An Accurate Estimate of the Amino Acid Content of Human Milk Collected from Chinese Women Adjusted for Differences in Amino Acid Digestibility.

BACKGROUND: The amino acid (AA) composition of human milk is used to define the AA requirements of the infant. Thus, it is important that estimates of composition be as complete and accurate as possible. When determining AA composition using standard hydrolysis methods, some AAs are progressively destroyed while others are incompletely released. For accuracy, AA composition needs to be determined using multiple hydrolysis times. The true ileal digestibility of AAs also needs to be taken into consideration. OBJECTIVE: The objective was to bring together AA compositional (determined using multiple hydrolysis intervals) and digestibility data determined using the piglet to give an estimate of the absorbed AA profile of human milk with reference in particular to Asian females. METHODS: Mature milk was collected from Chinese females. AA analysis using multiple hydrolysis intervals and a nonlinear regression model was used to accurately estimate AA composition. Human milk, as well as a protein-free diet, were fed to piglets (n = 6), and ileal digesta were collected (piglet age, 21 d) to determine the true ileal AA digestibility of AAs in human milk. RESULTS: True ileal AA digestibility coefficients ranged from (mean ± standard error of the mean) 0.61 ± 0.081 for tyrosine to 1.01 ± 0.030 for tryptophan, with a digestibility for total nitrogen of 0.90 ± 0.013. Convergence criteria were met for the modeling for each AA, and the model had a level of significance of P < 0.0001 for each AA. The amount of available AAs (total AA content as per the model prediction multiplied by the true ileal AA digestibility coefficient determined in the piglet) are reported. CONCLUSIONS: An estimate of the absorbed AA profile of mature milk collected from Chinese females is provided. For the first time, data is presented for cysteine.

The application of lactoferrin in infant formula: The past, present and future.

Human milk is universally regarded as the gold standard to fulfill nutrition needs of infants. Lactoferrin (LF) is a major multiple bioactive glycoprotein in human milk but little is presented in infant formula. LF can resist digestion in the infant gastrointestinal tract and is absorbed into the bloodstream in an intact form to perform physiological functions. Evidence suggest that LF prevents pathogen infection, promotes immune system development, intestinal development, brain development and bone health, as well as ameliorates iron deficiency anemia. However, more clinical studies of LF need to be further elucidated to determine an appropriate dosage for application in infant formula. LF is sensitive to denaturation induced by processing of infant formula such as heat treatments and spay drying. Thus, further studies should be focus on maximizing the retention of LF activity in the infant formula process. This review summarizes the structural features of LF. Then the digestion, absorption and metabolism of LF in infants are discussed, followed by the function of LF for infants. Further, we summarize LF in infant formula and effects of processing of infant formula on bioactivities of LF, as well as future perspectives of LF research.

Correction to: Cheese consumption and risk of cardiovascular disease: a meta­analysis of prospective studies.

In the original publication, the funding and conflict of interest statements were not correct.

[Differences between anthropometric indices in predicting dyslipidemia in Chinese urban adult population and finding optimal cut-off points].

OBJECTIVE: To assess the differences between anthropometric indices in predicting dyslipidemia in Chinese urban adult population and find optimal cut-off points. METHODS: A total of 1615 subjects with information on key variables were enrolled by multistage stratified sampling process from March to July in 2016. Information on sociodemographic characteristics( age, gender, nationality, education and income), and health and disease history of subjects was collected. Height, weight, waist circumference( WC), hip circumference, body fat percentage( % Fat), and fasting lipid profiles were measured for each participant. The receiver operating characteristic( ROC) curve was used to compare the efficacy of the various anthropometric indices to discriminate those with and without dyslipidemia. RESULTS: Waist-to-height ratio( WHtR) had the largest area under the ROC curve( AUC) for dyslipidemia in women( 0. 744). There weresignificant differences between AUC of WHtR and that of WC( P = 0. 008), body mass index( BMI, P = 0. 004), waist-to-hip ratio( WHR, P = 0. 005), and % Fat( P <0. 001) in pairwise comparisons. Cut-off point for WHtR was 0. 50 for dyslipidemia in urban adult women. Although the AUC for BMI was the highest for dyslipidemia in men, it did not differ significantly from other indices( P all > 0. 05). Cut-off point for BMI was24. 1 kg/m~2 for dyslipidemia in urban adult men. CONCLUSION: WHtR and BMI might be optimal indices for dyslipidemia for Chinese urban adult women and men, respectively. Regional and sexual differences should be considered when choosing proper indices.

