systematically characterize the socioeconomic landscape of prenatal exposures in a setting where social segregation was less distinct in a hypotheses-generating manner. METHODS We described the correlation structure of 134 prenatal exogenous and endogenous sources (e.g., micronutrients, hormones, immunomodulatory metabolites, environmental pollutants) collected in a diverse, population-representative, urban, high-income longitudinal mother-offspring cohort (N = 1341; 2009-2011). We examined the associations between maternal, paternal, household, and areal level SEP indicators and 134 exposures using multiple regressions adjusted for precision variables, as well as potential effect measure modification by ethnicity and nativity. Finally, we generated summary SEP indices using Multiple Correspondence Analysis to further explore possible curved relationships. RESULTS Individual and household SEP were associated with anthropometric/adiposity measures, folate, omega-3 fatty acids, insulin-like growth factor-II, fasting glucose, and neopterin, an inflammatory marker. We observed paternal education was more strongly and consistently related to maternal exposures than maternal education. This was most apparent amongst couples discordant on education. Analyses revealed additional non-linear associations between areal composite SEP and particulate matter. Environmental contaminants (e.g., per- and polyfluoroalkyl substances) and micronutrients (e.g., folate and copper) showed opposing associations by ethnicity and nativity, respectively. DISCUSSION SEP-exposome relationships are complex, non-linear, and context specific. Our findings reinforce the potential role of paternal contributions and context-specific modifiers of associations, such as between ethnicity and maternal diet-related exposures. Despite weak presumed areal clustering of individual exposures in our context, our approach reinforces subtle non-linearities in areal-level exposures.
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Affiliation(s)
- Ka Kei Sum
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore.
| | - Mya Thway Tint
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Rosana Aguilera
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, USA
| | - Borame Sue Lee Dickens
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Sue Choo
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Li Ting Ang
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Desiree Phua
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Evelyn C Law
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Sharon Ng
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Karen Mei-Ling Tan
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore; Department of Laboratory Medicine, National University Hospital, Singapore, Singapore
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Neerja Karnani
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore; Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Bioinformatics Institute, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore; Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Yap-Seng Chong
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Fabian Yap
- Duke-NUS Medical School, Singapore, Singapore; Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore, Singapore; Department of Maternal-Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Jonathan Huang
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore; Centre for Quantitative Medicine (CQM), Duke-NUS Medical School, Singapore, Singapore
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8
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Sugianto R, Toh JY, Wong SF, Tint MT, Colega MT, Lee YS, Yap F, Shek LPC, Tan KH, Godfrey KM, Chong YS, Tai BC, Chong MFF. Dietary patterns of 5-year-old children and their correlates: findings from a multi-ethnic Asian cohort. Br J Nutr 2022; 127:763-772. [PMID: 33910654 PMCID: PMC7612427 DOI: 10.1017/s0007114521001434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
There is limited data on the dietary patterns of 5-year-old children in Asia. The study examined childhood dietary patterns and their maternal and child correlates in a multi-ethnic Asian cohort. Based on caregiver-reported 1-month quantitative FFQ of 777 children from the Growing Up in Singapore Towards healthy Outcomes cohort, cluster analysis identified two mutually exclusive clusters. Children in the 'Unhealthy' cluster (43·9 %) consumed more fries, processed meat, biscuits and ice cream, and less fish, fruits and vegetables compared with those in the 'Healthy' cluster (56·1 %). Children with mothers of lower educational attainment had twice the odds of being assigned to the 'Unhealthy' cluster (adjusted OR (95 % CI) = 2·19 (95 % CI 1·49-3·24)). Children of Malay and Indian ethnicities had higher odds of being assigned to the 'Unhealthy' cluster (adjusted OR = 25·46 (95 % CI 15·40, 42·10) and 4·03 (95 % CI 2·68-6·06), respectively), relative to Chinese ethnicity. In conclusion, this study identified two dietary patterns in children, labelled as the 'Unhealthy' and 'Healthy' clusters. Mothers' educational attainment and ethnicity were two correlates that were associated with the children's assignments to the clusters. These findings can assist in informing health promotion programmes targeted at Asian children.
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Affiliation(s)
- R Sugianto
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - JY Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - SF Wong
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - MT Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - MT Colega
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - YS Lee
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital and National University Health System, Singapore
| | - F Yap
- Duke-NUS Medical School, Singapore
- KK Women’s and Children’s Hospital, Singapore
| | - LPC Shek
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital and National University Health System, Singapore
| | - KH Tan
- Duke-NUS Medical School, Singapore
- KK Women’s and Children’s Hospital, Singapore
| | - KM Godfrey
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - YS Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - BC Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - MFF Chong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
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9
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Chen L, Tan KML, Gong M, Chong MFF, Tan KH, Chong YS, Meaney MJ, Gluckman PD, Eriksson JG, Karnani N. Variability in newborn telomere length is explained by inheritance and intrauterine environment. BMC Med 2022; 20:20. [PMID: 35073935 PMCID: PMC8787951 DOI: 10.1186/s12916-021-02217-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/14/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Telomere length (TL) and its attrition are important indicators of physiological stress and biological aging and hence may vary among individuals of the same age. This variation is apparent even in newborns, suggesting potential effects of parental factors and the intrauterine environment on TL of the growing fetus. METHODS Average relative TLs of newborns (cord tissue, N = 950) and mothers (buffy coat collected at 26-28 weeks of gestation, N = 892) were measured in a birth cohort. This study provides a comprehensive analysis of the effects of heritable factors, socioeconomic status, and in utero exposures linked with maternal nutrition, cardiometabolic health, and mental well-being on the newborn TL. The association between maternal TL and antenatal maternal health was also studied. RESULTS Longer maternal TL (β = 0.14, P = 1.99E-05) and higher paternal age (β = 0.10, P = 3.73E-03) were positively associated with newborn TL. Genome-wide association studies on newborn and maternal TLs identified 6 genetic variants in a strong linkage disequilibrium on chromosome 3q26.2 (Tag SNP-LRRC34-rs10936600: Pmeta = 5.95E-08). Mothers with higher anxiety scores, elevated fasting blood glucose, lower plasma insulin-like growth factor-binding protein 3 and vitamin B12 levels, and active smoking status during pregnancy showed a higher risk of giving birth to offspring with shorter TL. There were sex-related differences in the factors explaining newborn TL variation. Variation in female newborn TL was best explained by maternal TL, mental health, and plasma vitamin B12 levels, while that in male newborn TL was best explained by paternal age, maternal education, and metabolic health. Mother's TL was associated with her own metabolic health and nutrient status, which may have transgenerational effects on offspring TL. CONCLUSIONS Our findings provide a comprehensive understanding of the heritable and environmental factors and their relative contributions to the initial setting of TL and programing of longevity in early life. This study provides valuable insights for preventing in utero telomere attrition by improving the antenatal health of mothers via targeting the modifiable factors. TRIAL REGISTRATION ClinicalTrials.gov , NCT01174875. Registered on 1 July 2010.
