Déterminants nutritionnels précoces du neurodéveloppement des enfants de l'étude EDEN (rôle des acides gras polyinsaturés)

Contexte : De la conception à l âge adulte, de nombreux déterminants environnementaux influencent le neurodéveloppement. Des études montrent que durant la fin de la grossesse et les premiers mois de vie, une grande quantité d acides gras polyinsaturés (AGPI), notamment à longue chaîne (AGPI-LC), se fixe dans le tissu cérébral. Un apport optimal durant ces périodes critiques pourrait soutenir précocement le bon développement du cerveau et de ses fonctions.Objectifs : Étudier les relations entre les expositions pré- et postnatales précoces aux AGPI, et le neurodéveloppement d enfants de 2 et 3 ans.Population : Les données utilisées étaient celles de l étude EDEN, une cohorte mère enfant ayant recruté 2002 femmes enceintes dans les maternités de Nancy et Poitiers entre 2003 et 2006. L alimentation maternelle pendant la grossesse a été évaluée par un questionnaire de fréquence alimentaire et une table de composition nutritionnelle. Quatre questionnaires postnatals ont permis d évaluer la durée d allaitement maternel, et la composition lipidique du colostrum des mères allaitantes a été analysée par chromatographie en phase gazeuse. Des questionnaires parentaux (2 et 3 ans) et un examen neuropsychologique (3 ans) ont permis d évaluer plusieurs aspects du neurodéveloppement. Les analyses statistiques ont été réalisées par régressions linéaires multivariées, après ajustement sur de nombreux facteurs de confusion potentiels.Résultats : Les scores de neurodéveloppement à 2 et 3 ans des enfants allaités étaient plus élevés que ceux des enfants non allaités. Chez les enfants allaités, la durée d allaitement maternel était associée positivement au neurodéveloppement. Le rapport n 6/n 3 dans l alimentation maternelle en acides gras en fin de grossesse était négativement associé à plusieurs mesures du neurodéveloppement, et cette association était renforcée chez les enfants non allaités. La composition du colostrum en AGPI et en AGPI-LC reflétait amplement les apports nutritionnels en AGPI et en AGPI-LC en fin de grossesse. L utilisation de matières grasses alimentaires était aussi associée à la composition du colostrum. Les différences de neurodéveloppement des enfants allaités ne semblait pas être expliquées par la composition du colostrum en AGPI ni en AGPI-LC, à l exception de la teneur en acide linoléique qui était négativement associée à certaines mesures du neurodéveloppement. Dans l ensemble, les associations avec le neurodéveloppement étaient plus fréquemment retrouvées avec les questionnaires parentaux, mais certaines évaluations par les psychologues venaient parfois conforter ces résultats.Conclusion : Associés à ceux de la littérature, ces résultats soulignent le rôle notable des AGPI durant les périodes pré- et postnatale précoce pour le neurodéveloppement de l enfant. Le suivi des enfants de l étude EDEN jusqu à leur 5 ans permettra d étudier la persistance de ces résultats. Dans une perspective de santé publique, ces travaux rappellent la nécessité de promouvoir l allaitement maternel dans la durée et de surveiller l équilibre des apports nutritionnels en AGPI pendant la grossesse et la période de lactation.Context: From conception to adulthood, many environmental determinants influence neurodevelopment. Studies showed that in late pregnancy and the first months of life, a large amount of polyunsaturated fatty acids (PUFA), especially long-chain-PUFA (LCPUFA), accretes in the brain. Optimal intake during these critical periods could support the brain development and its cognitive functions.Aims: To investigate the relationships between pre- and early postnatal exposures to PUFA, and neurodevelopment of 2 and 3 years old children.Population: Data were those from the EDEN mother-child cohort study, in which 2002 pregnant women were recruited between 2003 and 2006 in the maternities of Nancy and Poitiers. Maternal food intake during pregnancy was evaluated by food frequency questionnaire combined with a food composition table. Duration of breastfeeding was assessed by 4 postnatal questionnaires. Lipids in colostrum of breastfeeding mothers were analyzed by gas chromatography. Several aspects of the cognitive and motor development were assessed by both parental questionnaires (2 and 3 y) and neuropsychological examination (3 y). Statistical analyzes were performed by multiple linear regressions, after adjusting for many potential confounders.Results: At 2 and 3 years, scores of neurodevelopment were higher among breastfed children than among never breastfed children. Among breastfed children, breastfeeding duration was positively associated with neurodevelopment. Maternal dietary n 6/n 3 ratio during late pregnancy was negatively associated with measures of neurodevelopment, and this association was reinforced among never breastfed children. Colostrum composition in PUFA and LCPUFA greatly reflected maternal intake during pregnancy. Use of oils/fats for cooking and seasoning was associated with colostrum composition. The differences of neurodevelopment of breastfed children did not seem to be explained by PUFA nor LCPUFA in colostrum, except for total linoleic acid that was negatively associated with some measures of neurodevelopment. In general, associations with neurodevelopment were more frequently found with assessments by parental questionnaires, but measures by psychologists sometimes confirmed the results.Conclusion: Combined with the literature, these results underline the importance of PUFA exposures during pre- and postnatal periods for the child neurodevelopment. Follow-up of children up to 5 years will allow to investigate whether those results persist later in childhood. From a public health perspectives, this work reiterates the need to promote breastfeeding duration and to monitor the balance of PUFA intake during pregnancy and lactation periods.PARIS11-SCD-Bib. électronique (914719901) / SudocSudocFranceF

