Birth weight and growth from infancy to late adolescence in relation to fat and lean mass in early old age: findings from the MRC National Survey of Health and Development High-DHA eggs: Feasibility as a means to enhance circulating DHA in mother and infant Dietary composition of pregnant women is related to size of the baby at birth. Effect of a milk-based food supplement on maternal nutritional status and fetal growth in underweight Chilean women. Nutrition during pregnancy: the effects of an educational intervention program in Greece. Effect of food supplementation (WIC) during pregnancy on birth weight. Nutritional supplementation and the outcome of pregnancy. I. Birth weight. The Bacon Chow study: maternal nutrition supplementation and birth weight of offspring. Low-sodium diet in pregnancy: effects on blood pressure and maternal nutritional status. A Randomized Trial of Docosahexaenoic Acid Supplementation During the Third Trimester of Pregnancy A prospective study of diet quality and mortality in women. Perinatal outcomes in nutritionally monitored obese pregnant women: a randomized clinical trial. Effects of Dietary Calcium Intervention on Adolescent Mothers and Newborns: A Randomized Controlled Trial Effect of a cholesterol-lowering diet on maternal, cord, and neonatal lipids, and pregnancy outcome: a randomized clinical trial. Effects on birth weight and perinatal mortality of maternal dietary supplements in rural gambia: 5 year randomised controlled trial A randomized controlled trial of prenatal nutritional supplementation in New York City. Consumption of a DHA-containing functional food during pregnancy is associated with lower infant ponderal index and cord plasma insulin concentration. Low sodium diet and pregnancy‐induced hypertension: a multi‐centre randomised controlled trial Differing effects of low and high bulk maternal dietary supplements during pregnancy. Fat-modified diets during pregnancy and lactation and serum lipids after birth Primary Prevention of Gestational Diabetes Mellitus and Large-for-Gestational-Age Newborns by Lifestyle Counseling: A Cluster-Randomized Controlled Trial
Objective : High birth weight and greater weight gain in infancy have been associated with increased risk of obesity as assessed using body mass index , but few studies have examined associations with direct measures of fat and lean mass . This study examined associations of birth weight and weight and height gain in infancy , childhood and adolescence with fat and lean mass in early old age . Subjects : A total of 746 men and 812 women in Engl and , Scotl and and Wales from the MRC National Survey of Health and Development whose heights and weights had been prospect ively ascertained across childhood and adolescence and who had dual energy X-ray absorptiometry measures at age 60–64 years . Methods : Associations of birth weight and st and ardised weight and height ( 0–2 ( weight only ) , 2–4 , 4–7 , 7–11 , 11–15 , 15–20 years ) gain velocities with outcome measures were examined . Results : Higher birth weight was associated with higher lean mass and lower and roid/gynoid ratio at age 60–64 years . For example , the mean difference in lean mass per 1 st and ard deviation increase in birth weight was 1.54 kg in males ( 95 % confidence interval=1.04 , 2.03 ) and 0.78 kg in females ( 0.41 , 1.14 ) . Greater weight gain in infancy was associated with higher lean mass , whereas greater gains in weight in later childhood and adolescence were associated with higher fat and lean mass , and fat/lean and and roid/gynoid ratios . Across growth intervals greater height gain was associated with higher lean but not fat mass , and with lower fat/lean and and roid/gynoid ratios . Conclusion : Findings suggest that growth in early life may have lasting effects on fat and lean mass . Greater weight gain before birth and in infancy may be beneficial by leading to higher lean mass , whereas greater weight gain in later childhood and adolescence may be detrimental by leading to higher fat/lean and and roid/gynoid ratios Dietary DHA enhances infant  attention and visual development . Because the DHA content of red blood cells and plasma lipids varies approximately threefold in pregnancy , maternal DHA status may influence subsequent infant function . It would be feasible to study the effects of higher maternal  DHA intake on infant development if dietary intake of DHA could be increased by a reliable means . This study was design ed to determine whether women provided with