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Venter E, Zandberg L, Venter PVZ, Smuts CM, Kruger HS, Baumgartner J. Female rats consuming an iron and omega-3 fatty acid deficient diet preconception require combined iron and omega-3 fatty acid supplementation for the prevention of bone impairments in offspring. J Dev Orig Health Dis 2024; 15:e6. [PMID: 38653729 DOI: 10.1017/s2040174424000102] [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] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
We previously showed in rats that pre- and postnatal deficiencies in iron and omega-3 (n-3) fatty acids can impair bone development, with additive and potentially irreversible effects when combined. This study aimed to investigate, in female rats consuming a combined iron and n-3 fatty acid deficient (ID + n-3 FAD) diet preconception, whether supplementation with iron and docosahexaenoic/eicosapentaenoic acid (DHA/EPA), alone and in combination, can prevent bone impairments in offspring. Using a 2 × 2 factorial design, female Wistar rats consuming an ID + n-3 FAD diet preconception were randomised to receive an: 1) iron supplemented (Fe + n-3 FAD), 2) DHA/EPA supplemented (ID + DHA/EPA), 3) Fe + DHA/EPA, or 4) ID + n-3 FAD diet from gestational day 10 throughout pregnancy and lactation. Post-weaning, offspring (n = 24/group; male:female = 1:1) remained on the respective experimental diets for three weeks until postnatal day 42-45. Offspring born to female rats consuming a control diet preconception and an Fe+DHA/EPA diet throughout pregnancy and lactation served as non-deficient reference group (Control+Fe+DHA/EPA). Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry and bone strength using three-point bending tests. Only offspring in the Fe+DHA/EPA group had significantly higher spine and femur BMD, and higher femur stiffness than offspring in the ID + n-3 FAD group, and had similar spine BMD and femur stiffness as the Control + Fe + DHA/EPA group. Offspring in the Fe + DHA/EPA group further had significantly higher femur strength (ultimate load) than the other experimental groups, and a similar femur strength as the Control + Fe + DHA/EPA group. This study shows that only combined iron and DHA/EPA supplementation can prevent bone impairments in offspring of female rats consuming an iron and n-3 FA deficient diet preconception.
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Affiliation(s)
- Estelle Venter
- Centre of Excellence for Nutrition (CEN), North-West University (NWU), Potchefstroom, South Africa
| | - Lizelle Zandberg
- Centre of Excellence for Nutrition (CEN), North-West University (NWU), Potchefstroom, South Africa
| | - Philip vZ Venter
- Department of Industrial Engineering, Stellenbosch University, Stellenbosch, South Africa
| | - Cornelius M Smuts
- Centre of Excellence for Nutrition (CEN), North-West University (NWU), Potchefstroom, South Africa
| | - Herculina S Kruger
- Centre of Excellence for Nutrition (CEN), North-West University (NWU), Potchefstroom, South Africa
| | - Jeannine Baumgartner
- Centre of Excellence for Nutrition (CEN), North-West University (NWU), Potchefstroom, South Africa
- Department of Nutritional Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
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Wimalasena ST, Ramírez Silva CI, Gonzalez Casanova I, Rivera JA, Sun YV, Stein AD, Ferranti EP, Alvarez JA, Demmelmair H, Koletzko B, Ramakrishnan U. Maternal and Offspring Fatty Acid Desaturase Variants, Prenatal DHA Supplementation, and Dietary n-6:n-3 Fatty Acid Ratio in Relation to Cardiometabolic Health in Mexican Children. J Nutr 2024:S0022-3166(24)00152-4. [PMID: 38453026 DOI: 10.1016/j.tjnut.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/21/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Single-nucleotide polymorphisms (SNPs) in fatty acid desaturase (FADS) genes may modify dietary fatty acid requirements and influence cardiometabolic health (CMH). OBJECTIVES We evaluated the role of selected variants in maternal and offspring FADS genes on offspring CMH at the age of 11 y and assessed interactions of genotype with diet quality and prenatal docosahexaenoic acid (DHA) supplementation. METHODS We used data from offspring (n = 203) born to females who participated in a randomized controlled trial of DHA supplementation (400 mg/d) from midgestation to delivery. We generated a metabolic syndrome (MetS) score from body mass index, high-density lipoprotein cholesterol, triglycerides, systolic blood pressure, and fasting glucose and identified 6 distinct haplotypes from 5 offspring FADS SNPs. Dietary n-6 (ω-6):n-3 fatty acid ratios were derived from 24-h recall data (n = 141). We used generalized linear models to test associations of offspring diet and FADS haplotypes with MetS score and interactions of maternal and offspring FADS SNP rs174602 with prenatal treatment group and dietary n-6:n-3 ratio on MetS score. RESULTS Associations between FADS haplotypes and MetS score were null. Offspring SNP rs174602 did not modify the association of prenatal DHA supplementation with MetS score. Among children with TT or TC genotype for SNP rs174602 (n = 88), those in the highest n-6:n-3 ratio tertile (>8.61) had higher MetS score relative to the lowest tertile [<6.67) (Δ= 0.36; 95% confidence interval (CI): 0.03, 0.69]. Among children with CC genotype (n = 53), those in the highest n-6:n-3 ratio tertile had a lower MetS score relative to the lowest tertile (Δ= -0.23; 95% CI: -0.61, 0.16). CONCLUSIONS There was evidence of an interaction of offspring FADS SNP rs174602 with current dietary polyunsaturated fatty acid intake, but not with prenatal DHA supplementation, on MetS score. Further studies may help to determine the utility of targeted supplementation strategies and dietary recommendations based on genetic profile.
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Affiliation(s)
- Sonia Tandon Wimalasena
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, United States
| | | | | | - Juan A Rivera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Yan V Sun
- Department of Epidemiology, Emory University, Atlanta, GA, United States
| | - Aryeh D Stein
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| | - Erin P Ferranti
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
| | - Jessica A Alvarez
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Hans Demmelmair
- LMU - Ludwig Maximilians Universität Munich, Department of Pediatrics, LMU University Hospitals, Munich, Germany
| | - Berthold Koletzko
- LMU - Ludwig Maximilians Universität Munich, Department of Pediatrics, LMU University Hospitals, Munich, Germany
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States.
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Fernandes AC, Polizel GHG, Cracco RC, Cançado FACQ, Baldin GC, Poleti MD, Ferraz JBS, Santana MHDA. Metabolomics Changes in Meat and Subcutaneous Fat of Male Cattle Submitted to Fetal Programming. Metabolites 2023; 14:9. [PMID: 38248812 PMCID: PMC10819762 DOI: 10.3390/metabo14010009] [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: 11/28/2023] [Revised: 12/16/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
This study investigated changes in meat and subcutaneous fat metabolomes and possible metabolic pathways related to prenatal nutrition in beef cattle. For this purpose, 18 Nellore bulls were used for meat sampling and 15 for fat sampling. The nutritional treatments during the gestation were: NP-not programmed or control, without protein-energy supplementation; PP-partially programmed, with protein-energy supplementation (0.3% of body weight (BW)) only in the final third of pregnancy; and FP-full programming, with protein-energy supplementation (0.3% of BW) during the entire pregnancy. The meat and fat samples were collected individually 24 h after slaughter, and the metabolites were extracted using a combination of chemical reagents and mechanical processes and subsequently quantified using liquid chromatography or flow injection coupled to mass spectrometry. The data obtained were submitted to principal component analysis (PCA), analysis of variance (ANOVA), and functional enrichment analysis, with a significance level of 5%. The PCA showed an overlap between the treatments for both meat and fat. In meat, 25 metabolites were statistically different between treatments (p ≤ 0.05), belonging to four classes (glycerophospholipids, amino acids, sphingolipids, and biogenic amine). In fat, 10 significant metabolites (p ≤ 0.05) were obtained in two classes (phosphatidylcholine and lysophosphatidylcholine). The functional enrichment analysis showed alterations in the aminoacyl-tRNA pathway in meat (p = 0.030); however, there was no pathway enriched for fat. Fetal programming influenced the meat and fat metabolomes and the aminoacyl-tRNA metabolic pathway, which is an important candidate for the biological process linked to meat quality and related to fetal programming in beef cattle.
