Maternal Carbohydrate Intake During Pregnancy is Associated with Child Peripubertal Markers of Metabolic Health but not Adiposity

Objective: Examine the associations of trimester-specific maternal prenatal carbohydrate (CHO) intake with offspring adiposity and metabolic health during the peripuberty. Design: Prospective cohort study in which maternal dietary intake was collected via validated food frequency questionnaire (FFQ) during each trimester. Offspring adiposity and metabolic biomarkers were evaluated at age 8-14y. We used multivariable linear regression to examine associations between total-energy adjusted maternal CHO intake and offspring Body Mass Index z-score (BMIz), skinfold thickness, and metabolic syndrome risk z-score (MetRiskz) calculated as the average of waist circumference, fasting glucose, fasting C-peptide, triglyceride:HDL, and systolic blood pressure + diastolic blood pressure/2. Setting: Mexico City, Mexico Subjects: N=237 mother-child pairs in the ELEMENT cohort. Results: We found non-linear associations of maternal CHO intake during pregnancy with offspring metabolic health during peripuberty. After adjusting for maternal age, and child age, sex, and pubertal status, children whose mothers were in the 4th vs 1st quartile of total CHO intake during the 3rd trimester had 0.42 (95% CI: −0.01, 0.08) ng/mL lower C-peptide and 0.10 (95% CI: −0.02, 0.22) units lower CP-IR. We found similar magnitude and direction of association with respect to net CHO intake during the 1st trimester and offspring C-peptide and CP-IR. Maternal CHO intake during pregnancy was not associated with offspring adiposity. Conclusions: In this study of mother-child pairs in Mexico City, children born to women in the highest quartile of CHO intake during pregnancy had lowest C-peptide and CP-IR during peripuberty. Additional research is warranted to replicate and identify mechanisms.

Maternal Dietary Intake, Nutritional Status, and Macronutrient Composition of Human Breast Milk: Systematic Review

Introduction: Human breast milk is the best source of nutrition in early life, particularly during the first six months. Nevertheless, human breast milk composition is variable and more insight in the exact factors contributing to this variability is warranted. In this review, we explored the impact of maternal dietary intake and nutritional status (e.g., anthropometric measures, body mass index, bioimpedance) on human milk macronutrient composition. Method: PubMed, Scopus and Cochrane were systematically searched till November 2019. Results: In total, 4946 publications underwent title-abstract screening; 101 publications underwent full-text screening. Eventually, 50 publications were included in this review, investigating either associations between maternal dietary intake (n=29) and/or maternal nutritional status (n=29), and macronutrient composition of human breast milk. Reported energy composition ranged from 51-72 kcal/dl, and 67% and 54% of the studies reported associations between with maternal nutritional intake and status, respectively. Protein content ranged from 0.8-3.3g/dl and four studies suggested a negative association with nutritional status. Fat content ranged from 2.1- 9.8g/dl, and 68% of the studies reported positive associations with nutritional status. Carbohydrate content ranged from 5.8-7.5g/dl, and 67% of the included studies did not report an association between intake or status. Conclusion: Literature investigating associations of maternal dietary intake and nutrition status with breast milk composition of macronutrients and energy content is diversified, both in terms of used methodology as well as results. Further studies using well defined and standard parameters are essential to aid the formulation of scientific recommendations.

Effects of maternal taurine supplementation on maternal dietary intake, plasma metabolites and fetal growth and development in cafeteria diet fed rats

