Maternal Energy Intake Research Articles

Pre- and post-natal macronutrient supplementation for HIV-positive women in Tanzania: Effects on infant birth weight and HIV transmission.

ObjectiveTo determine if a protein-calorie supplement (PCS) plus a micronutrient supplement (MNS) improves outcomes for HIV-infected lactating women and their infants.DesignRandomized, controlled trial.SettingDar es Salaam, TanzaniaSubjects, participantsPregnant HIV-infected women enrolled in PMTCT programs who intended to breastfeed for 6 months.InterventionRandomization 1:1 to administration of a PCS plus MNS versus MNS alone among 96 eligible women beginning in the third trimester and continuing for 6 months of breast-feeding.Main outcome measure(s)Primary: infant weight at 3 months. Secondary: maternal BMI at 6 months.ResultsPCS resulted in significant increases in daily energy intake compared to MNS at all time points (range of differences: +388–719 Kcal); and increases in daily protein intake (range of differences: +22–33 gm). Infant birth weight (excluding twins) was higher in the PCS than MNS groups: 3.30 kg vs 3.04 kg (p = 0.04). Infant weight at 3 months did not differ between PCS and MNS groups: 5.63 kg vs 5.99 kg (p = 0.07). Maternal BMI at 6 months did not differ between PCS and MNS groups: 24.3 vs 23.8 kg/m2 (p = 0.68). HIV transmission occurred in 0 infants in the PCS group vs 4 in the MNS group (p = 0.03).ConclusionsIn comparison to MNS the PCS + MNS intervention was well tolerated, increased maternal energy and protein intake, and increased infant birth weight, but not weight at 3 months or maternal BMI at 6 months. Reduced infant HIV transmission in the PCS + MNS group was observed.Trial registrationClinical Trials.Gov NCT01461863.

PENGARUH PEMBERIAN MIXED JUICE TERHADAP ASUPAN ENERGI IBU BERSALIN

The process of labor, especially the second stage of increased contraction in the uterine muscle that causes decreased blood supply and oxygen needed by muscles to convert glucose into energy. Anaerobic metabolism usually occurs in activities that require large energy and briefly.This study to analyze differences in energy intake in mothers giving birth between those who were given mixed juice and those who were given the freedom to consume food and beverages during labor. This study uses randomized controlled trial design, single blinded. There was a significant difference in control group energy intake and intervention group (p <0.05). Giving mixed juice during delivery in maternal mothers affects maternal satisfaction and the difference of maternal energy intake, but there is no difference in lactate levels of infants born.

Maternal Peripartum Serum DDT/E and Urinary Pyrethroid Metabolite Concentrations and Child Infections at 2 Years in the VHEMBE Birth Cohort.

Background:Indoor residual spraying (IRS) of insecticides, conducted in low- and middle-income countries to control malaria, may result in high exposure to dichlorodiphenyltrichloroethane (DDT), its breakdown product dichlorodiphenyldichloroethylene (DDE), or pyrethroids. Animal studies suggest in utero exposure to these chemicals may increase childhood infection frequency.Objectives:We investigated associations between maternal DDT/E and pyrethroid metabolite concentration and child infection associations in an IRS setting in which susceptibility factors are common and infections are leading causes of child morbidity and mortality.Methods:Using gas chromatography–mass spectrometry, we measured serum DDT/E and urinary pyrethroid metabolite concentrations in peripartum samples from 674 women participating in the Venda Health Examination of Mother, Babies and their Environment (VHEMBE) study. Counts of persistent child fevers, otitis media, and severe sore throat between 1 and 2 y of age were ascertained from maternal interviews. Associations between DDT/E and pyrethroid metabolite concentrations and infections were estimated using zero-inflated Poisson regression. We estimated relative excess risks due to interaction (RERI) with poverty, maternal energy intake, and maternal HIV status.Results:Concentrations of DDT/E, particularly p,p′-DDE, were associated with higher rates of persistent fevers [ (95% CI: 1.01, 1.46)], for a 10-fold increase in p,p′-DDE). This association was stronger among children from households below versus above the South African food poverty line [ (95% CI: 1.08, 1.59) vs. (95% CI: 0.69, 1.25), respectively] and for children whose mothers had insufficient versus sufficient caloric intake during pregnancy [ (95% CI: 1.07, 1.58) vs. (95% CI: 0.72, 1.28), respectively].Conclusions:In utero IRS insecticide exposure may increase childhood infection rates. This was particularly apparent among children from poorer households or whose mothers had low energy intake during pregnancy. https://doi.org/10.1289/EHP2657

