Nutrition and pubertal development

A behavioural change intervention study for the prevention of childhood obesity in South Africa: protocol for a randomized controlled trial

Background

South Africa is currently undergoing a nutrition transition, and overweight and obesity is on the increase in South African children. Urbanization and other health determinants have led to reduced physical activity and unhealthy eating that have increased the risk of adverse chronic health conditions. This study aims to provide evidence of the effectiveness of a school-based intervention study that targets diet and physical activity for the prevention of child and adolescent overweight and/or obesity.

Methods

We will employ a mixed method study design which is divided into two phases. Phase 1, namely the qualitative elicitation research phase will inform the development of the quantitative intervention phase (phase 2), consisting of a cluster-randomized trial, based on input from key stakeholders. The study will be undertaken in 16 government-funded primary schools in the iLembe district of KwaZulu-Natal, South Africa. The study will target learners in Grades 4 and 7, their parents, Life Orientation educators, school principals and members of school governing bodies. Assessment for the primary objective (BMI Z scores), and the secondary objectives (change in knowledge, attitudes and behaviours regarding diet and physical activity) in both study arms will be conducted at baseline in March 2020 and at the end of the study in October 2020.

Discussion

The study will be a novel combined mixed methods/RCT design that focuses on diet, physical activity school and family-based interventions in the context of rapidly increasing overweight and obesity prevalence in KwaZulu-Natal. To encourage behaviour change and management of malnutrition, education including diet and physical activity, is an important strategy that must be considered. Nutrition education extends beyond the dissemination of food information; it includes addressing the needs of participants, empowers and encourages decision-making and choice of foods, change in nutrition attitudes, beliefs and influences based on resources available and within cultural boundaries.

Trial registration

Pan African Clinical Trial Registry PACTR201711002699153. Protocol registered on 16 November 2017.

Profile of Overweight and Obesity in Children and Adolescents and Frequency of Type 2 Diabetes Mellitus and Glucose Intolerance: A Study in Public School in Brazil

OBJECTIVE

To verify if there is an increase in frequency of type 2 diabetes mellitus (DM2) and glucose intolerance in children and adolescents who are overweight and obese.

METHODS

This was a cross-sectional survey. The study population consisted of 2757 students of both sexes (1415 girls and 1342 boys) attending public schools in São Paulo state, Brazil,aged 10-19 years, from 2011 to 2012. Students not within this age range and those with type 1 diabetes mellitus were excluded. Upon interview, anthropometry, capillary blood glucose testing, fasting glucosemia (FG) and glucosemia 2 hours after 75 g of dextrose (AD) variables were obtained. We emphasize that, inspite of the 2757 students included in the next stage, only 88 students agreed to participate, and low compliance of those participants is due to the fact that they were children and adolescents who depend on the authorization of their parents or tutors, who have demonstrated deficient knowledge of familial chronic diseases such as obesity and its consequences, and the risk of DM2.

RESULTS

More often girls, 1415 (51.3%). A total of 27.3% was overweight/obese/severely obese. Capillary blood glucose testing was performed in 88 (3.2%) children and adolescents with low values of glycemic results after the glucose load. There was no statistical significance between sex and glucosemia, with an average FG and AD of 92.8 mg/dL (male), 91.8 mg/dL (female) and 89.1 mg/dL (male) and 88.9 mg/dL (female), respectively.

CONCLUSION

This survey emphasizes that more attention should be paid to diet interventions and practicing of physical activities demanding habit changes and acquisition of special behaviour for self-care, and provision of a better educational health program, suggesting the effective participation of the family.

Weight Loss and Illness Severity in Adolescents With Atypical Anorexia Nervosa

BACKGROUND

Lower weight has historically been equated with more severe illness in anorexia nervosa (AN). Reliance on admission weight to guide clinical concern is challenged by the rise in patients with atypical anorexia nervosa (AAN) requiring hospitalization at normal weight.

METHODS

We examined weight history and illness severity in 12- to 24-year-olds with AN (n = 66) and AAN (n = 50) in a randomized clinical trial, the Study of Refeeding to Optimize Inpatient Gains (www.clinicaltrials.gov; NCT02488109). Amount of weight loss was the difference between the highest historical percentage median BMI and admission; rate was the amount divided by duration (months). Unpaired t tests compared AAN and AN; multiple variable regressions examined associations between weight history variables and markers of illness severity at admission. Stepwise regression examined the explanatory value of weight and menstrual history on selected markers.

RESULTS

Participants were 16.5 ± 2.6 years old, and 91% were of female sex. Groups did not differ by weight history or admission heart rate (HR). Eating Disorder Examination Questionnaire global scores were higher in AAN (mean 3.80 [SD 1.66] vs mean 3.00 [SD 1.66]; P = .02). Independent of admission weight, lower HR (β = -0.492 [confidence interval (CI) -0.883 to -0.100]; P = .01) was associated with faster loss; lower serum phosphorus was associated with a greater amount (β = -0.005 [CI -0.010 to 0.000]; P = .04) and longer duration (β = -0.011 [CI -0.017 to 0.005]; P = .001). Weight and menstrual history explained 28% of the variance in HR and 36% of the variance in serum phosphorus.

CONCLUSIONS

Weight history was independently associated with markers of malnutrition in inpatients with restrictive eating disorders across a range of body weights and should be considered when assessing illness severity on hospital admission.

Early menarche and blood pressure in adulthood: systematic review and meta-analysis

Background

It has been reported that early menarche is associated with high blood pressure and hypertension. However, some studies have failed to observe such association. We carried out a systematic review and meta-analysis on the association of early menarche with hypertension and high blood pressure in adulthood.

Methods

PUBMED, SciELO, Scopus and LILACS databases were searched. Studies that evaluated the association of early menarche with hypertension or high blood pressure, among women aged 20 years or more were included. Random effects models were used to pool the estimates. Meta-regression was used to evaluate the contribution of different co-variables to heterogeneity.

Results

We identified 17 studies with 18 estimates on the association of early menarche with hypertension and high blood pressure. The odds of hypertension/high blood pressure was higher among women with early menarche [pooled (OR):1.25; 95% confidence interval (CI): 1.17-1.34; P < 0.001]. In the meta-regression analysis, studies evaluating 1500 subjects or more had a higher pooled OR [1.27; 95%CI (1.19;1.36)] than those with less participants. Although funnel plots showed some asymmetry, Egger tests were not statistically significant. Therefore, it is unlikely that the observed association was to publication bias.

Conclusions

Early menarche is associated with hypertension among adult woman.

