Fetal programming of health and disease; follow-up of children whose mothers took part in a pre-conceptional nutrition trial in Mumbai, India
胎儿健康和疾病规划;
基本信息
- 批准号:MR/M005186/1
- 负责人:
- 金额:$ 50.82万
- 依托单位:
- 依托单位国家:英国
- 项目类别:Research Grant
- 财政年份:2014
- 资助国家:英国
- 起止时间:2014 至 无数据
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
The Mumbai Maternal Nutrition Project was a randomised controlled trial which took place in a slum community in the city of Mumbai, India. The participants were women planning to have children. They had diets low in vitamins and minerals (micronutrients) and their newborns were at high risk of low birth weight. The aim of the trial was to test whether improving the micronutrient quality of their diet for a sustained period of time before conception, and throughout pregnancy, increases birth weight and improves the children's long-term health. Women were offered, in addition to their usual diet, a specially designed daily snack made from (treatment group) micronutrient-rich foods including green leafy vegetables, fruit and milk, or (controls) low micronutrient vegetables such as potato and onion. On average the treatment snacks contained 10-23% of the WHO recommended Reference Nutrient Intake for beta-carotene, folate, vitamins B2 and B12, calcium and iron. The trial was unusual in two ways: (a) in supplementing women before pregnancy and (b) in using local micronutrient-rich foods rather than pharmaceutical micronutrient supplements. The primary outcome was birth weight, but it was powered to enable the study of longer term outcomes in the children. We pre-specified that we planned to test the effect of starting the intervention at least three months before conception, and we expected greater effects on birth weight among thinner women. The first women were recruited in January 2006 and the last baby was born in May 2012. We enrolled 6513 women, of whom 2291 became pregnant, resulting in 1962 singleton live births; 1826 of the 2291 women started the supplement at least three months before becoming pregnant and had 1562 live births. Among all the women who gave birth, the intervention had a positive but non-significant effect on birth weight (+26 g [95% CI -15, 68 g], p=0.22). There was a greater effect among women who started supplementation at least three months before pregnancy (+48g [95% CI 1, 96 g], p=0.046). In these women, the intervention reduced the rate of low birth weight babies (Treatment: 34%, Controls 41%; OR 0.76 [95% CI 0.59, 0.98], p=0.03). The birth weight effect increased with maternal pre-pregnant body mass index: -8g, +79g and +113g in the lowest, middle and highest thirds of maternal BMI respectively (p for interaction=0.001). An unexpected benefit of the intervention was that it reduced the prevalence of diabetes in the mothers during pregnancy (Treatment: 7%, Controls: 13%, p<0.01). In the proposed study, we now aim to assess the effect of the intervention on outcomes in the children (N~1800) at the age of 6 years. We will measure a range of growth, functional and health outcomes, including height, body composition, risk markers for later diabetes and heart disease, and brain function. The study has already started (from Sept 2013) in order assess children in a narrow age window. Ethical approval was obtained from the JJ Hospital, Mumbai. Families are visited by a health worker to explain the study. As close as possible to the child's 6th birthday, the child and both parents are asked to attend a research clinic at the Centre for the Study of Social Change in Bandra, Mumbai, after an overnight fast. Detailed body measurements of the parents and child are performed. A fasting blood sample is taken from the child for glucose, insulin and lipids. Further blood samples are drawn at 30 and 120 minutes after an oral glucose load. Blood pressure and hand grip strength are measured. Cognitive (intelligence) testing is carried out using tests validated for Indian children. The children have fat, lean and bone mass measured using dual X-ray absorptiometry at a local hospital. In parents, a full blood count and fasting glucose are measured. DNA and RNA samples for future genetic and epigenetic analyses are collected from the children and parents and frozen. The study will take 3 years to complete.
