Nutrition during pregnancy Latvia eng
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Fig. 4. Nutritional st ressors involved in metabolic p rogramming of obesity and NCDs Sources : adapted f rom Koletzko et al. [7]; Martin-G ronert & Ozanne [24]; Li, Sloboda & Vickers [30]; Devlin & Bouxsein [42]; W ar ner & Ozanne [47]; Knudson [54]; Fainberg, Budge & Symonds [55]; Viljakainen et al. [56]; Palinski et al. [57].
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Effect of maternal diet before and after pregnancy on the life-‐‑long health of the child Fetal development depends on a proper supply of nutrients, including micronutrients in the mother’s bloodstream. Maternal nutrition has a direct impact on their child’s health during adulthood, which may be a major factor in the global epidemics of obesity and NCDs. Furthermore, there are direct relations between low birth weight and susceptibility to a number of diseases in later life, including insulin-‐related metabolic disorders, type II diabetes, central adiposity, abnormal lipid metabolism, obesity, arterial hypertension, cardiovascular diseases, fatal ischaemic diseases and renal disorders. BMI is evaluated according to the classification adopted by WHO in 1995: BMI < 18.5 kg/m 2 : underweight; 18.5–24.9 kg/m 2 : normal; 25–29.9 g/m 2 : overweight; and > 30 kg/m 2 : obese. Obesity before and after conception increases the risks for a range of complications in pregnancy. Being overweight or obese before conception increases the risks for arterial hypertension and gestational diabetes mellitus during pregnancy, with corresponding negative consequences for health, and is a direct cause of macrosomia, which may alter the child’s glucose and lipid metabolism and trigger hypertension.
The recommended weight gain during pregnancy for a woman of normal weight is 10–16 kg for those with a normal BMI, 13–18 kg for those who are underweight, 7–11 for those who are overweight and 5–9 kg for those who are obese. Both excessive and insufficient weight gain during pregnancy have negative impacts. With every additional kilogram that a mother gains over that recommended, the risk of the child for being obese during adulthood increases by 8%. A high pre-‐pregnancy maternal BMI is associated with an even higher risk for obesity than excessive weight gain during pregnancy. Reducing body weight to within the normal range before conception and dietary control to limit weight gain during pregnancy are safe, cost– effective methods for lowering the risk for NCDs.
Intake of w-‐3 fatty acids has been decreasing during the past 50 years, whereas intake of w-‐6 fatty acids has increased. The main dietary source of w-‐3 is oily fish (for example, salmon, trout, sardines and sprats), and those of w-‐6 fatty acids are sunflower, grapeseed and corn oil, as well as poultry fat. Studies in experimental animals have shown a positive effect of w-‐3 fatty acids on macrosomia, as reduced hyperlipidaemia restores the antioxidant balance and immune function. In humans, w-‐3 fatty acids reduced the risk for the pre-‐eclampsia, reduced the weight of the placenta, stimulated the cognitive development of the child and stimulated linear growth. Other studies in experimental animals, however, led to the conclusion that a high intake of w-‐6 fatty acids in the maternal diet has a negative effect on regulation of the child’s appetite and energy metabolism. |