Prenatal Nutrition Research Articles

Prenatal exposure to famine and the development of hyperglycemia and type 2 diabetes in adulthood across consecutive generations: a population-based cohort study of families in Suihua, China

There has been increased recognition that prenatal or perinatal nutrition has an effect on the development of type 2 diabetes (T2D) in adulthood, although studies that have directly examined whether the effect could be transmitted to the next generation remain sparse. We investigated the role of prenatal exposure to the Chinese famine in affecting future T2D risk in adulthood in 2 consecutive generations. A total of 1034 families, including 2068 parents [parental generation (F1)] and 1183 offspring [offspring generation (F2)], were recruited from the Suihua rural area that was affected by the Chinese Famine of 1959-1961. Participants born between 1 October 1959 and 30 September 1961 were defined as famine exposed, and those born between 1 October 1962 and 30 September 1964 were defined as nonexposed. The F2 were classified as having 1) no parent exposed to famine, 2) only a mother exposed to famine, 3) only a father exposed to famine, or 4) both parents exposed to famine. Classical risk factors for T2D as well as fasting-glucose- and oral-glucose-tolerance tests were measured in both the F1 and F2. Prenatal exposure to famine was associated with elevated risks of hyperglycemia (multivariable-adjusted OR: 1.93; 95% CI: 1.51, 2.48) and T2D (OR: 1.75; 95% CI: 1.20, 2.54) in adulthood in F1. Furthermore, compared with the offspring of nonexposed parents, the F2 with exposed parents- especially both exposed parents-had increased hyperglycemia risk (OR: 2.02; 95% CI: 1.12, 3.66) in adulthood. Prenatal exposure to famine remarkably increases hyperglycemia risk in 2 consecutive generations of Chinese adults independent of known T2D risk factors, which supports the notion that prenatal nutrition plays an important role in the development of T2D across consecutive generations of Chinese adults. This trial was registered at www.chictr.org.cn as ChiCTR-ECH-13003644.

Nature of nurture: Mentally superior young adults in the Philippines

This article compares aspects of the nurturance of giftedness discovered in primary data with those found in secondary research, and pinpoints similarities or convergences. The qualitative research project involved 34 pairs of mentally superior young adults and their respective biological mothers, living in the National Capital Region of the Philippines at the time of the data collection. Convergences in the primary and secondary data indicate that mothers’ educational background and training affect their parenting; and that prenatal care, medical supervision and nutrition during the early years are of utmost importance. The family configurations are similar in terms of parental ages and number of siblings. Nature of nurture comes in the form of deficiency and growth motivations that could develop the intended traits and behavior associated with gifted individuals; knowledge of these possible links to intellectual development can improve parents’ and schools’ practices in nurturing children. The findings provide information that can be used in curriculum planning and mentoring programs to direct the nurturance of identified mentally superior individuals towards optimizing their potential.

Pregnancy Pack: Branding with Adwords

After identifying a need in the market for a simpler way to manage prenatal nutrition, three Darden classmates develop an idea for a subscription e-commerce business that provides a monthly box of nutritionist-approved prenatal snacks, recipes, personal care products, and information for expectant mothers. To determine the best name for their product, the women run Google AdWords campaigns and choose the one that performed best. But was this the right decision, or should they rerun the test with the two best-performing names? And was this the most important business decision they needed to make at this point, or were there more pressing matters to address? Excerpt UVA-M-0875 Rev. Jun. 17, 2015 Pregnancy Pack: Branding with AdWords In September 2013, a second-year student at the University of Virginia's Darden School of Business, Patrice Ju, and her husband learned they were expecting a baby. Having little time to devote to calculating her nutritional intake based on her doctor's recommendations, Patrice looked online for help, but she was soon overwhelmed by the excess of vague—and sometimes conflicting—information. It was easy to find details on her baby's weekly development, but when it came to nutrition, the advice was unclear and difficult to navigate. After identifying a need in the market for a simpler way to manage prenatal nutrition, Ju decided to launch a business that would solve this problem for other busy moms-to-be. She recruited Darden classmates Meghan Guinee and Emily Weinman, who helped hone the idea and develop what would ultimately become Pregnancy Pack: a subscription e-commerce business that provided a monthly box of nutritionist-approved prenatal snacks, recipes, personal care products, and information for expectant mothers. The team envisioned lovely boxes that would arrive in subscribers' mailboxes once a month. Each would contain delicious snacks and meaningful content from reliable sources, conveyed in a relatable voice. Similar subscription and delivery businesses were becoming more common; industry leaders such as Birchbox had created successful models for other companies. . . .

