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Chouli M, Bothou A, Kyrkou G, Kaliarnta S, Dimitrakopoulou A, Diamanti A. An updated review of popular dietary patterns during pregnancy and lactation: Trends, benefits, and challenges. Metabol Open 2025; 25:100353. [PMID: 40034803 PMCID: PMC11874815 DOI: 10.1016/j.metop.2025.100353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2024] [Revised: 01/29/2025] [Accepted: 01/31/2025] [Indexed: 03/05/2025] Open
Abstract
This review examines nutritional needs during pregnancy and lactation, focusing on the critical nutrients required for both maternal and fetal health. Essential nutrients such as folic acid, vitamin D, iron, calcium, and omega-3 fatty acids play a significant role in supporting fetal development and minimizing the risk of complications like gestational diabetes, hypertension, and preterm birth. Various dietary patterns, including the Mediterranean, vegetarian/vegan, and gluten-free diets, were evaluated for their adequacy and potential benefits. The Mediterranean diet was highlighted for its protective effects against pregnancy-related health issues. In contrast, the review identified vegetarian and vegan diets as requiring careful planning to ensure sufficient intake of key nutrients. Additionally, the review explored the implications of gestational diabetes and dietary strategies for managing blood sugar levels. The effects of intermittent fasting during pregnancy were also discussed, with mixed evidence regarding its safety and impact on pregnancy outcomes. Overall, the review stresses the importance of tailored nutritional guidance to ensure optimal health for both the mother and the developing fetus during pregnancy and lactation.
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Affiliation(s)
- Maria Chouli
- Department of Midwifery, Faculty of Health and Caring Sciences, University of West Attica, Egaleo, Greece
| | - Anastasia Bothou
- Department of Midwifery, Faculty of Health and Caring Sciences, University of West Attica, Egaleo, Greece
| | - Giannoula Kyrkou
- Department of Midwifery, Faculty of Health and Caring Sciences, University of West Attica, Egaleo, Greece
| | | | - Aikaterini Dimitrakopoulou
- Department of Midwifery, Faculty of Health and Caring Sciences, University of West Attica, Egaleo, Greece
| | - Athina Diamanti
- Department of Midwifery, Faculty of Health and Caring Sciences, University of West Attica, Egaleo, Greece
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Hou HL, Sun GX. Associations between food insecurity with gestational diabetes mellitus and maternal outcomes mediated by dietary diversity: A cross-sectional study. World J Diabetes 2025; 16:95463. [PMID: 39959276 PMCID: PMC11718469 DOI: 10.4239/wjd.v16.i2.95463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 09/10/2024] [Accepted: 10/22/2024] [Indexed: 12/30/2024] Open
Abstract
BACKGROUND Food insecurity (FI) during pregnancy negatively impacts maternal health and raises the risk of gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH), resulting in adverse outcomes for both mother and baby. AIM To investigate the relationships between FI and pregnancy outcomes, particularly GDM and PIH, while also examining the mediating role of the dietary diversity score (DDS). METHODS A cross-sectional study was undertaken to examine this relationship, involving 600 pregnant women. Participants were women aged 18 years or older who provided complete data on FI and pregnancy outcomes. The FI was measured via the Household Food Security Survey Module, with GDM defined as fasting plasma glucose levels of ≥ 5.1 mmol/L or a 2-hour oral glucose tolerance test value of ≥ 8.5 mmol/L. The DDS is determined by evaluating one's food consumption based on nine distinct food groups. A logistic regression model was used to explore the relationship between FI and PIH, and GDM. RESULTS Seventeen percent of participants reported experiencing FI during pregnancy. The study found a significant association between FI and an elevated risk of GDM [odds ratio (OR) = 3.32, 95%CI: 1.2-5.4]. Once more, food-insecure pregnant women had higher rates of PIH (OR = 0.10, 95%CI: 0.02-0.45) and they also faced a higher likelihood of neonatal complications, such as neonatal intensive care unit's admissions and the birth of infants with extremely low birth weight. The FI was further linked to metabolic disruptions, such as elevated fasting blood sugar (FBS), low-density lipoprotein cholesterol, and triglyceride levels. Our results indicate that the DDS acts as a significant mediator in the relationship between FI and the incidence of GDM. In particular, the mediation analysis showed that approximately 65% of the effect was mediated through DDS (P = 0.002). CONCLUSION These findings underscore the serious challenges that FI presents during pregnancy and its effects on maternal and infant health. Additionally, the study explored how DDS mediates the relationship between FI and the incidence of GDM.
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Affiliation(s)
- Hong-Li Hou
- Department of Gynecology and Obstetrics, Children’s Hospital of Shanxi, Women Health Center of Shanxi, Taiyuan 030001, Shanxi Province, China
| | - Gui-Xia Sun
- Department of Gynecology and Obstetrics, Children’s Hospital of Shanxi, Women Health Center of Shanxi, Taiyuan 030001, Shanxi Province, China
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Cull ME, Winn LM. Bisphenol A and its potential mechanism of action for reproductive toxicity. Toxicology 2025; 511:154040. [PMID: 39725262 DOI: 10.1016/j.tox.2024.154040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2024] [Revised: 12/16/2024] [Accepted: 12/23/2024] [Indexed: 12/28/2024]
Abstract
Bisphenol A (BPA) is an organic synthetic chemical used worldwide. Billions of pounds of BPA are produced annually through industrial processes to be used in commercial products, making human exposure to BPA ubiquitous. Concerns have been raised due to the potential adverse health effects of BPA, specifically in vulnerable populations, such as pregnant persons and children. BPA is an endocrine-disrupting chemical, and through this function has been linked to reproductive toxicity. We review BPA's historical and current use, health and safety concerns and regulations, sources of exposure, and evidence for male and female reproductive toxicity. Evidence from epidemiological and animal studies idenfity that low- and high-exposure levels of BPA (prenatal, postnatal and adulthood exposure) can adversely affect male and female fertility and reproductive organs. While the cause of BPA-induced reproductive toxicity is not fully understood, we discuss BPA's estrogenic and androgenic activity, and its ability to disrupt the hypothalamic-pituitary-gonadal axis as a potential associated mechanism. There are significant differences in tolerable daily intakes of BPA set by global agencies, making interpretation of previous and emerging research findings challenging and inconsistent. Although BPA is deemed toxic by some government agencies, most do not currently consider it a health risk due to low populational exposure levels. However, we highlight evidence that even at acute, low exposure, BPA can adversely affect reproductive function. We recommend continuing research into the adverse effects of BPA on human health and revisiting the regulatory measures of BPA to limit exposure and promote public awareness of its potential to cause reproductive toxicity.
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Affiliation(s)
- Megan E Cull
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada
| | - Louise M Winn
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada; School of Environmental Studies, Queen's University, Kingston, Canada.
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Wang R, Xu S, Hao X, Jin X, Pan D, Xia H, Liao W, Yang L, Wang S. Anemia during pregnancy and adverse pregnancy outcomes: a systematic review and meta-analysis of cohort studies. Front Glob Womens Health 2025; 6:1502585. [PMID: 39959784 PMCID: PMC11825799 DOI: 10.3389/fgwh.2025.1502585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2024] [Accepted: 01/10/2025] [Indexed: 02/18/2025] Open
Abstract
Objectives Anemia in pregnancy has been a topic of interest for researchers due to its potential impact on various adverse pregnancy outcomes. This study aims to explore the relationship between anemia and adverse pregnancy outcomes such as preterm birth, low birth weight, and maternal mortality. Methods We conducted both a systematic review and a meta-analysis on the associations between anemia during pregnancy and adverse pregnancy outcomes. We searched Chinese databases (CNKI, Wanfang, CBM, VIP) and English ones (Cochrane Library, PubMed, Embase, Web of Science). Two researcher-authors independently assessed study quality with the Newcastle-Ottawa Scale. After extracting data, we analyzed heterogeneity and used a random-effects model for higher heterogeneity and a fixed-effects model for low heterogeneity in the meta-analysis while also systematically synthesizing and narratively describing findings in the systematic review. Results A total of 31 cohort studies were included. Meta-analysis showed that the risk of postpartum hemorrhage [RR [95% CI], 2.76 [1.63, 4.66]], premature rupture of membranes (PROM) [1.94 (1.26, 3.00)], preterm delivery [1.51 (1.33, 1.72)], low birth weight (LBW) [1.40 (1.19, 1.63)], cesarean section[1.33 (1.02, 1.74)], gestational hypertension[1.28 (1.14, 1.44)] and neonatal asphyxia[1.21 (1.07, 1.37)] was higher in the group of anemia in pregnancy than in the control group. Conclusion Maternal anemia is associated with an increased risk of seven adverse pregnancy outcomes: postpartum hemorrhage, PROM, preterm delivery, LBW, cesarean section, gestational hypertension and neonatal asphyxia. Appropriate nutritional supplementation and screening for anemia before and during pregnancy are recommended to improve maternal health and manage adverse pregnancy outcomes.
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Affiliation(s)
- Rui Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Shan Xu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Xiaoyu Hao
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Xingyi Jin
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Da Pan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Hui Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Wang Liao
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Ligang Yang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Shaokang Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
- Clinical Medical Research Center for Plateau Gastroenterological Disease of Xizang Autonomous Region, and School of Medicine, Xizang Minzu University, Xianyang, China
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Anderson CE, Whaley SE. Household WIC Benefit Redemption Varies by Participant and Household Characteristics in Southern California. J Acad Nutr Diet 2025:S2212-2672(25)00035-8. [PMID: 39880286 DOI: 10.1016/j.jand.2025.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 01/13/2025] [Accepted: 01/22/2025] [Indexed: 01/31/2025]
Abstract
BACKGROUND The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides benefits redeemable for select healthy foods, aligned with the 2020-2025 Dietary Guidelines for Americans, to support healthy diets among pregnant and postpartum women, and their children to age 5 years, living in low-income households. WIC benefits are often not fully redeemed, limiting nutritional benefits of participation. OBJECTIVE The objective of this study was to assess the associations of WIC participant, caregiver, and household characteristics with WIC food benefit redemption. DESIGN This was a longitudinal study using WIC administrative data. PARTICIPANTS/SETTING WIC participants served by a program in Southern California from November 2019 to June 2023 (n = 501 527 certification periods; n = 271 116 individuals) were included in this study. MAIN OUTCOME MEASURES Mean WIC benefit redemption percentage in certification periods in benefit categories (ie, cheese/tofu, eggs, breakfast cereal, legumes, canned fish, fruits and vegetables, infant foods [cereal, fruits and vegetables, meats, contract and therapeutic formula], whole grains/bread, yogurt, whole and reduced-fat milk, and 100% juice) and across all categories, continuous and interval-scaled in 10% increments was measured. STATISTICAL ANALYSIS Multivariable quantile regression and generalized estimating equation ordinal logistic regression models were used to assess associations of WIC participant, caregiver, and household characteristics with median and interval-scaled redemption percentage, respectively, in each and across all categories. RESULTS Redemption ranged from very low (infant meats, 5.4%) to very high (infant formula, 96.2%). Median redemption across all categories was 70.6%. Significantly lower redemption was observed for households of Black, White, and other race/ethnicity-language preference individuals (compared with households of Hispanic English-speaking individuals); households with caregivers with lower educational attainment; and households with at least 1 month without food benefits issued, participating in the Supplemental Nutrition Assistance Program, income <100% of the federal poverty level, ≤5 individuals, or only 1 WIC participant. CONCLUSIONS WIC benefits are used at different rates by WIC participant, caregiver, and household characteristics. Groups with lower redemption may need additional support in using benefits. Maximizing redemption might help all WIC participants derive the full positive nutritional impact of program participation.
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Affiliation(s)
- Christopher E Anderson
- Division of Research and Evaluation, Public Health Foundation Enterprises WIC, City of Industry, California.
| | - Shannon E Whaley
- Division of Research and Evaluation, Public Health Foundation Enterprises WIC, City of Industry, California
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van Lonkhuijzen RM, de Vries JHM, Brouwer-Brolsma E, Cremers S, Faessen JPM, Feskens EJM, Wagemakers A. An empowerment programme to improve diet quality during pregnancy - the Power 4 a Healthy Pregnancy cluster randomised controlled trial. BMC Public Health 2025; 25:338. [PMID: 39871233 PMCID: PMC11771105 DOI: 10.1186/s12889-025-21344-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Accepted: 01/06/2025] [Indexed: 01/29/2025] Open
Abstract
BACKGROUND A healthy diet during pregnancy is vital for the well-being of both mothers and babies. However, navigating dietary choices amidst the unique psychological and physiological changes of pregnancy can be challenging. Empowerment, defined as the ability to improve capacities, critically analyse situations, and take actions to improve them, can support pregnant women to make healthier choices. This intervention study assessed the effects of the 'Power 4 a Healthy Pregnancy' (P4HP) programme on diet quality and empowerment. METHODS In a nonblinded, two-arm, parallel cluster randomised controlled trial, the P4HP programme was implemented in 16 randomly allocated Dutch midwifery practices, recruiting 342 participants. Participants were assigned to either the intervention (n = 186) or the control group (n = 156). The P4HP programme offered four additional consultations during pregnancy to discuss nutrition with both a midwife and dietitian, using an empowerment approach. The effectiveness of the P4HP programme was evaluated using pre- and post-intervention questionnaires assessing diet quality, empowerment, quality of life, sense of coherence, and self-rated health. The data were analysed using linear mixed models with an intention-to-treat approach. RESULTS The P4HP programme was conducted from approximately week 11 to week 34 of pregnancy. The total diet quality score significantly improved during pregnancy in the intervention group compared to the control group (4.28; 95% CI: 7.87 to 0.70; p = 0.019), particularly driven by improvements in the scores for vitamin D, iodine, and fish. Although other components, including fruit, whole-grain foods, nuts, dairy foods, iodine, and fish showed greater average increases in diet quality scores within the intervention group, these differences were not significant. Women across all empowerment levels expressed uncertainty regarding their weight gain during pregnancy. CONCLUSION The P4HP programme positively influenced the dietary habits of pregnant women through empowerment. The observed improvement in diet quality underscores the potential of the P4HP programme as an effective intervention during pregnancy. This study lays the foundation for future empowerment-based interventions in maternal health contexts. TRIAL REGISTRATION International Clinical Trial Registry Platform NL-OMON23191, date of registration: 19/05/2021.
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Affiliation(s)
- Renske M van Lonkhuijzen
- Health and Society, Department of Social Sciences, Wageningen University & Research, Hollandseweg 1, Wageningen, 6706KN, The Netherlands.
