Vitamin D is well recognized for its essentiality in maintaining skeletal health. Recent research has suggested that vitamin D may exert a broad range of roles throughout the human life cycle starting from reproduction to adult chronic disease risk. Rates of vitamin D deficiency during pregnancy remain high worldwide. Vitamin D deficiency has been associated with an increased risk of fertility problems, preeclampsia, gestational diabetes, and allergic disease in the offspring. Vitamin D is found naturally in only a few foods thus supplementation can provide an accessible and effective way to raise vitamin D status when dietary intakes and sunlight exposure are low. However, the possibility of overconsumption and possible adverse effects is under debate. The effect of vitamin D supplementation during pregnancy and early life on maternal and infant outcomes will be of particular focus in this review.

Excessive alcohol consumption has been shown to increase serum plasma levels of numerous immune cytokines. Maternal immune activation and elevated cytokines have been implicated in certain neurological disorders (e.g., autism and schizophrenia) in the offspring. We investigated the hypothesis that elevated cytokines during pregnancy are a risk factor in women who gave birth to a child with Fetal Alcohol Spectrum Disorder (FASD) or a child with neurobehavioral impairment, regardless of prenatal alcohol exposure. Moderate to heavy alcohol-exposed (AE) (N = 149) and low or no alcohol-exposed (LNA) (N = 92) women were recruited into the study during mid pregnancy (mean of 19.8 ± 5.8 weeks' gestation) in two regions of Ukraine: Khmelnytsky and Rivne. Maternal blood samples were obtained at enrollment into the study at early to mid-pregnancy and during a third-trimester follow-up visit and analyzed for plasma cytokines. Children were examined at 6 and/or 12 months of age and were classified as having FASD if their mothers reported alcohol use and if they had at least one standardized score (Bayley Scales of Infant Development II Mental Development Index [MDI], or Psychomotor Development Index [PDI]) below 85 with the presence or absence of physical features of FASD. In multivariate analyses of maternal cytokine levels in relation to infant MDI and PDI scores in the entire sample, increases in the ratio of TNF-α/IL-10 and IL-6/IL-10 were negatively associated with PDI scores at 6 months (p = 0.020 and p = 0.036, respectively) and 12 months (p = 0.043 and p = 0.029, respectively), and with MDI scores at 12 months (p = 0.013 and p = 0.050, respectively). A reduction in the odds ratio of having an FASD child was observed with increasing levels of IL-1β, IL-2, IL-4, IL-6, and IL-10 in early to mid-pregnancy and IL-1β and IL-10 during late pregnancy. However, women that failed to increase IL-10 levels in the third trimester in order to maintain the balance of pro- and anti-inflammatory cytokines had an elevated risk of having an FASD child, specifically a significant increase in the odds ratio of FASD with every one-unit log increase in late pregnancy TNF-α/IL-10 levels (aOR: 1.654, CI: 1.096-2.495, p = 0.017). These data support the concept that disruptions in the balance between pro- and anti-inflammatory cytokines may contribute to neurobehavioral impairment and alter the risk of FASD.

Objective: Polyunsaturated fatty acids are vital for optimal fetal neuronal development. The relationship between maternal alcohol consumption and smoking with third trimester plasma fatty acids were examined and their association with Fetal Alcohol Spectrum Disorders (FASD). Methods: Moderate to heavy alcohol-using and low/unexposed comparison women were recruited during mid-pregnancy from two prenatal clinics in Ukraine. The participants' infants underwent physical and neurobehavioral exams prior to one-year of age and classified as having FASD by maternal alcohol consumption and neurobehavioral scores. A subset of mother-child pairs was selected representing three groups of cases and controls: Alcohol-Exposed with FASD (AE-FASD, n ¼ 30), Alcohol-Exposed Normally Developing (AE-ND, n ¼ 33), or Controls (n ¼ 46). Third trimester maternal plasma samples were analyzed for fatty acids and levels were compared across groups. Results: The percent of C18:0 (p < 0.001), arachidonic acid (AA, C20:4n-6, p ¼ 0.017) and C22:5n-6 (p ¼ 0.001) were significantly higher in AE-FASD women than controls or AE-ND women. Alcoholexposed women who smoked had lower C22:5n-3 (p ¼ 0.029) and docosahexaenoic acid (DHA, C22:6n-3, p ¼ 0.005) and higher C22:5n-6 (p ¼ 0.013) than women consuming alcohol alone or abstainers. Conclusion: Alterations in fatty acid profiles were observed in moderate to heavy alcohol-consuming mothers with infants classified with FASD compared to alcohol-exposed normally developing infants or controls.

