The Association between Dietary Patterns and Pre-Pregnancy BMI with Gestational Weight Gain: The “Born in Shenyang” Cohort

The reported associations of maternal dietary patterns during pregnancy with gestational weight gain are inconsistent, especially among the less studied Asian Chinese populations. In a prospective pre-birth cohort study conducted in northern China, we determined the associations between maternal dietary patterns and the probability of excess gestational weight gain (EGWG) among 1026 pregnant women. We used 3-day food diaries to assess maternal diet and performed principal component analysis to identify dietary patterns. Maternal adherence to a traditional pattern, which was characterized by a higher intake of tubers, vegetables, fruits, red meat, and rice, was associated with a higher probability of EGWG (quartile 3 vs. quartile 1, odds ratio [OR] = 1.62, 95% confidence interval [CI] = 1.10−2.38). This risk association was more pronounced among women who were overweight/obese before pregnancy (quartile 4 vs. quartile 1, OR = 5.17, 95% CI = 1.45–18.46; p for interaction < 0.01). Maternal adherence to a high protein pattern, which was characterized by a higher intake of fried foods, beans and bean products, dairy products, and fruits, was associated with a lower risk of EGWG (quartile 3 vs. quartile 1, OR = 0.56, 95% CI, 0.39−0.81). The protective association was more pronounced among non-overweight/obese women (p for interaction < 0.01). These findings may help to develop interventions and better define target populations for EGWG prevention.     

Adherence to Clinical Practice Guideline Recommendations in Women with Gestational Diabetes and Associations with Maternal and Infant Health—A Cohort Study

Gestational diabetes mellitus (GDM) is managed by dietary advice, but limited evidence exists about the impact of adherence on health. We assessed whether adherence to the New Zealand Ministry of Health dietary recommendations is associated with maternal and infant health in women with GDM. Data from 313 women with GDM were used. Adherence to food-related recommendations was scored from 0 (no adherence) to 10 (adhered to all recommendations) and analysed in tertile groups (high, moderate, low adherence). Adherence to visiting a dietitian and appropriate weight gain were assessed as yes or no. Chi-square, ANOVA, and odds ratios were used to compare groups. High dietary adherence compared to low adherence was associated with reduced oral hypoglycaemic and insulin use (OR = 0.55, CI = 0.30–1.00). Visiting a dietitian compared to not was associated with increased oral hypoglycaemic and insulin use (OR = 2.96, CI = 1.12–7.80), decreased odds of a large-for-gestational-age infant (OR = 0.32, CI = 0.14–0.73) and neonatal hyperbilirubinaemia (OR = 0.27, CI = 0.08–0.95). Greater than recommended compared with recommended weight gain was associated with increased oral hypoglycaemic and insulin use (OR = 2.51, CI = 1.26–5.01), while lower than recommended weight gain was associated with decreased postpartum haemorrhage (OR = 0.45, CI = 0.23–0.91) and increased breastfeeding (OR = 1.96, CI = 1.04–3.70). Adherence to dietary recommendations for women with GDM likely improves health outcomes.     

Maternal Compliance to Recommended Iron and Folic Acid Supplementation in Pregnancy,Sri Lanka: A Hospital-Based Cross-Sectional Study

Iron deficiency anaemia during pregnancy is a common public health problem that negatively affects maternal and newborn health. This study aims to identify the rate of maternal compliance with the recommended iron and folic acid (IFA) supplementation during pregnancy and to identify factors associated with maternal compliance and non-compliance. A hospital-based cross-sectional study was conducted among 703 women at 0–4 days postpartum. The prevalence of anaemia at the initial antenatal clinic (ANC) visit and at the third trimester were 20.8% and 44.9%, respectively. The rate of IFA supplementation compliance during pregnancy was 80.1%. Forgetfulness (66.9%) was the major reason for non-compliance, followed by side effects (15.7%). Maternal employment [OR (95%CI): 1.7 (1.00–2.89)], history of a low birth weight infant [OR (95%CI): 0.4 (0.19–0.9)] and history of anaemia [OR (95%CI): 0.4 (0.12–0.98] were significantly associated with maternal compliance with IFA supplementation. Only 26.6% of the participants adhered to dietary recommendations during the period when IFA supplements were provided. The rate of maternal compliance with IFA supplementation was high. However, the prevalence of maternal anaemia during pregnancy was also high, which was presumably due to poor dietary compliance despite high IFA supplementation compliance.     