Maternal Exposure to Nitrogen Dioxide during Pregnancy and Offspring Birth Weight: Comparison of Two Exposure Models

International audienceThe two exposure models tended to give consistent results in terms of association with birth weight, despite the moderate concordance between exposure estimates

Birth Weight, Body Silhouette Over the Life Course, and Incident Diabetes in 91,453 Middle-Aged Women From the French Etude Epidemiologique de Femmes de la Mutuelle Générale de l'Education Nationale (E3N) Cohort

International audienceOBJECTIVE: Obesity and increases in body weight in adults are considered to be among the most important risk factors for type 2 diabetes. Low birth weight is also associated with a higher diabetes incidence. We aimed to examine to what extent the evolution of body shape, from childhood to adulthood, is related to incident diabetes in late adulthood. RESEARCH DESIGN AND METHODS: Etude Epidemiologique de Femmes de la Mutuelle Générale de l'Education Nationale (E3N) is a cohort study of French women born in 1925-1950 and followed by questionnaire every 2 years. At baseline, in 1990, women were asked to report their current weight, height, and body silhouette at various ages. Birth weight was recorded in 2002. Cases of diabetes were self-reported or obtained by drug reimbursement record linkage and further validated. RESULTS: Of the 91,453 women who were nondiabetic at baseline, 2,534 developed diabetes over the 15 years of follow-up. Birth weight and body silhouette at 8 years, at menarche, and in young adulthood (20-25 years) were inversely associated with the risk of diabetes, independently of adult BMI during follow-up (all P(trend) < 0.001). In mid-adulthood (35-40 years), the association was reversed, with an increase in risk related to a larger body silhouette. An increase in body silhouette from childhood to mid-adulthood amplified the risk of diabetes. CONCLUSIONS: Low birth weight and thinness until young adulthood may increase the risk of diabetes, independently of adult BMI during follow-up. Young women who were lean children should be especially warned against weight gain

Parent-Offspring Correlations in Pedometer-Assessed Physical Activity

Physical activity is a major component of a healthy lifestyle in youth and adults. To identify determinants of this complex behavior is an important research objective in the process of designing interventions to promote physical activity at population level. In addition to individual determinants, there is evidence documenting familial influences on physical activity. However, the few studies that have addressed this issue with objective measures did not provide data on parent-offspring physical activity relationships throughout childhood and adolescence. The purpose of this study was to assess familial correlations in pedometer-assessed physical activity.We measured ambulatory activity in 286 French nuclear families (283 mothers, 237 fathers, and 631 children aged 8-18 years) by pedometer recordings (Yamax Digiwalker DW 450) over a week. Correlations were computed with their 95% confidence intervals (CI) for spouse pairs, siblings, mother-offspring, and father-offspring. Data were expressed as steps per day and computed both for the full recording period and separately for weekdays and weekends.The correlations were the highest between siblings (r=0.28, 95%CI: 0.17-0.38). Parent-offspring correlations were significant in mothers (r=0.21, 95%CI: 0.12-0.30), especially between mothers and daughters (r=0.24, 95%CI: 0.12-0.36 vs. r=0.18, 95%CI: 0.05-0.31 for sons), but were almost nonexistent in fathers. Correlations were generally higher on weekend days compared to weekdays. Mother-offspring correlations did not decrease with increasing age of children (r=0.17, 95%CI: 0.00-0.34 in 8-11-year-olds, r=0.20, 95%CI: 0.07-0.33 in 12-15-year-olds, and r=0.25, 95%CI: 0.07-0.39 in ≥16-year-olds). Finally, between-spouse correlations were significant only during weekend days (r=0.14, 95%CI: 0.01-0.27).Ambulatory activity correlated within families, with a possible mother effect. Mother-offspring correlations remained significant through the transition from childhood to adolescence. Further studies are required to better understand the respective influences of shared activities, parental modeling and support as well as genetic factors on the familial aggregation of physical activity

