Optimal protein intake during pregnancy for reducing the risk of fetal growth restriction: the Japan Environment and Children’s Study
Clinical trials show that protein supplement increases infant size in malnourished populations; however, epidemiological studies in high-income countries have reported mixed results. Although these findings suggest a non-linear relationship between maternal macronutrient intake and fetal growth, thi...
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| Veröffentlicht in: | British journal of nutrition 2018-12, Vol.120 (12), p.1432-1440 |
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| creator | Morisaki, Naho Nagata, Chie Yasuo, Shinobu Morokuma, Seiichi Kato, Kiyoko Sanefuji, Masafumi Shibata, Eiji Tsuji, Mayumi Senju, Ayako Kawamoto, Toshihiro Ohga, Shouichi Kusuhara, Koichi |
| description | Clinical trials show that protein supplement increases infant size in malnourished populations; however, epidemiological studies in high-income countries have reported mixed results. Although these findings suggest a non-linear relationship between maternal macronutrient intake and fetal growth, this relationship has not been closely examined. We assessed the association between maternal protein intake and fetal growth among 91 637 Japanese women with singletons in a nation-wide cohort study using validated FFQ. The respondents answered the FFQ twice, once during early pregnancy (FFQ1; 16·3 (sd 6·0) weeks), and second during mid-pregnancy (FFQ2, 28·1 (sd 4·1) weeks). Daily energy intake and percentage energy from protein, fats and carbohydrates were 7477 (sd 2577) kJ and 13·5 (sd 2·0), 29·5 (sd 6·5) and 55·3 (sd 7·8) %, respectively, for FFQ1, and 7184 (sd 2506) kJ and 13·6 (sd 2·1), 29·8 (sd 6·6) and 55·3 (sd 7·9) %, respectively, for FFQ2. The average birth weight was 3028 (sd 406) g, and 6350 infants (6·9 %) were small for gestational age (SGA). In both phases of the survey, birth weight was highest and the risk of SGA was lowest when the percentage energy from protein was 12 %, regardless of whether isoenergetic replacement was with fat or carbohydrates. Furthermore, when protein density in the maternal diet was held constant, birth weight was highest when 25 % of energy intake came from fat and 61 % came from carbohydrates during early pregnancy. We found maternal protein intake to have an inverse U-curve relationship with fetal growth. Our results strongly suggest that the effect of protein on birth weight is non-linear, and that a balanced diet fulfilling the minimum requirement for all macronutrients was ideal for avoiding fetal growth restriction. |
| doi_str_mv | 10.1017/S000711451800291X |
| format | Article |
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Although these findings suggest a non-linear relationship between maternal macronutrient intake and fetal growth, this relationship has not been closely examined. We assessed the association between maternal protein intake and fetal growth among 91 637 Japanese women with singletons in a nation-wide cohort study using validated FFQ. The respondents answered the FFQ twice, once during early pregnancy (FFQ1; 16·3 (sd 6·0) weeks), and second during mid-pregnancy (FFQ2, 28·1 (sd 4·1) weeks). Daily energy intake and percentage energy from protein, fats and carbohydrates were 7477 (sd 2577) kJ and 13·5 (sd 2·0), 29·5 (sd 6·5) and 55·3 (sd 7·8) %, respectively, for FFQ1, and 7184 (sd 2506) kJ and 13·6 (sd 2·1), 29·8 (sd 6·6) and 55·3 (sd 7·9) %, respectively, for FFQ2. The average birth weight was 3028 (sd 406) g, and 6350 infants (6·9 %) were small for gestational age (SGA). In both phases of the survey, birth weight was highest and the risk of SGA was lowest when the percentage energy from protein was 12 %, regardless of whether isoenergetic replacement was with fat or carbohydrates. Furthermore, when protein density in the maternal diet was held constant, birth weight was highest when 25 % of energy intake came from fat and 61 % came from carbohydrates during early pregnancy. We found maternal protein intake to have an inverse U-curve relationship with fetal growth. Our results strongly suggest that the effect of protein on birth weight is non-linear, and that a balanced diet fulfilling the minimum requirement for all macronutrients was ideal for avoiding fetal growth restriction.