Evaluation of a Technological Image-Based Dietary Assessment Tool for Children during Pubertal Growth: A Pilot Study

We designed an image-based dietary assessment tool called COFIT, which means “fit together” and pilot-tested it in the Taipei Puberty Longitudinal Study (TPLS). Children aged 6–17 years were invited to use COFIT over three days for recording all instances of eating in addition to maintaining written food records (FR). Spearman’s correlation and Bland–Altman analysis were used to compare the intake of macronutrients and micronutrients estimated using the image-based dietary assessment and the FR method. Intra-class correlation coefficients were used to estimate reliability between dietitians. In the final analysis, 23 children (mean age: 10.47 ± 0.47 years) with complete data obtained using two dietary assessment methods were included. Reliability among dietitians was high. Most assessments of macronutrients and micronutrients revealed moderate correlations between the two methods (range: 0.27–0.94); moreover, no significant differences in nutrients assessments were observed between the two methods, except for energy and fat. The average difference in energy intake between the methods was 194 kcal/day. Most limits of agreement were within an acceptable range. The Bland–Altman plots showed robust agreement with minimum bias. The limitation was the small sample size and not dividing the population into children and teenagers since the two groups may have different food consumption habits. Overall, the results showed that the image-based assessment tool is suitable for assessing children’s dietary intake of macronutrients and micronutrients during pubertal growth.

Evaluation of plasma and erythrocyte fatty acids C15:0, t-C16:1n-7 and C17:0 as biomarkers of dairy fat consumption in adolescents

INTRODUCTION

Pentadecanoic (C15:0), heptadecanoic (C17:0) and trans-palmitoleic (t-C16:1n-7) fatty acids (FAs) are often used as biomarkers for dairy fat in adults. This study aimed to investigate the relationship between dairy product intake and these FAs in adolescents.

MATERIAL AND METHODS

Healthy adolescents were randomized to one of three groups (Group 1: control; Group 2: consume 3 dairy servings/day; and Group 3: consume ≥ 4 servings/d). C15:0, C17:0 and t-C16:1n-7 were quantified using gas chromatography. Dietary intakes were assessed by 24 h diet recalls.

RESULTS

No difference was observed in FAs at baseline or 6 months (mo), however, at 12 mo, erythrocyte C15:0 increased in group 3 (+0.37 µg/ml, p = 0.01). Dairy intake increased in both intervention groups (Group 2: +1.4 servings/d; Group 3: +2.4 servings/d, p < 0.0001) and positively correlated with erythrocyte C15:0 at 12 mo.

CONCLUSION

Erythrocyte FAs appear to be associated with increasing dairy intakes during adolescence.

Affective reactivity during adolescence: Associations with age, puberty and testosterone

Adolescence is a period of heightened social engagement that is accompanied by normative changes in neural reactivity to affective stimuli. It is also a period of concurrent endocrine and physical changes associated with puberty. A growing body of research suggests that hormonal shifts during adolescence impact brain development, but minimal research in humans has examined the relationship between intra-individual changes in puberty and brain function. The current study examines linear and nonlinear changes in affective reactivity in a longitudinal sample of 82 adolescents who underwent three fMRI sessions between the ages of 9 and 18 years. Changes in response to affective facial stimuli were related to age, pubertal stage, and testosterone levels. Using multilevel modeling, we highlight extensive nonlinear development of socio-emotional responsivity across the brain. Results include mid-pubertal peaks in amygdala and hippocampus response to fearful expressions, as well as sex differences in regions subserving social and self-evaluative processes. However, testosterone levels exhibited inverse patterns of association with neural response compared to pubertal stage in females (e.g., U-shaped relationship with the amygdala and hippocampus). Findings highlight potentially unique roles of age, pubertal stage and testosterone on socio-emotional development during adolescence, as well as sex differences in these associations.

Dietary Intake of Selenium in Relation to Pubertal Development in Mexican Children

Alterations in pubertal timing have been associated with long-term health outcomes. While a few reports have shown that dietary intake of selenium is associated with fertility and testosterone levels in men, no human studies have considered the association between selenium and pubertal development in children. We examined the cross-sectional association of childhood dietary intake of selenium with pubertal development among 274 girls and 245 boys aged 10–18 years in Mexico City. Multiple logistic and ordinal regression models were used to capture the association between energy-adjusted selenium intake (below Recommended Dietary Allowance (RDA) vs. above RDA) and stages of sexual maturity in children, adjusted for covariates. We found that boys with consumption of selenium below the RDA had lower odds of a higher stage for pubic hair growth (odds ratio (OR) = 0.51, 95% confidence interval (95% CI): 0.27–0.97) and genital development (OR = 0.53, 95% CI: 0.28–0.99) as well as a lower probability of having matured testicular volume (OR = 0.37, 95% CI: 0.15–0.88) compared with boys who had adequate daily dietary intake of selenium (above RDA). No associations were found in girls. According to our results, it is possible that inadequate consumption of selenium may be associated with later pubertal development in boys, suggesting a sex-specific pattern. Future work with a larger sample size and measures of selenium biomarkers is needed to confirm our findings and improve understanding of the role of this mineral in children’s sexual development.

Relationship between early-life nutrition and ages at menarche and first pregnancy, and childbirth rates of young adults: Evidence from APCAPS in India

India's Integrated Child Development Services (ICDS) provides daily supplementary nutrition and other public health services to women and children. We estimated associations between exposure to early‐childhood ICDS nutrition and adult reproductive outcomes. During 1987–1990, a balanced protein–calorie supplement called “upma”—made from locally available corn–soya ingredients—was rolled out by subdistricts near Hyderabad and offered to pregnant women and children under age 6 years. In a controlled trial, 15 villages received the supplement and 14 did not. We used data from a 2010–2012 resurvey of adults born during the trial (n = 715 in intervention and n = 645 in control arms). We used propensity score matching methods to estimate the associations between birth in an intervention village and menarcheal age, age at first pregnancy, and fertility of adults. We found that women born in the intervention group during the trial, as compared with the control group, had menarche 0.45 (95% confidence interval [CI: 0.22, 0.68]; p < .001) years later and first pregnancy 0.53 (95% CI [0.04, 1.02]; p < .05) years later. Married women from the intervention group had menarche 0.36 (95% CI [0.09, 0.64]; p < .01) years later, first cohabitation with partner 0.8 (95% CI [0.27, 1.33]; p < .01) years later, and first pregnancy 0.53 (95% CI [0.04, 1.02]; p < .05) years later than married women in the control group. There was no significant difference between intervention and control group women regarding whether they had at least one childbirth or the total number of children born. The findings were similar when we employed inverse propensity score weighted regression models.

