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Moon RJ, D'Angelo S, Crozier SR, Fernandes M, Fall C, Gale CR, Godfrey KM, Davies JH, Cooper C, Harvey NC. Cognitive function and skeletal size and mineral density at age 6-7 years: Findings from the Southampton Women's Survey. Bone 2024; 182:117067. [PMID: 38438096 DOI: 10.1016/j.bone.2024.117067] [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: 12/11/2023] [Revised: 02/23/2024] [Accepted: 03/01/2024] [Indexed: 03/06/2024]
Abstract
INTRODUCTION Poor cognitive function and osteoporosis commonly co-exist in later life. In women, this is often attributed to post-menopausal estrogen loss. However, a common early life origin for these conditions and the associations between cognitive function and bone mineral density (BMD) in childhood have not previously been explored. We examined these relationships at age 6-7 years in the Southampton Women's Survey (SWS) mother-offspring cohort. METHODS Child occipitofrontal circumference (OFC), a proxy for brain volume, intelligence quotient (IQ) [Wechsler Abbreviated Scale of Intelligence] and visual recognition and working memory [CANTAB® Delayed Matching to Sample (DMS) and Spatial Span Length (SSP), respectively] were assessed. Whole-body-less-head (WBLH) and lumbar spine dual-energy X-ray absorptiometry [Hologic Discovery] (DXA) were performed to measure bone area (BA), bone mineral content (BMC), BMD and bone mineral apparent density (BMAD). Linear regression was used to examine associations between age and sex standardized variables (β represent standard deviation (SD) difference per SD of cognitive function). RESULTS DXA was performed in 1331 children (mean (SD) age 6.8 (0.33) years, 51.5 % male), with OFC, IQ, DMS and SSP assessed in 1250, 551, 490 and 460, respectively. OFC (β = 0.25 SD/SD, 95%CI 0.20,0.30), IQ (β = 0.11 SD/SD, 95%CI 0.02,0.19), and DMS (β = 0.11, SD/SD, 95%CI 0.01,0.20) were positively associated with WBLH BA, with similar associations for lumbar spine BA. OFC and DMS were also positively associated with WBLH BMC, but only OFC was associated with BMD (WBLH: β = 0.38 SD/SD, 95%CI 0.33,0.43; LS: β = 0.19 SD/SD, 95%CI 0.13,0.24). CONCLUSION Childhood brain volume was positively associated with measures of skeletal size and BMD, whereas IQ and memory were associated only with skeletal size. These findings suggest that common early life determinants for skeletal growth and BMD and cognitive function should be explored to identify potential early-life approaches to preventing osteoporosis and cognitive decline.
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Affiliation(s)
- Rebecca J Moon
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; Paediatric Endocrinology, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton SO16 7NP, UK
| | - Michelle Fernandes
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; Department of Neonatal Medicine, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Princess Anne Hospital, Tremona Road, Southampton SO16 5YA, UK
| | - Caroline Fall
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
| | - Catharine R Gale
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
| | - Justin H Davies
- Paediatric Endocrinology, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; Faculty of Medicine, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; NIHR Biomedical Research Centre, University of Oxford, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
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Wilson MG, Bone JN, Slade LJ, Mistry HD, Singer J, Crozier SR, Godfrey KM, Baird J, von Dadelszen P, Magee LA. Blood pressure measurement and adverse pregnancy outcomes: A cohort study testing blood pressure variability and alternatives to 140/90 mmHg. BJOG 2023. [PMID: 38054262 DOI: 10.1111/1471-0528.17724] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/19/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVE To examine the association with adverse pregnancy outcomes of: (1) American College of Cardiology/American Heart Association blood pressure (BP) thresholds, and (2) visit-to-visit BP variability (BPV), adjusted for BP level. DESIGN An observational study. SETTING Analysis of data from the population-based UK Southampton Women's Survey (SWS). POPULATION OR SAMPLE 3003 SWS participants. METHODS Generalised estimating equations were used to estimate crude and adjusted relative risks (RRs) of adverse pregnancy outcomes by BP thresholds, and by BPV (as standard deviation [SD], average real variability [ARV] and variability independent of the mean [VIM]). Likelihood ratios (LRs) were calculated to evaluate diagnostic test properties, for BP at or above a threshold, compared with those below. MAIN OUTCOME MEASURES Gestational hypertension, severe hypertension, pre-eclampsia, preterm birth (PTB), small-for-gestational-age (SGA) infants, neonatal intensive care unit (NICU) admission. RESULTS A median of 11 BP measurements were included per participant. For BP at ≥20 weeks' gestation, higher BP was associated with more adverse pregnancy outcomes; however, only BP <140/90 mmHg was a good rule-out test (negative LR <0.20) for pre-eclampsia and BP ≥140/90 mmHg a good rule-in test (positive LR >8.00) for the condition. BP ≥160/110 mmHg could rule-in PTB, SGA infants and NICU admission (positive LR >5.0). Higher BPV (by SD, ARV, or VIM) was associated with gestational hypertension, severe hypertension, pre-eclampsia, PTB, SGA and NICU admission (adjusted RRs 1.05-1.39). CONCLUSIONS While our findings do not support lowering the BP threshold for pregnancy hypertension, they suggest BPV could be useful to identify elevated risk of adverse outcomes.
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Affiliation(s)
- Milly G Wilson
- Department of Women and Children's Health, Faculty of Medicine, School of Life Course and Population Sciences, King's College London, London, UK
| | - Jeffrey N Bone
- British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Laura J Slade
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
- Department of Obstetrics and Gynaecology, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Hiten D Mistry
- Department of Women and Children's Health, Faculty of Medicine, School of Life Course and Population Sciences, King's College London, London, UK
| | - Joel Singer
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Southampton, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Janis Baird
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Peter von Dadelszen
- Department of Women and Children's Health, Faculty of Medicine, School of Life Course and Population Sciences, King's College London, London, UK
| | - Laura A Magee
- Department of Women and Children's Health, Faculty of Medicine, School of Life Course and Population Sciences, King's College London, London, UK
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Hesketh KR, Baird J, Crozier SR, Godfrey KM, Harvey NC, Cooper C, van Sluijs EM. Activity Behaviors Before and During Pregnancy Are Associated With Women's Device-Measured Physical Activity and Sedentary Time in Later Parenthood: A Longitudinal Cohort Analysis. J Phys Act Health 2023; 20:803-811. [PMID: 37573030 PMCID: PMC7615174 DOI: 10.1123/jpah.2022-0630] [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: 11/30/2022] [Revised: 07/03/2023] [Accepted: 07/10/2023] [Indexed: 08/14/2023]
Abstract
PURPOSE To explore how activity behaviors before/during pregnancy relate to those in later parenthood, we assessed associations between sitting and moderate-/strenuous exercise before/during pregnancy, and sedentary time (SED) and moderate to vigorous physical activity (MVPA) 4-7 years postpartum ("later parenthood"). METHODS Longitudinal data were from the Southampton Women's Survey, United Kingdom. Women reported time spent sitting (in hours per day), in moderate-strenuous exercise (hours per week), and in strenuous exercise (hours per week) at 3 time points before/during pregnancy (ie, preconception, at ∼12-wk and ∼34-wk gestation). From this, we derived 3 behavior trajectories for each woman. In later parenthood, women wore an accelerometer for ≤7 days (mean: 5.4 [SD: 1.8] d), which we used to derive 2 outcomes: minutes per day SED and in MVPA. Multilevel linear regression was used to explore associations between trajectories before/during pregnancy and device-measured SED/MVPA in later parenthood. RESULTS A total of 780 women provided valid data before/during pregnancy and in later parenthood. Consistent high sitters (vs low) were more sedentary 4-7 years postpartum (β = 39.5 min/d [95% confidence interval, 23.26 to 55.82]), as were women in groups who sat more in later pregnancy. Consistently high moderate/-strenuous exercisers (vs low) were 22% (95% confidence interval, 2%-47%) more active in later parenthood; those engaging in strenuous activity preconception tended to have higher MVPA as parents. CONCLUSIONS Trajectories of sitting and exercise before/during pregnancy are associated with SED and MVPA, respectively, in later parenthood. Interventions to reduce sitting in pregnancy and to encourage higher intensity activity preconception may benefit maternal and child health.
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Affiliation(s)
- Kathryn R. Hesketh
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Janis Baird
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Southampton, United Kingdom
| | - Sarah R. Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Southampton, United Kingdom
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Nicholas C. Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Esther M.F. van Sluijs
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
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Moon RJ, D’Angelo S, Crozier SR, Curtis EM, Fernandes M, Kermack AJ, Davies JH, Godfrey KM, Bishop NJ, Kennedy SH, Prentice A, Schoenmakers I, Fraser R, Gandhi SV, Inskip HM, Javaid MK, Papageorghiou AT, Cooper C, Harvey NC. Does antenatal cholecalciferol supplementation affect the mode or timing of delivery? Post hoc analyses of the MAVIDOS randomized controlled trial. J Public Health (Oxf) 2023; 45:738-747. [PMID: 36585903 PMCID: PMC10470377 DOI: 10.1093/pubmed/fdac160] [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: 06/13/2022] [Revised: 11/07/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Observational studies relating maternal 25-hydroxyvitamin D status to timing and mode of delivery have reported inconsistent results. We assessed the effect of antenatal cholecalciferol supplementation on the incidence of preterm birth, delivery mode and post-partum haemorrhage (PPH). METHODS MAVIDOS was a randomized, double-blind, placebo-controlled trial of 1000 IU/day cholecalciferol from 14 weeks' gestation until delivery. Gestational age, mode of delivery [categorized as spontaneous vaginal delivery (SVD), instrumental (including forceps and vacuum extraction) or Caesarean section] and PPH (>500 ml estimated blood loss) were determined from medical records. RESULTS A total of 965 women participated in the study until delivery. Gestation at birth and incidence of preterm birth (cholecalciferol 5.7%, placebo 4.5%, P = 0.43) were similar between the two treatment groups. SVD (versus instrumental or Caesarean delivery) was more likely in women randomized to cholecalciferol [Relative Risk (RR) 1.13, 95% confidence interval (CI) 1.02,1.25] due to lower instrumental (RR 0.68, 95%CI 0.51,0.91) but similar risk of Caesarean delivery (RR 0.94, 95%CI 0.74,1.19). PPH was less common in women randomized to cholecalciferol [32.1% compared with placebo (38.1%, P = 0.054) overall], but similar when stratified by delivery mode. CONCLUSIONS Antenatal cholecalciferol supplementation did not alter timing of birth or prevalence of preterm birth but demonstrated a possible effect on the likelihood of SVD.
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Affiliation(s)
- Rebecca J Moon
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- Paediatric Endocrinology, University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK
| | - Stefania D’Angelo
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Elizabeth M Curtis
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Michelle Fernandes
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Alexandra J Kermack
- Department of Women’s Health, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Justin H Davies
- Paediatric Endocrinology, University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Nicholas J Bishop
- Academic Unit of Child Health, Sheffield Children’s Hospital, University of Sheffield, Sheffield, UK
| | - Stephen H Kennedy
- Nuffield Department of Women’s & Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Ann Prentice
- MRC Epidemiology Unit, University of Cambridge, previously at MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK
| | - Inez Schoenmakers
- Faculty of Medicine and Health Sciences, Department of Medicine, University of East Anglia, Norwich, UK
| | - Robert Fraser
- Department of Obstetrics and Gynaecology, Sheffield Hospitals NHS Trust, University of Sheffield, Sheffield, UK
| | - Saurabh V Gandhi
- Department of Obstetrics and Gynaecology, Sheffield Hospitals NHS Trust, University of Sheffield, Sheffield, UK
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Muhammad Kassim Javaid
- National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Aris T Papageorghiou
- Nuffield Department of Women’s & Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Moon RJ, D’Angelo S, Holroyd CR, Crozier SR, Godfrey KM, Davies JH, Cooper C, Harvey NC. Parent-Offspring Associations in Body Composition: Findings From the Southampton Women's Survey Prospective Cohort Study. J Clin Endocrinol Metab 2023; 108:e726-e733. [PMID: 36943299 PMCID: PMC10438875 DOI: 10.1210/clinem/dgad128] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Indexed: 03/23/2023]
Abstract
CONTEXT Children born to parents who are overweight or obese have a high risk of adult obesity, but it is unclear if transgenerational associations relating to unfavorable body composition differ by parent. OBJECTIVE To examine differential mother-offspring and father-offspring associations in body composition in early childhood. METHODS A total of 240 mother-father-offspring trios from a prospective UK population-based pre-birth cohort (Southampton Women's Survey) were included for anthropometry and dual-energy x-ray absorptiometry assessment of whole-body-less-head body composition in the offspring at 3 different ages (4, 6-7, and 8-9 years) and in the mother and father at the 8- to 9-year offspring visit. Associations were assessed using linear regression adjusting for the other parent. RESULTS Positive associations between mother-daughter body mass index (BMI) and fat mass were observed at ages 6 to 7 (BMI: β = .29 SD/SD, 95% CI = .10, .48; fat mass β = .27 SD/SD, 95% CI = .05, .48) and 8 to 9 years (BMI: β = .33 SD/SD, 95% CI = .13, .54; fat mass β = .31 SD/SD, 95% CI = .12, .49), with similar associations at age 4 years but bounding the 95% CI. The mother-son, father-son, and father-daughter associations for BMI and fat mass were weaker at each of the ages studied. CONCLUSION A strong association between the fat mass of mothers and their daughters but not their sons was observed. In contrast, father-offspring body composition associations were not evident. The dimorphic parent-offspring effects suggest particular attention should be given to early prevention of unfavorable body composition in girls born to mothers with excess adiposity.
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Affiliation(s)
- Rebecca J Moon
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Stefania D’Angelo
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
| | - Christopher R Holroyd
- Department of Rheumatology, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, Southampton, SO16 7NP, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Justin H Davies
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- NIHR Biomedical Research Centre, University of Oxford, Oxford OX4 2PG, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
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Dalrymple KV, Vogel C, Godfrey KM, Baird J, Hanson MA, Cooper C, Inskip HM, Crozier SR. Evaluation and interpretation of latent class modelling strategies to characterise dietary trajectories across early life: a longitudinal study from the Southampton Women's Survey. Br J Nutr 2023; 129:1945-1954. [PMID: 35968701 PMCID: PMC10167664 DOI: 10.1017/s000711452200263x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 02/25/2022] [Revised: 07/07/2022] [Accepted: 08/05/2022] [Indexed: 11/05/2022]
Abstract
There is increasing interest in modelling longitudinal dietary data and classifying individuals into subgroups (latent classes) who follow similar trajectories over time. These trajectories could identify population groups and time points amenable to dietary interventions. This paper aimed to provide a comparison and overview of two latent class methods: group-based trajectory modelling (GBTM) and growth mixture modelling (GMM). Data from 2963 mother-child dyads from the longitudinal Southampton Women's Survey were analysed. Continuous diet quality indices (DQI) were derived using principal component analysis from interviewer-administered FFQ collected in mothers pre-pregnancy, at 11- and 34-week gestation, and in offspring at 6 and 12 months and 3, 6-7 and 8-9 years. A forward modelling approach from 1 to 6 classes was used to identify the optimal number of DQI latent classes. Models were assessed using the Akaike and Bayesian information criteria, probability of class assignment, ratio of the odds of correct classification, group membership and entropy. Both methods suggested that five classes were optimal, with a strong correlation (Spearman's = 0·98) between class assignment for the two methods. The dietary trajectories were categorised as stable with horizontal lines and were defined as poor (GMM = 4 % and GBTM = 5 %), poor-medium (23 %, 23 %), medium (39 %, 39 %), medium-better (27 %, 28 %) and best (7 %, 6 %). Both GBTM and GMM are suitable for identifying dietary trajectories. GBTM is recommended as it is computationally less intensive, but results could be confirmed using GMM. The stability of the diet quality trajectories from pre-pregnancy underlines the importance of promotion of dietary improvements from preconception onwards.
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Affiliation(s)
- Kathryn V. Dalrymple
- School of Life Course Sciences, King’s College London, London, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Christina Vogel
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Janis Baird
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK
| | - Mark A. Hanson
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Institute of Developmental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Hazel M. Inskip
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sarah R. Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK
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El‐Heis S, Crozier SR, Harvey NC, Healy E, Godfrey KM. Early life exposure to antibiotics and laxatives in relation to infantile atopic eczema. Pediatr Allergy Immunol 2023; 34:e13964. [PMID: 37232281 PMCID: PMC10947323 DOI: 10.1111/pai.13964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023]
Affiliation(s)
- Sarah El‐Heis
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Sarah R. Crozier
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Applied Research Collaboration WessexSouthampton Science Park, Innovation CentreSouthamptonUK
| | - Nicholas C. Harvey
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Eugene Healy
- Dermatopharmacology, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
- Developmental SciencesUniversity of SouthamptonSouthamptonUK
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Dalrymple KV, Vogel C, Flynn AC, Seed PT, Godfrey KM, Poston L, Inskip HM, Crozier SR. Longitudinal dietary trajectories from pregnancy to 3 years post delivery in women with obesity: relationships with adiposity. Obesity (Silver Spring) 2023; 31:1159-1169. [PMID: 36876599 PMCID: PMC10947498 DOI: 10.1002/oby.23706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 12/07/2022] [Accepted: 12/09/2022] [Indexed: 03/07/2023]
Abstract
OBJECTIVE The study aim was to examine the relationships between longitudinal dietary trajectories from early pregnancy to 3 years post delivery and adiposity measures in women with obesity. METHODS The diets of 1208 women with obesity in the UPBEAT (UK Pregnancy Better Eating and Activity Trial) study were assessed using a food frequency questionnaire (FFQ) at 15+0 to 18+6 weeks' gestation (baseline), 27+0 to 28+6 weeks' gestation, and 34+0 to 36+0 weeks' gestation, as well as 6 months and 3 years post delivery. Using factor analysis of the baseline FFQ data, four dietary patterns were identified: fruit & vegetable, African/Caribbean, processed, and snacking. The baseline scoring system was applied to the FFQ data at the four subsequent time points. Group-based trajectory modeling was used to extract longitudinal dietary pattern trajectories. Using adjusted regression, associations between dietary trajectories and log-transformed/standardized adiposity measures (BMI and waist and mid-upper arm circumferences) at 3 years post delivery were examined. RESULTS Two trajectories were found to best describe the data for the four individual dietary patterns; these were characterized as high and low adherence. A high adherence to the processed pattern was associated with a higher BMI (β = 0.38 [95% CI: 0.06-0.69]) and higher waist (β = 0.35 [0.03-0.67]) and mid-upper arm circumferences (β = 0.36 [0.04-0.67]) at 3 years post delivery. CONCLUSIONS In women with obesity, a processed dietary pattern across pregnancy and 3 years post delivery is associated with higher adiposity.