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Affiliation(s)
- Li Chen
- Singapore Institute for Clinical Sciences, A*STAR, Singapore, Singapore.
| | | | - Min Gong
- Singapore Institute for Clinical Sciences, A*STAR, Singapore, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, A*STAR, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore, Singapore
| | - Kok Hian Tan
- KK Women's and Children's Hospital, Singapore, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, A*STAR, Singapore, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences, A*STAR, Singapore, Singapore.,Sackler Program for Epigenetics & Psychobiology at McGill University, Montréal, Canada.,Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montréal, Canada
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, A*STAR, Singapore, Singapore.,Centre for Human Evolution, Adaptation and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences, A*STAR, Singapore, Singapore.,Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montréal, Canada.,Folkhalsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Neerja Karnani
- Singapore Institute for Clinical Sciences, A*STAR, Singapore, Singapore. .,Bioinformatics Institute, A*STAR, Singapore, Singapore. .,Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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10
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Quek J, Lim G, Lim WH, Ng CH, So WZ, Toh J, Pan XH, Chin YH, Muthiah MD, Chan SP, Foo RSY, Yip J, Neelakantan N, Chong MFF, Loh PH, Chew NWS. The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies. Front Cardiovasc Med 2021; 8:756810. [PMID: 34805312 PMCID: PMC8604150 DOI: 10.3389/fcvm.2021.756810] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/24/2021] [Indexed: 12/17/2022] Open
Abstract
Background: The association between plant-based diets and cardiovascular disease (CVD) remains poorly characterized. Given that diet represents an important and a modifiable risk factor, this study aimed to assess (1) the relationships between the impact of adherence to plant-based diets on cardiovascular mortality, incident CVD, and stroke; (2) if associations differed by adherence to healthful and less healthful plant-based diets. Methods and Findings: MEDLINE and EMBASE databases were searched up to May 2021. Studies assessing CVD outcomes with relation to plant-based dietary patterns or according to plant-based dietary indices (PDI) were included. A meta-analysis of hazard ratios (HR) was conducted using DerSimonian and Laird random effects model. Thirteen studies involving 410,085 participants were included. Greater adherence to an overall plant-based dietary pattern was significantly associated with a lower risk of cardiovascular mortality (pooled HR: 0.92, 95% CI: 0.86–0.99 p = 0.0193, I2 = 88.5%, N = 124,501) and a lower risk of CVD incidence (pooled HR: 0.90, 95% CI: 0.82–0.98, p = 0.0173, I2 = 87.2%, N = 323,854). Among the studies that used PDI, unhealthful plant-based diets were associated with increased risk of cardiovascular mortality (pooled HR: 1.05, 95% CI: 1.01–1.09, p = 0.0123, I2 = 0.00%, N = 18,966), but not CVD incidence. Conversely, healthful plant-based diets were associated with decreased CVD incidence (pooled HR: 0.87, 95% CI: 0.80–0.95, p = 0.0011, I2 = 57.5%, N = 71,301), but not mortality. Vegetarians also had significantly lower CVD incidence (HR: 0.81, 95% CI: 0.72–0.91, p = 0.0004, I2 = 22.2%, N = 16,254), but similar CVD mortality or stroke risk when compared to the meat-eaters. Conclusion: To date, this comprehensive study examines the effects of a plant-based diet on major clinical endpoints using more holistic PDIs. These findings highlight the favorable role of healthful plant-based foods in reducing cardiovascular mortality and CVD.
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Affiliation(s)
- Jingxuan Quek
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Grace Lim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Wen Hui Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cheng Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wei Zheng So
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jonathan Toh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xin Hui Pan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yip Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mark D Muthiah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore.,National University Centre for Organ Transplantation, National University Health System, Singapore, Singapore
| | - Siew Pang Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
| | - Roger S Y Foo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
| | - James Yip
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
| | - Nithya Neelakantan
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
| | - Mary F F Chong
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
| | - Poay Huan Loh
- Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
| | - Nicholas W S Chew
- Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
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11
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Sampathkumar A, Tan KM, Chen L, Chong MFF, Yap F, Godfrey KM, Chong YS, Gluckman PD, Ramasamy A, Karnani N. Genetic Link Determining the Maternal-Fetal Circulation of Vitamin D. Front Genet 2021; 12:721488. [PMID: 34621292 PMCID: PMC8490770 DOI: 10.3389/fgene.2021.721488] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/10/2021] [Indexed: 12/31/2022] Open
Abstract
Vitamin D is an essential micronutrient whose demand is heightened during pregnancy to support the growth of the fetus. Furthermore, the fetus does not produce vitamin D and hence relies exclusively on the supply of maternal vitamin D through the placenta. Vitamin D inadequacy is linked with pregnancy complications and adverse infant outcomes. Hence, early predictive markers of vitamin D inadequacy such as genetic vulnerability are important to both mother and offspring. In this multi-ethnic Asian birth cohort study, we report the first genome-wide association analysis (GWAS) of maternal and fetal vitamin D in circulation. For this, 25-hydroxyvitamin D (25OHD) was measured in the antenatal blood of mothers during mid gestation (n=942), and the cord blood of their offspring at birth (n=812). Around ~7 million single nucleotide polymorphisms (SNPs) were regressed against 25OHD concentrations to identify genetic risk variants. About 41% of mothers had inadequate 25OHD (≤75nmol/L) during pregnancy. Antenatal 25OHD was associated with ethnicity [Malay (Β=−22.32nmol/L, p=2.3×10−26); Indian (Β=−21.85, p=3.1×10−21); reference Chinese], age (Β=0.47/year, p=0.0058), and supplement intake (Β=16.47, p=2.4×10−13). Cord blood 25OHD highly correlated with antenatal vitamin D (r=0.75) and was associated with ethnicity [Malay (Β=−4.44, p=2.2×10−7); Indian (Β=−1.99, p=0.038); reference Chinese]. GWAS analysis identified rs4588, a missense variant in the group-specific component (GC) gene encoding vitamin D binding protein (VDBP), and its defining haplotype, as a risk factor for low antenatal (Β=−8.56/T-allele, p=1.0×10−9) and cord blood vitamin D (Β=−3.22/T-allele, p=1.0×10−8) in all three ethnicities. We also discovered a novel association in a SNP downstream of CYP2J2 (rs10789082), a gene involved in 25-hydroxylation of vitamin D, with vitamin D in pregnant women (Β=−7.68/G-allele, p=1.5×10−8), but not their offspring. As the prevention and early detection of suboptimal vitamin D levels are of profound importance to both mother and offspring’s health, the genetic risk variants identified in this study allow risk assessment and precision in early intervention of vitamin D deficiency.
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Affiliation(s)
- Aparna Sampathkumar
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Karen M Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Li Chen
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore.,Saw Swee Hock School of Public Health (SSHPH), National University of Singapore (NUS), Singapore, Singapore
| | - Fabian Yap
- Department of Pediatric Endocrinology, KK Women's and Children's Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Keith M Godfrey
- Lee Kong Chian School of Medicine, Singapore, Singapore.,Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital, Southampton, United Kingdom
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Adaikalavan Ramasamy
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore.,Genome Institute of Singapore (GIS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Neerja Karnani
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore.,Department of Biochemistry, National University of Singapore (NUS), Singapore, Singapore.,Bioinformatics Institute (BII), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
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12
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Toh JY, Quah PL, Wong CH, Lun Yuan W, Aris IM, McCrickerd K, Godfrey KM, Chong YS, Shek LP, Tan KH, Yap F, Meaney MJ, Forde CG, Lee YS, Broekman BFP, Chong MFF. Evaluation of a child food reward task and its association with maternal feeding practices. PLoS One 2021; 16:e0254773. [PMID: 34288967 PMCID: PMC8294516 DOI: 10.1371/journal.pone.0254773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 07/04/2021] [Indexed: 11/18/2022] Open
Abstract
Food reward is defined as the momentary value of a food to the individual at the time of ingestion and is characterised by two psychological processes-"liking" and "wanting". We aimed to validate an age-appropriate food reward task to quantify implicit wanting of children from the GUSTO cohort (n = 430). At age 5 years, child appetitive traits and maternal feeding practices were reported by mothers via questionnaires. At age 6, a write-for-food task based on the child's preference for food or toy rewards was undertaken in laboratory conditions. Child BMI and skinfold measurements were taken at age 7. Convergent validity of the food reward task was assessed by associating with child appetitive traits, where enjoyment of food/food responsiveness (OR: 1.51; 95% CI: 1.06, 2.15) and emotional overeating (OR: 1.64; 95% CI: 1.09, 2.48) were positively associated with high food reward in children. Criterion validity was tested by associating with child BMI, however no significant relationships were observed. Multivariable logistic regression analysis with maternal feeding practices revealed that children whose mother tend to restrict unhealthy food (OR: 1.37; 95% CI: 1.03, 1.82) and girls whose mothers taught them about nutrition (OR: 2.09; 95% CI: 1.19, 3.67) were more likely to have high food reward. No further significant associations were observed between food reward, other appetitive traits and feeding practices. Despite the lack of association with child weight status, this study demonstrated the value of the write-for-food task to assess food reward in children and presented sex-specific associations with maternal feeding practices.
