Introduction: Nutritional requirements increase during lactation. However, maternal dietary intakes of Malaysian mothers are subjected to restrictions commonly included in traditional postpartum practices. This study aimed to assess the maternal dietary intake status during the recommended six month exclusive breastfeeding (part of which included the traditional confinement) period. Methods: Thirty-two Malay mothers aged 18-35 years, who had delivered full-term (at ≥37 weeks) singleton babies and were exclusively breastfeeding, were included in the study. Maternal dietary intake was assessed using multiple-pass diet recall on Days 10, 30, 60, 90, 120, 150, and 180, postpartum. The average total energy and macronutrient intakes were compared against recommended values. Results: The findings of this study demonstrated that maternal intakes of total energy ranged from 1,500-2,000kcal/day, carbohydrate 189-272g/day, protein 58-72g/day, and total fat 32-70g/day. Total calorie intake was the lowest during confinement period (Days 10 and 30) compared to the rest of the exclusive breastfeeding period. This is similar with total fat consumption. On the other hand, protein intake was the highest during confinement period whereas carbohydrate intake was consistent throughout the six-month period. Despite the increased requirements, intakes of total calories, protein, total fat, dietary fibre, and water, did not meet the recommended values throughout the exclusive breastfeeding period. Conclusion: Mothers’ inability to fulfil their nutritional requirements during exclusive breastfeeding period may be associated with traditional postpartum dietary practices. Dietary advice with consideration for cultural food taboos practiced by local mothers during confinement may help to improve maternal nutritional intakes during this crucial time.
Maternal diet

Gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset or first recognition during pregnancy, is characterized by underlying maternal defects in the β-cell response to insulin during pregnancy. Women with a previous history of GDM have a greater than 7-fold higher risk of developing postpartum diabetes compared with women without GDM. Various risk factors for postpartum diabetes have been identified, including maternal age, glucose levels in pregnancy, family history of diabetes, pre-pregnancy and postpartum body mass index, dietary patterns, physical activity, and breastfeeding. Genetic studies revealed that GDM shares common genetic variants with type 2 diabetes. A number of lifestyle interventional trials that aimed to ameliorate modifiable risk factors, including diet, exercise, and breastfeeding, succeeded in reducing the incidence of postpartum diabetes, weight retention, and other obesity-related morbidities. The present review summarizes the findings of previous studies on the incidence and risk factors of postpartum diabetes and discusses recent lifestyle interventional trials that attempted to prevent postpartum diabetes.
Body Mass Index ; Breast Feeding ; Diabetes Mellitus, Type 2* ; Diabetes, Gestational* ; Diet ; Epidemiology ; Female ; Glucose ; Glucose Intolerance ; Humans ; Incidence ; Insulin ; Life Style ; Maternal Age ; Motor Activity ; Postpartum Period ; Pregnancy ; Risk Factors

PURPOSE: Proper management of nutrition or health care for pregnant women is known to have better perinatal outcomes for maternal and neonatal health. In this study, we investigated the effect of regular medical and nutritional counseling provided to pregnant women for improved-results for mother and neonates. METHODS: Thirty-five pregnant women participated in the study and received information on nutrition management via telephone or e-mail every four weeks until childbirth. The nutrition management program comprised proper diet, low-salt diet, low-sugar diet, breast-feeding preparation, and provision of a healthy menu according to their pregnancy trimesters. We categorized them by their degree of participation into a “low participation group” that formed the control group, and a “high participation group” as the study group. RESULTS: No significant differences were found in maternal age, and body mass index between the two groups at the time of enrollment in the study. Post-natal exclusive breast feeding rate was significantly higher in the high participation group (62%) than in the low participation group (32%) (p<0.05). In the neonatal results, gestational age at birth and neonatal birth weight were significantly higher in the high participation group than in the low participation group (p<0.05). Neonatal complication rate, neonatal admission rate to intensive care unit, rate of low birth weight, Apgar score at 1 and 5 minutes, as well as the rate of transient tachypnea were higher in the low participation group, but lacked any statistically significant difference. CONCLUSION: Collaborative nutrition management with obstetricians and nutritionists is helpful in achieving better perinatal outcomes.
Apgar Score ; Birth Weight ; Body Mass Index ; Breast Feeding ; Counseling ; Delivery of Health Care ; Diet ; Diet, Sodium-Restricted ; Electronic Mail ; Female ; Gestational Age ; Gyeonggi-do* ; Humans ; Infant Health ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care Units ; Maternal Age ; Mothers ; Nutritionists ; Parturition ; Pregnancy Outcome ; Pregnancy Trimesters ; Pregnancy* ; Pregnant Women ; Tachypnea ; Telephone

