The effect of lowering the _w63-6/_w63-3 [omega-6/omega-3] long-chain polyunsaturated fatty acid ratio in the diet of pregnant and lactating women on fatty acid levels and body composition of the women and their newborns [Elektronische Ressource] / Christiane Vollhardt

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• Publié par: technische_universitat_munchen
• Publié le: 01 janvier 2010
• Nombre de lectures: 43
• Langue: Deutsch
• Poids de l'ouvrage: 9 Mo

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TECHNISCHE UNIVERSITÄT MÜNCHEN
Lehrstuhl für Ernährungsmedizin




The effect of lowering the ω-6/ω-3 long-chain polyunsaturated fatty acid
ratio in the diet of pregnant and lactating women on fatty acid levels and
body composition of the women and their newborns

Christiane Vollhardt



Vollständiger Abdruck der von der Fakultät Wissenschaftszentrum Weihenstephan
für Ernährung, Landnutzung und Umwelt der Technischen Universität München
zur Erlangung des akademischen Grades eines
Doktors der Naturwissenschaften
genehmigten Dissertation.

Vorsitzender: Univ.-Prof. Dr. M. Klingenspor
Prüfer der Dissertation:
1. Univ.-Prof. Dr. J. J. Hauner
2. Univ.-Prof. Dr. K.-Th. M. Schneider


Die Dissertation wurde am 19.01.2010 bei der Technischen Universität München
eingereicht und durch die Fakultät Wissenschaftszentrum Weihenstephan für
Ernährung, Landnutzung und Umwelt am 14.05.2010 angenommen. Table of contents I
Table of contents
Table of contents ......................................................................................................... I
Figures.........................................................................................................................V
Tables ..........................................................................................................................V
Abbreviations............................................................................................................VII
1 Introduction...................................................................................................... 1
2 Survey of existing literature............................................................................ 3
2.1 Long-chain polyunsaturated fatty acid physiology .............................................. 3
2.2 Fatty acids as biomarkers of fatty acid intake..................................................... 6
2.3 Adipose tissue ................................................................................................... 6
2.3.1 Human adipose tissue development .................................................................. 7
2.3.2 The role of LC-PUFAs in adipocyte differentiation.............................................. 9
2.4 Transport of lipids across the placenta............................................................. 12
2.5 Fetal and infant lipid accretion.......................................................................... 16
2.6 Metabolism in pregnancy and lactation ............................................................ 17
2.6.1 Anthropometry ................................................................................................. 17
2.6.2 Lipid metabolism.............................................................................................. 18
2.7 Programming - impact on birth weight and body composition........................... 20
2.8 Birth weight - association with later body composition and obesity................... 23
2.9 Lipids in human milk ........................................................................................ 25
2.10 n-3 LC-PUFA supplementation in pregnancy and lactation .............................. 27
3 Aim of the thesis............................................................................................ 32
4 Materials and Methods .................................................................................. 33
4.1 Study design.................................................................................................... 33
4.2 Recruitment ..................................................................................................... 38
4.3 Supplementation.............................................................................................. 38
4.4 Dietary intervention.......................................................................................... 39
4.5 Dietary intake................................................................................................... 40
4.6 Maternal anthropometric measurements.......................................................... 40
4.6.1 Growth parameters and skinfold thickness....................................................... 40
4.6.2 Body fat and lean body mass........................................................................... 41
4.7 Anthropometric measurements of infants......................................................... 43
4.7.1 Growth parameters .......................................................................................... 43 Table of contents II
4.7.2 Skinfold and circumference measurements...................................................... 43
4.7.3 Assessment of subcutaneous and preperitoneal fat by ultrasound................... 44
4.7.4 Assessment of adipose tissue volume by MRI ................................................. 45
4.8 Maternal blood count ....................................................................................... 46
4.9 Blood and milk fatty acid pattern analysis ........................................................ 46
4.9.1 Plasma Phospholipids...................................................................................... 46
4.9.2 Red blood cells ................................................................................................ 48
4.9.3 Breast milk....................................................................................................... 48
4.10 Placental tissue preparation............................................................................. 49
4.11 Sample size calculation and statistical analysis ............................................... 49
4.12 Data management and legal requirements....................................................... 51
5 Results............................................................................................................ 52
5.1 Trial profile and sample size ............................................................................ 52
5.2 Baseline characteristics of the participants....................................................... 53
5.3 Compliance, maternal dietary intake and the effect of dietary intervention ....... 56
5.4 Maternal anthropometry................................................................................... 58
5.5 Maternal biochemical parameters .................................................................... 59
5.5.1 Maternal blood count ....................................................................................... 61
5.5.2 Blood lipids ...................................................................................................... 62
5.5.3 Blood glucose and coagulation ........................................................................ 63
5.6 Fatty acid pattern in maternal plasma PL and red blood cells .......................... 64
5.6.1 Plasma PLs...................................................................................................... 64
5.6.2 Red blood cells ................................................................................................ 70
5.6.3 Relation of PL and RBC fatty acids in maternal blood samples........................ 75
5.6.4 Relation of PL and RBC fatty acids and blood lipids......................................... 75
5.7 Fatty acid pattern in cord blood plasma PL and red blood cells........................ 76
5.7.1 Plasma PL ....................................................................................................... 76
5.7.2 Red blood cells ................................................................................................ 77
5.7.3 Relation of maternal and cord blood fatty acid pattern ..................................... 78
5.8 Fatty acid pattern in infant red blood cells 16 weeks pp ................................... 79
5.9 Fatty acid pattern in breast milk ....................................................................... 80
5.9.1 Relation of maternal PL and RBC fatty acid and BM fatty acid pattern............. 81
5.10 Birth outcomes................................................................................................. 82
5.10.1 Mother ............................................................................................................. 82
5.10.2 Infant................................................................................................................ 85
5.11 Infant anthropometry and body fat during the first week pp.............................. 89
5.11.1 Association of cord blood fatty acids and infant anthropometry........................ 91
5.11.2 Association of maternal PL and RBC fatty acids and infant anthropometry ...... 92
5.11.3 Association of maternal and infant anthropometry............................................ 92 Table of contents III
6 Discussion...................................................................................................... 93
6.1 Baseline characteristics and compliance.......................................................... 93
6.2 Dietary intake................................................................................................... 93
6.3 Maternal anthropometry....................................................................