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Affiliation(s)
- Jia Ying Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Phaik Ling Quah
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Chun Hong Wong
- Department of Food Science and Technology, National University of Singapore, Singapore, Singapore
| | - Wen Lun Yuan
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Izzuddin M. Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America
| | - Keri McCrickerd
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore, Singapore
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital, Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lynette P. Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Divisions of Paediatric Allergy, Immunology, and Rheumatology, Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Kok Hian Tan
- Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
- Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Fabian Yap
- Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
- Departments of Paediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Michael J. Meaney
- Integrative Neurosciences, Singapore Institute for Clinical Sciences, Agency for Science and Technology, Brenner Centre for Molecular Medicine, Singapore, Singapore
- Department of Psychiatry, McGill University, Montréal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Montréal, QC, Canada
| | - Ciarán G. Forde
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore, Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Paediatric Endocrinology, Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Birit F. P. Broekman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Psychiatry, OLVG and AmsterdamUMC, VU University, Amsterdam, Netherlands
| | - Mary F. F. Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- * E-mail:
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13
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Ooi DSQ, Ling JQR, Sadananthan SA, Velan SS, Ong FY, Khoo CM, Tai ES, Henry CJ, Leow MKS, Khoo EYH, Tan CS, Lee YS, Chong MFF. Branched-Chain Amino Acid Supplementation Does Not Preserve Lean Mass or Affect Metabolic Profile in Adults with Overweight or Obesity in a Randomized Controlled Weight Loss Intervention. J Nutr 2021; 151:911-920. [PMID: 33537760 DOI: 10.1093/jn/nxaa414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/18/2020] [Accepted: 12/01/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Branched-chain amino acid (BCAA) supplementation has been shown to increase muscle mass or prevent muscle loss during weight loss. OBJECTIVE We aimed to investigate the effects of a BCAA-supplemented hypocaloric diet on lean mass preservation and insulin sensitivity. METHODS A total of 132 Chinese adults (63 men and 69 women aged 21-45 y, BMI 25-36 kg/m2) were block randomly assigned by gender and BMI into 3 hypocaloric diet (deficit of 500 kcal/d) groups: standard-protein (14%) with placebo (control, CT) or BCAA supplements at 0.1 g · kg-1 body weight · d-1 (BCAA) or high-protein (27%) with placebo (HP). The subjects underwent 16 wk of dietary intervention with provision of meals and supplements, followed by 8 wk of weight maintenance with provision of supplements only. One-way ANOVA analysis was conducted to analyze the primary (lean mass and insulin sensitivity) and secondary outcomes (anthropometric and metabolic parameters) among the 3 groups. Paired t-test was used to analyze the change in each group. RESULTS The 3 groups demonstrated similar significant reductions in body weight (7.97%), fat mass (13.8%), and waist circumference (7.27%) after 16 wk of energy deficit. Lean mass loss in BCAA (4.39%) tended to be lower than in CT (5.39%) and higher compared with HP (3.67%) (P = 0.06). Calf muscle volume increased 3.4% in BCAA and intramyocellular lipids (IMCLs) decreased in BCAA (17%) and HP (18%) (P < 0.05) over 16 wk. During the 8 wk weight maintenance period, lean mass gain in BCAA (1.03%) tended to be lower compared with CT (1.58%) and higher than in HP (-0.002%) (P = 0.04). Lean mass gain differed significantly between CT and HP (P = 0.03). Insulin sensitivity and metabolic profiles did not differ among the groups throughout the study period. CONCLUSIONS BCAA supplementation does not preserve lean mass or affect insulin sensitivity in overweight and obese adults during weight loss. A higher protein diet may be more advantageous for lean mass preservation.
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Affiliation(s)
- Delicia S Q Ooi
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Jennifer Q R Ling
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Suresh Anand Sadananthan
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - S Sendhil Velan
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.,Singapore Bioimaging Consortium, Agency for Science, Technology and Research, Singapore
| | - Fang Yi Ong
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Chin Meng Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - E Shyong Tai
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Melvin K S Leow
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.,Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore
| | - Eric Y H Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yung Seng Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Mary F F Chong
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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14
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van Lee L, Chia A, Phua D, Colega M, Padmapriya N, Bernard JY, Cai S, Tham EKH, Teoh OH, Goh D, Gooley JJ, Gluckman PD, Yap F, Shek LPC, Godfrey KM, Tan KH, Chong YS, Müller-Riemenschneider F, Broekman B, Meaney M, Chen H, Chong MFF. Multiple modifiable lifestyle factors and the risk of perinatal depression during pregnancy: Findings from the GUSTO cohort. Compr Psychiatry 2020; 103:152210. [PMID: 33045668 DOI: 10.1016/j.comppsych.2020.152210] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 09/24/2020] [Accepted: 09/24/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Studies have identified lifestyle risk factors for perinatal depression, but none have examined the cumulative effect of these risk factors in pregnant women. METHODS We considered the following six factors during pregnancy: poor diet quality (Healthy eating index for Singapore pregnant women<median), poor sleep quality (global Pittsburgh sleep quality index score > 5), physical inactivity (<600 MET-minutes/week), vitamin D insufficiency (<50 nmol/l), smoking before or during pregnancy, and the perceived need for social support. Probable depression was assessed using the Edinburgh postnatal depression scale during pregnancy (>15) and at three months postpartum (≥13). Prevalence risk ratios were calculated with Poisson regressions while adjusting for potential confounders. RESULTS Of 535 pregnant women, 207 (39%) had zero or one risk factor, 146 (27%) had two, 119 (22%) had three, 48 (9%) had four, and 15 (3%) had ≥5 risk factors at 26-28 weeks' gestation. These six lifestyle habits contributed to 32% of the variance in depressive symptoms during pregnancy. The prevalence of being probably depressed was 6.4 (95% CI 2.1, 19.8; ptrend < 0.001) for expecting women who had ≥4 risk factors compared to women who had ≤1 risk factor. No association was observed between the number of risk factors and depressive symptoms at 3 months postpartum (ptrend = 0.746). CONCLUSION Pregnant women with ≥4 lifestyle risk factors showed a higher prevalence of depression during pregnancy, while no associations were observed for postpartum depression. CLINICAL TRIAL REGISTRATION This cohort is registered under the Clinical Trials identifier NCT01174875; http://www.clinicaltrials.gov/ct2/show/NCT01174875?term=GUSTO&rank=2.
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Affiliation(s)
- Linde van Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Airu Chia
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Desiree Phua
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Marjorelee Colega
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Natarajan Padmapriya
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jonathan Y Bernard
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Early Life Research On Later Health Unit, Centre for Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), National Institute of Health and Medical Research (Inserm), Villejuif, France
| | - Shirong Cai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Elaine K H Tham
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Oon Hoe Teoh
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - Daniel Goh
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joshua J Gooley
- Center for Cognitive Neuroscience, Program in Neuroscience and behavioural disorders, Duke-NUS Medical School, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Fabian Yap
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Lynette P C Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore, Singapore; Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Institute for Social Medicine, Epidemiology and Health Economics, Charite University Medical Centre, Berlin, Germany
| | - Birit Broekman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Department of Psychiatry, Amsterdam UMC, location VUmc, VU University, Amsterdam, the Netherlands; Department of Psychiatry, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - Michael Meaney
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Departments of Psychiatry and Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Helen Chen
- Department of Psychological Medicine, KK Women's and Children's hospital, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Clinical Nutrition Research Centre, Agency for Science, Technology and Research, Singapore.
