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Fulltext Fructans in the first 1000 days of life and beyond, and for pregnancy

Firmansyah A, Chongviriyaphan N, Dillon DH, Khan NC, Morita T, Tontisirin K, et al.

Asia Pac J Clin Nutr, 2016 Dec;25(4):652-675.
PMID: 27702710 DOI: 10.6133/apjcn.092016.02

Inulin-based prebiotics are non-digestible polysaccharides that influence the composition of the gut microbiota in infants and children, notably eliciting a bifidogenic effect with high short chain fatty acid levels. Inulin, a generic term that comprises β-(2,1)-linked linear fructans, is typically isolated from the chicory plant root, and derivatives such as oligofructose and long chain inulin appear to have different physiological properties. The first 1000 days of a child's life are increasingly recognized as a critical timeframe for health also into adulthood, whereby nutrition plays a key role. There is an ever increasing association between nutrition and gut microbiota composition and development, with life health status of an individual. This review summarizes the latest knowledge in the infant gut microbiota from preterms to healthy newborns, as well as in malnourished children in developing countries. The impact of inulin or mixtures thereof on infants, toddlers and young children with respect to intestinal function and immunity in general, is reviewed. Possible benefits of prebiotics to support the gut microbiome of malnourished infants and children, especially those with infections in the developing world, are considered, as well as for the pregnant mothers health. Importantly, novel insights in metabolic programming are covered, which are being increasing recognized for remarkable impact on long term offspring health, and eventual potential beneficial role of prebiotic inulins. Overall increasing findings prompt the potential for gut microbiota-based therapy to support health or prevent the development of certain diseases from conception to adulthood where inulin prebiotics may play a role.

Matched MeSH terms: Maternal Nutritional Physiological Phenomena*
Factors associated with dietary glycemic index and glycemic load in pregnant women and risk for gestational diabetes mellitus

Hasbullah FY, Mohd Yusof BN, Shariff ZM, Rejali Z, Yong HY, Mitri J

Int J Food Sci Nutr, 2020 Jun;71(4):516-524.
PMID: 31686557 DOI: 10.1080/09637486.2019.1686752

The risk of gestational diabetes mellitus (GDM) increases during the second trimester of pregnancy. However, the role of dietary glycemic index (GI) and glycemic load (GL) on GDM risk is controversial. We aimed to determine the association of established risk factors of GDM with GI and GL among healthy pregnant women, and whether GI and GL were subsequently related to GDM risk. Dietary GI and GL were assessed in healthy pregnant women from the Seremban Cohort Study using a food frequency questionnaire. After adjusting for energy intake, high GI was significantly associated with lower household income, shorter stature, higher proportion of carbohydrate intake, lower sugar proportion and lower fibre intake. High GL was significantly associated with younger maternal age, higher carbohydrate proportion and lower fibre intake. GI and GL intakes were not significantly associated with GDM risk. However, they were associated with a few established risk factors of GDM.

Matched MeSH terms: Maternal Nutritional Physiological Phenomena*
Fulltext Maternal intake of dietary virgin coconut oil modifies essential fatty acids and causes low body weight and spiky fur in mice

Gunasekaran R, Shaker MR, Mohd-Zin SW, Abdullah A, Ahmad-Annuar A, Abdul-Aziz NM

BMC Complement Altern Med, 2017 Jan 28;17(1):79.
PMID: 28129764 DOI: 10.1186/s12906-017-1600-z

Coconut oil is commonly used as herbal medicine worldwide. There is limited information regarding its effects on the developing embryo and infant growth.

Matched MeSH terms: Maternal Nutritional Physiological Phenomena*
Fulltext Anemia in pregnancy in Malaysia: a cross-sectional survey

Haniff J, Das A, Onn LT, Sun CW, Nordin NM, Rampal S, et al.

Asia Pac J Clin Nutr, 2007;16(3):527-36.
PMID: 17704035

Anemia is the most prevalent nutritional deficiency during pregnancy. Except for a study conducted 10 years ago in Kelantan, Malaysia's available statistics are based on isolated small urban maternity hospital studies from the 1980s. There was therefore, a need for a large study at national level to estimate the magnitude of the problem in the country as well as to understand its epidemiology. This multi-center, cross-sectional study was conducted from February to March 2005, to assess the prevalence of anemia. Multistage stratified random sampling technique was used and 59 Ministry of Health (MOH) primary health care clinics were selected. Our final dataset consisted of 1,072 antenatal mothers from 56 clinics. The overall prevalence of anemia in this population was 35 % (SE 0.02) if the cut off level is 11 g/dL and 11 % (SE 0.03) if the cut-off level is 10 g/dL. The majority was of the mild type. The prevalence was higher in the teenage group, Indians followed by Malays and Chinese being the least, grandmultiparas, the third trimester and from urban residence. After multiple linear regression analysis, only gestational age remained significant. These findings are useful for our Maternal Health program planners and implementers to target and evaluate interventions. Work is in progress for outcomes and cost-effectiveness studies to best tackle this problem. In conclusion, the prevalence of anemia is 35% and mostly of the mild type and more prevalent in the Indian and Malays.

