In utero preeclampsia exposure, milk intake and pubertal development

Genetic correlation and Mendelian randomization analyses support causal relationships between dietary habits and age at menarche

Dietary habits are essential in the mean age at menarche (AAM). However, the causal relationship between these factors remains unclear. Therefore, this study aimed to elucidate the genetic relationship between dietary habits and AAM. Genetic summary statistics for dietary habits were obtained from the UK Biobank. GWAS summary data for AAM was obtained from the ReproGen Consortium. Linkage disequilibrium score regression was used to test genetic correlations between dietary habits and AAM. The Mendelian randomization (MR) analyses used the inverse-variance weighted method. Genetic correlations with AAM were identified for 29 candi-date dietary habits, such as milk type (skimmed, semi-skimmed, full cream; coefficient = 0.2704, Pldsc = 1.13 × 10-14). MR evaluations revealed that 19 dietary habits were associated with AAM, including bread type (white vs. any other; OR 1.71, 95% CI 1.28-2.29, Pmr = 3.20 × 10-4), tablespoons of cooked vegetables (OR 0.437, 95% CI 0.29-0.67; Pmr = 1.30 × 10-4), and cups of coffee per day (OR 0.72, 95% CI 0.57-0.92, Pmr = 8.31 × 10-3). These results were observed to be stable under the sensitivity analysis. Our study provides potential insights into the genetic mechanisms underlying AAM and evidence that dietary habits are associated with AAM.

A review of dairy food intake for improving health among black children and adolescents in the US

Adequate nutrition during childhood and adolescence is crucial for proper neurological, musculoskeletal, immunological, and cardiometabolic health and development. Yet, disparities among socially underserved racial/ethnic groups in the United States (US) provide significant challenges to achieving adequate nutrition during these years of rapid growth and maturation. For example, Black children and adolescents are at greater risk for having food insecurity, lower-quality diets, obesity, and numerous associated health challenges that result from these disparities compared to their White peers. A growing body of evidence indicates that improving diet quality is critical for improving childhood and adolescent health and well-being, and that the diverse nutritional profile and bioactive compounds found within dairy foods may play multiple roles in promoting proper growth and development during these life stages. Therefore, to support overall health and development among Black youth, greater education and implementation efforts are needed to help this population meet the national dietary recommendations of 2.5 to 3 servings of dairy foods per day. Continuing to fall short of these recommendations puts Black children and adolescents at risk of multiple nutrient inadequacies and health disparities that can have lifelong impacts on disease development, mental health, and quality of life. This review presents the state of knowledge on health disparities and modifiable nutritional strategies involving milk and dairy foods to support the growth and maturation of children and adolescents, with a special focus on Black youth in the US.

A systematic review on maternal and perinatal factors influencing breast development

BACKGROUND

A secular trend towards earlier age at menarche has been reported, but the trend in breast development is less clear. We reviewed the evidence on the relationship between in utero and early life events and breast onset/development.

METHODS

Eligible studies were identified in PubMed and Embase databases. We selected studies in which female human exposure during fetal or the first years of life was measured or estimated, and associations with breast onset or development were evaluated.

RESULTS

Of the 49 cohort studies and 5 cross-sectional studies identified, 43 provided sufficient data to assess associations. High maternal weight, primiparity, and early weight gain, were related to an increased risk of early breast onset/development in most of the studies that analysed these associations, whereas late breast onset/development was associated with preterm birth. Results were inconsistent for smoking in pregnancy, maternal hypertensive disorders, breastfeeding, diabetes, and small for gestational age. No association emerged for maternal age at delivery, alcohol drinking, and selected drug use during pregnancy, and low birth weight.

CONCLUSIONS

The results of this review show that high maternal weight, primiparity and early weight gain were associated with an increased risk of early breast onset/development. Late breast onset/development was associated with preterm birth. Breast development is a key physical marker of puberty onset, and early puberty development is linked to consequences that can reverberate throughout life. Answering the questions about the interconnections between pre/postnatal environmental exposures and their impact on puberty, represents an important area of multidisciplinary research.

