title: Energy and Protein Supplementation Does Not Affect Protein and Amino Acid Kinetics or Pregnancy Outcomes in Underweight Indian Women.
abstract: BACKGROUND
  In India, the prevalence of low birth weight is high in women with a low body mass index (BMI), suggesting that underweight women are not capable of providing adequate energy and protein for fetal growth. Furthermore, as pregnancy progresses, there is increased need to provide methyl groups for methylation reactions associated with the synthesis of new proteins and, unlike normal-BMI American women, low-BMI Indian women are unable to increase methionine transmethylation and remethylation rates as pregnancy progresses from trimester 1 to 3. This also negatively influences birth weight.
  
  
  OBJECTIVE
  The aim was to determine the effect of dietary supplementation with energy and protein from 12 ± 1 wk of gestation to time of delivery compared with no supplement on pregnancy outcomes, protein kinetics, and the fluxes of the methyl group donors serine and glycine.
  
  
  METHODS
  Protein kinetics and serine and glycine fluxes were measured by using standard stable isotope tracer methods in the fasting and postprandial states in 24 pregnant women aged 22.9 ± 0.7 y with low BMIs [BMI (in kg/m(2)) ≤18.5] at 12 ± 1 wk (trimester 1) and 30 ± 1 wk (trimester 3) of gestation. After the first measurement, subjects were randomly assigned to either receive the supplement (300 kcal/d, 15 g protein/d) or no supplement.
  
  
  RESULTS
  Supplementation had no significant effect on any variable of pregnancy outcome, and except for fasting state decreases in leucine flux (125 ± 7.14 compared with 113 ± 5.06 μmol ⋅ kg(-1) ⋅ h(-1); P = 0.04) and nonoxidative disposal (110 ± 6.97 compared with 101 ± 3.69 μmol ⋅ kg(-1) ⋅ h(-1); P = 0.02) from trimesters 1 to 3, it had no effect on any other leucine kinetic variable or urea, glycine, and serine fluxes.
  
  
  CONCLUSIONS
  We conclude that in Indian women with a low BMI, supplementation with energy and protein from week 12 of pregnancy to time of delivery does not improve pregnancy outcome, whole-body protein kinetics, or serine and glycine fluxes.
authors.affiliation: Division of Nutrition, St. John's Research Institute, Bangalore, India;
authors.forename: Pratibha
authors.initials: P
authors.lastname: Dwarkanath
authors.affiliation: USDA/Agricultural Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX; and.
authors.forename: Jean W
authors.initials: JW
authors.lastname: Hsu
authors.affiliation: USDA/Agricultural Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX; and.
authors.forename: Grace J
authors.initials: GJ
authors.lastname: Tang
authors.affiliation: Division of Nutrition, St. John's Research Institute, Bangalore, India;
authors.forename: Pauline
authors.initials: P
authors.lastname: Anand
authors.affiliation: Division of Nutrition, St. John's Research Institute, Bangalore, India;
authors.forename: Tinku
authors.initials: T
authors.lastname: Thomas
authors.affiliation: Department of Obstetrics and Gynecology, St. John's Medical College Hospital, Bangalore, India.
authors.forename: Annamma
authors.initials: A
authors.lastname: Thomas
authors.affiliation: Department of Obstetrics and Gynecology, St. John's Medical College Hospital, Bangalore, India.
authors.forename: C N
authors.initials: CN
authors.lastname: Sheela
authors.affiliation: Division of Nutrition, St. John's Research Institute, Bangalore, India;
authors.forename: Anura V
authors.initials: AV
authors.lastname: Kurpad
authors.affiliation: USDA/Agricultural Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX; and fjahoor@bcm.edu.
authors.forename: Farook
authors.initials: F
authors.lastname: Jahoor
mesh_terms: D000328:Adult; D000596:Amino Acids / Q000378:metabolism*; D001724:Birth Weight / Q000187:drug effects*; D015992:Body Mass Index; D004044:Dietary Proteins / Q000378:metabolism / Q000494:pharmacology*; D019587:Dietary Supplements; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D006801:Humans; D007194:India; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007700:Kinetics; D008745:Methylation; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011264:Pregnancy Trimesters; D013851:Thinness / Q000150:complications*; D055815:Young Adult
chemical_list: D000596:Amino Acids; D004044:Dietary Proteins
keywords: birth weight; glycine; leucine; low birth weight; maternal weight gain; serine; urea