Modifying effect of maternal nutritional status on the impact of maternal multiple micronutrient supplementation on birthweight in Indonesia

Sebayang, Susy Katikana; Dibley, Michael J.; Kelly, Patrick J.; Shankar, Anita; Shankar, Anuraj H.

doi:10.1038/ejcn.2011.97

Cited by 18 publications

(7 citation statements)

References 28 publications

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“…the diet, body composition and lifestyle of the mother and to a lesser extent the father. There is considerable data from experimental studies in a range of animal species and prospective studies in humans that the mother’s diet and body composition before and in early pregnancy are related to phenotypic characteristics of the child, such as adiposity at birth and in childhood, and markers of cardiovascular risk such as carotid artery intima-media thickness [67-69]. The processes involved in influencing embryonic and fetal development are gradually being unravelled.…”

Section: Discussionmentioning

confidence: 99%

Early life opportunities for prevention of diabetes in low and middle income countries

et al. 2012

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BackgroundThe global burden of diabetes and other non-communicable diseases is rising dramatically worldwide and is causing a double poor health burden in low- and middle-income countries. Early life influences play an important part in this scenario because maternal lifestyle and conditions such as gestational diabetes and obesity affect the risk of diabetes in the next generation. This indicates important periods during the lifecourse when interventions could have powerful affects in reducing incidence of non-communicable diseases. However, interventions to promote diet and lifestyle in prospective parents before conception have not received sufficient attention, especially in low- and middle-income countries undergoing socio-economic transition.DiscussionInterventions to produce weight loss in adults or to reduce weight gain in pregnancy have had limited success and might be too late to produce the largest effects on the health of the child and his/her later risk of non-communicable diseases. A very important factor in the prevention of the developmental component of diabetes risk is the physiological state in which the parents enter pregnancy. We argue that the most promising strategy to improve prospective parents’ body composition and lifestyle is the promotion of health literacy in adolescents. Multiple but integrated forms of community-based interventions that focus on nutrition, physical activity, family planning, breastfeeding and infant feeding practices are needed. They need to address the wider social economic context in which adolescents live and to be linked with existing public health programmes in sexual and reproductive health and maternal and child health initiatives.SummaryInterventions aimed at ensuring a healthy body composition, diet and lifestyle before pregnancy offer a most effective solution in many settings, especially in low- and middle-income countries undergoing socio-economic transition. Preparing a mother, her partner and her future child for “the 1000 days”, whether from planned or unplanned conception would break the cycle of risk and demonstrate benefit in the shortest possible time. Such interventions will be particularly important in adolescents and young women in disadvantaged groups and can improve the physiological status of the fetus as well as reduce the prevalence of pregnancy conditions such as gestational diabetes mellitus which both predispose to non-communicables diseases in both the mother and her child. Pre-conception interventions require equipping prospective parents with the necessary knowledge and skills to make healthy lifestyle choices for themselves and their children. Addressing the promotion of such health literacy in parents-to-be in low- and middle-income countries requires a wider social perspective. It requires a range of multisectoral agencies to work together and could be linked to the issues of women’s empowerment, to reproductive health, to communicable disease prevention and to the Millennium Development Goals 4 and 5.

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Section: Discussionmentioning

confidence: 99%

Early life opportunities for prevention of diabetes in low and middle income countries

et al. 2012

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“…Some human trials support the initial animal observations. For example, supplementation with iron and folic acid in pregnancy has been shown to increase birthweight but this response was modified by maternal nutritional status, with infants born to women with better shortterm nutrition having greater birthweight response [164] . Whether there is an epigenetic basis to these observations similar to those reported for the rat models is not well established although it has been suggested that alterations at the H19 differentially methylated region is a likely mechanism by which folic acid risks and/or benefits are conferred in utero [165] .…”

Section: Critical Windows Of Development and Avenues For Interventionmentioning

confidence: 99%

Developmental programming of the metabolic syndrome - critical windows for intervention

