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Ashley-Martin J, Huang R, MacPherson S, Brion O, Owen J, Gaudreau E, Bienvenu JF, Fisher M, Borghese MM, Bouchard MF, Lanphear B, Foster WG, Arbuckle TE. Urinary concentrations and determinants of glyphosate and glufosinate in pregnant Canadian participants in the MIREC study. ENVIRONMENTAL RESEARCH 2023; 217:114842. [PMID: 36410462 DOI: 10.1016/j.envres.2022.114842] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/26/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Glyphosate is the most widely applied herbicide in agriculture. Glufosinate is a broad spectrum herbicide used to manage glyphosate-resistant weeds. Despite the widespread use of these herbicides, biomonitoring data - which inform risk assessment and management - are sparse. OBJECTIVES To identify determinants of urinary concentrations of these herbicides and their metabolites in pregnancy. METHODS We measured urinary concentrations of glyphosate, glufosinate, and their primary metabolites aminomethylphosphonic acid (AMPA) and 3-methylphosphinicopropionic acid (3-MPPA) in a single spot urine specimen collected during the first trimester of pregnancy from the Maternal-Infant Research on Environmental Chemicals (MIREC) study. MIREC recruited about 2000 pregnant women from 10 Canadian cities between 2008 and 2011. We used UItra-Performance Liquid Chromatography coupled to tandem mass spectrometry (UPLC-MS/MS) with sensitive limits of detection to quantify analyte concentrations. We examined urinary concentrations according to maternal sociodemographics, sample collection characteristics, reported pesticide use, and consumption of fruits, vegetables, legumes, and grain products. We used ANOVA models with specific gravity-standardized chemical concentrations as the dependent variable to determine associations with maternal and sample determinants. RESULTS Among women with biobanked urine samples (n = 1829-1854), 74% and 72% had detectable concentrations of glyphosate and AMPA, respectively. In contrast, one and six percent of women had detectable concentrations of glufosinate and 3-MPPA, respectively. The specific gravity-standardized geometric mean (95% CI) concentrations of glyphosate and AMPA were 0.112 (0.099-0.127) μg/L and 0.159 (0.147-0.172) μg/L, respectively. We observed a dose-response relationship between consumption of whole grain bread and higher urinary glyphosate concentrations. Season of urine collection and self-reported pesticide use were not associated with increased concentrations of any analyte. CONCLUSIONS We detected glyphosate and AMPA in the majority of pregnant women from this predominantly urban Canadian cohort. Diet was a probable route of exposure.
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Affiliation(s)
- Jillian Ashley-Martin
- Population Studies Division, Environmental Health, Research Science Bureau, Health Ottawa, ON, K1A 0K9, Canada.
| | - Rong Huang
- Population Studies Division, Environmental Health, Research Science Bureau, Health Ottawa, ON, K1A 0K9, Canada.
| | - Susan MacPherson
- Population Studies Division, Environmental Health, Research Science Bureau, Health Ottawa, ON, K1A 0K9, Canada.
| | - Orly Brion
- Population Studies Division, Environmental Health, Research Science Bureau, Health Ottawa, ON, K1A 0K9, Canada.
| | - James Owen
- Population Studies Division, Environmental Health, Research Science Bureau, Health Ottawa, ON, K1A 0K9, Canada.
| | - Eric Gaudreau
- INSPQ, Centre de Toxicologie du Québec, Direction de la Santé Environnementale et de la Toxicologie, Quebec, QC, G1V 5B3, Canada.
| | - Jean-Francois Bienvenu
- INSPQ, Centre de Toxicologie du Québec, Direction de la Santé Environnementale et de la Toxicologie, Quebec, QC, G1V 5B3, Canada.
| | - Mandy Fisher
- Population Studies Division, Environmental Health, Research Science Bureau, Health Ottawa, ON, K1A 0K9, Canada.
| | - Michael M Borghese
- Population Studies Division, Environmental Health, Research Science Bureau, Health Ottawa, ON, K1A 0K9, Canada.
| | - Maryse F Bouchard
- University of Montreal, Department of Environmental Health and Occupational Health, Montreal, QC, H3T 1J4, Canada.
| | - Bruce Lanphear
- Simon Fraser, Faculty of Health Sciences, Burnaby, BC V5A 1S6, Canada.
| | - Warren G Foster
- McMaster University, Department of Obstetrics & Gynecology, Hamilton, ON, L8S 4L8, Canada.
| | - Tye E Arbuckle
- Population Studies Division, Environmental Health, Research Science Bureau, Health Ottawa, ON, K1A 0K9, Canada.