one dozen high-DHA hen eggs ( 135 mg DHA/egg ) would consume the eggs and have higher blood DHA levels than women consuming ordinary eggs  ( 18 mg DHA/egg ) . The study was a r and omized , double-masked comparison of the effect of eggs with different concentrations of DHA on intake and blood lipid DHA content of women and their infants . A third nonr and omized group ate few eggs . In this study , DHA intake reported from eggs was eightfold higher in the high-DHA egg group compared to the ordinary egg group . Including all groups , DHA intake ranged from 0 to 284 mg/d . In this intake range , maternal blood lipid DHA content at enrollment best predicted DHA content at delivery , accounting for 36.5 and 51.7 % of the variance in ordinary and high-DHA egg intake groups , respectively . The high-DHA vs. ordinary egg groups had similar maternal and cord blood lipid DHA , but there was a positive relationship between maternal plasma phospholipid DHA and daily DHA intake from eggs controlled for study duration ( r=0.278 , P=0.048 ) . DHA intake and birth weight were also correlated ( r=0.299 , P=0.041 ) . High-DHA eggs were well accepted and increased DHA intake . Other benefits of DHA intake during pregnancy were also suggested The fetal origins theory of adult disease suggests that term infants who are small for their gestational age have an increased susceptibility to chronic disease in adulthood as a consequence of physiologic adaptations to undernutrition during fetal life . Consistent evidence for an influence of women 's dietary composition during pregnancy on growth of their babies is lacking , despite robust effects in animal experiments . We undertook a prospect i ve observational study of 557 women aged 18 - 41 y , living in Adelaide , South Australia .  Diet was assessed in early and late pregnancy using an FFQ . In early pregnancy , medians for energy intake , the proportion of energy derived from protein and from carbohydrate were 9.0 MJ , 17 and 48 % , respectively . In late pregnancy the corresponding medians were 9.2 MJ , 16 and 49 % . In early pregnancy , the percentage of energy derived from protein was positively associated with birth weight ( P = 0.02 ) and placental weight ( P = 0.07 ) , independently of energy intake and weight gain during pregnancy , and after adjustment for potential confounders , including maternal age , parity , and smoking . Effects were stronger among women ( n = 429 ) who had reliable data , based on prespecified criteria including the plausibility of dietary data when referenced against estimated energy expenditure . In addition , for this subgroup , the percentage of energy from carbohydrate in early and late pregnancy was negatively associated with ponderal index of the baby , and a specific effect of protein from dairy sources was identified . These data support the proposition that maternal dietary composition has an effect on fetal growth . Maternal diet in Western societies may therefore be important for the long-term health of the child The effects on  pregnancy outcome  and  maternal iron status of powdered milk ( PUR ) and a milk-based fortified product ( V-N ) were compared in a group of underweight gravidas . These take-home products were distributed during regular prenatal visits . Women in the V-N group had greater weight gain ( 12.29 vs 11.31 kg , p less than 0.05 ) and mean birth weights ( 3178 vs 3105 g , p less than 0.05 ) than those in the PUR group . Values for various indicators of maternal Fe status were also higher in the V-N group . Compared with self-selected noncompliers , similar in all control variables to compliers , children of women who consumed powdered milk or the milk-based fortified product had mean birth weights that were higher by 258 and 335 g , respectively . Data indicate a beneficial effect of the fortified product on both maternal nutritional status and fetal growth An intervention program was undertaken to assess dietary habits and the impact of nutrition education among pregnant women in the rural county of Florina , northern Greece . Analysis of dietary habits , nutrient intake , hemoglobin , and serum vitamin concentrations in an intervention and control group indicated that the population was adequately nourished although nutrient intake was below recommended levels for pregnant women . Nutrition counseling was associated with improvements in dietary intake and significantly greater maternal weight gain ( p less than 0.05 ) . Mean birth weight was slightly higher in the