Carbohydrate intake in children - associations with dietary intakes, growth, serum lipids,and dental health. The STRIP Project

This study is part of the STRIP study, which is a long-term, randomized controlled trial, designed to decrease the exposure of children in the intervention group (n=540) to known risk factors of atherosclerosis. The main focus of the intervention was the quality of dietary fat. The control group (n=522) did not receive any individualized counselling. Food consumption was evaluated with food records, and blood samples were drawn and growth was measured regularly for all participating children from 13 months to 9 years. A subsample of 66 children participated in a dental health survey. The number of studies on children’s carbohydrate intake, especially fibre intake, is insufficient. The current international recommendations for fibre intake in children are based on average assumptions and data extrapolated from intakes in adults and intake recommendations for adults. Finnish nutrition recommendations lack strict recommendations for dietary fibre in children. Due to fibre’s high bulk volume, excessive dietary fibre is considered to decrease energy density and hence it may have an adverse effect on growth. If fats are reduced from the diet, the low-fat diet may become high in sucrose. Therefore, especially in the STRIP study, it is important to determine the use of fibre and sucrose in children and possible associations with growth and nutrition as well as dental health. The results of the present study indicate that a high fibre intake does not displace energy or disturb growth in children and that children with high fibre intake have better quality of diet than those with low fibre intake. Additionally, dietary fibre intake associated inversely with serum cholesterol concentration. Other carbohydrates also affected serum lipid levels as well, since total carbohydrates, sucrose, and fructose increased serum triglyceride concentration. Total carbohydrate intake reduced HDL cholesterol concentration only in children with apoE3 or apoE4 phenotype. Over the period from the 1970s to the 1990s the dental health of children in Finland has substantially improved despite an increase in sucrose intake. The improvement was thought to be due to improved dental hygiene and the use of fluorine. However, during the past twenty years improvement in dental health has stopped. The present study showed that high long-term sugar intake increases risk of caries in children. High intake of sugar had also negative effects on the diet of children, because it worsens dietary quality by displacing essential nutrients. Furthermore, the quality of dietary fat was worse in children with high sucrose intake. In this study the children’s high sucrose intake was not associated with overweight, but interestingly, it associated inversely with growth.

The role of emotional state, sexual arousal, and alcohol intoxication as situational factors associated with adults’ online sexual contact with children and adolescents

In the present study we explored whether and how the situational factors; emotional states, sexual arousal, and alcohol intoxication influenced the propensity in adults to engage in online sexual contact with children (13 or younger) and adolescents (14 – 17 year olds). The results were compared to a group of adults that had engaged in online sexual contact with adults only (18 or older). We also looked at the variation over time within these situational factors during the online sexual contact with a child, an adolescent, or an adult. The present study was an online self-report survey to the adult populations in Finland, Sweden, and Germany, with a final sample (N = 776) of women and men who were active on the Internet. The participants were asked to report whether, how, and with whom they had engaged in online sexual contact. The results showed that more men than women reported online sexual contact with persons of all age groups, and that the situational factors; emotional states and sexual arousal influenced the propensity in both women and men to engage in online sexual contact with children and adolescents. However, the effects of alcohol intoxication were small and significant only for men. These results indicate that higher levels of emotional state and sexual arousal might increase the propensity to go against social norms and contact children and adolescents online for sexual purposes, but it can also imply that that those who look for online sexual contact online with children and adolescents, are more emotionally and/or sexually aroused than the group that only seek adult company or that these are post-hoc explanations for such sexual activities.

Genetic, prenatal and postnatal determinants of weight gain and obesity in young children – The STEPS Study