- Division of Human Nutrition & Health, Wageningen University & Research, Stippeneng 4, Wageningen, 6708WE, The Netherlands.
| | - Jeanne H M de Vries
- Division of Human Nutrition & Health, Wageningen University & Research, Stippeneng 4, Wageningen, 6708WE, The Netherlands
| | - Elske Brouwer-Brolsma
- Division of Human Nutrition & Health, Wageningen University & Research, Stippeneng 4, Wageningen, 6708WE, The Netherlands
| | | | - Janine P M Faessen
- Division of Human Nutrition & Health, Wageningen University & Research, Stippeneng 4, Wageningen, 6708WE, The Netherlands
| | - Edith J M Feskens
- Division of Human Nutrition & Health, Wageningen University & Research, Stippeneng 4, Wageningen, 6708WE, The Netherlands
| | - Annemarie Wagemakers
- Health and Society, Department of Social Sciences, Wageningen University & Research, Hollandseweg 1, Wageningen, 6706KN, The Netherlands
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Mulatu S, Mulatu G, Gedif A. Dietary practice and associated factors among lactating mothers in Dangila District in the Awi Zone Amhara region Ethiopia, 2022: a cross-sectional study. Front Nutr 2025; 11:1506707. [PMID: 39834454 PMCID: PMC11743997 DOI: 10.3389/fnut.2024.1506707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2024] [Accepted: 12/10/2024] [Indexed: 01/22/2025] Open
Abstract
Introduction Lactation is the critical time for meeting the nutritional demands of mothers and infants. Mothers from low-income countries, including Ethiopia, are considered nutritionally vulnerable. Good dietary practices for mothers during lactation are therefore important for the good health of their children. The main objective of this study was to assess dietary practice and associated factors of lactating mothers in Dangila Zuria District, Amhara region, Ethiopia, 2022. Methods A community-based cross-sectional study was conducted among 609 lactating women from March 1st to May 1st 2022. The study participants were selected using a straightforward simple random sampling techniques. Data was collected by using structured questionnaires. The data was entered in Epi-data and exported to SPSS version 23 for analysis. Bi-variable and multi-variable logistic regression analyses were used to see the relevant associations. The variable significantly associated with dietary practice was identified based on a P-value ≤ 0.05. Results This study revealed that only one-third 204 lactating mothers, demonstrated good dietary practices. Notably, several factors were significantly associated with poor dietary practices: mothers with a family size greater than four had 3.01 times higher odds of inadequate dietary habits (AOR = 3.01; 95% CI: 1.56, 9.28), while those with birth intervals of <2 years faced 2.31 times greater odds (AOR = 2.31; 95% CI: 1.49, 3.56). Additionally, daily laborers exhibited a striking 9.35 times higher likelihood of poor dietary practices (AOR = 9.35; 95% CI: 8.02, 19.96), and food-insecure mothers had 4.93 times higher odds of inadequate nutrition (AOR = 4.93; 95% CI: 3.40, 7.16). Conclusion In conclusion, the dietary practices of lactating mothers were found to be suboptimal, falling below WHO and FAO recommendations. Factors such as family size, birth intervals, maternal occupation (especially daily laborers), and food insecurity were identified as significant contributors. Addressing these issues is crucial. Key stakeholders, including the Ministry of Health (MOH), Regional Health Bureaus (RHB), and health professionals, must work together to alleviate food insecurity, promote optimal family planning, and educate mothers on proper nutrition. Addressing these challenges is essential to achieving global objectives such as reducing malnutrition, improving maternal health, and ensuring healthy child development.
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Affiliation(s)
- Sileshi Mulatu
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Getasew Mulatu
- Department of Emergency and Critical Care Nursing, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Azeb Gedif
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Albajri E, Almasaudi AS, Mosli HH, Hakim NA, Basaqr RO, Naseeb M. Assessing the impact of magnesium-based nutritional education on lipid profiles in individuals with type 2 diabetes mellitus: a quasi-experimental study. Diabetol Metab Syndr 2025; 17:3. [PMID: 39754233 PMCID: PMC11699773 DOI: 10.1186/s13098-024-01566-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Accepted: 12/24/2024] [Indexed: 01/06/2025] Open
Abstract
BACKGROUND The potential therapeutic role of magnesium (Mg) in type 2 diabetes mellitus (T2DM) remains insufficiently studied despite its known involvement in critical processes like lipid metabolism and insulin sensitivity. This study examines the impact of Mg-focused nutritional education on lipid profile parameters, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in T2DM patients. METHODS Thirty participants with T2DM were recruited for this within-subject experimental study. Participants underwent a three-month dietary intervention focused on increasing the intake of Mg-rich foods through nutritional education. Anthropometric measurements and lipids were assessed at baseline and after the intervention period, with the primary outcome variables including changes in lipid parameters. RESULTS The findings showed a significant inverse association between dietary Mg intake and total cholesterol levels (r = - 0.36, p = 0.05). However, other parameters, TG, LDL-C, and HDL-C, were not found to be associated with Mg intake. CONCLUSION The study demonstrated an inverse association between Mg intake and cholesterol level. Providing nutritional education and guidance on incorporating Mg-rich foods into the diet may be a crucial strategy for improving the health and well-being of T2DM patients in Saudi Arabia. The feasibility and practicality of focused nutritional education as an intervention make it a low-cost, scalable, and sustainable approach that can be readily implemented in clinical and community settings. Further studies are needed to explore the long-term impact of dietary Mg interventions on a larger sample with longer education periods.
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Affiliation(s)
- Eram Albajri
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Obesity and Lifestyle Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Arwa S Almasaudi
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hala H Mosli
- Obesity and Lifestyle Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Noor A Hakim
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Reem O Basaqr
- Clinical Nutrition Department, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Manal Naseeb
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
- Obesity and Lifestyle Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
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Onji M, Sigl V, Lendl T, Novatchkova M, Ullate-Agote A, Andersson-Rolf A, Kozieradzki I, Koglgruber R, Pai TP, Lichtscheidl D, Nayak K, Zilbauer M, Carranza García NA, Sievers LK, Falk-Paulsen M, Cronin SJF, Hagelkruys A, Sawa S, Osborne LC, Rosenstiel P, Pasparakis M, Ruland J, Takayanagi H, Clevers H, Koo BK, Penninger JM. RANK drives structured intestinal epithelial expansion during pregnancy. Nature 2025; 637:156-166. [PMID: 39633049 PMCID: PMC11666467 DOI: 10.1038/s41586-024-08284-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 10/24/2024] [Indexed: 12/07/2024]
Abstract
During reproduction, multiple species such as insects and all mammals undergo extensive physiological and morphological adaptions to ensure health and survival of the mother and optimal development of the offspring. Here we report that the intestinal epithelium undergoes expansion during pregnancy and lactation in mammals. This enlargement of the intestinal surface area results in a novel geometry of expanded villi. Receptor activator of nuclear factor-κΒ (RANK, encoded by TNFRSF11A) and its ligand RANKL were identified as a molecular pathway involved in this villous expansion of the small intestine in vivo in mice and in intestinal mouse and human organoids. Mechanistically, RANK-RANKL protects gut epithelial cells from cell death and controls the intestinal stem cell niche through BMP receptor signalling, resulting in the elongation of villi and a prominent increase in the intestinal surface. As a transgenerational consequence, babies born to female mice that lack Rank in the intestinal epithelium show reduced weight and develop glucose intolerance after metabolic stress. Whereas gut epithelial remodelling in pregnancy/lactation is reversible, constitutive expression of an active form of RANK is sufficient to drive intestinal expansion followed by loss of villi and stem cells, and prevents the formation of Apcmin-driven small intestinal stem cell tumours. These data identify RANK-RANKL as a pathway that drives intestinal epithelial expansion in pregnancy/lactation, one of the most elusive and fundamental tissue remodelling events in mammalian life history and evolution.
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Affiliation(s)
- Masahiro Onji
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter (VBC), Vienna, Austria.
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
| | - Verena Sigl
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter (VBC), Vienna, Austria
| | - Thomas Lendl
- Institute of Molecular Pathology (IMP), Vienna BioCenter (VBC), Vienna, Austria
| | - Maria Novatchkova
- Institute of Molecular Pathology (IMP), Vienna BioCenter (VBC), Vienna, Austria
| | - Asier Ullate-Agote
- Biomedical Engineering Program, Center for Applied Medical Research (CIMA), Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Amanda Andersson-Rolf
- Oncode Institute, Hubrecht Institute, Royal Netherlands Academy of Arts and Sciences (KNAW) and University Medical Center, Utrecht, The Netherlands
| | - Ivona Kozieradzki
- Department of Medical Genetics, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Rubina Koglgruber
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter (VBC), Vienna, Austria
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Tsung-Pin Pai
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter (VBC), Vienna, Austria
| | - Dominic Lichtscheidl
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter (VBC), Vienna, Austria
| | - Komal Nayak
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - Matthias Zilbauer
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK
- Department of Paediatrics, University of Cambridge, Cambridge, UK
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, Cambridge University Hospitals (CUH), Addenbrooke's, Cambridge, UK
| | - Natalia A Carranza García
- Department of Microbiology and Immunology, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Laura Katharina Sievers
- Institute of Clinical Molecular Biology, Kiel University and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Maren Falk-Paulsen
- Institute of Clinical Molecular Biology, Kiel University and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Shane J F Cronin
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter (VBC), Vienna, Austria
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Astrid Hagelkruys
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter (VBC), Vienna, Austria
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Shinichiro Sawa
- Division of Mucosal Immunology, Research Center for Systems Immunology, Medical Institute of Bioregulation, Kyushu University, Fukuoka, Japan
| | - Lisa C Osborne
- Department of Microbiology and Immunology, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Philip Rosenstiel
- Institute of Clinical Molecular Biology, Kiel University and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Manolis Pasparakis
- Institute for Genetics and Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Jürgen Ruland
- Institute of Clinical Chemistry and Pathobiochemistry, School of Medicine and Health, TUM University Hospital, Munich, Germany
- Center for Translational Cancer Research (TranslaTUM), Munich, Germany
| | - Hiroshi Takayanagi
- Department of Immunology, Graduate School of Medicine and Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Hans Clevers
- Oncode Institute, Hubrecht Institute, Royal Netherlands Academy of Arts and Sciences (KNAW) and University Medical Center, Utrecht, The Netherlands
- The Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Institute of Human Biology (IHB), Roche Pharma Research and Early Development, Roche innovation Centre, Basel, Switzerland
| | - Bon-Kyoung Koo
- Center for Genome Engineering, Institute for Basic Science, Daejeon, Republic of Korea
| | - Josef M Penninger
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter (VBC), Vienna, Austria.
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
- Department of Medical Genetics, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada.
- Helmholtz Centre for Infection Research, Braunschweig, Germany.
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10
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Cheon BK, Bittner JMP, Pink AE. Contributions of subjective status to eating behaviors, obesity, and metabolic health across development. Appetite 2025; 204:107735. [PMID: 39481682 PMCID: PMC11609012 DOI: 10.1016/j.appet.2024.107735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 09/20/2024] [Accepted: 10/28/2024] [Indexed: 11/02/2024]
Abstract
Subjective status is the evaluation of one's social or socioeconomic status relative to others. Lower subjective status has been associated with risk of overweight/obesity, poorer metabolic health, and obesogenic food preferences and eating behaviors. However, these findings are predominantly based on studies of adolescents and young adults. This indicates major gaps in knowledge and application of this social determinant of obesity and metabolic health, given that perceived status develops throughout the life course along with food environments and eating habits. Here, we review the relationships that subjective status shares with the outcomes of eating behaviors, obesity, and metabolic health across milestones and periods of development: during the prenatal period, as caregivers who feed children, during childhood (prior to age 10) and from adolescence into emerging adulthood (until mid-20's). For each developmental period, we explore why the period critically contributes to these outcomes and how subjective status may affect eating behaviors and metabolic health. We propose that subjective status contributes to eating/feeding behaviors and metabolic health both within and across developmental periods, such that the effect of low subjective status at an earlier period may contribute to obesogenic eating behaviors and metabolic health in later developmental periods and intergenerationally. The influence of low subjective status on higher body weight may also threaten subjective status later in development through heightened vulnerability to social stressors, such as weight-based stigma. Overall, subjective status may be a broadly influential factor to consider when examining social determinants of obesity and metabolic health across development.
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Affiliation(s)
- Bobby K Cheon
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, Bethesda, MD, 20817, USA.
| | - Julia M P Bittner
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
| | - Aimee E Pink
- Institute of High Performance Computing (IHPC), Agency for Science, Technology and Research (A∗STAR), 1 Fusionopolis Way, #16-16 Connexis, 138632, Republic of Singapore; Institute of Human Development and Potential (IHDP), Agency for Science, Technology and Research (A∗STAR), 30 Medical Drive, Brenner Centre for Molecular Medicine, 117609, Republic of Singapore
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11
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Bragg A, Markcrow S, Monk S, Minehan M, Knight-Agarwal CR. Unveiling the Craving: A systematic review of pregnant women's desires for expert nutrition care in Australia. Midwifery 2025; 140:104210. [PMID: 39504871 DOI: 10.1016/j.midw.2024.104210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 08/29/2024] [Accepted: 10/10/2024] [Indexed: 11/08/2024]
Abstract
PROBLEM Poor nutrition during the antenatal period can contribute to adverse health outcomes for both mother and baby. BACKGROUND Despite the importance of nutrition during pregnancy, there is limited research exploring the attitudes and experiences pregnant women possess towards nutrition care, particularly within the Australian context. Existing literature has indicated that pregnant women lack knowledge of and are not adhering to pregnancy related nutrition recommendations. Furthermore, although pregnant women rely on many health professionals for nutrition care, there are deficiencies in both the quality and quantity of care provided. AIM The aim of this meta-aggregative review was to explore the experiences and attitudes pregnant women in Australia have towards nutrition care. METHODS Meta-aggregation was used to synthesise qualitative studies. A search strategy was applied to four electronic databases in May 2023.The findings were extracted and synthesised via the JBI approach. FINDINGS A total of 719 studies were identified in the initial database search with seven eligible studies included in the meta-aggregation. From 11 categories, three synthesised findings were developed: (i) approaches to nutrition care delivery matters, (ii) quality and quantity of nutrition care is insufficient, and (iii) pregnant women value nutrition care. CONCLUSION This review highlights pregnant women's desires for better nutrition care in Australia, with current provision of nutrition care lacking in quality and quantity. Improved antenatal dietetics services and increased health professional nutrition training is necessary to address these concerns.
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Affiliation(s)
- Angela Bragg
- Faculty of Health, University of Canberra, Bruce ACT 2617, Australia
| | - Sophie Markcrow
- Faculty of Health, University of Canberra, Bruce ACT 2617, Australia
| | - Sean Monk
- Faculty of Health, University of Canberra, Bruce ACT 2617, Australia
| | - Michelle Minehan
- Faculty of Health, University of Canberra, Bruce ACT 2617, Australia
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12
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Zhang Y, Gao X, Zhu H, Zhou Q, Cai X, Koch PA, Sun S, Yu H. Integrative development of a concise screening questionnaire for early detection of pregnant women at risk for dystrophy. BMC Pregnancy Childbirth 2024; 24:861. [PMID: 39725876 DOI: 10.1186/s12884-024-07051-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Accepted: 12/09/2024] [Indexed: 12/28/2024] Open
Abstract
BACKGROUND Maintaining a healthy diet during pregnancy is vital for reducing the risk of adverse birth outcomes. However, conventional methods of assessing the dietary behavior of pregnant women, such as the FFQ, are often time-consuming. This study aims to develop a concise nutritional screening questionnaire tailored for pregnant women, empowering prenatal healthcare providers to quickly identify key adverse dietary behaviors and provide targeted guidance. METHODS To validate the Pregnancy Nutrition Checklist, we enrolled 208 women in early pregnancy and 200 women were included to analysis (with an average age of 31.54 ± 4.24 years). Spearman rank correlation analysis was used to assess the relative reliability of the Pregnancy Nutrition Checklist compared with the FFQ scale. Exploratory factor analysis was used to test the structural validity of the scale. A generalized linear model was used to analyze the correlation between dietary behavior and birth weight. RESULTS The pregnancy nutrition checklist includes 15 dietary items and 3 other lifestyle habit items. Compared with traditional FFQ questionnaires, the correlation analysis of corresponding items in the pregnancy nutrition checklist revealed statistical significance (p < 0.05), except for fat intake. EFA identified three underlying factors, namely, "high-fat foods," "moderate-fat foods," and "low-fat foods," indicating that the questionnaire has good construct validity. Insufficient consumption of vegetables by pregnant women(OR = 2.64, 95% CI: 1.08-6.46, p = 0.033) was associated with a significantly greater risk of developing LGA fetuses. Pregnant women whose sugar, coffee, or tea intake did not exceed the classification criteria had significantly greater fetal birth weights than those whose intake exceeded the classification criteria (OR = 3.38, 95% CI: 1.18-9.68, p = 0.023). In contrast, consuming fewer highly palatable snacks can reduce the incidence of LGA babies (OR = 0.29, 95% CI: 0.11-0.74, p = 0.010). CONCLUSIONS This tool has great potential for identifying unhealthy dietary behaviors, potentially leading to improved pregnancy outcomes. TRIAL REGISTRATION This study was preregistered on May 5, 2023, at the Chinese Clinical Trial Registry (ChiCTR2300071126).