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15
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Lai JS, Cai S, Lee BL, Godfrey KM, Gluckman PD, Shek LP, Yap F, Tan KH, Chong YS, Ong CN, Meaney MJ, Rifkin-Graboi A, Broekman BFP, Chong MFF. Higher maternal plasma β-cryptoxanthin concentration is associated with better cognitive and motor development in offspring at 2 years of age. Eur J Nutr 2020; 60:703-714. [PMID: 32435993 DOI: 10.1007/s00394-020-02277-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/11/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE Current literature on the roles of α-, β-carotene and β-cryptoxanthin in neurocognitive function has largely focused on preventing cognitive decline in older people, and less on neuro-development in children. We examined the relations of maternal plasma carotenoids concentrations with offspring cognitive development up to age 4.5 years in the Growing Up in Singapore Towards healthy Outcomes mother-offspring cohort study. METHODS Maternal plasma α-, β-carotene and β-cryptoxanthin concentrations at delivery were determined by ultra-performance liquid chromatography. Children's cognition was assessed at ages 2 (Bayley Scales of Infant and Toddler Development) and 4.5 (Kaufman Brief Intelligence Test) years. Associations were examined in 419 mother-offspring pairs using linear regressions adjusting for key confounders. RESULTS Median and interquartile range of maternal plasma concentrations (mg/L) were: α-carotene 0.052 (0.032, 0.081), β-carotene 0.189 (0.134, 0.286), and β-cryptoxanthin 0.199 (0.123, 0.304). In 2 years old children, higher maternal carotenoids [per standard deviation (SD) log-concentration] were positively associated with neurocognitive functions: β-cryptoxanthin with higher scores in cognitive [β = 0.18, (0.08, 0.28) SD], receptive language [β = 0.17 (0.07, 0.27) SD], fine motor [β = 0.16 (0.05, 0.26) SD], and gross motor [β = 0.16 (0.06, 0.27) SD] scales; β-carotene with higher cognitive score [β = 0.17 (0.05, 0.29) SD]. No significant associations were observed with neurocognitive functions at age 4.5 years. CONCLUSION Our study provides novel data suggesting a potential role of prenatal carotenoids, particularly β-cryptoxanthin, on early offspring cognitive and motor development. Whether the prenatal influences sustain beyond early childhood requires further investigation in longer term studies.
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Affiliation(s)
- Jun S Lai
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore
| | - Shirong Cai
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - Bee Lan Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, NIHR Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore.,Liggins Institute, University of Auckland, Grafton, Auckland, New Zealand
| | - Lynette P Shek
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - Fabian Yap
- Duke-NUS Medical School, Singapore, Singapore.,Department of Paediatric Endocrinology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - Choon Nam Ong
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore.,Department of Psychiatry and Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Anne Rifkin-Graboi
- Department Office of Education Research, National Institute of Education, Singapore, Singapore
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore.,Department of Psychiatry, OLVG and VU Medical Centre, Amsterdam, The Netherlands
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore. .,Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore.
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16
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Fries LR, Chan MJ, Quah PL, Toh JY, Fogel A, Goh AT, Aris IM, Broekman BFP, Cai S, Tint MT, Chong YS, Shek LP, Lee YS, Yap F, Tan KH, Gluckman PD, Godfrey KM, Silva Zolezzi I, Forde CG, Chong MFF. Maternal feeding practices and children's food intake during an ad libitum buffet meal: Results from the GUSTO cohort. Appetite 2019; 142:104371. [PMID: 31323246 PMCID: PMC6682493 DOI: 10.1016/j.appet.2019.104371] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/24/2019] [Accepted: 07/15/2019] [Indexed: 12/16/2022]
Abstract
Parents' feeding practices have been shown to be associated with children's food intake and weight status, but little is known about feeding practices in Asian countries. This study used behavioral observation to explore the feeding practices of 201 mothers of 4.5 year-old children in Singapore during an ad libitum buffet lunch. Feeding practices were coded from videos, focusing on behaviors used to prompt the child to eat more food (autonomy-supportive and coercive-controlling prompts to eat, suggesting items from buffet), those to reduce intake (restriction, questioning food choice), and those related to eating rate (hurrying or slowing child eating). Child outcome measures included energy consumed, variety of food items selected, and BMI. Maternal restriction and trying to slow child eating rate were associated with higher energy consumed by the child (r = 0.19 and 0.13, respectively; p < 0.05). Maternal autonomy-supportive prompts and restriction were associated with a greater variety of items selected by children (r = 0.19 and 0.15, respectively; p < 0.05). The frequency of maternal feeding practice use differed across ethnic groups, with Malay mothers using the most prompts to eat (p < 0.05), Chinese mothers most likely to question a child's food choice (p < 0.01), and Indian mothers the last likely to tell the child to eat faster (p < 0.001). There were no differences between ethnic groups for other feeding practices. No associations were found between feeding practices and child BMI. It is possible that feeding practices related to restriction and slowing child eating are adopted in response to children who consume larger portions, although longitudinal or intervention studies are needed to confirm the direction of this relationship and create local recommendations.
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Affiliation(s)
- Lisa R Fries
- Nestlé Research, Vers-chez-les-Blanc, Case Postale 44, CH-1000, Lausanne, Switzerland.
| | - Mei Jun Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
| | - Phaik Ling Quah
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
| | - Anna Fogel
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, 117599, Singapore.
| | - Ai Ting Goh
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, 117599, Singapore.
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Psychiatry, VU Medical Centre, Amsterdam, The Netherlands, Research & Innovation, Location GGZ InGeest, Oldenaller 1, 1081, HJ, Amsterdam, the Netherlands.
| | - Shirong Cai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore.
| | - Mya Thway Tint
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore.
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore.
| | - Lynette P Shek
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, 5 Lower Kent Ridge Road, 119074, Singapore.
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, 5 Lower Kent Ridge Road, 119074, Singapore.
| | - Fabian Yap
- Pediatric Endocrinology, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore; Duke-National University of Singapore Graduate Medical School, 8 College Road, 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Experimental Medicine Building, 59 Nanyang Drive, 636921, Singapore.
| | - Kok Hian Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Experimental Medicine Building, 59 Nanyang Drive, 636921, Singapore; Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Level 3, Singapore, 229899.
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Liggins Institute, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand.
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS FT, Tremona Road, SO16 6YD, Southampton, UK.
| | - Irma Silva Zolezzi
- Nestlé Research Singapore Hub, 21 Biopolis Road Nucleos (South Tower), #04-22/23, 138567, Singapore.
| | - Ciaran G Forde
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, 117599, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, 117599, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10-01, 117549, Singapore.
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17
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Lai JS, Cai S, Feng L, Shek LP, Yap F, Tan KH, Chong YS, Godfrey KM, Meaney MJ, Rifkin-Graboi A, Broekman BFP, Chong MFF. Associations of maternal zinc and magnesium with offspring learning abilities and cognitive development at 4 years in GUSTO. Nutr Neurosci 2019; 24:467-476. [PMID: 31331255 DOI: 10.1080/1028415x.2019.1643624] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objectives: Minerals deficiencies during pregnancy have been shown to be associated with poorer cognitive outcomes in offspring. This study aimed to investigate associations of maternal plasma zinc and magnesium concentrations with cognitive development in 4-year old children from the Growing Up in Singapore Towards healthy Outcome cohort.Methods: Maternal plasma zinc and magnesium concentrations were measured at 26-28 weeks' gestation. The Lollipop test of school readiness, tests of working memory, number knowledge, receptive vocabulary, and phonological awareness were performed in children at 4 years. Associations were examined in 715 mother-offspring pairs using linear regressions adjusted for key confounders.Results: Maternal plasma zinc and magnesium concentrations were 812 ± 144 µg/L and 19.9 ± 1.8 mg/L (mean±SD); 19% and 71% of mothers were zinc deficient and magnesium insufficient, respectively. After adjustment for multiple testing, higher maternal zinc concentrations (per SD increment) were associated with 0.35 higher scores in Lollipop subtest 2 of picture description and spatial identification (95% CI: 0.13, 0.58); higher maternal magnesium concentrations (per SD increment) were associated with 0.65 higher scores in Lollipop subtest 4 of letters and writing identification (95% CI: 0.23, 1.07).Discussion: No significant associations were observed for other tests, suggesting little long term influences of maternal zinc and magnesium on child's cognitive development.