Effects of Dietary Patterns during Pregnancy on Preterm Birth: A Birth Cohort Study in Shanghai

The objective of this study was to analyse representative dietary patterns during pregnancy in Shanghai and explore the effects of dietary patterns during pregnancy on preterm birth. Data were derived from the ‘Iodine Status in Pregnancy and Offspring Health Cohort’ (ISPOHC) study. Multistage, stratified random sampling was used to select survey participants from 16 districts in Shanghai, which were divided into five sampling areas; 40–70 pregnant women were selected from each area. A total of 4361 pregnant women and their offspring were involved in the study. The male-to-female ratio of the babies was 1.04:1, and the incidence of single preterm birth was 4.2%. Three dietary patterns were extracted by factor analysis: a ‘Vegetarian Pattern’, an ‘Animal Food Pattern’ (AFP), and a ‘Dairy and Egg Pattern’. These patterns explained 40.513% of the variance in dietary intake. Binary logistic regression, which was used to analyse the association between birth outcomes and scores measuring maternal dietary patterns, found only the AFP was a significant risk factor for preterm birth. Higher AFP scores were positively associated with preterm birth (Q2 vs. Q1 OR = 1.487, 95% CI: 1.002–2.207; Q3 vs. Q1 OR = 1.885, 95% CI: 1.291–2.754). After adjusting for other potential contributors, a higher AFP score was still a significant risk factor for preterm birth (Q2 vs. Q1 OR = 1.470, 95% CI: 0.990–2.183; Q3 vs. Q1 OR = 1.899, 95% CI: 1.299–2.776). The incidence of preterm birth was 4.2%. A higher score of AFP was significantly associated with a higher risk of preterm birth. The animal food intake of pregnant women should be reasonably consumed during pregnancy.     

The Associations of Maternal Hemoglobin Concentration in Different Time Points and Its Changes during Pregnancy with Birth Weight Outcomes

Maternal hemoglobin (Hb) is related to nutritional status, which affects neonatal birth weight. However, it is very common for maternal Hb to fluctuate during pregnancy. To evaluate the associations of maternal Hb in different time points and its changes during pregnancy with neonatal birth weight, small for gestational age (SGA)/low birth weight (LBW) and large for gestational age (LGA)/macrosomia, we conducted this study by using data from the Electronic Medical Record System (EMRS) database of Zhoushan Maternal and Child Care Hospital in Zhejiang province, China. The pregnancy was divided into five periods: first, early-second, mediate-second, late-second, early-third and late-third trimesters; we further calculated the maternal Hb changes during pregnancy. Overall, the socio-demographic characteristics, health-related information and childbirth-related information of 24,183 mother–infant pairs were obtained. The average Hb concentration during the different periods were 123.95 ± 10.14, 117.95 ± 9.84, 114.31 ± 9.03, 113.26 ± 8.82, 113.29 ± 8.68 and 115.01 ± 8.85 g/L, respectively. Significant dose–response relationships between maternal Hb and birth weight were observed in the first, late-second and later trimesters (p non-linear < 0.05). Maternal Hb < 100 g/L was related to a high risk of LGA/macrosomia in the late-second (OR: 1.47, 95% CI: 1.18, 1.83) and later trimesters; additionally, high maternal Hb (>140 g/L) increased the risk of SGA/LBW in the first (OR: 1.26, 95% CI: 1.01, 1.57) and late-third trimesters (OR: 1.96, 95% CI: 1.20, 3.18). In addition, the increase in maternal Hb from the late-second to late-third trimesters had a positive correlation with SGA/LBW. In conclusion, maternal Hb markedly fluctuated during pregnancy; the negative dose–response association of maternal Hb in the late-second and third trimesters, and Hb change during pregnancy with neonatal birth weight outcomes were observed, respectively. Furthermore, the phenomenon of high Hb in the first trimester and after the late-second trimester and the increase of maternal Hb from the late-second to late-third trimesters more significantly increasing the risk of SGA/LBW should especially be given more attention. Its biological mechanism needs to be further explored.     

