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1.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(8): 1352-1358, 2020 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-32867449

RESUMO

Objective: To explore the effects of dietary glycemic load (GL) during first trimester on the risk of gestational diabetes mellitus (GDM). Methods: A prospective study was conducted among healthy women with singleton pregnancy at 8-14 weeks of gestation in a maternity out-patient clinic of maternal-and-child health care institution in Chengdu, Sichuan province. Information on dietary intake during the first trimester was collected through a 3-day 24-hour dietary recall. Glycemic index (GI) values were obtained from China Food Composition Tables (Standard Edition) and International Tables of Glycemic Index and Glycemic Load Values (2008). Dietary GL and GLs of staple foods were calculated based on GI values and the amount of carbohydrate consumed per day. Diagnostic criteria of GDM was followed the Guidelines for Diagnosis and Treatment of Pregnancy Diabetes in China (2014), and used on participants who underwent an oral glucose tolerant test during 24-28 weeks of gestation. Log-binomial regression models were used to explore the associations between both quartiles of dietary GL, GLs of staple foods and the risks of GDM,respectively. Results: The medians of dietary GL and GL of staple foods were 145.70 (113.23-180.85) and 121.05 (89.08-155.70), respectively. The median GL of both rice and tubers were 73.14 (43.89-107.50) and 3.43 (0.00-9.84), respectively. After adjusting for the age at pregnancy, pre-pregnancy body mass index and other confounding factors, results of log-binomial regressions analysis showed that when compared with the lowest quartile of dietary GL group, the third and highest quartiles of dietary GL groups increased the risk of GDM (RR=1.47, 95%CI: 1.20-1.80; RR=1.31, 95%CI: 1.04-1.64), respectively. Compared with the lowest quartile of GL of staple foods, the third and highest quartiles of GL of staple foods groups also increased the risk of GDM (RR=1.28, 95%CI: 1.04-1.58; RR=1.27, 95%CI: 1.02-1.60), respectively. The third and highest quartiles of GL of rice groups increased the risk of GDM (RR=1.30, 95%CI: 1.06-1.59; RR=1.28, 95%CI: 1.03-1.59), respectively, than the lowest quartile of GL of rice group. When compared with the lowest quartile of GL of tubers group, the highest quartile of GL of tubers group increased the risk of GDM (RR=1.30, 95%CI: 1.09-1.54). However, we did not notice the effects of wheat GL and coarse grain GL on the risk of GDM. Conclusions: A positive association was found between dietary glycemic load and the risk of GDM. Higher dietary glycemic load, especially in rice and tubers during first trimester, seemed to have increased the risk of GDM.


Assuntos
Diabetes Gestacional/epidemiologia , Carboidratos da Dieta/efeitos adversos , Carga Glicêmica , Fenômenos Fisiológicos da Nutrição Materna , Primeiro Trimestre da Gravidez , China/epidemiologia , Feminino , Humanos , Gravidez , Estudos Prospectivos , Medição de Risco
2.
Adv Exp Med Biol ; 1265: 111-131, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32761573

RESUMO

Amino acids are not only the building blocks of proteins, an indispensable component of cells, but also play versatile roles in regulating cell metabolism, proliferation, differentiation and growth by themselves or through their derivatives. At the whole body level, the bioavailability and metabolism of amino acids, interacting with other macronutrients, is critical for the physiological processes of reproduction including gametogenesis, fertilization, implantation, placentation, fetal growth and development. In fertilization and early pregnancy, histotroph in oviductal and uterine secretions provides nutrients and microenvironment for conceptus (embryo and extraembryonic membranes) development. These nutrients include select amino acids in histotroph (arginine, leucine and glutamine of particular interest) that stimulate conceptus growth and development, as well as interactions between maternal uterus and the conceptus, thus impacting maintenance of pregnancy, placental growth, development and functions, fetal growth and development, and consequential pregnancy outcomes. Gestational protein undernutrition causes fetal growth restriction and predisposes cardiovascular, metabolic diseases and others in offspring via multiple mechanisms, whereas the supplementation of glycine, leucine and taurine during pregnancy partially rescues growth restriction and beneficially modulates fetal programming. Thus, amino acids are essential for the fertility of humans and all animals.