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Affiliation(s)
- Yadi Zhang
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, People's Republic of China
| | - Xiaoge Gao
- Program in Nutrition, Department of Health Studies & Applied Educational Psychology, Teachers College, Columbia University, New York, USA
| | - Haiyan Zhu
- FuXing Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Qi Zhou
- Xuanwu Hospital Capital Medical University, Beijing, People's Republic of China
| | - Xiaxia Cai
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, People's Republic of China
| | - Pamela Ann Koch
- Program in Nutrition, Department of Health Studies & Applied Educational Psychology, Teachers College, Columbia University, New York, USA
| | - Shengzhi Sun
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, People's Republic of China.
| | - Huanling Yu
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, People's Republic of China.
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13
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Qi X, Zhang R, Zhu H, Luo J, Zhang Q, Wang W, Wang T, Zhang D. Dietary Iron Intake and Mental and Behavioral Disorders Due to Use of Tobacco: A UK Biobank Study. Nutrients 2024; 17:39. [PMID: 39796473 PMCID: PMC11722800 DOI: 10.3390/nu17010039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2024] [Revised: 12/21/2024] [Accepted: 12/25/2024] [Indexed: 01/13/2025] Open
Abstract
BACKGROUND Over 1 billion smokers worldwide, one-third of whom have mental and behavioral disorders, exist. However, factors influencing mental and behavioral disorders due to the use of tobacco remain largely unexplored. This study aims to investigate the relationship between dietary iron intake and mental and behavioral disorders due to the use of tobacco. METHODS Using large population cohort data from the UK Biobank (500,000 participants at 22 assessment centers between 2006 and 2010), we employed logistic and Cox regression analyses to explore both cross-sectional and longitudinal associations between dietary iron intake and mental and behavioral disorders due to the use of tobacco. Additionally, we assessed the nonlinear relationship between dietary iron intake and these disorders using restricted cubic spline plots. RESULTS Logistic regression analysis indicated that dietary iron intake was negatively associated with mental and behavioral disorders due to the use of tobacco. The Cox regression results supported a protective effect of increased dietary iron intake against these disorders. Stratified and sensitivity analyses were consistent with the primary findings. Restricted cubic spline plots revealed a nonlinear relationship between dietary iron intake and mental and behavioral disorders due to the use of tobacco. In the total sample, as well as in both age groups and the male subgroup, the risk reduction rate initially accelerated before slowing down. In contrast, the risk reduction rate in the female group declined rapidly at first and then leveled off. CONCLUSIONS This study demonstrates that dietary iron intake has a protective effect against mental and behavioral disorders due to the use of tobacco, revealing a nonlinear association between these two traits. These findings provide important insights for the profilaxy and treatment of mental and behavioral disorders due to the use of tobacco in the future.
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Affiliation(s)
- Xueting Qi
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, 308 Ningxia Road, Qingdao 266071, China; (X.Q.); (R.Z.); (J.L.); (Q.Z.); (W.W.); (D.Z.)
| | - Ronghui Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, 308 Ningxia Road, Qingdao 266071, China; (X.Q.); (R.Z.); (J.L.); (Q.Z.); (W.W.); (D.Z.)
| | - Hailong Zhu
- Department of Operations Management, Qingdao Municipal Center for Disease Control and Prevention, Qingdao 266033, China;
| | - Jia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, 308 Ningxia Road, Qingdao 266071, China; (X.Q.); (R.Z.); (J.L.); (Q.Z.); (W.W.); (D.Z.)
| | - Qiuge Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, 308 Ningxia Road, Qingdao 266071, China; (X.Q.); (R.Z.); (J.L.); (Q.Z.); (W.W.); (D.Z.)
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, 308 Ningxia Road, Qingdao 266071, China; (X.Q.); (R.Z.); (J.L.); (Q.Z.); (W.W.); (D.Z.)
| | - Tong Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, 308 Ningxia Road, Qingdao 266071, China; (X.Q.); (R.Z.); (J.L.); (Q.Z.); (W.W.); (D.Z.)
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, 308 Ningxia Road, Qingdao 266071, China; (X.Q.); (R.Z.); (J.L.); (Q.Z.); (W.W.); (D.Z.)
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Suri P, Bellini A, Bloemhard ME, Choi JY, Hoyt-Austin A, McCreary RJ, Kennedy C, Clapp B, Husain F, Ma P, Hilton-Rowe LR, Lyo V. Breastfeeding in metabolic and bariatric patients: a comprehensive guide for surgeons, patients, and the multidisciplinary team. Surg Obes Relat Dis 2024:S1550-7289(24)00949-3. [PMID: 39779445 DOI: 10.1016/j.soard.2024.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2024] [Revised: 10/24/2024] [Accepted: 11/23/2024] [Indexed: 01/11/2025]
Abstract
Since nearly 40% of metabolic and bariatric surgery (MBS) patients are individuals with the ability to bear children, many may seek to become pregnant or may be currently lactating when seeking surgery. While many patients plan to breastfeed, MBS patients are at high risk for premature cessation of breastfeeding. Limited literature exists on the impact of MBS on lactation and there are no established guidelines to help clinicians support and educate MBS patients about breastfeeding. Herein, we aim to fill that gap by providing a comprehensive guide for bariatric surgeons, obstetricians, women's health providers, lactation consultants, registered dietitians, bariatric nurse coordinators, and advanced practice providers to support breastfeeding in patients with a history of MBS or who are considering MBS. We review physician-patient discussion points on how MBS impacts lactation, the micronutrient and caloric needs for this unique population, and data to support successful breastfeeding in post-MBS patients who are lactating regarding practical, anesthetic, and imaging considerations.
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Affiliation(s)
- Priya Suri
- Department of Surgery, University of California Davis, Sacramento, California
| | - Alyssa Bellini
- Department of Surgery, University of California Davis, Sacramento, California
| | | | - Justin Yoon Choi
- School of Medicine, University of California Davis, Sacramento, California
| | - Adrienne Hoyt-Austin
- Department of Pediatrics, University of California Davis, Sacramento, California
| | | | | | | | - Farah Husain
- Department of Surgery, University of Arizona College of Medicine, Phoenix, Arizona
| | - Pearl Ma
- Advanced Laparoscopic Surgical Associates/Community Health Partners, Fresno, California
| | | | - Victoria Lyo
- Department of Surgery, University of California Davis, Sacramento, California; Center for Alimentary and Metabolic Sciences, University of California Davis.
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15
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Basri H, Widiyanto S, Saragih HTS, Zuprizal Z. The effect of quail egg supplements enriched with marine macroalgae Eucheuma spinosum on the physiological condition of Sprague Dawley rats during pregnancy. J Adv Vet Anim Res 2024; 11:1114-1121. [PMID: 40013288 PMCID: PMC11855413 DOI: 10.5455/javar.2024.k862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 09/30/2024] [Accepted: 12/03/2024] [Indexed: 02/28/2025] Open
Abstract
Objective To investigate the effect of quail egg supplements enriched with marine macroalgae Eucheuma spinosum on body weight and physiological conditions of Sprague Dawley rats during pregnancy. Materials and Methods This study used a completely randomized experimental design. The test animals were 25 pregnant white rats aged 3 months and weighed ± 200 gm. Pregnant rats were divided into five treatments and five repetitions; each repetition contained one pregnant rat. T0: control treatment; T1: treatment group consuming quail eggs from quail fed commercial feed; T2: treatment group consuming quail eggs from quail fed with 3% E. spinosum; T3: treatment group consuming quail eggs from quail fed with 4% E. spinosum; T4: treatment group consuming quail eggs from quail fed with 5% E. spinosum. The parameters measured were egg proximate, egg iron, egg cholesterol, red blood cell (RBC), hemoglobin (Hb), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular Hb (MCH), mean corpuscular Hb concentration (MCHC), white blood cell (WBC), lymphocytes (LYM), neutrophils (NEUT), RBC distribution width (RDW), platelet distribution width (PDW), mean platelet volume (MPV), cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), glucose, superoxide dismutase (SOD), and malondialdehyde (MDA). Results The addition of E. spinosum into quail feed at concentrations of 3%, 4%, and 5% did not show statistically significant differences (p > 0.05) in the proximate levels (water, ash, fat, protein, and carbohydrates) compared to the control. However, the analysis of iron in quail eggs indicated a significant increase (p < 0.05) in comparison to the control treatment. In addition, the supplementation of E. spinosum in the quail feed resulted in significantly reduced (p < 0.05) quail egg cholesterol levels when compared to the control treatment. Furthermore, the supplementation of quail egg produced by quail fed with E. spinosum did not significantly affect the birth weight of the pups, RBC, MCV, MCH, MCHC, WBC, LYM, NEUT, RDW, PDW, MPV, MDA, and SOD when compared to the control treatment (p > 0.05). Meanwhile, the mother weight, Hb, HCT, cholesterol, HDL, LDL, and glucose levels significantly increased (p < 0.05) compared to the control. Conclusion The administration of E. spinosum with concentrations of 3%, 4%, and 5% can increase iron levels and decrease cholesterol levels in quail eggs. The administration of quail egg supplements produced by quail-fed additional macroalgae E. spinosum can increase body weight, Hb, and HCT in pregnant rats. The addition of marine macroalgae with concentrations of 4% and 5% can decrease the levels of cholesterol, LDL, and glucose and increase serum HDL levels in pregnant rats.
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Affiliation(s)
- Hasan Basri
- Biology Doctoral Study Program, Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Biology Study Program, Faculty of Mathematics and Natural Science, Universitas Islam Al-Azhar, Mataram, Indonesia
| | - Slamet Widiyanto
- Department of Animal Physiology, Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Hendry T. S. Saragih
- Laboratory of Animal Development Structure, Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Zuprizal Zuprizal
- Department of Animal Nutrition and Feed Science, Faculty of Animal Science, Universitas Gadjah Mada, Yogyakarta, Indonesia
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16
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Freire JKS, da Silveira JAC, Longo-Silva G, Silva-Neto LGR, de Andrade MIS, de Lima Soares L, Oliveira JS, de Melo Barros L, de Menezes Marinho P, de Menezes RCE. Micronutrient Consumption Among Postpartum Women and Food Insecurity. Ecol Food Nutr 2024; 63:605-622. [PMID: 39244777 DOI: 10.1080/03670244.2024.2399019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2024]
Abstract
This study aimed to assess the prevalence of inadequate micronutrient intake and its risk factors among women one year after giving birth. 240 women of reproductive age were assessed. Micronutrient intake was assessed from two 24-hour records at three stages (3-6-12 months after childbirth). A generalized linear mixed-effect model was used to assess the factors associated with food intake. A prevalence of inadequate micronutrient intake was observed, with the exception of iron. Intake was lower among food-insecure women (zinc: β -0.13; iron: β -0.09; vitamin C: β -0.44). The postpartum period and food insecurity remained statistically associated with lower food consumption in the explanatory models tested.
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Affiliation(s)
- Jéssica Karlla Silva Freire
- Laboratório de Nutrição em Saúde Pública, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Brazil
- Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Brazil
| | | | - Giovana Longo-Silva
- Laboratório de Nutrição em Saúde Pública, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Brazil
- Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Brazil
| | | | | | - Larissa de Lima Soares
- Laboratório de Nutrição em Saúde Pública, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Brazil
- Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Brazil
| | | | | | - Patrícia de Menezes Marinho
- Laboratório de Nutrição em Saúde Pública, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Brazil
| | - Risia Cristina Egito de Menezes
- Laboratório de Nutrição em Saúde Pública, Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Brazil
- Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Brazil
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Abstract
AIMS High diet quality is related to better health outcomes in general. During pregnancy, a high-quality diet is of paramount importance to promote optimal maternal and neonatal outcomes. This is a scoping review of research available on diet quality indexes (DQIs) for use during pregnancy that summarizes the DQIs in terms of development, country of origin, population used, components, scoring and weighting of components, and evaluation. Furthermore, the DQIs are discussed narratively to inform and direct the development of improved and country-specific DQIs for pregnancy. METHODS The EBSCOhost database was used to identify English-language, peer-reviewed articles published between 2000 and 2023, from which 11 publications were identified that describe the development of pregnancy-specific DQIs. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews model. RESULTS Almost all DQIs (n = 9 of 11) were developed in high-income countries, using dietary intake data from food frequency questionnaires. Several DQIs (n = 5 of 11) used the US Healthy Eating Index as basis and modified it in various ways. Almost all DQIs included both foods and nutrients as components (n = 9 of 11), with vegetables being the most commonly included component alone (n = 8 of 11) or combined with fruit (n = 2 of 11). CONCLUSION Because most DQIs were developed using dietary guidelines, recommendations, and dietary intake data from high-income countries, it is recommended that pregnancy-specific DQIs be developed and validated to reflect the nutrition guidelines for lower-income and culturally diverse countries.
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Affiliation(s)
- Liska Robb
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
| | - Gina Joubert
- Department of Biostatistics, School of Biomedical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
| | - Corinna May Walsh
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
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18
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Lipsky LM, Wright B, Lin TC, Liu A, Abbott C, Siega-Riz AM, Nansel TR. Diet quality from early pregnancy through 1-y postpartum: a prospective cohort study. Am J Clin Nutr 2024; 120:1284-1293. [PMID: 39307187 PMCID: PMC11600023 DOI: 10.1016/j.ajcnut.2024.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 08/27/2024] [Accepted: 09/13/2024] [Indexed: 10/09/2024] Open
Abstract
BACKGROUND Although diet quality during pregnancy and postpartum is important for multiple parent and child outcomes, within-person changes in diet quality throughout these periods have not been extensively examined. OBJECTIVES This study investigated diet quality from early pregnancy through 1 y postpartum and examined differences by sociodemographic characteristics in participants receiving obstetric care in Chapel Hill, North Carolina, United States. METHODS Participants completed 24-h dietary recalls at 6 study visits (each pregnancy trimester and 6 wk, 6 mo, and 1 y postpartum) (n = 383). Between-visit mean Healthy Eating Index-2015 (HEI) scores (min = 0, max = 100) were compared using the population ratio (PR) method. The NCI usual intakes method estimated the distribution of HEI scores in pregnancy and postpartum; unpaired t-tests compared usual mean HEI scores by covariates; paired t-tests compared differences between mean pregnancy and postpartum. RESULTS The total HEI mean ± standard error scores (NCI method) were 61.4 ± 0.8 in pregnancy and 61.7 ± 0.9 in postpartum. Mean HEI scores differed by sociodemographic characteristics, particularly education, marital status, and federal assistance participation. The highest scores were observed in participants with at least a bachelor's degree (64.1 ± 0.9 in pregnancy, 64.5 ± 1.0 in postpartum, n = 257) and those with other non-Hispanic White race/ethnicity (64.7 ± 1.8 in pregnancy, 66.4 ± 2.2 in postpartum). There were no between-visit differences in mean total HEI scores (PR). Although differences were observed in some mean HEI component scores between pregnancy and postpartum visits, they were small (mostly <1 point) in magnitude and in inconsistent directions. CONCLUSIONS Stable total HEI mean scores suggest that adherence to dietary guidelines was consistent throughout pregnancy and postpartum in this sample. Although some sociodemographic characteristics may identify individuals at greater risk of diet-related pregnancy complications, low diet quality was pervasive throughout all subgroups and reflects an urgent need for widespread improvement.