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Affiliation(s)
- Kathryn V. Dalrymple
- Department of Women and Children's HealthSchool of Life Course and Population Sciences, King's College LondonLondonUK
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Christina Vogel
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
- NIHR Applied Research Collaboration WessexSouthampton Science ParkSouthamptonUK
| | - Angela C. Flynn
- Department of Nutritional SciencesSchool of Life Course and Population Sciences, King's College LondonLondonUK
| | - Paul T. Seed
- Department of Women and Children's HealthSchool of Life Course and Population Sciences, King's College LondonLondonUK
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Lucilla Poston
- Department of Women and Children's HealthSchool of Life Course and Population Sciences, King's College LondonLondonUK
| | - Hazel M. Inskip
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Sarah R. Crozier
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Applied Research Collaboration WessexSouthampton Science ParkSouthamptonUK
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9
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Simpson RF, Hesketh KR, Crozier SR, Baird J, Cooper C, Godfrey KM, Harvey NC, Westgate K, Inskip HM, van Sluijs EMF. The association between number and ages of children and the physical activity of mothers: Cross-sectional analyses from the Southampton Women's Survey. PLoS One 2022; 17:e0276964. [PMID: 36383511 PMCID: PMC9668156 DOI: 10.1371/journal.pone.0276964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Physical activity (PA) has many health benefits, but motherhood is often associated with reduced PA. Considering that ages and number of children may be associated with maternal PA, and that PA patterns may change as children transition to formal schooling, we aimed to investigate the associations between ages and number of children and device-measured maternal PA. METHODS Cross-sectional analyses were conducted using data from 848 mothers from the Southampton Women's Survey at two different timepoints. Two-level random intercept linear models were used to investigate associations between ages (≤4y(ears) ("younger"), school-aged, both age groups) and number (1, 2, ≥3) of children, and their interaction, and accelerometer-assessed minutes of maternal moderate or vigorous PA (log-transformed MVPA) and light, moderate or vigorous PA (LMVPA). RESULTS Women with any school-aged children engaged in more MVPA than those with only ≤4y (e.g. % difference in minutes of MVPA [95% confidence interval]: 46.9% [22.0;77.0] for mothers with only school-aged vs only ≤4y). Mothers with multiple children did less MVPA than those with 1 child (e.g. 12.5% [-1.1;24.3] less MVPA for those with 2 children). For mothers with multiple children, those with any school-aged children did less LMVPA than those with only ≤4y (e.g. amongst mothers with 2 children, those with only school-aged children did 34.0 [3.9;64.1] mins/day less LMVPA). For mothers with any ≤4y, those with more children did more LMVPA (e.g. amongst mothers with only ≤4y, those with 2 children did 42.6 [16.4;68.8] mins/day more LMVPA than those with 1 child). CONCLUSIONS Mothers with multiple children and only children aged ≤4y did less MVPA. Considering that many of these women also did more LMVPA than mothers with fewer or older children, interventions and policies are needed to increase their opportunities for higher intensity PA to maximise health benefits. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04715945.
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Affiliation(s)
- Rachel F. Simpson
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Kathryn R. Hesketh
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Sarah R. Crozier
- MRC Lifecourse Epidemiology Centre (University of Southampton), Southampton General Hospital, Southampton, United Kingdom
- NIHR Applied Research Collaboration Wessex, Southampton, United Kingdom
| | - Janis Baird
- MRC Lifecourse Epidemiology Centre (University of Southampton), Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre (University of Southampton), Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Centre (University of Southampton), Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Nicholas C. Harvey
- MRC Lifecourse Epidemiology Centre (University of Southampton), Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Kate Westgate
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Hazel M. Inskip
- MRC Lifecourse Epidemiology Centre (University of Southampton), Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Esther M. F. van Sluijs
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
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10
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El‐Heis S, D’Angelo S, Curtis EM, Healy E, Moon RJ, Crozier SR, Inskip H, Cooper C, Harvey NC, Godfrey KM. Maternal antenatal vitamin D supplementation and offspring risk of atopic eczema in the first 4 years of life: evidence from a randomized controlled trial. Br J Dermatol 2022; 187:659-666. [PMID: 35763390 PMCID: PMC9804289 DOI: 10.1111/bjd.21721] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/14/2022] [Accepted: 06/26/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Evidence linking prenatal maternal vitamin D supplementation with the offspring's risk of atopic eczema is inconsistent, with most data coming from observational studies. OBJECTIVES To examine the influence of maternal cholecalciferol supplementation during pregnancy on the risk of atopic eczema in the offspring at ages 12, 24 and 48 months. METHODS Within the UK Maternal Vitamin D Osteoporosis Study (MAVIDOS) double-blind, randomized placebo-controlled trial, we examined the relationship of maternal vitamin D supplementation during pregnancy with offspring atopic eczema at ages 12, 24 and 48 months. In MAVIDOS, pregnant women were allocated to either cholecalciferol 1000 IU per day or matched placebo, taken from around 14 weeks' gestation until delivery, with the primary outcome of neonatal whole-body bone mineral content. The prevalence of atopic eczema in the offspring was ascertained at ages 12 (n = 635), 24 (n = 610) and 48 (n = 449) months, based on the UK Working Party criteria for the definition of atopic dermatitis. The trial was registered with ISRCTN (82927713) and EudraCT (2007-001716-23). RESULTS The characteristics of mothers and offspring were similar between the intervention and placebo groups, apart from longer breastfeeding duration in the intervention group. Adjusting for breastfeeding duration, offspring of mothers who received cholecalciferol 1000 IU daily had a lower odds ratio (OR) of atopic eczema at age 12 months [OR 0·55, 95% confidence interval (CI) 0·32-0·97, P = 0·04]; this effect weakened and was not statistically significant at ages 24 months (OR 0·76, 95% CI 0·47-1·23) or 48 months (OR 0·75, 95% CI 0·37-1·52). The statistical interaction of intervention and breastfeeding duration in relation to eczema at age 12 months was not significant (P = 0·41), but stratification showed reduced infantile eczema risk in the intervention group for infants breastfed for ≥ 1 month (OR 0·48, 95% CI 0·24-0·94, P = 0·03) but not in those breastfed for < 1 month (OR 0·80, 95% CI 0·29-2·17, P = 0·66). CONCLUSIONS Our data provide the first randomized controlled trial evidence of a protective effect of antenatal cholecalciferol supplementation on the risk of infantile atopic eczema, with the effect potentially being via increased breast milk cholecalciferol levels. The findings support a developmental influence on atopic eczema, and point to a potentially modifiable perinatal influence on atopic eczema. What is already known about this topic? There are currently no antenatal interventions proven to reduce the incidence of infantile atopic eczema in the general population. However, observational studies have led to speculation that antenatal vitamin D supplementation may be beneficial.
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Affiliation(s)
- Sarah El‐Heis
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Stefania D’Angelo
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Elizabeth M. Curtis
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Eugene Healy
- Dermatopharmacology, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
| | - Rebecca J. Moon
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Sarah R. Crozier
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Applied Research Collaboration WessexSouthampton Science Park, Innovation CentreSouthamptonUK
| | - Hazel Inskip
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Nutrition Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Nutrition Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
- NIHR Musculoskeletal Biomedical Research UnitUniversity of OxfordOxfordUK
| | - Nicholas C. Harvey
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Nutrition Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Nutrition Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
- Developmental SciencesUniversity of SouthamptonSouthamptonUK
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11
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Stannard S, Holland E, Crozier SR, Hoyle R, Boniface M, Ahmed M, McMahon J, Ware W, Zlatev Z, Alwan NA, Fraser SD. Early-onset burdensome multimorbidity: an exploratory analysis of sentinel conditions, condition accrual sequence and duration of three long-term conditions using the 1970 British Cohort Study. BMJ Open 2022; 12:e059587. [PMID: 36216416 PMCID: PMC9557794 DOI: 10.1136/bmjopen-2021-059587] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The prevalence of multiple long-term condition (LTC) multimorbidity is increasing with younger onset among socioeconomically deprived populations. Research on life course trajectories towards multimorbidity is limited and early-onset multimorbidity poorly characterised. Understanding sentinel conditions (the first LTC occurring in the life course), the sequence of LTC accrual and the permanency of the reporting of LTCs may help identify time points for prevention efforts. We used a longitudinal birth cohort to estimate the prevalence of a common three-condition early-onset multimorbidity (multiple long-term condition multimorbidity (MLTC-M)) group at midlife, describe the frequency of sentinel conditions, the sequence of LTC accrual and explore the permanency of one of these conditions: psychological distress. SETTING 1970 British Cohort Study (BCS70). PARTICIPANTS 17 196 cohort members born in 1970. OUTCOME MEASURES Prevalence of the most common three-condition multimorbidity group at age 46. The nature and timing of sentinel conditions, the sequencing patterns of subsequent LTC accrual and the permanency of the reporting of psychological distress. RESULTS At age 46 high blood pressure, psychological distress and back pain were the most common three-condition MLTC-M group, (4.3%, n=370). A subgroup of 164 (44.3%) people provided complete information on LTC across all time points. Psychological distress measured by the Malaise Index was the most common sentinel condition, occurring in 25.0% (n=41), followed by back pain (22%, n=36). At age 26, 45.1% (75/164) reported their sentinel condition. The most common sequence of LTC accrual was the co-reporting of psychological distress and back pain followed by high blood pressure. Almost one-third (30.5%, n=50) reported a variation of psychological distress across the adult life course. CONCLUSION In these exploratory analyses, psychological distress and back pain were the most common sentinel conditions, and along with high blood pressure these three conditions represented the most common three-condition MLTC-M group. These analyses suggest that birth cohorts, like the BCS70, may usefully inform life course-multimorbidity research.
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Affiliation(s)
- Sebastian Stannard
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Emilia Holland
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton Faculty of Medicine, Southampton, UK
- Applied Research Collaboration Wessex, NIHR, Southampton, London, UK
| | - Rebecca Hoyle
- School of Mathematical Sciences, University of Southampton, Southampton, UK
| | - Michael Boniface
- IT Innovation Centre, University of Southampton, Southampton, Hampshire, UK
| | - Mazen Ahmed
- IT Innovation Centre, University of Southampton, Southampton, Hampshire, UK
| | - James McMahon
- Applied Research Collaboration Wessex, NIHR, Southampton, London, UK
| | - William Ware
- Applied Research Collaboration Wessex, NIHR, Southampton, London, UK
| | - Zlatko Zlatev
- IT Innovation Centre, University of Southampton, Southampton, Hampshire, UK
| | - Nisreen A Alwan
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
- Applied Research Collaboration Wessex, NIHR, Southampton, London, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, Hampshire, UK
| | - Simon Ds Fraser
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
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12
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Aubert AM, Chen LW, Shivappa N, Cooper C, Crozier SR, Duijts L, Forhan A, Hanke W, Harvey NC, Jankowska A, Kelleher CC, de Lauzon-Guillain B, McAuliffe FM, Mensink-Bout SM, Polanska K, Relton CL, Suderman M, Hebert JR, Phillips CM, Bernard JY, Heude B. Predictors of maternal dietary quality and dietary inflammation during pregnancy: An individual participant data meta-analysis of seven European cohorts from the ALPHABET consortium. Clin Nutr 2022; 41:1991-2002. [PMID: 35964423 DOI: 10.1016/j.clnu.2022.06.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 02/23/2022] [Revised: 06/10/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND & AIMS Maternal diet during pregnancy is a modifiable behaviour which plays an important role in maternal, neonatal and child health outcomes. Thus, knowledge of predictors of dietary quality and dietary inflammatory potential in European countries may contribute to developing maternal diet-related public health policies that target specific at-risk populations in Europe. METHODS We used harmonised data from >26,000 pregnant women enrolled in the ALSPAC, EDEN, Generation R, Lifeways, REPRO_PL, ROLO and SWS cohorts, as part of the ALPHABET consortium. Maternal dietary quality and inflammatory potential were assessed using the Dietary Approaches to Stop Hypertension (DASH) and the energy-adjusted Dietary Inflammatory Index (E-DII). We conducted an individual participant data meta-analysis to investigate the maternal sociodemographic, health and behavioural predictors of maternal diet before and during pregnancy. RESULTS DASH and E-DII scores were moderately correlated: from -0.63 (95% CI: -0.66, -0.59) to -0.48 (95% CI: -0.49, -0.47) across cohorts. Higher maternal age, education, household income, and physical activity during pregnancy were associated with a better dietary quality and a more anti-inflammatory diet. Conversely, multiparity and smoking during pregnancy were associated with a poorer dietary quality and a more proinflammatory diet. Women with obesity had a poorer pregnancy dietary quality than women with a normal body mass index range. CONCLUSIONS The results will help identify population subgroups who may benefit from targeted public health strategies and interventions aimed at improving women's dietary quality during pregnancy.
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Affiliation(s)
- Adrien M Aubert
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France.
| | - Ling-Wei Chen
- School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), 117609, Singapore.
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital Southampton, Southampton SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford OX1 2JD, UK.
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital Southampton, Southampton SO16 6YD, UK; NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, Southampton SO16 7NP, UK.
| | - Liesbeth Duijts
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands; Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, 3000 CB Rotterdam, the Netherlands; Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center Rotterdam, 3000 CB Rotterdam, the Netherlands.
| | - Anne Forhan
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France.
| | - Wojciech Hanke
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital Southampton, Southampton SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
| | - Agnieszka Jankowska
- Department of Environmental and Occupational Health Hazards, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Cecily C Kelleher
- School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Blandine de Lauzon-Guillain
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France.
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland.
| | - Sara M Mensink-Bout
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands; Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, 3000 CB Rotterdam, the Netherlands.
| | - Kinga Polanska
- Department of Environmental and Occupational Health Hazards, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Caroline L Relton
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK.
| | - Matthew Suderman
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK.
| | - James R Hebert
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
| | - Catherine M Phillips
- School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Jonathan Y Bernard
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), 117609, Singapore.
| | - Barbara Heude
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France.
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Woolford SJ, D'Angelo S, Mancano G, Curtis EM, Ashai S, Shivappa N, Hébert JR, Crozier SR, Phillips CM, Suderman M, Relton CL, Cooper C, Harvey NC. Associations Between Late Pregnancy Dietary Inflammatory Index (DII) and Offspring Bone Mass: A Meta-Analysis of the Southampton Women's Survey (SWS) and the Avon Longitudinal Study of Parents and Children (ALSPAC). J Bone Miner Res 2022; 37:1511-1519. [PMID: 35689423 PMCID: PMC9542867 DOI: 10.1002/jbmr.4623] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 04/20/2022] [Accepted: 06/04/2022] [Indexed: 01/30/2023]
Abstract
Systemic inflammation is associated with reduced bone mineral density and may be influenced by pro-inflammatory diets. We undertook an observational analysis of associations between late pregnancy energy-adjusted dietary inflammatory index (E-DII) scores and offspring bone outcomes in childhood. E-DII scores (higher scores indicating pro-inflammatory diets) were derived from food frequency questionnaires in late pregnancy in two prospective mother-offspring cohorts: the Southampton Women's Survey (SWS) and the Avon Longitudinal Study of Parents and Children (ALSPAC). The mean (SD) offspring age at dual-energy X-ray absorptiometry (DXA) scanning was 9.2 (0.2) years. Linear regression was used to assess associations between E-DII and bone outcomes, adjusting for offspring sex and age at DXA and maternal age at childbirth, educational level, pre-pregnancy body mass index (BMI), parity, physical activity level, and smoking in pregnancy. Associations were synthesized using fixed-effect meta-analysis. Beta coefficients represent the association per unit E-DII increment. In fully adjusted models (total n = 5910) late pregnancy E-DII was negatively associated with offspring whole body minus head bone area (BA: β = -3.68 [95% confidence interval -6.09, -1.27] cm2 /unit), bone mineral content (BMC: β = -4.16 [95% CI -6.70, -1.62] g/unit), and areal bone mineral density (aBMD: β = -0.0012 [95% CI -0.0020, -0.0004] g.cm-2 /unit), but there was only a weak association with BMC adjusted for BA (β = -0.48 [95% CI -1.11, 0.15] g/unit) at 9 years. Adjustment for child height partly or, for weight, fully attenuated the associations. Higher late pregnancy E-DII scores (representing a more pro-inflammatory diet) are negatively associated with offspring bone measures, supporting the importance of maternal and childhood diet on longitudinal offspring bone health. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Stephen J Woolford
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Giulia Mancano
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Elizabeth M Curtis
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Shanze Ashai
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and BiostatisticsArnold School of Public Health, University of South CarolinaColumbiaSCUSA
| | - James R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and BiostatisticsArnold School of Public Health, University of South CarolinaColumbiaSCUSA
- Department of Nutrition, Connecting Health Innovations LLCColumbiaSCUSA
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Applied Research Collaboration WessexSouthampton Science ParkSouthamptonUK
| | - Catherine M Phillips
- School of Public Health, Physiotherapy, and Sports ScienceUniversity College DublinBelfieldIreland
| | - Matthew Suderman
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Caroline L Relton
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
- NIHR Biomedical Research CentreUniversity of OxfordOxfordUK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Biomedical Research CentreUniversity of OxfordOxfordUK
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14
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Hesketh KR, Brage S, Inskip HM, Crozier SR, Godfrey KM, Harvey NC, Cooper C, Van Sluijs EM. Activity Behaviors in British 6-Year-Olds: Cross-Sectional Associations and Longitudinal Change During the School Transition. J Phys Act Health 2022; 19:558-565. [PMID: 35894892 PMCID: PMC7613624 DOI: 10.1123/jpah.2021-0718] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/04/2022] [Accepted: 06/22/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND To explore activity behaviors at school entry, we describe temporal/demographic associations with accelerometer-measured physical activity in a population-based sample of British 6-year-olds, and examine change from ages 4 to 6. METHODS A total of 712 six-year-olds (308 at both ages) wore Actiheart accelerometers for ≥3 (mean 6.0) days. We derived minutes per day sedentary (<20 cpm) and moderate to vigorous physical activity (MVPA, ≥460 cpm), also segmented across mornings (06:00 AM to 09:00 AM), school (09:00 AM to 3:00 PM), and evenings (3:00 PM to 11:00 PM). Using mixed effects linear regression, we analyzed associations between temporal/demographic factors and children's activity intensities at age 6, and change between ages 4 and 6. RESULTS Six-year-old children engaged in MVPA (mean [SD]): 64.9 (25.7) minutes per day (53% met UK guidelines). Girls did less MVPA than boys, particularly during school hours. Children were less active on weekends (vs weekdays) and more active on spring/summer evenings (vs winter). Longitudinally, 6-year-old children did less light physical activity (-43.0; 95% confidence interval, -47.5 to -38.4 min/d) but were more sedentary (29.4; 24.6 to 34.2), and engaged in greater MVPA (7.1; 5.2 to 9.1) compared to when they were aged 4. CONCLUSION Half of 6-year-old children met current activity guidelines; MVPA levels were lower in girls and at weekends. UK children became more sedentary but did more MVPA as they entered formal schooling. Physical activity promotion efforts should capitalize on these changes in MVPA, to maintain positive habits.
