期刊
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
卷 45, 期 5, 页码 1656-1667出版社
OXFORD UNIV PRESS
DOI: 10.1093/ije/dyw199
关键词
Prenatal; Micronutrient; Food; Supplementation; early childhood; metabolic
资金
- International Centre for Diarrhoeal Disease Research, Bangladesh
- UK Medical Research Council
- Swedish Research Council
- UK Department for International Development
- Global Health Research Fund, Japan
- Child Health and Nutrition Research Initiative
- Uppsala University, Sweden
- US Agency for International Development [388-G-00-02-00125-00]
- Australian International Development Agency
- Government of Bangladesh
- Canadian International Development Agency
- Kingdom of Saudi Arabia
- Government of The Netherlands
- Government of Sri Lanka
- Swedish International Development Cooperative Agency
- Swiss Agency for Development and Cooperation
- Family Erling Persson Foundation
Background: Fetal nutritional insults may alter the later metabolic phenotype. We hypothesized that early timing of prenatal food supplementation and multiple micronutrient supplementation (MMS) would favourably influence childhood metabolic phenotype. Methods: Pregnant women recruited 1 January to 31 December 2002 in Matlab, Bangladesh, were randomized into supplementation with capsules of either 30 mg of iron and 400 mu g of folic acid, 60 mg of iron and 400 mu g of folic acid, or MMS containing a daily allowance of 15 micronutrients, and randomized to food supplementation (608 kcal) either with early invitation (9 weeks' gestation) or usual invitation (at 20 weeks). Their children (n = 1667) were followed up at 4.5 years with assessment of biomarkers of lipid and glucose metabolism, inflammation and oxidative stress. Results: Children in the group with early timing of food supplementation had lower cholesterol (difference -0.079 mmol/l, 95% confidence interval (CI) -0.156; -0.003), low-density lipoprotein (LDL) (difference -0.068 mmol/l, 95% CI -0.126; -0.011) and ApoB levels (difference -0.017 g/l, 95% CL -0.033; -0.001). MMS supplementation resulted in lower high-density lipoprotein (HDL) (difference -0.028 mmol/l, 95% CL -0.053; -0.002), lower glucose (difference -0.099 mmol/l, 95% CL -0.179; -0.019) and lower insulin-like growth factor 1 (IGF-1) (difference on log scale -0.141 mu g/l, 95% CL -0.254; -0.028) than 60 mg iron and 400 mu g folic acid. There were no effects on markers of inflammation or oxidative stress. Conclusions: Findings suggest that in a population where malnutrition is prevalent, nutrition interventions during pregnancy may modify the metabolic phenotype in the young child that could have consequences for later chronic disease risks.
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