1
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Wang N, Yang S, Mu GQ, Qian F, Zhu XM. Exploring lipid digestion discrepancies between preterm formula and human milk: Insights from in vitro gastrointestinal digestion and the impact of added milk fat. Food Res Int 2024; 186:114317. [PMID: 38729709 DOI: 10.1016/j.foodres.2024.114317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 03/23/2024] [Accepted: 04/16/2024] [Indexed: 05/12/2024]
Abstract
Lipids play a pivotal role in the nutrition of preterm infants, acting as a primary energy source. Due to their underdeveloped gastrointestinal systems, lipid malabsorption is common, leading to insufficient energy intake and slowed growth. Therefore, it is critical to explore the reasons behind the low lipid absorption rate in formulas for preterm infants. This study utilized a simulated in intro gastrointestinal digestion model to assess the differences in lipid digestion between preterm human milk and various infant formulas. Results showed that the fatty acid release rates for formulas IF3, IF5, and IF7 were 58.90 %, 56.58 %, and 66.71 %, respectively, lower than human milk's 72.31 %. The primary free fatty acids (FFA) and 2-monoacylglycerol (2-MAG) released during digestion were C14:0, C16:0, C18:0, C18:1n-9, and C18:2n-6, in both human milk and formulas. Notably, the higher release of C16:0 in formulas may disrupt fatty acid balance, impacting lipid absorption. Further investigations are necessary to elucidate lipid absorption differences, which will inform the optimization of lipid content in preterm infant formulas.
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Affiliation(s)
- Ning Wang
- School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, PR China
| | - Sen Yang
- School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, PR China
| | - Guang-Qing Mu
- School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, PR China
| | - Fang Qian
- School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, PR China
| | - Xue-Mei Zhu
- School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, PR China.
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2
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Zhang W, Zhang Q, Cao Z, Zheng L, Hu W. Physiologically Based Pharmacokinetic Modeling in Neonates: Current Status and Future Perspectives. Pharmaceutics 2023; 15:2765. [PMID: 38140105 PMCID: PMC10747965 DOI: 10.3390/pharmaceutics15122765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
Rational drug use in special populations is a clinical problem that doctors and pharma-cists must consider seriously. Neonates are the most physiologically immature and vulnerable to drug dosing. There is a pronounced difference in the anatomical and physiological profiles be-tween neonates and older people, affecting the absorption, distribution, metabolism, and excretion of drugs in vivo, ultimately leading to changes in drug concentration. Thus, dose adjustments in neonates are necessary to achieve adequate therapeutic concentrations and avoid drug toxicity. Over the past few decades, modeling and simulation techniques, especially physiologically based pharmacokinetic (PBPK) modeling, have been increasingly used in pediatric drug development and clinical therapy. This rigorously designed and verified model can effectively compensate for the deficiencies of clinical trials in neonates, provide a valuable reference for clinical research design, and even replace some clinical trials to predict drug plasma concentrations in newborns. This review introduces previous findings regarding age-dependent physiological changes and pathological factors affecting neonatal pharmacokinetics, along with their research means. The application of PBPK modeling in neonatal pharmacokinetic studies of various medications is also reviewed. Based on this, we propose future perspectives on neonatal PBPK modeling and hope for its broader application.
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Affiliation(s)
| | | | | | - Liang Zheng
- Department of Clinical Pharmacology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China; (W.Z.); (Q.Z.); (Z.C.)
| | - Wei Hu
- Department of Clinical Pharmacology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China; (W.Z.); (Q.Z.); (Z.C.)
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3
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Sabari S, Julmohammad N, Jahurul HAM, Matanjun P, Ab. Wahab N. In Vitro Infant Digestion of Whey Proteins Isolate-Lactose. Foods 2023; 12:foods12030667. [PMID: 36766193 PMCID: PMC9914322 DOI: 10.3390/foods12030667] [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: 11/24/2022] [Revised: 12/31/2022] [Accepted: 01/06/2023] [Indexed: 02/05/2023] Open
Abstract
The model in vitro protein digestion technique has received greater attention due to providing significant advantages compared to in vivo experiments. This research employed an in vitro infant digestive static model to examine the protein digestibility of whey proteins isolate-lactose (WPI-Lac). The polyacrylamide gel electrophoresis (PAGE) pattern for alpha-lactalbumin of WPI at 60 min showed no detectable bands, while the alpha-lactalbumin of the WPI-Lac was completely digested after 5 min of gastric digestion. The beta-lactoglobulin of the WPI-Lac was found to be similar to the beta-lactoglobulin of the WPI, being insignificant at pH 3.0. The alpha-lactalbumin of the WPI decreased after 100 min of duodenal digestion at pH 6.5, and the WPI-Lac was completely digested after 60 min. The peptides were identified as ~2 kilodalton (kDa) in conjugated protein, which indicated that the level of degradation of the protein was high, due to the hydrolysis progress. The conjugated protein increased the responsiveness to digestive proteolysis, potentially leading to the release of immunogenic protein by lactose, and to the creation of hypoallergenic protein.
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Affiliation(s)
- Sarizan Sabari
- Faculty of Food Science and Nutrition, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
| | - Norliza Julmohammad
- Faculty of Food Science and Nutrition, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
- Correspondence:
| | - Haque Akanda Md Jahurul
- Department of Agriculture, School of Agriculture, University of Arkansas, 1200 North University Dr., M/S 4913, Pine Bluff, AR 71601, USA
| | - Patricia Matanjun
- Faculty of Food Science and Nutrition, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
| | - Noorakmar Ab. Wahab
- Faculty of Food Science and Nutrition, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
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4
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Alonso-Miravalles L, Barone G, Waldron D, Bez J, Joehnke MS, Petersen IL, Zannini E, Arendt EK, O'Mahony JA. Formulation, pilot-scale preparation, physicochemical characterization and digestibility of a lentil protein-based model infant formula powder. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2022; 102:5044-5054. [PMID: 33682129 DOI: 10.1002/jsfa.11199] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/25/2021] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Infant formula is a human milk substitute for consumption during the first months of life. The protein component of such products is generally of dairy origin. Alternative sources of protein, such as those of plant origin, are of interest due to dairy allergies, intolerances, and ethical and environmental considerations. Lentils have high levels of protein (20-30%) with a good amino acid profile and functional properties. In this study, a model lentil protein-based formula (LF), in powder format, was produced and compared to two commercial plant-based infant formulae (i.e., soy; SF and rice; RF) in terms of physicochemical properties and digestibility. RESULTS The macronutrient composition was similar between all the samples; however, RF and SF had larger volume-weighted mean particle diameters (D[4,3] of 121-134 μm) than LF (31.9 μm), which was confirmed using scanning electron and confocal laser microscopy. The larger particle sizes of the commercial powders were attributed to their agglomeration during the drying process. Regarding functional properties, the LF showed higher D[4,3] values (17.8 μm) after 18 h reconstitution in water, compared with the SF and RF (5.82 and 4.55 μm, respectively), which could be partially attributed to hydrophobic protein-protein interactions. Regarding viscosity at 95 °C and physical stability, LF was more stable than RF. The digestibility analysis showed LF to have similar values (P < 0.05) to the standard SF. CONCLUSION These results demonstrated that, from the nutritional and physicochemical perspectives, lentil proteins represent a good alternative to other sources of plant proteins (e.g., soy and rice) in infant nutritional products. © 2021 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
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Affiliation(s)
| | - Giovanni Barone
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - David Waldron
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Juergen Bez
- Fraunhofer Institute for Process Engineering and Packaging, Freising, Germany
| | | | - Iben Lykke Petersen
- Department of Food Science, University of Copenhagen, Frederiksberg C, Denmark
| | - Emanuele Zannini
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Elke K Arendt
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - James A O'Mahony
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
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5
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Dougherty D, Cham P, Church JT. Management of Extreme Prematurity (Manuscript for Seminars in Pediatric Surgery). Semin Pediatr Surg 2022; 31:151198. [PMID: 36038216 DOI: 10.1016/j.sempedsurg.2022.151198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
| | - Parul Cham
- Clinical Assistant Professor of Pediatrics, University of Michigan
| | - Joseph T Church
- Assistant Professor of Surgery, UPMC Children's Hospital of Pittsburgh.
