Thesis (MVoeding)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: Introduction: Heavy alcohol consumption during pregnancy is teratogenic.49-51 A woman’s nutritional requirements increase during pregnancy.4 The dangers of heavy drinking in the presence of malnutrition may put the fetus at a further disadvantage to normal development and life. Objectives: To determine the nutritional status of pregnant women in relation to alcohol consumption during pregnancy, and pregnancy outcome. To relate the combined effect of maternal alcohol consumption and nutritional status to pregnancy outcome. Study design: Prospective, longitudinal and cohort. Study population: Pregnant women attending Hanover Park MOU for pre-natal care. They were classified as subjects (heavy drinkers) or controls (light drinkers or abstainers), and 15 pairs were matched according to race, parity and gestational age at the onset of their participation in the study. Methodology: A skilled FARR worker determined the alcohol consumption of the individuals through a validated questionnaire, whilst the investigator gathered the study data blinded to the participants’ alcohol consumption status. The investigator conducted three interviews with the pregnant individuals. Anthropometrical, clinical and biochemical investigations were done and questionnaires completed to determine dietary intake, sociodemographics, health and eating habits. An experienced FARR paediatrician examined the newborns, assessing their anthropometric status, health and the presence of any alcohol-related signs. Results: The nutritional status of the matched subjects and controls did not differ significantly in terms of dietary intake, anthropometric or clinical assessment. There were significant differences between the 2 groups’ serum vitamin A values (p<0.0097). Significant associations were found between the mother and newborn data; specifically energy intake and gestational age at birth (p<0.0083), MUAC and birth weight (p<0.04), and weight gain and weight for age (p<0.0056). The participants’ energy intake also had a significant correlation with their weight gain during pregnancy (r=0.0389, p<0.01). The prevalence of FAS in the total population was 6.67%; a finding that confirms previously reported data in nearby Wellington, Western Cape.49 Conclusion: Some mothers’ good nutritional status did not protect their offspring against alcohol’s teratogenic effects. Nutritional status did have a few statistical significant effects on pregnancy. However, the investigator is of the opinion that the few significant findings were not enough to accept or reject the hypothesis; therefore, making the results inconclusive. / AFRIKAANSE OPSOMMING: Inleiding: Swaar alkoholgebruik tydens swangerskap is teratogenies.49-51 Vroue se voedingsbehoeftes verhoog met swangerskap.4 Die gevare van swaar alkoholgebruik in die teenwoordigheid van wanvoeding mag die fetus verhoed om normal te ontwikkel en groei. Doelwitte: Om die voedingstatus van swanger vroue te bepaal in verhouding met alkoholgebruik tydens swangerskap, en die swangerskapsuitkoms. Asook om die gekombineerde effek van die moeder se voedingstatus en alkoholgebruik op haar swangerskapsuitkoms te bepaal. Studie-ontwerp: Prospektief, longitudinaal en kohort. Studiepopulasie: Swanger vroue wat Hanover Park MOU besoek vir voorgeboorte sorg. Hulle is of as toetslinge (swaar drinkers) of as kontroles (ligte drinkers of geheelonthouers) geklassifiseer, en 15 pare is gepaar na aanleiding van ras, pariteit en gestasionele ouderdom by die aanvang van deelname aan die studie. Metodologie: ‘n Ervare SAVN lid het die individue se alkoholgebruik bepaal deur middel van ‘n gevalideerde vraelys. Die navorser was geblind vir die individue se alkoholgebruik. Die navorser het drie onderhoude gevoer met elke individu. Antropometriese, kliniese en biochemiese ondersoeke is gedoen. Vraelyste is voltooi om dieetinname, gesondheid, sosiodemografiese en eetgewoonte- inligting te versamel. ‘n Ervare SAVN pediater het alle pasgeborenes ondersoek om hulle antropometriese status, gesondheid en die teenwoordigheid van enige alkohol-verwante tekens te bepaal. Resultate: Die voedingstatus van die gepaarde toets-en kontrolegroepe het nie beduidend verskil in terme van dieetinname, antropometriese of kliniese evaluering nie. Daar was ‘n beduidende verskil tussen die 2 groepe se serum vitamien A vlakke (p<0.0097). Beduidende assosiasies is gevind tussen die moeder en pasgebore se data; naamlike tussen energie-inname en gestasionele ouderdom by geboorte (p<0.0083), bo-armomtrek en geboortegewig (p<0.0056), en gewigstoename tydens swangerskap en die baba se gewig vir ouderdom (p<0.0056). Die deelnemers se energie-inname het ook ‘n beduidende positiewe korrelasie met hul gewigstoename tydens swangerskap gehad (r=0.0389, p<0.01). Die prevalensie van FAS in die totale populasie was 6.67%; wat ook gevind is onlangs in die nabygeleë Wellington, Weskaap.49 Gevolgtrekking: Sommige moeders se goeie voedingstatus het nie hul kinders teen alkohol se teratogeniese effekte beskerm nie. Voedingstatus se effek op swangerskapsuitkoms was statisties beduidend in ‘n paar gevalle. Tog is die navorser van mening dat daar nie genoeg beduidende bewyse is om die nulhipotese te aanvaar of verwerp nie; dus is die gevolgtrekking onopgelos.

Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: Introduction : The health status of women in peri-urban areas has been influence by the South African political transition. Despite some progress, maternal and child mortality rates are still unacceptably high. A mother’s nutritional status is one of the most important determinants of maternal and birth outcomes. The Institute of Medicine’s pre-pregnancy Body Mass Index (BMI) method is not always appropriate to use in a peri-urban setting as many women attend their first antenatal clinic later on in their pregnancy. Two alternative methods, the gestational BMI (GBMI) and the gestational risk score (GRS), have been used elsewhere to screen for at risk pregnancies, but have not been used in a South African peri-urban setting. Furthermore, examining socio-economic variables (SEV) aids in the explanation of the impact of social structures on an individual. Risk factors can then be established and pregnant women in these higher risk groups can be identified and given additional antenatal clinic appointments and priority during labour. Aim: The first aim was to investigate the strength of the GBMI and GRS methods for predicting birth outcomes and maternal morbidities. The second aim was to investigate the relationships between SEV, GBMI and maternal morbidities. Methods: This was a sub-study of the Philani Mentor Mothers Study. A sample of 103 and 205 were selected for investigating the prediction methods and SEV respectively. Maternal anthropometry, gestational weeks and SEV were obtained during interviews before birth. Information obtained was used to calculate GBMI and GRS and to assess the SEV. Birth outcomes were obtained from the infant’s clinic cards and maternal morbidities were obtained from interviews two days after the birth. Results No significant association was found between GBMI and birth outcomes and maternal morbidities. A significant positive association was found between GRS and birth head circumference percentile (r=0.22, p<0.05). The higher the GRS, the higher the risk of an infant spending longer time in the hospital (Kruskal Wallis X2 = 4, p<0.05). A significant positive association was found between GBMI and the following SEV factors; age (r=0.33, p<0.05), height (r=0.15, p<0.05), parity (r=0.23, p<0.05), income (r=0.2, p<0.05), marital status (X2 = 9.35, p<0.05), employment (U=2.9, p<0.05) and HIV status (U=2.54, p<0.05). No statistically significant relationships were found between gestational hypertension and gestational diabetes mellitus and SEV. Conclusion: From the findings of this sub-study there were some promising results, however it is still unclear as to which method is the most appropriate to predict adverse birth outcomes and maternal morbidity. It is recommended that the GBMI and GRS once-off methods be repeated in a larger population to see if there are more parameters that could be predicted. Women who were older, shorter, married, had more pregnancies, HIV negative and had a higher socioeconomic status tended to have a greater GBMI. This can lead to adverse birth outcomes and increases the risk of women developing maternal morbidities and other chronic diseases later in their life. Optimal nutrition and health promotion strategies targeting women before conception should be implemented. / AFRIKAANSE OPSOMMING: Inleiding: Die gesondheidstatus van vroue in semi-stedelike areas is beïnvloed deur die Suid-Afrikaanse politiese oorgang. Ten spyte van ’n mate van vooruitgang is die sterftesyfers vir moeders en kinders steeds onaanvaarbaar hoog. ‘n Moeder se voedingstatus is een van die mees belangrike bepalende faktore van moeder- en geboorteuitkomste. Die Instituut van Geneeskunde se voorswangerskap Liggaamsmassa Indeks (LMI) metode is nie altyd toepaslik om te gebruik in ‘n semi-stedelike opset nie aangesien baie vroue hul eerste voorgeboorte-kliniek eers later in hul swangerskap bywoon. Twee alternatiewe metodes, die swangerskap LMI (SLMI) en die swangerskap risiko telling (SRT) is al elders gebruik as sifting vir hoë risiko swangerskappe, maar is nog nie gebruik in ‘n Suid-Afrikaanse semi-stedelike opset nie. Vervolgens kan ‘n ondersoek na sosio-ekonomiese veranderlikes (SEV) help om die impak van maatskaplike strukture op ‘n individu te verduidelik. Risiko faktore kan dan vasgestel word en swanger vroue wat in hierdie hoër risiko groepe val kan geïdentifiseer word. Dié vroue kan addisionele voorgeboorte-kliniek afsprake ontvang asook voorkeurbehandeling tydens die geboorteproses. Doelstellings: Die eerste doelstelling was om die sterkte van die SLMI en SRT metodes te ondersoek as voorspellers van geboorte uitkomste en moeder-morbiditeite. Die tweede doelstelling was om die verhoudings tussen SEV, SLMI en moeder-morbiditeite te ondersoek. Metodes: Hierdie projek was ‘n sub-studie van die Philani Mentor Moeders Studie. ‘n Steekproefgrootte van 103 en 205 was geselekteer om onderskeidelik die voorspeller metodes en SEV te ondersoek. Die moeder se antropometrie, swangerskap weke en SEV was verkry gedurende onderhoude voor geboorte. Informasie ingewin was gebruik om die SLMI en SRT te bereken en om die SEV te ondersoek. Geboorteuitkomste was verkry vanaf die babas se kliniekkaarte en moeder-morbiditeite was verkry tydens onderhoude twee dae na die geboorte. Resultate: Geen betekenisvolle assosiasie was gevind tussen SLMI, geboorteuitkomste en moeder-morbiditeite nie. ‘n Betekenisvolle positiewe assosiasie was gevind tussen SRT en die geboorte kopomtrek persentiel (r=0.22, p<0.05). Hoe hoër die SRT, hoe hoër die risiko dat ‘n baba langer in die hospitaal sou bly (Kruskal Wallis X2=4, p<0.05). ‘n Betekenisvolle positiewe assosiasie was gevind tussen SLMI en die volgende SEV faktore: ouderdom (r=0.33, p<0.05), lengte (r=0.15, p<0.05), pariteit (r=0.23, p<0.05), inkomste (r=0.2, p<0.05), huwelikstatus (X2=9.35, p<0.05), besit van ‘n identiteitsdokument (U=1.75, p<0.05), werkstatus (U=2.9, p<0.05) en MIV status (U=2.54, p<0.05). Geen statisties beduidende verhoudings was gevind tussen swangerskap hipertensie, swangerskap diabetes mellitus en SEV nie. Gevolgtrekking Sommige bevindinge van hierdie sub-studie dui op belowende resultate, alhoewel dit steeds nie duidelik is watter metode die mees toepaslike is om ongewenste geboorteuitkomste en moeder-morbiditeit te voorspel nie. Dit word aanbeveel dat die SLMI en SRT eenmalige metodes herhaal word in ‘n groter populasie om te sien of daar meer parameters is wat voorspel kan word. Vroue wat ouer, korter, getroud, meer swangerskappe, MIV negatief en ‘n hoër sosio-ekonomiese status gehad het was geneig om ‘n hoër SLMI te hê. Dit kan lei tot ongewenste geboorteuitkomste en verhoogde risiko om moeder-morbiditeite en ander chroniese siektes later in hul lewe te ontwikkel. Optimale voeding en gesondheidsbevordering strategieë wat vroue teiken voor bevrugting behoort geïmplementeer te word.

