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1.
Nutrients ; 13(9)2021 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-34578833

RESUMO

Diet influences the health of pregnant women and their children in prenatal, postnatal and adult periods. GC-FID fatty acids profile analysis in maternal serum and a survey of dietary habits were performed in 161 pregnant patients from the II Faculty and Clinic of Obstetrics and Gynaecology of the Medical University of Warsaw. Their diet did not fulfil all nutritional recommendations regarding dietary fat sources. Olive and rapeseed oil were the most popular edible oils. High usage of sunflower oil as well as high consumption of butter were also observed, whereas fish and fish oil intake by pregnant women was low. A chemometric approach for nutritional data, connected with anthropometric, sociodemographic and biochemical parameters regarding mothers and newborns, was conducted for diet and its impact estimation. It revealed four clusters of patients with differing fatty acids profile, which resulted from differences in their dietary habits. Multiparous women to a lesser extent followed dietary recommendations, which resulted in deterioration of fatty acids profile and higher frequency of complications. Observed high usage of sunflower oil is disquieting due to its lower oxidative stability, whereas high butter consumption is beneficial due to conjugated linoleic acids supply. Pregnant women should also be encouraged to introduce fish and fish oil into their diet, as these products are rich sources of long chain polyunsaturated fatty acids (LC PUFA). Multiparous women should be given special medical care by medical providers (physicians, midwifes and dietitians) and growing attention from the government to diminish the risk of possible adverse effects affecting mother and child.


Assuntos
Antropometria/métodos , Dieta/métodos , Ácidos Graxos/sangue , Trabalho de Parto , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Adulto , Feminino , Humanos , Gravidez , Fatores Socioeconômicos
2.
J Dev Orig Health Dis ; 12(1): 79-87, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32063257

RESUMO

The aim of this study was to identify social and biological drivers of fetal growth by examining associations with household, preconception, and pregnancy factors in a cohort from Soweto, South Africa. Complete data and ultrasound scans were collected on 519 women between 2013 and 2016 at 6 time points during pregnancy (<14, 14-18, 19-23, 24-28, 29-33 weeks, and 34-38 weeks). Household-level factors, preconception health, baseline body mass index (BMI), and demographic data were collected at the first visit. During pregnancy, gestational weight gain (GWG; kg/week) was calculated. At 24-28 weeks of gestation, oral glucose tolerance test was used to determine gestational diabetes mellitus (GDM) status, and hypertension status was characterised. Longitudinal growth in head circumference, abdominal circumference, biparietal diameter, and femur length were modelled using the Superimposition by Translation and Rotation, a shape-invariant model which produces growth curves against gestational age. A priori identified exposure variables were then included in a series of sex-stratified hierarchical regression models for each fetal growth outcome. No household-level factors were associated with fetal growth. Maternal BMI at baseline was positively associated with all outcome parameters in males and females. Both GWG (in males and females) and GDM (in males) were significant positive predictors of abdominal growth. Males showed more responsiveness to abdominal growth, while females were more responsive to linear growth. Thus, fetal growth was largely predicted by maternal biological factors, and sexual dimorphism in the responsiveness of fetal biometry to biological exposures was evident.


Assuntos
Diabetes Gestacional/epidemiologia , Desenvolvimento Fetal/fisiologia , Ganho de Peso na Gestação/fisiologia , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Fatores Socioeconômicos , Adolescente , Adulto , Índice de Massa Corporal , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/fisiopatologia , Feminino , Idade Gestacional , Teste de Tolerância a Glucose , Humanos , Estudos Longitudinais , Masculino , Idade Materna , Gravidez , Estudos Prospectivos , Fatores Sexuais , África do Sul/epidemiologia , Ultrassonografia Pré-Natal/estatística & dados numéricos , Adulto Jovem
3.
Nutrients ; 12(6)2020 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-32481554

RESUMO

The aim of this study was to determine the prevalence and analyze the factors associated with food insecurity during gestation in a maternal-infant cohort in Brazilian Western Amazon. A population-based cross-sectional study was conducted with parturients from a maternal-infant cohort in Rio Branco, located in the Western Brazilian Amazon. The dependent variable food insecurity (FI) was obtained through the Brazilian Scale of Food Insecurity, and associated factors were identified through multiple logistic regression. The prevalence of FI in pregnancy was of 34.8%. Regarding severity, the prevalence of mild food insecurity was 24.6%, moderate food insecurity was 4.8%, and severe food insecurity was 5.4%. The factors directly associated with FI were the presence of open sewage in the peridomestic environment; belonging to the lower economic classes; being an income transfer program beneficiary, while the factors inversely associated with FI were schooling equal to or greater than 8 years; having a partner; primigestation; and regular consumption of fruits and vegetables during pregnancy. These findings reinforce the need for the ratification of actions aimed at the domestic economy in the income transfer programs and the development of actions of food and nutritional education in the gestational period.