Associations between maternal age at menarche and anthropometric and metabolic parameters in the adolescent offspring

OBJECTIVE

We examined the associations between maternal age at menarche and anthropometry and metabolism in adolescent offspring.

METHODS

Anthropometric, metabolic and blood pressure data were obtained from 304 girls and 190 boys aged 11-16 years attending school in Hangzhou (China). Age at menarche for both mothers and daughters was self-reported. Fasting blood samples were obtained and all participants underwent clinical examinations. Obesity was defined as BMI ≥95th percentile for age and sex.

RESULTS

Older maternal age at menarche was associated with older age of their daughters at menarche (r = 0.21; P < 0.001). Mother's age at menarche was not associated with anthropometry or metabolism of daughters. However, younger maternal age at menarche was associated with increased hip and waist circumferences, and BMI SDS of their sons. Boys whose mothers were ≤13 years at menarche had an adjusted relative risk of obesity 3-fold greater than sons of mothers with a later menarcheal onset (2.96; 95% CI 1.49, 5.87). Among daughters, every 1-year increase in their age at menarche was associated with a 0.34 SDS reduction in BMI. Increasing age at menarche was also associated with reduced waist and hip circumferences (-1.5 and -1.8 cm/y, respectively) and waist-to-height ratio (-0.008 per year). Girls in the youngest menarcheal age tertile (8.8-11.6 years) had diastolic blood pressure 2.2 mm Hg higher than other girls (P = 0.029).

CONCLUSIONS

Younger maternal age at menarche is associated with increased obesity risk in their sons, but not daughters. However, girls who experience menarche earlier have a less favourable anthropometric profile.

Makorin 1 is required for Drosophila oogenesis by regulating insulin/Tor signaling

Reproduction is a process that is extremely sensitive to changes in nutritional status. The nutritional control of oogenesis via insulin signaling has been reported; however, the mechanism underlying its sensitivity and tissue specificity has not been elucidated. Here, we determined that Drosophila Makorin RING finger protein 1 gene (Mkrn1) functions in the metabolic regulation of oogenesis. Mkrn1 was endogenously expressed at high levels in ovaries and Mkrn1 knockout resulted in female sterility. Mkrn1-null egg chambers were previtellogenic without egg production. FLP-FRT mosaic analysis revealed that Mkrn1 is essential in germline cells, but not follicle cells, for ovarian function. As well, AKT phosphorylation via insulin signaling was greatly reduced in the germline cells, but not the follicle cells, of the mutant clones in the ovaries. Furthermore, protein-rich diet elevated Mkrn1 protein levels, without increased mRNA levels. The p-AKT and p-S6K levels, downstream targets of insulin/Tor signaling, were significantly increased by a nutrient-rich diet in wild-type ovaries whereas those were low in Mkrn1^exS compared to wild-type ovaries. Taken together, our results suggest that nutrient availability upregulates the Mkrn1 protein, which acts as a positive regulator of insulin signaling to confer sensitivity and tissue specificity in the ovaries for proper oogenesis based on nutritional status.

Normative range of blood biochemical parameters in urban Indian school-going adolescents

Adolescence is the most critical phase of human growth that radically alters physiology of the body and wherein any inconsistency can lead to serious health consequences in adulthood. The timing and pace at which various developmental events occur during adolescence is highly diverse and thus results in a drastic change in blood biochemistry. Monitoring the physiological levels of various biochemical measures in ample number of individuals during adolescence can call up for an early intervention in managing metabolic diseases in adulthood. Today, only a couple of studies in different populations have investigated blood biochemistry in a small number of adolescents however, there is no comprehensive biochemical data available worldwide. In view, we performed a cross-sectional study in a sizeable group of 7,618 Indian adolescents (3,333 boys and 4,285 girls) aged between 11–17 years to inspect the distribution of values of common biochemical parameters that generally prevails during adolescence and we observed that various parameters considerably follow the reported values from different populations being 3.56–6.49mmol/L (fasting glucose), 10.60–199.48pmol/L (insulin), 0.21–3.22nmol/L (C–peptide), 3.85–6.25% (HbA₁c), 2.49–5.54mmol/L (total cholesterol), 1.16–3.69mmol/L (LDL), 0.78–1.85mmol/L (HDL), 0.33–2.24mmol/L (triglycerides), 3.56–11.45mmol/L (urea), 130.01–440.15μmol/L (uric acid) and 22.99–74.28μmol/L (creatinine). Barring LDL and triglycerides, all parameters differed significantly between boys and girls (p< 0.001). Highest difference was seen for uric acid (p = 1.3 x10^-187) followed by C–peptide (p = 6.6 x10^-89). Across all ages during adolescence, glycemic and nitrogen metabolites parameters varied markedly with gender. Amongst lipid parameters, only HDL levels were found to be significantly associated with gender following puberty (p< 0.001). All parameters except urea, differed considerably in obese and lean adolescents (p< 0.0001). The present study asserts that age, sex and BMI are the essential contributors to variability in blood biochemistry during adolescence. Our composite data on common blood biochemical measures will benefit future endeavors to define reference intervals in adolescents especially when the global availability is scarce.

Disorders of Puberty in Severely Neurologically Impaired Children: Is Delayed Puberty an Underestimated Problem?

Introduction: In children with disabilities, precocious puberty (PP) has been reported, however there is a paucity of studies on delayed puberty (DP) in neurologically impaired (NI) children. Patients and Methods: We retrospectively evaluated 65 patients with severe disabilities (6-18 years). DP was considered whenever the following criteria where satisfied, respectively, for girls and boys, absence of breast development by age 13 or menarche by age 15, absence of at least 4 mL testicular growth volume or 2.5 cm length by age 14. PP was defined as the presence of puberty signs at <8 and 9 years of age, respectively, for girls and boys. In all patients, a physical examination was performed and a family history of DP was obtained. A hormonal panel was evaluated when puberty disorders were detected. As a control group we evaluated 50 age-matched healthy subjects. Results: Puberty disorders were observed in 12 NI patients and in one control (18.5 vs. 2%, p < 0.01). DP was detected in 8 NI subjects (3M/5F) and in one healthy boy (p = 0.04), without differences between genders among patients from the NI group (p = 0.2), and compared with the controls (p = 0.4). In five of the eight NI subjects, Tanner stage 1 was observed; in three subjects adrenarche was present without pubertal progression for more than 2 years. Low levels of gonadotropins were detected in all NI subjects with DP. The number of subjects with a BMI <-3SDS was higher in NI patients with DP compared to NI subjects with normal puberty (p < 0.01); normal weight was detected in one healthy boy. The family history for pubertal delay was negative in all NI patients with DP and positive in the control subject. Conclusion: NI children and adolescents may experience delayed pubertal changes. An endocrinological follow-up with pubertal development monitoring is strongly recommended in order to evaluate whether targeted interventions may improve outcomes.

