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      Influence of breakfast and meal frequency in calcium intake among pregnant adolescents

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          Abstract

          Calcium is an essential micronutrient that plays a role in growing and pregnancy, and its necessity is increased during pregnancy in adolescence. Thus, the aim of the study is to describe the daily calcium intake and its associations with dietetic habits, sociodemographic data and perinatal outcomes among pregnant adolescents. A prospective cohort study was conducted among primiparous adolescents who started prenatal care before 20 weeks of gestation. Sociodemographic data, weight and height, 24‐h dietary recall (24hRec) and perinatal outcomes were collected over four meetings (three during pregnancy and one in puerperium). All 24hRecs were analysed by the Nutrition Data System for Research (NDSR)® programme, and descriptive analysis and univariate and multivariate logistic regression were done. A total of 150 pregnant adolescents were included, with a mean of daily calcium intake of 659.9 mg (50% of recommended intake). Adolescents who ate more than three meals per day (89.3%), and ate breakfast every day (69.3%), were shown to have higher daily calcium intake, odds ratio (OR CI 95%) of 3.4 (1.0, 11.0) and 16.8 (1.0, 302.1), respectively. No correlation was observed between calcium daily intake and sociodemographic data or perinatal outcomes. Dairy products were the foods that mostly contributed to achieving recommended daily calcium intake. In our cohort, pregnant adolescents had a low daily calcium intake. They should be advised to eat more than three meals per day, eat breakfast in particular, increase the consumption of calcium rich‐foods, such as dairy products and green leafy vegetables, and consider calcium supplementation.

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          Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery.

          Christopher Kovacs (2016)
          During pregnancy and lactation, female physiology adapts to meet the added nutritional demands of fetuses and neonates. An average full-term fetus contains ∼30 g calcium, 20 g phosphorus, and 0.8 g magnesium. About 80% of mineral is accreted during the third trimester; calcium transfers at 300-350 mg/day during the final 6 wk. The neonate requires 200 mg calcium daily from milk during the first 6 mo, and 120 mg calcium from milk during the second 6 mo (additional calcium comes from solid foods). Calcium transfers can be more than double and triple these values, respectively, in women who nurse twins and triplets. About 25% of dietary calcium is normally absorbed in healthy adults. Average maternal calcium intakes in American and Canadian women are insufficient to meet the fetal and neonatal calcium requirements if normal efficiency of intestinal calcium absorption is relied upon. However, several adaptations are invoked to meet the fetal and neonatal demands for mineral without requiring increased intakes by the mother. During pregnancy the efficiency of intestinal calcium absorption doubles, whereas during lactation the maternal skeleton is resorbed to provide calcium for milk. This review addresses our current knowledge regarding maternal adaptations in mineral and skeletal homeostasis that occur during pregnancy, lactation, and post-weaning recovery. Also considered are the impacts that these adaptations have on biochemical and hormonal parameters of mineral homeostasis, the consequences for long-term skeletal health, and the presentation and management of disorders of mineral and bone metabolism.
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            A Systematic Review of the Association of Skipping Breakfast with Weight and Cardiometabolic Risk Factors in Children and Adolescents. What Should We Better Investigate in the Future?

            Alice Monzani, Roberta Ricotti, Marina Caputo … (2019)
            The incidence of skipping breakfast in pediatric subjects is rising, and a relationship with overweight (OW) and obesity (OB) has been shown. Associations with cardiovascular outcomes and skipping breakfast in adults have been reported. The purpose of this systematic review was to summarize the association of skipping breakfast with body weight and metabolic outcomes in the pediatric population. We searched relevant databases (2008–2018) and identified 56 articles, of which 39 were suitable to be included, basing on inclusion criteria (observational; defined breakfast skipping; weight and/or metabolic outcomes). Overall, 286,804 children and adolescents living in 33 countries were included. The definitions of OW/OB, skipping breakfast, and the nutrient assessment were highly heterogeneous. Confounding factors were reported infrequently. The prevalence of skipping breakfast ranged 10–30%, with an increasing trend in adolescents, mainly in girls. Skipping breakfast was associated with OW/OB in the 94.7% of the subjects. The lack of association was shown mainly in infants. Moreover, 16,130 subjects were investigated for cardiometabolic outcomes. Skipping breakfast was associated with a worse lipid profile, blood pressure levels, insulin-resistance, and metabolic syndrome. Five studies reported a lower quality dietary intake in breakfast skippers. This review supports skipping breakfast as an easy marker of the risk of OW/OB and metabolic diseases, whether or not it is directly involved in causality. We encourage intervention studies using standardized and generalizable indicators. Data on confounders, time of fasting, chronotypes, and nutrition quality are needed to establish the best practice for using it as a tool for assessing obesity risk.
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              Relationships between consumption of ultra-processed foods, gestational weight gain and neonatal outcomes in a sample of US pregnant women

