Nutrient insult in early pregnancy

Nutrient insults in early pregnancy, such as nutrient deprivation during famines, are often associated with an unfavourable outcome. Suboptimal nutrition in the early stage of gestation has been linked to a number of adverse effects on fetal growth and development. Historically, nausea and vomiting in pregnancy (NVP) was an important contributor to pregnancy-related mortality; indeed, Charlotte Bronte died from starvation and dehydration after suffering very severe NVP 4 months into her first pregnancy (Gaskell, 1858). Although NVP seldom now progresses to be life-threatening, it affects the majority of pregnant women, and potentially presents a challenge to nutrient intake in the most vulnerable period of development. Symptoms range from mild (nausea only) to severe (a level of vomiting that restricts nutrient intake and ultimately threatens metabolic and electrolyte balance). Although NVP has been documented for thousands of years, its cause has not yet been satisfactorily elucidated, but seems to be related to endocrinological changes. Pregnant women also frequently report dietary cravings and aversions during pregnancy which can be linked to both the incidence and severity of NVP. Paradoxically, NVP appears to be positively associated with a favourable outcome of pregnancy, including increased birth weight and gestational age. The mechanisms by which NVP favours the outcome of pregnancy are not known. They may be related to women increasing their nutrient intake to alleviate symptoms, improving the quality of their diet or reducing energy expenditure. Alternatively, adaptation to a reduced nutrient intake might stimulate the expression of growth factors and affect placentation or metabolism, thus favouring fetal growth when NVP resolves.     

Nausea and vomiting in late pregnancy

Nausea and vomiting in late pregnancy is a little-studied phenomenon. In this study of 116 midwestern women, 32% of the women had nausea and vomiting after 20 weeks gestation. The purpose of this study was to examine demographic, anthropometric, maternal health factors, and pregnancy outcomes in women who had late nausea and vomiting in pregnancy (NVP) and those that did not. Women who experienced late NVP had significantly higher parity, were older, gained less weight in pregnancy, and slept fewer hours per night than women who did not experience late NVP. By being aware of prenatal factors that may affect nausea and vomiting in late pregnancy, health care providers will be better able to maximize the quality of life for these women.     

Nausea and Vomiting in Late Pregnancy

Nausea and vomiting in late pregnancy is a little-studied phenomenon. In this study of 116 midwestern women, 32% of the women had nausea and vomiting after 20 weeks gestation. The purpose of this study was to examine demographic, anthropometric, maternal health factors, and pregnancy outcomes in women who had late nausea and vomiting in pregnancy (NVP) and those that did not. Women who experienced late NVP had significantly higher parity, were older, gained less weight in pregnancy, and slept fewer hours per night than women who did not experience late NVP. By being aware of prenatal factors that may affect nausea and vomiting in late pregnancy, health care providers will be better able to maximize the quality of life for these women.     

Nausea and vomiting during teenage pregnancy: Effects on birth weight

Early pregnancy nausea and vomiting (NVP) has been reported to be a favorable risk factor for pregnancy outcome. We studied nausea and vomiting in 239 randomly selected teens from a geographic-based cohort of nearly 2800 pregnant adolescents from Camden County, New Jersey. Early (first trimester) NVP was reported by 20.9%, and an additional 17.6% reported that their NVP persisted into the second or third trimester (late NVP). After adjusting for confounding factors (length of gestation, maternal age, ethnicity, prepregnant body mass index, weight gain, and smoking), we found that early NVP alone did not significantly effect birth weight. Late NVP, however, was associated with a significant decrement in birth weight (−256.5 ± 108.0 g, p < 0.05). Further, the effect of late NVP was greater when maternal weight gain was inadequate. Teenagers with continued NVP are more likely to be nutritionally stressed during the course of their pregnancy.     