Effect of hypertensive disorders of pregnancy on pubertal development in daughters and sons: a systematic review and meta-analysis

Hypertensive disorders of pregnancy (HDP) are a major cause of maternal and offspring morbidity and mortality worldwide. Several studies in recent years have focused on the link between HDP and pubertal development in offspring. The goal of this study was to synthesize the published literature on the effect of HDP on pubertal development in offspring by a systematic review and meta-analysis (PROSPERO 2021: CRD42020148736). A systematic literature search of several databases was conducted through December 2021, focusing on studies reporting pubertal development in offspring of women with and without HDP exposure. Primary outcomes of interest included offspring body mass index (BMI), height, waist and hip circumference, fat mass, pubarche, thelarche, and age at menarche. A total of 21 studies were finally included. Significantly higher values of BMI (SMD: 0.16 [0.11, 0.22]; p < 0.01) and waist circumference (SMD: 0.21 [0.14, 0.29]; p < 0.01) were found in offspring exposed to maternal HDP. In addition, a tendency of the early development of secondary sexual characteristics only in daughters was presented in offspring whose mothers were diagnosed with HDP. The findings imply a possible effect of HDP on pubertal development in offspring, especially for their BMI and waist circumference, which highlights the importance of focusing on adolescent developmental abnormalities in offspring exposed to HDP.

Early-life exposures and age at thelarche in the Sister Study cohort

BACKGROUND

Early age at breast development (thelarche) has been associated with increased breast cancer risk. Average age at thelarche has declined over time, but there are few established risk factors for early thelarche. We examined associations between pre- and postnatal exposures and age at thelarche in a US cohort of women born between 1928 and 1974.

METHODS

Breast cancer-free women ages 35-74 years who had a sister diagnosed with breast cancer were enrolled in the Sister Study from 2003 to 2009 (N = 50,884). At enrollment, participants reported information on early-life exposures and age at thelarche, which we categorized as early (≤ 10 years), average (11-13 years), and late (≥ 14 years). For each exposure, we estimated odds ratios (ORs) and 95% confidence intervals (CIs) for early and late thelarche using polytomous logistic regression, adjusted for birth cohort, race/ethnicity and family income level in childhood.

RESULTS

Early thelarche was associated with multiple prenatal exposures: gestational hypertensive disorder (OR = 1.25, 95% CI 1.09-1.43), diethylstilbestrol use (OR = 1.23, 95% CI 1.04-1.45), smoking during pregnancy (OR = 1.20, 95% CI 1.13-1.27), young maternal age (OR 1.30, 95% CI 1.16-1.47 for < 20 vs. 25-29 years), and being firstborn (OR = 1.25, 95% CI 1.17-1.33). Birthweight < 2500 g and soy formula use in infancy were positively associated with both early and late thelarche.

CONCLUSIONS

Associations between pre- and postnatal exposures and age at thelarche suggest that the early-life environment influences breast development and therefore may also affect breast cancer risk by altering the timing of pubertal breast development.

The overall diet quality in childhood is prospectively associated with the timing of puberty

PURPOSE

The influences of nutrition in childhood on puberty onset could have sustained consequences for health and wellbeing later in life. The aim of this study was to investigate the prospective association of diet quality prior to puberty with the timing of puberty onset.

METHODS

We considered data from 3983 SCCNG (Southwest China Childhood Nutrition and Growth) study participants with dietary data, anthropometric measurement, and information on potential confounders at their baseline assessment (mean age: 7.1 years for girls and 7.3 years for boys; mean length of follow-up was 4.2 years). Cox proportional hazard regression estimating hazard ratios (HRs) and 95% confidence intervals (CIs) were used to examine the relationship between diet quality and puberty onset. Dietary intake at baseline was assessed using a validated food frequency questionnaire. Diet quality was determined using the Chinese Children Dietary Index (CCDI) which measures adherence to current dietary recommendations (theoretical range: 0-160 points). Age at Tanner stage 2 for breast/genital development (B2/G2), menarche or voice break (M/VB) were used as pubertal markers.

RESULTS

The CCDI score ranged from 56.2 to 136.3 for girls and 46.1-131.5 for boys. Pubertal markers consistently indicate that girls and boys with higher diet quality were more likely to enter their puberty later than their counterparts with lower CCDI scores (higher vs. lower CCDI tertiles: adjusted HR for age at B2: 0.85 (95% CI, 0.81-0.94), p for trend = 0.02; G2: 0.86 (95% CI,0.80-0.96), p for trend = 0.02; M: 0.86 (95% CI,0.80-0.95), p for trend = 0.02; VB: 0.86 (95% CI,0.79-0.98), p for trend = 0.03), after adjustment for paternal education level, baseline energy intake, and pre-pubertal body fat.

CONCLUSIONS

Our data suggested a later puberty onset and later timing of progressed puberty stages in children with a high diet quality, which were independent of pre-pubertal body fat.

Hypertensive disorders in pregnancy and timing of pubertal development in daughters and sons

STUDY QUESTION

Do maternal hypertensive disorders affect pubertal development in daughters and sons?

SUMMARY ANSWER

Pubertal development tended to occur earlier in daughters of mothers with 'preeclampsia, eclampsia or HELLP syndrome' (hemolysis, elevated liver enzymes and low blood platelets) or hypertension in pregnancy compared to daughters born of normotensive mothers.