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Affiliation(s)
- Jun S Lai
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore
| | - Shirong Cai
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lynette P Shek
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Fabian Yap
- Duke-NUS Medical School, Singapore, Singapore.,Department of Paediatric Endocrinology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore.,Department of Psychiatry and Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Anne Rifkin-Graboi
- Department Office of Education Research, National Institute of Education, Singapore, Singapore
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore.,Department of Psychiatry, VU Medical Centre, VU University, Amsterdam, the Netherlands
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
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18
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Quah PL, Fries LR, Chan MJ, Fogel A, McCrickerd K, Goh AT, Aris IM, Lee YS, Pang WW, Basnyat I, Wee HL, Yap F, Godfrey KM, Chong YS, Shek LPC, Tan KH, Forde CG, Chong MFF. Validation of the Children's Eating Behavior Questionnaire in 5 and 6 Year-Old Children: The GUSTO Cohort Study. Front Psychol 2019; 10:824. [PMID: 31031683 PMCID: PMC6470280 DOI: 10.3389/fpsyg.2019.00824] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 03/27/2019] [Indexed: 01/30/2023] Open
Abstract
Revised subscales of the Children’s Eating Behavior Questionnaire (CEBQ) have been proposed to be more appropriate for assessing appetitive traits in Singaporean 3 year-olds, but the CEBQ has not yet been validated in older children in this population. The current study aimed to validate the CEBQ at ages 5 (n = 653) and 6 (n = 449) in the ethnically diverse GUSTO cohort. Confirmatory factor analysis (CFA) examined whether the established eight-factor model of the CEBQ was supported in this sample. Overall, the CFA showed a poor model fit at both ages 5 and 6. At both ages 5 and 6, an exploratory factor analysis revealed a six-factor structure: food fussiness, enjoyment of food, slowness in eating, emotional undereating, emotional overeating and desire to drink. Cronbach’s alpha estimates ranged from 0.70 to 0.85 for all subscales. Criterion validity was tested by correlating subscales with the weight status of 6 years of age. At age 5 and 6, lower scores of slowness of eating while higher scores of enjoyment of food was associated with child overweight. At age 6, higher scores of desire to drink was also associated child overweight. In conclusion, a revised six factor-structure of the CEBQ at ages 5 and 6 were more appropriate for examining appetitive traits in this sample.
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Affiliation(s)
- Phaik Ling Quah
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | | | - Mei Jun Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Anna Fogel
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Keri McCrickerd
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Ai Ting Goh
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore, Singapore.,Divisions of Pediatric Endocrinology and Diabetes, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Wei Wei Pang
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore - National University Health System, Singapore, Singapore
| | - Iccha Basnyat
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Hwee Lin Wee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Fabian Yap
- Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, National Institute for Health Research Southampton Biomedical Research Centre, The University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore - National University Health System, Singapore, Singapore
| | - Lynette P C Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore, Singapore
| | - Kok Hian Tan
- Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Ciaran G Forde
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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19
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Quah PL, Ng JC, Fries LR, Chan MJ, Aris IM, Lee YS, Yap F, Godfrey KM, Chong YS, Shek LP, Tan KH, Forde CG, Chong MFF. Longitudinal Analysis Between Maternal Feeding Practices and Body Mass Index (BMI): A Study in Asian Singaporean Preschoolers. Front Nutr 2019; 6:32. [PMID: 31001535 PMCID: PMC6454195 DOI: 10.3389/fnut.2019.00032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 03/06/2019] [Indexed: 12/13/2022] Open
Abstract
Bidirectional studies between maternal feeding practices with subsequent child weight are limited, with no studies in Asian populations. In longitudinal analyses, we assessed the directionality of the associations between maternal feeding practices and body mass index (BMI) in preschoolers. Participants were 428 mother child dyads from the GUSTO (Growing Up in Singapore Toward healthy Outcomes) cohort. Feeding practices were assessed using the Comprehensive Feeding Practices Questionnaire (CFPQ) at age 5 y. Child BMI was measured at ages 4 and 6 y. BMI and maternal feeding practices subscales were transformed to SD scores and both directions of their associations examined with multivariable linear regression and pathway modeling. Higher BMI at age 4 was associated with lower encouragement of balance and variety (β = −0.33; 95%CI: −0.53, −0.13), lower pressure to eat (β = −0.49; −0.68, −0.29) and higher restriction (β = 1.10; 0.67, 1.52) at age 5, adjusting for confounders and baseline feeding practices at 3 years. In the reverse direction, only pressure and restriction at age 5 were associated with lower and higher child BMI at age 6 years, respectively. After the adjustment for baseline BMI at age 5, the association with pressure was attenuated to non-significance (β = 0.01 (−0.01, 0.03), while the association with restriction remained significant (β = 0.02; 0.002, 0.03). Overall, associations from child BMI to maternal restriction for weight control and pressure feeding practices was stronger than the association from these maternal feeding practices to child BMI (Wald's statistics = 24.3 and 19.5, respectively; p < 0.001). The strength and directionality suggests that the mothers in the Asian population were likely to adopt these feeding practices in response to their child's BMI, rather than the converse. Clinical Trial Registry Number and Website This study was registered at clinicaltrials.gov as NCT01174875 (www.clinicaltrials.gov, NCT01174875).
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Affiliation(s)
- Phaik Ling Quah
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Jing Chun Ng
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Lisa R Fries
- Nestlé Research, Vers-chez-les-Blanc, Lausanne, Switzerland
| | - Mei Jun Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Division of Paediatric Endocrinology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Fabian Yap
- Departments of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore.,Duke-National University of Singapore Graduate Medical School, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital, Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Lynette P Shek
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Divisions of Pediatric Allergy, Immunology, and Rheumatology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Kok Hian Tan
- Duke-National University of Singapore Graduate Medical School, Singapore, Singapore.,Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Ciaran G Forde
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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20
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Quah PL, Syuhada G, Fries LR, Chan MJ, Lim HX, Toh JY, Sugianto R, Aris IM, Lee YS, Yap F, Godfrey KM, Gluckman PD, Chong YS, Shek LP, Tan KH, Forde CG, Chong MFF. Maternal feeding practices in relation to dietary intakes and BMI in 5 year-olds in a multi-ethnic Asian population. PLoS One 2018; 13:e0203045. [PMID: 30226881 PMCID: PMC6143183 DOI: 10.1371/journal.pone.0203045] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 08/14/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In Asia, little is known about how maternal feeding practices are associated with dietary intakes and body mass index (BMI) in preschoolers. OBJECTIVE To assess the relationships between maternal feeding practices with dietary intakes and BMI in preschoolers in Asia using cross-sectional analysis in the GUSTO (Growing Up in Singapore Towards healthy Outcomes) cohort. PARTICIPANT SETTINGS Mothers (n = 511) who completed the Comprehensive Feeding Practices Questionnaire (CFPQ) and a semi-quantitative Food Frequency Questionnaire (FFQ) when children were 5 years old. STATISTICAL ANALYSIS Associations between 12 maternal feeding practices (mean scores divided into tertiles) and children's dietary intakes of seven food groups and BMI z-scores were examined using the general linear regression model. Weight and height of the child were measured, and dietary intakes derived from the FFQ. RESULTS Compared to those in the low tertile, mothers in the high tertile of modelling healthy food intakes had children with higher intakes of vegetables[+20.0g/day (95%CI:11.6,29.5)] and wholegrains[+ 20.9g/day (9.67,31.1)] but lower intakes of sweet snacks[-10.1g/day (-16.3,-4.94)] and fast-foods[-5.84g/day (-10.2,-1.48)]. Conversely, children of mothers in the high tertile for allowing child control (lack of parental control) had lower intake of vegetables[-15.2g/day (-26.6,-5.21)] and wholegrains[-13.6g/day (-22.9,-5.27)], but higher intakes of sweet snacks[+13.7g/day (7.7, 19.8)] and fast-foods[+6.63g/day (3.55,9.72)]. In relation to BMI at 5 years, food restrictions for weight was associated with higher BMI z-scores [0.86SD (0.61,1.21)], while use of pressure was associated with lower BMI z-scores[-0.49SD(-0.78,-0.21)]. CONCLUSIONS AND IMPLICATIONS Modelling healthy food intakes by mothers was the key feeding practice associated with higher intakes of healthy foods and lower intakes of discretionary foods. The converse was true for allowing child control. Only food restrictions for weight and use of pressure were associated with BMI z-scores.
