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The fetus has an absolute requirement for the n-3/n-6 fatty acids and docosahexaenoic acid (22:6 n-3; DHA) in particular is essential for the development of the brain and retina. Most of the fat deposition in the fetus occurs in the last 10 weeks of pregnancy. The likely rate of DHA utilisation during late pregnancy cannot be met from dietary sources alone in a significant proportion of mothers. De novo synthesis makes up some of the shortfall but the available evidence suggests that the maternal adipose tissue makes a significant contribution to placental transport to the fetus. The placenta plays a crucial role in mobilising the maternal adipose tissue and actively concentrating and channelling the important n-3/n-6 fatty acids to the fetus via multiple mechanisms including selective uptake by the syncytiotrophoblast, intracellular metabolic channelling, and selective export to the fetal circulation. These mechanisms protect the fetus against low long-chain polyunsaturated fatty acid (LCPUFA) intakes in the last trimester of pregnancy and have the effect of reducing the maternal dietary requirement for preformed DHA at this time. As a result of these adaptations, small changes in the composition of the habitual maternal diet before pregnancy are likely to be more effective in improving LCPUFA delivery to the fetus than large dietary changes in late pregnancy. There is little evidence that DHA intake/status in the second half of pregnancy affects visual and cognitive function in the offspring, but more studies are needed, particularly in children born to vegetarian and vegan and mothers who may have very low intakes of DHA.

There is a need to understand what affects the success of in-vitro fertilisation (IVF) and the rate of resulting twin births so that pregnancy rates can be improved and multiple gestations avoided. Our aim was to assess the role of B vitamins and genetics. We did a prospective cohort study of 602 women undergoing fertility treatment. We assessed intake of folate and vitamin B12 with a questionnaire and measured their plasma and red-blood-cell concentrations by radioimmunoassay. We measured five B-vitamin-related gene variants in women who received treatment and in 932 women who conceived naturally. The likelihood of a twin birth after IVF rose with increased concentrations of plasma folate (1·52, 1·01–2·28; p=0·032) and red-cell folate (1·28, 1·00–1·65; p=0·039). There was no association between folate and vitamin B12 levels and likelihood of a successful pregnancy. Women homozygous for the 1298 CC variant of methylenetetrahydro-folate reductase ( MTHFR), rather than the AA variant, were less likely to produce a livebirth after IVF (0·24, 0·08–0·71; p=0·003) or to have had a previous pregnancy (0·42, 0·21–0·81; p=0·008). Our findings suggest that MTHFR genotype is linked to a woman's potential to produce healthy embryos (possibly through interaction with genes related to DNA methylation). In women likely to have a successful IVF pregnancy, high folate status increases the likelihood of twin birth after multiple embryo transfer. Proposals to fortify the UK diet with folic acid could lead to an increase in the number of twins born after IVF.

