Effect of a milk-based food supplement on maternal nutritional status and fetal growth in underweight Chilean women

Mardones, Francisco; Rosso, Pedro; Stekel, A; Ahumada, Eugenia; Llaguno, S; Pizarro, Fernando; Salinas, Judith; Díez‐Vial, Isabel; Walter, Tomás

doi:10.1093/ajcn/47.3.413

Cited by 82 publications

(80 citation statements)

References 7 publications

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“…Several trials have showed a reduction in mean birth weight with isocaloric-balanced protein supplementation group vs control diet but the results of such trials have been heterogeneous (Kramer, 2003). One study was of particular concern as isocaloric supplementation was associated with an increased risk of a small-for-gestational age infant (RR ¼ 1.35; 95% CI: 1.12, 1.61) (Mardones-Santander et al, 1988), leading to the conclusion that such supplementation may be harmful. Although randomized intervention trials may be needed to further determine the influence of nutritional supplementation on pregnancy outcomes such as body composition as well as birth weight, supplementation may be unethical in some cases and also supplement composition will not accurately reflect natural maternal dietary intake and indeed could modify food choice.…”

Section: Discussionmentioning

confidence: 99%

Higher maternal dietary protein intake in late pregnancy is associated with a lower infant ponderal index at birth

et al. 2006

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Aim: A high ponderal index at birth has been associated with later obesity and it has been suggested that intervention to prevent obesity and its sequela should consider the antenatal period. In this context, we investigated the association between maternal nutrition and birth anthropometry. Design: We analyzed data on 1040 mother-infant pairs collected during the Tasmanian Infant Health Survey (TIHS), Tasmania, 1988Tasmania, -1989. Maternal dietary intake during pregnancy was measured by food frequency questionnaire (FFQ) applied soon after birth. Outcomes of interest were birth weight, birth length, head circumference, ponderal index, head circumference -toponderal index ratio, placenta-to-birth weight ratio and head circumference-to-birth length index. Results: In multiple regression model, an increase of 10 g of absolute protein intake/day was associated with a reduction in birth weight of 17.8 g (95% CI: À32.7, À3.0; P ¼ 0.02). Protein intake was also associated negatively with ponderal index (b ¼ À0.01; 95% CI: À0.02, À0.00; P ¼ 0.01). A 1 % increase in carbohydrate intake resulted in a 1% decline in placental weight relative to birth weight. Higher protein intake in the third trimester was associated with a reduced ponderal index among large birth weight infants but not low birth weight infants. Conclusions: This raises the possibility that any effect of high protein in altering infant anthropometry at birth may involve changes in body composition and future work to examine how a high-protein diet influences body composition at birth is warranted.

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Section: Discussionmentioning

confidence: 99%

Higher maternal dietary protein intake in late pregnancy is associated with a lower infant ponderal index at birth

et al. 2006

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“…95 Such interventions have been tried historically in a variety of malnourished and at-risk populations including poor communities in developed countries. 96,97 In 3 studies among Asian women in the United Kingdom and Chile, where the usual maternal energy intake was isocalorically replaced with 10% to 11% protein, [98][99][100] there was no effect on pregnancy outcomes, although there was a trend toward reduced birth weight. Even higher levels of protein supplementation (Ͼ25% of energy) in relatively well-nourished populations failed to show any benefit on pregnancy outcomes and birth weight.…”

Section: Protein Supplementationmentioning

confidence: 99%

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

et al. 2005

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ABSTRACT. Background. Infant and under-5 childhood mortality rates in developing countries have declined significantly in the past 2 to 3 decades. However, 2 critical indicators, maternal and newborn mortality, have hardly changed. World leaders at the United Nations Millennium Summit in September 2000 agreed on a critical goal to reduce deaths of children <5 years by two thirds, but this may be unattainable without halving newborn deaths, which now comprise 40% of all under-5 deaths. Greater emphasis on wide-scale implementation of proven, cost-effective measures is required to save women's and newborns' lives. Approximately 99% of neonatal deaths take place in developing countries, mostly in homes and communities. A comprehensive review of the evidence base for impact of interventions on neonatal health and survival in developingcountry communities has not been reported.Objective. This review of community-based antenatal, intrapartum, and postnatal intervention trials in developing countries aimed to identify (1) key behaviors and interventions for which the weight of evidence is sufficient to recommend their inclusion in communitybased neonatal care programs and (2) key gaps in knowledge and priority areas for future research and program learning.Methods. Available published and unpublished data on the impact of community-based strategies and interventions on perinatal and neonatal health status outcomes were reviewed. Evidence was summarized systematically and categorized into 4 levels of evidence based on study size, location, design, and reported impact, particularly on perinatal or neonatal mortality. The evidence was placed in the context of biological plausibility of the intervention; evidence from relevant developed-country studies; health care program experience in implementation; and recommendations from the World Health Organization and other leading agencies.Results. A paucity of community-based data was found from developing-country studies on health status impact for many interventions currently being considered for inclusion in neonatal health programs. However, review of the evidence and consideration of the broader context of knowledge, experience, and recommendations regarding these interventions enabled us to categorize them according to the strength of the evidence base and confidence regarding their inclusion now in programs. This article identifies a package of priority interventions to include in programs and formulates research priorities for advancing the state of the art in neonatal health care.Conclusions. This review emphasizes some new findings while recommending an integrated approach to safe motherhood and newborn health. The results of this study provide a foundation for policies and programs related to maternal and newborn health and emphasizes the importance of health systems research and evaluation of interventions. The review offers compelling support for using research to identify the most effective measures to save newborn lives. It also may facilitate dialogue with policy...

