Vascular Effects, Potential Pathways and Mediators of Fetal Exposure to Alcohol and Cigarette Smoking during Pregnancy: A Narrative Review.

(1) Background: Programming of atherosclerosis results in vascular structure and function alterations, which may be attributed to fetal exposure to maternal tobacco smoking, alcohol consumption and several lifestyle factors in the first few years of life. This review aims to study the effects of teratogen exposure in utero on vascular dysfunction in offspring and consider mediators and pathways originating from the fetal environment. (2) Methods: Eligible studies were identified in the PubMed, Scopus and Web of Science databases. After the full-text screening, 20 articles were included in the narrative synthesis. (3) Results: The literature presents evidence supporting the detrimental effects of fetal exposure to tobacco smoking on vascular alterations in both human and animal studies. Alcohol exposure impaired endothelial dilation in animal studies, but human studies on both tobacco and alcohol exposure are still sparse. Reduction in nitric oxide (NO) bioavailability and alterations in the epigenome in infants through the upregulation of pro-oxidative and proinflammatory genes may be the common denominators. (4) Conclusion: While maternal smoking and alcohol consumption have more negative outcomes on the infant in the short term, several factors during the first few years of life may mediate the development of vascular dysfunction. Therefore, more prospective studies are needed to ascertain the long-term effects of teratogen exposure, specifically in South Africa.

Effect of maternal cigarette smoking and alcohol consumption during pregnancy on birth weight and cardiometabolic risk factors in infants, children and adolescents: a systematic review protocol.

INTRODUCTION: Tobacco smoking and alcohol consumption during pregnancy are particularly prevalent in low socioeconomic status populations, with an adverse association with birth outcomes and cardiometabolic risk factors. However, the direct and indirect effects of prenatal cigarette smoking and alcohol consumption during pregnancy on cardiometabolic risk in offspring have been rather inconsistent. This may be attributed to multiple factors, such as the amount and timing of exposure to tobacco smoking and alcohol during pregnancy; the influence of maternal, environmental and socioeconomic factors; or how risk factors were defined by individual researchers and studies. Therefore, this review aims to provide a summary of the most recent evidence on birth outcomes and cardiometabolic risk in children associated with alcohol and/or tobacco exposure in utero. METHODS AND ANALYSIS: PubMed, Scopus and Web of Science will be searched to identify published articles from 1 January 2001. Clinical studies that investigate the association between maternal cigarette smoking or alcohol consumption and birth weight and cardiometabolic risk factors in infants, children and adolescents will be included. Prospective cohort, case-control studies and birth cohort studies will be eligible for inclusion. Grey literature will be searched including conference proceedings, Google Scholar and the ProQuest Dissertation and Theses database. Only studies published in English will be included, with no restrictions regarding country, race or gender. Two independent reviewers will conduct the literature search and article screening. Eligibility criteria will be based on the population (infants, children, adolescents), exposure (maternal cigarette smoking, alcohol consumption or both), comparator (control group with no exposure during pregnancy) and outcomes (birth weight and cardiometabolic risk factors). Quality assessment and risk of bias will be assessed using a risk of bias tool for observational studies, and data will be extracted for analysis using a researcher-generated data extraction form. A meta-analysis will be performed to estimate pooled effect sizes if there are sufficient good-quality studies available. Sources of heterogeneity will be explored using subgroup analysis. ETHICS AND DISSEMINATION: Ethical clearance will not be required as this review will extract publicly available secondary data. Findings from this review will be disseminated via publication in a peer-review journal. PROSPERO REGISTRATION NUMBER: CRD42021286630.

Effects of aqueous soaking on the phytate and mineral contents and phytate:mineral ratios of wholegrain normal sorghum and maize and low phytate sorghum.

Soaking of cereal grains has been suggested as a method to reduce their phytate content and hence increase their mineral availability. Whole and milled wholegrain, normal and low phytate sorghum and normal maize were studied. Soaking of unmilled sorghum and maize did not result in substantial reductions in phytate or mineral contents. With milled grains, phytate solubilisation was somewhat greater in maize than in sorghum after a short (1 h) soaking period but not after 6-12 h of soaking when practically all phytate had been solubilised. Also, with milled, low phyate sorghums, phytate solubilisation was not substantially higher than in their null controls. Soaking milled grain substantially reduced mineral contents and Ca × phytate:zinc molar ratios. However, the loss in soluble minerals could have a greater negative effect on mineral availability, compared to the positive effect of the phytate reduction. Thus, soaking does not seem to be a viable household method to improve sorghum and maize mineral availability.

Effect of phytate reduction of sorghum, through genetic modification, on iron and zinc availability as assessed by an in vitro dialysability bioaccessibility assay, Caco-2 cell uptake assay, and suckling rat pup absorption model.

Improved iron and zinc availability from sorghum, a commonly consumed staple, will benefit many malnourished communities in rural Africa burdened with high prevalence of iron and zinc deficiency. This research compared the effect of genetic phytate reduction in sorghum on iron and zinc bioaccessibility and uptake measured by in vitro dialysability and Caco-2 cell uptake assays to that of iron and zinc absorption measured by a suckling rat pup model. The phytate reduction (80-86%) in these sorghums significantly increased zinc availability. The Caco-2 cell method, but not the dialysability assay, proved useful in estimating zinc absorption. The measured increase in iron availability differed between the methods, possibly due to the effect of varying mineral (Ca, Fe, Zn, P) contents of the sorghums. This effect was most prominent in the iron uptake results. More research is needed to determine the effect of naturally occurring variations in mineral contents of sorghum on the iron uptake by Caco-2 cells.

Rat bioassay of the protein nutritional quality of soy-fortified sorghum biscuits for supplementary feeding of school-age children.

BACKGROUND: Protein-energy malnutrition (PEM) remains a major deficiency disease among children in developing countries. The protein nutritional quality of soy-fortified sorghum biscuits was evaluated with respect to their potential as a protein-rich supplementary food. Three isonitrogenous diets based on 50:50 ratio decorticated sorghum:defatted soy flour biscuits, 100% sorghum biscuits, casein, and a protein-free diet were fed to male Sprague Dawley weanling rats. RESULTS: Protein efficiency ratio (PER) for the sorghum-soy biscuit diet was equivalent to the reference casein diet, and zero for the 100% sorghum diet. Faecal bulk for 100% sorghum diet was 1.5 times higher than sorghum-soy and casein diets. True protein digestibility of the three diets was high-88-95%-agreeing with previous rat studies with sorghum. Biological value and net protein utilization of the sorghum-soy biscuit diet were similar to the casein diet, but lower than the 100% sorghum biscuit diet CONCLUSION: Notwithstanding limitations of rat bioassay for assessing sorghum food protein quality, the high PER of defatted soy flour-fortified sorghum biscuits (sorghum:soy 50:50 ratio) indicates they have considerable potential as a supplementary food to young children to alleviate PEM.