The role of the placenta in controlling the supply of fatty acids to the fetus was investigated in term placentas from non-smokers (n 5), smokers (>ten cigarettes/d; n 5) and after addition of ethanol at 2 mg/ml (n 4). The maternal side was of the placenta was perfused ex vivo for 90 min with a physiological mixture of fatty acids and fatty acid:human albumin ratio. There was no effect of smoking on the transfer of linoleic (LA, 18: 2 n-6), alpha-linolenic (alphaLN, 18: 3 n-3), arachidonic (AA, 20: 4 n-6) or docosahexaenoic acid (DHA, 22: 6 n-3), expressed per perfused area (calculated from H2(18)O exchange). However, the presence of ethanol in the perfusate at a concentration of 2 mg/ml significantly reduced (P<0.01) the absolute rate of transfer of the two n-3 polyunsaturated fatty acids, alphaLN and DHA. This specific effect of ethanol on alphaLN and DHA also resulted in an altered selectivity for transfer of individual fatty acids. In the non-smoking control group the placenta selectively transferred polyunsaturated fatty acids to the fetus in the order DHA > AA > alphaLN > LA. The order of selectivity was unaltered in placentas from smokers, but the addition of ethanol to the perfusion medium altered the order of selectivity to AA > alphaLN > LA > DHA. The presence of ethanol in the perfusate was also associated with a significant reduction (P<0.05) in the clearance of H2(18)O. These results suggest that the presence of ethanol at a concentration of 2mg/ml may reduce the availability of polyunsaturated fatty acids to the developing fetus.The role of the placenta in controlling the supply of fatty acids to the fetus was investigated in term placentas from non-smokers (n 5), smokers (>ten cigarettes/d; n 5) and after addition of ethanol at 2 mg/ml (n 4). The maternal side was of the placenta was perfused ex vivo for 90 min with a physiological mixture of fatty acids and fatty acid:human albumin ratio. There was no effect of smoking on the transfer of linoleic (LA, 18: 2 n-6), alpha-linolenic (alphaLN, 18: 3 n-3), arachidonic (AA, 20: 4 n-6) or docosahexaenoic acid (DHA, 22: 6 n-3), expressed per perfused area (calculated from H2(18)O exchange). However, the presence of ethanol in the perfusate at a concentration of 2 mg/ml significantly reduced (P<0.01) the absolute rate of transfer of the two n-3 polyunsaturated fatty acids, alphaLN and DHA. This specific effect of ethanol on alphaLN and DHA also resulted in an altered selectivity for transfer of individual fatty acids. In the non-smoking control group the placenta selectively transferred polyunsaturated fatty acids to the fetus in the order DHA > AA > alphaLN > LA. The order of selectivity was unaltered in placentas from smokers, but the addition of ethanol to the perfusion medium altered the order of selectivity to AA > alphaLN > LA > DHA. The presence of ethanol in the perfusate was also associated with a significant reduction (P<0.05) in the clearance of H2(18)O. These results suggest that the presence of ethanol at a concentration of 2mg/ml may reduce the availability of polyunsaturated fatty acids to the developing fetus.

Despite a great deal of research effort there is still considerable uncertainty surrounding the importance of the B-vitamins in health and disease. This continuing uncertainty is partly a result of the difficulty of measuring intake, confounding in observational studies and the very large numbers required to evaluate primary prevention in randomised controlled trials. Consequently, genetic data are increasingly being used to infer nutritional effects on health and even in the formulation of nutrition policy using the approach of ‘mendelian randomisation’. Genetic information has already contributed greatly to the understanding of B-vitamin metabolism and the heterogeneity of responses to intake. It has the potential to provide further nutritional insights and to assist in the elucidation of causal mechanisms, but it is important that genetic data is not viewed as an alternative to nutritional information, both are necessary when addressing nutritional problems. Similarly, the interpretation of nutrient and biomarker status in some experimental designs may require knowledge of genotype. Formal tests of gene–gene and gene–nutrient interaction are of limited value in nutritional studies and the formulation of policy. Graphical representation of diet–genotype–health data greatly assists in the elucidation of the nature of genetic effects, their interaction with nutrition and the implications for nutrition policy.

Objective : The validation of dietary assessment methods is critical in the evaluation of the relation between dietary intake and health. The aim of this study was to assess the validity of a food frequency questionnaire by comparing energy intake with energy expenditure measured with the doubly labelled water method. Design : Total energy expenditure was measured with the doubly labelled water (DLW) method during a 10 day period. Furthermore, the subjects filled in the food frequency questionnaire about 18–35 days after the DLW phase of the study was completed. Subjects : Twenty-one healthy, non-pregnant females volunteered to participate in the study; only 17 subjects completed the study. Results : The group energy intake was on average 10% lower than the energy expenditure, but the difference was not statistically significant. However, there was a wide range in reporting accuracy: seven subjects were identified as acceptable reporters, eight as under-reporters and two were identified as over-reporters. The width of the 95% confidence limits of agreement in a Bland and Altman plot for energy intake and energy expenditure varied from −5 to 3 MJ. Conclusion : The data showed that there was substantial variability in the accuracy of the food frequency questionnaire at the individual level. Furthermore, the results showed that the questionnaire was more accurate for groups than individuals.