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2
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Weiler HA, Vanstone CA, Razaghi M, Gharibeh N, Patel S, Wei SQ, McNally D. Disparities in Vitamin D Status of Newborn Infants from a Diverse Sociodemographic Population in Montreal, Canada. J Nutr 2021; 152:255-268. [PMID: 34612495 PMCID: PMC8754562 DOI: 10.1093/jn/nxab344] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/02/2021] [Accepted: 09/17/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Vitamin D status at birth is reliant on maternal-fetal transfer of vitamin D during gestation. OBJECTIVES We aimed to examine the vitamin D status of newborn infants in a diverse population and to subsequently identify the modifiable correlates of vitamin D status. METHODS In this cross-sectional study, healthy mother-infant dyads (n = 1035) were recruited within 36 h after term delivery (March 2016-March 2019). Demographic and lifestyle factors were surveyed. Newborn serum 25-hydroxyvitamin D [25(OH)D] was measured (standardized chemiluminescence immunoassay) and categorized as deficient [serum 25(OH)D <30 nmol/L] or adequate (≥40 nmol/L). Serum 25(OH)D was compared among categories of maternal characteristics using ANOVA; each characteristic was tested in a separate model. Subgroups (use of multivitamins preconception and continued in pregnancy compared with during pregnancy only) were matched (n = 352/group) for maternal factors (ancestry, age, income, education, parity, and prepregnancy BMI) using propensity scores; logistic regression models were generated for odds of deficiency or adequacy. RESULTS Infants' mean serum 25(OH)D was 45.9 nmol/L (95% CI: 44.7, 47.0 nmol/L) (n = 1035), with 20.8% (95% CI: 18.3%, 23.2%) deficient and 60.7% (95% CI: 55.2%, 66.2%) adequate. Deficiency prevalence ranged from 14.6% of white infants to 41.7% of black infants. Serum 25(OH)D was higher (P < 0.0001) in infants of mothers with higher income, BMI < 25 kg/m2, exercise and sun exposure in pregnancy, and use of multivitamins preconception. In the matched-subgroup analysis, multivitamin supplementation preconception plus during pregnancy relative to only during pregnancy was associated with lower odds for vitamin D deficiency (ORadj: 0.55; 95% CI: 0.36, 0.86) and higher odds for adequate vitamin D status (ORadj: 1.47; 95% CI: 1.04, 2.07). CONCLUSIONS In this study most newborn infants had adequate vitamin D status, yet one-fifth were vitamin D deficient with disparities between population groups. Guidelines for a healthy pregnancy recommend maternal use of multivitamins preconception and continuing in pregnancy. An emphasis on preconception use may help to achieve adequate neonatal vitamin D status.This trial was registered at clinicaltrials.gov as NCT02563015.
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Affiliation(s)
| | - Catherine A Vanstone
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Maryam Razaghi
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Nathalie Gharibeh
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Sharina Patel
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Shu Q Wei
- Québec National Institute of Public Health, Montréal, Québec, Canada
| | - Dayre McNally
- Division of Critical Care, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
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3
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England-Mason G, Dewey D. Strengthening research investigating maternal nutrition and children's neurodevelopment: How can we do it better? Where do we go from here? Am J Clin Nutr 2021; 114:1272-1274. [PMID: 34375383 DOI: 10.1093/ajcn/nqab256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Gillian England-Mason
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Deborah Dewey
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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4
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Mortaji N, Krzeczkowski JE, Boylan K, Booij L, Perreault M, Van Lieshout RJ. Maternal pregnancy diet, postnatal home environment and executive function and behavior in 3- to 4-y-olds. Am J Clin Nutr 2021; 114:1418-1427. [PMID: 34159358 PMCID: PMC8491573 DOI: 10.1093/ajcn/nqab202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 05/27/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Optimal maternal nutrition during pregnancy has been linked to better cognitive and behavioral development in children. However, its influence on the effects of suboptimal postnatal exposures like reduced stimulation and support in the home is not known. OBJECTIVES To examine the effect of maternal pregnancy diet on executive function and/or behavioral development in children raised in suboptimal home environments. METHODS Data were provided by 808 mother-infant dyads from the Canadian Maternal-Infant Research on Environmental Chemicals-Child Development study. Maternal pregnancy diet was self-reported using the Healthy Eating Index 2010 questionnaire. Stimulation and support in the home was assessed using the Home Observation for Measurement of the Environment (HOME) when children were 3-4 y old. Child executive function was reported by mothers at this age using the Behavior Rating Inventory of Executive Functioning-Preschool Edition, and child behavior was assessed using the Behavior Assessment System for Children-2nd Edition. We examined the interaction of maternal pregnancy diet and postnatal HOME scores on child executive function and behavior using linear regression adjusted for maternal education, postpartum depression, prepregnancy BMI, and smoking. RESULTS Maternal pregnancy diet was associated with an increasingly positive association with child working memory (β: 0.21; 95% CI: 0.82, 3.41; P = 0.001), planning (β: 0.17; 95% CI: 0.38, 2.84; P = 0.007), and adaptability (β: -0.13; 95% CI: -1.72, -0.08; P = 0.032) as levels of postnatal stimulation decreased. CONCLUSIONS The positive association of maternal pregnancy diet quality and executive function and adaptability in 3- to 4-y-olds appeared to increase with decreasing levels of postnatal stimulation and support. These results suggest that overall maternal pregnancy diet could be linked to better child neurodevelopment in families experiencing barriers to providing stimulation and support to children in their home.