The purpose of these studies was to investigate the impact of high-fat diet (HFD) exposure during pregnancy and the early post-natal period on fetal and post-natal development of the endocrine pancreas of the Japanese macaque. Specifically I hypothesized that the HFD would alter islet morphology and lead to disturbances in glucose homeostasis in these animals. Adult female Japanese macaques were placed on either a control (CTR) or HFD diet for 4 years. Fetuses were collected at gestational day 130 (G130), while other offspring from the CTR and HFD mothers were carried to term. After birth, infant animals were maintained with their mothers on the same diet then weaned onto either the CTR or HFD diet for five months. Animals were studied up to 13 months of age, yielding 4 postnatal groups: CTR/CTR, CTR/HFD, HFD/CTR and HFD/HFD. Pancreata were collected from these offspring for gene expression and immunohistochemical analysis. Physiological measurements, including body weight, body fat percentage, fasting glucose, insulin, glucagon and response to intravenous glucose tolerance tests (IVGTTs) and an intravenous insulin tolerance test (IVITT) were collected from the post-natal offspring. Total fetal islet mass and β cell mass were not changed, but α cell mass was significantly decreased in HFD fetuses, leading to a significant increase in the β cell to α cell ratio in HFD fetal offspring. The HFD offspring displayed a significant change from CTR offspring in expression of genes involved in glucose homeostasis and islet neogenesis, including PDX1, NeuroD, Glucokinase and Glut2. Postnatal HFD animals were significantly heavier than CTR offspring and had increased adiposity by 6-7 months of age. There was no significant effect on fasting or stimulated insulin secretion at this time point, but HFD offspring were significantly insulin resistant just prior to weaning. At 13 months of age, basal and glucose-stimulated insulin secretion were elevated in HFD/HFD animals and the CTR/HFD group displayed moderate insulin resistance. There was also a significant sex effect, with males from the HFD/CTR and HFD/HFD group having increased body weight and elevated fasting glucose. Although pancreata from both the HFD/HFD and CTR/HFD animals displayed significant changes in expression of genes involved in glucose homeostasis, the pattern was distinct for the two groups. Islet mass was also elevated in both of these groups; yet, HFD/HFD only displayed an increase in β cell area, while CTR/HFD had a concomitant increase in α cell area, which served to normalize the β cell to α cell ratio to control levels. In contrast, the HFD/HFD group exhibited a 40% increase in the β cell to α cell ratio. These studies demonstrate that in-utero exposure to a HFD leads to decreased α cell plasticity in response to chronic post-natal HFD consumption. Animals exposed to the HFD during pregnancy and the early post-natal period become insulin resistant, but remain normoglycemic. HFD consumption during the post-weaning period causes similar complications in glucose homeostasis and islet mass in both the CTR/HFD and HFD/HFD animals. However, there are distinct differences in the molecular and cellular adaptive response between these two groups.

