Folic Acid Supplementation during Pregnancy and Its Association with Telomere Length in Children at Four Years: Results from the INMA Birth Cohort Study.

This study examined the association between folic acid supplements (FAs) during different periods of pregnancy and offspring telomere length (TL) at age four in 666 children from the INMA study. FAs were self-reported using food-structured questionnaires during three periods of pregnancy (the first three months of pregnancy, from month fourth onward, and the whole pregnancy). For each period, the average daily dosage of FAs was categorised into (i) <400 µg/d, (ii) ≥400 to 999 µg/d, (iii) ≥1000 to 4999 µg/d, and (iv) ≥5000 µg/d. Leucocyte TL at age four was measured using quantitative PCR methods. Multiple robust linear log-level regression models were used to report the % difference among FA categories. During the first period, and compared with children whose mothers were classified in the reference group (<400 µg/d), children whose mothers took higher dosages of FAs showed shorter TL at age four (≥5000 µg/d). When the first and the second periods were mutually adjusted, children whose mothers self-reported ≥5000 µg/d during the first period of pregnancy had a statistically significant shorter TL than their counterparts (% difference: -7.28% [95% CI: -14.42 to -0.13]). Similar trends were observed for the whole period of pregnancy. When the analysis was stratified by sex, the association was more evident in boys (% difference: -13.5% [95% CI: -23.0 to -4.04]), whereas no association was observed in girls. This study suggests that high dosages of FAs in the first pregnancy period may be associated with a shorter TL in children at age four, particularly among boys. Further studies should confirm these results.

Nutrition recommendations for patients with pseudohypoparathyroidism.

Pseudohypoparathyroidism (PHP) is a spectrum of diseases characterized by insensitivity of target tissues to the action of parathyroid hormone and, consequently, by the presence of hyperphosphatemia and hypocalcaemia of varying severity. Early-onset obesity is a feature of PHP type 1A. This article discusses the need to establish uniform criteria to guide the nutritional management of patients with PHP. A decrease in energy expenditure calls for an adjustment of the energy content of the diet. Reducing the intake of foods rich in inorganic phosphorus helps to manage hyperphosphataemia. Targeted nutrition should be part of the treatment plan of children and adolescents with PHP, since it contributes to modulating the calcium and phosphorus metabolism imbalances characteristic of these patients.

Omega-3 Fatty Acid Intake during Pregnancy and Child Neuropsychological Development: A Multi-Centre Population-Based Birth Cohort Study in Spain.

Background: There are few studies that look at the intake of all types of omega-3 polyunsaturated fatty acids (n-3 PUFAs) during the different stages of pregnancy along with a long-term neuropsychological follow-up of the child. This study aims to explore the association between maternal n-3 PUFA intake during two periods of pregnancy and the child's neuropsychological scores at different ages. Methods: Prospective data were obtained for 2644 pregnant women recruited between 2004 and 2008 in population-based birth cohorts in Spain. Maternal n-3 PUFA intake during the first and third trimester of pregnancy was estimated using validated food frequency questionnaires. Child neuropsychological functions were assessed using Bayley Scales of Infant Development version one (BSID) at 1 year old, the McCarthy Scale of Children's Abilities (MSCA) at 4 years old, and the Attention Network Test (ANT) at 7 years old. Data were analysed using multivariate linear regression models and adjusted for potential covariates, such as maternal social class, education, cohort location, alcohol consumption, smoking, breastfeeding duration, and energy intake. Results: Compared to participants in the lowest quartile (<1.262 g/day) of n-3 PUFA consumption during the first trimester, those in the highest quartile (>1.657 g/day) had a 2.26 points (95% confidence interval (CI): 0.41, 4.11) higher MSCA general cognitive score, a 2.48 points (95% CI: 0.53, 4.43) higher MSCA verbal score, and a 2.06 points (95% CI: 0.166, 3.95) higher MSCA executive function score, and a 11.52 milliseconds (95% CI: −22.95, −0.09) lower ANT hit reaction time standard error. In the third pregnancy trimester, the associations were weaker. Conclusions: Positive associations between n-3 PUFA intake during early pregnancy and child neuropsychological functions at 4 and 7 years of age were found, and further clinical research is needed to confirm these findings.

