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Perichart-Perera O, Reyes-Muñoz E, Borboa-Olivares H, Rodríguez-Cano AM, Solis Paredes JM, Hernández-Hernández L, Rodríguez-Hernández C, González-Ludlow I, Suárez-Rico BV, Sánchez-Martínez M, Torres-Herrera U, Canul-Euan AA, Tolentino-Dolores M, Espejel-Nuñez A, Estrada-Gutierrez G. Optimizing perinatal wellbeing in pregnancy with obesity: a clinical trial with a multi-component nutrition intervention for prevention of gestational diabetes and infant growth and neurodevelopment impairment. Front Med (Lausanne) 2024; 11:1339428. [PMID: 38681052 PMCID: PMC11045894 DOI: 10.3389/fmed.2024.1339428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/18/2024] [Indexed: 05/01/2024] Open
Abstract
Pregnancy complicated by obesity represents an increased risk of unfavorable perinatal outcomes such as gestational diabetes mellitus (GDM), hypertensive disorders in pregnancy, preterm birth, and impaired fetal growth, among others. Obesity is associated with deficiencies of micronutrients, and pregnant women with obesity may have higher needs. The intrauterine environment in pregnancies complicated with obesity is characterized by inflammation and oxidative stress, where maternal nutrition and metabolic status have significant influence and are critical in maternal health and in fetal programming of health in the offspring later in life. Comprehensive lifestyle interventions, including intensive nutrition care, are associated with a lower risk of adverse perinatal outcomes. Routine supplementation during pregnancy includes folic acid and iron; other nutrient supplementation is recommended for high-risk women or women in low-middle income countries. This study is an open label randomized clinical trial of parallel groups (UMIN Clinical Trials Registry: UMIN000052753, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000060194) to evaluate the effect of an intensive nutrition therapy and nutrient supplementation intervention (folic acid, iron, vitamin D, omega 3 fatty acids, myo-inositol and micronutrients) in pregnant women with obesity on the prevention of GDM, other perinatal outcomes, maternal and newborn nutritional status, and infant growth, adiposity, and neurodevelopment compared to usual care. Given the absence of established nutritional guidelines for managing obesity during pregnancy, there is a pressing need to develop and implement new nutritional programs to enhance perinatal outcomes.
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Affiliation(s)
- Otilia Perichart-Perera
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Enrique Reyes-Muñoz
- Gynecological and Perinatal Endocrinology Coordination, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Hector Borboa-Olivares
- Community Interventions Research Branch, Instituto Nacional de Perinatología, Mexico City, Mexico
| | | | - Juan Mario Solis Paredes
- Department of Research in Reproductive and Perinatal Health, Instituto Nacional de Perinatología, Mexico City, Mexico
| | | | | | - Isabel González-Ludlow
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City, Mexico
| | | | | | | | | | | | - Aurora Espejel-Nuñez
- Department of Immunobiochemistry, Instituto Nacional de Perinatología, Mexico City, Mexico
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Perichart-Perera O, Rodríguez-Cano AM, González-Ludlow I, Rodríguez-Hernández C, Suárez-Rico B, Reyes-Muñoz E, Villalobos-Alcázar G, Estrada-Gutierrez G. Gestational diabetes mellitus and size at birth modify early adiposity accretion. Evidence from the OBESO cohort. Diabetes Res Clin Pract 2023; 203:110889. [PMID: 37633339 DOI: 10.1016/j.diabres.2023.110889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 08/28/2023]
Abstract
AIM To evaluate the association between maternal obesity, gestational diabetes (GDM), and birth size with infant fat-mass (FM) accretion from 1 to 6 months (M). METHODS Healthy pregnant women and their term babies from the OBESO cohort were studied (1 M-3 M, n = 122; 1 M-6 M, n = 90). Registered maternal data was: pregestational body-mass-index (preBMI), GDM (2hOGTT), medications, gestational weight gain. Macrosomia (>4000 g), large/small for gestational age (LGA/SGA)(weight/age > 90° and < 90°, respectively-WHO) were recorded at birth. Infant FM (air-displacement plethysmography) was measured (1 M, 3 M, 6 M) and FM accretion computed (ΔkgFM from 1 M-3 M and 1 M-6 M). Exclusive breastfeeding (EBF) was assessed. Adjusted-multiple linear regression models were performed. RESULTS PreBMI was 27.4 ± 5.2 kg/m2. GDM was present in9%(n = 11) of women; 12.3%(n = 15) of them received metformin/insulin. One newborn was LGA; 20.7%(n = 25) were SGA. From 1 M-3 M, SGA was a predictor of higher FM accretion (B:0.28, 95%CI:0.14-0.43); GDM was not associated. From 1 M-6 M, higher FM accretion was observed in SGA newborns (B:0.43, 95%CI:0.19-0.67) and GDM infants (B:0.48, 95%CI:0.06-0.89). In all models (R2 ≥ 0.48, p < 0.001), infant weight and being female were positively associated, while maternal obesity, metformin/insulin, and EBF were not. CONCLUSIONS GDM appears to program early higher adiposity accretion, independently of excessive fetal growth. SGA was associated with higher FM accretion in early infancy.