Maternal Energy Intake at the Sixth Month as Dominant Factor of Exclusive Breastfeeding Success

Breastfeeding mothers needed adequate energy intake to provide 6-month exclusive breastfeeding that is necessary for infant growth and development. This study aimed to investigate real intake at the first and sixth month of breastfeeding and determine the dominant factor affecting 6-month exclusive breastfeeding provision. The design of this study was cross-sectional conducted in March-April 2015 among 109 mothers with 6-12- month-old infant living and registered at integrated health care in Kalangan Primary Health Care area. Data were collected through interview using questionnaires. Breastfeeding mothers’ intake was asked using Semi-Quantitative Food Frequency Questionnaire. The study found that 6-month exclusive breastfeeding proportion was 22.9%. Mean energy intake of breastfeeding mothers declined from 2551 kcal/day in the first month of breastfeeding to 1718 kcal/day in the sixth month of breastfeeding. After controlled by other variables, energy intake in the sixth month of breastfeeding was found to be the most dominant factor affecting 6-month exclusive breastfeeding provision. Mothers with low energy intake at the sixth month of breastfeeding period were likely 9 times more to fail in providing 6-month exclusive breastfeeding compared to those with adequate energy intake.

Stunting dan perkembangan anak usia 12-60 bulan di Kalasan

PurposeThis study determine the relationship between stunting incidence with development in children aged 12-60 months.MethodsThe type of research used was observational with cross sectional study design. This research will be conducted in the working area of Puskesmas Kalasan Sleman regency Yogyakarta with subject children aged 12 to 60 months as many as 106 children. Data analysis with univariable, bivariable with chi-square test with significance level of p <0,05 and CI 95% and multivariable by using statistical test of logistic regression.ResultsBivariable analysis between stunting status and child development showed significant relationship (p <0,05) and OR 3,9 (95% CI; 1,8-8,9). The result of the multivariable analysis is the relationship between stunting status and the development of children aged 12-60 months who consider the energy intake.ConclusionsThere is a relationship between stunting and the development of children aged 12-60 months but between maternal education, infectious diseases, parenting, energy intake, long-term birth, and parental income, energy intake most closely related to child development when jointly considered.

Assessment of the nutrient intake and micronutrient status in the first trimester of pregnant women in Jakarta

Background: Maternal nutrition before and during pregnancy is important for a healthy pregnancy outcome. According to National Basic Health Research (Riskesdas) 2013, 24.2% of pregnant women are at risk of chronic malnutrition and 37.1% of them suffer from anemia. The aim of this study was to obtain information about the nutrient intake and serum micronutrient status in the first trimester of pregnant women in Jakarta.Methods: A descriptive study was conducted towards 234 pregnant women with gestational age no more than 14 weeks. The nutrient intake data was obtained from the conversion of frequency food questionnaire (FFQ) which was semi quantitative data using a Nutrisurvey application. The maternal serum was examined to obtain data about nutrient level.Results: The mean of daily maternal energy intake was 1,256.1 kcal. Most subjects had nutrient intake below the recommendations of Institute of Medicine (IOM) and recommended dietary allowances (RDA), i.e. energy (88.9%), protein (80.8%), iron (85%), folic acid (74.8%), calcium (90.6%), and zinc (94.9%). However, they showed a high intake level of vitamin A (70.5%). Most subjects had deficiency in vitamin A (69.7%), vitamin D (99.6%), and zinc (81.2). No correlation was found between the maternal nutrient intake and nutritional status.Conclusion: Most of the first-trimester-pregnant-women in Jakarta had low maternal energy and nutrient intake, except for vitamin A, as well as low serum vitamin A, vitamin D, and zinc level.