intervention group but so was the incidence of low birth weight ( 4.5 % vs 3.9 % ) . The prematurity rate was marginally lower in the intervention group ( p less than 0.04 ) , as was the number of perinatal deaths ( 9 vs 11 ) . The results indicate that nutrition counseling during pregnancy can improve dietary intake and maternal weight gain but the mediating influence on low frequency pregnancy outcomes is indeterminate in a population that is not nutritionally at risk Of 824 women screened , 410 were enrolled at midpregnancy in a prospect i ve , r and omized , controlled nutrition intervention study . Of these , 226 were predicted as likely to have small or large babies , 184 to have average-sized babies . Two hundred thirty eight mothers received USDA Women , Infants and Children ( WIC )  Food Supplementation vouchers from midpregnancy , 172 did not . Leukocyte protein synthesis ( as a cell model ) was significantly higher ( p = 0.009 ) by 36 weeks gestation in supplemented mothers . Mean birth weight of their babies was greater , 3254 vs 3163 g , ( + 91 g ) p = 0.039 , adjusted for sex , gestational age , prenatal visits , pregnancy interval , smoking , and previous low birth weight infants . Controlling for entry weight obviated the significance of the difference , except for WIC supplemented smokers ( greater than 10 cigarettes/day ) whose babies were significantly heavier by + 168 g ( p = 0.017 ) than those of unsupplemented smokers . WIC partially protects fetal growth in smokers Colombian women at risk of malnutrition were enrolled in a health care program and r and omly assigned to supplementation and control groups at the beginning of the third trimester of pregnancy . The net dietary intake increments result ing from supplementation amounted to 155 cal and 20 g of protein per day . Supplementation had a significant effect on the mean birth weight of male infants , but not that of female infants ; the mechanisms responsible for the sex differences remain to be eluci date d. The r and omized trial design of the experiment and the documented similarity between the experimental and control groups at the onset permit the conclusion that the observed differences were caused by the food supplementation program . The effect of  supplementation  on maternal weight gain and the association of the latter with birth weight strongly suggest that improved maternal nutrition mediated the effect on birth weight This study is a r and omized controlled double-blind trial on the effects of nutrition supplement of pregnant and lactating women on their offspring . The study was conducted by the late Dr. Bacon Chow in 14 villages in Sui-Lin township , a farming area about 180 miles from Taipei , Taiwan . Two hundred ninety-four women were r and omly assigned to one of two treatment groups . The daily supplement for one group provided 800 kcal and 40 g of protein/day ; for the other group it only provided 80 kcal/day . Supplementation began after 3 wk of the delivery of a first study infant , continued throughout lactation , and through the pregnancy and lactation of a second study infant . Between group comparisons on the birth weight , number of low birth weight infants , or incidence of fetal deaths showed no statistically significant findings . However , the birth weight of the second study infant was statistically different and higher than that of the first study infant in the high supplement group . Moreover , in the low supplement group there was a correlation of 0.22 ( p = 0.06 ) between the change scores for birth weight from the first to the second study infant and the quantity of supplements consumed during the last trimester of pregnancy . There was also in this same group a significant slope in a linear regression of birth weight on total daily caloric intake during the 3rd trimester of pregnancy for the male second study infants . These findings are partly in agreement with findings from three other large supplementation studies in Colombia , Guatemala , and New York . In this study the findings indicate that caloric supplementation does result in a small yet statistically meaningful increment in birth weight within a population which is not nutritionally at risk In ninety-four Dutch nulliparous women the effects of a  low-Na diet  in pregnancy on blood pressure , energy and nutrient intake , Ca metabolism , Zn and Mg status and body composition were studied longitudinally . The women were r and omly divided into an intervention group ( n 41 ) , which