Objectives Polyunsaturated fatty acids (PUFA) are vital for optimal fetal neuronal development. This study examined the relationship between maternal alcohol consumption and smoking with plasma fatty acids measured in the third trimester and their association with Fetal Alcohol Spectrum Disorders (FASD). Methods In the parent study, moderate to heavy alcohol-using and low/unexposed comparison women were recruited during mid-pregnancy from two prenatal clinics in Ukraine. The participants’ live-born infants underwent physical and neurobehavioral exams prior to one-year of age. Infants were classified as having FASD if their mothers reported moderate to heavy alcohol consumption and the infant had at least one standardized score below 85 on the Bayley Scales of Infant Development II (BISD-II) with or without physical features of FASD. From the overall cohort, a subset of mother-child pairs was selected representing three groups of cases and controls: Alcohol-Exposed with FASD (n = 30), Alcohol-Exposed Normally Developing (n = 33), or low/unexposed Controls (n = 46). Third trimester maternal plasma samples were analyzed for fatty acids and levels were compared across groups. Results Plasma compositions of omega-6 fatty acids were altered in mothers with FASD infants compared to other groups. More specifically, the % of stearic acid (C18:0), arachidonic acid (AA, C20:4n6) and docosapentaenoic acid (DPAn6, C22:5n6) were significantly higher in mothers with FASD infants than low/unexposed controls or alcohol-exposed mothers with typically developing infants. Alcohol-exposed women who smoked had lower n3-docosapentaenoic acid (DPAn3, C22:5n3) and docosahexaenoic acid (DHA, C22:6n3) and higher DPAn6 than women consuming alcohol alone or abstainers. Conclusions Alterations in fatty acid profiles were observed in moderate to heavy alcohol-consuming mothers with infants classified with FASD compared to alcohol-exposed typically developing infants or controls. These results support the idea that maternal fatty acid status can play a role in the etiology of FASD. Funding Sources This research was funded by support from NIH Research Grant and conducted in conjunction with the Collaborative Initiative on Fetal Alcohol Spectrum Disorders(CIFASD).

Objectives Eating behavior changes are an essential component in long-term weight loss and key in reducing the risk of chronic disease. With increased access and use of app-based technology to monitor individual's health, the role of technology in eliciting eating behavior changes was investigated. Methods 498 African Americans were enrolled into Weight Matters, a culturally tailored, weight management intervention aimed at reducing risk factors of chronic disease in African Americans. Participants were randomized into a Tech group (N = 249, 89% female, 51.5 ± 13.4 yrs, BMI: 36.6 ± 8.3) that utilized app-based technology to track their fitness, diet, and health data and a Non-Tech group (N = 248, 88% female, 51.5 ± 12.5 yrs, BMI: 36.4 ± 7.7) that used paper-based tracking. The intervention consisted of bi-weekly educational sessions focused on health, fitness, and nutrition during an 18-week period with scheduled follow ups post-test and 12 months. In addition, participants received a one-year fitness membership. The Three Factor Eating Questionnaire (TFEQ-R18) was used to measure cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE) at enrollment, post-test, and 12 months. Results Repeated measures ANOVA was used to compare the changes in the construct scores of CR, UE, and EE within-subjects as well as between-subjects. There were no significant differences in mean scores of CR (F(2, 426) = .78, P = 0.46), UE (F(2, 426) = .28, P = 0.76), and EE (F(2, 426) = 1.07, P = 0.34) between Tech and Non-tech groups. For CR, the mean differences between enrollment and posttest (χ = −1.03, P &lt; 0.001) as well as enrollment and 12-month follow-up (χ = −.86, P &lt; 0.001) were statistically significant. There was a significant mean difference between the enrollment and 12-month (χ = 1.15, P &lt; 0.001) for UE while the other two comparisons were not significant. There were no significant differences observed in EE throughout the study. Conclusions Improvements in cognitive restraint and uncontrolled eating were observed in participants enrolled in an 18-week weight management intervention and the effect persisted after 12 months. However, the use of app-based technology to monitor their fitness, diet, and health data did not impact eating behavior change. Funding Sources Supported by the Centers for Medicare & Medicaid Services (CMS) (DHHS Grant # 1102017000118).