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Affiliation(s)
- Arícia Christofaro Fernandes
- Department of Animal Science, College of Animal Science and Food Engineering, University of São Paulo (USP), Av. Duque de Caxias Norte, 225, Pirassununga 13635-900, SP, Brazil; (G.H.G.P.); (M.H.d.A.S.)
| | - Guilherme Henrique Gebim Polizel
- Department of Animal Science, College of Animal Science and Food Engineering, University of São Paulo (USP), Av. Duque de Caxias Norte, 225, Pirassununga 13635-900, SP, Brazil; (G.H.G.P.); (M.H.d.A.S.)
| | - Roberta Cavalcante Cracco
- Department of Animal Science, College of Animal Science and Food Engineering, University of São Paulo (USP), Av. Duque de Caxias Norte, 225, Pirassununga 13635-900, SP, Brazil; (G.H.G.P.); (M.H.d.A.S.)
| | - Fernando Augusto Correia Queiroz Cançado
- Department of Animal Science, College of Animal Science and Food Engineering, University of São Paulo (USP), Av. Duque de Caxias Norte, 225, Pirassununga 13635-900, SP, Brazil; (G.H.G.P.); (M.H.d.A.S.)
| | - Geovana Camila Baldin
- Department of Animal Science, College of Animal Science and Food Engineering, University of São Paulo (USP), Av. Duque de Caxias Norte, 225, Pirassununga 13635-900, SP, Brazil; (G.H.G.P.); (M.H.d.A.S.)
| | - Mirele Daiana Poleti
- Department of Veterinary Medicine, Faculty of Animal Science and Food Engineering, University of São Paulo (USP), Av. Duque de Caxias Norte, 225, Pirassununga 13635-900, SP, Brazil; (M.D.P.); (J.B.S.F.)
| | - José Bento Sterman Ferraz
- Department of Veterinary Medicine, Faculty of Animal Science and Food Engineering, University of São Paulo (USP), Av. Duque de Caxias Norte, 225, Pirassununga 13635-900, SP, Brazil; (M.D.P.); (J.B.S.F.)
| | - Miguel Henrique de Almeida Santana
- Department of Animal Science, College of Animal Science and Food Engineering, University of São Paulo (USP), Av. Duque de Caxias Norte, 225, Pirassununga 13635-900, SP, Brazil; (G.H.G.P.); (M.H.d.A.S.)
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Wimalasena ST, Ramírez-Silva CI, Gonzalez Casanova I, Stein AD, Sun YV, Rivera JA, Demmelmair H, Koletzko B, Ramakrishnan U. Effects of prenatal docosahexaenoic acid supplementation on offspring cardiometabolic health at 11 years differs by maternal single nucleotide polymorphism rs174602: follow-up of a randomized controlled trial in Mexico. Am J Clin Nutr 2023; 118:1123-1132. [PMID: 37839707 PMCID: PMC10797513 DOI: 10.1016/j.ajcnut.2023.10.005] [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: 03/29/2023] [Revised: 09/20/2023] [Accepted: 10/11/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND There is limited evidence regarding long-term effects of prenatal docosahexaenoic acid (DHA) supplementation on offspring cardiometabolic health (CMH). Inconsistent results may be attributable to variants of fatty acid desaturase (FADS) genes. OBJECTIVE We aimed to evaluate the effect of prenatal DHA supplementation on offspring CMH and investigate effect modification by maternal FADS2 single nucleotide polymorphism (SNP) rs174602. METHODS We used follow-up data from a double-blind, randomized controlled trial in Mexico in which pregnant females received 400 mg/d of algal DHA or placebo from midgestation until delivery. The study sample included 314 offspring with data at age 11 y and maternal FADS genetic data (DHA: n = 160; Placebo: n = 154). We derived a Metabolic Syndrome (MetS) score from body mass index, HDL, triglycerides, fasting glucose concentrations, and systolic blood pressure. Generalized linear models were used to evaluate the effect of the intervention on offspring MetS score and test interactions between treatment group and genotype, adjusting for maternal, offspring, and household factors. RESULTS Offspring MetS score did not differ significantly by treatment group. We observed evidence of effect modification by maternal SNP rs174602 (P = 0.001); offspring of maternal TT genotype who received DHA had lower MetS score relative to the placebo group (DHA (mean ± standard error of the mean (SEM)): -0.21 ± 0.11, n = 21; Placebo: 0.05 ± 0.11, n = 23; Δ= -0.26 (95% CI: -0.55, 0.04), P = 0.09); among CC maternal genotype carriers, offspring of mothers who received DHA had higher MetS score (0.18 ± 0.06, n = 62) relative to the placebo group (-0.05 ± 0.06, n = 65, Δ=0.24 (0.06, 0.41), P < 0.01). CONCLUSION The effect of prenatal DHA supplementation on offspring MetS score differed by maternal FADS SNP rs174602. These findings further support incorporating genetic analysis of FADS polymorphisms in DHA supplementation trials. CLINICAL TRIAL DETAILS This trial was registered at clinicaltrials.gov as NCT00646360.
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Affiliation(s)
- Sonia Tandon Wimalasena
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, United States
| | | | | | - Aryeh D Stein
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, United States; Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| | - Yan V Sun
- Department of Epidemiology, Emory University, Atlanta, GA, United States
| | - Juan A Rivera
- National Institute of Public Health, Cuernavaca, Mexico
| | - Hans Demmelmair
- LMU-Ludwig Maximilians Universität, Department of Pediatrics, LMU University Hospitals, Munich, Germany
| | - Berthold Koletzko
- LMU-Ludwig Maximilians Universität, Department of Pediatrics, LMU University Hospitals, Munich, Germany
| | - Usha Ramakrishnan
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, United States; Hubert Department of Global Health, Emory University, Atlanta, GA, United States.
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Christofaro Fernandes A, Beline M, Polizel GHG, Cavalcante Cracco R, Ferreira Dias EF, Furlan É, da Luz e Silva S, de Almeida Santana MH. Fetal Programming and Its Effects on Meat Quality of Nellore Bulls. Vet Sci 2023; 10:672. [PMID: 38133223 PMCID: PMC10748345 DOI: 10.3390/vetsci10120672] [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: 09/10/2023] [Revised: 11/11/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
This work aimed to evaluate the effects of prenatal nutritional stimulation at different pregnancy stages on carcass traits and meat quality in bovine progeny. For this purpose, 63 Nellore bulls, born from cows submitted to three nutritional plans, were used: not programmed (NP), which did not receive protein supplementation; partially programmed (PP), which had protein-energy supplementation (0.3% of mean body weight of each batch) only in the final third of pregnancy; and full programming (FP), which received supplementation (0.3% of mean body weight of each batch) throughout pregnancy. The averages of parameters were submitted to the ANOVA, and the supplementation periods, which were different when p value < 0.05, were compared. Carcass weights and rib eye area (REA) did not differ between treatments (p > 0.05), but subcutaneous fat thickness (SFT) showed a tendency (p = 0.08) between groups. For lipids and marbling, no differences were found (p > 0.05). In the analyses of maturation time and shelf life, no difference was observed between treatments. However, there was a tendency between treatments at 14 days of maturation time for cooking loss (CL) (p = 0.08). Treatments did not affect shear force in the progenies (p > 0.05). Fetal programming had no effect on the meat quality of Nellore bulls.