used a low-Na diet ( mean urinary Na excretion 61 mmol/24 h ) from week 14 of pregnancy until delivery and a control group ( n 53 ; mean urinary Na excretion 142 mmol/24 h ) . No effect of the diet on blood pressure was observed . The use of a low-Na diet result ed in significantly reduced intakes of energy , protein , carbohydrates , fat , Ca , Zn , Mg , Fe and cholesterol . However , the women on the low-Na diet appeared to be able to adapt quite well to the reduced intake since Ca , Zn and Mg homeostasis was maintained . In the case of Ca and Mg this was probably due to the observed reduced urinary excretions of these nutrients . Non-significant reductions in weight gain ( 1.5 kg ) and fat-mass gain ( 0.9 kg ) over pregnancy were found in the women on the low-Na diet . No significant effects of the diet on birth weight or placental weight were observed OBJECTIVE To hypothesize that higher intake of docosahexaenoic acid , an n-3 long chain polyunsaturated fatty acid , would increase duration of gestation and birth weight in US women . METHODS This was a r and omized , double-blind , controlled , clinical trial . Subjects were enrolled in an ambulatory clinic where they received prenatal care . This was a population -based sample . Most subjects received government assistance for  medical care and most were black ( 73 % ) . Subjects were enrolled between the 24th and 28th week of pregnancy and consumed docosahexaenoic acid ( 33 or 133 mg ) from eggs until parturition . Gestational age and birth weight were the main study outcomes . Infant length and head circumference , preterm birth , and low birth weight were secondary outcomes . RESULTS Eighty-three percent of subjects completed the study ( 291 of 350 enrolled ) . No subject was discontinued for an adverse event . After controlling for important predefined risk factors and confounding variables , gestation increased by 6.0 ± 2.3 days ( P = .009 ) in the higher docosahexaenoic acid group . Birth weight , length , and head circumference increased , but did not reach statistical significance ( P = .06–.18 ) , although the increases could be clinical ly important indications of enhanced intrauterine growth . No safety concerns were raised by the study . CONCLUSION Duration of gestation increased significantly when docosahexaenoic acid intake was increased during the last trimester of pregnancy . The increase in gestation was similar to that reported for interventions with much larger amounts of n-3 long chain polyunsaturated fatty CONTEXT Most studies of diet and health care have focused on the role of single nutrients , foods , or food groups in disease prevention or promotion . Few studies have addressed the health effects of dietary patterns , which include complex mixtures of foods containing multiple nutrients and nonnutrients . OBJECTIVE To examine the association of mortality with a multifactorial diet quality index . DESIGN AND SETTING Data from phase 2 ( 1987 - 1989 ) of a prospect i ve cohort study of breast cancer screening , the Breast Cancer Detection Demonstration Project , with a median follow-up of 5.6 years . PARTICIPANTS A total of 42,254 women ( mean age , 61.1 years ) who completed the food frequency question naire portion of the survey .  MAIN OUTCOME MEASURE All-cause mortality by quartile of Recommended Food Score ( RFS ; the sum of the number of foods recommended by current dietary guidelines [ fruits , vegetables , whole grains , low-fat dairy , and lean meats and poultry ] that were reported on the question naire to be consumed at least once a week , for a maximum score of 23 ) . RESULTS There were 2065 deaths due to all causes in the cohort . The RFS was inversely associated with all-cause mortality . Compared with those in the lowest quartile , subjects in the upper quartiles of the RFS had relative risks for all-cause mortality of 0.82 ( 95 % confidence interval [ CI ] , 0.73 - 0.92 ) for quartile 2 , 0.71 ( 95 % CI , 0.62 - 0.81 ) for quartile 3 , and 0.69 ( 95 % CI , 0.61 - 0.78 ) for quartile 4 adjusted for education , ethnicity , age , body mass index , smoking status , alcohol use , level of physical activity , menopausal hormone use , and history of disease ( chi2 for trend = 35.64 , P<.001 for trend ) . CONCLUSIONS These data suggest that a dietary pattern characterized by consumption of foods recommended in current dietary guidelines is associated with decreased risk of mortality in women BACKGROUND Although obesity in pregnancy continues to be associated with ongoing health problems , many clinicians have been reluctant to place nondiabetic , obese , pregnant women on a monitored , calorie-appropriate nutritional regimen for fear of fetal growth restriction , low birth weight , or starvation ketosis . METHODS A total of 257 patients were enrolled in the r and omized study , with a loss-to-follow-up rate of 9.73 % . Patients were assigned r and omly to either the control ( unmonitored ) group ( n=116 ) , consisting of conventional prenatal dietary management , or to the study ( monitored ) group ( n=116 ) , which was prescribed a balanced nutritional regimen and were asked to record in a diary all of the foods eaten during each day .  