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Affiliation(s)
- Otilia Perichart-Perera
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000 Ciudad de México, Mexico
| | - Ameyalli M Rodríguez-Cano
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000 Ciudad de México, Mexico.
| | - Isabel González-Ludlow
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000 Ciudad de México, Mexico
| | - Carolina Rodríguez-Hernández
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000 Ciudad de México, Mexico
| | - Blanca Suárez-Rico
- Community Interventions Research Branch, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000 Ciudad de México, Mexico
| | - Enrique Reyes-Muñoz
- Gynecological and Perinatal Endocrinology Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000 Ciudad de México, Mexico
| | - Gicela Villalobos-Alcázar
- Neonatal Ward, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000 Ciudad de México, Mexico
| | - Guadalupe Estrada-Gutierrez
- Research Division, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000 Ciudad de México, Mexico
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Rodríguez-Cano AM, Piña-Ramírez O, Rodríguez-Hernández C, Mier-Cabrera J, Villalobos-Alcazar G, Estrada-Gutierrez G, Cardona-Pérez A, Coronado-Zarco A, Perichart-Perera O. Development and validation of anthropometric-based fat-mass prediction equations using air displacement plethysmography in Mexican infants. Eur J Clin Nutr 2023; 77:748-756. [PMID: 37055482 PMCID: PMC10335931 DOI: 10.1038/s41430-023-01285-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND/OBJECTIVES Fat-mass (FM) assessment since birth using valid methodologies is crucial since excessive adiposity represents a risk factor for adverse metabolic outcomes. AIM To develop infant FM prediction equations using anthropometry and validate them against air-displacement plethysmography (ADP). SUBJECTS/METHODS Clinical, anthropometric (weight, length, body-mass index -BMI-, circumferences, and skinfolds), and FM (ADP) data were collected from healthy-term infants at 1 (n = 133), 3 (n = 105), and 6 (n = 101) months enrolled in the OBESO perinatal cohort (Mexico City). FM prediction models were developed in 3 steps: 1) Variable Selection (LASSO regression), 2) Model behavior evaluation (12-fold cross-validation, using Theil-Sen regressions), and 3) Final model evaluation (Bland-Altman plots, Deming regression). RESULTS Relevant variables in the FM prediction models included BMI, circumferences (waist, thigh, and calf), and skinfolds (waist, triceps, subscapular, thigh, and calf). The R2 of each model was 1 M: 0.54, 3 M: 0.69, 6 M: 0.63. Predicted FM showed high correlation values (r ≥ 0.73, p < 0.001) with FM measured with ADP. There were no significant differences between predicted vs measured FM (1 M: 0.62 vs 0.6; 3 M: 1.2 vs 1.35; 6 M: 1.65 vs 1.76 kg; p > 0.05). Bias were: 1 M -0.021 (95%CI: -0.050 to 0.008), 3 M: 0.014 (95%CI: 0.090-0.195), 6 M: 0.108 (95%CI: 0.046-0.169). CONCLUSION Anthropometry-based prediction equations are inexpensive and represent a more accessible method to estimate body composition. The proposed equations are useful for evaluating FM in Mexican infants.