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Affiliation(s)
- Leah M Lipsky
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States.
| | - Breanne Wright
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States
| | | | - Aiyi Liu
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States
| | - Craig Abbott
- Office of the Clinical Director, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States
| | - Anna Maria Siega-Riz
- School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, United States
| | - Tonja R Nansel
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States
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19
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Ahmed HS. Limb-girdle muscular dystrophy in pregnancy: a narrative review. Arch Gynecol Obstet 2024; 310:2373-2386. [PMID: 39285011 DOI: 10.1007/s00404-024-07738-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Accepted: 09/06/2024] [Indexed: 10/17/2024]
Abstract
Limb-girdle muscular dystrophy (LGMD) poses unique challenges for women during pregnancy, necessitating comprehensive care and tailored management strategies. The present narrative review aims to examine the unique challenges and management strategies required for women with LGMD during pregnancy. With over 30 genetic subtypes identified and the potential for additional discoveries through advanced diagnostic techniques, preconception counseling plays a crucial role in informing prospective parents about reproductive risks and available options. Baseline assessments, including cardiac and pulmonary evaluations, are essential to guide antenatal care, alongside genetic testing for precise diagnosis and counseling. Optimizing maternal health through respiratory exercises, cardiac monitoring, and individualized exercise and nutrition plans is paramount to avoid potential complications. During pregnancy, close monitoring of maternal and fetal well-being is important, with collaborative care between obstetricians and specialists. An individualized approach to delivery mode considering factors such as muscle strength, pelvic size, and fetal presentation is crucial. While vaginal delivery has been proven to be possible, the need for an emergency cesarean delivery should always be kept in mind. Regional anesthesia is preferred, with proactive planning for potential respiratory support. Bupivacaine has been shown to be effective with epidural catheters that may be used for prolonged relief with opioids like morphine and fentanyl, while also evaluating the patients' respiratory function. Postpartum considerations include pain management, mobility support, breastfeeding assistance, and emotional support. Early mobilization and tailored physiotherapy regimens may promote optimal recovery, while comprehensive breastfeeding guidance is needed to address challenges related to muscle weakness. Access to mental health resources and support networks is essential to helping individuals cope with the emotional demands of parenthood alongside managing LGMD. By addressing the unique needs of pregnant individuals with LGMD, healthcare providers can optimize maternal and fetal outcomes while supporting individuals in their journey to parenthood.
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Affiliation(s)
- H Shafeeq Ahmed
- Bangalore Medical College and Research Institute, K.R Road, Bangalore, Karnataka, 560002, India.
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Hossain MZ, Uddin MJ, Rahman MM, Uddin MS, Ahmed T. Determinants of minimum dietary diversity for lactating and pregnant women. PLoS One 2024; 19:e0309213. [PMID: 39361657 PMCID: PMC11449314 DOI: 10.1371/journal.pone.0309213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 08/08/2024] [Indexed: 10/05/2024] Open
Abstract
INTRODUCTION Maternal and child health, which is integral to public health, depends on maintaining a healthy diet during pregnancy and lactation to achieve optimal outcomes. This study aimed to investigate the prevalence and determinants of minimum dietary diversity (MDD) among pregnant and lactating women (PLW) in this particular context. METHODS A stratified cluster sampling approach was employed, encompassing intervention areas (Rangpur and Nilphamari in Bangladesh) as strata, with 30 clusters. The study included 631 pregnant and lactating women (PLW) aged 15 to 49 years, focusing on their consumption of a minimally diverse diet. The outcome variable was binary: MDD (1 = if they consumed ≥ 5 food items from a basket of 10 food groups, indicating they met the MDD; 0 = if they consumed < 5 items, indicating they did not meet the MDD), assessed based on ten food groups over a 24-hour period. The data were analyzed using a binary logistic regression model. RESULTS The study found that 51.19% of PLW met MDD criteria, indicating positive dietary practices. Those aged 21-49 years had significantly lower odds of meeting MDD than those aged 15-20 years. Education played a key role, with completion of primary (p = 0.029) and secondary incomplete education (p = 0.055) associated with higher odds of meeting MDD. Other identified predictors included climate-smart techniques for agriculture, women's empowerment, food security, producing legume, nut and seeds and negative impact on family expenditure due to increase in commodity prices, especially food prices. Employing climate-smart agriculture increased odds by 1.58 times (p = 0.028), empowered women had 2.31 times higher odds (p < 0.001), and food security played a crucial role (p = 0.006). Moreover, producing legumes, nuts, or seeds was significantly associated with higher odds of meeting MDD (OR = 1.55, p = 0.039), while experiencing negative economic impacts lowered the odds (OR = 0.63, p = 0.034). CONCLUSION The study provides insights into factors influencing MDD among PLW in northern Bangladesh. Empowering women and promoting climate-smart techniques for agriculture emerged as pivotal determinants, alongside enhancing education levels, increasing food security, and addressing economic barriers. Implementing multifaceted interventions that consider socio-demographic diversity, economic disparities, and dietary preferences is crucial for enhancing dietary diversity and improving health outcomes in this vulnerable population.
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Affiliation(s)
- Md. Zakir Hossain
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
- Team Leader of 5 Year Annual Evaluation of JANO Project, Sylhet, Bangladesh
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
- Team Member (Data Analysis Expert) of 5 Year Annual Evaluation of JANO Project, Sylhet, Bangladesh
- Faculty of Graduate Studies, Daffodil International University, Savar, Dhaka, Bangladesh
| | - Md Mizanur Rahman
- Cooperative for Assistance and Relief Everywhere (CARE) Bangladesh, Dhaka, Bangladesh
| | - Md Shahab Uddin
- Cooperative for Assistance and Relief Everywhere (CARE) Bangladesh, Dhaka, Bangladesh
| | - Toufique Ahmed
- Cooperative for Assistance and Relief Everywhere (CARE) Bangladesh, Dhaka, Bangladesh
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21
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Bayked EM, Yimer EM, Gelaw T, Mohammed AS, Mekonen NA. Dietary knowledge, attitude, practice, and associated factors among pregnant mothers in Ethiopia: a systematic review and meta-analysis. Front Public Health 2024; 12:1393764. [PMID: 39328997 PMCID: PMC11425043 DOI: 10.3389/fpubh.2024.1393764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/31/2024] [Indexed: 09/28/2024] Open
Abstract
Background Despite global efforts, progress in reducing maternal malnutrition falls short of international goals, which is the same for Ethiopia, provided that studying dietary knowledge, attitude, and practice and their determinants is crucial to developing and implementing effective interventions, which this review tried to investigate in an Ethiopian context. Methods We searched on Scopus, HINARI, PubMed, and Google Scholar on January 3, 2024. We used the Joanna Briggs Institute's (JBI's) tools and the "preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 statement" to evaluate bias and frame the review, respectively. The data were analyzed using Stata 17. Certainty was assessed using sensitivity and subgroup analyses and the Luis Furuya-Kanamori (LFK) index. The random effects model was used to determine the effect estimates with a p value less than 0.05 and a 95% CI. Results The pooled good dietary knowledge, favorable attitude, and good practice were 48.0% (95% CI: 39.0-57.0%), 47.0% (95% CI: 38.0-55.0%), and 34.0% (95% CI: 28.0-40.0%), respectively. Knowledge and attitude had bidirectional relationships and were affected by sociodemographic variables and gynecological issues. The dietary practice was influenced by urban residency (OR = 6.68, 95% CI: 2.49-10.87), food security (OR = 3.51, 95% CI: 1.02-5.99), knowledge (OR = 4.53, 95% CI: 3.22-5.74), nutrition information (OR = 3.07, 95% CI: 1.13-5.02), attitude (OR = 2.32, 95% CI: 1.34-3.30), family support (OR = 2.14, 95% CI: 1.43-2.85), perceived severity of malnutrition (OR = 2.07, 95% CI: 1.82-2.31), and positive perception of dietary benefit (OR = 2.19, 95% CI: 1.56-2.82). Conclusion The good dietary practice was lower than the knowledge and the favorable attitude toward it. It was influenced by sociodemographic variables, income and wealth, knowledge and information, attitudes and intentions, gynecological and illness experiences, family support and decision-making, and expectations of nutrition outcomes and habits. Sociodemographic and gynecological issues were also found to influence both dietary knowledge and attitude, which were also found to have bidirectional relationships.Systematic review registration: PROSPERO identifier: CRD42023440688.
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Affiliation(s)
- Ewunetie Mekashaw Bayked
- Department of Pharmacy, College of Medicine and Health Sciences (CMHS), Wollo University, Dessie, Ethiopia
| | - Ebrahim M. Yimer
- Department of Pharmacy, College of Medicine and Health Sciences (CMHS), Wollo University, Dessie, Ethiopia
| | - Tiruset Gelaw
- Department of Midwifery, College of Medicine and Health Sciences (CMHS), Wollo University, Dessie, Ethiopia
| | - Abdu Seid Mohammed
- Department of Midwifery, College of Medicine and Health Sciences (CMHS), Wollo University, Dessie, Ethiopia
| | - Nigusie Abebaw Mekonen
- Department of Midwifery, College of Medicine and Health Sciences (CMHS), Wollo University, Dessie, Ethiopia
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Tomczyk-Warunek A, Winiarska-Mieczan A, Blicharski T, Blicharski R, Kowal F, Pano IT, Tomaszewska E, Muszyński S. Consumption of Phytoestrogens Affects Bone Health by Regulating Estrogen Metabolism. J Nutr 2024; 154:2611-2627. [PMID: 38825042 DOI: 10.1016/j.tjnut.2024.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 05/07/2024] [Accepted: 05/28/2024] [Indexed: 06/04/2024] Open
Abstract
Osteoporosis is a significant concern in bone health, and understanding its pathomechanism is crucial for developing effective prevention and treatment strategies. This article delves into the relationship between estrogen metabolism and bone mineralization, shedding light on how phytoestrogens can influence this intricate process. Estrogen, a hormone primarily associated with reproductive health, plays a pivotal role in maintaining bone density and structure. The article explores the positive effects of estrogen on bone mineralization, highlighting its importance in preventing conditions like osteoporosis. Phytoestrogens, naturally occurring compounds found in certain plant-based foods, are the focal point of the discussion. These compounds have the remarkable ability to mimic estrogen's actions in the body. The article investigates how phytoestrogens can modulate the activity of estrogen, thereby impacting bone health. Furthermore, the article explores the direct effects of phytoestrogens on bone mineralization and structure. By regulating estrogen metabolism, phytoestrogens can contribute to enhanced bone density and reduced risk of osteoporosis. Finally, the article emphasizes the role of plant-based diets as a source of phytoestrogens. By incorporating foods rich in phytoestrogens into one's diet, individuals may potentially bolster their bone health, adding a valuable dimension to the ongoing discourse on osteoporosis prevention. In conclusion, this article offers a comprehensive overview of 137 positions of literature on the intricate interplay between phytoestrogens, estrogen metabolism, and bone health, shedding light on their potential significance in preventing osteoporosis and promoting overall well-being.
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Affiliation(s)
- Agnieszka Tomczyk-Warunek
- Department of Rehabilitation and Physiotherapy, Laboratory of Locomotor Systems Research, Medical University of Lublin, Lublin, Poland
| | - Anna Winiarska-Mieczan
- Department of Bromatology and Nutrition Physiology, Institute of Animal Nutrition and Bromatology, University of Life Sciences in Lublin, Lublin, Poland.
| | - Tomasz Blicharski
- Department of Orthopedics and Rehabilitation, Medical University of Lublin, Lublin, Poland
| | - Rudolf Blicharski
- Department of Orthopedics and Rehabilitation, Medical University of Lublin, Lublin, Poland
| | - Filip Kowal
- Department of Orthopedics and Rehabilitation, Medical University of Lublin, Lublin, Poland
| | - Inés Torné Pano
- Department of Orthopedics and Rehabilitation, Medical University of Lublin, Lublin, Poland
| | - Ewa Tomaszewska
- Department of Animal Physiology, University of Life Sciences in Lublin, Lublin, Poland
| | - Siemowit Muszyński
- Department of Biophysics, University of Life Sciences in Lublin, Lublin, Poland
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23
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Singh VK, Hu XH, Singh AK, Solanki MK, Vijayaraghavan P, Srivastav R, Joshi NK, Kumari M, Singh SK, Wang Z, Kumar A. Precision nutrition-based strategy for management of human diseases and healthy aging: current progress and challenges forward. Front Nutr 2024; 11:1427608. [PMID: 39183982 PMCID: PMC11341379 DOI: 10.3389/fnut.2024.1427608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 07/29/2024] [Indexed: 08/27/2024] Open
Abstract
Currently, the treatment of various human ailments is based on different therapeutic approaches including traditional and modern medicine systems. Precision nutrition has come into existence as an emerging approach considering the diverse aspects such as age, sex, genetic and epigenetic makeup, apart from the pathophysiological conditions. The continuously and gradually evolving disciplines of genomics about nutrition have elucidated the importance of genetic variations, epigenetic information, and expression of myriads of genes in disease progression apart from the involvement in modulating therapeutic responses. Further, the investigations have presented the considerable role of gut microbiota comprising of commensal and symbionts performing innumerable activities such as release of bioactive molecules, defense against pathogenic microbes, and regulation of immunity. Noteworthy, the characteristics of the microbiome change depending on host attributes, environmental factors, and habitat, in addition to diet, and therefore can be employed as a biomarker to unravel the response to given food. The specific diet and the components thereof can be suggested for supporting the enrichment of the desired microbial community to some extent as an important part of precision nutrition to achieve not only the goal of human health but also of healthy aging.
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Affiliation(s)
| | - Xiao-Hu Hu
- Guangxi Key Laboratory of Agricultural Resources Chemistry and Biotechnology, Agricultural College, Yulin Normal University, Yulin, China
| | - Amit Kishore Singh
- Botany Department, B.N. College, T.M. Bhagalpur University, Bhagalpur, India
| | - Manoj Kumar Solanki
- Department of Life Sciences and Biological Sciences, IES University, Bhopal, Madhya Pradesh, India
| | | | - Rajpal Srivastav
- Amity Institute of Biotechnology, Amity University, Noida, India
| | - Naveen Kumar Joshi
- Amity Institute of Microbial Biotechnology, Amity University, Noida, India
| | - Madhuree Kumari
- Department of Biochemistry, Indian Institute of Science, Bengaluru, India
| | - Sandeep Kumar Singh
- Department of Microbiology, Indian Agriculture Research Institute, New Delhi, India
| | - Zhen Wang
- Guangxi Key Laboratory of Agricultural Resources Chemistry and Biotechnology, Agricultural College, Yulin Normal University, Yulin, China
| | - Ajay Kumar
- Amity Institute of Biotechnology, Amity University, Noida, India
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Serin Y, Manini C, Amato P, Verma AK. The Impact of a Gluten-Free Diet on Pregnant Women with Celiac Disease: Do We Need a Guideline to Manage Their Health? GASTROINTESTINAL DISORDERS 2024; 6:675-691. [DOI: 10.3390/gidisord6030045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2025] Open
Abstract
A healthy and balanced diet is a critical requirement for pregnant women as it directly influences both the mother’s and infant’s health. Poor maternal nutrition can lead to pregnancy-related complications with undesirable effects on the fetus. This requirement is equally important for pregnant women with celiac disease (CD) who are already on a gluten-free diet (GFD). Although the GFD is the sole treatment option for CD, it still presents some challenges and confusion for celiac women who wish to conceive. Poorly managed CD has been linked to miscarriages, preterm labor, low birth weight, and stillbirths. Current CD guidelines primarily focus on screening, diagnosis, treatment, and management but lack an evidence-based approach to determine appropriate energy requirements, recommended weight gain during pregnancy, target macronutrient distribution from the diet, the recommended intake of vitamins and minerals from diet and/or supplementation, timing for starting supplementation, and advised portions of gluten-free foods during pregnancy. We recommend and call for the development of such guidelines and/or authoritative papers in the future.
