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Nutrition During Pregnancy and Lactation: Implications for Maternal and Infant Health

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (28 February 2019) | Viewed by 101811

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Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, USA
Interests: obesity; calorie restriction; dietary interventions; overfeeding; pregnancy; gestational diabetes; breast feeding; infant formula
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Special Issue Information

Dear Colleagues,

Pregnancy is a viewed as a window to future health. With the birth of the developmental origins of human adult disease hypothesis, research and clinical practice has turned its attention to the influence of maternal factors such as health and lifestyle surrounding pregnancy as a means to understand and prevent the inter-generational inheritance of chronic disease susceptibility. Outcomes during pregnancy have long-lasting impacts on both women on children. Moreover, nutrition early in life can influence growth and the establishment of lifelong eating habits and behaviors.

Maternal nutrition is probably one of the most well described factors known to directly impact fetal development and infant health. For example, inadequate folate intake in mothers who gave birth to children with neural tube defects led to studies on folate supplementation, widespread food fortification programs and clinically to the routine prescription of vitamin and mineral supplements to pregnant women. In the modern world, pregnancy and lactation is now plagued by new challenges brought about by poor quality diets irrespective of their energy content. Dubbed the double burden of malnutrition, the maternal diet can influence the healthy progression of pregnancy. For women, the maternal diet in pregnancy can influence the likelihood of gestational diabetes and gestational hypertension disorders. For children, a mother’s diet can influence size at birth and lifelong progression for obesity, type 2 diabetes and cardiovascular disease. New research is emerging on the unique role the maternal diet can have on breastmilk, influencing the nutritive and non-nutritive components which not only impacts normal growth but susceptibility to allergies and asthma.

Efforts have been made to improve the quality and quantity of the maternal diet in pregnancy and during lactation to alter the downstream implications on maternal and child health. Approaches while varied most often times result in an improvement in diet quality yet studies vary in their impacts on adverse pregnancy outcomes and child health. New research that investigates the influence of specific dietary components, maternal eating attitudes and behaviors and the interactions with the gut microbiome is needed to advance our understanding of maternal nutrition during pregnancy and lactation to optimize health outcomes of women and children.

This Special Issue on “Nutrition during Pregnancy and Lactation: Implications for Maternal and Infant Health” is intended to highlight new epidemiological, mechanistic and interventional studies that investigate maternal nutrition around the pregnancy period on maternal and infant outcomes. Submissions may include original research, narrative reviews, and systematic reviews and meta-analyses.

Dr. Leanne M. Redman
Guest Editor

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Keywords

  • Pregnancy
  • Pre-conception
  • Nutrition
  • Diet
  • Diet quality
  • Intervention
  • Gestational weight gain
  • Gestational diabetes
  • Childhood obesity

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Published Papers (15 papers)

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Research

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14 pages, 982 KiB  
Article
Behavioral Determinants of Objectively Assessed Diet Quality in Obese Pregnancy
by Jasper Most, Candida J. Rebello, Abby D. Altazan, Corby K. Martin, Marshall St Amant and Leanne M. Redman
Nutrients 2019, 11(7), 1446; https://doi.org/10.3390/nu11071446 - 26 Jun 2019
Cited by 15 | Viewed by 4520
Abstract
Interventions to promote healthy pregnancy in women with obesity by improving diet quality have been widely unsuccessful. We hypothesized that diet quality is determined by eating behaviors, but evidence in women with obesity is lacking. We evaluated diet quality and eating behavior in [...] Read more.
