Search Results (1,242)

Background/Objectives: Maternal nutrition and physical activity are modifiable behaviours relevant to pregnancy outcomes, but higher activity may coexist with both favourable and unfavourable dietary patterns. This study examined associations between pregnancy physical activity, individualised fruit–vegetable adequacy, energy-dense, nutrient-poor (EDNP) food and beverage intake, and preterm birth. Methods: This cross-sectional study included 1048 postpartum women with singleton live births recruited consecutively at a tertiary maternity hospital in Romania. Physical activity during the last three months of pregnancy was assessed using the Pregnancy Physical Activity Questionnaire and categorised into quartiles of total MET-hours/week. Dietary intake was assessed using an adapted food frequency questionnaire. Fruit–vegetable adequacy was evaluated against individualised recommendations, and EDNP intake was summarised using a composite score derived from fast food, sweets, chocolate, and sugar-sweetened beverages. Preterm birth was defined as delivery before 37 completed weeks of gestation. Results: Preterm birth occurred in 118 cases (11.3%). Higher physical activity categories showed greater fruit–vegetable intake and adequacy, but also higher EDNP intake. After adjustment for maternal age, pregestational BMI, parity, education, and income, physical activity category remained associated with all modelled dietary outcomes. Category 4 had higher odds of fruit–vegetable adequacy than category 1 (OR 2.24, 95% CI 1.55–3.24). In diet-informed models, category 3 had the lowest odds of preterm birth (OR 0.38, 95% CI 0.21–0.68). Conclusions: Total physical activity during pregnancy was associated with a complex dietary profile rather than a uniformly favourable lifestyle pattern. The lowest odds of preterm birth were observed in the third activity category, suggesting a non-linear association. Full article

The global obesity epidemic is expanding at an alarming rate, posing significant health risks for women of reproductive age due to immediate pregnancy complications and adverse long-term effects on offspring. Consequently, several non-pharmacological strategies have been proposed to mitigate these impacts. Therefore, we hypothesized that the combined application of the probiotic Lacticaseibacillus rhamnosus GG (LGG) and enriched environment (EE) will result in improved metabolic and histopathologic findings within a model of maternal obesity, surpassing the efficacy of individual therapeutic strategies. Using nulliparous Wistar rats, LGG was administered before, during, and after gestation, while EE was implemented during pregnancy and lactation. LGG supplementation and an enriched environment separately improved blood triacylglycerols. The enriched environment was more effective in reducing the effects of maternal obesity, even lessening liver damage observed in obese subjects in the form of vacuolar infiltrates. The results obtained suggest a potential functional interaction in this combined model, and the findings indicate that LGG may have influenced the modulation of enriched environment effects on metabolic parameters. Diet, probiotic supplementation, and environmental setting during the perinatal period have specific effects on biochemical and tissular parameters, establishing their descriptive role as non-pharmacological intervention strategies and underscoring the need for mechanistic studies to elucidate the biological pathways underlying these effects. Full article

Background: Pregnancy is a vital period during which maternal nutrition profoundly influences both maternal health and fetal development. Carotenoids, predominantly found in fruits and vegetables, are bioactive compounds that enhance antioxidant defenses and facilitate vitamin A metabolism throughout pregnancy. However, assessing carotenoids intake presents challenges due to the lack of dietary assessment tools capable of quantifying individual carotenoids, coupled with limited data from populations in Eastern Europe. Methods: A cross-sectional study involving 621 pregnant women in Romania was conducted to estimate dietary carotenoids intake and investigate associations with dietary patterns and overall diet quality. Dietary data were obtained using the EPIC Food Frequency Questionnaire (EPIC-FFQ), adapted for Romanian populations. A dedicated carotenoid estimation model was developed utilizing the USDA Carotenoid Database. Principal component analysis (PCA) was employed to identify dietary patterns, and diet quality was evaluated using the Diet Quality Index during Pregnancy (DQI-P). Results: The findings revealed significant individual variability. The median intake was highest for β-carotene (2464 μg), and lycopene (1664 μg), followed by lutein and zeaxanthin (908 μg), α-carotene (615 μg), and β-cryptoxanthin (121 μg). The Vegetable-meal pattern exhibited the strongest positive correlation with carotenoids intake, whereas the Energy-dense pattern was primarily associated with vitamin E and tocopherols/tocotrienols, and the Mixed pattern with vitamins A and D. Higher DQI-P scores were consistently correlated with increased carotenoids consumption. Conclusions: Overall, maternal carotenoids intake during pregnancy was frequently insufficient and showed considerable variation among women. A diet rich in vegetables and higher overall diet quality were associated with elevated carotenoids intake levels. These findings enhance the understanding of dietary carotenoids intake among pregnant women in Eastern Europe. Full article

