ABSTRACT
Findings on the relations of maternal dietary patterns during pregnancy and risk of preterm birth and offspring birth size remain inconclusive. We aimed to systematically review and quantify ...these associations. We searched MEDLINE, Embase, CENTRAL, and CINAHL up to December 2017. Three authors independently conducted a literature search, study selection, data extraction, and quality assessment. Summary effect sizes were calculated with random effects models and studies were summarized narratively if results could not be pooled. We included 36 studies and pooled results from 25 observational studies (167,507 participants). Two common dietary patterns—“healthy” and “unhealthy”—were identified. Healthy dietary patterns—characterized by high intakes of vegetables, fruits, wholegrains, low-fat dairy, and lean protein foods—were associated with lower risk of preterm birth (OR for top compared with bottom tertile: 0.79; 95% CI: 0.68, 0.91; I2 = 32%) and a weak trend towards a lower risk of small-for-gestational-age (OR: 0.86; 95% CI: 0.73, 1.01; I2 = 34%). Only statistically data-driven healthy dietary patterns, and not dietary index-based patterns, were associated with higher birth weight (mean difference: 67 g; 95% CI: 37, 96 g; I2 = 75%). Unhealthy dietary patterns—characterized by high intakes of refined grains, processed meat, and foods high in saturated fat or sugar—were associated with lower birth weight (mean difference: −40 g; 95% CI: −61, −20 g; I2 = 0%) and a trend towards a higher risk of preterm birth (OR: 1.17; 95% CI: 0.99, 1.39; I2 = 76%). Data from observational studies indicate that greater adherence to healthy dietary patterns during pregnancy is significantly related to lower risk of preterm birth. No consistent associations with birth weight and small- or large-for-gestational-age were observed.
This study aimed to fill the current gap in the understanding of the knowledge, attitudes and behaviours (KAB) related to dietary Na among adult residents in Singapore.
A cross-sectional online ...survey was conducted between October and December 2020 on 955 participants selected through random sampling.
The survey was conducted in Singapore.
Participants were recruited from the Singapore Population Health Study Online Panel.
Participants' mean age was 46·6 ± 14·1 years old and 58 % of them were females. Most of the participants were Chinese (82·1 %), 10·5 % were Indian and 4·5 % were Malay. Findings from the weighted data showed that most participants were aware of the health impact of high Na consumption. However, many participants were unaware of the recommended intake for salt (68%) and Na (83%), had misconceptions, and were unable to correctly use food labels to assess NA content (69%). Findings also alluded to the presence of knowledge gaps in the sources of Na in their diet. While 59 % of the participants reported to be limiting their consumption of Na, many reported facing barriers such as not knowing how to limit their Na intake. Participants also felt that there were limited options for low-Na foods when eating out and were lacking awareness of low-Na products.
Findings highlighted substantial gaps in participants' knowledge and skills in managing their Na consumption. This suggests the need for more public education and improvements in the food environment.
Abstract Background Omega-3 (or n-3) polyunsaturated fatty acids (PUFAs) are promising antidepressant treatments for perinatal depression (PND) because of supporting evidence from clinical trials, ...the advantage in safety, and their anti-inflammatory and neuroplastic effects. Although several observational studies have showed n-3 PUFA deficits in women with PND, the results of individual PUFAs from different studies were inconsistent. Methods This systematic review and meta-analysis aim to compare the levels of PUFA indices, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA), total n-3, total n-6, and the n-6/n-3 ratio between women with PND and healthy controls. The meta-analysis included 12 eligible studies available by December 2016. The effect sizes (ESs) were synthesized by using a random effects model. In addition, we performed subgroup analysis for the PUFA levels in patients with prenatal and postnatal depression, both of which were compared with healthy controls. Results There were significant lower levels of total n-3 PUFAs and DHA, and a significant increased n-6/n-3 ratio in PND patients. In the subgroup analyses, there were significant lower levels of n-3 PUFAs, EPA, and DHA in women with prenatal depression. The n-6/n-3 ratio was significantly increased in both prenatal and postnatal depression subgroups. Conclusions Our meta-analysis consolidates the important role of n-3 PUFAs in PND. As nutritional medicine is an important strategy to improve the effectiveness of depression treatment, our findings provide the strong rationale to conduct clinical trials to test the therapeutic and prophylactic effects of n-3 PUFAs in PND.