Fruit and Vegetable Intake and Body Mass Index in a Large Sample of Middle-Aged Australian Men and Women

Dietary guidelines around the world recommend increased intakes of fruits and non-starchy vegetables for the prevention of chronic diseases and possibly obesity. This study aimed to describe the association between body mass index (BMI) and habitual fruit and vegetable consumption in a large sample of 246,995 Australian adults aged 45 + year who had been recruited for the “45 and Up” cohort study. Fruit and vegetable intake was assessed using validated short questions, while weight and height were self-reported. Multinomial logistic regression was used, by sex, to assess the association between fruit and vegetable intake and BMI. Compared to the referent normal weight category (BMI 18.5 to 24.9), the odds ratio (OR) of being in the highest vegetable intake quartile was 1.09 (95% confidence interval (CI) 1.04–1.14) for overweight women (BMI 25.0–29.9) and 1.18 (95% CI 1.12–1.24) for obese women. The association was in the opposite direction for fruit for overweight (OR 0.85; 95% CI 0.80–0.90) and obese women (OR 0.75; 95% CI 0.69–0.80). Obese and overweight women had higher odds of being in the highest intake quartile for combined fruit and vegetable intake, and were more likely to meet the “2 and 5” target or to have five or more serves of fruit and vegetables per day. In contrast, overweight men were less likely to be in high intake quartiles and less likely to meet recommended target of 5 per day, but there was no consistent relationship between obesity and fruit and vegetable intake. Underweight women and underweight men were less likely to be in the highest intake quartiles or to meet the recommended targets. These data suggest that improving adherence to dietary targets for fruit and vegetables may be a dietary strategy to overcome overweight among men, but that overweight and obese women are already adhering to these targets. The association between fruit and vegetable intake and underweight in adults suggests that improving fruit and vegetables intakes are important for the overall dietary patterns of people in this group.     

Environmental Risk Factors for Congenital Heart Disease in the Shandong Peninsula,China: A Hospital-based Case–Control Study

Background

In China, and in Shandong province, the proportionate contribution of birth defects to infant mortality has increased, and congenital heart disease (CHD) is now the most common cause of birth defects. The cause of approximately 90% of cases of congenital heart disease is multifactorial. Little is known about modifiable environmental risk factors or regional differences. We investigated putative environmental risk factors for congenital heart disease in the Shandong province of China in order to improve prevention of CHD.

Methods

We conducted a hospital-based 1:2 matched case–control study of 164 patients with congenital heart diseases and 328 controls, all of whom were retrospectively interviewed. Univariate and multivariate analyses were conducted to identify environmental risk factors for CHD.

Results

The environmental risk factors associated with CHD were mother’s education level (odds ratio [OR], 0.31; 95% confidence interval [CI], 0.15–0.67), neonatal asphyxia or hypoxia (OR, 3.74; 95% CI, 1.25–11.18), number of previous pregnancies (OR, 2.68; 95% CI, 1.44–4.97), maternal upper respiratory tract infection (OR, 4.12; 95% CI, 1.56–10.85), maternal infection (OR, 7.98; 95% CI, 2.14–29.72), maternal B-mode ultrasound examination (OR, 4.05; 95% CI, 1.48–11.08), and maternal mental stress (OR, 3.93; 95% CI, 1.94–7.94) during early pregnancy. No significant interactions were observed among these factors.

Conclusions

Augmenting maternal mental healthcare, obtaining regular health counseling and testing during pregnancy, preventing upper respiratory tract infections, limiting medication during early pregnancy, offering health promotion and health education to women of childbearing age (especially those with less formal education), and improving obstetric procedures and techniques may lower the occurrence of congenital heart disease.Key words: heart defects, congenital; hospital-based; matched case–control study; risk factors; Shandong peninsular area of China     

Dietary Pattern Associated with the Risk of Hyperuricemia in Chinese Elderly: Result from China Nutrition and Health Surveillance 2015–2017