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Affiliation(s)
- Ameyalli M Rodríguez-Cano
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México
| | - Omar Piña-Ramírez
- Bioinformatics and Statistical Analysis Department, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México
| | - Carolina Rodríguez-Hernández
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México
| | - Jennifer Mier-Cabrera
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México
| | - Gicela Villalobos-Alcazar
- Neonatal Ward, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México
| | - Guadalupe Estrada-Gutierrez
- Research Division, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México
| | - Arturo Cardona-Pérez
- General Director, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México
| | - Alejandra Coronado-Zarco
- Neonatology Division, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México
| | - Otilia Perichart-Perera
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, CP 11000, Ciudad de México, México.
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Rodríguez-Cano AM, González-Ludlow I, Suárez-Rico BV, Montoya-Estrada A, Piña-Ramírez O, Parra-Hernández SB, Reyes-Muñoz E, Estrada-Gutierrez G, Calzada-Mendoza CC, Perichart-Perera O. Ultra-Processed Food Consumption during Pregnancy and Its Association with Maternal Oxidative Stress Markers. Antioxidants (Basel) 2022; 11:antiox11071415. [PMID: 35883909 PMCID: PMC9312096 DOI: 10.3390/antiox11071415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/15/2022] [Accepted: 07/20/2022] [Indexed: 02/04/2023] Open
Abstract
Ultra-processed food (UPF) consumption during gestation may lead to increased oxidative stress (OS) and could affect pregnancy outcomes. This study aims to evaluate the association of UPF consumption during pregnancy with circulating levels of OS markers. Diet was assessed (average of three assessments) in 119 pregnant women enrolled in the OBESO perinatal cohort (Mexico), obtaining quantitative data and the percentage of energy that UPFs (NOVA) contributed to the total diet. Sociodemographic, clinical (pregestational body-mass index and gestational weight gain) and lifestyle data were collected. Maternal circulating levels of OS markers (malondialdehyde (MDA), protein carbonylation (PC), and total antioxidant capacity (TAC)) were determined at the third trimester of pregnancy. Adjusted linear regression models were performed to analyze the association between UPFs and OS markers. UPFs represented 27.99% of the total energy intake. Women with a lower UPF consumption (<75 percentile°) presented a higher intake of fiber, ω-3, ω-6, and a lower ω-6/3 ratio. Linear regression models showed that UPFs were inversely associated with TAC and MDA. Fiber intake was associated with PC. UPF intake during pregnancy may result in an increase in oxidative stress. When providing nutrition care, limiting or avoiding UPFs may be an intervention strategy that could promote a better antioxidant capacity in the body.
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Affiliation(s)
- Ameyalli M. Rodríguez-Cano
- Section for Postgraduate Studies and Research, Higher School of Medicine, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón s/n, Casco de Santo Tomas, Miguel Hidalgo, Mexico City 11340, Mexico; (A.M.R.-C.); (C.C.C.-M.)
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Montes Urales 800, Lomas de Virreyes, Miguel Hidalgo, Mexico City 11000, Mexico;
| | - Isabel González-Ludlow
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Montes Urales 800, Lomas de Virreyes, Miguel Hidalgo, Mexico City 11000, Mexico;
| | - Blanca V. Suárez-Rico
- Community Interventions Research Branch, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Montes Urales 800, Lomas de Virreyes, Miguel Hidalgo, Mexico City 11000, Mexico;
| | - Araceli Montoya-Estrada
- Gynecological and Perinatal Endocrinology Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Montes Urales 800, Lomas de Virreyes, Miguel Hidalgo, Mexico City 11000, Mexico; (A.M.-E.); (E.R.-M.)
| | - Omar Piña-Ramírez
- Bioinformatics and Statistical Analysis Department, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Montes Urales 800, Lomas de Virreyes, Miguel Hidalgo, Mexico City 11000, Mexico;
| | - Sandra B. Parra-Hernández
- Immunobiochemistry Department, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Montes Urales 800, Lomas de Virreyes, Miguel Hidalgo, Mexico City 11000, Mexico;
| | - Enrique Reyes-Muñoz
- Gynecological and Perinatal Endocrinology Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Montes Urales 800, Lomas de Virreyes, Miguel Hidalgo, Mexico City 11000, Mexico; (A.M.-E.); (E.R.-M.)
