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Does the impact of a plant-based diet during pregnancy on birth weight differ by ethnicity? A dietary pattern analysis from a prospective Canadian birth cohort alliance.

ABSTRACT: OBJECTIVE:Birth weight is an indicator of newborn health and a strong predictor of health outcomes in later life. Significant variation in diet during pregnancy between ethnic groups in high-income countries provides an ideal opportunity to investigate the influence of maternal diet on birth weight. SETTING:Four multiethnic birth cohorts based in Canada (the NutriGen Alliance). PARTICIPANTS:3997 full-term mother-infant pairs of diverse ethnic groups who had principal component analysis-derived diet pattern scores-plant-based, Western and health-conscious-and birth weight data. RESULTS:No associations were identified between the Western and health-conscious diet patterns and birth weight; however, the plant-based dietary pattern was inversely associated with birth weight (?=-67.6?g per 1-unit increase; P<0.001), and an interaction with non-white ethnicity and birth weight was observed. Ethnically stratified analyses demonstrated that among white Europeans, maternal consumption of a plant-based diet associated with lower birth weight (?=-65.9?g per 1-unit increase; P<0.001), increased risk of small-for-gestational age (SGA; OR=1.46; 95%?CI 1.08 to 1.54;P=0.005) and reduced risk of large-for-gestational age (LGA; OR=0.71; 95%?CI 0.53 to 0.95;P=0.02). Among South Asians, maternal consumption of a plant-based diet associated with a higher birth weight (?=+40.5?g per 1-unit increase; P=0.01), partially explained by cooked vegetable consumption. CONCLUSIONS:Maternal consumption of a plant-based diet during pregnancy is associated with birth weight. Among white Europeans, a plant-based diet is associated with lower birth weight, reduced odds of an infant born LGA and increased odds of SGA, whereas among South Asians living in Canada, a plant-based diet is associated with increased birth weight.

SUBMITTER: Zulyniak MA

PROVIDER: S-EPMC5695448 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Does the impact of a plant-based diet during pregnancy on birth weight differ by ethnicity? A dietary pattern analysis from a prospective Canadian birth cohort alliance.

Zulyniak Michael A MA de Souza Russell J RJ Shaikh Mateen M Desai Dipika D Lefebvre Diana L DL Gupta Milan M Wilson Julie J Wahi Gita G Subbarao Padmaja P Becker Allan B AB Mandhane Piush P Turvey Stuart E SE Beyene Joseph J Atkinson Stephanie S Morrison Katherine M KM McDonald Sarah S Teo Koon K KK Sears Malcolm R MR Anand Sonia S SS

BMJ open 20171114 11

<h4>Objective</h4>Birth weight is an indicator of newborn health and a strong predictor of health outcomes in later life. Significant variation in diet during pregnancy between ethnic groups in high-income countries provides an ideal opportunity to investigate the influence of maternal diet on birth weight.<h4>Setting</h4>Four multiethnic birth cohorts based in Canada (the NutriGen Alliance).<h4>Participants</h4>3997 full-term mother-infant pairs of diverse ethnic groups who had principal compon ...[more]

