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Is there an association between adolescents' high caloric food portion size and body mass index?
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Adolescents' preferences in developing a UK online dietary assessment tool (myfood24): focus group study
Get PDFThe relationship between dietary supplement use in late pregnancy and birth outcomes: a cohort study in British women
Full text linkPlease cite this paper as: Alwan N, Greenwood D, Simpson N, McArdle H, Cade J. The relationship between dietary supplement use in late pregnancy and birth outcomes: a cohort study in British women. BJOG 2010; DOI: 10.1111/j.1471-0528.2010.02549.x.Objective To examine the relationship between dietary supplement use during pregnancy and birth outcomes.Design A prospective birth cohort.Setting Leeds, UK.Sample One thousand two hundred and seventy-four pregnant women aged 18201345 years.Methods Dietary supplement intake was ascertained using three questionnaires for the first, second and third trimesters. Dietary intake was reported in a 24-hour dietary recall administered by a research midwife at 8201312 weeks of gestation. Information on delivery details and antenatal pregnancy complications was obtained from the hospital maternity records.Main outcome measures Birthweight, birth centile and preterm birth.Results Reported dietary supplement use declined from 82% of women in the first trimester of pregnancy to 22% in the second trimester and 33% in the third trimester. Folic acid was the most commonly reported supplement taken. Taking any type of daily supplement during any trimester was not significantly associated with size at birth taking into account known relevant confounders. Women taking multivitamin-mineral supplements in the third trimester were more likely to experience preterm birth (adjusted OR = 3.4, 95% CI 1.2, 9.6, P = 0.02).Conclusions Regular multivitamin2013mineral supplement use during pregnancy, in a developed country setting, is not associated with size at birth. However, it appears to be associated with preterm birth if taken daily in the third trimester. The mechanism for this is unclear and our study's findings need confirming by other cohorts and/or trials in developed countries
Food frequency questionnaires: a review of their design, validation and utilisation
Get PDFA review of the literature concerning the design, utilisation and validation of food-frequency questionnaires (FFQ) has been carried out using a semi-systematic approach to obtaining, reviewing and extracting data from articles. Databases were searched from 1980 to 1999. The present review identified 227 validation (from 1980 to September 1999) and 164 utilisation (for 1998 only) studies. A number of design issues have been evaluated through the present review. These include: the need to consider how portion sizes have been described, self-defined giving higher mean correlations; how an FFQ was administered, interviewer-administered giving higher mean correlations for some nutrients; how many items to include on an FFQ, those with the largest number of items having higher correlations. Validation techniques were described. Most validation studies involved comparing an FFQ against another dietary assessment method; only 19 % compared an FFQ to a biomarker. Measurement differences were most commonly assessed by correlation coefficients as opposed to other more appropriate methods. Mean correlation coefficients were highest for Ca and fat, and lowest for vitamin A and vegetables. The utilisation studies showed that FFQ were most commonly used in cross-sectional surveys, with ninety-three of the FFQ being designed to be disease-specific. The present review results were presented to a group of experts and a consensus arrived at concerning the development, validation and use of FFQ. Recommendations derived from the consensus arising from the literature review are presented as an appendix to the present paper
Iron intake during early pregnancy and birth size: insights revealed through structural equation modelling
Get PDFMaternal alcohol intake prior to and during pregnancy and risk of adverse birth outcomes: evidence from a British cohort
Full text linkBackground: Evidence is conflicting regarding the relationship between low maternal alcohol consumption and birth outcomes. This paper aimed to investigate the association between alcohol intake before and during pregnancy with birth weight and gestational age and to examine the effect of timing of exposure.
Methods: A prospective cohort in Leeds, UK, of 1303 pregnant women aged 18–45 years. Questionnaires assessed alcohol consumption before pregnancy and for the three trimesters separately. Categories of alcohol consumption were divided into ≤2 units/week and >2 units/week with a non-drinking category as referent. This was related to size at birth and preterm delivery, adjusting for confounders including salivary cotinine as a biomarker of smoking status.