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Affiliation(s)
- Arícia Christofaro Fernandes
- Department of Animal Science, College of Animal Science and Food Engineering—USP, Av. Duque de Caxias Norte, 225, Pirassununga 13635-900, SP, Brazil; (M.B.); (G.H.G.P.); (É.F.)
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Bliznashka L, Sudfeld CR, Garba S, Guindo O, Soumana I, Adehossi I, Langendorf C, Grais RF, Isanaka S. Prenatal supplementation with multiple micronutrient supplements or medium-quantity lipid-based nutrient supplements has limited effects on child growth up to 24 months in rural Niger: a secondary analysis of a cluster randomized trial. Am J Clin Nutr 2021; 115:738-748. [PMID: 34871344 PMCID: PMC8895211 DOI: 10.1093/ajcn/nqab404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/06/2021] [Revised: 11/06/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Prenatal multiple micronutrient supplementation (MMS) and lipid-based nutrient supplementation (LNS) can improve birth outcomes relative to iron-folic acid supplementation (IFA); however, effects on child postnatal growth remain unclear. OBJECTIVES The aim was to compare the effect of prenatal MMS, medium-quantity LNS (MQ-LNS), and IFA on child growth up to 2 y of age. METHODS We conducted a cluster randomized controlled trial of prenatal nutritional supplementation in Madarounfa, Niger. Villages were randomly assigned for pregnant women to receive IFA (17 villages, 1105 women), MMS (18 villages, 1083 women) or MQ-LNS (18 villages, 1144 women). Pregnant women received nutritional supplements weekly until delivery, and children were followed up monthly from 6-8 wk to 24 mo of age. We assessed the effect of prenatal MMS and MQ-LNS compared with IFA and the effect of prenatal MMS compared with MQ-LNS on child length-for-age z scores (LAZ), weight-for-age z scores (WAZ), and weight-for-length z scores (WLZ) at 24 mo of age using generalized linear models. In secondary analyses, we used mixed-effects models to assess the trajectories of anthropometric z scores longitudinally from 6-8 wk to 24 mo. RESULTS Compared with IFA, MMS and MQ-LNS had no effect on child LAZ, WAZ, or WLZ at 24 mo of age (P > 0.05). Children in the MQ-LNS arm had significantly higher mid-upper arm circumference at 24 mo than children in the MMS arm: mean difference 0.50 cm (95% CI 0.10, 0.91 cm). WAZ and WLZ trajectories were more negative in the MQ-LNS arm compared with IFA and MMS, with lower z scores from 14 to 20 mo of age. However, WAZ and WLZ trajectories converged after 20 mo of age, and there were no differences by 24 mo of age. CONCLUSIONS Prenatal MMS and MQ-LNS had limited effect on anthropometric measures of child growth up to 24 mo of age as compared with IFA in rural Niger.
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Affiliation(s)
- Lilia Bliznashka
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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7
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Tandon S, Gonzalez-Casanova I, Barraza-Villarreal A, Romieu I, Demmelmair H, Jones DP, Koletzko B, Stein AD, Ramakrishnan U. Infant Metabolome in Relation to Prenatal DHA Supplementation and Maternal Single-Nucleotide Polymorphism rs174602: Secondary Analysis of a Randomized Controlled Trial in Mexico. J Nutr 2021; 151:3339-3349. [PMID: 34494106 PMCID: PMC8562085 DOI: 10.1093/jn/nxab276] [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: 03/19/2021] [Revised: 04/23/2021] [Accepted: 07/28/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Although DHA (22:6n-3) is critical for fetal development, results from randomized controlled trials (RCTs) of prenatal DHA supplementation report inconsistent effects on offspring health. Variants in fatty acid desaturase (FADS) genes that regulate the conversion of n-3 and n-6 essential fatty acids into their biologically active derivatives may explain this heterogeneity. OBJECTIVES We investigated the effect of prenatal DHA supplementation on the offspring metabolome at age 3 mo and explored differences by maternal FADS single-nucleotide polymorphism (SNP) rs174602. METHODS Data were obtained from a double-blind RCT in Mexico [POSGRAD (Prenatal Omega-3 Fatty Acid Supplementation and Child Growth and Development)] in which women (18-35 y old) received DHA (400 mg/d) or placebo from mid-gestation until delivery. Using high-resolution MS with LC, untargeted metabolomics was performed on 112 offspring plasma samples. Discriminatory metabolic features were selected via linear regression (P < 0.05) with false discovery rate (FDR) correction (q = 0.2). Interaction by SNP rs174602 was assessed using 2-factor ANOVA. Stratified analyses were performed, where the study population was grouped into carriers (TT, TC; n = 70) and noncarriers (CC; n = 42) of the minor allele. Pathway enrichment analysis was performed with Mummichog (P < 0.05). RESULTS After FDR correction, there were no differences in metabolic features between infants whose mothers received prenatal DHA (n = 58) and those whose mothers received placebo (n = 54). However, we identified 343 differentially expressed features in the interaction analysis after FDR correction. DHA supplementation positively enriched amino acid and aminosugars metabolism pathways and decreased fatty acid metabolism pathways among offspring of minor allele carriers and decreased metabolites within the tricarboxylic acid cycle and galactose metabolism pathways among offspring of noncarriers. CONCLUSIONS Our findings demonstrate differences in infant metabolism in response to prenatal DHA supplementation by maternal SNP rs174602 and further support the need to incorporate genetic analysis of FADS polymorphisms into DHA supplementation trials.This trial was registered at clinicaltrials.gov as NCT00646360.