Evolution of Lipid Profile,Liver Function,and Pattern of Plasma Fatty Acids According to the Type of Lipid Emulsion Administered in Parenteral Nutrition in the Early Postoperative Period After Digestive Surgery

Background: The metabolic effects of intravenous lipid emulsions (ILEs) used in parenteral nutrition (PN) depend on their fatty acid composition. Methods: Subjects in this prospective and randomized double‐blind study were 28 adult patients post digestive surgery. PN was started after surgery and lasts for 5 days. Randomly, patients receive 1 of 4 different ILEs: medium‐chain triglycerides/long‐chain triglycerides (soybean oil; MCT/LCT), olive/soybean oil (oleic), long‐chain triglycerides (soybean oil; LCT), and structured lipid. On days 0 and 6, serum liver function tests were analyzed for cholesterol, triglycerides, lipoproteins, and serum fatty acids. Results: No differences were found in the 4 groups according to their gender, age, body mass index, diagnosis, baseline white blood cell, C‐reactive protein, glucose levels, and other study parameters. Differential significant changes were not observed in any of the hepatic function parameters or plasmatic lipid levels between the groups. A significant decrease was observed in cis monounsaturated fatty acids (MUFAs) and a significant increase in ω‐6 polyunsaturated fatty acids (PUFAs) andω ‐3 PUFA values in LCT and structured groups compared with MCT/LCT and oleic groups, and a tendency for a decrease in trans fatty acids in the oleic and structured groups was found. Conclusions: All ILEs administered were safe and well tolerated. The changes in serum fatty acids reflected the pattern of fatty acids administered with different ILEs. The group receiving the olive oil emulsion achieved a fatty acid composition of serum lipids that could offer major therapeutic or biological advantages.     

Diets rich in saturated and polyunsaturated fatty acids: metabolic shifting and cardiac health

OBJECTIVE: The aim of this study was to determine the effects of diets rich in saturated and polyunsaturated fatty acids on metabolic pathways and the relation of metabolic shifting to oxidative stress in cardiac tissue. METHODS: Male Wistar rats (age, 60 d; n = 10) were fed with a control low-fat diet, a diet rich in saturated fatty acids (SFAs), or a diet rich in polyunsaturated fatty acids (PUFAs). After 5 wk of treatment, sera were used for protein and lipid determinations. Protein, glycogen, triacylglycerol, lactate dehydrogenase, citrate synthase, beta-hydroxyacyl coenzyme-A dehydrogenase, catalase, glutathione peroxidase, superoxide dismutase, lipoperoxide, and lipid hydroperoxide were measured in cardiac tissue. RESULTS: The SFA group had higher triacylglycerol, cholesterol, low-density lipoprotein cholesterol, and atherogenic index (ratio of cholesterol to high-density lipoprotein) than did the PUFA and control groups. The PUFA group had low serum cholesterol, triacylglycerol, and low-density lipoprotein cholesterol as compared with the SFA group. SFA increased myocardial lipid hydroperoxide and diminished glutathione peroxidase. Despite the beneficial effects on serum lipids, the PUFA diet led to the highest levels of myocardial lipoperoxide and lipid hydroperoxide and diminished superoxide dismutase and catalase activities. The PUFA effects were related to increased feed efficiency, increased susceptibility to lipoperoxidation, and metabolic shifting in cardiac tissue. PUFA elevated triacylglycerol levels and decreased myocardial glycogen concentrations. The ratios of lactate dehydrogenase to citrate synthase and beta-hydroxyacyl coenzyme-A dehydrogenase to citrate synthase were increased, indicating myocardial reduction of tricarboxylic acid cycle. CONCLUSIONS: PUFAs have been recommended as a therapeutic measure in preventive medicine to lower serum cholesterol, but PUFAs increased oxidative stress in the heart by providing cardiac susceptibility to lipoperoxidation and shifting the metabolic pathway for energy production. The control diet, which was much lower in calories and fat, produced better overall clinical outcomes, better fat profiles, and less oxidative stress than did the diets rich in fatty acids.     

Appetite sensations and nausea and vomiting in pregnancy: an overview of the explanations

We review information about the potential mechanisms underlying nausea and vomiting in pregnancy (NVP), food cravings, and/or aversions in pregnancy. In addition to providing overviews about genetic predispositions and hormonal associations with appetite sensations and NVP, we review two functional explanations: the "maternal and embryo protection" and the "placental growth and development" hypotheses. We conclude with a discussion about the kinds of data that would enable us to better evaluate the relative advantages and disadvantages of NVP across disparate resource and ecological conditions.     

