Annals of the New York Academy of Sciences is the premier publication of the Academy offering original research articles and commissioned review articles.
Setting Research Priorities for Multiple Micronutrient Supplementation in Pregnancy
Important throughout the life cycle, adequate nutrition is particularly important during pregnancy to support both maternal health and fetal development. Many micronutrients have critical roles during this life stage (especially vitamins A, B6, B9, B12, C, D, and E and minerals iron, zinc, iodine, copper, and selenium), for which the recommended intakes may increase by up to 50% to accommodate the higher maternal, placental, and fetal demands.
The increased nutritional demands of pregnancy, in combination with the preexisting nutritional deficiencies among some undernourished (and/or the even higher nutritional demands for adolescent) pregnant women, may put their health, and that of their offspring, at risk.
Maternal micronutrient malnutrition is associated with low birth weight (<2500 grams), preterm birth (<37 weeks), being born small-for-gestational-age, and perinatal and maternal mortality, among other pregnancy-related adverse outcomes. Prenatal multiple micronutrient supplementation provides a good solution for supplying essential nutrients.
To clarify research needs for successfully implementing multiple micronutrient supplementation, the New York Academy of Sciences, acting on behalf of the recently assembled Multiple Micronutrient Supplementation Technical Advisory Group (MMS-TAG), conducted a research prioritization exercise using the Child Health and Nutrition Research Initiative methodology—a systematic and transparent method for setting priorities in health research using a rationale, conceptual framework, application guidelines, and strategies to address the needs of various stakeholders.
The Ann NY Acad Sci paper by Gomes et al. summarizes the research prioritization exercise. The MMS-TAG, a group of international specialists, ranked the most urgent gaps in knowledge, focusing particularly on aspects that would improve the delivery and effectiveness of MMS in low- and middle-income country populations.
The paper describes the process of prioritizing 35 non-redundant research questions that should be considered and addressed if the positive potential of multiple micronutrient supplementation is to be fully realized in low- and middle-income countries.
Given the simple nature and relatively low cost of the process, this research prioritization exercise could be repeated periodically as new information becomes available.
Ann. N.Y. Acad. Sci.
Published online ahead of print: 06 November 2019
Gut Microbiome and its Role in Obesity and Insulin Resistance
The microbes living in the human gut—the gut microbiota—play an important role in metabolism and function together as an “organ” that consists of trillions of bacteria and other biological agents, weighs ~1.5 kilograms, and contains at least 150 times more genes than human cells.
Residing in the distal colon, the gut microbiota comprises bacteria, viruses, phages, yeast, and fungi that have evolved a symbiotic relationship with humans, even though they outnumber human cells by a factor of ten.
A recent article by Clare J. Lee, Cynthia L. Sears, and Nisa Maruthur, published in the Ann NY Acad Sci reviews series The Year in Diabetes and Obesity, provides information on the gut microbiome and possible mechanisms through which it contributes to human obesity and insulin resistance.
The advent of high-throughput DNA sequencing technologies has substantially boosted scientists’ abilities to study complex microbial communities. These new tools now enable study of the gut microbiota in depth, a goal that was only recently out of reach owing to high cost and inability to culture most of the gut microbiota organisms in the laboratory.
In 2012, the Human Microbiome Project Consortium reported that the dominant microbial phyla in the human gut include Bacteroidetes, Firmicutes, and Proteobacteria. And as computational analytical approaches have advanced since, identification of specific bacterial species and strains associated with diseases have been possible.
The authors cover many areas of human physiology and diet that influence obesity and insulin resistance, including that the gut microbiota likely affect metabolism and obesity through several metabolic pathways—energy extraction, gut barrier integrity, production of metabolites affecting satiety and insulin resistance, and metabolism of bile acids and subsequent changes in metabolic signaling.
They conclude that additional human studies are required to distinguish the contribution of the gut microbiome from effects of diet, medications, and environment, and how gut dysbiosis (microbial imbalance or maladaptation) causes obesity and when it can potentially be reversed to treat obesity.
Studying the gut microbiome presents a promising window through which significant advances can be made in understanding human physiology. And it may open the door to developing new microbiota-based therapies to prevent and treat diseases such as obesity and insulin resistance.
Ann. N.Y. Acad. Sci. 1462: 37–52.