Interventions to promote healthy pregnancy in women with obesity by improving diet quality have been widely unsuccessful. We hypothesized that diet quality is determined by eating behaviors, but evidence in women with obesity is lacking. We evaluated diet quality and eating behavior in 56 women with obesity (mean ± SEM, 36.7 ± 0.7 kg/m2, 46% White, 50% nulliparous) early in pregnancy (14.9 ± 0.1 weeks). Diet quality was objectively assessed with food photography over six days and defined by Healthy Eating Index. Eating behaviors were assessed by validated questionnaires. Women reported consuming diets high in fat (38 ± 1% of energy) and the HEI was considered “poor” on average (46.7 ± 1.3), and for 71% of women. Diet quality was independently associated with education level (p = 0.01), food cravings (p < 0.01), and awareness towards eating (p = 0.01). Cravings for sweets and fast foods were positively correlated with respective intakes of these foods (p < 0.01 and p = 0.04, respectively), whereas cravings for fruits and vegetables did not relate to diet intake. We provide evidence of the determinants of poor diet quality in pregnant women with obesity. Based on this observational study, strategies to improve diet quality and pregnancy outcomes are to satisfy cravings for healthy snacks and foods, and to promote awareness towards eating behaviors. Full article
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16 pages, 982 KiB  
Article
Dysregulation of Neuronal Genes by Fetal-Neonatal Iron Deficiency Anemia Is Associated with Altered DNA Methylation in the Rat Hippocampus
by Yu-Chin Lien, David E Condon, Michael K Georgieff, Rebecca A Simmons and Phu V Tran
Nutrients 2019, 11(5), 1191; https://doi.org/10.3390/nu11051191 - 27 May 2019
Cited by 29 | Viewed by 7281
Abstract
Early-life iron deficiency results in long-term abnormalities in cognitive function and affective behavior in adulthood. In preclinical models, these effects have been associated with long-term dysregulation of key neuronal genes. While limited evidence suggests histone methylation as an epigenetic mechanism underlying gene dysregulation, [...] Read more.
Early-life iron deficiency results in long-term abnormalities in cognitive function and affective behavior in adulthood. In preclinical models, these effects have been associated with long-term dysregulation of key neuronal genes. While limited evidence suggests histone methylation as an epigenetic mechanism underlying gene dysregulation, the role of DNA methylation remains unknown. To determine whether DNA methylation is a potential mechanism by which early-life iron deficiency induces gene dysregulation, we performed whole genome bisulfite sequencing to identify loci with altered DNA methylation in the postnatal day (P) 15 iron-deficient (ID) rat hippocampus, a time point at which the highest level of hippocampal iron deficiency is concurrent with peak iron demand for axonal and dendritic growth. We identified 229 differentially methylated loci and they were mapped within 108 genes. Among them, 63 and 45 genes showed significantly increased and decreased DNA methylation in the P15 ID hippocampus, respectively. To establish a correlation between differentially methylated loci and gene dysregulation, the methylome data were compared to our published P15 hippocampal transcriptome. Both datasets showed alteration of similar functional networks regulating nervous system development and cell-to-cell signaling that are critical for learning and behavior. Collectively, the present findings support a role for DNA methylation in neural gene dysregulation following early-life iron deficiency. Full article
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14 pages, 716 KiB  
Article
Prenatal Intervention with Partial Meal Replacement Improves Micronutrient Intake of Pregnant Women with Obesity
by Suzanne Phelan, Barbara Abrams and Rena R. Wing
Nutrients 2019, 11(5), 1071; https://doi.org/10.3390/nu11051071 - 14 May 2019
Cited by 5 | Viewed by 4607
Abstract
A behavioral lifestyle intervention with partial meal replacement reduced excess gestational weight gain in ethnically diverse women with overweight/obesity, but the effects on micronutrient intake remained unknown. A secondary analysis of a randomized, controlled trial tested whether the intervention improved micronutrient intake relative [...] Read more.
