Thursday, September 20, 2012

Pregnant Women Consuming Choline - Nutrient in Eggs and Meat A Key To Healthy Children



Just as women are advised to get plenty of folic acid around the time of conception and throughout early pregnancy, new research suggests another very similar nutrient may one day deserve a spot on the obstetrician’s list of recommendations.

Consuming greater amounts of choline – a nutrient found in eggs and meat – during pregnancy may lower an infant’s vulnerability to stress-related illnesses, such as mental health disturbances, and chronic conditions, like hypertension, later in life.

In an early study in The FASEB Journal, nutrition scientists and obstetricians at Cornell University and the University of Rochester Medical Center found that higher-than-normal amounts of choline in the diet during pregnancy changed epigenetic markers – modifications on our DNA that tell our genes to switch on or off, to go gangbusters or keep a low profile – in the fetus. While epigenetic markers don’t change our genes, they make a permanent imprint by dictating their fate: If a gene is not expressed – turned on – it’s as if it didn’t exist.


The finding became particularly exciting when researchers discovered that the affected markers were those that regulated the hypothalamic-pituitary-adrenal or HPA axis, which controls virtually all hormone activity in the body, including the production of the hormone cortisol that reflects our response to stress and regulates our metabolism, among other things.

More choline in the mother’s diet led to a more stable HPA axis and consequently less cortisol in the fetus. As with many aspects of our health, stability is a very good thing: Past research has shown that early exposure to high levels of cortisol, often a result of a mother’s anxiety or depression, can increase a baby’s lifelong risk of stress-related and metabolic disorders.


Eva K. Pressman, M.D.
“The study is important because it shows that a relatively simple nutrient can have significant effects in prenatal life, and that these effects likely continue to have a long-lasting influence on adult life,” said Eva K. Pressman, M.D., study author and director of the high-risk pregnancy program at the University of Rochester Medical Center. “While our results won’t change practice at this point, the idea that maternal choline intake could essentially change fetal genetic expression into adulthood is quite novel.”

Pressman, who advises pregnant women every day, says choline isn’t something people think a lot about because it is already present in many things we eat and there is usually no concern of choline deficiency. Though much more research has focused on folate – functionally very similar to choline and used to decrease the risk of neural tube defects like spina bifida – a few very compelling studies sparked her interest, including animal studies on the role of choline in mitigating fetal alcohol syndrome and changing outcomes in Down syndrome.

A long-time collaborator with researchers at Cornell, Pressman joined a team led by Marie Caudill, Ph.D., R.D., professor in the Division of Nutritional Sciences at Cornell, in studying 26 pregnant women in their third trimester who were assigned to take 480 mg of choline per day, an amount slightly above the standard recommendation of 450 mg per day, or about double that amount, 930 mg per day. The choline was derived from the diet and from supplements and was consumed up until delivery.

The team found that higher maternal choline intake led to a greater amount of DNA methylation, a process in which methyl groups – one carbon atom linked to three hydrogen atoms – are added to our DNA. Choline is one of a handful of nutrients that provides methyl groups for this process. The addition of a single methyl group is all it takes to change an individual’s epigenome.

Measurements of cord blood and samples from the placenta showed that increased choline, via the addition of methyl groups, altered epigenetic markers that govern cortisol-regulating genes. Higher choline lessened the expression of these genes, leading to 33 percent lower cortisol in the blood of babies whose mom’s consumed 930 mg per day.

Study authors say the findings raise the exciting possibility that choline may be used therapeutically in cases where excess maternal stress from anxiety, depression or other prenatal conditions might make the fetal HPA axis more reactive and more likely to release greater-than-expected amounts of cortisol.

While more research is needed, Caudill says that her message to pregnant women would be to consume a diet that includes choline rich foods such as eggs, lean meat, beans and cruciferous vegetables like broccoli. For women who limit their consumption of animal products, which are richer sources of choline than plant foods, she adds that supplemental choline may be warranted as choline is generally absent in prenatal vitamin supplements.

“One day we might prescribe choline in the same way we prescribe folate to all pregnant women,” notes Pressman, the James R. Woods Professor in the Department of Obstetrics and Gynecology. “It is cheap and has virtually no side effects at the doses provided in this study. In the future, we could use choline to do even more good than we are doing right now.”

Thursday, August 2, 2012

Choline During Pregnancy May Prevent Stress-Related Problems In Offspring


New research in the FASEB Journal suggests that choline supplementation in pregnant women lowers cortisol in the baby by changing epigenetic expression of genes involved in cortisol production

If you're sick from stress, a new research report appearing in the August 2012 issue of The FASEB Journal suggests that what your mother ate - or didn't eat - may be part of the cause. The report shows that choline intake that is higher than what is generally recommended during pregnancy may improve how a child responds to stress. These improvements are the result of epigenetic changes that ultimately lead to lower cortisol levels. Epigenetic changes affect how a gene functions, even if the gene itself is not changed. Lowering cortisol is important as high levels of cortisol are linked to a wide range of problems ranging from mental health to metabolic and cardiovascular disorders.

"We hope that our data will inform the development of choline intake recommendations for pregnant women that ensure optimal fetal development and reduce the risk of stress-related diseases throughout the life of the child," said Marie A. Caudill, Ph.D., a researcher involved in the work from the Division of Nutritional Sciences and Genomics at Cornell University in Ithaca, New York.