| | - Guadalupe Estrada-Gutierrez
- Research Division, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Montes Urales 800, Lomas de Virreyes, Miguel Hidalgo, Mexico City 11000, Mexico;
| | - Claudia C. Calzada-Mendoza
- Section for Postgraduate Studies and Research, Higher School of Medicine, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón s/n, Casco de Santo Tomas, Miguel Hidalgo, Mexico City 11340, Mexico; (A.M.R.-C.); (C.C.C.-M.)
| | - Otilia Perichart-Perera
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Montes Urales 800, Lomas de Virreyes, Miguel Hidalgo, Mexico City 11000, Mexico;
- Correspondence:
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Reyes-López MA, González-Leyva CP, Rodríguez-Cano AM, Rodríguez-Hernández C, Colin-Ramírez E, Estrada-Gutierrez G, Muñoz-Manrique CG, Perichart-Perera O. Diet Quality Is Associated with a High Newborn Size and Reduction in the Risk of Low Birth Weight and Small for Gestational Age in a Group of Mexican Pregnant Women: An Observational Study. Nutrients 2021; 13:nu13061853. [PMID: 34071717 PMCID: PMC8227044 DOI: 10.3390/nu13061853] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/04/2021] [Accepted: 05/24/2021] [Indexed: 01/21/2023] Open
Abstract
A high-quality diet during pregnancy may have positive effects on fetal growth and nutritional status at birth, and it may modify the risk of developing chronic diseases later in life. The aim of this study was to evaluate the association between diet quality and newborn nutritional status in a group of pregnant Mexican women. As part of the ongoing Mexican prospective cohort study, OBESO, we studied 226 healthy pregnant women. We adapted the Alternated Healthy Eating Index-2010 for pregnancy (AHEI-10P). The association between maternal diet and newborn nutritional status was investigated by multiple linear regression and logistic regression models. We applied three 24-h recalls during the second half of gestation. As the AHEI-10P score improved by 5 units, the birth weight and length increased (β = 74.8 ± 35.0 g and β = 0.3 ± 0.4 cm, respectively, p < 0.05). Similarly, the risk of low birth weight (LBW) and small for gestational age (SGA) decreased (OR: 0.47, 95%CI: 0.27–0.82 and OR: 0.55, 95%CI: 0.36–0.85, respectively). In women without preeclampsia and/or GDM, the risk of stunting decreased as the diet quality score increased (+5 units) (OR: 0.62, 95%IC: 0.40–0.96). A high-quality diet during pregnancy was associated with a higher newborn size and a reduced risk of LBW and SGA in this group of pregnant Mexican women.
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Affiliation(s)
- María A. Reyes-López
- Nutrition and Bioprogramming Coordination, National Institute of Perinatology Nacional de Perinatología, Montes Urales 800, Lomas de Virreyes, Mexico City 11000, Mexico; (M.A.R.-L.); (C.P.G.-L.); (A.M.R.-C.); (C.R.-H.); (C.G.M.-M.)
| | - Carla P. González-Leyva
- Nutrition and Bioprogramming Coordination, National Institute of Perinatology Nacional de Perinatología, Montes Urales 800, Lomas de Virreyes, Mexico City 11000, Mexico; (M.A.R.-L.); (C.P.G.-L.); (A.M.R.-C.); (C.R.-H.); (C.G.M.-M.)
| | - Ameyalli M. Rodríguez-Cano
- Nutrition and Bioprogramming Coordination, National Institute of Perinatology Nacional de Perinatología, Montes Urales 800, Lomas de Virreyes, Mexico City 11000, Mexico; (M.A.R.-L.); (C.P.G.-L.); (A.M.R.-C.); (C.R.-H.); (C.G.M.-M.)
| | - Carolina Rodríguez-Hernández
- Nutrition and Bioprogramming Coordination, National Institute of Perinatology Nacional de Perinatología, Montes Urales 800, Lomas de Virreyes, Mexico City 11000, Mexico; (M.A.R.-L.); (C.P.G.-L.); (A.M.R.-C.); (C.R.-H.); (C.G.M.-M.)
