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Tagi VM, Fiore G, Tricella C, Eletti F, Visioli A, Bona F, Zuccotti G, Corsello A, Verduci E. Sex- and gender-based medicine in pediatric nutrition. Ital J Pediatr 2024; 50:159. [PMID: 39218991 PMCID: PMC11368030 DOI: 10.1186/s13052-024-01734-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024] Open
Abstract
Consistent evidence increasingly highlights the significance of integrating sex and gender medicine to ensure a precision approach according to individual patient needs. Gender discrepancies emerge across various areas, even from pediatric age. The importance of recognizing these differences in pediatric nutrition is critical for the development of targeted nutritional strategies and interventions, particularly in cases of associated pathologies, including obesity, metabolic-associated fatty liver disease, eating disorders, and inflammatory bowel disease. The review highlights the biological and sociocultural factors that contribute to different nutritional needs and health outcomes in male and female children. By examining current evidence, we underscore the necessity for precision medicine approaches in pediatric care that consider these sex- and gender-based differences. Moreover, differences in dietary requirements and dietary patterns between males and females are evident, underscoring the need for precise nutrition strategies for a more accurate management of children and adolescents. This approach is essential for improving clinical outcomes and promoting equitable healthcare practices. This review aims to provide an overview of nutrition-related medical conditions exhibiting sex- and gender-specific discrepancies, which might lead to distinct outcomes requiring unique management and prevention strategies. Future research and public health initiatives should address these differences in designing effective lifestyle education programs and nutrition interventions targeting both children and adolescents.
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Affiliation(s)
- Veronica Maria Tagi
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Biomedical and Clinical Science, University of Milan, Milan, Italy
| | - Giulia Fiore
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Chiara Tricella
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Francesca Eletti
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Biomedical and Clinical Science, University of Milan, Milan, Italy
| | - Alessandro Visioli
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Federica Bona
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Biomedical and Clinical Science, University of Milan, Milan, Italy
| | - Antonio Corsello
- Department of Health Sciences, University of Milan, Milan, Italy.
| | - Elvira Verduci
- Department of Health Sciences, University of Milan, Milan, Italy
- Metabolic Diseases Unit, Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
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Capra ME, Decarolis NM, Monopoli D, Laudisio SR, Giudice A, Stanyevic B, Esposito S, Biasucci G. Complementary Feeding: Tradition, Innovation and Pitfalls. Nutrients 2024; 16:737. [PMID: 38474864 DOI: 10.3390/nu16050737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
According to WHO, "complementary feeding (CF) is the process starting when breast milk alone or infant formula alone is no longer sufficient to meet the nutritional requirements of infants, and therefore, other foods and liquids are needed, along with breast human milk or a breastmilk substitute". CF is one of the most important "critical and sensitive periods" in human life: indeed, timing and approaches to solid foods introduction in an infant's nutrition are of utmost importance as potential epigenetic factors from infancy to adulthood. CF is also deeply influenced by each country and single-family traditions, culture, and beliefs. The aim of our narrative review is to analyze traditional CF practices, including innovative and alternative ones that emerged in the last decades, such as baby-led weaning or plant-based weaning, and to evaluate their effects on the risk of developing non-communicable diseases. Moreover, we will discuss pitfalls and misunderstandings that pediatricians frequently have to face when dealing with complementary feeding. Health care professionals must not have prejudices against parents' wishes or traditions about CF; rather, they should support and educate them in case of any alternative CF choice, always pursuing the infant's adequate growth, neuro- and taste development, and the achievement of correct eating behavior as the primary goal.
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Affiliation(s)
- Maria Elena Capra
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Italian Society of Pediatric Nutrition (SINUPE), 20126 Milan, Italy
| | - Nicola Mattia Decarolis
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Delia Monopoli
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Serena Rosa Laudisio
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Antonella Giudice
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Brigida Stanyevic
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Giacomo Biasucci
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Italian Society of Pediatric Nutrition (SINUPE), 20126 Milan, Italy
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
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Ulloa E, Saure C, Giudici V, Armeno M. Causes of possible excessive weight gain in exclusively breastfed infants in the first six months of life. Minerva Pediatr (Torino) 2023; 75:844-851. [PMID: 32731728 DOI: 10.23736/s2724-5276.20.05735-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
BACKGROUND The aim of this study was to describe factors related to the infant, mother, and breastmilk composition that may be associated with excessive weight gain in a cohort of exclusively breastfed infants younger than 6 months of life with excessive weight gain, and to compare these findings with data from a group of normal-weight exclusively breastfed infants. METHODS Thirty-six exclusively breastfed infants younger than 6 months of life seen at two health-care centers between July 2016 and 2017 were enrolled in the study. The clinical features of the infants, their mothers, and the macronutrient composition of the breast milk were evaluated. We classified infants according to weight gain velocity between birth and 6 months of life into an excessive weight gain (EWG) and an adequate weight gain (AWG) group. RESULTS Mean age at protocol entry was 3.8 months. Thirteen patients were classified as EWG and 23 patients as AWG. Co-sleeping was more often observed in EWG than in AWG infants. Mothers in the EWG group were younger and more often had gained more than 18 kg during pregnancy than those in the AWG group. No significant differences were found in the macronutrient content of the breast milk between both groups. CONCLUSIONS Greater weight gain in infants under 6 months of age may be related to greater weight gain of the mother during pregnancy, younger age of the mother, and co-sleeping of the mother and child.
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Affiliation(s)
- Eugenia Ulloa
- Department of Clinical Nutrition, J. P. Garrahan National Pediatrics Hospital, Buenos Aires, Argentina
| | - Carola Saure
- Department of Clinical Nutrition, J. P. Garrahan National Pediatrics Hospital, Buenos Aires, Argentina -
| | - Vanesa Giudici
- Laboratory for Physical-chemical Food Analysis, Department of Food Sciences, National University of Entre Ríos, Entre Ríos, Argentina
| | - Marisa Armeno
- Department of Clinical Nutrition, J. P. Garrahan National Pediatrics Hospital, Buenos Aires, Argentina
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Tang M, Ma C, Weinheimer-Haus EM, Robertson CE, Kofonow JM, Berman LM, Waljee A, Zhu J, Frank DN, Krebs NF. Different gut microbiota in U.S. formula-fed infants consuming a meat vs. dairy-based complementary foods: A randomized controlled trial. Front Nutr 2023; 9:1063518. [PMID: 36778973 PMCID: PMC9909089 DOI: 10.3389/fnut.2022.1063518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/29/2022] [Indexed: 01/27/2023] Open
Abstract
Objective This project aimed to evaluate the impact of meat- vs. dairy-based complementary foods on gut microbiota and whether it relates to growth. Design Full-term, formula-fed infants were recruited from the metro Denver area (Colorado, US) and randomized to a meat- or dairy-based complementary diet from 5 to 12 months of age. Infant's length and weight were measured, and stool samples were collected at 5, 10, and 12 months for 16S rRNA gene sequencing and short-chain fatty acids (SCFAs) quantification. Results Sixty-four infants completed the dietary intervention (n = 32/group). Weight-for-age Z (WAZ) scores increased in both groups and length-for-age Z scores (LAZ) increased in the meat group only, which led to a significant group-by-time interaction (P = 0.02) of weight-for-length Z (WLZ) score. Microbiota composition (Beta-diversity) differed between groups at 12 months (weighted PERMANOVA P = 0.01) and had a group-by-time interaction of P = 0.09. Microbial community richness (Chao1) increased in the meat group only. Genus Akkermansia had a significant group-by-time interaction and increased in the dairy group and decreased in the meat group. A significant fold change of butyric acid from 5 to 12 months was found in the meat group (+1.75, P = 0.011) but not in the dairy group. Regression analysis showed that Chao1 had a negative association with WLZ and WAZ. Several genera also had significant associations with all growth Z scores. Conclusion Complementary feeding not only impacts infant growth but also affects gut microbiota maturation. Complementary food choices can affect both the gut microbiota diversity and structures and these changes in gut microbiota are associated with infant growth.
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Affiliation(s)
- Minghua Tang
- Section of Nutrition, Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Cheng Ma
- Department of Statistics, University of Michigan, Ann Arbor, MI, United States
| | - Eileen M. Weinheimer-Haus
- Division of Gastroenterology, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, United States
| | - Charles E. Robertson
- Division of Infectious Disease, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Jennifer M. Kofonow
- Division of Infectious Disease, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Lillian M. Berman
- Section of Nutrition, Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Akbar Waljee
- Division of Gastroenterology, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, United States
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - Ji Zhu
- Department of Statistics, University of Michigan, Ann Arbor, MI, United States
| | - Daniel N. Frank
- Division of Infectious Disease, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Nancy F. Krebs
- Section of Nutrition, Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
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Fauste E, Donis C, Pérez-Armas M, Rodríguez L, Rodrigo S, Álvarez-Millán JJ, Otero P, Panadero MI, Bocos C. Maternal fructose boosts the effects of a Western-type diet increasing SARS-COV-2 cell entry factors in male offspring. J Funct Foods 2023; 100:105366. [PMID: 36506002 PMCID: PMC9722681 DOI: 10.1016/j.jff.2022.105366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 12/02/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022] Open
Abstract
Fructose-rich beverages and foods consumption correlates with the epidemic rise in cardiovascular disease, diabetes and obesity. Severity of COVID-19 has been related to these metabolic diseases. Fructose-rich foods could place people at an increased risk for severe COVID-19. We investigated whether maternal fructose intake in offspring affects hepatic and ileal gene expression of proteins that permit SARS-CoV2 entry to the cell. Carbohydrates were supplied to pregnant rats in drinking water. Adult and young male descendants subjected to water, liquid fructose alone or as a part of a Western diet, were studied. Maternal fructose reduced hepatic SARS-CoV2 entry factors expression in older offspring. On the contrary, maternal fructose boosted the Western diet-induced increase in viral entry factors expression in ileum of young descendants. Maternal fructose intake produced a fetal programming that increases hepatic viral protection and, in contrast, exacerbates fructose plus cholesterol-induced diminution in SARS-CoV2 protection in small intestine of progeny.
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Key Words
- ACE2, angiotensin-converting enzyme 2
- ADAM17, ADAM metallopeptidase domain 17
- Cholesterol
- Fetal programming
- Fructose
- HDL, high-density lipoprotein
- HFCS, high fructose corn syrup
- Ileum
- Liver
- MetS, metabolic syndrome
- NAFLD, non-alcoholic fatty liver disease
- SARS-CoV-2
- SARS-CoV-2, severe acute respiratory syndrome coronavirus-2
- SRB1, HDL-scavenger receptor B type 1
- SSB, sugar-sweetened beverages
- T2DM, type 2 diabetes
- TMPRSS2, transmembrane protease serine 2
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Affiliation(s)
- Elena Fauste
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Montepríncipe, Boadilla del Monte, Madrid, Spain
| | - Cristina Donis
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Montepríncipe, Boadilla del Monte, Madrid, Spain
| | - Madelín Pérez-Armas
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Montepríncipe, Boadilla del Monte, Madrid, Spain
| | - Lourdes Rodríguez
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Montepríncipe, Boadilla del Monte, Madrid, Spain
| | - Silvia Rodrigo
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Montepríncipe, Boadilla del Monte, Madrid, Spain
| | | | - Paola Otero
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Montepríncipe, Boadilla del Monte, Madrid, Spain
| | - María I. Panadero
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Montepríncipe, Boadilla del Monte, Madrid, Spain
| | - Carlos Bocos
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Montepríncipe, Boadilla del Monte, Madrid, Spain,Corresponding author at: Facultad de Farmacia, Universidad San Pablo-CEU, Urbanización Montepríncipe, 28668 Boadilla del Monte, Madrid, Spain
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Totzauer M, Escribano J, Closa-Monasterolo R, Luque V, Verduci E, ReDionigi A, Langhendries JP, Martin F, Xhonneux A, Gruszfeld D, Socha P, Grote V, Koletzko B, Carlier C, Hoyos J, Poncelet P, Dain E, Martin F, Xhonneux A, Langhendries J, Van Hees J, Closa‐Monasterolo R, Escribano J, Luque V, Mendez G, Ferre N, Zaragoza‐Jordana M, Giovannini M, Riva E, Agostoni C, Scaglioni S, Verduci E, Vecchi F, Re Dionigi A, Socha J, Socha P, Dobrzańska A, Gruszfeld D, Stolarczyk A, Kowalik A, Janas R, Pietraszek E, Perrin E, von Kries R, Groebe H, Reith A, Hofmann R, Koletzko B, Grote V, Totzauer M, Rzehak P, Schiess S, Beyer J, Fritsch M, Handel U, Pawellek I, Verwied‐Jorky S, Hannibal I, Demmelmair H, Haile G, Theurich M. Different protein intake in the first year and its effects on adiposity rebound and obesity throughout childhood: 11 years follow-up of a randomized controlled trial. Pediatr Obes 2022; 17:e12961. [PMID: 36355369 DOI: 10.1111/ijpo.12961] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 06/06/2022] [Accepted: 06/30/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Infant feeding affects child growth and later obesity risk. We examined whether protein supply in infancy affects the adiposity rebound, body mass index (BMI) and overweight and obesity up to 11 years of age. METHODS We enrolled healthy term infants from five European countries in a double blind randomized trial, with anticipated 16 examinations within 11 years follow-up. Formula-fed infants (n = 1090) were randomized to isoenergetic formula with higher or lower protein content within the range stipulated by EU legislation in 2001. A breastfed reference group (n = 588) was included. Adiposity rebound and BMI trajectories were estimated by generalized additive mixed models in 917 children, with 712 participating in the 11 year follow-up. RESULTS BMI trajectories were elevated in the higher compared to the lower protein group, with significantly different BMI at adiposity rebound (0.24 kg/m2, 0.01-0.47, p = 0.040), and an increased risk for overweight at 11 years (adjusted Odds Ratio 1.70; 1.06-2.73; p = 0.027) but no significant difference for obesity (adjusted Odds Ratio 1.47; 0.66-3.27). The two formula groups did not differ in the timing of adiposity rebound, but all children with obesity at 11 years had an early adiposity rebound before four years. CONCLUSIONS Compared to conventional high protein formula, feeding lower protein formula in infancy lowers BMI trajectories up to 11 years and achieves similar BMI values at adiposity rebound as observed in breastfed infants.