Practice and lived experience of menstrual exiles (Chhaupadi) among adolescent girls in far-western Nepal

Background

Menstrual exile, also known as Chhaupadi, is a tradition of “untouchability” in far-western Nepal. Forbidden from touching other people and objects, women and girls are required to live away from the community, typically in a livestock shed, during menstruation. We assessed the lived experiences of Chhaupadi among Nepalese adolescent girls in the far-western Achham district of Nepal, observed the safety and sanitation of their living spaces during Chhaupadi, and assessed the perceptions of local adult stakeholders towards the practice of Chhaupadi.

Methods

We collected data from 107 adolescent girls using a self-administered survey in two local schools in Achham. We also conducted a focus group discussion with seven girls, held key informant interviews, and observed the girls’ living spaces during Chhaupadi, using a checklist. Descriptive statistics of the quantitative survey and thematic analyses of qualitative interviews are presented.

Results

The majority of the girls (n = 77, 72%) practiced exile, or Chhaupadi, during their menstruation, including 3 (4%) exiled to traditional Chhau sheds, 63 (82%) to livestock sheds, and 11 (14%) to courtyards outside their home. The remaining girls (n = 30, 28%) stayed inside the house, yet practiced some form of menstrual taboos. Of the 77 observed living spaces where the girls stayed during exile, only 30% (n = 23) had a toilet facility. Most exiled girls (97.4%) were restricted from eating dairy products. Participants reported having various psychological problems, including lonliness and difficulty sleeping while practicing Chhaupadi. Three of the girls were physically abused; nine were bitten by a snake. Notably high proportions of the living spaces lacked ventilation/windows (n = 20, 26%), electricity (n = 29, 38%), toilets (n = 54, 70%) and a warm blanket and mattress for sleeping (n = 29, 38%). Our qualitative findings supported our quantitative results.

Conclusions

Chhaupadi has been condemned by human rights organizations. While the government has banned the practice, implementation on the ban is proceeding slowly, especially in far-western Nepal. Thus, as a temporary measure, public health professionals must work towards promoting the health and safety of Nepalese women and girls still practicing Chhaupadi.

Distinguishing between endocrine disruption and non-specific effects on endocrine systems

The endocrine system is responsible for growth, development, maintaining homeostasis and for the control of many physiological processes. Due to the integral nature of its signaling pathways, it can be difficult to distinguish endocrine-mediated adverse effects from transient fluctuations, adaptive/compensatory responses, or adverse effects on the endocrine system that are caused by mechanisms outside the endocrine system. This is particularly true in toxicological studies that require generation of effects through the use of Maximum Tolerated Doses (or Concentrations). Endocrine-mediated adverse effects are those that occur as a consequence of the interaction of a chemical with a specific molecular component of the endocrine system, for example, a hormone receptor. Non-endocrine-mediated adverse effects on the endocrine system are those that occur by other mechanisms. For example, systemic toxicity, which perturbs homeostasis and affects the general well-being of an organism, can affect endocrine signaling. Some organs/tissues can be affected by both endocrine and non-endocrine signals, which must be distinguished. This paper examines in vitro and in vivo endocrine endpoints that can be altered by non-endocrine processes. It recommends an evaluation of these issues in the assessment of effects for the determination of endocrine disrupting properties of chemicals. This underscores the importance of using a formal weight of evidence (WoE) process to evaluate potential endocrine activity.

Puberty and the human brain: Insights into adolescent development

Alongside the exponential flourish of research on age-related trajectories of human brain development during childhood and adolescence in the past two decades, there has been an increase in the body of work examining the association between pubertal development and brain maturation. This review systematically examines empirical research on puberty-related structural and functional brain development in humans, with the aim of identifying convergent patterns of associations. We emphasize longitudinal studies, and discuss pervasive but oft-overlooked methodological issues that may be contributing to inconsistent findings and hindering progress (e.g., conflating distinct pubertal indices and different measurement instruments). We also briefly evaluate support for prominent models of adolescent neurodevelopment that hypothesize puberty-related changes in brain regions involved in affective and motivational processes. For the field to progress, replication studies are needed to help resolve current inconsistencies and gain a clearer understanding of pubertal associations with brain development in humans, knowledge that is crucial to make sense of the changes in psychosocial functioning, risk behavior, and mental health during adolescence.

The prevalence of malnutrition based on anthropometry among primary schoolchildren in Binh Dinh province, Vietnam in 2016

Objective

The study was conducted to determine the prevalence of malnutrition based on anthropometry among primary schoolchildren in Binh Dinh province, Vietnam.

Material and Methods

This was a school-based cross-sectional survey using random sample technique with multistage process. Variables in malnutrition were classifed as thinness, stunting, underweight, overweight, and obesity based on z-scores according to the World Health Organization (WHO) (2007). Anthropometric measurements were taken according to WHO's standard procedures. The Chi-square test was used to compare prevalences and the Chi-square test for trend was employed to assess the trend of the prevalence of malnutrition forms by age.

Results

6,514 pupils from 6 to 10 years old including 3,298 males and 3,216 females were observed. The prevalence of thinness, stunting, underweight, overweight and obesity among schoolchildren accounted for 11.19%, 6.16%, 10.79%, and 30.1%, respectively. The prevalence of underweight and that of overweight-obesity of all pupils at the age of 6 were 13.1% and 32.11%, respectively, and tended to decrease to age 10 (p < 0.01). The prevalence of thin and stunted pupils had little sign of change over ages (p > 0.05). There was a statistically significant difference in the prevalence of malnutrition in three areas of Binh Dinh (p < 0.05), in which the highest prevalence of undernutrition was in mountainous area and midland, and the highest prevalence of overweight-obesity was in urban areas.

Conclusion

The prevalence of malnutrition of primary schoolchildren in Binh Dinh was relatively high, in which the prevalence of overweight-obesity was rather high in urban areas and the prevalence of undernutrition was pretty high in mountainous area and midland. This study has characterized an important public health challenge, highlighting the need for attention to potential interventions.

Theory-informed nutrition education curriculum Tools For Feeling Good promotes healthy eating patterns among fifth grade pupils: cross-sectional study

BACKGROUND

The eating patterns of school-aged children rarely meet recommendations: meal frequency is irregular and the consumption of vegetables is lower and sugar-sweetened products higher than recommended. Although school is an excellent arena for nutrition education to support pupils eating patterns, teachers usually lack efficient tools. The present study aimed to develop a curriculum for nutrition education to be used by teachers and to examine its efficacy in the school environment with respect to the eating patterns of pupils.