Assuntos
Ingestão de Alimentos/fisiologia , Insegurança Alimentar , Abastecimento de Alimentos/economia , Educação em Saúde , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Estado Nutricional , Gestantes/educação , Brasil , Estudos de Coortes , Estudos Transversais , Feminino , Frutas , Humanos , Gravidez , Esgotos , Fatores Socioeconômicos , Verduras
4.
PLoS One ; 15(6): e0234545, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32544180

RESUMO

The Minangkabau people of West Sumatra in Indonesia are renowned for their matrilineal culture with property and land passing down from mother to daughter. Despite there being a fairly balanced social status for women in the community, the impact of health inequalities is uneven. This study was therefore carried out to explore the relationship between the social, cultural and economic contexts in such a distinctive community with maternal nutrition and pregnancy-related health outcomes, from the perspectives of the mothers, fathers and care providers. Qualitative methods were used to undertake this study in collaboration with partners from the University of Andalas in a suburban area of Padang district. The data collection method was qualitative, semi-structured interviews (n = 19) with women, men, midwives and community health workers. The data were recorded with informed consent, transcribed in the local language and then translated into English prior to being thematically analysed. The major themes which emerged from the data included 'Minangkabau matrilineality and role of women'; 'culture and supportive attitude towards pregnant women'; 'dietary patterns, attitude and access to food'; and 'limited access to information about food and nutrition'. The findings showed healthy dietary patterns such as regular consumption of vegetables and fruit among the participants. However, the issues of poverty, access to food, dietary taboos and inadequate nutritional information remained major challenges for the mothers and the families who participated in the study. The evidence from this study suggests that the matrilineal culture of the Minangkabau promotes the empowerment of women and offers an encouraging environment for enhancing reproductive health. This lends itself to co-developing locally sensitive and sustainable complex interventions incorporating professional support and building on family and community back-up, enhancing knowledge and demystifying dietary misinformation to improve maternal health and nutrition.


Assuntos
Saúde Materna , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Estado Nutricional/fisiologia , Gestantes , Adulto , Dieta , Feminino , Frutas , Humanos , Indonésia/epidemiologia , Mães , Pobreza , Gravidez
5.
Br J Nutr ; 124(7): 742-753, 2020 10 14.
Artigo em Inglês | MEDLINE | ID: mdl-32381134

RESUMO

Thermodynamic analyses are performed to quantify allocation of the nutritional energy and exergy to most of the life processes by pregnant mice. In these analyses, 'internal work performance' is calculated for the first time in the literature for metabolism during pregnancy and found substantially higher than the 'external work performance'. Variation of the daily entropy generation rates and the daily internal work performance rates during the course of pregnancy showed a highly similar phasic behaviour. With the progression of the pregnancy, external work performance decreased and second law efficiency increased significantly. On the 13th day of pregnancy, net energy extracted from the food at the cellular energy metabolism subsystem was 15·0 kJ; approximately 3 kJ of it was employed for daily internal work performance, 0·8 kJ was allocated to daily external work performance and 0·8 kJ was stored in the adipose tissue without entering into the cellular energy metabolism subsystem. Heat generation in association with internal and external work performance was 9·1 and 2·2 kJ, respectively. Energy, pertinent to the first law, and exergy (useful energy), pertinent to the second law, balances are described graphically, and comparison of these plots showed that the total exergy of the nutrients allocated to internal and external work performance and heat generation is substantially smaller in magnitude when compared with those of energy balance.


Assuntos
Ingestão de Alimentos/fisiologia , Metabolismo Energético/fisiologia , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Nutrientes/metabolismo , Termodinâmica , Fenômenos Fisiológicos da Nutrição Animal/fisiologia , Animais , Feminino , Camundongos , Gravidez
6.
Nutrients ; 12(2)2020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-32053977