</description><identifier>ISSN: 0007-1145</identifier><identifier>EISSN: 1475-2662</identifier><identifier>DOI: 10.1017/S000711451800291X</identifier><identifier>PMID: 30394228</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Birth Weight ; Births ; Carbohydrates ; Childbirth & labor ; Clinical trials ; Diet ; Dietary Proteins - administration & dosage ; Dietary Surveys and Nutritional Epidemiology ; Ecological risk assessment ; Energy Intake ; Epidemiology ; Fats ; Female ; Fetal Development - drug effects ; Fetal Growth Retardation - prevention & control ; Fetuses ; Gestational age ; Health risk assessment ; Humans ; Infant, Small for Gestational Age ; Infants ; Japan ; Maternal Nutritional Physiological Phenomena ; Medical research ; Nutrients ; Population studies ; Pregnancy ; Prospective Studies ; Proteins ; Risk reduction ; Small for gestational age ; Surveys and Questionnaires ; Weight ; Weight Gain ; Womens health</subject><ispartof>British journal of nutrition, 2018-12, Vol.120 (12), p.1432-1440</ispartof><rights>The Authors 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c482t-8b95c3f130813af75303749004fecd13d63b6872e442614d2cc8f06592e4f9c43</citedby><cites>FETCH-LOGICAL-c482t-8b95c3f130813af75303749004fecd13d63b6872e442614d2cc8f06592e4f9c43</cites><orcidid>0000-0001-6151-4513</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S000711451800291X/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,314,777,781,27905,27906,55609</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30394228$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morisaki, Naho</creatorcontrib><creatorcontrib>Nagata, Chie</creatorcontrib><creatorcontrib>Yasuo, Shinobu</creatorcontrib><creatorcontrib>Morokuma, Seiichi</creatorcontrib><creatorcontrib>Kato, Kiyoko</creatorcontrib><creatorcontrib>Sanefuji, Masafumi</creatorcontrib><creatorcontrib>Shibata, Eiji</creatorcontrib><creatorcontrib>Tsuji, Mayumi</creatorcontrib><creatorcontrib>Senju, Ayako</creatorcontrib><creatorcontrib>Kawamoto, Toshihiro</creatorcontrib><creatorcontrib>Ohga, Shouichi</creatorcontrib><creatorcontrib>Kusuhara, Koichi</creatorcontrib><creatorcontrib>Japan Environment and Children’s Study Group</creatorcontrib><title>Optimal protein intake during pregnancy for reducing the risk of fetal growth restriction: the Japan Environment and Children’s Study</title><title>British journal of nutrition</title><addtitle>Br J Nutr</addtitle><description>Clinical trials show that protein supplement increases infant size in malnourished populations; however, epidemiological studies in high-income countries have reported mixed results. Although these findings suggest a non-linear relationship between maternal macronutrient intake and fetal growth, this relationship has not been closely examined. We assessed the association between maternal protein intake and fetal growth among 91 637 Japanese women with singletons in a nation-wide cohort study using validated FFQ. The respondents answered the FFQ twice, once during early pregnancy (FFQ1; 16·3 (sd 6·0) weeks), and second during mid-pregnancy (FFQ2, 28·1 (sd 4·1) weeks). Daily energy intake and percentage energy from protein, fats and carbohydrates were 7477 (sd 2577) kJ and 13·5 (sd 2·0), 29·5 (sd 6·5) and 55·3 (sd 7·8) %, respectively, for FFQ1, and 7184 (sd 2506) kJ and 13·6 (sd 2·1), 29·8 (sd 6·6) and 55·3 (sd 7·9) %, respectively, for FFQ2. The average birth weight was 3028 (sd 406) g, and 6350 infants (6·9 %) were small for gestational age (SGA). In both phases of the survey, birth weight was highest and the risk of SGA was lowest when the percentage energy from protein was 12 %, regardless of whether isoenergetic replacement was with fat or carbohydrates. Furthermore, when protein density in the maternal diet was held constant, birth weight was highest when 25 % of energy intake came from fat and 61 % came from carbohydrates during early pregnancy. We found maternal protein intake to have an inverse U-curve relationship with fetal growth. Our results strongly suggest that the effect of protein on birth weight is non-linear, and that a balanced diet fulfilling the minimum requirement for all macronutrients was ideal for avoiding fetal growth restriction.</description><subject>Birth Weight</subject><subject>Births</subject><subject>Carbohydrates</subject><subject>Childbirth & labor</subject><subject>Clinical trials</subject><subject>Diet</subject><subject>Dietary Proteins - administration & dosage</subject><subject>Dietary Surveys and Nutritional Epidemiology</subject><subject>Ecological risk assessment</subject><subject>Energy Intake</subject><subject>Epidemiology</subject><subject>Fats</subject><subject>Female</subject><subject>Fetal Development - drug effects</subject><subject>Fetal Growth Retardation - prevention & control</subject><subject>Fetuses</subject><subject>Gestational age</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Infant, Small for Gestational Age</subject><subject>Infants</subject><subject>Japan</subject><subject>Maternal Nutritional Physiological Phenomena</subject><subject>Medical research</subject><subject>Nutrients</subject><subject>Population studies</subject><subject>Pregnancy</subject><subject>Prospective Studies</subject><subject>Proteins</subject><subject>Risk reduction</subject><subject>Small