EUCCONET International Workshop Bristol, 18th and 19th October
Brief description of maternal/dietary parameters recorded
Margaretha Haugen
Division of Environmental Medicine, NIPH
In Norway
• All citizens have a unique identity number
• National Population Registry
• Medical Birth Registry of Norway
• Centralised ultrasound scans
• 98% of all pregnant women have scan in week 17/18
at birthing hospital
MoBa - recruitment
• Pregnant women invited in week 15
• Informed consent from both mother and father
• No exclusion criteria (apart from language)
• Recruitment June 1999-December 2008
• Total response rate = 39%
MoBa - participation
No.
No.
Women
90 700
Pregnancies
108 000
Men
72 100
Pregnancies
83 200
Singeltons
104 700 Pairs of twins
Sets of triplets
1 865
21
Dietary assessment in MoBa
Mother
Ultrasound
week 17
QI
Dietary supplements, caffeine and alcohol
week 22
QII
FFQ, supplements during first 4-5 months of pregnancy
QIII
Fish and game intake, supplements, caffeine, alcohol and
sweet drinks
6 months
QIV
Breastfeeding, weaning foods and supplements
18 months
QV
The child's intake of milk, bread, dinners, drinks
and cereals/porridge. Supplements
3 years
QVI
The child's intake of milk, bread, dinners, drinks.
Supplements
7 years
QVII
Child
week 30
8 years
14 years
QVIII
The child's intake of milk, bread, dinners, drinks.
Supplements
No diet questions
Plan to assess total diet
Dietary assessment in MoBa – in pregnancy
• 340 questions, 40 groups of questions
• 255 foods and dishes
• 14 pages
Meltzer et al., “Methodologcial challenges when monitoring the diet of
pregnant women in a large study: experiences from the Norwegian Mother
and Child Cohort Study” MCN; 2008: 4:14-27
Validation study, MoBa FFQ
n=119, 4-d FD + biomarkers in blood and in 24-hurine + motion sensor
Validation study, MoBa FFQ
• Acceptable agreement between the FFQ and the FD
for all nutrients and major foods
• Biomarkers confirmed that the FFQ estimates were
valid for fruit, juice, vegetables, tea, milk/dairy foods,
protein, vitamin D, folate, iodine, n-3 fatty acids
• The MoBa FFQ provide valid estimates of nutrients
supplied by dietary supplements
Brantsæter et al., Maternal and Child Nutrition, 2008
Brantsæter et al, Annals of Nutrition and Metabolism, 2008
Brantsæter et al., Public Health Nutrition, 2007
Use of dietary supplements in MoBa
82 % of the women register use of one or more
dietary supplement
Type of supplement
n (%)
n-3 FA (Cod liver oil/Fish oil)
23 615 (58.6 %)
Folic acid
14 259 (35.6%)
Multi- vitamins and minerals
12 351 (30.8%)
Iron tablets/formulation
8 668 (21.6 %)
Multivitamins
5 648 (16,3 %)
Pregnancy formulations
1 865 (4.6%)
Calcium tablets
1 273 (3.2 %)
Herb supplements
871 (2.1 %)
Haugen et al. Ann Nutr and Metab 2008.
RESULTS
Birth weight (mean and 95%CI) by categories of total seafood intake in
62099 women in the Norwegian Mother and Child Cohort Study
Conclusion: a consistent increase in infant birth weight and head
circumference with increasing maternal seafood consumption, this
association was mainly driven by lean fish.
Brantsæter et al. Br J Nutr. 2011
Dietary assessment in MoBa – children
• 6 months: retrospective reporting
– Supplementation during the first week of life
– What kind of milk the baby had received at each
month since birth to estimate duration and
intensity of breastfeeding
– Weaning foods and at which month they were
introduced
– Dietary supplements supplied to the baby
Breastfeeding, MoBa women
Häggkvist et al. Public Health Nutr. 2010
Dietary assessment in MoBa – children
• Eighteen months (Q5):
– Breast milk after 6 months of age
– Selected foods, drinks and dietary supplements
• Three years (Q6), Five years (Q7)
– Selected foods, drinks and dietary supplements
The questions are not complete for assessing total diet
or to estimate intake of energy, nutrient or any daily
intakes quantitatively, only to study dietary patterns
and distinguish dietary behaviours
Future perspectives
To examine longitudinal dietary exposure in relation to
health outcomes for the child (weight gain/obesity,
developmental milestones, asthma/allergy, cognitive
development etc)
In utero
+
Breast milk
+
Weaning foods and
early diet
MoBa continues……
Two new questionnaires are planned:
• Q-12 years pre-puberty – mental health
• Q-14 years nutrition – to be completed by the
teenager
More information:
ww.fhi.no/morogbarn
All questionnaires can be downloaded and are translated to
English.
The core diet group in MoBa
Helle Margrete
Meltzer
Margaretha
Haugen
Jan Alexander
Bryndis Eva
Birgisdottir
Hanne
Torjusen
Helle Knutsen
Anne Lise
Brantsæter
Helen E
Kvalem
Collaborators
Epidemiology
• Per Magnus
• Lill Trogstad
• Ronny Myhre
• Roy M Nilsen (UiB)
• Bo Jacobsson (Gøteborg)
• Sven Ove Samuelsen (UiO)
International
• Sjurdur Olsen
• Inga Thorsdottir
• Matt Longnecker
• Stephanie London
• Anna-Maria Siega-Riz
• Cindy Bulik
• Michelle Mendez