RESUMO

Resting energy expenditure (REE) comprises 60% of total energy expenditure and variations may be associated with gestational weight gain (GWG) or maternal diet. The objective of this study was to examine the impact of metabolic tracking on GWG and the association with maternal macronutrients. Pregnant women aged 29.8 ± 4.9 years (78.6% non-Hispanic, White) with gestational age (GA) < 17 week were randomized to Breezing™ (n = 16) or control (n = 12) groups for 13 weeks. REE by Breezing™ indirect calorimetry, anthropometrics and dietary intake were collected every two weeks. Early (14-21 weeks), late (21-28 weeks), and overall (14-28 weeks) changes in macronutrients and GWG were calculated. The Breezing™ group had a significantly greater rate of GWG [F (1,23) = 6.8, p = 0.02] in the latter half of the second trimester. Late (-155.3 ± 309.2 vs. 207.1 ± 416.5 kcal, p = 0.01) and overall (-143.8 ± 339.2 vs. 191.8 ± 422.2 kcal, p = 0.03) changes in energy consumption were significantly different between Breezing™ and control groups, respectively. Early changes in REE were positively correlated with overall changes in carbohydrates (r = 0.58, p = 0.02). Regular metabolism tracking alone did not have an impact on GWG. Early shifts in REE might impact GWG later in pregnancy. Investigation in a larger population from preconception through postpartum is needed.


Assuntos
Ingestão de Alimentos/fisiologia , Metabolismo Energético/fisiologia , Ganho de Peso na Gestação/fisiologia , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Nutrientes/metabolismo , Gravidez/metabolismo , Descanso/fisiologia , Adulto , Carboidratos da Dieta , Feminino , Humanos , Projetos Piloto
7.
PLoS One ; 14(12): e0225027, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31805081

RESUMO

OBJECTIVE: Maternal obesity is associated with an increase in maternal, foetal and neonatal morbidity and mortality. The aim of our study was to evaluate the relationships between maternal pre-pregnancy body mass index and (1) neonatal outcome in preterm infants, and (2) neurodevelopmental outcome at 2 years of corrected age. METHOD: We conducted a single-centre cohort study. Infants born between 24+0 and 33+6 weeks of gestation between January 2009 and December 2013, hospitalised in the neonatal intensive care unit of Angers University Hospital, and with available data regarding maternal pre-pregnancy body mass index were eligible. Three groups were defined according to maternal body mass index: normal (n = 418), overweight (n = 136) and obese (n = 89). The primary outcome was neurodevelopment at 2 years of corrected age. Children with a non-optimal neuromotor and/or psychomotor assessment and/or a sensory disability were regarded as having a "non-optimal neurodevelopmental outcome". Neuromotor function was regarded as non-optimal when cerebral palsy was present or when the clinical examination revealed neurological signs of abnormal muscular tone. Psychomotor assessment was regarded as non-optimal if the revised Brunet-Lézine test was < 85 or when the overall score in the parental Ages and Stages Questionnaire (ASQ) was < 185. Finally, sensory disabilities such as blindness and children who required a hearing aid were taken into account. The secondary outcome was the composite criteria of neonatal complications. Multivariable analysis included the following variables: mother's age, gestational age, smoking during pregnancy, magnesium sulphate and steroid treatment during pregnancy, twin status, gender, socioeconomic status and social security benefits for those with low incomes. RESULTS: The study population was composed of 643 preterm infants. Among them, 520 were assessed at 2 years. There was no difference in the proportion of infants with non-optimal neurodevelopmental outcomes between the three groups (16.6% for obese, 13.5% for overweight, 16.9% for normal body mass index mothers; p = 0.73). According to multivariable analysis, being born from an overweight or obese mother was not associated with an increased risk of non-optimal neuro-development at 2 years (adjusted OR = 0.84 [0.40-1.76] for obese, adjusted OR = 0.83 [0.43-1.59] for overweight mothers). There was no difference in the proportion of preterm infants with a non-optimal composite criterion of neonatal complications between the three groups. In the multivariable analysis, being born from an overweight or obese mother was not associated with an increased risk of non-optimal neonatal outcomes (adjusted OR = 0.95 [0.49-1.83] for obese, adjusted OR = 1.18 [0.69-2.01] for overweight mothers). CONCLUSION: In this large prospective cohort of preterm infants born before 34 weeks of gestation, we found no relationship between maternal body mass index and neurodevelopmental outcomes at 2 years of corrected age and no relationship between maternal body mass index and neonatal outcomes. Other prematurity-related factors may be more relevant for neurodevelopmental outcome than the mother's pre-pregnancy BMI.


Assuntos
Índice de Massa Corporal , Desenvolvimento Infantil/fisiologia , Recém-Nascido Prematuro/crescimento & desenvolvimento , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Sobrepeso/fisiopatologia , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Obesidade/fisiopatologia , Gravidez , Estudos Prospectivos
8.
Med Sci Monit ; 25: 4430-4437, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31199783