Nutrition Education in Australian Midwifery Programmes: A Mixed-Methods Study

Little research has explored how nutrition content in midwifery education prepares midwives to provide prenatal nutrition advice. This study examined the nature and extent of nutrition education provided in Australian midwifery programmes. A mixed-methods approach was used, incorporating an online survey and telephone interviews. The survey analysis included 23 course coordinators representing 24 of 50 accredited midwifery programmes in 2012. Overall, the coordinators considered nutrition in midwifery curricula and the midwife’s role as important. All programmes included nutrition content; however, eleven had only 5 to <10 hours allocated to nutrition, while two had a designated unit. Various topics were covered. Dietitians/other nutrition experts were rarely involved in teaching or reviewing the nutrition content. Interviews with seven coordinators revealed that nutrition education tended to be problem-oriented and at times based on various assumptions. Nutrition content was not informed by professional or theoretical models. The development of nutrition assessment skills or practical training for midwifery students in providing nutrition advice was lacking. As nutrition is essential for maternal and foetal health, nutrition education in midwifery programmes needs to be reviewed and minimum requirements should be included to improve midwives’ effectiveness in this area. This may require collaboration between nutrition experts and midwifery bodies.

Parent and Clinician Perspectives on Sustained Behavior Change after a Prenatal Obesity Program: A Qualitative Study.

Infants of obese women are at a high risk for development of obesity. Prenatal interventions targeting gestational weight gain among obese women have not demonstrated consistent benefits for infant growth trajectories. To better understand why such programs may not influence infant growth, qualitative semi-structured interviews were conducted with 19 mothers who participated in a prenatal nutrition intervention for women with BMI 30 kg/m2 or greater, and with 19 clinicians (13 pediatric, 6 obstetrical). Interviews were transcribed and coded with themes emerging inductively from the data, using a grounded theory approach. Mothers were interviewed a mean of 18 months postpartum and reported successful postnatal maintenance of behaviors that were relevant to the family food environment (Theme 1). Ambivalence around the importance of postnatal behavior maintenance (Theme 2) and enhanced postnatal healthcare (Theme 3) emerged as explanations for the failure of prenatal interventions to influence child growth. Mothers acknowledged their importance as role models for their children's behavior, but they often believed that body habitus was beyond their control. Though mothers attributed prenatal behavior change, in part, to additional support during pregnancy, clinicians had hesitations about providing children of obese parents with additional services postnatally. Both mothers and clinicians perceived a lack of interest or concern about infant growth during pediatric visits (Theme 4). Prenatal interventions may better influence childhood growth if paired with improved communication regarding long-term modifiable risks for children. The healthcare community should clarify a package of enhanced preventive services for children with increased risk of developing obesity.

Effect of a randomised exclusive breastfeeding counselling intervention nested into the MINIMat prenatal nutrition trial in Bangladesh.