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6
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Zhang N, Zeng JP, Wu YP, Wei M, Zhang H, Zheng L, Deng ZY, Li J. Human Milk sn-2 Palmitate Triglyceride Rich in Linoleic Acid Had Lower Digestibility but Higher Absorptivity Compared with the sn-2 Palmitate Triglyceride Rich in Oleic Acid in Vitro. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2021; 69:9137-9146. [PMID: 33337143 DOI: 10.1021/acs.jafc.0c05116] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The digestion and absorption of different structural lipids in human milk may be different. Hence, by simulating in vitro infant digestion and Caco-2 cells to explore the effects of 1-oleoyl-2-palmitoyl-3-linoleoylglycerol (OPL)/1,3-dilinoleoyl-2-palmitoylglycerol (LPL)/1,3-dioleoyl-2-palmitoylglycerol (OPO) and their mixtures (M) (OPL/LPL/OPO in M1, M2, and M3 were 1.5/0.5/1, 1.2/1.2/1, and 0.5/0.2/1, respectively) on digestion and absorption. The digestibility of the OPO group was higher than those of the OPL and LPL groups, and the M3 group was higher than the M1 and M2 groups. The synthesis and transport of triglycerides in Caco-2 cells in OPL and LPL groups were higher than the OPO group, and the M1 group was significantly higher than that of M3. The expression of FABP1, PPARα, and MTT protein in OPL and M1 groups was significantly higher than OPO and M3, respectively. There are differences in the digestion and absorption of differently structured lipids from this study.
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Affiliation(s)
- Niu Zhang
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Jun-Peng Zeng
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Yan-Ping Wu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Meng Wei
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Hong Zhang
- Wilmar (Shanghai) Biotechnology Research & Development Center Co. Ltd., Shanghai 200137, China
| | - Liufeng Zheng
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Ze-Yuan Deng
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Jing Li
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
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7
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Fournier E, Roussel C, Dominicis A, Ley D, Peyron MA, Collado V, Mercier-Bonin M, Lacroix C, Alric M, Van de Wiele T, Chassard C, Etienne-Mesmin L, Blanquet-Diot S. In vitro models of gut digestion across childhood: current developments, challenges and future trends. Biotechnol Adv 2021; 54:107796. [PMID: 34252564 DOI: 10.1016/j.biotechadv.2021.107796] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 02/08/2023]
Abstract
The human digestion is a multi-step and multi-compartment process essential for human health, at the heart of many issues raised by academics, the medical world and industrials from the food, nutrition and pharma fields. In the first years of life, major dietary changes occur and are concomitant with an evolution of the whole child digestive tract anatomy and physiology, including colonization of gut microbiota. All these phenomena are influenced by child exposure to environmental compounds, such as drugs (especially antibiotics) and food pollutants, but also childhood infections. Due to obvious ethical, regulatory and technical limitations, in vivo approaches in animal and human are more and more restricted to favor complementary in vitro approaches. This review summarizes current knowledge on the evolution of child gut physiology from birth to 3 years old regarding physicochemical, mechanical and microbial parameters. Then, all the available in vitro models of the child digestive tract are described, ranging from the simplest static mono-compartmental systems to the most sophisticated dynamic and multi-compartmental models, and mimicking from the oral phase to the colon compartment. Lastly, we detail the main applications of child gut models in nutritional, pharmaceutical and microbiological studies and discuss the limitations and challenges facing this field of research.
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Affiliation(s)
- Elora Fournier
- Université Clermont Auvergne, INRAE, UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, CRNH Auvergne, 63000 Clermont-Ferrand, France; Toxalim, Research Centre in Food Toxicology, INRAE, ENVT, INP-Purpan, UPS, Université de Toulouse, 31000 Toulouse, France
| | - Charlène Roussel
- Laval University, INAF Institute of Nutrition and Functional Foods, G1V 0A6 Quebec, Canada
| | - Alessandra Dominicis
- European Reference Laboratory for E. coli, Istituto Superiore di Sanità, Rome, Italy
| | - Delphine Ley
- Université Lille 2, Faculté de Médecine, Inserm U995 Nutritional Modulation of Infection and Inflammation, 59045 Lille, France
| | - Marie-Agnès Peyron
- Université Clermont Auvergne, INRAE, UNH, Unité de Nutrition Humaine, CRNH Auvergne, 63000 Clermont-Ferrand, France
| | - Valérie Collado
- Université Clermont Auvergne, EA 4847, CROC, Centre de Recherche en Odontologie Clinique, 63000 Clermont-Ferrand, France
| | - Muriel Mercier-Bonin
- Toxalim, Research Centre in Food Toxicology, INRAE, ENVT, INP-Purpan, UPS, Université de Toulouse, 31000 Toulouse, France
| | - Christophe Lacroix
- Laboratory of Food Biotechnology, Institute of Food, Nutrition and Health, ETH Zurich, 8092 Zürich, Switzerland
| | - Monique Alric
- Université Clermont Auvergne, INRAE, UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, CRNH Auvergne, 63000 Clermont-Ferrand, France
| | - Tom Van de Wiele
- Ghent University, Center for Microbial Ecology and Technology (CMET), Coupure Links 653, 9000 Ghent, Belgium
| | - Christophe Chassard
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMRF, 15000 Aurillac, France
| | - Lucie Etienne-Mesmin
- Université Clermont Auvergne, INRAE, UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, CRNH Auvergne, 63000 Clermont-Ferrand, France
| | - Stéphanie Blanquet-Diot
- Université Clermont Auvergne, INRAE, UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, CRNH Auvergne, 63000 Clermont-Ferrand, France.
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8
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Kandavel P, Singer AAM. Recurrent Vomiting in an Otherwise Healthy Infant. Pediatr Rev 2021; 42:44-47. [PMID: 33386306 DOI: 10.1542/pir.2019-0294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Prashanthi Kandavel
- Division of Pediatric Gastroenterology, Department of Pediatrics, University of Michigan Health System, Ann Arbor, MI
| | - Andrew A M Singer
- Division of Pediatric Gastroenterology, Department of Pediatrics, University of Michigan Health System, Ann Arbor, MI
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9
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Mackie A, Mulet-Cabero AI, Torcello-Gómez A. Simulating human digestion: developing our knowledge to create healthier and more sustainable foods. Food Funct 2020; 11:9397-9431. [DOI: 10.1039/d0fo01981j] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The gold standard for nutrition studies is clinical trials but they are expensive and variable, and do not always provide the mechanistic information required, hence the increased use ofin vitroand increasinglyin silicosimulations of digestion.