Our current study aimed to estimate the relationship between dietary patterns and hyperuricemia among the Chinese elderly over 60 years old. All the data were obtained from China Nutrition and Health Surveillance during 2015–2017. A total of 18,691 participants who completed the whole survey were included in our statistical analysis. The definition of hyperuricemia was 420 μmmol/L (7 mg/dL) for male and 360 μmmol/L (6 mg/dL) for female. Exploratory factor analysis was applied to explore posterior dietary patterns in our samples, and five dietary patterns were recognized, namely “Typical Chinese”, “Modern Chinese”, “Western”, “Animal products and alcohol”, and “Tuber and fermented vegetables”. After multiple adjusted logistic regression, participants in the highest quartile of “typical Chinese” (Q4 vs. Q1, OR = 0.32, 95% CI: 0.28–0.37, p-trend < 0.0001), “modern Chinese” (Q4 vs. Q1, OR = 0.81, 95% CI: 0.71–0.93, p-trend = 0.0021) and “tuber and fermented vegetables” (Q4 vs. Q1, OR = 0.78, 95% CI: 0.69–0.88, p-trend < 0.0001) showed a lower risk of hyperuricemia, while animal products and alcohol was positively associated with hyperuricemia (Q4 vs. Q1, OR = 1.49, 95% CI: 1.31–1.7, p-trend < 0.0001). We also found that participants who mainly ate a modern Chinese diet tended to meet the RNI/AI of nutrients we discuss in this paper, which may supply some information for hyperuricemia prevention and management by dietary methods.     

Dietary Patterns and Birth Weight—a Review

Being born with low birth weight (LBW) is recognized as a disadvantage due to risk of early growth retardation, fast catch up growth, infectious disease, developmental delay, and death during infancy and childhood, as well as development of obesity and non-communicable diseases (NCDs) later in life. LBW is an indicator of fetal response to a limiting intrauterine environment, which may imply developmental changes in organs and tissue. Numerous studies have explored the effect of maternal intake of various nutrients and specific food items on birth weight (BW). Taking into account that people have diets consisting of many different food items, extraction of dietary patterns has emerged as a common way to describe diets and explore the effects on health outcomes. The present article aims to review studies investigating the associations between dietary patterns derived from a posteriori analysis and BW, or being small for gestational age (SGA). A PubMed search was conducted with the Mesh terms “pregnancy” OR “fetal growth retardation” OR “fetal development” OR “infant, small for gestational age” OR “birth weight” OR “infant, birth weight, low” AND “diet” OR “food habits”. Final number of articles included was seven, all which assessed diet by use of food frequency questionnaire (FFQ). Five studies explored dietary patterns using principal component analyses (PCA), while one study used cluster analyses and one study logistic regression. The studies reported between one and seven dietary patterns. Those patterns positively associated with BW were labeled “nutrient dense”, “protein rich”, “health conscious”, and “Mediterranean”. Those negatively associated with BW were labeled “Western”, “processed”, “vegetarian”, “transitional”, and “wheat products”. The dietary patterns “Western” and “wheat products” were also associated with higher risk of SGA babies, whereas a “traditional” pattern in New Zealand was inversely associated with having a SGA baby. The dietary patterns associated with higher BW or lower risk of having babies born SGA were named differently, but had similar characteristics across studies, most importantly high intakes of fruits, vegetables and dairy foods. Dietary patterns associated with lower BW or higher risk for giving birth to a SGA baby were characterized by high intakes of processed and high fat meat products, sugar, confectionaries, sweets, soft drinks, and unspecified or refined grains. All studies in this review were performed in high-income countries. More research is warranted to explore such associations in low and middle income countries, where underweight babies are a major health challenge many places. Furthermore, results from studies on associations between diet and BW need to be translated into practical advice for pregnant women, especially women at high risk of giving birth to babies with LBW.     

Maternal Low-Level Lead Exposure and Fetal Growth

Background

Limited epidemiologic studies have examined the association between maternal low-level lead exposure [blood lead (PbB) < 10 μg/dL] and fetal growth.

Objective

We examined whether maternal low-level lead exposure is associated with decreased fetal growth.

Methods

We linked New York State Heavy Metals Registry records of women who had PbB measurements with birth certificates to identify 43,288 mother–infant pairs in upstate New York in a retrospective cohort study from 2003 through 2005. We used multiple linear regression with fractional polynomials and logistic regression to relate birth weight, preterm delivery, and small for gestational age to PbB levels, adjusting for potential confounders. We used a closed-test procedure to identify the best fractional polynomials for PbB among 44 combinations.

Results

We found a statistically significant association between PbB (square root transformed) and birth weight. Relative to 0 μg/dL, PbBs of 5 and 10 μg/dL were associated with an average of 61-g and 87-g decrease in birth weight, respectively. The adjusted odds ratio for PbBs between 3.1 and 9.9 μg/dL (highest quartile) was 1.04 [95% confidence interval (CI), 0.89–1.22] for preterm delivery and 1.07 (95% CI, 0.93–1.23) for small for gestational age, relative to PbBs ≤ 1 μg/dL (lowest quartile). No clear dose–response trends were evident when all of the quartiles were assessed.

