HJAR Mar/Apr 2020

HEALTHCARE JOURNAL OF ARKANSAS  I  MAR / APR 2020 51 Aline Andres, PhD, RD Associate Professor of Pediatrics University of Arkansas for Medical Sciences Dr. Andres is an associate professor in the Department of Pediatrics at the University of Arkansas for Medical Science, and the associate director for clinical research at Arkansas Children’s Nutrition Center. She has a Bachelor of Science, a Master of Science in nutrition, a PhD in nutritional sciences from the University of Illinois at Urbana- Champaign, and is a registered dietitian. Dr. Andres joined the Arkansas Children’s Nutrition Center in 2007 as a post-doctoral fellow before being appointed to assistant professor in 2008, and to associate professor with tenure in 2014. Her research interests are focused on optimizing pediatric nutrition to prevent childhood and adult diseases, as well as understanding the effects of maternal health during pregnancy on the future health of their children. pregnancy are based on weight just pri- or to getting pregnant; however, health care providers typically use your weight at your first trimester visit instead. When we assigned weight gain guide- lines based on first trimester weight ver- sus pre-pregnancy weight, more than 90 percent of the women were assigned to the same weight gain category 4 . To help participants meet the guidelines for weight gain during pregnancy they had coaches guide them throughout pregnancy. 4. We learned that the intervention with coaches was well-accepted, and re- duced weight gain during pregnancy in women with normal weight and obe- sity 5 . We also learned that if women expected to gain more weight than the recommendations, they actually gained more weight than recommended, so in- terventions to help reset these expecta- tions could be very important 6 . Finally, while the assessment of the participants’ pantries helped us understand that the home food environment influences the weight status of overweight and obese pregnant women, we learned that it does not influence weight gain during pregnancy 7 . 5. At delivery, we collected cord blood, um- bilical cord, and placenta. We learned that the higher the mother’s weight, the more changes were seen in the expres- sion of the infant genetic code that is in- volved in inflammation and blood sugar control 8 , although they were not due to adjustments (epigenetic changes) to the genetic code of infants 9 . 6. When we applied new techniques to iso- late special cells of the umbilical cord 10 , we discovered that cells from infants whose mothers had higher weights were more likely to become fat cells rather than bone cells, when compared to cells from infants whose mothers had lower weight 11 . Finally, we found that moms with higher weight in early pregnancy had more fat and inflammation in their placentas compared to placentas from moms that weighed less 12 , and that a protein called EGR-1 was higher in pla- centa of moms that weighed more. This allowed us to understand the pathway involved with inflammation 13 . It has been a privilege for our research team to be part of this amazing journey and we thank all of the families who participated, donating their time to research. n REFERENCES 1 Diaz EC et al. Journal of Pediatrics. In press 2 Allman BR et al. Nutrients. 2019 11(9). E2190. 3 Diaz EC et al. JCEM 2019 104(5):1394-1403. 4 Krukowski RA et al. BMC Pregnancy & Childhood 2016 16(1):357. 5 Krukowski R et al. Maternal and Child Health Journal 2017 21(3):485-491. 6 Krukowski RA et al. Obstetrics & Gynecolo- gy 2017 129(1):76-82. 7 Porter H et al. Journal of Women Health. 2018 27(8):1064-1070. 8 Thakali K et al. Pediatric Research. 2014 76(2):202-210 . 9 Thakali KM et al. Placenta 2017 57:194-203. 10 Saben J et al. Exp Biol Med 2014 239(10):1340-51. 11 Chen JR et al. Endocrinology 2016 157(11):4172-4183. 12 Saben J et al. Placenta. 2014 35(3):171-177. 13 Saben J et al. AJP – Endocrinology and metabolism. 2013 305(1):E1-14. “Maternal health, body composition, and nutrition are important factors that can influence fetal and neonatal development.”