To make this discovery, Caudill and colleagues conducted a 12-week study involving pregnant women in their third trimester who consumed either the control diet providing 480 mg choline per day, a level that approximates current dietary recommendations, or the treatment diet which provided 930 mg choline per day. Maternal blood, cord blood and placenta tissue were collected to measure the blood levels of cortisol, the expression levels of genes that regulate cortisol, and the number of methyl groups attached to the DNA of the cortisol regulating genes (the epigenetic changes). Those from mothers who consumed the higher levels of choline showed reduced levels of cortisol.

"Depending on the relationship, one's mother can either produce stress or relieve it," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "This report shows that her effect on stress begins even before birth. The importance of choline cannot be overstated as we continue to unravel the role it plays in human health and development."

Friday, June 15, 2012

FOLIC ACID INTAKE DURING EARLY PREGNANCY ASSOCIATED WITH REDUCED RISK OF AUTISM IN OFFSPRING


A new study by researchers at the UC Davis MIND Institute suggests that women who consume the recommended daily dosage of folic acid, the synthetic form of folate or vitamin B-9, during the first month of pregnancy may have a reduced risk of having a child with autism.

The study furthers the researchers' earlier investigations, which found that women who take prenatal vitamins around the time of conception have a reduced risk of having a child with autism. The current study sought to determine whether the folic acid consumed in those supplements was the source of the protective effect. The finding suggests that, in addition to women who already have conceived, those who are attempting to become pregnant should consider consuming folic acid supplements, the authors said.

_Rebecca J. Schmidt

The study found that women who each day consumed the recommended amount of folic acid (600 micrograms, or .6 milligrams) during the first month of pregnancy experienced a reduced risk of having a child with autism spectrum disorder, specifically when the mother and/or her child had a specific genetic variant (MTHFR 677 C>T) associated with less efficient folate metabolism. The study will be published in the July issue of the American Journal of Clinical Nutrition.

"This research is congruent with the findings of earlier studies that suggest that improved neurodevelopmental outcomes are associated with folic acid intake in early pregnancy," said lead study author Rebecca J. Schmidt, assistant professor of public health sciences in the UC Davis School of Medicine and a researcher with the UC Davis MIND Institute. "It further supports recommendations that women with any chance of becoming pregnant should consider consuming folic acid at levels of 600 micrograms or greater per day."_ _Autism is a neurodevelopmental disorder characterized by impairments in social interaction, communication deficits and repetitive behaviors and often is accompanied by intellectual disability. An estimated 1 in 88 children born today will be diagnosed with autism spectrum disorder, according to the U.S. Centers for Disease Control and Prevention.

"What's reassuring here is knowing that, by taking specific action in terms of their intake of folic acid from food or supplements, women can reduce the risk of autism spectrum disorder in their future children," said study senior author Irva Hertz-Picciotto, chief of the division of environmental and occupational health in the Department of Public Health Sciences and a MIND Institute researcher.

The study authors said that folic acid might offer protection against problems in embryonic brain development by facilitating DNA methylation reactions that can lead to changes in the way that the genetic code is read. An ample supply of methyl donors such as folic acid could be especially important in the period around conception, when the DNA methylation road map is set forth.

For the study, the researchers collected data from approximately 835 Northern California mothers of 2- to 5-year-old children who had autism, developmental delay or typical development and who were participants in the Childhood Autism Risk from Genetics and the Environment (CHARGE) study between 2003 and 2009.

_The study found that women who each day consumed the recommended amount of folic acid (600 micrograms, or .6 milligrams) during the first month of pregnancy experienced a reduced risk of having a child with autism spectrum disorder.

Each mother's average daily folic acid intake was assessed on the basis of the amount and the frequency of consumption of folic acid-containing dietary supplements such as prenatal vitamins and multivitamins, as well as the consumption of food supplemented with folic acid such as fortified breakfast cereals or energy bars. Information was collected for the period when the women were pregnant and for the three months before they became pregnant.

The study found that mothers of typically developing children reported greater-than-average intake of folic acid, and were more likely to meet intake recommendations during the first month of pregnancy than were mothers of children with autism spectrum disorder. Among study participants, as the amount of folic acid consumed increased, the associated risk for autism spectrum disorder decreased. Mothers of children with developmental delay tended to have lower estimated folic acid intake when compared with mothers of typically developing children during the three months before pregnancy.

The mothers of infants who were developing normally said they consumed an estimated average of 779 micrograms of folic acid daily and 69 percent of them at least met the daily guidelines. The mothers of children with autism consumed an estimated average of 655 micrograms of folic acid. Fifty-four percent of them consumed the recommended 600 micrograms or more per day.

Consuming supplemental folic acid before and during early pregnancy has been recommended for decades, after studies demonstrated its potential to prevent up to 70 percent of neural tube defects, or improper formation of the embryonic brain and spinal cord. Folic acid's protective effect on neural tube defects also was stronger when mothers and/or children carried the MTHFR 677 C>T gene variant. Early maternal folic acid supplementation has more recently been shown to improve other social, attention and behavioral outcomes in the developing child.


Tuesday, May 22, 2012

Vitamin C improves pulmonary function in newborns of pregnant smoking women



Vitamin C supplementation in pregnant women who are unable to quit smoking significantly improves pulmonary function in their newborns, according to a new study.