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Affiliation(s)
- Kathryn R. Hesketh
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Hazel M. Inskip
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sarah R. Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Southampton, UK
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Nicholas C. Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- -NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Esther M.F. Van Sluijs
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
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15
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Curtis EM, Moon RJ, D'Angelo S, Crozier SR, Bishop NJ, Gopal‐Kothandapani JS, Kennedy SH, Papageorghiou AT, Fraser R, Gandhi SV, Schoenmakers I, Prentice A, Inskip HM, Godfrey KM, Javaid MK, Eastell R, Cooper C, Harvey NC. Pregnancy Vitamin D Supplementation and Childhood Bone Mass at Age 4 Years: Findings From the Maternal Vitamin D Osteoporosis Study (MAVIDOS) Randomized Controlled Trial. JBMR Plus 2022; 6:e10651. [PMID: 35866154 PMCID: PMC9289979 DOI: 10.1002/jbm4.10651] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/25/2022] [Accepted: 04/28/2022] [Indexed: 01/04/2023] Open
Abstract
In the Maternal Vitamin D Osteoporosis Study (MAVIDOS) randomized trial, vitamin D supplementation in pregnancy did not lead to greater neonatal bone mass across the trial as a whole, but, in a prespecified secondary analysis by season of birth, led to greater neonatal bone mass among winter-born babies. Demonstrating persistence of this effect into childhood would increase confidence in a long-term benefit of this intervention. We investigated whether antenatal vitamin D supplementation increases offspring bone mineralization in early childhood in a prespecified, single-center follow-up of a double-blinded, multicenter, randomized controlled clinical trial based in the UK (MAVIDOS). A total of 1123 women in early pregnancy with a baseline 25-hydroxyvitamin D level 25-100 nmol/L from three research centers (2008-2014) were randomized to 1000 IU/d cholecalciferol or matched placebo from 14 weeks of gestation to delivery. Offspring born at the Southampton, UK research center were assessed at age 4 years (2013-2018). Anthropometry and dual-energy X-ray absorptiometry (DXA) were performed (yielding whole body less head [WBLH] bone mineral content [BMC], areal bone mineral density [aBMD], bone area [BA], and body composition). Of 723 children, 564 (78.0%) children attended the 4-year visit, 452 of whom had a useable DXA. Maternal vitamin D supplementation led to greater WBLH aBMD in the children compared with placebo (mean [95% confidence interval {CI}]: supplemented group: 0.477 (95% CI, 0.472-0.481) g/cm2; placebo group: 0.470 (95% CI, 0.466-0.475) g/cm2, p = 0.048). Associations were consistent for BMC and lean mass, and in age- and sex-adjusted models. Effects were observed across the whole cohort irrespective of season of birth. Maternal-child interactions were observed, with a greater effect size among children with low milk intake and low levels of physical activity. Child weight, height, and body mass index (BMI) were similar by maternal randomization group. These findings suggest a sustained beneficial effect of maternal vitamin D supplementation in pregnancy on offspring aBMD at age 4 years, but will require replication in other trials. © 2022 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Elizabeth M. Curtis
- Medical Research Council (MRC) Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Rebecca J. Moon
- Medical Research Council (MRC) Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- Paediatric EndocrinologyUniversity Hospital Southampton National Health Service (NHS) Foundation TrustSouthamptonUK
| | - Stefania D'Angelo
- Medical Research Council (MRC) Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Sarah R. Crozier
- Medical Research Council (MRC) Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Nicholas J. Bishop
- Academic Unit of Child Health, Sheffield Children's HospitalUniversity of SheffieldSheffieldUK
| | | | - Stephen H. Kennedy
- Nuffield Department of Women's & Reproductive Health, John Radcliffe HospitalUniversity of OxfordOxfordUK
| | - Aris T. Papageorghiou
- Nuffield Department of Women's & Reproductive Health, John Radcliffe HospitalUniversity of OxfordOxfordUK
| | - Robert Fraser
- Department of Obstetrics and Gynaecology, Sheffield Hospitals National Health Service (NHS) TrustUniversity of SheffieldSheffieldUK
| | - Saurabh V. Gandhi
- Department of Obstetrics and Gynaecology, Sheffield Hospitals National Health Service (NHS) TrustUniversity of SheffieldSheffieldUK
| | - Inez Schoenmakers
- Department of Medicine, Faculty of Medicine and Health SciencesUniversity of East AngliaNorwichUK
| | - Ann Prentice
- Medical Research Council (MRC) Nutrition and Bone Health, Clifford Allbutt BuildingUniversity of CambridgeCambridgeUK
| | - Hazel M. Inskip
- Medical Research Council (MRC) Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- National Institute for Health Research (NIHR) Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton National Health Service (NHS) Foundation TrustSouthamptonUK
| | - Keith M. Godfrey
- Medical Research Council (MRC) Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- National Institute for Health Research (NIHR) Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton National Health Service (NHS) Foundation TrustSouthamptonUK
| | - M. Kassim Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal SciencesUniversity of OxfordOxfordUK
- National Institute for Health Research (NIHR) Oxford Biomedical Research CentreUniversity of OxfordOxfordUK
| | - Richard Eastell
- Department of Oncology and MetabolismUniversity of SheffieldSheffieldUK
| | - Cyrus Cooper
- Medical Research Council (MRC) Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- National Institute for Health Research (NIHR) Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton National Health Service (NHS) Foundation TrustSouthamptonUK
- National Institute for Health Research (NIHR) Oxford Biomedical Research CentreUniversity of OxfordOxfordUK
| | - Nicholas C. Harvey
- Medical Research Council (MRC) Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- National Institute for Health Research (NIHR) Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton National Health Service (NHS) Foundation TrustSouthamptonUK
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16
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Moon RJ, D'Angelo S, Crozier SR, Godfrey KM, Davies JH, Cooper C, Harvey NC. Is the skull responsive to bone mineralisation stimuli in children? Bone 2022; 160:116415. [PMID: 35398588 DOI: 10.1016/j.bone.2022.116415] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/22/2022] [Accepted: 04/02/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Whole-body-less-head (WBLH) is the recommended skeletal region of interest (ROI) for dual-energy X-ray absorptiometry (DXA) assessment of bone mineral density (BMD) in children. Historically it has been suggested that the skull is less responsive than the rest of the skeleton to stimuli that affect BMD but there are few published data to support this notion. We compared the associations of BMD with anthropometric, body composition, diet, and activity variables across various ROI. METHODS Children from the Southampton Women's Survey (SWS) mother-offspring cohort participated at age 6-7 years, including measurement of height, weight, and whole-body and lumbar spine (LS) BMD by DXA (Hologic Discovery). Physical activity was assessed by accelerometry (Actiheart) and diet by interviewer-led questionnaire. BMD was measured in the following skeletal ROI: whole-body, skull, WBLH and lower limbs (all derived from the whole-body scan) and LS. RESULTS 1218 children participated. Height z-score, weight z-score, lean mass and milk intake were associated with skull BMD, but associations were weaker than observed for other ROI; for example, the association between lean mass and skull BMD was β (95% CI) 0.11 (0.08, 0.14) SD/kg, compared with 0.32 (0.30, 0.34), 0.38 (0.37, 0.40) and 0.23 (0.21, 0.25) SD/kg for whole body, WBLH and lumbar spine, respectively. Relationships with whole-body BMD were attenuated compared with WBLH. CONCLUSION Associations between skull BMD and anthropometry, body composition and dietary variables were weaker than for other DXA sites. These findings support, and importantly provide a quantitative basis for, the recommendation that the skull should be excluded from whole-body DXA analyses in children.
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Affiliation(s)
- Rebecca J Moon
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton SO16 7NP, UK.
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Justin H Davies
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK; National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Unit, University of Oxford, UK.
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
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17
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Mahendra A, Kehoe SH, Crozier SR, Kumaran K, Krishnaveni GV, Arun N, Padmaja, Kini P, Taskeen U, Kombanda KT, Johnson M, Osmond C, Fall CHD. Peri-conceptional diet patterns and the risk of Gestational diabetes mellitus in South Indian women. Public Health Nutr 2022; 26:1-34. [PMID: 35620916 PMCID: PMC10131144 DOI: 10.1017/s1368980022001288] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 04/22/2022] [Accepted: 05/12/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To identify peri-conceptional diet patterns among women in Bangalore, and examine their associations with risk of gestational diabetes mellitus. DESIGN BANGLES, started in June 2016, was a prospective observational study, in which women were recruited at 5-16 weeks' gestation. Peri-conceptional diet was recalled at recruitment, using a validated 224-item food frequency questionnaire. GDM was assessed by a 75-gram oral glucose tolerance test at 24-28 weeks' gestation, applying WHO 2013 criteria. Diet patterns were identified using principal component analysis and diet pattern-GDM associations were examined using multivariate logistic regression, adjusting for 'a priori' confounders. SETTING Antenatal clinics of two hospitals, Bangalore, South India. PARTICIPANTS 785 pregnant women of varied socio-economic status. RESULTS GDM prevalence was 22%. Three diet patterns were identified: a) High-diversity, urban (HDU) characterised by diverse, home-cooked and processed foods was associated with older, more affluent, better-educated and urban women; b) Rice-fried snacks-chicken-sweets (RFCS), characterised by low diet-diversity, was associated with younger, less-educated, and lower income, rural and joint families; c) Healthy, traditional vegetarian (HTV), characterised by home-cooked-vegetarian and non-processed foods was associated with less-educated, more affluent, and rural and joint families. The HDU pattern was associated with a lower GDM risk (aOR: 0.80 per SD, 95% CI: 0.64, 0.99, p=0.04) after adjusting for confounders. BMI was strongly related to GDM risk and possibly mediated diet-GDM associations. CONCLUSIONS The findings support global recommendations to encourage women to attain a healthy pre-pregnancy BMI and increase diet-diversity. Both healthy and unhealthy foods in the patterns indicate low-awareness about healthy foods and a need for public-education.
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Affiliation(s)
- Anvesha Mahendra
- MRC Lifecourse Epidemiology Centre, University of Southampton, SouthamptonSO16 6YD, UK
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
| | - Sarah H Kehoe
- MRC Lifecourse Epidemiology Centre, University of Southampton, SouthamptonSO16 6YD, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, SouthamptonSO16 6YD, UK
| | - Kalyanaraman Kumaran
- MRC Lifecourse Epidemiology Centre, University of Southampton, SouthamptonSO16 6YD, UK
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
| | - GV Krishnaveni
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
| | - Nalini Arun
- Department of Obstetrics and Gynaecology, Bangalore Baptist Hospital, Bangalore, India
| | - Padmaja
- Department of Obstetrics and Gynaecology, Bangalore Baptist Hospital, Bangalore, India
| | - Prakash Kini
- Department of Obstetrics and Gynaecology, Cloudnine Hospital, Bangalore, India
| | - Unaiza Taskeen
- Previously Affiliated to Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
| | - Krupa T Kombanda
- School of Exercise and Nutrition, Deakin University, Geelong, Australia
| | - Matthew Johnson
- MRC Lifecourse Epidemiology Centre, University of Southampton, SouthamptonSO16 6YD, UK
| | - Clive Osmond
- MRC Lifecourse Epidemiology Centre, University of Southampton, SouthamptonSO16 6YD, UK
| | - Caroline HD Fall
- MRC Lifecourse Epidemiology Centre, University of Southampton, SouthamptonSO16 6YD, UK
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18
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Mensink-Bout SM, van Meel ER, de Jongste JC, Annesi-Maesano I, Aubert AM, Bernard JY, Chen LW, Cooper C, Crozier SR, Hanke W, Harvey NC, Hébert JR, Heude B, Jerzynska J, Kelleher CC, Mehegan J, McAuliffe FM, Phillips CM, Polanska K, Relton CL, Shivappa N, Suderman M, Jaddoe VWV, Duijts L. Maternal diet in pregnancy and child's respiratory outcomes: an individual participant data meta-analysis of 18 000 children. Eur Respir J 2022; 59:2101315. [PMID: 34503987 PMCID: PMC9030071 DOI: 10.1183/13993003.01315-2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 08/20/2021] [Indexed: 11/18/2022]
Abstract
RATIONALE Severe fetal malnutrition has been related to an increased risk of respiratory diseases later in life, but evidence for the association of a suboptimal diet during pregnancy with respiratory outcomes in childhood is conflicting. We aimed to examine whether a pro-inflammatory or low-quality maternal diet during pregnancy was associated with child's respiratory health. METHODS We performed an individual participant meta-analysis among 18 326 mother-child pairs from seven European birth cohorts. Maternal pro-inflammatory and low-quality diets were estimated by energy-adjusted Dietary Inflammatory Index (E-DII) and Dietary Approaches to Stop Hypertension (DASH) scores. Preschool wheezing and school-age asthma were measured using questionnaires and lung function by spirometry. RESULTS After adjustment for lifestyle and sociodemographic factors, we observed that a higher maternal E-DII score (a more pro-inflammatory diet) during pregnancy was associated only with a lower forced vital capacity (FVC) in children (z-score difference -0.05, 95% CI -0.08- -0.02, per interquartile range increase). No linear associations of the maternal E-DII or DASH score with child's wheezing or asthma were observed. In an exploratory examination of the extremes, a very low DASH score (<10th percentile) (a very low dietary quality) was associated with an increased risk of preschool wheezing and a low forced expiratory volume in 1 s/FVC (z-score <-1.64) (OR 1.20, 95% CI 1.06-1.36 and z-score difference 1.40, 95% CI 1.06-1.85, compared to ≥10th percentile), with corresponding population attributable risk fractions of 1.7% and 3.3%, respectively. CONCLUSION The main results from this individual participant data meta-analysis do not support the hypothesis that maternal pro-inflammatory or low-quality diet in pregnancy are related to respiratory diseases in childhood.
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Affiliation(s)
- Sara M Mensink-Bout
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Evelien R van Meel
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Johan C de Jongste
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Adrien M Aubert
- Centre for Research in Epidemiology and StatisticS (CRESS), Université de Paris, Paris, France
| | - Jonathan Y Bernard
- Centre for Research in Epidemiology and StatisticS (CRESS), Université de Paris, Paris, France
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Ling-Wei Chen
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Wojciech Hanke
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - James R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Nutrition Connecting Health Innovations LLC, Columbia, SC, USA
| | - Barbara Heude
- Centre for Research in Epidemiology and StatisticS (CRESS), Université de Paris, Paris, France
| | - Joanna Jerzynska
- Department of Pediatrics and Allergy, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland
| | - Cecily C Kelleher
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - John Mehegan
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Catherine M Phillips
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Kinga Polanska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Caroline L Relton
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Nutrition Connecting Health Innovations LLC, Columbia, SC, USA
| | - Matthew Suderman
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Liesbeth Duijts
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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19
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Dalrymple KV, Vogel C, Godfrey KM, Baird J, Harvey NC, Hanson MA, Cooper C, Inskip HM, Crozier SR. Longitudinal dietary trajectories from preconception to mid-childhood in women and children in the Southampton Women's Survey and their relation to offspring adiposity: a group-based trajectory modelling approach. Int J Obes (Lond) 2022; 46:758-766. [PMID: 34916617 PMCID: PMC8960403 DOI: 10.1038/s41366-021-01047-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/23/2021] [Accepted: 11/26/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Rates of childhood obesity are increasing globally, with poor dietary quality an important contributory factor. Evaluation of longitudinal diet quality across early life could identify timepoints and subgroups for nutritional interventions as part of effective public health strategies. OBJECTIVE This research aimed to: (1) define latent classes of mother-offspring diet quality trajectories from pre-pregnancy to child age 8-9 years, (2) identify early life factors associated with these trajectories, and (3) describe the association between the trajectories and childhood adiposity outcomes. DESIGN Dietary data from 2963 UK Southampton Women's Survey mother-offspring dyads were analysed using group-based trajectory modelling of a diet quality index (DQI). Maternal diet was assessed pre-pregnancy and at 11- and 34-weeks' gestation, and offspring diet at ages 6 and 12 months, 3, 6-7- and 8-9-years using interviewer-administered food frequency questionnaires. At each timepoint, a standardised DQI was derived using principal component analysis. Adiposity age 8-9 years was assessed using dual-energy X-ray absorptiometry (DXA) and BMI z-scores. RESULTS A five-trajectory group model was identified as optimal. The diet quality trajectories were characterised as stable, horizontal lines and were categorised as poor (n = 142), poor-medium (n = 667), medium (n = 1146), medium-better (n = 818) and best (n = 163). A poorer dietary trajectory was associated with higher maternal pre-pregnancy BMI, smoking, multiparity, lower maternal age and lower educational attainment. Using linear regression adjusted for confounders, a 1-category decrease in the dietary trajectory was associated with higher DXA percentage body fat (0.08 SD (95% confidence interval 0.01, 0.15) and BMI z-score (0.08 SD (0.00, 0.16) in the 1216 children followed up at age 8-9 years. CONCLUSION Mother-offspring dietary trajectories are stable across early life, with poorer diet quality associated with maternal socio-demographic and other factors and childhood adiposity. The preconception period may be an important window to promote positive maternal dietary changes in order to improve childhood outcomes.
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Affiliation(s)
- Kathryn V Dalrymple
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Christina Vogel
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Janis Baird
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mark A Hanson
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Institute of Developmental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK.
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK.
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20
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Ashley B, Simner C, Manousopoulou A, Jenkinson C, Hey F, Frost JM, Rezwan FI, White CH, Lofthouse EM, Hyde E, Cooke LDF, Barton S, Mahon P, Curtis EM, Moon RJ, Crozier SR, Inskip HM, Godfrey KM, Holloway JW, Cooper C, Jones KS, Lewis RM, Hewison M, Garbis SDD, Branco MR, Harvey NC, Cleal JK. Placental uptake and metabolism of 25(OH)vitamin D determine its activity within the fetoplacental unit. eLife 2022; 11:71094. [PMID: 35256050 PMCID: PMC8903835 DOI: 10.7554/elife.71094] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 01/20/2022] [Indexed: 12/13/2022] Open
Abstract
Pregnancy 25-hydroxyvitamin D [25(OH)D] concentrations are associated with maternal and fetal health outcomes. Using physiological human placental perfusion and villous explants, we investigate the role of the placenta in regulating the relationships between maternal 25(OH)D and fetal physiology. We demonstrate active placental uptake of 25(OH)D3 by endocytosis, placental metabolism of 25(OH)D3 into 24,25-dihydroxyvitamin D3 and active 1,25-dihydroxyvitamin D [1,25(OH)2D3], with subsequent release of these metabolites into both the maternal and fetal circulations. Active placental transport of 25(OH)D3 and synthesis of 1,25(OH)2D3 demonstrate that fetal supply is dependent on placental function rather than simply the availability of maternal 25(OH)D3. We demonstrate that 25(OH)D3 exposure induces rapid effects on the placental transcriptome and proteome. These map to multiple pathways central to placental function and thereby fetal development, independent of vitamin D transfer. Our data suggest that the underlying epigenetic landscape helps dictate the transcriptional response to vitamin D treatment. This is the first quantitative study demonstrating vitamin D transfer and metabolism by the human placenta, with widespread effects on the placenta itself. These data demonstrate a complex interplay between vitamin D and the placenta and will inform future interventions using vitamin D to support fetal development and maternal adaptations to pregnancy.