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Affiliation(s)
- Yeliz Serin
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Cukurova University, 01380 Adana, Turkey
| | - Camilla Manini
- Department of Medicine, Marche Polytechnic University, 60123 Ancona, Italy
| | - Pasqualino Amato
- Department of Medicine, Marche Polytechnic University, 60123 Ancona, Italy
| | - Anil K. Verma
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON L8S 4K1, Canada
- Celiac Disease Research Laboratory, Marche Polytechnic University, 60123 Ancona, Italy
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Uriza-Pinzón JP, Verstraete FF, Franco OH, Artola Arita V, Nicolaou M, Van der Schouw YT. Planetary Health Diet Compared to Dutch Dietary Guidelines: Nutritional Content and Adequacy. Nutrients 2024; 16:2219. [PMID: 39064662 PMCID: PMC11280056 DOI: 10.3390/nu16142219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 06/28/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024] Open
Abstract
In 2019, the EAT-Lancet Commission proposed a Planetary Health Diet (PHD) to address challenges toward sustainable and healthy diets. However, its suitability within the Dutch context and a comparison with the Dutch Dietary Guidelines (DDG) needs investigation. Our study aimed to compare the PHD with DDG in terms of food groups, servings, nutritional content, and adequacy in adults. We modeled two theoretical diets, the PHD (PHD-NL) and another based on the DDG (DDG-NL), using the Dutch National Food Consumption Survey (FCS-2016) and Dutch Food Composition Database to calculate the nutritional content and compared it with the Dutch Dietary Reference Values (DRVs). The PHD included higher quantities of vegetables, fish, legumes, and nuts, while the DDG suggested more significant amounts of cereals, tubers, starchy vegetables, dairy, and red meat. We observed differences in macronutrient distribution; while both diets lacked sufficient vitamin D, calcium content was lower in the PHD-NL. The PHD-NL had higher levels of fiber, vegetable protein, unsaturated fats, and non-heme iron, while vitamins B2, B6, B12, and calcium were lower than the DDG-NL diet. The PHD-NL has nutritional adequacy in the Dutch context, except for vitamin D and calcium, although it is essential to be cautious with iron because of the bioavailability of non-heme iron in plant-based diets. These findings have implications for the adoption of a sustainable diet according to nutritional requirements, population health status, and sociocultural context, as well as compliance with specific dietary behaviors of populations.
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Affiliation(s)
- Julieth Pilar Uriza-Pinzón
- Department of Global Public Health & Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (J.P.U.-P.)
| | - Femke Fleur Verstraete
- Department of Global Public Health & Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (J.P.U.-P.)
- Division of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, The Netherlands
| | - Oscar H. Franco
- Department of Global Public Health & Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (J.P.U.-P.)
| | - Vicente Artola Arita
- Department of Global Public Health & Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (J.P.U.-P.)
| | - Mary Nicolaou
- Department of Public and Occupational Health, Amsterdam University Medical Center, University of Amsterdam, 1081 BT Amsterdam, The Netherlands
| | - Yvonne T. Van der Schouw
- Department of Global Public Health & Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (J.P.U.-P.)
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El-Sayed AA, Sallam AM, Abou-Soliman I. Metabolic profile and gene expression pattern of cytokines and antioxidants markers during different physiological stages in Barki ewes. BMC Vet Res 2024; 20:206. [PMID: 38760770 PMCID: PMC11100279 DOI: 10.1186/s12917-024-04018-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/15/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND In livestock, identifying the physiological and reproductive stages is valuable in guiding management decisions related to nutrition, veterinary procedures, and breeding programs. To achieve this goal, a cohort of Barki ewes in this research underwent observation across three pivotal physiological conditions: pre-pregnancy, late pregnancy, and early lactation. Blood samples were collected to investigate the changes in serum metabolic profile as well as gene expression pattern of cytokines and antioxidants markers during these stages. RESULTS Our results showed that during late pregnancy, there was a significant (P < 0.05) increase in red blood cells (11.9 ± 0.5 1012/L), hemoglobin (10.8 ± 0.4 g/dl) and neutrophils count (7 ± 0.1 109/L) with significant decrease (P < 0.05) of total white blood cell count (9.1 ± 0.05 109/L). The packed cell volume (%) and monocyte count showed a significant (P < 0.05) decrease during both late pregnancy and early lactation stages. The serum concentrations of glucose, cholesterol, GSH, GPx, SOD and catalase displayed significant (P < 0.05) decrease during late pregnancy and early-lactation. Notably, during late pregnancy, there was a significant (P < 0.05) increase in the serum concentrations of albumin, globulin, urea, IGF-1, and malondialdehyde with significant decrease (P < 0.05) of total protein (4.9 ± 0.08 g/dl). Additionally, during early lactation, there was a significant (P < 0.05) increase in the serum levels of non-esterified fatty acids, triiodothyronine (T3), and thyroxin (T4). The gene expression profiles of cytokines (IL-4, IL-6, IL-8, and NFKB) were decreased in the ewes during late pregnancy compared to pre-pregnant and early lactation stages. In addition, the expression profile of antioxidant genes (SOD, CAT, GPX, and Nrf2) was significantly upsurged in the non-pregnant ewes compared to late pregnancy and early lactation ones. CONCLUSIONS The results concluded that different physiological status significantly affects the blood metabolic profile and gene expression pattern in Barki sheep. Our findings can be helpful in monitoring animal health and applying in breeding programs of Barki sheep under harsh environmental conditions.
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Affiliation(s)
- Ahmed Adel El-Sayed
- Department of Animal Health and Poultry, Animal and Poultry Production Division, Desert Research Center (DRC), Mataryia, Cairo, Egypt
| | - Ahmed M Sallam
- Department of Animal and Poultry Breeding, Animal and Poultry Production Division, Desert Research Center (DRC), Mataryia, Cairo, Egypt
| | - Ibrahim Abou-Soliman
- Department of Animal and Poultry Breeding, Animal and Poultry Production Division, Desert Research Center (DRC), Mataryia, Cairo, Egypt.
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Caviness PC, Lazarenko OP, Blackburn ML, Chen JF, Randolph CE, Zabaleta J, Zhan F, Chen JR. Phenolic acids prevent sex-steroid deficiency-induced bone loss and bone marrow adipogenesis in mice. J Nutr Biochem 2024; 127:109601. [PMID: 38367948 DOI: 10.1016/j.jnutbio.2024.109601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/19/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
Phenolic acids, such as hippuric acid (HA) and 3-(3-hydroxyphenyl) propionic acid (3-3-PPA), can be produced from microbiome digestion of polyphenols. Previously it was found that HA and 3-3-PPA facilitate bone formation and suppress bone resorption. However, the mechanism of action by which HA and 3-3-PPA protect bone from degeneration is currently unknown. In this report, we present that HA and 3-3-PPA suppression of bone resorption is able to ameliorate bone loss in an ovariectomy (OVX) osteopenic mouse model though not to the extent of Zoledronic acid (ZA). HA and 3-3-PPA treatments were shown to significantly decrease bone marrow adipocyte-like cell formation and inhibited gene expression of key adipogenesis regulator peroxisome proliferator activated receptor gamma (PPARγ) and lipoprotein lipase (Lpl) in bone from OVX mice. In addition, ChIP experiments showed that the association between PPARγ and Lpl promoter region in preadipocyte-like cells was significantly suppressed following HA or 3-3-PPA treatment. Contrasting HA and 3-3-PPA, ZA significantly increased TRAP activity in the area close to growth plate and significantly suppressed bone cell proliferation. These data suggest that phenolics acids such as HA or 3-3-PPA may prevent bone degeneration after OVX through suppression of inflammatory milieu in the bone.
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Affiliation(s)
- Perry C Caviness
- Arkansas Children's Nutrition Center, Little Rock, Arkansas 72205, USA; Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA
| | - Oxana P Lazarenko
- Arkansas Children's Nutrition Center, Little Rock, Arkansas 72205, USA; Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA
| | - Michael L Blackburn
- Arkansas Children's Nutrition Center, Little Rock, Arkansas 72205, USA; Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA
| | - Jennifer F Chen
- Undergraduate Pre-Medical Program, University of Arkansas at Fayetteville, Fayetteville, Arkansas 72701, USA
| | - Christopher E Randolph
- Center for Translational Pediatric Research, Arkansas Children's Research Institute, Little Rock, Arkansas 72202, USA
| | - Jovanny Zabaleta
- Department of Interdisciplinary Oncology, Louisiana State University Health Sciences Center, New Orleans, Los Angeles 70112, USA
| | - Fenghuang Zhan
- Myeloma Center, Winthrop P. Rockefeller Cancer Institute, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jin-Ran Chen
- Arkansas Children's Nutrition Center, Little Rock, Arkansas 72205, USA; Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA.
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Kokkinari A, Dagla M, Antoniou E, Lykeridou A, Kyrkou G, Bagianos K, Iatrakis G. The Correlation between Maternal and Neonatal Vit D (25(OH)D) Levels in Greece: A Cross-Sectional Study. Clin Pract 2024; 14:749-764. [PMID: 38804392 PMCID: PMC11130881 DOI: 10.3390/clinpract14030060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/10/2024] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Few studies have correlated maternal and neonatal Vit D (25(OH)D) levels at birth in Greece. We investigated this potential association, taking into account the administration or not of low doses (400-800 IU) of prenatal Vit D supplements. Our study contributes evidence not only to the small amount of existing literature regarding the above correlation, but also to the topic of maternal and neonatal vitamin D deficiency (VDD) during pregnancy in Mediterranean countries, such as Greece. METHODS A cross-sectional study was conducted on 248 neonates and their mothers from September 2019 to January 2022. Blood samples of 25(OH)D were studied at the time of delivery. Frequency counts and percentages were registered, and logistic regression was used to investigate the independent factors associated with maternal Vit D status. The Chi-square test and the Pearson coefficient were used to demonstrate a possible association between maternal and neonatal 25(OH)D levels. RESULTS Our findings show a high prevalence of VDD in Greek women and their newborns at birth. This was observed not only in women who did not receive Vit D supplements, but also in all the study groups, especially in the autumn and winter months. We observed that mothers who received low doses (400-800 IU) of prenatal Vit D supplements increased both their own 25(OH)D concentrations and those of their newborns; however, the latter did not seem to be completely covered by the prenatal administration of Vit D because, although their 25(OH)D concentrations increased, they never reached sufficient 25(OH)D levels, unlike their mothers who reached sufficient concentrations. CONCLUSIONS Overall, this study highlights the strong association between maternal and neonatal 25(OH)D concentrations at the end of gestation. However, neonates tended to show even lower 25(OH)D concentrations relative to maternal 25(OH)D concentrations. The same phenomenon was observed irrespective of the administration of Vit D supplements during pregnancy. Moreover, this is what was observed concerning the administration of formulations with 400-800 IU of Vit D, which the doctors in our clinic used in the present study. In any case, more clinical studies related to the administration of higher doses of Vit D supplementation to pregnant women would lead to more reliable conclusions. Without a doubt, the measurement of maternal vitamin D status during pregnancy provides opportunities for preventive and therapeutic interventions in the mother-infant pair.
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Affiliation(s)
- Artemisia Kokkinari
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
| | - Maria Dagla
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
| | - Evangelia Antoniou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
| | - Aikaterini Lykeridou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
| | - Giannoula Kyrkou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
| | - Kostas Bagianos
- Biochemical Department of Tzaneio Piraeus General Hospital, 18536 Piraeus, Greece
| | - Georgios Iatrakis
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
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Taylor RR, Jabori S, Kim M, Smartz T, Hale ES, Peleg M, Kassira W, Lessard AS, Thaller SR. Management of Maxillofacial Trauma in Pregnant Women. J Craniofac Surg 2024:00001665-990000000-01447. [PMID: 38597660 DOI: 10.1097/scs.0000000000009977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/10/2024] [Indexed: 04/11/2024] Open
Abstract
INTRODUCTION Trauma during pregnancy deserves special attention as management must be directed towards both the mother and the fetus. Management of maxillofacial fractures in pregnancy can adversely affect the well-being of the fetus by impinging on normal functions such as respiration, mastication, and nutrition. Pregnancy complicates the management of facial injury due to the maintenance of the patent airway, anesthesia considerations, and imaging restraints. The purpose of this study is to use three illustrative from our own institution to further elucidate education on the management of mandible fracture in pregnancy with a focus on multidisciplinary treatment and outcomes. METHODS A retrospective chart review was performed for all cases of facial fractures admitted to Ryder Trauma Center from 2012 to 2022. During this time, 4,910 patients presented with facial fractures 1319 patients were female. Three of the patients were pregnant at the time of admission. Demographics, mechanism of injury, associated injuries, and management information were collected. RESULTS Patient 1 was a 20-year-old female presented to Ryder Trauma Center following a motor vehicle collision. She was 17 weeks pregnant at the time of admission and was found to have a left mandibular angle fracture. Patient 2 was a 14-year-old female who presented to Ryder Trauma Center status post gunshot wound to the mandible after she and her brother were unknowingly playing with a loaded gun. She was 18 weeks pregnant at the time of admission, with a past medical history of domestic violence, suicidal ideation, and major depressive disorder. Patient 3 was a 20-year-old female 36 weeks pregnant at the time of admission. She presented with a right paraymphyseal fracture and left mandibular angle fracture as a result of falling on the stairs. Patients all underwent surgical repair of fractures.