Assuntos
Aminoácidos/metabolismo , Fenômenos Fisiológicos da Nutrição Materna , Reprodução/fisiologia , Animais , Implantação do Embrião , Feminino , Desenvolvimento Fetal , Humanos , Gravidez , Útero/metabolismo
3.
Nutrients ; 12(8)2020 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-32731389

RESUMO

Reproductive health is a significant public health issue during pandemics; however, the impacts of the novel 2019 coronavirus disease (COVID-19) on noninfected pregnant women are still unknown. This study intends (1) to examine whether emotional eating (EE) occurred during the pandemic triggered by disease concerns and (2) to explore the associations among EE, dietary changes, and gestational weight gain (GWG). Based on an online survey, 640 new mothers who experienced the lockdown in their third trimester were recruited from seven provinces in China. EE was evaluated with the Chinese version of the Dutch Eating Behavior Questionnaire, EE domain. A self-designed e-questionnaire was used to collect the data of participants on the sociodemographic characteristics, concerns about the COVID-19 pandemic, maternity information, physical activities, and dietary changes during lockdown. The results show that the average EE score was 26.5 ± 8.3, and women living in a severely affected area, who are very worried about the pandemic and who had less physical activity had a higher tendency of EE. Although there is a dietary pattern changed during pandemic, the average GWG in the studied group was in the normal range. However, a higher EE score was associated with a significant excess of GWG in women not from Wuhan (EE score 33-65 vs. 13-22: adjusted Odd Ratio (OR), 95% Confidence Interval (CI) = 1.90, 1.08-3.32). The sensitivity analysis that additionally adjusted for the pregestational body mass index and gestational metabolic disease was consistent with this result. The mediation model was also examined and showed that, after adjusting for living area and exercise, EE was associated with significantly increased consumption of cereals (EE score 33-65 vs. 13-22: adjusted OR, 95% CI = 2.22, 1.29-3.82) and oil (EE score 33-65 vs. 13-22: adjusted OR, 95% CI = 3.03, 1.06-8.69) but decreased consumption of fish and seafood (EE score 33-65 vs. 13-22: adjusted OR, 95% CI = 1.88, 1.14-3.11; 23-32 vs. 13-22: adjusted OR, 95% CI = 1.79, 1.20-2.66). In conclusion, this study indicated that EE occurred in a proportional number of pregnant women during the COVID-19 pandemic and is associated with excess GWG mediated by increased intake of certain foods. The findings suggest the need for psychosocial and nutritional education and interventions during pregnancy checkups. Further studies are needed to determine modifiable psychosocial predictors and potential nutritional concerns in pregnant women during disease outbreaks.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Dieta , Comportamento Alimentar/psicologia , Ganho de Peso na Gestação , Pandemias , Pneumonia Viral/epidemiologia , Adulto , China/epidemiologia , Emoções , Feminino , Humanos , Saúde Materna/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Gravidez , Terceiro Trimestre da Gravidez , Estudos Retrospectivos , Inquéritos e Questionários
4.
PLoS One ; 15(8): e0216848, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32764747

RESUMO

Maternal nutritional status influences fetal development and long-term risk for adult non-communicable diseases. However, the underlying mechanisms remain poorly understood. We examined whether biomarkers for metabolism and inflammation during pregnancy were associated with maternal health and with child biomarkers and health at 9-12 years of age in 44 maternal-child dyads from the Supplementation with Multiple Micronutrients Intervention Trial (SUMMIT, ISRCTN34151616) in Lombok, Indonesia. Archived blood for each dyad from maternal enrollment, later in pregnancy, postpartum, and from children at 9-12 years comprised 132 specimens. Multiplex microbead immunoassays were used to quantify vitamin D-binding protein (D), adiponectin (A), retinol-binding protein 4 (R), C-reactive protein (C), and leptin (L). Principal component analysis (PCA) revealed distinct variance patterns, i.e. principal components (PC), for baseline pregnancy, bp.pc1.D↓A↓R↓ and bp.pc2.C↓L↑; combined follow-up during pregnancy and postpartum, dp-pp.pc1.D↑↓A↑R↑↓L↓ and dp-pp.pc2.A↑C↑L↑; and children, ch.pc1.D↑R↑C↑ and ch.pc2.D↓A↑L↑. Maternal multiple micronutrient (MMN) supplementation led to an association of baseline maternal bp.pc2.C↓L↑ with decreased post-supplementation maternal dp-pp.pc2.A↑C↑L↑ (p = 0.022), which was in turn associated with both increased child ch.pc1.D↑R↑C↑ (p = 0.036) and decreased child BMI z-score (BMIZ) (p = 0.022). Further analyses revealed an association between maternal dp-pp.pc1.D↑↓A↑R↑↓L↓ and increased child BMIZ (p = 0.036). Child ch.pc1.D↑R↑C↑ was associated with decreased birth weight (p = 0.036) and increased child BMIZ (p = 0.002). Child ch.pc2.D↓A↑L↑ was associated with increased child BMIZ (p = 0.005), decreased maternal height (p = 0.030) and girls (p = 0.002). A pattern of elevated maternal adiponectin and leptin in pregnancy was associated with increased C-reactive protein, vitamin A, and D binding proteins pattern in children, suggesting biomarkers acting in concert may have qualitative as well as quantitative influence beyond single biomarker effects. Patterns in pregnancy proximal to birth were more associated with child status. In addition, child patterns were more associated with child status, particularly child BMI. MMN supplementation affects maternal biomarker patterns of metabolism and inflammation in pregnancy, and potentially in the child. However, child nutrition conditions after birth may have a greater impact on metabolism and inflammation.