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Affiliation(s)
- Brogan Ashley
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom
| | - Claire Simner
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom
| | - Antigoni Manousopoulou
- Beckman Research Institute, City of Hope National Medical CenterDuarteUnited States,Proteas Bioanalytics Inc, BioLabs at the Lundquist InstituteTorranceUnited States
| | - Carl Jenkinson
- Institute of Metabolism and Systems Research, The University of BirminghamBirminghamUnited Kingdom
| | - Felicity Hey
- NIHR Cambridge Biomedical Research Centre, Nutritional Biomarker Laboratory. MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Clifford Allbutt Building, Cambridge Biomedical CampusCambridgeUnited Kingdom,Formerly at MRC Elsie Widdowson Laboratory, Cambridge, CB1 9NL l Merck Exploratory Science Center, Merck Research LaboratoriesCambridgeUnited States
| | - Jennifer M Frost
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of LondonLondonUnited Kingdom
| | - Faisal I Rezwan
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom,School of Water, Energy and Environment, Cranfield UniversityCranfieldUnited Kingdom
| | - Cory H White
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom,Merck Exploratory Science Center, Merck Research LaboratoriesCambridgeUnited States
| | - Emma M Lofthouse
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom
| | - Emily Hyde
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom
| | - Laura DF Cooke
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom
| | - Sheila Barton
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom
| | - Pamela Mahon
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom
| | - Elizabeth M Curtis
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom
| | - Rebecca J Moon
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom,NIHR Applied Research Collaboration Wessex, Southampton Science ParkSouthamptonUnited Kingdom
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUnited Kingdom
| | - John W Holloway
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUnited Kingdom,NIHR Oxford Biomedical Research Center, University of OxfordOxfordUnited Kingdom
| | - Kerry S Jones
- NIHR Cambridge Biomedical Research Centre, Nutritional Biomarker Laboratory. MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Clifford Allbutt Building, Cambridge Biomedical CampusCambridgeUnited Kingdom,Formerly at MRC Elsie Widdowson Laboratory, Cambridge, CB1 9NL l Merck Exploratory Science Center, Merck Research LaboratoriesCambridgeUnited States
| | - Rohan M Lewis
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom
| | - Martin Hewison
- Institute of Metabolism and Systems Research, The University of BirminghamBirminghamUnited Kingdom
| | - Spiros DD Garbis
- Proteas Bioanalytics Inc, BioLabs at the Lundquist InstituteTorranceUnited States
| | - Miguel R Branco
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of LondonLondonUnited Kingdom
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of SouthamptonSouthamptonUnited Kingdom,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUnited Kingdom
| | - Jane K Cleal
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine University of SouthamptonSouthamptonUnited Kingdom
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21
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Holroyd CR, Carter S, Crozier SR, D'Angelo S, Curtis EM, Moon RJ, Davies JH, Ward KA, Dennison EM, Inskip HM, Godfrey KM, Cooper C, Harvey NC. Differential relationships between parent-child DXA and pQCT bone measures: Results from the Southampton Women's Survey. Bone 2021; 153:116134. [PMID: 34332160 PMCID: PMC7611825 DOI: 10.1016/j.bone.2021.116134] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/13/2021] [Accepted: 07/24/2021] [Indexed: 10/20/2022]
Abstract
AIM To investigate the associations between indices of bone health in childhood and corresponding parental measures. METHODS The Southampton Women's Survey characterised 12,583 non-pregnant women aged 20-34 years; 3158 subsequently had singleton live births. In a subset, dual-energy X-ray absorptiometry (DXA) measurements of bone area (BA), bone mineral content (BMC) and areal bone mineral density (aBMD) lumbar spine and total hip were obtained in the parent/offspring (aged 8-9 years) trios. Another subset of children (aged 6-7 years), and their parents, had peripheral quantitative computed tomography (pQCT; 4% and 38% tibia) measures. Using multivariable linear regression we examined relationships between mother/father and offspring, adjusting for parental age, habitual walking speed and education; offspring age and sex; and the corresponding bone measure in the other parent (β-coefficients (95%CI) unit/unit for each bone measure). RESULTS Data were available for 260 trios with DXA and 99 with pQCT. There were positive associations for BA, BMC and aBMD between either parent and offspring. Mother-child associations were of greater magnitude than father-child; for example, mother-child aBMD (β = 0.26 g·cm-2/g·cm-2 (0.21,0.32)) and father-child aBMD (β = 0.16 g·cm-2/g·cm-2 (0.11,0.21)), P-difference in β = 0.007. In the subset with pQCT there was a positive association for mother-offspring 4% tibial total area (β = 0.33 mm2/mm2 (0.17,0.48)), but little evidence of a father-offspring association (β = -0.06 mm2/mm2 (-0.17,0.06)). In contrast offspring 38% cortical density was more strongly associated with this measure in fathers (β = 0.48 mg·cm-3/mg·cm-3 (0.15,0.82)) than mothers (β = 0.27 mg·cm-3/mg·cm-3 (-0.03,0.56)). In general mother-father differences were attenuated by adjustment for height. CONCLUSIONS Whilst offspring bone measures are independently associated with those of either parent, the magnitude of the association is often greater for maternal than paternal relationships. These findings are consistent with an in utero influence on offspring growth but might also reflect genetic and/or epigenetic parent of origin effects. SUMMARY In an established parent-offspring cohort, associations between parent and offspring bone indices were generally greater in magnitude for mother-offspring than father-offspring relationships.
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Affiliation(s)
- C R Holroyd
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Rheumatology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - S Carter
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - S R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - S D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - E M Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Rheumatology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - R J Moon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - J H Davies
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - K A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - H M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - K M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK; NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
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22
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Curtis EM, Parsons C, Maslin K, D'Angelo S, Moon RJ, Crozier SR, Gossiel F, Bishop NJ, Kennedy SH, Papageorghiou AT, Fraser R, Gandhi SV, Prentice A, Inskip HM, Godfrey KM, Schoenmakers I, Javaid MK, Eastell R, Cooper C, Harvey NC. Bone turnover in pregnancy, measured by urinary CTX, is influenced by vitamin D supplementation and is associated with maternal bone health: findings from the Maternal Vitamin D Osteoporosis Study (MAVIDOS) trial. Am J Clin Nutr 2021; 114:1600-1611. [PMID: 34297067 PMCID: PMC8574710 DOI: 10.1093/ajcn/nqab264] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 02/13/2021] [Accepted: 07/19/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The pattern of change in maternal bone turnover throughout pregnancy is poorly characterized. OBJECTIVES We investigated changes across pregnancy in a marker of maternal bone resorption, urinary C-terminal telopeptide of type I collagen (CTX), the influence of gestational vitamin D supplementation, and associations between CTX and maternal postnatal bone indices. METHODS MAVIDOS (the Maternal Vitamin D Osteoporosis Study) is a randomized, double-blind, placebo-controlled trial of 1000 IU cholecalciferol/d compared with placebo from 14 weeks of gestation to birth. Maternal second-void urinary α- and β-CTX were measured (ELISA) at 14 and 34 weeks of gestation; DXA was performed within 2 wk postpartum. The Mann-Whitney Rank Sum test, Spearman's rank correlation, and linear regression were used to compare median CTX values within and between groups from early to late pregnancy, and associations with maternal bone outcomes. RESULTS In total, 372 women had CTX and 25-hydroxyvitamin D [25(OH)D] measured in early and late pregnancy. CTX at 14 and 34 weeks of gestation were correlated in both placebo (r = 0.31) and cholecalciferol (r = 0.45) groups (P < 0.0001). Median CTX increased from 14 to 34 weeks of gestation in both groups (n = 372 total) [placebo (n = 188): from 223.6 to 449.7 μg/mmol creatinine; cholecalciferol (n = 184): from 222.3 to 419.3 μg/mmol creatinine; P = 0.03 for placebo compared with cholecalciferol difference in CTX at 34 weeks of gestation]. The conditional mean ± SD increase in CTX [z-score (SD)] from early to late pregnancy was greater in the placebo group (n = 188) than in the cholecalciferol group (n = 184) (placebo: 0.16 ± 0.92; cholecalciferol: -0.16 ± 1.06; P-difference < 0.01). Higher CTX at 34 weeks of gestation was associated, similarly in both groups, with lower maternal total hip and lumbar spine bone mineral content and bone mineral density (BMD) (e.g., lumbar spine BMD: β = -0.02 g · cm-2 · SD-1 increase in CTX; 95% CI: -0.027, -0.002 g · cm-2 · SD-1; P = 0.02, n = 283). CONCLUSIONS Maternal urinary CTX, a bone resorption marker, rises through pregnancy, although to a lesser degree with gestational cholecalciferol supplementation, and is inversely associated with maternal bone mass postpartum.This trial was registered at www.isrctn.com as ISRCTN 82927713 and eudract.ema.europa.eu as EudraCT 2007-001716-23.
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Affiliation(s)
- Elizabeth M Curtis
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Camille Parsons
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Kate Maslin
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- School of Nursing and Midwifery, University of Plymouth, Plymouth, United Kingdom
| | - Stefania D'Angelo
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Rebecca J Moon
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- Paediatric Endocrinology, University Hospitals Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Sarah R Crozier
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Fatma Gossiel
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Nicholas J Bishop
- Academic Unit of Child Health, Sheffield Children's Hospital, University of Sheffield, Sheffield, United Kingdom
| | - Stephen H Kennedy
- Nuffield Department of Women's & Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Aris T Papageorghiou
- Nuffield Department of Women's & Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Robert Fraser
- Department of Obstetrics and Gynaecology, Sheffield Hospitals National Health Service Trust, University of Sheffield, Sheffield, United Kingdom
| | - Saurabh V Gandhi
- Department of Obstetrics and Gynaecology, Sheffield Hospitals National Health Service Trust, University of Sheffield, Sheffield, United Kingdom
| | - Ann Prentice
- Medical Research Council Nutrition and Bone Health, University of Cambridge, Cambridge, United Kingdom
| | - Hazel M Inskip
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Inez Schoenmakers
- Department of Medicine, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - M Kassim Javaid
- National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Richard Eastell
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
- National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Nicholas C Harvey
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
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23
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Simpson RF, Hesketh KR, Crozier SR, Baird J, Cooper C, Godfrey KM, Harvey NC, Westgate K, Inskip HM, van Sluijs EMF. Cross-sectional associations between number and ages of children and maternal physical activity. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Physical activity (PA) has many health benefits, but parenthood is often associated with reduced PA in mothers. Determinants of adult PA are diverse, but ages and number of children may be key factors linked to maternal PA. Few studies have compared PA levels of mothers of school-aged children with those who have younger children, which is vital considering that maternal PA patterns may change at transition to formal schooling. Studies using device-assessment to investigate this association are also sparse. We aimed to investigate the association between number and ages of children and maternal device-measured moderate-to-vigorous PA (MVPA).
Methods
Cross-sectional analyses were conducted using data from 848 mothers from the Southampton Women's Survey when the index child was 4 or 6-7 years old. Two-level random intercept linear models were run to investigate associations between self-reported number (1, 2, 3+) and ages (4y and under, 5y and over, both age groups) of children, and their potential interaction, and accelerometer-assessed log-transformed minutes of maternal MVPA. Results are presented as % difference in minutes of MVPA.
Results
41% of mothers met PA guidelines (150 minutes of MVPA/week). Women who had any children 5y and over engaged in more MVPA than those with only children 4y and under (e.g. % difference in minutes of MVPA: 42.2, 95% CI 18.7 to 70.4 for mothers with only children 5y and over vs those with only children 4y and under). Mothers with 2 or 3+ children did less MVPA than those with 1 child (e.g. 13.9, 1.0 to 25.2 less MVPA for women with 2 children vs those with 1 child).
Conclusions
Mothers with multiple children or any children 4y and under do less MVPA than those with 1 child or only school-aged children. Interventions and policies are needed to support these mothers to increase their time spent doing MVPA, especially considering the additional health benefits associated with this level of intensity of PA.
Key messages
Most mothers are insufficiently physically active to gain the associated health benefits. Interventions to increase MVPA particularly need to target mothers of younger children and those with multiple children.
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Affiliation(s)
- RF Simpson
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - KR Hesketh
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - SR Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, Chilworth, Southampton, UK
| | - J Baird
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - KM Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - NC Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - K Westgate
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - HM Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - EMF van Sluijs
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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24
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Chen LW, Aubert AM, Shivappa N, Bernard JY, Mensink-Bout SM, Geraghty AA, Mehegan J, Suderman M, Polanska K, Hanke W, Jankowska A, Relton CL, Crozier SR, Harvey NC, Cooper C, Hanson M, Godfrey KM, Gaillard R, Duijts L, Heude B, Hébert JR, McAuliffe FM, Kelleher CC, Phillips CM. Maternal dietary quality, inflammatory potential and childhood adiposity: an individual participant data pooled analysis of seven European cohorts in the ALPHABET consortium. BMC Med 2021; 19:33. [PMID: 33612114 PMCID: PMC7898733 DOI: 10.1186/s12916-021-01908-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 01/11/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Mounting evidence suggests that maternal diet influences pregnancy and birth outcomes, but its contribution to the global epidemic of childhood obesity has not as yet been definitively characterized. We investigated whether maternal whole diet quality and inflammatory potential influence childhood adiposity. METHODS We harmonized and pooled individual participant data from 16,295 mother-child pairs in seven European birth cohorts. Maternal pre-, early-, late-, and whole-pregnancy (any time during pregnancy) dietary quality and inflammatory potential assessed with the Dietary Approaches to Stop Hypertension (DASH) score and the energy-adjusted Dietary Inflammatory Index (E-DII™) score, respectively. Primary outcome was childhood overweight and obesity (OWOB) (age-and-sex-specific BMI z-score > 85th percentile). Secondary outcomes were sum of skinfold thickness (SST), fat mass index (FMI) and fat-free mass index (FFMI). We used multivariable regression analyses (adjusting for maternal lifestyle and sociodemographic factors) to assess the associations of maternal DASH and E-DII scores with offspring adiposity outcomes in cohort-specific analyses, with subsequent random-effect meta-analyses. RESULTS The study mothers had a mean (SD) age of 30.2 (4.6) years and a mean BMI of 23.4 (4.2) kg/m2. Higher early-pregnancy E-DII scores (more pro-inflammatory diet) tended to be associated with a higher odds of late-childhood [10.6 (1.2) years] OWOB [OR (95% CI) 1.09 (1.00, 1.19) per 1-SD E-DII score increase], whereas an inverse association was observed for late-pregnancy E-DII score and early-childhood [2.8 (0.3) years] OWOB [0.91 (0.83, 1.00)]. Higher maternal whole pregnancy DASH score (higher dietary quality) was associated with a lower odds of late-childhood OWOB [OR (95% CI) 0.92 (0.87, 0.98) per 1-SD DASH score increase]; associations were of similar magnitude for early and late-pregnancy [0.86 (0.72, 1.04) and 0.91 (0.85, 0.98), respectively]. These associations were robust in several sensitivity analyses and further adjustment for birth weight and childhood diet did not meaningfully alter the associations and conclusions. In two cohorts with available data, a higher whole pregnancy E-DII and lower DASH scores were associated with a lower late-childhood FFMI in males and a higher mid-childhood FMI in females (P interactions < 0.10). CONCLUSIONS A pro-inflammatory, low-quality maternal antenatal diet may adversely influence offspring body composition and OWOB risk, especially during late-childhood. Promoting an overall healthy and anti-inflammatory maternal dietary pattern may contribute to the prevention of childhood obesity, a complex health issue requiring multifaceted strategy.
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Affiliation(s)
- Ling-Wei Chen
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Republic of Ireland.
| | - Adrien M Aubert
- Université de Paris, Centre for Research in Epidemiology and StatisticS (CRESS), Inserm, Inrae, F-75004, Paris, France
| | - Nitin Shivappa
- Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Connecting Health Innovations, LLC, Columbia, SC, 29201, USA
| | - Jonathan Y Bernard
- Université de Paris, Centre for Research in Epidemiology and StatisticS (CRESS), Inserm, Inrae, F-75004, Paris, France
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, 117609, Singapore
| | - Sara M Mensink-Bout
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Aisling A Geraghty
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - John Mehegan
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Matthew Suderman
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK
| | | | | | | | - Caroline L Relton
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Unit (University of Southampton) University Hospital Southampton, Southampton, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit (University of Southampton) University Hospital Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit (University of Southampton) University Hospital Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mark Hanson
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Institute of Developmental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit (University of Southampton) University Hospital Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Romy Gaillard
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Liesbeth Duijts
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Barbara Heude
- Université de Paris, Centre for Research in Epidemiology and StatisticS (CRESS), Inserm, Inrae, F-75004, Paris, France
| | - James R Hébert
- Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Connecting Health Innovations, LLC, Columbia, SC, 29201, USA
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Cecily C Kelleher
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Catherine M Phillips
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Republic of Ireland.
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Robinson N, Brown H, Antoun E, Godfrey KM, Hanson MA, Lillycrop KA, Crozier SR, Murray R, Pearce MS, Relton CL, Albani V, McKay JA. Childhood DNA methylation as a marker of early life rapid weight gain and subsequent overweight. Clin Epigenetics 2021; 13:8. [PMID: 33436068 PMCID: PMC7805168 DOI: 10.1186/s13148-020-00952-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 10/19/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND High early postnatal weight gain has been associated with childhood adiposity; however, the mechanism remains unknown. DNA methylation is a hypothesised mechanism linking early life exposures and subsequent disease. However, epigenetic changes associated with high early weight gain have not previously been investigated. Our aim was to investigate the associations between early weight gain, peripheral blood DNA methylation, and subsequent overweight/obese. Data from the UK Avon Longitudinal study of Parents and Children (ALSPAC) cohort were used to estimate associations between early postnatal weight gain and epigenome-wide DNA CpG site methylation (Illumina 450 K Methylation Beadchip) in blood in childhood (n = 125) and late adolescence (n = 96). High weight gain in the first year (a change in weight z-scores > 0.67), both unconditional (rapid weight gain) and conditional on birthweight (rapid thrive), was related to individual CpG site methylation and across regions using the meffil pipeline, with and without adjustment for cell type proportions, and with 5% false discovery rate correction. Variation in methylation at high weight gain-associated CpG sites was then examined with regard to body composition measures in childhood and adolescence. Replication of the differentially methylated CpG sites was sought using whole-blood DNA samples from 104 children from the UK Southampton Women's Survey. RESULTS Rapid infant weight gain was associated with small (+ 1% change) increases in childhood methylation (age 7) for two distinct CpG sites (cg01379158 (NT5M) and cg11531579 (CHFR)). Childhood methylation at one of these CpGs (cg11531579) was also higher in those who experienced rapid weight gain and were subsequently overweight/obese in adolescence (age 17). Rapid weight gain was not associated with differential DNA methylation in adolescence. Childhood methylation at the cg11531579 site was also suggestively associated with rapid weight gain in the replication cohort. CONCLUSIONS This study identified associations between rapid weight gain in infancy and small increases in childhood methylation at two CpG sites, one of which was replicated and was also associated with subsequent overweight/obese. It will be important to determine whether loci are markers of early rapid weight gain across different, larger populations. The mechanistic relevance of these differentially methylated sites requires further investigation.
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Affiliation(s)
- N Robinson
- Population Health Sciences, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, UK.
| | - H Brown
- Population Health Sciences, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - Elie Antoun
- Institute of Developmental Sciences, Biological Sciences and NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mark A Hanson
- Institute of Developmental Sciences, Biological Sciences and NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Karen A Lillycrop
- Institute of Developmental Sciences, Biological Sciences and NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Robert Murray
- Institute of Developmental Sciences, Biological Sciences and NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - M S Pearce
- Population Health Sciences, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - C L Relton
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - V Albani
- Population Health Sciences, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - J A McKay
- Department of Applied Sciences, Northumbria University, Newcastle upon Tyne, UK
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26
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Norris T, Crozier SR, Cameron N, Godfrey KM, Inskip H, Johnson W. Fetal growth does not modify the relationship of infant weight gain with childhood adiposity and blood pressure in the Southampton women's survey. Ann Hum Biol 2020; 47:150-158. [PMID: 32429761 PMCID: PMC7261399 DOI: 10.1080/03014460.2020.1717616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background: Rapid infant weight gain is a risk factor for childhood obesity. This relationship may depend on whether infant weight gain is preceded by in-utero growth restriction. Aim: Examine whether fetal growth modifies the relationship between infant weight gain and childhood adiposity and blood pressure. Subjects and methods: 786 children in the Southampton Women’s Survey. We related infant weight gain (weight at 2 years-birth weight) to body mass index (BMI), %body fat, trunk fat (kg), systolic (SBP) and diastolic blood pressure (DBP) at age 6–7 years. Mean estimated fetal weight (EFW) between 19–34 weeks and change in EFW (19–34 weeks) were added to models as effect modifiers. Results: Infant weight gain was positively associated with all childhood outcomes. We found no evidence that these effects were modified by fetal growth (p > .1 for all interaction terms). For example, a 1 standard deviation (SD) increase in infant weight gain was associated with an increase in BMI z-score of 0.51 (95% CI 0.37;0.64) when EFW-change was set at -2 SD-scores compared with an increase of 0.41 (95% CI 0.27;0.54, p(interaction)=.48) when set at 2 SD-scores. Conclusion: The documented adverse consequences of rapid infant weight gain may occur regardless of whether growth was constrained in-utero.
