Effects Of Maternal Nutritional Supplementation Research Articles

Impact of Maternal Nutritional Supplementation during Pregnancy and Lactation on the Infant Gut or Breastmilk Microbiota: A Systematic Review.

Recent evidence indicates that maternal dietary intake, including dietary supplements, during pregnancy and lactation may alter the infant gut or breastmilk microbiota, with implications for health outcomes in both the mother and infant. To review the effects of maternal nutritional supplementation during pregnancy and lactation on the infant gut or breastmilk microbiota a systematic literature search was conducted. A total of 967 studies published until February 2020 were found, 31 were eligible and 29 randomized control trials were included in the qualitative synthesis. There were 23 studies that investigated the effects of probiotic supplementation, with the remaining studies investigating vitamin D, prebiotics or lipid-based nutrient supplements (LNS). The effects of maternal nutritional supplementation on the infant gut microbiota or breastmilk microbiota were examined in 21 and 12 studies, respectively. Maternal probiotic supplementation during pregnancy and lactation generally resulted in the probiotic colonization of the infant gut microbiota, and although most studies also reported alterations in the infant gut bacterial loads, there was limited evidence of effects on bacterial diversity. The data available show that maternal probiotic supplementation during pregnancy or lactation results in probiotic colonization of the breastmilk microbiota. There were no observed effects between probiotic supplementation and breastmilk bacterial counts of healthy women, however, administration of Lactobacillus probiotic to nursing women affected by mastitis was associated with significant reductions in breastmilk Staphylococcal loads. Maternal LNS supplementation during pregnancy and lactation increased bacterial diversity in the infant gut, whilst vitamin D and prebiotic supplementation did not alter either infant gut bacterial diversity or counts. Heterogeneity in study design precludes any firm conclusions on the effects of maternal nutritional supplementation during pregnancy and lactation on the infant gut or breastmilk microbiota, warranting further research.

Impact of nutritional supplementation during pregnancy on antibody responses to diphtheria-tetanus-pertussis vaccination in infants: A randomised trial in The Gambia.

BackgroundExposure to a nutritionally deficient environment during fetal life and early infancy may adversely alter the ontogeny of the immune system and affect an infant’s ability to mount an optimal immune response to vaccination. We examined the effects of maternal nutritional supplementation during pregnancy on infants’ antibody responses to the diphtheria-tetanus-pertussis (DTP) vaccine included in the Expanded Programme on Immunisation (EPI).Methods and findingsThe Early Nutrition and Immune Development (ENID) trial was a randomised, partially blinded trial conducted between April 2010 and February 2015 in the rural West Kiang region of The Gambia, a resource-poor region affected by chronic undernutrition. Pregnant women (<20 weeks’ gestation) with a singleton pregnancy (n = 875) were randomised to receive one of four supplements: iron-folic acid (FeFol; standard of care), multiple micronutrient (MMN), protein-energy (PE), or PE + MMN daily from enrolment (mean [SD] 13.7 [3.3] weeks’ gestation) until delivery. Infants were administered the DTP vaccine at 8, 12, and 16 weeks of age according to the Gambian Government protocol. Results for the primary outcome of the trial (infant thymic size) were described previously; here, we report on a secondary outcome, infant antibody response to vaccination. The effects of supplementation on mean DTP antibody titres measured in blood samples collected from infants at 12 weeks (n = 710) and 24 weeks (n = 662) were analysed with adjustment for confounders including maternal age, compliance to supplement, and infant sex and season. At 12 weeks, following a single dose of the vaccine, compared with FeFol (mean 95% confidence interval [CI]; 0.11 IU/mL, 0.09–0.12), antenatal supplementation with MMN or MMN + PE resulted in 42.4% (95% CI 20.1–64.6; p < 0.001) and 29.4% (6.4–52.5; p = 0.012) higher mean anti-diphtheria titres, respectively. Mean anti-tetanus titres were higher by 9.0% (5.5–12.5), 7.8% (4.3–11.4), and 7.3% (4.0–10.7) in MMN, PE, and PE + MMN groups (all, p < 0.001), respectively, than in the FeFol group (0.55 IU/mL, 0.52–0.58). Mean anti-pertussis titres were not significantly different in the FeFol, MMN, and PE + MNN groups but were all higher than in the PE group (all, p < 0.001). At 24 weeks, following all three doses, no significant differences in mean anti-diphtheria titres were detected across the supplement groups. Mean anti-tetanus titres were 3.4% (0.19–6.5; p = 0.038) higher in the PE + MMN group than in the FeFol group (3.47 IU/mL, 3.29–3.66). Mean anti-pertussis titres were higher by 9.4% (3.3–15.5; p = 0.004) and 15.4% (9.6–21.2; p < 0.001) in PE and PE + MMN groups, compared with the FeFol group (74.9 IU/mL, 67.8–82.8). Limitations of the study included the lack of maternal antibody status (breast milk or plasma) or prevaccination antibody measurements in the infants.ConclusionAccording to our results from rural Gambia, maternal supplementation with MMN combined with PE during pregnancy enhanced antibody responses to the DTP vaccine in early infancy. Provision of nutritional supplements to pregnant women in food insecure settings may improve infant immune development and responses to EPI vaccines.Trial registrationISRCTN49285450.