WHAT IS KNOWN ALREADY

The existing literature suggests some or no association between preeclampsia and pubertal development in daughters, but not in sons. None of the previous studies has investigated the possible association between other types of hypertensive disorders (hypertension, eclampsia or HELLP syndrome) and pubertal timing in children.

STUDY DESIGN, SIZE, DURATION

Longitudinal cohort study consisting of 15 819 mother-child pairs with information on maternal hypertensive disorders collected during pregnancy and information on pubertal development collected half-yearly from the age of 11 years and until fully developed or 18 years of age.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Participants are children from the Puberty Cohort nested within the Danish National Birth Cohort. The exposure was register-based and self-reported information on maternal hypertensive disorders during pregnancy. The outcomes were children's self-reported information on pubertal development, including Tanner stage 1-5 (pubic hair (both daughters and sons) and breast development (daughters) or genital development (sons)), first menstrual bleeding (daughters) or first ejaculation (sons), voice break episode (sons), axillary hair development and acne occurrence (both daughters and sons). The main outcome was mean difference in age at attaining each pubertal milestone and a combined pubertal marker in children of mothers with hypertensive disorders in pregnancy (either hypertension (n = 490), 'preeclampsia, eclampsia or HELLP syndrome' (n = 419) or 'unspecific hypertensive disorders' (n = 334) with unexposed children as reference (n = 14 576)).

MAIN RESULTS AND THE ROLE OF CHANCE

In daughters of mothers with 'preeclampsia, eclampsia or HELLP syndrome', we observed tendencies of earlier pubertal timing (combined marker: -2.0 (95% CI: -3.9; 0.0) months). In daughters of mothers with hypertension, several pubertal milestones tended to occur earlier than in daughters of normotensive mothers; however, all 95% CIs overlapped the null resulting in a combined pubertal marker of -1.0 (95% CI: -3.2; 1.1) months. In sons of mothers with any of the hypertensive disorders, we observed no difference in pubertal timing (combined markers: 'preeclampsia, eclampsia or HELLP syndrome': 0.1 (95% CI: -2.0; 2.1) months; hypertension: -0.6 (95% CI: -2.3; 1.1) months; 'unspecific hypertensive disorders': 0.2 (95% CI: -1.9; 2.2) months).

LIMITATIONS, REASONS FOR CAUTION

The study is subject to non-differential misclassification of self-reported information on maternal hypertensive disorders in pregnancy and current pubertal status; possibly causing bias toward the null.

WIDER IMPLICATIONS OF THE FINDINGS

Hypertensive disorders in pregnancy might accelerate pubertal timing in daughters; however, more studies are needed for causal conclusions.

STUDY FUNDING/COMPETING INTEREST(S)

The study was funded by the Faculty of Health at Aarhus University. The authors have no financial relationships or competing interests to disclose.

TRIAL REGISTRATION NUMBER

N/A.

Breast Cancer and Nutrition: A Paradigm for Prevention in 3D Across the Life Course

Breast cancer, the most common cancer in women worldwide, has recognized reproductive and anthropometric risk factors including age at menarche and adult height. Yet the age when a woman attains her adult height or experiences menarche for example is simply the timing of the major life event at the end of a long trail of exposures that began in utero. The objective of this article is to investigate through a review of the literature the role of nutrition in breast cancer prevention through three dimensions (D). Each D offers a different lens. The First D identifies windows/ages of exposures or conditions that convey vulnerability or protection from breast cancer. The Second D addresses the intensity and duration of the exposure; and the (Third D) examines the pace, i.e., how rapid or slow the young woman experiences her growth and development. Birthweight illustrative of the First D reveals a strong signal across the life course on BC risk, but the risk group varies from low to high birthweight. Stressful life events like being a pubertal aged girl living in a household with an unemployed father during the Great Depression or high levels of environmental contaminants exposure are representative of the Second D. Height velocity at specific ages and weight loss in postmenopausal years are illustrative of anthropometric trajectories that reveal an adaptive biosystem that provides a contextual state to interact with the other two Ds. This article presents a new paradigm of nutrition and breast cancer prevention through the lens of three very different dimensions. It is the premise of this article that all three dimensions are essential tasks to tease apart the life course and identify windows for preventive strategies.

Preeclampsia exposed offspring have greater body mass index than non-exposed offspring during peripubertal life: A meta-analysis

BACKGROUND

This study evaluates the effect of preeclampsia on body mass index (BMI) of offspring who were exposed to preeclampsia in utero.