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Affiliation(s)
- Tom Norris
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Noël Cameron
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Hazel Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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27
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Woolford SJ, Curtis EM, D'Angelo S, Mahon P, Cooke L, Cleal JK, Crozier SR, Godfrey KM, Inskip HM, Cooper C, Harvey NC. Placental volume at 11 weeks is associated with offspring bone mass at birth and in later childhood: Findings from the Southampton Women's Survey. Placenta 2020; 99:101-107. [PMID: 32784052 PMCID: PMC7116131 DOI: 10.1016/j.placenta.2020.07.017] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate associations between placental volume (PV) at 11 weeks' gestation and offspring bone outcomes at birth, 6 years and 8 years. METHODS 3D ultrasound scanning was used to assess 11 week PV in a subset (n = 236) of the Southampton Women's Survey (a prospective mother-offspring cohort). Maternal anthropometric measures and lifestyle information were obtained pre-pregnancy and at 11 weeks' gestation. Offspring dual-energy x-ray absorptiometry scanning was performed within 2 weeks postnatally and at 6 and 8 years. Linear regression was used to assess associations between PV and bone outcomes, adjusting for offspring age at DXA and sex, and maternal age, height, smoking status, walking speed and triceps skinfold thickness. β are SD change in bone outcome per SD change in PV. RESULTS In adjusted models, 11 week PV was positively associated with bone area (BA) at all time points, with evidence of persisting associations with increasing childhood age (birth: n = 80, β = 0.23 [95%CI = 0.03, 0.42], 6 years: n = 110, β = 0.17 [-0.01, 0.36], 8 years: n = 85, β = 0.13 [-0.09, 0.36]). Similar associations between 11 week PV and bone mineral content (BMC) were observed. Associations with size-corrected bone mineral content were weaker at birth but strengthened in later childhood (birth: n = 78, β = 0.07 [-0.21, 0.35], 6 years: n = 107, β = 0.13 [-0.08, 0.34], 8 years: n = 71, β = 0.19 [-0.05, 0.43]). CONCLUSIONS 11 week PV is associated with DXA bone measures at birth, with evidence of persisting associations into later childhood. Further work is required to elucidate the contributions of placental morphology and function to gestational influences on skeletal development.
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Affiliation(s)
- S J Woolford
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - E M Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - S D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - P Mahon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - L Cooke
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
| | - J K Cleal
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
| | - S R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - K M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - H M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
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Curtis EM, Moon RJ, D'Angelo S, Crozier SR, Bishop NJ, Gopal- Kothandapani S, Kennedy S, Papageorghiou AT, Fraser R, Gandhi SV, Schoenmakers I, Prentice A, Inskip HM, Godfrey KM, Javaid K, Eastell R, Cooper C, Harvey NC. O13 Pregnancy vitamin D supplementation leads to greater offspring bone mineral density at 4 years: the MAVIDOS randomised placebo controlled trial. Rheumatology (Oxford) 2020. [DOI: 10.1093/rheumatology/keaa110.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Observational studies have demonstrated associations between maternal gestational vitamin D status and offspring bone health. We have recently shown, in a randomised controlled trial, that pregnancy vitamin D supplementation leads to improved offspring bone mass at birth amongst winter deliveries (when background 25(OH)-vitamin D levels are lowest). In the present analysis, we aimed to evaluate whether the beneficial effect of pregnancy vitamin D supplementation on neonatal bone mass is sustained into early childhood, with bone indices assessed at age 4 years in a subset of participants of the MAVIDOS trial.
Methods
Pregnant women were randomised in Southampton, Oxford and Sheffield, in a double-blind design, to 1000 IU/day cholecalciferol or matched placebo from 14 weeks’ gestation to birth. At 4 years of age (Southampton participants only, n = 723 births), offspring assessments included anthropometry, whole-body dual-energy x-ray absorptiometry (DXA) [Hologic Horizon, yielding whole body less head (WBLH) bone mineral content (BMC), bone mineral density (BMD), bone area (BA) and lean mass (LM)], and a maternal questionnaire. Linear regression was used to estimate the mean difference (represented by β) in outcomes between the two randomisation arms, adjusted for sex and age at DXA. Further models were additionally adjusted for gestational age, maternal BMI, and child’s sedentary time. All outcomes were standardised to a standard deviation scale, for ease of comparison. Full ethics and MHRA approvals were granted.
Results
564 children attended the 4-year visit; 452 had a useable DXA with minimal movement artefact. Maternal pregnancy vitamin D supplementation led to greater offspring indices of bone mass compared with placebo, irrespective of season. For example, WBLH BMD at age 4 years was greater in the offspring of supplemented mothers [β = 0.18 SD (95%CI: 0.00, 0.35), p = 0.047]; there was also evidence of greater LM in the intervention group [β = 0.15 SD (95%CI: -0.02, 0.31), p = 0.081]. In fully adjusted models associations were consistent for lumbar spine indices and for BA and BMC. In keeping with the offspring findings, maternal vitamin D supplementation led to significantly higher maternal plasma 25(OH)D concentrations in late pregnancy (34 weeks’ gestation): placebo group (median(IQR)): 42.4 nmol/l (23.3, 56.4); vitamin D group: 67.4 nmol/l (56.2, 80.3); p < 0.001.
Conclusion
This is the first ever demonstration in a large placebo-controlled, double-blind randomised controlled trial that maternal pregnancy vitamin D supplementation leads to improved bone and lean mass in children. Our findings suggest that maternal cholecalciferol supplementation may have lasting benefits for offspring musculoskeletal health and thus represent an important public health message. This work was supported by grants from Versus Arthritis 17702, Medical Research Council (MRC #405050259; #U105960371), Bupa Foundation, NIHR Southampton Biomedical Research Centre (BRC), University of Southampton, and NIHR Oxford BRC, University of Oxford. EC was supported by the Wellcome Trust (#201268/Z/16/Z).
Disclosures
E.M. Curtis None. R.J. Moon None. S. D'Angelo None. S.R. Crozier None. N.J. Bishop None. S. Gopal- Kothandapani None. S. Kennedy None. A.T. Papageorghiou None. R. Fraser None. S.V. Gandhi None. I. Schoenmakers None. A. Prentice None. H.M. Inskip None. K.M. Godfrey None. K. Javaid None. R. Eastell None. C. Cooper None. N.C. Harvey None.
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Affiliation(s)
- Elizabeth M Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UNITED KINGDOM
| | - Rebecca J Moon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UNITED KINGDOM
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UNITED KINGDOM
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UNITED KINGDOM
| | - Nicholas J Bishop
- Academic Unit of Child Health, Sheffield Children's Hospital, Sheffield, UNITED KINGDOM
| | | | - Stephen Kennedy
- Nuffield Department of Womens & Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, UNITED KINGDOM
| | - Aris T Papageorghiou
- Nuffield Department of Womens & Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, UNITED KINGDOM
| | - Robert Fraser
- Department of Obstetrics and Gynaecology, Sheffield Hospitals NHS Trust, University of Sheffield, Sheffield, UNITED KINGDOM
| | - Saurabh V Gandhi
- Department of Obstetrics and Gynaecology, Sheffield Hospitals NHS Trust, University of Sheffield, Sheffield, UNITED KINGDOM
| | - Inez Schoenmakers
- Department of Medicine, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UNITED KINGDOM
| | - Ann Prentice
- MRC Nutrition and Bone Health, University of Cambridge, Cambridge, UNITED KINGDOM
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UNITED KINGDOM
| | - Keith M Godfrey
- NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UNITED KINGDOM
| | - Kassim Javaid
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UNITED KINGDOM
| | - Richard Eastell
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UNITED KINGDOM
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UNITED KINGDOM
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UNITED KINGDOM
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29
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Crozier SR, Godfrey KM, Calder PC, Robinson SM, Inskip HM, Baird J, Gale CR, Cooper C, Sibbons CM, Fisk HL, Burdge GC. Vegetarian Diet during Pregnancy Is Not Associated with Poorer Cognitive Performance in Children at Age 6-7 Years. Nutrients 2019; 11:nu11123029. [PMID: 31835868 PMCID: PMC6949927 DOI: 10.3390/nu11123029] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/05/2019] [Accepted: 12/10/2019] [Indexed: 12/26/2022] Open
Abstract
Compared with omnivorous mothers, vegetarian mothers have lower intakes of some nutrients required for neurological development. However, there is a lack of information about the impact of vegetarianism during pregnancy on subsequent cognitive function in children. The aim of this study was to investigate whether vegetarianism during pregnancy is associated with altered maternal nutritional status and with cognitive function in children at six to seven years of age. Women aged 20–34 years participating in a prospective observational study who provided dietary data and blood samples in early pregnancy (11 weeks; 78 vegetarians and 2144 omnivores) or late pregnancy (34 weeks; 91 vegetarians and 2552 omnivores). Compared with omnivorous women, vegetarian women had lower blood concentrations of arachidonic acid, docosahexaenoic acid, and cobalamin in early and late pregnancy. Vegetarianism in pregnancy was linked to higher maternal educational attainment, longer breastfeeding duration, lower incidence of smoking during pregnancy and a tendency towards higher IQ in the mothers. Concentrations of some nutrients required for neurodevelopment were lower in maternal blood during gestation; however, after controlling for confounders consuming a vegetarian diet during pregnancy was not associated with poorer neurocognitive development of the children in this study.
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Affiliation(s)
- Sarah R. Crozier
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
| | - Philip C. Calder
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Sian M. Robinson
- AGE Research Group, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Hazel M. Inskip
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
| | - Janis Baird
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
| | - Catharine R. Gale
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
- Centre for Cognitive Ageing & Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh EH8 9AZ, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
| | - Charlene M. Sibbons
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Helena L. Fisk
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Graham C. Burdge
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- Correspondence: ; Tel.: +44-(0)23-812-05259
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30
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Aubert AM, Forhan A, de Lauzon-Guillain B, Chen LW, Polanska K, Hanke W, Jankowska A, Mensink-Bout SM, Duijts L, Suderman M, Relton CL, Crozier SR, Harvey NC, Cooper C, McAuliffe FM, Kelleher CC, Phillips CM, Heude B, Bernard JY. Deriving the Dietary Approaches to Stop Hypertension (DASH) Score in Women from Seven Pregnancy Cohorts from the European ALPHABET Consortium. Nutrients 2019; 11:E2706. [PMID: 31717283 PMCID: PMC6893477 DOI: 10.3390/nu11112706] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 10/31/2019] [Accepted: 11/04/2019] [Indexed: 02/07/2023] Open
Abstract
The ALPHABET consortium aims to examine the interplays between maternal diet quality, epigenetics and offspring health in seven pregnancy/birth cohorts from five European countries. We aimed to use the Dietary Approaches to Stop Hypertension (DASH) score to assess diet quality, but different versions have been published. To derive a single DASH score allowing cross-country, cross-cohort and cross-period comparison and limiting data heterogeneity within the ALPHABET consortium, we harmonised food frequency questionnaire (FFQ) data collected before and during pregnancy in ≥26,500 women. Although FFQs differed strongly in length and content, we derived a consortium DASH score composed of eight food components by combining the prescriptive original DASH and the DASH described by Fung et al. Statistical issues tied to the nature of the FFQs led us to re-classify two food groups (grains and dairy products). Most DASH food components exhibited pronounced between-cohort variability, including non-full-fat dairy products (median intake ranging from 0.1 to 2.2 servings/day), sugar-sweetened beverages/sweets/added sugars (0.3-1.7 servings/day), fruits (1.1-3.1 servings/day), and vegetables (1.5-3.6 servings/day). We successfully developed a harmonized DASH score adapted to all cohorts being part of the ALPHABET consortium. This methodological work may benefit other research teams in adapting the DASH to their study's specificities.
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Affiliation(s)
- Adrien M. Aubert
- Centre for Research in Epidemiology and StatisticS (CRESS), Université de Paris, Inserm, Inra, F-75004 Paris, France; (A.M.A.); (A.F.); (B.d.L.-G.); (J.Y.B.)
| | - Anne Forhan
- Centre for Research in Epidemiology and StatisticS (CRESS), Université de Paris, Inserm, Inra, F-75004 Paris, France; (A.M.A.); (A.F.); (B.d.L.-G.); (J.Y.B.)
| | - Blandine de Lauzon-Guillain
- Centre for Research in Epidemiology and StatisticS (CRESS), Université de Paris, Inserm, Inra, F-75004 Paris, France; (A.M.A.); (A.F.); (B.d.L.-G.); (J.Y.B.)
| | - Ling-Wei Chen
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland; (L.-W.C.); (C.C.K.); (C.M.P.)
| | - Kinga Polanska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland; (K.P.); (W.H.); (A.J.)
| | - Wojciech Hanke
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland; (K.P.); (W.H.); (A.J.)
| | - Agnieszka Jankowska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland; (K.P.); (W.H.); (A.J.)
| | - Sara M. Mensink-Bout
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (S.M.M.-B.); (L.D.)
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, 3000 CB Rotterdam, The Netherlands
| | - Liesbeth Duijts
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (S.M.M.-B.); (L.D.)
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, 3000 CB Rotterdam, The Netherlands
- Department of Pediatrics, division of Neonatology, Erasmus MC, University Medical Center Rotterdam, 3000 CB Rotterdam, The Netherlands
| | - Matthew Suderman
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK; (M.S.); (C.L.R.)
| | - Caroline L. Relton
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK; (M.S.); (C.L.R.)
| | - Sarah R. Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital Southampton, Southampton SO16 6YD, UK; (S.R.C.); (N.C.H.); (C.C.)
| | - Nicholas C. Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital Southampton, Southampton SO16 6YD, UK; (S.R.C.); (N.C.H.); (C.C.)
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital Southampton, Southampton SO16 6YD, UK; (S.R.C.); (N.C.H.); (C.C.)
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford OX1 2JD, UK
| | - Fionnuala M. McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland;
| | - Cecily C. Kelleher
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland; (L.-W.C.); (C.C.K.); (C.M.P.)
| | - Catherine M. Phillips
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland; (L.-W.C.); (C.C.K.); (C.M.P.)
| | - Barbara Heude
- Centre for Research in Epidemiology and StatisticS (CRESS), Université de Paris, Inserm, Inra, F-75004 Paris, France; (A.M.A.); (A.F.); (B.d.L.-G.); (J.Y.B.)
| | - Jonathan Y. Bernard
- Centre for Research in Epidemiology and StatisticS (CRESS), Université de Paris, Inserm, Inra, F-75004 Paris, France; (A.M.A.); (A.F.); (B.d.L.-G.); (J.Y.B.)
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609 Singapore, Singapore
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Huang T, Wang T, Zheng Y, Ellervik C, Li X, Gao M, Fang Z, Chai JF, Ahluwalia TVS, Wang Y, Voortman T, Noordam R, Frazier-Wood A, Scholz M, Sonestedt E, Akiyama M, Dorajoo R, Zhou A, Kilpeläinen TO, Kleber ME, Crozier SR, Godfrey KM, Lemaitre R, Felix JF, Shi Y, Gupta P, Khor CC, Lehtimäki T, Wang CA, Tiesler CMT, Thiering E, Standl M, Rzehak P, Marouli E, He M, Lecoeur C, Corella D, Lai CQ, Moreno LA, Pitkänen N, Boreham CA, Zhang T, Saw SM, Ridker PM, Graff M, van Rooij FJA, Uitterlinden AG, Hofman A, van Heemst D, Rosendaal FR, de Mutsert R, Burkhardt R, Schulz CA, Ericson U, Kamatani Y, Yuan JM, Power C, Hansen T, Sørensen TIA, Tjønneland A, Overvad K, Delgado G, Cooper C, Djousse L, Rivadeneira F, Jameson K, Zhao W, Liu J, Lee NR, Raitakari O, Kähönen M, Viikari J, Grote V, Langhendries JP, Koletzko B, Escribano J, Verduci E, Dedoussis G, Yu C, Tham YC, Lim B, Lim SH, Froguel P, Balkau B, Fink NR, Vinding RK, Sevelsted A, Bisgaard H, Coltell O, Dallongeville J, Gottrand F, Pahkala K, Niinikoski H, Hyppönen E, Pedersen O, März W, Inskip H, Jaddoe VWV, Dennison E, Wong TY, Sabanayagam C, Tai ES, Mohlke KL, Mackey DA, Gruszfeld D, Deloukas P, Tucker KL, Fumeron F, Bønnelykke K, Rossing P, Estruch R, Ordovas JM, Arnett DK, Meirhaeghe A, Amouyel P, Cheng CY, Sim X, Teo YY, van Dam RM, Koh WP, Orho-Melander M, Loeffler M, Kubo M, Thiery J, Mook-Kanamori DO, Mozaffarian D, Psaty BM, Franco OH, Wu T, North KE, Davey Smith G, Chavarro JE, Chasman DI, Qi L. Association of Birth Weight With Type 2 Diabetes and Glycemic Traits: A Mendelian Randomization Study. JAMA Netw Open 2019; 2:e1910915. [PMID: 31539074 PMCID: PMC6755534 DOI: 10.1001/jamanetworkopen.2019.10915] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
IMPORTANCE Observational studies have shown associations of birth weight with type 2 diabetes (T2D) and glycemic traits, but it remains unclear whether these associations represent causal associations. OBJECTIVE To test the association of birth weight with T2D and glycemic traits using a mendelian randomization analysis. DESIGN, SETTING, AND PARTICIPANTS This mendelian randomization study used a genetic risk score for birth weight that was constructed with 7 genome-wide significant single-nucleotide polymorphisms. The associations of this score with birth weight and T2D were tested in a mendelian randomization analysis using study-level data. The association of birth weight with T2D was tested using both study-level data (7 single-nucleotide polymorphisms were used as an instrumental variable) and summary-level data from the consortia (43 single-nucleotide polymorphisms were used as an instrumental variable). Data from 180 056 participants from 49 studies were included. MAIN OUTCOMES AND MEASURES Type 2 diabetes and glycemic traits. RESULTS This mendelian randomization analysis included 49 studies with 41 155 patients with T2D and 80 008 control participants from study-level data and 34 840 patients with T2D and 114 981 control participants from summary-level data. Study-level data showed that a 1-SD decrease in birth weight due to the genetic risk score was associated with higher risk of T2D among all participants (odds ratio [OR], 2.10; 95% CI, 1.69-2.61; P = 4.03 × 10-5), among European participants (OR, 1.96; 95% CI, 1.42-2.71; P = .04), and among East Asian participants (OR, 1.39; 95% CI, 1.18-1.62; P = .04). Similar results were observed from summary-level analyses. In addition, each 1-SD lower birth weight was associated with 0.189 SD higher fasting glucose concentration (β = 0.189; SE = 0.060; P = .002), but not with fasting insulin, 2-hour glucose, or hemoglobin A1c concentration. CONCLUSIONS AND RELEVANCE In this study, a genetic predisposition to lower birth weight was associated with increased risk of T2D and higher fasting glucose concentration, suggesting genetic effects on retarded fetal growth and increased diabetes risk that either are independent of each other or operate through alterations of integrated biological mechanisms.