AimIt is unknown whether maternal malnutrition reduces the effect of counselling on exclusive breastfeeding. This study evaluated the effect of breastfeeding counselling on the duration of exclusive breastfeeding, and whether the timing of prenatal food and different micronutrient supplements further prolonged this duration.MethodsPregnant women in Matlab, Bangladesh, were randomised to receive daily food supplements of 600 kcal at nine weeks of gestation or at the standard 20 weeks. They also were allocated to either 30 mg of iron and 400 μg folic acid, or the standard programme 60 mg of iron and folic acid or multiple micronutrients. At 30 weeks of gestation, 3188 women were randomised to receive either eight breastfeeding counselling sessions or the usual health messages.ResultsThe median duration of exclusive breastfeeding was 135 days in the counselling group and 75 days in the usual health message group (p < 0.001). Prenatal supplements did not modify the effects of counselling. Women in the usual health message group who were randomised to multiple micronutrients exclusively breastfed for 12 days longer than mothers receiving the standard iron–folate combination (p = 0.003).ConclusionBreastfeeding counselling increased the duration of exclusive breastfeeding by 60 days. This duration was not influenced by the supplements.

Prenatal nutrition and 4-year-old McCarthy Scores

There is increasing literature suggesting a link between prenatal dietary/supplement nutrition and later life neurodevelopment. A prenatal diet rich in vitamins, minerals, and protein should be ben...

Advances in TRH signaling.

The activity of the hypothalamus-pituitary-thyroid axis (HPT) is coordinated by hypophysiotropic thyrotropin releasing hormone (TRH) neurons present in the paraventricular nucleus of the hypothalamus. Hypophysiotropic TRH neurons act as energy sensors. TRH controls the synthesis and release of thyrotropin, which activates the synthesis and secretion of thyroid hormones; in target tissues, transporters and deiodinases control their local availability. Thyroid hormones regulate many functions, including energy homeostasis. This review discusses recent evidence that covers several aspects of TRH role in HPT axis regulation. Knowledge about the mechanisms of TRH signaling has steadily increased. New transcription factors engaged in TRH gene expression have been identified, and advances made on how they interact with signaling pathways and define the dynamics of TRH neurons response to acute and/or long-term influences. Albeit yet incomplete, the relationship of TRH neurons activity with positive energy balance has emerged. The importance of tanycytes as a central relay for the feedback control of the axis, as well as for HPT responses to alterations in energy balance, and other stimuli has been reinforced. Finally, some studies have started to shed light on the interference of prenatal and postnatal stress and nutrition on HPT axis programing, which have confirmed the axis susceptibility to early insults.

Effect of Modifiable Risk Factors on Preterm Birth: A Population Based-Cohort.

Objectives The purpose of this study is to evaluate the prevalence, impact, and interaction of short interpregnancy interval (IPI), pre-pregnancy body mass index (BMI) category, and pregnancy weight gain (PWG) on the rate of preterm birth. Methods This is a population-based retrospective cohort study using vital statistics birth records from 2006 to 2011 in OH, US, analyzing singleton live births to multiparous mothers with recorded IPI (n = 393,441). Preterm birth rate at <37weeks gestational age was compared between the referent pregnancy (defined as normal pre-pregnancy maternal BMI, IPI of 12-24months, and Institute of Medicine (IOM) recommended PWG) and those with short or long IPI, abnormal BMI (underweight, overweight, and obese), and high or low PWG (under or exceeding IOM recommendations). Results Only 6 % of the women in this study had a referent pregnancy, with a preterm birth rate of 7.6 % for this group. Short IPIs of <6 and 6-12months were associated with increased rates of preterm birth rate to 12.9 and 10.4 %, respectively. Low PWG compared to IOM recommendations for pre-pregnancy BMI class was also associated with increased preterm birth rate of 13.2 % for all BMI classes combined. However, the highest rate of preterm birth of 25.2 % occurred in underweight women with short IPI and inadequate weight gain with adjOR 3.44 (95 % CI 2.80, 4.23). The fraction of preterm births observed in this cohort that can be attributed to short IPIs is 5.9 %, long IPIs is 8.3 %, inadequate PWG is 7.5 %, and low pre-pregnancy BMI is 2.2 %. Conclusions Our analysis indicates that a significant proportion of preterm births in Ohio are associated with potentially modifiable risk factors. These data suggest public health initiatives focused on preterm birth prevention could include counseling and interventions to optimize preconception health and prenatal nutrition.

