Dr Jun Shi Lai, Senior Researcher at the Singapore Institute of Clinical Sciences, highlighted the above in his speech at the Growth Asia Summit held in Singapore from September 26 to 28.
It presented the theme “Optimizing maternal nutrition from preconception to post-pregnancy for the health of mothers and their children”.
During the presentation, she highlighted the results of two clinical studies, namely Growing Up in Singapore Towards healthy Outcomes (GUSTO) and Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO).
These are said to be the largest and most comprehensive birth cohort studies in Singapore.
The first involved 1,200 pregnant women from their first trimester, where they and their children were followed until the age of 13.
Information on children’s nutrition, physical activities, anthropometric measurements, body composition and neurocognitive development, genes and gut microbiome was collected.
The latter studied women who were not yet pregnant but were considering becoming pregnant. They and their children were followed until the children reached seven years old.
“The aim (of both studies) is to discover how pre-conception and post-conception factors influence the health of offspring later in life. » said Dr. Lai.
Based on the results of S-PRESTO, it was found that women with high folic concentration and vitamin B12 insufficiency had a higher risk of gestational diabetes.
“We noticed that among women with high folate and vitamin B12 insufficiency, they tended to have a higher risk of gestational diabetes.
“However, the same association was not observed in women with sufficient levels of B12.”
The results suggest that prenatal supplementation should go beyond just folic acid, but also address micronutrient deficiencies.
“This finding has important implications for prenatal supplementation, as it highlights the importance of ensuring vitamin B12 sufficiency and not always focusing on increasing folate intake and concentration.”she says.
Other deficiencies and impacts on offspring
Magnesium-deficient women have also been reported to have young children with lower school readiness test scores.
The results showed that by the age of four, children whose mothers had magnesium deficiency performed lower in areas such as the number knowledge test, letter identification and handwriting .
Higher concentration of lutein and zeaxanthin in mothers was also associated with a lower risk of poor visual acuity in offspring at three years of age.
Visual acuity is linked to the ability to distinguish the shapes and details of a given object from a distance.
Micronutrient deficiencies observed in wealthy societies
Micronutrient deficiencies are thought to be a problem in less wealthy countries, but this was also the case for wealthy societies like Singapore.
“A fairly large proportion of our GUSTO mothers have a high prevalence of deficiencies and insufficiencies in vitamin D, B12, magnesium and iron,
“It’s quite surprising because we thought that Singapore, being a rich country, would not have a problem with food availability and accessibility, but there is still a high prevalence of nutrient deficiencies,” said Dr. Lai.
Women involved in the GUSTO study also had lower average carotenoid concentrations than pregnant women involved in other studies.
She said this could reflect the lower consumption of fruit and vegetables among GUSTO mothers, as only about a third of them maintained the nationally recommended servings of two fruits and two vegetables per day.
Healthy eating and body composition are important
When it comes to preconception, overall diet and body composition are two crucial factors.
Results showed that greater adherence to a healthy plant-based diet was significantly associated with greater fecundability and vice versa.
Fecundability refers to the likelihood of conceiving during a menstrual cycle.
The plant-based foods studied were categorized into healthy foods, such as fruits, vegetables, nuts, legumes, and unhealthy foods, such as refined grains, sweets and desserts.
Another study comparing the diet of dried fast food snacks versus the healthier diet of seafood, fish and vegetables, showed that women taking the former would have a significantly lower concentration of nutrients good for babies, even after taking supplements.
“We noticed that women who consistently adhere to less healthy habits have significantly lower concentrations of many nutrients important for fetal growth and development.
“We also noticed that even with the consumption of prenatal supplements, women who consistently adhered to the less healthy pattern had a significantly lower concentration of number of nutrients. she says.
Supplements such as folic acid and iodine were also associated with greater fecundability.
Besides diet types, body composition, such as body mass index (BMI), is also linked to fecundability.
For example, higher BMI and higher skinfold thickness were associated with higher total body fat percentage, which led to lower fecundability.
“This study tells us that having an optimal BMI as well as lower adiposity can improve fertility.” said Dr. Lai.
Being underweight has also been found to be linked to lower fecundability.
“It appears that being underweight may also reduce the likelihood of conceiving, but in our adjusted analysis model the results are not statistically significant,”she says.