Leucine, an essential branched-chain amino acid, serves not only as a substrate for protein synthesis but also as a key regulator of placental function and fetal development. This study investigated the effects of dietary supplementation with RP-Leu during late gestation on placental development and offspring performance in Hu sheep. Sixty twin-pregnant ewes at day 80 of pregnancy were randomly assigned to either a control group (fed a basal diet) or an RP-Leu group (fed a basal diet supplemented with 19 g/day RP-Leu). The feeding trial lasted for 60 d. The ewes were slaughtered at day 140 of gestation. Maternal slaughter traits and fetal organ weights were recorded. Blood and milk samples were collected for milk composition analysis and targeted metabolomic profiling. Leucine supplementation significantly increased the percentage of milk fat content, total solid content, and the birth weight of lambs (p < 0.05). Improvements in placental morphology and antioxidant capacity were observed, including a significant increase in cotyledon density and a significant enhancement of catalase (CAT) activity (p < 0.05). Gene expression analysis indicated that the NOS3, SLC38A1 and FABP4 genes in the placental cotyledons (p < 0.05), and the VEGFA, NOS3, SLC27A1 and FABP4 genes were significantly upregulated in the maternal caruncles (p < 0.05). Plasma metabolomic profiling revealed increased L-glutamic acid levels and alterations in several amino acids, with pathway enrichment indicating involvement in amino acid metabolism and membrane transport processes. Transcriptomic analysis identified 739 differentially expressed genes, which were mainly enriched in the PI3K/Akt signaling pathway, ECM–receptor interaction pathway, and cytokine–cytokine receptor interaction pathway. Collectively, these findings suggest that RP-Leu supplementation during late gestation may enhance offspring growth by modulating amino acid metabolism, promoting placental development, and improving placental nutrient transport capacity, thereby supporting fetal growth and development. Full article

The objectives of this study were to evaluate the effects of different dietary omega-6 to omega-3 (n-6:n-3) fatty acid ratios during timed artificial insemination (TAI) on reproductive responses, luteal development, and offspring characteristics in lactating dairy cows. Holstein cows (n = 60) averaging 109 ± 10 days in milk (DIM) were randomly assigned to receive either a greater n-6:n-3 diet or a lower n-6:n-3 diet for 42 days. All cows were synchronized using a modified Ovsynch protocol. Although synchronized ovulation rates and pregnancy outcomes were not significantly affected by treatment, cows fed the lower n-6:n-3 ratio exhibited significantly greater corpus luteum (CL) volume and cross-sectional area on days 11 and 14 post-TAI, indicating enhanced luteal development. Pregnancy rates following the first AI and cumulative AI, as well as the number of services per conception, did not differ between treatments. However, cows fed the lower n-6:n-3 ratio tended to produce a greater proportion of female offspring (66.67% vs. 42.90%; p = 0.09). In addition, calves born to cows receiving the lower n-6:n-3 ratio had greater birth weights than calves born to cows fed the greater n-6:n-3 ratio diet. Additionally, the lower n-6:n-3 diet tended to increase milk yield and significantly increased lactose and solids-not-fat yields. In conclusion, a lower dietary n-6:n-3 ratio during a TAI program enhanced luteal development, tended to increase the proportion of female offspring and increased calf birth weight. These findings suggest that reducing the dietary n-6:n-3 ratio during the breeding period may enhance luteal development and may influence offspring sex ratio and calf birth weight in lactating dairy cows. Full article