"Smoking during pregnancy is known to adversely affect the lung development of the developing baby," said Cindy McEvoy, MD, associate professor of pediatrics at Oregon Health & Science University Doernbecher Children's Hospital. "We found that daily use of vitamin C (500 mg/day) by smoking pregnant woman significantly improved pulmonary function tests administered to their offspring at about 48 hours postpartum."

The results will be presented at the ATS 2012 International Conference in San Francisco.

The study enrolled the newborns of 159 smoking women and randomized them to daily vitamin C (500 mg) or placebo before 22 weeks gestation and treatment was continued through delivery.76 non smoking pregnant women were also studied. The primary outcome of the study was the measurement of the newborn's lung function with a pulmonary function test at about 48 hours of life. This assessment included measurement of peak tidal expiratory flow to expiratory time (TPTEF:TE) and respiratory compliance (Crs).

Smokers treated with placebo had significantly lower levels of ascorbic acid than non-smokers, but levels returned to those of non-smokers in smokers randomized to vitamin C. Newborns of smoking women randomized to placebo had decreased TPTEF:TE and Crs compared to non-smokers. Both TPTEF:TE and Crs were significantly increased by vitamin C supplementation, returning them nearly to the levels seen in non-smokers.

"In our pilot study, we were able to show that babies born to smoking pregnant women who were randomized to daily supplemental vitamin C had significantly improved pulmonary/lung function tests compared to babies born to smoking women who were randomized to placebo," said Dr. McEvoy.

"Moreover, although our study numbers were small, we found that one particular genetic variant that has been shown to increase the risk of smokers developing cancer and is associated with both a reduced ability to quit smoking and a high likelihood of relapse, also seemed to intensify the harmful effects of maternal smoking on babies' lungs. Although the lung function of all babies born to smokers in our study was improved by supplemental vitamin C, our preliminary data suggest, importantly, that vitamin C may help those babies at the greatest risk of harm during their development from their mother's smoking in pregnancy."

"Getting women to quit smoking during pregnancy has to be priority one, but this study provides a way to potentially help the infants born to at least 12% of pregnant women who cannot quit smoking when pregnant." said Dr. McEvoy. "Vitamin C supplementation may block some of the in-utero effects of smoking on fetal lung development."

"Our findings are important because improved lung function tests at birth are associated with less wheezing and asthma in childhood," concluded Dr. McEvoy. "Vitamin C is a simple, safe, and inexpensive treatment that may decrease the impact of smoking during pregnancy on the respiratory health of children."


Flu shot during pregnancy shows unexpected benefits in large study



Getting a flu shot during pregnancy provides unanticipated benefits to the baby, according to the authors of a large population-based study examining the issue. Specifically, the study showed that H1N1 vaccination during the pandemic was associated with a significantly reduced risk of stillbirth, preterm birth and extremely small babies at birth.

Researchers at the Ottawa Hospital Research Institute (OHRI), the CHEO Research Institute and the University of Ottawa (uOttawa) used data from Ontario's birth record database, BORN, to examine 55,570 single-child births that took place in Ontario during the H1N1 pandemic. The resulting paper, "H1N1 Influenza Vaccination during Pregnancy and Fetal and Neonatal Outcomes," was recently published by the American Journal of Public Health.

The study shows that, compared to pregnant women who were not immunized against H1N1, mothers who received the H1N1 vaccination were:

34% less likely to have a stillbirth, •

28% less likely to deliver before 32 weeks, and •

19% less likely to give birth to a child with a birth weight for gestational age in the bottom third percentile. •

"These are all significant results, but especially interesting is the finding that the vaccinated mothers were one-third less likely to have a stillborn child," says lead author Deshayne Fell, an epidemiologist for BORN Ontario. "This is one of the only studies large enough to evaluate the association between maternal flu vaccination and stillbirth—a very rare event."

"What surprised me and the research team was the strength of the protective benefits we found," says co-author Dr. Ann Sprague, the Scientific Manager of BORN Ontario at the Children's Hospital of Eastern Ontario (CHEO) Research Institute.

The study also found no increase in adverse outcomes for H1N1-vaccinated mothers and their babies during the weeks before and just after birth, also referred to as the perinatal period.

"The findings of this study are very helpful," says co-author Dr. Mark Walker, a Senior Scientist at OHRI, a High-Risk Obstetrician at The Ottawa Hospital, and a Professor and Tier One Research Chair in Perinatal Research at the University of Ottawa.

"Pregnant women are generally very, very careful about what they put into their bodies. For health-care providers like me, such a large-scale study that shows no adverse perinatal outcomes resulting from the H1N1 flu vaccine will be extremely helpful when discussing maternal vaccination."

Of all the single-child births recorded from November 2009 to April 2010, 42% of the women received the H1N1 vaccination, which makes the findings robust. BORN—the Better Outcomes Registry & Network—collects data from all births in Ontario. In order to conduct the research for this study, questions about H1N1 vaccination were added to the database in advance of the H1N1 vaccine becoming available. BORN includes demographic data that allowed the research team to correct for smoking, education and income; however, as with any population-based study, it may not be possible to account for all influencing factors.