A behavioral lifestyle intervention with partial meal replacement reduced excess gestational weight gain in ethnically diverse women with overweight/obesity, but the effects on micronutrient intake remained unknown. A secondary analysis of a randomized, controlled trial tested whether the intervention improved micronutrient intake relative to usual care. Pregnant women (n = 211; 30.5 years of age, body mass index, BMI, of 32.0 kg/m2) were enrolled and randomized within site and ethnicity (40% were Hispanic) into intervention (n = 102) or usual care (n = 109) groups. Two 24 h dietary recalls were conducted on random days at study entry and late pregnancy (35–36 weeks gestation). Nutrient adequacy was defined using the Estimated Average Requirement cut-point method. At study entry and including prenatal vitamins, ≥90% of participants reported inadequate intake of vitamins D and E and iron; 40–50% reported inadequate intake of calcium, protein, vitamins A, C, B6, folate, magnesium, and zinc. From study entry to late pregnancy, the behavioral intervention with partial meal replacement increased the overall intake of vitamins A, E, and D and copper and reduced the odds of inadequate intake of calcium (odds ratio (OR) = 0.37 (0.18, 0.76)), vitamins A (OR = 0.39 (0.21, 0.72)) and E (OR = 0.17 (0.06, 0.48)), and magnesium (OR = 0.36 (0.20, 0.65)). A behavioral intervention with partial meal replacement during pregnancy improved the intake of several micronutrients in Hispanic and non-Hispanic women with overweight/obesity. Full article
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12 pages, 370 KiB  
Article
Association of Full Breastfeeding Duration with Postpartum Weight Retention in a Cohort of Predominantly Breastfeeding Women
by Muna J. Tahir, Jacob L. Haapala, Laurie P. Foster, Katy M. Duncan, April M. Teague, Elyse O. Kharbanda, Patricia M. McGovern, Kara M. Whitaker, Kathleen M. Rasmussen, David A. Fields, Lisa J. Harnack, David R. Jacobs, Jr. and Ellen W. Demerath
Nutrients 2019, 11(4), 938; https://doi.org/10.3390/nu11040938 - 25 Apr 2019
Cited by 21 | Viewed by 9979
Abstract
Full breastfeeding (FBF) is promoted as effective for losing pregnancy weight during the postpartum period. This study evaluated whether longer FBF is associated with lower maternal postpartum weight retention (PPWR) as compared to a shorter FBF duration. The MILK (Mothers and Infants Linked [...] Read more.
Full breastfeeding (FBF) is promoted as effective for losing pregnancy weight during the postpartum period. This study evaluated whether longer FBF is associated with lower maternal postpartum weight retention (PPWR) as compared to a shorter FBF duration. The MILK (Mothers and Infants Linked for Healthy Growth) study is an ongoing prospective cohort of 370 mother–infant dyads, all of whom fully breastfed their infants for at least 1 month. Breastfeeding status was subsequently self-reported by mothers at 3 and 6 months postpartum. Maternal PPWR was calculated as maternal weight measured at 1, 3, and 6 months postpartum minus maternal prepregnancy weight. Using linear mixed effects models, by 6 months postpartum, adjusted means ± standard errors for weight retention among mothers who fully breastfed for 1–3 (3.40 ± 1.16 kg), 3–6 (1.41 ± 0.69 kg), and ≥6 months (0.97 ± 0.32 kg) were estimated. Compared to mothers who reported FBF for 1–3 months, those who reported FBF for 3–6 months and ≥6 months both had lower PPWR over the period from 1 to 6 months postpartum (p = 0.04 and p < 0.01, respectively). However, PPWR from 3 to 6 months was not significantly different among those who reported FBF for 3–6 versus ≥6 months (p > 0.05). Interventions to promote FBF past 3 months may increase the likelihood of postpartum return to prepregnancy weight. Full article
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14 pages, 1150 KiB  
Article
Differences in Maternal Immunoglobulins within Mother’s Own Breast Milk and Donor Breast Milk and across Digestion in Preterm Infants
by Veronique Demers-Mathieu, Robert K. Huston, Andi M. Markell, Elizabeth A. McCulley, Rachel L. Martin, Melinda Spooner and David C. Dallas
Nutrients 2019, 11(4), 920; https://doi.org/10.3390/nu11040920 - 24 Apr 2019
Cited by 39 | Viewed by 7045
Abstract
Maternal antibody transfer to the newborn provides essential support for the infant’s naïve immune system. Preterm infants normally receive maternal antibodies through mother’s own breast milk (MBM) or, when mothers are unable to provide all the milk required, donor breast milk (DBM). DBM [...] Read more.
