Pregnancy Related Clinical Trial
Official title:
Methionine Requirements During Healthy Human Pregnancy
The current recommendations for dietary amino acid intake in pregnant women are based on calculations from requirements of adult men. The study aims to determine methionine requirements during early (11-20 weeks) and late (31-38 weeks) stages of pregnancy. Methionine, an essential amino acid (building block of body protein), is necessary for protein synthesis and for DNA related cellular functions. A non-invasive, novel method based on different diets, stable isotopes (the safe kind) and simple breath collection will be used. This method has recently been used by our laboratory to study other amino acids during pregnancy.
Pre-study day protocol:
Participants will be asked to meet for a brief (1 hour) pre-study assessment in preparation
for the study day. Participants' eligibility will be assessed during this time. Subjects will
arrive at the British Columbia Children's Hospital Research Institute's Clinical Research and
Evaluation Unit (CREU) having fasted overnight (at least 8 hours since last caloric intake;
no morning exercise, and assisted transportation to minimize stress). The consent form will
be thoroughly explained, with the subject instructed to stop and ask questions at any point
in which they are confused or uncomfortable. If the participants are willing to participate,
verbal consent and a signature will be obtained. On this day, participants will fill out a
questionnaire, and the following measurements will be taken: height (Harpenden Stadiometer;
Holtain Limited, UK) and weight (electric scale; HealthOMeter Professional, Sunbeam Products,
Inc.), bioelectrical impedance analysis (BIA; Q4 Bioimpedance Analyzer, RJL Systems, MI), 3
site skinfold (Harpenden Calipers; Baty International, UK), blood glucose (One Touch Ultra,
LifeScan, Inc.), and resting energy expenditure (REE; Vmax Encore, Viasys, CA). The REE
describes the caloric requirement for vital function in the absence of physical exertion.
This value will be used to calculate the total energy content of the experimental diets in
order to ensure that the specific caloric needs of each participant will be met. Blood
glucose will be assessed for gestational diabetes mellitus (GDM; fasting plasma glucose level
of 5.3 mmol/L indicative of GDM). Skinfold and BIA measurements will be collected to
determine maternal fat and fat free mass.
Study day protocol:
Healthy pregnant women (20-40 y) who have consented and participated in the pre-study day
will be studied at two stages of gestation (n=15/stage) over a range of test methionine
intakes (ranging from 0-40mg/kg/day). At the beginning and end of the day a urine dipstick
test will be performed. Each study day will be separated by a week and will receive a
different, random methionine test intake. On the day of the study, participants will come in
fasted at ~8 am for a total of eight hours. They will receive eight hourly meals, which
represent 1/12 of their balanced nutritional need for the day. The meals consist of an orange
flavoured shake with egg protein composition, balanced with sufficient carbohydrates and
lipids. A tracer amino acid (L-[1-13C] phenylalanine) will be provided with the test meals to
assess oxidation of the tracer to 13CO2 (13C- carbon dioxide) in breath in response to the
test/limiting amino acid (methionine). Open-circuit indirect calorimetry will be performed
until 5 steady state data points will be obtained for the measurement of VCO2 (Carbon Dioxide
Output; Vmax Encore, Viasys, CA). This technique, called the indicator amino acid oxidation
method, is a novel, non-invasive and completely safe approach especially in pregnancy.
Throughout the 8-hour study period biological samples (breath, urine, blood) will be
collected and analyzed for 13CO2 content and sulfur amino acid metabolites.
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