Cheese consumption and risk of cardiovascular disease: a meta-analysis of prospective studies.

PURPOSE: Cheese contains a high content of saturated fatty acids but also lists of potentially beneficial nutrients. How long-term cheese consumption affects the development of cardiovascular disease (CVD) is unclear. A meta-analysis of prospective observational studies was conducted to evaluate the risks of total CVD, coronary heart disease (CHD), and stroke associated with cheese consumption. METHODS: Potentially eligible studies were identified by searching PubMed and EMBASE databases and by carefully reviewing the bibliographies of retrieved publications and related reviews. The summary relative risks (RRs) with 95 % confidence intervals (CIs) were calculated using the random-effects model. RESULTS: The final analyses included 15 prospective studies. Most of the studies excluded prevalent CVD at baseline (14/15) and had a duration >10 years (13/15). The summary RR for high vs. low cheese consumption was 0.90 (95 % CI 0.82-0.99) for total CVD (7 studies, 8076 events), 0.86 (95 % CI 0.77-0.96) for CHD (8 studies, 7631 events), and 0.90 (95 % CI 0.84-0.97) for stroke (7 studies, 10,449 events), respectively. The restricted cubic model indicated evidence of nonlinear relationships between cheese consumption and risks of total CVD (P nonlinearity < 0.001) and stroke (P nonlinearity = 0.015), with the largest risk reductions observed at the consumption of approximately 40 g/d. CONCLUSIONS: This meta-analysis of prospective studies suggests a nonlinear inverse association between cheese consumption and risk of CVD.

Pre-pregnancy BMI, gestational weight gain and postpartum weight retention: a meta-analysis of observational studies.

OBJECTIVE: To determine the association of gestational weight gain (GWG) or pre-pregnancy BMI with postpartum weight retention (PPWR). DESIGN: Meta-analysis. SETTING: PubMed, Cochrane Controlled Trials Register, EMBASE, Science Citation Index Expanded, Current Contents Connects and Biosis Previews were used to search articles. SUBJECTS: Publications that described the influence of pre-pregnancy BMI or GWG on PPWR. RESULTS: Seventeen studies that satisfied the eligibility criteria were included in the analyses. Women with inadequate and excessive GWG had significantly lower mean PPWR of -2·14 kg (95 % CI -2·43, -1·85 kg) and higher PPWR of 3·21 kg (95 % CI 2·79, 3·62 kg), respectively, than women with adequate GWG. When postpartum time spans were stratified into 1-3 months, 3-6 months, 6-12 months, 12-36 months and ≥15 years, the association between inadequate GWG and PPWR faded over time and became insignificant (-1·42 kg; 95 % CI -3·08, 0·24 kg) after ≥15 years. However, PPWR in women with excess GWG exhibited a U-shaped trend; that is, a decline during the early postpartum time span (year 1) and then an increase in the following period. Meta-analysis of qualitative studies showed a significant relationship between excessive GWG and higher PPWR risk (OR=2·08; 95 % CI 1·60, 2·70). Moreover, meta-analysis of pre-pregnancy BMI on PPWR indicated that mean PPWR decreased with increasing BMI group. CONCLUSIONS: These findings suggest that GWG, rather than pre-pregnancy BMI, determines the shorter- or longer-term PPWR.

[Postpartum weight retention in Beijing, Suzhou and Guangzhou women and its associated factors].