Insulin resistance (IR) is a significant risk factor for various diseases, particularly during pregnancy. Dietary patterns have been reported to influence IR susceptibility. High-protein (HP) diet has gained popularity for its role in weight management. However, whether trimethylamine N-oxide (TMAO), which is produced in the liver from gut microbiota-derived metabolites of dietary protein, influences IR remains uncertain. In this study, we established a pregnant mouse model to examine the effect of an HP diet on IR, assess its impact on liver function, and investigate associated signaling pathways. The role of gut microbiota was also evaluated. We found that the HP diet induced liver injury in pregnant mice following significantly decreased body weight. The HP diet also elevated plasma TMAO levels and upregulated hepatic FMO₃ expression. Transcriptomic analysis revealed enrichment of insulin-related signaling pathways in the HP group, with notable downregulation of the Insrr gene. IR was induced through the IRS-1/PI3K/Akt signal pathway. Gut microbiota composition was disrupted in HP group, characterized by an increased Firmicutes/Bacteroidetes ratio and a higher abundance of the TMA-producing genus Coprococcus, indicating an elevated potential for TMA generation. Furthermore, several amino acid metabolism pathways closely linked to IR were also enriched in the HP group. In conclusion, our study demonstrates that HP diet induces liver injury and increases IR risk during pregnancy. Gut microbiota contributes to this process, in part through an enhanced capacity for TMA production. These findings highlight the need for greater attention to dietary patterns in pregnancy to mitigate metabolic risks. Full article

Background: Increasing evidence suggests that breast milk and its bioactive components, including short-chain fatty acids and the milk microbiome, are influenced by maternal nutrition and body mass index (BMI). Bioactive components transferred to the infant through breast milk play a pivotal role in infant growth and development and have indications in the child’s future short- and long-term health outcomes. This study aimed to assess the impact of maternal pre-pregnancy BMI (PP-BMI) on human breast milk macronutrient composition, short- and long-chain fatty acid profiles, and breast milk microbiome profiles. Approach: This was an exploratory cohort study of forty-four lactating Caucasian women, two to fourteen weeks postpartum, divided into groups based on pre-pregnancy body mass index (BMI). Study participants signed informed consent, completed health and nutritional surveys, and provided a breast milk sample. Breast milk samples were subjected to proximate analysis, microbiome identification and short- and long-chain fatty acid extraction and analysis. Results: Maternal age, maternal physical activity, infant birth weight, and time of lactation at sample collection were not significantly different between the maternal PP-BMI groups. PP-BMI was significantly different between the two maternal groups. No significant differences were found between the maternal BMI groups concerning nutritional intake. No differences in breast milk microbiomes were observed in alpha diversity and beta diversity between the maternal PP-BMI groups. For long-chain fatty analysis in breast milk samples, myristic acid was significantly higher in the PP-BMI overweight/obese group while stearic acid was significantly higher in the PP-BMI normal-weight group. Butyric, valeric, and isocaproic acid concentrations in HBM were significantly higher in the PP-BMI normal-weight group and lower or undetectable in the PP-BMI overweight/obese group. Conclusions: Data from this exploratory cohort study indicate that maternal diet and pre-pregnancy BMI may be associated with differences in selected HBM fatty acids. There were no significant differences in microbiomes for alpha and beta diversity in breast milk between maternal PP-BMI groups; however, lower relative abundance was observed in the breast milk of the PP-BMI overweight/obese group. These findings should be interpreted in the context of the study’s limitations, including convenience recruitment from a Facebook group, the modest sample size, and restriction to Caucasian women from a single geographic region. Full article

Background: Adolescence is a critical developmental period for emotional health, and anxiety disorders are a major public health concern. Adherence to the Mediterranean diet has been associated with improved mental health outcomes in adults; however, evidence in adolescents remains limited. Methods: We analyzed data from 86 adolescents participating in the KLOTHO birth cohort. Dietary quality was assessed using the KIDMED index, whereas maternal adherence to the Mediterranean diet during pregnancy was evaluated using a Mediterranean diet score. Psychological outcomes included behavioral difficulties (Strengths and Difficulties Questionnaire), anxiety symptoms (Spence Children’s Anxiety Scale), and mood-related outcomes (Mood and Feelings Questionnaire). Associations were examined using Spearman’s correlation analyses and multivariate linear regression models adjusted for sex, body mass index (BMI), sleep duration, and physical activity. Results: Higher adherence to the Mediterranean diet in adolescents was inversely associated with anxiety levels in correlation analyses (ρ = −0.294, p = 0.029). However, after adjustment for sex, body mass index, sleep duration, and physical activity, the association with total anxiety score was attenuated and no longer statistically significant associated with lower anxiety levels in correlation analyses (ρ = −0.294, p = 0.029). In adjusted models, the KIDMED score was not associated with total anxiety score but was independently associated with lower scores in specific anxiety domains, including social phobia and separation anxiety. Maternal adherence to the Mediterranean diet was associated with lower overall anxiety in offspring but not with specific anxiety subdomains. Conclusions: Adherence to the Mediterranean diet during adolescence is modestly associated with lower levels of specific anxiety symptoms, suggesting a modest domain-specific association between dietary patterns and emotional health. Full article