Food aversions and cravings during early pregnancy: association with nausea and vomiting

The prospective cohort study examined whether Ecuadorian women with early pregnancy nausea and vomiting (NVP) are more likely to develop food aversions and cravings, and if so, whether the specific foods identified as aversive or craved are the same as those predicted by the popular maternal-embryo protection hypothesis (MEPH). Consistent with MEPH predictions, women with NVP were more likely to report increased odor sensitivity and aversions for some predicted "toxic" foods and more likely to crave fruits. However, other hypothesis predictions were not supported. The relationship of food aversions and cravings with NVP appears more complicated than that explained by the MEPH.     

Adipose tissue fatty acid composition and its relations to diet and plasma lipid concentrations in hemodialysis patients

Adipose tissue fatty acid composition, serum lipid profile, and dietary intake of 37 patients on maintenance hemodialysis were studied. In August 1982, 1984, and 1986, analyses were carried out in 15 normotriglyceridemic (NTG) and 22 hypertriglyceridemic (HTG; type IV hyperlipidemia) patients. No correlations were found between dietary intake of polyunsaturated fatty acids (PUFAs), ratio of polyunsaturated to saturated fatty acids (P-S ratio), and carbohydrate content on the one hand and serum lipid concentrations on the other in the two groups. Adipose tissue linolenic acid correlated negatively with serum cholesterol in both groups. Strong correlations were found between dietary intake of PUFAs and adipose tissue linoleic acid content, between PUFAs and the double-bond index, between P-S ratio and adipose tissue linoleic acid content, and between P-S ratio and the double-bond index. No significant differences in dietary intake or adipose tissue fatty acid composition were observed between NTG and HTG patients. Thus, no evidence was found for exogenous dietary influences on serum lipid concentrations. The adipose tissue linoleic acid content did reflect the dietary intake of PUFAs.     

Phyllis Stern: Mentor,Friend, and Collaborator

Twenty‐seven pregnant women (5–22 weeks gestation) participated in a study to determine the efficacy of SeaBands for the control of nausea and vomiting in pregnancy (NVP). NVP was reduced by 50% for these women. SeaBands are more effective if applied early in the symptom experience; less if applied late. SeaBands have considerable potential for a drug‐free and noninvasive approach to control NVP.     

Serum Omega-6 Polyunsaturated Fatty Acids and the Metabolic Syndrome: A Longitudinal Population-based Cohort Study

The serum fatty acid composition reflects the dietary fatty acid composition from the past few days to several weeks. However, the role of serum omega-3 (from fish and fish oils) and omega-6 (from vegetable oils) polyunsaturated fatty acids (PUFAs) in the course of metabolic syndrome is poorly understood. At the Primary Health Care Unit in Pieks?m?ki, Finland, all subjects born in 1942, 1947, 1952, 1957, and 1962 (n = 1,294) were invited for health checkups in 1997-1998 and 2003-2004. Metabolic syndrome was defined by using the new, harmonized criteria. The serum omega-3 PUFAs, omega-6 PUFAs, and total fatty acids were analyzed by proton nuclear magnetic resonance spectroscopy. Altogether, data from both checkups were available for 665 subjects. After adjustment for age, sex, and baseline body mass index, the incidence of metabolic syndrome between the 2 checkups with a 6.4-year follow-up was inversely associated (P < 0.001) with the increased relative proportion of omega-6 PUFAs in serum lipids. Further adjustment for body mass index change, lipid medication, smoking, alcohol intake, and physical activity conveyed similar results. The authors did not find any significant associations between omega-3 PUFAs and the incidence of metabolic syndrome. Therefore, their results suggest that the change in the relative proportion of omega-6 PUFAs in serum lipids is inversely related to the incidence of metabolic syndrome.     