Conclusions

Low-level PbB was associated with a small risk of decreased birth weight with a supralinear dose–response relationship, but was not related to preterm birth or small for gestational age. The results have important implications regarding maternal PbB.     

Association of Preoperative Prognostic Nutritional Index and Postoperative Acute Kidney Injury in Patients with Colorectal Cancer Surgery

The prognostic nutritional index (PNI) has been reported to be associated with postoperative complications and prognosis in cancer surgery. However, few studies have evaluated the association between preoperative PNI and postoperative acute kidney injury (AKI) in colorectal cancer patients. This study evaluated association of preoperative PNI and postoperative AKI in patients who underwent colorectal cancer surgery. This study retrospectively analyzed 3543 patients who underwent colorectal cancer surgery between June 2008 and February 2012. The patients were classified into four groups by the quartile of PNI: Q1 (≤43.79), Q2 (43.79–47.79), Q3 (47.79–51.62), and Q4 (≥51.62). Multivariate regression analysis was performed to assess the risk factors for AKI and 1-year mortality. AKI was defined according to Kidney Disease Improving Global Outcomes classification (KDIGO) criteria. Additionally, we assessed surgical outcomes such as hospital stay, ICU admission, and postoperative complications. The incidence of postoperative AKI tended to increase in the Q1 group (13.4%, 9.2%, 9.4%, 8.8%). In the multivariate analysis, high preoperative PNI was significantly associated with low risk of postoperative AKI (adjusted odds ratio [OR]: 0.96, 95% confidence interval [CI]: 0.93–0.99, p = 0.003) and low 1-year mortality (OR: 0.92, 95% CI: 0.86–0.98, p = 0.011). Male sex, body mass index, diabetes mellitus, and hypertension were risk factors for AKI. The Q1 (≤43.79) group had poor surgical outcomes, such as postoperative AKI (OR: 1.52, 95% CI: 1.18–1.95, p = 0.001), higher rates of ICU admission (OR: 3.13, 95% CI: 1.82–5.39, p < 0.001) and higher overall mortality (OR: 3.81, 95% CI: 1.86–7.79, p < 0.001). In conclusion, low preoperative PNI levels, especially in the Q1 (≤43.79), were significantly associated with postoperative AKI and surgical outcomes, such as hospital stay, postoperative ICU admission, and mortality.     

Association between Dietary Patterns and Serum Hepatic Enzyme Levels in Adults with Dyslipidemia and Impaired Fasting Plasma Glucose

We investigated the association between dietary patterns and serum hepatic enzyme levels in adults with dyslipidemia and impaired fasting glucose in Taiwan. A total of 15,005 subjects (5452 men and 9553 women) aged 35–69 years were selected. Two major dietary patterns were identified by principal component analysis: Western dietary pattern and Mediterranean dietary pattern. Subjects in the highest quartile (Q4) of the Western dietary pattern showed an increased risk of elevated serum alanine aminotransferase (ALT) levels (OR: 1.24, 95% CI: 1.06–1.45, p-trend = 0.01). Fur-thermore, in the highest quartile of the Western dietary pattern, subjects with high waist circum-ference were observed to have a greater risk for developing abnormal serum ALT levels compared to those in the lowest quartile (Q1) (OR: 1.43, 95% CI: 1.04–1.97, p-trend = 0.01). In the highest quartile of the Western dietary pattern, only women were at an increased risk for having abnormal serum ALT levels (OR: 1.28, 95% CI: 1.04–1.59, p-trend = 0.03). By contrast, in the highest quartile of the Mediterranean dietary pattern, only men were at a reduced risk for having abnormal serum gamma-glutamyl transferase (GGT) levels (OR: 0.72, 95% CI: 0.53–0.97, p-trend = 0.048). We report a positive association between the Western dietary pattern and abnormal serum ALT levels.     