Assuntos
Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Micronutrientes/metabolismo , Estado Nutricional/fisiologia , Adiponectina/análise , Adiponectina/sangue , Adulto , Biomarcadores/sangue , Proteína C-Reativa/análise , Criança , Suplementos Nutricionais , Família , Feminino , Ácido Fólico/análise , Humanos , Indonésia , Recém-Nascido , Inflamação , Leptina/análise , Masculino , Terapia Nutricional/métodos , Gravidez , Proteínas Plasmáticas de Ligação ao Retinol/análise , Vitamina A/análise , Proteína de Ligação a Vitamina D/análise , Proteína de Ligação a Vitamina D/sangue
5.
PLoS Med ; 17(7): e1003183, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32692751

RESUMO

BACKGROUND: Undernutrition during intrauterine life and early childhood is hypothesised to increase the risk of cardiovascular disease (Developmental Origins of Health and Disease Hypothesis), but experimental evidence from humans is limited. This hypothesis has major implications for control of the cardiovascular disease epidemic in South Asia (home to a quarter of world's population), where a quarter of newborns have low birth weight. We investigated whether, in an area with prevalent undernutrition, supplemental nutrition offered to pregnant women and their offspring below the age of 6 years was associated with a lower risk of cardiovascular disease in the offspring when they were young adults. METHODS AND FINDINGS: The Hyderabad Nutrition Trial was a community-based nonrandomised controlled intervention trial conducted in 29 villages near Hyderabad, India (1987-1990). Protein-calorie food supplement was offered daily to pregnant and lactating women (2.09 MJ energy and 20-25 g protein) and their offspring (1.25 MJ energy and 8-10 g protein) until the age of six years in the 15 intervention villages, but not in the 14 control villages. A total of 1,826 participants (949 from the intervention villages and 877 from the control villages, representing 70% of the cohort) at a mean age of 21.6 years (62% males) were examined between 2009 and 2012. The mean body mass index (BMI) of the participants was 20 kg/m2 and the mean systolic blood pressure was 115 mm Hg. The age, sex, socioeconomic position, and urbanisation-adjusted effects of intervention (beta coefficients and 95% confidence intervals) on outcomes were as follows: carotid intima-media thickness, 0.01 mm (-0.01 to 0.03), p = 0.36; arterial stiffness (augmentation index), -1.1% (-2.5 to 0.3), p = 0.097; systolic blood pressure, 0.5 mm Hg (-0.6 to 1.6), p = 0.36; BMI, -0.13 kg/m2 (-0.75 to 0.09), p = 0.093; low-density lipoprotein (LDL) cholesterol, 0.06 mmol/L (-0.07 to 0.2), p = 0.37; and fasting insulin (log), -0.06 mU/L (-0.19 to 0.07), p = 0.43. The limitations of this study include nonrandomised allocation of intervention and lack of data on compliance, and potential for selection bias due to incomplete follow-up. CONCLUSIONS: Our results showed that in an area with prevalent undernutrition, protein-calorie food supplements offered to pregnant women and their offspring below the age of 6 years were not associated with lower levels of cardiovascular risk factors among offspring when they were young adults. Our findings, coupled with evidence from other intervention studies to date, suggest that policy makers should attach limited value to cardiovascular health benefits of maternal and child protein-calorie food supplementation programmes.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Suplementos Nutricionais , Adolescente , Índice de Massa Corporal , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Espessura Intima-Media Carotídea , Feminino , Seguimentos , Humanos , Índia , Masculino , Desnutrição/dietoterapia , Fenômenos Fisiológicos da Nutrição Materna , Gravidez , Fatores de Risco , Adulto Jovem
6.
Nat Rev Endocrinol ; 16(9): 519-533, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32620937

RESUMO

Reproductive function adjusts in response to environmental conditions in order to optimize success. In humans, this plasticity includes age of pubertal onset, hormone levels and age at menopause. These reproductive characteristics vary across populations with distinct lifestyles and following specific childhood events, and point to a role for the early-life environment in shaping adult reproductive trajectories. Epigenetic mechanisms respond to external signals, exert long-term effects on gene expression and have been shown in animal and cellular studies to regulate normal reproductive function, strongly implicating their role in these adaptations. Moreover, human cohort data have revealed differential DNA methylation signatures in proxy tissues that are associated with reproductive phenotypic variation, although the cause-effect relationships are difficult to discern, calling for additional complementary approaches to establish functionality. In this Review, we summarize how adult reproductive function can be shaped by childhood events. We discuss why the influence of the childhood environment on adult reproductive function is an important consideration in understanding how reproduction is regulated and necessitates consideration by clinicians treating women with diverse life histories. The resolution of the molecular mechanisms responsible for human reproductive plasticity could also lead to new approaches for intervention by targeting these epigenetic modifications.