Hipovitaminosis D y factores asociados a los 4 años en el norte de España / Hypovitaminosis D and associated factors in 4-year old children in northern Spain

INTRODUCCIÓN: La vitamina D es una prohormona esencial en la homeostasis del calcio y el fósforo. Estudios recientes muestran una elevada frecuencia de insuficiencia/deficiencia de vitamina D en población general a nivel mundial. Nuestro objetivo ha sido estimar la prevalencia de deficiencia e insuficiencia de vitamina D sérica [25(OH)D3] y examinar sus factores asociados en la infancia. MATERIAL Y MÉTODOS: Se ha estudiado a 283 niños participantes en la cohorte INMA-Asturias. Se determinó la 25(OH)D3 mediante cromatografía líquida de alta resolución. Se han estimado las prevalencias de deficiencia ([25(OH)D3 < 20 ng/ml) e insuficiencia (20-29,9 ng/ml) de vitamina D y se ha analizado la distribución de 25(OH)D3 por mes de extracción, ingesta y otros factores. RESULTADOS: La 25(OH)D3 media fue 20,1 ng/ml (rango 2,7-49,8). El 8,8% tenía 25(OH)D3 ≥ 30 ng/ml, el 38,5% entre 20-20,9 ng/ml y el 52,7% < 20 ng/ml. Se halló variación estacional con menores valores en invierno. No se encontró relación entre los niveles plasmáticos y la ingesta de vitamina D (mediana 2,7 g/día, rango 0,81-12,62), el tiempo al aire libre (mediana 3 h, rango: 0:21-6:55), el índice de masa corporal, ni el sexo, pero sí con los niveles de sus madres durante la gestación. CONCLUSIONES: Existe una elevada prevalencia de deficiencia/insuficiencia de vitamina D a los 4 años. La exposición solar podría no ser suficiente en nuestra región. Se deberían promover actividades al aire libre con una adecuada exposición a la luz solar. Dado el déficit de ingesta en la infancia, es necesario hacer recomendaciones de una alimentación variada rica en vitamina D en este periodo especialmente durante el invierno, valorando la necesidad de suplementar con vitamina D en los niños de riesgo

INTRODUCTION: Vitamin D is an essential prohormone in calcium and phosphorus homeostasis. Recent studies show a high frequency of insufficiency/deficiency of vitamin D in the general population worldwide. Our objective was to estimate the prevalence of circulating vitamin D [25(OH)D3] deficiency and insufficiency in children and examine the associated factors. MATERIAL AND METHODS: A total of 283 children, participants in the cohort INMA-Asturias, were studied. The 25(OH)D3 concentrations were quantified by high performance liquid chromatography. The prevalence of deficiency [25(OH)D3 < 20 ng/ml] and insufficiency [20-29.9 ng/ml] of vitamin D was estimated. Distribution of 25(OH)D3 for month of extraction of specimen, ingestion, and other factors were analysed. RESULTS: The mean 25(OH)D3 was 20.1 ng/ml (range 2.7-49.8), with 8.8% ≥ 30 ng/ml, 38.5% from 20-20.9 ng/ml, and 52.7% < 20 ng/ml. Seasonal variation was found, with lower values in winter. There was no relationship between plasma levels and intake of vitamin D (median 2.7 g/day, range 0.81-12.62), time outdoors (mean 3 hours, range: 0:21-6:55), or BMI or gender, but there was one found with the mother's levels during gestation. CONCLUSIONS: There is a high prevalence of vitamin D deficiency/insufficiency in children at 4 years. Solar exposure might not be enough in our region. Healthy children should be encouraged to follow adequate outdoor activities with associated sun exposure. Due the deficit of intake in childhood, recommendations are needed about a varied diet with vitamin D-containing foods in this age group, especially during the winter, and assessing the need of vitamin D supplementation in children at risk

[Hypovitaminosis D and associated factors in 4-year old children in northern Spain]. / Hipovitaminosis D y factores asociados a los 4 años en el norte de España.

