Targeting the Infant Gut Microbiota Through a Perinatal Educational Dietary Intervention: Protocol for a Randomized Controlled Trial

Samantha L Dawson; Jeffrey M Craig; Gerard Clarke; Mohammadreza Mohebbi; Phillip Dawson; Mimi Lk Tang; Felice N Jacka

doi:10.2196/14771

Targeting the Infant Gut Microbiota Through a Perinatal Educational Dietary Intervention: Protocol for a Randomized Controlled Trial

JMIR Res Protoc. 2019 Oct 21;8(10):e14771. doi: 10.2196/14771.

Authors

Samantha L Dawson^{1

2}, Jeffrey M Craig^{2

3}, Gerard Clarke^{4

5

6}, Mohammadreza Mohebbi⁷, Phillip Dawson⁸, Mimi Lk Tang^{9

10}, Felice N Jacka^{1

11

12}

Affiliations

¹ Food & Mood Centre, IMPACT Strategic Research Centre, Deakin University, Geelong, Australia.
² Environmental & Genetic Epidemiology Research, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia.
³ School of Medicine, Deakin University, Waurn Ponds, Australia.
⁴ Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland.
⁵ APC Microbiome Ireland, University College Cork, Cork, Ireland.
⁶ INFANT Research Centre, University College Cork, Cork, Ireland.
⁷ Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Australia.
⁸ Centre for Research in Assessment and Digital Learning, Deakin University, Melbourne, Australia.
⁹ Allergy and Immune Disorders, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia.
¹⁰ Department of Paediatrics, University of Melbourne, Parkville, Australia.
¹¹ Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia.
¹² Black Dog Institute, New South Wales, Australia.

PMID: 31638593
PMCID: PMC6914305
DOI: 10.2196/14771

Abstract

Background: The early life gut microbiota are an important regulator of the biological pathways contributing toward the pathogenesis of noncommunicable disease. It is unclear whether improvements to perinatal diet quality could alter the infant gut microbiota.

Objective: The aim of this study is to assess the efficacy of a perinatal educational dietary intervention in influencing gut microbiota in mothers and infants 4 weeks after birth.

Methods: The Healthy Parents, Healthy Kids randomized controlled trial aimed to recruit 90 pregnant women from Melbourne, Victoria, Australia. At week 26 of gestation, women were randomized to receive dietary advice from their doctor (n=45), or additionally receive a dietary intervention (n=45). The intervention included an educational workshop and 2 support calls aiming to align participants' diets with the Australian Dietary Guidelines and increase intakes of prebiotic and probiotic foods. The educational design focused on active learning and self-assessment. Behavior change techniques were used to support dietary adherence, and the target behavior was eating for the gut microbiota. Exclusion criteria were age under 18 years, diagnosed mental illnesses, obesity, diabetes mellitus, diagnosed bowel conditions, exclusion diets, illicit drug use, antibiotic use, prebiotic or probiotic supplementation, and those lacking dietary autonomy. The primary outcome measure is a between-group difference in alpha diversity in infant stool collected 4 weeks after birth. Secondary outcomes include evaluating the efficacy of the intervention in influencing infant and maternal stool microbial composition and short chain fatty acid concentrations, epigenetic profile, and markers of inflammation and stress, as well as changes in maternal dietary intake and well-being. The study and intervention feasibility and acceptance will also be evaluated as secondary outcomes.

Results: The study results are yet to be written. The first participant was enrolled on July 28, 2016, and the final follow-up assessment was completed on October 11, 2017.

Conclusions: Data from this study will provide new insights regarding the ability of interventions targeting the perinatal diet to alter the maternal and infant gut microbiota. If this intervention is proven, our findings will support larger studies aiming to guide the assembly of gut microbiota in early life.

Trial registration: Australian Clinical Trials Registration Number ACTRN12616000936426; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370939.

International registered report identifier (irrid): DERR1-10.2196/14771.

Keywords: diet; gastrointestinal microbiome; infant; newborn; pregnancy; randomized controlled trial.

©Samantha L L. Dawson, Jeffrey M Craig, Gerard Clarke, Mohammadreza Mohebbi, Phillip Dawson, Mimi LK Tang, Felice N Jacka. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 21.10.2019.