Assuntos
Adaptação Fisiológica/genética , Meio Ambiente , Epigênese Genética/fisiologia , Reprodução/genética , Envelhecimento , Animais , Metilação de DNA , Feminino , Fertilidade , Desenvolvimento Fetal , Humanos , Estilo de Vida , Masculino , Fenômenos Fisiológicos da Nutrição Materna , Fenótipo , Gravidez , Progesterona/sangue , Puberdade/genética , Reprodução/fisiologia , Testosterona/sangue , Migrantes
7.
Sante Publique ; Vol. 32(1): 113-122, 2020 Jun 18.
Artigo em Francês | MEDLINE | ID: mdl-32706221

RESUMO

INTRODUCTION: Madagascar has adopted strategies to fight against maternal malnutrition, but the evaluation of their implementation is not effective.Purpose of research: The present study aims to describe beneficiary appreciation of interventions to fight maternal malnutrition and to identify their expectations. METHOD: A qualitative study was conducted in the Amoron’i Mania region, Madagascar. The study included mothers of children under 5, pregnant women, and other family members and community members (fathers, grandmothers, matrons and community workers). Six focus groups and 16 individual interviews were conducted to collect the data. The thematic analysis was used. RESULTS: Food supplementation, improved production of agriculture and livestock, and nutrition education, operated by NGOs, are the best-known interventions. The health centers were not mentioned as interveners and their interventions were ignored. The effectiveness of the intervention is generally judged on the benefits perceived by the beneficiaries. Interveners working on a project basis were assessed as unsustainable. Two main problems were mentioned: first, the insufficiency of agricultural production resulting in the inaccessibility of the ingredients required for the nutrition education, and second the low coverage of the interventions. The improvement of agricultural production is the main suggestion mentioned to fight against maternal undernutrition. CONCLUSIONS: Beneficiaries thought that existing interventions in the region are insufficient to address the problem of malnutrition among mothers.


Assuntos
Desnutrição/prevenção & controle , Fenômenos Fisiológicos da Nutrição Materna , Mães/estatística & dados numéricos , Agricultura/estatística & dados numéricos , Feminino , Grupos Focais , Abastecimento de Alimentos , Educação em Saúde , Humanos , Madagáscar/epidemiologia , Desnutrição/epidemiologia , Gravidez , Pesquisa Qualitativa
8.
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
9.
Matern Child Nutr ; 16(3): e13036, 2020 07.
Artigo em Inglês | MEDLINE | ID: covidwho-378014

RESUMO

Globally, the COVID-19 pandemic has already led to major increases in unemployment and is expected to lead to unprecedented increases in poverty and food and nutrition insecurity, as well as poor health outcomes. Families where young children, youth, pregnant and lactating women live need to be protected against the ongoing protracted pandemic and the aftershocks that are very likely to follow for years to come. The future wellbeing of the vast majority of the world now depends on reconfiguring the current ineffective food, nutrition, health, and social protection systems to ensure food and nutrition security for all. Because food, nutrition, health, and socio-economic outcomes are intimately inter-linked, it is essential that we find out how to effectively address the need to reconfigure and to provide better intersecoral coordination among global and local food, health care, and social protection systems taking equity and sutainability principles into account. Implementation science research informed by complex adaptive sytems frameworks will be needed to fill in the major knowledge gaps. Not doing so will not only put the development of individuals at further risk, but also negatively impact on the development potential of entire nations and ultimately our planet.