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Affiliation(s)
- Ruby R Taylor
- University of Miami Miller School of Medicine, Miami, FL
| | - Sinan Jabori
- DeWitt Daughtry Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Minji Kim
- University of Miami Miller School of Medicine, Miami, FL
| | - Taylor Smartz
- University of Miami Miller School of Medicine, Miami, FL
| | - Eva S Hale
- University of Miami Miller School of Medicine, Miami, FL
| | - Michael Peleg
- Division of Oral and Maxillofacial Surgery, DeWitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Wrood Kassira
- Division of Oral and Maxillofacial Surgery, DeWitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Anne-Sophie Lessard
- DeWitt Daughtry Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Seth R Thaller
- DeWitt Daughtry Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL
- Division of Oral and Maxillofacial Surgery, DeWitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL
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Hu R, Xu J, Hua Y, Li Y, Li J. Could early life DHA supplementation benefit neurodevelopment? A systematic review and meta-analysis. Front Neurol 2024; 15:1295788. [PMID: 38645744 PMCID: PMC11032049 DOI: 10.3389/fneur.2024.1295788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Background Docosahexaenoic acid (DHA) plays a crucial role in the growth and functional development of the infant brain. However, the impact of additional DHA supplementation on neurodevelopment in infants remains controversial in randomized controlled trials. In this systematic review and meta-analysis, we aimed to investigate the effects of prenatal and postnatal DHA supplementation on neurodevelopment. Methods We systematically searched the MEDLINE, EMBASE, and Cochrane Library electronic databases using a predefined strategy until 8 February 2024. We extracted relevant study characteristics and outcomes related to the nervous system. Two independent reviewers critically evaluated the included studies to assess their validity and risk of bias. Results A total of 21 studies met our inclusion criteria, one study was removed after quality assessment, and the meta-analysis included 9 randomized controlled trials. The meta-analysis results indicated that there was no statistically significant difference between the DHA supplementation group and the placebo group, as assessed by the Mental Development Index [MDI; mean difference (MD), 0.41; 95% confidence interval (CI), -0.91 to 1.73; p = 0.55]. However, the DHA group had a significantly higher Psychomotor Development Index (PDI) than the placebo group (MD, 1.47; 95% CI, 0.23 to 2.72; p = 0.02). Subgroup analyses based on populations showed that DHA supplementation was superior to placebo for infants in both MDI (language score conversion; MD, 2.05; 95% CI, -0.16 to 4.26; p = 0.07) and PDI (MD, 1.94; 95% CI, 0.23 to 3.65; p = 0.03). Other subgroup analyses indicated no statistical differences between the two groups. The remaining assessments that could not be summarized quantitatively underwent a narrative evaluation. Conclusion Based on the BSID assessments, DHA supplementation in infants may have potential neurodevelopmental benefits. Because the meta-analysis included few high-quality articles and had some limitations, more relevant articles are needed to address the need for separate DHA supplementation in infants, pregnant women, and lactating mothers. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022348100, identifier: CRD42022348100.
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Affiliation(s)
| | | | | | - Yifei Li
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jinrong Li
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
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Lawson Y, Comerford KB, Mitchell EP. A review of dairy food intake for improving health for black women in the US during pregnancy, fetal development, and lactation. J Natl Med Assoc 2024; 116:219-227. [PMID: 38368233 DOI: 10.1016/j.jnma.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 02/19/2024]
Abstract
Pregnancy and lactation are special life stages that require regular nutritional and medical attention to help protect the health of the mother and promote the growth and development of the offspring. Despite an increased focus on maternal and fetal health over the last several decades, the rates of pregnancy-related morbidity and mortality are increasing in the United States (US). On average, Black women who are pregnant or lactating face greater health disparities and birth complications than other racial/ethnic groups in the US. The issues contributing to these disparities are multi-faceted and include sociocultural, economic, medical, and dietary factors. For example, Black women face greater rates of food insecurity, worse access to healthcare, and lower nutrient status when compared to White women. A growing body of research suggests that consuming a healthier dietary pattern is one of the most potent modifiable risk factors associated with improved fertility and reducing pregnancy-related complications. Recent publications have also shed light on the role of dairy foods in improving diet quality and nutrient status among Black women and for impacting maternal and fetal health outcomes, such as preeclampsia, spontaneous abortion, preterm birth, and fetal growth. To support healthy pregnancy and lactation, the current national dietary guidelines recommend the consumption of 3 servings of dairy foods per day. However, the vast majority of Black women in the US are falling short of these recommendations and are not meeting nutrient requirements for calcium and vitamin D. Therefore, strategies that target misconceptions surrounding lactose intolerance and focus on the health value of adequate dairy intake among Black women of child-bearing age may benefit both prenatal and postpartum health. This review presents the current evidence on health disparities faced by pregnant and lactating Black women in the US, and the role of dairy foods in supporting healthy pregnancy, fetal development, and lactation outcomes in this population.
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Affiliation(s)
- Yolanda Lawson
- FACOG, Associate Attending, Baylor University Medical Center, Dallas, TX, United States
| | - Kevin B Comerford
- OMNI Nutrition Science, California Dairy Research Foundation, Davis, CA, United States.
| | - Edith P Mitchell
- Sidney Kimmel Cancer at Jefferson, Philadelphia, PA, United States
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Muñoz Y, Mercado L, Farias C, Beyer MP, Alvear I, Echeverría F, Valenzuela R. Impact of polyunsaturated fatty acids during and pregnancy and lactation: A comprehensive review. Prostaglandins Leukot Essent Fatty Acids 2024; 203:102656. [PMID: 39481326 DOI: 10.1016/j.plefa.2024.102656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 07/17/2024] [Accepted: 10/25/2024] [Indexed: 11/02/2024]
Abstract
BACKGROUND Docosahexaenoic acid (DHA) and arachidonic acid (ARA) are relevant polyunsaturated fatty acids (PUFA) derived from alpha-linolenic acid (ALA) and linoleic acid (LA), respectively. These are important in pregnancy and lactation periods because of their benefits to the developing fetus and infant. Currently, the high prevalence of gestational obesity has led to a revision of PUFAs recommendations in these periods, due to changes in the lipid profile of women marked by a higher consumption of n-6 PUFA. OBJECTIVE This review aims to present an updated compilation of evidence on DHA and ARA during gestation and lactation. METHODS The literature review was performed in different databases, PubMed, Scopus, Web of Science, Scielo, ISI, and Ovid MedLine, highlighting the importance of DHA and ARA for newborn development. RESULTS An adequate intake of n-3 PUFA, especially DHA, in the mother during pregnancy and the postnatal period is important for the normal development of the child's brain. Maternal DHA supplementation increases DHA levels in mothers, but its direct link to infant neurodevelopment remains unclear. Obesity generates changes in the FA profile of pregnant women, causing an imbalance of n-3 and n-6 PUFA. An adequate level of DHA benefits children's cognitive function. However, a potential connection exists to the infants' inflammatory profile. CONCLUSION During gestation and lactation periods, an adequate DHA intake and n-6/ n-3 PUFA ratio (especially for obese women) are important for the optimal growth and brain development of the child.
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Affiliation(s)
- Yasna Muñoz
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile; Escuela de Nutrición y Dietética, Facultad de Farmacia, Universidad de Valparaíso, Chile
| | - Lorena Mercado
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile; Dirección de Postgrado, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370035, Chile
| | - Camila Farias
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - María Paz Beyer
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile; Escuela de Nutrición y Dietética, Facultad de Farmacia, Universidad de Valparaíso, Chile
| | - Ignacio Alvear
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Francisca Echeverría
- Carrera Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo Valenzuela
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile.
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Stafford L, Munns L, Crossland AE, Kirk E, Preston CEJ. Bonding with bump: Interoceptive sensibility moderates the relationship between pregnancy body satisfaction and antenatal attachment. Midwifery 2024; 131:103940. [PMID: 38335693 DOI: 10.1016/j.midw.2024.103940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/19/2023] [Accepted: 01/28/2024] [Indexed: 02/12/2024]
Abstract
PROBLEM There is limited understanding and contradictory results regarding the contribution of the pregnant bodily experience to antenatal attachment. BACKGROUND Antenatal attachment is an important aspect of pregnancy, which has been linked with positive maternal and infant outcomes. Given the profound physical process of pregnancy, it is likely that bodily experience is implicated in antenatal attachment, with research supporting the involvement of pregnancy body (dis)satisfaction. However, previous research reveals conflicting results and has only focused on exteroceptive bodily experience (appearance) rather than internal physiological sensations (interoception). AIM To examine the relative contributions of both external and internal bodily experience in antenatal attachment. METHODS This cross-sectional study collected online survey data from 159 pregnant participants with measures capturing interoceptive sensibility (subjective experience of interoception), pregnancy body dissatisfaction and antenatal attachment. FINDINGS We replicated previous findings that pregnancy body dissatisfaction is related to antenatal attachment. However, the relationship between pregnancy body dissatisfaction and antenatal attachment was moderated by worry about interoceptive signals. The interoceptive construct of body trust was most strongly associated with antenatal attachment. DISCUSSION The results suggest that interoception is important for antenatal attachment, particularly feelings of body trust. Moreover, for individuals who were less worried about bodily sensations, high levels of body dissatisfaction were associated with low attachment scores, whilst for those who were more concerned about these sensations, the relationship between body dissatisfaction and antenatal attachment was mitigated. CONCLUSION The results suggest that focusing on internal sensations may be a protective strategy against pregnancy body dissatisfaction to strengthen maternal bonds.
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Affiliation(s)
- Lucy Stafford
- Department of Psychology, University of York, York, United Kingdom
| | - Lydia Munns
- Department of Psychology, University of York, York, United Kingdom
| | - Anna E Crossland
- Department of Psychology, University of York, York, United Kingdom
| | - Elizabeth Kirk
- Department of Psychology, Anglia Ruskin University, Cambridge, United Kingdom
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Agarwal S, Fulgoni VL. Contribution of Beef to Key Nutrient Intakes and Nutrient Adequacy in Pregnant and Lactating Women: NHANES 2011-2018 Analysis. Nutrients 2024; 16:981. [PMID: 38613015 PMCID: PMC11013741 DOI: 10.3390/nu16070981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
Beef is an important source of high-quality protein and several micronutrients, including iron, zinc, and B-vitamins. The objective was to assess the association of beef intake with nutrient intake and adequacy among pregnant and lactating women using 24-h dietary recall data. Usual intakes from foods were determined with the National Cancer Institute (NCI) method and % population below Estimated Average Requirement (EAR) or above Adequate Intake (AI) were estimated. A high proportion of pregnant and lactating women had inadequate intakes for vitamin D (94%), vitamin E (82%), vitamin C (52%), and vitamin A (50%), magnesium (35%), folate (31%), zinc (25%), and vitamin B6 (22%); only 4% and 35% met AI for choline and potassium, respectively. About 67% of pregnant and lactating women were beef consumers, consuming 49 g beef/day. Beef consumers had higher intakes (p < 0.05) of energy, protein, calcium, iron, phosphorus, selenium, sodium, zinc, thiamin, riboflavin, and niacin, and a higher proportion (p < 0.05) met nutrient recommendations for protein, calcium, iron, zinc, thiamin, riboflavin, niacin, vitamin B6, and vitamin B12 compared to non-consumers. In conclusion, pregnant and lactating women generally have inadequate nutrient intakes from their diets. Beef consumers have higher intakes and adequacy for certain nutrients, many of which are inherently available in beef or in foods eaten with beef.
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Zhang X, Han X, Chen B, Fu X, Gong Y, Yang W, Chen Q. Influence of nutritional supplements on antibody levels in pregnant women vaccinated with inactivated SARS-CoV-2 vaccines. PLoS One 2024; 19:e0289255. [PMID: 38452000 PMCID: PMC10919710 DOI: 10.1371/journal.pone.0289255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/03/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Because of the significantly higher demand for nutrients during pregnancy, pregnant women are more likely to have nutrient deficiencies, which may adversely affect maternal and fetal health. The influence of nutritional supplements on the immune effects of inactivated SARS-CoV-2 vaccines during pregnancy is not clear. METHODS In a multicenter cross-sectional study, we enrolled 873 pregnant women aged 18-45 y in Guangdong, China. The general demographic characteristics of pregnant women and their use of nutritional supplements were investigated, and the serum antibody levels induced by inactivated SARS-CoV-2 vaccines were measured. A logistic regression model was used to analyze the association between nutritional supplements and SARS-CoV-2 antibody levels. RESULTS Of the 873 pregnant women enrolled, 825 (94.5%) took folic acid during pregnancy, 165 (18.9%) took iron supplements, and 197 (22.6%) took DHA. All pregnant women received at least one dose of inactivated SARS-CoV-2 vaccine, and the positive rates of serum SARS-CoV-2 neutralizing antibodies (NAbs) and immunoglobulin G (IgG) antibodies were 44.7% and 46.4%, respectively. After adjustment for confounding factors, whether pregnant women took folic acid, iron supplements, or DHA did not influence NAb positivity or IgG positivity (P > 0.05). Compared with pregnant women who did not take folic acid, the odds ratios (ORs) for the presence of SARS-CoV-2 NAb and IgG antibody in pregnant women who took folic acid were 0.67 (P = 0.255; 95% CI, 0.34-1.32) and 1.24 (P = 0.547; 95% CI, 0.60-2.55), respectively. Compared with pregnant women who did not take iron supplements, the ORs for the presence of NAb and IgG antibody in pregnant women who took iron supplements were 1.16(P = 0.465; 95% CI, 0.77-1.76) and 0.98 (P = 0.931; 95% CI, 0.64-1.49), respectively. Similarly, the ORs for NAb and IgG antibody were 0.71 (P = 0.085; 95% CI, 0.49-1.04) and 0.95 (P = 0.801; 95% CI, 0.65-1.38) in pregnant women who took DHA compared with those who did not. CONCLUSIONS Nutritional supplementation with folic acid, iron, or DHA during pregnancy was not associated with antibody levels in pregnant women who received inactivated SARS-CoV-2 vaccines.
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Affiliation(s)
- Xi Zhang
- Department of Occupational and Environmental Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Xue Han
- Department of Occupational and Environmental Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Baolan Chen
- Department of Occupational and Environmental Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Xi Fu
- Department of Occupational and Environmental Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Yajie Gong
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Wenhan Yang
- Department of Child and Adolescent Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Qingsong Chen
- Department of Occupational and Environmental Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
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Rizk J, Andreou E, Hileti D, Ghaddar A, Zampelas A. Nutrition knowledge among pregnant women in Lebanon: A cross-sectional study. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241272216. [PMID: 39206637 PMCID: PMC11363051 DOI: 10.1177/17455057241272216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/06/2024] [Accepted: 07/02/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Women's knowledge of the nutritional guidelines during pregnancy can affect the health and nutritional status of both mother and child. Having good nutritional information related to maternal dietary intake and healthy lifestyles is therefore of great importance. However, there is limited published research that demonstrates pregnant women's knowledge of the nutritional guidelines during pregnancy in Lebanon. OBJECTIVE To assess the knowledge on food sources and energy recommendations as well as food safety practices and diet-health relationship among women during pregnancy in Lebanon. DESIGN A cross-sectional study. METHODS The study was conducted at prenatal care clinics in Lebanon, and all pregnant women present, regardless of nationality, were invited to complete the self-administered nutrition knowledge questionnaire. The study assessed five different nutrition knowledge domains (food sources of nutrients, dietary behaviors, food safety knowledge, micronutrients for fetal development, and energy requirements and weight gain) and the demographic characteristics of pregnant women who completed a multidimensional online survey based on validated and existing measures. RESULTS Four-hundred and ten responses were obtained. Approximately half of respondents (47%) held a university degree, for 42% of women this was their first pregnancy, and 71% had a planned pregnancy. Among the different nutrition knowledge domains, the highest levels of knowledge were for the behaviors that can minimize the effect of nausea/vomiting, heartburn, and constipation during pregnancy (63.9%) and the lowest levels of knowledge was for the importance of iodine and omega-3 fatty acids in pregnancy (28.4%). Most of females knew about food safety practices during pregnancy (72.9%) but less than half were knowledgeable about listeriosis contamination (45.9%), and the types of fish that are the safest to select during pregnancy (47.8%). CONCLUSION Despite the fact that pregnant women had an adequate level of knowledge in different nutrition-related areas, there was inadequate level of awareness related to critical nutrients and behaviors that can have adverse effects on mother and/or baby. Therefore, there is a need to focus on specific maternal nutrition aspects such as iron-rich foods, listeriosis food contamination, and nutrients that aid in fetal brain and retina development.