Maternal Prenatal Nutrition and Birth Outcomes on Malnutrition among 7- to 10-Year-Old Children: A 10-Year Follow-Up

To identify postnatal predictors of malnutrition among 7- to 10-year-old children and to assess the long-term effects of antenatal micronutrient supplementation on malnutrition. A follow-up study was conducted to assess the nutritional status of 7- to 10-year-olds (1747 children) whose mothers participated in a cluster-randomized double-blind controlled trial from 2002 to 2006. The rate of malnourished 7- to 10-year-olds was 11.1%. A mixed-effects logistic regression model adjusted for the cluster-sampling design indicated that mothers with low prepregnant midupper arm circumference had boys with an increased risk of thinness (aOR 2.05, 95% CI 1.11, 3.79) and girls who were more likely to be underweight (aOR 2.01, 95% CI 1.05, 3.85). Antenatal micronutrient supplementation was not significantly associated with malnutrition. Low birth weight was significantly associated with increased odds of malnutrition among boys (aOR 4.34, 95% CI 1.82, 10.39) and girls (aOR 7.50, 95% CI 3.48, 16.13). Being small for gestational age significantly increased the odds of malnutrition among boys (aOR 1.75, 95% CI 1.01, 3.04) and girls (aOR 4.20, 95% CI 2.39, 7.39). In addition, household wealth, parental height, being picky eater, and illness frequency also predicted malnutrition. Both maternal prenatal nutrition and adverse birth outcomes are strong predictors of malnutrition among early school-aged children. Currently, available evidence is insufficient to support long-term effects of antenatal micronutrient supplementation on children's nutrition. www.isrctn.com: ISRCTN08850194.

A simple recipe: The effect of a prenatal nutrition program on child health at birth

We study the impact of a Canadian prenatal nutrition program on child health at birth. The objective of the “oeuf-lait-orange” (eggs–milk–oranges) (OLO) program is to reduce the incidence of prematurity and low birth weight by providing a specific food basket and nutritional guidance to pregnant women in situations of poverty. Our identification strategy exploits exogenous variations in access to the program caused by the progressive implementation of the program. Using detailed administrative birth records for over 1.5 million newborns, we find that the program significantly increased the birth weight of treated children by 69.8g and reduced the probability of low birth weight by 3.6 percentage points. W also find that prematurity decreased by 2.2 percentage points and gestation increased by 1.5days, but these effects are generally not significant. While the cost of the program is equivalent to the comparable United States Supplemental Nutrition Program for Women, Infants and Children (WIC), the food basket is simpler and the gains on birth weight are larger.

Infant Growth following Maternal Participation in a Gestational Weight Management Intervention.

Obesity is widespread and treatment strategies have demonstrated limited success. Changes to obstetrical practice in response to obesity may support obesity prevention by influencing offspring growth trajectories. This retrospective cohort study examined growth among infants born to obese mothers who participated in Nutrition in Pregnancy (NIP), a prenatal nutrition intervention at one urban hospital. NIP participants had Medicaid insurance and BMIs of 30 kg/m(2) or greater. We compared NIP infant growth to a historical control cohort, matched on maternal factors: age, race/ethnicity, prepregnancy BMI, parity, and history of prepregnancy hypertension or preterm birth. Growth data were available for 61 NIP and 145 control infants. Most mothers were African American (94%). Mean maternal BMI was 39.9 kg/m(2) (standard deviation [SD], 5.6) for NIP participants and 38.8 kg/m(2) (SD, 6.0) for controls. Pregnancy outcomes, including preterm birth, gestational diabetes, and birth weight, did not differ between groups. NIP participants were more likely to attend a postpartum visit (69% vs. 52%; p value, 0.03). At 1 year, 17% of NIP infants and 15% of controls had weight-for-length (WFL) ≥95th percentile (p value, 0.66). Other markers of accelerated infant growth, including crossing WFL percentiles and peak infant BMI, did not differ between groups. There was no difference in growth between infants whose mothers participated in a prenatal nutrition intervention and those whose mothers did not. Existing prenatal programs for obese women may be inadequate to prevent pediatric obesity without pediatric collaboration to promote family-centered support beyond pregnancy.

