Maternal nut consumption during pregnancy linked to improvements in neurodevelopment in children
May 7, 2019
Science Daily/Barcelona Institute for Global Health (ISGlobal)
Nuts are known to help reduce the risk of hypertension, oxidative stress and diabetes and they may exercise a protective effect against cognitive decline in older age. To this list of beneficial health effects, we can now add new evidence from a study led by the Barcelona Institute for Global Health (ISGlobal), an institute supported by "la Caixa." The study, published in the European Journal of Epidemiology, found links between a maternal diet rich in nuts during the first trimester of pregnancy and improved neurodevelopment in the child.
The study was carried out in Spain and included over 2,200 mother and child pairs enrolled in cohorts belonging to the INMA Project located in Asturias, Guipuzcoa, Sabadell and Valencia. Information on maternal nut intake was obtained from questionnaires on eating habits, which the mothers completed during the first and last trimester of their pregnancy. The children's neuropsychological development was assessed using several internationally validated standard tests 18 months, 5 years, and 8 years after birth.
Analysis of the results showed that the group of children whose mothers ate more nuts during the first trimester of pregnancy obtained the best results in all the tests measuring cognitive function, attention capacity and working memory.
"This is the first study to explore the possible benefits of eating nuts during pregnancy for the child's neurodevelopment in the long term. The brain undergoes a series of complex processes during gestation and this means that maternal nutrition is a determining factor in fetal brain development and can have long-term effects, explains Florence Gignac, ISGlobal researcher and first author of the study. "The nuts we took into account in this study were walnuts, almonds, peanuts, pine nuts and hazelnuts. We think that the beneficial effects observed might be due to the fact that the nuts provided high levels of folic acid and, in particular, essential fatty acids like omega-3 and omega-6. These components tend to accumulate in neural tissue, particularly in the frontal areas of the brain, which influence memory and executive functions."
The benefits described in this study were observed in the group of mothers who reported the highest consumption of nuts -- a weekly average of just under three 30g servings. This is slightly lower than the average weekly consumption recommended in the healthy eating guide published by the Spanish Society of Community Nutrition (SENC: Guía de la alimentación saludable), which is between three and seven servings per week. "This makes us think that if the mothers consumed the recommended weekly average the benefits could be much greater," Gignac explains. Estimated nut consumption in Spain is more than double the European average (4.8 g vs. 2.2 g).
The study also analysed the mothers' nut consumption during the third trimester of their pregnancy, but in this case either no associations were observed with the neuropsychological outcomes or the associations found were weaker. "This is not the first time we have observed more marked effects when an exposure occurs at a specific stage of the pregnancy. While our study does not explain the causes of the difference between the first and third trimesters, the scientific literature speculates that the rhythm of fetal development varies throughout the pregnancy and that there are periods when development is particularly sensitive to maternal diet" explains Jordi Júlvez, ISGlobal researcher and last author of the study.
"In any case," adds Júlvez, "as this is the first study to explore this effect, we must treat the findings with caution and work on reproducing them in the future with more cohort studies as well as randomised controlled trials."
https://www.sciencedaily.com/releases/2019/05/190507080134.htmMay 7, 2019
Overweight pregnant women can safely cut calories, restrict weight gain
Healthier for mom and baby to control mom's weight gain during pregnancy
September 24, 2018
Science Daily/Northwestern University
With proper nutrition guidance, it is safe and feasible to restrict weight gain in obese and overweight pregnant women, a new study shows.
Being obese or overweight during pregnancy can result in serious health problems for the mother and child. Obstetricians are often reluctant to recommend restricted weight gain for pregnant women due to safety concerns for the baby and lack of time and tools to safely guide women in their weight control efforts.
A new Northwestern Medicine study shows with proper nutrition guidance it is safe and feasible to restrict weight gain in obese and overweight pregnant women. The obese and overweight women in the study gained five pounds less during their pregnancy than those in the control group. Their babies were born in the normal weight range.
The approach included nutritional counseling on a healthy diet and lifestyle as supported by a commercially available smartphone diet app, with ongoing coaching via the phone and online.
"We need to help these women, who make up the majority of pregnancies in the U.S, leverage this unique opportunity during their pregnancy to adopt a healthier diet and lifestyle plan that they can follow throughout pregnancy and, hopefully, post-partum," said lead study author Linda Van Horn, professor of preventive medicine at Northwestern University Feinberg School of Medicine. "These results show promise in harnessing modern technology to help a mom achieve those goals."
The majority of U.S. women of reproductive age are overweight or obese, and the risk of excess gestational weight gain is higher for them than women of healthy weight. Among the risks for women and their babies: diabetes, preeclampsia, hypertension and birth defects.