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Affiliation(s)
| | - John E Krzeczkowski
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Khrista Boylan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Linda Booij
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Maude Perreault
- Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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5
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Weiler HA, Brooks SPJ, Sarafin K, Fisher M, Massarelli I, Luong TM, Johnson M, Morisset AS, Dodds L, Taback S, Helewa M, von Dadelszen P, Smith G, Lanphear BP, Fraser WD, Arbuckle TE. Early prenatal use of a multivitamin diminishes the risk for inadequate vitamin D status in pregnant women: results from the Maternal-Infant Research on Environmental Chemicals (MIREC) cohort study. Am J Clin Nutr 2021; 114:1238-1250. [PMID: 34081131 PMCID: PMC8408885 DOI: 10.1093/ajcn/nqab172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 04/26/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Reports on the adequacy of vitamin D status of pregnant women are not available in Canada. OBJECTIVES The objectives of this study were to examine vitamin D status across pregnancy and identify the correlates of vitamin D status of pregnant women in Canada. METHODS Pregnant women (≥18 years) from 6 provinces (2008-2011) participating in a longitudinal cohort were studied. Sociodemographic data, obstetrical histories, and dietary and supplemental vitamin D intakes were surveyed. Plasma 25-hydroxyvitamin D (25OHD) was measured using an immunoassay standardized to LC-MS/MS from samples collected during the first (n = 1905) and third trimesters (n = 1649) and at delivery (n = 1543). The proportion of women with ≥40 nmol/L of plasma 25OHD (adequate status) was estimated at each time point, and factors related to achieving this cut point were identified using repeated-measures logistic regression. Differences in 25OHD concentrations across trimesters and at delivery were tested a using repeated-measures ANOVA with a post hoc Tukey's test. RESULTS In the first trimester, 93.4% (95% CI: 92.3%-94.5%) of participants had 25OHD ≥40 nmol/L. The mean plasma 25OHD concentration increased from the first to the third trimester and then declined by delivery (69.8 ± 0.5 nmol/L, 78.6 ± 0.7 nmol/L, and 75.7 ± 0.7 nmol/L, respectively; P < 0.0001). A lack of multivitamin use early in pregnancy reduced the odds of achieving 25OHD ≥40 nmol/L (ORadj = 0.33; 95% CI: 0.25-0.42) across all time points. Factors associated with not using a prenatal multivitamin included multiparity (ORadj = 2.08; 95% CI: 1.42-3.02) and a below-median income (ORadj = 1.39; 95% CI: 1.02-1.89). CONCLUSIONS The results from this cohort demonstrate the importance of early multivitamin supplement use to achieve an adequate vitamin D status in pregnant women.
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Affiliation(s)
| | - Stephen P J Brooks
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Kurtis Sarafin
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Mandy Fisher
- Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario, Canada
| | - Isabelle Massarelli
- Bureau of Food Surveillance and Science Integration, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - The Minh Luong
- Bureau of Food Surveillance and Science Integration, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Markey Johnson
- Exposure Assessment Section, Air Health Science Division, Health Canada, Ottawa, Ontario, Canada
| | | | - Linda Dodds
- Department of Obstetrics & Gynecology, Dalhousie University, Halifax, Nova Scotia, Canada,Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Shayne Taback
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Canada
| | - Michael Helewa
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Canada
| | - Peter von Dadelszen
- School of Life Course Sciences, King's College London, London, United Kingdom
| | - Graeme Smith
- Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Bruce P Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - William D Fraser
- Obstetrics and Gynecology, University of Sherbrooke, Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke (CRCHUS), Québec, Canada,Sainte-Justine University Hospital and Research Center, University of Montreal, Montreal, Québec, Canada
| | - Tye E Arbuckle
- Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario, Canada
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6
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Louopou RC, Trottier H, Arbuckle TE, Fraser WD. Dental amalgams and risk of gestational hypertension in the MIREC study. Pregnancy Hypertens 2020; 21:84-89. [PMID: 32447273 DOI: 10.1016/j.preghy.2020.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 04/25/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The potential association between the presence or replacement of dental amalgams and gestational hypertension (GH) is unclear. OBJECTIVE To assess the association between the presence or replacement of dental amalgams and the risk of GH in a prospective cohort study. METHODS We assessed dental amalgam status (presence or replacement), blood mercury concentrations, and measured blood pressure (BP) in 1817 pregnant women recruited in 10 Canadian cities. BP was assessed in each trimester of pregnancy and mercury concentrations in 1st and 3rd trimesters. Logistic regression analysis was performed to estimate the adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the associations between dental amalgam status and GH. Concurrent measures with systolic BP (SBP) and diastolic BP (DBP) were assessing through linear generalized estimating equations. RESULTS Dental amalgam status was weakly statistically correlated with mercury concentrations but there was no evidence of an association with GH in women having 1-4 (aOR = 1.31 (0.92, 1.85)) or ≥ 5 dental amalgams (aOR = 1.32 (0.86, 2.04)), compared to women without amalgam reported at first trimester. Dental amalgam replacement reported in the first or third trimester was similarly not associated with GH (aOR = 0.75 (0.40, 1.42) and 0.73 (0.39, 1.34), respectively) but with SBP (beta = -1.58 (-2.95, -0.02)). CONCLUSION We found weak correlations between dental amalgams and blood mercury among pregnant women. However, the presence of dental amalgams or their replacement was not associated with GH but with decreased SBP for the replacement. Further studies are required.
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Affiliation(s)
- Rosalie Camara Louopou
- Social and Preventive Medicine Department, Public Health School, Université de Montreal, QC, Canada; Research Center, CHU Sainte-Justine, Mother and Child University Hospital Center, Montreal, QC, Canada
| | - Helen Trottier
- Social and Preventive Medicine Department, Public Health School, Université de Montreal, QC, Canada; Research Center, CHU Sainte-Justine, Mother and Child University Hospital Center, Montreal, QC, Canada
| | - Tye Elaine Arbuckle
- Population Studies Division, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada
| | - William Donald Fraser
- Research Center, CHU Sainte-Justine, Mother and Child University Hospital Center, Montreal, QC, Canada; Centre de recherche du CHUS, Department of Obstetrics and Gynecology, Université de Sherbrooke, Sherbrooke, QC, Canada.
