dc.contributor.advisor |
Harding, Dame Jane |
|
dc.contributor.author |
Amissah, Emma Ayorkor |
|
dc.date.accessioned |
2021-06-21T22:18:56Z |
|
dc.date.available |
2021-06-21T22:18:56Z |
|
dc.date.issued |
2021 |
en |
dc.identifier.uri |
https://hdl.handle.net/2292/55373 |
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dc.description.abstract |
The rising prevalence of obesity and cardio-metabolic disorders is a public health concern worldwide. Early life nutritional exposures may adversely influence an infant's growth trajectory and lifelong health, but the optimal nutrition for infants born pre term and to women with gestational diabetes mellitus (GDM) remains unclear.
Aim: To assess the effects of early life nutrition on developmental, cardio-metabolic, growth, and feeding outcomes in infants born preterm and to women with GDM.
Method: The Cochrane systematic reviews on the effects of protein, carbohydrate, and fat supplementation of human milk for preterm infants were updated. Evidence on post-weaning effects of macronutrient supplements fed between birth and weaning to animals born preterm or small for gestational age was synthesised using SYRCLE methodology. Associations between maternal diet at
36 weeks' gestation and infant growth, body composition, and appetitive feeding behaviour at birth and six months of age were assessed using data from a prospective cohort of women with GDM.
Results: Protein supplementation for preterm infants increased short-term growth and led to longer hospital stays and higher blood urea nitrogen concentrations. One trial showed no clear effectof fat supplementation, while another showed an increase in mean weight after carbohydrate supplementation. All three reviews were limited by small sample sizes, low precision, low to very-low quality evidence, and no available data to assess long-term effects.
Six studies of different animal species with low to very-low quality evidence showed that macronutrient supplementation of animals born small improved spatial learning and memory in pubertal pups, increased weight in juveniles, and decreased serum leptin concentrations in young adults but increased leptin in older adults. There was insufficient data to reliably assess other outcomes, sexspecific, and long-term health effects.
Among women with GDM, five maternal dietary patterns at 36 weeks' gestation were associated with sex-specific effects on offspring appetitive feeding behaviour, growth, and body composition at birth and six months of age.
Conclusions: High-quality longitudinal studies reporting standardized outcome measures and sex-specific data are needed to develop optimal early nutritional interventions for infants born small. Dietary intake in women with GDM may be important for the optimum health of their offspring. |
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dc.publisher |
ResearchSpace@Auckland |
en |
dc.relation.ispartof |
PhD Thesis - University of Auckland |
en |
dc.relation.isreferencedby |
UoA |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. |
|
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.rights.uri |
http://creativecommons.org/licenses/by-nc-nd/3.0/nz/ |
|
dc.title |
Early life nutrition and long-term health outcomes |
|
dc.type |
Thesis |
en |
thesis.degree.discipline |
Medicine |
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thesis.degree.grantor |
The University of Auckland |
en |
thesis.degree.level |
Doctoral |
en |
thesis.degree.name |
PhD |
en |
dc.date.updated |
2021-06-09T17:17:53Z |
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dc.rights.holder |
Copyright: The author |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/OpenAccess |
en |