Dietary and clinical impacts of nausea and vomiting during pregnancy

Background: Nutrition during pregnancy is important for the health of both mother and infant. Nausea and vomiting in pregnancy (NVP) may alter food intake but the dietary and clinical consequences of NVP are poorly understood. The present study aimed to identify the differences in dietary intakes and clinical characteristics of women with NVP compared with those without. Methods: Women with (n = 134) or without (n = 53) NVP were studied in each trimester of pregnancy. The babies were studied at birth, and at 1 and 6 months. The presence of nausea and vomiting was established by interviews using standard questions. Daily intakes of foods and nutrients were assessed from 3‐day food diaries. Weight gain during pregnancy and weights and lengths of the infants at birth and at 1 and 6 months of age were recorded. Results: In the first trimester, intake of meat products and thus protein in women with NVP was lower both quantitatively (P = 0.007) and as a proportion of energy (16.4E% [interquartile range (IQR) 14.9–18.4]) compared to non‐NVP [18.3E% (IQR 16.3–19.8), P = 0.003]. The proportional intakes of carbohydrates were higher in NVP subjects [50.1E% (IQR 46.7–53.6)] than in non‐NVP [46.8E% (IQR 43.6–51.9), P = 0.008]. Dietary and total intakes of vitamin B₁₂, total intake of magnesium and dietary intake of zinc were lower in women with NVP. Changes in diet remained throughout pregnancy. Women with NVP had shorter pregnancies [39.9 (95% CI 39.6–40.1)] compared with those without [40.4 (95% CI 40.1–40.8) weeks, P = 0.018], but neither pregnancy weight gain nor infants’ weight and length differed. Conclusions: Nausea and vomiting in pregnancy modified dietary intake and has potential clinical impacts as suggested by the altered pregnancy duration. In view of the programming effect of early nutrition, these alterations may carry long‐term health consequences.     

Polyunsaturated fatty acid intake is adversely related to liver function in HIV-infected subjects: the THUSA study

BACKGROUND: Dietary fat intake in the South African population is increasing. This population also has a high prevalence of HIV infection. However, information about metabolic effects of dietary fatty acids on HIV-infected subjects is lacking. OBJECTIVE: Our objective was to investigate the relation between dietary fatty acid intake and liver function in HIV-infected compared with HIV-uninfected subjects. DESIGN: This cross-sectional epidemiologic survey included a representative sample of 1854 apparently healthy black volunteers aged > or =15 y, who were recruited from 37 randomly selected sites throughout the North West province of South Africa. Data from 216 asymptomatic HIV-infected and 1604 HIV-uninfected subjects were used. RESULTS: Intakes of polyunsaturated fatty acids (PUFAs), linoleic acid (n-6), and the ratio of PUFAs to saturated fatty acids (SFAs) were positively associated with all the liver enzymes measured in HIV-infected subjects (R = 0.16-0.65). Most of these R values differed significantly from the R values for HIV-uninfected subjects. No associations were seen between liver enzymes and intakes of SFAs and monounsaturated fatty acids. Vitamin E intake was positively associated with serum gamma-glutamyl transpeptidase (R = 0.23), alanine aminotransferase (R = 0.37), and aspartate aminotransferase (R = 0.58) in HIV-infected subjects; these correlations differed significantly from those of the HIV-uninfected subjects because PUFA sources are the main carriers of vitamin E. CONCLUSIONS: The results suggest that n-6 PUFA intakes may be related to liver damage in these HIV-infected asymptomatic subjects. The reasons or mechanisms responsible are not clear, and further research is necessary to determine the optimal safe amounts for intake of n-6 PUFAs by HIV-infected subjects, especially in countries with traditionally high intakes of n-6 PUFA-rich vegetable oils.     

A carbohydrate-rich diet not only leads to incorporation of medium-chain fatty acids (6:0-14:0) in milk triglycerides but also in each milk-phospholipid subclass

We isolated phospholipid (PL) subclasses from milk of women in Dominica and Belize. Fatty acid (FA) compositions of PLs and total lipids were determined. In the total-lipid fraction Dominican milk showed higher relative amounts of medium-chain saturated fatty acids (MC-SAFAs; 6:0-14:0) and 22:6n-3 and lower amounts of long-chain saturated fatty acids (LC-SAFAs) and monounsaturated fatty acids (MUFAs). There was a positive relationship between the MC-SAFA content in total lipids and total PLs. Incorporation of MC-SAFAs in PLs occurred at the expense of LC-SAFAs, MUFAs, polyunsaturated fatty acids (PUFAs), and long-chain PUFAs with greater than or equal to 20 carbon atoms (LC-PUFAs greater than or equal to C20). Previous studies from Western countries revealed low amounts of MCSAFAs and high amounts of PUFAs and LC-PUFAs greater than or equal to C20 in milk PLs. Our data show that carbohydrate-rich diets give rise to incorporation of MC-SAFAs in PLs at the expense of PUFAs and LC-PUFAs greater than or equal to C20. The data are discussed in relation to the presumed origin of fat-globule membrane phospholipids.     