PMID: 29138203

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Project description:BackgroundPrevious studies have yielded inconsistent results on the association between maternal dietary protein intake and birth weight. Moreover, little is known about the effects of dietary protein intake from different sources on fetal growth. This study aimed to investigate the associations of different dietary protein sources (total protein, animal protein, plant protein, and major dietary protein sources) during pregnancy with birth weight and the related adverse birth outcomes.Methods7310 women were recruited using a stratified multistage random sampling method at 0-12 months (median: 3; 10-90th percentile: 0-7) after delivery in Shaanxi, China. Maternal diets were gathered by a validated FFQ and other characteristics were collected by a standard questionnaire. Multilevel linear or logistic regression models were used to estimate birth weight changes or ORs (95% CIs) for adverse birth outcomes associated with different dietary protein sources during pregnancy.ResultsThe mean percentage of energy from total protein was 11.4% (SD 2.2), with only 27.4% of total protein derived from animal protein. Per 3% increase in energy from total protein, animal protein, and dairy protein was associated with birth weight increases of 19.4 g (95% CI 6.0-32.9), 20.6 g (4.8-36.5), and 18.2 g (4.7-31.7), respectively. Per 3% increase in energy from total protein, animal protein, and dairy protein was also associated with lower risks of low birth weight (LBW) (total protein: OR = 0.78, 95% CI 0.64-0.94; animal protein: 0.79, 0.65-0.96; dairy protein: 0.71, 0.56-0.91), small for gestational age (SGA) (total protein: 0.88, 0.79-0.98; animal protein: 0.87, 0.78-0.97; dairy protein: 0.81, 0.68-0.96), and intrauterine growth retardation (IUGR) (total protein: 0.84, 0.72-0.98; animal protein: 0.86, 0.75-0.98; dairy protein: 0.78, 0.66-0.92). We observed no associations of plant protein and other major dietary protein sources with birth weight and the above birth outcomes. The results did not change when maternal protein was substituted for fat or carbohydrate.ConclusionsAmong Chinese pregnant women with low intake of protein, higher intake of dietary protein, in particular animal protein and dairy protein, is associated with higher birth weight and lower risks of LBW, SGA, and IUGR.

Project description:BackgroundAdvances in metabolomics are anticipated to decipher associations between dietary exposures and health. Replication biomarker studies in different populations are critical to demonstrate generalizability.ObjectivesTo identify and validate robust serum metabolites associated with diet quality and specific foods in a multiethnic cohort of pregnant women.DesignIn this cross-sectional analysis of 3 multiethnic Canadian birth cohorts, we collected semiquantitative FFQ and serum data from 900 women at the second trimester of pregnancy. We calculated a diet quality score (DQS), defined as daily servings of "healthy" minus "unhealthy" foods. Serum metabolomics was performed by multisegment injection-capillary electrophoresis-mass spectrometry, and specific serum metabolites associated with maternal DQSs were identified. We combined the results across all 3 cohorts using meta-analysis to classify robust dietary biomarkers (r > ± 0.1; P < 0.05).ResultsDiet quality was higher in the South Asian birth cohort (mean DQS = 7.1) than the 2 white Caucasian birth cohorts (mean DQS <3.2). Sixty-six metabolites were detected with high frequency (>75%) and adequate precision (CV <30%), and 47 were common to all cohorts. Hippuric acid was positively associated with healthy diet score in all cohorts, and with the overall DQS only in the primarily white Caucasian cohorts. We observed robust correlations between: 1) proline betaine-citrus foods; 2) 3-methylhistidine-red meat, chicken, and eggs; 3) hippuric acid-fruits and vegetables; 4) trimethylamine N-oxide (TMAO)-seafood, meat, and eggs; and 5) tryptophan betaine-nuts/legumes.ConclusionsSpecific serum metabolites reflect intake of citrus fruit/juice, vegetables, animal foods, and nuts/legumes in pregnant women independent of ethnicity, fasting status, and delays to storage across multiple collection centers. Robust biomarkers of overall diet quality varied by cohort. Proline betaine, 3-methylhistidine, hippuric acid, TMAO, and tryptophan betaine were robust dietary biomarkers for investigations of maternal nutrition in diverse populations.