for gestational age</subject><subject>Surveys and Questionnaires</subject><subject>Weight</subject><subject>Weight Gain</subject><subject>Womens health</subject><issn>0007-1145</issn><issn>1475-2662</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kcluFDEQhi0EIkPCA3CJLHHh0uCtF-cWjRIWRcohROLW8niZcdJtT2w30dy48Qy8Hk9CNRlAAnGyXPXVX8uP0AtKXlNC2zdXhJCWUlHTjhAm6adHaEFFW1esadhjtJjT1Zw_QM9yvoFvR4l8ig444VIw1i3Q18tt8aMa8DbFYn3APhR1a7GZkg9riNp1UEHvsIsJJ2smPYfLxuLk8y2ODjtboHyd4n3ZAJFL8rr4GE5-Uh_UVgV8Fj77FMNoQ8EqGLzc-MEkG75_-ZbxVZnM7gg9cWrI9vn-PUTX52cfl--qi8u375enF5UWHStVt5K15o5y2IQr19awSSskIcJZbSg3DV81XcusEKyhwjCtO0eaWkLESS34IXr1oAv73k0wbT_6rO0wqGDjlHsG0qRuGJnRl3-hN3FKAaYDSnIpGdwdKPpA6RRzTtb12wQHTbuekn52qf_HJag53itPq9Ga3xW_bAGA70XVuErerO2f3v-X_QFKhZ18</recordid><startdate>20181228</startdate><enddate>20181228</enddate><creator>Morisaki, Naho</creator><creator>Nagata, Chie</creator><creator>Yasuo, Shinobu</creator><creator>Morokuma, Seiichi</creator><creator>Kato, Kiyoko</creator><creator>Sanefuji, Masafumi</creator><creator>Shibata, Eiji</creator><creator>Tsuji, Mayumi</creator><creator>Senju, Ayako</creator><creator>Kawamoto, Toshihiro</creator><creator>Ohga, Shouichi</creator><creator>Kusuhara, Koichi</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7T5</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6151-4513</orcidid></search><sort><creationdate>20181228</creationdate><title>Optimal protein intake during pregnancy for reducing the risk of fetal growth restriction: the Japan Environment and Children’s Study</title><author>Morisaki, Naho ; Nagata, Chie ; Yasuo, Shinobu ; Morokuma, Seiichi ; Kato, Kiyoko ; Sanefuji, Masafumi ; Shibata, Eiji ; Tsuji, Mayumi ; Senju, Ayako ; Kawamoto, Toshihiro ; Ohga, Shouichi ; Kusuhara, Koichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c482t-8b95c3f130813af75303749004fecd13d63b6872e442614d2cc8f06592e4f9c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Birth Weight</topic><topic>Births</topic><topic>Carbohydrates</topic><topic>Childbirth & labor</topic><topic>Clinical trials</topic><topic>Diet</topic><topic>Dietary Proteins - 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Although these findings suggest a non-linear relationship between maternal macronutrient intake and fetal growth, this relationship has not been closely examined. We assessed the association between maternal protein intake and fetal growth among 91 637 Japanese women with singletons in a nation-wide cohort study using validated FFQ. The respondents answered the FFQ twice, once during early pregnancy (FFQ1; 16·3 (sd 6·0) weeks), and second during mid-pregnancy (FFQ2, 28·1 (sd 4·1) weeks). Daily energy intake and percentage energy from protein, fats and carbohydrates were 7477 (sd 2577) kJ and 13·5 (sd 2·0), 29·5 (sd 6·5) and 55·3 (sd 7·8) %, respectively, for FFQ1, and 7184 (sd 2506) kJ and 13·6 (sd 2·1), 29·8 (sd 6·6) and 55·3 (sd 7·9) %, respectively, for FFQ2. The average birth weight was 3028 (sd 406) g, and 6350 infants (6·9 %) were small for gestational age (SGA). In both phases of the survey, birth weight was highest and the risk of SGA was lowest when the percentage energy from protein was 12 %, regardless of whether isoenergetic replacement was with fat or carbohydrates. Furthermore, when protein density in the maternal diet was held constant, birth weight was highest when 25 % of energy intake came from fat and 61 % came from carbohydrates during early pregnancy. We found maternal protein intake to have an inverse U-curve relationship with fetal growth. Our results strongly suggest that the effect of protein on birth weight is non-linear, and that a balanced diet fulfilling the minimum requirement for all macronutrients was ideal for avoiding fetal growth restriction.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>30394228</pmid><doi>10.1017/S000711451800291X</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-6151-4513</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Birth Weight Births Carbohydrates Childbirth & labor Clinical trials Diet Dietary Proteins - administration & dosage Dietary Surveys and Nutritional Epidemiology Ecological risk assessment Energy Intake Epidemiology Fats Female Fetal Development - drug effects Fetal Growth Retardation - prevention & control Fetuses Gestational age Health risk assessment Humans Infant, Small for Gestational Age Infants Japan Maternal Nutritional Physiological Phenomena Medical research Nutrients Population studies Pregnancy Prospective Studies Proteins Risk reduction Small for gestational age Surveys and Questionnaires Weight Weight Gain Womens health |
| title | Optimal protein intake during pregnancy for reducing the risk of fetal growth restriction: the Japan Environment and Children’s Study |
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