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7
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Willemse JPMM, Meertens LJE, Scheepers HCJ, Achten NMJ, Eussen SJ, van Dongen MC, Smits LJM. Calcium intake from diet and supplement use during early pregnancy: the Expect study I. Eur J Nutr 2020; 59:167-174. [PMID: 30661104 PMCID: PMC7000487 DOI: 10.1007/s00394-019-01896-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 01/08/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE Adequate calcium intake during pregnancy is of major importance for the health of both mother and fetus. Up to date, evidence on the prevalence of inadequate calcium intake among pregnant women is sparse for Western countries, and it is unknown to what extent inadequate dietary calcium intake is adequately balanced by supplement use. The objective of this study was to estimate calcium intake from diet and supplement use during the early pregnancy in The Netherlands. METHODS As part of the Expect cohort study, 2477 pregnant women (8-16 weeks of gestation) completed an online questionnaire including questions on baseline characteristics, the use of calcium containing supplements, and a short food-frequency questionnaire (FFQ). Intake data were used to calculate median calcium intakes from diet, from supplements, and combined, and to compare these values with currently accepted requirement levels. RESULTS Forty-two percent of the pregnant women had a total calcium intake below the estimated average requirement of 800 mg/day. Median (interquartile range) calcium intake was 886 (611-1213) mg/day. Calcium or multivitamin supplements were used by 64.8% of the women at 8 weeks of gestation, with a median calcium content of 120.0 (60.0-200.0) mg/day. Prenatal vitamins were the most often used supplements (60.6%). CONCLUSIONS Forty-two percent of Dutch pregnant women have an inadequate calcium intake. Supplements are frequently used, but most do not contain sufficient amounts to correct this inadequate intake.
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Affiliation(s)
- Jessica P M M Willemse
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Linda J E Meertens
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Hubertina C J Scheepers
- Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, PO 5800, 6202 AZ, Maastricht, The Netherlands
| | - Nina M J Achten
- Maastricht University, PO 616, 6200 MD, Maastricht, The Netherlands
| | - Simone J Eussen
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Martien C van Dongen
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Luc J M Smits
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands
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8
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Krzeczkowski JE, Boylan K, Arbuckle TE, Muckle G, Poliakova N, Séguin JR, Favotto LA, Savoy C, Amani B, Mortaji N, Van Lieshout RJ. Maternal Pregnancy Diet Quality Is Directly Associated with Autonomic Nervous System Function in 6-Month-Old Offspring. J Nutr 2020; 150:267-275. [PMID: 31573610 DOI: 10.1093/jn/nxz228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 08/15/2019] [Accepted: 08/28/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Many pregnant women are consuming diets of poor overall quality. Although many studies have linked poor prenatal diet quality to an increased risk of specific diseases in offspring, it is not known if exposure to poor prenatal diet affects core neurophysiological regulatory systems in offspring known to lie upstream of multiple diseases. OBJECTIVE We aimed to examine the association between prenatal diet quality and autonomic nervous system (ANS) function in infants at 6 mo of age. METHODS Data from 400 women (aged >18 y, with uncomplicated pregnancies) and their infants participating in the Maternal-Infant Research on Environmental Chemicals-Infant Development cohort were used to investigate links between prenatal diet quality and infant ANS function at 6 mo of age. Prenatal diet quality was assessed using the Healthy Eating Index (2010), calculated from a validated FFQ completed by women during the first trimester. Infant ANS function was measured using 2 assessments of heart rate variability (HRV) including root mean square of successive differences (RMSSD) and SD of N-N intervals (SDNN). Associations were analyzed before and after adjustment for socioeconomic status, maternal depression symptoms, maternal cardiometabolic dysfunction, breastfeeding, and prenatal smoking. RESULTS Poorer prenatal diet quality was associated with lower infant HRV assessed using RMSSD (B: 0.07; 95% CI: 0.01, 0.13; R2 = 0.013) and SDNN (B: 0.18; 95% CI: 0.02, 0.35; R2 = 0.011). These associations remained significant after adjustment for confounding variables [RMSSD: B: 0.09; 95% CI: 0.003, 0.18; squared semipartial correlation (sp2) = 0.14 and SDNN B: 0.24; 95% CI: 0.0, 0.49; sp2 = 0.13]. CONCLUSIONS In a large cohort study, poorer prenatal diet quality was associated with lower offspring HRV, a marker of decreased capacity of the ANS to respond adaptively to challenge. Therefore, poor prenatal diet may play a significant role in the programming of multiple organ systems and could increase general susceptibility to disease in offspring.
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Affiliation(s)
- John E Krzeczkowski
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Khrista Boylan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Tye E Arbuckle
- Population Studies Division, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario, Canada
| | - Gina Muckle
- School of Psychology, Université Laval, Quebec City, Quebec, Canada.,Research Centre of CHU de Québec-Université Laval, Quebec City, Quebec, Canada
| | - Natalia Poliakova
- Population Health and Optimal Health Practices Research Branch, CHU de Québec Research Centre, Quebec City, Quebec, Canada
| | - Jean R Séguin
- Department of Psychiatry and Addiction, CHU Ste-Justine Research Centre, Montreal, Quebec, Canada
| | - Lindsay A Favotto
- Department of Health Research Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Calan Savoy
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Bahar Amani
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Neda Mortaji
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Department of Health Research Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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9
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Moore CJ, Perreault M, Mottola MF, Atkinson SA. Diet in Early Pregnancy: Focus on Folate, Vitamin B12, Vitamin D, and Choline. CAN J DIET PRACT RES 2019; 81:58-65. [PMID: 31512510 DOI: 10.3148/cjdpr-2019-025] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: Prenatal multivitamins are recommended in pregnancy. This study assessed food and supplement intakes of folate, vitamin B12 (B12), vitamin D, and choline in pregnant women living in Southern Ontario in comparison with current recommendations. Methods: Women recruited to the Be Healthy in Pregnancy RCT (NCT01693510) completed 3-day diet/supplement records at 12-17 weeks gestation. Intakes of folate, B12, vitamin D, and choline were quantified and compared with recommendations for pregnant women. Results: Folate intake (median (min, max)) was 1963 μg/day dietary folate equivalents (153, 10 846); 90% of women met the Estimated Average Requirement (EAR) but 77% exceeded the Tolerable Upper Intake Level (UL) (n = 232). B12 intake was 12.1 μg/day (0.3, 2336); 96% of women met the EAR with 7% exceeding the EAR 100-fold (n = 232). Vitamin D intake was 564 IU/day (0.0, 11 062); 83% met the EAR, whereas 1.7% exceeded the UL (n = 232). Choline intake was 338 mg/day (120, 1016); only 18% met the Adequate Intake and none exceeded the UL (n = 158). Conclusion: To meet the nutrient requirements of pregnancy many women rely on prenatal vitamins. Reformulating prenatal multivitamin supplements to provide doses of vitamins within recommendations to complement a balanced healthy diet would ensure appropriate micronutrient intakes for pregnant women.