Prevalence and Correlates of Overweight,Obesity and Physical Activity in Italian Children and Adolescents from Lombardy,Italy

Investigating pediatric overweight and physical activity correlates is essential to design effective preventive programs. We used regional data (Lombardy, northern Italy) from the 2019 survey “OKKio alla Salute” (3093 children aged 8–9 years with measured anthropometric data), and from the 2018 wave of the “Health Behaviour in School-aged Children” survey (2916 adolescents aged 11–15 years with self-reported anthropometric data). In both the surveys, a cluster sampling methodology was used. Unconditional multiple logistic regression models were applied to estimate the odds ratios (OR) and corresponding 95% confidence intervals (CI) of overweight, obesity and poor physical activity. The prevalence of overweight (including obesity) was 22.4% for children aged 8–9 years and 14.4% for adolescents aged 11–15 years. A higher prevalence of overweight was observed among males, children with greater birth weight and those with obese parents. Scant physical activity was higher among females and older adolescents. There was a direct relationship between obesity and increased psychological distress (OR = 2.44; 95% CI: 1.12–5.27) or being victims of bullying (OR = 2.25; 95% CI: 1.17–4.34). Increasing physical activity significantly decreased the frequency of mental health outcomes. Prevention campaigns should be promoted to safeguard childhood physical and psychological wellbeing.     

Prenatal maternal blood triglyceride and fatty acid levels in relation to exposure to di(2-ethylhexyl)phthalate: a cross-sectional study

Objectives

The hypolipidemic effects of di(2-ethylhexyl)phthalate (DEHP) exposure in humans have not been investigated. And the influences of maternal prenatal DEHP exposure on birth outcomes are not well-known. We aimed to estimate prenatal DEHP exposure in maternal blood, and evaluate its relationships to maternal blood triglyceride (TG) and fatty acid (FA) levels and to birth outcomes.

Methods

We studied 318 mother–newborn pairs residing in Sapporo, Japan. Blood was taken one time during pregnancy for each mother. Maternal and infant characteristics were obtained from medical records and questionnaire survey. We measured DEHP metabolite, mono(2-ethylhexyl) phthalate (MEHP), along with TG and 9 FAs using maternal blood, and analyzed associations of MEHP level with maternal blood TG/FA levels and infant birth dimensions.

Results

Maternal blood TG and palmitoleic/oleic acid levels were higher, but stearic/docosahexaenoic acids and MEHP were lower during late pregnancy. Maternal blood MEHP levels inversely correlated with TG and palmitic/palmitoleic/oleic/linoleic/α-linolenic acids. After adjustment for confounders, we found that a tenfold increase in blood MEHP levels correlated with a decrease in TG of 25.1 mg/dl [95 % confidence interval (CI) 4.8–45.3 mg/dl], and similar relations in palmitic (β = −581.8; 95 % CI −906.5, −257.0), oleic (β = −304.2; 95 % CI −518.0, −90.5), linoleic (β = −348.6; 95 % CI −510.6, −186.6), and α-linolenic (β = −6.3; 95 % CI −9.5, −3.0) acids. However, we observed no correlations between maternal blood MEHP levels and infant birth weight, length, chest circumference, or head circumference.

Conclusions

Ambient DEHP exposure during pregnancy inversely correlated with maternal blood TG and 4 FA levels, but not birth outcomes.     

Biochemical Validation of the Older Australian’s Food Frequency Questionnaire Using Carotenoids and Vitamin E

Background: Validation of a food frequency questionnaire (FFQ) is important, as inaccurate and imprecise information may affect the association between dietary exposure and health outcomes. Objective: This study assessed the validity of the Older Australian’s FFQ against plasma carotenoids and Vitamin E. Methods: A random subsample (n = 150) of 2420 participants in the Hunter Community Study, aged 55–85 years, were included. Correlations between crude and energy-adjusted FFQ estimates of carotenoids, Vitamin E, and fruit and vegetables with corresponding biomarkers were determined. Percentages of participants correctly classified in the same quartile, and in the same ± 1 quartile, by the two methods were calculated. Results: Significant correlations (P < 0.05) were observed for α-carotene (r = 0.26–0.28), β-carotene (r = 0.21–0.25), and β-cryptoxanthin (r = 0.21–0.23). Intakes of fruits and vegetables also showed similar correlations with these plasma carotenoids. Lycopene was only significantly correlated with fruit and vegetable intakes (r = 0.19–0.23). Weak correlations were observed for lutein + zeaxanthin (r = 0.12–0.16). For Vitamin E, significant correlation was observed for energy-adjusted FFQ estimate and biomarker (r = 0.20). More than 68% of individuals were correctly classified within the same or adjacent quartile, except for lutein + zeaxanthin. Conclusion: With the exception of lutein + zeaxanthin, the Older Australian’s FFQ provides reasonable rankings for individuals according to their carotenoids, Vitamin E, fruit and vegetable intakes.     

