Progress 07/01/11 to 06/30/13
Outputs
Target Audience: The target audience was pregnant and breastfeeding women in Northern Colorado age 18 - 40y and their babies followed throuth 12 months of age. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided? The project provided training in conducting human clinical research, IRB trainingand experience with data anaylsis andlaboratory techniques including gas chromatographic fatty acid analysis for one PhD student. How have the results been disseminated to communities of interest? A summary of results was developed and disseminated to the study participants. The results have been disseminated at the annual breastfeeding conference hosted by St. Lukes Presbyterian Hospital, Denver, CO. Abstracts have been submitted for presentation to the scientific community at theExperimental biology meeting April 2014. the results will be presentedin an invited presentationattheFetal Maternal Medicine conference in New Orleans, Feb 6, 2014. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
The Omega Smart Baby Project (OSBP) Pregnancy and Breastfeeding Coaching program was completed to examine the effect of DHA on infant growth and cognitive development. 115 pregnant women were supplemented with 300 mg DHA or placebo from 24-26 weeks of gestation through the first 3 months of breastfeeding. Total intake from supplements and food were combined and analyzed by tertile. DHA supplementation resulted in a 1 wk increase in gestation with a significant (p<.03) 8 d increase in gestational length comparing the highest intake of DHA( > 600 mg/d) to the lowest (< 300 mg/d). Bayley’s Scores of Human Development cognitive and language scales were measured at 4 and 12 months of age. Two single nucleotide polymorphisms in the fatty acid desaturase cluster (rs174575 and rs 174561) were evaluated. Plasma n-3 DHA and breastmilk(BM) DHA (% fatty acids) were significantly increased as intake of DHA (supplement plus dietary intake ) increased from <300 mg/day to 600 mg/day or more (p <.05) in those with major allele (wild type) but not in carriers or homozygotes of the minor rs174575 allelle. At 12 months of age, Bayley's cognitive and language scales were each 10 points higher in babies born to mothers with total intake of DHA > 600 mg/day compared to < 300 mg/d (p<.05). The efect was examined in realtionship to ther presence of the minor alleles of the desaturase gene. the effect on Bayley's scores was only significant in babies form to mothers with the wildtype phenotype. There was no association with BM arachidonic acid levels by genotype nor upon the measures of cognitive development. Weight/age and recumbant length/age z-scores were calculated in 54 infants born to mothers in the control group and 62 babies born to mothers in the DHA supplemented group. There were no significant effects of DHA supplementation, norBM DHA, on infant wt/age or wt/length Z-scores at 2 or 4 months of age. There was a consistent trend for lower wt/age and wt/ht scores at birth, 2 and 4 months as mothers intake of n-3 DHA increased from <300 mg/d to > 600 mg/d, and as breast milk DHA increased, but these trends did not reach statistical significance.
Publications
|
Progress 01/01/12 to 12/31/12
Outputs
OUTPUTS: The Omega Smart Baby Project (OSBP) Pregnancy and Breastfeeding Coaching program was developed to improve breastfeeding initiation and retention rates and to examine the effect of DHA on infant growth and cognitive development. 116 pregnant women were recruited for the study at 24 - 26 weeks of gestation and 95 were followed to delivery. The breastfeeding coaching program was highly successful. 100% initiated BF, 92/95 and (96.8%) were exclusively BF at 2 months and 89/95 (93.7%) at 4 months. Of the original cohort, 84% were still breastfeeding(25.5% exclusively) at 6 months and 59% were still breastfeeding at one year. RBC omega-3 DHA levels at entry into the study (n=116) expressed as % total lipid were 5.94 +/- 1.52 (mean +/- SD) and plasma phospholipid DHA was 5.04 +/- 1.44. Total dietary intake during pregnancy 81.9 +/- 5.8 mg/day (95% CI 72.3,91.5). In addition to dietary intake subjects in this randomized double bind study were supplemented with 0 or 300 mg DHA per day. Since some subjects were taking prescription renatal vitamins with 200 - 300 mg DHA, total omega-3 DHA intake ranges from 80 mg/day to over 1000 mg/day. Average intake of dietary omega-3 DHA from food during breastfeeding, obtained by 7 day diet record, was 90 mg/at 2 months and 99 mg/ day at 4 months. Fish intake was low, average comsumption was only .65 +/- .55 (mean +/- sem) servings per week at 22 - 24 weeks of gestation and increased to .78 =/-.11 (mean +/- sem) servings and .94 +/-.14 servings per week at 2 and 4 months of breastfeeding respectively. Infant weight and length were recorded at birth and at 2 and 4 months of age. Bayley's MDI and auditory mismatch electronegativity were measured at 4 months and 1 year, as indicators of neurocognitive development. Breastmilk DHA (n=92) was .53 +/- .037 (mean +/- sem) at 2 months and dropped to .35 +/- /039 percent of total fatty acids at 4 months. White blood cell DNA was analyzed to examine presence or absence of twosingle nucleotide polymorphisms in the fatty acid desaturase enzyme coding reagions to explain low breastmilk omega-3 DHA levels. Control data were collected on infant temperament and the home environment using validated survey instruments. Outcome data are currently being analyzed. PARTICIPANTS: Mary Harris, PhD,RD PI Susan Baker, EdD, CO-PI Deanna DAvalos, PhD Co-PI Kathryn