| | - Eloisa Colin-Ramírez
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2E1, Canada;
| | - Guadalupe Estrada-Gutierrez
- Research Direction National Institute of Perinatology, Montes Urales 800, Lomas de Virreyes, Mexico City 11000, Mexico;
| | - Cinthya G. Muñoz-Manrique
- Nutrition and Bioprogramming Coordination, National Institute of Perinatology Nacional de Perinatología, Montes Urales 800, Lomas de Virreyes, Mexico City 11000, Mexico; (M.A.R.-L.); (C.P.G.-L.); (A.M.R.-C.); (C.R.-H.); (C.G.M.-M.)
| | - Otilia Perichart-Perera
- Nutrition and Bioprogramming Coordination, National Institute of Perinatology Nacional de Perinatología, Montes Urales 800, Lomas de Virreyes, Mexico City 11000, Mexico; (M.A.R.-L.); (C.P.G.-L.); (A.M.R.-C.); (C.R.-H.); (C.G.M.-M.)
- Correspondence: ; Tel.: +52-55-55209900 (ext. 402/120)
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Rodríguez-Cano AM, Perichart-Perera O, Gutiérrez-Castrellón P. Importancia de la vitamina B12 y el folato en la salud perinatal. GAC MED MEX 2021; 156:S27-S36. [PMID: 33373350 DOI: 10.24875/gmm.m20000435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Fetal development is characterized by great plasticity and the ability to respond to environmental factors, where DNA methylation is essential for proper embryonic development. One-carbon metabolism provides methyl groups for methylation and fetal DNA development and is highly dependent on maternal nutritional status. During pregnancy, the supply of methyl donors is critical and the demand for nutrients that support this process, such as folate and vitamin B12, is increased. Insufficiency or imbalance of these 2 micronutrients can alter epigenetic patterns, DNA synthesis and repair, and affect fetal growth and development, having negative long-term consequences on the offspring's health. Folate and vitamin B12 status have been associated with wide DNA methylation, as well as with specific genes related to neurological functions, embryonic development, energy metabolism, growth, and leptin. Furthermore, inadequate concentrations of both vitamins have been associated with an increased risk of perinatal outcomes such as neural tube defects, prematurity, low birth weight, pre-eclampsia, as well as maternal and infant obesity and insulin resistance, and decreased infant neurocognitive development. Supplementation, combined with a healthy diet, could be an essential strategy to prevent these results and improve maternal and fetal health.
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Affiliation(s)
- Ameyalli M Rodríguez-Cano
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes. Ciudad de México, México
| | - Otilia Perichart-Perera
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes. Ciudad de México, México
| | - Pedro Gutiérrez-Castrellón
- Centro de Investigación Translacional en Ciencias de la Salud, Hospital General Dr. Manuel Gea González. Ciudad de México, México
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Perichart-Perera O, Rodríguez-Cano AM, Gutiérrez-Castrellón P. Importancia de la suplementación en el embarazo: papel de la suplementación con hierro, ácido fólico, calcio, vitamina D y multivitamínicos. GAC MED MEX 2021; 156:S1-S26. [PMID: 33373348 DOI: 10.24875/gmm.m20000434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Health promotion and disease prevention are essential components of prenatal care. Maternal nutrient insufficiencies could negatively impact the morbidity and mortality of the mother-fetus pair as well as the health of the next generations. Although a healthy diet is usually sufficient to meet the increased nutrient needs, supplementation is part of routine care to ensure a healthy pregnancy and optimal fetal development. Currently, iron and folic acid supplementation is the only globally accepted recommendation for all pregnant women. However, there are vulnerable groups of women who could benefit from complementary individualized supplementation schemes. Recently, relevant information has been published related to the supplementation of single and multiple micronutrients with significant effects on maternal and fetal health, which could have implications in the clinical practice of health professionals. This review presents scientific evidence and the recommendations of different entities on the supplementation of iron, folic acid, calcium, vitamin D and multiple micronutrient supplementation during pregnancy.
