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5-2014

Nutrition and Associated With Orofacial Cleft Birth Defects in Utah

Huong Dieu Meeks Utah State University

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Recommended Citation Meeks, Huong Dieu, "Nutrition and Genes Associated With Orofacial Cleft Birth Defects in Utah" (2014). All Graduate Theses and Dissertations. 3306. https://digitalcommons.usu.edu/etd/3306

This Dissertation is brought to you for free and open access by the Graduate Studies at DigitalCommons@USU. It has been accepted for inclusion in All Graduate Theses and Dissertations by an authorized administrator of DigitalCommons@USU. For more information, please contact [email protected]. NUTRITION AND GENES ASSOCIATED WITH OROFACIAL CLEFT BIRTH DEFECTS IN UTAH

by

Huong Dieu Meeks

A dissertation submitted in partial fulfillment of the requirements for the degree

of

DOCTOR OF PHILOSOPHY

in

Nutrition and Food Sciences

Approved:

Dr. Ronald G. Munger Dr. Heidi J. Wengreen Major Professor Committee Member

Dr. Christopher D. Corcoran Dr. Korry Hintze Committee Member Committee Member

Dr. Adele Cutler Dr. Mark R. McLellan Committee Member Vice President for Research and Dean of the School of Graduate Studies

UTAH STATE UNIVERSITY Logan, Utah

2014 ii

Copyright c Huong Dieu Meeks 2014

All Rights Reserved iii

Abstract

Nutrition and Genes Associated with Orofacial Cleft Birth Defects in Utah

by

Huong Dieu Meeks, Doctor of Philosophy

Utah State University, 2014

Major Professor: Dr. Ronald G. Munger Department: Nutrition, Dietetics, and Food Sciences

Orofacial clefts (OFCs) are facial malformations that happen during early pregnancy

and have a complex and heterogeneous etiology, involving both genetic and environmental

risk factors. This project examined the association between maternal nutrition, -

related biomarkers, candidate genes involved in one-carbon (OCM), and OFCs

in order to achieve more comprehensive knowledge of how nutrition and genetics influence

OFC risk.

First, the association between maternal periconceptional multivitamin (PCMV) use,

maternal dietary patterns during the periconceptional period, and OFC risk was examined.

This study showed that neither PCMV use nor healthy dietary pattern score alone was

individually associated with OFC risk. However, the combination of PCMV use and a

higher score reflecting the ideal Dietary Approach to Stop Hypertension diet was associated

with 55% reduction in the risk of isolated OFCs, evidence that the prevention of OFCs may

require attention to both PCMV use and improving maternal diets.

Second, the association between maternal multivitamin use, folic acid supplemental in-

take, and measured blood folate levels in case mothers of OFC children and control mothers

was examined. Mothers who had an OFC-affected pregnancy compared with control moth-

ers had lower mean levels of plasma folate in both multivitamin users and non-users. At iv levels of folic acid intake >400µg/day, the difference in plasma folate between case mothers and control mothers narrowed, evidence that higher folate intake levels may be required for mothers with a history of OFC-affected pregnancy. The ability to utilize supplement folic acid might be modified by MTHFR C677T genotype. In mothers with 677CC genotype, both case and control mothers’ plasma folate concentrations responded to increased levels of folic acid supplemental intake, although case mothers’ plasma folate concentrations were always significantly lo