Traditional Galactagogue Foods and Their Connection to Human Milk Volume in Thai Breastfeeding Mothers.

Thai traditional galactagogue consumption is still observed today. However, there are few scientific studies that describe this practice. Research aim: The aim of this study was to describe the connection between traditional galactagogue consumption and human milk volume. Self-reported maternal surveys ( N = 36) were conducted of mothers and their infants who breastfeed exclusively. The mothers were interviewed about traditional galactagogue consumption and intake of protein-rich foods using a semiquantitative food-frequency questionnaire. They were also assessed for energy and nutrient intake using the 24-hr dietary recall method. Their infants were between 1 and 3 months of age and were test weighed for 24 hr to measure their mother's own milk volume. Partial correlation was used to test the relationship between galactagogue consumption and milk volume by controlling the infants' birth weight, weight-for-age, maternal energy, and carbohydrate intake. The results revealed that consumption of some traditional galactagogues was significantly correlated to human milk volume, including banana flower, lemon basil, Thai basil, bottle gourd, and pumpkin ( p < .05). Furthermore, there were significant correlations between consumption of some kinds of protein and milk volume, including egg tofu, chicken, fish, and seafood ( p < .05). Maternal energy and carbohydrate intake were related to milk volume ( p < .05), but protein intake was not. Certain kinds of traditional galactagogues and proteins are associated with human milk volume. However, studies related to the active ingredients in these galactagogues are required to secure a recommendation about use of traditional galactagogues among breastfeeding mothers.

Higher maternal vitamin D concentrations are associated with longer leukocyte telomeres in newborns.

Gestational vitamin D insufficiency is related with increased risks of various diseases and poor health outcomes later in life. Telomere length at birth or early in life is known to be a predictor of individual health. Both vitamin D and telomere length are related with various health conditions, and vitamin D concentrations are associated with leukocyte telomere lengths in women. We investigated the association between maternal vitamin D concentrations and newborn leukocyte telomere lengths. This cross-sectional study included 106 healthy pregnant women without adverse obstetric outcomes and their offspring. We examined the maternal age, weight before pregnancy, health behaviours, and nutritional intakes, along with each newborn's sex and birthweight, and we measured maternal height, telomere length, total white blood cell count, and glycosylated haemoglobin as covariates. Pearson's correlation coefficients were calculated to evaluate the relationship between the baseline variables and newborn leukocyte telomere lengths. To confirm that there was an independent association between newborn leukocyte telomere lengths and maternal vitamin D concentrations, we performed a stepwise multiple linear regression analysis. Newborn leukocyte telomere lengths correlated positively with maternal leukocyte telomere lengths (r=.76, p<.01), maternal 25-hydroxyvitamin D concentrations (r=.72, p<.01), maternal energy intakes (r=.22, p=.03), and newborn body weights (r=.51, p<.01). In the multivariate model, newborn leukocyte telomere lengths were associated with maternal vitamin D concentrations (β=.33, p<.01). These findings suggest that the maternal vitamin D concentration during pregnancy may be a significant determinant of the offspring's telomere length.

Undernourishment in utero and hepatic steatosis in later life: A potential issue in Japanese people.

Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of metabolic syndrome. The prevalence of NAFLD in Japan has nearly doubled in the last 10-15 years. Increasing evidence supports undernourishment in utero being causatively connected with the risk of NAFLD in later life. Low body mass index (BMI) has been common among Japanese women of childbearing age for several decades due to their strong desire to be thin. It is plausible that insufficient maternal energy intake by pregnant Japanese women may underlie the rapid increase in the prevalence of NAFLD in Japan. In order to clarify the mechanisms by which undernourishment in utero primes adult hepatic steatosis, we developed a mouse model of fetal undernourishment with a hepatic fat deposit-prone phenotype on an obesogenic high fat diet in later life. We found that endoplasmic reticulum (ER) stress response parameters were activated concomitantly with the deterioration of hepatic steatosis and also that the alleviation of ER stress with the chemical chaperone, tauroursodeoxycholic acid (TUDCA), significantly improved hepatic steatosis. Therefore, undernourishment in utero may program the future integration of ER stress in the liver on an obesogenic diet in later life and also induce the deterioration of hepatic steatosis. These results also provide an insight into interventions for the potential high-risk population of NAFLD, such as those born small or exposed to maternal undernourishment during the fetal period, with the alleviation of ER stress by dietary supplements and/or specific food including chaperones.

A Theory-Based Dietary Intervention for Overweight, Postpartum Mothers and Their Children Improves Maternal Vegetable Intake

Objective: To evaluate the effectiveness of a dietary intervention to increase target vegetable intake in overweight, postpartum mothers; and their children. Methods: Overweight mothers attending their six-week postpartum follow-up visit and their infants (n = 104 pairs) were randomized to intervention or usual care groups during the time period 2008-2011. Mothers received four 60 minute education sessions with a nutrition professional and eight monthly follow-up phone calls. Counseling began at the obstetrician office and continued at the regularly scheduled pediatric visits. The primary study outcome was the change in maternal target vegetable intake. Secondary outcomes included child target vegetable intake and whether child vegetable intake was modified by exposure to breastfeeding. Mother/child energy intake and weight indices were also assessed. Outcomes were measured at baseline (6-weeks postpartum), 6, 12 (post-intervention), and 18 (follow-up) months. Mixed-effects models were used to estimate the impact of the dietary intervention on study outcomes relative to usual care. Results: Mothers randomized to the intervention had greater consumption of target vegetables at 6, 12 and 18 months (P P P = 0.03, respectively). There were no differences between groups in maternal energy intake, body mass index, or child target vegetable or energy intake. The child’s target vegetable intake at 12 months was related to the mother’s intake at 6 months (P = 0.03), however, this relationship was not modified by exposure to breastfeeding. Conclusion: A dietary intervention targeting the diet of the mother/child dyad resulted in improved maternal vegetable intake.

Mitochondrial biogenesis is decreased in skeletal muscle of pig fetuses exposed to maternal high-energy diets

Mitochondria plays an important role in the regulation of energy homeostasis. Moreover, mitochondrial biogenesis accompanies skeletal myogenesis, and we previously reported that maternal high-energy diet repressed skeletal myogenesis in pig fetuses. Therefore, the aim of this study was to evaluate the effects of moderately increased maternal energy intake on skeletal muscle mitochondrial biogenesis and function of the pig fetuses. Primiparous purebred Large White sows were allocated to a normal energy intake group (NE) as recommended by the National Research Council (NRC) and a high energy intake group (HE, 110% of NRC recommendations). On day 90 of gestation, fetal umbilical vein blood and longissimus (LM) muscle were collected. Results showed that the weight gain of sows fed HE diet was higher than NE sows on day 90 of gestation (P<0.05). Maternal HE diet increased fetal umbilical vein serum triglyceride and insulin concentrations (P<0.05), and tended to increase the homeostasis model assessment index (P=0.08). Furthermore, HE fetuses exhibited increased malondialdehyde concentration (P<0.05), and decreased activities of antioxidative enzymes (P<0.05) and intracellular NAD+ level (P<0.05) in LM muscle. These alterations in metabolic traits of HE fetuses were accompanied by reduced mitochondrial DNA amount (P<0.05) and down-regulated messenger RNA expression levels of genes responsible for mitochondrial biogenesis and function (P<0.05). Our results suggest that moderately increased energy supply during gestation decreases mitochondrial biogenesis, function and antioxidative capacity in skeletal muscle of pig fetuses.