Tuesday, May 8, 2012

LINK BETWEEN PREPREGNANCY OBESITY AND LOWER CHILD TEST SCORES



Women who are obese before they become pregnant are at higher risk of having children with lower cognitive function - as measured by math and reading tests taken between ages 5 to 7 years - than are mothers with a healthy prepregnancy weight, new research suggests.

In this large observational study, prepregnancy obesity was associated, on average, with a three-point drop in reading scores and a two-point reduction in math scores on a commonly used test of children’s cognitive function.

Previous research has suggested that a woman’s prepregnancy obesity can have a negative effect on fetal organs, such as the heart, liver and pancreas. Because fetal development is rapid and sensitive to a mother’s physiological characteristics, Ohio State University researchers sought to find out whether a mother’s obesity also could affect the fetal brain.

“One way you measure the effects on the brain is by measuring cognition,” said Rika Tanda, lead author of the study and a doctoral candidate in nursing at Ohio State.

The research also supported findings in previous studies suggesting that several other conditions affect childhood cognition, including how stimulating the home environment is, family income and a mother’s education and cognitive skills.

“The new piece here is we have a measure associated with the fetus’s environment to add to that set of potential risk factors,” said Pamela Salsberry, senior author of the study and a professor of nursing at Ohio State. “If we have a good way to understand the risks each child is born with, we could tailor the post-birth environment in such a way that they could reach their maximum capabilities.”

The research appears online and is scheduled for future print publication in the Maternal and Child Health Journal.

The researchers used data from the National Longitudinal Survey of Youth (NLSY) 1979 Mother and Child Survey, a nationally representative sample of men and women who were 14-21 years old in December 1978. From that dataset, Tanda collected information on 3,412 children born to NLSY mothers who had been full-term births, were between 5 and almost 7 years old at the time of their interview and who had no diagnosed physical or cognition problems.

In addition to documenting a number of characteristics about the mothers and the family environment, the researchers gauged the children’s cognitive function based on their performance on Peabody Individual Achievement Test reading recognition and math assessments.

The researchers calculated the mothers’ body mass index (BMI) based on their reported heights and weights. More than half of mothers had normal BMIs before pregnancy, and 9.6 percent were obese, meaning they had a BMI of 30 or higher.

Controlling for all other variables, the analysis showed that maternal prepregnancy obesity was negatively associated with math and reading test scores. Children of obese women scored, on average, three points lower on reading and two points lower on math than did children of healthy-weight women. The mean reading score among all the children was 106.1 points and the mean math score was 99.9.

Though the score differences seem small, Tanda noted that these effects of prepregnancy obesity were equivalent to a seven-year decrease in the mothers’ education and significantly lower family income, two other known risk factors that negatively affect childhood cognitive function.

Tanda said clinicians could use these findings to help encourage women patients of childbearing age to maintain a healthy weight, especially if they plan to get pregnant.

“This is a large population study, so at the individual level we can’t say that one person’s decision to change her weight will change her child’s outcome,” she said. “But these findings suggest that children born to women who are obese before pregnancy might need extra support.”

Added Salsberry, “It’s not only for their child’s sake. It’s also important for the health of the mother. But it is important to understand that maternal obesity during pregnancy could have implications for their children as well.”

“If we have a good way to understand the risks each child is born with, we could tailor the post-birth environment in such a way that they could reach their maximum capabilities.”

Without actual measures of women’s and fetuses’ insulin levels, inflammation and blood sugar readings, scientists can’t say for sure how prepregnancy obesity might affect the fetal brain. But previous studies have suggested that a mother’s impaired metabolic processes affect the fetal brain cell growth and formation of synapses.

The researchers also noted that obesity doesn’t automatically equate to unhealthy.

“There may be two obese moms that in fact have very different metabolic profiles. For the purposes of this study, her weight is a stand-in for biological data that we would like to have but don’t,” Salsberry said.

Socioeconomic data from the study supported previous findings that several post-birth conditions can have a positive association with higher children’s test scores. These include a stimulating home environment with plenty of books, a safe play environment and frequent family meals; higher family income; and higher maternal education levels and cognitive function. Girls and first-born children also performed better on the math and reading tests than did boys and younger siblings.

With all these data combined, Tanda said, the study also reveals how health disparities can have long-lasting effects.

“Young females who grow up poor, who have less access to healthy foods resulting in diets that are of poorer quality, are at higher risk of having children with disadvantages and repeating this cycle,” she said.

The researchers are continuing to examine additional influences on childhood cognition, including race, sex and age differences among mothers.

Thursday, May 3, 2012

Prenatal choline may 'program' healthier babies



Pregnant women may have added incentive to bulk up on broccoli and eggs now that a Cornell University study has found increased maternal intake of the nutrient choline could decrease their children's chances of developing hypertension and diabetes later in life.

In a study led by Marie Caudill, associate professor of nutritional sciences, and graduate student Xinyin Jiang, a group of third-trimester pregnant women consumed 930 milligrams of choline, more than double the recommended 450 milligram daily intake. The result for their babies was 33 percent lower concentrations of cortisol – a hormone produced in response to stress that also increases blood sugar – compared to those from a control group of women who consumed about 480 milligrams of choline.

Caudill believes this happened because the choline changed the expression patterns of genes involved in cortisol production. The work, published online this week in The Journal of the Federation of American Societies for Experimental Biology, is the first human study to suggest a role for choline in the "programming" of key biological processes in the baby.