Objective: To investigate whether gestational diabetes mellitus (GDM), including insulin-treated GDM, affects cerebroplacental ratio (CPR) values in monochorionic diamniotic (MCDA) twin pregnancies. Methods: This retrospective single-center cohort study included a total of 262 MCDA twin pregnancies managed at a tertiary referral center, comprising pregnancies without GDM (n = 120), with diet-controlled GDM (n = 80), and with insulin-treated GDM (n = 62). Doppler ultrasound examinations were performed at three gestational time points between 24 and 36 weeks of gestation. CPR, umbilical artery pulsatility index (UA-PI), and middle cerebral artery pulsatility index (MCA-PI) were compared longitudinally between groups. Doppler indices were compared between groups without adjustment for baseline differences such as BMI and parity Results: Maternal body mass index was significantly higher in pregnancies complicated by GDM, particularly in those requiring insulin therapy (p < 0.001). Estimated fetal weight was higher in the insulin-treated GDM group at mid-gestation (28–32 weeks; p = 0.01). However, CPR values remained within normal ranges throughout all screening points across all three groups. No relevant differences in UA-PI, MCA-PI, gestational age at delivery, Apgar scores, or umbilical cord pH were observed between groups. Conclusions: In MCDA twin pregnancies, gestational diabetes—regardless of insulin treatment—does not appear to significantly influence cerebroplacental ratio values throughout gestation. No statistically significant differences in CPR values were observed between groups. No statistically significant differences in CPR values were detected between groups. However, given the exploratory design and lack of adjustment for confounders, subtle effects cannot be excluded. The clinical utility of CPR in this population requires further investigation. Full article

Backgroud and Objectives: To evaluate conventional Doppler indices and the novel middle cerebral artery (MCA) diastolic deceleration area (DDA) in pregnancies complicated by gestational diabetes mellitus (GDM), and to explore their associations with perinatal outcomes. Prospective case–control study conducted at a tertiary referral perinatology center. Materials and Methods: The study included 83 women with GDM and 92 healthy controls. Standard fetal biometric and Doppler parameters—umbilical artery, MCA, ductus venosus, cerebroplacental ratio, and umbilicocerebral ratio—were assessed, alongside calculation of MCA DDA. Perinatal outcomes were recorded. Results: Most conventional Doppler indices did not differ between groups, except for lower MCA dicrotic notch velocity and higher ductus venosus time-averaged maximum velocity in the GDM group. MCA DDA values did not differ significantly between GDM and control groups (6.67 [5.02–8.20] vs. 7.05 [5.21–8.39] cm·s, p = 0.444) and showed no difference between insulin- and diet-controlled subgroups (p > 0.05). MCA DDA showed significant correlations with gestational age, MCA peak systolic velocity, and birth weight. However, after adjustment for potential confounders, gestational age remained the only independent determinant of MCA DDA. The multivariable analysis evaluating composite adverse neonatal outcomes was limited by the small number of adverse events (n = 14). Conclusions: MCA DDA did not differ between GDM and control pregnancies and primarily reflected gestational age-related physiological variation rather than diabetes specific hemodynamic changes. However, its relationship with adverse neonatal outcomes remains uncertain and requires further investigation in larger prospective studies. Full article