McGirr, MS, RD, project assistant Alena Clark,CLC,PHD,RD consultant/lactation trainer Annaliese Zeiler, breastfeeding coach Rene Noland, recruiter Janice Gillespie, MS, RD, breastfeeding coach Adam Chicco,PhD collaborator Stacy Miller, MS (PhD Candidate), graduate researxh assistant Christopher Mulligan, MS ( PhD candidate), graduate research assistant Carlynn Barnard,MS,RD, graduate student Jamie Williams, MS, graduate student Alana Campbell, MS, graduate research assistant Rebecca Foright, research assistnat Kathryn Nelson, undergradute Hughs Scinece Program research scholar TARGET AUDIENCES: Target audiences are pregnant and breastfeeding women seen in the private obstetrical practices in nortnern colorado. The Omega Smart Baby Breastfeeding Support program can be used to promote breastfeeding in this group and can be extended to meet the needs ot mothers participating in the WIC program in the future. Inforamtion on cognitive fevelopment and dietary DHA may be sued to provide education to pregnant and breastfeeding mothers to promote optimal growth and neurocognitive development in their babies. PROJECT MODIFICATIONS: Major changes included change in number of subjects recruited due to a much higher retention rate than was originally predicted. Change in physiological cognitive testing procedure from visually based to auditory based processing as a sensitive measure of neurocognitive development. Addition of genotyping to explain breastmilk response to DHA intake and effect of DHA supplementation on cognitive development.
Impacts
This study developed a highly successful breastfeeding support program using a peer coaching model which can be used to promote exclusive breastfeeding and support breastfeeding mothers throughout the first 6 months of life, as recommended by the American Academy of Pediatrics. Additionally, it may provide dose response data to assist with setting the omega-3 DHA requirements to promote optimum infant growth and cognitive development pregnancy and breastfeeding and explain individual variance inthe need for DHA based upon genetic changes altering the ability to convert plant based omega-3 fatty acids to DHA to meet the needs of growth and development.
Publications
- No publications reported this period
|
Progress 01/01/11 to 12/31/11
Outputs
OUTPUTS: The goals of this project are to: 1) determine level of n-3 DHA intake throughout the third trimester of pregnancy and breastfeeding which promotes optimal breastmilk DHA and infant fetal and post natal growth and healthy BMI. 2) determine level of n-3 DHA intake throughout the third trimester of pregnancy and breastfeeding which promotes optimal neurocognitive development (objective of the USDA/AFRI funded study to which this study will link). 3) determine the effect of n-3 DHA and breastfeeding duration on IQ and BMI as a function of maternal genotype for 3 genes associated with the ability to convert dietary n-3 ALA to DHA and express DHA in breastmilk PARTICIPANTS: Mary Harris, PhD,RD (Dept of Food Science and Human Nutrition) Susan Baker, EdD (Dept of Food Science and Human Nutrition) Kathryn McGirr, MS (Dept of Food Science and Human Nutrition) Regina Reynolds, MD (Dept of Neonatology,The Childrens Hospital) Melanie Reece, PhD (Dept of Pediatrics, The Children's Hospital) Research Assistants: Stacy Miller, PhD candidate (Dept of Food Science and Human Nutrition) Christopher Mulligan, PhD candidate(Dept of Food Science and Human Nutrition) TARGET AUDIENCES: The target audience is pregnant and breastfeeding women. The potential impact of the dose response trial of omega-3 DHA supplementation during pregnancy and lactation may provide further evidence for increased need for DHA by pregnant women and lactating mothers to promote optimal cognitive development, particularly women who are unable to synthesize adequate amounts of DHA from vegetable sources of omega-3. It has been noted by the Institute of Medicine that more information is needed before preformed DHA can be considered to be a conditionally essential nutrient and identification of large segments of the population at risk for suboptimal DHA status may provide evidence for the need for a DRI for preformed DHA. Additionally, fish consumption by pregnant women in the US falls well below the current Dietary Guidelines. Study results may be used to educate pregnant and breastfeeding women on the importance of adequate seafood intake for its many benefits including promotion of desirable BMI and infant growth. PROJECT MODIFICATIONS: No significant changes since last report.
Impacts
Recruitment of participants has been completed for this randomized double blind placebo controlled trial of fish oil supplementation during pregnancy and lactation on breast milk omega-3 DHA status and infant cognitive development. Baseline dietary DHA intake at entry into the study were assessed using a validated food frequency questionnaire, Data has been gathered on maternal weight, height, BMI, gestational age at delivery and infant birth weight, birth length head circumference at delivery, maternal IQ and infant temperament. Maternal plasma samples obtained at 24 weeks of gestation and breastmilk samples obtained at 2 and 4 months of age have been almost all analyzed for fatty acid composition. Fatty acid analyses have been performed on plasma phospholipids and red blood cells. DNA extraction and FADs genotyping is currently being conducted. Follow up of infant cognitive development to one year of age is ongoing and the study results remain blinded.
Publications
- No publications reported this period
|