Maternal antibody transfer to the newborn provides essential support for the infant’s naïve immune system. Preterm infants normally receive maternal antibodies through mother’s own breast milk (MBM) or, when mothers are unable to provide all the milk required, donor breast milk (DBM). DBM is pasteurized and exposed to several freeze–thaw cycles, which could reduce intact antibody concentration and the antibody’s resistance to digestion within the infant. Whether concentrations of antibodies in MBM and DBM differ and whether their survival across digestion in preterm infants differs remains unknown. Feed (MBM or DBM), gastric contents (MBM or DBM at 1-h post-ingestion) and stool samples (collected after a mix of MBM and DBM feeding) were collected from 20 preterm (26–36 weeks gestational age) mother–infant pairs at 8–9 and 21–22 days of postnatal age. Samples were analyzed via ELISA for the concentration of secretory IgA (SIgA), total IgA (SIgA/IgA), total IgM (SIgM/IgM) and IgG. Total IgA, SIgA, total IgM and IgG concentrations were 55.0%, 71.6%, 98.4% and 41.1% higher in MBM than in DBM, and were 49.8%, 32.7%, 73.9% and 39.7% higher in gastric contents when infants were fed with MBM than when infants were fed DBM, respectively. All maternal antibody isotypes present in breast milk were detected in the infant stools, of which IgA (not sIgA) was the most abundant. Full article
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16 pages, 827 KiB  
Article
Uncontrolled Eating during Pregnancy Predicts Fetal Growth: The Healthy Mom Zone Trial
by Jennifer S. Savage, Emily E. Hohman, Katherine M. McNitt, Abigail M. Pauley, Krista S. Leonard, Tricia Turner, Jaimey M. Pauli, Alison D. Gernand, Daniel E. Rivera and Danielle Symons Downs
Nutrients 2019, 11(4), 899; https://doi.org/10.3390/nu11040899 - 21 Apr 2019
Cited by 10 | Viewed by 5243
Abstract
Excess maternal weight gain during pregnancy elevates infants’ risk for macrosomia and early-onset obesity. Eating behavior is also related to weight gain, but the relationship to fetal growth is unclear. We examined whether Healthy Mom Zone, an individually tailored, adaptive gestational weight gain [...] Read more.
Excess maternal weight gain during pregnancy elevates infants’ risk for macrosomia and early-onset obesity. Eating behavior is also related to weight gain, but the relationship to fetal growth is unclear. We examined whether Healthy Mom Zone, an individually tailored, adaptive gestational weight gain intervention, and maternal eating behaviors affected fetal growth in pregnant women (n = 27) with a BMI > 24. At study enrollment (6–13 weeks gestation) and monthly thereafter, the Three-Factor Eating Questionnaire was completed. Ultrasounds were obtained monthly from 14–34 weeks gestation. Data were analyzed using multilevel modeling. Higher baseline levels of uncontrolled eating predicted faster rates of fetal growth in late gestation. Cognitive restraint was not associated with fetal growth, but moderated the effect of uncontrolled eating on fetal growth. Emotional eating was not associated with fetal growth. Among women with higher baseline levels of uncontrolled eating, fetuses of women in the control group grew faster and were larger in later gestation than those in the intervention group (study group × baseline uncontrolled eating × gestational week interaction, p = 0.03). This is one of the first intervention studies to use an individually tailored, adaptive design to manage weight gain in pregnancy to demonstrate potential effects on fetal growth. Results also suggest that it may be important to develop intervention content and strategies specific to pregnant women with high vs. low levels of disinhibited eating. Full article
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17 pages, 2283 KiB  
Article
A Slow-Digesting Carbohydrate Diet during Rat Pregnancy Protects Offspring from Non-Alcoholic Fatty Liver Disease Risk through the Modulation of the Carbohydrate-Response Element and Sterol Regulatory Element Binding Proteins
by Rafael Salto, Manuel Manzano, María Dolores Girón, Ainara Cano, Azucena Castro, José Dámaso Vílchez, Elena Cabrera and José María López-Pedrosa
Nutrients 2019, 11(4), 844; https://doi.org/10.3390/nu11040844 - 14 Apr 2019
Cited by 10 | Viewed by 3889
Abstract
High-fat (HF) and rapid digestive (RD) carbohydrate diets during pregnancy promote excessive adipogenesis in offspring. This effect can be corrected by diets with similar glycemic loads, but low rates of carbohydrate digestion. However, the effects of these diets on metabolic programming in the [...] Read more.