Results: Nearly two-thirds of women before pregnancy and over half in the first trimester reported alcohol intakes above the Department of Health (UK) guidelines of ≤2 units/week. Associations with birth outcomes were strongest for intakes >2 units/week before pregnancy and in trimesters 1 and 2 compared to non-drinkers. Even women adhering to the guidelines in the first trimester were at significantly higher risk of having babies with lower birth weight, lower birth centile and preterm birth compared to non-drinkers, after adjusting for confounders (p<0.05).
Conclusions: We found the first trimester to be the period most sensitive to the effect of alcohol on the developing fetus. Women adhering to guidelines in this period were still at increased risk of adverse birth outcomes. Our findings suggest that women should be advised to abstain from alcohol when planning to conceive and throughout pregnanc
Maternal alcohol intake up to and during pregnancy and risk of adverse birth outcomes: evidence from a British cohort
No full textBackground High maternal alcohol consumption has been linked to adverse birth outcomes such as small for gestational age and preterm birth, which in turn have been linked to increased risk of development of cardiovascular diseases and type 2 diabetes in adulthood. The UK Department of Health (DH) recommends that pregnant women and those trying to conceive should avoid alcohol and never drink more than 1GÇô2 units once or twice a week. This study aimed to investigate the association between alcohol intake before and during different stages of pregnancy with both birthweight and gestational age. Methods Data were used from the Caffeine and Reproductive Health Study (CARE), a prospective birth cohort that included 1303 low-risk pregnant women aged 18GÇô45 years, recruited from September, 2003, to June, 2006. Questionnaires administered in the first and second trimester and postpartum assessed alcohol consumption before pregnancy and for the three trimesters. Frequency of weekly alcohol consumption was analysed by categories of intake to accord with DH guidelines (Gëñ2 units per week, >2 units per week, and a non-drinking category as the referent) and was related to preterm birth and size at birth, measured as grams and as customised birthweight centile, which takes into account maternal prepregnancy weight, height, parity, ethnicity, gestation, and baby's sex in multivariable linear and logistic regression models. We also adjusted for maternal age, caffeine intake, education, energy intake, and salivary cotinine as a biomarker of smoking status. Only participants with complete data for all variables were included in the analyses, which excluded just under 10% of the sample. All women provided informed consent and the study was approved by the Leeds West Local Research Ethics Committee (ref 03/054). Findings 1153, 1135, 793, and 377 women, respectively, had data available for birth outcomes and alcohol consumption before pregnancy and during the three trimesters. 74% of women before pregnancy and 53% in the first trimester reported alcohol intakes above the DH recommendation. For intakes above 2 units per week compared with non-drinkers, the adjusted differences in birth centile were GêÆ7-À7 (95% CI GêÆ12-À8 to GêÆ2-À6; ptrend=0-À009), GêÆ8-À2 (GêÆ12-À6 to GêÆ3-À7; ptrend=0-À002), and GêÆ6-À4 (GêÆ11-À8 to GêÆ1-À1, ptrend=0-À06) before pregnancy and during trimesters 1 and 2, respectively. The association with small for gestational age and preterm birth was strongest in trimester 1, with adjusted odds ratios of 2-À0 (95% CI 1-À2GÇô3-À4; ptrend=0-À03) and 3-À5 (1-À1GÇô11-À2, ptrend=0-À04), respectively. Women who adhered to the recommendations in the first trimester of 2 units or fewer per week were also at a significantly higher risk of having babies born with lower birthweight (adjusted difference GêÆ98-À5, 95% CI GêÆ170-À9 to GêÆ26-À1; ptrend=0-À007), birth centile (GêÆ5-À8, GêÆ10-À8 to GêÆ0-À7; ptrend=0-À002), and preterm birth (adjusted odds ratio 4-À6, 95% CI 1-À4GÇô14-À7; ptrend=0-À04) compared with non-drinkers. Interpretation The first trimester was the most sensitive period for the association of alcohol with restricted fetal growth. However, this finding could be explained by under-reporting of alcohol intake. Our small sample size in the third trimester did not allow us to detect a change in birthweight, and larger prospective studies that take into account timing of exposure to alcohol are needed. We showed no evident safe level of alcohol consumption in pregnancy, and the safe advice should be to abstain from alcohol when planning to conceive and during pregnancy, particularly during its early stages. Funding The CARE study was supported by a grant from the Food Standards Agency, UK (T01033
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