The ultimate methyl donor for methylation reactions is the folate-methylation cycle and feeding pregnant dams diets deficient in methyl donors results in altered regulation of specific genes in the offspring which are under imprinting control(2).

Cognitive decline is a feared aspect of growing old. It is a major contributor to lower quality of life and loss of independence in old age. We investigated the genetic contribution to individual differences in nonpathological cognitive ageing in five cohorts of older adults. We undertook a genome-wide association analysis using 549 692 single-nucleotide polymorphisms (SNPs) in 3511 unrelated adults in the Cognitive Ageing Genetics in England and Scotland (CAGES) project. These individuals have detailed longitudinal cognitive data from which phenotypes measuring each individual’s cognitive changes were constructed. One SNP—rs2075650, located in TOMM40 ( translocase of the outer mitochondrial membrane 40 homolog )—had a genome-wide significant association with cognitive ageing ( P =2.5 × 10 −8 ). This result was replicated in a meta-analysis of three independent Swedish cohorts ( P =2.41 × 10 −6 ). An Apolipoprotein E ( APOE ) haplotype (adjacent to TOMM40 ), previously associated with cognitive ageing, had a significant effect on cognitive ageing in the CAGES sample ( P =2.18 × 10 −8 ; females, P =1.66 × 10 −11 ; males, P =0.01). Fine SNP mapping of the TOMM40/APOE region identified both APOE (rs429358; P =3.66 × 10 −11 ) and TOMM40 (rs11556505; P =2.45 × 10 −8 ) as loci that were associated with cognitive ageing. Imputation and conditional analyses in the discovery and replication cohorts strongly suggest that this effect is due to APOE (rs429358). Functional genomic analysis indicated that SNPs in the TOMM40/APOE region have a functional, regulatory non-protein-coding effect. The APOE region is significantly associated with nonpathological cognitive ageing. The identity and mechanism of one or multiple causal variants remain unclear.

The role of the placenta in controlling the supply of fatty acids to the fetus was investigated in term placentas (n = 5) from normal pregnancies. The maternal side was perfused ex vivo for 90 min with a modified Krebs Ringer solution containing a physiological mixture of fatty acids - designed to mimic the composition of non-esterified fatty acids (NEFA) measured in the last trimester of pregnancy (n = 10) - and ratio of fatty acid to human albumin. The selectivity for alpha-linolenic acid (alphaLN) transfer to the fetal circulation was not significantly different from that observed when using the triglyceride (TG) composition (1.21 +/- 0.04), but significantly different for AA (1.43 +/- 0.12; p < 0.001) and docosahexaenoic acid (DHA; 2.02 +/- 0.09; p = 0.048). The absolute rate of transfer (nmol. ml-1) compared to that using the TG maternal perfusate composition was significantly different for LA (0.562 +/- 0.038; p = 0.50), alphaLN (0.130 +/- 0.009; p < 0.001), arachidonic acid (AA; 0.218 +/- 0.022; p = 0.001) and DHA (0.383 +/- 0.04; p < 0.001). Thus, placental selectivity for alphaLN and DHA appears to be relatively unresponsive to changes in the mixture of fatty acids in the maternal circulation but the selectivity for AA increased with the increase in the maternal AA concentration. For an 8-fold increase in the concentration of DHA in the maternal circulation there was a 13-fold increase in the transfer of DHA to the fetal circulation. For a 2-fold increase in the concentration of AA, transfer was increased 8-fold. For a 1.3-fold increase in the concentration of alphaLN, transfer was increased 2.1-fold. These results suggest that the maternal concentration of individual fatty acids, and hence the composition of the maternal diet, can have large effects on polyunsaturated/long-chain polyunsaturated fatty acids delivery to the fetus.