METHODS

The curriculum was developed in collaboration with school teachers using self-determination theory as a theoretical standpoint. The Health at Every Size concept and sensory-based food education were utilised in the curriculum. Self-reported questionnaires were used to assess the feasibility and impact of the curriculum. Fourteen teachers implemented the curriculum during 2012-2013 with 194 pupils aged 10-13 years (fifth and sixth grades). The control schools included 140 pupils of the same age not following the curriculum.

RESULTS

The teachers reported that the curriculum was easy to integrate in the school environment. The fifth graders improved their breakfast frequency, increased their consumption of vegetables and reduced their consumption of ice cream, sweets and sugar-sweetened drinks. No improvement was found in the fifth graders at the control schools. In the sixth graders, no dietary changes were detected in the intervention or control schools.

CONCLUSIONS

The pupils in the fifth grade appeared to comprise a responsive target group for nutrition education at schools. The curriculum offers a promising approach for developing healthy eating patterns among fifth graders. Collaboration with teachers in developing the curriculum likely enhanced its feasibility and teacher commitment for implementation.

Prevalence of obesity, overweight, underweight, and stunting among school children in Argo city, Northern Sudan

School children pass through great physical and mental changes, which affect both their growth and school performance. We aim at determining the prevalence of obesity, overweight, underweight, and stunting among the primary school children in Argo city, Northern Sudan. This cross-section study recruited all primary school children aged 6 to 14 years in the city. Out of 1,387 participants, 1,223 were enrolled in the study (88.2%). The rest were excluded because of age over 14 years or parental refusal to participate in the study. Growth analysis of this cohort showed that 19 children (1.5%) were obese, 76 (6.2%) overweight, 56 (4.6%) underweight, 45 (3.7%) severely underweight, and 46 (3.8%) children were stunted. These findings indicate that establishing intervention measures to prevent risk factors leading to obesity and overweight is highly needed.

A High Fat Diet during Adolescence in Male Rats Negatively Programs Reproductive and Metabolic Function Which Is Partially Ameliorated by Exercise

An interaction between obesity, impaired glucose metabolism and sperm function in adults has been observed but it is not known whether exposure to a diet high in fat during the peri-pubertal period can have longstanding programmed effects on reproductive function and gonadal structure. This study examined metabolic and reproductive function in obese rats programmed by exposure to a high fat (HF) diet during adolescence. The effect of physical training (Ex) in ameliorating this phenotype was also assessed. Thirty-day-old male Wistar rats were fed a HF diet (35% lard w/w) for 30 days then subsequently fed a normal fat diet (NF) for a 40-day recovery period. Control animals were fed a NF diet throughout life. At 70 days of life, animals started a low frequency moderate exercise training that lasted 30 days. Control animals remained sedentary (Se). At 100 days of life, biometric, metabolic and reproductive parameters were evaluated. Animals exposed to HF diet showed greater body weight, glucose intolerance, increased fat tissue deposition, reduced VO_2max and reduced energy expenditure. Consumption of the HF diet led to an increase in the number of abnormal seminiferous tubule and a reduction in seminiferous epithelium height and seminiferous tubular diameter, which was reversed by moderate exercise. Compared with the NF-Se group, a high fat diet decreased the number of seminiferous tubules in stages VII-VIII and the NF-Ex group showed an increase in stages XI-XIII. HF-Se and NF-Ex animals showed a decreased number of spermatozoa in the cauda epididymis compared with animals from the NF-Se group. Animals exposed to both treatments (HF and Ex) were similar to all the other groups, thus these alterations induced by HF or Ex alone were partially prevented. Physical training reduced fat pad deposition and restored altered reproductive parameters. HF diet consumption during the peri-pubertal period induces long-term changes on metabolism and the reproductive system, but moderate and low frequency physical training is able to recover adipose tissue deposition and reproductive system alterations induced by high fat diet. This study highlights the importance of a balanced diet and continued physical activity during adolescence, with regard to metabolic and reproductive health.

Early life undernutrition and adult height: The Dutch famine of 1944-45

Current research shows strong associations between adult height and several positive outcomes such as higher cognitive skills, better earning capacity, increased chance of marriage and better health. It is therefore relevant to investigate the determinants of adult height. There is mixed evidence on the effects of undernutrition during early life on adult height. Therefore, our study aims at assessing the impact of undernutrition during gestation and at ages younger than 15 on adult height. We used data from the Longitudinal Aging Study Amsterdam. Exposure to undernutrition was determined by place of residence during the Dutch famine during World War II. Included respondents were born between 15 May 1930 and 1 November 1945 and lived in the northern part of the Netherlands during the famine period (n=1008). Exposure data was collected using interviews and questionnaires and adult height was measured. Exposed and non-exposed respondents were classified in the age categories pregnancy- age 1 (n=85), age 1-5 (n=323), age 6-10 (n=326) or puberty (age 11-15, n=274). Linear regression analyses were used to test the associations of adult height with exposure. The robustness of the regression results was tested with sensitivity analyses. In the models adjusted for covariates (i.e., number of siblings, education level of parents, and year of birth) and stratified by gender, adult height was significantly shorter for females exposed at ages younger than 1 (-4.45cm [-7.44--1.47]) or at ages younger than 2 (-4.08cm [-7.20--0.94]). The results for males were only borderline significant for exposure under age 1 (-3.16 [-6.82-0.49]) and significant for exposure under age 2 (-4.09cm [-7.20--0.96]). Exposure to the Dutch famine at other ages was not consistently significantly associated with adult height. In terms of public health relevance, the study's results further underpin the importance of supporting pregnant women and young parents exposed to undernutrition.

Identification of differential genomic DNA Methylation in the hypothalamus of pubertal rat using reduced representation Bisulfite sequencing

BACKGROUND

There are many variables affecting the onset of puberty in animals, including genetic, nutritional, and environmental factors. Recent studies suggest that epigenetic regulation, especially DNA methylation, plays a majorrole in the regulation of puberty. However, there have been no reports on DNA methylation of the pubertal genome.

METHODS

We investigated DNA methylation in the female rat hypothalamus at prepuberty and puberty using reduced representation bisulfite sequencing technology. The identified genes and signaling pathways exhibiting changes to DNA methylation in pubertal rats were determined by Gene Ontogeny and Kyoto Encyclopedia of Genes and Genomes analysis.