Leucine-rich diet alters the (1) H-NMRI serum metabolomic profile of tumour-bearing adult rats from offspring of mothers supplemented with this branched-chain amino acid

Cancer-cachexia is a multifactorial chronic disease associated with high inflammation and loss of muscular and adipose tissues and affects 30% of cancer patients. A maternal diet with leucine could alter the inflammatory state and regulate protein synthesis positively, modulating the effects of cachexia. Metabolomic analyses are an important technique to value the effects of cachexia because of the identification of altered metabolites in serum samples and consequently evaluate the impacted metabolic pathways in these patients. Thus, we analysed the regulatory effects of maternal nutritional supplementation with leucine over the serum metabolic profile (using the 1H-NMR analysis) of the adult offspring rats bearing the Walker 256 tumour.The cachexia leads to a characteristic metabolic profile related to an increase in the glycolytic pathway, which is likely modulated by maternal leucine-rich diet that altered the 1H-NMRI serum metabolomic profile, improving the oxidative pathway.

(1)H-NMRI metabolomic profile of skeletal muscle was altered by maternal nutritional supplementation with leucine in adult offspring tumour-bearing rats

Cachexia is a cancer-associated metabolic syndrome that causes muscle spoliation, which leads to a reduced life quality of cancer patients. Maternal nutritional supplementation with the branched-chain amino acid leucine has been studied as an attempt to minimise/prevent the muscle waste, as an epigenetic effect from pregnancy and weaning periods during the environment modulatory role. Metabolomic analysis is an important technique to evaluate the preventive effects of maternal nutritional supplementation in a cachexia process. Thus, the present study analysed the possible regulatory effects of this supplementation on muscle metabolic profile of the adult offspring rats bearing a Walker-256 tumour. The skeletal muscle (gastrocnemius) was processed by 1H-NMRI analysis to determine the metabolomic profiles. The tumour-bearing rats were spoiled and had an increased muscle energy expenditure. The maternal leucine supplementation improved the energy availability for muscle function and activity.

Lactoferrin during lactation protects the immature hypoxic-ischemic rat brain.

ObjectiveLactoferrin (Lf) is an iron-binding glycoprotein secreted in maternal milk presenting anti-inflammatory and antioxidant properties. It shows efficient absorption into the brain from nutritional source. Brain injury frequently resulting from cerebral hypoxia-ischemia (HI) has a high incidence in premature infants with ensuing neurodevelopmental disabilities. We investigated the neuroprotective effect of maternal nutritional supplementation with Lf during lactation in a rat model of preterm HI brain injury using magnetic resonance imaging (MRI), brain gene, and protein expression.MethodsModerate brain HI was induced using unilateral common carotid artery occlusion combined with hypoxia (6%, 30 min) in the postnatal day 3 (P3) rat brain (24–28 weeks human equivalent). High-field multimodal MRI techniques were used to investigate the effect of maternal Lf supplementation through lactation. Expression of cytokine coding genes (TNF-α and IL-6), the prosurvival/antiapoptotic AKT protein and caspase-3 activation were also analyzed in the acute phase after HI.ResultsMRI analysis demonstrated reduced cortical injury in Lf rats few hours post-HI and in long-term outcome (P25). Lf reduced HI-induced modifications of the cortical metabolism and altered white matter microstructure was recovered in Lf-supplemented rats at P25. Lf supplementation significantly decreased brain TNF-α and IL-6 gene transcription, increased phosphorylated AKT levels and reduced activation of caspase-3 at 24 h post-injury.InterpretationLf given through lactation to rat pups with cerebral HI injury shows neuroprotective effects on brain metabolism, and cerebral gray and white matter recovery. This nutritional intervention may be of high interest for the clinical field of preterm brain neuroprotection.