Human milk (HM) is recognized as the optimal source of nutrition for infants, providing essential nutrients, bioactive compounds, and immunological protection crucial for proper growth and development. However, due to increasing environmental pollution, HM may also serve as a vector for exposure to toxic substances, including heavy metals. These contaminants originate from both current environmental exposure and long-term accumulation in maternal tissues, which may be mobilized during pregnancy and lactation. Objectives: The aim of this review was to comprehensively analyze the occurrence, sources, and determinants of heavy and toxic metals in human milk, with particular emphasis on maternal–infant transfer pathways and geographical variability of exposure. Methods: A structured narrative review with systematic literature search elements was conducted using PubMed, Scopus, and Web of Science databases. The search covered studies published between 2010 and 2025 and was limited to articles written in English. The search strategy included terms related to human milk and heavy metal exposure (Pb, Cd, Hg, As, Cr, Al). Predefined inclusion and exclusion criteria were applied, and a qualitative synthesis of environmental, dietary, physiological, and lifestyle-related determinants, as well as geographical variability, was performed. Results: The available evidence indicates that heavy metals are commonly detected in human milk worldwide, with concentrations strongly influenced by environmental pollution, maternal diet, and lifestyle factors. Under typical exposure conditions, reported concentration ranges are approximately 2–5 µg/L for lead (Pb), 1.4–1.7 µg/L for mercury (Hg), and below 1 µg/L for cadmium (Cd). However, substantially higher levels have been reported in highly contaminated regions, with extreme values exceeding 1000 µg/L for Pb and 100 µg/L for Hg in isolated cases. Key exposure pathways include contaminated food, drinking water, air pollution, and endogenous mobilization of metals stored in maternal tissues (particularly bone and adipose tissue). Significant geographical variability was observed, with higher concentrations reported in industrialized and mining regions. Infants represent a highly vulnerable population due to immature detoxification systems, increased gastrointestinal absorption, and ongoing neurodevelopment, which may amplify toxic effects even at low exposure levels. Conclusions: Although human milk remains the gold standard for infant nutrition, the presence of heavy metals highlights the need for continuous environmental monitoring and preventive strategies aimed at reducing maternal exposure. The benefits of breastfeeding clearly outweigh the potential risks; however, minimizing environmental contamination remains a critical public health priority. Future research should focus on standardizing analytical methods, improving biomonitoring strategies, and better characterizing long-term health outcomes associated with early-life exposure to toxic metals. Full article

Background/Objectives: Preterm birth (PTB) is a major public health concern worldwide, which may lead to detrimental maternal and neonatal outcomes. Maternal nutritional status, gestational weight gain (GWG), and lifestyle factors are potentially modifiable determinants of adverse pregnancy outcomes. This study examined the association between PTB and maternal GWG and assessed whether maternal dietary habits and lifestyle factors were related to GWG in women delivering preterm versus at term. Methods: A retrospective case–control study was conducted at a tertiary center in Hungary (MANOR Study, 2019). The case group included n = 100 women with PTB, while n = 200 matched term deliveries served as controls (1:2 ratio). Data were collected using a self-administered questionnaire and medical records. Pre-pregnancy body mass index (BMI) was categorized using standard definitions, while GWG was classified as inadequate, recommended, or excessive according to the US 2009 Institute of Medicine guidelines. A 7-item dietary index score was calculated based on gestational dietary habits. Results: Pre-pregnancy BMI distribution did not considerably differ between groups (p > 0.05); over one-third of women in both groups were overweight or had obesity (38.7% vs. 36.7%). Previous PTB (p < 0.001) and gestational hypertension (GHT) (p = 0.003) were more common among current PTB cases, while smoking, alcohol consumption, and gestational diabetes mellitus (GDM) showed negligible differences (p > 0.05)—28.0% of cases, and 34.5% of controls were classified as having healthy dietary habits, based on the dietary index score calculated. Inadequate GWG was more prevalent among PTB cases (49.0% vs. 26.8%), whereas excessive GWG was less frequent among cases (21.9% vs. 38.4%). Being within the recommended GWG range and the manifestation of gestational hypertension were associated with lower (aOR: 0.39; 95% CI: 0.18–0.87; p = 0.020) and higher (aOR: 3.43; 95% CI: 1.44–8.19; p = 0.005) odds of PTB, respectively. Conclusions: Inadequate GWG was more common in PTB, while excessive GWG was more frequent in term pregnancies. Fast-food consumption was associated with excessive GWG among term births. Optimizing GWG and improving maternal diet quality should be included as key, cross-cutting interventions targeting the improvement of antenatal care. Full article