PURPOSE: This study investigated self-food restriction during breastfeeding, reviewed the literature showing the effect of maternal diet on the health of breast-fed infants, and explored the validity of dietary restrictions. METHODS: Questionnaire data were collected from breastfeeding Korean mothers who visited the pediatric clinic of Cheil General Hospital & Women's Healthcare Center from July 2015 through August 2015. The survey included items assessing maternal age, number of children, maternal educational attainment, household income, degree of difficulty with self-food restriction, types of self-restricted foods, dietary customs during breastfeeding, and sources of information about breastfeeding. RESULTS: The questionnaire was completed by 145 mothers. More than a third (n=56, 39%) had discomfort from and usually avoided 4–5 types of food (mean, 4.92). Mothers younger than 40 years had more discomfort (odds ratio [OR], 12.762; P=0.017). Primiparas felt less discomfort than multiparas (OR, 0.436; P=0.036). Dietary practices were not influenced by maternal educational attainment or household income. The most common self-restricted foods were caffeine (n=131, 90.3%), spicy foods (n=124, 85.5%), raw foods (n=109, 75.2%), cold foods (n=100, 69%), and sikhye (traditional sweet Korean rice beverage) (n=100, 69%). Most mothers (n=122, 84.1%) avoided foods for vague reasons. CONCLUSION: Most mothers restricted certain foods unnecessarily. Literature review identified no foods that mothers should absolutely avoid during breastfeeding unless the infant reacts negatively to the food.
Breast Feeding* ; Caffeine ; Child ; Delivery of Health Care ; Diet ; Family Characteristics ; Female ; Health Care Surveys ; Hospitals, General ; Humans ; Infant ; Lactation ; Maternal Age ; Mothers ; Raw Foods

The objective of this study was to investigate the association of nutrient intake and pregnancy outcome mediated by weight gain during pregnancy, job status, and household income. Maternal age, educational level, self-reported pre-pregnancy weights, educational level, and household income were collected from the women at 2 months postpartum. For each offspring, weight at birth, length at birth, and gestational age were collected. Participants were asked to report the frequency of consumption of foods between 28–42 weeks into the pregnancy. Diet was assessed by using a validated 106-item semi-quantitative food-frequency questionnaire (SQFFQ) and women were asked portions and quantities based on pictures, food models, and measuring tools such as cups or teaspoons. Results showed that women who gained below the recommended weight gain during pregnancy, within, and over were 25.3%, 38.7%, 36.0%, respectively. In comparison to weight gain and the offspring's length and weight at birth, the offspring of mothers with a lower weight gain had a higher length. Energy, protein, vitamin B2, vitamin C, calcium, and potassium were significantly lower at employed group. We did not observe a significant difference between birth characteristics and maternal nutrient intake by income. Infants with a higher ponderal index at birth were born to women with a higher pre-pregnancy body mass index (BMI).
Ascorbic Acid ; Body Mass Index ; Calcium ; Diet ; Family Characteristics* ; Female ; Gestational Age ; Humans ; Infant ; Maternal Age ; Mothers ; Parturition ; Postpartum Period ; Potassium ; Pregnancy Outcome ; Pregnancy* ; Riboflavin ; Weight Gain* ; Weights and Measures