Associations between Children's Genetic Susceptibility to Obesity, Infant's Appetite and Parental Feeding Practices in Toddlerhood.

Previous findings suggest that parental feeding practices may adapt to children's eating behavior and sex, but few studies assessed these associations in toddlerhood. We aimed to study the associations between infant's appetite or children's genetic susceptibility to obesity and parental feeding practices. We assessed infant's appetite (three-category indicator: low, normal or high appetite, labelled 4-to-24-month appetite) and calculated a combined obesity risk-allele score (genetic risk score of body mass index (BMI-GRS)) in a longitudinal study of respectively 1358 and 932 children from the EDEN cohort. Parental feeding practices were assessed at 2-year-follow-up by the CFPQ. Three of the five tested scores were used as continuous variables; others were considered as binary variables, according to the median. Associations between infant's appetite or child's BMI-GRS and parental feeding practices were assessed by linear and logistic regression models, stratified on child's sex if interactions were significant. 4-to-24-month appetite was positively associated with restrictive feeding practices among boys and girls. Among boys, high compared to normal 4-to-24-month appetite was associated with higher use of food to regulate child's emotions (OR [95% CI] = 2.24 [1.36; 3.68]). Child's BMI-GRS was not related to parental feeding practices. Parental feeding practices may adapt to parental perception of infant's appetite and child's sex

Early determinants of food liking among 5y-old children: a longitudinal study from the EDEN mother-child cohort

International audienceAbstractBackgroundIdentifying the determinants of child’s liking for different foods may help to prevent future choices of unhealthy food.ObjectiveTo study early-life food-related characteristics associated with child’s liking for different foods at 5y with a longitudinal study.Design1142 5y- old children completed a liking test for “fruit and vegetables”, “meat, fish and eggs”, desserts and cheese. Data related to maternal food intake before pregnancy, infant feeding during the first year of life, maternal feeding practices at 2y, child’s food intake at 3y, and child’s food neophobia from 1 to 4y were collected prospectively from the mother. The associations between these factors and child‘s liking for each category of foods were analyzed using structural equation modelling.ResultsHigh food neophobia at 4 y was related to lower child’s liking for all food groups. Maternal feeding practices at 2y were associated with liking for dessert: negatively for the practices allowing child to control his/her own food intake, positively for restriction of child’s food intake for weight reasons. Moreover, child’s food intake at 3y was positively associated with child’s liking for “fruit and vegetables” as well as for cheese. Finally, adherence to the infant feeding pattern “long breastfeeding, later introduction of main meal components and use of home-made products” was positively associated with child’s liking for meat/fish/eggs.ConclusionsFor all food groups, food neophobia was a common determinant of child’s liking for food at 5y, whereas other factors were associated with food liking for specific food groups

Measuring Child Socio-Economic Position in Birth Cohort Research: The Development of a Novel Standardized Household Income Indicator