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Affiliation(s)
- Alan Mackie
- The School of Food Science and Nutrition
- University of Leeds
- Leeds
- UK
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10
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Van Daele E, Knol J, Belzer C. Microbial transmission from mother to child: improving infant intestinal microbiota development by identifying the obstacles. Crit Rev Microbiol 2019; 45:613-648. [DOI: 10.1080/1040841x.2019.1680601] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Emmy Van Daele
- Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands
| | - Jan Knol
- Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands
- Gut Biology and Microbiology, Danone Nutricia Research, Utrecht, The Netherlands
| | - Clara Belzer
- Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands
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11
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Lu J, Tu P, Feng Y, Li N, Xu X, Li K, Yao Y, Han J, Liu W. Dietary interference on the oxidation and hydrolysis of liposomes during
in vitro
digestion. Int J Food Sci Technol 2019. [DOI: 10.1111/ijfs.14356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Junmeng Lu
- School of Food Science and Biotechnology Zhejiang Gongshang University Hangzhou 310018 China
| | - Piaohan Tu
- School of Food Science and Biotechnology Zhejiang Gongshang University Hangzhou 310018 China
| | - Yanwen Feng
- School of Food Science and Biotechnology Zhejiang Gongshang University Hangzhou 310018 China
| | - Na Li
- School of Food Science and Biotechnology Zhejiang Gongshang University Hangzhou 310018 China
| | - Xiankang Xu
- School of Food Science and Biotechnology Zhejiang Gongshang University Hangzhou 310018 China
| | - Kexuan Li
- School of Food Science and Biotechnology Zhejiang Gongshang University Hangzhou 310018 China
| | - Yixin Yao
- School of Food Science and Biotechnology Zhejiang Gongshang University Hangzhou 310018 China
| | - Jianzhong Han
- School of Food Science and Biotechnology Zhejiang Gongshang University Hangzhou 310018 China
| | - Weilin Liu
- School of Food Science and Biotechnology Zhejiang Gongshang University Hangzhou 310018 China
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12
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McKeen S, Young W, Mullaney J, Fraser K, McNabb WC, Roy NC. Infant Complementary Feeding of Prebiotics for theMicrobiome and Immunity. Nutrients 2019; 11:nu11020364. [PMID: 30744134 PMCID: PMC6412789 DOI: 10.3390/nu11020364] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/01/2019] [Accepted: 02/06/2019] [Indexed: 02/06/2023] Open
Abstract
Complementary feeding transitions infants from a milk-based diet to solid foods, providing essential nutrients to the infant and the developing gut microbiome while influencing immune development. Some of the earliest microbial colonisers readily ferment select oligosaccharides, influencing the ongoing establishment of the microbiome. Non-digestible oligosaccharides in prebiotic-supplemented formula and human milk oligosaccharides promote commensal immune-modulating bacteria such as Bifidobacterium, which decrease in abundance during weaning. Incorporating complex, bifidogenic, non-digestible carbohydrates during the transition to solid foods may present an opportunity to feed commensal bacteria and promote balanced concentrations of beneficial short chain fatty acid concentrations and vitamins that support gut barrier maturation and immunity throughout the complementary feeding window.
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Affiliation(s)
- Starin McKeen
- AgResearch, Food Nutrition & Health, Grasslands Research Centre, Private Bag 11008, Palmerston north4442, New Zealand.
- Riddet Institute, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
- High-Value Nutrition National Science Challenge, Auckland, New Zealand.
| | - Wayne Young
- AgResearch, Food Nutrition & Health, Grasslands Research Centre, Private Bag 11008, Palmerston north4442, New Zealand.
- Riddet Institute, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
- High-Value Nutrition National Science Challenge, Auckland, New Zealand.
| | - Jane Mullaney
- AgResearch, Food Nutrition & Health, Grasslands Research Centre, Private Bag 11008, Palmerston north4442, New Zealand.
- Riddet Institute, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
- High-Value Nutrition National Science Challenge, Auckland, New Zealand.
| | - Karl Fraser
- AgResearch, Food Nutrition & Health, Grasslands Research Centre, Private Bag 11008, Palmerston north4442, New Zealand.
- Riddet Institute, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
- High-Value Nutrition National Science Challenge, Auckland, New Zealand.
| | - Warren C McNabb
- Riddet Institute, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
- High-Value Nutrition National Science Challenge, Auckland, New Zealand.
| | - Nicole C Roy
- AgResearch, Food Nutrition & Health, Grasslands Research Centre, Private Bag 11008, Palmerston north4442, New Zealand.
- Riddet Institute, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
- High-Value Nutrition National Science Challenge, Auckland, New Zealand.
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13
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Jang HJ, Park JH, Kim CS, Lee SL, Lee WM. Amino Acid-Based Formula in Premature Infants with Feeding Intolerance: Comparison of Fecal Calprotectin Level. Pediatr Gastroenterol Hepatol Nutr 2018; 21:189-195. [PMID: 29992119 PMCID: PMC6037800 DOI: 10.5223/pghn.2018.21.3.189] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 12/01/2017] [Accepted: 12/29/2017] [Indexed: 01/13/2023] Open
Abstract
PURPOSE We investigated fecal calprotectin (FC) levels in preterm infants with and without feeding intolerance (FI), and compared the FC levels according to the type of feeding. METHODS The medical records of 67 premature infants were reviewed retrospectively. The fully enteral-fed infants were classified into two groups; the FI group (29 infants) and the control group (31 infants). Seven infants with necrotizing enterocolitis, sepsis, and perinatal asphyxia were excluded. If breast milk (BM) or preterm formula (PF) could not be tolerated by infants with FI, amino acid-based formula (AAF) was tried temporarily. Once FI improved, AAF was discontinued, and BM or PF was resumed. We investigated the FC levels according to the type of feeding. RESULTS Significant differences were found in gestational age, birth weight, age when full enteral feeding was achieved, and hospital stay between the FI and control group (p<0.05). The FC levels in the FI group were significantly higher than those in the control group (p<0.05). The FC levels in the AAF-fed infants with FI were significantly lower than those in the BM- or PF-fed infants (p<0.05). The growth velocities (g/d) and z scores were not significantly different between the FI and control group (p>0.05). CONCLUSION The FC levels in AAF-fed infants with FI showed significantly lower than those in the BM- or PF-fed infants with FI. The mitigation of gut inflammation through the decrease of FC levels in AAF-fed infants with FI could be presumed.
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Affiliation(s)
- Hyo-Jeong Jang
- Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
| | - Jae Hyun Park
- Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
| | - Chun Soo Kim
- Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
| | - Sang Lak Lee
- Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
| | - Won Mok Lee
- Department of Laboratory Medicine, Keimyung University School of Medicine, Daegu, Korea
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14
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In vitro lipolysis of dairy and soy based infant formula. Food Res Int 2018; 106:696-705. [DOI: 10.1016/j.foodres.2018.01.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/03/2017] [Accepted: 01/05/2018] [Indexed: 11/18/2022]
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15
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Shani-Levi C, Alvito P, Andrés A, Assunção R, Barberá R, Blanquet-Diot S, Bourlieu C, Brodkorb A, Cilla A, Deglaire A, Denis S, Dupont D, Heredia A, Karakaya S, Giosafatto CVL, Mariniello L, Martins C, Ménard O, El SN, Vegarud GE, Ulleberg E, Lesmes U. Extending in vitro digestion models to specific human populations: Perspectives, practical tools and bio-relevant information. Trends Food Sci Technol 2017. [DOI: 10.1016/j.tifs.2016.10.017] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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16
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Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients. JPEN J Parenter Enteral Nutr 2016. [DOI: 10.1177/014860719301700401] [Citation(s) in RCA: 152] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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17
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Porcine milk-derived exosomes promote proliferation of intestinal epithelial cells. Sci Rep 2016; 6:33862. [PMID: 27646050 PMCID: PMC5028765 DOI: 10.1038/srep33862] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 09/02/2016] [Indexed: 02/07/2023] Open
Abstract
Milk-derived exosomes were identified as a novel mechanism of mother-to-child transmission of regulatory molecules, but their functions in intestinal tissues of neonates are not well-studied. Here, we characterized potential roles of porcine milk-derived exosomes in the intestinal tract. In vitro, treatment with milk-derived exosomes (27 ± 3 ng and 55 ± 5 ng total RNA) significantly promoted IPEC-J2 cell proliferation by MTT, CCK8, EdU fluorescence and EdU flow cytometry assays. The qRT-PCR and Western blot analyses indicated milk-derived exosomes (0.27 ± 0.03 μg total RNA) significantly promoted expression of CDX2, IGF-1R and PCNA, and inhibited p53 gene expression involved in intestinal proliferation. Additionally, six detected miRNAs were significantly increased in IPEC-J2 cell, while FAS and SERPINE were significantly down-regulated relative to that in control. In vivo, treated groups (0.125 μg and 0.25 μg total RNA) significantly raised mice' villus height, crypt depth and ratio of villus length to crypt depth of intestinal tissues, significantly increased CDX2, PCNA and IGF-1R' expression and significantly inhibited p53' expression. Our study demonstrated that milk-derived exosomes can facilitate intestinal cell proliferation and intestinal tract development, thus giving a new insight for milk nutrition and newborn development and health.