Adversity exposures in the prenatal and postnatal period are associated with an increased risk for psychopathology, which can be perpetuated across generations. Nonhuman animal research highlights ...the gut microbiome as a putative biological mechanism underlying such generational risks. In a sample of 450 mother-child dyads living in Singapore, we examined associations between three distinct adversity exposures experienced across two generations-maternal childhood maltreatment, maternal prenatal anxiety, and second-generation children's exposure to stressful life events-and the gut microbiome composition of second-generation children at 2 y of age. We found distinct differences in gut microbiome profiles linked to each adversity exposure, as well as some nonaffected microbiome features (e.g., beta diversity). Remarkably, some of the microbial taxa associated with concurrent and prospective child socioemotional functioning shared overlapping putative functions with those affected by adversity, suggesting that the intergenerational transmission of adversity may have a lasting impact on children's mental health via alterations to gut microbiome functions. Our findings open up a new avenue of research into the underlying mechanisms of intergenerational transmission of mental health risks and the potential of the gut microbiome as a target for intervention.
Advances in technology enabled the development of a web-based, pictorial FFQ to collect parent-report dietary intakes of 7-year-old children in the Growing Up in Singapore Towards healthy Outcomes ...study. This study aimed to compare intakes estimated from a paper-FFQ and a web-FFQ and examine the relative validity of both FFQ against 3-d diet records (3DDR). Ninety-two mothers reported food intakes of their 7-year-old child on a paper-FFQ, a web-FFQ and a 3DDR. A usability questionnaire collected participants' feedback on the web-FFQ. Correlations and agreement in energy, nutrients and food groups intakes between the dietary assessments were evaluated using Pearson's correlation, Lin's concordance, Bland-Altman plots, Cohen's κ and tertile classification. The paper- and web-FFQ had good correlations (≥ 0·50) and acceptable-good agreement (Lin's concordance ≥ 0·30; Cohen's κ ≥ 0·41; ≥ 50 % correct and ≤ 10 % misclassification into same or extreme tertiles). Compared with 3DDR, both FFQ showed poor agreement (< 0·30) in assessing absolute intakes except micronutrients (web-FFQ had acceptable-good agreement), but showed acceptable-good ability to classify children into tertiles (κ ≥ 0·21; ≥ 40 % and ≤ 15 % correct or misclassification). Bland-Altman plots suggest good agreement between web-FFQ and 3DDR in assessing micronutrients and several food groups. The web-FFQ was well-received, and majority (81 %) preferred the web-FFQ over the paper-FFQ. The newly developed web-FFQ produced intake estimates comparable to the paper-FFQ, has acceptable-good agreement with 3DDR in assessing absolute micronutrients intakes and has acceptable-good ability to classify children according to categories of intakes. The positive acceptance of the web-FFQ makes it a feasible tool for future dietary data collection.
To assess the association between maternal caffeine intake and risk of pregnancy loss using a systematic review and meta-analysis.
Categorical and dose-response meta-analysis of prospective studies.
...Relevant articles were identified by searching MEDLINE and SCOPUS databases through 30 January 2015. Two authors independently extracted information from eligible studies. Random-effects models were used to derive the summary relative risks (RR) and corresponding 95% CI for specific categories of caffeine consumption and for a continuous association using generalized least-squares trend estimation.
A total of 130 456 participants and 3429 cases in fourteen included studies.