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Affiliation(s)
- Phaik Ling Quah
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Ginanjar Syuhada
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | | | - Mei Jun Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Hui Xian Lim
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Ray Sugianto
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Izzuddin M. Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
| | - Fabian Yap
- Pediatric Endocrinology, KK Women’s and Children’s Hospital, Singapore, Singapore
- Duke-NUS Graduate Medical School, Lee Kong Chian School of Medicine, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital, Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Peter D. Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yap- Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Lynette P. Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Kok Hian Tan
- Department of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Ciaran G. Forde
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mary F. F. Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
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21
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Bernard JY, Tint MT, Aris IM, Chen LW, Quah PL, Tan KH, Yeo GSH, Fortier MV, Yap F, Shek L, Chong YS, Gluckman PD, Godfrey KM, Calder PC, Chong MFF, Kramer MS, Botton J, Lee YS. Maternal plasma phosphatidylcholine polyunsaturated fatty acids during pregnancy and offspring growth and adiposity. Prostaglandins Leukot Essent Fatty Acids 2017; 121:21-29. [PMID: 28651694 PMCID: PMC5501311 DOI: 10.1016/j.plefa.2017.05.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 05/24/2017] [Accepted: 05/30/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Polyunsaturated fatty acids (PUFA) are essential for offspring development, but it is less clear whether pregnancy PUFA status affects growth and adiposity. METHODS In 985 mother-offspring pairs from the ongoing Singaporean GUSTO cohort, we analyzed the associations between offspring growth and adiposity outcomes until age 5 years and five PUFAs of interest, measured in maternal plasma at 26-28 weeks' gestation: linoleic acid (LA), arachidonic acid, α-linolenic acid, eicosapentaenoic acid, and docosahexaenoic acid (DHA). We measured fetal growth by ultrasound (n=924), neonatal body composition (air displacement plethysmography (n=252 at birth, and n=317 at age 10 days), and abdominal magnetic resonance imaging (n=317)), postnatal growth (n=979) and skinfold thicknesses (n=981). Results were presented as regression coefficients for a 5% increase in PUFA levels. RESULTS LA levels were positively associated with birthweight (β (95% CI): 0.04 (0.01, 0.08) kg), body mass index (0.13 (0.02, 0.25) kg/m2), head circumference (0.11 (0.03, 0.19) cm), and neonatal abdominal adipose tissue volume (4.6 (1.3, 7.8) mL for superficial subcutanous tissue, and 1.2 (0.1, 2.4) mL for internal tissue), but not with later outcomes. DHA levels, although not associated with birth outcomes, were related to higher postnatal length/height: 0.63 (0.09, 1.16) cm at 12 months and 1.29 (0.34, 2.24) cm at 5 years. CONCLUSIONS LA was positively associated with neonatal body size, and DHA with child height. Maternal PUFA status during pregnancy may influence fetal and child growth and adiposity.
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Affiliation(s)
- Jonathan Y Bernard
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A⁎STAR), Singapore.
| | - Mya-Thway Tint
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A⁎STAR), Singapore
| | - Ling-Wei Chen
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Phaik Ling Quah
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A⁎STAR), Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - George Seow-Heong Yeo
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - Marielle V Fortier
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore
| | - Fabian Yap
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - Lynette Shek
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A⁎STAR), Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Paediatric Allergy, Immunology & Rheumatology, Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A⁎STAR), Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A⁎STAR), Singapore; Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit; Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Philip C Calder
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A⁎STAR), Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences, Centre for Translational Medicine, Singapore
| | - Michael S Kramer
- Department of Pediatrics and of Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | - Jérémie Botton
- U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Centre (CRESS), Early Origin of the Child's Health and Development (ORCHAD) Team, Inserm, Villejuif, France; Univ Paris Descartes, Villejuif, France; Faculty of Pharmacy, Univ Paris-Sud, Université Paris-Saclay, Châtenay-Malabry, France
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A⁎STAR), Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Paediatric Endocrinology and Diabetes, Khoo Teck Puat, National University Children's Medical Institute, National University Health System, Singapore
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22
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Lai JS, Pang WW, Cai S, Lee YS, Chan JKY, Shek LPC, Yap FKP, Tan KH, Godfrey KM, van Dam RM, Chong YS, Chong MFF. High folate and low vitamin B12 status during pregnancy is associated with gestational diabetes mellitus. Clin Nutr 2017; 37:940-947. [PMID: 28381340 DOI: 10.1016/j.clnu.2017.03.022] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/10/2017] [Accepted: 03/12/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND & AIMS B-vitamins and homocysteine may contribute to the development of gestational diabetes mellitus (GDM), but existing studies are inconsistent. We examined the cross-sectional associations of plasma folate, vitamins B6, B12, and homocysteine concentrations with GDM and glycemia in a sample of multi-ethnic Asian pregnant women. METHODS Plasma concentrations of folate, vitamins B6, B12, homocysteine and glucose were measured at 26-weeks' gestation in 913 pregnant women. GDM was diagnosed using the 1999 World Health Organization criteria. Associations were examined with linear or logistic regression, adjusted for confounders and stratified by ethnicity. RESULTS Higher plasma folate was associated with higher 2-h glucose and higher odds of GDM [0.15 (0.02, 0.23) per 1-SD increment in folate, OR 1.29 (1.00, 1.60)], mainly among Indian mothers. Higher plasma vitamin B12 and homocysteine were associated with lower fasting and 2-h glucose, and lower odds of GDM [-0.04 (-0.07, -0.01) per 1-SD increment in B12 and -0.09 (-0.18, -0.003) respectively, OR: 0.81 (0.68, 0.97); -0.05 (-0.08, -0.02) per 1-SD increment in homocysteine and -0.12 (-0.21, -0.02) respectively, OR: 0.76 (0.62, 0.92)]. The highest odds of GDM were observed among women with combined vitamin B12 insufficiency and high folate concentration [OR: 1.97 (1.05, 3.68)]. An association between higher vitamin B6 and higher 2-h glucose shifted towards null adjusting for other B-vitamins. CONCLUSIONS Higher maternal folate coupled with vitamin B12 insufficiency was associated with higher GDM risk. This finding has potential implications for antenatal supplement recommendations but will require confirmation in future studies.
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Affiliation(s)
- Jun S Lai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Wei Wei Pang
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Shirong Cai
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Jerry K Y Chan
- Duke-NUS Medical School, Singapore; Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore
| | - Lynette P C Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Fabian K P Yap
- Duke-NUS Medical School, Singapore; Department of Paediatric Endocrinology, KK Women's and Children's Hospital, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
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de Seymour J, Chia A, Colega M, Jones B, McKenzie E, Shirong C, Godfrey K, Kwek K, Saw SM, Conlon C, Chong YS, Baker P, Chong MFF. Maternal Dietary Patterns and Gestational Diabetes Mellitus in a Multi-Ethnic Asian Cohort: The GUSTO Study. Nutrients 2016; 8:nu8090574. [PMID: 27657116 PMCID: PMC5037559 DOI: 10.3390/nu8090574] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 09/08/2016] [Accepted: 09/13/2016] [Indexed: 11/16/2022] Open
Abstract
Gestational Diabetes Mellitus (GDM) is associated with an increased risk of perinatal morbidity and long term health issues for both the mother and offspring. Previous research has demonstrated associations between maternal diet and GDM development, but evidence in Asian populations is limited. The objective of our study was to examine the cross-sectional relationship between maternal dietary patterns during pregnancy and the risk of GDM in a multi-ethnic Asian cohort. Maternal diet was ascertained using 24-h dietary recalls from participants in the Growing up in Singapore towards healthy outcomes (GUSTO) study—a prospective mother-offspring cohort, and GDM was diagnosed according to 1999 World Health Organisation guidelines. Dietary patterns were identified using factor analysis, and multivariate regression analyses performed to assess the association with GDM. Of 909 participants, 17.6% were diagnosed with GDM. Three dietary patterns were identified: a vegetable-fruit-rice-based-diet, a seafood-noodle-based-diet and a pasta-cheese-processed-meat-diet. After adjusting for confounding variables, the seafood-noodle-based-diet was associated with a lower likelihood of GDM (Odds Ratio (95% Confidence Interval)) = 0.74 (0.59, 0.93). The dietary pattern found to be associated with GDM in our study was substantially different to those reported previously in Western populations.
