Dietary Acrylamide Intake during Pregnancy and Fetal Growth—Results from the Norwegian Mother and Child Cohort Study (MoBa)

Background: Acrylamide has shown developmental and reproductive toxicity in animals, as well as neurotoxic effects in humans with occupational exposures. Because it is widespread in food and can pass through the human placenta, concerns have been raised about potential developmental effects of dietary exposures in humans.Objectives: We assessed associations of prenatal exposure to dietary acrylamide with small for gestational age (SGA) and birth weight.Methods: This study included 50,651 women in the Norwegian Mother and Child Cohort Study (MoBa). Acrylamide exposure assessment was based on intake estimates obtained from a food frequency questionnaire (FFQ), which were compared with hemoglobin (Hb) adduct measurements reflecting acrylamide exposure in a subset of samples (n = 79). Data on infant birth weight and gestational age were obtained from the Medical Birth Registry of Norway. Multivariable regression was used to estimate associations between prenatal acrylamide and birth outcomes.Results: Acrylamide intake during pregnancy was negatively associated with fetal growth. When women in the highest quartile of acrylamide intake were compared with women in the lowest quartile, the multivariable-adjusted odds ratio (OR) for SGA was 1.11 (95% CI: 1.02, 1.21) and the coefficient for birth weight was –25.7 g (95% CI: –35.9, –15.4). Results were similar after excluding mothers who smoked during pregnancy. Maternal acrylamide– and glycidamide–Hb adduct levels were correlated with estimated dietary acrylamide intakes (Spearman correlations = 0.24; 95% CI: 0.02, 0.44; and 0.48; 95% CI: 0.29, 0.63, respectively).Conclusions: Lowering dietary acrylamide intake during pregnancy may improve fetal growth.     

Are Current Dietary Habits in Mediterranean Islands a Reflection of the Past? Results from the MEDIS Study

In the 1960s, the recorded dietary pattern of Southern European populations was typical of the traditional Mediterranean diet. However, diets have been rapidly changing. The aim of the current work was to examine the extent by which present food habits of inhabitants residing in various Mediterranean islands uphold past dietary traditions of the Mediterranean diet. A population-based, multi-stage sampling method was used to voluntarily enroll 876 men and 936 women (aged > 65 years) from 12 Mediterranean islands. Demographic, behavioral, clinical, and dietary data were collected. Principal component analysis derived fruits, vegetables, and greens as part of the main dietary pattern across most Mediterranean regions. Surprisingly, Crete had the highest frequency of fast-food and sweets consumption. Malta had the lowest frequency of fish and vegetable consumption and the lowest MedDietScore. As Mediterranean populations gradually move away from traditional dietary patterns, public-health efforts to preserve these diets are needed.     

Changes in Dietary Intake in Pregnant Women from Periconception to Pregnancy in the Japan Environment and Children’s Study: A Nationwide Japanese Birth Cohort Study

Maternal and Child Health Journal - Nutritional requirements increase during pregnancy. However, relatively few studies have examined longitudinal changes in dietary intake from periconception to...     

Is there a fetal origin of depression? Evidence from the Mater University Study of Pregnancy and its outcomes

It is unclear whether there is a fetal origin of adult depression. In particular, previous studies have been unable to adjust for the potential effect of maternal depression during pregnancy on any association. The association of birth weight with adult symptoms of depression was examined in an Australian prospective birth cohort, the Mater University Study of Pregnancy and its outcomes. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale among 3,719 participants at the 21-year follow-up in 2002-2005. In multivariable analyses, there were a weak inverse association between birth weight and symptoms of depression in the whole cohort and some evidence of sex differences in this association. Among females, there was a graded inverse association: In the fully adjusted model, the odds ratio for a high level of depressive symptoms for a 1-standard deviation increase in birth weight (gestational age-standardized z score) was 0.82 (95% confidence interval: 0.73, 0.92). Among males, there was no association (with sex in all models: p(interaction) < 0.004). Study results provide some support for a fetal origin of adult depression and suggest that the association is not explained by maternal mental health characteristics during pregnancy. Further research is needed to better understand the mechanisms underlying the association.     

Are Family Meal Patterns Associated with Overall Diet Quality during the Transition from Early to Middle Adolescence?