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10
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Cormick G, Betrán AP, Romero IB, Lombardo CF, Gülmezoglu AM, Ciapponi A, Belizán JM. Global inequities in dietary calcium intake during pregnancy: a systematic review and meta-analysis. BJOG 2019; 126:444-456. [PMID: 30347499 PMCID: PMC6518872 DOI: 10.1111/1471-0528.15512] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Evidence shows that adequate calcium intake during pregnancy reduces the risk of hypertensive disorders of pregnancy. In most low- and middle-income countries (LMICs) the daily calcium intake is well below recommendations. Mapping calcium intake during pregnancy worldwide and identifying populations with low calcium intake will provide the evidence base for more targeted actions to improve calcium intake. OBJECTIVE To assess dietary calcium intake during pregnancy worldwide. SEARCH STRATEGY MEDLINE and EMBASE (from July 2004 to November 2017). SELECTION CRITERIA Cross-sectional, cohort, and intervention studies reporting calcium intake during pregnancy. DATA COLLECTION AND ANALYSIS Five reviewers working in pairs independently performed screening, extraction, and quality assessment. We reported summary measures of calcium intake and calculated the weighted arithmetic mean for high-income countries (HICs) and LMICs independently, and for geographic regions, among studies reporting country of recruitment, mean intake, and total number of participants. When available, inadequate intakes were reported. MAIN RESULTS From 1880 citations 105 works met the inclusion criteria, providing data for 73 958 women in 37 countries. The mean calcium intake was 948.3 mg/day (95% CI 872.1-1024.4 mg/day) for HICs and 647.6 mg/day (95% CI 568.7-726.5 mg/day) for LMICs. Calcium intakes below 800 mg/day were reported in five (29%) countries from HICs and in 14 (82%) countries from LMICs. CONCLUSION These results are consistent with a lack of improvement in calcium dietary intake during pregnancy and confirm the gap between HICs and LMICs, with alarmingly low intakes recorded for pregnant women in LMICs. From the public health perspective, in the absence of specific local data, calcium supplementation of pregnant women in these countries should be universal. TWEETABLE ABSTRACT Despite dietary recommendations, women in LMICs face pregnancy with diets low in calcium.
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Affiliation(s)
- G Cormick
- Department of Mother and Child Health ResearchInstitute for Clinical Effectiveness and Health Policy (IECS‐CONICET)Buenos AiresArgentina
- Department of Human BiologyFaculty of Health SciencesUniversity of Cape TownCape TownSouth Africa
| | - AP Betrán
- Department of Reproductive Health and ResearchWorld Health OrganizationHRP – UNDP, UNFPA, UNICEF, WHO, World Bank Special Programme of Research, Development and Research Training in Human ReproductionGenevaSwitzerland
| | - IB Romero
- Departamento de SaludUniversidad Nacional de la MatanzaSan JustoArgentina
| | - CF Lombardo
- Departamento de SaludUniversidad Nacional de la MatanzaSan JustoArgentina
| | - AM Gülmezoglu
- Department of Reproductive Health and ResearchWorld Health OrganizationHRP – UNDP, UNFPA, UNICEF, WHO, World Bank Special Programme of Research, Development and Research Training in Human ReproductionGenevaSwitzerland
| | - A Ciapponi
- Department of Mother and Child Health ResearchInstitute for Clinical Effectiveness and Health Policy (IECS‐CONICET)Buenos AiresArgentina
| | - JM Belizán
- Department of Mother and Child Health ResearchInstitute for Clinical Effectiveness and Health Policy (IECS‐CONICET)Buenos AiresArgentina
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11
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Perreault M, Moore CJ, Fusch G, Teo KK, Atkinson SA. Factors Associated with Serum 25-Hydroxyvitamin D Concentration in Two Cohorts of Pregnant Women in Southern Ontario, Canada. Nutrients 2019; 11:nu11010123. [PMID: 30634435 PMCID: PMC6356629 DOI: 10.3390/nu11010123] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/05/2019] [Accepted: 01/06/2019] [Indexed: 12/31/2022] Open
Abstract
Vitamin D deficiency in pregnancy is widely reported, but whether this applies in North America is unclear since no population-based surveys of vitamin D status in pregnancy exist in Canada or the United States. The objectives were to assess (i) the intake and sources of vitamin D, (ii) vitamin D status, and (iii) factors associated with serum 25-hydroxyvitamin D (25-OHD) concentration in two cohorts of pregnant women from Southern Ontario, Canada, studied over a span of 14 years. Maternal characteristics, physical measurements, fasting blood samples and nutrient intake were obtained at enrolment in 332 pregnant women from the Family Atherosclerosis Monitoring In early Life (FAMILY) study and 191 from the Be Healthy in Pregnancy (BHIP) study. Serum 25-OHD was measured by LC/MS-MS. The median (Q1, Q3) total vitamin D intake was 383 IU/day (327, 551) in the FAMILY study and 554 IU/day (437, 796) in the BHIP study. Supplemental vitamin D represented 64% of total intake in participants in FAMILY and 78% in BHIP. The mean (SD) serum 25-OHD was 76.5 (32.9) nmol/L in FAMILY and 79.7 (22.3) nmol/L in BHIP. Being of European descent and blood sampling in the summer season were significantly associated with a higher maternal serum 25-OHD concentration. In summary, health care practitioners should be aware that vitamin D status is sufficient in the majority of pregnant Canadian women of European ancestry, likely due to sun exposure.