Project description:BACKGROUND:Evidence for a relationship between trihalomethane (THM) or haloacetic acid (HAA) exposure and adverse fetal growth is inconsistent. Disinfection by-products exist as complex mixtures in water supplies, but THMs and HAAs have typically been examined separately. OBJECTIVES:We investigated joint exposure at the individual level to THMs and HAAs in relation to birth weight in the multi-ethnic Born in Bradford birth cohort. METHODS:Pregnant women reported their water consumption and activities via questionnaire. These data were combined with area-level THM and HAA concentrations to estimate integrated uptake of THMs into blood and HAA ingestion, accounting for boiling/filtering. We examined the relationship between THM and HAA exposures and birth weight of up to 7,438 singleton term babies using multiple linear regression, stratified by ethnicity. RESULTS:Among Pakistani-origin infants, mean birth weight was significantly lower in association with the highest versus lowest tertiles of integrated THM uptake (e.g., -53.7 g; 95% CI: -89.9, -17.5 for ? 1.82 vs. < 1.05 ?g/day of total THM) and there were significant trends (p < 0.01) across increasing tertiles, but there were no associations among white British infants. Neither ingestion of HAAs alone or jointly with THMs was associated with birth weight. Estimated THM uptake via showering, bathing, and swimming was significantly associated with lower birth weight in Pakistani-origin infants, when adjusting for THM and HAA ingestion via water consumption. CONCLUSIONS:To our knowledge, this is the largest DBP and fetal growth study to date with individual water use data, and the first to examine individual-level estimates of joint THM-HAA exposure. Our findings demonstrate associations between THM, but not HAA, exposure during pregnancy and reduced birth weight, but suggest this differs by ethnicity. This study suggests that THMs are not acting as a proxy for HAAs, or vice-versa. CITATION:Smith RB, Edwards SC, Best N, Wright J, Nieuwenhuijsen MJ, Toledano MB. 2016. Birth weight, ethnicity, and exposure to trihalomethanes and haloacetic acids in drinking water during pregnancy in the Born in Bradford cohort. Environ Health Perspect 124:681-689; http://dx.doi.org/10.1289/ehp.1409480.

Project description:BackgroundBoth obesity and gestational diabetes (GDM) are associated with adverse outcomes. Diet during pregnancy impacts weight gain and fetal growth. Therefore, we aimed to explore non-pharmacological treatment success depending on pre-pregnancy body weight and its association with large for gestational age (LGA) infants in women with GDM.MethodsIn our observational study we investigated 57 singleton pregnant women with GDM. All women received standard treatment, including healthy diet education and regular medical checkups. Data were collected through blood analysis, medical records and questionnaires assessing diet before conception and during pregnancy. Differences in dietary patterns were compared in normal weight and overweight/obese group using Mann-Whitney U, Wilcoxon Signed Rank Test or Kruskal-Wallis test, as appropriate. Logistic regression was used for prediction of LGA. p-value less than 0.05 was used for statistical significance.ResultsPreconceptionally, the Mann-Whitney U test showed that the normal-weight group (n = 41) more frequently consumed fruits (U = 116.5, p < 0.001), eggs (U = 189.5, p = 0.02), cheese (U = 148.0, p = 0.003) compared to the overweight/obese group (n = 16), that consumed more beef (U = 407.0, p = 0.03) and low-calorie beverages (U = 397.0, p = 0.05). During pregnancy both groups improved their diet, with no differences detected. Personality types differed only preconceptionally with regard to healthy diet. Excessive gestational weight gain did not significantly differ between body-weight groups (16.6% vs. 23.1%), neither did the incidence of LGA infants (46.2% vs. 43.8%). Significant predictors of LGA were paternal height (OR = 1.12, 95% CI 1.01-1.23), 3rd trimester HbA1c (OR = 0.50, 95% CI 0.26-0.97), unemployment (OR = 4.80, 95% CI 1.12-20.61) and diet improvement during pregnancy (OR = 1.19, 95% CI 1.02-1.39). After adjustment improvement in diet was no longer a significant predictor for LGA.ConclusionEven though dietary patterns of the participants significantly improved during pregnancy, LGA infants were born independently of pre-pregnancy weight or diet and despite good glycemic control. Further research is needed to explore social determinants of health and whether solutions outside the health sector could provide efficient means in preventing adverse pregnancy outcomes as well as improving metabolic health.

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Does the impact of a plant-based diet during pregnancy on birth weight differ by ethnicity? A dietary pattern analysis from a prospective Canadian birth cohort alliance.

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Does the impact of a plant-based diet during pregnancy on birth weight differ by ethnicity? A dietary pattern analysis from a prospective Canadian birth cohort alliance.

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