L’intervention auprès de jeunes mères et de leur enfant : perspective de la théorie de l’attachement

The children of adolescent mothers are among those presenting the highest level of psychosocial risk, compromising their socio-emotional development on a number of levels. Several intervention strategies have been designed to address some of the problems that characterize these mother-infant dyads. While these strategies have proven to be beneficial to young mothers, relatively little impact has been found on the level of infant and child development. The purpose of this article is to address the issue of intervention aimed at adolescent mothers and their infant, and underline that the relational dimension, while absent from most intervention programs, is necessary to our understanding of the problems presented by these dyads. An intervention program, currently undergoing evaluation, is described having as a main objective the improvement of the early mother-infant relationship. Attachment theory is presented as an organizing construct. Characteristics of the intervention, as well as the evaluation strategy, are described

Validation of a newly automated web-based 24-hour dietary recall using fully controlled feeding studies

BACKGROUND: Assessment of food intake is a cornerstone of nutritional research. However, the use of minimally validated dietary assessment methods is common and can generate misleading results. Thus, there is a need for valid, precise and cost-effective dietary assessment tools to be used in large cohort studies. The objective is to validate a newly developed automated self-administered web-based 24-h dietary recall (R24W), within a population of adults taking part in fully controlled feeding studies. METHODS: Sixty two adults completed the R24W twice while being fed by our research team. Actual intakes were precisely known, thereby allowing the analysis of the proportion of adequately self-reported items. Association between offered and reported portion sizes was assessed with correlation coefficients and agreement with the kappa score while systematics biases were illustrated with Bland-Altman Plot. RESULTS: Participants received an average of 16 food items per testing day. They reported 89.3% of the items they received. The more frequently omitted food categories were vegetables included in recipes (40.0%) as well as side vegetables (20.0%) and represented less than 5% of the actual daily energy intake. Offered and self-reported portion sizes were significantly correlated (r = 0.80 P < 0.001) and demonstrated a strong agreement as assessed by the kappa score of 0.62. Reported portion sizes for individual food items were on average 3.2 g over the offered portion sizes. Portions of 100 g and above were on average underestimated by 2.4% (r = 0.68 P < 0.01; kappa score = 0.50) while small portions (less than 100 g) were overestimated by 17.1% (r = 0.46 P < 0.01; kappa score = 0.43). A nonsignificant underestimation (−13.9 kcal ± 646.3 kcal; P = 0.83) of energy intake was noted. CONCLUSION: R24W performed well as participants were able to report the great majority of items they ate and selected portion size strongly related to the one they received. This suggests that food items are easily to find within the R24W and images of portion sizes used in this dietary assessment tool are adequate and can provide valid food intake evaluation

Validity and reliability of self-reported measures of foods and nutrients in pregnancy : a systematic review

This systematic review aims to critically appraise evidence on validity and reliability of self-reported measures of foods and nutrients in pregnancy. PubMed and EMBASE were investigated. Fifty-four studies were included. Food-frequency questionnaires had acceptable evidence of validity when compared with biomarkers (͞r between 0.04 and 0.58; k=19), 24-hour recalls (͞r between 0.12 and 0.63; k=11) and food records: (͞r between 0.28 and 0.65; k=12). Dietary history (͞r between 0.07 and 0.47; k=7) and food records (͞r between 0.25 and 0.53; k=7) had acceptable evidence of validity when compared with biomarkers. 24-hour recalls had poor evidence of validity against biomarkers. Evidence on reliability was good for food-frequency questionnaires, acceptable for the dietary history and inconclusive for 24-hour recalls. The results suggest that food-frequency questionnaires and food records have the strongest evidence of validity when assessing nutrition during pregnancy and more studies are needed to validate 24-hour recalls and the dietary history

Promoting fruit and vegetable intake in childbearing age women at risk for gestational diabetes mellitus : a randomised controlled trial

This randomised controlled trial verified the efficacy of an implementation intentions intervention (n=24) to promote fruit and vegetable consumption among childbearing age women at risk for gestational diabetes mellitus against a control condition based on the question-behaviour effect (n=26). There was only a significant time effect (F(2,85)=5.69, p=0.0048). Both groups increased their vegetable consumption compared to baseline at 3 months (p=0.0022) and 6 months (p=0.0042). There were no significant effects on weight, waist circumference and blood glucose levels. Implementation intentions and the question-behaviour effect appear to be effective behaviour change techniques to promote vegetable intake among this high-risk population

Association of prenatal exposure to gestational diabetes with offspring body composition and regional body fat distribution