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Affiliation(s)
- Otilia Perichart-Perera
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes. Ciudad de México, México
| | - Ameyalli M Rodríguez-Cano
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes. Ciudad de México, México
| | - Pedro Gutiérrez-Castrellón
- Centro de Investigación Translacional en Ciencias de la Salud, Hospital General Dr. Manuel Gea González. Ciudad de México, México.,Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica. Ciudad de México, México
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Rodríguez-Cano AM, Calzada-Mendoza CC, Estrada-Gutierrez G, Mendoza-Ortega JA, Perichart-Perera O. Nutrients, Mitochondrial Function, and Perinatal Health. Nutrients 2020; 12:E2166. [PMID: 32708345 PMCID: PMC7401276 DOI: 10.3390/nu12072166] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/13/2020] [Accepted: 07/20/2020] [Indexed: 12/16/2022] Open
Abstract
Mitochondria are active independent organelles that not only meet the cellular energy requirement but also regulate central cellular activities. Mitochondria can play a critical role in physiological adaptations during pregnancy. Differences in mitochondrial function have been found between healthy and complicated pregnancies. Pregnancy signifies increased nutritional requirements to support fetal growth and the metabolism of maternal and fetal tissues. Nutrient availability regulates mitochondrial metabolism, where excessive macronutrient supply could lead to oxidative stress and contribute to mitochondrial dysfunction, while micronutrients are essential elements for optimal mitochondrial processes, as cofactors in energy metabolism and/or as antioxidants. Inadequate macronutrient and micronutrient consumption can result in adverse pregnancy outcomes, possibly through mitochondrial dysfunction, by impairing energy supply, one-carbon metabolism, biosynthetic pathways, and the availability of metabolic co-factors which modulate the epigenetic processes capable of establishing significant short- and long-term effects on infant health. Here, we review the importance of macronutrients and micronutrients on mitochondrial function and its influence on maternal and infant health.
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Affiliation(s)
- Ameyalli M Rodríguez-Cano
- Section for Postgraduate Studies and Research, Higher School of Medicine, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (A.M.R.-C.); (C.C.C.-M.)
- Nutrition and Bioprogramming Department, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Montes Urales 800, Lomas de Virreyes, Mexico City 11000, Mexico
| | - Claudia C Calzada-Mendoza
- Section for Postgraduate Studies and Research, Higher School of Medicine, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (A.M.R.-C.); (C.C.C.-M.)
| | - Guadalupe Estrada-Gutierrez
- Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Research Division; Montes Urales 800, Lomas de Virreyes, Mexico City 11000, Mexico;
| | - Jonatan A Mendoza-Ortega
- Immunobiochemistry Department, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Montes Urales 800, Lomas de Virreyes, Mexico City 11000, Mexico;
- Immunology Department, National School of Biological Sciences, Instituto Politécnico Nacional, Mexico City 11350, Mexico
| | - Otilia Perichart-Perera
- Nutrition and Bioprogramming Department, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Montes Urales 800, Lomas de Virreyes, Mexico City 11000, Mexico
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9
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Rodríguez-Cano AM, Mier-Cabrera J, Allegre-Dávalos AL, Muñoz-Manrique C, Perichart-Perera O. Higher fat mass and fat mass accretion during the first six months of life in exclusively breastfed infants. Pediatr Res 2020; 87:588-594. [PMID: 31434104 PMCID: PMC7033039 DOI: 10.1038/s41390-019-0542-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 04/16/2019] [Accepted: 07/25/2019] [Indexed: 12/03/2022]
Abstract
BACKGROUND Early nutrition influences infant growth and body composition, which may play a role in the infant's metabolic programming. Breastfed infants appear to have higher fat mass than formula-fed infants, but most comparisons have been cross-sectional, and evidence is scarce. The aim of this study was to describe fat mass and fat mass accretion during the first six months of life and evaluate differences by type of feeding (OMS). METHODS Prospective cohort of healthy pregnant women and their infants (Mexico City, 2009-2014). At 1 (T1), 3 (T2) and 6 (T3) months of age, fat mass (FM) (PEAPOD) and type of feeding (feeding questionnaire) were evaluated. RESULTS We included 109 healthy infants (mean ± SD age: 39 ± 1.1 weeks; birthweight: 2959 ± 294 g). Exclusive/predominant breastfed (EBF) infants had higher FM at T2 and T3 compared with non-EBF (%FM T3: 29.7 ± 5.9% vs 24.7 ± 5.6%, respectively) (p < 0.05). All infants increased their FM throughout time (p < 0.001). EBF infants showed a significant higher FM accretion (β: 3.61; 95% CI: 1.57-5.66, p < 0.01); the difference was maintained after controlling for confounding variables. CONCLUSIONS Exclusive/predominant breastfeeding promotes higher accretion of FM during the first six months of life which could have an important effect in the programming of health outcomes later in life.