OBJECTIVE: To investigate the prevalence of postpartum weight retention (PPWR) in urban Chinese women, and to explore its associated factors. METHODS: Cluster sampling methods were used to select a total of 6 hospitals in Beijing, Guangzhou and Suzhou. A total of 578 women in the 0 - 1 months, 1 - 2 months, 2 - 4 months and 4 - 8 months postpartum participated in this study. Anthropometric indicators of height and weight were measured for each participant. Questionnaire was used to obtain the sociodemographic characteristics. Maternal information of pre-pregnancy weight and gestational weight gain were obtained by medical records. RESULTS: The pre-pregnancy BMI of participants was (20. 8 ± 2. 7), while postpartum BMI was (23. 4 ± 3. 2). PPWR decreased over time, however, 53. 4% of women had PPWR over 5kg at the 4 - 8 months postpartum. 32. 6% of women were overweight or obese at 4 - 8 months postpartum. Women with PPWR >0kg at 4 - 8 months postpartum had a higher gestational weight gain ((16.5 ± 5.5) kg) compared to those with PPWR≤0 kg ((13.0 ±4.7) kg). Women with higher education experience had a higher proportion of weight retention over 0 kg at 4 - 8 month postpartum. CONCLUSION: PPWR is a serious health and nutritional problem in Chinese women, where excess in gestational weight gain is associated with PPWR. To improve the health and lifestyle of perinatal women, a comprehensive health education and health intervention should be explored.

Bitter gourd inhibits the development of obesity-associated fatty liver in C57BL/6 mice fed a high-fat diet.

Bitter gourd (BG) is a popular fruit in Asia with numerous well-known medicinal uses, including as an antidiabetic. In the current study, we aimed to explore the effects of BG on mitochondrial function during the development of obesity-associated fatty liver. C57BL/6 mice were divided into 4 experimental groups: mice fed a normal diet (control; included for reference only), mice fed a high-fat diet (HFD), and mice fed an HFD supplemented with freeze-dried BG powder through daily gavage at doses of 0.5 (HFD+0.5BG) and 5 (HFD+5BG) g/kg, respectively. After 16 wk, mice in the HFD+5BG group showed less body and tissue weight gain and less hyperglycemia and hyperlipidemia compared with those in the HFD group (P < 0.05). In both HFD+0.5BG and HFD+5BG groups, serum interleukin-6 concentration was lower than that in the HFD group (P < 0.02). The serum C-reactive protein concentration was lower in the HFD+5BG group compared with the HFD group (P < 0.04). An analysis of liver tissue revealed lower liver triglyceride and cholesterol concentrations in both HFD+0.5BG and HFD+5BG groups than in the HFD group (P < 0.01). The HFD+5BG group had less activation of the sterol regulatory element binding protein/fatty acid synthase (SREBP-1/FAS) pathway, greater superoxide dismutase activity, and less total protein and mitochondrial protein oxidation than did the HFD group (P < 0.05). Mitochondrial complex I, II, III, and V activity was greater in the HFD+0.5BG group than in the HFD group (P < 0.03). The HFD+5BG group only had greater complex V activity compared with the HFD group (P < 0.05). Mitochondrial dynamics regulators, including dynamin related protein 1 (DRP1) and mitofusin 1 (MFN1), as well as proapoptotic protein expression levels were restored by BG treatment (P < 0.02). Taken together, our results suggest that BG prevents inflammation and oxidative stress, modulates mitochondrial activity, suppresses apoptosis activation, and inhibits lipid accumulation during the development of fatty liver.

Short-chain fatty acids in breast milk and their relationship with the infant gut microbiota.