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“…Amino acid-stimulated increases in fetal glucagon, cortisol, and NE may contribute to a shift in substrate oxidation by the fetus from glucose to amino acids. pregnancy; insulin; fetal protein metabolism; fetal growth PREVIOUS ATTEMPTS TO IMPROVE fetal outcomes with use of maternal high-protein supplementation have actually increased the risk for small-for-gestational-age birth and infant mortality (26,36). Similarly, supplementation of pregnant sheep with intravenous amino acids for several days at the end of gestation demonstrated adverse fetal effects, including hypoxia and respiratory and metabolic acidosis (34).…”

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confidence: 99%

Prolonged infusion of amino acids increases leucine oxidation in fetal sheep

Maliszewski

Gadhia

O'Meara

et al. 2012

American Journal of Physiology-Endocrinology and Metabolism

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Maliszewski AM, Gadhia MM, O'Meara MC, Thorn SR, Rozance PJ, Brown LD. Prolonged infusion of amino acids increases leucine oxidation in fetal sheep. Am J Physiol Endocrinol Metab 302: E1483-E1492, 2012. First published March 27, 2012 doi:10.1152/ajpendo.00026.2012.-Maternal high-protein supplements designed to increase birth weight have not been successful. We recently showed that maternal amino acid infusion into pregnant sheep resulted in competitive inhibition of amino acid transport across the placenta and did not increase fetal protein accretion rates. To bypass placental transport, singleton fetal sheep were intravenously infused with an amino acid mixture (AA, n ϭ 8) or saline [control (Con), n ϭ 10] for ϳ12 days during late gestation. Fetal leucine oxidation rate increased in the AA group (3.1 Ϯ 0.5 vs. 1.4 Ϯ 0.6 mol·min Ϫ1 ·kg Ϫ1 , P Ͻ 0.05). Fetal protein accretion (2.6 Ϯ 0.5 and 2.2 Ϯ 0.6 mol·min Ϫ1 ·kg Ϫ1 in AA and Con, respectively), synthesis (6.2 Ϯ 0.8 and 7.0 Ϯ 0.9 mol·min Ϫ1 ·kg Ϫ1 in AA and Con, respectively), and degradation (3.6 Ϯ 0.6 and 4.5 Ϯ 1.0 mol·min Ϫ1 ·kg Ϫ1in AA and Con, respectively) rates were similar between groups. Net fetal glucose uptake decreased in the AA group (2.8 Ϯ 0.4 vs. 3.9 Ϯ 0.1 mg·kg Ϫ1 ·min Ϫ1 , P Ͻ 0.05). The glucose-O2 quotient also decreased over time in the AA group (P Ͻ 0.05). Fetal insulin and IGF-I concentrations did not change. Fetal glucagon increased in the AA group (119 Ϯ 24 vs. 59 Ϯ 9 pg/ml, P Ͻ 0.05), and norepinephrine (NE) also tended to increase in the AA group (785 Ϯ 181 vs. 419 Ϯ 76 pg/ml, P ϭ 0.06). Net fetal glucose uptake rates were inversely proportional to fetal glucagon (r 2 ϭ 0.38, P Ͻ 0.05), cortisol (r 2 ϭ 0.31, P Ͻ 0.05), and NE (r 2 ϭ 0.59, P Ͻ 0.05) concentrations. Expressions of components in the mammalian target of rapamycin signaling pathway in fetal skeletal muscle were similar between groups. In summary, prolonged infusion of amino acids directly into normally growing fetal sheep increased leucine oxidation. Amino acid-stimulated increases in fetal glucagon, cortisol, and NE may contribute to a shift in substrate oxidation by the fetus from glucose to amino acids. pregnancy; insulin; fetal protein metabolism; fetal growth PREVIOUS ATTEMPTS TO IMPROVE fetal outcomes with use of maternal high-protein supplementation have actually increased the risk for small-for-gestational-age birth and infant mortality (26,36). Similarly, supplementation of pregnant sheep with intravenous amino acids for several days at the end of gestation demonstrated adverse fetal effects, including hypoxia and respiratory and metabolic acidosis (34). The mechanisms that explain poor fetal outcomes in response to maternal protein supplementation during pregnancy are unknown.Experiments using normal pregnant sheep have led to some testable explanations for how high-protein supplementation during pregnancy might adversely affect fetal outcomes (4). Short-and long-term maternal amino acid infusions using mixtures of amino acids with a higher essential-nonessential ...

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Effect of a milk-based food supplement on maternal nutritional status and fetal growth in underweight Chilean women

Cited by 82 publications

References 7 publications

Higher maternal dietary protein intake in late pregnancy is associated with a lower infant ponderal index at birth

Higher maternal dietary protein intake in late pregnancy is associated with a lower infant ponderal index at birth

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

Prolonged infusion of amino acids increases leucine oxidation in fetal sheep

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