Genetic, Prenatal and Postnatal Determinants of Weight Gain and Obesity in Young Children – The STEPS Study University of Turku, Faculty of Medicine, Department of Paediatrics, University of Turku Doctoral Program of Clinical Investigation (CLIPD), Turku Institute for Child and Youth Research. Conditions of being overweight and obese in childhood are common health problems with longlasting effects into adulthood. Currently 22% of Finnish boys and 12% of Finnish girls are overweight and 4% of Finnish boys and 2% of Finnish girls are obese. The foundation for later health is formed early, even before birth, and the importance of prenatal growth on later health outcomes is widely acknowledged. When the mother is overweight, had high gestational weight gain and disturbances in glucose metabolism during pregnancy, an increased risk of obesity in children is present. On the other hand, breastfeeding and later introduction of complementary foods are associated with a decreased obesity risk. In addition to these, many genetic and environmental factors have an effect on obesity risk, but the clustering of these factors is not extensively studied. The main objective of this thesis was to provide comprehensive information on prenatal and early postnatal factors associated with weight gain and obesity in infancy up to two years of age. The study was part of the STEPS Study (Steps to Healthy Development), which is a follow-up study consisting of 1797 families. This thesis focused on children up to 24 months of age. Altogether 26% of boys and 17% of girls were overweight and 5% of boys and 4% of girls were obese at 24 months of age according to New Finnish Growth references for Children BMI-for-age criteria. Compared to children who remained normal weight, the children who became overweight or obese showed different growth trajectories already at 13 months of age. The mother being overweight had an impact on children’s birth weight and early growth from birth to 24 months of age. The mean duration of breastfeeding was almost 2 months shorter in overweight women in comparison to normal weight women. A longer duration of breastfeeding was protective against excessive weight gain, high BMI, high body weight and high weight-for-length SDS during the first 24 months of life. Breast milk fatty acid composition differed between overweight and normal weight mothers, and overweight women had more saturated fatty acids and less n-3 fatty acids in breast milk. Overweight women also introduced complementary foods to their infants earlier than normal weight mothers. Genetic risk score calculated from 83 obesogenic- and adiposity-related single nucleotide polymorphisms (SNPs) showed that infants with a high genetic risk for being overweight and obese were heavier at 13 months and 24 months of age than infants with a low genetic risk, thus possibly predisposing to later obesity in obesogenic environment. Obesity Risk Score showed that children with highest number of risk factors had almost 6-fold risk of being overweight and obese at 24 months compared to children with lowest number of risk factors. The accuracy of the Obesity Risk Score in predicting overweight and obesity at 24 months was 82%. This study showed that many of the obesogenic risk factors tend to cluster within children and families and that children who later became overweight or obese show different growth trajectories already at a young age. These results highlight the importance of early detection of children with higher obesity risk as well as the importance of prevention measures focused on parents. Keywords: Breastfeeding, Child, Complementary Feeding, Genes, Glucose metabolism, Growth, Infant Nutrition Physiology, Nutrition, Obesity, Overweight, Programming

Teacher’s Conceptions of Caring and Protective Teaching Elements in Rwamwanja Refugee Settlement Schools

The purpose of this study is to find out what conceptions Rwamwanja refugee settlement teachers have about caring teaching methods. The study was conducted by analysing the data gathered from semi-structured interviews. Twelve teachers were interviewed in four different refugee settlement schools. The main theory of this study is based on ethics of care research by Nel Noddings. In addition, the framework was developed by combining the theories of resilience and psychosocial support which are often employed in research concerning emergency contexts. This study uses qualitative content analysis to describe the conceptions of caring teachers have and protective teaching elements they employ. The results of this study show that many of the key elements of caring and protective teaching were present in teacher’s answers. For example, in their answers, the majority of the teachers pointed out the significance of using soft discipline. However, many teaching elements considered ideal in emergency contexts were missing. These missing methods include routines and flexibility which are considered essential for vulnerable children. The teachers’ levels of conceptual thinking varied remarkably depending on their language skills. The communication was limited to very basic and concrete language in some of the interviews due to lack of mutual understanding. This also raised a question about the level of understanding between refugee pupils and teachers since there is no strong common language between them. The results of this research call for further studies about the effect of caring teaching elements in growth of resilience in refugee children. Keywords: The ethics of care, resilience, psychosocial support, education in emergencies, refugees, education, protection.