Protective effects of maternal nutritional supplementation with lactoferrin on growth and brain metabolism

Intrauterine growth restriction (IUGR) is a major risk factor for both perinatal and long-term morbidity. Bovine lactoferrin (bLf) is a major milk glycoprotein considered as a pleiotropic functional nutrient. The impact of maternal supplementation with bLf on IUGR-induced sequelae, including inadequate growth and altered cerebral development, remains unknown. IUGR was induced through maternal dexamethasone infusion (100 μg/kg during last gestational week) in rats. Maternal supplementation with bLf (0.85% in food pellet) was provided during both gestation and lactation. Pup growth was monitored, and Pup brain metabolism and gene expression were studied using in vivo (1)H NMR spectroscopy, quantitative PCR, and microarray in the hippocampus at postnatal day (PND)7. Maternal bLf supplementation did not change gestational weight but increased the birth body weight of control pups (4%) with no effect on the IUGR pups. Maternal bLf supplementation allowed IUGR pups to recover a normalized weight at PND21 (weaning) improving catch-up growth. Significantly altered levels of brain metabolites (γ-aminobutyric acid, glutamate, N-acetylaspartate, and N-acetylaspartylglutamate) and transcripts (brain-derived neurotrophic factor (BDNF), divalent metal transporter 1 (DMT-1), and glutamate receptors) in IUGR pups were normalized with maternal bLf supplementation. Our data suggest that maternal bLf supplementation is a beneficial nutritional intervention able to revert some of the IUGR-induced sequelae, including brain hippocampal changes.

Reporting of compliance in randomised controlled trials investigating the effect of maternal nutritional supplementation on infant outcomes

The Consolidated Standards of Reporting Trials (CONSORT) group comprises medical journal editors, epidemiologists and clinical trialists and was established in 1996 with the aim of developing scales to assess the quality of randomised controlled trial (RCT) reports. The group have since developed several evidence-based initiatives to improve the reporting of RCT. One of these initiatives is the Revised CONSORT Statement (1) that is made up of a checklist and participant flow diagram to be utilised by authors when reporting trials. The participant flow diagram specifies the data that should be reported to describe the progress of participants through a trial. It is recommended that the number of participants that ‘received’ the treatment and the number that ‘discontinued’ treatment be stated. The flow chart does not, however, specify that the percentage of participants complying with the treatment protocol be reported. This information is particularly important in long-term supplementation trials where poor compliance may influence the way in which study findings are interpreted. The aim of the present study was to investigate the adequacy of reporting of: (1) participant flow data as recommended by CONSORT; (2) participant compliance data (using criteria developed for the purpose of the current study) from RCT that studied the effect of maternal nutritional supplementation during pregnancy on neonatal and infant outcomes including birth weight, mortality and nutritional status. A literature search of MEDLINE, EMBASE, CINAHL and AMED databases was carried out using the following combination of

P2-136 Reporting of participant compliance in randomised controlled trials investigating the effect of maternal nutritional supplementation on infant outcomes

P2-136 Reporting of participant compliance in randomised controlled trials investigating the effect of maternal nutritional supplementation on infant outcomes

Prospective study of protein-energy supplementation early in life and of growth in the subsequent generation in Guatemala