Relation of Maternal Low Birth Weight to Infant Growth Retardation and Prematurity

Objectives: This study sought to determine the relationship between maternal birth weight, infant intrauterine growth retardation, and prematurity. Methods: Stratified and logistic regression analyses were performed on a dataset of computerized Illinois vital records of African American (N = 61,849) and White (N = 203,698) infants born between 1989 and 1991 and their mothers born between 1956 and 1975. Results: Race-specific rates of small-for-gestational age (weight-for-gestational age <10th percentile) and preterm (<37 weeks) infants rose as maternal birth weight declined. The adjusted (controlling for maternal age, education, marital status, parity, prenatal care utilization, and cigarette smoking) odds ratio (95% confidence interval) of small-for-gestational age for maternal low birth weight (<2500 g) among African Americans and Whites were 1.7 (1.1.4–1.9) and 1.8 (1.7–2.0), respectively. The adjusted odds ratio (95% confidence interval) of prematurity for maternal low birth weight (<2500 g) among African Americans and Whites were 1.6 (1.3–1.9) and 1.3 (1.0–1.6), respectively. The racial disparity in the rates of small-for-gestational age and prematurity persisted independent of maternal birth weight: adjusted odds ratio equaled 2.2 (2.1–2.4) and 1.5 (1.4–1.7), respectively. Conclusions: Maternal low birth weight is a risk factor for infant intrauterine growth retardation and prematurity among African Americans independent of maternal risk status during pregnancy; it is a risk factor for infant intrauterine growth retardation among Whites. Maternal low birth weight fails to explain the racial disparity in the rates of small-for-gestational age and premature infants.     

Are Dietary Patterns of Mothers during Pregnancy Related to Children's Weight Status? Evidence from the Lifeways Cross- Generational Cohort Study

Children''s diet patterns are likely to be influenced by their mothers'' diet pattern. The primary objective of this study was to examine whether children''s adiposity could be influenced by diet patterns of mothers during pregnancy. A secondary objective was to study the relative influence of fathers'' and children''s dietary patterns on childhood adiposity. The design was a prospective cross-generational cohort study initiated with 1,124 mothers recruited during pregnancy. Self-reported questionnaires included a food frequency instrument (FFQ) to assess parental intakes during the perinatal period. Child body mass index (BMI) was measured at 5 years and an age-appropriate FFQ was administered. Dietary patterns for each group were identified by principal components analysis. Pearson''s correlation and logistic regression were used to test for associations. Dietary patterns were described for n = 1,042 mothers during pregnancy and n = 331 fathers during the perinatal period. Dietary patterns and BMI data were available for n = 443 children at age 5 years. The diet patterns identified for mothers correlated with the corresponding diet patterns for fathers. The children''s “pasta & vegetable” pattern was positively correlated with “healthy patterns” in mothers (r = 0.195, p < 0.01) and fathers (r = 0.250, p < 0.01). The children''s “junk” food pattern was correlated with the “processed” pattern in mothers (r = 0.245, p < 0.01) and fathers (r = 0.257, p < 0.01). In multivariate logistic regression analysis the upper tertiles of children''s “cereal and juice” [Tertile 2 (T2): OR 0.44, 95% CI (0.22–0.90); T3: 0.41, (0.19–0.85)] and the middle tertile of the “pasta and veg” patterns [T3: 0.37, (0.18–0.75)] were negatively associated with overweight and obesity. The mothers'' processed pattern during pregnancy was positively associated with offspring overweight and obesity [T2: 2.64, (1.28–5.45); T3: 2.03, (0.87–4.73)]. No significant associations were observed for the paternal diet patterns. This analysis shows that the influence of maternal diet pattern on child obesity is apparent early in the lifecourse.     