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Affiliation(s)
- Sonia Tandon
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA
| | - Ines Gonzalez-Casanova
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA
- Indiana University Bloomington School of Public Health, Bloomington, IN, USA
| | | | - Isabelle Romieu
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA
- National Institute of Public Health, Cuernavaca, Mexico
| | - Hans Demmelmair
- Department of Paediatrics, Dr. von Hauner Children's Hospital, LMU University Hospitals, (LMU - Ludwig-Maximilians-Universität Munich), Munich, Germany
| | - Dean P Jones
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA
- Department of Medicine, Emory University, Atlanta, GA, USA
| | - Berthold Koletzko
- Department of Paediatrics, Dr. von Hauner Children's Hospital, LMU University Hospitals, (LMU - Ludwig-Maximilians-Universität Munich), Munich, Germany
| | - Aryeh D Stein
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA
| | - Usha Ramakrishnan
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA
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Siddiqua TJ, Roy AK, Akhtar E, Haq MA, Wagatsuma Y, Ekström EC, Afsar MNA, Hossain MI, Ahmed T, El Arifeen S, Raqib R. Prenatal nutrition supplementation and growth biomarkers in preadolescent Bangladeshi children: A birth cohort study. Matern Child Nutr 2021; 18:e13266. [PMID: 34467639 PMCID: PMC8710124 DOI: 10.1111/mcn.13266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 07/25/2021] [Accepted: 08/02/2021] [Indexed: 11/28/2022]
Abstract
Little is known about the usefulness of biomarkers to study the influence of prenatal nutrition supplementation in improving child growth. Anthropometry is not always straightforward to understand how nutrition might impact growth, especially in settings with high rates of malnutrition and infections. We examined the effects of prenatal supplementation on growth and growth biomarkers and the relationship between anthropometric measures and growth biomarkers of children at 4.5 and 9 years of age. Children were enrolled from a longitudinal cohort, where mothers were randomized into daily supplementation with either early‐food (≤9 gestation week [GW]) or usual‐food (~20 GW) (608 kcal 6 days/week); they were further randomized to receive 30‐mg or 60‐mg iron with 400‐μg folic acid, or multiple micronutrients (MM) in rural Bangladesh. Anthropometric data were collected from mothers at GW8 and children at 4.5 (n = 640) and 9 years (n = 536). Fasting blood was collected from children at each age. Early‐food supplementation showed reduced stunting and underweight at 4.5 and 9 years age respectively compared to usual‐food. Prenatal supplementations did not have any effect on growth biomarkers except for STAT5b expression which was lower in the early‐food compared to the usual‐food group (β = −0.21; 95 CI% = −0.36, −0.07). Plasma concentrations of 25‐hydroxy vitamin D and calcium were both inversely associated with weight‐for‐age and body mass index‐for‐age Z‐scores at 9 years, particularly in early‐food and MM groups. Although there was minimal effect on child growth by prenatal supplementations, the associations of biomarkers with anthropometric indices were predominantly driven by timing of food or MM supplementations.
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Affiliation(s)
- Towfida Jahan Siddiqua
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Anjan Kumar Roy
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Evana Akhtar
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Ahsanul Haq
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Yukiko Wagatsuma
- Department of Clinical Trial and Clinical Epidemiology, University of Tsukuba, Tsukuba, Japan
| | - Eva-Charlotte Ekström
- International Maternal and Child Health, Womens and Childrens Health, Uppsala University, Uppsala, Sweden
| | - Md Nure Alam Afsar
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Iqbal Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Shams El Arifeen
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Rubhana Raqib
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Abstract
Background: Previous studies on preclinical models have shown that giving supplemental choline during the embryonic period improves performance on memory tasks during adulthood. However, the effects of an early intervention on the development of cognitive functions in the immature brain have not been widely studied. In addition, it has been well established that short-term memory in rats emerges at an earlier stage than long-term memory.Objective: The aim of this work was to examine the effect of prenatal dietary choline supplementation on long-term memory development in rats.Methods: In order to assess long-term memory, we used an object-recognition task, which evaluates the ability to recall a previously presented stimulus. Pregnant rats were fed with the diets AIN 76-A standard (1.1 g choline/Kg food) or supplemented (5 g choline/Kg food) between embryonic days (E) 12 and E18. On the first post-natal day (PN 0), male offspring of the rats fed with the supplemented and standard diet were cross-fostered to rat dams fed a standard diet during pregnancy and tested at the age of PN21-22 or PN29-31 applying 24-hour retention tests.Results: The supplemented animals spent less time exploring the familiar object after a 24-hour retention interval, an effect that was observed in both the group tested at PN21-22 days of age and that tested at PN29-31 days. The non-supplemented rats only showed this effect in the group tested at PN29-31 days.Conclusions: These results suggest that prenatal supplementation with choline accelerates the development of long-term memory in rats.
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Affiliation(s)
- Hayarelis Moreno
- Department of Psychology of Education and Psychobiology, International University of La Rioja, La Rioja, Spain
| | - Isabel de Brugada
- Department of Experimental Psychology, University of Granada, Granada, Spain
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
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Campoy C, Azaryah H, Torres-Espínola FJ, Martínez-Zaldívar C, García-Santos JA, Demmelmair H, Haile G, Györei E, Ramírez-Tortosa MDC, Reischl E, Rzehak P, Molloy AM, Décsi T, Luna JD, Koletzko B, Pérez-García M. Long-Chain Polyunsaturated Fatty Acids, Homocysteine at Birth and Fatty Acid Desaturase Gene Cluster Polymorphisms are Associated with Children's Processing Speed up to Age 9 Years. Nutrients 2020; 13:E131. [PMID: 33396458 DOI: 10.3390/nu13010131] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/18/2020] [Accepted: 12/29/2020] [Indexed: 01/26/2023] Open
Abstract
Both pre- and early postnatal supplementation with docosahexaenoic acid (DHA), arachidonic acid (AA) and folate have been related to neural development, but their long-term effects on later neural function remain unclear. We evaluated the long-term effects of maternal prenatal supplementation with fish-oil (FO), 5-methyltetrahydrofolate (5-MTHF), placebo or FO + 5-MTHF, as well as the role of fatty acid desaturase (FADS) gene cluster polymorphisms, on their offspring’s processing speed at later school age. This study was conducted in NUHEAL children at 7.5 (n = 143) and 9 years of age (n = 127). Processing speed tasks were assessed using Symbol Digit Modalities Test (SDMT), Children Color Trails Test (CCTT) and Stroop Color and Word Test (SCWT). Long-chain polyunsaturated fatty acids, folate and total homocysteine (tHcy) levels were determined at delivery from maternal and cord blood samples. FADS and methylenetetrahydrofolate reductase (MTHFR) 677 C > T genetic polymorphisms were analyzed. Mixed models (linear and logistic) were performed. There were significant differences in processing speed performance among children at different ages (p < 0.001). The type of prenatal supplementation had no effect on processing speed in children up to 9 years. Secondary exploratory analyses indicated that children born to mothers with higher AA/DHA ratio at delivery (p < 0.001) and heterozygotes for FADS1 rs174556 (p < 0.05) showed better performance in processing speed at 9 years. Negative associations between processing speed scores and maternal tHcy levels at delivery were found. Our findings suggest speed processing development in children up to 9 years could be related to maternal factors, including AA/DHA and tHcy levels, and their genetic background, mainly FADS polymorphism. These considerations support that maternal prenatal supplementation should be quantitatively adequate and individualized to obtain better brain development and mental performance in the offspring.