"The study findings raise the exciting possibility that a higher maternal choline intake may counter some of the adverse effects of prenatal stress on behavioral, neuroendocrine and metabolic development in the offspring," Caudill said.

This could be especially useful for women experiencing anxiety and depression during their pregnancy, as well as conditions such as pre-eclampsia.

"A dampening of the baby's response to stress as a result of mom consuming extra choline during pregnancy would be expected to reduce the risk of stress-related diseases such as hypertension and type 2 diabetes throughout the life of the child," she added.

She said additional studies are needed to confirm the study findings and further explore long-term effects. Dietary sources of choline include egg yolks, beef, pork, chicken, milk, legumes and some vegetables. Most prenatal vitamin supplements do not include choline.

"We hope that our data will inform the development of choline intake recommendations for pregnant women that ensure optimal fetal development and reduce the risk of stress-related diseases," Caudill said.

Thursday, April 26, 2012

Link Between Smoking During Pregnancy, Autism



Women who smoke in pregnancy may be more likely to have a child with high-functioning autism, such as Asperger’s Disorder, according to preliminary findings from a study by researchers involved in the U.S. autism surveillance program of the Centers for Disease Control and Prevention.

"It has long been known that autism is an umbrella term for a wide range of disorders that impair social and communication skills,” says Amy Kalkbrenner, assistant professor in the University of Wisconsin-Milwaukee’s Joseph J. Zilber School of Public Health, lead author of the study. “What we are seeing is that some disorders on the autism spectrum, more than others, may be influenced by a factor such as whether a mother smokes during pregnancy.” The study was published April 25 online by the journal Environmental Health Perspectives. Smoking during pregnancy is still common in the U.S. despite its known harmful impacts on babies. Kalkbrenner found that 13 percent of mothers whose children were included in the study had smoked during pregnancy.

Kalkbrenner and colleagues’ population-based study compared smoking data from birth certificates of thousands of children from 11 states to a database of children diagnosed with autism maintained by the CDC’s Autism and Developmental Disabilities Monitoring Network (ADDMN). Of the 633,989 children, born in 1992, 1994, 1996 and 1998, 3,315 were identified as having an autism spectrum disorder at age 8.

“The study doesn’t say for certain that smoking is a risk factor for autism,” Kalkbrenner says. “But it does say that if there is an association, it’s between smoking and certain types of autism,” implicating the disorders on the autism spectrum that are less severe and allow children to function at a higher level. That connection, she adds, needs further study. April is Autism Awareness Month, and several studies of possible links between environmental factors and autism are being published by Environmental Health Perspectives at the same time as Kalkbrenner’s study. “The CDC recently released data indicating that 1 in 88 children has an autism spectrum disorder, making such environmental studies even more timely,” says Kalkbrenner.

Because autism involves a broad spectrum of conditions and the interplay of genetics and environment is so complex, no one study can explain all the causes of autism, she adds. “The goal of this work is to help provide a piece of the puzzle. And in this we were successful.”

Monday, April 2, 2012

Dieting During Pregnancy Increases Risk Of Obesity And Diabetes For Offspring

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If you're expecting, this might make you feel a little better about reaching for that pint of ice cream: New research published online in the FASEB Journal suggests that twins, and babies of mothers who diet around the time of conception and in early pregnancy, may have an increased risk of obesity and type 2 diabetes throughout their lives. This study provides exciting insights into how behavior can lead to epigenetic changes in offspring related to obesity and disease.

"This study may provide a new understanding of why twins can develop diabetes," said Anne White, Ph.D., study author from the Faculty of Life Sciences at the University of Manchester in Manchester, UK. "It also suggests that dieting around the time a baby is conceived may increase the chance of the child becoming obese later in life."

To make this discovery, White and colleagues conducted experiments involving sheep to investigate twin pregnancies and the effects of altering nutrition around the time of conception and early pregnancy. Specifically, scientists examined the brain tissue of fetal sheep before birth and found that there were changes in the genes that control food intake and glucose levels that may lead to obesity and diabetes. These findings are unique because the differences found in the genes are not inherited changes in the DNA sequence, but rather, epigenetic changes with alterations in the structure of the DNA and its associated proteins, histones, which affects the way that genes can behave in later life.

"This study shows that expecting mothers have to walk a really fine line when it comes to diet and nutrition," said Gerald Weissmann, M.D., Editor-in-Chief of the FASEB Journal. "It also shows that epigenetics is the 'new genetics': both our DNA and the histones in which it is wrapped are susceptible to binge eating and dieting - we are what our mothers ate."

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Thursday, March 8, 2012

Maternal obesity may influence brain development of premature infants

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Maternal obesity may contribute to cognitive impairment in extremely premature babies, according to a new study by researchers at Wake Forest Baptist Medical Center.

"Although in the past decade medical advances have improved the survival rate of babies born at less than seven months, they are still at very high risk for mental developmental delays compared with full-term infants," said Jennifer Helderman, M.D., assistant professor of pediatrics at Wake Forest Baptist and lead author of the study. "This study shows that obesity doesn't just affect the mother's health, but might also affect the development of the baby."