INTRODUCTION: Vitamin D is an essential prohormone in calcium and phosphorus homeostasis. Recent studies show a high frequency of insufficiency/deficiency of vitamin D in the general population worldwide. Our objective was to estimate the prevalence of circulating vitamin D [25(OH)D3] deficiency and insufficiency in children and examine the associated factors. MATERIAL AND METHODS: A total of 283 children, participants in the cohort INMA-Asturias, were studied. The 25(OH)D3 concentrations were quantified by high performance liquid chromatography. The prevalence of deficiency [25(OH)D3<20 ng/ml] and insufficiency [20-29.9 ng/ml] of vitamin D was estimated. Distribution of 25(OH)D3 for month of extraction of specimen, ingestion, and other factors were analysed. RESULTS: The mean 25(OH)D3 was 20.1 ng/ml (range 2.7-49.8), with 8.8% ≥ 30 ng/ml, 38.5% from 20-20.9 ng/ml, and 52.7%<20 ng/ml. Seasonal variation was found, with lower values in winter. There was no relationship between plasma levels and intake of vitamin D (median 2.7µg/day, range 0.81-12.62), time outdoors (mean 3hours, range: 0:21-6:55), or BMI or gender, but there was one found with the mother's levels during gestation. CONCLUSIONS: There is a high prevalence of vitamin D deficiency/insufficiency in children at 4 years. Solar exposure might not be enough in our region. Healthy children should be encouraged to follow adequate outdoor activities with associated sun exposure. Due the deficit of intake in childhood, recommendations are needed about a varied diet with vitamin D-containing foods in this age group, especially during the winter, and assessing the need of vitamin D supplementation in children at risk.

Prevalencia de deficiencia e insuficiencia de vitamina D y factores asociados en mujeres embarazadas del norte de España / Prevalence of vitamin D deficiency and insuffiency and associated factors in pregnant women of northern Spain

Introducción y objetivos: El déficit de vitamina D durante el embarazo se ha relacionado con sucesos adversos durante la gestación y con el desarrollo infantil postnatal. En este estudio examinamos los niveles plasmáticos de vitamina D [25(OH)D3] y los factores asociados a su deficiencia e insuficiencia plasmática en embarazadas del norte de España. Material y método: Se han analizado los datos de 453 gestantes participantes en la cohorte INMA-Asturias a las que se determinó la 25(OH)D3 mediante cromatografía líquida de alta resolución. Se ha estimado la ingesta dietética de vitamina D mediante un cuestionario de frecuencia alimentaria validado. Se han estimado las prevalencias de deficiencia [25(OH)D3 <20ng/ml] e insuficiencia [20-29,9 ng/ml] de vitamina D y se ha analizado la distribución de 25(OH)D3 por mes de extracción y otros factores. Resultados: La concentración media de 25(OH)D3 fue 27,7 ng/ml (rango 6,4-69,5). Un 27,4% de gestantes presentaron niveles deficientes y un 35,3% insuficientes. Los niveles de 25(OH)D3 fueron mayores en los meses de verano (mediana 34,1 ng/ml). Hubo un mayor porcentaje de deficiencia en las gestantes con sobrepeso/obesidad (34,5%) y en las menores de 25 años (47,8%). La ingesta media diaria de vitamina D fue 5,48 µg/día (DT 2,82 rango 1,09-32,52). Durante los meses de octubre a mayo la ingesta se relacionó con los niveles de 25(OH)D3. Un 8,6% refirieron tomar suplementos de vitamina D. Conclusiones: Se ha detectado una elevada proporción de embarazadas con niveles de vitamina D considerados como deficientes o insuficientes, especialmente en los meses de octubre a mayo, en las gestantes con sobrepeso y obesidad y en las de menor edad (AU)