RESULTS

The distribution of the three types of methylated C bases in promoter and CpG island (CGI) regions in the hypothalamus was as follows: 87.79% CG, 3.05% CHG, 9.16% CHH for promoters, and 88.35% CG, 3.21% CHG, 88.35% CHH for CGI in prepubertal rats; and 90.78% CG, 2.13% CHG, 7.09% CHH for promoters, and 88.59% CG, 88.59% CHG, 8.35% CHH for CGI in pubertal animals. CG showed the highest percentage of methylation, and was the highest methylation state in CGI. Compared to prepubertal hyoyhalamus samples, we identified ten genes with altered methylation in promoter regions in the pubertal hypothalamus samples, and 43 genes with altered methylation in the CGI. Changes in DNA methylation were found in gonadotropin-releasing hormone signaling pathways, and the oocyte meiosis pathway.

CONCLUSION

Our results demonstrate changes in DNA methylation occur in female rats from prepuberty to puberty suggestng DNA methylation may play a crucial role in the regulation of puberty onset. This study provides essential information for future studies on the role of epigenetics in the regulation of puberty.

Helicobacter pylori infection and serum leptin, obestatin, and ghrelin levels in Mexican schoolchildren

BackgroundThere is little information about the possible role of Helicobacter pylori infection on appetite-regulating peptides in children. This study evaluated the association between H. pylori infection and serum levels of ghrelin, leptin, and obestatin in schoolchildren.MethodsOne hundred seventy-eight schoolchildren, students at boarding schools in Mexico City, participated. H. pylori infection status was determined every 6 months for 1 year by a breath test using ¹³C-urea; schoolchildren with consistently positive or negative results were selected to participate. Age, sex, and body mass index (BMI) were recorded. Serum concentrations of total ghrelin, leptin, and obestatin via specific enzyme-linked immunosorbent assays were determined.ResultsSchoolchildren with H. pylori infection had lower concentration of leptin, -0.54 pg/ml (95% CI: -0.98 to -0.09), compared to the schoolchildren without infection, after adjustment by age, gender, and BMI. And the children with the infection had a median of obestatin lower in 0.99 ng/ml (95% CI: -1.93 to -0.06) compared with the uninfected children after adjustment by BMI.ConclusionAssociation was found between H. pylori infection and decreased serum concentrations of leptin and obestatin. These results suggest that in schoolchildren, H. pylori infection affects the levels of hormones implicated in regulating appetite and energy homeostasis.

Dietary Patterns Exhibit Sex-Specific Associations with Adiposity and Metabolic Risk in a Cross-Sectional Study in Urban Mexican Adolescents

Background: Studies in Western nations have shown associations of certain dietary patterns with obesity and metabolic risk in youth. Little is known about these relations in newly industrialized countries where obesity prevalence is surpassing those of developed countries.Objective: We sought to characterize dietary patterns in a cross-sectional study in 224 adolescents aged 8-14 y in Mexico and to investigate associations of the dietary patterns with adiposity and metabolic risk.Methods: We used principal components analysis to derive dietary patterns from food-frequency questionnaire data. By using linear regression models that accounted for mother's marital status, education, and smoking habits and child's age and physical activity, we examined associations of the dietary patterns with adiposity [body mass index z score, waist circumference, the sum and ratio of the subscapular and triceps skinfold thicknesses, blood pressure, serum fasting glucose and a C-peptide-based measure of insulin resistance (CP-IR), lipid profile, and a metabolic syndrome risk z score (MetS z score)].Results: We identified a "prudent" dietary pattern characterized by high intakes of vegetables, fruit, fish, chicken, and legumes and a "transitioning" dietary pattern, which comprises processed meats, Mexican foods, and sweetened beverages. Each unit increase in the prudent pattern factor score corresponded with 0.33 ng/mL (95% CI: 0.09, 0.57 ng/mL) lower C-peptide, 0.08 units (95% CI: 0.02, 0.13 units) lower CP-IR, and a 0.14 unit (0.00, 0.27 unit) lower MetS z score in boys. In girls, the transitioning pattern corresponded with higher subscapular + triceps skinfold thickness (per 1-unit increase in the factor score: 2.46 mm; 95% CI: 0.10, 4.81 mm). These results did not change after accounting for pubertal status.Conclusions: A prudent dietary pattern was protective against metabolic risk in adolescent boys, whereas a transitioning dietary pattern corresponded with higher adiposity among adolescent girls. Given that adolescence is a key developmental period for long-term health, efforts to elucidate dietary determinants of metabolic risk during this life stage may have long-term benefits.

Comparison of Tanner staging of HIV-infected and uninfected girls at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria

BACKGROUND

A number of factors influence sexual maturation in adolescents, including chronic illnesses like HIV. Marshall and Tanner devised a method of classifying the adolescent based on the level of sexual maturation into five stages. This study compared the Tanner staging of HIV-infected and uninfected girls.

METHODS

This was a cross-sectional study of 100 HIV-infected girls aged 8-18 years and 100 uninfected counterparts matched for age and social class. Using standard photographs as a guide, stages of sexual maturation were determined according to the method proposed by Marshall and Tanner. Data analysis was done with SPSS version 20. p-values <0.05 were regarded as significant.

RESULTS

The study participants were aged 8-17 years. Fifty-five subjects compared to 39 controls were still in pre-pubertal breast developmental stages while 45 subjects (45%) compared to 61 controls (61%) have commenced breast development (p=0.024). Similarly, 52 subjects compared to 31 controls were in the pre-pubertal pubic hair developmental stages, while 48 subjects (48%) compared to 69 controls (69%) had commenced pubic hair development (p=0.003).

CONCLUSIONS

Perinatal HIV infection affected the onset of pubic hair and breast development but did not significantly affect the attainment of sexual maturation.

Identifying Eating Occasion-Based Opportunities to Improve the Overall Diets of Australian Adolescents

Adolescents in Australia have a poor dietary intake, leading to large numbers of them being at risk for inadequate intake of micronutrients, and excessive intake of less healthful dietary components. This study examined dietary intakes at multiple eating occasions to identify opportunities for more targeted recommendations and strategies to improve dietary intakes among adolescents. Data from the first 24-h recall of 14-18 years old in the 2011-2012 National Nutrition and Physical Activity Survey were analysed (n = 772). Participant-defined eating occasions were classified as breakfast, lunch, dinner or other eating occasions combined. The mean percent contribution to the total day intake of top shortfall nutrients (calcium, magnesium, vitamin A, iron), discretionary calories, saturated fat, free sugars and sodium, as well as nutrient density, the foods consumed and the percent of consumers at each eating occasion, were calculated. Breakfast had the lowest prevalence of consumers (81%), contributed the least to total daily energy (14.6%) and almost a quarter of daily calcium and iron. Other eating occasions combined contributed 47.5% of free sugars and were top contributors of daily calcium (34.6%) and magnesium (31.7%). Discretionary foods contributed 32.4% of the energy at lunch, and the sodium content at lunch was 415 mg/1000 kJ. Key opportunities identified for adolescents were to increase breakfast consumption, given the high nutrient densities of breakfasts consumed; improve overall lunch quality, particularly the sodium content; promote the intake of milk, fruit and a variety of vegetables at both lunch and dinner; maintain healthful choices at in-between meal eating occasions while focusing on decreasing the intake of discretionary foods.