Background Maternal obesity may disrupt the developmental process of the fetus during gestation in rats. Recent evidence suggests that taurine can exert protective role against detrimental influence of obesogenic diets. This study aimed to examine the effect of maternal cafeteria diet and/or taurine supplementation on maternal dietary intake, plasma metabolites, fetal growth and development. Methods Female Wistar rats were fed a control diet (CON), CON supplemented with 1.5% taurine in drinking water (CONT), cafeteria diet (CAF) or CAF supplemented with taurine (CAFT) from weaning. After 8 weeks all animals were mated and maintained on the same diets during pregnancy and lactation. Results Dietary intakes were significantly different between the groups. Both CAF and CAFT fed dams consumed less water in comparison to CON and CONT dams. Taurine supplementation only increased plasma taurine concentrations in CONT group. Maternal plasma adiponectin concentrations increased in CAF and CAFT fed dams compared to CON and CONT fed dams and there was no effect of taurine. Hyperleptinemia was observed in CAF fed dams but not in CAFT fed dams. Malondialdehyde was significantly increased only in CAF fed dams. Litter size, sex ratio and birth weight were similar between the groups. There was an increase in neonatal mortality in CONT group. Discussion This study showed that maternal taurine supplementation exerted modest protective effects on cafeteria diet induced maternal obesity. The increased neonatal mortality in CONT neonates indicates possible detrimental effects of taurine supplementation in the setting of normal pregnancy. Therefore, future studies should investigate the optimal dose of taurine supplementation and long term potential effects on the offspring.

Association Between Maternal Pre-pregnancy Body Mass Index, Dietary Intake, and Birth Size Outcomes: Results From the VDPM Cohort Study in Indonesia

Objectives This study analyzed the association between pre-pregnancy body mass index (PPBMI), dietary intake status, and birth size outcomes in the VDPM cohort study in West Sumatra, Indonesia. Methods The VDPM study is a prospective longitudinal study including 239 healthy pregnant women of Indonesian women with singleton pregnancies. Data on maternal dietary intake including energy, carbohydrate, protein, and fat intake, and anthropometry were collected during pregnancy. New-born anthropometry for 195 new-born babies was measured immediately after delivery. Bivariate and multivariate regression analyses were constructed to determine the association between PPBMI, dietary intake status, and birth size outcomes. Results The mean birth weight was 3195 ± 463 g. Dietary intake of pregnant mothers had a significant correlation with newborn birth weight, length of birth, head circumference, and placental weight as pregnancy outcome indicators (p ≤ 0.05). This study showed that no association between pre-pregnancy BMI status and birth size outcomes (p ≥ 0.05). Conclusions Our studies have not shown a statistically significant difference between PPBMI and birth size outcomes. However, maternal dietary intake associated with birth size outcomes, more research is warranted to confirm these findings. Funding Sources Indonesian Danone Institute Foundation.

Impact of Maternal Nutritional Supplementation during Pregnancy and Lactation on the Infant Gut or Breastmilk Microbiota: A Systematic Review

Recent evidence indicates that maternal dietary intake, including dietary supplements, during pregnancy and lactation may alter the infant gut or breastmilk microbiota, with implications for health outcomes in both the mother and infant. To review the effects of maternal nutritional supplementation during pregnancy and lactation on the infant gut or breastmilk microbiota a systematic literature search was conducted. A total of 967 studies published until February 2020 were found, 31 were eligible and 29 randomized control trials were included in the qualitative synthesis. There were 23 studies that investigated the effects of probiotic supplementation, with the remaining studies investigating vitamin D, prebiotics or lipid-based nutrient supplements (LNS). The effects of maternal nutritional supplementation on the infant gut microbiota or breastmilk microbiota were examined in 21 and 12 studies, respectively. Maternal probiotic supplementation during pregnancy and lactation generally resulted in the probiotic colonization of the infant gut microbiota, and although most studies also reported alterations in the infant gut bacterial loads, there was limited evidence of effects on bacterial diversity. The data available show that maternal probiotic supplementation during pregnancy or lactation results in probiotic colonization of the breastmilk microbiota. There were no observed effects between probiotic supplementation and breastmilk bacterial counts of healthy women, however, administration of Lactobacillus probiotic to nursing women affected by mastitis was associated with significant reductions in breastmilk Staphylococcal loads. Maternal LNS supplementation during pregnancy and lactation increased bacterial diversity in the infant gut, whilst vitamin D and prebiotic supplementation did not alter either infant gut bacterial diversity or counts. Heterogeneity in study design precludes any firm conclusions on the effects of maternal nutritional supplementation during pregnancy and lactation on the infant gut or breastmilk microbiota, warranting further research.