Social Cognition and Behavior in Relationship Context

Social information processing (SIP; Crick & Dodge, 1994) and social-cognitive learning theories have been often used to understand children’s problem behaviors, such as aggression. According to these theories, children’s thinking guides their subsequent behaviors. Although most of us agree that social behavior and underlying thought processes are context-dependent, personality and social development researchers have usually engaged in searching for stable patterns of dispositions and behaviors, ignoring (or treating as error) the variance across different situations and relationship types. This, however, can result in erroneous conclusions and question the interpretation of previous findings. Four studies were conducted to explore the influence of relationship context on children’s social-cognitive evaluations and behavior. Samples were fourth to sixth graders from Estonia and Finland. Social cognitions were assessed by presenting children with hypothetical vignettes where the previously identified relationship partner’s behavior had a negative consequence for the child (Studies I, II, and IV), followed by questions measuring different social-cognitive processes (e.g., hostile attributions, behavioral strategies, outcome expectations and self-efficacy beliefs for aggression). In addition, in Studies II and IV, children provided information about their behavior within a specific relationship context. In Study III, an affective priming paradigm was employed where participants were presented with a short display of photographs of children’s liked and disliked classmates, and unknown peers. The results of this thesis suggest that children’s thinking and behavior are largely influenced by the affective valence of the relationship. Moreover, cognitions guide behavior within the relationship. The current findings offer a fruitful avenue for studying the heterogeneity of peer interactions.

Islet antigen-specific T cells and regulatory T cells in type 1 diabetes

T cells are the key players in the development of type 1 diabetes (T1D), mediating autoimmune reactions leading to the destruction of insulin producing beta cells in the islets. We aimed to analyze the role of different T-cell subtypes in the autoimmunity and pathogenesis of T1D. The frequency of islet antigen-specific (GAD65-, proinsulin-, and insulin-specific) CD4+ T cells was investigated in vitro in T1D patients, at-risk individuals (diabetes-associated autoantibody positive), and in controls, using MHC class II tetramers. An overall higher frequency of CD4+ T-cells recognizing the GAD65 555−567 peptide was detected in at-risk individuals. In addition, increased CD4+ T-cell responses to the same GAD65 epitope displaying a memory phenotype were observed in at-risk and diabetic children, which demonstrate a previous encounter with the antigen in vivo. Avidity and phenotypic differences were also observed among CD4+ T-cell clones induced by distinct doses of GAD65 autoantigen. T-cell clones generated at the lowest peptide dose displayed the highest avidity and expressed more frequently the TCR Vβ5.1 chain than low-avidity T cells. These findings raise attention to the antigen dose when investigating the diversity of antigen-specific T cells. Furthermore, an increased regulatory response during the preclinical phase of T1D was also found in genetically at-risk children. Higher frequencies of regulatory T (Treg) cells (CD4+CD25_high HLA-DR-/CD69-) and natural killer T (NKT) cells (CD161+Vbeta11+) were observed in children with multiple autoantibodies compared to autoantibody-negative controls. Taken together, these data showed increased frequency of islet-specific CD4+ T-cells, especially to the GAD65 555-567 epitope, and Treg and NKT cell upregulation in children at-risk for T1D, suggesting their importance in T1D pathogenesis

Targeting of caries prevention at preschool children, a practice based study

Aim and design: To evaluate an oral health program directed to expecting families and their children. The intervention was carried out in one of the four health care areas of the city of Turku. Another area acted as a control. Subjects and methods: Children (n = 1217), born between January 1, 1998 and June 30, 1999, in the respective health care areas were screened for mutans streptococci bacteria (MS), and their caretakers were interviewed when the child was 18 months old. MScolonization was used as the child’s risk indicator. Intensified health education and the use of xylitol lozenges targeted at the children at risk were the main elements of the program. Controls and the non-MS-colonized children received routine prevention –examination and education at the ages of three and five years. Altogether 794 subjects were followed for 42 months after receiving consent from their caretakers. Associations of oral-health-related factors with MS colonization and caries increment were studied inside the control group. Results: MS colonization associated with the occupation of the caretaker and ethnicity. The program was effective in white-collar families; prevented fraction being 67 %. In blue-collar families no effect was achieved. At the age of five years, caries increment was strongly related to the occupation of the caretaker, MS at 18 months, child’s sugar use, night feeding, use of thirst quencher at the age of 18 months, and father’s reported oral health. Conclusions: Programs targeted at MS-colonized children can reduce caries in whitecollar families. A program mainly based on activity at home seems to favor white-collar families, whereas different kind of support is needed for the blue-collar families.