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11
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Kumordzie SM, Adu-Afarwuah S, Arimond M, Young RR, Adom T, Boatin R, Ocansey ME, Okronipa H, Prado EL, Oaks BM, Dewey KG. Maternal and Infant Lipid-Based Nutritional Supplementation Increases Height of Ghanaian Children at 4-6 Years Only if the Mother Was Not Overweight Before Conception. J Nutr 2019; 149:847-855. [PMID: 31034033 PMCID: PMC6499103 DOI: 10.1093/jn/nxz005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 09/26/2018] [Revised: 10/31/2018] [Accepted: 01/08/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Few studies have evaluated the long-term effects of nutritional supplementation during the first 1000 d of life. We previously reported that maternal and child lipid-based nutrient supplements (LNS) increased child length by 18 mo. OBJECTIVE The aim of this study was to examine the effects of LNS on later growth and body composition at 4-6 y of age. DESIGN This was a follow-up of children in the International Lipid-based Nutrient Supplements (iLiNS)-DYAD trial in Ghana. Women (n = 1320) at ≤20 weeks of gestation were randomly assigned to: 1) iron and folic acid during pregnancy and 200 mg calcium/d for 6 mo postpartum, 2) multiple micronutrients (1-2 RDA of 18 vitamins and minerals) during both periods, or 3) maternal LNS during both periods plus child LNS from 6 to 18 mo. At 4-6 y, we compared height, height-for-age z score (HAZ), and % body fat (deuterium dilution method) between the LNS group and the 2 non-LNS groups combined. RESULTS Data were available for 961 children (76.5% of live births). There were no significant differences between LNS compared with non-LNS groups in height [106.7 compared with 106.3 cm (mean difference, MD, 0.36; P = 0.226)], HAZ [-0.49 compared with -0.57 (MD = 0.08; P = 0.226)], stunting (< -2 SD) [6.5 compared with 6.3% (OR = 1.00; P = 0.993)], or % body fat [15.5 compared with 15.3% (MD = 0.16; P = 0.630)]. However, there was an interaction with maternal prepregnancy BMI (kg/m2) (P-interaction = 0.046 before correction for multiple testing): among children of women with BMI < 25 , LNS children were taller than non-LNS children (+1.1 cm, P = 0.017), whereas there was no difference among children of women with BMI ≥ 25 (+0.1 cm; P = 0.874). CONCLUSIONS There was no overall effect of LNS on height at 4-6 y in this cohort, which had a low stunting rate, but height was greater in the LNS group among children of nonoverweight/obese women. There was no adverse impact of LNS on body composition. This trial was registered at clinicaltrials.gov as NCT00970866.
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Affiliation(s)
- Sika M Kumordzie
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA,Address correspondence to SMK (E-mail: )
| | - Seth Adu-Afarwuah
- Department of Nutrition and Food Science, University of Ghana, Ghana
| | - Mary Arimond
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA,Intake – Center for Dietary Assessment, FHI 360, Washington, DC
| | - Rebecca R Young
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
| | - Theodosia Adom
- Nutrition Research Centre, Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Legon, Ghana
| | - Rose Boatin
- Nutrition Research Centre, Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Legon, Ghana
| | - Maku E Ocansey
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
| | - Harriet Okronipa
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
| | - Elizabeth L Prado
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
| | - Brietta M Oaks
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA,Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI
| | - Kathryn G Dewey
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
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12
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Ocansey ME, Adu-Afarwuah S, Kumordzie SM, Okronipa H, Young RR, Tamakloe SM, Oaks BM, Dewey KG, Prado EL. Prenatal and postnatal lipid-based nutrient supplementation and cognitive, social-emotional, and motor function in preschool-aged children in Ghana: a follow-up of a randomized controlled trial. Am J Clin Nutr 2019; 109:322-334. [PMID: 30721937 PMCID: PMC6367954 DOI: 10.1093/ajcn/nqy303] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 10/03/2018] [Indexed: 01/12/2023] Open
Abstract
Background Adequate nutrition is necessary for brain development during pregnancy and infancy. Few randomized controlled trials of supplementation during these periods have measured later developmental outcomes. Objective Our objective was to investigate the effects of provision of prenatal and postnatal lipid-based nutrient supplements (LNS) on child development at preschool age. Methods We conducted a follow-up study of 966 children aged 4-6 y in 2016, born to women who participated in the International Lipid-Based Nutrient Supplements-DYAD trial conducted in Ghana in 2009-2014, representing 79% of eligible children. Women ≤20 weeks of gestation were randomized to daily LNS or multiple micronutrient (MMN) capsules during pregnancy through 6 mo postpartum or iron and folic acid (IFA) capsules during pregnancy and calcium placebo capsules during 6 mo postpartum. Children in the LNS group received LNS from 6 to 18 mo. Primary outcomes of this follow-up study were (1) a cognitive factor score based on a test battery adapted from several standard tests, 2) fine motor score (9-hole pegboard test), and (3) social-emotional difficulties (Strengths and Difficulties Questionnaire; SDQ). Eight secondary outcomes were calculated in specific domains (e.g., language, SDQ prosocial). Analysis was by a complete case intention to treat in a 2-group comparison: LNS compared with non-LNS (MMN + IFA). Results Children in the LNS group had significantly lower social-emotional difficulties z-scores than children in the non-LNS group (adjusted for child age β = -0.12, 95% CI: -0.25, 0.02, P = 0.087; fully adjusted β = -0.16, 95% CI: -0.29, -0.03, P = 0.013). The effect of LNS on social-emotional difficulties score was larger among children living in households with lower home environment scores (P-interaction = 0.081). No other outcomes differed between the 2 intervention groups. Conclusions Provision of LNS during the first 1000 d of development improved behavioral function, particularly for children from low nurturing and stimulation households, but did not affect cognition at preschool age in this setting. Trial Registration: clinicaltrials.gov, Identifier NCT00970866.
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Affiliation(s)
- Maku E Ocansey
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
| | - Seth Adu-Afarwuah
- Department of Nutrition and Food Science, University of Ghana, Legon, Ghana
| | - Sika M Kumordzie
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
| | - Harriet Okronipa
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
| | - Rebecca R Young
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
| | - Solace M Tamakloe
- Department of Nutrition and Food Science, University of Ghana, Legon, Ghana
| | - Brietta M Oaks
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI
| | - Kathryn G Dewey
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
| | - Elizabeth L Prado
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
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13
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Hess SY, Ouédraogo CT, Bamba IF, Wessells KR, Keith N, Faye T, Ndiaye B, Doudou M, Nielsen J. Using formative research to promote antenatal care attendance and iron folic acid supplementation in Zinder, Niger. Matern Child Nutr 2017; 14:e12525. [PMID: 28924978 DOI: 10.1111/mcn.12525] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/12/2017] [Accepted: 08/30/2017] [Indexed: 12/12/2022]
Abstract
In Niger, use of antenatal care (ANC) and iron folic acid (IFA) supplements is suboptimal. The objectives of this paper are as follows: (a) to conduct formative research to understand barriers and beliefs among pregnant women related to ANC, IFA supplementation, and pregnancy outcomes; (b) assess the quality of currently provided ANC services; (c) use the findings to guide the development of programmatic interventions to improve coverage of ANC services and IFA supplementation of pregnant women. Structured in-home interviews (n = 72) and focus groups (n = 4) were conducted with pregnant women in 4 randomly selected villages in rural Zinder. ANC consultations (n = 33) were observed in 5 randomly selected health centres, and exit interviews were conducted with all pregnant women and seven health agents following these observations. During workshops with stakeholders, results of the formative research were interpreted, and programmatic interventions were developed. In home interviews, 72% of women reported having attended at least one ANC visit. They also reported husbands (71%), mothers (40%), and friends (33%) supporting ANC attendance. Among those having attended ANC, only 65% reported taking IFA the day prior to the interview. Three of five health centres visited had IFA in stock. Health staff did not provide IFA supplements during 18 of 33 observed ANC consultations of which only 7 cases could be explained by the lack of IFA supplements in stock. Findings were used to design a 3-pronged intervention: (a) behaviour change communication activities in communities; (b) quality improvement activities in health centres to strengthen ANC; and (c) provision of key supplies required for ANC.