High-fat (HF) and rapid digestive (RD) carbohydrate diets during pregnancy promote excessive adipogenesis in offspring. This effect can be corrected by diets with similar glycemic loads, but low rates of carbohydrate digestion. However, the effects of these diets on metabolic programming in the livers of offspring, and the liver metabolism contributions to adipogenesis, remain to be addressed. In this study, pregnant insulin-resistant rats were fed high-fat diets with similar glycemic loads but different rates of carbohydrate digestion, High Fat-Rapid Digestive (HF–RD) diet or High Fat-Slow Digestive (HF–SD) diet. Offspring were fed a standard diet for 10 weeks, and the impact of these diets on the metabolic and signaling pathways involved in liver fat synthesis and storage of offspring were analyzed, including liver lipidomics, glycogen and carbohydrate and lipid metabolism key enzymes and signaling pathways. Livers from animals whose mothers were fed an HF–RD diet showed higher saturated triacylglycerol deposits with lower carbon numbers and double bond contents compared with the HF–SD group. Moreover, the HF–RD group exhibited enhanced glucose transporter 2, pyruvate kinase (PK), acetyl coenzyme A carboxylase (ACC) and fatty acid (FA) synthase expression, and a decrease in pyruvate carboxylase (PyC) expression leading to an altered liver lipid profile. These parameters were normalized in the HF–SD group. The changes in lipogenic enzyme expression were parallel to changes in AktPKB phosphorylation status and nuclear expression in carbohydrate-response element and sterol regulatory element binding proteins. In conclusion, an HF–RD diet during pregnancy translates to changes in liver signaling and metabolic pathways in offspring, enhancing liver lipid storage and synthesis, and therefore non-alcoholic fatty liver disease (NAFLD) risk. These changes can be corrected by feeding an HF–SD diet during pregnancy. Full article
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14 pages, 277 KiB  
Article
Higher Maternal Diet Quality during Pregnancy and Lactation Is Associated with Lower Infant Weight-For-Length, Body Fat Percent, and Fat Mass in Early Postnatal Life
by Muna J. Tahir, Jacob L. Haapala, Laurie P. Foster, Katy M. Duncan, April M. Teague, Elyse O. Kharbanda, Patricia M. McGovern, Kara M. Whitaker, Kathleen M. Rasmussen, David A. Fields, David R. Jacobs, Jr., Lisa J. Harnack and Ellen W. Demerath
Nutrients 2019, 11(3), 632; https://doi.org/10.3390/nu11030632 - 15 Mar 2019
Cited by 71 | Viewed by 9815
Abstract
Maternal pregnancy nutrition influences fetal growth. Evidence is limited, however, on the relationship of maternal diet during pregnancy and lactation on infant postnatal growth and adiposity. Our purpose was to examine associations between maternal diet quality during pregnancy and lactation with offspring growth [...] Read more.
Maternal pregnancy nutrition influences fetal growth. Evidence is limited, however, on the relationship of maternal diet during pregnancy and lactation on infant postnatal growth and adiposity. Our purpose was to examine associations between maternal diet quality during pregnancy and lactation with offspring growth and body composition from birth to six months. Maternal diet quality was serially assessed in pregnancy and at one and three months postpartum, using the Healthy Eating Index–2015 in a cohort of 354 fully breastfeeding mother–infant dyads. Infant length-for-age (LAZ), weight-for-age (WAZ), and weight-for-length (WLZ) Z-scores were assessed at birth, one, three, and six months. Infant body fat percent (BF%), fat mass (FM), and fat-free mass (FFM) were measured at six months using dual-energy X-ray absorptiometry. Higher maternal diet quality from pregnancy through three months postpartum was associated with lower infant WLZ from birth to six months (p = 0.02) and BF% at six months (p ≤ 0.05). Higher maternal diet quality at one and three months postpartum was also associated with lower infant FM at six months (p < 0.01). In summary, maternal diet quality during pregnancy and lactation was inversely associated with infant relative weight and adiposity in early postnatal life. Additional research is needed to explore whether associations persist across the life course. Full article
11 pages, 1311 KiB  
Article
Growth Patterns of Neonates Treated with Thermal Control in Neutral Environment and Nutrition Regulation to Meet Basal Metabolism
by Shiro Kubota, Masayoshi Zaitsu and Tatsuya Yoshihara
Nutrients 2019, 11(3), 592; https://doi.org/10.3390/nu11030592 - 11 Mar 2019
Cited by 1 | Viewed by 3383
Abstract
Little is known about the growth patterns of low birth weight neonates (<2500 g) during standardized thermal control and nutrition regulation to meet basal metabolism requirements compared to those of non-low birth weight neonates (2500 g and above). We retrospectively identified 10,544 non-low [...] Read more.