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Affiliation(s)
- Martina Totzauer
- LMU - Ludwig-Maximilians-Universität Munich, Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospitals, Munich, Germany
| | - Joaquin Escribano
- Department of Pediatrics, Hospital Sant Joan, Reus, Universitat Rovira i Virgili, IISPV, Reus, Spain
| | - Ricardo Closa-Monasterolo
- Neonatal Unit, Hospital Joan XXIII, Tarragona, Universitat Rovira i Virgili, IISPV, Tarragona, Spain
| | - Veronica Luque
- Department of Pediatrics, Hospital Sant Joan, Reus, Universitat Rovira i Virgili, IISPV, Reus, Spain
| | - Elvira Verduci
- Department of Paediatrics, San Paolo Hospital, University of Milan, Milan, Italy
| | - Alice ReDionigi
- Department of Paediatrics, San Paolo Hospital, University of Milan, Milan, Italy
| | | | | | | | - Dariusz Gruszfeld
- Children's Memorial Health Institute, Neonatal Intensive Care Unit, Warsaw, Poland
| | - Piotr Socha
- Children's Memorial Health Institute, Department of Gastroenterology, Hepatology and Eating Disorders, Warsaw, Poland
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Kuehn D, Zeisel SH, Orenstein DF, German JB, Field CJ, Teerdhala S, Knezevic A, Patil S, Donovan SM, Lönnerdal B. Effects of a Novel High-Quality Protein Infant Formula on Energetic Efficiency and Tolerance: A Randomized Trial. J Pediatr Gastroenterol Nutr 2022; 75:521-528. [PMID: 35666855 PMCID: PMC9470040 DOI: 10.1097/mpg.0000000000003490] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/24/2022] [Indexed: 12/10/2022]
Abstract
OBJECTIVES Protein overfeeding in infants can have negative effects, such as diabetes and childhood obesity; key to reducing protein intake from formula is improving protein quality. The impact of a new infant formula [study formula (SF)] containing alpha-lactalbumin, lactoferrin, partially hydrolyzed whey, and whole milk on growth and tolerance compared to a commercial formula (CF) and a human milk reference arm was evaluated. METHODS This randomized, double-blind trial included healthy, singleton, term infants, enrollment age ≤14 days. Primary outcome was mean daily weight gain. Secondary outcomes were anthropometrics, formula intake, serum amino acids, adverse events, gastrointestinal characteristics, and general disposition. RESULTS Non-inferiority was demonstrated. There were no differences between the formula groups for z scores over time. Formula intake [-0.33 oz/kg/day, 95% confidence interval (CI): -0.66 to -0.01, P = 0.05] and mean protein intake (-0.13 g/kg/day, 95% CI: -0.26 to 0.00, P = 0.05) were lower in the SF infants, with higher serum essential amino acid concentrations (including tryptophan) compared to the CF infants. Energetic efficiency was 14.0% (95% CI: 8.3%, 19.7%), 13.0% (95% CI: 6.0%, 20.0%), and 18.1% (95% CI: 9.4%, 26.8%) higher for weight, length, and head circumference, respectively, in SF infants compared to the CF infants. SF infants had significantly fewer spit-ups and softer stool consistency than CF infants. CONCLUSIONS The SF resulted in improved parent-reported gastrointestinal tolerance and more efficient growth with less daily formula and protein intake supporting that this novel formula may potentially reduce the metabolic burden of protein overfeeding associated with infant formula.
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Affiliation(s)
| | - Steven H. Zeisel
- the University of North Carolina at Chapel Hill, Chapel Hill, NC
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Cheshmeh S, Nachvak SM, Hojati N, Elahi N, Heidarzadeh‐Esfahani N, Saber A. The effects of breastfeeding and formula feeding on the metabolic factors and the expression level of obesity and diabetes-predisposing genes in healthy infants. Physiol Rep 2022; 10:e15469. [PMID: 36200185 PMCID: PMC9535349 DOI: 10.14814/phy2.15469] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/23/2022] [Accepted: 09/01/2022] [Indexed: 11/24/2022] Open
Abstract
Diabetes mellitus (DM) and obesity are common illnesses characterized by glucose metabolism issues and excessive weight gain. Breastfeeding is the best way to feed a newborn up to 6 months old and it has been shown to reduce the risk of diabetes and obesity later in life due to its nutritional properties. The purpose of this study was to investigate the effects of breastfeeding, formula feeding, and formula-plus breastfeeding (mix-feeding) on the anthropometric indices, metabolic variables, and the expression level of obesity and diabetes-predisposing genes of healthy infants. A total of 150 healthy infants were enrolled in this cross-sectional study. All infants (aged 24 months) were divided into three groups based on the type of feeding, breastfeeding, formula feeding, and mix-feeding. The anthropometric indices, glycemic indexes, lipid profile, and the expression levels of acetyl-coenzyme A carboxylase beta (ACACB), brain-derived neurotrophic factor (BDNF), liver X receptor α (LXR-α), peroxisome proliferator-activated receptor γ (PPAR-γ), and phosphatase and tensin homolog (PTEN) genes were measured in all infants using reverse transcription-polymerase chain reaction (RT-PCR) method. The anthropometric indices including weight, height, head circumference, insulin, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were lower in the breastfeeding infants in comparison to other groups. As well, the expression level of the ACACB gene was significantly downregulated in breastfeeding infants, while the PPAR-γ gene was significantly upregulated, but the expression levels of LXR- α, PTEN and BDNF did not change significantly across groups. Breastfeeding compared to formula feeding had positive effects on anthropometric indices, metabolic variables, and diabetes-predisposing genes.
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Affiliation(s)
- Sahar Cheshmeh
- Department of Nutritional Sciences, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
- Student Research Committee, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
| | - Seyed Mostafa Nachvak
- Department of Nutritional Sciences, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
| | - Niloofar Hojati
- Department of Nutritional Sciences, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
- Student Research Committee, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
| | - Negin Elahi
- Department of Nutritional Sciences, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
- Student Research Committee, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
| | - Neda Heidarzadeh‐Esfahani
- Department of Nutritional Sciences, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
- Student Research Committee, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
| | - Amir Saber
- Department of Nutritional Sciences, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
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9
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Tummolo A, Carella R, Paterno G, Bartolomeo N, Giotta M, Dicintio A, De Giovanni D, Fischetto R. Body Composition in Adolescent PKU Patients: Beyond Fat Mass. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9091353. [PMID: 36138662 PMCID: PMC9497631 DOI: 10.3390/children9091353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/10/2022] [Accepted: 08/31/2022] [Indexed: 11/21/2022]
Abstract
There is a lack of evidence on the impact on body composition of high protein intake and types of protein substitutes in PKU patients—particularly in adolescents, who are more inclined to dietary transgressions. In this observational, cross-sectional study, PKU patients were observed during prepubertal age (p) or after the pubertal spurt (P), assessing body composition and bone quality and correlating these parameters with dietary compliance and types of protein substitutes. Anthropometric and dietary data were evaluated together with bioelectrical impedance analysis (BIA), quantitative ultrasound (QUS) and branched-chain amino acids (BCAAs). A total of 36 patients (16 males, 17 prepubertal and 19 post-pubertal; mean ± SD age 11.4 ± 3.9 years) were included. A higher BMI was observed in adolescents (p-value: 0.018). The BIA revealed a significant increase in total body water (TBW) and muscle mass (MM) in P subjects either compliant (p-value: 0.001) or non-compliant with the diet (p-value: 0.001). MM content correlated with increased Phe intake (r = 0.63; p < 0.001). In the subgroup of five patients taking L-AAs and glycomacropeptides (GMPs), BCAA values tended to be lower than those taking only L-AA mixtures, with a significant trend for valine. Maintenance of body composition parameters within the normal range—for both fat and muscle mass—and levels of BCAAs can be helpful in reducing the risk of becoming overweight in adulthood. Further studies are needed to confirm these findings.
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Affiliation(s)
- Albina Tummolo
- Department of Metabolic Diseases and Clinical Genetics, Giovanni XXIII Children Hospital, Azienda Ospedaliero-Universitaria Consorziale, 70126 Bari, Italy
- Correspondence:
| | - Rosa Carella
- Department of Metabolic Diseases and Clinical Genetics, Giovanni XXIII Children Hospital, Azienda Ospedaliero-Universitaria Consorziale, 70126 Bari, Italy
| | - Giulia Paterno
- Department of Metabolic Diseases and Clinical Genetics, Giovanni XXIII Children Hospital, Azienda Ospedaliero-Universitaria Consorziale, 70126 Bari, Italy
| | - Nicola Bartolomeo
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Massimo Giotta
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Annamaria Dicintio
- Department of Metabolic Diseases and Clinical Genetics, Giovanni XXIII Children Hospital, Azienda Ospedaliero-Universitaria Consorziale, 70126 Bari, Italy
| | - Donatella De Giovanni
- Department of Metabolic Diseases and Clinical Genetics, Giovanni XXIII Children Hospital, Azienda Ospedaliero-Universitaria Consorziale, 70126 Bari, Italy
| | - Rita Fischetto
- Department of Metabolic Diseases and Clinical Genetics, Giovanni XXIII Children Hospital, Azienda Ospedaliero-Universitaria Consorziale, 70126 Bari, Italy
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10
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Wilms JN, Ghaffari MH, Steele MA, Sauerwein H, Martín-Tereso J, Leal LN. Macronutrient profile in milk replacer or a whole milk powder modulates growth performance, feeding behavior, and blood metabolites in ad libitum-fed calves. J Dairy Sci 2022; 105:6670-6692. [PMID: 35787324 DOI: 10.3168/jds.2022-21870] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/26/2022] [Indexed: 11/19/2022]
Abstract
Milk replacers (MR) for calves usually contain more lactose and less fat than bovine whole milk (WM). There are insufficient data to determine whether these MR formulations are optimal for calves fed at high planes of nutrition. Thus, the effect of 3 MR formulations and a WM powder were evaluated on growth, feeding behavior, and blood metabolites in 96 male Holstein calves fed ad libitum and with 45.5 ± 4.30 kg (mean ± SD) BW at arrival. Calves were blocked based on arrival sequence, and randomly assigned within block to one of the 4 treatments (n = 24 calves/group): a high-fat MR (25.0% fat, dry matter basis; 22.5% protein, 38.6% lactose; 21.3 MJ/kg; HF), a high lactose MR (44.6% lactose, 22.5% protein, 18.0% fat; 19.7 MJ/kg; HL), a high protein MR (26.0% protein, 18.0% fat, 41.5% lactose; 20.0 MJ/kg; HP), and a WM powder (26.0% fat; 24.5% protein, 38.0% lactose; 21.6 MJ/kg; WP). In the first 2 wk after arrival, calves were individually housed and were fed 3.0 L of their respective liquid feed 3 times daily at 135 g/L. They were then moved to group housing and fed ad libitum until d 42 after arrival. Weaning was gradual and took place between d 43 and 70 after arrival; thereafter, calves were fed solids only. Concentrates, chopped straw, and water were available ad libitum throughout the study. Body weight was measured, and blood was collected at arrival and then weekly thereafter from wk 1 to 12. Weight gain and height were greater in HL than WP calves. In the preweaning phase, HL and HP-fed calves consumed more milk than WP, and HL-fed calves consumed more milk than HF calves. In wk 10, starter feed intakes were lower in HF calves than in the other groups. In the preweaning phase, ME intakes were the same for all treatments. This suggests that milk intakes were regulated by the energy density of the milk supplied. The percentage of calves requiring therapeutic interventions related to diarrhea was greater in WP-fed calves (29%) than HF and HL calves (4%), whereas HP (13%) did not differ with other groups. This was coupled with lower blood acid-base, blood gas, and blood sodium in WP than in MR-fed calves. Calves fed HF had greater serum nonesterified fatty acids compared with other groups, and greater serum amyloid A compared with WP and HL calves. Among the serum parameters, insulin-like growth factor-1 and lactate dehydrogenase correlated positively with MR intake and average daily gain. The high lactose and protein intakes in HL and HP calves led to greater insulin-like growth factor-1 concentrations than in WP-fed calves. Although growth differences were limited among MR groups, the metabolic profile largely differed and these differences require further investigation.