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Affiliation(s)
| | - Tao Huang
- Key Laboratory of Molecular Cardiovascular Sciences, Peking University, Ministry of Education, Beijing, China
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Tiange Wang
- Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| | - Yan Zheng
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- School of Life Sciences, Fudan University, Shanghai, China
| | - Christina Ellervik
- Department of Research and Innovation Region Zealand, Region Zealand, Denmark
- Division of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Laboratory Medicine, Boston Children's Hospital, Boston, Massachusetts
- Department of Pathology, Harvard Medical School, Boston, Massachusetts
| | - Xiang Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| | - Meng Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Zhe Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jin-Fang Chai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Tarun Veer S Ahluwalia
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Yujie Wang
- Department of Epidemiology, University of North Carolina, Chapel Hill
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Raymond Noordam
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Alexis Frazier-Wood
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Markus Scholz
- LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Emily Sonestedt
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Masato Akiyama
- RIKEN Center for Integrative Medical Sciences, Laboratory for Statistical Analysis, Yokohama, Japan
| | - Rajkumar Dorajoo
- Genome Institute of Singapore, Agency for Science Technology and Research, Singapore
| | - Ang Zhou
- Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, Australia
- Sansom Institute of Health Research, University of South Australia, Adelaide, Australia
| | - Tuomas O Kilpeläinen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marcus E Kleber
- Competence Cluster of Nutrition and Cardiovascular Health, Halle-Jena-Leipzig, Germany
- Institute of Nutrition, Friedrich Schiller University, Jena, Germany
- Vth Department of Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton, United Kingdom
| | - Rozenn Lemaitre
- Cardiovascular Health Research Institute, Department of Medicine, University of Washington, Seattle
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Yuan Shi
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Preeti Gupta
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Chiea-Chuen Khor
- Genome Institute of Singapore, Agency for Science Technology and Research, Singapore
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Carol A Wang
- Division of Obstetrics and Gynaecology, School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Carla M T Tiesler
- Ludwig-Maximilians-University of Munich, Dr von Hauner Children's Hospital, Division of Metabolic Diseases and Nutritional Medicine, Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Elisabeth Thiering
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
- Division of Metabolic and Nutritional Medicine, Dr von Hauner Children's Hospital, Klinikum der Universitaet Muenchen, Munich, Germany
| | - Marie Standl
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Peter Rzehak
- Division of Metabolic and Nutritional Medicine, Dr von Hauner Children's Hospital, Klinikum der Universitaet Muenchen, Munich, Germany
| | - Eirini Marouli
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Meian He
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Cécile Lecoeur
- University of Lille Nord de France, Lille, France
- Institut Pasteur de Lille, Lille, France
| | - Dolores Corella
- Department of Preventive Medicine and Public Health, University of Valencia, Valencia, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Chao-Qiang Lai
- United States Department of Agriculture Research Service, Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts
| | - Luis A Moreno
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Growth Exercise, Nutrition and Development Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
| | - Niina Pitkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Colin A Boreham
- UCD Institute for Sport & Health, University College Dublin, Dublin, Ireland
| | - Tao Zhang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Seang Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Paul M Ridker
- Division of Preventive Medicine, Brigham & Women's Hospital, Boston, Massachusetts
| | - Mariaelisa Graff
- Department of Epidemiology, University of North Carolina, Chapel Hill
| | - Frank J A van Rooij
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Andre G Uitterlinden
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Diana van Heemst
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Ralph Burkhardt
- LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
- Institute for Laboratory Medicine, University of Leipzig, Leipzig, Germany
| | | | - Ulrika Ericson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Yoichiro Kamatani
- RIKEN Center for Integrative Medical Sciences, Laboratory for Statistical Analysis, Yokohama, Japan
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Chris Power
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Public Health, Section of Epidemiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- MRC Integrative Epidemiology Unit & School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | | | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
- Aalborg University Hospital, Aalborg, Denmark
| | - Graciela Delgado
- Vth Department of Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton, United Kingdom
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, The Botnar Research Centre, University of Oxford, Oxford, United Kingdom
| | - Luc Djousse
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Fernando Rivadeneira
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Karen Jameson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Wanting Zhao
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Jianjun Liu
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Genome Institute of Singapore, Agency for Science Technology and Research, Singapore
| | - Nanette R Lee
- USC Office of Population Studies Foundation Inc, University of San Carlos, Cebu City, Philippines
- Department of Anthropology, Sociology, and History, University of San Carlos, Cebu City, Philippines
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jorma Viikari
- Division of Medicine, Turku University Hospital, Turku, Finland
- Department of Medicine, University of Turku, Turku, Finland
| | - Veit Grote
- Division of Metabolic and Nutritional Medicine, Dr von Hauner Children's Hospital, Klinikum der Universitaet Muenchen, Munich, Germany
| | | | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Dr von Hauner Children's Hospital, Klinikum der Universitaet Muenchen, Munich, Germany
| | - Joaquin Escribano
- Paediatrics Research Unit, Universitat Rovira i Virgili, IISPV, Reus, Spain
| | - Elvira Verduci
- Department of Pediatrics, San Paolo Hospital, University of Milan, Milan, Italy
| | - George Dedoussis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Caizheng Yu
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Blanche Lim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sing Hui Lim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Philippe Froguel
- University of Lille Nord de France, Lille, France
- Institut Pasteur de Lille, Lille, France
- University of Lille Nord de France, Lille, France
| | - Beverley Balkau
- INSERM, Centre for Research in Epidemiology and Population Health, Villejuif, France
- University Versailles Saint-Quentin-en-Yvelines, Versailles, France
- University Paris Sud 11, Villejuif, France
| | - Nadia R Fink
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Rebecca K Vinding
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Astrid Sevelsted
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Hans Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Oscar Coltell
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Computer Languages and Systems, University Jaume I, Castellon, Spain
| | - Jean Dallongeville
- INSERM U1167, Institut Pasteur de Lille, University of Lille, Lille, France
| | - Frédéric Gottrand
- INSERM U995, Hôpital Jeanne de Flandre, CHU-Lille, University of Lille, Lille, France
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physical Activity and Health, Turku, Finland
| | - Harri Niinikoski
- Department of Pediatrics, Turku University Hospital, Turku, Finland
- Department of Physiology, University of Turku, Turku, Finland
| | - Elina Hyppönen
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Australian Centre for Precision Health, University of South Australia Cancer Research Institute, University of South Australia, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Oluf Pedersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Winfried März
- Vth Department of Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany
- Synlab Academy, Synlab Holding Deutschland GmbH, Mannheim, Germany
- Clinical Institute of Medical and Chemical Laboratory Diagnostics Medical University of Graz, Graz, Austria
| | - Hazel Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton, United Kingdom
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- Victoria University of Wellington, Wellington, New Zealand
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - E-Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Karen L Mohlke
- Department of Genetics, University of North Carolina, Chapel Hill
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Crawley, Western Australia, Australia
| | - Dariusz Gruszfeld
- Department of Neonatology and Neonatal Intensive Care, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, Warsaw, Poland
| | - Panagiotis Deloukas
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders (PACER-HD) King Abdulaziz University, Jeddah, Saudi Arabia
| | - Katherine L Tucker
- Biomedical and Nutritional Sciences, University of Massachusetts, Lowell
| | - Frédéric Fumeron
- INSERM, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
- University of Paris Diderot, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Ramon Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Internal Medicine, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Jose M Ordovas
- United States Department of Agriculture Research Service, Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts
- Department of Epidemiology and Population Genetics, Centro Nacional Investigación, Cardiovasculares (CNIC), Madrid, Spain
| | - Donna K Arnett
- College of Public Health, University of Kentucky, Lexington
| | - Aline Meirhaeghe
- INSERM U1167, Institut Pasteur de Lille, University of Lille, Lille, France
| | - Philippe Amouyel
- INSERM U1167, Institut Pasteur de Lille, University of Lille, Lille, France
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yik Ying Teo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Department of Statistics and Applied Probability, Faculty of Science, National University of Singapore, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Woon-Puay Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | | | - Markus Loeffler
- LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Laboratory for Statistical Analysis, Yokohama, Japan
| | - Joachim Thiery
- LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
- Institute for Laboratory Medicine, University of Leipzig, Leipzig, Germany
| | - Dennis O Mook-Kanamori
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science & Policy, Tufts University, Boston, Massachusetts
| | - Bruce M Psaty
- Cardiovascular Health Research Institute, Department of Medicine, University of Washington, Seattle
- Department of Epidemiology, University of Washington, Seattle
- Department of Health Sciences, University of Washington, Seattle
- Kaiser Permanent Washington Health Research Institute, Seattle
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Tangchun Wu
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Kari E North
- Department of Epidemiology, University of North Carolina, Chapel Hill
- Carolina Center for Genome Sciences, University of North Carolina, Chapel Hill
| | - George Davey Smith
- MRC Integrative Epidemiology Unit & School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Daniel I Chasman
- Division of Preventive Medicine, Brigham & Women's Hospital, Boston, Massachusetts
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lu Qi
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
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Curtis EM, Parsons C, Maslin K, D’Angelo S, Moon RJ, Crozier SR, Gossiel F, Bishop NJ, Kennedy S, Papageorghiou AT, Fraser R, Gandhi S, Prentice A, Inskip HM, Godfrey KM, Schoenmakers I, Javaid MK, Eastell R, Cooper C, Harvey NC. O29 Bone turnover in pregnancy, measured by urinary C-terminal telopeptide of type I collagen (CTX), is influenced by vitamin D supplementation and is associated with maternal bone health: findings from the MAVIDOS trial. Rheumatology (Oxford) 2019. [DOI: 10.1093/rheumatology/kez105.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Elizabeth M Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Camille Parsons
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Kate Maslin
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Stefania D’Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Rebecca J Moon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Fatma Gossiel
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Nicholas J Bishop
- Academic Unit of Child Health, University of Sheffield, Sheffield, United Kingdom
| | - Stephen Kennedy
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Aris T Papageorghiou
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Robert Fraser
- Department of Obstetrics and Gynaecology, University of Sheffield, Sheffield, United Kingdom
| | - Saurabh Gandhi
- Department of Obstetrics and Gynaecology, University of Sheffield, Sheffield, United Kingdom
| | - Ann Prentice
- MRC Elsie Widdowson Laboratory, Cambridge, Cambridge, United Kingdom
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Inez Schoenmakers
- Department of Medicine, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - M Kassim Javaid
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Richard Eastell
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
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van Lee L, Crozier SR, Aris IM, Tint MT, Sadananthan SA, Michael N, Quah PL, Robinson SM, Inskip HM, Harvey NC, Barker M, Cooper C, Velan SS, Lee YS, Fortier MV, Yap F, Gluckman PD, Tan KH, Shek LP, Chong YS, Godfrey KM, Chong MFF. Prospective associations of maternal choline status with offspring body composition in the first 5 years of life in two large mother-offspring cohorts: the Southampton Women's Survey cohort and the Growing Up in Singapore Towards healthy Outcomes cohort. Int J Epidemiol 2019; 48:433-444. [PMID: 30649331 PMCID: PMC6751083 DOI: 10.1093/ije/dyy291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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] [Accepted: 12/20/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Choline status has been positively associated with weight and fat mass in animal and human studies. As evidence examining maternal circulating choline concentrations and offspring body composition in human infants/children is lacking, we investigated this in two cohorts. METHODS Maternal choline concentrations were measured in the UK Southampton Women's Survey (SWS; serum, n = 985, 11 weeks' gestation) and Singapore Growing Up Towards healthy Outcomes (GUSTO); n = 955, 26-28 weeks' gestation) mother-offspring cohorts. Offspring anthropometry was measured at birth and up to age 5 years. Body fat mass was determined using dual-energy x-ray absorptiometry at birth and age 4 years for SWS; and using air-displacement plethysmography at birth and age 5 years for GUSTO. Linear-regression analyses were performed, adjusting for confounders. RESULTS In SWS, higher maternal choline concentrations were associated with higher neonatal total body fat mass {β = 0.60 standard deviation [SD]/5 µmol/L maternal choline [95% confidence interval (CI) 0.04-1.16]} and higher subscapular skinfold thickness [β = 0.55 mm/5 µmol/L (95% CI, 0.12-1.00)] at birth. In GUSTO, higher maternal choline concentrations were associated with higher neonatal body mass index-for-age z-score [β = 0.31 SD/5 µmol/L (0.10-0.51)] and higher triceps [β = 0.38 mm/5 µmol/L (95% CI, 0.11-0.65)] and subscapular skinfold thicknesses [β = 0.26 mm/5 µmol/L (95% CI, 0.01-0.50)] at birth. No consistent trends were observed between maternal choline and offspring gain in body mass index, skinfold thicknesses, abdominal circumference, weight, length/height and adiposity measures in later infancy and early childhood. CONCLUSION Our study provides evidence that maternal circulating choline concentrations during pregnancy are positively associated with offspring BMI, skinfold thicknesses and adiposity at birth, but not with growth and adiposity through infancy and early childhood to the age of 5 years.
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Affiliation(s)
- Linde van Lee
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
| | - Izzuddin M Aris
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mya T Tint
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
| | - Phaik Ling Quah
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
| | - Sian M Robinson
- MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and Hospital Southampton NHS Foundation Trust, United Kingdom
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and Hospital Southampton NHS Foundation Trust, United Kingdom
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and Hospital Southampton NHS Foundation Trust, United Kingdom
| | - Mary Barker
- MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and Hospital Southampton NHS Foundation Trust, United Kingdom
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and Hospital Southampton NHS Foundation Trust, United Kingdom
| | - Sendhil S Velan
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Laboratory of Molecular Imaging, Singapore Bioimaging Consortium, Agency for Science Technology and Research, Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
| | - Marielle V Fortier
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Department of Diagnostic and Interventional Imaging, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Fabian Yap
- Duke-NUS Medical School, Singapore, Nanyang Technological University, Singapore, Singapore
- Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Liggings Institute, University of Auckland, New Zealand
| | - Kok Hian Tan
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Lynette P Shek
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and Hospital Southampton NHS Foundation Trust, United Kingdom
| | - Mary FF Chong
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore
- Clinical Nutrition Research Centre, Agency for Science, Technology, and Research, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Pastorino S, Bishop T, Crozier SR, Granström C, Kordas K, Küpers LK, O'Brien EC, Polanska K, Sauder KA, Zafarmand MH, Wilson RC, Agyemang C, Burton PR, Cooper C, Corpeleijn E, Dabelea D, Hanke W, Inskip HM, McAuliffe FM, Olsen SF, Vrijkotte TG, Brage S, Kennedy A, O'Gorman D, Scherer P, Wijndaele K, Wareham NJ, Desoye G, Ong KK. Associations between maternal physical activity in early and late pregnancy and offspring birth size: remote federated individual level meta-analysis from eight cohort studies. BJOG 2019; 126:459-470. [PMID: 30230190 PMCID: PMC6330060 DOI: 10.1111/1471-0528.15476] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Evidence on the impact of leisure time physical activity (LTPA) in pregnancy on birth size is inconsistent. We aimed to examine the association between LTPA during early and late pregnancy and newborn anthropometric outcomes. DESIGN Individual level meta-analysis, which reduces heterogeneity across studies. SETTING A consortium of eight population-based studies (seven European and one US) comprising 72 694 participants. METHODS Generalised linear models with consistent inclusion of confounders (gestational age, sex, parity, maternal age, education, ethnicity, BMI, smoking, and alcohol intake) were used to test associations between self-reported LTPA at either early (8-18 weeks gestation) or late pregnancy (30+ weeks) and the outcomes. Results were pooled using random effects meta-analyses. MAIN OUTCOME MEASURES Birth weight, large-for-gestational age (LGA), macrosomia, small-for-gestational age (SGA), % body fat, and ponderal index at birth. RESULTS Late, but not early, gestation maternal moderate to vigorous physical activity (MVPA), vigorous activity, and LTPA energy expenditure were modestly inversely associated with BW, LGA, macrosomia, and ponderal index, without heterogeneity (all: I2 = 0%). For each extra hour/week of MVPA, RR for LGA and macrosomia were 0.97 (95% CI: 0.96, 0.98) and 0.96 (95% CI: 0.94, 0.98), respectively. Associations were only modestly reduced after additional adjustments for maternal BMI and gestational diabetes. No measure of LTPA was associated with risk for SGA. CONCLUSIONS Physical activity in late, but not early, pregnancy is consistently associated with modestly lower risk of LGA and macrosomia, but not SGA. TWEETABLE ABSTRACT In an individual participant meta-analysis, late pregnancy moderate to vigorous physical activity modestly reduced birth size outcomes.
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Affiliation(s)
- S Pastorino
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - T Bishop
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - SR Crozier
- MRC Lifecourse Epidemiology Unit (University of Southampton)Southampton General HospitalSouthamptonUK
| | - C Granström
- Department of Epidemiology ResearchCentre for Fetal ProgrammingState Serum InstituteCopenhagenDenmark
| | - K Kordas
- Epidemiology and Environmental HealthSchool of Public Health and Health ProfessionsUniversity at BuffaloBuffaloNYUSA
| | - LK Küpers
- Department of EpidemiologyUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
- MRC Integrative Epidemiology UnitSchool of Social and Community MedicineUniversity of BristolBristolUK
| | - EC O'Brien
- Obstetrics & GynaecologyUCD Perinatal Research CentreSchool of MedicineUniversity College DublinNational Maternity HospitalDublinIreland
| | - K Polanska
- Department of Environmental EpidemiologyNofer Institute of Occupational MedicineLodzPoland
| | - KA Sauder
- Department of PediatricsUniversity of Colorado School of MedicineAuroraCOUSA
| | - MH Zafarmand
- Department of Public HealthAmsterdam Public Health Research Institute, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
- Department of Obstetrics & GynaecologyAmsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
- Department of Clinical EpidemiologyBiostatistics and BioinformaticsAmsterdam Public Health Research InstituteAmsterdam UMCUniversity of Amsterdamthe Netherlands
| | - RC Wilson
- Institute of Health and SocietyNewcastle UniversityNewcastleUK
| | - C Agyemang
- Department of Public HealthAmsterdam Public Health Research Institute, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | - PR Burton
- Institute of Health and SocietyNewcastle UniversityNewcastleUK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit (University of Southampton)Southampton General HospitalSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity Hospital Southampton NHS Foundation Trust and University of SouthamptonSouthamptonUK
| | - E Corpeleijn
- Department of EpidemiologyUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
| | - D Dabelea
- Department of EpidemiologyColorado School of Public HealthUniversity of Colorado Anschutz Medical CampusDenverCOUSA
| | - W Hanke
- Department of Environmental EpidemiologyNofer Institute of Occupational MedicineLodzPoland
| | - HM Inskip
- MRC Lifecourse Epidemiology Unit (University of Southampton)Southampton General HospitalSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity Hospital Southampton NHS Foundation Trust and University of SouthamptonSouthamptonUK
| | - FM McAuliffe
- Obstetrics & GynaecologyUCD Perinatal Research CentreSchool of MedicineUniversity College DublinNational Maternity HospitalDublinIreland
| | - SF Olsen
- Department of Epidemiology ResearchCentre for Fetal ProgrammingState Serum InstituteCopenhagenDenmark
| | - TG Vrijkotte
- Department of Public HealthAmsterdam Public Health Research Institute, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | - S Brage
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - A Kennedy
- 3U Diabetes Consortium and School of Health and Human PerformanceDublin City UniversityDublinIreland
- School of Biological SciencesDublin Institute of TechnologyDublinIreland
| | - D O'Gorman
- NIHR Southampton Biomedical Research CentreUniversity Hospital Southampton NHS Foundation Trust and University of SouthamptonSouthamptonUK
| | - P Scherer
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - K Wijndaele
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - NJ Wareham
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - G Desoye
- Department of Obstetrics & GynaecologyMedical University of GrazGrazAustria
| | - KK Ong
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
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Crozier SR, Johnson W, Cole TJ, Macdonald-Wallis C, Muniz-Terrera G, Inskip HM, Tilling K. A discussion of statistical methods to characterise early growth and its impact on bone mineral content later in childhood. Ann Hum Biol 2019; 46:17-26. [PMID: 30719940 PMCID: PMC6518455 DOI: 10.1080/03014460.2019.1574896] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 11/22/2018] [Accepted: 12/31/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Many statistical methods are available to model longitudinal growth data and relate derived summary measures to later outcomes. AIM To apply and compare commonly used methods to a realistic scenario including pre- and postnatal data, missing data, and confounders. SUBJECTS AND METHODS Data were collected from 753 offspring in the Southampton Women's Survey with measurements of bone mineral content (BMC) at age 6 years. Ultrasound measures included crown-rump length (11 weeks' gestation) and femur length (19 and 34 weeks' gestation); postnatally, infant length (birth, 6 and 12 months) and height (2 and 3 years) were measured. A residual growth model, two-stage multilevel linear spline model, joint multilevel linear spline model, SITAR and a growth mixture model were used to relate growth to 6-year BMC. RESULTS Results from the residual growth, two-stage and joint multilevel linear spline models were most comparable: an increase in length at all ages was positively associated with BMC, the strongest association being with later growth. Both SITAR and the growth mixture model demonstrated that length was positively associated with BMC. CONCLUSIONS Similarities and differences in results from a variety of analytic strategies need to be understood in the context of each statistical methodology.