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Affiliation(s)
- Sonja Y Hess
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, California, USA
| | - Césaire T Ouédraogo
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, California, USA.,Helen Keller International, Niamey, Niger
| | | | - K Ryan Wessells
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, California, USA
| | - Nancy Keith
- Independent Consultant, Iowa City, Iowa, USA
| | | | - Banda Ndiaye
- Nutrition International, Africa Regional Office, Dakar, Senegal
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14
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Ramakrishnan U, Gonzalez-Casanova I, Schnaas L, DiGirolamo A, Quezada AD, Pallo BC, Hao W, Neufeld LM, Rivera JA, Stein AD, Martorell R. Prenatal supplementation with DHA improves attention at 5 y of age: a randomized controlled trial. Am J Clin Nutr 2016; 104:1075-1082. [PMID: 27604770 PMCID: PMC5039806 DOI: 10.3945/ajcn.114.101071] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [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: 10/31/2014] [Accepted: 07/28/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Docosahexanoic acid (DHA) is an important constituent of the brain. Evidence from well-designed intervention trials of the long-term benefits of increasing DHA intake during pregnancy has been sparse. OBJECTIVE We evaluated global cognition, behavior, and attention at age 5 y in the offspring of Mexican women who participated in a randomized controlled trial of prenatal DHA supplementation. DESIGN A total of 1094 women were randomly assigned to receive 400 mg of either DHA or placebo/d from 18 to 22 wk of pregnancy until delivery. We assessed cognitive development and behavioral and executive functioning, including attention, in 797 offspring at age 5 y (82% of 973 live births) with the use of the McCarthy Scales of Children's Abilities (MSCA), the parental scale of the Behavioral Assessment System for Children, Second Edition (BASC-2), and the Conners' Kiddie Continuous Performance Test (K-CPT). We compared the groups on raw scores, T-scores, and standardized scores, as appropriate. We examined heterogeneity by the quality of the home environment, maternal intelligence, and socioeconomic status. RESULTS There were no group differences for MSCA scores (P > 0.05), but the positive effect of the home environment at 12 mo on general cognitive abilities was attenuated in the DHA group compared with in the placebo group (P-interaction < 0.05). There were no differences between groups on the BASC-2. On the K-CPT, offspring in the DHA group showed improved mean ± SD T-scores compared with those of the placebo group for omissions (DHA: 47.6 ± 10.3; placebo: 49.6 ± 11.2; P < 0.01) with no differences (P > 0.05) for the other K-CPT scores or of the proportion who were clinically at risk of attention deficit hyperactivity disorders after Bonferroni correction for multiple comparisons. CONCLUSION Prenatal exposure to DHA may contribute to improved sustained attention in preschool children. This trial was registered at clinicaltrials.gov as NCT00646360.
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Affiliation(s)
- Usha Ramakrishnan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA;
| | - Ines Gonzalez-Casanova
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Lourdes Schnaas
- Division of Public Health, National Institute of Perinatology, Mexico City, Mexico
| | - Ann DiGirolamo
- Center of Excellence for Children's Behavioral Health, Georgia Health Policy Center, Georgia State University, Atlanta, GA
| | - Amado D Quezada
- Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Mexico; and
| | - Beth C Pallo
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Wei Hao
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | - Juan A Rivera
- Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Mexico; and
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
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15
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Ershow AG, Goodman G, Coates PM, Swanson CA. Research needs for assessing iodine intake, iodine status, and the effects of maternal iodine supplementation. Am J Clin Nutr 2016; 104 Suppl 3:941S-9S. [PMID: 27534640 PMCID: PMC5004498 DOI: 10.3945/ajcn.116.134858] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The Office of Dietary Supplements of the NIH convened 3 workshops on iodine nutrition in Rockville, Maryland, in 2014. The purpose of the current article is to summarize and briefly discuss a list of research and resource needs developed with the input of workshop participants. This list is composed of the basic, clinical, translational, and population studies required for characterizing the benefits and risks of iodine supplementation, along with related data, analyses, evaluations, methods development, and supporting activities. Ancillary studies designed to use the participant, biological sample, and data resources of ongoing and completed studies (including those not originally concerned with iodine) may provide an efficient, cost-effective means to address some of these research and resource needs. In the United States, the foremost question is whether neurobehavioral development in the offspring of mildly to moderately iodine-deficient women is improved by maternal iodine supplementation during pregnancy. It is important to identify the benefits and risks of iodine supplementation in all population subgroups so that supplementation can be targeted, if necessary, to avoid increasing the risk of thyroid dysfunction and related adverse health effects in those with high iodine intakes. Ultimately, there will be a need for well-designed trials and other studies to assess the impact of maternal supplementation on neurodevelopmental outcomes in the offspring. However, 2 basic information gaps loom ahead of such a study: the development of robust, valid, and convenient biomarkers of individual iodine status and the identification of infant and toddler neurobehavioral development endpoints that are sensitive to mild maternal iodine deficiency during pregnancy and its reversal by supplementation.
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Affiliation(s)
- Abby G Ershow
- Office of Dietary Supplements, NIH, Bethesda, MD; and
| | | | - Paul M Coates
- Office of Dietary Supplements, NIH, Bethesda, MD; and
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16
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Gonzalez-Casanova I, Rzehak P, Stein AD, Garcia Feregrino R, Rivera Dommarco JA, Barraza-Villarreal A, Demmelmair H, Romieu I, Villalpando S, Martorell R, Koletzko B, Ramakrishnan U. Maternal single nucleotide polymorphisms in the fatty acid desaturase 1 and 2 coding regions modify the impact of prenatal supplementation with DHA on birth weight. Am J Clin Nutr 2016; 103:1171-8. [PMID: 26912491 PMCID: PMC4807702 DOI: 10.3945/ajcn.115.121244] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [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] [Received: 08/10/2015] [Accepted: 01/21/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Specific single nucleotide polymorphisms (SNPs) in the fatty acid desaturase (FADS) gene affect the activity and efficiency of enzymes that are responsible for the conversion of polyunsaturated fatty acids (PUFAs) into their long-chain active form. A high prevalence of SNPs that are associated with slow PUFA conversion has been described in Hispanic populations. OBJECTIVE We assessed the heterogeneity of the effect of prenatal supplementation with docosahexaenoic acid (DHA) on birth weight across selected FADS SNPs in a sample of Mexican women and their offspring. DESIGN We obtained information on the maternal genotype from stored blood samples of 654 women who received supplementation with 400 mg DHA/d or a placebo from weeks 18 to 22 of gestation through delivery as part of a randomized controlled trial conducted in Cuernavaca, Mexico. We selected 4 tag SNPs (rs174455, rs174556, rs174602, and rs498793) in the FADS region for analysis. We used an ANOVA to test for the heterogeneity of the effect on birth weight across each of the 4 SNPs. RESULTS The mean ± SD birth weight was 3210 ± 470 g, and the weight-for-age z score (WAZ) was -0.24 ± 1.00. There were no intention-to-treat differences in birth weights. We showed significant heterogeneity by SNP rs174602 (P= 0.02); offspring of carriers of alleles TT and TC in the intervention group were heavier than those in the placebo group (WAZ: -0.13 ± 0.14 and -0.20 ± 0.08 compared with -0.55 ± 0.15 and -0.39 ± 0.09, respectively); there were no significant differences in offspring of rs174602 CC homozygotes (WAZ: -0.26 ± 0.09 in the intervention group compared with -0.04 ± 0.09 in the placebo group). We showed no significant heterogeneity across the other 3 FADS SNPs. CONCLUSION Differential responses to prenatal DHA supplementation on the basis of the genetic makeup of target populations could explain the mixed evidence of the impact of DHA supplementation on birth weight. This trial was registered at clinicaltrials.gov as NCT00646360.