Published in the March issue of the journal Pediatrics, the study looked at 921 infants born before 28 weeks of gestation during 2002 to 2004 at 14 participating institutions. The researchers assessed the babies' placenta for infection and other abnormalities, interviewed the mothers and reviewed their medical records. At age 2, the children's cognitive skills were evaluated using the Mental Development Index (MDI) portion of the Bayley Scales of Infant Development, a commonly used measure.

The scientists found that both maternal obesity and lack of high school education were associated with impaired early cognitive function, as was pre-term thrombosis (blood clot) in the placenta.

"We weren't really surprised by the socioeconomic factors because it has been repeatedly shown that social disadvantage predicts worse infant outcomes," Helderman said. "However, obesity is of particular interest because it is becoming more prevalent and it is potentially modifiable during the pre-conception period and pregnancy."

Obesity has been linked to inflammation, and inflammation can damage the developing brain, Helderman said. What isn't known is if the obesity-related inflammation in the mother is transmitted to the fetus.

"Few studies have addressed prenatal risk factors of cognitive impairment for infants born this prematurely. The long-term goal is to use information from studies like ours to develop treatments that prevent cognitive impairment in extremely premature babies," Helderman said.

Helderman's colleague, Michael O'Shea, M.D., section head of neonatology at Wake Forest Baptist, is currently conducting a study that follows these same babies into mid-childhood to determine long-term cognitive problems.

More than 30,000 extremely premature babies are born each year in the United States.

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Friday, March 2, 2012

An Unlikely Bond: Prenatal Health and Dental Hygiene

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Oral health doesn’t always top the list of concerns that expectant mothers may have, but it certainly should. Proper dental health and control of oral disease can safeguard a mother’s health before and during pregnancy and reduces the transmission of bacteria from women to their children. According to numerous studies by the American Congress of Obstetricians and Gynecologists, many women do not seek, nor are instructed to seek, proper oral healthcare as part of their routine prenatal care.

“Caring for a pregnant mother’s teeth and gums should start before she becomes pregnant,” said Doron Kochman, DDS and Associate Clinical Professor of Pediatric Dentistry in the Department of Clinical Dentistry, at the University of Rochester Strong Memorial Hospital, and Eastman Dental Center in Rochester, NY. “Ideally, women who are planning to get pregnant should visit their dentists and have any necessary work done before the pregnancy. Mothers should continue to visit their dentists for routine prevention visits during their pregnancies.”

Due to the natural hormonal fluctuations during pregnancy, gums are more susceptible to swelling and inflammation. Because of this, bacteria can accumulate causing gum disease and further medical complications for both mother and baby. “We now know that the bacteria responsible for gum disease can also cause problems in places other than the mother’s mouth,” said Kochman. Periodontal disease increases the risk that bacteria will enter the bloodstream, causing potential infections in either mother or baby.

Studies have shown a link between periodontal disease in mothers and an increased chance of delivering premature or low birth weight babies. Because many pregnant women routinely experience swollen and bleeding gums after they brush, they may not recognize a true problem if it exists. Regular check-ups before and during pregnancy are highly recommended.

In addition to prematurity and low birth weight, other problems can result from oral health issues. Studies have suggested that periodontal disease can increase the risk for preeclampsia, a life-threatening disorder caused by high blood pressure which usually occurs mid-to-late pregnancy.

People with diabetes are also more likely to have periodontal disease. Diabetic mothers need to be vigilant about their blood glucose levels to protect their unborn children from fetal obesity, high blood insulin levels and blood disorders, among other conditions.

Furthermore, there is growing evidence that if a mother’s oral hygiene is less than optimal, her baby’s oral health can suffer. “An expectant mother’s diet and oral hygiene can affect her baby's teeth,” said Kochman. “The baby’s teeth start developing in the 5th or 6th week after conception. A mother's balanced diet during pregnancy provides the calcium, phosphorous, other minerals and vitamins needed for the baby’s teeth to form properly.”

Most dentists recommend the following tips for expectant moms:
• Brush at least twice a day to remove plaque buildup
• Floss regularly
• Avoid sugary snacks
• Eat a healthy, balanced diet
• Get regular dental exams (speak to your dentist to see what is right for you)

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Tuesday, February 21, 2012

Influenza vaccination of pregnant women helps their babies

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Vaccinating pregnant women against the influenza virus appears to have a significant positive effect on birth weight in babies, according to a study published in CMAJ (Canadian Medical Association Journal).

The study, a randomized controlled trial involving 340 healthy pregnant women in Bangladesh in the third trimester, looked at the effect of immunization with the influenza vaccine on babies born to vaccinated mothers. It was part of the Mother'sGift project looking at the safety and efficacy of pneumococcal and influenza vaccines in pregnant women in Bangladesh. The participants were divided into two groups, one with 170 women who received the influenza vaccine, and the second who received the pneumococcal vaccine as a control. Researchers compared the weight of babies born in two periods, one in which there was circulation of an influenza virus and one with limited circulation.

Babies that are small for their gestational age are at increased risk of health and other issues over their lives.

The researchers found that there were fewer babies who were small for their gestational age born to mothers in the influenza vaccine group when the virus was circulating, with 25.9% who were small compared with 44.8% in the control group. When the virus was dormant, the proportion of small-for-gestational-age births was similar in both groups. During the period with circulating influenza virus, the mean birth weight was 3178 g in the influenza vaccine group and 7% higher than 2978 g in the control group. The rate of premature births was lower in the influenza vaccine group as well.

