1,721,147 research outputs found
An offspring's health starts before conception and results of the NiPPeR randomized trial
No full textImproved maternal nutritional status is hypothesized to promote good pregnancy and infant health outcomes but trial evidence supporting the commencement of nutritional supplementation before conception is sparse. The NiPPeR (Nutritional Intervention Preconception and During Pregnancy to Maintain Healthy Glucose Metabolism and Offspring Health) multinational double-blind randomized controlled trial conducted in United Kingdom, Singapore and New Zealand tested a nutritional formulation containing myo-inositol, probiotics and multiple micronutrients (intervention), compared with a standard micronutrient supplement (control), taken preconception and throughout pregnancy. The primary outcome of gestational glycemia at 28 weeks’ gestation showed no difference. However, differences in several pre-specified secondary outcomes were notable. The intervention reduced the incidence of preterm delivery particularly those associated with preterm pre-labor rupture of membranes, operative delivery for delayed second stage and major postpartum hemorrhage. It may also shorten time-to-conception in overweight women, to that similar to non-overweight/obese women. Importantly, the intervention associated with a reduction in the incidence of rapid infant weight gain and high body mass index at 2 years among offspring. Such evidence indicate the potential for preconception maternal nutritional interventions to have appreciable impact in shaping the long-term health of an individual and building resilience against non-communicable chronic diseases in the future
The fetal, neonatal, and infant environments: the long-term consequences for disease risk
No full textThe developmental origins of health and disease can be understood by reference to the fundamentals of developmental plasticity. It is essential to distinguish between those environmental effects acting during development that are disruptive from those that have adaptive value. The latter are likely to underpin programming and the developmental origins of adult disease. It is suggested that greater disease risk is created by a mismatch between the environment predicted during the plastic phase of development and the actual environment experienced in the postplastic phase. This plastic phase extends from conception to after birth at least for some systems. It is not necessary to invoke a particular mechanism in the neonatal or infant period. There is increasing evidence that prematurity can be associated with long-term consequences, and this is to be anticipated from conceptual considerations. Different preventative strategies may be relevant in different populations
High but decreasing prevalence of overweight in preschool children: encouragement for further action
No full textDo human milk oligosaccharides protect against infant atopic disorders and food allergy?
No full textAtopic disorders (AD), often coexistent with food allergy (FA), start developing in early life and have lifelong health consequences. Breastfeeding is thought to be protective against AD and FA, but the data are controversial, and mechanisms are not well understood. Human milk oligosaccharides (HMOs) are complex carbohydrates that are abundant in human milk. These are thought to contribute to the development of the infant immune system by (i) promoting healthy microbiome, (ii) inhibiting pathogen binding to gut mucosa and (iii) modulating the immune system. Differences in microbiome composition between allergic and healthy infants have been observed, regardless of breastfeeding history. To date, limited studies have examined the preventive effects of HMOs on AD and FA in infants and current data relies on observation studies as trials of varying HMO intake through randomising individuals to breastfeeding are unethical. There is evidence for beneficial e ects of breastfeeding on lowering the risks of FA, eczema and asthma but there are inconsistencies amongst studies in the duration of breastfeeding, diagnostic criteria for AD and the age at which the outcome was assessed. Furthermore, current analytical methods primarily used today only allow detection of 16–20 major HMOs while more than 100 types have been identified. More large-scale longitudinal studies are required to investigate the role of HMO composition and the impact of changes over the lactation period in preventing AD and FA later in life.</p
Cross-calibration of two dual-energy X-ray absorptiometry devices for the measurement of body composition in young children.
No full textThis study aimed to cross-calibrate body composition measures from the GE Lunar Prodigy and GE Lunar iDXA in a cohort of young children. 28 children (mean age 3.4 years) were measured on the iDXA followed by the Prodigy. Prodigy scans were subsequently reanalysed using enCORE v17 enhanced analysis (“Prodigy enhanced”). Body composition parameters were compared across three evaluation methods (Prodigy, Prodigy enhanced, iDXA), and adjustment equations were developed. There were differences in the three evaluation methods for all body composition parameters. Body fat percentage (%BF) from the iDXA was approximately 1.5-fold greater than the Prodigy, whereas bone mineral density (BMD) was approximately 20% lower. Reanalysis of Prodigy scans with enhanced software attenuated these differences (%BF: − 5.2% [95% CI − 3.5, − 6.8]; and BMD: 1.0% [95% CI 0.0, 1.9]), although significant differences remained for all parameters except total body less head (TBLH) total mass and TBLH BMD, and some regional estimates. There were large differences between the Prodigy and iDXA, with these differences related both to scan resolution and software. Reanalysis of Prodigy scans with enhanced analysis resulted in body composition values much closer to those obtained on the iDXA, although differences remained. As manufacturers update models and software, researchers and clinicians need to be aware of the impact this may have on the longitudinal assessment of body composition, as results may not be comparable across devices and software versions
Transcription shifts in gut bacteria shared between mothers and their infants
No full textThe infant gut microbiome contains a portion of bacteria that originate from the maternal gut. In the infant gut these bacteria encounter a new metabolic environment that differs from the adult gut, consequently requiring adjustments in their activities. We used pilot community RNA sequencing data (metatranscriptomes) from ten mother-infant dyads participating in the NiPPeR Study to characterize bacterial gene expression shifts following mother-to-infant transmission. Maternally-derived bacterial strains exhibited large scale gene expression shifts following the transmission to the infant gut, with 12,564 activated and 14,844 deactivated gene families. The implicated genes were most numerous and the magnitude shifts greatest in Bacteroides spp. This pilot study demonstrates environment-dependent, strain-specific shifts in gut bacteria function and underscores the importance of metatranscriptomic analysis in microbiome studies.</p