孟买产妇营养项目是一项随机对照试验,在印度孟买市的一个贫民窟社区进行。参与者是计划生育的妇女。他们的饮食中维生素和矿物质(微量营养素)含量低,他们的新生儿出生体重低的风险很高。试验的目的是测试在怀孕前和整个怀孕期间持续改善饮食中微量营养素的质量是否会增加出生体重并改善儿童的长期健康。除了她们通常的饮食外,还为妇女提供了一种特别设计的每日零食,这些零食由(治疗组)富含微量营养素的食物制成,包括绿色叶菜、水果和牛奶,或(对照组)低微量营养素蔬菜,如土豆和洋葱。平均而言,治疗零食含有WHO推荐的参考营养素摄入量的10-23%,包括β-胡萝卜素、叶酸、维生素B2和B12、钙和铁。该试验在两个方面不同寻常:(a)在妇女怀孕前补充微量营养素;(B)使用当地富含微量营养素的食物,而不是药物微量营养素补充剂。主要结果是出生体重,但它有能力使儿童的长期结果的研究。我们预先规定,我们计划在怀孕前至少三个月测试开始干预的效果,我们预计对较瘦的妇女的出生体重有更大的影响。2006年1月招募了第一批妇女,最后一名婴儿于2012年5月出生。我们招募了6513名妇女,其中2291名怀孕,导致1962例单胎活产; 2291名妇女中有1826名在怀孕前至少三个月开始补充,有1562例活产。在所有分娩的妇女中,干预对出生体重有积极但不显著的影响(+26 g [95% CI-15,68 g],p=0.22)。在怀孕前至少三个月开始补充的女性中,效果更大(+48 g [95% CI 1,96 g],p=0.046)。在这些妇女中,干预降低了低出生体重婴儿的发生率(治疗组:34%,对照组41%; OR 0.76 [95% CI 0.59,0.98],p=0.03)。出生体重效应随母体孕前体重指数增加而增加:母体BMI最低、中间和最高三分之一分别为-8g、+79g和+113g(相互作用p =0.001)。干预的一个意想不到的好处是,它降低了怀孕期间母亲的糖尿病患病率(治疗:7%,对照:13%,p<0.01)。在拟议的研究中,我们现在的目标是评估干预对6岁儿童(N~1800)结局的影响。我们将测量一系列生长,功能和健康结果,包括身高,身体成分,后期糖尿病和心脏病的风险标志物以及脑功能。这项研究已经开始(从2013年9月开始),以评估一个狭窄的年龄窗口中的儿童。获得了孟买JJ医院的伦理批准。一名卫生工作者访问家庭,解释这项研究。在孩子6岁生日临近时,孩子和父母被要求在禁食一夜后前往位于孟买班德拉的社会变革研究中心的研究诊所。父母和孩子的详细身体测量。从孩子身上采集空腹血液样本,用于葡萄糖、胰岛素和脂质。在口服葡萄糖负荷后30分钟和120分钟抽取另外的血液样品。测量血压和握力。认知(智力)测试是使用经印度儿童验证的测试进行的。这些孩子在当地医院用双X射线吸收法测量了脂肪、瘦肉和骨量。在父母中,测量全血细胞计数和空腹血糖。从孩子和父母那里收集DNA和RNA样本,用于未来的遗传和表观遗传分析,并冷冻。这项研究将需要3年时间才能完成。
项目成果
期刊论文数量(10)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Comparing BMI with skinfolds to estimate age at adiposity rebound and its associations with cardio-metabolic risk markers in adolescence.
- DOI:10.1038/s41366-018-0144-8
- 发表时间:2019-04
- 期刊:
- 影响因子:0
- 作者:Di Gravio C;Krishnaveni GV;Somashekara R;Veena SR;Kumaran K;Krishna M;Karat SC;Fall CHD
- 通讯作者:Fall CHD
Effect of a daily snack containing green leafy vegetables on women's fatty acid status: a randomized controlled trial in Mumbai, India.
含有绿叶蔬菜的每日零食对女性脂肪酸状况的影响:印度孟买的一项随机对照试验。
- DOI:10.6133/apjcn.032018.01
- 发表时间:2018
- 期刊:
- 影响因子:1.3
- 作者:Chopra HV
- 通讯作者:Chopra HV
The Association of Maternal Age With Fetal Growth and Newborn Measures: The Mumbai Maternal Nutrition Project (MMNP).
- DOI:10.1177/1933719118799202
- 发表时间:2019-07
- 期刊:
- 影响因子:0
- 作者:Di Gravio C;Lawande A;Potdar RD;Sahariah SA;Gandhi M;Brown N;Chopra H;Sane H;Kehoe SH;Marley-Zagar E;Margetts BM;Jackson AA;Fall CHD
- 通讯作者:Fall CHD
DNA methylation signatures associated with cardiometabolic risk factors in children from India and The Gambia: results from the EMPHASIS study.