Little is known about the growth patterns of low birth weight neonates (<2500 g) during standardized thermal control and nutrition regulation to meet basal metabolism requirements compared to those of non-low birth weight neonates (2500 g and above). We retrospectively identified 10,544 non-low birth weight and 681 low birth weight neonates placed in thermo-controlled incubators for up to 24 h after birth. All neonates were fed a 5% glucose solution 1 h after birth and breastfed every 3 h (with supplementary formula milk if applicable) to meet basal metabolism requirements. Maximum body-weight loss (%), percentage body-weight loss from birth to peak weight loss (%/day), and percentage body-weight gain from peak weight loss to day 4 (%/day) were assessed by multivariable linear regression. Overall, the growth curves showed a uniform J-shape across all birth weight categories, with a low mean maximum body-weight loss (1.9%) and incidence of neonatal jaundice (0.3%). The body-weight loss patterns did not differ between the two groups. However, low birth weight neonates showed significantly faster growth patterns for percentage body-weight gain: β = 0.52 (95% confidence interval, 0.46 to 0.58). Under thermal control and nutrition regulation, low birth weight neonates might not have disadvantages in clinical outcomes or growth patterns. Full article
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16 pages, 456 KiB  
Article
Vitamin B12 Status in Pregnant Adolescents and Their Infants
by Julia L. Finkelstein, Ronnie Guillet, Eva K. Pressman, Amy Fothergill, Heather M. Guetterman, Tera R. Kent and Kimberly O. O’Brien
Nutrients 2019, 11(2), 397; https://doi.org/10.3390/nu11020397 - 13 Feb 2019
Cited by 16 | Viewed by 6587
Abstract
Vitamin B12 deficiency has been associated with increased risk of adverse pregnancy outcomes. Few prospective studies have investigated the burden or determinants of vitamin B12 deficiency early in life, particularly among pregnant adolescents and their children. The objectives of this study [...] Read more.
Vitamin B12 deficiency has been associated with increased risk of adverse pregnancy outcomes. Few prospective studies have investigated the burden or determinants of vitamin B12 deficiency early in life, particularly among pregnant adolescents and their children. The objectives of this study were to determine the prevalence of vitamin B12 deficiency and to examine associations between maternal and neonatal vitamin B12 status in a cohort study of healthy pregnant adolescents. Serum vitamin B12 and folate concentrations were measured in adolescents at mid-gestation (n = 124; 26.4 ± 3.5 weeks) and delivery (n = 131; 40.0 ± 1.3 weeks), and in neonates at birth using cord blood. Linear regression was used to examine associations between maternal and neonatal vitamin B12 status. Although the prevalence of vitamin B12 deficiency (<148.0 pmol/L; 1.6%) in adolescents was low during pregnancy, 22.6% of adolescents were vitamin B12 insufficient (<221.0 pmol/L; 22.6%) at mid-gestation. Maternal vitamin B12 concentrations significantly decreased from mid-gestation to delivery (p < 0.0001), and 53.4% had insufficient vitamin B12 status at delivery. Maternal vitamin B12 concentrations (p < 0.001) and vitamin B12 deficiency (p = 0.002) at delivery were significantly associated with infant vitamin B12 concentrations in multivariate analyses, adjusting for gestational age, maternal age, parity, smoking status, relationship status, prenatal supplement use, pre-pregnancy body mass index, race, and intake of vitamin B12 and folate. Maternal vitamin B12 concentrations significantly decreased during pregnancy and predicted neonatal vitamin B12 status in a cohort of healthy pregnant adolescents. Full article
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16 pages, 453 KiB  
Article
Effectiveness of an Intervention of Dietary Counseling for Overweight and Obese Pregnant Women in the Consumption of Sugars and Energy
by Elisa Anleu, Marcela Reyes, Marcela Araya B, Marcela Flores, Ricardo Uauy and María Luisa Garmendia
Nutrients 2019, 11(2), 385; https://doi.org/10.3390/nu11020385 - 13 Feb 2019
Cited by 9 | Viewed by 4476
Abstract
Objective: Evaluate if an intervention based on nutritional counseling decreases total sugars and energy consumption in overweight and obese pregnant women, compared to their previous consumption and compared to women who only received routine counseling. Methods: Randomized study of two groups: dietary counseling [...] Read more.