Myo-inositol – a potential prophylaxis against premature onset of labour and preterm birth
No full textThe incidence of preterm birth (PTB), delivery before 37 completed weeks of gestation, is rising in most countries. Several recent small clinical trials of myo-inositol supplementation in pregnancy, which were primarily aimed at preventing gestational diabetes, have suggested an effect on reducing the incidence of PTB as a secondary outcome, highlighting the potential role of myo-inositol as a preventive agent. However, the underlying molecular mechanisms by which myo-inositol might be able to do so remain unknown; these may occur through directly influencing the onset and progress of labour, or by suppressing stimuli that trigger or promote labour. This paper presents hypotheses outlining the potential role of uteroplacental myo-inositol in human parturition and explains possible underlying molecular mechanisms by which myo-inositol might modulate the uteroplacental environment and inhibit preterm labour-onset. We suggest that a physiological decline in uteroplacental inositol levels to a critical threshold with advancing gestation, in concert with an increasingly pro-inflammatory uteroplacental environment, permits spontaneous membrane rupture and labour-onset. A higher uteroplacental inositol level, potentially promoted by maternal myo-inositol supplementation, might affect lipid metabolism, eicosanoid production, and secretion of pro-inflammatory chemocytokines, that overall dampen the pro-labour uteroplacental environment responsible for labour-onset and progress, thus, reducing the risk of PTB. Understanding how and when inositol may act to reduce PTB risk would facilitate the design of future clinical trials of maternal myo-inositol supplementation and definitively address the efficacy of myo-inositol prophylaxis against PTB
Assessment of body composition in infancy and early childhood
No full textIntroduction: Obesity is a global health problem with a demonstrable tendency to track across the age span and generations. Many pre- and postnatal factors may influence the development of obesity; however, much of obesity research has relied on measurements of
body size. As obesity is a condition of excessive adiposity, there is a need to measure body
composition specifically. Few tools are available to assess body composition in early life,
and their accuracy is unclear. Furthermore, many factors may influence measurements.
Therefore, this thesis aimed to evaluate body composition assessment tools and factors
that influence body composition in early life.
Methods: Offspring data was sourced from a multinational randomised controlled trial
of maternal supplementation. Multiple measurements of body composition were made
among offspring from the NiPPeR trial using bioelectrical impedance spectroscopy (BIS),
dual-energy X-ray absorptiometry (DXA), and air displacement plethysmography. A systematic
literature review was conducted to identify bioimpedance equations suitable for
use in early life; subsequently, new equations were developed in infancy and at 3.5 years.
Factors that influence body composition tools were also evaluated. Finally, differences in
infant growth and body composition following maternal supplementation were assessed.
Results: Few high-quality studies were identified that developed bioimpedance equations
in infancy. The equations developed among our cohort could more accurately predict
body composition at the group level compared to anthropometry-based equations.
However, improvements at the individual level were limited. Differences in BIS estimates
of body composition were observed according to body position (standing vs supine), and
DXA estimates according to device and software. Analyses of data from the NiPPeR cohort
demonstrated that maternal supplementation was associated with improved offspring
outcomes, including less rapid infant weight gain and reduced incidence of high BMI at
2 years. However, there were no clinically meaningful differences in body composition.
Conclusion: Pre- and antenatal nutritional supplementation improved body size in
early life, but no differences in body composition were detected. There are many uncertainties
related to body composition assessment in early life, and further research is required to optimise techniques
Maternal Nutrition Supplementation during Preconception and Pregnancy and Human Milk Composition
No full textBackground: Human milk (HM) provides essential nutrients and energy for infant growth and development. HM composition can be influenced by a range of maternal, infant, and environmental
factors, and is suggested to be tailored for each infant. Understanding the factors that influence HM
nutrient composition, such as maternal supplement use and lactation stage, is essential to ensure
optimal outcomes for breastfeeding infants.
Aim: Through an international, double-blind, randomised controlled trial, the effects of a maternal
supplementation from preconception throughout pregnancy until birth on HM nutrient composition
were investigated in association with a range of maternal and infant factors. Moreover, longitudinal
changes in HM nutrients were characterised over 12 months of lactation.
Methods: HM samples were collected at 1 week, 3 weeks, 6 weeks, and/or 3 months of lactation from
158 mothers in Singapore and 180 mothers in New Zealand. In New Zealand, HM samples were also
collected at 6, 9, and 12 months of lactation. HM samples were quantified for macronutrients,
minerals including zinc, vitamins D3, B1, B2, B3, B6, and B9, and HM oligosaccharides (HMOs).
Effects of the supplementation on HM nutrients were examined on all samples collected over the first
3 months of lactation. Temporal changes in HM components from 1 week to 12 months of lactation
were examined for the New Zealand site only.
Findings: Over the first 3 months of lactation, increases in HM fat and energy content in mothers with
overweight/obesity or gestational diabetes mellitus were attenuated with maternal supplementation.
Furthermore, the intervention supplement led to higher HM concentrations of zinc and vitamin D3.
However, there were no effects on HM concentrations of other minerals and B-vitamins. HMO
composition was altered among mothers with a specific genetic background, implying an effect of
the supplement on the activities of certain enzymes. Finally, HM composition changed dynamically
throughout 12 months of lactation.
Conclusion: Maternal nutritional supplementation during preconception and pregnancy resulted in
alterations of certain HM components. Further research is required to understand the underlying
mechanisms of these alterations and ascertain whether the alterations in HM composition are
associated with both short- and long-term offspring outcomes
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