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Affiliation(s)
- Sarah R. Crozier
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK
| | - William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Tim J. Cole
- Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Corrie Macdonald-Wallis
- MRC Integrative Epidemiology Unit, Oakfield House, University of Bristol, Bristol, UK
- Department of Population Health Sciences, Oakfield House, Bristol, UK
| | | | - Hazel M. Inskip
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit, Oakfield House, University of Bristol, Bristol, UK
- Department of Population Health Sciences, Oakfield House, Bristol, UK
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36
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Curtis EM, Krstic N, Cook E, D'Angelo S, Crozier SR, Moon RJ, Murray R, Garratt E, Costello P, Cleal J, Ashley B, Bishop NJ, Kennedy S, Papageorghiou AT, Schoenmakers I, Fraser R, Gandhi SV, Prentice A, Javaid MK, Inskip HM, Godfrey KM, Bell CG, Lillycrop KA, Cooper C, Harvey NC. Gestational Vitamin D Supplementation Leads to Reduced Perinatal RXRA DNA Methylation: Results From the MAVIDOS Trial. J Bone Miner Res 2019; 34:231-240. [PMID: 30321476 PMCID: PMC6372078 DOI: 10.1002/jbmr.3603] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 10/10/2018] [Accepted: 10/06/2018] [Indexed: 11/20/2022]
Abstract
We have previously demonstrated inverse associations between maternal 25(OH)-vitamin D status and perinatal DNA methylation at the retinoid-X-receptor-alpha (RXRA) locus and between RXRA methylation and offspring bone mass. In this study, we used an existing randomized trial to test the hypothesis that maternal gestational vitamin D supplementation would lead to reduced perinatal RXRA locus DNA methylation. The Maternal Vitamin D Osteoporosis Study (MAVIDOS) was a multicenter, double-blind, randomized, placebo-controlled trial of 1000 IU/day cholecalciferol or matched placebo from 14 weeks' gestation until delivery. Umbilical cord (fetal) tissue was collected at birth and frozen at -80°C (n = 453). Pyrosequencing was used to undertake DNA methylation analysis at 10 CpG sites within the RXRA locus (identified previously). T tests were used to assess differences between treatment groups in methylation at the three most representative CpG sites. Overall, methylation levels were significantly lower in the umbilical cord from offspring of cholecalciferol-supplemented mothers, reaching statistical significance at four CpG sites, represented by CpG5: mean difference in % methylation between the supplemented and placebo groups was -1.98% (95% CI, -3.65 to -0.32, p = 0.02). ENCODE (Encyclopedia of DNA Elements) evidence supports the functionality of this locus with strong DNase hypersensitivity and enhancer chromatin within biologically relevant cell types including osteoblasts. Enrichment of the enhancer-related H3K4me1 histone mark is also seen in this region, as are binding sites for a range of transcription factors with roles in cell proliferation, response to stress, and growth factors. Our findings are consistent with previous observational results and provide new evidence that maternal gestational supplementation with cholecalciferol leads to altered perinatal epigenetic marking, informing mechanistic understanding of early life mechanisms related to maternal vitamin D status, epigenetic marks, and bone development. © 2018 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals Inc.
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Affiliation(s)
| | - Nevena Krstic
- Institute of Developmental SciencesUniversity of SouthamptonUK
| | - Eloïse Cook
- Institute of Developmental SciencesUniversity of SouthamptonUK
| | | | | | - Rebecca J Moon
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonUK
- Paediatric EndocrinologyUniversity Hospitals Southampton NHS Foundation TrustSouthamptonUK
| | - Robert Murray
- Institute of Developmental SciencesUniversity of SouthamptonUK
| | - Emma Garratt
- Institute of Developmental SciencesUniversity of SouthamptonUK
| | - Paula Costello
- Institute of Developmental SciencesUniversity of SouthamptonUK
| | - Jane Cleal
- Institute of Developmental SciencesUniversity of SouthamptonUK
| | - Brogan Ashley
- Institute of Developmental SciencesUniversity of SouthamptonUK
| | - Nicholas J Bishop
- Academic Unit of Child HealthSheffield Children's HospitalUniversity of SheffieldSheffieldUK
| | - Stephen Kennedy
- Nuffield Department of Obstetrics and GynaecologyJohn Radcliffe HospitalUniversity of OxfordOxfordUK
| | - Aris T Papageorghiou
- Nuffield Department of Obstetrics and GynaecologyJohn Radcliffe HospitalUniversity of OxfordOxfordUK
| | - Inez Schoenmakers
- MRC Elsie Widdowson LaboratoryCambridgeUK
- Department of MedicineFaculty of Medicine and Health SciencesUniversity of East AngliaNorwichUK
| | - Robert Fraser
- Sheffield Hospitals NHS Trust(University of Sheffield)SheffieldUK
| | - Saurabh V Gandhi
- Sheffield Hospitals NHS Trust(University of Sheffield)SheffieldUK
| | | | - M Kassim Javaid
- NIHR Oxford Biomedical Research CentreUniversity of OxfordOxfordUK
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Christopher G Bell
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonUK
- Institute of Developmental SciencesUniversity of SouthamptonUK
| | | | - Cyrus Cooper
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonUK
- NIHR Oxford Biomedical Research CentreUniversity of OxfordOxfordUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
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Braithwaite VS, Crozier SR, D'Angelo S, Prentice A, Cooper C, Harvey NC, Jones KS. The Effect of Vitamin D Supplementation on Hepcidin, Iron Status, and Inflammation in Pregnant Women in the United Kingdom. Nutrients 2019; 11:E190. [PMID: 30669280 PMCID: PMC6356300 DOI: 10.3390/nu11010190] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 01/14/2019] [Accepted: 01/14/2019] [Indexed: 12/29/2022] Open
Abstract
Iron and vitamin D deficiencies are common during pregnancy. Our aim was to identify whether antenatal vitamin D₃ supplementation affects iron status (via hepcidin suppression) and/or inflammation. Using a subset of the UK multicenter Maternal Vitamin D Osteoporosis Study (MAVIDOS)-a double-blinded, randomized, placebo-controlled trial (ISRCTN82927713; EudraCT2007-001716-23)-we performed a secondary laboratory analysis. Women with blood samples from early and late pregnancy (vitamin D₃ (1000 IU/day from ~14 weeks gestation n = 93; placebo n = 102) who gave birth in the springtime (March⁻May) were selected as we anticipated seeing the greatest treatment group difference in change in 25-hydroxyvitamin D (25OHD) concentration. Outcomes were hepcidin, ferritin, C-reactive protein, and α1-acid glycoprotein concentration in late pregnancy (25OHD concentration was measured previously). By late pregnancy, 25OHD concentration increased by 17 nmol/L in the vitamin D₃ group and decreased by 11 nmol/L in the placebo group; hepcidin, ferritin, and inflammatory markers decreased but no treatment group differences were seen. In late pregnancy, positive relationships between 25OHD and hepcidin and 25OHD and ferritin in the placebo group were observed but not in the treatment group (group × 25OHD interaction, p < 0.02). Vitamin D₃ supplementation had no effect on hepcidin, ferritin, or inflammatory status suggesting no adjunctive value of vitamin D₃ in reducing rates of antenatal iron deficiency.
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Affiliation(s)
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK.
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK.
| | - Ann Prentice
- MRC Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK.
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
- Oxford NIHR Biomedical Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, The Botnar Research Centre, University of Oxford, Oxford OX1 2JD, UK.
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
| | - Kerry S Jones
- MRC Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK.
- NIHR BRC Nutritional Biomarker Laboratory, University of Cambridge, Cambridge CB2 0AH, UK.
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38
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El-Heis S, Crozier SR, Healy E, Robinson SM, Harvey NC, Cooper C, Inskip HM, Baird J, Godfrey KM. Faltering of prenatal growth precedes the development of atopic eczema in infancy: cohort study. Clin Epidemiol 2018; 10:1851-1864. [PMID: 30588116 PMCID: PMC6296686 DOI: 10.2147/clep.s175878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Infants with atopic eczema have an increased risk of impaired growth, but the origin of this impairment is unclear. The aim of this study was to examine fetal and infant growth in relation to infantile atopic eczema. Methods Within the UK Southampton Women's Survey, 1,759 infants with known maternal menstrual data had anthropometric measurements at 11, 19, and 34 weeks' gestation, birth, and ages 6 and 12 months, enabling derivation of growth velocity SD scores. Infantile atopic eczema at ages 6 and/or 12 months was ascertained using modified UK Working Party diagnostic criteria. Results Expressed per SD increase, higher femur length and abdominal circumference at 34 weeks' gestation were associated with decreased risks of atopic eczema (eczema OR/SD increase 0.81 [95% CI 0.69-0.96], P=0.017 and 0.78 [95% CI 0.65-0.93], P=0.006, respectively), while every SD increase in head to abdominal circumference ratio (indicating disproportionate growth) was associated with an increase in risk of atopic eczema (1.37 [1.15-1.63], P=0.001). Lower velocities of linear growth from 11 weeks' gestation to birth and birth to age 6 months were associated with atopic eczema (atopic eczema OR/SD increase 0.80 [0.65-0.98], P=0.034 and 0.8 [1 0.66-1.00], P=0.051, respectively). Infants with atopic eczema at age 12 months had a larger head circumference in early gestation and faltering of abdominal growth velocity from 19 to 34 weeks' gestation (atopic eczema OR/SD increase 0.67 [0.51-0.88], P=0.003). Conclusion Infants with atopic eczema demonstrate altered patterns of fetal growth, including faltering of linear growth in utero, prior to the clinical onset of atopic eczema. These findings suggest growth falters prior to the start of clinical atopic eczema and its treatment.
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Affiliation(s)
- Sarah El-Heis
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK,
| | - Sarah R Crozier
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK,
| | - Eugene Healy
- Dermatopharmacology, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Sian M Robinson
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK, .,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK,
| | - Nicholas C Harvey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK, .,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK,
| | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK, .,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK, .,NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - Hazel M Inskip
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK, .,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK,
| | - Janis Baird
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK, .,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK,
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK, .,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK, .,Institute of Developmental Sciences, University of Southampton, Southampton, UK,
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Ireland A, Crozier SR, Heazell AEP, Ward KA, Godfrey KM, Inskip HM, Cooper C, Harvey NC. Breech presentation is associated with lower bone mass and area: findings from the Southampton Women's Survey. Osteoporos Int 2018; 29:2275-2281. [PMID: 30003305 PMCID: PMC6173302 DOI: 10.1007/s00198-018-4626-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/27/2018] [Indexed: 02/01/2023]
Abstract
UNLABELLED We compared bone outcomes in children with breech and cephalic presentation at delivery. Neonatal whole-body bone mineral content (BMC) and area were lower in children with breech presentation. At 4 years, no differences in whole-body or spine measures were found, but hip BMC and area were lower after breech presentation. INTRODUCTION Breech presentation is associated with altered joint shape and hip dysplasias, but effects on bone mineral content (BMC), area (BA) and density (BMD) are unknown. METHODS In the prospective Southampton Women's Survey mother-offspring cohort, whole-body bone outcomes were measured using dual-energy X-ray absorptiometry (DXA) in 1430 offspring, as neonates (mean age 6 days, n = 965, 39 with a breech presentation at birth) and/or at age 4.1 years (n = 999, 39 breech). Hip and spine bone outcomes were also measured at age 4 years. RESULTS Neonates with breech presentation had 4.2 g lower whole-body BMC (95% CI -7.4 to - 0.9 g, P = 0.012) and 5.9 cm2 lower BA (- 10.8 to - 1.0 cm2, P = 0.019), but BMD was similar between groups (mean difference - 0.007, - 0.016 to 0.002 g/cm2, P = 0.146) adjusting for sex, maternal smoking, gestational diabetes, mode of delivery, social class, parity, ethnicity, age at scan, birthweight, gestational age and crown-heel length. There were no associations between breech presentation and whole-body outcomes at age 4 years, but, in similarly adjusted models, regional DXA (not available in infants) showed that breech presentation was associated with lower hip BMC (- 0.51, - 0.98 to - 0.04 g, P = 0.034) and BA (- 0.67, - 1.28 to - 0.07 cm2, P = 0.03) but not with BMD (- 0.009, - 0.029 to 0.012 g, P = 0.408), or spine outcomes. CONCLUSIONS These results suggest that breech presentation is associated with lower neonatal whole-body BMC and BA, which may relate to altered prenatal loading in babies occupying a breech position; these differences did not persist into later childhood. Modest differences in 4-year hip BMC and BA require further investigation.
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Affiliation(s)
- A Ireland
- School of Healthcare Science, Manchester Metropolitan University, Manchester, UK
| | - S R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - A E P Heazell
- Division of Developmental Biology and Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - K A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - K M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - H M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
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Sletner L, Mahon P, Crozier SR, Inskip HM, Godfrey KM, Chiesa S, Bhowruth DJ, Charakida M, Deanfield J, Cooper C, Hanson M. Childhood Fat and Lean Mass: Differing Relations to Vascular Structure and Function at Age 8 to 9 Years. Arterioscler Thromb Vasc Biol 2018; 38:2528-2537. [PMID: 30354210 PMCID: PMC6248304 DOI: 10.1161/atvbaha.118.311455] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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] [Indexed: 12/20/2022]
Abstract
Objective- Childhood body mass index (BMI) has been related to vascular structure and function. However, little is known about the differing contributions of fat and lean mass to this relationship. Our objectives were to relate the fat and lean mass (bone excluded) components of BMI (fat mass index and lean mass index; mass [kg]/height [m]2) to vascular measures in prepubertal children. Approach and Results- In the UK Southampton Women's Survey mother-offspring cohort, 983 children had dual x-ray absorptiometry and vascular measurements at 8 to 9 years. Using linear regression analyses, we found that most vascular measures were related to BMI, but fat and lean mass contributed differently. Systolic blood pressure was positively associated with both fat mass index (β=0.91 [95% CI, 0.52-1.30] mm Hg) and lean mass index (β=2.16 [95% CI, 1.47-2.85] mm Hg), whereas pulse rate was positively associated with fat mass index (β=0.93 [95% CI, 0.48-1.38] b/min) but negatively associated with lean mass index (β=-1.79 [95% CI, -2.59 to -0.99] b/min). The positive relation between BMI and carotid intima-media thickness was mainly due to a positive association with lean mass index (β=0.013 [95% CI, 0.008-0.019] mm). Carotid-femoral pulse wave velocity, but not carotid-radial pulse wave velocity, was positively associated with fat mass index (β=0.06 [95% CI, 0.03-0.09] m/s). For systolic blood pressure, carotid-femoral pulse wave velocity and reactive hyperemia significant interactions indicated that the association with fat mass depended on the amount of lean mass. Conclusions- In prepubertal children, differences in vascular structure and function in relation to BMI probably represent combinations of adverse effects of fat mass, adaptive effects of body size, and relatively protective effects of lean mass.
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Affiliation(s)
- Line Sletner
- Dept. of Pediatric and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Pamela Mahon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Sarah R. Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Hazel M. Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Scott Chiesa
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK
| | - Devina J. Bhowruth
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK
| | - Marietta Charakida
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK
| | - John Deanfield
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mark Hanson
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
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Robinson SM, Crozier SR, Miles EA, Gale CR, Calder PC, Cooper C, Inskip HM, Godfrey KM. Preconception Maternal Iodine Status Is Positively Associated with IQ but Not with Measures of Executive Function in Childhood. J Nutr 2018; 148:959-966. [PMID: 29767745 PMCID: PMC5991217 DOI: 10.1093/jn/nxy054] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 02/26/2018] [Indexed: 12/30/2022] Open
Abstract
Background Adverse effects of severe maternal iodine deficiency in pregnancy on fetal brain development are well-established, but the effects of milder deficiency are uncertain. Most studies examine iodine status in pregnancy; less is known about iodine nutrition before conception. Objective We examined relations between maternal preconception iodine status and offspring cognitive function, within a prospective mother-offspring cohort. Methods Maternal iodine status was assessed through the use of the ratio of iodine:creatinine concentrations (I/Cr) in spot urine samples [median (IQR) period before conception 3.3 y (2.2-4.7 y)]. Childhood cognitive function was assessed at age 6-7 y. Full-scale IQ was assessed via the Wechsler Abbreviated Scale of Intelligence, and executive function through the use of tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Analyses (n = 654 mother-child dyads) were adjusted for potential confounders including maternal intelligence, education, and breastfeeding duration. Results The median (IQR) urinary iodine concentration was 108.4 µg/L (62.2-167.8 µg/L) and the I/Cr ratio 114 µg/g (76-164 µg/g). The preconception I/Cr ratio was positively associated with child IQ, before and after adjustment for potential confounding influences [β = 0.13 (95% CI: 0.04, 0.21)/SD, P = 0.003]. 8.9% of women had a preconception urinary I/Cr ratio <50 µg/g; compared with those with an I/Cr ratio ≥150 µg/g, the IQ of their offspring was 0.49 (95% CI: 0.79, 0.18) SD lower. There were no associations with the executive function outcomes assessed via CANTAB, before or after adjustment for confounders. Conclusion The positive association between iodine status before conception and child IQ provides some support for demonstrated links between low maternal iodine status in pregnancy and poorer cognitive function reported in other studies. However, given the negative effects on school performance previously observed in children born to iodine-deficient mothers, the lack of associations with measures of executive function in the present study was unexpected. Further data are needed to establish the public health importance of low preconception iodine status.
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Affiliation(s)
- Sian M Robinson
- Medical Research Council (MRC) Lifecourse Epidemiology Unit,National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, United Kingdom,Address correspondence to SMR (e-mail: )
| | | | - Elizabeth A Miles
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Catharine R Gale
- Medical Research Council (MRC) Lifecourse Epidemiology Unit,Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Philip C Calder
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom,National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, United Kingdom
| | - Cyrus Cooper
- Medical Research Council (MRC) Lifecourse Epidemiology Unit,National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, United Kingdom,National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom
| | - Hazel M Inskip
- Medical Research Council (MRC) Lifecourse Epidemiology Unit,National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, United Kingdom
| | - Keith M Godfrey
- Medical Research Council (MRC) Lifecourse Epidemiology Unit,National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, United Kingdom
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Stephenson J, Heslehurst N, Hall J, Schoenaker DAJM, Hutchinson J, Cade JE, Poston L, Barrett G, Crozier SR, Barker M, Kumaran K, Yajnik CS, Baird J, Mishra GD. Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health. Lancet 2018; 391:1830-1841. [PMID: 29673873 PMCID: PMC6075697 DOI: 10.1016/s0140-6736(18)30311-8] [Citation(s) in RCA: 592] [Impact Index Per Article: 98.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 12/03/2017] [Accepted: 01/31/2018] [Indexed: 12/15/2022]
Abstract
A woman who is healthy at the time of conception is more likely to have a successful pregnancy and a healthy child. We reviewed published evidence and present new data from low-income, middle-income, and high-income countries on the timing and importance of preconception health for subsequent maternal and child health. We describe the extent to which pregnancy is planned, and whether planning is linked to preconception health behaviours. Observational studies show strong links between health before pregnancy and maternal and child health outcomes, with consequences that can extend across generations, but awareness of these links is not widespread. Poor nutrition and obesity are rife among women of reproductive age, and differences between high-income and low-income countries have become less distinct, with typical diets falling far short of nutritional recommendations in both settings and especially among adolescents. Several studies show that micronutrient supplementation starting in pregnancy can correct important maternal nutrient deficiencies, but effects on child health outcomes are disappointing. Other interventions to improve diet during pregnancy have had little effect on maternal and newborn health outcomes. Comparatively few interventions have been made for preconception diet and lifestyle. Improvements in the measurement of pregnancy planning have quantified the degree of pregnancy planning and suggest that it is more common than previously recognised. Planning for pregnancy is associated with a mixed pattern of health behaviours before conception. We propose novel definitions of the preconception period relating to embryo development and actions at individual or population level. A sharper focus on intervention before conception is needed to improve maternal and child health and reduce the growing burden of non-communicable diseases. Alongside continued efforts to reduce smoking, alcohol consumption, and obesity in the population, we call for heightened awareness of preconception health, particularly regarding diet and nutrition. Importantly, health professionals should be alerted to ways of identifying women who are planning a pregnancy.