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Jovani M, Barbera R, Farre R. Lactoferrin and Its Possible Role in Iron Enrichment of Infant Formulas. FOOD SCI TECHNOL INT 2016. [DOI: 10.1177/108201320100700201] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The properties and functions of lactoferrin in relation to its use in the supplementation of infant formulas are discussed. Special attention is paid to lactoferrin functions directly related to its ability to bind iron, that is, its effect on iron absorption and bacteriostatic and antioxidant activities. From the results obtained by different authors, it can be concluded that the addition of lactoferrin, usually bovine, to infant formulas, does not affect iron absorption. However, given its ability to bind iron, its use in infant formulas could be useful for protecting the gut of infants against infections from microbial-requiring iron, its ability to reduce interelemental interactions and especially to protect infant formulas supplemented with iron and ascorbic acid against free radical formation. Although bovine lactoferrin is at the moment the most easily available, today it is possible to have human recombinant lactoferrin. The possibility of adding it to infant formulas should be considered, if and when the toxicological evaluation proves favorable, because of the possible additional improvement of iron bioavailability.
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Affiliation(s)
- M. Jovani
- Nutrition and Food Chemistry, Faculty of Pharmacy, University of Valencia, Avda. Vicente Andres Estellis s/n, 46100 Burjassot, Spain
| | - R. Barbera
- Nutrition and Food Chemistry, Faculty of Pharmacy, University of Valencia, Avda. Vicente Andres Estellis s/n, 46100 Burjassot, Spain
| | - R. Farre
- Nutrition and Food Chemistry, Faculty of Pharmacy, University of Valencia, Avda. Vicente Andres Estellis s/n, 46100 Burjassot, Spain
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Villiger A, Stillhart C, Parrott N, Kuentz M. Using Physiologically Based Pharmacokinetic (PBPK) Modelling to Gain Insights into the Effect of Physiological Factors on Oral Absorption in Paediatric Populations. AAPS JOURNAL 2016; 18:933-47. [DOI: 10.1208/s12248-016-9896-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 02/21/2016] [Indexed: 12/27/2022]
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Somani AA, Thelen K, Zheng S, Trame MN, Coboeken K, Meyer M, Schnizler K, Ince I, Willmann S, Schmidt S. Evaluation of changes in oral drug absorption in preterm and term neonates for Biopharmaceutics Classification System (BCS) class I and II compounds. Br J Clin Pharmacol 2015; 81:137-47. [PMID: 26302359 DOI: 10.1111/bcp.12752] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 08/11/2015] [Accepted: 08/17/2015] [Indexed: 12/24/2022] Open
Abstract
AIMS Evidence suggests that the rate of oral drug absorption changes during early childhood. Yet, respective clinical implications are currently unclear, particularly for preterm neonates. The objective of this study was to evaluate changes in oral drug absorption after birth for different Biopharmaceutics Classification System (BCS) class I and II compounds to better understand respective implications for paediatric pharmacotherapy. METHODS Two paradigm compounds were selected for BCS class I (paracetamol (acetaminophen) and theophylline) and II (indomethacin and ibuprofen), respectively, based on the availability of clinical literature data following intravenous and oral dosing. A comparative population pharmacokinetic analysis was performed in a step-wise manner in NONMEM® 7.2 to characterize and predict changes in oral drug absorption after birth for paracetamol, theophylline and indomethacin. RESULTS A one compartment model with an age-dependent maturation function for oral drug absorption was found appropriate to characterize the pharmacokinetics of paracetamol. Our findings indicate that the rate at which a drug is absorbed from the GI tract reaches adult levels within about 1 week after birth. The maturation function for paracetamol was found applicable to theophylline and indomethacin once solubility limitations were overcome via drug formulation. The influence of excipients on solubility and, hence, oral bioavailability was confirmed for ibuprofen, a second BCS class II compound. CONCLUSIONS The findings of our study suggest that the processes underlying changes in oral drug absorption after birth are drug-independent and that the maturation function identified for paracetamol may be generally applicable to other BCS class I and II compounds for characterizing drug absorption in preterm as well as term neonates.
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Affiliation(s)
- Amit A Somani
- Center for Pharmacometrics and Systems Pharmacology, College of Pharmacy, University of Florida, Orlando, FL, USA
| | - Kirstin Thelen
- Computational Systems Biology, Bayer Technology Services GmbH, Leverkusen, Germany
| | - Songmao Zheng
- Center for Pharmacometrics and Systems Pharmacology, College of Pharmacy, University of Florida, Orlando, FL, USA
| | - Mirjam N Trame
- Center for Pharmacometrics and Systems Pharmacology, College of Pharmacy, University of Florida, Orlando, FL, USA
| | - Katrin Coboeken
- Computational Systems Biology, Bayer Technology Services GmbH, Leverkusen, Germany
| | - Michaela Meyer
- Computational Systems Biology, Bayer Technology Services GmbH, Leverkusen, Germany
| | - Katrin Schnizler
- Computational Systems Biology, Bayer Technology Services GmbH, Leverkusen, Germany
| | - Ibrahim Ince
- Computational Systems Biology, Bayer Technology Services GmbH, Leverkusen, Germany
| | - Stefan Willmann
- Computational Systems Biology, Bayer Technology Services GmbH, Leverkusen, Germany
| | - Stephan Schmidt
- Center for Pharmacometrics and Systems Pharmacology, College of Pharmacy, University of Florida, Orlando, FL, USA
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21
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A comprehensive review on in vitro digestion of infant formula. Food Res Int 2015; 76:373-386. [DOI: 10.1016/j.foodres.2015.07.016] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/30/2015] [Accepted: 07/10/2015] [Indexed: 11/22/2022]
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Prakash S, Ma Q, Bhandari B. Rheological behaviour of selected commercially available baby formulas in simulated human digestive system. Food Res Int 2014; 64:889-895. [DOI: 10.1016/j.foodres.2014.08.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 08/05/2014] [Accepted: 08/24/2014] [Indexed: 11/16/2022]
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Havenaar R, Anneveld B, Hanff LM, de Wildt SN, de Koning BA, Mooij MG, Lelieveld JP, Minekus M. In vitro gastrointestinal model (TIM) with predictive power, even for infants and children? Int J Pharm 2013; 457:327-32. [DOI: 10.1016/j.ijpharm.2013.07.053] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 07/08/2013] [Accepted: 07/16/2013] [Indexed: 10/26/2022]
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Dallas DC, Underwood MA, Zivkovic AM, German JB. Digestion of Protein in Premature and Term Infants. JOURNAL OF NUTRITIONAL DISORDERS & THERAPY 2012; 2:112. [PMID: 24744976 PMCID: PMC3988022 DOI: 10.4172/2161-0509.1000112] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Premature birth rates and premature infant morbidity remain discouragingly high. Improving nourishment for these infants is the key for accelerating their development and decreasing disease risk. Dietary protein is essential for growth and development of infants. Studies on protein nourishment for premature infants have focused on protein requirements for catch-up growth, nitrogen balance, and digestive protease concentrations and activities. However, little is known about the processes and products of protein digestion in the premature infant. This review briefly summarizes the protein requirements of term and preterm infants, and the protein content of milk from women delivering preterm and at term. An in-depth review is presented of the current knowledge of term and preterm infant dietary protein digestion, including human milk protease and anti-protease concentrations; neonatal intestinal pH, and enzyme activities and concentrations; and protein fermentation by intestinal bacteria. The advantages and disadvantages of incomplete protein digestion as well as factors that increase resistance to proteolysis of particular proteins are discussed. In order to better understand protein digestion in preterm and term infants, future studies should examine protein and peptide fragment products of digestion in saliva, gastric, intestinal and fecal samples, as well as the effects of the gut micro biome on protein degradation. The confluence of new mass spectrometry technology and new bioinformatics programs will now allow thorough identification of the array of peptides produced in the infant as they are digested.