METHODS

Data were obtained from studies identified by a literature search in electronic databases. Random-effects metanalyses were conducted to achieve mean difference in BMI, waist circumference, gestation length, and birthweight between preeclampsia exposed (PE) and non-exposed (non-PE) offspring older than 5 years. Metaregression analyses were performed to identify factors affecting offspring BMI.

RESULTS

Sixteen studies (11639 PE offspring; age 15.5 years [14.2, 16.8]; 33.3% [32.6, 33.9] males vs 526,576 non-PE offspring; age 15.7 years [15.0, 16.4]; 42.6% [40.6, 44.5] male) were used. Gestation duration and birthweight of PE fetuses were significantly lesser than those of non-PE fetuses (mean difference (MD) -0.66 weeks [-1.25, -0.07]; p = 0.03 and MD -207.9 [-344.0, -71.8]; p = 0.003) respectively. BMI of PE offspring was significantly higher than non-PE offspring (MD 0.54 kg/m² [0.27, 0.82]; p = 0.0001). Odds of being obese was significantly higher in PE than non-PE offspring (odds ratio 2.12 [1.70, 2.66]; P < 0.00001). Waist circumference was also significantly higher in PE than in non-PE offspring (MD 1.37 cm [0.67, 2.06]; p = 0.0001). Offspring BMI was significantly inversely associated with maternal age in both PE and non-PE groups.

CONCLUSION

Preeclampsia poses risk of higher BMI and waist circumference especially to the offspring of older mothers.

Associations of Current, Childhood, and Adolescent Milk Intake with Serum Insulin-like Growth Factor (IGF)-1 and IGF Binding Protein 3 Concentrations in Adulthood

Previous studies have shown that insulin-like growth factor (IGF)-1 levels are positively and IGF binding protein (IGFBP)-3 levels negatively associated with risk of certain cancers. Also, dietary factors may influence the IGF system. We aimed to analyze the associations of current, childhood and adolescent milk intake with IGF-1 levels, IGFBP-3 levels and IGF-1:IGFBP-3 molar ratio in adulthood. Multivariable linear regression analyses by sex and race/ethnicity were performed using cross-sectional data from the Third National Health and Nutrition Examination Survey. A total of 5,805 participants were included in the analyses. Adult IGF-1 levels and IGF-1:IGFBP-3 molar ratio had significant inverse associations (P-trend = 0.02) with adolescent milk intake in non-Hispanic white men, but not in men of other race/ethnicities or in women. There were no associations between current or childhood milk intake and IGF-1 levels or IGF-1:IGFBP-3 molar ratio in adulthood. Current milk intake and childhood milk intake had significant positive associations (P-trend = 0.02) with adult IGFBP-3 levels in non-Hispanic white and non-Hispanic black women, respectively, but no associations were observed in Mexican American women or in men. Overall, there were long-term and short-term associations between milk intake and IGF-1 and IGFBP-3 levels, but the associations varied by race/ethnicity and sex.

MicroRNA-30a-3p is overexpressed in the placentas of patients with preeclampsia and affects trophoblast invasion and apoptosis by its effects on IGF-1

OBJECTIVE

Preeclampsia (PE) affects many women globally and remains a primary cause of neonatal and maternal morbidity and mortality. Aberrant placental microRNA (miRNA) expression might be associated with PE. Previously, 33 PE-related miRNAs, 11 up-regulated and 23 down-regulated, were detected in placentas of women with severe PE when compared with those of normal patients. One of the most up-regulated miRNAs in PE is miR-30a-3p. The predicted target of it is insulin-like growth factor 1 (IGF-1), which has been reported to have a relatively low expression level in PE patients. This study was conducted to determine the aberrant increased of miR-30a-3p in the placentas of women with preeclampsia and to elucidate the target and function of it in trophoblast cells.

STUDY DESIGN

miR-30a-3p expression in placenta tissues was compared between women with preeclampsia (n = 25) and normal pregnant women (n = 20). The miRNA target was studied by in silico and functional assay. The effects of the miRNA were verified by apoptosis assay and invasion assay in the trophoblast cell line.

RESULTS

miR-30a-3p was increased significantly in the placenta of women with preeclampsia when compared to those with normal pregnancies. Luciferase assay confirmed direct regulation of miR-30a-3p on the expression of IGF-1. Forced expression of miR-30a-3p suppressed IGF-1 protein expression in the HTR-8/SVneo cells. The functional assay suggests that the over-expression of miR-30a-3p alter the invasive capacity of JEG-3 cells and induce the apoptosis of HTR-8/SVneo cells (Figure).

CONCLUSION

Expression of miR-30a-3p was significantly increased in the placentas of patients with preeclampsia. miR-30a-3p might be involved in the pathogenesis of preeclampsia by targeting IGF-1 and regulating the invasion and apoptosis of trophoblast cells.