Typescript (photocopy). / Digitized by Kansas Correctional Industries

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The placenta and fetal intestines are two key nutrient transport organs that sustain and nurture growing fetus. Insufficient placental development and consequently inadequate fetal nutrient supply can lead to IUGR resulting in low birth weight offspring. Our experimental objectives were to investigate the effects of elevated maternal nutrition, IUGR, and E2 supplementation during mid-gestation (in an attempt to rescue IUGR offspring) on placental and fetal intestinal cell proliferation, angiogenic gene expression, and vascularity. Limited responsiveness in placental development and vascularization to E2 supplementation was observed, likely due to inappropriate timing or dose of E2. However, maternal E2 supplementation increased fetal small intestinal length and GUCY1b3 mRNA expression, suggesting that E2 supplementation has positive effects on IUGR fetal intestinal growth. In conclusion, understanding molecular mechanisms associated with IUGR and possible effects of E2 supplementation in rescuing IUGR may lead to enhanced human health and livestock production efficiency.

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Childhood obesity disproportionately affects low-income families and those of Hispanic origin. Obesity is prevalent even among preschool children, and effective preventive interventions remain to be developed. Mothers, through their food choices and modeling behaviors, exert powerful influence over children’s diets and may therefore be ideal targets for such interventions. The purpose of this study was to assess the association between maternal diet quality and children’s body size. Data came from a study of Endotoxin, Obesity, and Asthma in NYC Head Start, to which African American and Hispanic families were recruited. Mothers answered a food frequency questionnaire (FFQ) and a questionnaire about maternal and child characteristics. Children’s body size was measured by child’s BMI z-score and percentile, child’s Waist-to-Height Ratio (WHtR), and child’s triceps and subscapular skinfold thicknesses. For the dissertation, we assessed maternal diet quality measured by HEI-2015 Total Score, and children’s adiposity at baseline and at one- and two-year follow-ups. This secondary analysis used data from 380 mother-child dyads with complete exposure and outcome data at baseline and, of those dyads, 167 mothers and 235 children who provided data at one-year follow-up, and 73 mothers and 110 children who did so at two-year follow-up. Mean HEI-2015 total score at baseline was 64.3±8.7 of 100, but 69.8±8.6 for Dominican and 60.2±6.5 for Mexican mothers. HEI scores were also associated with mothers’ marital status. Of the children, 44% were considered overweight or obese and 75% had WHtR > 0.5. Children of Mexican descent had higher WHtR than other groups. Maternal diet quality was not associated with any of the adiposity variables (BMI z-score, Triceps nor Subscapular z-score, or WHtR) at baseline or one-year follow-up. In regression models, Mexican ethnicity and younger age were associated with greater WHtR at baseline, but not one year later. Although HEI-2015 score was not related to child adiposity, it was related to national origin, which was related to adiposity. Maternal diet quality needs further study and consideration as a target for intervention; it may be an important indicator of family health.

Periods of rapid growth are periods of special vulnerability to nutritional injury. Growth during pregnancy and in the first two years of life is more rapid than at any other stage in the life cycle and hence, optimum nutrition is vital at this time. Physicians are frequently the primary professionals concerned with the dissemination of nutrition advice to pregnant women and mothers of new infants. However, there are no studies in the literature that assess the quality of nutrition information provided by physicians in this important area of maternal and infant nutrition. A study was designed to investigate the nutrition attitudes and practices of general practitioners, pediatricians and obstetricians in the province of British Columbia. The influence of selected variates upon the criterion variables, nutrition attitudes and practices, was assessed. Variates studied included demographic and professional data on country of medical training, sex of respondent, location and type of practice, years of practice, number of patients seen weekly, sources of nutrition information consulted, attendance at continuing education programs, additional training for specialization, and inclusion of nutrition in medical school education. The nature of the relationship between nutrition attitudes and practices was also assessed. In March 1975, questionnaires were mailed to all 1981 practising general practitioners, pediatricians and obstetricians in the province of British Columbia. Questionnaires were returned by 724 ( 41.3% ) general practitioners, 69 ( 62.7% ) pediatricians and 51 ( 43.2% ) obstetricians. Responses from completed questionnaires were analyzed by computer; all tests were conducted at the 5% level of significance. Results were reported at the highest level of significance. Mean scores for nutrition attitudes for general practitioners, pediatricians and obstetricians were 72%, 81% and 64% respectively. Nutrition practices' scores were 60%, 66% and 65% for general practitioners, pediatricians and obstetricians respectively. Regression analysis indicated that nutrition attitude and practice scores of general practitioners were significantly higher for physicians who: (a) were female (b) consulted with a nutritionist-dietitian (c) had additional training (d) attended continuing education programs and (e) had nutrition in their medical school education. General practitioners who were in practice more than 10 years scored significantly lower on the attitude and practice tests. Nutrition practice scores were significantly higher for pediatricians trained in Canada while nutrition attitude scores were higher for pediatricians who were in practice more than five but fewer than 10 years. Obstetricians' attitude scores were significantly lower for physicians who were in practice more than 10 years. Obstetricians who consulted with non-human sources of nutrition information other than professional journals and human sources of information other than nutritionist-dietitians scored significantly higher on the nutrition practice test. Correlation analysis showed that nutrition attitudes were significantly correlated to nutrition practices for general practitioners ( r = 0.370 ), pediatricians ( r = 0.259 ) and obstetricians ( r = 0.424 ). Student t-test analysis indicated that pediatricians' and obstetricians' practice test scores were significantly higher than those of general practitioners. There were no significant differences among the nutrition attitude scores for the three groups. Implications for nutrition educators included the need for nutrition in the medical school curriculum, the incorporation of nutrition into continuing education programs and the need for nutritionists to act as consultants to physicians. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate

Thesis (Ph.D (Nutrition)) --University of Limpopo, 2009 / AIM: This study aimed to assess the nutritional status of non-pregnant women of childbearing age residing in a rural area of Limpopo Province, South Africa, and the effect of fortification of staple foods on their folate and iron status. The following objectives were carried out:  To assess the socio-demographic status and maternity history of non-pregnant rural women of childbearing age.  To determine the following anthropometric measurements; body weight, height, body mass index, waist and hip circumference, and waist hip ratio of women of childbearing age.  To assess dietary intake of non-pregnant rural women of childbearing age using 24-hour recall and quantitative food frequency questionnaires prior to fortification of foods.  To determine folate status of non-pregnant rural women of childbearing age by levels of serum and red blood cell folate, and assessing vitamin B12 and homocysteine levels before and after fortification of foods.  To determine iron status of non-pregnant rural women of childbearing age by full blood count, serum ferritin, iron, total iron binding capacity, transferrin saturation and C–reactive protein before and after fortification of foods.  To determine albumin and liver enzymes (ALP, ALT, AST and GGT) of women of childbearing age before and after fortification.  To assess mycotoxins (i.e. fumonisins) in morogo samples collected randomly among participants from the study area. / the University of Limpopo Research Department,and the National Research Foundation

Background: Breastfeeding is known to have benefits both for maternal and child health. Some questions around the benefits and risks of breastfeeding in the presence of HIV infection still remain unclear. Aims: To study the effects of infant feeding mode by HIV-positive mothers, on maternal and child health. In addition, to assess the effect of nutritional supplementation to HIV-positive lactating mothers on nutritional and health status of mothers and their infants and on the quality of breastmilk. Methods: The study had 2 components; a prospective study to examine the impact of infant feeding mode on nutritional and health indices in mothers and their infants and within it a nested randomized controlled clinical trial to study the impact of a daily 50 g soya/peanut based supplement during breastfeeding on the above parameters. The measurements included anthropometry; body composition indicators (using both deuterium dilution and BIA); haematology and biochemical markers; as well as incidence rates of opportunistic infections and clinical disease progression. Breastmilk was analysed for both macro and micronutrients. Cervical screening was offered to all the women. Results: AFASS criteria were fulfilled by 38.7% of the formula feeding mothers. No significant differences between the formula feeding and breastfeeding groups in terms of haematological, immunological and body composition changes were seen. Breastfeeding mothers had significantly lower events with high depression scores (p=0.043). Longer duration of breastfeeding was observed to be significantly associated with a mean increase in CD4 count (74 cells/μL) and better health outcomes. The supplement made no significant impact on any maternal or child outcomes except for a limited effect on mothers with low BMI, where it was significantly associated with preventing loss of lean body mass (p=0.026). Breastfeeding infants had a significantly lower risk of diarrhoea and hospitalisation at 3 months (p=0.006 and 0.014 respectively). Both breastfeeding and longer duration of breastfeeding was significantly associated with better development scores and growth parameters. Supplementation made no impact on breastmilk composition. Of the 86 mothers who agreed for cervical screening, 27.6% had human papilloma virus infection. Conclusions: Breastfeeding is not harmful to the mother despite the presence of HIV infection. On the contrary we observed both breastfeeding and longer breastfeeding duration to be associated with better maternal and child outcomes. Mothers are still choosing formula feeding inappropriately presumably because of the availability of free formula and/or sub-optimal counseling. The new (2010) local PMTCT guidelines based on WHO recommendations should reverse this. Food insecurity was prevalent amongst 32% of our study population, highlighting the need to include sustainable and empowering solutions to encounter this problem. Less sustainable solutions such as nutritional supplementation should be targeted to the malnourished and in emergency situations. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2012.

Maternal folate intake and levels of folate in milk, serum and red cells were assessed in 57 healthy, lactating women, ages 22-38 years, throughout early (0-6 months) and later (7-23 months) lactation. Average maternal folate intake from diet alone was 212 µg/day or 78.5% RDA (1989) and mean total folate intake from diet and supplements was 314% RDA (878 µg/day) at 0-6 months and 238% RDA (620 µg/day) at >6 months. Human milk folate was sufficient to meet the RDA (1989) for infants. Milk folate was not related to maternal folate intake, maternal serum or red cell folate and was unaffected by extended lactation (7-23 months), perhaps at the expense of maternal folate stores. Compared with early lactation, serum folate decreased (p=0.0004) and red cell folate tended to decrease (p=0.08) in later lactation and were both increased by folate supplementation (p < 0.001).Level of folic acid supplementation appeared to predict red cell folate concentration. An average of 884 µg supplemental folate/day was associated with red cell folate levels >400 ng/mL, which have previously been reported as optimal for prevention of folateresponsive neural tube defects. The addition of an 880 µg/day folic acid supplement to the diet of lactating women may raise red cell folate concentrations of lactating women to protective levels. / Department of Family and Consumer Sciences