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Affiliation(s)
- J N Wilms
- Trouw Nutrition R&D, P.O. Box 299, 3800 AG, Amersfoort, the Netherlands; Department of Animal Biosciences, Animal Science and Nutrition, University of Guelph, Guelph, ON, Canada N1G 1Y2.
| | - M H Ghaffari
- Institute of Animal Science, University of Bonn, 53111 Bonn, Germany
| | - M A Steele
- Department of Animal Biosciences, Animal Science and Nutrition, University of Guelph, Guelph, ON, Canada N1G 1Y2
| | - H Sauerwein
- Institute of Animal Science, University of Bonn, 53111 Bonn, Germany
| | - J Martín-Tereso
- Trouw Nutrition R&D, P.O. Box 299, 3800 AG, Amersfoort, the Netherlands
| | - L N Leal
- Trouw Nutrition R&D, P.O. Box 299, 3800 AG, Amersfoort, the Netherlands
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11
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Camier A, Davisse-Paturet C, Scherdel P, Lioret S, Heude B, Charles MA, de Lauzon-Guillain B. Early growth according to protein content of infant formula: Results from the EDEN and ELFE birth cohorts. Pediatr Obes 2021; 16:e12803. [PMID: 33973734 DOI: 10.1111/ijpo.12803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/16/2021] [Accepted: 04/26/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND In several systematic reviews, rapid weight gain in early life has been related to increased risk of later obesity. In line with this finding, the "early protein hypothesis" suggests that reducing early protein intake is a potential lever for obesity prevention. OBJECTIVE To determine whether the variability of protein content of infant formula used in France over the period 2003-2012 is significantly associated with early growth in children. METHODS A pooled sample of infants from the EDEN (Etude des Déterminants pré et postnatals de la santé et du développement de l'Enfant) mother-child cohort (born in 2003-2006) and the ELFE (Etude Longitudinale Française depuis l'Enfance) birth cohort (born in 2011) (ntotal = 5846) was used. Protein content of the infant formula received at 4 months was classified into five groups. Associations between protein content (or breastfed status) at 4 months and weight-, length- and BMI-for-age z-scores at 6, 12 and 18 months were analysed by multivariable linear regression. RESULTS This analysis showed a positive association between protein content and weight-, length- and BMI-for-age z-scores at 6 months and only for weight-for-age at 12 months. At 6 months, as compared with the intermediate protein-content group (2.1-2.5 g/100 kcal), infants receiving very-high protein content (>2.8 g/100 kcal) had higher BMI-for-age z-score and those from the very-low protein-content group (<2.0 g/100 kcal) had lower BMI-for-age z-score. Exclusively breastfed infants had lower length and weight z-scores than formula-fed infants at any age. CONCLUSIONS Our findings show a positive association, under real conditions of use, between protein contents in infant formula still on the market and weight-, length- and BMI-for-age z-scores from 6 to 18 months.
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Affiliation(s)
- Aurore Camier
- Université de Paris, CRESS, INSERM, INRAE, Paris, France
| | | | | | | | - Barbara Heude
- Université de Paris, CRESS, INSERM, INRAE, Paris, France
| | - Marie-Aline Charles
- Université de Paris, CRESS, INSERM, INRAE, Paris, France.,Unité mixte Inserm-Ined-EFS ELFE, Ined, F-75020, Paris, France
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12
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Newton-Tanzer E, Demmelmair H, Horak J, Holdt L, Koletzko B, Grote V. Acute Metabolic Response in Adults to Toddler Milk Formulas with Alternating Higher and Lower Protein and Fat Contents, a Randomized Cross-Over Trial. Nutrients 2021; 13:nu13093022. [PMID: 34578900 PMCID: PMC8472683 DOI: 10.3390/nu13093022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/24/2021] [Accepted: 08/27/2021] [Indexed: 01/23/2023] Open
Abstract
Protein intake in early life influences metabolism, weight gain, and later obesity risk. As such, a better understanding of the effects of protein intake on the postprandial metabolism and its dynamics over time may elucidate underlying mechanisms. In a randomized crossover study, we observed fasted adults who consumed two isocaloric toddler milk formulas concentrated as meals of 480 kcal with 67 g of carbohydrates 30 g (HP) or 7 g (LP) protein, and 10 g or 20 g fat, respectively. Anthropometry and body plethysmography were assessed, and blood samples collected at baseline and over five hours. Time-specific concentrations, areas under concentration curves (AUC), and maximum values of metabolites were compared by paired t-tests to examine the effects of protein content of toddler milks on postprandial plasma concentrations of insulin, glucose, branched-chain amino acids (BCAA), urea and triglycerides. Twenty-seven men and women aged 26.7 ± 5.0 years (BMI: 22.2 ± 2.5 kg/m2) (mean ± SD) participated. BCAA AUC, and Cmax values were significantly higher with HP than LP (144,765 ± 21,221 vs. 97,089 ± 14,650 µmol·min/L, p < 0.001; 656 ± 120 vs. 407 ± 66 µmol/L, p < 0.001), as were insulin AUC and Cmax values (6674 ± 3013 vs. 5600 ± 2423 µmol·min/L, p = 0.005; 71 ± 37 vs. 55 ± 28 µmol/L, p = 0.001). Higher glucose, urea, and triglyceride concentrations occurred in the late postprandial phase (≥180 min) with HP. In conclusion, we noted that higher milk protein intake induces increased postprandial BCAA concentrations for at least 5 h and led to higher initial insulin secretion. Gluconeogenesis due to an influx of amino acids and their degradation after HP meal might explain the late effects of protein intake on glucose and insulin.
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Affiliation(s)
- Emily Newton-Tanzer
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, LMU University Hospital Munich, 80337 Munich, Germany; (E.N.-T.); (H.D.); (J.H.); (V.G.)
| | - Hans Demmelmair
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, LMU University Hospital Munich, 80337 Munich, Germany; (E.N.-T.); (H.D.); (J.H.); (V.G.)
| | - Jeannie Horak
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, LMU University Hospital Munich, 80337 Munich, Germany; (E.N.-T.); (H.D.); (J.H.); (V.G.)
| | - Lesca Holdt
- Institute of Laboratory Medicine, LMU University Hospital Munich, 81377 Munich, Germany;
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, LMU University Hospital Munich, 80337 Munich, Germany; (E.N.-T.); (H.D.); (J.H.); (V.G.)
- Correspondence: ; Tel.: +49-(0)89-4400-52826
| | - Veit Grote
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, LMU University Hospital Munich, 80337 Munich, Germany; (E.N.-T.); (H.D.); (J.H.); (V.G.)
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13
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Madrigal C, Soto-Méndez MJ, Hernández-Ruiz Á, Valero T, Lara Villoslada F, Leis R, Martínez de Victoria E, Moreno JM, Ortega RM, Ruiz-López MD, Varela-Moreiras G, Gil Á. Dietary Intake, Nutritional Adequacy, and Food Sources of Protein and Relationships with Personal and Family Factors in Spanish Children Aged One to <10 Years: Findings of the EsNuPI Study. Nutrients 2021; 13:1062. [PMID: 33805229 PMCID: PMC8064310 DOI: 10.3390/nu13041062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/19/2021] [Accepted: 03/19/2021] [Indexed: 01/15/2023] Open
Abstract
Diet in the first years of life is an important factor in growth and development. Dietary protein is a critical macronutrient that provides both essential and nonessential amino acids required for sustaining all body functions and procedures, providing the structural basis to maintain life and healthy development and growth in children. In this study, our aim was to describe the total protein intake, type and food sources of protein, the adequacy to the Population Reference Intake (PRI) for protein by the European Food Safety Authority (EFSA), and the Recommended Dietary Allowance (RDA) by the Institute of Medicine (IoM). Furthermore, we analyzed whether the consumption of dairy products (including regular milk, dairy products, or adapted milk formulas) is associated with nutrient adequacy and the contribution of protein to diet and whole dietary profile in the two cohorts of the EsNuPI (in English, Nutritional Study in the Spanish Pediatric Population) study; one cohort was representative of the Spanish population from one to <10 years old (n = 707) (Spanish reference cohort, SRS) who reported consuming all kinds of milk and one was a cohort of the same age who reported consuming adapted milk over the last year (including follow-on formula, growing up milk, toddler's milk, and enriched and fortified milks) (n = 741) (adapted milk consumers cohort, AMS). The children of both cohorts had a high contribution from protein to total energy intake (16.79% SRS and 15.63% AMS) and a high total protein intake (60.89 g/day SRS and 53.43 g/day AMS). We observed that protein intake in Spanish children aged one to <10 years old was above the European and international recommendations, as well as the recommended percentages for energy intakes. The main protein sources were milk and dairy products (28% SRS and 29% AMS) and meat and meat products (27% SRS and 26% AMS), followed by cereals (16% SRS and 15% AMS), fish and shellfish (8% in both cohorts), eggs (5% SRS and 6% AMS), and legumes (4% in both cohorts). In our study population, protein intake was mainly from an animal origin (meat and meat products, milk and dairy products, fish and shellfish, and eggs) rather than from a plant origin (cereals and legumes). Future studies should investigate the long-term effect of dietary protein in early childhood on growth and body composition, and whether high protein intake affects health later in life.
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Affiliation(s)
- Casandra Madrigal
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain;
- Iberoamerican Nutrition Foundation (FINUT), Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
| | - María José Soto-Méndez
- Iberoamerican Nutrition Foundation (FINUT), Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
| | - Ángela Hernández-Ruiz
- Iberoamerican Nutrition Foundation (FINUT), Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
| | - Teresa Valero
- Spanish Nutrition Foundation (FEN), 28010 Madrid, Spain; (T.V.); (G.V.-M.)
| | | | - Rosaura Leis
- Unit of Pediatric Gastroenterology, Department of Pediatrics, Hepatology and Nutrition University Clinical Hospital of Santiago, 15706 Santiago de Compostela, Spain;
- Health Research Institute of Santiago (IDIS), University of Santiago de Compostela, 15706 Santiago de Compostela, Spain
- Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Emilio Martínez de Victoria
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain;
- Biomedical Research Center, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, 18100 Granada, Spain
| | - José Manuel Moreno
- Pediatric Department, University of Navarra Clinic, 28027 Madrid, Spain;
| | - Rosa M. Ortega
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain;
| | - María Dolores Ruiz-López
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain;
- Iberoamerican Nutrition Foundation (FINUT), Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
- Biomedical Research Center, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, 18100 Granada, Spain
| | - Gregorio Varela-Moreiras
- Spanish Nutrition Foundation (FEN), 28010 Madrid, Spain; (T.V.); (G.V.-M.)
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, 28668 Madrid, Spain
| | - Ángel Gil
- Iberoamerican Nutrition Foundation (FINUT), Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
- Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Biomedical Research Center, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, 18100 Granada, Spain
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071 Granada, Spain
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14
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Growth patterns and breast milk/infant formula energetic efficiency in healthy infants up to 18 months of life: the COGNIS study. Br J Nutr 2021; 126:1809-1822. [PMID: 33602357 DOI: 10.1017/s000711452100057x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Type of feeding during early life influences growth trajectory and metabolic risk at later ages. Modifications in infant formula composition have led to evaluate their effects on growth and energetic efficiency (EE) compared with breast-feeding. Main goal was to analyse type of feeding potential effects during first months of life, plus its EE, on growth patterns in healthy formula fed (standard infant formula (SF) vs. experimental infant formula enriched with bioactive nutrients (EF)) and breastfed (BF) infants participating in the COGNIS RCT (http://www.ClinicalTrials.gov, Identifier: NCT02094547) up to 18 months of age. Infants follow-up to 18 months of age (n 141) fed with a SF (n 48), EF(n 56), or BF (n 37), were assessed for growth parameters using WHO standards. Growth velocity (GV) and catch-up were calculated to identify growth patterns. EE of breast milk/infant formula was also estimated. Infants' growth at 6 months showed higher length and lower head circumference gains in SF and EF infants than BF infants. Both weight-for-length and weight-for-age catch-up growth showed significant differences in formula fed groups compared with the BF. No significant differences in GV or catch-up were found at 6-12 and 12-18 months. Regarding EE, infant formula groups showed significantly lower weight and length gains/g of milk protein, and higher weight and length gains/g of milk lipids, than the BF infants. GV during first 6 months, which may be influenced by feeding, seems to be the main predictor of subsequent growth trajectory. Breast-feeding may have positive effects on growth programming due to its nutrients' EE.
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15
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Bolton KA, Kremer P, Laws R, Campbell KJ, Zheng M. Longitudinal analysis of growth trajectories in young children of Chinese-born immigrant mothers compared with Australian-born mothers living in Victoria, Australia. BMJ Open 2021; 11:e041148. [PMID: 33593772 PMCID: PMC7888327 DOI: 10.1136/bmjopen-2020-041148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Chinese immigrants are the third largest immigrant group in Australia. Little is known about growth trajectories of their offspring when moving to a Western country. The aim was to describe the growth trajectories between birth to 3.5 years in children of Chinese-born immigrant mothers compared with Australian-born mothers living in Victoria, Australia. METHODS Ten nurse measured weights and lengths from birth to 3.5 years were used to examine growth trajectory using linear spline multilevel models. Five knot points were identified at visit 2 (0.5 months), visit 4 (2 months), visit 5 (4.5 months), visit 8 (18 months) and visit 9 (25 months). RESULTS Ethnic disparities in growth trajectories between these two groups were revealed in models adjusted for birth weight, sex and level of socioeconomic disadvantage. Children of Chinese-born compared with Australian-born mothers revealed different growth rates and significant differences in predicted mean body mass index Z score (zBMI) at all time points from birth to 44 months, except for 12 months. Specifically, when compared with children of Australian-born mothers, children of Chinese-born mothers started with lower predicted zBMI from birth until 0.5 months, had a higher zBMI from 1 to 8 months and a lower zBMI from 12 to 44 months. Early and sharp acceleration of growth was also observed for children of Chinese-born mothers (0.5-2 months) when compared with children of Australian-born mothers (2-18 months). CONCLUSION Differences in growth trajectories exist between young children of Chinese-born and Australian-born mothers. Better understanding of these ethnically patterned growth trajectories is important for identifying key opportunities to promote healthy growth in early life.