Human Milk Oligosaccharide Profiles and Associations with Maternal Nutritional Factors: A Scoping Review

Human milk oligosaccharides (HMOs) are complex unconjugated glycans associated with positive infant health outcomes. This study has examined current knowledge of the effect of maternal diet and nutritional status on the composition of HMOs in breast milk. Using the PRISMA-ScR guidelines, a comprehensive, systematic literature search was conducted using Scopus, Web of Science, Global Health (CABI), and MEDLINE. Titles and abstracts were screened independently by two reviewers against predefined inclusion and exclusion criteria. Fourteen studies met the inclusion criteria and reported on maternal dietary intake (n = 3), maternal body composition indices (n = 9), and dietary supplementation interventions (n = 2). In total, data from 1388 lactating mothers (4011 milk samples) were included. Design methodologies varied substantially across studies, particularly for milk sample collection, HMO analysis, dietary and body composition assessment. Overall, this review has identified potential associations between maternal dietary intake and nutritional status and the HMO composition of human milk, though an abundance and sufficiency of evidence is lacking. Standardised procedures for human milk sample collection and HMO analysis, along with robust and validated nutrition assessment techniques, should be employed to further investigate the impact of maternal nutritional factors on HMO composition.

Nutrition in Reproductive Health: Nutritional Conditioning Factors during Pregnancy and Its Impact on Health

During the gestational period, women need to have optimal health to meet fetal requirements for growth and development. Nutrition is one of the most important factors that can ensure a mother`s health and also that of their offspring. The role of maternal diet, before and during pregnancy, has been associated with adverse birth outcomes and a worsening of maternal health. Medical conditions that are closely related to dietary intake and may affect women before or during pregnancy have also been associated with the appearance of pathology in a newborn. To date, several studies have been carried out in order to identify the role of diet as a factor associated with child physiological and psychological health, both in the short and long term. Educating mothers regarding the influence of maternal dietary intake during pregnancy on infants’ health could represent a simple but effective target for public health policies to improve pregnancy nutrition, and therefore help to avoid newborn diseases through the development.

Maternal Nitrate and Nitrite Intakes during Pregnancy and Risk of Islet Autoimmunity and Type 1 Diabetes: The DIPP Cohort Study

ABSTRACT Background High dietary intake of nitrate and nitrite might increase the risk of type 1 diabetes. To our knowledge, no earlier prospective study has explored whether maternal dietary intake of nitrate and nitrite during pregnancy is associated with the risk of type 1 diabetes in the offspring. Objective Our aim was to study association between maternal intake of nitrate and nitrite during pregnancy and the risk of islet autoimmunity and type 1 diabetes in the offspring. Design Children born between 1997 and 2004 at Oulu and Tampere University Hospitals in Finland and carrying increased human leukocyte antigen (HLA)–conferred risk for type 1 diabetes were followed in the Type 1 Diabetes Prediction and Prevention (DIPP) study from 3 mo of age. Islet autoantibodies were screened at 3- to 12-mo intervals from serum samples. Of 4879 children, 312 developed islet autoimmunity and 178 developed type 1 diabetes during a 15-y follow-up. Maternal intake of nitrate and nitrite during the eighth month of pregnancy was assessed after birth using a validated self-administered FFQ. Cox proportional hazards regression was used for the statistical analyses. Results Maternal intake of nitrate and nitrite during pregnancy was not associated with the child's risk of islet autoimmunity [nitrate: HR 0.99 (95% CI: 0.88, 1.11); nitrite: HR 1.03 (95% CI: 0.92, 1.15)] or type 1 diabetes [nitrate: HR 1.02 (95% CI: 0.88, 1.17); nitrite: HR 0.97 (95% CI: 0.83, 1.12)] when adjusted for energy (residual method), sex, HLA risk group, and family history of diabetes. Further adjustment for dietary antioxidants (vitamin C, vitamin E, and selenium) did not change the results. Conclusion Maternal dietary intake of nitrate or nitrite during pregnancy is not associated with the risk of islet autoimmunity or type 1 diabetes in the offspring genetically at risk for type 1 diabetes.