Gene Regulation in The Human Immune System. Gene Expression Signatures of Th2 Cell Differentiation, Type 1 Diabetes, and Intrauterine Immune Adaptation

The human immune system is constantly interacting with the surrounding stimuli and microorganisms. However, when directed against self or harmless antigens, these vital defense mechanisms can cause great damage. In addition, the understanding the underlying mechanism of several human diseases caused by aberrant immune cell functions, for instance type 1 diabetes and allergies, remains far from being complete. In this Ph.D. study these questions were addressed using genome-wide transcriptomic analyses. Asthma and allergies are characterized by a hyperactive response of the T helper 2 (Th2) immune cells. In this study, the target genes of the STAT6 transcription factor in naïve human T cells were identified with RNAi for the first time. STAT6 was shown to act as a central activator of the genes expression upon IL-4 signaling, with both direct and indirect effects on Th2 cell transcriptome. The core transcription factor network induced by IL-4 was identified from a kinetic analysis of the transcriptome. Type 1 diabetes is an autoimmune disease influenced by both the genetic susceptibility of an individual and the disease-triggering environmental factors. To improve understanding of the autoimmune processes driving pathogenesis in the prediabetic phase in humans, a unique series of prospective whole-blood RNA samples collected from HLA-susceptible children in the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) study was studied. Changes in different timewindows of the pathogenesis process were identified, and especially the type 1 interferon response was activated early and throughout the preclinical T1D. The hygiene hypothesis states that allergic diseases, and lately also autoimmune diseases, could be prevented by infections and other microbial contacts acquired in early childhood, or even prenatally. To study the effects of the standard of hygiene on the development of neonatal immune system, cord blood samples from children born in Finland (high standard of living), Estonia (rapid economic growth) and Russian Karelia (low standard of living) were compared. Children born in Russian Karelia deviated from Finnish and Estonian children in many aspects of the neonatal immune system, which was developmentally more mature in Karelia, resembling that of older infants. The results of this thesis offer significant new information on the regulatory networks associated with immune-mediated diseases in human. The results will facilitate understanding and further research on the role of the identified target genes and mechanisms driving the allergic inflammation and type 1 diabetes, hopefully leading to a new era of drug development.

Nasopharyngeal colonization by pathogenic bacteria: effect of polymorphisms in innate immune genes of young children

Nasopharyngeal bacteria can asymptomatically colonize the nasopharynx of infants and young children but are also associated with the development of respiratory infections and diseases. Such nasopharyngeal bacteria include Streptococcus pneumoniae, Moraxella catarrhalis, Haemophilus influenzae and Staphylococcus aureus. The host defense against invading pathogens is largely relies germline-encoded pattern recognition receptors (PRR), which are expressed on the cells of innate immunity, and different cytokines. These include toll-like receptors (TLR), mannose-binding lectin (MBL) and different cytokines such as IL-17A. Single nucleotide polymorphisms (SNP) in these receptors and cytokines have been reported. The aim of this study was to investigate genetic polymorphisms in the genes for TLR2, 3 and 4, MBL as well as for IL-17A and their associations with nasopharyngeal pathogenic bacterial colonization during a two-year follow-up. The study revealed that polymorphisms in TLRs, MBL2 and IL17A are associated with the nasopharyngeal bacterial colonization in young children. Healthy young (2.6 months of age) children with variant types of MBL2, TLR2 R753Q or TLR4 D299G had an increased risk to be colonized by S. pneumonia, S. aureus or M. catarrhalis, respectively. Moreover, variant types of MBL2 in healthy children with might facilitate human rhinovirus (HRV)-induced S. pneumoniae colonization at 2.6 months of age. The polymorphism of TLR4 D299G was shown to be associated with M. catarrhalis colonization throughout the whole two-year follow-up (2.6, 13 and 24 months of age) and also with the bacterial load of this pathogen. Also, the polymorphism of IL17A G152A was shown to be associated with increased risk to be colonized by S. pneumoniae at 13 and 24 months of age. Furthermore, the results suggest that IL17A G152A has an effect on production of serum IL-17A already at young age. In conclusion, the results of this study indicate that polymorphisms in the key PRRs and IL17A seem to play an important role to colonization of S. pneumoniae, M. catarrhalis, and S. aureus in healthy young Finnish children. The nasopharyngeal colonization by these pathogenic bacteria may further promote the development of respiratory infections and may be related to development of asthma and allergy in the later life of children. These findings offer a possible explanation why some children have more respiratory infections than other children and provide a rational basis for future studies in this field.

