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      A randomized longitudinal dietary intervention study during pregnancy: effects on fish intake, phospholipids, and body composition

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          Abstract

          Background

          Fish and meat intake may affect gestational weight gain, body composition and serum fatty acids. We aimed to determine whether a longitudinal dietary intervention during pregnancy could increase fish intake, affect serum phospholipid fatty acids, gestational weight gain and body composition changes during pregnancy in women of normal weight participating in the Pregnancy Obesity Nutrition and Child Health study. A second aim was to study possible effects in early pregnancy of fish intake and meat intake, respectively, on serum phospholipid fatty acids, gestational weight gain, and body composition changes during pregnancy.

          Methods

          In this prospective, randomized controlled study, women were allocated to a control group or to a dietary counseling group that focused on increasing fish intake. Fat mass and fat-free mass were measured by air-displacement plethysmography. Reported intake of fish and meat was collected from a baseline population and from a subgroup of women who participated in each trimester of their pregnancies. Serum levels of phospholipid arachidonic acid (s-ARA), eicosapentaenoic acid (s-EPA), and docosahexaenoic acid (s-DHA) were measured during each trimester.

          Results

          Weekly fish intake increased only in the intervention group (n = 18) from the first to the second trimester (median difference 113 g, p = 0.03) and from the first to the third trimester (median difference 75 g, p = 0.01). In the first trimester, fish intake correlated with s-EPA (r = 0.36, p = 0.002, n = 69) and s-DHA (r = 0.34, p = 0.005, n = 69), and meat intake correlated with s-ARA (r = 0.28, p = 0.02, n = 69). Fat-free mass gain correlated with reported meat intake in the first trimester (r = 0.39, p = 0.01, n = 45).

          Conclusions

          Dietary counseling throughout pregnancy could help women increase their fish intake. Intake of meat in early pregnancy may increase the gain in fat-free mass during pregnancy.

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          Most cited references60

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          Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans.

          Insulin resistance plays an important role in the pathophysiology of diabetes and is associated with obesity and other cardiovascular risk factors. The "gold standard" glucose clamp and minimal model analysis are two established methods for determining insulin sensitivity in vivo, but neither is easily implemented in large studies. Thus, it is of interest to develop a simple, accurate method for assessing insulin sensitivity that is useful for clinical investigations. We performed both hyperinsulinemic isoglycemic glucose clamp and insulin-modified frequently sampled iv glucose tolerance tests on 28 nonobese, 13 obese, and 15 type 2 diabetic subjects. We obtained correlations between indexes of insulin sensitivity from glucose clamp studies (SI(Clamp)) and minimal model analysis (SI(MM)) that were comparable to previous reports (r = 0.57). We performed a sensitivity analysis on our data and discovered that physiological steady state values [i.e. fasting insulin (I(0)) and glucose (G(0))] contain critical information about insulin sensitivity. We defined a quantitative insulin sensitivity check index (QUICKI = 1/[log(I(0)) + log(G(0))]) that has substantially better correlation with SI(Clamp) (r = 0.78) than the correlation we observed between SI(MM) and SI(Clamp). Moreover, we observed a comparable overall correlation between QUICKI and SI(Clamp) in a totally independent group of 21 obese and 14 nonobese subjects from another institution. We conclude that QUICKI is an index of insulin sensitivity obtained from a fasting blood sample that may be useful for clinical research.
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            Polyunsaturated fatty acids and inflammation.

            The n-6 polyunsaturated fatty acid arachidonic acid gives rise to the eicosanoid family of mediators (prostaglandins, thromboxanes, leukotrienes and related metabolites). These have inflammatory actions in their own right and also regulate the production of other mediators including inflammatory cytokines. Consumption of long chain n-3 polyunsaturated fatty acids decreases the amount of arachidonic acid in cell membranes and so available for eicosanoid production. Thus, n-3 polyunsaturated fatty acids decrease production of arachidonic acid-derived eicosanoids. These fatty acids also decrease the production of the classic inflammatory cytokines tumour necrosis factor, interleukin-1, and interleukin-6 and the expression of adhesion molecules involved in inflammatory interactions between leukocytes and endothelial cells. These latter effects may occur by eicosanoid-independent mechanisms including modulation of the activation of transcription factors involved in inflammatory processes. The anti-inflammatory actions of long chain n-3 fatty acid-induced effects may be of therapeutic use in conditions with an acute or chronic inflammatory component.
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              Improved recovery of fatty acid through direct transesterification without prior extraction or purification.

              Methods currently in use for the quantitative measurement of fatty acids by gas-liquid chromatography after transesterification are usually lengthy and cumbersome. The technique described is a one-step reaction that is carried out in the same tube and bypasses all the extraction and purification steps. Recoveries of fatty acid and triglyceride standards (C6:0 to C24:1) were better than 96%. When the direct transesterification method was compared to the Folch extraction procedure, increases of fatty acid concentration of 11.4% and 15.8% were observed in human milk and adipose tissue, respectively. The method appears to be particularly advantageous for the recovery of the highly volatile medium chain triglycerides and there is no need to add an antioxidant to protect unsaturated lipids.
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                Author and article information

                Contributors
                marja.bosaeus@neuro.gu.se
                aysha.hussain@neuro.gu.se
                therese.karlsson@neuro.gu.se
                louise.andersson@neuro.gu.se
                lena.hulthen@medfak.gu.se
                cecilia.svelander@chalmers.se
                ann-sofie.sandberg@chalmers.se
                ingrid.larsson@medfak.gu.se
                lasse.ellegard@nutrition.gu.se
                agneta.holmang@neuro.gu.se
                Journal
                Nutr J
                Nutr J
                Nutrition Journal
                BioMed Central (London )
                1475-2891
                2 January 2015
                2 January 2015
                2015
                : 14
                : 1
                : 1
                Affiliations
                [ ]Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
                [ ]Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
                [ ]Division of Life Sciences/Food Science, Department of Chemical and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
                [ ]Department of Endocrinology, Diabetology and Metabolism, Sahlgrenska University Hospital, Gothenburg, Sweden
                Article
                858
                10.1186/1475-2891-14-1
                4292819
                25554072
                21bb5cde-3ae3-404a-943b-81daa7d897ca
                © Bosaeus et al.; licensee BioMed Central. 2015

                This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 20 May 2014
                : 17 December 2014
                Categories
                Research
                Custom metadata
                © The Author(s) 2015

                Nutrition & Dietetics
                pregnancy,fish intake,meat intake,body composition,fatty acids
                Nutrition & Dietetics
                pregnancy, fish intake, meat intake, body composition, fatty acids

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