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Affiliation(s)
- David C Dallas
- Department of Food Science, University of California at Davis, One Shields Avenue, Davis, CA, 95616, USA
- Foods for Health Institute, University of California at Davis, One Shields Avenue, Davis, CA, 95616, USA
| | - Mark A Underwood
- Foods for Health Institute, University of California at Davis, One Shields Avenue, Davis, CA, 95616, USA
- Department of Pediatrics, University of California Davis, 2315 Stockton Blvd., Sacramento, CA, 95817, USA
| | - Angela M. Zivkovic
- Department of Food Science, University of California at Davis, One Shields Avenue, Davis, CA, 95616, USA
- Foods for Health Institute, University of California at Davis, One Shields Avenue, Davis, CA, 95616, USA
| | - J. Bruce German
- Department of Food Science, University of California at Davis, One Shields Avenue, Davis, CA, 95616, USA
- Foods for Health Institute, University of California at Davis, One Shields Avenue, Davis, CA, 95616, USA
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Abstract
The level of gastrointestinal (GI) maturity of an individual infant is a major determinant of whether the infant will be able to meet nutritional needs by sole use of the GI tract or if parenteral means will be necessary. The GI tract is not only an organ for digestion and absorption of nutrients; it also performs major endocrine, neural and immunologic functions. In this review, anatomic, functional and biochemical development will be described and related to means by which enteral nutrition can be used in the prematurely born infant to optimize health and prevent disease.
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Affiliation(s)
- Josef Neu
- Department of Pediatrics, Division of Neonatology, University of Florida, FL, USA.
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26
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Robayo-Torres CC, Quezada-Calvillo R, Nichols BL. Disaccharide digestion: clinical and molecular aspects. Clin Gastroenterol Hepatol 2006; 4:276-87. [PMID: 16527688 DOI: 10.1016/j.cgh.2005.12.023] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Sugars normally are absorbed in the small intestine. When carbohydrates are malabsorbed, the osmotic load produced by the high amount of low molecular weight sugars and partially digested starches in the small intestine can cause symptoms of intestinal distention, rapid peristalsis, and diarrhea. Colonic bacteria normally metabolize proximally malabsorbed dietary carbohydrate through fermentation to small fatty acids and gases (ie, hydrogen, methane, and carbon dioxide). When present in large amounts, the malabsorbed sugars and starches can be excreted in the stool. Sugar intolerance is the presence of abdominal symptoms related to the proximal or distal malabsorption of dietary carbohydrates. The symptoms consist of meal-related abdominal cramps and distention, increased flatulence, borborygmus, and diarrhea. Infants and young children with carbohydrate malabsorption show more intense symptoms than adults; the passage of undigested carbohydrates through the colon is more rapid and is associated with detectable carbohydrates in copious watery acid stools. Dehydration often follows feeding of the offending sugar. In this review we present the clinical and current molecular aspects of disaccharidase digestion.
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Affiliation(s)
- Claudia C Robayo-Torres
- Department of Pediatrics, USDA/ARS, Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas 77030, USA
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27
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Daschner M. Drug dosage in children with reduced renal function. Pediatr Nephrol 2005; 20:1675-86. [PMID: 16133064 DOI: 10.1007/s00467-005-1922-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2005] [Revised: 02/18/2005] [Accepted: 02/22/2005] [Indexed: 11/26/2022]
Abstract
Drug dosing in paediatric nephrology requires multiple considerations and is therefore time-consuming and error-prone. This review combines dose adjustment guidelines for children with renal failure and information on the immature renal function of neonates and premature babies in order to help both paediatric nephrologists and neonatologists estimate drug doses for their patients.
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Affiliation(s)
- Markus Daschner
- Division of Paediatric Nephrology, University Children's Hospital, Heidelberg, Germany.
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Yang Q, Wen SW, Dubois L, Chen Y, Walker MC, Krewski D. Determinants of breast-feeding and weaning in Alberta, Canada. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2005; 26:975-81. [PMID: 15560860 DOI: 10.1016/s1701-2163(16)30419-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the determinants of breast-feeding initiation and duration at the population level in Alberta, Canada. METHODS Determinants of breast-feeding were assessed based on data from a sample of 1113 women, who represented 150,898 fertile women in Alberta, in the second cycle of the National Population Health Survey conducted 1996-97. Logistic regression analysis was used to estimate the independent effects of various determinants of breast-feeding initiation and duration dichotomized at 4 weeks, 8 weeks, 12 weeks, and 6 months postpartum. All analyses used analytic weights to take both the average design effect and population weights for the complex survey design into account. RESULTS The proportion of breast-feeding initiation was 85.6%. It was observed that 71.3% of mothers continued breast-feeding for at least 3 months, and 37.2% of mothers breast-fed their infants for more than 6 months. Determinants of breast-feeding initiation were marital status, education, maternal smoking behaviour, and annual family income. White women and women who were older than 35 years of age were more likely to continue breast-feeding for longer periods, whereas those who smoked during pregnancy were less likely to breast-feed their infants for extended periods. The primary reasons for weaning were breast problems at less than 1 week, insufficient milk production during weeks 1 to 12, and infants who weaned themselves after 3 months. CONCLUSIONS Smoking cessation during pregnancy, adequate treatment of early breast problems, and breast-feeding promotion campaigns targeting socioeconomically disadvantaged populations could serve to increase breast-feeding in Canada.