Punaisten naisten tiet. Valtiorikosoikeuteen vuonna 1918 joutuneiden Porin seudun naisten toiminta sota-aikana, tuomiot ja myöhemmät elämänvaiheet

Suomen sisällissotaan osallistui vuonna 1918 naisia molemmin puolin rintamaa erilaisissa tehtävissä. Taisteluiden jälkeen yli 5500 punaista naista joutui valtiorikosoikeuteen syytettynä valtiopetoksellisesta toiminnasta. Ne noin 2000 naista, jotka palvelivat punakaartissa aseistettuina, ovat pitkään hallinneet sitä kuvaa, joka suomalaisilla on ollut punaisista naisista. Sen sijaan on tiedetty hyvin vähän niistä naisista, joiden valkoiset katsoivat edistäneen valtiopetosta muilla keinoilla. Tässä tutkimuksessa tarkastellaan, millaisia olivat Porin seudulla ne kapinasta syytetyt naiset, jotka eivät olleet tarttuneet aseisiin ja mikä oli heidän myöhempi kohtalonsa. Työn ensimmäisessä osassa tutkitaan valtiorikosoikeuteen joutuneiden naisten taustaa, toimintaa sota-aikana ja tästä aiheutuneita välittömiä seuraamuksia. Millaisia henkilöitä päätyi valtiorikosoikeuden eteen tuomittavaksi? Millaisissa tehtävissä he olivat sota-aikana toimineet ja miksi? Mitkä seikat olivat oikeudessa raskauttavia, kun valtiorikostuomioita jaettiin? Työn jälkimmäisessä osassa tutkitaan, mitä punaisille naisille tapahtui sodan jälkeen ja miksi näin kävi. Sisällissodan jälkeistä maailmaa hahmotetaan etsimällä vastauksia seuraaviin kysymyksiin: Millainen oli se yhteiskunnassa vallinnut ajan henki, jonka vaikutuspiiriin naiset valtiorikosoikeudesta ja vankilasta palasivat? Miten yhteisö otti heidät vastaan? Miten heihin suhtauduttiin työmarkkinoilla? Miten käsiteltiin punaisia leskiä ja orpoja? Mitä punaisilta odotettiin kansalaisina ja miten heistä pyrittiin muokkaamaan yhteiskuntakelpoisia? Miten poliittisen elämän uudelleenvirittely onnistui ja kiinnostiko se enää näitä naisia? Miten suomalaisen yhteiskunnan muuttuessa myös sen suhtautuminen punaisiin muuttui? Millaisilla toimilla valtiovalta pyrki eri vaiheissa yhtenäistämään rikkirevennyttä kansaa ja miten se näkyi yksittäisten ihmisten elämässä? Ajan kuluessa asenteet muuttuivat ja naiset vanhenivat. Miten naiset kuvasivat kokemaansa myöhemmin omaisilleen? Kysymyksiä pohditaan paikallisesta, Porin seudun näkökulmasta, mutta niitä peilataan kuitenkin jatkuvasti valtakunnalliseen tilanteeseen. Kontekstualisoi- malla paikalliskokemukset laajempaan kokonaisuuteen on voitu paremmin selittää tapahtunutta, ja paikallistutkimuksen kautta on nähty myös koko maassa vallinneita yleisiä olosuhteita. Tutkimuksen kohteena on 267 Porista, Porin maalaiskunnasta ja Ulvilasta kotoisin olevaa naista, jotka joutuivat valtiorikosoikeuden tutkittaviksi. Keskeisimpänä lähdeaineistona ovat seurakuntien rippikirjat ja maistraattien henkikirjat sekä Kansallisarkiston, Kansan arkiston ja Työväen arkistojen sisällissotaa ja sen jälkeistä poliittista elämää valottavat kokoelmat. Tutkimuksen naisista enemmistö oli 18−37-vuotiaita työläisnaisia. Aiemmin rikoksista tuomittuja heidän joukossaan oli hyvin vähän. Suurin osa (n. 71 %) työskenteli punakaartin huollossa keittiö-, siivous- ja vaatetusosastoilla. Noin 21 % työskenteli sairaanhoidossa, ja loput kahdeksan prosenttia olivat punakaartin hallintoa avustavissa muissa tehtävissä. Naiset saivat pääosin lieviä, 2−3 vuoden ehdollisia tuomioita. Vain joka kymmenes nainen tuomittiin ehdottomaan rangaistukseen. Punakaartiin vasta pakomatkalla liittyneet ja kaartissa vähäisissä tehtävissä lyhytaikaisesti toimineet henkilöt vapautettiin syytteistä. Tutkimuksessani olen osoittanut, millaisia vaikeuksia paluu sodanjälkeiseen arkeen tuotti naisille. Varsinkin yksin lastensa kanssa jääneillä oli monenlaisia ongelmia. Sodan aikana levitetty propaganda oli osaltaan lisäämässä vaikeuksia. Toisaalta työtilanne parantui monen naisen osalta jo vuoden 1918 aikana, ja oman punaisen yhteisön tarjoama tuki helpotti arjesta selviytymistä. Elämä tasaantui, naiset perustivat perheitä ja osa palasi työelämään ja politiikkaan. Säilyneiden lähteiden valossa sisällissota näyttäisi radikalisoineen vain pienen osan naisista, kun taas enemmistö kannatti maltillisia sosialidemokraatteja tai jäi kokonaan pois politiikasta. Punaiseksi leimautuminen valtiorikosoikeudessa ei pakottanut naisia muuttamaan uudelle paikkakunnalle; Porin seudulla ja yleensä vielä omassa suvussakin oli riittävästi entisiä punaisia luomassa kollektiivista tukea. Myös valtiovalta pyrki rauhoittamaan poliittista tilannetta ja sopeuttamaan punaisia yhteiskuntaan monin uudistuksin. Naisten kannalta merkittävin myönnytys tapahtui jatkosodan aikana, kun punalesket lopulta oikeutettiin valtiollisen eläkkeen piiriin. Tämä tutkimus on ensimmäinen punaisista naisista laadittu eräänlainen kollektiivinen elämäkerta, jossa on tarkasteltu heidän sodanjälkeistä elämäänsä. Yhteenvetona voidaan todeta, että Porin seudulta valtiorikosoikeuteen joutuneet naiset olivat tavallisia työläisnaisia. Sota ja osallisuus siihen ei tätä asiaa muuttanut. Naiset sopeutuivat yhteiskuntaan nopeasti ja elivät pääosin tavallista työläisperheen arkea sodan jälkeenkin.