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Affiliation(s)
- Ines Gonzalez-Casanova
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Peter Rzehak
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | | | | | - Hans Demmelmair
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
| | | | | | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA;
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Adu-Afarwuah S, Lartey A, Okronipa H, Ashorn P, Zeilani M, Baldiviez LM, Oaks BM, Vosti S, Dewey KG. Impact of small-quantity lipid-based nutrient supplement on hemoglobin, iron status and biomarkers of inflammation in pregnant Ghanaian women. Matern Child Nutr 2016; 13. [PMID: 26924599 DOI: 10.1111/mcn.12262] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/11/2015] [Accepted: 11/17/2015] [Indexed: 01/30/2023]
Abstract
We examined hemoglobin (Hb, g/L), iron status (zinc protoporphyrin, ZPP, µmol/mol heme, and transferrin receptor, TfR, mg/L) and inflammation (C-reactive protein, CRP and alpha-1 glycoprotein, AGP) in pregnant Ghanaian women who participated in a randomized controlled trial. Women (n = 1320) received either 60 mg Fe + 400-µg folic acid (IFA); 18 micronutrients including 20-mg Fe (MMN) or small-quantity lipid-based nutrient supplements (SQ-LNS, 118 kcal/d) with the same micronutrient levels as in MMN, plus four additional minerals (LNS) daily during pregnancy. Intention-to-treat analysis included 349, 354 and 354 women in the IFA, MMN and LNS groups, respectively, with overall baseline mean Hb and anemia (Hb <100) prevalence of 112 and 13.3%, respectively. At 36 gestational weeks, overall Hb was 117, and anemia prevalence was 5.3%. Compared with the IFA group, the LNS and MMN groups had lower mean Hb (120 ± 11 vs. 115 ± 12 and 117 ± 12, respectively; P < 0.001), higher mean ZPP (42 ± 30 vs. 50 ± 29 and 49 ± 30; P = 0.010) and TfR (4.0 ± 1.3 vs. 4.9 ± 1.8 and 4.6 ± 1.7; P < 0.001), and greater prevalence of anemia (2.2% vs. 7.9% and 5.8%; P = 0.019), elevated ZPP (>60) [9.4% vs. 18.6% and 19.2%; P = 0.003] and elevated TfR (>6.0) [9.0% vs. 19.2% and 15.1%; P = 0.004]. CRP and AGP concentrations did not differ among groups. We conclude that among pregnant women in a semi-urban setting in Ghana, supplementation with SQ-LNS or MMN containing 20 mg iron resulted in lower Hb and iron status but had no impact on inflammation, when compared with iron (60 mg) plus folic acid (400 µg). The amount of iron in such supplements that is most effective for improving both maternal Hb/iron status and birth outcomes requires further evaluation. This trial was registered at ClinicalTrials.gov as: NCT00970866.
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Affiliation(s)
- Seth Adu-Afarwuah
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana
| | - Anna Lartey
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana
| | - Harriet Okronipa
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana
| | - Per Ashorn
- Center for Child Health Research and Department of Pediatrics, University of Tampere School of Medicine and Tampere University Hospital, Finland
| | | | - Lacey M Baldiviez
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, California, USA
| | - Brietta M Oaks
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, California, USA
| | - Stephen Vosti
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, California, USA
| | - Kathryn G Dewey
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, California, USA
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18
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Best KP, Gold M, Kennedy D, Martin J, Makrides M. Omega-3 long-chain PUFA intake during pregnancy and allergic disease outcomes in the offspring: a systematic review and meta-analysis of observational studies and randomized controlled trials. Am J Clin Nutr 2016; 103:128-43. [PMID: 26675770 DOI: 10.3945/ajcn.115.111104] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [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: 03/18/2015] [Accepted: 10/09/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is some evidence that increased maternal intake of omega-3 (n-3) long-chain polyunsaturated fatty acids (LC-PUFAs) during pregnancy may reduce the incidence of immunoglobulin E (IgE)-mediated allergic disease. OBJECTIVE We aimed to evaluate prenatal n-3 LC-PUFA dietary exposure in observational studies and n-3 LC-PUFA supplementation in randomized controlled trials (RCTs) on outcomes of IgE-mediated allergic disease. DESIGN We conducted searches of the Cochrane Central Register of Controlled Trials, PubMed, Ovid MEDLINE, EMBASE, CINAHL, SCOPUS, and Web of Science to 30 July 2015. We included prospective cohort studies that showed an association between maternal fish or n-3 LC-PUFA intake during pregnancy and RCTs with a prenatal intervention to modify maternal n-3 LC-PUFA intake and outcomes of allergic disease (eczema, rhino-conjunctivitis, asthma) or sensitization in the offspring. RESULTS A total of 13 publications from 10 prospective cohort studies and 7 publications representing 5 unique RCTs were included. Three RCTs were combined in a meta-analysis for selected outcomes. Nine of 13 observational study publications and 5 of 7 publications from RCTs found a protective association between increased prenatal n-3 LC-PUFA or fish intake and incidence of allergic disease symptoms in the child. Meta-analysis was limited because of the heterogeneity of the RCTs. Pooled results showed a significant reduction in the incidence of "atopic eczema," "any positive SPT [skin-prick test]," "sensitization to egg," and "sensitization to any food" in the first 12 mo of life [RRs (95% CIs): 0.53 (0.35, 0.81), P = 0.004; 0.68 (0.52-0.89), P = 0.006; 0.55 (0.39-0.76), P = 0.0004; and 0.59 (0.46, 0.76), P < 0.0001, respectively]. CONCLUSIONS Our systematic review and meta-analysis was suggestive of benefits of increased n-3 LC-PUFAs in the maternal diet and outcomes of childhood allergic disease. However, due to the inconsistency in results, the hypothesis linking maternal n-3 LC-PUFA intake to childhood allergic disease cannot unequivocally be confirmed or rejected.
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Affiliation(s)
- Karen P Best
- Women's & Children's Health Research Institute and Discipline of Pediatrics, University of Adelaide, Adelaide, Australia; South Australian Health and Medical Research Institute, Adelaide, Australia;
| | - Michael Gold
- Department of Allergy and Immunology, Children's Youth and Women's Health Network, North Adelaide, Australia
| | - Declan Kennedy
- Discipline of Pediatrics, University of Adelaide, Adelaide, Australia; Department of Respiratory and Sleep Medicine, Women's & Children's Hospital, North Adelaide, Australia; and
| | - James Martin
- Discipline of Pediatrics, University of Adelaide, Adelaide, Australia; Department of Respiratory and Sleep Medicine, Women's & Children's Hospital, North Adelaide, Australia; and
| | - Maria Makrides
- Women's & Children's Health Research Institute and Discipline of Pediatrics, University of Adelaide, Adelaide, Australia; South Australian Health and Medical Research Institute, Adelaide, Australia
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Gonzalez-Casanova I, Stein AD, Hao W, Garcia-Feregrino R, Barraza-Villarreal A, Romieu I, Rivera JA, Martorell R, Ramakrishnan U. Prenatal Supplementation with Docosahexaenoic Acid Has No Effect on Growth through 60 Months of Age. J Nutr 2015; 145:1330-4. [PMID: 25926416 PMCID: PMC4442112 DOI: 10.3945/jn.114.203570] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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: 09/05/2014] [Revised: 10/11/2014] [Accepted: 04/07/2015] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Prenatal supplementation with docosahexaenoic acid (DHA) has been shown to increase birth size, but it is unclear whether these differences translate into improved postnatal growth. OBJECTIVE We assessed the effect of prenatal supplementation with DHA on offspring weight, length, and body mass index (BMI) through 60 mo of age. METHODS We examined growth patterns (height, weight, and BMI) in a cohort of 802 Mexican children whose mothers participated in a randomized, controlled trial of daily supplementation with 400 mg/d of DHA or a placebo from week 18-22 of gestation through delivery, with the use of a longitudinal multilevel model of growth. RESULTS Overall, means ± SDs of height-, weight-, and BMI-for-age z scores relative to WHO growth standards at 60 mo were -0.49 ± 0.91, -1.15 ± 1.07 and 0.13 ± 1.11, respectively. There were no significant differences by treatment group (all P > 0.05) for height, weight, or BMI at any age through 60 mo. Similarly, DHA did not affect the average growth or the trajectories for these measures through 60 mo. CONCLUSION Prenatal DHA supplementation did not affect height, weight, or BMI through 60 mo of age. This trial was registered at clinicaltrials.gov as NCT00646360.
