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

Includes bibliographical references (leaves 228-257). Aims to determine the impact of maternal undernutrition during late gestation and during the periconceptional and gestational periods on fetal growth, fetal blood pressure and the fetal hypothalamo-pituitary adrenal axis in the sheep.

Background Excessive gestational weight gain (GWG) poses significant risk for maternal and neonatal health. Various guidelines have recommended healthy diets and enhancing physical activity during pregnancy to prevent excessive GWG. However, results of intervention studies are inconsistent in the developed countries, and there are no official guidelines and few interventions for GWG in China. This paper aims to review and synthesize relevant studies on diet and physical activity interventions to prevent excessive GWG so that practical suggestions can be provided to public health authorities in China. Methods This systematic review was performed using PubMed, Google and Google Scholar to search all relevant studies in English and randomised controlled trials (RCTs) that investigated diet and physical activity interventions to limit excessive GWG up to May 2014. The quality of included studies was assessed using CONSORT statement and JADAD scale. Results Nine studies describing diet and physical activity interventions to prevent excessive GWG were incorporated in the systematic review. Overall, the contents of interventions were diverse, which consisted of one-to-one counselling, and community-based physical activity interventions. Weekly mailed newsletters and supportive telephone calls were used as assistive tools to remind pregnant women of limiting excessive GWG. Seven studies showed less weight gain in pregnant women receiving the intervention, of which four studies demonstrated a reduction in excessive GWG in women with varying body mass index (BMI) spanning the normal, overweight and obese categories, while three studies reported a reduction of excessive GWG only in normal weight women and obese women need to be paid attention in the future. Conclusions The effectiveness of diet and physical interventions to limit excessive GWG may not be confirmed because of limited quality or sample size of intervention studies. However, studies have demonstrated reduction of excessive GWG during pregnancy, in addition to persistent healthy behaviours following such interventions during pregnancy. Further meta-analyses of RCTs studies should be done to confirm the effectiveness of such interventions among Chinese women. / published_or_final_version / Public Health / Master / Master of Public Health

To test the hypothesis that maternal glucose restriction (GR) would compromise small intestine (SI) growth and development, we used a diet induced model of IUGR. Pregnant rats and offspring were fed isoenergetic diets {0% (deficient), 12, 24% (restricted), 60% (adequate) glucose) from gestation day (gd) 0 through adolescence. SI tissue was collected at gd20, birth, 12--24h, postnatal day (pd) 7, 15, 21, 28, 35, 49 and in controls. GR affected pup weight at early timepoints, resulting in IUGR; beyond effects due to differences in body wt, GR compromised SI length at 12--24h and promoted SI growth during peak lactation (pd15; total and distal wts). Dietary glucose regulated in utero (gd20) expression of sodium-dependent glucose co-transporter (SGLT1) protein. Diet-induced precocious maturation of lactase and sucrase was observed in glucose deficient animals. In summary, there were periodic but no permanent effects of dietary glucose intake on gut growth and development.

The premise of this case study research is that nutritional requirements increase when women fall pregnant and that obtaining adequate nutrition is of particular importance for the maternal environment and fetal growth on both short-term and long-term outcomes, impacting everything from individual well-being to Gross Domestic Product of a nation. Nutrition is a complex and multi-faceted area of study. An important part of this study is the nature of intra-household allocation. This study explores the allocation of food and resources within a sample of rural households to identify whether the onset of pregnancy changes a woman’s ability to claim (receive) additional food and resources to meet her increased nutritional needs. Using case study methodology, I collected a combination of quantitative and qualitative data on individual and household level information of 32 pregnant women in the area of Inchanga, South Africa. Almost all pregnant women in this sample report that their absolute needs are met. I also find that a majority of respondents report a relative increase in food, money and/or resources during pregnancy. This indicates that for the greater part of households in this sample, women’s access to nutrition does change because they are pregnant. Where a pregnant woman’s nutritional needs were not met, important individual and household correlates include the pregnant woman’s relationship to the head of household, to other household members as well as to the father of the child, in addition to the woman’s individual access to and control over income. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

The interrelation among maternal dietary intake, pregravid weight, amount and pattern of gestational weight gain and cigarette smoking in influencing the balance between fetal growth and maternal postpartum weight retention was in investigated in 1,330 healthy participants in the PEI Nutritional Counselling Program. Among nonsmokers, gestational weight gain was the main predictor of postpartum weight retention and explained 65.3% of its variability, while explaining only 4.7% of infant birth weight variability. Women with higher postpartum weight retention gained more weight during pregnancy and most of the difference between higher and lower weight retention groups occurred in the first 20 weeks. When comparing infant size between smoking and nonsmoking mothers, birth weight increased linearly with maternal weight gain in all weight status groups except in overweight nonsmokers where birth weight reached a plateau at weight gains $>$17 kg. Among smokers, infant length increased at a higher rate with weight gain than nonsmokers. Although higher weight gains seemed to partially mitigate the effect of smoking on the risk of small-for-gestational-age (SGA) infants, such risk remained $>$10% at elevated weight gains among underweight smokers. The effects of smoking in reducing maternal and infant weights were not mediated by lower energy intake, as smokers consumed more energy than nonsmokers after controlling for physical activity and pregravid weight. The independent relative risks of SGA infants due to maternal smoking, pregravid underweight and low weight gain, were 3.23, 1.80 and 1.72 respectively, implying that smoking has the greatest effect on SGA. Based on current smoking prevalence in Canada, the population etiologic fraction of SGA due to the direct effect of smoking is 30.8%; approximately twice that for maternal underweight or low weight gain. Efforts to increase infant birth weight through higher maternal weight gain would require impractically high ene