Objective: Evaluate if an intervention based on nutritional counseling decreases total sugars and energy consumption in overweight and obese pregnant women, compared to their previous consumption and compared to women who only received routine counseling. Methods: Randomized study of two groups: dietary counseling (Intervention Group: IG) and routine counseling (Control Group: CG). The intervention consisted of three educational sessions focused on decreasing intake of foods that most contribute to sugars consumption. Changes in sugars and energy consumption were evaluated by a food frequency questionnaire before and after the intervention. Results: We evaluated 433 pregnant women, 272 in IG and 161 in CG, who before intervention had a mean consumption of 140 g total sugars and 2134 kcal energy per day. At the end of the intervention, the IG showed 15 g/day lower consumption of total sugars (95% CI: −25 and −5 g/day), 2% less total energy from sugars (95% CI: −3% and −1% g/day), and 125 kcal/day less energy than the CG (95% CI: −239 and −10 kcal/day). Table sugar, sweets, and soft drinks had the greatest reduction in consumption. Conclusions: The intervention focused on counseling on the decrease in consumption of the foods that most contribute to sugars consumption in overweight and obese pregnant women was effective in decreasing total sugars and energy consumption, mainly in the food groups high in sugars. Future studies should examine if this intervention has an effect on maternal and fetal outcomes. Full article
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8 pages, 1108 KiB  
Article
Impact of Maternal Nutrition and Perinatal Factors on Breast Milk Composition after Premature Delivery
by Jean-Michel Hascoët, Martine Chauvin, Christine Pierret, Sébastien Skweres, Louis-Dominique Van Egroo, Carole Rougé and Patricia Franck
Nutrients 2019, 11(2), 366; https://doi.org/10.3390/nu11020366 - 10 Feb 2019
Cited by 33 | Viewed by 5605
Abstract
(1) Background: Premature infants require mothers’ milk fortification to meet nutrition needs, but breast milk composition may be variable, leading to the risk of inadequate nutrition. We aimed at determining the factors influencing mothers’ milk macronutrients. (2) Methods: Milk samples were analyzed for [...] Read more.
(1) Background: Premature infants require mothers’ milk fortification to meet nutrition needs, but breast milk composition may be variable, leading to the risk of inadequate nutrition. We aimed at determining the factors influencing mothers’ milk macronutrients. (2) Methods: Milk samples were analyzed for the first five weeks after premature delivery by infrared spectroscopy. Mothers’ nutritional intake data were obtained during standardized interviews with dieticians, and then analyzed with reference software. (3) Results: The composition of 367 milk samples from 81 mothers was (median (range) g/100 mL): carbohydrates 6.8 (4.4–7.3), lipids 3.4 (1.3–6.4), proteins 1.3 (0.1–3.1). There was a relationship between milk composition and mothers’ carbohydrates intake only (r = 0.164; p < 0.01). Postnatal age was correlated with milk proteins (r = −0.505; p < 0.001) and carbohydrates (r = +0.202, p < 0.001). Multiple linear regression analyses showed (coefficient) a relationship between milk proteins r = 0.547 and postnatal age (−0.028), carbohydrate intake (+0.449), and the absence of maturation (−0.066); associations were also found among milk lipids r = 0.295, carbohydrate intake (+1.279), and smoking (−0.557). Finally, there was a relationship among the concentration of milk carbohydrates r = 0.266, postnatal age (+0.012), and smoking (−0.167). (4) Conclusions: The variability of mothers’ milk composition is differentially associated for each macronutrient with maternal carbohydrate intake, antenatal steroids, smoking, and postnatal age. Improvement in milk composition could be achieved by the modification of these related factors. Full article
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16 pages, 1824 KiB  
Article
Sialic Acid and Sialylated Oligosaccharide Supplementation during Lactation Improves Learning and Memory in Rats
by Elena Oliveros, Enrique Vázquez, Alejandro Barranco, María Ramírez, Agnes Gruart, Jose María Delgado-García, Rachael Buck, Ricardo Rueda and María J. Martín
Nutrients 2018, 10(10), 1519; https://doi.org/10.3390/nu10101519 - 16 Oct 2018
Cited by 103 | Viewed by 7765
Abstract
Sialic acids (Sia) are postulated to improve cognitive abilities. This study evaluated Sia effects on rat behavior when administered in a free form as N-acetylneuraminic acid (Neu5Ac) or conjugated as 6′-sialyllactose (6′-SL). Rat milk contains Sia, which peaks at Postnatal Day 9 and [...] Read more.