A novel, ecologically relevant, highly preferred, and non-invasive means of oral substance administration for rodents

Prenatal stress and nutrition are well-known to alter a broad range of physiological systems, notably metabolic, endocrine and neurobehavioral function. Commonly used methods for oral administration of xenobiotics can, by acting as a stressor or altering normal nutrition intake, alter these physiological systems as well. Taken together, oral administration methods may unintentionally introduce confounding physiological effects that can mask or enhance toxicity of xenobiotics, particularly if they share biological targets. Consequently, it should be preferable to develop alternative methods without these potential confounds. The aim of this study was to determine the suitability of mealworms as an alternative treat-based method to deliver xenobiotics via the orogastric route. Accurate oral administration is contingent on motivation and preference; mice reliably preferred mealworms over wafer cookie treats. Further, ingestion of wafer cookies significantly increased mouse blood glucose levels, whereas unaltered mealworms produced no such change. Mealworms functioned effectively to orally administer glucose, as glucose-spiked mealworms produced a rise in blood glucose equivalent to the ingestion of the wafer cookie. Mealworms did not interfere with the physiological function of orally administered d-amphetamine, as both mealworm and oral gavage administered d-amphetamine showed similar alterations in locomotor behavior (mice did not fully consume d-amphetamine-dosed cookies and thus could not be compared). Collectively, the findings indicate that mealworms are a preferred and readily consumed treat, which importantly mimics environmental-relevant nutritional intake, and mealworms per se do not alter glucose metabolic pathways. Additionally, mealworms accurately delivered xenobiotics into blood circulation and did not interfere with the physiological function of administered xenobiotics. Thus mealworm-based oral administration may be a preferable and accurate route of xenobiotic administration that eliminates physiological alterations associated with other methods of delivery.

Assessment of body composition in Wistar rat offspring by DXA in relation to prenatal and postnatal nutritional manipulation.

This experimental study aims to investigate the impact of combinations of prenatal and postnatal food manipulation on body composition in rat offspring. On day 12 of gestation, 100 timed pregnant rats were randomized into two nutritional groups: standard laboratory and 50% starved. Pups born to starved mothers were subdivided, based on birthweight (BiW), into fetal growth restricted (FGR) and non-FGR. Pups were born on day 21, cross-fostered, then left undisturbed lactating until the 26th postnatal day when they underwent dual-energy X-ray absorptiometry (DXA) examination. Prenatally control-fed animals had a significantly greater body weight at 26 d postnatally than the prenatally starved groups, irrespective of their postnatal diet (P < 0.001). Postnatal control diet was associated with significantly increased abdominal and total fat in non-FGR compared to FGR rats (P < 0.001). non-FGR/CONTROL rats showed higher values of abdominal fat than prenatally starved animals that were starved postnatally irrespective of their birth weight (P < 0.001). Postnatal control diet significantly increased total bone mineral content (BMC), head BMC, head area, abdominal BMC in non-FGR compared to FGR rats (P < 0.001). Interaction between prenatal and postnatal nutrition affects growth, abdominal adiposity, and bone accrual in Wistar rats' offspring at 26 d of life.

Lessons Learned from the Development of a Prenatal Nutrition Online Training for EFNEP Paraprofessional Nutrition Educators