Over recent decades, a substantial body of research has expanded our understanding of how early-life conditions influence long-term health. These observations led to the formulation of the Barker Hypothesis, which postulates that adverse nutritional exposures during fetal life can induce persistent physiological and metabolic adaptations, thereby increasing susceptibility to chronic diseases later in life. This narrative review aims to provide a comprehensive overview of current recommendations for adequate maternal nutrition during pregnancy, with particular emphasis on key nutrients and specific dietary patterns. In addition, the effects of maternal diet on placental function and fetal growth are examined. A literature search was conducted in the following electronic databases: MEDLINE (via PubMed), Scopus, Web of Science, Embase, and the Cochrane Library. Manuscripts published between 2005 and 2025 were considered. The impact of prenatal nutritional exposures on immune development, neurodevelopment, metabolic regulation, and gut microbiota is also discussed, highlighting how these mechanisms may contribute to an increased long-term risk of non-communicable diseases, including obesity, metabolic syndrome, and neuropsychiatric disorders. Maternal nutrition during pregnancy plays a crucial role in shaping infants’ and children’s health, particularly regarding the development of non-communicable diseases. Therefore, ensuring adequate nutritional intake during this critical period—both quantitatively and qualitatively—is essential to optimize health outcomes for the newborn and to promote long-term well-being throughout childhood and beyond. Full article

Objectives: The objectives of this review are to explore the effects of various nutrition and exercise lifestyle interventions on pregnancy outcomes in individuals with, or at risk of, gestational diabetes mellitus (GDM), as well as to examine whether interventions that are culturally and/or religiously sensitive influence clinical and behavioural outcomes. Methods: This study was conducted as a narrative review. PRISMA was used solely as a reporting guide to enhance transparency in the search and study selection process. PubMed/MEDLINE, CINAHL, and Scopus were searched for studies published up to November 2025. Intervention-based studies evaluating nutrition, physical activity, or combined lifestyle interventions targeting either GDM incidence, insulin use, or glycemic outcomes were included. Forty-three studies met eligibility criteria. Study designs consisted primarily of randomized controlled trials (RCTs) with one case–control and one quasi-experimental design trial. Results: Combined lifestyle interventions generally showed the most consistent improvements in glycemic control; however, findings were not uniform across all studies, and reporting on insulin outcomes was limited. The Mediterranean, low-glycemic index (LGI) and DASH diets, along with supervised, prenatal exercise programs with low–moderate intensity, delivered at least three times per week, were effective in managing GDM. Regarding culturally or religiously sensitive interventions, only one study was identified. Conclusions: Lifestyle interventions may improve glycemic outcomes in GDM; however, further high-quality research is needed, particularly studies incorporating culturally and religiously sensitive approaches and improved reporting of insulin-related outcomes. Full article

Maternal nutrition during critical windows of development plays a pivotal role in shaping long-term disease susceptibility, including cancer risk. This study investigated whether maternal exposure to lipotropes (methyl donor nutrients) during pregnancy and lactation modulates gene expression in 7,12-dimethylbenzanthracene (DMBA)-induced mammary tumors in adult female offspring. Timed-pregnant Sprague-Dawley rats were fed with either a control or lipotrope-supplemented diet, with or without vitamin B6. Female offspring were exposed to DMBA at puberty, and mammary tumors were evaluated histologically and molecularly. DMBA-induced tumors displayed ductal carcinoma in situ-like morphology and significant upregulation of fetal mammary developmental genes (Tbx2 and Tbx3), the tumorigenesis-associated gene Tp53, and key epigenetic regulators (Hdac1, Dnmt1, and Mthfr). Estrogen receptor 1 (Esr1) mRNA expression also showed a significant increase. Maternal lipotropes supplementation significantly attenuated the expression of these genes in offspring tumors. Collectively, these findings demonstrate that maternal methyl donor nutrition modulates tumor-associated gene expression patterns, potentially by limiting the reactivation of developmental and epigenetic pathways in adulthood. This study highlights maternal nutrition as a modifiable early-life factor with important implications for long-term health programming. Full article