Compared with the reference category with no or very low caffeine intake, the RR (95% CI) of pregnancy loss was 1·02 (0·85, 1·24; I(2)=28·3%) for low intake (50-149 mg/d), 1·16 (0·94, 1·41; I 2=49·6%) for moderate intake (150-349 mg/d), 1·40 (1·16, 1·68; I(2)=18·6%) for high intake (350-699 mg/d) and 1·72 (1·40, 2·13; I(2)=0·0%) for very high intake (≥ 700 mg/d). In the dose-response analysis, each 100 mg/d increment in maternal caffeine intake (~1 cup of coffee) was associated with 7% (95% CI 3%, 12%) higher risk of pregnancy loss. Our results may have been affected by publication bias, but the association remained significant for the subset of larger studies. Furthermore, adjustment for smoking and pregnancy symptoms may have been incomplete, potentially resulting in residual confounding.
Albeit inconclusive, higher maternal caffeine intake was associated with a higher risk of pregnancy loss and adherence to guidelines to avoid high caffeine intake during pregnancy appears prudent.
A bidirectional relationship between periodontitis and diabetes has been reported. Its mechanisms are yet to be elucidated. This study examines the interplays amongst dental conditions (periodontitis ...and functional dentition), diet, and glycaemic control of adults.
Relevant data of the NHANES surveys (2011–2012 and 2013–2014) (n = 6076) were extracted, including dental examination for generalised severe periodontitis (GSP) and functional dentition, laboratory tests for haemoglobin A1c (HbA1c), and 24-hour dietary recall. Multiple regressions and path analysis were conducted to assess the association between dental conditions and glycaemic control and the mediation effect of diet.
Higher HbA1c value was associated with GSP (coef: 0.34; 95% CI: 0.10 to 0.58) and nonfunctional dentition (coef: 0.12; 95% CI: 0.01 to 0.24). Associations were also found between lower fibre intake (g/1000 kcal) with GSP (coef: −1.16; 95% CI: −1.61 to −0.72) and nonfunctional dentition (coef: −0.80; 95% CI: −1.18 to −0.42). Mediation effect of diet (% energy from carbohydrate and energy-adjusted fibre intake) for the association between dental conditions and glycaemic control was not significant.
Periodontitis and functional dentition are significantly associated with fibre intake and glycaemic control in adults. Dietary intake, however, does not mediate the association between dental conditions and glycaemic control.
Background
Nicotinamide (vitamin B3) is a metabolite of tryptophan and dietary precursor of enzymes involved in many regulatory processes, which may influence fetal immune development.
Objective
We ...examined whether maternal plasma concentrations of nicotinamide, tryptophan or nine related tryptophan metabolites during pregnancy were associated with the risk of development of infant eczema, wheeze, rhinitis or allergic sensitization.
Methods
In the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) study, we analysed the associations between maternal plasma levels of nicotinamide, tryptophan and tryptophan metabolites at 26–28 weeks of gestation and allergic outcomes collected through interviewer‐administered questionnaires at multiple time‐points and skin prick testing to egg, milk, peanut and mites at age 18 months. Multivariate analysis was undertaken adjusting for all metabolites measured and separately adjusting for relevant demographic and environmental exposures. Analyses were also adjusted for multiple comparisons using the false discovery method.
Results
Tryptophan metabolites were evaluated in 976/1247 (78%) women enrolled in GUSTO. In multivariate analysis including all metabolites, maternal plasma 3‐hydrokynurenine was associated with increased allergic sensitization at 18 months (AdjRR 2.6, 95% CI 1.3–5.2 for highest quartile) but the association with nicotinamide was not significant (AdjRR 1.8, 95% CI 0.9–3.6). In analysis adjusting for other exposures, both 3‐hydrokynurenine and nicotinamide were associated with increased allergic sensitization (AdjRR 2.0, 95% CI 1.1–3.6 for both metabolites). High maternal plasma nicotinamide was associated with increased infant eczema diagnosis by 6 and 12 months, which was not significant when adjusting for all metabolites measured, but was significant when adjusting for relevant environmental and demographic exposures. Other metabolites measured were not associated with allergic sensitization or eczema, and maternal tryptophan metabolites were not associated with offspring rhinitis and wheeze.
Conclusions and Clinical Relevance
Maternal tryptophan metabolism during pregnancy may influence the development of allergic sensitization and eczema in infants.
Maternal tryptophan metabolism during pregnancy may influence the development of allergic sensitization and eczema in infants.
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