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Affiliation(s)
- Jessy Rizk
- Department of Life Sciences, University of Nicosia, Nicosia, Cyprus
| | - Eleni Andreou
- Department of Life Sciences, University of Nicosia, Nicosia, Cyprus
| | - Dona Hileti
- Department of Life Sciences, University of Nicosia, Nicosia, Cyprus
| | - Ali Ghaddar
- Department of Biomedical Science, Lebanese International University, Beirut, Lebanon
- Public Health Research Group, University of Alicante, Alicante, Spain
| | - Antonis Zampelas
- Department of Life Sciences, University of Nicosia, Nicosia, Cyprus
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece
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Svensson K, Gennings C, Hagenäs L, Wolk A, Håkansson N, Wikström S, Bornehag CG. Maternal nutrition during mid-pregnancy and children's body composition at 7 years of age in the SELMA study. Br J Nutr 2023; 130:1982-1992. [PMID: 37232113 PMCID: PMC10632724 DOI: 10.1017/s0007114523000983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/24/2023] [Accepted: 04/12/2023] [Indexed: 05/27/2023]
Abstract
Optimal nutrition during pregnancy is vital for both maternal and child health. Our objective was to explore if prenatal diet is associated with children's height and body fat. Nutrient intake was assessed through a FFQ from 808 pregnant women and summarised to a nutrition index, 'My Nutrition Index' (MNI). The association with children's height and body fat (bioimpedance) was assessed with linear regression models. Secondary analysis was performed with BMI, trunk fat and skinfolds. Overall, higher MNI score was associated with greater height (β = 0·47; (95 % CI 0·00, 0·94), among both sexes. Among boys, higher MNI was associated with 0·15 higher BMI z-scores, 0·12 body fat z-scores, 0·11 trunk fat z-scores, and larger triceps, and triceps + subscapular skinfolds (β = 0·05 and β = 0·06; on the log2 scale) (P-value < 0·05). Among girls, the opposite associations were found with 0·12 lower trunk fat z-scores, and smaller subscapular and suprailiac skinfolds (β = -0·07 and β = -0·10; on the log2 scale) (P-value < 0·05). For skinfold measures, this would represent a ± 1·0 millimetres difference. Unexpectedly, a prenatal diet in line with recommended nutrient intake was associated with higher measures of body fat for boys and opposite to girls at a pre-pubertal stage of development.
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Affiliation(s)
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Lars Hagenäs
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niclas Håkansson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sverre Wikström
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
- Centre for Clinical Research and Education, County Council of Värmland, Värmland County, Sweden
| | - Carl-Gustaf Bornehag
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
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Wanjari MB, Late SV, Sharma R, Munjewar PK. A critical evaluation of prenatal supplements: Are they meeting the mark? J Family Med Prim Care 2023; 12:3048-3054. [PMID: 38361856 PMCID: PMC10866212 DOI: 10.4103/jfmpc.jfmpc_1038_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/10/2023] [Accepted: 09/01/2023] [Indexed: 02/17/2024] Open
Abstract
Prenatal supplements are commonly used to support maternal health and fetal development during pregnancy. However, there are concerns regarding their efficacy and safety. This review article provides a critical evaluation of prenatal supplements, including their types, benefits, criticisms, factors affecting their efficacy, and popular brands. It also offers recommendations for their use and identifies future research directions. Our analysis suggests that while prenatal supplements can offer important benefits, including reduced risk of birth defects and improved fetal growth and development, there are also concerns regarding their regulation, dosages, and potential harm to the mother and fetus. Pregnant women should carefully evaluate the ingredients, dosages, efficacy, and safety of prenatal supplements with the guidance of their healthcare provider. Future research should focus on standardizing dosages and regulation of prenatal supplements to ensure consistent quality, safety, and efficacy.
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Affiliation(s)
- Mayur B. Wanjari
- Department of Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India
| | - Sampada V. Late
- Department of Nursing, Government Hospital Samudrapur, Wardha, Maharashtra, India
| | - Ranjana Sharma
- Department of Medical Surgical Nursing, Srimati Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India
| | - Pratiksha K. Munjewar
- Department of Medical Surgical Nursing, Srimati Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India
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Vyawahare AP, Gaidhane A, Wandile B. Asthma in Pregnancy: A Critical Review of Impact, Management, and Outcomes. Cureus 2023; 15:e50094. [PMID: 38186538 PMCID: PMC10770773 DOI: 10.7759/cureus.50094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
Asthma is a common chronic respiratory condition that can significantly impact the health of pregnant women and their developing fetuses. This comprehensive review provides insights into the prevalence of asthma in pregnant women, the physiological changes during pregnancy, and the multifaceted impact of asthma on maternal and fetal health. It emphasizes the importance of proper asthma diagnosis, medication management, and the development of personalized asthma action plans during pregnancy. Lifestyle modifications, trigger avoidance, and stress reduction are essential to effective management. Healthcare providers are pivotal in educating, monitoring, and individualized care to ensure optimal asthma control. The review underscores the critical significance of managing asthma during pregnancy, as it improves maternal and fetal outcomes and potentially influences long-term health for both mother and child. Future directions in this field involve ongoing research, personalized treatment, early intervention, and precision medicine to enhance the understanding and care of asthma during pregnancy.
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Affiliation(s)
- Anisha P Vyawahare
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Abhay Gaidhane
- Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Bhushan Wandile
- Hospital Administration, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science, Wardha, IND
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Naaz A, Muneshwar KN. How Maternal Nutritional and Mental Health Affects Child Health During Pregnancy: A Narrative Review. Cureus 2023; 15:e48763. [PMID: 38098932 PMCID: PMC10719542 DOI: 10.7759/cureus.48763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/13/2023] [Indexed: 12/17/2023] Open
Abstract
Throughout pregnancy, the mother's nutritional and mental health significantly influences the kid's long-term growth and wellness. This review's objective is to provide a comprehensive assessment of the literature on the link between pregnancy nutrition and a sound mind and a foetus' growth, considering factors in the physical, cognitive, emotional, and social domains. A balanced, nutrient-rich diet is crucial for the baby to grow and develop properly during pregnancy. An appropriate diet of significant macronutrients and micronutrients supports good foetal organ development, cognitive function, and immune system resiliency. For instance, studies have linked iron and omega-3 fatty acids to a reduced risk of developmental delays and improved cognitive performance. Contrarily, malnutrition in mothers, such as undernutrition or excessive weight gain, has been connected with negative results, including low birth weight, poor neurodevelopment, and increased susceptibility to chronic diseases in later life. The mother's mental health, including emotional equilibrium and psychological stability, significantly impacts the child's development. Stress, anxiety, and depression experienced by mothers during pregnancy harm the developing foetus and increase the risk of cognitive, behavioural, and emotional difficulties in the offspring. The growing foetus is exposed to high levels of stress hormones due to chronic maternal stress, which might alter the fetus's brain's shape and function. Factors influencing child development outcomes include maternal-infant attachment, breastfeeding start and duration, and general caring practices. A comprehensive approach is critical since new research indicates a synergistic relationship between maternal nutrition and mental health. Inadequate nutritional intake might result from maternal mental health problems that interfere with appetite control and eating habits. On the other hand, inadequate maternal nutrition may raise maternal stress and result in mental health problems. Therefore, integrative therapies focusing on both areas are essential to maximise child development results. In conclusion, maternal nutrition and mental health during pregnancy significantly impact a child's development in various domains. Understanding the complex relationships between maternal nutrition and mental health is necessary to develop effective therapies and promote the most remarkable results for children. Further research is needed to understand better the underlying mechanisms to develop evidence-based recommendations for optimal mother care throughout pregnancy. The need of this review is to know how maternal health, physical or mental affects the child's development and how we can further prevent it by taking precautions during pregnancy.
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Affiliation(s)
- Afsana Naaz
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Komal N Muneshwar
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Ong AKW, Yee AL, Fong AJH, Arasoo VJT, Ramadas A. Effects of Ramadan fasting on fetal health: A systematic review. Aust N Z J Obstet Gynaecol 2023; 63:625-637. [PMID: 37283305 DOI: 10.1111/ajo.13706] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/07/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Ramadan fasting (RF) is mandatory for all healthy Muslims in the ninth month of the Islamic calendar. Although pregnant women are exempt from fasting, many make the decision to practise it. Concerns that fasting during pregnancy harms the fetus remain, as there are no firm recommendations regarding its safety. OBJECTIVES To provide a systematic review on the effects of RF on fetal health. SEARCH STRATEGY We conducted a literature search for peer-reviewed articles through Ovid MEDLINE, PubMed, SCOPUS, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) until 31 December 2021. SELECTION CRITERIA All case-control and observational cohort studies that reported on fetal outcomes of pregnant women who underwent RF for at least one day during pregnancy are included. DATA COLLECTION AND ANALYSIS Two researchers independently reviewed the eligibility of all studies. A third researcher resolved any conflict between researchers. Findings are extracted from eligible papers and presented as narratives. MAIN RESULTS Fourteen articles are included based on eligibility criteria, with a total sample size of 2889. Studies demonstrate negative associations between RF and neonatal weight, amniotic fluid index, preterm birth and growth parameters mainly during the second and third trimesters. However, the evidence is not strongly supported. CONCLUSION There is limited data to elucidate the relationship between RF and fetal health, hence the need for more studies to provide a better understanding.
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Affiliation(s)
- Andrew Khai Weyn Ong
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Anne Li Yee
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Adrian Jing Hong Fong
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | | | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
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Ngongalah L, Rapley T, Rankin J, Heslehurst N. Cultural Influences on African Migrant Pregnant and Postnatal Women's Dietary Behaviours and Nutrition Support Needs in the UK. Nutrients 2023; 15:4135. [PMID: 37836419 PMCID: PMC10574463 DOI: 10.3390/nu15194135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/20/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
Black women in the UK face significantly higher risks of overweight and obesity and adverse pregnancy outcomes compared to women from other ethnic groups. Maternal nutrition plays a pivotal role in influencing the health outcomes of women and their children, especially during preconception and pregnancy. Cultural and environmental factors significantly influence the dietary experiences of African women after migration. This study explored the unique nutrition-related challenges faced by African migrant pregnant and postnatal women in the UK, and their nutrition support needs. Interviews were conducted with 23 African migrant women living in the UK, who were either pregnant or had a pregnancy within the past 3 years. These were analysed thematically, resulting in five overarching themes: food rituals and beliefs, pregnancy cravings, limited access to culturally appropriate food, limited access to culturally appropriate and evidence-based nutritional guidance, and the focus on healthy weight. The study identified challenges that African migrant women face in balancing their cultural heritage with the UK food environment and dietary recommendations, including potential implications on their health and pregnancy outcomes. It emphasised the importance of addressing these challenges through culturally sensitive approaches and tailored interventions, to enable informed decision making and enhance health outcomes for these women.
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Affiliation(s)
- Lem Ngongalah
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK; (J.R.); (N.H.)
| | - Tim Rapley
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne NE7 7XA, UK;
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK; (J.R.); (N.H.)
| | - Nicola Heslehurst
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK; (J.R.); (N.H.)
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Szczuko M, Golańska J, Palma J, Ziętek M. Impact of Selected Eicosanoids in Normal and Pathological Pregnancies. J Clin Med 2023; 12:5995. [PMID: 37762934 PMCID: PMC10532391 DOI: 10.3390/jcm12185995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Pregnancy is a physiological state in which the female body undergoes a series of changes and adaptations to provide the best possible conditions for the growth and development of the forming baby. The internal adaptations that take place lead to the production of inflammation, which is necessary for the initial and final stages of pregnancy (embryo implantation and induction of labor). Gestational diabetes mellitus is considered to be the most common pathology during this period. However, many more serious health complications can arise, which include pre-eclampsia, fetal stunting, and preterm labor. The purpose of this study was to analyze the impact of the levels of individual eicosanoids on the course of normal pregnancy and the possibility of pathologies including gestational diabetes and pre-eclampsia. METHODS Sixty-nine pregnant women who were overweight or obese before and during pregnancy were studied. Eicosanoids were extracted as appropriate and then determined using liquid chromatography. The levels of eicosanoids studied in pregnant women differed not only according to the week of pregnancy but also in relation to individual anthropometric and biochemical parameters. RESULTS There was a significant correlation between being overweight and having a high BMI before pregnancy-as well as biochemical parameters of lipid and carbohydrate profiles-and the occurrence of pathological conditions in pregnancy. CONCLUSIONS Eicosanoids are involved in the pathology of pregnancy associated with the occurrence of gestational diabetes and pre-eclampsia. Salicylic acid may find use in the treatment of pregnant women exposed to both phenomena, as well as in overweight and obese women found before pregnancy. Diets rich in natural salicylates, methods of administration, and pharmacotherapy and dosage need further study. Some of the mediators (lipoxin, prostaglandin and leucotrien) may be new diagnostic markers in pregnancy pathology and intervention pathways in the future.
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Affiliation(s)
- Małgorzata Szczuko
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, W. Broniewskiego 24, 71-460 Szczecin, Poland
| | - Justyna Golańska
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, W. Broniewskiego 24, 71-460 Szczecin, Poland
| | - Joanna Palma
- Department of Biochemical Sciences, Pomeranian Medical University, 70-204 Szczecin, Poland;
| | - Maciej Ziętek
- Department of Perinatology, Obstetrics and Gynecology Pomeranian Medical University in Szczecin, Siedlecka 2, 72-010 Police, Poland;
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Nikolajeva K, Aizbalte O, Piskurjova A, Rezgale R, Cauce V, Začs D, Meija L. Fatty Acid Composition of a Maternal Diet and Erythrocyte Phospholipid Status in Latvian Pregnant Women. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1514. [PMID: 37763633 PMCID: PMC10532992 DOI: 10.3390/medicina59091514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/07/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND AND OBJECTIVES Dietary fats are essential for maternal and fetal health. Fatty acids (FAs) in erythrocytes characterize the FA profile, which is influenced by diet and other factors. The aim of this study was to evaluate the association between the main FAs in erythrocyte membrane phospholipids and their influencing factors-dietary fat and supplement intake and lifestyle factors-in Latvian pregnant women. MATERIALS AND METHODS This cross-sectional study included 236 pregnant and postpartum women. The data were collected from medical documentation, a food frequency questionnaire, and a questionnaire on demographic, lifestyle, health status, and nutritional habits in outpatient clinics and maternity departments. FAs in erythrocyte membrane phospholipids were determined using gas chromatography. RESULTS Correlations were found between dietary SFAs and erythrocyte SFAs (r = -0.140, p = 0.032) and PUFAs (r = 0.167, p = 0.01) and between dietary PUFAs and erythrocyte MUFAs (r = -0.143, p = 0.028). Dietary SFAs, MUFAs, and PUFAs positively correlated with the studied n-3 and n-6 FAs in erythrocytes. Vitamin D correlated positively with MUFA and negatively with total PUFA and AA in erythrocytes. There was a negative correlation between dietary vitamin A and linoleic acid in erythrocytes. Physical activity negatively correlated with erythrocyte MUFAs and positively with erythrocyte PUFAs. Alcohol consumption positively correlated with erythrocyte SFAs and negatively with erythrocyte PUFAs. CONCLUSIONS There are indications that some dietary FAs may be correlated with erythrocyte FAs. Possible influencing factors for this association are alcohol, physical activity, vitamin D, and vitamin A.