Assuntos
Saúde da Criança , Infecções por Coronavirus , Abastecimento de Alimentos , Saúde Materna , Pandemias , Pneumonia Viral , Betacoronavirus , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Feminino , Saúde Global , Humanos , Fome , Fenômenos Fisiológicos da Nutrição Materna , Pobreza , Gravidez , Risco
10.
Matern Child Nutr ; 16(3): e13036, 2020 07.
Artigo em Inglês | MEDLINE | ID: covidwho-599152

RESUMO

Globally, the COVID-19 pandemic has already led to major increases in unemployment and is expected to lead to unprecedented increases in poverty and food and nutrition insecurity, as well as poor health outcomes. Families where young children, youth, pregnant and lactating women live need to be protected against the ongoing protracted pandemic and the aftershocks that are very likely to follow for years to come. The future wellbeing of the vast majority of the world now depends on reconfiguring the current ineffective food, nutrition, health, and social protection systems to ensure food and nutrition security for all. Because food, nutrition, health, and socio-economic outcomes are intimately inter-linked, it is essential that we find out how to effectively address the need to reconfigure and to provide better intersecoral coordination among global and local food, health care, and social protection systems taking equity and sutainability principles into account. Implementation science research informed by complex adaptive sytems frameworks will be needed to fill in the major knowledge gaps. Not doing so will not only put the development of individuals at further risk, but also negatively impact on the development potential of entire nations and ultimately our planet.


Assuntos
Saúde da Criança , Infecções por Coronavirus , Abastecimento de Alimentos , Saúde Materna , Pandemias , Pneumonia Viral , Betacoronavirus , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Feminino , Saúde Global , Humanos , Fome , Fenômenos Fisiológicos da Nutrição Materna , Pobreza , Gravidez , Risco
11.
Science ; 368(6491): 604-607, 2020 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-32381716

RESUMO

Molecules from symbiotic microorganisms pervasively infiltrate almost every organ system of a mammalian host, marking the initiation of microbial-host mutualism in utero, long before the newborn acquires its own microbiota. Starting from in utero development, when maternal microbial molecules can penetrate the placental barrier, we follow the different phases of adaptation through the life events of birth, lactation, and weaning, as the young mammal adapts to the microbes that colonize its body surfaces. The vulnerability of early-life mammals is mitigated by maternal detoxification and excretion mechanisms, the protective effects of maternal milk, and modulation of neonatal receptor systems. Host adaptations to microbial exposure during specific developmental windows are critical to ensure organ function for development, growth, and immunity.


Assuntos
Bactérias/metabolismo , Feto/imunologia , Feto/microbiologia , Interações entre Hospedeiro e Microrganismos/imunologia , Troca Materno-Fetal/imunologia , Microbiota , Adaptação Fisiológica/imunologia , Animais , Dieta , Feminino , Humanos , Imunidade Inata , Lactação/imunologia , Exposição Materna , Fenômenos Fisiológicos da Nutrição Materna , Camundongos , Placentação , Gravidez , Xenobióticos/toxicidade
12.
Matern Child Nutr ; 16(3): e13036, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32458574

RESUMO

Globally, the COVID-19 pandemic has already led to major increases in unemployment and is expected to lead to unprecedented increases in poverty and food and nutrition insecurity, as well as poor health outcomes. Families where young children, youth, pregnant and lactating women live need to be protected against the ongoing protracted pandemic and the aftershocks that are very likely to follow for years to come. The future wellbeing of the vast majority of the world now depends on reconfiguring the current ineffective food, nutrition, health, and social protection systems to ensure food and nutrition security for all. Because food, nutrition, health, and socio-economic outcomes are intimately inter-linked, it is essential that we find out how to effectively address the need to reconfigure and to provide better intersecoral coordination among global and local food, health care, and social protection systems taking equity and sutainability principles into account. Implementation science research informed by complex adaptive sytems frameworks will be needed to fill in the major knowledge gaps. Not doing so will not only put the development of individuals at further risk, but also negatively impact on the development potential of entire nations and ultimately our planet.


Assuntos
Saúde da Criança , Infecções por Coronavirus , Abastecimento de Alimentos , Saúde Materna , Pandemias , Pneumonia Viral , Betacoronavirus , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Feminino , Saúde Global , Humanos , Fome , Fenômenos Fisiológicos da Nutrição Materna , Pobreza , Gravidez , Risco
13.
PLoS One ; 15(5): e0232400, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32384084