Introduction: The short-chain fatty acids (SCFAs) contained in breast milk play a key role in infant growth, affecting metabolism and enhancing intestinal immunity by regulating inflammation. Methods: In order to examine the associations between the microbiota and SCFA levels in breast milk, and explore the roles of SCFAs in regulating the infant gut microbiota, we enrolled 50 paired mothers and infants and collected both breast milk and infant fecal samples. Breast milk SCFA contents were determined by UPLC-MS, and whole genome shotgun sequencing was applied to determine the microbial composition of breast milk and infant feces. The SCFA levels in breast milk were grouped into tertiles as high, medium, or low, and the differences of intestinal microbiota and KEGG pathways were compared among groups. Results: The results demonstrated that breast milk butyric acid (C4) is significantly associated with Clostridium leptum richness in breastmilk. Additionally, the specific Bifidobacterium may have an interactive symbiosis with the main species of C4-producing bacteria in human milk. Women with a low breast milk C4 tertile are associated with a high abundance of Salmonella and Salmonella enterica in their infants' feces. KEGG pathway analysis further showed that the content of C4 in breast milk is significantly correlated with the infants' metabolic pathways of lysine and arginine biosynthesis. Discussion: This study suggests that interactive symbiosis of the microbiota exists in breast milk. Certain breast milk microbes could be beneficial by producing C4 and further influence the abundance of certain gut microbes in infants, playing an important role in early immune and metabolic development.

Dietary intake of different ratios of ARA/DHA in early stages and its impact on infant development.

Long-chain polyunsaturated fatty acids (LC-PUFAs), arachidonic acid (ARA, 20:4n-6) and docosahexaenoic acid (DHA, 22:6n-3) are essential in the development of infants. ARA and DHA from breast milk or infant formula are the main sources of access for infants to meet their physiological and metabolic needs. The ratio of ARA to DHA in breast milk varies among regions and different lactation stages. Different ratios of ARA and DHA mainly from algal oil, animal fat, fish oil, and microbial oil, are added to infant formula in different regions and infant age ranges. Supplementing with appropriate ratios of ARA and DHA during infancy promotes brain, neural, visual, and other development aspects. In this review, we first introduced the current intake status of ARA and DHA in different locations, lactation stages, and age ranges in breast milk and infant formula. Finally, we discussed the effect of different ratios of ARA and DHA on infant development. This review provided a comprehensive research basis for the nutritional research of infants who consume different ratios of ARA and DHA.

Milk fat globule membrane regulates the physicochemical properties and surface composition of infant formula powders by improving the stability of the emulsion.

The milk fat globules in infant formula (IF) are encapsulated by a component known as milk fat globule membrane (MFGM). However, it is currently unclear whether the improved emulsion stability of MFGM can have a profound effect on the finished IF. Therefore, this study investigated the effects of MFGM on the particle size, stability, rheology, and microstructure of emulsions prepared by dairy ingredients via wet mixing. Further, IF were processed using such emulsions, the physicochemical properties, surface composition of the powders were examined. The results showed that MFGM reduced the particle size of the emulsion, increased the viscosity, and improved the microstructure of the MFGM. Furthermore, MFGM reduced the moisture content of the powder, increased the glass transition temperature, and reduced the presence of surface fat. In conclusion, the addition of MFGM enhance the finished powder stability by improving the emulsion stability prepared during IF manufacturing.

Evaluating the binding mechanism, structural changes and stability of ternary complexes formed by the interaction of folic acid with whey protein concentrate-80 and L-ascorbyl 6-palmitate.

In the present study, we investigated the mechanisms associated with the stabilizing effects of whey protein concentrate-80 (WPC80) and L-ascorbyl 6-palmitate (LAP) on folic acid (FA). Multispectral techniques show that WPC80 binds to FA and LAP mainly through hydrophobic interactions, and that energy is transferred from WPC80 to FA and LAP in a nonradiative form (FA/LAP); The combination of FA/LAP resulted in a change in the conformation and secondary structure content of WPC80, an increase in the absolute zeta potential of the system, and a shift in the particle size distribution towards smaller sizes. The compound system exhibits strengthened antioxidant properties and favorable binding properties. Besides, WPC80 improves the storage stability of FA under different conditions. These results demonstrated that the ternary complex formed by FA co-binding with WPC80 and LAP is an effective way to improve the stability against of FA.

Immunoregulation of bovine lactoferrin together with osteopontin promotes immune system development and maturation.