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Affiliation(s)
- Ameyalli M Rodríguez-Cano
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Ciudad de México, Mexico
| | - Jennifer Mier-Cabrera
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Ciudad de México, Mexico
| | - Ana L Allegre-Dávalos
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Ciudad de México, Mexico
| | - Cinthya Muñoz-Manrique
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Ciudad de México, Mexico
| | - Otilia Perichart-Perera
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Ciudad de México, Mexico.
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10
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Rodríguez-Cano AM, Mier-Cabrera J, Muñoz-Manrique C, Cardona-Pérez A, Villalobos-Alcázar G, Perichart-Perera O. Anthropometric and clinical correlates of fat mass in healthy term infants at 6 months of age. BMC Pediatr 2019; 19:60. [PMID: 30777039 PMCID: PMC6378706 DOI: 10.1186/s12887-019-1430-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 02/11/2019] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Body composition in infancy plays a central role in the programming of metabolic diseases. Fat mass (FM) is determined by personal and environmental factors. Anthropometric measurements allow for estimations of FM in many age groups; however, correlations of these measurements with FM in early stages of life are scarcely reported. The aim of this study was to evaluate anthropometric and clinical correlates of FM in healthy term infants at 6 months of age. METHODS Healthy term newborns (n = 102) from a prospective cohort. Weight, length, skinfolds (biceps, triceps, subscapular and the sum -SFS-) and waist circumference (WC) were measured at 6 months. Body mass index (BMI) and WC/length ratio were computed. Type of feeding during the first 6 months of age was recorded. Air displacement plethysmography was used to asses FM (percentage -%-) and FM index (FMI) was calculated. Correlations and general linear models were performed to evaluate associations. RESULTS Significant correlations were observed between all anthropometric measurements and FM (% and index)(p < 0.001). Exclusive/predominant breastfed infants had higher FM and anthropometric measurements at 6 months. Models that showed the strongest associations with FM (% and index) were SFS + WC + sex + type of feeding. CONCLUSIONS Anthropometry showed good correlations with FM at 6 months of age. Skinfolds sum and waist circumference were the strongest anthropometric variables associated to FM. Exclusive/predominant breastfeeding was strongly associated with FM.
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Affiliation(s)
- Ameyalli M Rodríguez-Cano
- Nutrition and Bioprogramming Department, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Montes Urales 800, Col. Lomas de Virreyes, 11000, Ciudad de México, CP, Mexico
| | - Jennifer Mier-Cabrera
- Nutrition and Bioprogramming Department, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Montes Urales 800, Col. Lomas de Virreyes, 11000, Ciudad de México, CP, Mexico
| | - Cinthya Muñoz-Manrique
- Nutrition and Bioprogramming Department, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Montes Urales 800, Col. Lomas de Virreyes, 11000, Ciudad de México, CP, Mexico
| | - Arturo Cardona-Pérez
- General Director, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Montes Urales 800, Col. Lomas de Virreyes, 11000, Ciudad de México, CP, Mexico
| | - Gicela Villalobos-Alcázar
- Neonatal Ward, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Montes Urales 800, Col. Lomas de Virreyes, 11000, Ciudad de México, CP, Mexico
| | - Otilia Perichart-Perera
- Nutrition and Bioprogramming Department, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Montes Urales 800, Col. Lomas de Virreyes, 11000, Ciudad de México, CP, Mexico.
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