Background Multinutrient insufficiencies as a consequence of nutritional and economic factors are common in India and other developing countries. We have examined the impact of multi-nutrient insufficiency on markers of one carbon metabolism in the blood, and response to a methionine load in clinically healthy young women. Design & Methods Young women from Pune, India (n=10) and Cleveland, USA (n=13) were studied. Blood samples were obtained in the basal state and following an oral methionine load (50mg/kg of body weight in orange juice). Plasma concentrations of vitamin B12, folate and B6 were measured in the basal state. The effect of methionine load on the levels of methionine, total homocysteine, cysteine, glutathione and amino acids was examined. Results Indian women were significantly shorter and lighter compared with the American women and had lower plasma concentration of vitamins B12, folate and B6, essential amino acids and glutathione, but higher concentration of total homocysteine. The homocysteine response to methionine load was higher in Indian women. The plasma concentrations of glycine and serine increased in the Indian women after methionine (in juice) load. A significant negative correlation between plasma B6 and homocysteine (r= −0.70), and plasma folate and glycine and serine levels were observed in the Indian group (P<0.05) but not in the American group. Conclusion Multi-nutrient insufficiency in the Indian women caused unique changes in markers of whole body protein and one carbon metabolism. These data would be useful in developing nutrient intervention strategies.
Background: Maternal nutrition during pregnancy is a strong determinant of fetal size, body composition and future health. A few studies have measured detailed neonatal anthropometry and body composition. We studied the association between maternal pregnancy measurements and neonatal size and body composition in GDM and NGT pregnancies. Methods: Mothers from antenatal clinics were tested with 75gm OGTT (IADPSG criteria). Maternal demographic, anthropometric, and nutritional (vit B12, folate, homocysteine) and metabolic (glucose, insulin, lipids) measurements were obtained. Detailed neonatal anthropometry and body composition (DXA) were measured. We studied maternal predictors of neonatal size and composition by adjusting for socio economic status (SES), gestation at delivery and sex of baby. Results: We studied 398 pregnancies (234 NGT, 164 GDM). GDM mothers were older, more affluent, obese, and had higher triglycerides but lower HDL and total cholesterol concentrations compared to NGT mothers. Neonates of GDM mothers were heavier and more adipose (skinfolds, DXA body fat%) but 25% were SGA (INTERGROWTH). In addition to the conventional predictors (maternal size, adiposity and weight gain), we found novel associations of neonatal size (birthweight and length) with maternal folate (direct) and homocysteine (inverse) and of neonatal adiposity with maternal glucose and insulin resistance (direct), and HDL cholesterol and disposition index (inverse). Conclusion: Our results highlight a role for maternal micronutrient nutrition, fuels and insulin resistance in influencing neonatal size and body composition. These findings expand the concept of ‘fuel mediated teratogenesis’ (Freinkel, 1980) to ‘dual teratogenesis’ (Yajnik, 2009) and offer additional opportunities to improve fetal growth and body composition. Increasing dietary methyl donors may be useful in addition to controlling maternal insulin resistance may reduce fetal adiposity. Disclosure M.K. Deshmukh: None. A.A. Bhalerao: None. D.A. Raut: None. N.S. Memane: None. R. Kamat: None. D. Bhat: None. H. Damle: None. S.S. Wagle: None. C.S. Yajnik: None.
Background: Based on studies in overweight-obese populations, it is tacitly assumed that maternal hyperglycemia is responsible for obesity-adiposity at birth and in later life. Study design: Two hospital based case control studies: 1) Neonatal outcomes, 2) Later life outcomes. Methods: We studied associations of neonatal and later life obesity-adiposity [age and sex-adjusted BMI, waist circumference, skinfolds, and body fat percent by Dual energy X-ray Absorptiometry (DXA)] in offspring of mothers with diabetes (ODM) and those of mothers without diabetes (ONDM). Exposures were parental hyperglycemia and overweight-obesity. Results: Neonatal study included 372 non-diabetic and 816 diabetic pregnancies [74 type 1 diabetes, 102 type 2 diabetes, 640 gestational diabetes (GDM)]. Mothers with type 1 diabetes were the youngest, thinnest, and with highest HbA1c. Maternal glycemia but not BMI was associated with neonatal obesity-adiposity. Thus, neonates of mothers with type 1 diabetes had highest ponderal index, abdominal circumference, and skinfolds. Later life study included 200 ODM (25 type 1 diabetes, 22 type 2 diabetes, 153 GDM) and 177 age, sex and socio-economic matched ONDM (2 to 26 y). Their obesity-adiposity was associated with bi-parental overweight-obesity in an additive manner, but not with parental diabetes. Offspring birth weight was also positively associated. Offspring of mothers with type 1 diabetes had the lowest and offspring of mothers with type 2 diabetes the highest obesity-adiposity. Conclusion: Neonatal obesity-adiposity is driven by maternal glycemia while later life obesity-adiposity by bi-parental obesity. Our results provide a clear insight into pathogenesis of obesity-adiposity in the offspring.
Background: It’s well known that maternal diabetes increases risk of obesity-adiposity and hyperglycemia in children. Few studies have explored the modifying influence of child’s lifestyle (nutrition and physical activity, PA). Intensive treatment of GDM have not shown any protection against adiposity in the child. We assessed the current lifestyle in offspring of diabetic mothers (ODM) 2-26 years after birth and investigated its association with obesity-adiposity and hyperglycemia. Methods: We studied 200 ODM and 177 offspring of nondiabetic mothers (ONDM, age and gender matched). Anthropometry, body composition (DXA) and blood glucose (capillary in <10y, 1.75g/kg OGTT in >10y) were measured. Overweight + obesity was classified by international standards [IOTF (≤18y), WHO (>18y)], glucose intolerance (ADA 2014). Dietary intake was assessed using food frequency questionnaire (preceding 6 months) and PA by recording time and frequency of vigorous, moderate, and sedentary activities. We studied the influence of diet and activity on risks of obesity-adiposity and hyperglycemia. Results: ODM consumed sweets, milk and milk products, vegetables and salads more frequently and cereals less frequently than ONDM. Frequent consumption of ‘healthy foods’ and infrequent consumption of ‘unhealthy foods’ were associated with decreased risk for obesity-adiposity. Higher level of moderate PA (>60min/day) and lower sedentary PA (<480 min/day) were associated with lower obesity-adiposity in both the groups. Hyperglycemia was not affected. These effects worked across both groups, there was no interaction with maternal diabetes. Conclusions: Healthy lifestyle (food and activity) is protective against obesity-adiposity but not against hyperglycemia in young Indian children (both ODM and ONDM). Our results suggest a need for a formal lifestyle intervention in children born in diabetic pregnancies for reduction in obesity-adiposity and hyperglycemia. Disclosure S.S. Wagle: None. K. Kumaran: None. R. Ladkat: None. D. Bhat: None. R. Kamat: None. S. Wadke: None. M.K. Deshmukh: None. P.C. Yajnik: None. C.S. Yajnik: None.
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