The immune system of infants is partly weak and immature, and supplementation of infant formula can be of vital importance to boost the development of the immune system. Lactoferrin (LF) and osteopontin (OPN) are essential proteins in human milk with immunoregulation function. An increasing number of studies indicate that proteins have interactions with each other in milk, and our previous study found that a ratio of LF : OPN at 1 : 5 (w/w, denoted as LOP) had a synergistic effect on intestinal barrier protection. It remains unknown whether LOP can also exert a stronger effect on immunoregulation. Hence, we used an in vitro model of LPS-induced macrophage inflammation and in vivo models of LPS-induced intestinal inflammation and early life development. We showed that LOP increased the secretion of the granulocyte-macrophage colony-stimulating factor (132%), stem cell factor (167%) and interleukin-3 (176%) in bone marrow cells, as well as thymosin (155%) and interleukin-10 (161%) in the thymus, more than LF or OPN alone during development, and inhibited changes in immune cells and cytokines during the LPS challenge. In addition, analysis of the components of digested proteins in vitro revealed that differentially expressed peptides may provide immunoregulation. Lastly, LOP increased the abundance of Rikenellaceae, Muribaculum, Faecalibaculum, and Elisenbergiella in the cecum content. These results imply that LOP is a potential immunomodifier for infants and offers a new theoretical basis for infant formula innovation.

Impact of dairy supplementation on bone acquisition in children's limbs: a 12-month cluster-randomized controlled trial and meta-analysis.

The impact of milk on bone health in rural preschoolers is under-researched. This study, through a clinical trial and a meta-analysis, finds that milk supplementation enhances forearm and calcaneus bone acquisition in children, supporting the benefits of daily milk consumption. PURPOSE: This study evaluated the impact of dairy supplementation on bone acquisition in children's limbs through a cluster-randomized controlled trial and a meta-analysis. METHODS: The trial involved 315 children (4-6 year) from Northwest China, randomized to receive either 390 ml of milk daily (n = 215) or 20-30 g of bread (n = 100) over 12 months. We primarily assessed bone mineral density (BMD) and content (BMC) changes at the limbs, alongside bone-related biomarkers, measured at baseline, the 6th and 12th months. The meta-analysis aggregated BMD or BMC changes in the forearm/legs/calcaneus from published randomized trials involving children aged 3-18 years supplemented with dairy foods (vs. control group). RESULTS: Of 278 completed the trial, intention-to-treat analysis revealed significant increases in BMD (4.05% and 7.31%) and BMC (4.69% and 7.34%) in the left forearm at the 6th and 12th months in the milk group compared to controls (P < 0.001). The calcaneus showed notable improvements in BMD (2.01%) and BMC (1.87%) at 6 months but not at 12 months. Additionally, milk supplementation was associated with beneficial changes in bone resorption markers, parathyroid hormone (- 12.70%), insulin-like growth factor 1 (6.69%), and the calcium-to-phosphorus ratio (2.22%) (all P < 0.05). The meta-analysis, encompassing 894 children, indicated that dairy supplementation significantly increased BMD (SMD, 0.629; 95%CI: 0.275, 0.983) and BMC (SMD, 0.616; 95%CI: 0.380, 0.851) (P < 0.05) in the arms, but not in the legs (P > 0.05). CONCLUSION: Milk supplementation significantly improves bone health in children's forearms, underscoring its potential as a strategic dietary intervention for bone development. Trial registration NCT05074836.

Infant Formulas With Partially or Extensively Hydrolyzed Milk Proteins for the Prevention of Allergic Diseases: A Systematic Review and Meta-Analysis of Clinical Trials.

