Maternal first-trimester diet and childhood bone mass: the Generation R Study

Generation R Study Group and the Departments of Paediatrics, Erasmus Medical Center, Rotterdam, Netherlands.
American Journal of Clinical Nutrition (Impact Factor: 6.92). 05/2013; 98(1). DOI: 10.3945/ajcn.112.051052
Source: PubMed

ABSTRACT BACKGROUND: Maternal diet during pregnancy has been suggested to influence bone health in later life. OBJECTIVE: We assessed the association of maternal first-trimester dietary intake during pregnancy with childhood bone mass. DESIGN: In a prospective cohort study in 2819 mothers and their children, we measured first-trimester daily energy, protein, fat, carbohydrate, calcium, phosphorus, and magnesium intakes by using a food-frequency questionnaire and homocysteine, folate, and vitamin B-12 concentrations in venous blood. We measured childhood total body bone mass by using dual-energy X-ray absorptiometry at the median age of 6.0 y. RESULTS: Higher first-trimester maternal protein, calcium, and phosphorus intakes and vitamin B-12 concentrations were associated with higher childhood bone mass, whereas carbohydrate intake and homocysteine concentrations were associated with lower childhood bone mass (all P-trend < 0.01). Maternal fat, magnesium intake, and folate concentrations were not associated with childhood bone mass. In the fully adjusted regression model that included all dietary factors significantly associated with childhood bone mass, maternal phosphorus intake and homocysteine concentrations most-strongly predicted childhood bone mineral content (BMC) [β = 2.8 (95% CI: 1.1, 4.5) and β = -1.8 (95% CI: -3.6, 0.1) g per SD increase, respectively], whereas maternal protein intake and vitamin B-12 concentrations most strongly predicted BMC adjusted for bone area [β = 2.1 (95% CI: 0.7, 3.5) and β = 1.8 (95% CI: 0.4, 3.2) g per SD increase, respectively]. CONCLUSION: Maternal first-trimester dietary factors are associated with childhood bone mass, suggesting that fetal nutritional exposures may permanently influence bone development.

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    ABSTRACT: We assessed the intrauterine influence of maternal smoking on childhood bone mass by comparing parental prenatal and postnatal smoking habits. We observed higher bone mass in children exposed to maternal smoking, explained by higher body weight. Maternal smoking or related lifestyle factors may affect childhood weight gain rather than skeletal growth. Maternal smoking during pregnancy may adversely affect bone health in later life. By comparing the associations of maternal and paternal smoking and of prenatal and postnatal exposure with childhood bone measures, we aimed to explore whether the suggested association could be explained by fetal programming or reflects confounding by familial factors. In 5565 mothers, fathers and children participating in a population-based prospective cohort study, parental smoking habits during pregnancy and current household smoking habits were assessed by postal questionnaires. Total body bone mineral content (BMC), bone area (BA) and bone mineral density (BMD) were measured by dual-energy X-ray absorptiometry (DXA) at the median age of 6.0 years (IQR 0.37). In confounder-adjusted models, maternal smoking during pregnancy was associated with a higher BMC of 11.6 g (95 % confidence interval (CI) 5.6, 17.5), a larger BA of 9.7 cm(2) (95 % CI 3.0, 16.4), a higher BMD of 6.7 g/cm(2) (95 % CI 2.4, 11.0) and a higher BMC of 5.4 g (95 % CI 1.3, 9.6) adjusted for BA of the child. Current weight turned out to mediate these associations. Among mothers who did not smoke, paternal smoking did not show evident associations with childhood bone measures. Also, household smoking practices during childhood were not associated with childhood bone measures. Our results do not support the hypothesis of fetal smoke exposure affecting childhood bone mass via intrauterine mechanisms. Maternal smoking or related lifestyle factors may affect childhood weight gain rather than skeletal growth.
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    ABSTRACT: PREGNANCY AND FOLIC ACID: Pregnancy is the most important period in life of every woman, partially for the number of physiological adaptations she is going through, partially for the expectance of new life. In addition, pregnancy is the "critical window" for development later in childhood, as a period of foetal programming during which nutrition plays one of crucial roles. Despite the general belief that nutrition through pregnancy is adequate and characterized by better nutritional habits, a number of studies do not corroborate this belief. ROLE OF FOLIC ACID: An adequate folate blood level is necessary for normal cell growth, synthesis of several compounds including deoxyribonucleic acid and ribonucleic acid, proper brain and neurologic functions; it is included in the regulation of homocysteine level, and closely related to the vitamin B12 metabolism. Folate deficiency in pregnancy is related to neural tube defects, other neurological disorders, preterm delivery and low birth weight. FOOD SOURCES: A correlation between folate and the prevention of broad spectrum of chronic diseases has been confirmed. Emerging evidence from the epigenetic studies is now bringing even more light on the level of significance of folic acid. A wide range of plant and animal foods are the natural sources of folate; liver, yeast, mushrooms, and green leafy vegetables being the most significant. Different ways of food preparation influence the folate stability and its bioavailability varies from 25 to 50% from foods, 85% from enriched foods or 100% from supplements. A great amount of scientific results has led to official recommendations for folic acid supplementation in pregnant women as well as in a number of obligatory or voluntary fortification programmes in order to prevent the folate deficiency on the level of different population groups. Nevertheless, there must be a certain level of precaution for elderly because folate can mask the vitamin B12 deficiency with possible fatal outcomes.
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Mar 19, 2015