Matched MeSH terms: Maternal Nutritional Physiological Phenomena/physiology*
Fulltext Food restrictions during pregnancy among Indigenous Temiar women in peninsular Malaysia

Sharifah Zahhura SA, Nilan P, Germov J

Malays J Nutr, 2012 Aug;18(2):243-53.
PMID: 24575670 MyJurnal

INTRODUCTION: A qualitative comparative case study was conducted to compare and contrast food taboos and avoidance practices during pregnancy among Orang Asli or indigenous Temiar women in four distinct locations that represent different lifestyle experiences and cultural practices.
METHODS: Through snowballing sampling, a total of 38 participants took part in five focus groups: one group each in Pos Simpor and Pos Tohoi in Kelantan state, one group in Batu 12, Gombak in Selangor state, and two groups in a regroupment scheme (RPSOA) in Kuala Betis, Kelantan. All the transcripts were coded, categorised and 'thematised' using the software package for handling qualitative data, NVivo 8.
RESULTS: Variant food prohibitions were recorded among the Temiar women residing in different locations, which differ in food sources and ways of obtaining food. Consumption of seventeen types of food items was prohibited for a pregnant Temiar woman and her husband during the prenatal period. Fear of difficulties during labour and delivery, convulsions or sawan, harming the baby (such as foetal malformation), and twin pregnancy seemed to trigger many food proscriptions for the pregnant Temiar women, most of which have been passed on from generation to generation.
CONCLUSION: The findings of this study confirm that beliefs about food restrictions are strong among those Temiar living a traditional lifestyle. However, those who have adopted a more modern lifestyle also preserve them to some extent.pregnancy among Orang Asli or indigenous Temiar women in four distinct locations that represent different lifestyle experiences and cultural practices.

Matched MeSH terms: Maternal Nutritional Physiological Phenomena
Fulltext Association between maternal food group intake and birth size

LOY S, MARHAZLINA M, HAMID JAN J

Sains Malaysiana, 2013;42(11):1633-1640.

Maternal nutrition is one of the dominant factors in determining fetal growth and subsequent developmental health for both mother and child. This study aimed to explore the association between maternal consumption of food groups and birth size among singleton, termed newborns. One hundred and eight healthy pregnant women in their third trimester, aged 19 to 40 years who visited the Obstetrics and Gynecology Clinic of Hospital Universiti Sains Malaysia completed an interviewed-administered, validated semi-quantitative food frequency questionnaire. The maternal socio-demographic, medical and obstetric histories and anthropometry measurements were recorded accordingly. The pregnancy outcomes, birth weight, birth length and head circumference were obtained from the medical records. The data were analyzed using multiple linear regression by controlling for possible confounders. Among all food groups, fruits intake was associated with higher birth weight (p=0.018). None of the food intake showed evident association with respect to birth length while only fruits intake was associated positively with head circumference (p=0.019). In contrast, confectioneries and condiments were associated with lower birth weight (p=0.013 and p=0.001, respectively). Also, condiments appeared to associate inversely with ponderal index (p=0.015). These findings suggest the potential beneficial effects of micronutrient rich food but detrimental effects of high sugar and sodium food on fetal growth. Such an effect may have long term health consequences to the lives of children.

Matched MeSH terms: Maternal Nutritional Physiological Phenomena
Guidelines for Medical Nutrition Therapy in Gestational Diabetes Mellitus: Systematic Review and Critical Appraisal

Tsirou E, Grammatikopoulou MG, Theodoridis X, Gkiouras K, Petalidou A, Taousani E, et al.