Despite the widely recommended usage of partially hydrolyzed formula (PHF) or extensively hydrolyzed formula (EHF) of milk protein for preventing allergic diseases (ADs), clinical studies have been inconclusive regarding their efficacy compared with that of cow's milk formula (CMF) or breast milk (BM). We aimed to systematically evaluate the effects of PHF or EHF compared with those of CMF or BM on risk of ADs (cow's milk allergy, allergic rhinitis, eczema, asthma, wheeze, food allergy, and sensitization) in children. We searched PubMed, Embase, Cochrane Library, and Web of Science for clinical trials published from inception to 21 October, 2022. We used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to grade the strength of evidence. Overall, 24 trials (10,950 infants) were included, 17 of which specifically included high-risk infants. GRADE was low for the evidence that, compared with CMF, infants early fed with EHF had lower risk of cow's milk allergy at age 0-2 y [relative risk (RR): 0.62; 95% CI: 0.39, 0.99]. Moderate evidence supported that PHF and EHF reduced risk of eczema in children aged younger or older than 2 y, respectively (RR: 0.71; 95% CI: 0.52, 0.96; and RR: 0.79; 95% CI: 0.67, 0.94, respectively). We also identified moderate systematic evidence indicating that PHF reduced risk of wheeze at age 0-2 y compared with CMF (RR: 0.50; 95% CI: 0.29, 0.85), but PHF and EHF increased the risk compared with BM (RR: 1.61; 95% CI: 1.11, 2.31; and RR: 1.64; 95% CI: 1.26, 2.14). Neither PHF nor EHF had significant effects on other ADs in children of any age. In conclusion, compared with CMF, PHF, or EHF had different preventive effect on cow's milk allergy, eczema, and wheeze. Compared with BM, both PHF and EHF may increase risk of wheeze but not other ADs. Given that most trials included only high-risk infants, more research on non-high-risk infants is warranted before any generalization is attempted. This protocol was registered at PROSPERO as CRD42022320787.

Effect of probiotic fermented milk on blood pressure: a meta-analysis of randomised controlled trials.

Previous studies have suggested that probiotic fermented milk may possess blood pressure (BP)-lowering properties. In the present study, we aimed to systematically examine the effect of probiotic fermented milk on BP by conducting a meta-analysis of randomised controlled trials. PubMed, Cochrane library and the ClinicalTrials.gov databases were searched up to March 2012 to identify eligible studies.The reference lists of the obtained articles were also reviewed. Either a fixed-effects or a random-effects model was used to calculate the combined treatment effect. Meta-analysis of fourteen randomised placebo-controlled trials involving 702 participants showed that probiotic fermented milk, compared with placebo, produced a significant reduction of 3·10 mmHg (95% CI 24·64, 21·56) in systolic BP and 1·09 mmHg (95% CI 22·11, 20·06) in diastolic BP. Subgroup analyses suggested a slightly greater effect on systolic BP in hypertensive participants than in normotensive ones (23·98 v. 22·09 mmHg). Analysis of trials conducted in Japan showed a greater reduction than those conducted in European countries for both systolic BP (26·12 v. 22·08 mmHg) and diastolic BP (23·45 v. 20·52 mmHg). Some evidence of publication bias was present, but sensitivity analysis excluding small trials that reported extreme results only affected the pooled effect size minimally. In summary, the present meta-analysis suggested that probiotic fermented milk has BP-lowering effects in pre-hypertensive and hypertensive subjects.

Soluble dietary fibres decrease α-glucosidase inhibition of epigallocatechin gallate through affecting polyphenol-enzyme binding interactions.

The effects of soluble dietary fibres (SDFs) on α-glucosidase inhibition of EGCG were studied. Three arabinoxylans and polygalacturonic acid (PGA) significantly decreased inhibitory activity of EGCG against α-glucosidase, while two ß-glucans hardly affected the inhibition. Although arabinoxylans and PGA weakened the competitive inhibition character of EGCG, they maintained the fluorescence quenching effect of EGCG. Then, arabinoxylans and PGA significantly decreased the particle size and turbidity of EGCG-enzyme complex. These results suggest that there formed SDFs-EGCG-enzyme ternary complexes. The stronger decreasing-effects of arabinoxylans and PGA on α-glucosidase inhibition of EGCG than ß-glucans resulted from the stronger non-covalent interactions of arabinoxylans and PGA with EGCG. This is considered to arise from the short-branches of arabinoxylans that provided more opportunity for capturing EGCG, and from the strong polarity of PGA carboxyl that promoted hydrogen bondings with EGCG. Conclusively, SDFs should be considered as an impact factor when evaluating α-glucosidase inhibition of dietary polyphenols.

Impact of casein-to-whey protein ratio on gastric emptying, proteolysis, and peptidome profile of fermented milk during in vitro dynamic gastrointestinal digestion in preschool children.