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Affiliation(s)
- Ines Gonzalez-Casanova
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Wei Hao
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | | | | | | | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA;
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Adu-Afarwuah S, Lartey A, Okronipa H, Ashorn P, Zeilani M, Peerson JM, Arimond M, Vosti S, Dewey KG. Lipid-based nutrient supplement increases the birth size of infants of primiparous women in Ghana. Am J Clin Nutr 2015; 101:835-46. [PMID: 25833980 DOI: 10.3945/ajcn.114.091546] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [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: 05/09/2014] [Accepted: 01/06/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The International Lipid-Based Nutrient Supplements Project developed a small-quantity (20 g/d) lipid-based nutrient supplement (LNS) for pregnant and lactating women. OBJECTIVE We evaluated the effects of prenatal LNS supplementation on fetal growth. DESIGN In a community-based, partially double-blind, individually randomized controlled trial, 1320 women ≤20 wk pregnant received 60 mg Fe/400 μg folic acid (IFA), or 1-2 Recommended Dietary Allowances of 18 micronutrients, including 20 mg Fe (MMN), or LNS with the same micronutrients as the MMN group, plus 4 minerals and macronutrients contributing 118 kcal (LNS) daily until delivery. Fetal growth was compared across groups by using intention-to-treat analysis. The primary outcome was birth length. RESULTS This analysis included 1057 women (IFA = 349, MMN = 354, LNS = 354). Groups did not differ significantly in mean birth length, length-for-age z score (LAZ), head circumference, or percentage low birth length but differed in mean birth weight (P = 0.044), weight-for-age z score (WAZ; P = 0.046), and BMI-for-age z score (BMIZ; P = 0.040), with a trend toward differences in low birth weight (P = 0.069). In pairwise comparisons, the LNS group had greater mean birth weight (+85 g; P = 0.040), WAZ (+0.19; P = 0.045), and BMIZ (+0.21; P = 0.035) and a lower risk of low birth weight (RR: 0.61, 95% CI: 0.39, 0.96; P = 0.032) than did the IFA group. The other group differences were not significant. The effect of intervention was modified by mother's parity, age, height, baseline hemoglobin, household food insecurity, and child sex, with parity being the most consistent modifier. Among primiparous women (IFA = 131; MMN = 110; LNS = 128), the LNS group had greater mean birth length (+0.91 cm; P = 0.001), LAZ (+0.47; P = 0.001), weight (+237 g; P < 0.001), WAZ (+0.56; P < 0.001), BMIZ (+0.52; P < 0.001), head circumference (0.50 cm; P = 0.017), and head circumference-for-age z score (+0.40; P = 0.022) than did the IFA group; similar differences were found when comparing the LNS and MMN groups among primiparous women, and no group differences were found among multiparous women. CONCLUSION Prenatal LNS supplementation can improve fetal growth among vulnerable women in Ghana, particularly primiparous women. This trial was registered at clinicaltrials.gov as NCT00970866.
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Affiliation(s)
- Seth Adu-Afarwuah
- From the Department of Nutrition and Food Science, University of Ghana, Legon, Ghana (SA-A, AL, and HO); the Department for International Health, University of Tampere School of Medicine, Tampere, Finland (PA); Nutriset S.A.S., Malaunay, France (MZ); Department of Agricultural and Resource Economics, University of California, Davis, Davis, CA (SV); and the Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA (JMP, MA, and KGD)
| | - Anna Lartey
- From the Department of Nutrition and Food Science, University of Ghana, Legon, Ghana (SA-A, AL, and HO); the Department for International Health, University of Tampere School of Medicine, Tampere, Finland (PA); Nutriset S.A.S., Malaunay, France (MZ); Department of Agricultural and Resource Economics, University of California, Davis, Davis, CA (SV); and the Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA (JMP, MA, and KGD)
| | - Harriet Okronipa
- From the Department of Nutrition and Food Science, University of Ghana, Legon, Ghana (SA-A, AL, and HO); the Department for International Health, University of Tampere School of Medicine, Tampere, Finland (PA); Nutriset S.A.S., Malaunay, France (MZ); Department of Agricultural and Resource Economics, University of California, Davis, Davis, CA (SV); and the Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA (JMP, MA, and KGD)
| | - Per Ashorn
- From the Department of Nutrition and Food Science, University of Ghana, Legon, Ghana (SA-A, AL, and HO); the Department for International Health, University of Tampere School of Medicine, Tampere, Finland (PA); Nutriset S.A.S., Malaunay, France (MZ); Department of Agricultural and Resource Economics, University of California, Davis, Davis, CA (SV); and the Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA (JMP, MA, and KGD)
| | - Mamane Zeilani
- From the Department of Nutrition and Food Science, University of Ghana, Legon, Ghana (SA-A, AL, and HO); the Department for International Health, University of Tampere School of Medicine, Tampere, Finland (PA); Nutriset S.A.S., Malaunay, France (MZ); Department of Agricultural and Resource Economics, University of California, Davis, Davis, CA (SV); and the Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA (JMP, MA, and KGD)
| | - Janet M Peerson
- From the Department of Nutrition and Food Science, University of Ghana, Legon, Ghana (SA-A, AL, and HO); the Department for International Health, University of Tampere School of Medicine, Tampere, Finland (PA); Nutriset S.A.S., Malaunay, France (MZ); Department of Agricultural and Resource Economics, University of California, Davis, Davis, CA (SV); and the Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA (JMP, MA, and KGD)
| | - Mary Arimond
- From the Department of Nutrition and Food Science, University of Ghana, Legon, Ghana (SA-A, AL, and HO); the Department for International Health, University of Tampere School of Medicine, Tampere, Finland (PA); Nutriset S.A.S., Malaunay, France (MZ); Department of Agricultural and Resource Economics, University of California, Davis, Davis, CA (SV); and the Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA (JMP, MA, and KGD)
| | - Stephen Vosti
- From the Department of Nutrition and Food Science, University of Ghana, Legon, Ghana (SA-A, AL, and HO); the Department for International Health, University of Tampere School of Medicine, Tampere, Finland (PA); Nutriset S.A.S., Malaunay, France (MZ); Department of Agricultural and Resource Economics, University of California, Davis, Davis, CA (SV); and the Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA (JMP, MA, and KGD)
| | - Kathryn G Dewey
- From the Department of Nutrition and Food Science, University of Ghana, Legon, Ghana (SA-A, AL, and HO); the Department for International Health, University of Tampere School of Medicine, Tampere, Finland (PA); Nutriset S.A.S., Malaunay, France (MZ); Department of Agricultural and Resource Economics, University of California, Davis, Davis, CA (SV); and the Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA (JMP, MA, and KGD)
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