J Acad Nutr Diet, 2019 08;119(8):1320-1339.
PMID: 31201104 DOI: 10.1016/j.jand.2019.04.002

BACKGROUND: Medical nutrition therapy is the cornerstone of gestational diabetes mellitus treatment. However, guidelines often present contradictory guidance to health care practitioners.
OBJECTIVE: To systematically review and critically appraise medical nutrition therapy guidelines for treating patients with gestational diabetes mellitus.
DESIGN: We searched Medline, the Cochrane Library, Guidelines International Network, and Google Scholar to retrieve clinical practice guidelines (CPGs) for medical nutrition therapy in gestational diabetes mellitus from professional or governmental organizations, published in English, between January 1, 2007, and November 24, 2018. CPGs were reviewed and appraised using the Appraisal of Guidelines, Research, and Evaluation II instrument.
RESULTS: Of 1,286 retrieved articles, 21 CPGs fulfilled the inclusion criteria. CPGs of the Academy of Nutrition and Dietetics, Diabetes Canada, and Malaysia Health Technology Assessment Section received the greatest overall scores and the highest scores concerning rigor of recommendations development. Many CPGs failed to involve multidisciplinary teams in their development, including patients, and often, dietitians. Applicability of the recommendations was low, lacking facilitators and tools to enhance implementation. Many CPGs demonstrated low editorial independence by failing to disclose funding and competing interests. More medical nutrition therapy recommendations were incorporated in the Academy of Nutrition and Dietetics and Malaysia Health Technology Assessment Section CPGs. The Malaysia Health Technology Assessment Section, Diabetes Canada, Academy of Nutrition and Dietetics, and Endocrine Society guidelines were recommended by the review panel herein without modifications. Overall, the CPGs suggested the consumption of adequate protein and the selection of foods with low glycemic index, divided into three main meals and two to four snacks. Weight gain recommendations were mostly based on the Institute of Medicine body mass index thresholds.
CONCLUSIONS: With few exceptions, the main developmental limitations of the appraised CPGs involved low rigor of recommendations development, lack of multidisciplinary stakeholder involvement, low applicability, and inadequate editorial independence. This indicates a need for developing more clear, unbiased, practical, and evidence-based CPGs.

Matched MeSH terms: Maternal Nutritional Physiological Phenomena
Fulltext Early Intervention of Elateriospermum tapos Yoghurt in Obese Dams Mitigates Intergenerational Cognitive Deficits and Thigmotactic Behaviour in Male Offspring via the Modulation of Metabolic Profile

Naomi R, Rusli RNM, Huat TS, Embong H, Bahari H, Kamaruzzaman MA

Nutrients, 2023 Mar 21;15(6).
PMID: 36986254 DOI: 10.3390/nu15061523

Maternal obesity is an intergenerational vicious cycle and one of the primary causes of cognitive deficits and high anxiety levels in offspring, which often manifest independently of sex. It is proven that curbing the intergenerational inheritance of obesity through early intervention during the gestation period has a positive outcome on the body composition, cognitive function, and anxiety level of the offspring. A recent discovery shows that the consumption of Elateriospermum tapos (E. tapos) seed extract modulates body mass and ameliorates stress hormones in obese dams, while a probiotic bacterial strain can cross the placenta and boost a child's memory. Thus, we speculate that probiotics are the best medium to integrate plant extract (E. tapos extract) to access the effect on the child's cognition. Thus, this study aimed to investigate the early intervention of E. tapos yoghurt in obese dams in the cognition and anxiety levels of male offspring. In this study, 40 female rats were fed with a high-fat diet (HFD) to induce obesity before pregnancy, while another 8 rats were fed with standard rat pellets for 16 weeks. Upon successful copulation, treatment was initiated for the obese dams up to the postnatal day (PND) 21. The groups included normal chow and saline (NS), HFD and saline (HS), HFD and yoghurt (HY), HFD and 5 mg/kg E. tapos yoghurt (HYT5), HFD and 50 mg/kg E. tapos yoghurt (HYT50), and HFD and 500 mg/kg E. tapos yoghurt (HYT500). All rats were euthanised on PND 21, and the body mass index (BMI), Lee index, and waist circumference were measured for the male offspring. Hippocampal-dependent memory tests and open field tests were conducted to access for cognition and anxiety status. Fasting blood glucose (FBG), total fat (%), insulin, leptin, lipid profile, and antioxidant parameter on serum and hypothalamus (FRAP and GSH) were accessed on PND 21. The result shows male offspring of 50 mg/kg-supplemented obese dams have comparable total fat (%), lipid profile, insulin level, FBG level, plasma insulin level, recognition index, low anxiety level, and improved hypothalamic FRAP and GSH levels to the normal group. In conclusion, this study highlights that the effect of early intervention of our novel formulation of E. tapos yoghurt in obese dams alleviates cognitive deficits and anxiety in male offspring by modulating metabolic profiles at the dose of 50 mg/kg.