"We found that immunization against influenza during pregnancy had a substantial effect on mean birth weight and the proportion of infants who were small for gestational age," writes Dr. Mark Steinhoff, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, with coauthors. "Our data suggest that the prevention of infection with seasonal influenza in pregnant women by vaccination can influence fetal growth," state the authors.

The researchers calculate that 10 maternal influenza vaccinations given year-round prevented one small-for-gestational-age birth, dropping to 6 vaccinations during the period in which the influenza virus was circulating.

The study was conducted by a team of US and Bangladeshi researchers from the Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Johns Hopkins University, Baltimore, Maryland; Emory University, Atlanta, Georgia; the International Centre for Diarrheal Disease Research, Dhaka, Bangladesh; and the Centers for Disease Control and Prevention, Atlanta, Georgia.

The authors suggest that if further research supports their findings, adding an influenza vaccine to routine vaccination programs during pregnancy could help children have a better start in life.

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Wednesday, February 1, 2012

Overweight Mothers Who Smoke While Pregnant Can Damage Baby's Heart

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Mothers-to-be who are both overweight and smoke during their pregnancy risk damaging their baby's developing heart, finds research published online in Heart.

Congenital heart abnormalities are some of the most common defects found at birth, with around eight in every 1000 babies affected. A likely cause is only found in 15% of cases.

The authors base their findings on an analysis of almost 800 babies and foetuses who were born with congenital heart abnormalities, but no other defects, between 1997 and 2008.

These babies were compared with 322 children and foetuses who were born with chromosomal abnormalities, but without any heart defects.

The analysis pointed to an enhanced damaging effect for a combination of overweight and smoking as opposed to one of these factors alone, after taking account of influential factors, such as the mother's alcohol consumption and educational attainment.

Mums to be who both smoked and were overweight, with a BMI of 25 or more, were more than 2.5 times as likely to have a child with a congenital heart defect as women who either smoked or were overweight, but not both.

The risk of outflow tract obstructive abnormalities, whereby blood flow from the ventricles of the heart to the pulmonary artery or aorta is reduced/blocked, more than tripled in babies born to overweight mums who smoked while pregnant.

"These results indicate that maternal smoking and overweight may both be involved in the same pathway that causes congenital heart defects," write the authors.

While the exact mode of action is not clear, they point to disturbances in plasma cholesterol, which is independently associated with obesity and smoking, and which results in lower levels of "good" cholesterol and higher levels of "bad" cholesterol.

The findings add to the growing body of evidence for the links between smoking and overweight during pregnancy with, variously, miscarriage/stillbirth, stunted growth, and premature birth, say the authors.

Tuesday, January 31, 2012

Consuming fish during pregnancy improves offspring’s cognitive development and prosocial conduct

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Can pregnant women improve their progeny’s intelligence by eating fish? A study recently submitted to the American Journal of Clinical Nutrition and coordinated by the University of Granada professor Cristina Campoy Folgoso revealed that infants born to mothers who consumed more fish during pregnancy score higher in verbal intelligence and fine motor skill tests, and present an increased prosocial behavior.

The aim of this study was to assess the effects of maternal fish intake -as a source of Omega-3 and Omega-6 fatty acids- on fetal development, and to determine how the different genotypes affect long-chain fatty acid concentrations in the fetus.Dr. Pauline Emmett (University of Bristol), Dr. Eva Lattka (Helmholtz Zentrum München, the German Research Center for Environmental Health) and their research teams have determined how FADS gene cluster polymorphisms affect long-chain polyunsaturated fatty acid concentrations in women during pregnancy.Maternal GenotypesAccording to the researchers, fatty acid concentrations in umbilical cord blood depend on maternal and offspring genotypes. Accordingly, maternal genotypes are mainly related with omega-6 fatty acid precursors, and offspring genotypes are related with the more highly elongated fatty acids of the omega-6 series. The study also revealed that concentrations of docosahexaenoic acid (DHA) of the Omega-3 series -main component of brain cell membranes- depend on maternal and offspring genotypes. Dr Lattka states that “the fetal contribution of long-chain polyunsaturated fatty acids of the omega-6 series is more relevant than expected; fetal DHA concentrations depend on maternal and fetal metabolism”, and concludes that “the amount of DHA transmitted to the fetus through the placenta might be crucial for fetal development”.In a previous study, this research team proved that fish intake during pregnancy is correlated with the IQ in 8-year old children. But, what causes that effect? The study revealed that fish intake is correlated with maternal blood DHA concentrations. However, it has not been clarified whether maternal DHA concentrations are directly correlated with the offspring’s IQ.

Can pregnant women improve their progeny’s intelligence by eating fish? A study recently submitted to the American Journal of Clinical Nutrition and coordinated by the University of Granada professor Cristina Campoy Folgoso revealed that infants born to mothers who consumed more fish during pregnancy score higher in verbal intelligence and fine motor skill tests, and present an increased prosocial behavior.

This study was conducted within the framework of the NUTRIMENTHE project (“Effect of diet on offspring’s cognitive development”), which received funding of 5.9 million Euros from the European 7th Framework Programme (7PM). This study was coordinated by the University of Granada professor Cristina Campoy Folgoso.Fish oil is the primary source of long-chain Omega-3 fatty acids as docosahexaenoic acid (DHA), the main component of brain cell membranes. The European Commission has confirmed and supports the healthy effects of DHA as “it contributes to the normal development of the brain and eye of the fetus and breastfed infants”.