- DOI:10.1186/s13148-021-01213-3
- 发表时间:2022-01-09
- 期刊:
- 影响因子:5.7
- 作者:Antoun E;Issarapu P;di Gravio C;Shrestha S;Betts M;Saffari A;Sahariah SA;Sankareswaran A;Arumalla M;Prentice AM;Fall CHD;Silver MJ;Chandak GR;Lillycrop KA;EMPHASIS study group
- 通讯作者:EMPHASIS study group
Conflicts between adolescents and their caregivers living in slums of Mumbai, India in relation to junk food consumption and physical activity.
- DOI:10.1017/s1368980020001640
- 发表时间:2021-11
- 期刊:
- 影响因子:3.2
- 作者:Chopra HV;Gandhi MJ;Sahariah SA;Weller S;Potdar RD;Barker M;Kehoe SH;Fall CH;Hardy-Johnson P;TALENT collaboration
- 通讯作者:TALENT collaboration
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Caroline Fall其他文献
Differential expression of genes influencing mitotic processes in cord blood mononuclear cells after a pre-conceptional micronutrient-based randomized controlled trial: Pune Rural Intervention in Young Adolescents (PRIYA)
基于孕前微量营养素的随机对照试验后影响脐带血单核细胞有丝分裂过程的基因的差异表达:普纳农村青少年干预 (PRIYA)
- DOI:
- 发表时间:
2021 - 期刊:
- 影响因子:0
- 作者:
Satyajeet P. Khare;Ayush Madhok;Indumathi Patta;K. Sukla;Vipul Wagh;P. Kunte;Deepa Raut;D. Bhat;K. Kumaran;Caroline Fall;U. Tatu;G. Chandak;Chittaranjan S. Yajnik;S. Galande - 通讯作者:
S. Galande
Longitudinal assessment of maternal micronutrients (folate and vitamin B12) and homocysteine levels in women who develop gestational diabetes mellitus
对发生妊娠期糖尿病的女性进行母体微量营养素(叶酸和维生素 B12)和同型半胱氨酸水平的纵向评估
- DOI:
10.1038/s41430-025-01581-6 - 发表时间:
2025-02-17 - 期刊:
- 影响因子:3.300
- 作者:
Shweta Madiwale;Nikita Joshi;Karuna Randhir;Hemlata Pisal;Vrushali Kadam;Ghattu Krishnaveni;Girija Wagh;Sanjay Gupte;Caroline Fall;Sadhana Joshi - 通讯作者:
Sadhana Joshi
Caroline Fall的其他文献
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{{ truncateString('Caroline Fall', 18)}}的其他基金
Collaborative network for adolescent nutrition and health in sub-Saharan Africa and India
撒哈拉以南非洲和印度青少年营养与健康合作网络
- 批准号:
MC_PC_MR/R018545/1 - 财政年份:2018
- 资助金额:
$ 50.82万 - 项目类别:
Research Grant
Epigenetic mechanisms linking maternal pre-conceptional micronutrient supplementation with offspring health in India and The Gambia
印度和冈比亚孕产前微量营养素补充与后代健康之间的表观遗传机制
- 批准号:
MR/N006208/1 - 财政年份:2015
- 资助金额:
$ 50.82万 - 项目类别:
Research Grant
Nutrition, Development and Lifelong Health: Studies in Developing and Transitioning Populations
营养、发育和终身健康:人口发展和转型研究
- 批准号:
MC_UU_12011/3 - 财政年份:2013
- 资助金额:
$ 50.82万 - 项目类别:
Intramural
Maternal vitamin B12, folic acid and homocysteine as determinants of gestational diabetes, fetal growth and intergenerational programming of diabesity
母体维生素 B12、叶酸和同型半胱氨酸是妊娠期糖尿病、胎儿生长和糖尿病代际规划的决定因素
- 批准号:
MR/J000094/1 - 财政年份:2011
- 资助金额:
$ 50.82万 - 项目类别:
Research Grant
Maternal nutrition, fetal and childhood growth, and programming of cardiovascular disease and diabetes in South Asians
南亚人的孕产妇营养、胎儿和儿童生长以及心血管疾病和糖尿病的规划
- 批准号:
G0400519/1 - 财政年份:2006
- 资助金额:
$ 50.82万 - 项目类别:
Research Grant
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Synergistic effect of maternal insulin-resistance and cortisol in pregnancy on fetal programming of child mitochondrial function and obesity risk
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