No description available.

M. S.

No description available.

No description available.

No description available.

No description available.

Obese, female Spraque-Dawley rats were assigned, on a weight basis, to one of three dietary treatments: ad lib, 15% caloric restriction, and 30% caloric restriction. All other nutrients were fed at levels to meet dietary requirements. Each treatment groups was further sub-divided into pregnant and non-pregnant animals. Rats were sacrificed on Day 20 of gestation and fetuses were taken by Caesearean section. Maternal and fetal body composition, maternal serum protein concentrations were examined. Weight change for pregnant rats was +85 gms in the ad lib-fed group, +82 gms in the 15% calorie restricted group, and +56 gms in the 30% calorie restricted group. Weight changes for the non-pregnant rats for 20 days of dietary treatment were +53 gms, +18 gms, and -7 gms respectively. Fetal body nitrogen and average pup weight did not differ between treatment groups. Total maternal body nitrogen was not decreased during pregnancy in ad lib-fed and 15% calorically restricted animals. It did decrease in 30% calorically restricted animals. Ad lib-fed animals showed no changes in total body fat. Animals on the 15% calorie restriction diet showed no change in total body fat percentages. Animals on the 30% calorie restriction showed a 10% decrease in total body fat content as compared to the ad lib and 15% restricted pregnant group. Serum protein levels decreased in pregnant animals as caloric restriction increased. Serum protein levels in nonpregnant animals increased as dietary restriction increased. The fetal compartment was not affected by maternal caloric restriction up to 30% provided that all other nutrients were adequate. Maternal stores were affected at a level of 30% caloric restriction. / Master of Science