Women were eligible for the study if they were pregnant with a single fetus between 12 and 28 weeks of gestation and had a prepregnancy body mass index of more than 30 kg/m2 . The primary outcome was to compare perinatal outcomes in the control vs the study groups . The secondary measure was to compare outcomes in adherent and nonadherent patients in the study group . RESULTS Omnibus MANOVA showed statistically significant differences between the study and control groups regarding 3 variables : ( 1 ) gestational hypertension , p < .46 ; ( 2 ) mother 's last weight before delivery , p < .001 ; and ( 3 ) mother 's 6-week postpartum weight , p < .001 . Patients gaining 15 pounds or more during their pregnancy showed statistically significant differences between the groups for 8 variables . CONCLUSION Obese pregnant women may be placed on a healthy , well-balanced , monitored nutritional program during their antepartum course without adverse perinatal outcomes OBJECTIVE : To evaluate the effects of dietary calcium ( Ca ) intervention on adolescent pregnant mothers and their newborns . METHODS : Seventy-two pregnant adolescent mothers were r and omized into one of 3 groups : control , orange juice fortified with calcium , and dairy . The orange juice and dairy groups were required to take more than 1,200 mg Ca . Calcium tablets were added for those not able to meet required Ca . Maternal and infant weight , length , and blood pressure ( BP ) were recorded . Maternal dietary records were evaluated . Mother ’s blood was drawn for serum Ca , phosphate ( P ) , magnesium ( Mg ) , and vitamin 25-hydroxyvitamin D ( D ) . Cord blood was collected for serum Ca and D. Newborn total body Ca was determined . RESULTS : All mothers were similar in weight , height , and BP . Mothers in the orange juice plus calcium and dairy groups had higher intakes of Ca ( 1,472 mg and 1,771 mg ) than controls ( 862 mg ) . One half of the mothers in the orange juice plus calcium group required Ca tablets . Mothers in the dairy group had higher intakes of P , D , and Mg , higher serum folate and D , and higher cord D levels . Mothers in the orange juice plus calcium group had higher serum P but lower serum folate and D. Infants ( 3,517±273 g ) in the dairy group were heavier than infants in the control ( 3,277±177 g ) and orange juice plus calcium ( 3,292±165 g ) groups . Infants in the dairy group had higher total body calcium than control infants . CONCLUSION : Calcium diet supplemented with dairy products during adolescent pregnancy result ed in higher maternal vitamin D and folate serum levels and higher newborn weight and bone mineralization compared with controls . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT00320125 LEVEL OF EVIDENCE : OBJECTIVE We assessed the effect of a cholesterol-lowering diet on  maternal , cord , and neonatal plasma lipids and pregnancy outcome . STUDY DESIGN Nonsmoking white women with singleton pregnancies ( n = 290 ) , aged 21 to 38 years , and with no previous pregnancy-related complications , were r and omized to either continue their usual diet or to adopt a diet that promoted fish , low-fat meats and dairy products , oils , whole grains , fruits , vegetables , and legumes from gestational week 17 to 20 to birth . RESULTS Maternal total and low-density lipoprotein cholesterol levels were lowered in the intervention compared with the control group ( P < .01 ) . Lipid levels in cord blood and in neonates born to mothers in the intervention versus the control groups did not differ . In the intention-to-treat cohort 1 ( 0.7 % ) of 141 women in the intervention group versus 11 ( 7.4 % ) of 149 women in the control group delivered before 37 weeks ( RR 0.10 ; 95 % CI 0.01 - 0.77 ) . The incidence of other pregnancy complications and birth weight was similar in both groups . CONCLUSION A