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How to Feed the Fetus Vol. 78, Suppl. 1, 20–21 How to Feed the Fetus Guest Editor Ferdinand Haschke, Salzburg Editorial Board Jatinder Bhatia, Augusta, GA Weili Lin, Chapel Hill, NC Carlos Lifschitz, Buenos Aires Andrew Prentice, Banjul/London Frank M. Ruemmele, Paris Hania Szajewska, Warsaw Supported by Basel • Freiburg • Hartford • Oxford • Bangkok • Dubai • Kuala Lumpur • Melbourne • Mexico City • Moscow • New Delhi • Paris • Shanghai • Tokyo https://www.nestlenutrition-institute.org Reprint of Annals of Nutrition and Metabolism Vol. 76, Suppl. 3, 2020 Sponsor Note This publication was supported by an unrestricted educational grant by the Nestlé Nutrition Institute. The institute is a not-for-profi t association which was created to provide latest medical and scientifi c information to health profes- sionals in the fi eld of pediatric and adult nutrition and nutrition-related disorders (available at www.nestlenutrition-institute.org). Any liability of the sponsors for the content of the papers is hereby expressly excluded. Disclosure Statement Guest Editor Ferdinand Haschke declares honoraria for scientifi c lectures from Nestlé and other food companies. S. Karger Disclaimer All rights reserved. Medical and Scientifi c Publishers Th e statements, opinions and data contained in this publica- No part of this publication may be translated into other tion are solely those of the individual authors and contributors languages, reproduced or utilized in any form or by any means, Basel • Freiburg • Hartford • Oxford • and not of the publisher and the editor(s). Th e appearance of electronic or mechanical, including photocopying, recording, Bangkok • Dubai • Kuala Lumpur • advertisements in the journal is not a warranty, endorsement, microcopying, or by any information storage and retrieval Melbourne • Mexico City • or approval of the products or services advertised or of their system, without permission in writing from the publisher or, Moscow • New Delhi • Paris • eff ectiveness, quality or safety. Th e publisher and the editor(s) in the case of photocopying, direct payment of a specifi ed fee to Shanghai • Tokyo disclaim responsibility for any injury to persons or property the Copyright Clearance Center (see “General Information”). resulting from any ideas, methods, instructions or products referred to in the content or advertisements. © 2020 Nestlé Nutrition Institute, Switzerland/ S. Karger AG, Basel Drug Dosage P.O. Box, CH–4009 Basel (Switzerland) Th e authors and the publisher have exerted every eff ort to en- e-ISBN 978–3–318–06859–7 sure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant fl ow of informa- tion relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precau- tions. Th is is particularly important when the recommended agent is a new and/or infrequently employed drug. [email protected] Vol. 78, Suppl. 1, 20–21 Contents 11 Editorial Haschke, F. (Salzburg) How to Feed the Fetus 13 Focus on: Gestational Diabetes Mellitus and Developmental Programming 14 Gestational Diabetes Mellitus and Developmental Programming Chu, A.H.Y. (Singapore); Godfrey, K.M. (Southampton) 15 Focus on: Nutrition Management of Gestational Diabetes Mellitus 16 Nutrition Management of Gestational Diabetes Mellitus Kapur, K. (Bangalore); Kapur, A. (Bagsvaerd); Hod, M. (Tel Aviv) 28 Focus on: Prenatal Nutritional Strategies to Reduce the Risk of Preterm Birth 29 Prenatal Nutritional Strategies to Reduce the Risk of Preterm Birth Best, K.P.; Gomersall, J.; Makrides, M. (Adelaide, SA) 37 Focus on: Maternal Undernutrition before and during Pregnancy and Offspring Health and Development 38 Maternal Undernutrition before and during Pregnancy and Offspring Health and Development Young, M.F.; Ramakrishnan, U. (Atlanta, GA) [email protected] © 2021 Nestlé Nutrition Institute, Switzerland/ S. Karger AG, Basell Policy Statement The Nestlé Nutrition Institute was created to provide health professionals with up-to-date information on nutrition and nutrition- related disorders in order to enable them to continuously improve patient care based on the latest medical and scientific developments. One of the key pillars of the Nestlé Nutrition Institute is Annales Nestlé, a pediatric journal that has been published on a regular basis since 1942. It contains review articles on clinical practice and research in all fields of pediatrics with focus on nutrition. Annales Nestlé appears three times a year. Each article is supported by a Focus Page, and each issue by an Infographic illustrating the core topic. Published on www.nestlenutrition-institute.org as well as in print, Annales Nestlé is one of the most widely