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Affiliation(s)
- Judith Stephenson
- Institute for Women's Health, University College London, London, UK.
| | - Nicola Heslehurst
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jennifer Hall
- Institute for Women's Health, University College London, London, UK
| | | | - Jayne Hutchinson
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Janet E Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Lucilla Poston
- Department of Women and Children's Health, King's College London, St Thomas' Hospital, London, UK
| | | | - Sarah R Crozier
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Mary Barker
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, Southampton General Hospital, Southampton, UK
| | - Kalyanaraman Kumaran
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK; Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, Karnataka, India
| | - Chittaranjan S Yajnik
- Diabetes Unit, King Edward Memorial Hospital and Research Centre, Pune, Maharashtra, India
| | - Janis Baird
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, Southampton General Hospital, Southampton, UK
| | - Gita D Mishra
- School of Public Health, University of Queensland, Herston, QLD, Australia
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Rajappan A, Pearce A, Inskip HM, Baird J, Crozier SR, Cooper C, Godfrey KM, Roberts G, Lucas JSA, Pike KC. Maternal body mass index: Relation with infant respiratory symptoms and infections. Pediatr Pulmonol 2017; 52:1291-1299. [PMID: 28816002 PMCID: PMC5612396 DOI: 10.1002/ppul.23779] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 07/09/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Maternal obesity is increasingly prevalent in many westernized countries. Many studies report associations between maternal obesity and childhood wheeze or asthma but few have considered maternal obesity in relation to respiratory infections or symptoms other than wheeze during infancy. This study assesses the relationship between maternal BMI and reported wheeze, cough and respiratory infections during the first year of life. METHODS In 2799 mother-child pairs, we examined the relations between maternal pre-pregnancy BMI and pregnancy weight gain and reported offspring wheeze, prolonged cough, lower respiratory tract infection, croup, and ear infection before age 1 year, along with reported diarrhea or vomiting. Maternally reported paternal BMI was included in the models as a proxy for unmeasured confounding by shared familial factors. RESULTS Higher maternal BMI was associated with increased risks of offspring wheeze, prolonged cough and lower respiratory tract infection (relative risks (95%CI) per 5 kg/m2 1.09 (1.05-1.13), 1.09 (1.03-1.14), and 1.13 (1.07-1.20), respectively). These associations remained after adjusting for maternally reported paternal BMI. No associations were found with croup, ear infection, or diarrhea or vomiting. Pregnancy weight gain was not associated with any of the offspring symptoms or illnesses. DISCUSSION Higher maternal BMI is associated with increased risk of wheeze, cough, and maternally reported lower respiratory tract infection in infancy. These associations were independent of maternally reported paternal BMI. These observations might be explained by intrauterine effects of maternal obesity upon respiratory or immune development.
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Affiliation(s)
- Ashley Rajappan
- University College Medical School, University College London, London, UK
| | - Anna Pearce
- Population, Policy and Practice Academic Programme, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Hazel M Inskip
- Human Development and Health Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK.,Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Janis Baird
- Human Development and Health Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK.,Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sarah R Crozier
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Cyrus Cooper
- Human Development and Health Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK.,Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Keith M Godfrey
- Human Development and Health Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK.,Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Graham Roberts
- Human Development and Health Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jane S A Lucas
- Human Development and Health Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK.,Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK
| | - Katharine C Pike
- Respiratory, Critical Care and Anaesthesia Section, Infection, Immunity and Inflammation Academic Programme, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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Moon RJ, Harvey NC, Cooper C, D’Angelo S, Curtis EM, Crozier SR, Barton SJ, Robinson SM, Godfrey KM, Graham NJ, Holloway JW, Bishop NJ, Kennedy S, Papageorghiou AT, Schoenmakers I, Fraser R, Gandhi SV, Prentice A, Inskip HM, Javaid MK. Response to Antenatal Cholecalciferol Supplementation Is Associated With Common Vitamin D-Related Genetic Variants. J Clin Endocrinol Metab 2017; 102:2941-2949. [PMID: 28575224 PMCID: PMC5546866 DOI: 10.1210/jc.2017-00682] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 05/24/2017] [Indexed: 01/08/2023]
Abstract
CONTEXT Single-nucleotide polymorphisms (SNPs) in genes related to vitamin D metabolism have been associated with serum 25-hydroxyvitamin D [25(OH)D] concentration, but these relationships have not been examined following antenatal cholecalciferol supplementation. OBJECTIVE To determine whether SNPs in DHCR7, CYP2R1, CYP24A1, and GC are associated with the response to gestational cholecalciferol supplementation. DESIGN Within-randomization group analysis of the Maternal Vitamin D Osteoporosis Study trial of antenatal cholecalciferol supplementation. SETTING Hospital antenatal clinics. PARTICIPANTS In total, 682 women of white ethnicity (351 placebo, 331 cholecalciferol) were included. SNPs at rs12785878 (DHCR7), rs10741657 (CYP2R1), rs6013897 (CYP24A1), and rs2282679 (GC) were genotyped. INTERVENTIONS 1000 IU/d cholecalciferol from 14 weeks of gestation until delivery. MAIN OUTCOME MEASURE 25(OH)D at randomization and 34 weeks of gestation were measured in a single batch (Liaison; Diasorin, Dartford, UK). Associations between 25(OH)D and the SNPs were assessed by linear regression using an additive model [β represents the change in 25(OH)D per additional common allele]. RESULTS Only rs12785878 (DHCR7) was associated with baseline 25(OH)D [β = 3.1 nmol/L; 95% confidence interval (CI), 1.0 to 5.2 nmol/L; P < 0.004]. In contrast, rs10741657 (CYP2R1) (β = -5.2 nmol/L; 95% CI, -8.2 to -2.2 nmol/L; P = 0.001) and rs2282679 (GC) (β = 4.2 nmol/L; 95% CI, 0.9 to 7.5 nmol/L; P = 0.01) were associated with achieved 25(OH)D status following supplementation, whereas rs12785878 and rs6013897 (CYP24A1) were not. CONCLUSIONS Genetic variation in DHCR7, which encodes 7-dehyrocholesterol reductase in the epidermal vitamin D biosynthesis pathway, appears to modify baseline 25(OH)D. In contrast, the response to antenatal cholecalciferol supplementation was associated with SNPs in CYP2R1, which may alter 25-hydroxylase activity, and GC, which may affect vitamin D binding protein synthesis or metabolite affinity.
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Affiliation(s)
- Rebecca J. Moon
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, United Kingdom
- Paediatric Endocrinology, University Hospitals Southampton National Health Service Foundation Trust, Southampton SO16 6YD, United Kingdom
| | - Nicholas C. Harvey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, United Kingdom
- National Institute for Health Research Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton SO16 6YD, United Kingdom
| | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, United Kingdom
- National Institute for Health Research Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton SO16 6YD, United Kingdom
- National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford OX3 7LD, United Kingdom
| | - Stefania D’Angelo
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, United Kingdom
| | - Elizabeth M. Curtis
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, United Kingdom
| | - Sarah R. Crozier
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, United Kingdom
| | - Sheila J. Barton
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, United Kingdom
| | - Sian M. Robinson
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, United Kingdom
- National Institute for Health Research Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton SO16 6YD, United Kingdom
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, United Kingdom
- National Institute for Health Research Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton SO16 6YD, United Kingdom
| | - Nikki J. Graham
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, United Kingdom
| | - John W. Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, United Kingdom
| | - Nicholas J. Bishop
- Academic Unit of Child Health, Sheffield Children’s Hospital, University of Sheffield, Sheffield S10 2TH, United Kingdom
| | - Stephen Kennedy
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, United Kingdom
| | - Aris T. Papageorghiou
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, United Kingdom
| | - Inez Schoenmakers
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, United Kingdom
- Department of Medicine, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7TJ, United Kingdom
| | - Robert Fraser
- Sheffield Hospitals National Health Service Trust (University of Sheffield), Sheffield S10 2SF, United Kingdom
| | - Saurabh V. Gandhi
- Sheffield Hospitals National Health Service Trust (University of Sheffield), Sheffield S10 2SF, United Kingdom
| | - Ann Prentice
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, United Kingdom
| | - Hazel M. Inskip
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, United Kingdom
- National Institute for Health Research Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton SO16 6YD, United Kingdom
| | - M. Kassim Javaid
- National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford OX3 7LD, United Kingdom
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Hollis JL, Crozier SR, Inskip HM, Cooper C, Godfrey KM, Harvey NC, Collins CE, Robinson SM. Modifiable risk factors of maternal postpartum weight retention: an analysis of their combined impact and potential opportunities for prevention. Int J Obes (Lond) 2017; 41:1091-1098. [PMID: 28337028 PMCID: PMC5500180 DOI: 10.1038/ijo.2017.78] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 02/12/2017] [Accepted: 03/14/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVES Pregnancy triggers a physiological change in weight status. Postpartum weight retention in the childbearing years can substantially alter a woman's weight gain trajectory, with several potential contributing factors identified. Most research has relied on women's recall of pre-pregnancy weight during pregnancy or later, and not considered risk factors in combination. Using measured pre-pregnancy weight, this study aimed to examine the associations of maternal postpartum weight retention with parity, pre-pregnancy BMI, excessive gestational weight gain (GWG), maternal serum vitamin D concentration and dietary Glycaemic Index in early and late pregnancy, and breastfeeding duration, including analysis of the combined impact of potentially modifiable risk factors. SUBJECTS/METHODS Prospective cohort study of 12 583 non-pregnant women aged 20-34 years in Southampton (UK) who were assessed prior to pregnancy, with those who subsequently became pregnant followed up in early and late gestation, and after delivery (n=2559 in the final sample). Linear regression models examined potential predictors of weight retention in adjusted individual and multivariate analyses, and as a risk factor score. RESULTS Compared with pre-pregnancy weight, 73% of women retained some weight at 6 months postpartum (mean (s.d.): 3.5 (6.2) kg). In the adjusted multivariate model, women who were primiparous, had a lower pre-pregnancy BMI, excessive GWG, a lower early pregnancy vitamin D concentration and breastfed for <6 months had greater weight retention 6 months postpartum (P<0.05 for all variables). For each additional modifiable risk factor (excessive GWG, low vitamin D concentration in early pregnancy and short breastfeeding duration; scale 0-3), women retained an additional 2.49 kg (95% CI: 2.16, 2.82; P<0.001). CONCLUSIONS Having a greater number of modifiable risk factors was associated with greater weight retention 6 months postpartum. Initiatives supporting women to target these risk factors in the years prior to, during and after pregnancy could impact on their weight gain trajectory and later risk of adverse weight-related outcomes.
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Affiliation(s)
- J L Hollis
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - S R Crozier
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - H M Inskip
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Cooper
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - K M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - N C Harvey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C E Collins
- Priority Research Centre in Physical Activity and Nutrition, School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - S M Robinson
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Cook E, Curtis EM, Krstic N, D'Angelo S, Crozier SR, Moon RJ, Murray R, Garratt E, Costello P, Bishop NJ, Kennedy S, Papageorghiou AT, Schoenmakers I, Fraser R, Gandhi SV, Prentice A, Kassim Javaid M, Inskip HM, Godfrey KM, Bell CG, Cooper C, Lillycrop K, Harvey NC. 157. PERINATAL DNA METHYLATION AT THE RXRA PROMOTER IS ASSOCIATED WITH GESTATIONAL VITAMIN D SUPPLEMENTATION: RESULTS FROM THE MAVIDOS TRIAL. Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex062.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | | | | | - Rebecca J. Moon
- MRC Lifecourse Epidemiology Unit, University of Southampton
- Paediatric Endocrinology, University Hospitals Southampton NHS Foundation Trust, Southampton
| | | | | | | | - Nicholas J. Bishop
- Academic Unit of Child Health, Sheffield Children's Hospital, University of Sheffield, Sheffield
| | - Stephen Kennedy
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford
| | | | - Inez Schoenmakers
- MRC Elsie Widdowson
- Department of Medicine, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich
| | - Robert Fraser
- Sheffield Hospitals NHS Trust, University of Sheffield, Sheffield
| | | | | | - M Kassim Javaid
- NIHR Biomedical Research Centre, University of Oxford, Oxford
| | - Hazel M. Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton
- NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton, Southampton, UNITED KINGDOM
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton
- NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton, Southampton, UNITED KINGDOM
| | - Christopher G. Bell
- Institute of Developmental Sciences
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton
- NIHR Biomedical Research Centre, University of Oxford, Oxford
| | | | - Nicholas C. Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton
- NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton, Southampton, UNITED KINGDOM
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Moon RJ, Harvey NC, Cooper C, D'Angelo S, Curtis EM, Crozier SR, Robinson SM, Graham NJ, Holloway JW, Bishop NJ, Kennedy S, Papageorghiou AT, Schoenmakers I, Fraser R, Gandhi S, Prentice A, Inskip HM, Javaid MK. 259. 25-HYDROXYVITAMIN D RESPONSE TO GESTATIONAL CHOLECALCIFEROL SUPPLEMENTATION IS ASSOCIATED WITH COMMON VITAMIN D RELATED GENETIC VARIANTS: FINDINGS FROM THE MAVIDOS TRIAL. Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex062.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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El-Heis S, Crozier SR, Healy E, Robinson SM, Harvey NC, Cooper C, Inskip HM, Baird J, Godfrey KM. Maternal stress and psychological distress preconception: association with offspring atopic eczema at age 12 months. Clin Exp Allergy 2017; 47:760-769. [PMID: 28218994 DOI: 10.1111/cea.12910] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 01/16/2017] [Accepted: 02/09/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND Perinatal maternal stress and low mood have been linked to offspring atopic eczema. OBJECTIVES To examine the relation of maternal stress/mood with atopic eczema in the offspring, focusing particularly on stress/psychological distress preconception. METHODS At recruitment in the UK Southampton Women's Survey, preconception maternal reports of perceived stress in daily living and the effect of stress on health were recorded; in a subsample, psychological distress was assessed (12-item General Health Questionnaire). Infants were followed up at ages 6 (n = 2956) and 12 (n = 2872) months and atopic eczema ascertained (based on UK Working Party Criteria for the Definition of Atopic Dermatitis). At 6 months post-partum, mothers were asked if they had experienced symptoms of low mood since childbirth and completed the Edinburgh Postnatal Depression Scale. RESULTS Preconception perceived stress affecting health [OR 1.21 (95% CI 1.08-1.35), P = 0.001] and stress in daily living [OR 1.16 (1.03-1.30), P = 0.014] were associated with an increased risk of offspring atopic eczema at age 12 months but not at 6 months, robust to adjustment for potentially confounding variables. Findings were similar for maternal psychological distress preconception. Low maternal mood between delivery and 6 months post-partum was associated with an increased risk of infantile atopic eczema at age 12 months, but no significant association between post-natal mood and atopic eczema was seen after taking account of preconception stress. CONCLUSION AND CLINICAL RELEVANCE Our data provide novel evidence linking maternal stress at preconception to atopic eczema risk, supporting a developmental contribution to the aetiology of atopic eczema and pointing to potentially modifiable influences.
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Affiliation(s)
- S El-Heis
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - S R Crozier
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - E Healy
- Dermatopharmacology, Faculty of Medicine, University of Southampton, Southampton, UK
| | - S M Robinson
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - N C Harvey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Cooper
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - H M Inskip
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - J Baird
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - K M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Institute of Developmental Sciences, University of Southampton, Southampton, UK
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Robinson SM, Jameson KA, Bloom I, Ntani G, Crozier SR, Syddall H, Dennison EM, Cooper CR, Sayer AA. Development of a Short Questionnaire to Assess Diet Quality among Older Community-Dwelling Adults. J Nutr Health Aging 2017; 21:247-253. [PMID: 28244562 DOI: 10.1007/s12603-016-0758-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the use of a short questionnaire to assess diet quality in older adults. DESIGN Cross-sectional study. SETTING Hertfordshire, UK. PARTICIPANTS 3217 community-dwelling older adults (59-73 years). MEASUREMENTS Diet was assessed using an administered food frequency questionnaire (FFQ); two measures of diet quality were defined by calculating participants' 'prudent diet' scores, firstly from a principal component analysis of the data from the full FFQ (129 items) and, secondly, from a short version of the FFQ (including 24 indicator foods). Scores calculated from the full and short FFQ were compared with nutrient intake and blood concentrations of vitamin C and lipids. RESULTS Prudent diet scores calculated from the full FFQ and short FFQ were highly correlated (0.912 in men, 0.904 in women). The pattern of associations between nutrient intake (full FFQ) and diet scores calculated using the short and full FFQs were very similar, both for men and women. Prudent diet scores calculated from the full and short FFQs also showed comparable patterns of association with blood measurements: in men and women, both scores were positively associated with plasma vitamin C concentration and serum HDL; in women, an inverse association with serum triglycerides was also observed. CONCLUSIONS A short food-based questionnaire provides useful information about the diet quality of older adults. This simple tool does not require nutrient analysis, and has the potential to be of value to non-specialist researchers.
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Affiliation(s)
- S M Robinson
- SM Robinson; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton. SO16 6YD; Telephone: +44 (0)23 8077 7624; Fax: +44 (0)23 8070 4021; e-mail:
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Moon RJ, Harvey NC, Cooper C, D'Angelo S, Crozier SR, Inskip HM, Schoenmakers I, Prentice A, Arden NK, Bishop NJ, Carr A, Dennison EM, Eastell R, Fraser R, Gandhi SV, Godfrey KM, Kennedy S, Mughal MZ, Papageorghiou AT, Reid DM, Robinson SM, Javaid MK. Determinants of the Maternal 25-Hydroxyvitamin D Response to Vitamin D Supplementation During Pregnancy. J Clin Endocrinol Metab 2016; 101:5012-5020. [PMID: 27788053 PMCID: PMC5155676 DOI: 10.1210/jc.2016-2869] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
CONTEXT Current approaches to antenatal vitamin D supplementation do not account for interindividual differences in 25-hydroxyvitamin D (25(OH)D) response. OBJECTIVE We assessed which maternal and environmental characteristics were associated with 25(OH)D after supplementation with cholecalciferol. DESIGN Within-randomization-group analysis of participants in the Maternal Vitamin D Osteoporosis Study trial of vitamin D supplementation in pregnancy. SETTING Hospital antenatal clinics. PARTICIPANTS A total of 829 pregnant women (422 placebo, 407 cholecalciferol). At 14 and 34 weeks of gestation, maternal anthropometry, health, and lifestyle were assessed and 25(OH)D measured. Compliance was determined using pill counts at 19 and 34 weeks. INTERVENTIONS 1000 IU/d of cholecalciferol or matched placebo from 14 weeks of gestation until delivery. MAIN OUTCOME MEASURE 25(OH)D at 34 weeks, measured in a single batch (Diasorin Liaison). RESULTS 25(OH)D at 34 weeks of gestation was higher in the women randomized to vitamin D (mean [SD], 67.7 [21.3] nmol/L) compared with placebo (43.1 [22.5] nmol/L; P < .001). In women randomized to cholecalciferol, higher pregnancy weight gain from 14 to 34 weeks of gestation (kg) (β = -0.81 [95% confidence interval -1.39, -0.22]), lower compliance with study medication (%) (β = -0.28 [-0.072, -0.48]), lower early pregnancy 25(OH)D (nmol/L) (β = 0.28 [0.16, 0.40]), and delivery in the winter vs the summer (β = -10.5 [-6.4, -14.6]) were independently associated with lower 25(OH)D at 34 weeks of gestation. CONCLUSIONS Women who gained more weight during pregnancy had lower 25(OH)D in early pregnancy and delivered in winter achieved a lower 25(OH)D in late pregnancy when supplemented with 1000 IU/d cholecalciferol. Future studies should aim to determine appropriate doses to enable consistent repletion of 25(OH)D during pregnancy.
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