The assessment of early life socioeconomic position (SEP) is essential to the tackling of social inequalities in health. Although different indicators capture different SEP dimensions, maternal education is often used as the only indicator in birth cohort research, especially in multi-cohort analyses. Household income, as a direct measure of material resources, is one of the most important indicators, but one that is underused because it is difficult to measure through questionnaires. We propose a method to construct a standardized, cross-cohort comparable income indicator, the “Equivalized Household Income Indicator (EHII)”, which measures the equivalized disposable household income, using external data from the pan-European Union Statistics on Income and Living Conditions (EUSILC) surveys, and data from the cohorts. We apply this method to four studies, Piccolipiù and NINFEA from Italy and ELFE and EDEN from France, comparing the distribution of EHII with other SEP-related variables available in the cohorts, and estimating the association between EHII and child body mass index (BMI). We found that basic parental and household characteristics may be used, with a fairly good performance, to predict the household income. We observed a strong correlation between EHII and both the self-reported income, whenever available, and other individual socioeconomic-related variables, and an inverse association with child BMI. EHII could contribute to improving research on social inequalities in health, in particular in the context of European birth cohort collaborative studies

Maternal Personal Exposure to Airborne Benzene and Intrauterine Growth

International audienceBACKGROUND: Studies relying on outdoor pollutants measures have reported associations between air pollutants and birth weight. OBJECTIVE: Our aim was to assess the relation between maternal personal exposure to airborne benzene during pregnancy and fetal growth. METHODS: We recruited pregnant women in two French maternity hospitals in 2005-2006 as part of the EDEN mother-child cohort. A subsample of 271 nonsmoking women carried a diffusive air sampler for a week during the 27th gestational week, allowing assessment of benzene exposure. We estimated head circumference of the offspring by ultrasound measurements during the second and third trimesters of pregnancy and at birth. RESULTS: Median benzene exposure was 1.8 microg/m(3) (5th, 95th percentiles, 0.5, 7.5 microg/m(3)). Log-transformed benzene exposure was associated with a gestational age-adjusted decrease of 68 g in mean birth weight [95% confidence interval (CI), -135 to -1 g] and of 1.9 mm in mean head circumference at birth (95% CI, -3.8 to 0.0 mm). It was associated with an adjusted decrease of 1.9 mm in head circumference assessed during the third trimester (95% CI, -4.0 to 0.3 mm) and of 1.5 mm in head circumference assessed at the end of the second trimester of pregnancy (95% CI, -3.1 to 0 mm). CONCLUSIONS: Our prospective study among pregnant women is one of the first to rely on personal monitoring of exposure; a limitation is that exposure was assessed during 1 week only. Maternal benzene exposure was associated with decreases in birth weight and head circumference during pregnancy and at birth. This association could be attributable to benzene and a mixture of associated traffic-related air pollutants

Exposure to Phthalates and Phenols during Pregnancy and Offspring Size at Birth

Background: Data concerning the effects of prenatal exposures to phthalates and phenols on fetal growth are limited in humans. Previous findings suggest possible effects of some phenols on male birth weight

Associations between genetic obesity susceptibility and early postnatal fat and lean mass: an individual participant meta-analysis

IMPORTANCE: Patterns of body size and body composition associated with genetic obesity susceptibility inform the mechanisms that increase obesity risk. OBJECTIVE: To test associations between genetic obesity susceptibility, represented by a combined obesity risk-allele score, and body size or body composition at birth to age 5 years. DESIGN, SETTING, AND PARTICIPANTS: A total of 3031 children from 4 birth cohort studies in England, France, and Spain were included in a meta-analysis. EXPOSURES: A combined obesity risk-allele score was calculated from genotypes at 16 variants identified by genome-wide association studies of adult body mass index (BMI). MAIN OUTCOMES AND MEASURES: Outcomes were age- and sex-adjusted SD scores (SDS) for weight, length/height, BMI, fat mass, lean mass, and percentage of body fat at birth as well as at ages 1, 2 to 3, and 4 to 5 years. RESULTS: The obesity risk-allele score was not associated with infant size at birth; at age 1 year it was positively associated with weight (β [SE], 0.020 [0.008] SDS per allele; P = .009) and length (β [SE], 0.020 [0.008] SDS per allele; P = .01), but not with BMI (β [SE], 0.013 [0.008] SDS per allele; P = .11). At age 2 to 3 years these associations were stronger (weight: β [SE], 0.033 [0.008] SDS per allele; P  .15 at all ages). CONCLUSIONS AND RELEVANCE: Genetic obesity susceptibility appears to promote a normally partitioned increase in early postnatal, but not prenatal, growth. These findings suggest that symmetrical rapid growth may identify infants with high life-long susceptibility for obesity