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Affiliation(s)
- Qiuying Yang
- McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, University of Ottawa, Ottawa ON
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29
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Mihatsch WA, Franz AR, Kuhnt B, Högel J, Pohlandt F. Hydrolysis of casein accelerates gastrointestinal transit via reduction of opioid receptor agonists released from casein in rats. Neonatology 2004; 87:160-3. [PMID: 15572871 DOI: 10.1159/000082367] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2004] [Accepted: 09/20/2004] [Indexed: 11/19/2022]
Abstract
BACKGROUND Protein hydrolysate accelerates gastrointestinal transit (GIT) and feeding advancement in preterm infants compared to native protein. In rat pups, opioid receptor agonists released from casein during digestion such as beta-casomorphins slow down GIT. We hypothesized that hydrolysis of casein reduces the opioid activity released during digestion thereby accelerating GIT compared to native casein. OBJECTIVE The aim of the present study was to investigate whether casein hydrolysate accelerates GIT compared to native casein and whether pretreatment with naloxone, an opioid receptor blocker, abolishes this difference in rat pups. METHODS In a randomized controlled trial following a 2 x 2 factorial design, 216 female Wistar rat pups were fed with pellets based on hydrolyzed or native casein. After pretreatment with naloxone or normal saline, carmine red was administered by oro-gastric gavage as a tracer for GIT velocity measurement. Four hours later the animals were sacrificed, their intestine was removed and the length of the colon from the cecocolonic junction to the anus was measured. GIT was recorded as percentage of the total colonic length (percentage of colonic transit) passed by carmine red. Data were given as mean +/- SD. RESULTS GIT was significantly higher with hydrolyzed casein compared to native casein formula (77.4 +/- 17 and 51.2 +/- 20%), but there was no difference after naloxone pretreatment (77.1 +/- 16 and 76.5 +/- 17%). DISCUSSION The present data suggest that hydrolysis of casein accelerates GIT via reduction of opioid activity released during digestion. Further studies are required to investigate to which extent these rat pub data apply to preterm infants.
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Affiliation(s)
- W A Mihatsch
- Department of Pediatrics, Ulm University, Ulm, Germany.
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Makri A, Goveia M, Balbus J, Parkin R. Children's susceptibility to chemicals: a review by developmental stage. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2004; 7:417-35. [PMID: 15586877 DOI: 10.1080/10937400490512465] [Citation(s) in RCA: 164] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Concerns about adequate protection of children's health from chemicals in the environment have created a need for research to identify how children's risks differ from adults'. A systematic review of factors that affect child sensitivity throughout development may be useful for research and practice in this area. We summarized available literature and other peer-reviewed information on factors that affect pharmacokinetics and exposure in an age-based developmental framework. Biological processes related to chemical absorption (gastrointestinal, dermal, and pulmonary), distribution, metabolism, and excretion were considered, along with reference to behaviors and other factors associated with child-specific exposures. The available information was summarized in a timeline of maturation for biological processes. It indicates variability in the duration and timing of maturation for each biological function. Possible implications for understanding pediatric sensitivity to environmental chemicals are discussed in light of factors affecting exposure through development. Themes that emerge from the evidence are presented as hypothesis-generating conclusions. This approach may be useful for evaluating developmental trends of susceptibility, and for identifying time periods and/or chemical classes of particular concern and thus important to consider in risk assessment.
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Affiliation(s)
- Anna Makri
- George Washington University, Center for Risk Science and Public Health, 2100 M Street, NW, Suite 203, Washington, DC 20052, USA.
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31
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de Zwart LL, Haenen HEMG, Versantvoort CHM, Wolterink G, van Engelen JGM, Sips AJAM. Role of biokinetics in risk assessment of drugs and chemicals in children. Regul Toxicol Pharmacol 2004; 39:282-309. [PMID: 15135209 DOI: 10.1016/j.yrtph.2004.02.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2003] [Indexed: 11/26/2022]
Abstract
Whether children incur different risks from xenobiotics than adults will depend on the exposure, biokinetics, and dynamics of compound. In this paper, current knowledge on developmental physiology and possible effects on biokinetics are evaluated and the role of biokinetics in risk assessment both for drugs and chemicals is discussed. It is concluded that most dramatic age-related physiological changes that may affect biokinetics occur in the first 6-12 months of age. The difference in internal exposure between children and adults can generally be predicted from already known developmental physiological differences. However, for risk assessment it will also be necessary to determine whether internal exposure is within the drug's therapeutic window or if it will exceed the NOAEL of a chemical. Furthermore, the effects of internal exposure of potentially harmful compounds on developing organ systems is of utmost importance. However, knowledge on this aspect is very limited. Risk assessment in children could be improved by: (1) application of pediatric PBPK-models in order to gain insight into internal exposure in children, (2) studies in juvenile animals for studying effects on developing systems, and (3) extrapolation of knowledge on the relationship between internal exposure and dynamics for drugs to other chemicals.
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Affiliation(s)
- L L de Zwart
- Center of Substances and Integrated Risk Assessment, National Institute of Public Health and the Environment, P.O. Box 1, Bilthoven NL-3720BA, The Netherlands
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32
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Brinkworth GD, Buckley JD. Bovine colostrum supplementation does not affect nutrient absorptive capacity in healthy young men. Nutr Res 2003. [DOI: 10.1016/j.nutres.2003.08.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kapellen TM, Galler A, Kiess W. Higher frequency of paronychia (nail bed infections) in pediatric and adolescent patients with type 1 diabetes mellitus than in non-diabetic peers. J Pediatr Endocrinol Metab 2003; 16:751-8. [PMID: 12880125 DOI: 10.1515/jpem.2003.16.5.751] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Paronychia occurs frequently in adolescents, but there are no data about its prevalence in adolescents with type 1 diabetes mellitus (DM1). We investigated the presence and characteristics of nail-bed infections in a group of adolescent patients with DM1 aged 10-20 years. METHODS Ninety-three children and adolescents with DM1 and 100 healthy age-matched controls were studied using a structured questionnaire. Frequency, duration and treatment of paronychia and, in the DM1 group, duration of DM, mean HbA1c, frequency of hypoglycemia, footwear and foot care were evaluated. All patients with DM1 underwent a complete neurological examination including vibration perception, thermal perception, and light touch perception. RESULTS Adolescents with DM1, particularly girls, had a higher frequency of paronychia than controls (34.4% vs 23%; p < 0.01). Diabetic patients with paronychia were older than those without and had a longer duration of DM1, while there was no difference in long-term HbA1c between the groups. Vibration perception was impaired in all regions measured, compared to healthy adolescents. Subclinical neuropathy and microalbuminuria was found to be more frequent in patients with paronychia than in those without. CONCLUSION We conclude that foot examination is important and mandatory in adolescents with DM1.
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Affiliation(s)
- T M Kapellen
- Children's Hospital, University of Leipzig, Leipzig, Germany.
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Abstract
Phthalates are plasticizers that are added to polyvinyl chloride (PVC) products to impart flexibility and durability. They are produced in high volume and generate extensive though poorly defined human exposures and unique childhood exposures. Phthalates are animal carcinogens and can cause fetal death, malformations, and reproductive toxicity in laboratory animals. Toxicity profiles and potency vary by specific phthalate. The extent of these toxicities and their applicability to humans remains incompletely characterized and controversial. Two phthalates, diethylhexyl phthalate (DEHP) and diisononyl phthalate (DINP), have received considerable attention recently because of specific concerns about pediatric exposures. Like all phthalates, DEHP and DINP are ubiquitous contaminants in food, indoor air, soils, and sediments. DEHP is used in toys and medical devices. DINP is a major plasticizer used in children's toys. Scientific panels, advocacy groups, and industry groups have analyzed the literature on DEHP and DINP and have come to different conclusions about their safety. The controversy exists because risk to humans must be extrapolated from animal data that demonstrate differences in toxicity by species, route of exposure, and age at exposure and because of persistent uncertainties in human exposure data. This report addresses sensitive endpoints of reproductive and developmental toxicity and the unique aspects of pediatric exposures to phthalates that generate concern. DEHP and DINP are used as specific examples to illustrate the controversy.