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Affiliation(s)
- Kristy A Bolton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Peter Kremer
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Rachel Laws
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Centre of Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, New South Wales, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Centre of Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, New South Wales, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Centre of Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, New South Wales, Australia
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16
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Tang M, Matz KL, Berman LM, Davis KN, Melanson EL, Frank DN, Hendricks AE, Krebs NF. Effects of Complementary Feeding With Different Protein-Rich Foods on Infant Growth and Gut Health: Study Protocol. Front Pediatr 2021; 9:793215. [PMID: 35096709 PMCID: PMC8793676 DOI: 10.3389/fped.2021.793215] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/06/2021] [Indexed: 11/21/2022] Open
Abstract
Background: An urgent need exists for evidence-based dietary guidance early in life, particularly regarding protein intake. However, a significant knowledge gap exists in the effects of protein-rich foods on growth and development during early complementary feeding. Methods: This is a randomized controlled trial of infant growth and gut health (primary outcomes). We directly compare the effects of dietary patterns with common protein-rich foods (meat, dairy, plant) on infant growth trajectories and gut microbiota development (monthly assessments) during early complementary feeding in both breast- and formula-fed infants. Five-month-old infants (up to n = 300) are randomized to a meat-, dairy-, plant-based complementary diet or a reference group (standard of care) from 5 to 12 months of age, with a 24-month follow-up assessment. Infants are matched for sex, mode of delivery and mode of feeding using stratified randomization. Growth assessments include length, weight, head circumference and body composition. Gut microbiota assessments include both 16S rRNA profiling and metagenomics sequencing. The primary analyses will evaluate the longitudinal effects of the different diets on both anthropometric measures and gut microbiota. The secondary analysis will evaluate the potential associations between gut microbiota and infant growth. Discussion: Findings are expected to have significant scientific and health implications for identifying beneficial gut microbial changes and dietary patterns and for informing dietary interventions to prevent the risk of overweight and later obesity, and promote optimal health. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT05012930.
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Affiliation(s)
- Minghua Tang
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Kinzie L Matz
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Lillian M Berman
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Kathryn N Davis
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Edward L Melanson
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Daniel N Frank
- Division of Infectious Disease, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Audrey E Hendricks
- Department of Mathematical and Statistical Sciences, University of Colorado Denver, Denver, CO, United States
| | - Nancy F Krebs
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
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17
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D’Auria E, Borsani B, Pendezza E, Bosetti A, Paradiso L, Zuccotti GV, Verduci E. Complementary Feeding: Pitfalls for Health Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7931. [PMID: 33137971 PMCID: PMC7662522 DOI: 10.3390/ijerph17217931] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/19/2020] [Accepted: 10/26/2020] [Indexed: 12/17/2022]
Abstract
The term complementary feeding is defined as the period in which a progressive reduction of breastfeeding or infant-formula feeding takes place, while the infant is gradually introduced to solid foods. It is a crucial time in the infant's life, not only because of the rapid changes in nutritional requirements and the consequent impact on infant growth and development, but also for a generation of lifelong flavor preferences and dietary habits that will influence mid and long-term health. There is an increasing body of evidence addressing the pivotal role of nutrition, especially during the early stages of life, and its link to the onset of chronic non-communicable diseases, such as obesity, hypertension, diabetes, and allergic diseases. It is clear that the way in which a child is introduced to complementary foods may have effects on the individual's entire life. The aim of this review is to discuss the effects of complementary feeding timing, composition, and mode on mid and long-term health outcomes, in the light of the current evidence. Furthermore, we suggest practical tips for a healthy approach to complementary feeding, aiming at a healthy future, and highlight gaps to be filled.
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Affiliation(s)
- Enza D’Auria
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20122 Milan, Italy; (B.B.); (E.P.); (A.B.); (L.P.); (G.V.Z.); (E.V.)
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18
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Ferguson MC, O'Shea KJ, Hammer LD, Hertenstein DL, Syed RM, Nyathi S, Gonzales MS, Domino M, S Siegmund S, Randall S, Wedlock P, Adam A, Lee BY. Can following formula-feeding recommendations still result in infants who are overweight or have obesity? Pediatr Res 2020; 88:661-667. [PMID: 32179869 PMCID: PMC7492437 DOI: 10.1038/s41390-020-0844-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/04/2020] [Accepted: 02/08/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Studies show that by 3 months, over half of US infants receive formula, and guidelines play a key role in formula feeding. The question then is, what might happen if caregivers follow guidelines and, more specifically, are there situations where following guidelines can result in infants who are overweight/have obesity? METHODS We used our "Virtual Infant" agent-based model representing infant-caregiver pairs that allowed caregivers to feed infants each day according to guidelines put forth by Johns Hopkins Medicine (JHM), Children's Hospital of Philadelphia (CHOP), Children's Hospital of the King's Daughters (CHKD), and Women, Infants, and Children (WIC). The model simulated the resulting development of the infants from birth to 6 months. The two sets of guidelines vary in their recommendations, and do not provide studies that support amounts at given ages. RESULTS Simulations identified several scenarios where caregivers followed JHM/CHOP/CHKD and WIC guidelines, but infants still became overweight/with obesity by 6 months. For JHM/CHOP/CHKD guidelines, this occurred even when caregivers adjusted feeding based on infant's weight. For WIC guidelines, when caregivers adjusted formula amounts, infants maintained healthy weight. CONCLUSIONS WIC guidelines may be a good starting point for caregivers who adjust as their infant grows, but the minimum amounts for JHM/CHKD/CHOP recommendations may be too high. IMPACT Our virtual infant simulation study answers the question: can caregivers follow current formula-feeding guidelines and still end up with an infant who is overweight or has obesity? Our study identified several situations in which unhealthy weight gain and/or weight loss could result from following established formula-feeding recommendations. Our study also suggests that the minimum recommended amount of daily formula feeding should be lower for JHM/CHOP/CHKD guidelines to give caregivers more flexibility in adjusting daily feeding levels in response to infant weight. WIC guidelines may be a good starting point for caregivers who adjust as their infant grows. In order to understand how to adjust guidelines, we can use computational simulation models, which serve as "virtual laboratories" to help overcome the logistical and ethical issues of clinical trials.
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Affiliation(s)
- Marie C Ferguson
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York (previously at Johns Hopkins University, Baltimore, MD), New York, NY, USA
| | - Kelly J O'Shea
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York (previously at Johns Hopkins University, Baltimore, MD), New York, NY, USA
| | | | - Daniel L Hertenstein
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York (previously at Johns Hopkins University, Baltimore, MD), New York, NY, USA
| | - Rafay M Syed
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York (previously at Johns Hopkins University, Baltimore, MD), New York, NY, USA
| | - Sindiso Nyathi
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York (previously at Johns Hopkins University, Baltimore, MD), New York, NY, USA
| | - Mario Solano Gonzales
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York (previously at Johns Hopkins University, Baltimore, MD), New York, NY, USA
| | - Molly Domino
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York (previously at Johns Hopkins University, Baltimore, MD), New York, NY, USA
| | - Sheryl S Siegmund
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York (previously at Johns Hopkins University, Baltimore, MD), New York, NY, USA
| | - Samuel Randall
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York (previously at Johns Hopkins University, Baltimore, MD), New York, NY, USA
| | - Patrick Wedlock
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York (previously at Johns Hopkins University, Baltimore, MD), New York, NY, USA
| | - Atif Adam
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York (previously at Johns Hopkins University, Baltimore, MD), New York, NY, USA
| | - Bruce Y Lee
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York (previously at Johns Hopkins University, Baltimore, MD), New York, NY, USA.
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19
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Fauste E, Rodrigo S, Aguirre R, Donis C, Rodríguez L, Álvarez-Millán JJ, Panadero MI, Otero P, Bocos C. Maternal Fructose Intake Increases Liver H 2 S Synthesis but Exarcebates its Fructose-Induced Decrease in Female Progeny. Mol Nutr Food Res 2020; 64:e2000628. [PMID: 32754997 DOI: 10.1002/mnfr.202000628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Indexed: 12/26/2022]
Abstract
SCOPE Fructose intake from added sugars correlates with the epidemic rise in metabolic syndrome and cardiovascular diseases (CVD). However, consumption of beverages containing fructose is allowed during gestation. Homocysteine (Hcy) is a well-known risk factor for CVD while hydrogen sulfide (H2 S), a product of its metabolism, has been proved to exert opposite effects to Hcy. METHODS AND RESULTS First, it is investigated whether maternal fructose intake produces subsequent changes in Hcy metabolism and H2 S synthesis of the progeny. Carbohydrates are supplied to pregnant rats in drinking water (10% wt/vol) throughout gestation. Adult female descendants from fructose-fed, control or glucose-fed mothers are studied. Females from fructose-fed mothers have elevated homocysteinemia, hepatic H2 S production, cystathionine γ-lyase (CSE) (the key enzyme in H2 S synthesis) expression and plasma H2 S, versus the other two groups. Second, it is studied how adult female progeny from control (C/F), fructose- (F/F), and glucose-fed (G/F) mothers responded to liquid fructose and compared them to the control group (C/C). Interestingly, hepatic CSE expression and H2 S synthesis are diminished by fructose intake, this effect being more pronounced in F/F females. CONCLUSION Maternal fructose intake produces a fetal programming that increases hepatic H2 S production and, in contrast, exacerbates its fructose-induced drop in female progeny.
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Affiliation(s)
- Elena Fauste
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Montepríncipe, Boadilla del Monte, Madrid, 28668, Spain
| | - Silvia Rodrigo
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Montepríncipe, Boadilla del Monte, Madrid, 28668, Spain
| | - Rodrigo Aguirre
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Montepríncipe, Boadilla del Monte, Madrid, 28668, Spain
| | - Cristina Donis
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Montepríncipe, Boadilla del Monte, Madrid, 28668, Spain
| | - Lourdes Rodríguez
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Montepríncipe, Boadilla del Monte, Madrid, 28668, Spain
| | | | - María I Panadero
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Montepríncipe, Boadilla del Monte, Madrid, 28668, Spain
| | - Paola Otero
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Montepríncipe, Boadilla del Monte, Madrid, 28668, Spain
| | - Carlos Bocos
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Montepríncipe, Boadilla del Monte, Madrid, 28668, Spain
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20
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Lyons KE, Ryan CA, Dempsey EM, Ross RP, Stanton C. Breast Milk, a Source of Beneficial Microbes and Associated Benefits for Infant Health. Nutrients 2020; 12:E1039. [PMID: 32283875 PMCID: PMC7231147 DOI: 10.3390/nu12041039] [Citation(s) in RCA: 236] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/03/2020] [Accepted: 04/04/2020] [Indexed: 12/27/2022] Open
Abstract
Human breast milk is considered the optimum feeding regime for newborn infants due to its ability to provide complete nutrition and many bioactive health factors. Breast feeding is associated with improved infant health and immune development, less incidences of gastrointestinal disease and lower mortality rates than formula fed infants. As well as providing fundamental nutrients to the growing infant, breast milk is a source of commensal bacteria which further enhance infant health by preventing pathogen adhesion and promoting gut colonisation of beneficial microbes. While breast milk was initially considered a sterile fluid and microbes isolated were considered contaminants, it is now widely accepted that breast milk is home to its own unique microbiome. The origins of bacteria in breast milk have been subject to much debate, however, the possibility of an entero-mammary pathway allowing for transfer of microbes from maternal gut to the mammary gland is one potential pathway. Human milk derived strains can be regarded as potential probiotics; therefore, many studies have focused on isolating strains from milk for subsequent use in infant health and nutrition markets. This review aims to discuss mammary gland development in preparation for lactation as well as explore the microbial composition and origins of the human milk microbiota with a focus on probiotic development.
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Affiliation(s)
- Katríona E. Lyons
- Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork P61 C996, Ireland
- School of Microbiology, University College Cork, Cork T12 YN60, Ireland
| | - C. Anthony Ryan
- APC Microbiome Ireland, University College Cork, Cork T12 YT20, Ireland
- Department of Neonatology, Cork University Maternity Hospital, Cork T12 YE02, Ireland
| | - Eugene M. Dempsey
- APC Microbiome Ireland, University College Cork, Cork T12 YT20, Ireland
- Department of Neonatology, Cork University Maternity Hospital, Cork T12 YE02, Ireland
- INFANT Research Centre, University College Cork, Cork T12 DFK4, Ireland
| | - R. Paul Ross
- APC Microbiome Ireland, University College Cork, Cork T12 YT20, Ireland
| | - Catherine Stanton
- Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork P61 C996, Ireland
- APC Microbiome Ireland, University College Cork, Cork T12 YT20, Ireland
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21
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Fabiano V, Albani E, Cammi GM, Zuccotti GV. Nutrition in developmental age: few rules to stay healthy. Minerva Pediatr 2020; 72:182-195. [PMID: 32274912 DOI: 10.23736/s0026-4946.20.05803-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The first 1000 days of life represent a critical window for infants' and children's development. Overweight and insulin resistance, at the basis of non-communicable diseases (NCDs), are linked to various risk factors that begin in childhood, including children's diet. Italian data on infants' and children's dietary habits show higher intake of proteins, simple sugars, unhealthy fats and salt than recommended, while the iron intake is below requirement. We reviewed current literature analyzing observational studies, meta-analysis, systematic review and randomized clinical trials of the last 10 years (from 2009) on nutrition in developmental age, providing some few rules to abide by. Exclusive breastfeeding is recommended by World Health Organization for the first 6 months of life and it should be continued alongside the complementary feeding period until 12 months, or even afterward. Complementary feeding should not be started before the 17th week of age with energetically adequate foods, paying attention to limit protein intake and favoring iron-rich foods. Intake of simple sugars should be limited or avoided at all; it has been demonstrated that substituting sugar-sweetened beverages with water decreases body fatness development in adolescence. Quality of the ingested fats is more important than their quantity: polyunsaturated fatty acids should be preferred. Sodium intake should be limited in the first 24 months of life, as first prevention measure of arterial hypertension later in adulthood. Healthy eating habits are the first important step toward the prevention of NCDs.