Ambient temperature affects postnatal litter size reduction in golden hamsters.

BackgroundTo better understand how different ambient temperatures during lactation affect survival of young, we studied patterns of losses of pups in golden hamsters (Mesocricetus auratus) at different ambient temperatures in the laboratory, mimicking temperature conditions in natural habitats. Golden hamsters produce large litters of more than 10 young but are also known to wean fewer pups at the end of lactation than they give birth to. We wanted to know whether temperature affects litter size reductions and whether the underlying causes of pup loss were related to maternal food (gross energy) intake and reproductive performance, such as litter growth. For that, we exposed lactating females to three different ambient temperatures and investigated associations with losses of offspring between birth and weaning.ResultsOverall, around one third of pups per litter disappeared, obviously consumed by the mother. Such litter size reductions were greatest at 30 °C, in particular during the intermediate postnatal period around peak lactation. Furthermore, litter size reductions were generally higher in larger litters. Maternal gross energy intake was highest at 5 °C suggesting that mothers were not limited by milk production and might have been able to raise a higher number of pups until weaning. This was further supported by the fact that the daily increases in litter mass as well as in the individual pup body masses, a proxy of mother’s lactational performance, were lower at higher ambient temperatures.ConclusionsWe suggest that ambient temperatures around the thermoneutral zone and beyond are preventing golden hamster females from producing milk at sufficient rates. Around two thirds of the pups per litter disappeared at high temperature conditions, and their early growth rates were significantly lower than at lower ambient temperatures. It is possible that these losses are due to an intrinsic physiological limitation (imposed by heat dissipation) compromising maternal energy intake and milk production.

High cholesterol dietary intake during pregnancy is associated with large for gestational age in a sample of low-income women of Rio de Janeiro, Brazil.

The association between the quality of maternal dietary fat intake during pregnancy and the infant's birthweight (BW) remains controversial. Our goal was to investigate the association between maternal dietary fat intake during pregnancy and the rate of large for gestational age (LGA) newborns. This study employed a cross-sectional analysis of 297 pairs of mothers/children attending a public maternity at Rio de Janeiro, Brazil. BW for gestational age according to the Intergrowth 21st was defined as follows: adequate for gestational age (AGA ≤ 90th percentile) and LGA (>90th percentile). The statistical analysis was a Poisson regression with robust estimations of the standard errors. Maternal dietary fat intake variables comprised lipids (% total energy); saturated (mg/1000 kcal), monounsaturated (mg/1000 kcal) and polyunsaturated (mg/1000 kcal) fats; and cholesterol (mg/1000 kcal), all of which were obtained with a Food Frequency Questionnaire. The mean BW was 3338 g (SD = 446.9), and the rate of LGA newborns was 13.1%. The mean maternal total energy intake was 2880 kcal (SD = 1074), cholesterol was 154.3 mg/1000 kcal (SD = 68.1) and monounsaturated fat was 6.9 mg/1000 kcal (SD = 2). Mothers of LGA newborns reported higher cholesterol dietary intake (195.8 vs. 148 mg/1000 kcal; P < 0.001), pre-pregnancy body mass index (25.1 vs. 23.5 kg/m2 ; P = 0.026) when compared with mothers of AGA newborns. Women with cholesterol intake within the fourth quartile were 2.48 (95% confidence interval: 1.31-4.66) times more likely to have an LGA infant compared with those in the 1-3 quartiles. Dietary intake of cholesterol during pregnancy influences LGA even after adjusting for other confounders.

Allometric scaling of the elevation of maternal energy intake during lactation.