Sialic acids (Sia) are postulated to improve cognitive abilities. This study evaluated Sia effects on rat behavior when administered in a free form as N-acetylneuraminic acid (Neu5Ac) or conjugated as 6′-sialyllactose (6′-SL). Rat milk contains Sia, which peaks at Postnatal Day 9 and drops to a minimum by Day 15. To bypass this Sia peak, a cohort of foster mothers was used to raise the experimental pups. A group of pups received a daily oral supplementation of Neu5Ac to mimic the amount naturally present in rat milk, and another group received the same molar amount of Sia as 6′-SL. The control group received water. After weaning, rats were submitted to behavioral evaluation. One year later, behavior was re-evaluated, and in vivo long-term potentiation (LTP) was performed. Brain samples were collected and analyzed at both ages. Adult rats who received Sia performed significantly better in the behavioral assessment and showed an enhanced LTP compared to controls. Within Sia groups, 6′-SL rats showed better scores in some cognitive outcomes compared to Neu5Ac rats. At weaning, an effect on polysialylated-neural cell adhesion molecule (PSA-NCAM) levels in the frontal cortex was only observed in 6′-SL fed rats. Providing Sia during lactation, especially as 6′-SL, improves memory and LTP in adult rats. Full article
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Review

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18 pages, 964 KiB  
Review
Energy Intake Requirements in Pregnancy
by Jasper Most, Sheila Dervis, Francois Haman, Kristi B Adamo and Leanne M Redman
Nutrients 2019, 11(8), 1812; https://doi.org/10.3390/nu11081812 - 6 Aug 2019
Cited by 92 | Viewed by 13376
Abstract
Energy intake requirements in pregnancy match the demands of resting metabolism, physical activity, and tissue growth. Energy balance in pregnancy is, therefore, defined as energy intake equal to energy expenditure plus energy storage. A detailed understanding of these components and their changes throughout [...] Read more.
Energy intake requirements in pregnancy match the demands of resting metabolism, physical activity, and tissue growth. Energy balance in pregnancy is, therefore, defined as energy intake equal to energy expenditure plus energy storage. A detailed understanding of these components and their changes throughout gestation can inform energy intake recommendations for minimizing the risk of poor pregnancy outcomes. Energy expenditure is the sum of resting and physical activity-related expenditure. Resting metabolic rate increases during pregnancy as a result of increased body mass, pregnancy-associated physiological changes, i.e., cardiac output, and the growing fetus. Physical activity is extremely variable between women and may change over the course of pregnancy. The requirement for energy storage depends on maternal pregravid body size. For optimal pregnancy outcomes, women with low body weight require more fat mass accumulation than women with obesity, who do not require to accumulate fat mass at all. Given the high energy density of fat mass, these differences affect energy intake requirements for a healthy pregnancy greatly. In contrast, the energy stored in fetal and placental tissues is comparable between all women and have small impact on energy requirements. Different prediction equations have been developed to quantify energy intake requirements and we provide a brief review of the strengths and weaknesses and discuss their application for healthy management of weight gain in pregnant women. Full article
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Review
The Function and Alteration of Immunological Properties in Human Milk of Obese Mothers
by Ummu D. Erliana and Alyce D. Fly
Nutrients 2019, 11(6), 1284; https://doi.org/10.3390/nu11061284 - 6 Jun 2019
Cited by 25 | Viewed by 5629
Abstract
Maternal obesity is associated with metabolic changes in mothers and higher risk of obesity in the offspring. Obesity in breastfeeding mothers appears to influence human milk production as well as the quality of human milk. Maternal obesity is associated with alteration of immunological [...] Read more.
Maternal obesity is associated with metabolic changes in mothers and higher risk of obesity in the offspring. Obesity in breastfeeding mothers appears to influence human milk production as well as the quality of human milk. Maternal obesity is associated with alteration of immunological factors concentrations in the human milk, such as C-reactive protein (CRP), leptin, IL-6, insulin, TNF-Alpha, ghrelin, adiponectin, and obestatin. Human milk is considered a first choice for infant nutrition due to the complete profile of macro nutrients, micro nutrients, and immunological properties. It is essential to understand how maternal obesity influences immunological properties of human milk because alterations could impact the nutrition status and health of the infant. This review summarizes the literature regarding the impact of maternal obesity on the concentration of particular immunological properties in the human milk. Full article
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