A Shrivastava

Maternal macronutrient intake during pregnancy and 5 years postpartum and associations with child weight status aged five.

BACKGROUND/OBJECTIVES:Animal models have demonstrated that maternal overnutrition during pregnancy influences offspring adiposity. Few human studies of normal pregnancy have replicated these findings. We examined the association between child body mass index at age 5 years and maternal nutrient intake during pregnancy and 5 years postpartum.SUBJECTS/METHODS:Five-year-old children (n=585) and their mothers were recruited during pregnancy from two maternity hospitals in Ireland. Data are from the Lifeways Cross-Generation Cohort study with detailed dietary information obtained during pregnancy and postpartum using a food frequency questionnaire. Nutrient intake was adjusted for energy intake (EI) and expressed in quartiles. Heights and weights were measured when the children were aged 5 years. We performed multivariate logistic regression analyses to examine the independent associations of macronutrients (protein, fat and carbohydrate) and their components (saturated fatty acid (SFA)/monounsaturated fatty acid/polyunsaturated fatty acid and sugar/starch) with child overweight/obesity. Associations were examined for nutrient intake during pregnancy (T1), at 5 years postpartum (T2) and the change in nutrient intake between T1 and T2.RESULTS:Total mean (s.d.) EI was significantly higher during pregnancy (2548±1239 kcal) than 5 years postpartum (2084±718 kcal). Increased odds of overweight/obesity were found in mothers with higher intakes of sugar at T1 (Q4 odds ratio (OR): 4.57, 95% confidence interval (CI): 1.01–20.69) and high intakes of SFA at T2 (Q4 OR: 3.35, 95% CI: 0.97–11.57). Mothers with persistently high intakes of SFA and those who reduce their sugar intake between T1 and T2 were more likely to have overweight/obese children.CONCLUSION:Maternal prenatal sugar and pre/postnatal SFA was associated with offspring adiposity.

Unmetabolized folic acid prevalence is widespread in the older Irish population despite the lack of a mandatory fortification program

BACKGROUND In 2006 the Food Safety Authority of Ireland recommended mandatory folic acid fortification of flour for the prevention of neural tube defects in addition to the existing extensive voluntary folic acid fortification culture in place there. This recommendation is now suspended until further scientific evidence surrounding safety becomes available. The safety issues include concerns about the masking of vitamin B-12 deficiency and potential cancer acceleration, both of which may be of concern for the elderly population. OBJECTIVE The aim of this study was to measure the basal (fasted) concentrations of unmetabolized folic acid in the plasma of an elderly population group exposed to this liberal voluntary fortification of foodstuffs in Ireland. DESIGN We invited participants aged 60-86 y from the Lifeways Cross-Generation Cohort Study to participate in this project. After providing informed consent, the participants were invited to provide fasting blood samples and to complete a standard food-frequency questionnaire and a questionnaire on recent and habitual intakes of folic acid. Samples were assayed for total plasma folate, red blood cell folate, homocysteine, and unmetabolized folic acid. RESULTS A total of 137 subjects with a mean age of 67.4 y were studied. Unmetabolized folic acid was detected in 94.1% of the cohort with a mean concentration of 0.39 nmol/L (range: 0.07-1.59 nmol/L), accounting for 1.3% of total plasma folate. CONCLUSION These results indicate unmetabolized folic acid in plasma in most of this elderly Irish cohort, even after an overnight fast. These results should be considered carefully by those legislating in this area.

Familial intergenerational and maternal aggregation patterns in nutrient intakes in the Lifeways Cross-Generation Cohort Study.

OBJECTIVE The current study prospectively examines the intra-uterine hypothesis by comparing maternal, paternal and grandparental lineage influences on children’s diet and also maternal–child aggregation patterns during pregnancy and early childhood. DESIGN Prenatal dietary information was available for expectant mothers, fathers and up to four grandparents through a detailed validated semi-quantitative FFQ. At 6-year follow-up, when children averaged 5 years of age, dietary information was re-collected for mothers and a subset of maternal grandmothers using the same FFQ. Child’s FFQ version was used for children. Anthropometric and sociodemographic variables were also collected. SETTINGS Three-generation familial cohort representative of the contemporary Irish national population. SUBJECTS Children aged 5 years (n 567) and their parents and grandparents. RESULTS Associations for energy, macronutrient and fibre intakes were compared using Pearson’s correlations, intra-class correlations (ICC) and linear regression models, adjusted for energy and potential confounders. Significant, moderatestrength positive correlations were observed for nutrient intakes in children’s nuclear families (ICC (range)50?22–0?28). The father–child associations (r (range)5 0?13–0?20) were weaker than the mother–child associations (r (range)50?14–0?33). In general, associations were stronger for maternal postnatal intake–child intake than for maternal prenatal intake–child intake, except for percentage of energy from fat (adjusted b50?16, 95% CI 0?05, 0?26; P50?004), which was stronger for maternal prenatal intake, specifically in non-breast-fed children (adjusted b50?28, 95% CI 0?12, 0?44; P50?001). Among all grandparents, correlations were significant only for maternal grandmother–mother pairs (r (range)50?10–0?36). Significant positive ICC were observed for nutrient intakes of maternal grandmother–mother–child triads (ICC (range)50?12–0?27), not found in paternal lines. CONCLUSIONS These findings suggest that maternal-environment programming influences dietary intake.

Longitudinal follow-up of the relationship between dietary intake and growth and development in the Lifeways cross-generation cohort study 2001-2013.