RESUMO

BACKGROUND Low nutrition status of mothers plays an important role in increasing the prevalence of poor pregnancy outcomes. Poor pregnancy outcomes are the most common in the Guangzhou region of China. The objective of the study was to evaluate the role of maternal nutrition in the improvement of health outcomes for mothers and their children in the Guangzhou region of China. MATERIAL AND METHODS In this study, pregnancy medical records of women were analyzed. Data related to questionnaires which had been provided during hospital stays for nutritional consumption were gathered. Demographic characteristics and health outcomes of mothers and their children were recorded. Correlations of health outcomes with maternal nutrition were tested with respect to Z-scores at 95% confidence level. RESULTS Based on the health outcomes of mothers and their children, the study divided participants into 2 groups. The first group was mothers and their children with good health outcomes (live births with weighing ≥2.5 kg; the GHO group, n=130) and the second group was mothers and their children with poor health outcomes (miscarriage or premature birth with weighing less than 2.5 kg; the PHO group, n=70). These results showed positive correlation between financial status of the mother (salaried, P<0.001), maternal body mass index (P=0.001), maternal nutrition (P<0.001), maternal education (in years, P<0.001), and maternal age (P=0.004)) with health outcomes of mothers and their children. CONCLUSIONS The financial status of the mother, maternal nutrition, maternal age, and maternal education were the key determinants for predicting health outcomes of mothers and their children.


Assuntos
Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Resultado da Gravidez/epidemiologia , Adolescente , Adulto , Peso ao Nascer , Índice de Massa Corporal , Criança , Pré-Escolar , China , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Idade Materna , Mães , Estado Nutricional , Gravidez , Fenômenos Fisiológicos da Nutrição Pré-Natal/fisiologia , Estudos Retrospectivos , População Rural , Fatores Socioeconômicos
9.
Placenta ; 78: 44-53, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30955710

RESUMO

INTRODUCTION: Maternal nutrition is an extremely important health issue. We evaluated the impact of maternal high fat diet (HFD) on pregnancy outcomes, elucidated how the rat placenta and fetus respond to diet manipulation based on fetal sex, and identified candidate genes and pathways. METHODS: Rats were fed a normal or HFD diet for 10 weeks before conception and during gestation. The placenta was collected on gestational day 21 and sexed. Placental histology was analyzed and placental candidate genes and pathways were identified using whole-genome RNA next-generation sequencing. RESULTS: Pup weights in both sexes from HFD dams were reduced. The weight of the placenta from the HFD group was also decreased in both sexes, but changes in placental layer distributions were only significant for female fetuses. Maternal HFD altered the placental transcriptome in a sex-specific manner. Activation of the placental renin-angiotensin system (RAS) by maternal HFD was associated with fetal growth restriction in both fetal sexes. CONCLUSIONS: The placenta reacts to maternal HFD by altering the placental layer distribution and gene expression in a sex-specific manner. The male placenta in late gestation is thought to exhibit greater plasticity relative to the female placenta; however, fetuses of both sexes exhibited similar growth restriction. Our data reveal an association between the placental RAS and HFD-induced fetal growth restriction.


Assuntos
Dieta Hiperlipídica , Gorduras na Dieta/farmacologia , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Placenta/efeitos dos fármacos , Placenta/metabolismo , Caracteres Sexuais , Transcriptoma/efeitos dos fármacos , Animais , Feminino , Perfilação da Expressão Gênica/métodos , Intolerância à Glucose/complicações , Intolerância à Glucose/genética , Intolerância à Glucose/metabolismo , Sequenciamento de Nucleotídeos em Larga Escala , Insulinas/genética , Insulinas/metabolismo , Masculino , Fenômenos Fisiológicos da Nutrição Materna/efeitos dos fármacos , Tamanho do Órgão/efeitos dos fármacos , Placenta/patologia , Gravidez , Complicações na Gravidez/genética , Complicações na Gravidez/metabolismo , Ratos , Ratos Sprague-Dawley , Sistema Renina-Angiotensina/genética
10.
Matern Child Nutr ; 14 Suppl 4: e12699, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30499258

RESUMO

The nutritional status of women before pregnancy, during pregnancy, and after delivery has far reaching consequences for maternal health and child survival, growth, and development. In South Asia, the high prevalence of short stature, thinness, and anaemia among women of reproductive age underlie the high prevalence of child undernutrition in the region, whereas overweight and obesity are rising concerns. A systematic review of evidence (2000-2017) was conducted to identify barriers and programme approaches to improving the coverage of maternal nutrition interventions in the region. The search strategy used 13 electronic bibliographic databases and 14 websites of development and technical agencies and identified 2,247 citations. Nine studies conducted in Bangladesh (n = 2), India (n = 5), Nepal (n = 1), and Pakistan (n = 1) were selected for the review, and outcomes included the receipt and consumption of iron and folic acid and calcium supplements and the receipt of information on dietary intake during pregnancy. The studies indicate that a range of barriers acting at the individual (maternal), household, and health service delivery levels affects intervention coverage during pregnancy. Programme approaches that were effective in improving intervention coverage addressed barriers at multiple levels and had several common features: use of formative research and client assessments to inform the design of programme approaches and actions; community-based delivery platforms to increase access to services; engagement of family members, as well as pregnant women, in influencing behavioural change; actions to improve the capacity, supervision, monitoring, and motivation of front-line service providers to provide information and counselling; and access to free supplements.