Prospective associations of meat consumption during childhood with measures of body composition during adolescence: results from the GINIplus and LISAplus birth cohorts

BACKGROUND

Higher meat and protein intakes have been associated with increased body weight in adults, but studies evaluating body composition are scarce. Furthermore, our knowledge in adolescents is limited. This study aimed to investigate the prospective associations of intakes of different meat types, and their respective protein contents during childhood, with body composition during adolescence.

METHODS

Dietary (using food frequency questionnaires) and body composition (measured by bioelectrical impedance) data were collected from the 10- and 15-year follow-up assessments respectively, of the GINIplus and LISAplus birth cohort studies. Sex-stratified prospective associations of meat and meat protein intakes (total, processed, red meat and poultry) with fat mass index (FMI) and fat free mass index (FFMI), were assessed by linear regression models (N = 1610).

RESULTS

Among males, higher poultry intakes at age 10 years were associated with a higher FMI at age 15 years [β = 0.278 (SE = 0.139), p = 0.046]; while higher intakes of total and red meat were prospectively associated with higher FFMI [0.386 (0.143), p = 0.007, and 0.333 (0.145), p = 0.022, respectively]. Additionally in males, protein was associated with FFMI for total and red meat [0.285 (0.145) and 0.356 (0.144), respectively].

CONCLUSIONS

Prospective associations of meat consumption with subsequent body composition in adolescents may differ by sex and meat source.

The impact of doubling dairy or plant-based foods on consumption of nutrients of concern and proper bone health for adolescent females

OBJECTIVE

To determine the effects of increasing plant-based foods v. dairy foods on energy and nutrients of concern in adolescent females via diet modelling exercises.

DESIGN

Data from the National Health and Nutrition Examination Survey (NHANES) were used to compare nutrient intakes from usual diet with those from three dietary scenarios that increased current intakes by 100 % of the following: (i) plant-based foods; (ii) protein-rich plant-based foods; and (iii) milk, cheese and yoghurt. The first two scenarios had commensurate reductions in animal products.

SETTING

What We Eat in America, NHANES 2007-2010.

SUBJECTS

Female adolescents (n 1594) aged 9-18 years.

RESULTS

When currently consumed plant-based foods were increased by 100 %, there were increases in dietary fibre, added sugar, vitamin E, Fe and folate intakes. These increases were accompanied by decreases in total fat, saturated fat, Zn, vitamin D, Ca and protein intakes. Protein-rich plant foods are consumed in very low quantities in this population such that doubling their intake resulted in no real nutritional impact. When dairy products were increased by 100 % there were increases in intakes of vitamin D, Mg, Zn, Ca, K, energy, saturated fat and protein.

CONCLUSIONS

Non-specific recommendations to increase plant foods can lead to unintended nutritional consequences. For adolescent girls, meeting the dietary recommendation of three daily servings of dairy improved the intake of the identified nutrients of concern while simultaneously providing adequate nutrients essential for proper growth and bone health critical during the adolescent phase.

Prenatal Alcohol Exposure and Pair Feeding Differentially Impact Puberty and Reproductive Development in Female Rats: Role of the Kisspeptin System

BACKGROUND

Reproductive maturation is initiated with the onset of puberty, which activates the hypothalamic-pituitary-gonadal axis and coincidences with increased expression of the hormone kisspeptin within the hypothalamus. Maturational events are sensitive to environmental factors, including alcohol, which is known to delay reproductive development. We hypothesized that, similar to alcohol's adverse effects during reproductive maturation, prenatal alcohol exposure (PAE) would alter pubertal markers, sex hormone profiles, and kisspeptin expression in the hypothalamus.

METHODS

Female offspring from control (C), pair-fed (PF), and PAE groups were sacrificed prior to puberty onset (postnatal day [PND] 30), during puberty [PND 35], or in adulthood [PND 65]. Estradiol (E₂ ), progesterone (P₄ ), prolactin, and luteinizing hormone levels, and Kiss1 mRNA expression were measured in the arcuate (ARC) and anteroventral periventricular (AVPV) nuclei of the hypothalamus. Pubertal markers (vaginal opening [VO], uterus/body wt ratio) were assessed.

RESULTS

Our findings indicate that (i) PAE inhibits the expected increases in E₂ levels with age and delays maturational increases of P₄ levels; (ii) PAE and pair feeding have similar adverse effects on VO and uterus/body wt ratio; (iii) differential relationships between PRL and P₄ suggest that different mechanisms may underlie delayed maturation in PAE and PF; that is, PF females have low PRL levels and no increase in P₄ with age, whereas PAE animals, despite low PRL, show the expected age-related increase in P₄ ; and (iv) there is higher mean density of Kiss1 mRNA in the ARC of adult PAE females and altered Kiss1 expression in the AVPV of both PAE and PF females.

CONCLUSIONS

PAE and pair feeding have some overlapping but important differential effects on hormonal profiles and Kiss1 mRNA expression during reproductive development. Preadolescent alterations in Kiss1 expression in the AVPV and ARC, which may change the balance of function in these 2 nuclei, may differentially contribute to delayed reproductive maturation in PAE and PF compared to C females.

Health of adolescent refugees resettling in high-income countries

Adolescent refugees are a vulnerable population with complex healthcare needs that are distinct from younger and older age groups. Physical health problems are common in this cohort with communicable diseases being the focus of attention followed by an emphasis on nutritional deficiencies and other chronic disorders. Adolescent refugees have also often experienced multiple traumatic stressors and are at a heightened risk of developing mental health problems. Navigating these problems at the time of pubertal development adds further challenges and can exacerbate or lead to the emergence of health risk behaviours. Educational difficulties and acculturation issues further compound these issues. Adolescents who have had experiences in detention or are unaccompanied by parents are particularly at risk. Despite a constantly growing number of adolescent refugees resettling in high-income countries, knowledge regarding their specific healthcare needs is limited. Research data are largely extrapolated from studies conducted within paediatric and adult cohorts. Holistic management of the medical and psychological issues faced by this group is challenging and requires an awareness of the socioeconomic factors that can have an impact on effective healthcare delivery. Legal and ethical issues can further complicate their management and addressing these in a culturally appropriate manner is essential. Early identification and management of the healthcare issues faced by adolescent refugees resettling in high-income countries are key to improving long-term health outcomes and future healthcare burden. This review article aims to increase knowledge and awareness of these issues among paediatricians and other health professionals.