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Affiliation(s)
- Maude Perreault
- Department of Pediatrics, McMaster University, Hamilton, L8S 4L8, Canada.
| | - Caroline J Moore
- Department of Pediatrics, McMaster University, Hamilton, L8S 4L8, Canada.
| | - Gerhard Fusch
- Department of Pediatrics, McMaster University, Hamilton, L8S 4L8, Canada.
| | - Koon K Teo
- Department of Medicine (Cardiology), McMaster University, Hamilton, L8S 4L8, Canada.
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12
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Sotunde OF, Laliberte A, Weiler HA. Maternal risk factors and newborn infant vitamin D status: a scoping literature review. Nutr Res 2018; 63:1-20. [PMID: 30824393 DOI: 10.1016/j.nutres.2018.11.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 11/19/2018] [Accepted: 11/30/2018] [Indexed: 01/20/2023]
Abstract
Low vitamin D (VitD) status is common among newborn infants, more so in temperate latitudes with evidence that maternal VitD deficiency is a major risk factor given that the neonate relies solely on maternal-fetal transfer of VitD. This scoping review was conducted to provide an overview of the latest evidence from studies regarding the impact of maternal risk factors on infant 25-hydryoxyvitamin D [25(OH)D] concentrations with a focus on studies in Canada and the United States. Several maternal risk factors that contribute to low maternal-fetal 25(OH)D concentrations have been reported over many decades, but no clear pattern has been established for multiethnic populations. For example, darker skin pigmentation and ethnicity are common risk factors for low VitD status. Studies in predominantly white women showed that supplementation of VitD during pregnancy causes significant increases in maternal serum 25(OH)D which often improves cord serum 25(OH)D values. In addition, VitD recommendations by health care professionals and adherence to supplementation by pregnant women appear to positively influence maternal and infant 25(OH)D concentrations. Conversely, winter season, obesity, lower socioeconomic status including lifestyle factors (smoking), and use of medication pose risk for lower maternal-fetal transfer of VitD. However, there is still a dearth of pertinent data on the relationship between some of the maternal risk factors and newborn 25(OH)D concentrations, for instance, relationships between gestational diabetes and neonatal VitD status. Additional research is required to determine if the same target for 25(OH)D concentrations applies for pregnant women, neonates, and infants.
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Affiliation(s)
- Olusola F Sotunde
- School of Human Nutrition, McGill University Ste Anne de Bellevue, Québec, Canada H9X 3V9.
| | - Alexandra Laliberte
- School of Human Nutrition, McGill University Ste Anne de Bellevue, Québec, Canada H9X 3V9.
| | - Hope A Weiler
- School of Human Nutrition, McGill University Ste Anne de Bellevue, Québec, Canada H9X 3V9.
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13
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Krzeczkowski JE, Boylan K, Arbuckle TE, Dodds L, Muckle G, Fraser W, Favotto LA, Van Lieshout RJ. Neurodevelopment in 3-4 year old children exposed to maternal hyperglycemia or adiposity in utero. Early Hum Dev 2018; 125:8-16. [PMID: 30149267 DOI: 10.1016/j.earlhumdev.2018.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/20/2018] [Accepted: 08/09/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Prenatal exposure to maternal metabolic complications has been linked to offspring neurodevelopmental problems. However, no studies investigating these links have examined the role of maternal prenatal diet. AIMS To determine if prenatal exposure to maternal adiposity or hyperglycemia is associated with neurodevelopmental problems in 3-4 year old children, and if links persist following adjustment for confounding variables, including prenatal diet. METHOD 808 mother-child pairs from the Maternal-Infant Research on Environmental Chemicals-Child Development Plus cohort were used to examine associations between pre-pregnancy body mass index (BMI), hyperglycemia and offspring verbal, performance and full-scale IQ scores, as well as internalizing and externalizing problems. Associations were examined before and after adjustment for prenatal diet along with home environment, maternal depression, education and prenatal smoking. Semi-partial correlations were examined post-hoc to assess the impact of each confounder in the adjusted models. RESULTS In the unadjusted models, BMI and hyperglycemia predicted lower verbal and full-scale IQ. BMI was also linked to externalizing problems. However, associations were not significant after adjustment. In adjusted models, post-hoc analysis revealed that prenatal diet and home environment accounted for significant variance in verbal and full-scale IQ. The home environment and maternal depression accounted for significant variance in externalizing problems. CONCLUSION In the adjusted models, maternal metabolic complications were not associated with offspring neurodevelopment. Even while adjusting for well-known risk factors for adverse offspring cognition (home environment, maternal depression), we show for the first time that maternal prenatal diet is an important confounder of the links between maternal metabolic complications and offspring cognition.