ObjectiveTo share lessons learned from the development of a national online training for nutrition educators from the Expanded Food and Nutrition Education Program (EFNEP) designed to prepare them to teach the prenatal lesson “Eating Smart and Being Active During Pregnancy” and to increase their self‐efficacy in teaching prenatal nutrition.MethodsSystematic development of a video based online training using Smith and Ragan's instructional design model, storyboards, scripts, Cognitive Theory of Multimedia Learning, and theoretical constructs that impact self‐efficacy.Summary of results obtainedA four hour video‐based online training was developed that included 41 short clips depicting a paraprofessional nutrition educator teaching the Eating Smart and Being Active During Pregnancy lesson to low‐income pregnant women. Clips also presented explanations of the nutrition lesson's content, so trainees could address pregnant participants’ questions and misconceptions.Lessons learned during the development process included the following: 1) the use of storyboards and scripts helped improve communication about expectations between the nutrition professional designing the training and the filming/editing crew; 2) filming locations need to provide adequate space for all elements in a scene and the filming crew and equipment; 3) environmental noise and light can affect video quality; poor quality videos can distract trainees and make the editing process longer; 4) editing can become the most time consuming step in the development process when raw footage is of bad quality; 5) nutrition professionals designing training need to be actively involved in reviewing footage at the end of every filming day to make sure that the nutrition messages are conveyed appropriately; 6) the use of a memorandum of understanding with anyone involved in the development of the video‐based training helps to clarify timelines, specify responsibilities, and provide alternative courses of actions when initial design or editing plans do not work as expected. In this era of visual learning, our development process can be informative to nutrition educators, charged with developing video‐based nutrition education materials.ConclusionThe development of video‐based online trainings is time consuming. The use of research based theories should facilitate the decision making process, increasing the likelihood that the online training will be an effective learning tool.Support or Funding InformationColorado's Expanded Food and Nutrition Education Program (EFNEP)

Effect of metabolic imprinting on growth and development in piglets

It has long been known that nutritional and environmental influences during the early developmental period affect the biological mechanisms which determine animal metabolism. This phenomenon, termed ‘metabolic imprinting’, can cause subtle but long-lasting responses to prenatal and postnatal nutrition and even be passed onto the next generation. A large amount of research data shows that nutrient availability, in terms of quantity as well as quality, during the early developing stages can decrease the number of newborn piglets and their body weight and increase their susceptibility to death before weaning. However, investigation of potential mechanisms of ‘the metabolic imprinting’ effect have been scant. Therefore, it remains unknown which factors are responsible for embryonic and early postnatal nutrition and which factors are major determinants of body weight and number of new born piglets. Intrauterine undernutrition, for example, was studied using a rat model providing dams 50% restricted nutrients during pregnancy and the results showed significant decreases in birth weight of newborns. This response may be a characteristic of a subset of modulations in embryonic development which is caused by the metabolic imprinting. Underlying mechanisms of intrauterine undernutrition and growth retardation can be explained in part by epigenetics. Epigenetics modulate animal phenotypes without changes in DNA sequences. Epigenetic modifications include DNA methylation, chromatin modification and small non-coding RNA-associated gene silencing.. Precise mechanisms must be identified at the morphologic, cellular, and molecular levels by using interdisciplinary nutrigenomics approaches to increase pig production. Experimental approaches for explaining these potential mechanisms will be discussed in this review.

Nutritional Determinants of the Timing of Puberty.

The timing of puberty has important public health, clinical, and social implications. The plasticity of sexual development onset could be a mechanism that adapts to prevailing environmental conditions. Early-life nutrition may provide cues for the environment's suitability for reproduction. This review focuses on recent developments in our understanding of the role of diet in the timing of sexual maturation. Population-based observational studies consistently indicate that childhood obesity is related to the earlier onset of puberty in girls. Similarly, intake of animal foods has been associated with earlier sexual development, whereas vegetable protein intake is related to delayed maturation. Evidence for prenatal nutrition, infant feeding practices, and childhood intake of fat, carbohydrate, and micronutrients is inconsistent. Secondary analyses of prenatal and early-life randomized nutritional interventions with extended follow-up through peripubertal years would help clarify the role of nutrition in the timing of sexual maturation.