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Affiliation(s)
- Jamie de Seymour
- Liggins Institute, The University of Auckland, Auckland 1023, New Zealand.
| | - Airu Chia
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Marjorelee Colega
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117609, Singapore.
| | - Beatrix Jones
- Institute of Natural and Mathematical Sciences, Massey University, Auckland 0632, New Zealand.
| | - Elizabeth McKenzie
- Liggins Institute, The University of Auckland, Auckland 1023, New Zealand.
| | - Cai Shirong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Keith Godfrey
- Medical Research Council Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
| | - Kenneth Kwek
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore 229899, Singapore.
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore.
| | - Cathryn Conlon
- School of Food and Nutrition, Massey University, Auckland 0632, New Zealand.
| | - Yap-Seng Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117609, Singapore.
| | - Philip Baker
- Liggins Institute, The University of Auckland, Auckland 1023, New Zealand.
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117609, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore.
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, Singapore 117609, Singapore.
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24
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Ross AB, Colega MT, Lim AL, Silva-Zolezzi I, Macé K, Saw SM, Kwek K, Gluckman P, Godfrey KM, Chong YS, Chong MFF. Whole grain intake, determined by dietary records and plasma alkylresorcinol concentrations, is low among pregnant women in Singapore. Asia Pac J Clin Nutr 2016; 24:674-82. [PMID: 26693753 DOI: 10.6133/apjcn.2015.24.4.19] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES To quantify whole grain intake in pregnant women in Singapore in order to provide the first detailed analysis of whole grain intake in an Asian country and in pregnant women. METHODS AND STUDY DESIGN Analysis of 24-h diet recalls in a cross-sectional cohort study and analysis of a biomarker of whole grain intake (plasma alkylresorcinols) in a subset of subjects. The Growing Up in Singapore Towards healthy Outcomes-mother offspring cohort study based in Singapore. 998 pregnant mothers with complete 24-h recalls taken during their 26-28th week of gestation. Plasma samples from a randomly select subset of 100 subjects were analysed for plasma alkylresorcinols. RESULTS Median (IQR) whole grain intake for the cohort and the 30% who reported eating whole grains were 0 (IQR 0, 9) and 23.6 (IQR 14.6, 44.2) g/day respectively. Plasma alkylresorcinol concentrations were very low [median (IQR)=9 (3, 15) nmol/L], suggesting low intake of whole grain wheat in this population. Plasma alkylresorcinols were correlated with whole grain wheat intake (Spearman's r=0.35; p<0.01). CONCLUSIONS Whole grain intake among pregnant mothers in Singapore was well below the 2-3 (60-95 g) servings of whole grains per day recommended by the Singapore Health Promotion Board. Efforts to increase whole grain intake should be supported to encourage people to choose whole grains over refined grains in their diet.
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Affiliation(s)
- Alastair B Ross
- Food and Nutritional Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden. .,Nestlé Research Centre, Vers chez les Blanc, Lausanne, Switzerland
| | - Marjorelee T Colega
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Ai Lin Lim
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | | | - Katherine Macé
- Nestlé Research Centre, Vers chez les Blanc, Lausanne, Switzerland
| | - Seang Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | | | - Peter Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore.,Liggins Institute, Auckland, New Zealand
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, UK
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore.,Clinical Nutrition Research Centre, SICS, A*STAR, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
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25
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Chong MFF, Ong YL, Calder PC, Colega M, Wong JXY, Tan CS, Lim AL, Fisk HL, Cai S, Pang WW, Broekman BFP, Saw SM, Kwek K, Godfrey KM, Chong YS, Gluckman P, Meaney MJ, Chen H. Long-chain polyunsaturated fatty acid status during pregnancy and maternal mental health in pregnancy and the postpartum period: results from the GUSTO study. J Clin Psychiatry 2015; 76:e848-56. [PMID: 26231011 DOI: 10.4088/jcp.14m09191] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 11/03/2014] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Studies have demonstrated a relationship between lower omega-3 long-chain polyunsaturated fatty acid (LC-PUFA) status and anxiety and depression. It is uncertain whether similar associations occur in pregnant women, when anxiety and depression could have long-term effects on the offspring. We examined the associations between plasma LC-PUFA status during pregnancy and perinatal mental health. METHOD At 26-28 weeks' gestation, plasma LC-PUFAs were measured in mothers of the Growing Up in Singapore Toward healthy Outcomes (GUSTO) mother-offspring cohort study, who were recruited between June 2009 and September 2010. Maternal symptoms of anxiety and depression were assessed with the State-Trait Anxiety Inventory (STAI) and Edinburgh Postnatal Depression Scale (EPDS) during the same period and at 3 months' postpartum. The STAI-state subscale was used as a continuous measure of current anxiety, while EPDS scores ≥ 15 during pregnancy or ≥ 13 postpartum were indicative of symptoms of probable depression. RESULTS In adjusted regression analyses (n = 698), lower plasma total omega-3 PUFA concentrations (β = -6.49 STAI-state subscale scores/unit increase of omega-3 fatty acid; 95% CI, -11.90 to -1.08) and higher plasma omega-6:omega-3 PUFA ratios (β = 6.58 scores/unit increase of fatty acid ratio; 95% CI, 1.19 to 12.66), specifically higher arachidonic acid (AA):docosahexaenoic acid, AA:eicosapentaenoic acid, and AA:docosapentaenoic acid ratios, were associated with increased antenatal anxiety (P < .05 for all), but not postpartum anxiety. There was no association between plasma PUFAs and perinatal probable depression. CONCLUSIONS No association was found with probable depression in pregnancy or postpartum. Lower plasma omega-3 fatty acids and higher omega-6:omega-3 fatty acid ratios were associated with higher antenatal anxiety, but not postpartum anxiety. Replication in other studies is needed to confirm the findings and determine the direction of causality. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01174875.
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Affiliation(s)
- Mary F F Chong
- Singapore Institute for Clinical Sciences, Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore 117609
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26
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Chong MFF, Wong JXY, Colega M, Chen LW, van Dam RM, Tan CS, Lim AL, Cai S, Broekman BFP, Lee YS, Saw SM, Kwek K, Godfrey KM, Chong YS, Gluckman P, Meaney MJ, Chen H. Relationships of maternal folate and vitamin B12 status during pregnancy with perinatal depression: The GUSTO study. J Psychiatr Res 2014; 55:110-6. [PMID: 24774647 DOI: 10.1016/j.jpsychires.2014.04.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 04/02/2014] [Accepted: 04/04/2014] [Indexed: 11/18/2022]
Abstract
UNLABELLED Studies in the general population have proposed links between nutrition and depression, but less is known about the perinatal period. Depletion of nutrient reserves throughout pregnancy and delayed postpartum repletion could increase the risk of perinatal depression. We examined the relationships of plasma folate and vitamin B12 concentrations during pregnancy with perinatal depression. At 26th-28th weeks of gestation, plasma folate and vitamin B12 were measured in women from the GUSTO mother-offspring cohort study in Singapore. Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS) during the same period and at 3-month postpartum. EPDS scores of ≥15 during pregnancy or ≥13 at postpartum were indicative of probable depression. Of 709 women, 7.2% (n = 51) were identified with probable antenatal depression and 10.4% (n = 74) with probable postnatal depression. Plasma folate concentrations were significantly lower in those with probable antenatal depression than those without (mean ± SD; 27.3 ± 13.8 vs 40.4 ± 36.5 nmol/L; p = 0.011). No difference in folate concentrations was observed in those with and without probable postnatal depression. In adjusted regression models, the likelihood of probable antenatal depression decreases by 0.69 for every unit variation (increase) in folate (OR = 0.69 per SD increase in folate; 95% CI: 0.52, 0.94). Plasma vitamin B12 concentrations were not associated with perinatal depression. Lower plasma folate status during pregnancy was associated with antenatal depression, but not with postnatal depression. Replication in other studies is needed to determine the direction of causality between low folate and antenatal depression. CLINICAL TRIAL REGISTRY NCT01174875.