read pediatric journals in the world. Annales Nestlé is edited by an independent editorial board of opinion leaders in pediatric research, thus guaranteeing the medical and scientific impartiality of the journal, and hence the high regard it enjoys in medical and scientific circles. The editorial board sets the editorial policy, identifies topics to be addressed, selects authors, and oversees the review process for each issue. Every issue of Annales Nestlé initially appears as a supplement to Annals of Nutrition and Metabolism – a journal from Karger Publishers, Basel, Switzerland – and is listed in all major bibliographic services, such as Medline, PubMed, and Web of Science. This has been our practice since 2011. We are pleased to offer you our innovative product, which results from a creative and effective cooperation with Karger Publishers, Switzerland. Nestlé Nutrition Institute (Switzerland) [email protected] © 2021 Nestlé Nutrition Institute, Switzerland/ S. Karger AG, Basell Editorial Reprinted with permission from: Ann Nutr Metab 2020;76(suppl 3):1–2 DOI: 10.1159/000511240 How to Feed the Fetus Ferdinand Haschke Department of Pediatrics, PMU Salzburg, Salzburg , Austria Many nutritional risks for maternal and child health begin GDM may also be associated with offspring negative health during the adolescent and young adult years prior to first outcomes, such as allergy, and neurocognitive conditions, pregnancy. Because they affect fetal development before the such as ADHD and autism. GDM as a maternal intrauterine initiation of antenatal care, the arguments for preventive ac- trigger could play a role in influencing offspring long-term tions in the field of nutrition during the adolescent and young outcomes through epigenetic modification of gene function adult years are compelling. Accelerating rates of female obe- [3] . Human studies indicate a causal relation between GDM sity have further complicated nutritional risks arising in fe- and the epigenetic regulation of the leptin gene, which could males between 15 and 25 years so that in many emerging explain offspring adiposity. Furthermore, GDM and altered societies, obesity coexists with food insecurity and undernu- methylation status has been reported of a gene associated trition. In 2017, the Nestlé Nutrition Institute provided an un- with autism spectrum disorder (OR2L13 promoter) and of the restricted educational grant to support a series of publications serotonin transporter gene (SLC6A4), which is involved in de- which summarize recent interventions and recommenda- pression, anxiety, and autism. A combined diet and exercise tions in the field of nutrition of young females before and dur- program before and during pregnancy can be useful in pre- ing pregnancy [1, 2] . The supplement “How to Feed the Fetus” venting GDM in high-risk women. In addition, there is some addresses short- and long-term consequences of nutrition evidence that probiotic and myo-inositol supplementation and health issues before and during pregnancy. can work [4] . Medical nutrition therapy provides the basis for One in 6 pregnancies worldwide is affected by the inabil- the management of GDM. The conventional approach of lim- ity of the mother’s metabolism to maintain normoglycemia. iting carbohydrates at the cost of increasing energy from fat Insulin resistance and insufficient insulin secretion result in source may not be the most optimal. Instead, allowing higher gestational diabetes mellitus (GDM). Because of the increas- levels of complex, low to medium glycemic index carbohy- ing number of pregnant women with higher body mass index drates and adequate fiber through higher consumption of (BMI), the prevalence is likely to increase. In addition to short- vegetables and fruits seems more beneficial. For medical nu- term consequences of non- or poorly treated GDM, such as trition therapy to work it is vital that dietary advice and nutri- fetal overgrowth, exposure of the fetus to hyperglycemia will tion counseling is provided by a dietician, is easy to under- predispose the offspring to noncommunicable diseases later stand and use, and includes healthy food options, cooking in life [3] : the effect of GDM on offspring overweight, obesity, methods, and practical guidance that empowers and moti- impaired glucose tolerance, and resulting cardio-metabolic vates to make changes towards a healthy eating pattern. disease may be in part triggered by maternal obesity. Maternal [email protected] © 2021 Nestlé Nutrition Institute, Switzerland/ Prof. Ferdinand Haschke, MD S. Karger AG, Basel Department of Pediatrics, PMU Salzburg 48 Muellner Hauptstrasse
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