Australian scientists at the Heart Research Institute (HRI) are hoping to prove a Mediterranean diet for pregnant women can positively impact their babies' heart development as they investigate macro and micronutrients after ingestion.
The researchers are expanding on a study out of Spain, involving 1,200 expectant mothers, that uncovered the direct influence of Mediterranean diet or meditation on the reduction of the percentage of newborns with birth weight below the 10th percentile.
Congenital heart disease (CHD) affects 1 in 100 live births in Australia.
HRI lead researcher Dr Xiao Suo Wang working with Prof John O'Sullivan said findings from the Australian study could reduce the incidence of CHD and other related disorders, and change the clinical care model for pregnant women around the world.
"We know that intra-uterine-growth-restriction (IUGR) - the poor growth of a baby while in the mother's womb - is a major risk factor for lifelong poor health, cardiovascular risk, metabolic disease, and a shorter lifespan," said Dr Wang.
"We also know the intra-uterine period is a time of major cardiac plasticity, where cardiac structure and function of the heart is most vulnerable."
Dr Wang said as a society we eat too many highly processed foods and about 50 per cent of women are overweight or obese at their reproductive age, which can cause cardiac malformations in their unborn babies.
"Maternal obesity and type two diabetes are associated with foetal cardiac hypertrophy, which is noted as one of most common cardiac malformations occurring in birth. Independent to that, research also found that dietary sugar is a stimulus for hypertrophy in the heart.
"If we can prove that a Mediterranean diet can dramatically reduce that risk and understand the beneficial cardiac reprogramming that ensues, then this will have huge implications and will change clinical care for pregnant women all over the world."
Dr Wang said obesogenic diets and pro-hypertrophic saccharides (sugar) raise huge concerns with maternal diet and the impact on foetal heart development during gestation. Shockingly, the pro-hypertrophic effects are independent of diabetes or insulin effects, causing a revisit of the provenance of adult hypertrophic cardiomyopathy.
In collaboration with Prof Fatima Crispi and her team in Barcelona, Spain, the team at HRI has secured blood plasma samples from 1,200 pregnant women who underwent a parallel-group randomised clinical trial.
"This was an intervention study, where one third of the cohort underwent usual care, another third Mediterranean dietary intervention, and the third cohort mindfulness-based stress reduction.
"The outcome from this clinical trial reveals these structured interventions, either on the Mediterranean diet or mindfulness-based stress reduction, significantly reduced the risk of small-for-gestational-age newborns."
Dr Wang said as part of a multi-layered approach, the researchers track the macro and micronutrients after they are digested, and also work with the Australian Nuclear Science and Technology Organisation (ANSTO) to identify the difference between the carbons and nitrogen isotopes in dietary patterns. This novel approach can dissect the origin and degree of processing of the maternal dietary carbohydrates and proteins.
Dr Wang working with a mass spectrometer
"We first want to understand what salutary effects preventing IUGR has on the heart and then understand what specific macro and micronutrients in the Mediterranean diet are protective and promote healthy baby heart development," she said.
"We will trace the carbon and nitrogen sources of the diets, whereby 'healthy' and 'unhealthy' dietary sources can be determined.
"Isotope ratio mass spectrometry can provide information on food origins and dietary patterns by accurately measuring isotope ratios of carbon that correlate with highly processed food, and high nitrogen isotope ratios that correspond to unhealthy animal protein sources," Dr Wang said.
The HRI researchers will then map metabolomic and lipidomic changes downstream of maternal diet, ingestion, absorption, and processing, and the relationships to foetal heart development.
"We will analyse both maternal blood plasma and foetal cord blood plasma in depth using liquid chromatography-tandem mass spectrometry (LCMS) to sensitively and simultaneously detect thousands of molecules, including lipids, metabolites and intermediates that play a role in central carbon metabolism, energy metabolism, oxidative stress, inflammation, extracellular homeostasis, and drug-to-drug interactions."
Dr Wang said the analysis will provide information for improved pregnancy management and potentially reduce CHDs and other related disorders, resulting in better health for babies when born and in their later lives.
The team will also work with an independent cohort of pregnant women in Sydney, based at the Charles Perkins Centre, Royal Prince Alfred Hospital, and The University of Sydney, called BABY1000.
Header image: Dr Xiao Suo Wang
Media coverage
This research appeared in The Australian, 13 February 2023