Vickers

2011

WJG

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Metabolic disease results from a complex interaction of many factors, including genetic, physiological, behavioral and environmental influences. The recent rate at which these diseases have increased suggests that environmental and behavioral influences, rather than genetic causes, are fuelling the present epidemic. In this context, the developmental origins of health and disease hypothesis has highlighted the link between the periconceptual, fetal and early infant phases of life and the subsequent development of adult obesity and the metabolic syndrome. Although the mechanisms are yet to be fully elucidated, this programming was generally considered an irreversible change in developmental trajectory. Recent work in animal models suggests that developmental programming of metabolic disorders is potentially reversible by nutritional or targeted therapeutic interventions during the period of developmental plasticity. This review will discuss critical windows of developmental plasticity and possible avenues to ameliorate the development of postnatal metabolic disorders following an adverse early life environment.

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“…Pregnant women who received MMN supplementation had similar characteristics to those receiving IFA. The characteristics of the children at 9–12 years of age whose mothers received MMN or IFA supplementation were also similar to the overall SUMMIT enrollees, as were the general characteristics of women in this study [ 38 , 45 ].…”

Section: Resultsmentioning

confidence: 59%

Maternal biomarker patterns for metabolism and inflammation in pregnancy are influenced by multiple micronutrient supplementation and associated with child biomarker patterns and nutritional status at 9-12 years of age

et al. 2020

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Maternal nutritional status influences fetal development and long-term risk for adult noncommunicable diseases. However, the underlying mechanisms remain poorly understood. We examined whether biomarkers for metabolism and inflammation during pregnancy were associated with maternal health and with child biomarkers and health at 9-12 years of age in 44 maternal-child dyads from the Supplementation with Multiple Micronutrients Intervention Trial (SUMMIT, ISRCTN34151616) in Lombok, Indonesia. Archived blood for each dyad from maternal enrollment, later in pregnancy, postpartum, and from children at 9-12 years comprised 132 specimens. Multiplex microbead immunoassays were used to quantify vitamin D-binding protein (D), adiponectin (A), retinol-binding protein 4 (R), C-reactive protein (C), and leptin (L). Principal component analysis (PCA) revealed distinct variance patterns, i.e. principal components (PC), for baseline pregnancy, bp.pc1.D#A#R# and bp.pc2. C#L"; combined follow-up during pregnancy and postpartum, dp-pp.pc1.D"#A"R"#L# and dp-pp.pc2.A"C"L"; and children, ch.pc1.D"R"C" and ch.pc2.D#A"L". Maternal multiple micronutrient (MMN) supplementation led to an association of baseline maternal bp.pc2. C#L" with decreased post-supplementation maternal dp-pp.pc2.A"C"L" (p = 0.022), which was in turn associated with both increased child ch.pc1.D"R"C" (p = 0.036) and decreased child BMI z-score (BMIZ) (p = 0.022). Further analyses revealed an association between maternal dp-pp.pc1.D"#A"R"#L# and increased child BMIZ (p = 0.036). Child ch.pc1. D"R"C" was associated with decreased birth weight (p = 0.036) and increased child BMIZ (p = 0.002). Child ch.pc2.D#A"L" was associated with increased child BMIZ (p = 0.005), decreased maternal height (p = 0.030) and girls (p = 0.002). A pattern of elevated maternal adiponectin and leptin in pregnancy was associated with increased C-reactive protein,

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Modifying effect of maternal nutritional status on the impact of maternal multiple micronutrient supplementation on birthweight in Indonesia

Cited by 18 publications

References 28 publications

Early life opportunities for prevention of diabetes in low and middle income countries

Early life opportunities for prevention of diabetes in low and middle income countries

Developmental programming of the metabolic syndrome - critical windows for intervention

Maternal biomarker patterns for metabolism and inflammation in pregnancy are influenced by multiple micronutrient supplementation and associated with child biomarker patterns and nutritional status at 9-12 years of age

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