cholesterol-lowering diet may modify maternal lipid levels but not cord and neonatal lipids . The marked observed effect of this diet on the reduction of preterm delivery in low-risk pregnancies should encourage future larger studies to clarify the role of such a diet in the prevention of preterm birth Abstract Objective : To test the efficacy in terms of birth weight and infant survival of a diet supplement programme in pregnant African women through a primary healthcare system . Design : 5 year controlled trial of all pregnant women in 28 villages r and omised to daily  supplementation with high energy groundnut biscuits ( 4.3MJ/day ) for about 20 weeks before delivery ( intervention ) or after delivery ( control ) . Setting : Rural Gambia . Subjects : Chronically undernourished women ( twin bearers excluded ) , yielding 2047 singleton live births and 35 stillbirths . Main outcome measures : Birth weight ; prevalence of low birth weight ( < 2500 g ) ; head circumference ; birth length ; gestational age ; prevalence of stillbirths ; neonatal and postneonatal mortality . Results : Supplementation increased weight gain in pregnancy and significantly increased birth weight , particularly during the nutritionally debilitating hungry season ( June to October ) . Weight gain increased by 201 g ( P<0.001 ) in the hungry season , by 94 g ( P<0.01 ) in the harvest season ( November to May ) , and by 136 g ( P<0.001 ) over the whole year . The odds ratio for low birthweight babies in supplemented women was 0.61 ( 95 % confidence interval 0.47 to 0.79 , P<0.001 ) . Head circumference was significantly increased ( P<0.01 ) , but by only 3.1 mm . Birth length and duration of gestation were not affected . Supplementation significantly reduced perinatal mortality : the odds ratio was 0.47 ( 0.23 to 0.99 , P<0.05 ) for stillbirths and 0.54 ( 0.35 to 0.85 , P<0.01 ) for all deaths in first week of life . Mortality after 7 days was unaffected . Conclusion : Prenatal dietary supplementation reduced retardation in intrauterine growth when effectively targeted at genuinely at-risk mothers . This was associated with a substantial reduction in the prevalence of stillbirths and in early neonatal mortality . The intervention can be successfully delivered through a primary healthcare system . Key messages In developing countries chronic maternal undernutrition is a prime contributor to the birth of over 25 million low birthweight babies annually and to high rates of neonatal mortality . An absence of well design ed field trials has created uncertainty about the potential efficacy of maternal feeding programmes This large scale r and omised controlled trial shows that dietary supplementation in pregnancy can be highly effective in reducing the proportion of low birthweight babies and perinatal mortality Incorporating supplementary feeding into a rural primary healthcare system is feasible Late pregnancy is the period most amenable to This r and omized controlled trial of nutritional supplementation in pregnancy , in a poor black urban population in the United States , aim ed to increase the birth weight and influence the postnatal development of the offspring of mothers at high risk of having low birth weight infants . The execution of the research design and adherence to the treatment regimen among the experimental population appeared adequate for a reasonable test of the treatments . At birth , the only significant favorable effect of supplementation observed was the prevention of depressed birth weight among the offspring of mothers who smoked heavily . With balanced protein-calorie supplementation , length of gestation was increased , the proportion of low-birth-weight infants reduced , and mean birth weight raised by 41 gm ( not statistically significant ) . With high protein supplementation , there was an excess of very early premature births and associated neonatal deaths , and there was significant growth retardation up to 37 weeks of gestation . At 1 year of age , significant effects of high protein supplement were found on three psychological measures : visual habituation , visual dishabituation , and mean length of free play episodes . These measures were unrelated to measures of growth at birth and at 1 year of age . There were no detectable residual adverse effects of high protein supplementation at 1 year of age DHA ( 22 : 6n-3 ) in pregnancy has previously been shown to benefit infant brain and retinal development . Fatty acid consumption during pregnancy may also