Assuntos
Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Estado Nutricional/fisiologia , Adulto , Cálcio/uso terapêutico , Suplementos Nutricionais , Feminino , Ácido Fólico/uso terapêutico , Promoção da Saúde , Humanos , Ferro/uso terapêutico , Gravidez
11.
J Hum Nutr Diet ; 31(4): 473-485, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29578261

RESUMO

BACKGROUND: Little is known about the adequacy of nutrient intakes and the overall diet quality of Indigenous Australian pregnant women. The aim of this cross-sectional study was to assess nutrient sufficiency and diet quality, as measured using the Australian Recommended Food Score (ARFS), in pregnant women from the Gomeroi gaaynggal cohort (n = 58). METHODS: Maternal dietary intake during pregnancy was assessed using the Australian Eating Survey Food Frequency Questionnaire, which was self-administered in the third trimester. Diet quality was determined using the ARFS. Food group servings and nutrient intakes were compared to the Australian Guide to Health Eating (AGHE) and Australian Nutrient Reference Values (NRVs). The current analysis examined the adequacy of usual intakes from food sources only, excluding supplements. RESULTS: None of the women met all AGHE daily food group serving recommendations. The highest alignment rates were for dairy (33%), meat/alternatives (31%) and vegetables (29.3%). Almost 93% of participants exceeded the recommended intake of energy-dense, nutrient-poor foods and percentage energy from saturated fat was high (15%). Of the five key nutrients for optimal reproductive health (folate, iron, calcium, zinc and fibre), the nutrients with the highest percentage of pregnant women achieving the NRVs were zinc (77.6%) and folate (68.9%), whereas iron was the lowest. Only one person achieved all NRVs (folate, iron, calcium, zinc and fibre) important in pregnancy. The median ARFS was 28 points (maximum of 73). CONCLUSIONS: Although the small cohort limits the generalisability of the findings of the present study, the data obtained indicate that the diets of these Indigenous pregnant women are inadequate. Therefore, strategies aiming to optimise nutrient intakes of Indigenous pregnant women are needed urgently.


Assuntos
Dieta , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Havaiano Nativo ou Outro Ilhéu do Pacífico , Política Nutricional , Adulto , Austrália , Estudos de Coortes , Estudos Transversais , Laticínios , Registros de Dieta , Dieta Saudável/estatística & dados numéricos , Ingestão de Energia , Feminino , Humanos , Estudos Longitudinais , Carne , Micronutrientes/administração & dosagem , Necessidades Nutricionais , Gravidez , Resultado da Gravidez , Estudos Prospectivos , Verduras
12.
Ann N Y Acad Sci ; 1332: 39-59, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24934307

RESUMO

Undernutrition among women and children contributes to almost half the global burden of child mortality in developing countries. The impact of nutrition on economic development has highlighted the need for evidence-based solutions and yielded substantial global momentum. However, it is now recognized that the impact of evidence-based interventions is limited by the lack of evidence on the best operational strategies for scaling up nutrition interventions. With the goal of encouraging greater engagement in implementation research in nutrition and generating evidence on implementation and utilization of nutrition interventions, this paper brings together a framework and a broad analysis of literature to frame and highlight the crucial importance of research on the delivery and utilization of nutrition interventions. The paper draws on the deliberations of a high-level working group, an e-consultation, a conference, and the published literature. It proposes a framework and areas of research that have been quite neglected, and yet are critical to better understanding through careful research to enable better translation of global and national political momentum for nutrition into public health impact.


Assuntos
Pesquisa Biomédica/tendências , Transtornos da Nutrição Infantil/prevenção & controle , Promoção da Saúde/tendências , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Estado Nutricional/fisiologia , Pesquisa Biomédica/métodos , Criança , Transtornos da Nutrição Infantil/epidemiologia , Feminino , Promoção da Saúde/métodos , Promoção da Saúde/estatística & dados numéricos , Humanos , Internet/estatística & dados numéricos , Internet/tendências
13.
Matern Child Health J ; 18(2): 450-61, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23780476