Nowadays in Korea, the number of pregnant women with diabetes mellitus is steadily growing due to increases in advanced maternal age and obesity in combination with changes in lifestyle and diet patterns. Pregnancy complicated with diabetes mellitus, whether it is gestational or pregestational, is associated with an increased number of maternal morbidities and adverse obstetric outcomes. Therefore, it is very important to screen, diagnose, manage, and prevent diabetes mellitus during, and even before, pregnancy. In order to improve maternal and perinatal outcomes of pregnancies complicated by diabetes mellitus, research is needed on the standardization of screening and the diagnostic criteria for gestational diabetes, appropriate surveillance techniques for diabetic mothers and fetuses, and the optimal timing of delivery. To facilitate compliance of women with diabetes, randomized studies on the long-term safety and effects of oral hypoglycemics are also needed.
Compliance ; Diabetes Mellitus ; Diabetes, Gestational ; Diet ; Female ; Fetus ; Humans ; Hypoglycemic Agents ; Korea ; Life Style ; Mass Screening ; Maternal Age ; Mothers ; Obesity ; Pregnancy in Diabetics ; Pregnancy* ; Pregnant Women

OBJECTIVEThis study aimed to explore the association between periconceptional fish consumption by parents and autism spectrum disorder (ASD) and intelligence deficiency (ID).

METHODSA case-control study was conducted through a questionnaire with 108 ASD cases, 79 ID cases, and 108 controls. The ASD and ID cases were students from special educational schools in Tianjin from 2012 to 2014. The age- and sex-matched controls were from a high school, three primary schools, and a kindergarten in Tianjin. Multivariate logistic regression was performed.

RESULTSPaternal habit of eating hairtail before fertilization, maternal preference for fruits during pregnancy, and maternal habit of eating grass carp during pregnancy were preventive factors for ASD. Paternal habit of drinking alcohol before fertilization was a risk factor for ID, whereas maternal preference for fruits during pregnancy and maternal habit of eating crucian carp during pregnancy were protective factors for ID.

CONCLUSIONParental fish consumption is beneficial for the prevention of ASD and ID. Meanwhile, the protective effects of fish consumption on ASD and ID differ. More attention should be paid to the combined effect of other food when eating fish.

Adolescent ; Animals ; Autism Spectrum Disorder ; epidemiology ; etiology ; Case-Control Studies ; Child ; Child, Preschool ; China ; epidemiology ; Diet ; adverse effects ; Environmental Exposure ; Female ; Fishes ; Humans ; Incidence ; Intellectual Disability ; epidemiology ; etiology ; Male ; Maternal Exposure ; Paternal Exposure ; Pregnancy ; Prenatal Exposure Delayed Effects ; epidemiology ; etiology ; Risk Factors ; Species Specificity

OBJECTIVETo investigate the association between autism and prenatal environmental risk factors.

METHODSA case-control study was conducted among 193 children with autism from the special educational schools and 733 typical development controls matched by age and gender by using questionnaire in Tianjin from 2007 to 2012. Statistical analysis included quick unbiased efficient statistical tree (QUEST) and logistic regression in SPSS 20.0.

RESULTSThere were four predictors by QUEST and the logistic regression analysis, maternal air conditioner use during pregnancy (OR=0.316, 95% CI: 0.215-0.463) was the single first-level node (χ²=50.994, P=0.000); newborn complications (OR=4.277, 95% CI: 2.314-7.908) and paternal consumption of freshwater fish (OR=0.383, 95% CI: 0.256-0.573) were second-layer predictors (χ²=45.248, P=0.000; χ²=24.212, P=0.000); and maternal depression (OR=4.822, 95% CI: 3.047-7.631) was the single third-level predictor (χ²=23.835, P=0.000). The prediction accuracy of the tree was 89.2%.

CONCLUSIONThe air conditioner use during pregnancy and paternal freshwater fish diet might be beneficial for the prevention of autism, while newborn complications and maternal depression might be the risk factors.