The aim of this cohort study was to compare body composition and regional body fat distribution between children exposed (GDM+) or unexposed (GDM−) in utero to gestational diabetes mellitus (GDM) and to investigate the association with the glycaemic and the insulin profile. Data from 56 GDM+ and 30 GDM− were analysed. Height, weight and waist circumference were measured. Total and regional body composition was measured by dual-energy X-ray absorptiometry. Insulin, glucose and HbA1c were obtained from a fasting plasma sample, and the HOMA-IR index was calculated. anova was performed to compare adiposity measures between GDM+ and GDM−. Associations between the glycaemic and insulin profile and adiposity measures were studied using partial Pearson correlations. Mean age was 6.6 ± 2.3 years. Waist circumference, fat mass percentage, android fat mass, android fat mass percentage and android-to-gynoid fat mass ratio were higher among GDM+, and lean mass percentage was lower (P < 0.05). Among GDM+ children, body mass index (BMI) z score, waist circumference, fat mass percentage, android fat mass percentage and android-to-gynoid fat mass ratio were all positively correlated with HbA1C (r = 0.32–0.43, P < 0.05). Prenatal exposure to GDM is associated with increased total and abdominal adiposity. This increased adiposity observed among GDM+ children is associated with an altered glycaemic profile. This study is registered in the Clinical Trials.gov registry (NCT01340924). What is already known about this subject? • Although body mass index (BMI) is frequently used to assess children adiposity, other anthropometric measures may be better indicators of cardiometabolic risk. • Few studies investigated others adiposity measures in children exposed to gestational diabetes. What this study adds? • In the current study, adiposity of children exposed to gestational diabetes is evaluated in a more complete and precise manner with assessment of body composition and fat distribution by dual-energy X-ray absorptiometry. • This study also investigates the association of those adiposity measures with children glycaemic and insulin profile

The metabolome regulates the epigenetic landscape during naive-to-primed human embryonic stem cell transition.

For nearly a century developmental biologists have recognized that cells from embryos can differ in their potential to differentiate into distinct cell types. Recently, it has been recognized that embryonic stem cells derived from both mice and humans exhibit two stable yet epigenetically distinct states of pluripotency: naive and primed. We now show that nicotinamide N-methyltransferase (NNMT) and the metabolic state regulate pluripotency in human embryonic stem cells (hESCs).  Specifically, in naive hESCs, NNMT and its enzymatic product 1-methylnicotinamide are highly upregulated, and NNMT is required for low S-adenosyl methionine (SAM) levels and the H3K27me3 repressive state. NNMT consumes SAM in naive cells, making it unavailable for histone methylation that represses Wnt and activates the HIF pathway in primed hESCs. These data support the hypothesis that the metabolome regulates the epigenetic landscape of the earliest steps in human development

Validity and reliability of a brief selfreported questionnaire assessing fruit and vegetable consumption among pregnant women

Background: Short instruments measuring frequency of specific foods, such as fruit and vegetable (FV), are increasingly used in interventions. The objective of the study was to verify the validity and test-retest reliability of such an instrument among pregnant women. Methods: Pregnant women from the region of Quebec City, Quebec, Canada, were recruited through e-mails sent to female students and employees of the local university from October 2014 to April 2015. To assess the validity of the fruit and vegetable questionnaire (FVQ) developed by Godin et al. (Can J Public Health 99: 494-498, 2008), pregnant women were asked in a first mailing to complete the FVQ assessing FV intake over the past 7 days and a 3-day estimated food record. A subsample (n¿=¿33) also gave a fasting blood sample and completed a validated semi-quantitative FFQ administered by a trained registered dietitian during a visit at the research center. FV intakes for all instruments were calculated in terms of servings of FV based on Canada’s Food Guide definition of a serving of fruit or vegetable. In order to assess its test-retest reliability, respondents were asked to complete the FVQ 14 days later in a second mailing. Results: Forty-eight pregnant women from all three trimesters completed the questionnaires in the first mailing. FV intake assessed using the FVQ was correlated to FV consumption measured using the food record (r¿=¿0.34, p¿=¿0.0180) and the FFQ (r¿=¿0.61, p¿=¿0.0002). Results were similar when controlling for energy intake and the experience of nausea in the past month. Only ß-cryptoxanthin was significantly correlated to FV intake assessed by the FFQ when adjusted for the presence of nausea (r¿=¿0.35, p¿=¿0.0471). Data on the test-retest reliability was available for 44 women and the intra-class coefficient for the FVQ was 0.72 at a mean 28-day interval. Conclusions: The FVQ has acceptable validity and test-retest reliability values, but seems to underestimate FV servings in pregnant women. It represents an interesting alternative for researchers or clinicians interested in estimating quickly FV intake among pregnant women, such as in large trials or during prenatal visits. The FVQ should however be coupled with other self-reported measures, such as a food record, for assessing precise individual FV intake