have an impact on infant adipose tissue development . The objective of the present study was to assess the prenatal impact of a DHA-containing functional food ( DHA-FF ) on  infant intra-uterine growth . This was a longitudinal , r and omised , double-blinded , placebo-controlled trial . Pregnant women were assigned to consume a DHA-FF or placebo bar from 24 weeks ' gestation until delivery . Blood sample s were collected from mothers at baseline and delivery and from the umbilical cord at delivery . Plasma and erythrocyte fatty acids were analysed by GLC and plasma insulin concentrations were analysed using a commercially available ELISA kit . Infant birth weight and length were obtained at delivery and ponderal index ( weight (g)/length (cm)3 × 100 ) was calculated . A total of forty-seven mothers completed the study . Infants of mothers consuming the DHA-FF during the last half of pregnancy had lower ponderal indices ( β = 0.198 , P < 0.05 ) and umbilical cord blood insulin concentrations ( β = 0.743 , P < 0.05 ) than infants of mothers consuming the placebo . Thus , DHA consumption during pregnancy may be advantageous with respect to infant body composition at birth and insulin sensitivity Objective To examine the effectiveness of the st and ard policy in the Netherl and s to prescribe a sodium restricted diet to prevent or to treat mild pregnancy‐induced hypertension The study attempted to determine if the bulk of dietary supplements given to pregnant women after midgestation affects fetal growth .  127 Zulu women were r and omly assigned to four groups , two of which received daily food supplements design ed to raise their energy , protein and vitamin intakes to levels recommended by the U.S. Food and Nutrition Board . One of these supplements had a high bulk , the other a low bulk . The third supplement contained only zinc and the fourth a placebo . Women in all four groups had a similar weight gain and length of gestation . Birth weights were from 6.5 to 9.5 % greater with the low bulk than with the other supplements Objective : This study investigated the influence of modifying the maternal dietary fat on the serum lipids of infants at birth and at one year of age . Methods : This single-blind r and omized clinical trial was done on 180 4-month-pregnant women . All subjects proved to have a fat-unmodified diet through a 4-day food record dietary question naire . They were divided r and omly into two groups . The intervention group was kept on a fat-modified diet including saturated fatty acid ( SFA ) < 10 % , monounsaturated fatty acids : ( MUFA ) 10 - 5 % , polyunsaturated fatty acid ( PUFA ) upto 10 % and cholesterol < 300 mg/day with dietary advice for the pregnancy period . The control group was given only the latter advice . All subjects were followed up monthly . The serum lipids including total cholesterol ( T.cho ) , triglyceride ( TG ) , and HDL cholesterol ( HDL-C ) were analyzed through enzymatic methods . The level of LDL-cholesterol ( LDL-C ) was calculated by Friedewald formula . The comparison of mean cord and one-year-old infant serum lipids were done through unpaired T-test in two groups . Results : The mean level of T.cho in the intervention and control group was ( 70.3±15.9 , vs 81.4±17.2 , P<0.009 ) , TG ( 85.3 ± 16.7 vs 97.5 ± 18.2 , P<0.007 ) , LDL-C ( 27.8 ± 15.2 vs 34.8 ±17.1 , P<0.04 ) and non-HDL-C ( 44.5±7.2 vs 54.5 ± 8.1 , P<0.02 ) and in one year old infant the comparison of serum lipids were as follows . T.cho ( 145.7 ± 51.4 vs 161.4 + 56.2 , P<0.003 ) , TG ( 90.1 ± 31.8 vs 98.3 ± 33.1 , P<0.02 ) , LDL-C ( 85.6 ± 20.4 vs 92.3 ± 19.6 , P<0,05 ) and non-HDL-C ( 113.6 ± 30.2 vs 128.8 ± 34.8 , P<0.04 ) . However , there was no significant difference in HDL-C of both groups . Conclusion : There is a significant decrease of T.cho , TG , LDL-C and non-HDL-C levels with no significant increase of HDL-C in the intervention group with the fat-modified diet . Maternal fatmodified diet could be suitable way to prevent cardiovascular disease among infants from the beginning of the life In a cluster-r and omized trial , Riitta Luoto and colleagues find that counseling on diet and activity can reduce the birthweight of babies born to women at risk of developing  gestational diabetes mellitus ( GDM  ) , but fail to find an effect on GDM
BACKGROUND Nutrition plays a fundamental role in fetal growth and birth outcomes .
OBJECTIVE We synthesized effects of dietary interventions before or during pregnancy on neonatal and infant outcomes .