RESUMO

The "Life Course Perspective" proposes that environmental exposures, including biological, physical, social, and behavioral factors, as well as life experiences, throughout the entire life span, influence health outcomes in current and future generations. Nutrition, from preconception to adulthood, encompasses all of these factors and has the potential to positively or negatively shape the individual or population health trajectories and their intergenerational differences. This paper applies the T2E2 model (timing, timeline, equity and environment), developed by Fine and Kotelchuck, as an overlay to examine advances in nutritional science, as well as the complex associations between life stages, nutrients, nutrigenomics, and access to healthy foods, that support the life course perspective. Examples of the application of nutrition to each of the four constructs are provided, as well as a strong recommendation for inclusion of nutrition as a key focal point for all health professionals as they address solutions to optimize health outcomes, both domestically and internationally. The science of nutrition provides strong evidence to support the concepts of the life course perspective. These findings lend urgency to the need to improve population health across the life span and over generations by ensuring ready access to micronutrient-dense foods, opportunities to balance energy intake with adequate physical activity and the need for biological, social, physical, and macro-level environments that support critical phases of human development. Recommendations for the application of the life course perspective, with a focus on the emerging knowledge of nutritional science, are offered in an effort to improve current maternal and child health programs, policies, and service delivery.


Assuntos
Saúde da Família , Disparidades nos Níveis de Saúde , Desenvolvimento Humano , Nutrigenômica , Estado Nutricional/fisiologia , Determinantes Sociais da Saúde , Adolescente , Adulto , Idoso , Criança , Fenômenos Fisiológicos da Nutrição Infantil/genética , Fenômenos Fisiológicos da Nutrição Infantil/fisiologia , Pré-Escolar , Meio Ambiente , Epigênese Genética , Feminino , Abastecimento de Alimentos/economia , Abastecimento de Alimentos/normas , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição Materna/genética , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Estado Nutricional/genética , Cuidado Pré-Concepcional , Gravidez , Cuidado Pré-Natal
14.
Lancet ; 382(9891): 536-51, 2013 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-23746780

RESUMO

Acceleration of progress in nutrition will require effective, large-scale nutrition-sensitive programmes that address key underlying determinants of nutrition and enhance the coverage and effectiveness of nutrition-specific interventions. We reviewed evidence of nutritional effects of programmes in four sectors--agriculture, social safety nets, early child development, and schooling. The need for investments to boost agricultural production, keep prices low, and increase incomes is undisputable; targeted agricultural programmes can complement these investments by supporting livelihoods, enhancing access to diverse diets in poor populations, and fostering women's empowerment. However, evidence of the nutritional effect of agricultural programmes is inconclusive--except for vitamin A from biofortification of orange sweet potatoes--largely because of poor quality evaluations. Social safety nets currently provide cash or food transfers to a billion poor people and victims of shocks (eg, natural disasters). Individual studies show some effects on younger children exposed for longer durations, but weaknesses in nutrition goals and actions, and poor service quality probably explain the scarcity of overall nutritional benefits. Combined early child development and nutrition interventions show promising additive or synergistic effects on child development--and in some cases nutrition--and could lead to substantial gains in cost, efficiency, and effectiveness, but these programmes have yet to be tested at scale. Parental schooling is strongly associated with child nutrition, and the effectiveness of emerging school nutrition education programmes needs to be tested. Many of the programmes reviewed were not originally designed to improve nutrition yet have great potential to do so. Ways to enhance programme nutrition-sensitivity include: improve targeting; use conditions to stimulate participation; strengthen nutrition goals and actions; and optimise women's nutrition, time, physical and mental health, and empowerment. Nutrition-sensitive programmes can help scale up nutrition-specific interventions and create a stimulating environment in which young children can grow and develop to their full potential.


Assuntos
Serviços de Saúde da Criança/organização & administração , Fenômenos Fisiológicos da Nutrição Infantil/fisiologia , Programas Gente Saudável/organização & administração , Serviços de Saúde Materna/organização & administração , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Política Nutricional , Agricultura/organização & administração , Pré-Escolar , Desenvolvimento Econômico , Feminino , Abastecimento de Alimentos/estatística & dados numéricos , Humanos , Renda , Estado Nutricional , Sobrepeso/etiologia , Magreza/etiologia
15.
Public Health Nutr ; 15(2): 341-51, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21729472