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Affiliation(s)
- Valentina Fabiano
- Department of Pediatrics, V. Buzzi Children's Hospital, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy -
| | - Elena Albani
- Department of Pediatrics, V. Buzzi Children's Hospital, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy
| | - Giulia M Cammi
- Department of Pediatrics, V. Buzzi Children's Hospital, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy
| | - Gian V Zuccotti
- Department of Pediatrics, V. Buzzi Children's Hospital, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy
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22
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Kincaid HJ, Nagpal R, Yadav H. Microbiome-immune-metabolic axis in the epidemic of childhood obesity: Evidence and opportunities. Obes Rev 2020; 21:e12963. [PMID: 31663251 PMCID: PMC7771488 DOI: 10.1111/obr.12963] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/12/2019] [Accepted: 09/29/2019] [Indexed: 02/06/2023]
Abstract
Obesity epidemic responsible for increase in diabetes, heart diseases, infections and cancer shows no signs of abating. Obesity in children is also on rise, indicating the urgent need of strategies for prevention and intervention that must begin in early life. While originally posited that obesity results from the simple concept of consuming more calories, or genetics, emerging research suggests that the bacteria living in our gut (gut microbiome) and its interactions with immune cells and metabolic organs including adipose tissues (microbiome-immune-metabolic axis) play significant role in obesity development in childhood. Specifically, abnormal changes (dysbiosis) in the gut microbiome, stimulation of inflammatory cytokines, and shifts in the metabolic functions of brown adipose tissue and the browning of white adipose tissue are associated with increased obesity. Many factors from as early as gestation appear to contribute in obesity, such as maternal health, diet, antibiotic use by mother and/or child, and birth and feeding methods. Herein, using evidence from animal and human studies, we discuss how these factors impact microbiome-immune-metabolic axis and cause obesity epidemic in children, and describe the gaps in knowledge that are warranted for future research.
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Affiliation(s)
- Halle J Kincaid
- Department of Internal Medicine- Molecular Medicine, and Department of Microbiology and Immunology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ravinder Nagpal
- Department of Internal Medicine- Molecular Medicine, and Department of Microbiology and Immunology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Hariom Yadav
- Department of Internal Medicine- Molecular Medicine, and Department of Microbiology and Immunology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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23
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Fauste E, Rodrigo S, Rodríguez L, Donis C, García A, Barbas C, Álvarez-Millán JJ, Panadero MI, Otero P, Bocos C. FGF21-protection against fructose-induced lipid accretion and oxidative stress is influenced by maternal nutrition in male progeny. J Funct Foods 2020. [DOI: 10.1016/j.jff.2019.103676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Agakidou E, Karagiozoglou-Lampoudi T, Parlapani E, Fletouris DJ, Sarafidis K, Tzimouli V, Diamanti E, Agakidis C. Modifications of Own Mothers' Milk Fortification Protocol Affect Early Plasma IGF-I and Ghrelin Levels in Preterm Infants. A Randomized Clinical Trial. Nutrients 2019; 11:nu11123056. [PMID: 31847328 PMCID: PMC6950485 DOI: 10.3390/nu11123056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/03/2019] [Accepted: 12/11/2019] [Indexed: 12/19/2022] Open
Abstract
The aim was to investigate the effect of two own mother’s milk (OMM) fortification protocols on (a) IGF-I and ghrelin plasma levels at 35 post-conceptional weeks (PCW, T2) and whether this effect is maintained after elimination of the differences in OMM fortification, and (b) growth until 12 months corrected age. Forty-eight OMM-fed preterm infants (GA 24–32 weeks) were randomly allocated to the fixed-fortification (FF) group (n = 23) and the protein-targeting fortification (PTF) group (n = 25) targeting the recommended daily protein intake (PI). Plasma IGF-I and ghrelin were assessed at 35 (T2) and 40 (T3) PCW while growth was longitudinally assessed until 12 months corrected age. PTF group had lower IGF-I and higher ghrelin than FF group at T2, while receiving lower daily protein and energy amounts. PI correlated positively to T2-IGF-I and inversely to T3-ghrelin while energy intake (EI) correlated inversely to T2- and T3-ghrelin. Group and PI were independent predictors of adjusted T2-IGF-I, while group and EI were predictors of adjusted and T2-ghrelin. Growth parameter z-scores were comparable between groups up to 12 months corrected age. Modifications of OMM fortification have a transient effect on early plasma IGF-I and ghrelin levels in preterm infants in a way consistent with the previously recognized protein-energy/endocrine balance, indicating a potential programming effect.
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Affiliation(s)
- Eleni Agakidou
- 1st Department of Neonatology & NICU, Aristotle University of Thessaloniki, Ippokration General Hospital, Konstantinoupoleos 49, 54246 Thessaloniki, Greece; (E.P.); (K.S.); (E.D.)
- Correspondence: ; Tel.: +30-69-3741-9910
| | - Thomais Karagiozoglou-Lampoudi
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute of Thessaloniki, 57400 Thessaloniki, Greece;
| | - Elisavet Parlapani
- 1st Department of Neonatology & NICU, Aristotle University of Thessaloniki, Ippokration General Hospital, Konstantinoupoleos 49, 54246 Thessaloniki, Greece; (E.P.); (K.S.); (E.D.)
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute of Thessaloniki, 57400 Thessaloniki, Greece;
| | - Dimitrios J. Fletouris
- Laboratory of Milk Hygiene and Technology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Kosmas Sarafidis
- 1st Department of Neonatology & NICU, Aristotle University of Thessaloniki, Ippokration General Hospital, Konstantinoupoleos 49, 54246 Thessaloniki, Greece; (E.P.); (K.S.); (E.D.)
| | - Vasiliki Tzimouli
- 1st Pediatric Department, Aristotle University of Thessaloniki, Ippokration General Hospital, Konstantinoupoleos 49, 54246 Thessaloniki, Greece; (V.T.); (C.A.)
| | - Elisavet Diamanti
- 1st Department of Neonatology & NICU, Aristotle University of Thessaloniki, Ippokration General Hospital, Konstantinoupoleos 49, 54246 Thessaloniki, Greece; (E.P.); (K.S.); (E.D.)
| | - Charalampos Agakidis
- 1st Pediatric Department, Aristotle University of Thessaloniki, Ippokration General Hospital, Konstantinoupoleos 49, 54246 Thessaloniki, Greece; (V.T.); (C.A.)
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Koletzko B, Demmelmair H, Grote V, Totzauer M. Optimized protein intakes in term infants support physiological growth and promote long-term health. Semin Perinatol 2019; 43:151153. [PMID: 31466703 DOI: 10.1053/j.semperi.2019.06.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Breastfeeding is associated with a reduced later obesity risk, relative to feeding convention infant formula. Breastfeeding induces less weight gain during the first two years of life, which predicts less obesity up to adulthood. We tested the hypothesis that a high infant protein supply promotes weight gain and obesity risk, mediated by increased plasma amino acids and growth factors, insulin and insulin like growth factor 1 (IGF-1). A large multi-centre double blind trial randomized formula-fed infants to conventional bottle milk with a high protein content, or an intervention formula with a reduced protein content more similar to levels provided with human milk. Protein-reduced formula normalized weight, body mass index and body fatness up to 6 years, relative to a breastfed reference group, and reduced the adjusted odds for obesity 2.6-fold. Available data indicate potential underlying mechanisms. We conclude that infant feeding has very marked long-term programming effects on later BMI, obesity and adiposity, with major public health implications. Breastfeeding lowers the risk for later obesity and adiposity. This provides additional motivation for proactively and enthusiastically promoting, protecting and supporting breastfeeding. A high milk protein intake in infancy increases the long-term risk for obesity and adiposity. Infants not or not fully breastfed should receive infant formula delivering protein in amounts more similar to human milk contents, with high protein quality. Other sources of very high infant protein intakes, particular drinking unmodified cows' milk, should be avoided in infancy.
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Affiliation(s)
- Berthold Koletzko
- Div. Metabolic and Nutritional Medicine, Dept. of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU - Ludwig-Maximilians-Universität Munich, Lindwurmstr. 4, D-80337 München, Germany.
| | - Hans Demmelmair
- Div. Metabolic and Nutritional Medicine, Dept. of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU - Ludwig-Maximilians-Universität Munich, Lindwurmstr. 4, D-80337 München, Germany
| | - Veit Grote
- Div. Metabolic and Nutritional Medicine, Dept. of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU - Ludwig-Maximilians-Universität Munich, Lindwurmstr. 4, D-80337 München, Germany
| | - Martina Totzauer
- Div. Metabolic and Nutritional Medicine, Dept. of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU - Ludwig-Maximilians-Universität Munich, Lindwurmstr. 4, D-80337 München, Germany
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Commercial complementary food use amongst European infants and children: results from the EU Childhood Obesity Project. Eur J Nutr 2019; 59:1679-1692. [PMID: 31263982 DOI: 10.1007/s00394-019-02023-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 06/05/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE The objective of this secondary analysis is to describe the types of commercial complementary foods (CCF) consumed by infants and young children enrolled in the European Childhood Obesity Project (CHOP), to describe the contribution of CCF to dietary energy intakes and to determine factors associated with CCF use over the first 2 years of life. METHODS The CHOP trial is a multicenter intervention trial in Germany, Belgium, Italy, Poland and Spain that tested the effect of varying levels of protein in infant formula on the risk for childhood obesity. Infants were recruited from October 2002 to June 2004. Dietary data on CCF use for this secondary analysis were taken from weighted, 3-day dietary records from 1088 infants at 9 time points over the first 2 years of life. RESULTS Reported energy intakes from CCF during infancy (4-9 months) was significantly higher (p ≤ 0.002) amongst formula-fed children compared to breastfed children. Sweetened CCF intakes were significantly higher (p ≤ 0.009) amongst formula-fed infants. Female infants were fed significantly less CCF and infant age was strongly associated with daily CCF intakes, peaking at 9 months of age. Infants from families with middle- and high-level of education were fed significantly less quantities of CCF compared to infants with parents with lower education. Sweetened CCF were very common in Spain, Italy and Poland, with over 95% of infants and children fed CCF at 9 and 12 months of age consuming at least one sweetened CCF. At 24 months of age, 68% of the CHOP cohort were still fed CCF. CONCLUSIONS CCF comprised a substantial part of the diets of this cohort of European infants and young children. The proportion of infants being fed sweetened CCF is concerning. More studies on the quality of commercial complementary foods in Europe are warranted, including market surveys on the saturation of the Western European market with sweetened CCF products.
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Pauwels S, Symons L, Vanautgaerden EL, Ghosh M, Duca RC, Bekaert B, Freson K, Huybrechts I, Langie SAS, Koppen G, Devlieger R, Godderis L. The Influence of the Duration of Breastfeeding on the Infant's Metabolic Epigenome. Nutrients 2019; 11:E1408. [PMID: 31234503 PMCID: PMC6628078 DOI: 10.3390/nu11061408] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 05/29/2019] [Accepted: 06/17/2019] [Indexed: 12/21/2022] Open
Abstract
Nutrition in the postnatal period is associated with metabolic programming. One of the presumed underlying mechanisms involves epigenetic modifications (e.g., DNA methylation). Breastfeeding has an unknown impact on DNA methylation at a young age. Within the Maternal Nutrition and Offspring's Epigenome (MANOE) study, we assessed the effect of breastfeeding duration on infant growth and buccal methylation in obesity-related genes (n = 101). A significant difference was found between infant growth and buccal RXRA and LEP methylation at 12 months of breastfeeding. For RXRA CpG2 methylation, a positive association was found with duration of breastfeeding (slope = 0.217; 95% confidence interval (CI) 1.03, 0.330; p < 0.001). For RXRA CpG3 and CpG, mean methylation levels were significantly lower when children were breastfed for 4-6 months compared to non-breastfed children (only CpG3), and those breastfed for 7-9 months, 10-12 months, or 1-3 months. On the other hand, higher LEP CpG3 methylation was observed when mothers breastfed 7-9 months (6.1%) as compared to breastfeeding for 1-3 months (4.3%; p = 0.007) and 10-12 months (4.6%; p = 0.04). In addition, we observed that infant weight was significantly lower when children were breastfed for 10-12 months. Breastfeeding duration was associated with epigenetic variations in RXRA and LEP at 12 months and with infant biometry/growth. Our results support the hypothesis that breastfeeding could induce epigenetic changes in infants.
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Affiliation(s)
- Sara Pauwels
- Department of Public Health and Primary Care, Environment and Health, KU Leuven-University of Leuven, 3000 Leuven, Belgium.
- VITO-Health, 2400 Mol, Belgium.
| | - Lin Symons
- Department of Public Health and Primary Care, Environment and Health, KU Leuven-University of Leuven, 3000 Leuven, Belgium.
| | - Eva-Lynn Vanautgaerden
- Department of Public Health and Primary Care, Environment and Health, KU Leuven-University of Leuven, 3000 Leuven, Belgium.
| | - Manosij Ghosh
- Department of Public Health and Primary Care, Environment and Health, KU Leuven-University of Leuven, 3000 Leuven, Belgium.
| | - Radu Corneliu Duca
- Department of Public Health and Primary Care, Environment and Health, KU Leuven-University of Leuven, 3000 Leuven, Belgium.
| | - Bram Bekaert
- Department of Imaging & Pathology, KU Leuven-University of Leuven, 3000 Leuven, Belgium.
- Laboratory of Forensic Genetics and Molecular Archeology, Department of Forensic Medicine, University Hospitals Leuven, KU Leuven-University of Leuven, 3000 Leuven, Belgium.
| | - Kathleen Freson
- Center for Molecular and Vascular Biology, KU Leuven-University of Leuven, 3000 Leuven, Belgium.
| | - Inge Huybrechts
- Nutrition and Metabolism Section, International Agency for Research on Cancer, 69372 Lyon CEDEX 08, France.
| | - Sabine A S Langie
- VITO-Health, 2400 Mol, Belgium.
- Centre for Environmental Sciences, Hasselt University, 3590 Diepenbeek, Belgium.
| | | | - Roland Devlieger
- Department of Development and Regeneration, KU Leuven-University of Leuven, 3000 Leuven, Belgium.
- Department of Obstetrics and Gynecology, University Hospitals of Leuven, 3000 Leuven, Belgium.
| | - Lode Godderis
- Department of Public Health and Primary Care, Environment and Health, KU Leuven-University of Leuven, 3000 Leuven, Belgium.
- IDEWE, External Service for Prevention and Protection at Work, 3001 Heverlee, Belgium.