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Erasmus HD, Ludwig-Auser HM, Paterson PG, Sun D, Sankaran K. Enhanced weight gain in preterm infants receiving lactase-treated feeds: a randomized, double-blind, controlled trial. J Pediatr 2002; 141:532-7. [PMID: 12378193 DOI: 10.1067/mpd.2002.127499] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate whether lactase-treated preterm feeds enhance weight gain and feeding tolerance in premature infants. STUDY DESIGN Prospective, double-blind, randomized, controlled trial involving 130 infants (26-34 weeks postconceptual age). The primary outcome variable was weight gain (g per day). Other outcome measures included gains in length and head circumference, biochemical indexes of nutritional status, feeding intolerance, and incidence of necrotizing enterocolitis. RESULTS On study day 10, weight gain (mean +/- SEM) of the treatment group was significantly greater (P <.05) than that of the control group (20.4 +/- 1.8 g/day vs 15.5 +/- 1.6 g/day). By study end, no significant difference in weight gain between treatment and control groups was observed. The difference in serum albumin level was significant at study day 14, with a value of 29.3 +/- 0.6 g/L in the treatment group compared with 27.1 +/- 0.4 g/L in the control group (P <.01). There were no significant differences in caloric intakes, length gain, head circumference gain, feeding intolerance, and incidence of necrotizing enterocolitis. CONCLUSIONS Weight gain may be enhanced during the period of low functional lactase activity of prematurity by addition of lactase to preterm feeds. No adverse effects on feeding tolerance resulted from this treatment.
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Affiliation(s)
- Helen D Erasmus
- Department of Nutrition Services and Neonatal Intensive Care Unit, Royal University Hospital, and the College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Abstract
Achieving appropriate growth and nutrient accretion of preterm and low birth weight (LBW) infants is often difficult during hospitalization because of metabolic and gastrointestinal immaturity and other complicating medical conditions. Advances in the care of preterm-LBW infants, including improved nutrition, have reduced mortality rates for these infants from 9.6 to 6.2% from 1983 to 1997. The Food and Drug Administration (FDA) has responsibility for ensuring the safety and nutritional quality of infant formulas based on current scientific knowledge. Consequently, under FDA contract, an ad hoc Expert Panel was convened by the Life Sciences Research Office of the American Society for Nutritional Sciences to make recommendations for the nutrient content of formulas for preterm-LBW infants based on current scientific knowledge and expert opinion. Recommendations were developed from different criteria than that used for recommendations for term infant formula. To ensure nutrient adequacy, the Panel considered intrauterine accretion rate, organ development, factorial estimates of requirements, nutrient interactions and supplemental feeding studies. Consideration was also given to long-term developmental outcome. Some recommendations were based on current use in domestic preterm formula. Included were recommendations for nutrients not required in formula for term infants such as lactose and arginine. Recommendations, examples, and sample calculations were based on a 1000 g preterm infant consuming 120 kcal/kg and 150 mL/d of an 810 kcal/L formula. A summary of recommendations for energy and 45 nutrient components of enteral formulas for preterm-LBW infants are presented. Recommendations for five nutrient:nutrient ratios are also presented. In addition, critical areas for future research on the nutritional requirements specific for preterm-LBW infants are identified.
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Affiliation(s)
- Catherine J Klein
- Life Sciences Research Office, 9650 Rockville Pike, Bethesda, Maryland 20814, USA.
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Rouwet EV, Heineman E, Buurman WA, ter Riet G, Ramsay G, Blanco CE. Intestinal permeability and carrier-mediated monosaccharide absorption in preterm neonates during the early postnatal period. Pediatr Res 2002; 51:64-70. [PMID: 11756641 DOI: 10.1203/00006450-200201000-00012] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Immaturity of intestinal epithelial barrier function and absorptive capacity may play a role in the pathophysiology of intestinal complications in preterm neonates during the early postnatal period. We determined the intestinal permeability and carrier-mediated absorption of monosaccharides in preterm neonates during the first 2 wk after birth. Fifty-nine preterm neonates born between 25 and 32 wk gestation were included within 24 h of birth. Neonates received exclusively parenteral nutrition during the first 7 d after birth; enteral feeding was initiated at d 8. An intestinal permeability-absorption test was performed at 1, 4, 7, and 14 d after birth. The lactulose-to-rhamnose ratio was determined as a marker of intestinal permeability. Urinary excretion percentages of D-xylose and 3-O-methyl-D-glucose were determined as markers of passive and active carrier-mediated monosaccharide absorption, respectively. Intestinal permeability transiently increased between d 1 and 7 in all neonates (p < 0.05). Carrier-mediated monosaccharide absorption increased between d 1 and 14 in neonates of 28-30 wk (p < 0.05) to the level observed in the neonates of 30-32 wk gestation. In neonates <28 wk, intestinal permeability at d 7 was higher (p < 0.05) and carrier-mediated monosaccharide absorption at d 14 was lower (p < 0.01) as compared with neonates >or=28 wk. The barrier function of the intestinal epithelium transiently decreases during the first week after birth in preterm neonates who are not enterally fed. Diminished barrier function and low monosaccharide absorptive capacity, particularly in neonates <28 wk, may predispose these patients to the development of intestinal complications during the early postnatal period.
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Affiliation(s)
- Ellen V Rouwet
- Department of Surgery, University Hospital Maastricht, 6202 AZ, The Netherlands
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Miclo L, Perrin E, Driou A, Papadopoulos V, Boujrad N, Vanderesse R, Boudier JF, Desor D, Linden G, Gaillard JL. Characterization of alpha-casozepine, a tryptic peptide from bovine alpha(s1)-casein with benzodiazepine-like activity. FASEB J 2001; 15:1780-2. [PMID: 11481228 DOI: 10.1096/fj.00-0685fje] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- L Miclo
- Laboratoire des Biosciences de l'Aliment UA 885 INRA, Faculté des Sciences, Université Henri Poincaré-Nancy 1, Vandoeuvre-lès-Nancy, France.
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Khan JM, Wingertzahn MA, Teichberg S, Vancurova I, Harper RG, Wapnir RA. Development of the intestinal SGLT1 transporter in rats. Mol Genet Metab 2000; 69:233-9. [PMID: 10767178 DOI: 10.1006/mgme.2000.2973] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Glucose absorption from the small intestine is largely mediated via the sodium-coupled glucose transporter (SGLT1). The goal of this study was to investigate the ontogenesis of the SGLT1, using the rat as an animal model at three stages of development: during lactation, at weaning, and at physiologic maturity. The techniques involved upper small intestinal perfusions with solutions containing 200 mM glucose and 50 mM NaCl, with or without 1 mM phloridzin (Phl), as an inhibitor of SGLT1. Molecular expression of the SGLT1 was also investigated via Western blot analysis from intestinal specimens of the three growth periods. Glucose absorption in weanling rats, in the absence of Phl, was several times higher than in sucklings and approximately double that of mature animals, and the effects of Phl were the greatest in weanlings. Furthermore, the physiologic data correlate to the molecular analysis of the SGLT1 which showed an increase in expression of the SGLT1 in both the weanlings and the adults compared to the sucklings. At all three stages of development Phl abolished Na absorption, and in sucklings there was a net outflow of Na. Due to the coupling between Na and water transport, net water absorption and the influx/efflux ratio, a more sensitive indicator of changes in unidirectional fluid movement, were similarly affected by Phl at the three stages of development. Net water absorption was highest in weanling animals. These findings are consistent with an early development of SGLT1 in rat small intestine and an apparent burst of activity at weaning. Less than complete maturity of other absorptive mechansims is occurring at this time.