The effects of casein-to-whey ratios (i.e., 4:1, 2:1, 1:1, 1:1.5) in fermented milk on gastric emptying, proteolysis and intestinal peptidome were investigated using an in vitro dynamic stomach-intestine system mimicking preschool children digestion. The gastric emptying rate varied insignificantly among the milk samples. After 120 min digestion, the protein digestibility was found in the range of 73.3-93.5 %, with the highest extent of proteolysis observed at a casein-to-whey ratio of 2:1 due to the fewest gastric protein aggregates and relatively abundant caseins. Intestinal peptides derived from caseins or whey proteins showed a positive correlation with their parent protein content. The most abundant bioactive whey peptides were found at casein-to-whey ratio of 1:1.5 after intestinal digestion. These findings demonstrated the importance of protein compositions in fermented milk on the gastrointestinal proteolysis and peptide release in vitro. This will be meaningful for future development of milk products that are more suitable for children.

Nausea and Vomiting during Early Pregnancy among Chinese Women and Its Association with Nutritional Intakes.

Nausea and vomiting in pregnancy (NVP) is one of the most common uncomfortable symptoms of women in early pregnancy. A total of 303 Chinese pregnant women from 10 urban cities in their first trimester were recruited in this study to collect their sociodemographic characteristics and their NVP occurrence. Their dietary nutrient and food intakes were also collected by a 24 h dietary recall and a semi-quantitative food frequency questionnaire (SFFQ). Using the univariate analysis and multiple linear regression analysis to estimate the correlation between NVP and dietary intake, we found that 255 (84.1%) pregnant women experienced NVP during their first trimester. The intake of energy, protein, fat, vitamin A, thiamin, riboflavin, vitamin E, phosphorus, potassium, iron and zinc was lower in women with NVP than in those with no NVP. Additionally, women with NVP were more likely to have insufficient intake of protein, riboflavin, calcium, phosphorus and selenium. In terms of specific food groups, the average daily intake of mushrooms, algae, nuts and seeds, meat, eggs and dairy products in the NVP group was lower. Women in the severe NVP group even had insufficient gestational weight gain. We should pay more attention to women who experience nausea and vomiting during pregnancy and provide them with targeted nutritional support.

Sleep quality, antepartum depression and self-harm thoughts in pregnant Chinese women.

BACKGROUND: Previous literature has shown a significant association between sleep and depression, whereas limited studies have examined the association of sleep quality with self-harm ideation in pregnant Chinese women. METHODS: A total of 898 pregnant women (first to third trimester) from the Young Investigation Study were enrolled in this study. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality. Antepartum depression and self-harm ideation were evaluated using the Edinburgh Postnatal Depression Scale (EPDS). Multivariable logistic regression models were used to calculate odds ratios (ORs) and 95 % confidence intervals (CIs). RESULTS: In this sample, the prevalence of poor sleep quality and antepartum depression was 44.3 % and 24.4 %, respectively. Furthermore, 12.8 % of women were considered as having self-harm ideation. Individuals in different trimesters reported similar prevalence of self-harm thoughts. Women were more likely to report self-harm thoughts if they were categorized as poor sleep quality or antepartum depression. And women with moderate or severe depression had higher risk of self-harm ideation and poor sleep, compared with those with mild depression. Although sleep quality indirectly influenced self-harm thoughts through the mediation effect of depressive symptoms, poor sleep quality was still associated with a 2.62-fold increased odds of self-harm ideation among women in the second trimester (OR = 2.62; 95 % CI: 1.11-6.21), after adjustment for depression. LIMITATIONS: Causality cannot be inferred. Results should be generalized carefully. Depression was evaluated by a screening tool rather than clinical interviews. CONCLUSIONS: The prevalence of poor sleep quality, depressive symptoms and self-harm ideation in pregnant Chinese women were noteworthy and high. Besides, a direct effect was also found between sleep quality and self-harm thoughts among women in the second trimester. Our findings suggest the need to identify and intervene when sleep disturbances are observed in women during pregnancy.