Background: Pregnancy induces transient bone mass loss. Dairy foods might promote bone health, yet few interventions have been conducted to optimize maternal bone health in the perinatal period.
Objectives: To conduct a Nutrition+Exercise randomized controlled trial (RCT) in pregnant women to assess the impact on maternal bone health by measures of calciotropic and bone biomarkers at the end of pregnancy and in the post-partum period.
Study design: In the Be Healthy in Pregnancy (BHIP) RCT, 203/241 women consented at randomization (12-17 weeks (wk) gestation) to the bone health sub-study and received either usual care or a Nutrition+Exercise intervention that provided an individualized high protein diet (50% as dairy products) and a walking program throughout pregnancy. Maternal characteristics and fasting blood samples were obtained at 12-17 wk and 36-38 wk gestation, and at six months post-partum. Vitamin D status from the BHIP participants was compared to the FAMILY birth cohort participants (assessed at 24-36 wk gestation) to assess changes over a ten-year span. The response of the calciotropic and bone biomarkers to the RCT intervention was assessed at the end of pregnancy and in the post-partum period.
Results: Adequate vitamin D status in pregnancy was observed in 322 participants from the FAMILY and 191 from the BHIP study, impacted by season and supplement intake. For participants in the BHIP study, serum 1,25-dihydroxyvitamin D concentrations increased throughout pregnancy and were not associated with serum 25(OH)D. Participants from the intervention group had lower serum bone resorption marker CTX compared to control group, which was reflected in cord serum. No differences were observed with other bone biomarkers at the end of pregnancy or in the post-partum period.
Conclusion: Higher protein and calcium intake compared to the control group during pregnancy minimized bone resorption, thus protecting maternal bone health in the perinatal period. / Thesis / Doctor of Philosophy (Medical Science) / Background: Adaptations in maternal bone metabolism during pregnancy and the post-partum period provide the offspring with the nutrients needed to mineralize their bones. Maternal diet and hormonal changes influence these metabolic changes.
Method: In 203 women recruited to the Bone-Be Healthy in Pregnancy Study randomized controlled trial, we compared changes in bone metabolism during pregnancy and at six months post-partum between women randomized to an individualized and monitored Nutrition + Exercise intervention or usual care (control) throughout pregnancy.
Results: The intervention group consumed more protein and calcium, but had similar and adequate vitamin D status. At the end of pregnancy, women in the intervention group had less bone loss compared to the control group, but all measures were similar at 6 months post-partum.
Clinical significance: The nutrition and exercise intervention reduced maternal bone loss during pregnancy, and could be a feasible intervention to support bone health of pregnant women.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/24867 |
| Date | January 2019 |
| Creators | Perreault, Maude |
| Contributors | Atkinson, Stephanie, Medical Sciences |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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