ObjectiveTo examine longitudinal associations of participation in regular family meals (≥ 5 meals/week) with eating habits and dietary intake during adolescence.DesignPopulation-based, longitudinal study (Project EAT: Eating Among Teens). Surveys were completed in Minnesota classrooms at Time 1 (1998-1999) and by mail at Time 2 (2003-2004).SettingBaseline surveys were completed in Minneapolis/St. Paul, Minnesota, schools and by mail at follow-up.Participants677 adolescents (303 males and 374 females) who were in middle school at Time 1 (mean age = 12.8 ± 0.74 years) and high school at Time 2 (mean age = 17.2 ± 0.59 years).Main Outcome MeasuresDietary intake, frequency of meals, and fast-food intake patterns.AnalysisGeneralized linear modeling stratified by gender and adjusted for race/ethnicity, socioeconomic status, and the Time 1 outcome.ResultsRegular family meals were positively associated with Time 2 frequency of breakfast, lunch, and dinner meals for males and breakfast and dinner meals for females. Among males, regular family meals were negatively associated with Time 2 fast-food intake. Regular family meals were also positively associated with Time 2 mean daily intakes of vegetables, calcium-rich food, fiber, calcium, magnesium, potassium, iron, zinc, folate, and vitamins A and B₆ among both genders.Conclusions and ImplicationsRegular family meals during early adolescence may contribute to the formation of healthful eating habits 5 years later. Parents should be made aware of the importance of shared mealtime experiences.     

Implications of Subdividing Marital Status: Are Unmarried Mothers with Partners Different from Unmarried Mothers without Partners? An Exploratory Analysis

Objective To determine the analytic advantages obtained from separating unmarried mothers with partners from unmarried mothers without partners when assessing risk of adverse birth outcomes. Methods Data were obtained from Listening to Mothers II, a national survey of women’s childbearing experiences. Marital status was asked with three choices: married (71%), unmarried with partner (24%), and unmarried without partner (5%). Demographic differences between the three marital status groups were compared using χ ² tests. Multiple logistic regressions, controlling for age, education, race/ethnicity, and parity, tested for associations between birth outcomes (birth weight and gestational age) and marital status. Results Unmarried mothers with partners and without partners were similar in age, education, and parity. Unmarried mothers without partners delivered by cesarean more often (39%) and were more likely to have a doctor as birth attendant (99%) than unmarried mothers with partners. The multiple logistic regressions indicated that, compared to married mothers, unmarried mothers with partners had the same risk of premature infants, while unmarried mothers without partners had greater risk. Unmarried first-time mothers with partners had over twice the risk of premature infants (OR = 2.71; 1.07–6.85) and unmarried mothers without partners had over 5 times the risk (OR = 5.64; 1.68–18.92) when compared to married first-time mothers. Conclusions Mothers without partners were at higher risk than unmarried mothers with partners indicating a gradient of risk. Future data collection on marital status should consider distinguishing between unmarried mothers with and without partners.     

Can We Distinguish Age-Related Frailty from Frailty Related to Diseases? Data from the MAPT Study

The journal of nutrition, health & aging - No study has tried to distinguish subjects that become frail due to diseases (frailty related to diseases) or in the absence of specific medical...     

Employment Hardships and Single Mothers’ Self-Rated Health: Evidence from the Panel Study of Income Dynamics

Using a national sample of single mothers from the 2007 and 2009 waves of the Panel Study of Income Dynamics, this study examined the effects of multiple employment statuses on the selfrated health of single mothers during the recent economic recession. Unlike other studies, the current study minimized selection bias by controlling for prior self-rated health, in addition to other predisposing factors, enabling factors, and need factors. We found that underemployment, but not unemployment, is associated with lower levels of self-rated health of single mothers. Results further indicate that the 25–39 age range (compared to the 18–24 age range), lower family income, prior lower self-rated health, more chronic diseases, and binge drinking place single mothers at an increased risk of lower levels of self-rated health. In contrast, strength-building physical activity is significantly associated with higher levels of self-rated health. Implications for health care policy and social work practice are drawn from the results.     

Are the EQ-5D-3L and the ICECAP-O responsive among older adults with impaired mobility? Evidence from the Vancouver Falls Prevention Cohort Study

Purpose

Preference-based generic measures are gaining increased use in mobility research to assess health-related quality of life and wellbeing. Hence, we examined the responsiveness of these two measures among individuals at risk of mobility impairment among adults aged ≥70 years.