BackgroundIn most mammals, lactating mothers dramatically increase their food intake after parturition and reach a peak intake rate after a certain time while their offspring continue to grow. A common view, perpetuated by the metabolic theory of ecology, is that the allometric scaling of maternal metabolic rate with body mass limits the changes in energy intake and expenditure. Therefore these potential effects of metabolic scaling should be reflected in the elevation of maternal energy intake during lactation. To test this hypothesis, we collected published data on 24 species (13 domesticated) and established scaling relationships for several characteristics of the patterns of energy intake elevation (amplitude of the elevation, time to peak, and cumulative elevation to peak).ResultsA curvilinear allometric scaling relationship with maternal body mass (in double-logarithmic space) was found for the amplitude of maternal energy intake elevation, similarly to what has been observed for scaling relationships of basal metabolic rate in non-breeding mammals. This result indirectly supports the metabolic theory of ecology. However, this curvilinear allometric scaling does not seem to drive the scaling relationships found for the other characteristics of maternal energy intake. Both the duration and shape of the energy intake patterns showed substantial variation independently of species’ body mass.ConclusionsData available for a few mammals, mostly domesticated, provides little evidence for the hypothesis that a single law of metabolic scaling governs the elevation of maternal energy intake after parturition. Obtaining further food intake data in wild species will be crucial to unravel the general mechanisms underlying variation in this unique adaptation of mammalian females.Electronic supplementary materialThe online version of this article (doi:10.1186/s12983-016-0164-y) contains supplementary material, which is available to authorized users.

Moderately decreased maternal dietary energy intake during pregnancy reduces fetal skeletal muscle mitochondrial biogenesis in the pigs.

BackgroundMitochondria are of major importance in oocyte and early embryo, playing a key role in maintaining energy homeostasis. Epidemiological findings indicate that maternal undernutrition-induced mitochondrial dysfunction during pregnancy is associated with the development of metabolic disorders in offspring. Here, we investigated the effects of moderately decreased maternal energy intake during pregnancy on skeletal muscle mitochondrial biogenesis in fetal offspring with pig as a model.MethodsPregnant Meishan sows were allocated to a standard-energy (SE) intake group as recommended by the National Research Council (NRC; 2012) and a low-energy (LE) intake group. Fetal umbilical vein serum and longissimus muscle samples were collected for further analysis on day 90 of pregnancy.ResultsSow and fetal weights and the concentrations of serum growth hormone (GH) and glucose were reduced in LE group. Maternal LE diet decreased the messenger RNA (mRNA) expression of genes involved in mitochondrial biogenesis and function such as peroxisome proliferator-activated receptor gamma coactivator 1α (PPARGC1A), nuclear respiratory factor 1 (NRF1), mitochondrial transcription factor A (TFAM), β subunit of mitochondrial H+-ATP synthase (ATB5B), sirtuin 1 (Sirt1), and citrate synthase (CS). The protein expression of PPARGC1A and Sirt1, intracellular NAD+-to-NADH ratio, and CS activity was reduced in LE group, and accordingly, mitochondrial DNA (mtDNA) content was decreased. Moreover, copper/zinc superoxide dismutase (CuZn-SOD) expression at both mRNA and protein levels and SOD and catalase (CAT) activities were reduced in LE group as well.ConclusionsThe observed decrease in muscle mitochondrial biogenesis and antioxidant defense capacity suggests that moderately decreased maternal energy intake during pregnancy impairs mitochondrial function in fetal pigs.

Gastroschisis and maternal intake of phytoestrogens.