This study was designed to measure the prevalence and nutritional impact of dairy product restriction in both pregnant and lactating women. Dairy product (DP) restriction was assessed in 2091 prenatal class attendees. Subsamples of 279 healthy pregnant and 175 exclusively breastfeeding women provided repeat 24-hour dietary recalls which were used to estimate nutrient intake and to assess dietary adequacy using adjusted nutrient distributions. Pregnancy outcome was recorded. Pregnancy. DP restriction was reported by 13.2% (95% CI: 12.7%,14.1%) of pregnant women. Significant differences were found in the proportion of restrictors (Rs, 20.8%) below the calculated EAR for adjusted protein intakes vs. nonrestrictors (NRs, 9.2%, chi 2 = 6.78, p = 0.009). Intake distributions of calcium and vitamin D were compared to their respective Als for descriptive purposes and were lower for Rs vs. NRs but dietary inadequacy could not be assessed. Infants of NRs weighed on average 120 g +/- 468.9 g more than those of Rs but this difference was not statistically significant (p = 0.06). However, in multiple regression analysis where maternal weight gain, age, education and pregravid weight were controlled for, restriction predicted a comparable loss in birthweight of 122.5 g's (p = 0.048) and vitamin D intakes were positively associated with fetal growth. Lactation. Restriction (≤250 ml milk/day) was reported by 23% (95% CI; 16%--29%) of exclusively lactating women. Protein was lower than the EAR for 60% of Rs and 37.8% of NRs (chi 2 = 6.22, p = 0.025). The proportion of Rs and NRs < EAR from diet differed for thiamin (15% vs. 0%, chi2 = 0.97, p < 0.001), riboflavin (15% vs. 1.5%, chi2 = 12.93, p < 0.001) and zinc (65.0% vs. 34.8%, chi2 = 11.6, p < 0.041). From diet and supplement intake vitamin D and calcium remained lower for Rs compared to NRs but inadequacy could not be assessed or compared. DP restriction was not associated with greater weight loss amo

To test the hypothesis that maternal dietary glucose restriction throughout pregnancy and lactation would perturb glucose transporter (GLUT) protein levels in offspring, isoenergetic diets containing graded levels of glucose (0, 12, 24 and 60%) were fed to pregnant rats and their offspring from gestation day (gd) 0 through postnatal day (pd) 49. Diets were defined as deficient (0%), restricted (12, 24%) or adequate (60%) in glucose. Plasma, small intestine, liver and kidney tissues were collected perinatally (gd20, birth, 12--24hrs postnatal), during lactation (pd7, 15, 21), post-weaning (pd28, 35, 49) and in adult controls. The proximal and distal regions of the small intestine responded differently to the dietary glucose restriction. Proximal small intestine GLUT2 protein levels did not change throughout postnatal development and remained unaltered with dietary glucose restriction, while distal small intestine GLUT2 protein expression changed throughout postnatal development and with dietary glucose restriction. These findings, together with information from the literature, indicate a dissociation between small intestine GLUT2 mRNA expression, GLUT2 protein levels and small intestine glycogen reserves.

The effect of maternal dietary glucose on perinatal phosphoenolpyruvate carboxykinase (PEPCK) gene expression was investigated in this study. Pregnant rats were fed isoclaoric diets containing graded levels of glucose (0%, 12%, 24% and 60%) from gestation day 2 to lactation day 15. The developmental profiles of PEPCK gene expression in fetal and neonatal liver and kidney were analyzed by northern blot. In the liver, feeding glucose free and glucose restriction (12% and 24%) diets precociously induced PEPCK gene expression at day 21 of gestation. In the kidney, PEPCK mRNA (2.8 kb) was detected at birth in the glucose free group, 12-16 hours postnatally in control group; it was not visualized until day 3 in the 12% and 24% glucose restriction groups. In our study, two species of RNA (1.8 kb and 2.8 kb) were hybridized with PEPCK cDNA probes, and there was a relationship between maternal dietary glucose levels and the 1.8 kb RNA fragment in the kidney.

Includes bibliographical references (leaves 228-257). / xxii, 257 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Aims to determine the impact of maternal undernutrition during late gestation and during the periconceptional and gestational periods on fetal growth, fetal blood pressure and the fetal hypothalamo-pituitary adrenal axis in the sheep. / Thesis (Ph.D.)--University of Adelaide, Dept. of Physiology, 2001