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Affiliation(s)
- John E Krzeczkowski
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada.
| | - Khrista Boylan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Tye E Arbuckle
- Population Studies Division, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario, Canada
| | - Linda Dodds
- Perinatal Epidemiology Research Unit, IWK Health Center, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gina Muckle
- Faculty of Social Sciences, Laval University, Montreal, Quebec, Canada
| | - William Fraser
- Centre de Recherche du Centre Hospitalier, Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Lindsay A Favotto
- Department of Health Research, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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14
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Savard C, Lemieux S, Weisnagel SJ, Fontaine-Bisson B, Gagnon C, Robitaille J, Morisset AS. Trimester-Specific Dietary Intakes in a Sample of French-Canadian Pregnant Women in Comparison with National Nutritional Guidelines. Nutrients 2018; 10:E768. [PMID: 29899222 PMCID: PMC6024697 DOI: 10.3390/nu10060768] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 06/06/2018] [Accepted: 06/12/2018] [Indexed: 01/11/2023] Open
Abstract
Diet during pregnancy greatly impacts health outcomes. This study aims to measure changes in dietary intakes throughout trimesters and to assess pregnant women’s dietary intakes in comparison with current Canadian nutritional recommendations. Seventy-nine pregnant women were recruited and completed, within each trimester, three Web-based 24-h dietary recalls and one Web questionnaire on supplement use. Dietary intakes from food, with and without supplements, were compared to nutritional recommendations throughout pregnancy. Energy and macronutrient intakes remained stable throughout pregnancy. A majority of women exceeded their energy and protein requirements in the first trimester, and fat intakes as a percentage of energy intakes were above recommendations for more than half of the women in all trimesters. Supplement use increased dietary intakes of most vitamins and minerals, but 20% of women still had inadequate total vitamin D intakes and most women had excessive folic acid intakes. This study showed that pregnant women did not increase their energy intakes throughout pregnancy as recommended. Furthermore, although prenatal supplementation reduces the risk of inadequate intake for most micronutrients, there is still a risk of excessive folic acid and insufficient vitamin D intake, which needs further investigation.
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Affiliation(s)
- Claudia Savard
- School of Nutrition, Laval University, Québec City, QC G1V 0A6, Canada.
- Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada.
- Institute of Nutrition and Functional Foods, Laval University, Québec City, QC G1V 0A6, Canada.
| | - Simone Lemieux
- School of Nutrition, Laval University, Québec City, QC G1V 0A6, Canada.
- Institute of Nutrition and Functional Foods, Laval University, Québec City, QC G1V 0A6, Canada.
| | - S John Weisnagel
- Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada.
- Department of Medicine, Laval University, Québec City, QC G1V 0A6, Canada.
| | - Bénédicte Fontaine-Bisson
- School of Nutrition Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada.
- Institut du Savoir Montfort, Montfort Hospital, Ottawa, ON K1K 0T2, Canada.
| | - Claudia Gagnon
- Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada.
- Institute of Nutrition and Functional Foods, Laval University, Québec City, QC G1V 0A6, Canada.
- Department of Medicine, Laval University, Québec City, QC G1V 0A6, Canada.
| | - Julie Robitaille
- School of Nutrition, Laval University, Québec City, QC G1V 0A6, Canada.
- Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada.
- Institute of Nutrition and Functional Foods, Laval University, Québec City, QC G1V 0A6, Canada.
| | - Anne-Sophie Morisset
- School of Nutrition, Laval University, Québec City, QC G1V 0A6, Canada.
- Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada.
- Institute of Nutrition and Functional Foods, Laval University, Québec City, QC G1V 0A6, Canada.
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15
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Kocyłowski R, Lewicka I, Grzesiak M, Gaj Z, Sobańska A, Poznaniak J, von Kaisenberg C, Suliburska J. Assessment of dietary intake and mineral status in pregnant women. Arch Gynecol Obstet 2018. [PMID: 29541858 PMCID: PMC5945726 DOI: 10.1007/s00404-018-4744-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Purpose To evaluate the dietary intake of pregnant women and their nutritional status of Ca, Mg, Fe, Zn, and Cu, as the nutritional status of pregnant women is an important factor for the proper progression of a pregnancy and the development and health of the foetus. Methods The study was conducted on 108 pregnant women ages 18–42, at 6–32 weeks of gestation. We used a questionnaire and a 24-h recall nutrition interview. Hair samples were taken for testing and the level of each mineral was assessed using atomic absorption spectrometry. The results were analysed using the Dietetyk and Statistica 10 software. Results Low levels of Fe, Zn, Ca, Mg, vitamin D, and folic acid intake were seen in the pregnant women, with the use of dietary supplements significantly increasing their intake of Fe, Zn, and folic acid. The concentration of zinc and magnesium in the women’s hair was shown to be affected by their age and, in the case of magnesium, by the week of pregnancy. Conclusions It was observed that the diet of pregnant women is characterised by low levels of Fe, Zn, Ca, Mg, vitamin D, and folic acid. Dietary supplementation with vitamins and minerals significantly increases the daily Fe and folic acid intake in pregnant women. The concentration of Zn and Mg in hair depends on the age of pregnant women and Mg level in the hair of women decreases during pregnancy.
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Affiliation(s)
- Rafał Kocyłowski
- Department of Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.,PreMediCare New Med Medical Centre, Poznan, Poland
| | - Iwona Lewicka
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, ul. Wojska Polskiego 31, 60-624, Poznan, Poland
| | - Mariusz Grzesiak
- Department of Gynecology and Obstetrics, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Zuzanna Gaj
- Department of Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.,Scientific Laboratory of the Center of Medical Laboratory Diagnostics and Screening, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland
| | - Anna Sobańska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, ul. Wojska Polskiego 31, 60-624, Poznan, Poland
| | - Joanna Poznaniak
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, ul. Wojska Polskiego 31, 60-624, Poznan, Poland
| | - Constantin von Kaisenberg
- Department of Obstetrics, Gynecology and Reproductive Medicine, Hannover Medical School, Hannover, Germany
| | - Joanna Suliburska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, ul. Wojska Polskiego 31, 60-624, Poznan, Poland.