The secular increase in height is assumed to result from long-term improvements in nutritional intakes and reductions in infectious disease burdens. Nutritional supplementation in early life reduces stunting in chronically undernourished populations. It is unknown whether these improvements can be transmitted to subsequent generations. Our objective was to estimate the intergenerational effect on offspring length of improved nutrition in the mother's childhood. We studied 263 children born in 1996-1999 to 231 women who had received nutritional supplementation, ie, atole (high-protein, moderate-energy drink) or fresco (nonprotein, low-energy drink), prenatally and up to age 7 y as part of a community trial in Guatemala between 1969 and 1977. Child length was measured at different times to age 36 mo. Children born to women who received the enhanced supplement were taller (age-adjusted difference: 0.80 cm; 95% CI: 0.16, 1.44 cm) than were children whose mothers received the low-energy supplement. This increment was independent of the children's birth weight or socioeconomic status but was substantially attenuated and no longer significant after adjustment for maternal height (adjusted difference: 0.43 cm; 95% CI: -0.10, 0.96 cm; P > 0.10). The effect of maternal nutritional supplementation was more pronounced in boys than in girls (P for interaction < 0.10) and in children born to women who received supplements at ages 3-7 y than in children born to women who received supplements at ages 0-3 y (P for interaction < 0.01). Nutritional supplementation in childhood has positive effects on both the supplemented persons and on the subsequent generation.

The bacon chow study: effects of maternal nutritional supplementation on birth measurements of children, accounting for the size of a previous (unsupplemented) child

Studies on nutritional supplementation of pregnant mothers have observed small but sometimes significant effects on fetal growth. Previously we also reported significant changes in physical resemblance of siblings at birth due to this kind of supplementation, using data collected by the late Dr. Bacon Chow and associates. This suggested that components of variation in physical growth may change as a result of supplementation. To explore this further, we sought the effects of nutritional supplementation on somatic growth, holding constant the birth measurements of a previous (unsupplemented) sibling. Only head circumference at birth came close to showing a statistically significant (P < 0.06) supplement effect on its mean ( + 0.36 cm) when the measurement of the first infant was held constant. Both increases and decreases in weight for length as assessed by Rohrer's Index (wt/1 3) occurred with supplementation. Increases in the index occurred by a significant (P < 0.01) gain in birth weight (238 g) between 1st and 2nd siblings in the supplement group but not in the placebo group. Decreases in this index resulted from a significant gain in birth length (1.3 cm) in supplemented families with a previous (untreated) sibling having a below average length for average weight. These non-linear effects on somatic growth suggest that responses to maternal nutritional supplementation may be more effective in a subgroup of the population where the normal adaptive responses to low energy protein intakes may have failed or where nutritional conditions over pregnancy may have varied considerably.

The Bacon Chow Study: Maternal Nutritional Supplementation and Infant Behavioral Development

The effect of maternal nutritional supplementation during pregnancy and lactation on the mental and motor development of infants was studied in a rural population in Taiwan. Women were randomly assigned to 2 treatment groups: 1 received a high-calorie and protein supplement ("supplement" group); the other received a placebo ("control" group). Infants received no direct supplementation. At approximately 8 months of age, the mental and motor development of the infants was assessed using a research to maternal supplementation in either scale, nor were the mental scale scores of infants of supplement mothers significantly higher than infants of control mothers. However, the motor scores of supplement infants were higher than those of control infants, which is consistent with the findings of 2 other large-scale nutritional supplementation studies.

The Bacon Chow Study: Effects of Maternal Nutritional Supplementation on Infant Mental and Motor Development

The Bacon Chow Study: Effects of Maternal Nutritional Supplementation on Infant Mental and Motor Development

Nutritional supplementation and the outcome of pregnancy. II. Visual habituation at 15 days

Colombian women at risk of mild-to-moderate malnutrition were enrolled in a health care program and randomly assigned into nutritional supplementation and control groups at the beginning of the third trimester of pregnancy. One hundred unsupplemented and 144 supplemented infants were tested at 15 days of age: a 2 × 2 checkerboard was presented eight times followed by a single presentation of a 6 × 6 checkerboard. Unsupplemented infants showed less initial attention followed by slower habituation and higher levels of movement than the supplemented infants. The observed effect of maternal nutritional supplementation during the last trimester of pregnancy on new-born attention was interpreted to be maturational in nature.