In this paper we will review evidence on the early life and familial influences on childhood growth and development, with particular reference to the Lifeways cross-generation cohort study in the Republic of Ireland. The Lifeways cross-generation cohort study was established in 2001-2013 through two maternity hospitals in the Republic of Ireland and was one of many new cohort studies established worldwide in the millennium period. Mothers were recruited at first booking visit, completing a self-administered questionnaire, which included a 147 item semi-quantitative FFQ. Longitudinal follow-up is ongoing in 2013, with linkage data to hospital and general practice records and examination of children when aged 5 and 9 years. The study is one of very few containing data on grandparents of both lineages with at least one grandparent recruited at baseline. There have been consistent associations between parental and grandparental health status characteristics and childrens outcomes, including infant birth-weight, BMI when child was aged 5 years and childhood wheeze or asthma when child was aged 3 and aged 5 years. In conclusion, empirical evidence to date shows consistent familial and cross-generational patterns, particularly in the maternal line.

Preschoolers’ parent-rated health disparities are strongly associated with measures of adiposity in the Lifeways cohort study children

Objective To examine the relationship between lifecourse factors from preschoolers’ microecosystem and their parent-reported (mother-reported) health (PRH), following them prospectively from preconception to age 5 years. To investigate if preschoolers’ body mass index (BMI) and waist circumference were associated with preschoolers’ PRH when controlled for lifecourse predictors. Design Lifeways cross-generation cohort study. Setting Ireland. Participants Of 1082 families, 62% mothers responded on a health and lifestyle questionnaire at follow-up. Food frequency, BMI and waist circumference were measured. There were 547 family data sets available for analysis of childrens PRH. Main outcome measure Mother-reported childrens PRH at age 5. Associations with childs individual and familial exposures from preconception to age 5 years examined using logistic regression. Results In univariate analysis, relatively positive rating of childrens PRH were associated with childrens lower intake of fats (OR (95% CI) 2.2 (1.1 to 4.3)), higher intake of fruits/vegetables (OR (95% CI) 2.2 (1.1 to 4.3)); as well as familial socioeconomic characteristics {higher household income (OR (95% CI) 3.0 (1.6 to 5.9)), non-entitlement to means-tested healthcare (OR (95% CI) 2.1 (1.0 to 4.3)), mothers’ higher education (OR (95% CI) 1.9 (1.0 to 3.6))}, psychosocial characteristics {fathers participation in study (OR (95% CI) 2.1 (1.0 to 4.3)), mothers’ perceiving better support from partner (OR (95% CI) 2.3 (1.2 to 4.3)), children (OR (95% CI) 1.9 (1.0 to 3.7)) or relatives (OR (95% CI) 2.2 (1.1 to 4.1))}, parents’ lifestyle {mothers’ lower intake of energy (OR (95% CI) 2.2 (1.1 to 4.3)), fathers’ non-smoking status (OR (95% CI) 2.2 (1.1 to 4.4))} and parents’ health {mothers’ self-rated health relatively positive (OR (95% CI) 5.1 (2.6 to 9.9)), fathers’ self-rated health relatively positive (OR (95% CI) 3.0 (1.5 to 6.0))}. In multivariable analysis (χ2=34.2, df=21, N=303, R2 = 0.26, p<0.05), one of the two strong predictors of childrens relatively positive PRH was child not being obese by International Obesity Task Force classification (OR (95% CI) 5.5 (1.4 to 21.0)), observed also using BMI (kg/m2; OR (95% CI) 0.73 (0.58 to 0.93)) or waist circumference (cm; OR (95% CI) 0.89 (0.81 to 0.98)) as continuous variables. The other significant predictor was mothers’ self-rated health relatively positive (OR (95% CI) 4.2 (1.5 to 12.2)). Conclusions Preschoolers’ health is adversely associated with obesity and this is independent of lifecourse and social and environmental inequalities. The findings suggest that reducing childhood obesity and improving maternal health may be useful ways to improve childs global health.

O1-5.4 Familial aggregation in nutrient intake patterns: comparing intergenerational and prenatal-postnatal effects in Lifeways Cross Generation Cohort Study

Introduction Familial influence on dietary behaviours of children is expressed through genetic predispositions, maternal-environment and home-environment. Disaggregating such effects requires relatively rare cross-generational study designs. This analysis examined associations of maternal, paternal and grandparental dietary intake prenatally; and maternal and maternal-grandmothers dietary intake post-natally with childs dietary intake. Methods Pre-natal dietary information was available for expectant mothers (N=1119), fathers (N=331), maternal-grandmothers (N=285), maternal-grandfathers (N=163), paternal-grandmothers (N=163), and paternal-grandfathers (N=96) through a validated food frequency questionnaire (FFQ). At 6 year follow-up, when children averaged age 5, dietary information was re-collected for mothers (n=558) and some maternal-grandmothers (N=53) using the same FFQ. A childs FFQ version was used for children (N=567). Association for energy, macronutrients and fibre intake were compared using Pearsons interclass and intraclass correlations. Nutrients were log transformed and adjusted for energy intake in interclass correlations. Results Though the correlations were weakly moderate (r <0.35) in strength, a clear pattern emerged. Positive statistically significant correlations were found for energy, macronutrients and fibre intake within childrens nuclear families. Correlations were stronger for maternal postnatal-child pairs compared to maternal prenatal-child pairs. The father-child associations were significant (except for fat) but weaker than mother-child associations. Maternal grandmother-mother associations were found for protein, fat and fibre intakes. A significant positive intraclass correlations was observed in nutrient intakes of maternal grandmothers-mothers-child triads, not found in paternal lines. Conclusion The stronger maternal associations with childrens nutrient intake and existence of maternal grandmother-mother-child associations support evidence for maternal-environment programming influences.