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16
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Page R, Robichaud A, Arbuckle TE, Fraser WD, MacFarlane AJ. Total folate and unmetabolized folic acid in the breast milk of a cross-section of Canadian women. Am J Clin Nutr 2017; 105:1101-1109. [PMID: 28298392 DOI: 10.3945/ajcn.116.137968] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 02/16/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Folate requirements increase during pregnancy and lactation. It is recommended that women who could become pregnant, are pregnant, or are lactating consume a folic acid (FA)-containing supplement.Objectives: We sought to determine breast-milk total folate and unmetabolized folic acid (UMFA) contents and their relation with FA-supplement use and doses in a cohort of Canadian mothers who were enrolled in the MIREC (Maternal-Infant Research on Environmental Chemicals) study.Design: Breast-milk tetrahydrofolate (THF), 5-methyl-THF, 5-formyl-THF, 5,10-methenyl-THF, and UMFA were measured with the use of liquid chromatography-tandem mass spectrometry (n = 561). Total daily supplemental FA intake was based on self-reported FA-supplement use.Results: UMFA was detectable in the milk of 96.1% of the women. Total daily FA intake from supplements was associated with breast folate concentration and species. Breast-milk total folate was 18% higher (P < 0.001) in supplement users (n = 401) than in nonusers (n = 160), a difference driven by women consuming >400 μg FA/d (P ≤ 0.004). 5-Methyl-THF was 19% lower (P < 0.001) and UMFA was 126% higher (P < 0.001) in supplement users than in nonusers. Women who consumed >400 μg FA/d had proportionally lower 5-methyl-THF and higher UMFA than did women who consumed ≤400 μg FA/d.Conclusions: FA-supplement use was associated with modestly higher breast-milk total folate. Detectable breast-milk UMFA was nearly ubiquitous, including in women who did not consume an FA supplement. Breast-milk UMFA was proportionally higher than 5-methyl-THF in women who consumed >400 μg FA/d, thereby suggesting that higher doses exceed the physiologic capacity to metabolize FA and result in the preferential uptake of FA in breast milk. Therefore, FA-supplement doses >400 μg may not be warranted, especially in populations for whom FA fortification is mandatory.
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Affiliation(s)
- Rachael Page
- Nutrition Research Division.,Department of Biology, Carleton University, Ottawa, Ontario, Canada; and
| | | | - Tye E Arbuckle
- Population Studies Division, Health Canada, Ottawa, Ontario, Canada
| | - William D Fraser
- Sainte-Justine University Hospital Research Center, University of Montreal, Montreal, Quebec, Canada
| | - Amanda J MacFarlane
- Nutrition Research Division, .,Department of Biology, Carleton University, Ottawa, Ontario, Canada; and
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17
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Arbuckle TE, Liang CL, Morisset AS, Fisher M, Weiler H, Cirtiu CM, Legrand M, Davis K, Ettinger AS, Fraser WD. Maternal and fetal exposure to cadmium, lead, manganese and mercury: The MIREC study. CHEMOSPHERE 2016; 163:270-282. [PMID: 27540762 DOI: 10.1016/j.chemosphere.2016.08.023] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 07/25/2016] [Accepted: 08/03/2016] [Indexed: 05/21/2023]
Abstract
Given the susceptibility of the fetus to toxicants, it is important to estimate their exposure. Approximately 2000 pregnant women were recruited in 2008-2011 from 10 cities across Canada. Cd, Pb, Mn and total Hg were measured in maternal blood from the 1st and 3rd trimesters, umbilical cord blood, and infant meconium. Nutrient intakes of vitamin D, iron, and calcium (Ca) were assessed using a food frequency questionnaire and a dietary supplement questionnaire. Median concentrations in 1st trimester maternal blood (n = 1938) were 0.20, 8.79 and 0.70 μg/L for Cd, Mn and Hg, respectively, and 0.60 μg/dL for Pb. While the median difference between the paired 1st and 3rd trimester concentrations of Cd was 0, there was a significant decrease in Pb (0.04 μg/dL) and Hg (0.12 μg/L) and an increase in Mn (3.30 μg/L) concentrations over the course of the pregnancy. While Cd was rarely detected in cord blood (19%) or meconium (3%), median Pb (0.77 μg/dL), Mn (31.87 μg/L) and Hg (0.80 μg/L) concentrations in cord blood were significantly higher than in maternal blood. Significant negative associations were observed between estimated Ca intake and maternal Cd, Pb, Mn and Hg, as well as cord blood Pb. Vitamin D intake was associated with lower maternal Cd, Pb, and Mn as well as Pb in cord blood. Even at current metal exposure levels, increasing dietary Ca and vitamin D intake during pregnancy may be associated with lower maternal blood Pb and Cd concentrations and lower Pb in cord blood.
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Affiliation(s)
- Tye E Arbuckle
- Population Studies Division, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada.
| | - Chun Lei Liang
- Population Studies Division, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada
| | - Anne-Sophie Morisset
- Centre de recherche du centre hospitalier universitaire de sherbrooke, Sherbrooke, QC, Canada; Sainte Justine University Hospital Research Center, University of Montreal, Montreal, QC, Canada
| | - Mandy Fisher
- Population Studies Division, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada
| | - Hope Weiler
- School of Dietetics and Human Nutrition, McGill University, Montreal, QC, Canada
| | - Ciprian Mihai Cirtiu
- Centre de toxicologie du Québec, Institut national de santé publique Québec, Quebec, QC, Canada
| | - Melissa Legrand
- Chemicals Surveillance Division, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada
| | - Karelyn Davis
- Population Studies Division, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada
| | - Adrienne S Ettinger
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - William D Fraser
- Centre de recherche du centre hospitalier universitaire de sherbrooke, Sherbrooke, QC, Canada; Sainte Justine University Hospital Research Center, University of Montreal, Montreal, QC, Canada
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