Diet and Probiotics during Pregnancy - Endorsing developmental Programming

Maternal obesity has been shown to increase the risk for adverse reproductive health outcomes such as gestational diabetes, hypertension, and preeclampsia. Moreover, several studies have indicated that overnutrition and maternal obesity adversely program the development of offspring by predisposing them to obesity and other chronic diseases later in life. The exact molecular mechanisms leading to developmental programming are not known, but it has recently been suggested that obesity-related low-grade inflammation, gut microbiota and epigenetic gene regulation (in particularly DNA methylation) participate in the developmental programming phenomenon. The aim of this thesis was to evaluate the effect of diet, dietary counseling and probiotic intervention during pregnancy in endorsing favorable developmental programming. The study population consisted of 256 mother-child pairs participating in a prospective, double-blinded dietary counselling and probiotic intervention (Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb12) NAMI (Nutrition, Allergy, Mucosal immunology and Intestinal microbiota) study. Further overweight women were recruited from maternal welfare clinics in the area of Southwest Finland and from the prenatal outpatient clinic at Turku University Hospital. Dietary counseling was aimed to modify women’s dietary intake to comply with the recommended intake for pregnant women. Specifically, counseling aimed to affect the type of fat consumed and to increase the amount of fiber in the women’s diets. Leptin concentration was used as a marker for obesity-related low-grade inflammation, antioxidant vitamin status as an efficiency marker for dietary counselling and epigenetic DNA methylation of obesity related genes as a marker for probiotics influence. Results revealed that dietary intake may modify obesity-associated low-grade inflammation as measured by serum leptin concentration. Specifically, dietary fiber intake may lower leptin concentration in women, whereas the intakes of saturated fatty acids and sucrose have an opposite effect. Neither dietary counselling nor probiotic intervention modified leptin concentration in women, but probiotics tended to increase children’s leptin concentration. Dietary counseling was an efficient tool for improving antioxidant vitamin intake in women, which was reflected in the breast milk vitamin concentration. Probiotic intervention affected DNA methylation of dozens of obesity and weight gain related genes both in women and their children. Altogether these results indicate that dietary components, dietary counseling and probiotic supplementation during pregnancy may modify the intrauterine environment towards favorable developmental programming.