Abstract
Background
With the exception of studies on folic acid, little evidence is available concerning other nutrients in the pathogenesis of congenital heart defects (CHDs). Fatty acids play a central role in embryonic development, and the B-vitamins riboflavin and nicotinamide are co-enzymes in lipid metabolism.
Aim of the study
To investigate associations between the maternal dietary intake of fats, riboflavin and nicotinamide, and CHD risk in the offspring.
Methods
A case-control family study was conducted in 276 mothers of a child with a CHD comprising of 190 outflow tract defects (OTD) and 86 non-outflow tract defects (non-OTD) and 324 control mothers of a non-malformed child. Mothers filled out general and food frequency questionnaires at 16 months after the index-pregnancy, as a proxy of the habitual food intake in the preconception period. Nutrient intakes (medians) were compared between cases and controls by Mann–Whitney U test. Odds ratios (OR) for the association between CHDs and nutrient intakes were estimated in a logistic regression model.
Results
Case mothers, in particular mothers of a child with OTD, had higher dietary intakes of saturated fat, 30.9 vs. 29.8 g/d; P < 0.05. Dietary intakes of riboflavin and nicotinamide were lower in mothers of a child with an OTD than in controls (1.32 vs. 1.41 mg/d; P < 0.05 and 14.6 vs. 15.1 mg/d; P < 0.05, respectively). Energy, unsaturated fat, cholesterol and folate intakes were comparable between the groups. Low dietary intakes of both riboflavin (<1.20 mg/d) and nicotinamide (<13.5 mg/d) increased more than two-fold the risk of a child with an OTD, especially in mothers who did not use vitamin supplements in the periconceptional period (OR 2.4, 95%CI 1.4–4.0). Increasing intakes of nicotinamide (OR 0.8, 95%CI 0.7–1.001, per unit standard deviation increase) decreased CHD risk independent of dietary folate intake.
Conclusions
A maternal diet high in saturated fats and low in riboflavin and nicotinamide seems to contribute to CHD risk, in particular OTDs.
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Acknowledgments
We gratefully acknowledge all participating families. We thank Prof. Dr W.A. Helbing and Dr F.M.H. Siebel for their participation in the recruitment of the case and control-families. We thank Mrs. S. Meyboom for data extraction from the FFQs. Dr M. Wildhagen is acknowledged for his contribution to the data management.
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Supported by Corporate Development International (CDI) (grant 2005) and Netherlands Heart Foundation (grant 2002.B027).
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Smedts, H.P.M., Rakhshandehroo, M., Verkleij-Hagoort, A.C. et al. Maternal intake of fat, riboflavin and nicotinamide and the risk of having offspring with congenital heart defects. Eur J Nutr 47, 357–365 (2008). https://doi.org/10.1007/s00394-008-0735-6
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DOI: https://doi.org/10.1007/s00394-008-0735-6