| Abstract | Metaboličke prilagodbe organizma trudnice osiguravaju fetusu adekvatnu opskrbu hranjivim tvarima. Opskrba fetusa hranjivim tvarima ovisi o funkciji posteljice, a transport lipida složen je proces u kojem sudjeluju brojni receptori i prijenosni proteini. Tijekom kataboličke faze trudnoće dolazi do fiziološke hiperlipidemije čime lipoproteini, a time trigliceridi i kolesterol te slobodne masne kiseline postaju dostupne za prijenos posteljicom. Dislipidemija majke tijekom trudnoće povezana je s komplikacijama trudnoće kao što su gestacijski dijabetes melitus, fetalna makrosomija, smanjena porođajna težina i preeklampsija.
Masne kiseline, osobito višestruko nezasićene masne kiseline imaju značajnu ulogu u rastu i razvoju fetusa. One sudjeluju u energetskom metabolizmu, staničnoj signalizaciji, regulaciji ekspresije gena, prekursori su u sintezi eikozanoida te su strukturna komponenta staničnih membrana. Esencijalne masne kiseline su linolna (n-6) i α-linolenska kiselina (n-3). Njihovi su derivati arahidonska kiselina, eikozapentaenska kiselina i dokozaheksaenska kiselina. Navedene masne kiseline imaju utjecaj na trajanje trudnoće i porođajnu težinu novorođenčeta, na neurološki razvoj i razvoj retine, imunološkog sustava te metabolizma fetusa što mu predodređuje zdravstvene ishode tijekom života.
Prehrana majke jedan je od najvažnijih promjenjivih čimbenika koji utječu na zdravstveni ishod majke i djeteta. Suvremena zapadnjačka prehrana bogata zasićenim i trans-masnim kiselinama te s visokim omjerom n-6 i n-3 masnih kiselina ističe se kao rizični čimbenik u razvoju pretilosti majke, djeteta i nepovoljnim ishodima trudnoće. Mediteranska prehrana, s druge strane, osigurava optimalan unos pojedinih makronutrijenata i mikronutrijenata, s naglaskom na višestruko nezasićene masne kiseline. Ima nizak omjer n-6 i n-3 masnih kiselina te se pokazala kao idealni model prehrane s dokazanim povoljnim učincima na zdravlje. |
| Abstract (english) | Metabolic adaptations during pregnancy ensure the fetus receives an adequate supply of nutrients. The fetus relies entirely on the placental function for its nutrient supply, with lipid transport being a complex process involving numerous receptors and transport proteins. During the catabolic phase of pregnancy, physiological hyperlipidemia ensures enough lipoproteins, including triglycerides, cholesterol, and free fatty acids, are available for placental transfer. Maternal dyslipidemia during pregnancy is associated with complications such as gestational diabetes mellitus, fetal macrosomia, low birth weight, and preeclampsia.
Fatty acids, particularly polyunsaturated fatty acids, are crucial for the growth and development of the fetus. They play vital roles in energy metabolism, cellular signaling, gene regulation, act as precursors for eicosanoid synthesis and are integral to the cell membrane structure. Essential fatty acids like linoleic acid (n-6) and α-linolenic acid (n-3), along with their derivatives such as arachidonic acid (ARA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), significantly impact pregnancy duration, birth weight, neurological and retinal development, as well as the development of the immune system and fetal metabolism. Consequently, these factors determine long-term health outcomes.
Maternal nutrition is one of the crucial modifiable factors influencing the health outcomes for both mother and child. The modern Western diet, rich in saturated and trans fatty acids, also characterized by a high n-6 to n-3 ratio, poses risks for maternal and child obesity as well as adverse pregnancy outcomes. The Mediterranean diet, on the other hand, provides an optimal and balanced intake of macronutrients and micronutrients with an emphasis on polyunsaturated fatty acids. Additionally, it maintains a low n-6 to n-3 ratio and is recognized as an ideal dietary model with proven health benefits. |