Effects of Fish Intake

The NUTRIMENTHE project is focused on the effects that genetic variants and maternal fish intake have on the offspring’s intellectual capacity. The researchers mainly focused on polymorphisms in the fatty acid desaturase (FADS) gene cluster that encodes the delta-5 and delta-6 desaturase enzymes involved in the synthesis of long-chain fatty acids of the series omega-3 and omega-6.

The researchers collected blood samples from 2 000 women at 20 gestational weeks and from the umbilical cord of the infant at birth, and analyzed concentrations of long-chain fatty acids of the series omega-3 and omega-6. Then, they determined the genotype of 18 polymorphisms in the FADS gene cluster. The aim of this study was to assess the effects of maternal fish intake -as a source of Omega-3 and Omega-6 fatty acids- on fetal development, and to determine how the different genotypes affect long-chain fatty acid concentrations in the fetus.

Dr. Pauline Emmett (University of Bristol), Dr. Eva Lattka (Helmholtz Zentrum München, the German Research Center for Environmental Health) and their research teams have determined how FADS gene cluster polymorphisms affect long-chain polyunsaturated fatty acid concentrations in women during pregnancy.

Maternal Genotypes

According to the researchers, fatty acid concentrations in umbilical cord blood depend on maternal and offspring genotypes. Accordingly, maternal genotypes are mainly related with omega-6 fatty acid precursors, and offspring genotypes are related with the more highly elongated fatty acids of the omega-6 series. The study also revealed that concentrations of docosahexaenoic acid (DHA) of the Omega-3 series -main component of brain cell membranes- depend on maternal and offspring genotypes. Dr Lattka states that “the fetal contribution of long-chain polyunsaturated fatty acids of the omega-6 series is more relevant than expected; fetal DHA concentrations depend on maternal and fetal metabolism”, and concludes that “the amount of DHA transmitted to the fetus through the placenta might be crucial for fetal development”.

In a previous study, this research team proved that fish intake during pregnancy is correlated with the IQ in 8-year old children. But, what causes that effect? The study revealed that fish intake is correlated with maternal blood DHA concentrations. However, it has not been clarified whether maternal DHA concentrations are directly correlated with the offspring’s IQ. The NUTRIMENTHE project –which is expected to conclude in 2013- is aimed at elucidating this question.

Saturday, January 14, 2012

Taking Anti-Depressants During Pregnancy Increases Pulmonary Hypertension Risk In Newborns

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An investigation published on bmj.com reveals that children are more likely to be born with persistent pulmonary hypertension (high blood pressure in the lungs) if the mother took anti-depressants during pregnancy. Persistent pulmonary hypertension is a rare, but severe disease associated to heart failure. The disease increases blood pressure in the lungs causing: shortness of breath dizziness fainting and difficulty breathing.

Friday, January 6, 2012

How poor maternal diet can increase risk of diabetes

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Researchers funded by the Biotechnology and Biological Sciences Research Council have shown one way in which poor nutrition in the womb can put a person at greater risk of developing type 2 diabetes and other age-related diseases in later life. This finding could lead to new ways of identifying people who are at a higher risk of developing these diseases and might open up targets for treatment.

The team, from the University of Cambridge and the Medical Research Council (MRC) Toxicology Unit at the University of Leicester, publish their findings today (Friday 6 January) in the journal Cell Death and Differentiation.

The research shows that, in both rats and humans, individuals who experience a poor diet in the womb are less able to store fats correctly in later life. Storing fats in the right areas of the body is important because otherwise they can accumulate in places like the liver and muscle where they are more likely to lead to disease.

Professor Anne Willis of the MRC Toxicology Unit at the University of Leicester explains "One of the ways that our bodies cope with a rich modern western diet is by storing excess calories in fat cells. When these cells aren't able to absorb the excess then fats get deposited in other places, like the liver, where they are much more dangerous and can lead to type 2 diabetes."

The team found that this process is controlled by a molecule called miR-483-3p. They found that miR-483-3p was produced at higher levels in individuals who had experienced a poor diet in their mother's wombs than those who were better nourished.

When pregnant rats were fed low protein diets their offspring had higher levels of miR-483-3p. This led to them developing smaller fat cells and left them less able to store fats in adulthood. These rats were less likely to get fat when fed a high calorie diet but were at a higher risk of developing diabetes. Rats are known to be a good model for studying human dietary diseases and the team also found that miR-483-3p was present in elevated levels in a group of people who were born with a low birth weight.

Dr Susan Ozanne, a British Heart Foundation Senior Fellow, who led the work at the University of Cambridge, adds "It has been known for a while that your mother's diet during pregnancy plays an important role in your adult health, but the mechanisms in the body that underlie this aren't well understood. We have shown in detail how one mechanism links poor maternal diet to diabetes and other diseases that develop as we age."

Dr Ozanne and Professor Willis and their team found that miR-483-3p works by suppressing a protein called GDF3. When they studied a group of adult humans who were born with a low birth weight, they found that GDF3 protein was present at around only thirty percent of the levels found in people born at a normal weight.

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