Adolescent ; Air Conditioning ; Air Pollution ; adverse effects ; Autistic Disorder ; epidemiology ; etiology ; Case-Control Studies ; Child ; Child, Preschool ; China ; epidemiology ; Delivery, Obstetric ; adverse effects ; methods ; Depression ; complications ; Diet ; Environmental Exposure ; Female ; Humans ; Income ; Logistic Models ; Male ; Maternal Exposure ; Obstetric Labor Complications ; epidemiology ; Paternal Exposure ; Pregnancy ; Prenatal Exposure Delayed Effects ; epidemiology ; Risk Factors ; Surveys and Questionnaires

Because linseed oil may influence maternal and fetal metabolisms, we investigated its role in the modulation of lipid metabolism in cafeteria diet-induced obese rats and their offspring. Female Wistar rats were fed control or cafeteria food, which were either supplemented or not supplemented with linseed oil (5%) for 1 month before and during gestation. At parturition, serum and tissue lipids and enzyme activities were analyzed. Cafeteria diet induced adverse metabolic alterations in both mothers and offspring. Linseed oil improved metabolic status. In conclusion, linseed oil displayed health benefits by modulating tissue enzyme activities in both obese mothers and their newborns.
Animal Feed ; analysis ; Animals ; Diet ; adverse effects ; Dietary Supplements ; analysis ; Female ; Linseed Oil ; administration & dosage ; metabolism ; Lipid Metabolism ; drug effects ; Maternal Nutritional Physiological Phenomena ; drug effects ; Obesity ; drug therapy ; etiology ; metabolism ; Pregnancy ; Prenatal Exposure Delayed Effects ; drug therapy ; etiology ; metabolism ; Random Allocation ; Rats ; Rats, Wistar

OBJECTIVETo explore the mechanism and effect of maternal high-fat diet before and during pregnancy on bone growth of neonatal offspring rats.

METHODSForty female Sprague-Dawley rats were divided into high-fat diet and control groups (n=20) that were fed with 35% high-fat diet and standard chow, respectively. After 8 weeks, 8 female rats from each group were sacrificed for liver pathological examinations and the other female rats were mated with male rats and fed continuously with 35% high-fat diet and standard chow throughout gestation, respectively. The body lengths (from apex nasi to end of tail) of the offspring rats from both groups were measured within 24 hours after birth. Enzyme-linked immunosorbent assay was used to detect serum insulin-like growth factor (IFG-I) levels. Liver pathological changes were observed under a light microscope. The expression of insulin receptor substrate 1 (IRS-1) and phosphorylation IRS-1 (Phospho-IRS-1) in tibia and femur samples were detected by immunohistochemistry. The expression of mitogen-activated protein kinase (MAPK) and phosphorylation MAPK (Phospho-MAPK), phosphatidylinositol 3-kinase (PI3K) and phosphorylation PI3K (Phospho-PI3K), protein kinase B (AKT1) and phosphorylation AKT1 (Phospho-AKT1) in tibia and femur samples were detected by Western blot.

RESULTSThe offspring rats from the high-fat diet group showed a significant shorter body length compared with those from the control group (P<0.05). The level of serum IGF-I in offspring rats from the high-fat diet group decreased by 20.1% in comparison to those from the control group, but there was no significant difference between the two groups (P>0.05). Fatty degeneration was found in livers of both high-fat diet-fed maternal rats and their offspring rats under a light microscope. There were no significant differences in IRS-1 and Phospho-IRS-1 expression in chondrocytes of tibia and femur samples between the offspring rats of the two groups (P>0.05). The protein expression of MAPK in chondrocytes of tibia and femur samples of offspring rats from the high-fat diet group was higher than that from the control group (P<0.05). There were no significant differences of PI3K and AKT1/Phospho-AKT1 between the offspring rats of the two groups (P>0.05).

CONCLUSIONSA maternal high-fat diet before and during pregnancy may affect the bone growth of offspring rats in utero, which is possibly associated with the decreased IGF-I level. However, further study on the exact mechanism of IGF-I on the bone growth is needed.

Animals ; Bone Development ; Diet, High-Fat ; Female ; Insulin-Like Growth Factor I ; analysis ; Liver ; pathology ; MAP Kinase Signaling System ; Maternal Nutritional Physiological Phenomena ; Phosphatidylinositol 3-Kinases ; physiology ; Pregnancy ; Proto-Oncogene Proteins c-akt ; physiology ; Rats ; Rats, Sprague-Dawley