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28
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Ahern GJ, Hennessy A, Ryan CA, Ross RP, Stanton C. Advances in Infant Formula Science. Annu Rev Food Sci Technol 2019; 10:75-102. [DOI: 10.1146/annurev-food-081318-104308] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Human milk contains a plethora of nutrients and bioactive components to help nourish the developing neonate and is considered the “gold standard” for early life nutrition—as befits the only food “designed” by evolution to feed human infants. Over the past decade, there is considerable evidence that highlights the “intelligence” contained in milk components that contribute to infant health beyond basic nutrition—in areas such as programming the developing microbiome and immune system and protecting against infection. Such discoveries have led to new opportunities for infant milk formula (IMF) manufacturers to refine nutritional content in order to simulate the functionality of breast milk. These include the addition of specialized protein fractions as well as fatty acid and complex carbohydrate components—all of which have mechanistic supporting evidence in terms of improving the health and nutrition of the infant. Moreover, IMF is the single most important dietary intervention whereby the human microbiome can be influenced at a crucial early stage of development. In this respect, it is expected that the complexity of IMF will continue to increase as we get a greater understanding of how it can modulate microbiota development (including the development of probiotics, prebiotics, and synbiotics) and influence long-term health. This review provides a scientific evaluation of key features of importance to infant nutrition, including differences in milk composition and emerging “humanized” ingredients.
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Affiliation(s)
- Grace J. Ahern
- APC Microbiome Ireland, University College Cork, Cork T12 YT20, Ireland
- Teagasc Food Research Centre, Moorepark, Fermoy, Cork P61 C996, Ireland
- School of Microbiology, University College Cork, Cork, Ireland
| | - A.A. Hennessy
- Teagasc Food Research Centre, Moorepark, Fermoy, Cork P61 C996, Ireland
| | - C. Anthony Ryan
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
- School of Medicine, University College Cork, Cork T12 K8AF, Ireland
| | - R. Paul Ross
- APC Microbiome Ireland, University College Cork, Cork T12 YT20, Ireland
- Teagasc Food Research Centre, Moorepark, Fermoy, Cork P61 C996, Ireland
- School of Microbiology, University College Cork, Cork, Ireland
| | - Catherine Stanton
- APC Microbiome Ireland, University College Cork, Cork T12 YT20, Ireland
- Teagasc Food Research Centre, Moorepark, Fermoy, Cork P61 C996, Ireland
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Dipasquale V, Serra G, Corsello G, Romano C. Standard and Specialized Infant Formulas in Europe: Making, Marketing, and Health Outcomes. Nutr Clin Pract 2019; 35:273-281. [PMID: 30742336 DOI: 10.1002/ncp.10261] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Infant formulas are the only suitable substitute for human milk. The most common infant formulas are standard formulas based on cow's milk. In addition, there are formulas for infants showing signs and symptoms of intolerance and for clinical conditions such as allergy, prematurity, and gastrointestinal diseases. A comprehensive review of the literature was made to review the composition of standard and specialized infant formulas and analyze indications for use, real or presumed nutrition differences and properties, and impact on infant growth. A brief consideration on costs is outlined for each formula. Over the past few years, industrial production and advertising of infant formulas have increased. Human milk still remains the most complete source of nutrition for infants and should be continued according to the current recommendations. Few differences exist between infant formulas, both for the nutrition action and the macronutrient/micronutrient composition. Specialized infant formulas have limited indications for use and high costs. The role of the pediatrician is crucial in the management of infant nutrition, promotion of breastfeeding, and prescribing of specialized formulas only in specific clinical conditions.
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Affiliation(s)
- Valeria Dipasquale
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - Gregorio Serra
- Neonatology and Neonatal Intensive Care Unit, Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Palermo, Italy
| | - Giovanni Corsello
- Neonatology and Neonatal Intensive Care Unit, Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Palermo, Italy
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
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Totzauer M, Luque V, Escribano J, Closa-Monasterolo R, Verduci E, ReDionigi A, Hoyos J, Langhendries JP, Gruszfeld D, Socha P, Koletzko B, Grote V. Effect of Lower Versus Higher Protein Content in Infant Formula Through the First Year on Body Composition from 1 to 6 Years: Follow-Up of a Randomized Clinical Trial. Obesity (Silver Spring) 2018; 26:1203-1210. [PMID: 29932518 DOI: 10.1002/oby.22203] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 03/29/2018] [Accepted: 04/10/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The objective of this study was to investigate the effect of lower protein (LP) versus higher protein (HP) content in infant formula on body composition from 3 months to 6 years. METHODS In a multicenter, double-blind European trial, healthy infants (N = 1,090) were randomly assigned to different protein content formulas (upper [HP] and lower [LP] limits of the European Union regulations in 2001) during the first year; breastfed infants (N = 588) were recruited for reference values. Weight, height, and triceps and subscapular skinfold (SF) thickness were measured repeatedly (N = 650 at 6 years), and body composition was estimated (Slaughter). The 99th percentile of fat mass index reference data were used to assess excess body fat at 6 years. RESULTS At 2 and 6 years, the study observed greater sum of SFs (Δ 2 years: 0.5 mm, P = 0.026, Δ 6 years: 0.6 mm, P = 0.045), fat mass index (Δ 2 years: 0.12 kg/m², P = 0.008, Δ 6 years: 0.15 kg/m², P = 0.011), and fat-free mass index (Δ 2 years: 0.17 kg/m², P = 0.003, Δ 6 years: 0.18 kg/m², P = 0.010) in the HP group compared with the LP group. At 6 years, the HP group had a twofold higher risk than the LP group for excess body fat (adjusted odds ratio: 2.13, P = 0.019). CONCLUSIONS Infant formula with HP levels induced greater fat mass in children from 2 to 6 years. Lowering the protein content of infant formula may result in a healthier body composition in early childhood.
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Affiliation(s)
- Martina Totzauer
- Division of Metabolic and Nutritional Medicine, Dr von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - Veronica Luque
- Research Unit, Universitat Rovira i Virgili, Reus, Spain
| | | | | | - Elvira Verduci
- Department of Pediatrics, San Paolo Hospital, University of Milan, Milan, Italy
| | - Alice ReDionigi
- Department of Pediatrics, San Paolo Hospital, University of Milan, Milan, Italy
| | - Joana Hoyos
- Department of Pediatrics, University Children's Hospital Queen Fabiola, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Dariusz Gruszfeld
- Neonatal Intensive Care Unit, Children's Memorial Health Institute, Warsaw, Poland
| | - Piotr Socha
- Department of Gastroenterology, Hepatology and Eating Disorders, Children's Memorial Health Institute, Warsaw, Poland
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Dr von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - Veit Grote
- Division of Metabolic and Nutritional Medicine, Dr von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
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Jen V, Braun KVE, Karagounis LG, Nguyen AN, Jaddoe VWV, Schoufour JD, Franco OH, Voortman T. Longitudinal association of dietary protein intake in infancy and adiposity throughout childhood. Clin Nutr 2018; 38:1296-1302. [PMID: 29914777 DOI: 10.1016/j.clnu.2018.05.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 04/12/2018] [Accepted: 05/22/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS Protein intake in infancy promotes growth, but excessive intake may lead to adiposity in children. However, whether this increased adiposity persists throughout childhood and is independent of diet in later life remains unclear. Therefore, we studied the associations of total protein intake and protein from different sources at age 1 year with repeatedly measured growth and body composition up to age 10 years. Additionally, we examined whether these associations are independent of protein intake and overall diet quality at age 8 years. METHODS We included 3573 children from the Generation R study, a population-based prospective cohort in the Netherlands. Dietary intakes were assessed with food-frequency questionnaires at ages 1 and 8 years and macronutrient intakes were expressed as energy percentages (E%). Height and weight were measured at eight time points between ages 1 and 10 years. Fat and fat-free masses were measured at ages 6 and 10 years with dual-energy X-ray-absorptiometry. We calculated body mass index (BMI), fat mass index (FMI) and fat-free mass index (FFMI). Outcomes were standardized for sex and age and expressed as standard deviation scores (SDS). Associations of protein intake with growth and body composition trajectories were examined with multivariable linear mixed models. RESULTS After adjustment for confounders, 5E% additional protein intake at age 1 year was associated with a 0.10 SDS higher weight (95% CI 0.04, 0.16), 0.10 SDS higher BMI (95% CI 0.04, 0.16), and 0.07 SDS higher FMI (95% CI 0.01, 0.13) up to age 10 years. These associations were explained by protein from animal sources and not plant sources. Associations were independent of protein intake and overall diet quality at age 8 years, and were independent of whether higher protein was consumed at the expense of carbohydrates or fat in the diet. CONCLUSIONS Our study suggests that high protein intake in infancy, particularly from animal food sources, is persistently associated with adiposity up to age 10 years. Restricting protein intake in this critical period of development may aid in the early prevention of adiposity in childhood.
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Affiliation(s)
- Vincent Jen
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Kim V E Braun
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Leonidas G Karagounis
- Nestlé Research Center, PO Box 44, 1000 Lausanne 26, Switzerland; Experimental Myology and Integrative Biology Research Cluster, Faculty of Sport and Health Sciences, University of St Mark and St John, Plymouth, Devon PL6 8BH, UK
| | - Anh N Nguyen
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Josje D Schoufour
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands; Department of Internal Medicine, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
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Dietary protein intake in school-age children and detailed measures of body composition: the Generation R Study. Int J Obes (Lond) 2018; 42:1715-1723. [PMID: 29777231 DOI: 10.1038/s41366-018-0098-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 03/14/2018] [Accepted: 04/04/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND A high-protein diet in infancy increases the risk of obesity, but the effects of dietary protein intake in mid-childhood on body composition are unclear. Therefore, we studied associations of protein intake (total, animal and plant-sourced) at 8 years of age with anthropometric measures and body composition up to age 10 years. METHODS We included 3991 children of the Generation R Study, a prospective cohort in the Netherlands. Dietary protein intake was assessed at 8 years of age using a food-frequency questionnaire and is expressed in energy percentage (E%). Anthropometric measures and body composition (using dual-energy X-ray absorptiometry (DXA)) were assessed at 6 years and during follow-up at 10 years. We calculated body mass index (BMI), fat mass index (FMI), and fat-free mass index (FFMI). All outcomes were sex- and age-standardized and overweight (yes/no) was derived from BMI-SDS. We examined associations of protein intake at 8 years with the combined risk of overweight and obesity, and body composition at 10 years using multivariable logistic and linear regression models. These analyses were adjusted for outcomes at 6 years and protein intake in early life. RESULTS In multivariable-adjusted models, a 5E% higher protein intake at 8 years was associated with a higher combined risk of overweight and obesity up to 10 years (odds ratio (OR) 1.51, 95% confidence interval (CI): 1.22,1.86), independent of whether it replaced carbohydrates or fat. However, this was mainly explained by an association of protein intake with a higher FFMI (0.07 standard deviation scores (SDS) per 5E%, 95% CI: 0.02,0.11), not FMI. Both plant and animal were associated with a higher FFMI, but the association was stronger for protein from plant sources. For FMI, our findings also suggest trends of higher plant protein intake with lower FMI, and higher animal protein intake with higher FMI. Following this, a higher plant protein intake at the expense of animal protein was associated with a lower FMI (-0.08 SDS per 5E%, 95% CI: -0.15,-0.01). CONCLUSIONS We observed that a higher protein intake in mid-childhood is associated with a higher fat-free mass. Our findings also suggest that protein from plant sources seems to be beneficial for body composition in school-age children.
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Hydrolyzed Formula With Reduced Protein Content Supports Adequate Growth: A Randomized Controlled Noninferiority Trial. J Pediatr Gastroenterol Nutr 2018; 66:822-830. [PMID: 29216020 DOI: 10.1097/mpg.0000000000001853] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE A high protein content of nonhydrolyzed infant formula exceeding metabolic requirements can induce rapid weight gain and obesity. Hydrolyzed formula with too low protein (LP) content may result in inadequate growth. The aim of this study was to investigate noninferiority of partial and extensively hydrolyzed formulas (pHF, eHF) with lower hydrolyzed protein content than conventionally, regularly used formulas, with or without synbiotics for normal growth of healthy term infants. METHODS In an European multi-center, parallel, prospective, controlled, double-blind trial, 402 formula-fed infants were randomly assigned to four groups: LP-formulas (1.9 g protein/100 kcal) as pHF with or without synbiotics, LP-eHF formula with synbiotics, or regular protein eHF (2.3 g protein/100 kcal). One hundred and one breast-fed infants served as observational reference group. As primary endpoint, noninferiority of daily weight gain during the first 4 months of life was investigated comparing the LP-group to a regular protein eHF group. RESULTS A comparison of daily weight gain in infants receiving LPpHF (2.15 g/day CI -0.18 to inf.) with infants receiving regular protein eHF showed noninferior weight gain (-3.5 g/day margin; per protocol [PP] population). Noninferiority was also confirmed for the other tested LP formulas. Likewise, analysis of metabolic parameters and plasma amino acid concentrations demonstrated a safe and balanced nutritional composition. Energetic efficiency for growth (weight) was slightly higher in LPeHF and synbiotics compared with LPpHF and synbiotics. CONCLUSIONS All tested hydrolyzed LP formulas allowed normal weight gain without being inferior to regular protein eHF in the first 4 months of life. This trial was registered at clinicaltrials.gov, NCT01143233.