RESUMO

Metabolic parameters ranging from circulating nutrient levels and substrate utilization to energy expenditure and thermogenesis are temporally modulated by the circadian timing system. During critical embryonic developmental periods, maternal over-nutrition could alter key elements in different tissues associated with the generation of circadian rhythmicity, compromising normal rhythmicity development. To address this issue, we determine whether maternal over-nutrition leads to alterations in the development of circadian rhythmicity at physiological and behavioral levels in the offspring. For this, female rabbits were fed a standard diet (SD) or high-fat and carbohydrate diet (HFCD) before mating and during gestation. Core body temperature and gross locomotor activity were continuously recorded in newborn rabbits, daily measurements of body weight and the amount of milk ingested was carried out. At the end of lactation, tissue samples, including brown adipose tissue (BAT) and white adipose tissue (WAT), were obtained for determining the expression of uncoupling protein-1 (UCP1) and cell death-inducing DNA fragmentation factor-like effector A (CIDEA) genes. HFCD pups exhibited conspicuous differences in the development of the daily rhythm of temperature and locomotor activity compared to the SD pups, including a significant increase in the daily mean core temperature, changes in the time when temperature or activity remains above the average, shifts in the acrophase, decrease in the duration and intensity of the anticipatory rise previous to nursing, and changes in frequency of the rhythms. HFCD pups exhibited a significant increase in BAT thermogenesis markers, and a decrease of these markers in WAT, indicating more heat generation by brown adipocytes and alterations in the browning process. These results indicate that maternal over-nutrition alters offspring homeostatic and chronostatic regulation at the physiological and behavioral levels. Further studies are needed to determine whether these alterations are associated with the changes in the organization of the circadian system of the progeny.


Assuntos
Regulação da Temperatura Corporal/fisiologia , Ritmo Circadiano/fisiologia , Lactação/fisiologia , Locomoção/fisiologia , Tecido Adiposo Marrom/fisiopatologia , Tecido Adiposo Branco/fisiopatologia , Animais , Proteínas Reguladoras de Apoptose/genética , Regulação da Temperatura Corporal/genética , Ritmo Circadiano/genética , Modelos Animais de Doenças , Feminino , Expressão Gênica , Lactação/genética , Locomoção/genética , Fenômenos Fisiológicos da Nutrição Materna , Hipernutrição/complicações , Hipernutrição/genética , Hipernutrição/fisiopatologia , Gravidez , Complicações na Gravidez/genética , Complicações na Gravidez/fisiopatologia , Coelhos , Proteína Desacopladora 1/genética
14.
Life Sci ; 254: 117764, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32407841

RESUMO

AIMS: Emerging evidence suggests that during gestation the in utero environment programs metabolism and can increase risk of obesity in adult offspring. Our aim was to study how alterations in maternal diets during gestation might alter body weight evolution, circulating leptin levels and caloric intake in offspring, leading to changes in body composition. MATERIALS AND METHODS: We fed gestating rats either a control diet (CD), high fat diet (HFD) or an isocaloric low protein diet (LPD), and examined the repercussions in offspring fed similar diets post-weaning on birth weight, body weight evolution, body composition, insulin sensitivity, glucose tolerance and in the relationship between plasma leptin concentration and caloric intake in offspring during growth and development. KEY FINDS: Offspring from dams fed LPD maintained reduced body weight with greater % lean mass and consumed fewer calories despite having leptin levels similar to controls. On the other hand, offspring from dams fed a HFD were insulin resistant and maintained increased body weight and % fat mass, while consuming more calories than controls despite elevated leptin concentrations. Therefore the uterine environment, modulated primarily through maternal nutrition, modified the relationship between circulating leptin levels, body fat, and caloric intake in the offspring, and dams fed a HFD produced offspring with excess adiposity, insulin resistance, and leptin resistance into adulthood. SIGNIFICANCE: Our data indicates that in utero environmental factors affected by maternal diet program alterations in the set point around which leptin regulates body weight in offspring into adulthood contributing to obesity.


Assuntos
Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Obesidade/etiologia , Fenômenos Fisiológicos da Nutrição Pré-Natal/fisiologia , Tecido Adiposo/metabolismo , Adiposidade/fisiologia , Animais , Animais Recém-Nascidos , Peso ao Nascer , Composição Corporal , Peso Corporal , Dieta Hiperlipídica , Gorduras na Dieta , Ingestão de Energia , Feminino , Resistência à Insulina , Lactação , Leptina/metabolismo , Masculino , Obesidade/metabolismo , Gravidez , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Ratos , Ratos Sprague-Dawley , Desmame
15.
Lancet Glob Health ; 8(5): e730-e736, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32353320

RESUMO

Intervention coverage-the proportion of the population with a health-care need who receive care-does not account for intervention quality and potentially overestimates health benefits of services provided to populations. Effective coverage introduces the dimension of quality of care to the measurement of intervention coverage. Many definitions and methodological approaches to measuring effective coverage have been developed, resulting in confusion over definition, calculation, interpretation, and monitoring of these measures. To develop a consensus on the definition and measurement of effective coverage for maternal, newborn, child, and adolescent health and nutrition (MNCAHN), WHO and UNICEF convened a group of experts, the Effective Coverage Think Tank Group, to make recommendations for standardising the definition of effective coverage, measurement approaches for effective coverage, indicators of effective coverage in MNCAHN, and to develop future effective coverage research priorities. Via a series of consultations, the group recommended that effective coverage be defined as the proportion of a population in need of a service that resulted in a positive health outcome from the service. The proposed effective coverage measures and care cascade steps can be applied to further develop effective coverage measures across a broad range of MNCAHN services. Furthermore, advances in measurement of effective coverage could improve monitoring efforts towards the achievement of universal health coverage.


