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Nutritional supplements in pregnancy (with special refernce to the developing countries)

LLEWELLYN-JONES D

Med J Malaya, 1962 Jun;16:260-6.
PMID: 14466036
Matched MeSH terms: Prenatal Nutritional Physiological Phenomena*
Higher intake of fruits and vegetables in pregnancy is associated with birth size

Loy SL, Marhazlina M, Azwany YN, Hamid Jan JM

Southeast Asian J. Trop. Med. Public Health, 2011 Sep;42(5):1214-23.
PMID: 22299448

Maternal nutrition has a programming effect on fetal growth. This cross-sectional study investigated the association between maternal micronutrient, fruit and vegetable intake with birth size. Nutrient and food intake were examined using a validated semi-quantitative food frequency questionnaire. One hundred twenty-one pregnant women at 28 to 38 weeks gestation aged 19-40 years, were recruited from the Universiti Sains Malaysia Hospital, Malaysia. Birth weight, length and head circumference were obtained from the medical records. Data were analyzed using multiple linear regression. Results indicate no significant association between any of the measured micronutrients and birth size. However, 2 of the 6 vegetable subgroups and those consumed fruit during pregnancy had children whose birth size was significantly associated with consumption. An increase of 10 g of leafy vegetables per day was associated with a 1.78 cm increase in head circumference (p = 0.04), and tuber vegetable intake was associated with birth length (beta = 0.21, p = 0.03) and head circumference (beta = 0.21, p = 0.01). Fruit intake was associated with birth weight (beta = 0.19, p = 0.04), birth length (beta = 0.20, p = 0.04) and head circumference (beta = 0.19, p = 0.03). The lack of association between maternal nutrient intake and fetal growth and the significant association between fruit and vegetable intake and birth size suggests the existence of other micronutrients and phytochemicals present in foods that play an important role in birth size. The types of nutrients and their roles in birth size warrant further investigation.

Matched MeSH terms: Prenatal Nutritional Physiological Phenomena/physiology*
Fulltext Dietary patterns and their associations with gestational weight gain in the United Arab Emirates: results from the MISC cohort

Itani L, Radwan H, Hashim M, Hasan H, Obaid RS, Ghazal HA, et al.

Nutr J, 2020 04 21;19(1):36.
PMID: 32316972 DOI: 10.1186/s12937-020-00553-9

BACKGROUND: Suboptimum weight gain during pregnancy may carry long term health consequences for the infant or mother. Nutritional imbalances are well recognized as a determinant of gestational weight gain. Few studies examined the effect of dietary patterns on gestational weight gain, especially in countries undergoing nutrition transition, such as the United Arab Emirates.
OBJECTIVES: To characterize dietary patterns among pregnant women living in the UAE and examine their associations with gestational weight gain and gestational weight rate.
METHODOLOGY: Data were drawn from the Mother-Infant Study Cohort, a two-year prospective cohort study of pregnant women living in the United Arab Emirates, recruited during their third trimester (n = 242). Weight gain during pregnancy was calculated using data from medical records. The Institute of Medicine's recommendations were used to categorize gestational weight gain and gestational weight gain rate into insufficient, adequate, and excessive. During face-to-face interviews, dietary intake was assessed using an 89-item culture-specific semi-quantitative food frequency questionnaire that referred to usual intake during pregnancy. Dietary patterns were derived by principal component analysis. Multiple logistic regression analyses were used to evaluate the associations of derived dietary patterns with gestational weight gain/gestational weight gain rate.
RESULTS: Two dietary patterns were derived, a "Diverse" and a "Western" pattern. The "Diverse" pattern was characterized by higher intake of fruits, vegetables, mixed dishes while the "Western" pattern consisted of sweets and fast food. The "Western" pattern was associated with excessive gestational weight gain (OR:4.04,95% CI:1.07-15.24) and gestational weight gain rate (OR: 4.38, 95% CI:1.28-15.03) while the "Diverse" pattern decreased the risk of inadequate gestational weight gain (OR:0.24, 95% CI:0.06-0.97) and gestational weight gain rate (OR:0.28, 95% CI:0.09-0.90).
CONCLUSION: The findings of this study showed that adherence to a "Diverse" pattern reduced the risk of insufficient gestational weight gain/gestational weight gain rate, while higher consumption of the "Western" pattern increased the risk of excessive gestational weight gain/gestational weight gain rate. In view of the established consequences of gestational weight gain on the health of the mother and child, there is a critical need for health policies and interventions to promote a healthy lifestyle eating through a life course approach.