Secular growth trends among children in Beijing (1955-2010)

OBJECTIVES

To analyze the growth trends of children in Beijing from 1955 to 2010.

METHODS

Data for the period 1955-1975 were derived from published records. Data for the period 1985-2010 were derived from the Chinese National Survey on Students' Constitution and Health (CNSSCH). Since 1985, the overall sampling and measurement methods have been consistent. The mean, the standard deviation, and the variance (ANOVA) of height, weight, and BMI by age and sex of students aged 7-17 were calculated and analyzed.

RESULTS

Between 1955 and 2010, the average height and weight of children in Beijing has increased. The average increments per decade for boys and girls were 2.45cm and 2.03cm in height and 2.68kg and 1.68kg in weight, respectively. The largest height increase per decade occurred between 1975 and 1985: 4.51cm and 3.23cm for boys and girls, respectively. The largest height increase for the entire 55-year period under study occurred among boys at age 13 (17.85cm) and among girls at age 11 (15.90cm.)

CONCLUSIONS

During the period 1955-2010, growth trends among children in Beijing were positive. The health and nutritional status of these children improved significantly. Since 2007, might be related to government intervention, childhood obesity has been curbed.

Skeletal age estimation in a contemporary Western Australian population using the Tanner-Whitehouse method

Various age estimation techniques have been utilised in Australia to evaluate the age of individuals who do not have documentation to determine legal majority/culpability. These age estimation techniques rely on the assessment of skeletal development as visualised in radiographs, CT scans, MRI or ultrasound modalities, and subsequent comparison to reference standards. These standards are not always population specific and are thus known to be less accurate when applied outside of the original reference sample, leading to potential ethical implications. Therefore, the present study aims to: (i) explore the variation in developmental trajectories between the established Tanner-Whitehouse (TW) age estimation standards and a Western Australian population; and (ii) develop specific hand-wrist age estimation standards for the latter population. The present study examines digital anterior-posterior hand-wrist radiographs of 360 individuals 0 to 24.9 years of age, equally represented by sex. Each radiograph was assessed using the RUS, Carpal and 20-bone methods of Tanner et al. The standard error of the estimate (SEE) was calculated for each method (range: ♀ SEE ±0.4-11.5 years; ♂ SEE ±0.9-10.1 years). The most accurate method was TW3 RUS for females and the TW2 Carpal system for males. The 50th centile skeletal maturity scores for each year age group were plotted against average chronological age to produce polynomial regression standards with a demonstrated accuracy of (♀ SEE ±0.09-3.46 years; ♂ SEE ±0.02-3.42 years) for females and males, respectively. The standards presented here can be used in future forensic investigations that require age estimation of hand-wrist bones in a Western Australian population, however, they are not appropriate for establishing age of majority (18 years), as skeletal maturity was attained on average earlier than 15 years of age in both sexes for all three systems examined.

Secular trends for age at spermarche among Chinese boys from 11 ethnic minorities, 1995-2010: a multiple cross-sectional study

OBJECTIVES

We compared the differences in median age at spermarche among 11 ethnic minorities in 2010, estimated the trends regarding age at spermarche in different ethnic minorities from 1995 to 2010, and explored the association of spermarche with body mass index (BMI).

METHODS

We used four cross-sectional Chinese National Surveys on Students' Constitution and Health (CNSSCH, 1995, 2000, 2005 and 2010), and the total sample size was 40,113 children aged 11-18 years. The median age at spermarche of each ethnic minority was determined by using probit analysis. Logistic regression was used to assess the association of spermarche with BMI.

RESULTS

In 2010, the ethnic minorities with earliest age at spermarche were Qiang (12.03 years), Zhuang (12.91 years) and Kirghiz (13.17 years); the three ethnic minorities with latest age at spermarche were Dong (14.73 years), Yao (14.60 years), and Naxi (14.36 years). From 1995 to 2010, age at spermarche showed a decline in almost each minority group except Yao and Dong. A higher BMI was associated with an increased likelihood of having reached spermarche after adjusting for age, regions or ethnic minorities.

CONCLUSIONS

A large variation in age at spermarche was observed among different ethnic minorities. The age at spermarche showed a downward shift in almost each of the 11 ethnic minorities with different patterns over time, and the children with higher BMI are more likely to enter puberty early.

Insulin-Like Growth Factor-I is a Marker for the Nutritional State

Measurement of the serum concentration of insulin-like growth factor-I (IGF-l) is generally used as a screening investigation for disorders of the growth hormone (GH)/IGF-I axis in children and adolescents with short stature. IGF-I concentration is sensitive to short-term and chronic alterations in the nutritional state, and the interpretation of IGF-I measurements requires knowledge of the child's nutritional status. In this review, we summarize the effects of nutrition on the GH/IGF-I axis, and review the clinical implications of these interactions throughout childhood, both in under-nutrition and over-nutrition.

Postnatal weight gain induced by overfeeding pups and maternal high-fat diet during the lactation period modulates glucose metabolism and the production of pancreatic and gastrointestinal peptides

The impact of rapid weight gain on glucose metabolism during the early postnatal period remains unclear. We investigated the influence of rapid weight gain under different nutritional conditions on glucose metabolism, focusing on the production of pancreatic and gastric peptides. On postnatal day (PND) 2, C57BL/6N pups were divided into three groups: control (C) pups whose dams were fed a control diet (10%kcal fat) and nursed 10 pups each; maternal high-fat diet (HFD) pups whose dams were fed an HFD (45%kcal fat) and nursed 10 pups each; and overfeeding (OF) pups whose dams were fed the control diet and nursed 4 pups each. Data were collected on PND 7, 14 and 21. The body weight gains of the HFD and OF pups were 1.2 times higher than that of the C pups. On PND 14, the HFD pups had higher blood glucose levels, but there were no significant differences in serum insulin levels between the HFD and C pups. The OF pups had higher blood glucose and serum insulin levels than that of the C pups. Insulin resistance was found in the HFD and OF pups. On PND 14, the content of incretins in the jejunum was increased in the OF pups, and acyl ghrelin in the stomach was upregulated in the HFD and OF pups. These results suggest that neonatal weight gain induced by overfeeding pups and maternal high-fat diet during the early postnatal period modulates the insulin sensitivity and the production of pancreatic and gastrointestinal peptides.