Methods

We conducted a 12-month prospective cohort study of community-dwelling older adults (n = 288 to n = 341 depending on analysis) who were seen at the Vancouver Falls Prevention Clinic who had a history of at least one fall in the previous 12 months. We compared the responsiveness of the EuroQol-5 Domain-3 Level (EQ-5D-3L) and the index of capability for older adults (ICECAP-O) by examining changes in these measures over time (i.e., over 6 and 12 months) and by examining whether their changes varied as a function of having experienced 2 or more falls over 6 and 12 months.

Results

Only the ICECAP-O showed a significant change over time from baseline through 12 months; however, neither measure showed change that exceeded the standard error of the mean. Both measures were responsive to falls that occurred during the first 6 months of the study (p < .05). These effects appeared to be amplified among individuals identified as having mild cognitive impairment (MCI) at baseline (p < .01). Additionally, the EQ-5D-3L was responsive among fallers who did not have MCI as well as individuals with MCI who did not fall (p < .05).

Conclusion

This study provides initial evidence suggesting that the EQ-5D-3L is generally more responsive, particularly during the first 6 months of falls tracking among older adults at risk of future mobility impairment.

     

Evidence That Changes in Community Food Environments Lead to Changes in Children’s Weight: Results from a Longitudinal Prospective Cohort Study

BackgroundStrategies to improve the community food environment have been recommended for addressing childhood obesity, but evidence substantiating their effectiveness is limited.ObjectiveOur aim was to examine the impact of changes in availability of key features of the community food environment, such as supermarkets, small grocery stores, convenience stores, upgraded convenience stores, pharmacies, and limited service restaurants, on changes in children’s body mass index z scores (zBMIs).DesignWe conducted a longitudinal cohort study.Participants/settingTwo cohorts of 3- to 15-year-old children living in 4 low-income New Jersey cities were followed during 2- to 5-year periods from 2009 through 2017. Data on weight status were collected at 2 time points (T1 and T2) from each cohort; data on food outlets in the 4 cities and within a 1-mile buffer around each city were collected multiple times between T1 and T2.Main outcome measuresWe measured change in children’s zBMIs between T1 and T2.Statistical analysisChanges in the food environment were conceptualized as exposure to changes in counts of food outlets across varying proximities (0.25 mile, 0.5 mile, and 1.0 mile) around a child’s home, over different lengths of time a child was exposed to these changes before T2 (12 months, 18 months, and 24 months). Multivariate models examined patterns in relationships between changes in zBMI and changes in the food environment.ResultsIncreased zBMIs were observed in children with greater exposure to convenience stores over time, with a consistent pattern of significant associations across varying proximities and lengths of exposure. For example, exposure to an additional convenience store over 24 months within 1 mile of a child’s home resulted in 11.7% higher odds (P = 0.007) of a child being in a higher zBMI change category at T2. Lower zBMIs were observed in children with increased exposure to small grocery stores selling an array of healthy items, with exposure to an additional small grocery store within 1 mile over 24 months, resulting in 37.3% lower odds (P < 0.05) of being in a higher zBMI change category at T2. No consistent patterns were observed for changes in exposure to supermarkets, limited service restaurants, or pharmacies.ConclusionsIncreased availability of small grocery stores near children’s homes may improve children’s weight status, whereas increased availability of convenience stores is likely to be detrimental.     

Are Four Simple Questions Able to Predict Weight Loss in Outpatients With Metastatic Cancer? A Prospective Cohort Study Assessing the Simplified Nutritional Appetite Questionnaire

Background: Severe weight loss is directly responsible for up to one-fifth of all cancer deaths and has a major impact on quality of life. The simplified nutritional appetite questionnaire (SNAQ) was validated to predict weight loss within 6 mo in community-dwelling adults and nursing home residents. Methods: We prospectively assessed the SNAQ in 133 palliative cancer outpatients. The SNAQ predictions were validated after 3 and 6 mo with the observed weight change. In addition, the treating oncologists gave their predictions concerning future weight loss according to their clinical judgment. Results: A significant weight loss of 5% of the original body weight within 6 mo occurred in 20 (24%) of the 133 patients. The SNAQ predicted weight loss with a sensitivity of 0.38 and a specificity of 0.66 (P-value 0.81). The treating oncologists predicted weight loss with a sensitivity of 0.67 and a specificity of 0.7 (P-value 0.002). Conclusion: The SNAQ does not represent a useful tool to predict impending weight loss in palliative cancer outpatients. The predictions of the treating oncologists were more reliable than those from the SNAQ, but remain poor. Better methods to predict weight loss in this patient group are therefore required.     