Background and objectives: The vitamin D deficiency during pregnancy has been associated with adverse events during pregnancy and the postnatal child development. In this study we examined plasma levels of vitamin D [25(OH)D3] and factors associated with plasma deficiency and insufficiency in pregnant women in northern Spain. Methods: We analyzed data from 453 pregnant women participating in the INMA-Asturias cohort in which was determined 25(OH)D3 by high resolution liquid chromatography. Dietary intake of vitamin D was estimated through a food frequency validated questionnaire. We estimated the prevalence of deficiency [25(OH)D3<20ng / ml] and insufficiency [20 to 29.9 ng / ml] of vitamin D and analyzed the distribution of 25(OH)D3 per month extraction and other factors. Results: The mean concentration of 25(OH)D3 was 27.7 ng/ml (range 6.4 to 69.5). 27.4% of pregnant women had deficient levels and 35.3% insufficient. Levels of 25(OH)D3 were higher in the summer months (median 34.1 ng/ml). There was a higher percentage of deficiency in pregnant women with overweight/obesity (34.5%) and under 25 years (47.8%). The average daily intake of vitamin D was 5.48 mg / day (SD 2.82 range 1.09 to 32.52). Intake during the months of October to May was associated with levels of 25(OH)D3. 8.6% reported taking supplements of vitamin D. Conclusions: We detected a high proportion of pregnant women with deficient or insufficient vitamin D levels, especially in the months of October to May, in pregnant women with overweight and obesity, and the youngest (AU)

[Prevalence of vitamin d deficiency and insuffiency and associated factors in pregnant women of northern Spain]. / Prevalencia de deficiencia e insuficiencia de vitamina D y factores asociados en mujeres embarazadas del norte de España.

BACKGROUND AND OBJECTIVES: The vitamin D deficiency during pregnancy has been associated with adverse events during pregnancy and the postnatal child development. In this study we examined plasma levels of vitamin D [25(OH)D3] and factors associated with plasma deficiency and insufficiency in pregnant women in northern Spain. METHODS: We analyzed data from 453 pregnant women participating in the INMA-Asturias cohort in which was determined 25(OH)D3 by high resolution liquid chromatography.Dietary intake of vitamin D was estimated through a food frequency validated questionnaire. We estimated the prevalence of deficiency [25(OH)D3 <20 ng/ml] and insufficiency [20 to 29.9 ng / ml] of vitamin D and analyzed the distribution of 25(OH)D3 per month extraction and other factors. RESULTS: The mean concentration of 25(OH)D3 was 27.7 ng/ml (range 6.4 to 69.5). 27.4% of pregnant women had deficient levels and 35.3% inssuficient. Levels of 25(OH)D3 were higher in the summer months (median 34.1 ng/ml). There was a higher percentage of deficiency in pregnant women with overweight/obesity (34.5%) and under 25 years (47.8%). The average daily intake of vitamin D was 5.48 mg / day (SD 2.82 range 1.09 to 32.52).Intake during the months of October to May was associated with levels of 25(OH)D3. 8.6% reported taking supplements of vitamin D. CONCLUSIONS: We detected a high proportion of pregnant women with deficient or insufficient vitamin D levels, especially in the months of October to May, in pregnant women with overweight and obesity, and the youngest.

Introducción y objetivos: El déficit de vitamina D durante el embarazo se ha relacionado con sucesos adversos durante la gestación y con el desarrollo infantil postnatal. En este estudio examinamos los niveles plasmáticos de vitamina D [25(OH)D3] y los factores asociados a su deficiencia e insuficiencia plasmática en embarazadas del norte de España. Material y método: Se han analizado los datos de 453 gestantes participantes en la cohorte INMA-Asturias a las que se determinó la 25(OH)D3 mediante cromatografía líquida de alta resolución. Se ha estimado la ingesta dietética de vitamina D mediante un cuestionario de frecuencia alimentaria validado. Se han estimado las prevalencias de deficiencia [25(OH)D3.