Matched MeSH terms: Maternal Nutritional Physiological Phenomena
Maternal dietary and environmental factors associated with infant circadian rhythm, growth, and temperament: Research protocol for a prospective cohort study

Kok EY, Kaur S, Mohd Shukri NH, Abdul Razak N, Takahashi M

Nutr Health, 2024 Dec;30(4):645-654.
PMID: 38584399 DOI: 10.1177/02601060241246354

Introduction: Emerging evidence has been explored to determine the factors affecting the development of infant circadian rhythm. While fetal programming happens during the pregnancy period, external environmental cues and infant nutritional programming can have substantial effects on the infant circadian rhythm. Understanding prenatal and postnatal factors determining infant circadian rhythm can improve future interventions in optimizing maternal and infant health. Methods: This is a prospective observational cohort study, targeting 216 pregnant women from government maternity clinics in Kuala Lumpur, Malaysia. Pregnant women will be recruited at third trimester (baseline), and follow up at 3 months, and 6 months. A subsample will be collected for salivary cortisol analysis to determine circadian rhythm of the mother and infant at third trimester and 3 months. Data of eating misalignment, light exposure, chronotype, infant temperament, sleep quality, and mood will be collected via validated questionnaires. Anthropometric data and birth outcomes will be collected from antenatal and postnatal health records. Summary: Studies on infant circadian rhythm development have yet to be explored and established, hence this study presents a novel approach to identify the factors from prenatal to postnatal periods on infant circadian rhythm and its influence on growth and temperament. Findings from this study will provide insights in the critical timing which has larger effects on infant circadian rhythm development for future interventions to be conducted.

Matched MeSH terms: Maternal Nutritional Physiological Phenomena
Fulltext Risk factors for low birth weight among rural and urban Malaysian women

Kaur S, Ng CM, Badon SE, Jalil RA, Maykanathan D, Yim HS, et al.

BMC Public Health, 2019 Jun 13;19(Suppl 4):539.
PMID: 31196034 DOI: 10.1186/s12889-019-6864-4

BACKGROUND: Low birth weight prevalence in Malaysia remains high. Socioeconomic background may lead to differences in physical activity and maternal nutritional status, which may play an important role in birth outcomes.
METHODS: This prospective cross-sectional study aimed to identify rural-urban differences in risk factors for low birth weight among women in Malaysia. Pregnant women at ≥20 weeks of gestation in urban and rural Malaysia (n = 437) completed questionnaires on sociodemographic characteristics and physical activity. Weight and middle-upper arm circumference were measured. Infant birth outcomes were extracted from medical records.
RESULTS: The overall prevalence of low birth weight infants was 6.38%. Rural women had more low birth weight infants than urban women (9.8% vs 2.0%, p = 0.03). Findings showed rural women were less sedentary (p = 0.003) and participated in more household/caregiving activities (p = 0.036), sports activities (p = 0.01) and less occupational activity (p

Matched MeSH terms: Maternal Nutritional Physiological Phenomena
Fulltext Maternal Serum and Breast Milk Adiponectin: The Association with Infant Adiposity Development

Mohamad M, Loy SL, Lim PY, Wang Y, Soo KL, Mohamed HJJ

Int J Environ Res Public Health, 2018 Jun 12;15(6).
PMID: 29895806 DOI: 10.3390/ijerph15061250

The prevalence of childhood obesity is increasing at an alarming rate in Malaysia. Metabolic changes during pregnancy are critical to the development of infant adiposity, due to imbalanced adipokines production. Hence, we aimed to investigate the association of maternal serum and breast milk adipokines with infant adiposity development. The study was conducted from April 2010 until December 2012. A total of 155 healthy pregnant mothers aged 19 to 40 years were recruited during the first and second trimester in Kelantan, Malaysia. Data consisted of maternal sociodemographic details, anthropometry and clinical biochemistry analysis; and the infant’s anthropometry and feeding patterns. Maternal fasting serum and breast milk samples were analysed for adiponectin and leptin levels. Data collection was performed in the second and third trimester of pregnancy, and continued with follow-up visits at birth, two, six, and 12 months postpartum. Multiple linear regression (MLR) analyses were performed to examine the associations between maternal serum and breast milk adiponectin and leptin and infant adiposity development. MLR models showed that, in the first year, as maternal serum and breast milk adiponectin increased, infant weight, BMI-for-age Z scores and abdominal circumference significantly decreased (p < 0.05). Maternal serum and/or breast milk adiponectin was associated with first-year infant adiposity development.

Matched MeSH terms: Maternal Nutritional Physiological Phenomena

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