Are the benefits of newer drugs worth their cost? Evidence from the 1996 MEPS

This study analyzes data on prescribed medicines from the 1996 Medical Expenditure Panel Survey (MEPS) to examine the association between the use of newer medicines and morbidity, mortality, and health spending. We find that people consuming newer drugs were significantly less likely to die by the end of the survey and were significantly less likely to experience work-loss days than were people consuming older drugs. Our most notable finding, however, is that use of newer drugs tends to lower all types of nondrug medical spending, resulting in a substantial net reduction in the total cost of treating a given condition.     

Do positive or negative experiences of social support relate to current and future health? Results from the Doetinchem Cohort Study

Background  

Cross-sectional studies have reported associations between social support and health, but prospective evidence is less conclusive. This study aims to investigate the associations of positive and negative experiences of social support with current and future lifestyle factors, biological risk factors, self-perceived health and mental health over a 10-year period.     

Are the health needs of young people with cerebral palsy met during transition from child to adult health care?

Background

The transition from child to adult health care is a particular challenge for young people with cerebral palsy, who have a range of needs. The measurement of reported needs, and in particular unmet needs, is one means to assess the effectiveness of services.

Methods

We recruited 106 young people with cerebral palsy, before transfer from child services, along with their parents to a 3‐year longitudinal study. Reported needs were measured with an 11‐item questionnaire covering speech, mobility, positioning, equipment, pain, epilepsy, weight, control of movement, bone or joint problems, curvature of the back, and eyesight. Categorical principal component analysis was used to create factor scores for bivariate and regression analyses.

Results

A high level of reported needs was identified particularly for control of movement, mobility, and equipment, but these areas were generally being addressed by services. The highest areas of unmet needs were for management of pain, bone or joint problems, and speech. Analysis of unmet needs yielded two factor scores, daily living health care and medical care. Unmet needs in daily living health care were related to severity of motor impairment and to attending nonspecialist education. Unmet needs tended to increase over time but were not significantly (p > .05) related to whether the young person had transferred from child services.

Conclusions

Reporting of unmet needs can indicate where service development is required, and we have shown that the approach to measurement can be improved. As the number of unmet health needs at the start of transition is considerable, unmet health needs after transition cannot all be attributed to poor transitional health care. The range and continuation of needs of young people with cerebral palsy argue for close liaison between adult services and child services and creation of models of practice to improve coordination.     

Are all contraceptive failures unintended pregnancies? Evidence from the 1995 National Survey of Family Growth

This study examines the alternative implications of the measurements of unintended pregnancy during contraceptive failure in the US. The data from the 1995 National Survey of Family Growth (NSFG) were used to compare levels of unintended pregnancy among contraceptive users based on two definitions: the standard definition based on women's report of contraceptive failure; and the NSFG definition based on pregnancy timing. An attitudinal scale was used to examine women's feeling about their unintended pregnancy. The results of the analysis revealed 68% were unintended pregnancies under the classification of standard definition, while 59% of women with contraceptive failure classified under NSFG definition and reported feeling unhappy or very unhappy about their pregnancy. About 90% of those with contraceptive failure classified as an intended pregnancy reported feeling happy or very happy. Although these results were consistent with one another, it is still unclear why these women feeling happy about their unintended pregnancy are practicing contraception.     

Immune System and Psychological State of Pregnant Women during COVID-19 Pandemic: Are Micronutrients Able to Support Pregnancy?

The immune system is highly dynamic and susceptible to many alterations throughout pregnancy. Since December 2019, a pandemic caused by coronavirus disease 19 (COVID-19) has swept the globe. To contain the spread of COVID-19, immediate measures such as quarantine and isolation were implemented. These containment measures have contributed to exacerbate situations of anxiety and stress, especially in pregnant women, who are already particularly anxious about their condition. Alterations in the psychological state of pregnant women are related to alterations in the immune system, which is more vulnerable under stress. COVID-19 could therefore find fertile soil in these individuals and risk more severe forms. Normally a controlled dietary regimen is followed during pregnancy, but the use of particular vitamins and micronutrients can help counteract depressive-anxiety states and stress, can improve the immune system, and provide an additional weapon in the defense against COVID-19 to bring the pregnancy to fruition. This review aims to gather data on the impact of COVID-19 on the immune system and psychological condition of pregnant women and to assess whether some micronutrients can improve their psychophysical symptoms.