Energy and Protein Supplementation Does Not Affect Protein and Amino Acid Kinetics or Pregnancy Outcomes in Underweight Indian Women

Dwarkanath, Pratibha; Hsu, Jean W.; Tang, Grace J.; Anand, Pauline; Thomas, Tinku; Thomas, Annie; Sheela, C. N.; Kurpad, Anura V; Jahoor, Farook

doi:10.3945/jn.115.218776

Cited by 11 publications

(63 citation statements)

References 20 publications

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“…On abstract screening, 61 articles were selected for full-text screening and, at the same time, eight articles were included through cross-referencing. Fifteen studies [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] were included for data extraction ( Figure S1). All included trials studied healthy pregnant women at varying gestational ages in LMIC settings.…”

Section: Study Selectionmentioning

confidence: 99%

“…Studies included both urban [26,28,32,35] and rural [21,[23][24][25]29,31,33,34] settings, with three studies not specifying their setting [22,27,30]. The characteristics of included studies are briefly mentioned in Table S3.…”

Section: Study Selectionmentioning

confidence: 99%

“…Eight studies on BEP supplementation were included (food supplementation in which proteins provided <25% energy) [21][22][23]25,28,30,32,33], which included pregnant women (Table S3). Three studies were conducted in Asia [21,30,32], three in Africa [22,23,33], one in Middle East [28], and one in South America [25]. Five were randomized controlled trials (RCTs) [21,22,28,32,33], and three were quasi-experimental studies [23,25,30].…”

Section: Description Of Studiesmentioning

confidence: 99%

“…Three studies were conducted in Asia [21,30,32], three in Africa [22,23,33], one in Middle East [28], and one in South America [25]. Five were randomized controlled trials (RCTs) [21,22,28,32,33], and three were quasi-experimental studies [23,25,30].…”

Section: Description Of Studiesmentioning

confidence: 99%

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Impact of Dietary Interventions during Pregnancy on Maternal, Neonatal, and Child Outcomes in Low- and Middle-Income Countries

et al. 2020

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Optimal nutrition plays a crucial role in pregnancy. Maternal malnutrition is a risk factor for maternal, fetal, and neonatal complications and is more prevalent in low and middle-income countries (LMICs). This review aims to study the effectiveness of antenatal macronutrient nutritional interventions on maternal, neonatal, and child outcomes. We searched the CENTRAL, PubMed, Embase, and other databases for randomized controlled trials and quasi-experimental designs on healthy pregnant women in LMICs. We also searched grey literature and reports from Google Scholar, Web of Science, and websites of different organizations. Title/abstract screening, full-text screening, and data extraction filtered 15 studies for inclusion. Balanced energy protein (BEP) supplementation (n = 8) studies showed a reduced incidence of perinatal mortality, stillbirths, low birth weight (LBW) infants, small for gestational age (SGA) babies and increased birth weight. Food distribution programs (FDPs) (n =5) witnessed reduced rates of SGA, stunting, wasting, and increased birth weight and birth length. Studies on intervention for obesity prevention (n = 2) showed reductions in birth weight. Other findings were statistically insignificant. Subgroup analyses were conducted to study the effectiveness of supplementation between regions, location, the timing of supplementation and nutritional status; however, there were a limited number of studies in each subgroup. Data from our review supports the antenatal supplementation of BEP and FDP for the prevention of adverse maternal, neonatal, and child outcomes that can be utilized for future policymaking. However, more research is required before recommending obesity prevention programs.Nutrients 2020, 12, 531 2 of 16 malnutrition in LMICs, with one study quoting rates from 20% in sub-Saharan Africa and south/central America to approximately 40% in India [3].Life course theory demonstrates the childhood experiences affecting health conditions at adulthood (e.g., diabetes, depression) [6]. Likewise, antenatal malnutrition forces a fetus to adapt to an environment of scarcity and, consequently, the adverse effects extend beyond the perinatal period and end up with the child having long-term chronic diseases such as cognitive dysfunction, obesity, diabetes mellitus, and hypertension. Conversely, evidence also suggests the harmful effects of overnutrition [7] in all phases of pregnancy. Nutrition transition has engulfed developing countries, which has caused reduced mortality leading to increased populations, followed by a decrease in fertility. The increase in intake of sugar and fats has also reduced physical activity, contributing to obesity in pregnant women that lead to complicated pregnancies, which also affects the neonate at birth and in future life [8]. It was found that obesity increases the risk of fetal macrosomia, stillbirth, congenital obesity [9][10][11], and infant mortality [12].Current guidelines have reported on the use and effectiveness of iron and other multi-nutrient formulations...