Matched MeSH terms: Prenatal Nutritional Physiological Phenomena*
Fulltext The association between dietary patterns before and in early pregnancy and the risk of gestational diabetes mellitus (GDM): Data from the Malaysian SECOST cohort

Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Appannah G, Bindels J, et al.

PLoS One, 2020;15(1):e0227246.
PMID: 31923230 DOI: 10.1371/journal.pone.0227246

Generally, dietary patterns (DP)s have been linked to the risk of diabetes mellitus, however, only few studies examined the associations between DPs in early pregnancy and the risk of gestational diabetes mellitus (GDM). This study aims to determine the association between DPs before and during pregnancy and risk of GDM in Malaysian pregnant women. DPs were derived using principal component analysis of consumed 126 food and beverage items assessed using a validated semi-quantitative food frequency questionnaire collecting data retrospectively for pre-pregnancy, but prospectively for the first and second trimester. Three different DPs were identified at each time point and labelled as DP 1-3 (pre-pregnancy), DP 4-6 (first trimester), and DP 7-9 (second trimester). About 10.6% (n = 48) of pregnant women were diagnosed with GDM in our cohort. Women with high adherence (HA) to DP 2 (adjusted OR: 0.45, 95% CI: 0.20-0.91) and DP 5 (adjusted OR: 0.28, 95% CI: 0.11-0.68) showed a significantly reduced risk of GDM compared to women with low adherence (LA). Other DPs were not significantly associated with GDM risk. Compared to women with GDM, non-GDM women showed HA scores for all DPs throughout pregnancy. Overall, a relative low percentage of women with GDM was found in this cohort. The risk was lower in women with HA to a relatively unhealthy dietary pattern, i.e. DP 2 and DP 5. The lower body mass index (BMI) status and energy intake of women showing a HA to DP 2 in the first trimester may underlie the observed association with a lower GDM risk. Additionally, genetic variance might explain the less susceptibility to GDM despite HA to unhealthy DPs among non-GDM women.

Matched MeSH terms: Prenatal Nutritional Physiological Phenomena*
The influence of maternal ethnic group and diet on breast milk fatty acid composition

Su LL, S K TC, Lim SL, Chen Y, Tan EA, Pai NN, et al.

Ann Acad Med Singap, 2010 Sep;39(9):675-5.
PMID: 20957301

INTRODUCTION: Breast milk fatty acids play a major role in infant development. However, no data have compared the breast milk composition of different ethnic groups living in the same environment. We aimed to (i) investigate breast milk fatty acid composition of three ethnic groups in Singapore and (ii) determine dietary fatty acid patterns in these groups and any association with breast milk fatty acid composition.
MATERIALS AND METHODS: This was a prospective study conducted at a tertiary hospital in Singapore. Healthy pregnant women with the intention to breastfeed were recruited. Diet profile was studied using a standard validated 3-day food diary. Breast milk was collected from mothers at 1 to 2 weeks and 6 to 8 weeks postnatally. Agilent gas chromatograph (6870N) equipped with a mass spectrometer (5975) and an automatic liquid sampler (ALS) system with a split mode was used for analysis.
RESULTS: Seventy-two breast milk samples were obtained from 52 subjects. Analysis showed that breast milk ETA (Eicosatetraenoic acid) and ETA:EA (Eicosatrienoic acid) ratio were significantly different among the races (P = 0.031 and P = 0.020), with ETA being the highest among Indians and the lowest among Malays. Docosahexaenoic acid was significantly higher among Chinese compared to Indians and Malays. No difference was demonstrated in n3 and n6 levels in the food diet analysis among the 3 ethnic groups.
CONCLUSIONS: Differences exist in breast milk fatty acid composition in different ethnic groups in the same region, although no difference was demonstrated in the diet analysis. Factors other than maternal diet may play a role in breast milk fatty acid composition.

Matched MeSH terms: Prenatal Nutritional Physiological Phenomena*