RESUMO

OBJECTIVE: To document nutrient and food group serving intakes from food sources among Latina subgroups living in the same geographical area. DESIGN: A cross-sectional study. Nutrient and food group serving intakes were assessed by means of a 24 h recall administered immediately after a prenatal survey. SETTING: Hartford, CT, USA. SUBJECTS: A total of 233 low-income pregnant Latinas. For analyses, Latinas were classified into two groups on the basis of self-reported ethnic identity: Puerto Ricans and non-Puerto Rican Latinas. RESULTS: Puerto Rican Latinas were more likely than non-Puerto Rican Latinas to be more acculturated and to consume foods (i.e. processed meat, cheese, soft drinks) and higher levels of nutrients (i.e. fat, SFA, MUFA, trans fatty acids) that have been implicated in the development of chronic diseases. By contrast, non-Puerto Rican Latinas were more likely to consume foods (i.e. fruits, dark green/yellow vegetables, tomatoes, non-starchy vegetables) and higher levels of nutrients (i.e. fibre, vegetable protein, folate, ß-carotene) that promote health when compared with Puerto Rican Latinas. CONCLUSIONS: Findings suggest that acculturation may play a role in dietary intake. Clinicians and dietitians need to be aware of these differences to encourage healthy eating patterns among more acculturated pregnant Latina clients.


Assuntos
Aculturação , Dieta/etnologia , Hispânico ou Latino/etnologia , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Assistência Pública , Adolescente , Adulto , Estudos Transversais , Dieta/estatística & dados numéricos , Inquéritos sobre Dietas , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Rememoração Mental , Americanos Mexicanos/etnologia , Pessoa de Meia-Idade , Valor Nutritivo , Gravidez , Porto Rico/etnologia , Adulto Jovem
17.
Public Health Nutr ; 14(2): 365-72, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20939942

RESUMO

OBJECTIVE: To examine various sociodemographic aspects related to consumption of micronutrient-rich foods like green leafy vegetables (GLV), which will be helpful in modifying dietary habits, a strategy that merits consideration for prevention of anaemia. DESIGN: Cross-sectional study for collecting data on socio-economic and anthropometric (weight, height) variables, Hb, dietary pattern (FFQ) and peripheral smear examination for classifying nutritional and iron-deficiency anaemia (IDA). SETTING: Three villages near Pune city, Maharashtra, India. SUBJECTS: Rural women (n 418) of childbearing age (15-35 years). RESULTS: Mean Hb was 11·07 g/dl. Seventy-seven per cent of the women were anaemic (Hb < 12 g/dl) and 28 % had IDA, indicating that a large proportion of the women had nutritional anaemia. Higher prevalence of IDA was associated with several sociodemographic and maternal parameters, but multiple logistic regression analysis showed significant (P < 0·05) risk of IDA with lower body weight (<40 kg), short maternal height (<145 cm), younger age at marriage (<19 years) and higher parity (≥ 2). Various socio-cultural reasons associated with low consumption of GLV included non-cultivation of GLV, priority for selling them rather than home consumption, dislike of GLV by husband and children, and lack of awareness about different recipes for GLV. CONCLUSIONS: Our findings highlight that low consumption of GLV, which are treasures of micronutrients including Fe, is associated with genuine social reasons. This indicates a need for developing action programmes to improve nutritional knowledge and awareness leading to enhanced consumption of Fe-rich foods for preventing anaemia in rural India.


Assuntos
Anemia Ferropriva/epidemiologia , Comportamento Alimentar , Ferro da Dieta/administração & dosagem , Estado Nutricional , População Rural/estatística & dados numéricos , Adolescente , Adulto , Anemia Ferropriva/etiologia , Antropometria , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Idade Materna , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Inquéritos Nutricionais , Paridade , Gravidez , Fatores de Risco , Fatores Socioeconômicos , Verduras/química , Verduras/economia , Adulto Jovem
18.
Reprod Biomed Online ; 21(6): 794-802, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21051285

RESUMO

Natural sex selection methods have been applied for several decades, but their use and effectiveness are still a matter of debate. Therefore, this study assessed the efficacy of a maternal diet low in sodium and high in calcium, in combination with timing of intercourse well before ovulation as a method to improve the chances of conceiving a girl. A total of 172 couples wanting a girl participated in the study. For the 150 couples that actually started, compliance with diet was assessed through mineral analyses of blood and timing of intercourse relative to ovulation was determined by ovulation tests. Based on mineral blood values and timing of intercourse of 28 participants, a prediction rule for conceiving a girl was constructed and was tested prospectively for validity on a subsequent group of 50 women. In this group, 21 women satisfied the criteria of the prediction rule and 16 gave birth to a daughter. It is concluded that the combination of maternal diet with timing of intercourse is capable of increasing the probability of conceiving a girl (P=0.005). The observed percentage of female babies for all 32 women satisfying the prediction rule was 81% (95% confidence interval 68-95%).