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Dutta S, Hazarika RD, Banerjee S, Anwar F, Rao S. Protein quality in early infancy and long-term health outcomes. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2017. [DOI: 10.1016/j.cegh.2017.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Saure C, Armeno M, Barcala C, Giudici V, Mazza CS. Excessive weight gain in exclusively breast-fed infants. J Pediatr Endocrinol Metab 2017; 30:719-724. [PMID: 28593913 DOI: 10.1515/jpem-2017-0028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 04/20/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND Breastfeeding is recommended as the best source of nutrition in the first months of life and observational studies have associated exclusive breastfeeding with decreased weight gain and a protective effect against obesity in childhood. The objective of this study was to describe the characteristics of a cohort of exclusively breastfed obese infants to determine factors that may lead to this unusual weight gain. METHODS Infants seen between 2003 and 2015 who were exclusively breastfed and showed excessive weight gain in the first year of life were followed with a focus on features of the mother, the child, feeding patterns and the presence of concomitant factors that influence nutritional status. Additionally, in a subset of the sample, macronutrients of the maternal breast milk were analyzed. A descriptive, prospective cross-sectional study was conducted. RESULTS Of 73 patients, 63% were girls. At 3 months of life, 64% had a weight-for-height standard deviation score (SDS) >2. At 6 and at 12 months, 100% of the patients had a weight-for-height >2 SDS. The mean age at semisolid-food introduction was 7 months. The mean age at weaning was 15.8 months. The babies were fed on demand and no hunger-satiety pattern was observed. In the breast milk samples analyzed, a significantly lower fat content was found. CONCLUSIONS The results of our study lead to the assumption that inter-individual variations in mother's milk composition may affect the growth patterns of children.
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Yang MZ, Xue HM, Pan J, Libuda L, Muckelbauer R, Yang M, Quan L, Cheng G. High protein intake along with paternal part-time employment is associated with higher body fat mass among girls from South China. Eur J Nutr 2017; 57:1845-1854. [PMID: 28536743 DOI: 10.1007/s00394-017-1468-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 05/01/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE Protein intake has been suggested to be associated with body composition among western children. Our aim was to determine whether protein intake is associated with body composition among Chinese children and to investigate whether parental socioeconomic status modifies these associations. METHODS Cross-sectional data were collected from the baseline survey of an ongoing population-based prospective open cohort study conducted in 2013. In this survey, 2039 children in South China were recruited using cluster random sampling. Information of 1704 children (47% girls), aged 7-12 years from three primary schools (42 classes), on diet and anthropometry was included finally. Their daily protein intake was obtained by 3-day 24-h dietary recalls. Skinfold thickness, body height, and weight were measured to calculate percent body fat (%BF), fat mass index (FMI), and fat-free mass index (FFMI). Parental characteristics were collected by questionnaires. RESULTS Among girls, protein intake was positively associated with %BF and FMI [estimate (SE) for %BF: 0.007 (0.003), p = 0.04; for FMI: 0.092 (0.002), p = 0.03], adjusted for pubertal stage, breast-feeding, maternal overweight, carbohydrate intake, energy intake, and physical activity level. Furthermore, there was interaction between paternal occupation and the relations of dietary protein with %BF and FMI (p for interaction ≤ 0.04). None of the associations between protein intake and %BF, FMI, or FFMI was found among boys. CONCLUSIONS Our data indicate that school-aged girls, but not boys, living in South China with higher dietary protein intake might have higher body fat mass, which could be modified by paternal occupation.
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Affiliation(s)
- Ming-Zhe Yang
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, No.16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, People's Republic of China
- Nutrition and Health Research Center, BY-HEALTH CO., LTD, No. 3 Kehui 3rd Street, No.99 Kexue Avenue Central, Huangpu District, Guangzhou, 510663, Guangdong, People's Republic of China
| | - Hong-Mei Xue
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, No.16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, People's Republic of China
| | - Jay Pan
- Department of Epidemiology and Statistic, West China School of Public Health, Sichuan University, No.16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, People's Republic of China
| | - Lars Libuda
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Pediatrics, Research Institute for the Prevention of Allergies and Respiratory Diseases in Childhood, Marien-Hospital Wesel, Wesel, Germany
| | - Rebecca Muckelbauer
- Berlin School of Public Health, Charité-Universitätsmedizin, Berlin, Germany
| | - Min Yang
- West China Research Center for Rural Health Development, Huaxi Medical Center, Sichuan University, No.16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, People's Republic of China
| | - Liming Quan
- Office of Scientific Research Management, West China School of Public Health, Sichuan University, No.16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, People's Republic of China
| | - Guo Cheng
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, No.16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, People's Republic of China.
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Wright M, Sotres-Alvarez D, Mendez MA, Adair L. The association of trajectories of protein intake and age-specific protein intakes from 2 to 22 years with BMI in early adulthood. Br J Nutr 2017; 117:750-758. [PMID: 28347359 PMCID: PMC5842682 DOI: 10.1017/s0007114517000502] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
No study has analysed how protein intake from early childhood to young adulthood relate to adult BMI in a single cohort. To estimate the association of protein intake at 2, 11, 15, 19 and 22 years with age- and sex-standardised BMI at 22 years (early adulthood), we used linear regression models with dietary and anthropometric data from a Filipino birth cohort (1985-2005, n 2586). We used latent growth curve analysis to identify trajectories of protein intake relative to age-specific recommended daily allowance (intake in g/kg body weight) from 2 to 22 years, then related trajectory membership to early adulthood BMI using linear regression models. Lean mass and fat mass were secondary outcomes. Regression models included socioeconomic, dietary and anthropometric confounders from early life and adulthood. Protein intake relative to needs at age 2 years was positively associated with BMI and lean mass at age 22 years, but intakes at ages 11, 15 and 22 years were inversely associated with early adulthood BMI. Individuals were classified into four mutually exclusive trajectories: (i) normal consumers (referent trajectory, 58 % of cohort), (ii) high protein consumers in infancy (20 %), (iii) usually high consumers (18 %) and (iv) always high consumers (5 %). Compared with the normal consumers, 'usually high' consumption was inversely associated with BMI, lean mass and fat mass at age 22 years whereas 'always high' consumption was inversely associated with male lean mass in males. Proximal protein intakes were more important contributors to early adult BMI relative to early-childhood protein intake; protein intake history was differentially associated with adulthood body size.
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Affiliation(s)
- Melecia Wright
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, Chapel Hill 27599, USA
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, Chapel Hill 27599, USA
| | - Michelle Ann Mendez
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, Chapel Hill 27599, USA
| | - Linda Adair
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, Chapel Hill 27599, USA
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Closa-Monasterolo R, Gispert-Llaurado M, Canals J, Luque V, Zaragoza-Jordana M, Koletzko B, Grote V, Weber M, Gruszfeld D, Szott K, Verduci E, ReDionigi A, Hoyos J, Brasselle G, Escribano Subías J. The Effect of Postpartum Depression and Current Mental Health Problems of the Mother on Child Behaviour at Eight Years. Matern Child Health J 2017; 21:1563-1572. [DOI: 10.1007/s10995-017-2288-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Besharat Pour M, Bergström A, Bottai M, Magnusson J, Kull I, Moradi T. Age at adiposity rebound and body mass index trajectory from early childhood to adolescence; differences by breastfeeding and maternal immigration background. Pediatr Obes 2017; 12:75-84. [PMID: 26910193 DOI: 10.1111/ijpo.12111] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 12/02/2015] [Accepted: 01/04/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This paper aims to assess association between breastfeeding and maternal immigration background and body mass index development trajectories from age 2 to 16 years. METHODS A cohort of children born in Stockholm during 1994 to 1996 was followed from age 2 to 16 years with repeated measurement of height and weight at eight time points (n = 2278). Children were categorized into groups by breastfeeding status during the first 6 months of life and maternal immigration background. Body mass index (BMI) trajectories and age at adiposity rebound were estimated using mixed-effects linear models. RESULTS Body mass index trajectories were different by breastfeeding and maternal immigration status (P-value < 0.0001). Compared with exclusively breastfed counterparts, never/short breastfed children of Swedish mothers had a higher BMI trajectory, whereas never/short breastfed children of immigrant mothers followed a lower BMI trajectory. Ages at adiposity rebound were earlier for higher BMI trajectories regardless of maternal immigration background. CONCLUSION Differences in BMI trajectories between offspring of immigrant and of Swedish mothers suggest a lack of beneficial association between breastfeeding and long-term BMI development among children of immigrant mothers. Given the relation between long-term BMI development and risk of overweight/obesity, these differences challenge the notion that exclusive breastfeeding is always beneficial for children's BMI development and subsequent risk of overweight/obesity.
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Affiliation(s)
- M Besharat Pour
- Institute of Environmental Medicine, Division of Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - A Bergström
- Institute of Environmental Medicine, Division of Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - M Bottai
- Institute of Environmental Medicine, Unit of Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - J Magnusson
- Institute of Environmental Medicine, Division of Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - I Kull
- Institute of Environmental Medicine, Division of Epidemiology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Science and Education, Stockholm South General Hospital, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Stockholm South General Hospital, Stockholm, Sweden
| | - T Moradi
- Institute of Environmental Medicine, Division of Epidemiology, Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
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Contarato AAPF, Rocha EDDM, Czarnobay SA, Mastroeni SSDBS, Veugelers PJ, Mastroeni MF. Independent effect of type of breastfeeding on overweight and obesity in children aged 12-24 months. CAD SAUDE PUBLICA 2016; 32:e00119015. [PMID: 28001206 DOI: 10.1590/0102-311x00119015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 03/11/2016] [Indexed: 11/21/2022] Open
Abstract
This study aimed to analyze the effect of type of breastfeeding on the nutritional status of children between 12-24 months of age. This cohort study included 435 children born in 2012 in a public hospital in Joinville, Santa Catarina State, Brazil. Two years after delivery the mothers and their children were contacted in their homes for a new investigation of demographic, economic, nutritional, and anthropometric data. In the unadjusted analysis, children who were not exclusively breastfed were more likely to be overweight (including obesity) at 2 years of age (OR = 1.6; p = 0.049) than exclusively breastfed children. After adjusting for several covariates, children who were not exclusively breastfed had a 12% higher risk of overweight including obesity compared to unadjusted analysis (OR = 2.6 vs. OR = 1.8; p = 0.043). In addition, birthweight was also an independent determinant of overweight including obesity (OR = 2.5; p = 0.002). The practice of exclusive breastfeeding can reduce the risk of overweight in children from developing countries such as Brazil.
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Affiliation(s)
| | | | - Sandra Ana Czarnobay
- Departamento de Nutrição, Associação Educacional Luterana Bom Jesus, Joinville, Brasil
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Bolton KA, Kremer P, Hesketh KD, Laws R, Campbell KJ. The Chinese-born immigrant infant feeding and growth hypothesis. BMC Public Health 2016; 16:1071. [PMID: 27724903 PMCID: PMC5057409 DOI: 10.1186/s12889-016-3677-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 09/16/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Rapid growth in the first six months of life is a well-established risk factor for childhood obesity, and child feeding practices (supplementation or substitution of breast milk with formula and early introduction of solids) have been reported to predict this. The third largest immigrant group in Australia originate from China. Case-studies reported from Victorian Maternal and Child Health nurses suggest that rapid growth trajectories in the infants of Chinese parents is common place. Furthermore, these nurses report that high value is placed by this client group on rapid growth and a fatter child; that rates of breastfeeding are low and overfeeding of infant formula is high. There are currently no studies which describe infant growth or its correlates among this immigrant group. PRESENTATION OF HYPOTHESIS We postulate that in Australia, Chinese-born immigrant mothers will have different infant feeding practices compared to non-immigrant mothers and this will result in different growth trajectories and risk of overweight. We present the Chinese-born immigrant infant feeding and growth hypothesis - that less breastfeeding, high formula feeding and early introduction of solids in infants of Chinese-born immigrant mothers living in Australia will result in a high protein intake and subsequent rapid growth trajectory and increased risk of overweight and obesity. TESTING THE HYPOTHESIS Three related studies will be conducted to investigate the hypothesis. These will include two quantitative studies (one cross-sectional, one longitudinal) and a qualitative study. The quantitative studies will investigate differences in feeding practices in Chinese-born immigrant compared to non-immigrant mothers and infants; and the growth trajectories over the first 3.5 years of life. The qualitative study will provide more in-depth understanding of the influencing factors on feeding practices in Chinese-born immigrant mothers. IMPLICATIONS OF THE HYPOTHESIS This study will provide evidence of the potential modifiable feeding practices and risk of overweight faced by Chinese-born immigrants living in Australia. This is important to help identify groups at risk of rapid growth and subsequent risk of obesity, to identify opportunities for intervention, and to be able to tailor prevention initiatives appropriately.
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Affiliation(s)
- Kristy A Bolton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
| | - Peter Kremer
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Rachel Laws
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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Wright M, Mendez MA, Sotres-Alvarez D, Adair L. Breastfeeding and Protein Intake Influence Body Mass Index from 2 Months to 22 Years in the Cebu Longitudinal Health and Nutrition Survey. J Nutr 2016; 146:2085-2092. [PMID: 27581582 PMCID: PMC6457088 DOI: 10.3945/jn.116.232470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/15/2016] [Accepted: 08/01/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Protein intake (PI) may alter adiposity but few studies have explored the age-specific associations of PI with body mass index (BMI). OBJECTIVE We analyzed how PI and breastfeeding relate to BMI in the CLHNS (Cebu Longitudinal Health and Nutrition Survey), an observational Filipino birth cohort (1983-2005). METHODS Random-effects longitudinal regression models estimated the association of daily breastfeeding frequency and energy-adjusted PI residuals with concurrent BMI z scores (zBMI) measured bimonthly from 2 to 24 mo (n = 2899), and the association of breastfeeding history and PI residuals with concurrent BMI using 5 surveys from 2 to 22 y (n = 2435). Models included statistical interactions between PI, breastfeeding, age, and energy intake and adjusted for potential confounders. RESULTS Breastfeeding was associated with higher predicted zBMI at 6 mo (β: 0.491 SD; 95% CI: 0.422, 0.560) and at 18 mo (β: 0.114 SD; 95% CI: 0.032, 0.197). Daily breastfeeding frequency contributed to higher predicted zBMI in younger infants and lower predicted zBMI in later infancy. Those with longer breastfeeding history (19 mo) were significantly smaller at age 11 y (in kg/m2; β: -0.220; 95% CI: -0.342, -0.097) than those with a shorter (4 mo) breastfeeding duration. Total complementary PI was positively associated with predicted zBMI. Complementary animal PI was positively associated with predicted zBMI in nonbreastfed infants. Plant PI was inversely associated with predicted zBMI of nonbreastfed infants at 6 mo. At 22 y contrasts between high (75th percentile) and low (25th percentile) PIs showed that animal PI was associated with higher predicted BMI (β: 0.187; 95% CI: 0.045, 0.329), and total PI was inversely related to predicted BMI (β: -0.008; 95% CI: -0.015, -0.001). CONCLUSION Breastfeeding frequency, breastfeeding history, and PI contribute to BMI from infancy to young adulthood in the CLHNS.
