Preconception Micronutrient Supplementation Affects Maternal BMI and Body Composition Postpartum: A Randomized Controlled Trial in Vietnam

BACKGROUND

Although there is growing evidence on the role of preconception nutrition for birth outcomes, limited evidence exists for its effects on maternal health.

OBJECTIVES

This study evaluates the impact of preconception micronutrient supplementation on maternal BMI (kg/m2) and body composition at 6 to 7 y postpartum (PP).

METHODS

We followed females who participated in a randomized controlled trial of preconception supplementation in Vietnam and delivered live offspring (n = 1599). Females received weekly supplements containing either 2800 μg folic acid (FA) only, 60 mg iron and 2800 μg FA (IFA), or multiple micronutrients (MMs) (15 micronutrients including IFA) from baseline until conception followed by daily prenatal IFA supplements until delivery. Height, weight, mid-upper arm circumference, triceps skinfold, and waist-hip circumference were measured at recruitment and at 1, 2, and 6 to 7 y PP. Body fat was assessed using bioelectric impedance at 6 to 7 y PP (n = 867). Group comparisons were made using analysis of variance or chi-square tests and general linear models for adjusted models.

RESULTS

At 6 to 7 y PP, we found significant differences (P < 0.05) by treatment group for mean percent fat (MM: 29.2%; IFA: 27.6%; FA: 27.8%), absolute fat mass (MM: 15.1 kg; IFA: 14.0 kg; FA: 14.3 kg), and prevalence of underweight based on BMI < 18.5 (MM: 5.8%; IFA: 10.3%; FA: 14.3%). Mean BMI and triceps skinfold thickness were higher in the MM group, but these differences were not statistically significant; the differences in absolute fat mass were also attenuated after controlling for body weight. No differences were observed for fat-free mass, prevalence of overweight (BMI >23), or other anthropometric measurements.

CONCLUSIONS

Preconception MM supplementation was associated with lower prevalence of underweight and higher percent fat when compared with IFA and/or FA only. Preconception micronutrient interventions may have long-term effects on maternal health and merit further examination. This trial was registered at clinicaltrials.gov as NCT01665378.

Prevalence of Diabetes and Prediabetes among Children Aged 11-14 Years Old in Vietnam

AIM

Diabetes in children is becoming more prevalent in some countries. However, in most countries, little is known about the epidemiology of this disease. This study is aimed at estimating the prevalence of type 1 and type 2 diabetes and prediabetes among children in Vietnam and examining factors associated with the conditions.

METHODS

A total of 2880 students aged 11-14 years old were recruited for the survey, using a school-based and nationally representative sampling frame. Capillary blood samples of participants were collected to measure fasting glucose level, using glucose meter OneTouch Verio Pro+. Diabetes and impaired fasting plasma glucose were initially diagnosed based on the cut-off points of the American Diabetes Association criteria. Diabetes status and type of diabetes of participants were confirmed at a hospital. Additionally, anthropometric and blood pressure measurements were conducted following a standardized procedure. Multivariate logistic regression was used to examine the association between outcome and independent variables.

RESULTS

The overall prevalence of diabetes among the participants was 1.04‰ (three cases), with 2 cases (0.75‰) diagnosed with type 1 diabetes (one known and one newly diagnosed) and 1 case newly diagnosed with type 2 diabetes (0.35‰). The prevalence of impaired fasting glucose was 6.1%. Body mass index, place of residence, and age were found to be significantly associated with the impaired fasting glucose condition in participants.

CONCLUSION

The prevalence of type 1 and type 2 diabetes in children in Vietnam is lower than that in some other countries reported recently. However, there is a high prevalence in impaired fasting glucose, requiring attention from policymakers to take action to prevent the occurrence of the epidemic of type 2 diabetes in children in the future.