Higher Intake of Milk-Replacer Pre-Weaning Enhances Post-Weaning Insulin-Like Growth Factor 1 Levels in Japanese Black Cattle

Alterations in early pre-natal nutrition of Japanese Black calves influence the glucose and lipid metabolism after weaning. However, the effects of early nutritional status on the endocrine system in later life stages in Japanese Black cattle are unknown. This study examined how post-weaning plasma levels of growth hormone (GH), insulin-like growth factor 1 (IGF-1), and blood insulin, which are hormones affecting growth and meat quality, and metabolites were affected by feeding 1800 g versus 500 g of milk replacer to Japanese Black cattle (5 per group) during nursing. Up to weaning (90 days post-birth), all calves received calf starter and hay ad libitum, and post-weaning, they received a concentrate feed and hay ad libitum. Plasma concentrations of GH and IGF-1 were greater at weaning in the high-milk-replacer group (P<0.1 and P<0.01, respectively), and elevated IGF-1 concentrations persisted until the study end (210 d) (P<0.05), suggesting that the levels were sustained independent of the influences of both GH and nutrient intake. Blood insulin and metabolites (plasma glucose, beta-hydroxybutyric acid, and non-esterified fatty acids) were not significantly different between the two groups. The results of this study suggest that feeding calves a high volume of milk replacer during nursing will increase IGF-1 secretion well beyond weaning.

Oral health, nutritional knowledge, and practices among pregnant women and their awareness relating to adverse pregnancy outcomes

Introduction: Oral health is often neglected by pregnant females, and physicians should evaluate and educate pregnant women regarding the routine dental checkups to prevent complications. Periodontitis is associated with preterm birth and low birth weight babies, and high levels of cariogenic bacteria in the oral cavity of the mother leads to dental caries in infants. Most of the pregnant women are unaware of periodontal diseases during pregnancy because of lack of knowledge. Aims and Objectives: The aim of the study was to assess the oral health-related awareness and practice among pregnant women in Bilaspur city. In addition, we assessed the knowledge of mothers towards nutrition during pregnancy because adequate prenatal nutrition is one of the most important environmental factors affecting the health of pregnant women and their babies. Materials and Methods: The study was a cross-sectional study. A total of 446 samples were selected by convenience sampling technique. A questionnaire containing 12 questions related to knowledge and practices pertaining to oral health and 12 questions related to diet and nutrition along with sociodemographic data were used for collecting information. Analysis were conducted using the Statistical Package for the Social Sciences (SPSS) for Windows (version 20.0, SPSS Inc., Chicago IL, USA). Results: Majority of women (74%) were not aware about periodontal diseases, which is common during pregnancy. Only 44.9% were aware which period was safe for dental treatment, and 33.4% were aware that exposure to high dose radiation is dangerous to the baby. A total of 50.1% experienced bleeding from gums during pregnancy; 99.8% maintained their oral hygiene by brushing twice daily and 96.8% visited dentist twice yearly. Concerning nutritional awareness, pregnant patients were aware of the meaning of food (40.1%) and the importance of food (45.5%), balanced (47%), and healthy diet (43.9%). They had adequate knowledge regarding requirement of food for proper functioning of the body (59.9%) as well as for fighting infections (67.2%). Knowledge regarding sources of carbohydrates/proteins, iron, zinc, vitamin A and iodine was low in our patients. Conclusion: The results suggest that knowledge and practices of pregnant women should be improved for better pregnancy outcomes. It requires proper coordinated effort between oral health and prenatal communities for maternal and child's oral health outcomes. Nutritional education programs should be carried out by medical centres, which should be directed towards women in rural areas.

Role of nutrition in preventing insulin resistance in children.

Nutrition during prenatal, early postnatal and pubertal period is crucial for the development of insulin resistance and its consequences. During prenatal period fetal environment and nutrition seems to interfere with metabolism programming later in life. The type of dietary carbohydrates, glycemic index, protein, fat and micronutrient content in maternal nutrition could influence insulin sensitivity in the newborn. The effects of lactation on metabolism and nutritional behavior later in life have been studied. Dietary habits and quality of diet during puberty could prevent the onset of a pathological insulin resistance through an adequate distribution of macro- and micronutrients, a diet rich in fibers and vegetables and poor in saturated fats, proteins and sugars. We want to overview the latest evidences on the risk of insulin resistance later in life due to both nutritional behaviors and components during the aforementioned periods of life, following a chronological outline from fetal development to adolescence.