Maternal intake of fat, riboflavin and nicotinamide and the risk of having offspring with congenital heart defects

Abstract

j Abstract Background With the exception of studies on folic acid, little evidence is available concerning other nutrients in the pathogenesis of congenital heart defects (CHDs). Fatty acids play a central role in embryonic development, and the B-vitamins riboflavin and nicotinamide are co-enzymes in lipid metabolism. Aim of the study To investigate associations between the maternal dietary intake of fats, riboflavin and nicotinamide, and CHD risk in the offspring. Methods A casecontrol family study was conducted in 276 mothers of a child with a CHD comprising of 190 outflow tract defects (OTD) and 86 non-outflow tract defects (non-OTD) and 324 control mothers of a non-malformed child. Mothers filled out general and food frequency questionnaires at 16 months after the index-pregnancy, as a proxy of the habitual food intake in the preconception period. Nutrient intakes (medians)were compared between cases and controls by Mann-Whitney U test. Odds ratios (OR) for the association between CHDs and nutrient intakes were estimated in a logistic regression model. Results Case mothers, in particular mothers of a child with OTD, had higher dietary intakes of saturated fat, 30.9 vs. 29.8 g/d; P < 0.05. Dietary intakes of riboflavin and nicotinamide were lower in mothers of a child with an OTD than in controls (1.32 vs. 1.41 mg/d; P < 0.05 and 14.6 vs. 15.1 mg/d; P < 0.05, respectively). Energy, unsaturated fat, cholesterol and folate intakes were comparable between the groups. Low dietary intakes of both riboflavin (<1.20 mg/d) and nicotinamide (<13.5 mg/d) increased more than two-fold the risk of a child with an OTD, especially in mothers who did not use vitamin supplements in the periconceptional period (OR 2.4, 95%CI 1.4-4.0). Increasing intakes of nicotinamide (OR 0.8, 95%CI 0.7-1.001, per unit standard deviation increase) decreased CHD risk independent of dietary folate intake. Conclusions A maternal diet high in saturated fats and low

Effect of lifestyle intervention on dietary habits, physical activity, and gestational weight gain in obese pregnant women: a randomized controlled trial

“…Total fat intake decreased in both the passive and active groups to a level within the recommended range (30-35% of energy). In both groups, saturated fat intake decreased, which is important because a lower intake of saturated fat reduces the fetus's risk of developing an orofacial cleft or a congenital heart defect (25,26). Nevertheless, saturated fat intake did not fall below the maximum level of 10% of energy.…”

Periconceptional nutrient intakes and risks of conotruncal heart defects

“…In particular, a Dutch study recently reported higher risks of a collection of heart defect phenotypes (approximately 25% of which were dTGA and TOF) among mothers with 1) higher intakes of vitamin E (24) and 2) lower intakes of riboflavin and nicotinamide (a niacin metabolite), particularly among nonsupplement users (25). The latter finding is supported by our finding (Table 3) that low dietary intakes of niacin and riboflavin were associated with increased risk of dTGA.…”

Disorders of riboflavin metabolism

“…Clinical problems associated with dietary deficiency of riboflavin, also known as ariboflavinosis, include night blindness, cataracts, fatigue, anaemia, growth retardation, migraines, peripheral neuropathy, and dermatological symptoms (cheilosis, glossitis, scaly skin rashes confined to the scrotum and vulva, and chapped lips) . Low riboflavin intake during pregnancy may be associated with an increased risk of congenital heart disease . Symptomatic riboflavin deficiency often occurs in association with deficiencies of other vitamins and has usually been attributed to dietary restriction; however, it is potentially more widespread than currently recognised with an estimated 10% to 15% of the global population having an inherited restriction in their ability to absorb or utilise riboflavin .…”