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Affiliation(s)
- Mary F F Chong
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, Singapore; Singapore Institute for Clinical Sciences, A*STAR, Singapore; Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
| | | | | | - Ling-Wei Chen
- Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Ai Lin Lim
- Singapore Institute for Clinical Sciences, A*STAR, Singapore
| | - Shirong Cai
- Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Yung Seng Lee
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, Singapore; Singapore Institute for Clinical Sciences, A*STAR, Singapore; Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Seang Mei Saw
- Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Kenneth Kwek
- KK Women's and Children's Hospital, Singapore; McGill University, Montreal, Canada
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton; University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Peter Gluckman
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, Singapore; Singapore Institute for Clinical Sciences, A*STAR, Singapore; Liggins Institute, Auckland, New Zealand
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; McGill University, Montreal, Canada
| | - Helen Chen
- KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore, Singapore
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27
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Teh AL, Pan H, Chen L, Ong ML, Dogra S, Wong J, MacIsaac JL, Mah SM, McEwen LM, Saw SM, Godfrey KM, Chong YS, Kwek K, Kwoh CK, Soh SE, Chong MFF, Barton S, Karnani N, Cheong CY, Buschdorf JP, Stünkel W, Kobor MS, Meaney MJ, Gluckman PD, Holbrook JD. The effect of genotype and in utero environment on interindividual variation in neonate DNA methylomes. Genome Res 2014; 24:1064-74. [PMID: 24709820 PMCID: PMC4079963 DOI: 10.1101/gr.171439.113] [Citation(s) in RCA: 224] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Integrating the genotype with epigenetic marks holds the promise of better understanding the biology that underlies the complex interactions of inherited and environmental components that define the developmental origins of a range of disorders. The quality of the in utero environment significantly influences health over the lifecourse. Epigenetics, and in particular DNA methylation marks, have been postulated as a mechanism for the enduring effects of the prenatal environment. Accordingly, neonate methylomes contain molecular memory of the individual in utero experience. However, interindividual variation in methylation can also be a consequence of DNA sequence polymorphisms that result in methylation quantitative trait loci (methQTLs) and, potentially, the interaction between fixed genetic variation and environmental influences. We surveyed the genotypes and DNA methylomes of 237 neonates and found 1423 punctuate regions of the methylome that were highly variable across individuals, termed variably methylated regions (VMRs), against a backdrop of homogeneity. MethQTLs were readily detected in neonatal methylomes, and genotype alone best explained ∼25% of the VMRs. We found that the best explanation for 75% of VMRs was the interaction of genotype with different in utero environments, including maternal smoking, maternal depression, maternal BMI, infant birth weight, gestational age, and birth order. Our study sheds new light on the complex relationship between biological inheritance as represented by genotype and individual prenatal experience and suggests the importance of considering both fixed genetic variation and environmental factors in interpreting epigenetic variation.
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Affiliation(s)
- Ai Ling Teh
- Singapore Institute of Clinical Sciences (SICS), A*STAR, Brenner Centre for Molecular Medicine, Singapore 117609
| | - Hong Pan
- Singapore Institute of Clinical Sciences (SICS), A*STAR, Brenner Centre for Molecular Medicine, Singapore 117609; School of Computer Engineering, Nanyang Technological University (NTU), Singapore 639798
| | - Li Chen
- Singapore Institute of Clinical Sciences (SICS), A*STAR, Brenner Centre for Molecular Medicine, Singapore 117609
| | - Mei-Lyn Ong
- Singapore Institute of Clinical Sciences (SICS), A*STAR, Brenner Centre for Molecular Medicine, Singapore 117609
| | - Shaillay Dogra
- Singapore Institute of Clinical Sciences (SICS), A*STAR, Brenner Centre for Molecular Medicine, Singapore 117609
| | - Johnny Wong
- Singapore Institute of Clinical Sciences (SICS), A*STAR, Brenner Centre for Molecular Medicine, Singapore 117609
| | - Julia L MacIsaac
- Centre for Molecular Medicine and Therapeutics, Child and Family Research Institute, Department of Medical Genetics, University of British Columbia, Vancouver, BC V5Z 4H4 Canada
| | - Sarah M Mah
- Centre for Molecular Medicine and Therapeutics, Child and Family Research Institute, Department of Medical Genetics, University of British Columbia, Vancouver, BC V5Z 4H4 Canada
| | - Lisa M McEwen
- Centre for Molecular Medicine and Therapeutics, Child and Family Research Institute, Department of Medical Genetics, University of British Columbia, Vancouver, BC V5Z 4H4 Canada
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, NUS, Singapore 117597
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, United Kingdom
| | - Yap-Seng Chong
- Singapore Institute of Clinical Sciences (SICS), A*STAR, Brenner Centre for Molecular Medicine, Singapore 117609; Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore 119228
| | - Kenneth Kwek
- KK Women's and Children's Hospital, Singapore 229899
| | - Chee-Keong Kwoh
- School of Computer Engineering, Nanyang Technological University (NTU), Singapore 639798
| | - Shu-E Soh
- Saw Swee Hock School of Public Health, NUS, Singapore 117597; Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore 119228
| | - Mary F F Chong
- Singapore Institute of Clinical Sciences (SICS), A*STAR, Brenner Centre for Molecular Medicine, Singapore 117609; Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore 119228
| | - Sheila Barton
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, United Kingdom
| | - Neerja Karnani
- Singapore Institute of Clinical Sciences (SICS), A*STAR, Brenner Centre for Molecular Medicine, Singapore 117609
| | - Clara Y Cheong
- Singapore Institute of Clinical Sciences (SICS), A*STAR, Brenner Centre for Molecular Medicine, Singapore 117609
| | - Jan Paul Buschdorf
- Singapore Institute of Clinical Sciences (SICS), A*STAR, Brenner Centre for Molecular Medicine, Singapore 117609
| | - Walter Stünkel
- Singapore Institute of Clinical Sciences (SICS), A*STAR, Brenner Centre for Molecular Medicine, Singapore 117609
| | - Michael S Kobor
- Centre for Molecular Medicine and Therapeutics, Child and Family Research Institute, Department of Medical Genetics, University of British Columbia, Vancouver, BC V5Z 4H4 Canada
| | - Michael J Meaney
- Singapore Institute of Clinical Sciences (SICS), A*STAR, Brenner Centre for Molecular Medicine, Singapore 117609; Ludmer Centre for Neuroinformatics and Mental Health, Douglas University Mental Health Institute, McGill University, Montreal, (Quebec) H4H 1R3 Canada
| | - Peter D Gluckman
- Singapore Institute of Clinical Sciences (SICS), A*STAR, Brenner Centre for Molecular Medicine, Singapore 117609; Centre for Human Evolution, Adaptation and Disease, Liggins Institute, University of Auckland, Auckland 1142, New Zealand
| | - Joanna D Holbrook
- Singapore Institute of Clinical Sciences (SICS), A*STAR, Brenner Centre for Molecular Medicine, Singapore 117609
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28
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Abstract
The elevation of blood lipid concentrations in response to the consumption of low-fat high-carbohydrate diets is known as carbohydrate-induced hypertriacylglycerolaemia (HPTG). An understanding of the mechanisms involved in the interaction between carbohydrates and plasma lipids may help determine whether carbohydrate-induced HPTG would increase cardiovascular risk. There is growing evidence to suggest that the sugar component of the diet may be largely responsible, rather than the total carbohydrate. In most studies designed to investigate the mechanisms of carbohydrate-induced HPTG, the amounts and types of sugars and starches used in the diets are not specified. Findings have been mixed and inconsistent. It is proposed that the elucidation of mechanisms from current studies could have been confounded by the different ways in which sugars are metabolized in the body. At present, there are few studies that have evaluated the independent effects of dietary sugars. Interest has been focused onde novolipogenesis (DNL), as it has recently been found to be positively correlated with increases in fasting TAG levels produced on high-carbohydrate diets, indicating that DNL may contribute to carbohydrate-induced HPTG. DNL has been found to be determined by starch:sugar in a high-carbohydrate diet and affected by different types of sugars. The presence of DNL in adipose tissue is supported by emerging gene-expression studies in human subjects. In the wake of rising intakes of sugars, further research is needed to investigate the mechanisms associated with different sugars, so that appropriate therapeutic strategies can be adopted.
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Affiliation(s)
- Mary F F Chong
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford OX3 7LJ, UK.
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