Van Horn, along with obstetrician colleague Dr. Alan Peaceman, developed and led the study, called MOMFIT (Maternal Offspring Metabolics: Family Intervention Trial). It was part of the Lifestyle Interventions for Expectant Moms (LIFE-Moms) Consortium, a National Institutes of Health (NIH)-supported research project, with each study implementing separate interventions.
The Northwestern study was novel because it concentrated on improving diet quality and healthy lifestyle in the moms using modern tools and focused on potential maternal fetal nutrition advantages that could have lifelong benefits, Van Horn said.
The study will be published Sept. 24 in the American Journal of Preventive Medicine.
This is believed to be the first study of obese and overweight pregnant women using a technologically advanced, commercially available weight-loss smartphone app to test the effects of a specially tailored diet combined with modest physical activity.
Existing commercial weight control technologies target non-pregnant women and don't address prenatal energy and nutrient needs, the authors said. Most commercial apps are designed to support weight loss. During pregnancy, weight gain is anticipated and appropriate, but it should be curtailed in overweight and obese women.
"MOMFIT demonstrates the feasibility of counseling pregnant women in healthy diet and lifestyle behaviors through nutrition coaching using modern technology," Van Horn said. "Applying this approach in a clinical setting could help women achieve recommended weight-gain goals during pregnancy and improve postpartum lifestyle behaviors for the whole family."
One unusual outcome of the trial was a higher rate of cesarean sections for the women in the intervention group. Researchers are investigating possible contributors to this finding.
Will MOMFIT kids have less risk of developing obesity?
"The next big question is whether the children born to moms who restricted their weight gain will have a reduced risk of becoming obese themselves compared to children whose moms were in the control group," Van Horn said.
Children born to overweight and obese moms have more than a 50 percent chance of becoming overweight themselves. If both parents are overweight or obese, this risk can increase to more than 70 percent, according to epidemiological data.
The difference in the children's obesity risk won't be evident until they are three, four and five years old, which is when weight trajectories start to separate. Van Horn and colleagues have recently launched a new study -- KIDFIT -- to monitor the children of the women in her MOMFIT study and determine whether prenatal and/or postpartum diet and lifestyle counseling can help these children lower their risk of obesity.
Rebooting the whole family's diet
The study's goal was not weight loss. "Weight loss during pregnancy is not encouraged. Rather, we aimed for controlled weight gain by developing healthy diet habits and increasing physical activity that could be sustained long term.
"The overarching goal of MOMFIT was to help the mom make these changes while she was still pregnant, a time when many women are more motivated to do what is right for their babies, and then maintain these new behaviors and become a role model for the family and better informed about how to feed them," Van Horn said.
"The perpetuation of obesity is a never-ending cycle. We're attempting to interrupt that cycle and successfully influence the risk for developing pediatric obesity starting in utero and -- with additional follow up -- protect that child from adopting that parental heritage in the family home."
Fewer participants in the intervention group, 68.6 percent versus 85 percent, exceeded the National Academy of Medicine recommendations for pregnancy weight gain for obese and overweight women, which is limited to 11 to 25 pounds compared to 25 to 35 pounds for women of healthy weight. This is important evidence demonstrating the challenges of encouraging pregnant women to adhere to recommended diet and activity levels at a time when emotional-eating and reluctance to exercise tend to increase.
How the study worked
MOMFIT studied 281 ethnically diverse overweight or obese women ages 18 to 45, who were divided into the intervention or control group. Women in the intervention group met with a nutritionist who calculated the appropriate amount of calories for each participant and counseled her on a DASH-type diet -- higher in fruits, vegetables, whole grains, nuts, fish and lean protein. It was modified to the restricted weight gain recommendations for each participant.
The DASH (Diet Approach to Stopping Hypertension) eating pattern is ideally suited to pregnancy, providing a pregnant woman with the calcium, potassium and protein she needs without the salt, sugar and saturated fat that she does not need, Van Horn said.
The women were also encouraged to walk at least 30 minutes or take 10,000 steps per day. The nutrition coach tracked each woman's weight gain, food intake and exercise. Telephone, text message prompts and e-mail reminders encouraged women to adhere to the program.
"It was technologically convenient yet strategic and nutritionally individualized," Van Horn said. "MOMFIT took a precision medicine approach to healthy eating utilizing a commercially available product."
Women tracked their food intake with the Lose It! app. Participants were also encouraged to sleep seven to nine hours daily, because sleep deprivation hampers metabolism and contributes to weight gain.
https://www.sciencedaily.com/releases/2018/09/180924084332.htm