外源性脂肪酸对结肠癌细胞生长的影响及其可能机制

目的：探讨八种外源性脂肪酸对人结肠癌细胞生长的影响及其作用机制。方法：体外实验中应用MTT法观察外源性脂肪酸对细胞生长的影响，并对细胞脂质过氧化反应产物丙二醛含量进行了测定。结果：多不饱和脂肪酸可抑制结肠癌细胞生长，饱和及单不饱和脂肪酸作用不明显，八种脂肪酸对正常成纤维细胞没有明显抑制作用。多不饱和脂肪酸可引起细胞内丙二醛含量升高。结论：多不饱和脂肪酸可选择性抑制肿瘤细胞生长，脂质过氧化反应增强，可能是其主要作用机制。     

Proportions of Polyunsaturated Fatty Acids in Umbilical Cord Blood at Birth Are Related to Atopic Eczema Development in the First Year of Life

Atopic eczema, the most common atopic disease in infants, may pave the way for sensitization and allergy later in childhood. Fatty acids have immune-regulating properties and may regulate skin permeability. Here we examine whether the proportions of fatty acids among the infant and maternal plasma phospholipids at birth were associated with maternal dietary intake during pregnancy and development of atopic eczema during the first year of age in the Nutritional impact on Immunological maturation during Childhood in relation to the Environment (NICE) birth cohort. Dietary data were collected with a semi-quantitative food frequency questionnaire, fatty acids were measured with GC-MS and atopic eczema was diagnosed by a pediatric allergologist at 12 months of age. We found that higher proportions of n-6 PUFAs (including arachidonic acid) but lower proportions of n-3 PUFAs (including DPA) in the infant’s phospholipids at birth were associated with an increased risk of atopic eczema at 12 months of age. The n-6 and n-3 PUFAs were related to maternal intake of meat and fish, respectively. Our results suggest that prenatal exposure to unsaturated fatty acids is associated with eczema development in the infant. Maternal diet during pregnancy may partly explain the fatty acid profiles in utero.     

Women's experiences with a pregnancy complication: causal explanations of hyperemesis gravidarum

There is a multiplicity of proposed causes, yet a scarcity of research regarding the pregnancy complication, hyperemesis gravidarum (HG), severe nausea and vomiting. This is not unlike other female medical conditions that have been underinvestigated, and perhaps as a result, erroneous assumptions about them persist. This is a report of qualitative findings from a larger study that investigated, in part, illness perspectives of 96 women with HG. Results reveal women view HG as biologically determined and that it has substantial impact on their daily functioning. The study challenges commonly held notions that HG is a psychosomatic disorder.     

Validation of a food frequency questionnaire for Japanese pregnant women with and without nausea and vomiting in early pregnancy

Background

No previous study has shown the validity of a food frequency questionnaire (FFQ) in early pregnancy with consideration of nausea and vomiting during pregnancy (NVP). The aim of this study was to evaluate the validity of a FFQ in early pregnancy for Japanese pregnant women.

二十碳五烯酸改变JurkatT细胞膜脂肪微区域脂肪环境的研究

目的:研究二十碳五烯酸(EPA)处理后T细胞膜脂肪微区域中脂肪酸组成改变及其对磷脂分子中脂肪酰基取代基团的作用。方法:用不连续蔗糖密度梯度超速离心法分离T细胞膜脂肪微区域,然后用气相色谱分析细胞膜亚区域中脂肪酸组成,高效液相质谱联用测定膜脂肪微区域磷脂分子脂肪酸酰基取代基团的构成。结果:EPA处理使T细胞脂肪微区域中多不饱和脂肪酸(PUFAs),n-3PUFAs和n-3PUFAs/n-6PUFAs的比值升高;磷脂分子中除了鞘磷脂以外,其他的磷脂分子如磷脂酰胆碱、磷脂酰乙醇胺、磷脂酰丝氨酸、磷脂酰肌醇分子中一些脂肪酰取代基团有显著改变。结论:EPA处理明显改变T细胞膜脂肪微区域和可溶膜组分中脂肪酸的组成,改变磷脂分子脂肪酰基取代基团的构成,从而改变细胞膜脂肪微区域的脂肪环境。