The prevalence of gastroschisis has increased significantly in the past few decades. The strongest risks have been observed for women <25 years old or of low body mass index, and maternal diet also been proposed to be associated with risk. The objective of this study was to evaluate whether the risk of gastroschisis is associated with maternal dietary intake of phytoestrogens. The analysis includes data on mothers of 409 gastroschisis cases and 3,007 controls who delivered their infants from 2005 to 2010 and participated in the National Birth Defects Prevention Study, a multistate, population-based, case-control study. Detailed information was obtained from maternal telephone interviews that included a validated food frequency questionnaire. We conducted logistic regression analyses that included each phytoestrogen in its continuous form (to test for linearity) and quadratic form (to test for non-linearity), adjusted for maternal energy intake, age, BMI, race-ethnicity, and smoking in 1st trimester. Logistic regression analysis indicated that biochanin A, formonoetin, and coumestrol had a significant non-linear association with gastroschisis (P-value <0.05 for quadratic term). Lower intakes were associated with increased risk, with somewhat stronger but relatively modest associations at the lower end of the distribution; for example, the ORs for the 10th versus 50th percentiles ranged from 1.1 to 1.2. Associations were not significant for the other phytoestrogens. This study provides some evidence for association with certain phytoestrogens, after adjusting for covariates. The implications of our findings for clinical practice are uncertain pending other studies examining this association. © 2016 Wiley Periodicals, Inc.

Relationships between misreported energy intake and pregnancy in the pregnancy, infection and nutrition study: new insights from a dynamic energy balance model.

SummaryObjectiveProviding effective dietary counselling so that pregnancy weight gain remains within the 2009 Institute of Medicine (IOM) guidelines requires accurate maternal energy intake measures. Current practice is based on self‐reported intake that has been demonstrated unreliable. This study applies an objective calculation of energy intake from a validated mathematical model to identify characteristics of individuals more likely to misreport during pregnancy.MethodsA validated maternal energy balance equation was used to calculate energy intake from gestational weight gain in 1,368 subjects. The difference between self‐reported and model‐predicted energy intake was tested for demographics, economic status, education level and maternal health status.ResultsA weight gain of 15.2 kg resulted in model‐predicted intake during pregnancy of 2,882.97 ± 135.71 kcal day−1, which differed from self‐reported intake of 2,180.5 ± 856.0 kcal day−1. The achieved weight gain exceeded the IOM guidelines; however, the model predicted weight gain from self‐reported energy intake was below IOM guidelines. Higher income (p = 0.004), education (p = 0.003), birth weight (p = 0.017), gestational diabetes (p = 0.008) and pre‐existing diabetes (p < 0.001) were associated with under‐reported energy intake. More children living at home (p = 0.001) were associated with more accurate self‐reported intake.ConclusionsWhen assessing self‐reported energy intake in pregnancy studies, birth weight, gestational diabetes status, pre‐existing diabetes, higher income and education predict higher under‐reporting. Clinicians providing dietary treatment recommendations during pregnancy should be aware that individuals with pre‐existing diabetes and gestational diabetes mellitus are more likely to misreport their intake. Additionally, the systems model approach can be applied early in intervention to objectively monitor dietary compliance to treatment recommendations.

Diet-induced changes in maternal gut microbiota and metabolomic profiles influence programming of offspring obesity risk in rats.

Maternal obesity and overnutrition during pregnancy and lactation can program an increased risk of obesity in offspring. In this context, improving maternal metabolism may help reduce the intergenerational transmission of obesity. Here we show that, in Sprague-Dawley rats, selectively altering obese maternal gut microbial composition with prebiotic treatment reduces maternal energy intake, decreases gestational weight gain, and prevents increased adiposity in dams and their offspring. Maternal serum metabolomics analysis, along with satiety hormone and gut microbiota analysis, identified maternal metabolic signatures that could be implicated in programming offspring obesity risk and highlighted the potential influence of maternal gut microbiota on maternal and offspring metabolism. In particular, the metabolomic signature of insulin resistance in obese rats normalized when dams consumed the prebiotic. In summary, prebiotic intake during pregnancy and lactation improves maternal metabolism in diet-induced obese rats in a manner that attenuates the detrimental nutritional programming of offspring associated with maternal obesity. Overall, these findings contribute to our understanding of the maternal mechanisms influencing the developmental programming of offspring obesity and provide compelling pre-clinical evidence for a potential strategy to improve maternal and offspring metabolic outcomes in human pregnancy.