Assuntos
Saúde/tendências , Fenômenos Fisiológicos da Nutrição , Cobertura Universal do Seguro de Saúde/estatística & dados numéricos , Adolescente , Saúde do Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Feminino , Previsões , Humanos , Saúde do Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Saúde Materna , Fenômenos Fisiológicos da Nutrição Materna , Gravidez , Qualidade da Assistência à Saúde
16.
Am J Clin Nutr ; 111(5): 1048-1058, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32282895

RESUMO

BACKGROUND: Findings from previous studies on associations between prepregnancy dietary patterns and preterm birth and low birth weight (LBW) are limited and inconsistent. OBJECTIVES: To examine the association between prepregnancy dietary patterns and the risk of preterm birth and LBW. METHODS: This study included 3422 and 3508 singleton live births from the Australian Longitudinal Study on Women's Health (ALSWH) for the analyses of preterm birth and LBW, respectively. We included women who were nulliparous and nonpregnant at baseline surveys. We used factor analyses and the Healthy Eating Index-2015 (HEI-2015) score to derive maternal dietary patterns. Four dietary patterns were identified with factor analyses: meats and high-fats; prudent diets; sugar, refined grains, and processed foods; and traditional vegetables. Preterm birth and LBW were assessed using maternal reports from ALSWH data between 2003 and 2015. Multivariable logistic regression analyses were used. RESULTS: Greater adherence to the traditional vegetables pattern before pregnancy was associated with a lower risk of preterm birth and spontaneous preterm birth after adjustments for lifestyle factors and pregnancy complications, highest compared with lowest tertile (adjusted OR = 0.72, 95% CI: 0.53, 0.99) and (RR ratio = 0.62, 95% CI: 0.39, 1.00), respectively. However, these associations were attenuated by the prepregnancy BMI. No significant associations were observed between prepregnancy dietary patterns and LBW. CONCLUSION: This study suggests that better adherence to the traditional vegetables pattern before pregnancy is associated with a lower risk of preterm birth, particularly spontaneous preterm birth among nulliparous women. This finding warrants further examination.


Assuntos
Complicações na Gravidez/prevenção & controle , Nascimento Prematuro/prevenção & controle , Saúde da Mulher , Adulto , Austrália/epidemiologia , Estudos de Coortes , Dieta , Feminino , Humanos , Recém-Nascido de Baixo Peso , Estudos Longitudinais , Fenômenos Fisiológicos da Nutrição Materna , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/metabolismo , Nascimento Prematuro/epidemiologia , Fatores de Risco , Verduras/metabolismo , Adulto Jovem
18.
Clin Sci (Lond) ; 134(7): 921-939, 2020 04 17.
Artigo em Inglês | MEDLINE | ID: mdl-32239178

RESUMO

Maternal obesity determines obesity and metabolic diseases in the offspring. The white adipose tissue (WAT) orchestrates metabolic pathways, and its dysfunction contributes to metabolic disorders in a sex-dependent manner. Here, we tested if sex differences influence the molecular mechanisms of metabolic programming of WAT in offspring of obese dams. To this end, maternal obesity was induced with high-fat diet (HFD) and the offspring were studied at an early phase [postnatal day 21 (P21)], a late phase (P70) and finally P120. In the early phase we found a sex-independent increase in WAT in offspring of obese dams using magnetic resonance imaging (MRI), which was more pronounced in females than males. While the adipocyte size increased in both sexes, the distribution of WAT differed in males and females. As mechanistic hints, we identified an inflammatory response in females and a senescence-associated reduction in the preadipocyte factor DLK in males. In the late phase, the obese body composition persisted in both sexes, with a partial reversal in females. Moreover, female offspring recovered completely from both the adipocyte hypertrophy and the inflammatory response. These findings were linked to a dysregulation of lipolytic, adipogenic and stemness-related markers as well as AMPKα and Akt signaling. Finally, the sex-dependent metabolic programming persisted with sex-specific differences in adipocyte size until P120. In conclusion, we do not only provide new insights into the molecular mechanisms of sex-dependent metabolic programming of WAT dysfunction, but also highlight the sex-dependent development of low- and high-grade pathogenic obesity.