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Temples HS, Willoughby D, Holaday B, Rogers CR, Wueste D, Bridges W, Saffery R, Craig JM. Breastfeeding and Growth of Children in the Peri/postnatal Epigenetic Twins Study (PETS): Theoretical Epigenetic Mechanisms. J Hum Lact 2016; 32:481-8. [PMID: 27009979 DOI: 10.1177/0890334416637594] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 02/10/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND The prevalence of overweight infants and toddlers has increased by 60% in the past 30 years and is a significant contributor to diabetes, cardiovascular disease, and early morbidity and mortality. The World Health Organization's updated meta-analysis in 2013 observed an association between breastfeeding and a lower prevalence of obesity later in life. The purpose of this study was to assess the growth of children in a cohort of Australian twins to examine associations between duration of breastfeeding and growth at 18 months of age. Our hypothesis is that the anthropometric measurements of the participants will be greater with shorter duration of breastfeeding. METHODS Methods include using cross-sectional data from a cohort at the 18-month visit (n = 179) in the Peri/postnatal Epigenetics Twins Study (PETS) to assess the relationship between duration of breastfeeding and infant size at 18 months of age. Inclusion criteria were birth weight of more than 2000 grams and breastfed for less than 1 month, 1 to 3 months, or 4 to 6 months. RESULTS The analysis suggested that infants breastfed for 1 to 3 months were significantly larger than infants breastfed for 4 to 6 months in terms of mean body mass index (BMI) (0.61 kg/m(2); P = .02; 95% confidence interval [CI], 0.17-1.05), arm circumference (0.66 cm; P = .006; 95% CI, 0.26-1.06), and abdominal circumference (1.16 cm; P = .03; 95% CI, 0.26-2.06). The analysis also suggested that infants breastfed for less than 1 month were significantly larger than infants breastfed for 4 to 6 months in terms of mean arm circumference (0.72 cm; P = .009; 95% CI, 0.26-1.17). CONCLUSION Results suggest that supplementing with non-breast milk before 4 months of age was associated with an increased BMI, arm circumference, and abdominal circumference at 18 months of age. The mean BMI decreased from 85% to 65% when infants were breastfeeding for 4 to 6 months as compared to breastfeeding for 1 to 3 months. Breastfeeding for 4 to 6 months appeared to protect against the risk of obesity for the children in the PETS.
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Affiliation(s)
| | | | | | | | | | | | - Richard Saffery
- Department of Paediatrics, University of Melbourne, Melbourne, Australia Cancer, Disease and Developmental Epigenetics Group, Cell Biology, Development and Disease Theme, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Jeffrey M Craig
- Department of Paediatrics, University of Melbourne, Melbourne, Australia Early Life Epigenetics Group, Public Health Genes and Environment Theme, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia
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Liquid fructose in pregnancy exacerbates fructose-induced dyslipidemia in adult female offspring. J Nutr Biochem 2016; 32:115-22. [PMID: 27142744 DOI: 10.1016/j.jnutbio.2016.02.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 01/19/2016] [Accepted: 02/23/2016] [Indexed: 01/06/2023]
Abstract
Fructose intake from added sugars correlates with the epidemic rise in metabolic syndrome and related events. Nevertheless, consumption of beverages sweetened with fructose is not regulated in gestation. Previously, we found that maternal fructose intake produces in the progeny, when fetuses, impaired leptin signaling and hepatic steatosis and then impaired insulin signaling and hypoadiponectinemia in adult male rats. Interestingly, adult females from fructose-fed mothers did not exhibit any of these disturbances. However, we think that, actually, these animals keep a programmed phenotype hidden. Fed 240-day-old female progeny from control, fructose- and glucose-fed mothers were subjected for 3weeks to a fructose supplementation period (10% wt/vol in drinking water). Fructose intake provoked elevations in insulinemia and adiponectinemia in the female progeny independently of their maternal diet. In accordance, the hepatic mRNA levels of several insulin-responsive genes were similarly affected in the progeny after fructose intake. Interestingly, adult progeny of fructose-fed mothers displayed, in response to the fructose feeding, augmented plasma triglyceride and NEFA levels and hepatic steatosis versus the other two groups. In agreement, the expression and activity for carbohydrate response element binding protein (ChREBP), a lipogenic transcription factor, were higher after the fructose period in female descendants from fructose-fed mothers than in the other groups. Furthermore, liver fructokinase expression that has been indicated as one of those responsible for the deleterious effects of fructose ingestion was preferentially augmented in that group. Maternal fructose intake does influence the adult female offspring's response to liquid fructose and so exacerbates fructose-induced dyslipidemia and hepatic steatosis.
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Xu S, Xue Y. Protein intake and obesity in young adolescents. Exp Ther Med 2016; 11:1545-1549. [PMID: 27168771 PMCID: PMC4840493 DOI: 10.3892/etm.2016.3137] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 03/09/2016] [Indexed: 11/27/2022] Open
Abstract
The abundance of protein and its functional diversity in living systems makes it essential for virtually all life processes. Dietary protein and amino acid requirements are affected by age, body size, body composition, physiological state, and the level of energy output. The requirement for dietary protein is based on the indispensable amino acids under all conditions and under specific physiological and pathological conditions as well as the synthesis of dispensable amino acids and other nitrogen-containing compounds. Previous findings have shown the influence of early intake of proteins on the development of overweight in healthy children. The present review focused on the possible association (if any) between protein intake and later development of obesity. The aim is to benefit physicians, dieticians as well as parents to understand future consequences of incorrect dietary habits in young adolescents and encourage healthy dietary habits to avoid obesity.
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Affiliation(s)
- Shumei Xu
- Department of Endocrinology, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China
| | - Ying Xue
- Department of Endocrinology, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China
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Koletzko B, Demmelmair H, Grote V, Hellmuth C, Kirchberg F, Uhl O, Weber M, Prell C. Langfristige Prägung der Gesundheit durch die Säuglingsernährung. Monatsschr Kinderheilkd 2016. [DOI: 10.1007/s00112-015-0002-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Pimpin L, Jebb S, Johnson L, Wardle J, Ambrosini GL. Dietary protein intake is associated with body mass index and weight up to 5 y of age in a prospective cohort of twins. Am J Clin Nutr 2016; 103:389-97. [PMID: 26718416 PMCID: PMC4733258 DOI: 10.3945/ajcn.115.118612] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 11/17/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Few large epidemiologic studies have investigated the role of postweaning protein intake in excess weight and adiposity of young children, despite children in the United Kingdom consistently consuming protein in excess of their physiologic requirements. OBJECTIVE We investigated whether a higher proportion of protein intake from energy beyond weaning is associated with greater weight gain, higher body mass index (BMI), and risk of overweight or obesity in children up to 5 y of age. DESIGN Participants were 2154 twins from the Gemini cohort. Dietary intake was collected by using a 3-d diet diary when the children had a mean age of 21 mo. Weight and height were collected every 3 mo, from birth to 5 y. Longitudinal models investigated associations of protein intake with BMI, weight, and height, with adjustment for age at diet diary, sex, total energy intake, birth weight/length, and rate of prior growth and clustering within families. Logistic regression investigated protein intake in relation to the odds of overweight or obesity at 3 and 5 y of age. RESULTS A total of 2154 children had a mean ± SD of 5.7 ± 3.2 weight and height measurements up to 5 y. Total energy from protein was associated with higher BMI (β = 0.043; 95% CI: 0.011, 0.075) and weight (β = 0.052; 95% CI: 0.031, 0.074) but not height (β = 0.088; 95% CI: -0.038, 0.213) between 21 mo and 5 y. Substituting percentage energy from fat or carbohydrate for percentage energy from protein was associated with decreases in BMI and weight. Protein intake was associated with a trend in increased odds of overweight or obesity at 3 y (OR = 1.10; 95% CI 0.99, 1.22, P = 0.075), but the effect was not statistically significant at 5 y. CONCLUSION A higher proportion of energy from protein during the complementary feeding stage is associated with greater increases in weight and BMI in early childhood in this large cohort of United Kingdom children.
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Affiliation(s)
- Laura Pimpin
- Medical Research Council Human Nutrition Research, Cambridge, United Kingdom
| | - Susan Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Jane Wardle
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom; and
| | - Gina L Ambrosini
- Medical Research Council Human Nutrition Research, Cambridge, United Kingdom; School of Population Health, The University of Western Australia, Perth, Western Australia
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Koletzko B, Demmelmair H, Grote V, Prell C, Weber M. High protein intake in young children and increased weight gain and obesity risk. Am J Clin Nutr 2016; 103:303-4. [PMID: 26791192 DOI: 10.3945/ajcn.115.128009] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Berthold Koletzko
- Ludwig-Maximilians-Universität Munich, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - Hans Demmelmair
- Ludwig-Maximilians-Universität Munich, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - Veit Grote
- Ludwig-Maximilians-Universität Munich, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - Christine Prell
- Ludwig-Maximilians-Universität Munich, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - Martina Weber
- Ludwig-Maximilians-Universität Munich, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
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Effect of dietary protein on plasma insulin-like growth factor-1, growth, and body composition in healthy term infants: a randomised, double-blind, controlled trial (Early Protein and Obesity in Childhood (EPOCH) study). Br J Nutr 2015; 115:271-84. [PMID: 26586096 PMCID: PMC4697297 DOI: 10.1017/s0007114515004456] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The effect of protein intake on growth velocity in infancy may be mediated by
insulin-like growth factor-1 (IGF-1). This study aimed to determine the effects of
formulae containing 1·8 (F1·8) or 2·7 g (F2·7) protein/418·4 kJ (100 kcal) on IGF-1
concentrations and growth. Healthy term infants were randomly assigned to receive F1·8
(n 74) or F2·7 (n 80) exclusively for the first 4
months of life. A group of breast-fed infants (n 84) was followed-up
simultaneously (reference). Growth and body composition were measured at 0·5, 4, 6, 12,
36, 48 and 60 months of life. The IGF-1 concentrations at 4 months (primary outcome) were
similar in the F1·8 (67·1 (sd 20·8) ng/l; n 70) and F2·7 (71·2
(sd 27·5) ng/l; n 73) groups (P=0·52). Both
formula groups had higher IGF-1 concentrations than the breast-fed group at 4 and 9 months
of age (P≤0·0001). During the first 60 months of life, anthropometric
parameters in the F1·8 group were lower compared with the F2·7 group, and the differences
were significant for head circumference from 2 to 60 months, body weight at 4 and 6 months
and length at 9, 12 and 36 months of age. There were no significant differences in body
composition between these two groups at any age. We conclude that, in formula-fed infants,
although increased protein intake did not affect the IGF-1 concentration during the first
12 months of life, it did affect length and head circumference growth, suggesting that
factors other than IGF-1 could play roles in determining growth velocity.
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50
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Hopkins D, Steer CD, Northstone K, Emmett PM. Effects on childhood body habitus of feeding large volumes of cow or formula milk compared with breastfeeding in the latter part of infancy. Am J Clin Nutr 2015; 102:1096-103. [PMID: 26354544 PMCID: PMC4625583 DOI: 10.3945/ajcn.114.100529] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 08/06/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is controversy over whether a lack of breastfeeding is related to obesity development. OBJECTIVE We examined the effects of feeding different types of milk in late infancy on childhood growth. DESIGN A cohort of 1112 term, singleton children (born in 1992) from the Avon Longitudinal Study of Parents and Children, United Kingdom, were studied prospectively. Food records collected at 8 mo of age were used to define the following 5 mutually exclusive feeding groups on the basis of the type and amount of milk consumed: breast milk (BM), <600 mL formula milk/d (FMlow), ≥600 mL formula milk/d (FMhigh), <600 mL cow milk/d (CMlow), and ≥600 mL cow milk/d (CMhigh). Weight, height, and BMI were measured at 14 time points from birth to 10 y of age, and SD scores (SDSs) were calculated. Dietary energy and macronutrient intakes were available at 7 time points. RESULTS CMhigh children were heavier than were BM children from 8 mo to 10 y of age with weight differences (after adjustment for maternal education, smoking, and parity) ≥0.27 SDSs and an average of 0.48 SDSs. The maximum weight difference was at 18 mo of age (0.70 SDS; 95% CI: 0.41, 1.00 SDS; P = <0.0001). CMhigh children were taller at some ages (25-43 mo; P < 0.01) and had greater BMI SDSs from ≥8 mo of age (at 9 y of age; P = 0.001). FMhigh children were heavier and taller than were BM children from 8 to 37 mo of age. There were marked dietary differences between milk groups at 8 mo of age, some of which persisted to 18 mo of age. Adjustments for current energy and protein intakes did not attenuate the growth differences observed. CONCLUSIONS The feeding of high volumes of cow milk in late infancy is associated with faster weight and height gain than is BM feeding. The feeding of bottle-fed infants with high volumes of cow milk in late infancy may have a persisting effect on body habitus through childhood.
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Affiliation(s)
- David Hopkins
- Nutrition and Dietetic Department, Southampton General Hospital, Southampton, United Kingdom; and
| | - Colin D Steer
- Centre for Child and Adolescent Health, School of Social and Community Medicine and
| | - Kate Northstone
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Pauline M Emmett
- Centre for Child and Adolescent Health, School of Social and Community Medicine and
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