Assuntos
Coito/fisiologia , Dieta , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Pré-Seleção do Sexo/métodos , Cálcio da Dieta/administração & dosagem , Simulação por Computador , Feminino , Humanos , Funções Verossimilhança , Magnésio/administração & dosagem , Método de Monte Carlo , Potássio na Dieta/administração & dosagem , Gravidez , Estudos Prospectivos , Sódio na Dieta/administração & dosagem , Fatores de Tempo
19.
J Am Diet Assoc ; 110(8): 1198-206, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20656095

RESUMO

Choline, a micronutrient found in food, serves as the starting material for several important metabolites that play key roles in fetal development, particularly the brain. Although human beings' requirement for choline is unknown, an Adequate Intake level of 425 mg/day was established for women with upward adjustments to 450 and 550 mg/day during pregnancy and lactation, respectively. The importance of choline in human development is supported by observations that a human fetus receives a large supply of choline during gestation; pregnancy causes depletion of hepatic choline pools in rats consuming a normal diet; human neonates are born with blood levels that are three times higher than maternal blood concentrations; and large amounts of choline are present in human milk. The development of the central nervous system is particularly sensitive to choline availability with evidence of effects on neural tube closure and cognition. Existing data show that the majority of pregnant (and presumably lactating) women are not achieving the target intake levels and that certain common genetic variants may increase requirements for choline beyond current recommendations. Because choline is not found in most varieties of prenatal vitamins (or regular multivitamins), increased consumption of choline-rich foods may be needed to meet the high pre- and postnatal demands for choline.


Assuntos
Colina/administração & dosagem , Desenvolvimento Fetal/efeitos dos fármacos , Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia , Recém-Nascido/sangue , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Necessidades Nutricionais , Colina/fisiologia , Feminino , Desenvolvimento Fetal/fisiologia , Humanos , Recém-Nascido/crescimento & desenvolvimento , Leite Humano/química , Política Nutricional , Assistência Perinatal , Gravidez/sangue
20.
J Anim Sci ; 88(8): 2717-28, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20453084

RESUMO

Mature Angus-cross beef cows (n = 144) were used to determine effects of late gestation dietary energy source on pre- and postpartum cow performance in a complete randomized block design experiment. Cows were adapted to diets starting at 167 +/- 9 d of gestation and fed until 1 wk before expected calving date. Cows were fed 1 of 3 dietary energy sources: grass hay (HY), corn (CN), or dried distillers grains (DDGS). Cows allotted to HY were allowed ad libitum access to round-bale grass hay, and average hay disappearance was 12.4 kg/d. Limit-fed corn and DDGS diets contained 5.3 kg of whole-shelled corn or 4.1 kg of DDGS, respectively, plus 2.1 kg of hay, and 1.0 kg of supplement to meet cow nutritional needs during late gestation and to allow for an energy intake similar to HY. Every 21 d, BW, BCS, and ultrasound measurement of backfat between the 12th and 13th ribs were collected. At 210 d in gestation, jugular blood samples were collected from cows at 0, 3, 6, and 9 h postfeeding and were analyzed for glucose, insulin, NEFA, and blood urea N (BUN) concentrations. After parturition, cows were fed a common diet and managed similarly. Milk production was determined by weigh-suckle-weigh procedure on d 31, 100, and 176 postpartum. Cows fed DDGS during late gestation gained more (P = 0.04) BW than cows fed HY or CN; however, no difference in BCS change was detected (P = 0.28) among treatments. Plasma glucose concentrations were similar among treatments (P = 0.64), whereas insulin concentrations at 3 h postfeeding were greater (P = 0.002) for cows fed DDGS than those fed HY or CN. Plasma BUN concentrations were greater (P < or = 0.02) for cows fed DDGS vs. CN or HY up to 6 h postfeeding. Birth weight was greater (P < 0.001) for calves from cows fed CN and DDGS than for those fed HY, but this did not result in any differences in frequency of dystocia (P = 0.21). Prepartum energy source did not affect conception rates (P = 0.79), milk production (P > or = 0.51), or milk composition (P > or = 0.39). Maternal dietary energy source in late gestation did not affect pre- or postpartum cow performance, but did change plasma hormones and metabolites during gestation. Heavier birth weights in calves from cows fed CN or DDGS indicate the changes in maternal metabolism affected energy partitioning of nutrients to the fetus and subsequent fetal growth.


Assuntos
Bovinos/crescimento & desenvolvimento , Ingestão de Energia/fisiologia , Ração Animal/economia , Animais , Animais Recém-Nascidos/crescimento & desenvolvimento , Peso ao Nascer/fisiologia , Glicemia/análise , Nitrogênio da Ureia Sanguínea , Bovinos/fisiologia , Custos e Análise de Custo , Ácidos Graxos não Esterificados/sangue , Feminino , Desenvolvimento Fetal/fisiologia , Insulina/sangue , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Carne/normas , Período Pós-Parto/fisiologia , Gravidez , Progesterona/sangue
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