Mother's diet, baby's health
The first Singapore birth in a novel multinational clinical study aiming to optimise mother’s nutritional health and investigate the long-term effects of a woman’s diet on her future child’s health, was reported on 6 July at the National University Hospital (NUH).
The double-blind randomised controlled study, known as Nutritional Intervention Preconception and during Pregnancy to maintain healthy glucosE levels and offspRing health (NiPPeR), includes collaborators in the EpiGen Global Research Consortium from three centres, in Singapore; Auckland, New Zealand; and Southampton, UK. Associate Professor Chong Yap Seng, Vice-Dean (Academic Medicine) at the NUS Yong Loo Lin School of Medicine is the Principal Investigator of the study in Singapore. Co-investigators for Singapore's NiPPeR study include Associate Professor Lynette Shek and Associate Professor Lee Yung Seng from NUS Medicine.
Diabetes, with its rising rates worldwide, can affect women at reproductive age. The National Health Survey shows that 15 per cent of women in their twenties and thirties in Singapore have impaired glucose tolerance, considered a prediabetic condition. A sizable 20 per cent of pregnancies in Singapore are complicated by gestational diabetes, said Associate Professor Chang Shiao-Yng, consultant at NUH’s Department of Obstetrics and Gynaecology and co-investigator of the study.
These numbers are cause for concern as gestational diabetes, a condition where the mother’s blood sugar levels become high during pregnancy, can affect the baby’s future health. Research has revealed that these babies are at greater risk of developing type 2 diabetes, obesity and heart disease later in life. The increased risk will also be passed down to the next generation. The NiPPeR study hopes to halt this transgenerational cycle of disease, shared Prof Chang, who is also an adjunct investigator at the Singapore Institute for Clinical Sciences.
Said Assoc Prof Chong, “Through this novel study, we can glean new insights into the long-term effects of preconception nutrition on the health of future offspring. This has significant potential to change the way we manage prenatal care and nutrition. Greater awareness has the potential to improve public health in the long run.”
Women between the ages of 18 and 38 planning to conceive within the next six months are recruited into the study and given a nutrient drink recommended for pregnancy. Half of the participants receive a specially formulated NiPPeR intervention containing additional supplements such as myo-inositol and probiotics, while the rest get the standard formulation. Participants take the drink twice a day before conception and throughout the entire course of pregnancy. Those on the NiPPeR intervention are anticipated to report lowered blood sugar.
Follow-ups are conducted at regular milestones during the women’s pregnancy and for the first year of the child’s life. The growth of the baby in the womb and after birth will be measured, as will its fat to lean mass ratio.
Ms Wong Xue Yun, mother of the first Singapore baby born in the study, hopes that her participation can help future mothers avoid gestational diabetes and lower the risk of their children becoming obese.
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