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The impact of macronutrients on retinal microvasculature among Singapore pregnant women during the mid-late gestation

The impact of macronutrients on retinal microvasculature among Singapore pregnant women during the mid-late gestation
The impact of macronutrients on retinal microvasculature among Singapore pregnant women during the mid-late gestation
Background

Imbalanced macronutrient intakes can induce impairment of endothelial and vascular function, and further lead to metabolic and cardiovascular disease. However, little is known about the influence of such diets on endothelial and vascular dysfunction in pregnant women, even though high-fat diet is a known risk for pregnancy complications such as gestational diabetes and pre-eclampsia.

Objective

We aimed to assess the association between maternal macronutrient intakes (protein, fat and carbohydrates), dietary quality and retinal microvascular changes in a multi-ethnic Asian mother-offspring cohort.
Methods Pregnant women (n=614) with singleton pregnancies were recruited during their first trimester from June 2009 to Sep 2010. Maternal diet quality and macronutrient intakes, expressed as a percentage of total energy during pregnancy, were ascertained using 24 hr recalls and 3 d food diaries at 26-28 weeks gestation. Retinal examination was completed at the same clinic visit. Dietary quality was assessed and scored using the Health Eating Index in Asian Pregnant women (HEI-AP), while macronutrients intakes ware expressed as percentages of total energy and further log transformed for analysis. Associations were examined cross-sectionally by substitution models with the use of multiple linear regression.

Results

In adjusted model, each 20 points decrease in HEI-AP score was associated with a significant increase of 1.70 µm (p<0.05) in retinal venular calibre. Each 0.1 log increase in percentage of total fat intake was associated with a significant increment of 1.84 µm (p<0.05) in retinal venular caliber. Additionally, each 0.1 log increase in percentage of mono-unsaturated fat intake was associated with an increment of 1.84 µm (p<0.01) in retinal venular caliber.

Conclusions

In this cross-sectional study, we found that women with higher fat and lower protein intakes, and lower diet quality tended to have wider retinal venular caliber, which is suggestive of suboptimal microvasculature.
1932-6203
1-28
Li, L.J.
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Ong, P.G.
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Colega, M.T.
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Han, C.Y.
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Chen, L.W.
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Kidd, R.M.E.
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Lamoureux, E.
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Gluckman, P.
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Kwek, K.
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Chong, Y.S.
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Saw, S.M.
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Godfrey, K.
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Wong, T.Y.
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Foong-Fong, M.C.
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Li, L.J.
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Ong, P.G.
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Colega, M.T.
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Han, C.Y.
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Chen, L.W.
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Kidd, R.M.E.
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Lamoureux, E.
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Gluckman, P.
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Kwek, K.
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Chong, Y.S.
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Saw, S.M.
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Godfrey, K.
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Wong, T.Y.
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Foong-Fong, M.C.
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Li, L.J., Ong, P.G., Colega, M.T., Han, C.Y., Chen, L.W., Kidd, R.M.E., Lamoureux, E., Gluckman, P., Kwek, K., Chong, Y.S., Saw, S.M., Godfrey, K., Wong, T.Y. and Foong-Fong, M.C. (2016) The impact of macronutrients on retinal microvasculature among Singapore pregnant women during the mid-late gestation. PLoS ONE, 1-28. (In Press)

Record type: Article

Abstract

Background

Imbalanced macronutrient intakes can induce impairment of endothelial and vascular function, and further lead to metabolic and cardiovascular disease. However, little is known about the influence of such diets on endothelial and vascular dysfunction in pregnant women, even though high-fat diet is a known risk for pregnancy complications such as gestational diabetes and pre-eclampsia.

Objective

We aimed to assess the association between maternal macronutrient intakes (protein, fat and carbohydrates), dietary quality and retinal microvascular changes in a multi-ethnic Asian mother-offspring cohort.
Methods Pregnant women (n=614) with singleton pregnancies were recruited during their first trimester from June 2009 to Sep 2010. Maternal diet quality and macronutrient intakes, expressed as a percentage of total energy during pregnancy, were ascertained using 24 hr recalls and 3 d food diaries at 26-28 weeks gestation. Retinal examination was completed at the same clinic visit. Dietary quality was assessed and scored using the Health Eating Index in Asian Pregnant women (HEI-AP), while macronutrients intakes ware expressed as percentages of total energy and further log transformed for analysis. Associations were examined cross-sectionally by substitution models with the use of multiple linear regression.

Results

In adjusted model, each 20 points decrease in HEI-AP score was associated with a significant increase of 1.70 µm (p<0.05) in retinal venular calibre. Each 0.1 log increase in percentage of total fat intake was associated with a significant increment of 1.84 µm (p<0.05) in retinal venular caliber. Additionally, each 0.1 log increase in percentage of mono-unsaturated fat intake was associated with an increment of 1.84 µm (p<0.01) in retinal venular caliber.

Conclusions

In this cross-sectional study, we found that women with higher fat and lower protein intakes, and lower diet quality tended to have wider retinal venular caliber, which is suggestive of suboptimal microvasculature.

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Macronutrients and matrnal retinal vascular changes during mid-late pregncy_Plos One.docx - Accepted Manuscript
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Figure 1. SIVA grading platform.pdf - Other
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Figure 2. Comparison of two subjects with differnt macronutrient intake and retinal venular caliber.pdf - Other
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Supplementary Figure. HEI-AP raw score break down.pdf - Other
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More information

Accepted/In Press date: 4 August 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 399148
URI: http://eprints.soton.ac.uk/id/eprint/399148
ISSN: 1932-6203
PURE UUID: e3e6fdc0-f800-43e2-8b96-1128266017e9
ORCID for K. Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

Catalogue record

Date deposited: 08 Aug 2016 13:55
Last modified: 07 Oct 2020 01:35

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Contributors

Author: L.J. Li
Author: P.G. Ong
Author: M.T. Colega
Author: C.Y. Han
Author: L.W. Chen
Author: R.M.E. Kidd
Author: E. Lamoureux
Author: P. Gluckman
Author: K. Kwek
Author: Y.S. Chong
Author: S.M. Saw
Author: K. Godfrey ORCID iD
Author: T.Y. Wong
Author: M.C. Foong-Fong

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