Assuntos
Adipócitos Brancos/metabolismo , Adipogenia , Tecido Adiposo Branco/metabolismo , Adiposidade , Dieta Hiperlipídica , Metabolismo Energético , Obesidade Materna/metabolismo , Efeitos Tardios da Exposição Pré-Natal , Adipócitos Brancos/patologia , Adipogenia/genética , Tecido Adiposo Branco/patologia , Tecido Adiposo Branco/fisiopatologia , Adiposidade/genética , Fenômenos Fisiológicos da Nutrição Animal , Animais , Tamanho Celular , Modelos Animais de Doenças , Metabolismo Energético/genética , Feminino , Regulação da Expressão Gênica , Hipertrofia , Masculino , Fenômenos Fisiológicos da Nutrição Materna , Camundongos Endogâmicos C57BL , Estado Nutricional , Obesidade Materna/genética , Obesidade Materna/patologia , Obesidade Materna/fisiopatologia , Gravidez , Caracteres Sexuais , Fatores Sexuais , Transdução de Sinais , Fatores de Tempo
19.
Am J Obstet Gynecol ; 223(2): 211-218, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32275895

RESUMO

In an effort to reduce sugar consumption to prevent diabetes mellitus and cardiovascular diseases, "sugar-free" or "no added sugar" products that substitute sugar with non-nutritive sweeteners (NNSs) (eg, Splenda, Sweet'N Low, and Stevia) have become increasingly popular. The use of these products during pregnancy has also increased, with approximately 30% of pregnant women reporting intentional NNS consumption. In clinical studies with nonpregnant participants and animal models, NNSs were shown to alter gut hormonal secretion, glucose absorption, appetite, kidney function, in vitro insulin secretion, adipogenesis, and microbiome dysbiosis of gut bacteria. In pregnant animal models, NNS consumption has been associated with altered sweet taste preference later in life and metabolic dysregulations in the offspring (eg, elevated body mass index, increased risk of obesity, microbiome dysbiosis, and abnormal liver function tests). Despite the accumulating evidence, no specific guidelines for NNS consumption are available for pregnant women. Furthermore, there are limited clinical studies on the effects of NNS consumption during pregnancy and postpartum and long-term outcomes in the offspring.


Assuntos
Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Efeitos Tardios da Exposição Pré-Natal , Dieta , Feminino , Humanos , Adoçantes não Calóricos/efeitos adversos , Adoçantes não Calóricos/farmacologia , Gravidez
20.
PLoS Med ; 17(3): e1003032, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32119659

RESUMO

BACKGROUND: The relationship between maternal gluten intake in pregnancy, offspring intake in childhood, and offspring risk of type 1 diabetes has not been examined jointly in any studies. Our aim was to study the relationship between maternal and child intake of gluten and risk of type 1 diabetes in children. METHODS AND FINDINGS: We included 86,306 children in an observational nationwide cohort study, the Norwegian Mother and Child Cohort Study (MoBa), with recruitment from 1999 to 2008 and with follow-up time to April 15, 2018. We used registration of type 1 diabetes in the Norwegian childhood diabetes registry as the outcome. We used Cox proportional hazard regression to estimate hazard ratios (HRs) for the mother's intake of gluten up to week 22 of pregnancy and offspring gluten intake when the child was 18 months old. The average time followed was 12.3 years (0.70-16.0). A total of 346 children (0.4%) children were diagnosed with type 1 diabetes, resulting in an incidence rate of 32.6/100,000 person-years. Mean gluten intake per day was 13.6 g for mothers and 8.8 g for children. There was no association between the mother's intake of gluten in pregnancy and offspring type 1 diabetes, with an adjusted HR (aHR) of 1.02 (95% confidence interval [CI] 0.73-1.43, p = 0.91) for each 10-g-per-day increment. There was an association between offspring intake of gluten and a higher risk of type 1 diabetes, with an aHR of 1.46 (95% CI 1.06-2.01, p = 0.02) for each 10-g-per-day increment. Among the limitations are the likely imprecision in estimation of gluten intake and that we only had information regarding gluten intake at 2 time points in early life. CONCLUSIONS: Our results show that, while the mother's intake of gluten in pregnancy was not associated with type 1 diabetes, a higher intake of gluten by the child at an early age may give a higher risk of type 1 diabetes.


Assuntos
Diabetes Mellitus Tipo 1/epidemiologia , Glutens/efeitos adversos , Fenômenos Fisiológicos da Nutrição do Lactente , Fenômenos Fisiológicos da Nutrição Materna , Efeitos Tardios da Exposição Pré-Natal , Fatores Etários , Diabetes Mellitus Tipo 1/diagnóstico , Feminino , Glutens/administração & dosagem , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Noruega/epidemiologia , Gravidez , Estudos Prospectivos , Sistema de Registros , Medição de Risco , Fatores de Risco , Fatores de Tempo
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