Associations of Maternal Consumption of Dairy Products during Pregnancy with Perinatal Fatty Acids Profile in the EDEN Cohort Study

Maternal diet is the main source of fatty acids for developing offspring in-utero and in breastfed infants. Dairy products (DP) are important sources of fat in the European population diet. C15:0 and C17:0 fatty acids have been suggested as biomarkers of dairy fat consumption. This study’s aim is to describe the associations between maternal DP (milk included) consumption during pregnancy and C15:0, C17:0 and polyunsaturated fatty acid (PUFA) levels in perinatal biofluids. Study populations were composed of 1763, 1337 and 879 French mothers from the EDEN (“Étude des Déterminants pre- et post-natals de la santé de l’ENfant”) study, with data on maternal and cord red blood cells’ (RBC) membrane and colostrum, respectively. Associations were assessed using linear regression models adjusted for recruitment center, maternal age, healthy dietary pattern or fish consumption. Greater adherence to a ”cheese” consumption pattern was associated with lower linoleic acid level in colostrum and higher C15:0 and C17:0 levels but in a less consistent manner for C17:0 across biofluids. Greater adherence to “semi-skimmed milk, yogurt” and “reduced-fat DP” patterns was related to higher docosahexaenoic acid and total n-3 PUFA levels and lower n-6/n-3 long-chain PUFA ratio in maternal and cord RBC. Our results suggest that C15:0 could be a good biomarker of maternal dairy fat consumption in perinatal biofluids.     

Maternal Consumption of Non-Staple Food in the First Trimester and Risk of Neural Tube Defects in Offspring

To study the associations between maternal consumption of non-staple food in the first trimester and risk of neural tube defects (NTDs) in offspring. Data collected from a hospital-based case-control study conducted between 2006 and 2008 in Shandong/Shanxi provinces including 459 mothers with NTDs-affected births and 459 mothers without NTDs-affected births. Logistic regression models were used to examine the associations between maternal consumption of non-staple food in the first trimester and risk of NTDs in offspring. The effects were evaluated by odds ratio (OR) and 95% confidence intervals (95% CIs) with SAS9.1.3.software. Maternal consumption of milk, fresh fruits and nuts in the first trimester were protective factors for total NTDs. Compared with consumption frequency of ˂1 meal/week, the ORs for milk consumption frequency of 1–2, 3–6, ≥7 meals/week were 0.50 (95% CI: 0.28–0.88), 0.56 (0.32–0.99), and 0.59 (0.38–0.90), respectively; the ORs for fresh fruits consumption frequency of 1–2, 3–6, ≥7 meals/week were 0.29 (95% CI: 0.12–0.72), 0.22 (0.09–0.53), and 0.32 (0.14–0.71), respectively; the ORs for nuts consumption frequency of 1–2, 3–6, ≥7 meals/week were 0.60 (95% CI: 0.38–0.94), 0.49 (0.31–0.79), and 0.63 (0.36–1.08), respectively. Different effects of above factors on NTDs were found for subtypes of anencephaly and spina bifida. Maternal non-staple food consumption of milk, fresh fruits and nuts in the first trimester was associated with reducing NTDs risk in offspring.     

Early childhood risk factors associated with type 1 diabetes – is gender important?

Background: The incidence of childhood diabetes is increasing in Denmark as in the rest of the world. The aim of this investigation was to study intrauterine and early childhood risk factors for insulin dependent diabetes mellitus, and to evaluate gender differences in the effect of these. Methods/material: A number of 602 diabetic cases aged 0–14 years diagnosed 1996–1999 were identified from the Danish register of childhood diabetes. A total of 1490 non-diabetic healthy children matched by gender and date of birth were randomly selected from the Danish population register. In addition a combination of national register data and questionnaire data was used. Results: High parental age, neonatal infections and pre-eclampsia were associated with type 1 diabetes in boys, whereas being preterm was associated with an increased risk in girls. An increased risk was associated with a family history of diabetes and amniocentesis, while a decreased risk was associated with increasing birth order and maternal smoking. In a multiple logistic regression analysis, the following risk factors were significantly associated with case-control status: maternal smoking (OR: 0.6(0.4–0.9)), neonatal infection in boys (OR: 5.5(1.4–21.8)), neonatal infection in girls (OR: 0.6(0.1–3.0)), amniocentesis (OR: 1.6(1.0–2.6)), pre-school siblings (OR: 0.8(0.6–1.0)), introduction of cow’s milk after the age of 3 months (OR: 0.7(0.4–0.9)) and a 1st degree family member with diabetes (OR: 9.1(95 CI:5.2–16)). Conclusion: The study showed associations between several risk factors and childhood diabetes, for some risk factors the odds ratio in boys were different from the odds ratio in girls.