Maternal Employment Status, Ethnicity, Food Intake, and Their Effects on Teenage Obesity, in Surakarta

Background : Obesity is one of the main causesof premature death in adulthood. The prevalence of teenage obesity in Indonesia hasbeen increasing from 1.4% in 2007 to 7.3%. It is hypothesized that the risk of obesity is influenced by lifestyle and socio-economic status. This study aimed to determine the effect of maternal job status, ethnicity, and food intake, on the risk of obesity in teenagers. Subjects and Method: This was an analytical observational using case-control design. This study was conducted in Surakarta, in September – November 2016. A total of 120 teenagers were selected for the study, consisting of 41obese teenagers aged 16-18 years old and 79 normal weight teenagers, using fixed disease sampling. The dependent variable was obesity. The independent variables were maternal employment status, ethnicity, carbohydrate intake, fat intake, and energy intake. The data were collected using a set of questionnaires. Food intake was measured by 24 hour food recall. The data were analyzed using path analysis model. Result s : Energy intake had positive, significant, and direct effect on the risk of teenage obesity (b = 6.75; 95%CI = 4.36 to 9.14; p = <0.001). Working mother indirectly had positive and significant effect on teenage obesity, via fat intake (b=0.77; 95% CI = 0.03 to 1.52; p=0.040). Fat intake indirectly had positive and significant effect on teenage obesity, via energy intake (b=4.16; 95%CI=1.95 to 6.38; p=0.001). Likewise, carbohydrateintake had positive and significant effect on teenage obesity, via energy intake(b = 3.31; 95% CI= 1.73 to 4.88; p = 0.001). Ethnicity (Chinese versus Javanese) did not have significant effect on teenage obesity (b =-1.14; 95% CI =-3.56 to 1.28; p = 0.355). Conclusion : Energy intake has direct effect on the risk of teenage obesity. Fat intake, carbohydrate intake, and maternal employment status, have indirect effect on the risk of teenage obesity. Keywords : maternal employment status, ethnicity,food intake, obesity, teenager. Correspondence: Rahmah Purwaningsih Febri Susanti. Master Program in Public Health Sebelas Maret University. Email: rahmahpfs77@gmail.com Journal of Epidemiology and Public Health (2016), 1(2): 75-85 https://doi.org/10.26911/jepublichealth.2016.01.02.01

Protein and Micronutrient Intakes Are Associated with Child Growth and Morbidity from Infancy to Adulthood in the Philippines

Background: Interactions between nutrition and infections in developing countries are complex, and analyses of the interrelations require data from longitudinal studies that span several years and a comprehensive framework facilitating the formulation of food and health policies.Objective: The effects of dietary intakes in the Philippines for birth outcomes, heights, weights, and morbidity during ages 2–24 mo; heights and weights during ages 8–19 y; and completed adult heights were analyzed.Methods: Data on >3000 children from the Cebu Longitudinal Health and Nutrition Survey were modeled in 4 sets of analyses. Cross-sectional and multilevel models were estimated for length and weight at birth. Dynamic random-effects models were estimated for children's heights, weights, and morbidity levels during ages 2–24 mo. Children's heights and weights during ages 8–19 y were modeled by using random-effects models. Children's heights at age 22 y were modeled for investigating the effects of nutritional intakes in early childhood and in adolescence.Results: Maternal anthropometric indicators, energy intakes, and sociodemographic variables were significantly associated with children's length and weight at birth. Dynamic models for children's heights and weights during ages 2–24 mo showed significant effects of calcium and protein intakes; child morbidity levels were significantly associated with height and weight. Higher β-carotene intakes were significantly associated with lower morbidity levels. Analyses of data on children during ages 8–19 y showed significant effects of protein and calcium intakes and of morbidity levels on heights and weights. Models for children's heights at age 22 y indicated significant effects of protein and calcium intakes during early childhood and in adolescence.Conclusions: The results underscored the need for formulating long-term food and health policies for the Philippines that enhance children's physical development and ultimately their adult stature, which is important for physical work capacity and labor productivity.