              Karthik Rohatgi, Rachel A. Tinius, W Cade … (2017)
              Background An increasingly large share of diet comes from ultra-processed foods (UPFs), which are assemblages of food substances designed to create durable, convenient and palatable ready-to-eat products. There is increasing evidence that high UPF consumption is indicative of poor diet and is associated with obesity and metabolic disorders. This study sought to examine the relationship between percent of energy intake from ultra-processed foods (PEI-UPF) during pregnancy and maternal gestational weight gain, maternal lipids and glycemia, and neonatal body composition. We also compared the PEI-UPF indicator against the US government’s Healthy Eating Index-2010 (HEI-2010). Methods Data were used from a longitudinal study performed in 2013–2014 at the Women’s Health Center and Obstetrics & Gynecology Clinic in St. Louis, MO, USA. Subjects were pregnant women in the normal and obese weight ranges, as well as their newborns (n = 45). PEI-UPF and the Healthy Eating Index-2010 (HEI-2010) were calculated for each subject from a one-month food frequency questionnaire (FFQ). Multiple regression (ANCOVA-like) analysis was used to analyze the relationship between PEI-UPF or HEI-2010 and various clinical outcomes. The ability of these dietary indices to predict clinical outcomes was also compared with the predictive abilities of total energy intake and total fat intake. Results An average of 54.4 ± 13.2% of energy intake was derived from UPFs. A 1%-point increase in PEI-UPF was associated with a 1.33 kg increase in gestational weight gain (p = 0.016). Similarly, a 1%-point increase in PEI-UPF was associated with a 0.22 mm increase in thigh skinfold (p = 0.045), 0.14 mm in subscapular skinfold (p = 0.026), and 0.62 percentage points of total body adiposity (p = 0.037) in the neonate. Discussion PEI-UPF (percent of energy intake from ultra-processed foods) was associated with and may be a useful predictor of increased gestational weight gain and neonatal body fat. PEI-UPF was a better predictor of all tested outcomes than either total energy or fat intake, and a better predictor of the three infant body fat measures than HEI-2010. UPF consumption should be limited during pregnancy and diet quality should be maximized in order to improve maternal and neonatal health.
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                Author and article information

                Contributors
                Fernanda Garanhani Surita:
                ORCID: https://orcid.org/0000-0003-4335-0337
                surita@unicamp.br
                Journal
                Journal ID (nlm-ta): Matern Child Nutr
                Journal ID (iso-abbrev): Matern Child Nutr
                Journal ID (doi): 10.1111/(ISSN)1740-8709
                Journal ID (publisher-id): MCN
                Title: Maternal & Child Nutrition
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 1740-8695
                ISSN (Electronic): 1740-8709
                Publication date (Electronic): 08 June 2020
                Publication date Collection: October 2020
                Volume: 16
                Issue: 4 ( doiID: 10.1111/mcn.v16.4 )
                Electronic Location Identifier: e13034
                Affiliations
                [ 1 ] Department of Obstetrics and Gynecology University of Campinas Campinas Brazil
                Author notes
                [*] [* ] Correspondence

                Fernanda Garanhani Surita, Department of Gynecology and Obstetrics, School of Medical Science, University of Campinas, 101 Alexander Fleming Street, Campinas, São Paulo, Brazil, Postcode 13083‐881.

                Email: surita@ 123456unicamp.br

                Author information
                https://orcid.org/0000-0002-8905-5870
                https://orcid.org/0000-0002-6365-5608
                https://orcid.org/0000-0003-4335-0337
                Article
                Publisher ID: MCN13034 Other ID: MCN-01-20-OA-4262.R2
                DOI: 10.1111/mcn.13034
                PMC ID: 7507371
                PubMed ID: 32510806
                SO-VID: 19f6c1e3-94bc-46ac-97f2-bd51d8d38b32
                Copyright © © 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons, Ltd.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 13 January 2020
                Date revision received : 05 May 2020
                Date accepted : 07 May 2020
                Page count
                Figures: 0, Tables: 3, Pages: 8, Words: 6408
                Funding
                Funded by: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES) , open-funder-registry 10.13039/501100002322;
                Award ID: 88882.329824/2019‐01
                Categories
                Subject: Original Article
                Subject: Original Articles
                Custom metadata
                source-schema-version-number 2.0
                cover-date October 2020
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.1 mode:remove_FC converted:22.09.2020

                Keywords: breakfast frequency,calcium intake,dairy products,diet records,meal frequency,pregnancy in adolescence
                Data availability:
                Keywords: breakfast frequency, calcium intake, dairy products, diet records, meal frequency, pregnancy in adolescence

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