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Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Description Of Studiesmentioning

confidence: 99%

Section: Description Of Studiesmentioning

confidence: 99%

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Impact of Dietary Interventions during Pregnancy on Maternal, Neonatal, and Child Outcomes in Low- and Middle-Income Countries

et al. 2020

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“…In this context it is of interest that a high protein (21% of energy) supplement in healthy men caused a significant increase in postprandial total homocysteine concentration in the plasma (Verhoef et al 2005). Additionally energy and protein supplement in Indian underweight pregnant women did not impact serine and glycine kinetics (Dwarkanath et al 2016). The physiological and biological implication of these studies, in relation to maternal and neonatal health, requires further evaluation.…”

Section: One Carbon Metabolism and The Health Of The Mother Fetusmentioning

confidence: 99%

One carbon metabolism in pregnancy: Impact on maternal, fetal and neonatal health

Kalhan

2016

Molecular and Cellular Endocrinology

100

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One carbon metabolism or methyl transfer, a crucial component of metabolism in all cells and tissues, supports the critical function of synthesis of purines, thymidylate and methylation via multiple methyl transferases driven by the ubiquitous methyl donor s-adenosylmethionine. Serine is the primary methyl donor to the one carbon pool. Intracellular folates and methionine metabolism are the critical components of one carbon transfer. Methionine metabolism requires vitamin B12, B6 as cofactors and is modulated by endocrine signals and is responsive to nutrient intake. Perturbations in one carbon transfer can have profound effects on cell proliferation, growth and function. Epidemiological studies in humans and experimental model have established a strong relationship between impaired fetal growth and the immediate and long term consequences to the health of the offspring. It is speculated that during development, maternal environmental and nutrient influences by their effects on one carbon transfer can impact the health of the mother, impair growth and reprogram metabolism of the fetus, and cause long term morbidity in the offspring. The potential for such effects is underscored by the unique responses in methionine metabolism in the human mother during pregnancy, the absence of transsulfuration activity in the fetus, ontogeny of methionine metabolism in the placenta and the unique metabolism of serine and glycine in the fetus. Dietary protein restriction in animals and marginal protein intake in humans causes characteristic changes in one carbon metabolism. The impact of perturbations in one carbon metabolism on the health of the mother during pregnancy, on fetal growth and the neonate are discussed and their possible mechanism explored.

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PROTOCOL: Effects of nutritional interventions during pregnancy on birth, child health, and development outcomes: A systematic review of evidence from low‐ and middle‐income countries

Lassi

Padhani

Rabbani

et al. 2019

Campbell Systematic Reviews

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Energy and Protein Supplementation Does Not Affect Protein and Amino Acid Kinetics or Pregnancy Outcomes in Underweight Indian Women

Abstract: We conclude that in Indian women with a low BMI, supplementation with energy and protein from week 12 of pregnancy to time of delivery does not improve pregnancy outcome, whole-body protein kinetics, or serine and glycine fluxes.

Cited by 11 publications

References 20 publications

Impact of Dietary Interventions during Pregnancy on Maternal, Neonatal, and Child Outcomes in Low- and Middle-Income Countries

Impact of Dietary Interventions during Pregnancy on Maternal, Neonatal, and Child Outcomes in Low- and Middle-Income Countries

One carbon metabolism in pregnancy: Impact on maternal, fetal and neonatal health

PROTOCOL: Effects of nutritional interventions during pregnancy on birth, child health, and development outcomes: A systematic review of evidence from low‐ and middle‐income countries

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