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Affiliation(s)
- Ksenija Nikolajeva
- Doctoral Department, Faculty of “Medicine”, Rīga Stradiņš University, 16 Dzirciema Street, LV-1007 Rīga, Latvia
- Riga East Clinical University Hospital, 2 Hipokrata Street, LV-1038 Rīga, Latvia;
| | - Olga Aizbalte
- Department of Public Health and Epidemiology, Rīga Stradiņš University, 9 Kronvalda bulvāris, LV-1010 Rīga, Latvia; (O.A.); (A.P.)
| | - Anna Piskurjova
- Department of Public Health and Epidemiology, Rīga Stradiņš University, 9 Kronvalda bulvāris, LV-1010 Rīga, Latvia; (O.A.); (A.P.)
| | - Roberta Rezgale
- Faculty of Medicine, Rīga Stradiņš University, 16 Dzirciema Street, LV-1007 Rīga, Latvia; (R.R.); (V.C.)
| | - Vinita Cauce
- Faculty of Medicine, Rīga Stradiņš University, 16 Dzirciema Street, LV-1007 Rīga, Latvia; (R.R.); (V.C.)
| | - Dzintars Začs
- Institute of Food Safety, Animal Health and Environment “BIOR”, Lejupes Street 3, LV-1076 Rīga, Latvia;
| | - Laila Meija
- Riga East Clinical University Hospital, 2 Hipokrata Street, LV-1038 Rīga, Latvia;
- Department of Public Health and Epidemiology, Rīga Stradiņš University, 9 Kronvalda bulvāris, LV-1010 Rīga, Latvia; (O.A.); (A.P.)
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Lira GVDAG, Barros MAMT, Andrade MEB, Sarinho FW, Fernandes FR, Kuschnir FC, Sarinho ESC. Immunobiography and women's health: repercussions from conception to senility. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e2023S104. [PMID: 37556623 PMCID: PMC10411709 DOI: 10.1590/1806-9282.2023s104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 08/11/2023]
Affiliation(s)
| | | | - Maria Elisa Bertocco Andrade
- Instituto de Assistência Médica ao Servidor Público Estadual, Department of Allergy and Immunology – São Paulo (SP), Brazil
| | - Filipe Wanick Sarinho
- Universidade Federal de Pernambuco, Allergy and Immunology Research Center – Recife (PE), Brazil
| | - Fátima Rodrigues Fernandes
- Instituto de Assistência Médica ao Servidor Público Estadual, Department of Allergy and Immunology – São Paulo (SP), Brazil
| | - Fabio Chigres Kuschnir
- Universidade Federal do Rio de Janeiro, Faculty of Medical Sciences, Department of Pediatrics – Rio de Janeiro (RJ), Brazil
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Ter Borg S, Koopman N, Verkaik-Kloosterman J. An Evaluation of Food and Nutrient Intake among Pregnant Women in The Netherlands: A Systematic Review. Nutrients 2023; 15:3071. [PMID: 37447397 DOI: 10.3390/nu15133071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Nutritional deficiencies during pregnancy can have serious consequences for the health of the (unborn) child. This systematic review provides an updated overview of the available food and nutrient intake data for pregnant women in The Netherlands and an evaluation based on the current recommendations. Embase, MEDLINE, and national institute databases were used. Articles were selected if they had been published since 2008 and contained data on food consumption, nutrient intake, or the status of healthy pregnant women. A qualitative comparison was made with the 2021 Dutch Health Council recommendations and reference values. A total of 218 reports were included, representing 54 individual studies. Dietary assessments were primarily performed via food frequency questionnaires. Protein, vitamin A, thiamin, riboflavin, vitamin B6, folate, vitamin B12, vitamin C, iron, calcium, and magnesium intakes seemed to be adequate. For folate and vitamin D, supplements were needed to reach the recommended intake. The reasons for concern are the low intakes of fruits, vegetables, and (fatty) fish, and the intakes of alcohol, sugary drinks, and salt. For several foods and nutrients, no or limited intake data were found. High-quality, representative, and recent data are needed to evaluate the nutrient intake of pregnant women in order to make accurate assessments and evaluations, supporting scientific-based advice and national nutritional policies.
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Affiliation(s)
- Sovianne Ter Borg
- National Institute for Public Health and the Environment, 3721 BA Bilthoven, The Netherlands
| | - Nynke Koopman
- National Institute for Public Health and the Environment, 3721 BA Bilthoven, The Netherlands
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Masina M, Medithi S, Muley A. Impact of Maternal Essential Fatty Acid Intake on the Birth Weight of Infants. JOURNAL OF MOTHER AND CHILD 2023; 27:147-157. [PMID: 37843970 PMCID: PMC10578463 DOI: 10.34763/jmotherandchild.20232701.d-22-00052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 06/05/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Increased uptake of essential fatty acids during pregnancy through seafood and supplementation has been shown to positively correlate with gestational age and increased infant birth weight. We aimed to evaluate the effect of maternal dietary intake of essential fatty acids, supplementation on gestational period and infant birth weight. MATERIALS A literature search with the help of various databases such as PubMed, Google Scholar, Web of Science and Scopus was conducted. METHODS Original research articles and intervention-based studies, which involve an association between dietary intake and supplementation of essential fatty acids during full-term pregnancy on human infant birth outcomes and published from 2011 to 2021, were included. RESULTS In total, there were 21 intervention-based studies, including full-term pregnant women with or without existing comorbidities, which compared essential fatty acids in the form of dietary sources and supplementation with dietary counseling and with or without placebo. The intervention trials included in this review were conducted in developed and developing countries. Half of the pregnant women who enrolled in the study had comorbidities such as diabetes and hypertension, which might increase their risk of adverse maternal and infant birth outcomes. Most of the studies included in the review have reported a positive association between improvised dietary and supplementation intake of essential fatty acids with increased length of gestation, infant birth weight and other parameters such as head circumference, infant birth length and growth velocity. CONCLUSION Positive correlations were found between increased consumption of essential fatty acids in food sources and supplements with improvised infant birth weight and gestational period.
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Affiliation(s)
- Manojna Masina
- Symbiosis Institute of Health Sciences (SIHS), Symbiosis International (Deemed University), Pune, Maharashtra, India
| | - Srujana Medithi
- Symbiosis Institute of Health Sciences (SIHS), Symbiosis International (Deemed University), Pune, Maharashtra, India
| | - Arti Muley
- Symbiosis Institute of Health Sciences (SIHS), Symbiosis International (Deemed University), Pune, Maharashtra, India
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Mayasari NR, Bai CH, Chao JCJ, Chen YC, Huang YL, Wang FF, Wiratama BS, Chang JS. Relationships between Dietary Patterns and Erythropoiesis-Associated Micronutrient Deficiencies (Iron, Folate, and Vitamin B 12) among Pregnant Women in Taiwan. Nutrients 2023; 15:nu15102311. [PMID: 37242193 DOI: 10.3390/nu15102311] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/05/2023] [Accepted: 05/13/2023] [Indexed: 05/28/2023] Open
Abstract
Globally, anemia affects 56 million pregnant women, especially women with a low household income. Functional erythropoiesis requires a constant supply of micronutrients, and the demands significantly increase during fetal development. This study aims to identify dietary patterns for preventing gestational erythropoiesis-associated micronutrient deficiencies (e.g., iron, folic acid, and vitamin B12). A Nationwide Nutrition and Health Survey in Pregnant Women, Taiwan (NAHSIT-PW), was conducted between 2017 and 2019. Data on baseline information, diet, anthropometrics, and blood biochemistry were collected during a prenatal visit. Dietary patterns were identified using a reduced rank regression (RRR). Erythropoiesis-related micronutrient deficiencies were defined as single, double, and triple micronutrient deficiencies of an iron deficiency, folate depletion, and a vitamin B12 deficiency. In total, 1437 singleton pregnancies aged ≥20-48 years were included in the analysis. Prevalences of normal nutrition, and single, double, and triple erythropoiesis-related micronutrient deficiencies were 35.7%, 38.2%, 18.6%, and 7.5%, respectively. Anemic pregnant women with a low household income had the highest prevalence rates of double (32.5%) and triple (15.8%) erythropoiesis-related micronutrient deficiencies. Dietary pattern scores were positively correlated with nuts and seeds, fresh fruits, total vegetables, breakfast cereals/oats and related products, soybean products, and dairy products but negatively correlated with processed meat products and liver, organs, and blood products. After adjusting for covariates, the dietary pattern had 29% (odds ratio (OR): 0.71; 95% confidence interval (CI): 0.055-0.091, p = 0.006)) and 43% (OR: 0.57; 95% CI: 0.41-0.80, p = 0.001)) reduced odds of having double and triple erythropoiesis-related micronutrient deficiencies for those pregnant women with a low household income. For those women with anemia, dietary patterns had 54% (OR: 046, 95% CI: 0.27-0.78) and 67% (OR: 0.33; 95% CI: 0.170.64) reduced odds of double and triple erythropoiesis-related micronutrient deficiencies. In conclusion, increased consumption of breakfast cereals and oats, nuts, and seeds, fresh fruits and vegetables, soybean products, and dairy products may protect women against erythropoiesis-related micronutrient deficiencies during pregnancy.
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Affiliation(s)
- Noor Rohmah Mayasari
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
- Department of Nutrition, Faculty of Sports and Health Sciences, Universitas Negeri Surabaya, Surabaya 60213, Indonesia
| | - Chyi-Huey Bai
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Jane C-J Chao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
| | - Yi-Chun Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
| | - Ya-Li Huang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Fan-Fen Wang
- Department of Internal Medicine, Yangming Branch, Taipei City Hospital, Taipei 11146, Taiwan
| | - Bayu Satria Wiratama
- Department of Biostatistics and Epidemiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Jung-Su Chang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Chinese Taipei Society for the Study of Obesity (CTSSO), Taipei 100, Taiwan
- TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei 11031, Taiwan
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Morales-Suárez-Varela M, Peraita-Costa I, Perales-Marín A, Marcos Puig B, Llopis-Morales J, Picó Y. Effect of Adherence to the Mediterranean Diet on Maternal Iron Related Biochemical Parameters during Pregnancy and Gestational Weight Gain. Life (Basel) 2023; 13:life13051138. [PMID: 37240783 DOI: 10.3390/life13051138] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
Gestation is a crucial life stage for both women and offspring, and outcomes are affected by many environmental factors, including diet. The Mediterranean dietary pattern (MD) is considered a healthy eating pattern that can provide the nutritional requirements of pregnancy. Meanwhile, iron deficiency anemia is one of the most frequent complications related to pregnancy. This study aimed to evaluate how the level of adherence to the MD influences maternal gestational weight gain and specific iron-related maternal biochemical parameters during the pregnancy. Accordingly, an observational, population-based study using data from pregnant women conducted over the entire course of their pregnancy was carried out. Adherence to the MD was assessed once using the MEDAS score questionnaire. Of the 506 women studied, 116 (22.9%) were classified as demonstrating a high adherence, 277 (54.7%) a medium adherence, and 113 (22.3%) a low adherence to the MD. No differences were observed in gestational weight gain among the MD adherence groups but the adequacy of weight gain did vary among the groups, with the proportions of inadequate (insufficient or excessive) weight gain presenting the most notable differences. Total anemia prevalence was 5.3%, 15.6%, and 12.3%, respectively, during the first, second, and third trimesters. For iron-related biochemical parameters, no differences are observed among the adherence groups during pregnancy. With high adherence to the MD as the reference group, the crude odds of iron deficiency diagnosis are significant in the first trimester for both the medium [OR = 2.99 (1.55-5.75)] and low [OR = 4.39 (2.15-8.96)] adherence groups, with deficient adherence to the Mediterranean dietary pattern being responsible for 66.5% (35.5-82.6) and 77.2% (53.5-88.8) of the risk of iron deficiency diagnosis for medium and low adherence, respectively. However, adjusted odds ratios were not significant, possibly due to the small sample size. Our data suggest that MD adherence could be related to gestational weight gain adequacy and that optimal adherence could reduce iron deficiency and/or anemia during pregnancy in the studied population.
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Affiliation(s)
- María Morales-Suárez-Varela
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot, València, Spain
- Biomedical Research Center in Epidemiology and Public Health Network, Carlos III Health Institute, Av. Monforte de Lemos 3-5 Pabellón 11 Planta 0, 28029 Madrid, Madrid, Spain
| | - Isabel Peraita-Costa
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot, València, Spain
- Biomedical Research Center in Epidemiology and Public Health Network, Carlos III Health Institute, Av. Monforte de Lemos 3-5 Pabellón 11 Planta 0, 28029 Madrid, Madrid, Spain
| | - Alfredo Perales-Marín
- Department of Gynecology and Obstetrics, La Fé University and Polytechnic Hospital, Avda. Fernando Abril Martorell, 106, 46026 València, Valencia, Spain
| | - Beatriz Marcos Puig
- Department of Gynecology and Obstetrics, La Fé University and Polytechnic Hospital, Avda. Fernando Abril Martorell, 106, 46026 València, Valencia, Spain
| | - Juan Llopis-Morales
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot, València, Spain
| | - Yolanda Picó
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estelles s/n, 46100 Burjassot, València, Spain
- Biomedical Research Center in Epidemiology and Public Health Network, Carlos III Health Institute, Av. Monforte de Lemos 3-5 Pabellón 11 Planta 0, 28029 Madrid, Madrid, Spain
- Environmental and Food Safety Research Group (SAMA-UV), Desertification Research Centre, (CIDE, CSIC-UV-GV), Moncada-Naquera Road Km 4.5, 46113 Moncada, Valencia, Spain
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Shareef J, Sridhar SB, Bhupathyraaj M, Shariff A, Thomas S, Salim Karattuthodi M. Assessment of the scope, completeness, and consistency of various drug information resources related to COVID-19 medications in pregnancy and lactation. BMC Pregnancy Childbirth 2023; 23:296. [PMID: 37106456 PMCID: PMC10134615 DOI: 10.1186/s12884-023-05609-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Drug use in pregnancy and lactation is challenging. It becomes more challenging in pregnant and lactating women with certain critical clinical conditions such as COVID-19, because of inconsistent drug safety data. Therefore, we aimed to evaluate the various drug information resources for the scope, completeness, and consistency of the information related to COVID-19 medications in pregnancy and lactation. METHODS Data related to COVID-19 medications from various drug information resources such as text references, subscription databases, and free online tools were used for the comparison. The congregated data were analyzed for scope, completeness, and consistency. RESULTS Scope scores were highest for Portable Electronic Physician Information Database (PEPID), Up-to-date, and drugs.com compared to other resources. The overall completeness scores were higher for Micromedex and drugs.com (p < 0.05 compared to all other resources). The inter-reliability analysis for overall components by Fleiss kappa among all the resources was found to be 'slight' (k < 0.20, p < 0.0001). The information related to the older drugs in most of the resources, provides in-depth details on various components such as pregnancy safety, clinical data related to lactation, the effect of the drug distribution into breast milk, reproductive potential/infertility risk and the pregnancy category/recommendations. However, the information related to these components for newer drugs was superficial and incomplete, with insufficient data and inconclusive evidence, which is a statistically significant observation. The strength of observer agreement for the various COVID-19 medications ranged from poor to fair and moderate for the various recommendation categories studied. CONCLUSION This study reports discrepancies in the information related to pregnancy, lactation, drug level, reproductive risk, and pregnancy recommendations among the resources directing to refer to more than one resource for information about the safe and quality use of medications in this special population.The present study also emphasizes the need for development of comprehensive, evidence-based, and precise information guide that can promote safe and effective drug use in this special population.
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Affiliation(s)
- Javedh Shareef
- Department of Clinical Pharmacy & Pharmacology, RAK College of Pharmacy, RAK Medical & Health Sciences University, Ras Al Khaimah, United Arab Emirates.
| | - Sathvik Belagodu Sridhar
- Department of Clinical Pharmacy & Pharmacology, RAK College of Pharmacy, RAK Medical & Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | | | - Atiqulla Shariff
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Sabin Thomas
- School of Pharmacy, College of Health Sciences, University of Nizwa, Nizwa, 616, Oman
| | - Mohammed Salim Karattuthodi
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
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