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Affiliation(s)
- J M Khan
- Division of Perinatal Medicine, New York University School of Medicine, Manhasset, New York 11030, USA
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Averette LA, Odle J, Monaco MH, Donovan SM. Dietary fat during pregnancy and lactation increases milk fat and insulin-like growth factor I concentrations and improves neonatal growth rates in swine. J Nutr 1999; 129:2123-9. [PMID: 10573538 DOI: 10.1093/jn/129.12.2123] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Primiparous (n = 24) and multiparous (n = 24) sows were used to examine the effects of supplemental dietary fat and induction of parturition (d 112) on colostrum and milk composition and suckling piglet growth. Sows were assigned to one of eight treatments on d 90 of gestation that included variables such as parity (1 vs. >/=3), dietary fat (0 vs. 10%), and farrowing (natural vs. induction via lutalyse on d 112). Piglets suckling fat-supplemented dams grew up to 25% faster than control pigs nursing unsupplemented sows (250 vs. 200 g/d; P < 0.01). Improved growth was correlated with elevated milk fat and insulin-like growth factor (IGF) concentrations associated with fat supplementation. Dietary fat elevated milk fat concentration at 48 and 72 h postfarrowing by 21.6 and 22.6%, respectively (P < 0.05). Compared with nonfat-fed controls, multiparous sows fed 10% fat showed a more consistent rise in milk fat concentration, with 26% and 41% elevations for induced or naturally farrowing sows, respectively, vs. a 19% reduction or a 1% elevation in induced or naturally farrowing gilts (P < 0.01). The concentration of milk IGF-I tended to be lower in gilts than in multiparous sows (P < 0.2, 95.7 vs. 117.4 microg/L), and levels were particularly low in milk from induced gilts receiving no additional dietary fat (44.7 microg/L). However, fat supplementation elevated IGF-I to levels (110.6 microg/L) exceeding those measured in unsupplemented, naturally farrowing control sows and gilts (95.8 microg/L). In conclusion, supplemental dietary fat elevates milk fat in multiparous sows more than primiparous gilts regardless of farrowing treatment (induced vs. natural farrowing) and improves piglet growth throughout lactation irrespective of parity or farrowing treatment. The potential of supplemental dietary fat to reverse the reductions in milk IGF-I observed in first-parity females and in dams induced to farrow merits further investigation.
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Affiliation(s)
- L A Averette
- Department of Animal Science and North Carolina Institute of Nutrition, North Carolina State University, Raleigh, NC 27603, USA
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41
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Abstract
The primary factors in feeding premature infants are dependent on the development and maturation of digestion and absorption. The maturation of digestive and absorptive functions of carbohydrates, proteins, fats, minerals, and vitamins in the young premature infant were determined in relation to availability of hydrolytic enzymes, such as lipases, proteases, amylases, glucosidases, and lactase. The feeding is dependent on the ability of the premature infant to secrete salivary enzymes, gastric acid, pepsin, pancreatic exocrine enzymes, the presence of enterohepatic circulation, and the hydrolytic and absorptive capacity of the entercocyte. To evaluate the complexity of the gut maturation process, we proposed a unified concept where the ontogeny of the gastrointestinal system is the result of the following four major determinants: genetic endowment, intrinsic developmental and biological clock, endogenous regulatory mechanisms, and environmental influences. The developmental clock represents a predetermined temporal sequence of happenings in ontogeny that is inherently controlled. By 20 weeks of gestation, the anatomic differentiation of the fetal gut has progressed to the extent that it resembles that of a newborn. Secretory and absorptive functions, however, develop at different rates; the intestinal absorptive process is only partially available before 26 weeks of gestation, whereas gastric and pancreatic secretion is only basal and can be stimulated only partially even in the full-term newborn period. Regulatory mechanisms control the expression of the genetic endowment at various stages in gastrointestinal development. Neural-hormonal factors play major roles in the ontogeny of the gut. Adrenalectomy, hypophysectomy, and thyroidectomy delay the development of the gut. Administration of glucocorticoids or thyroxine at the critical stage in maturation causes early appearance of enzymes within the intestine. Other hormones that are potentially important in regulating gastrointestinal development include cholecystokinin, gastrin, secretin, which have trophic effects on the gastrointestinal tract, and insulin, insulin-like growth factors, and epidermial growth factor. The development of gastrointestinal secretory function, particularly in response to hormonal stimulation, has received considerable attention. The degree of response of the target cell is determined not only by the amount of effective hormone reaching it but also by the number and affinity of receptors on its surface. Human newborns have high levels of gastrin in their sera, yet have low acid output. Exogenous gastrin is an ineffective stimulant despite the presence of seemingly "anatomically developed" parietal cells. It seems that neither endogenous nor exogenous gastrin has an effect on the target cell. If one accepts the role of circulating gastrin levels in the regulation of its own receptor, one can hypothesize the absence of a regulatory effect of gastrin in the newborn period. It was shown that hormonal regulation of migrating activity by motilin is also absent in the preterm and term infant. Plasma levels of motilin in neonates are comparable to those found in adults, but migrating motor complexes occur in the absence of cycling of plasma concentrations. Interestingly, however, the motilin receptor appears to be present. In conclusion, the feeding mode content, concentration, and volume of the very young premature infant can be assessed by the development of digestive and absorptive capacity and gut motility. The concomitant changes in gut hormones and regulatory peptides during ontogeny and feeding will add a new dimension in the understanding of when, what, and how to feed the very young premature infant.
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Affiliation(s)
- A Lebenthal
- Department of Pediatrics, Mt Scopus, Hadassah University Hospital, Jerusalem, Israel
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Abstract
Similar to adults, children under physiologic stress can develop an imbalance in defensive (mucosal layer, motility) and aggressive (gastric acid, bile salts, enzymes) factors responsible for maintaining a healthy gastrointestinal tract. Hypoxia in the gastrointestinal tract likely disrupts the defensive factors, thereby permitting damage by aggressive factors to upper gastrointestinal epithelium that may progress to stress ulceration and acute upper gastrointestinal tract bleeding (UGIB). The basic pathophysiology may be similar in children and adults; however, differences in the time to developing ulceration, ulcer location, and number of ulcers have been reported. Functional development of the gastrointestinal tract is influenced by disease, gestational and postnatal age, and exposure to and type of enteral feedings, thereby confounding the development and prophylaxis of UGIB in neonates and infants. In addition, pharmacotherapy decisions are often complicated by drug administration issues and adverse effects.
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Affiliation(s)
- C M Crill
- Department of Clinical Pharmacy, University of Tennessee, Memphis, Center for Pediatric Pharmacokinetics and Therapeutics, USA
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Graham VA, Gibbons K, Marraffa C, Henry L, Myers J. Filling the gap: weaning practices of children aged 0-2 years in western metropolitan Melbourne. J Paediatr Child Health 1998; 34:513-7. [PMID: 9928641 DOI: 10.1046/j.1440-1754.1998.00288.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate weaning practices of children aged 0-2 years in Melbourne's western metropolitan region (WMR). METHODOLOGY The study group comprised children aged 0-2 years attending six maternal and child health centres in the City of Brimbank in Melbourne's WMR. One hundred and nineteen parents were asked to complete a questionnaire about their child. Interpreters were used as required. In total, 115 questionnaires were completed representing a response rate of 97%. All maternal and child health nurses working in the target region were asked to complete a questionnaire. Of these, five were selected randomly to participate in follow-up indepth interviews. Weaning was defined as the addition of food/fluids other than breast milk or formula. RESULTS The mean age for the introduction of solids was 4.3 months. Of the children already introduced to solids, 67% had commenced between 4 and 6 months whilst 29% of the infants were taking solids by 3 months of age. Of the children already having juice, 85% had done so by the age of 6 months. The mean age for the introduction of cow's milk as the main drink was 10.7 months (S.D. 2.8). For English speaking families the mean age was 11.3 months (S.D. 1.8) whilst for families speaking languages other than English the mean age was 9.7 months (S.D. 4.1). CONCLUSIONS Most parents in this group were following the recommended guidelines for weaning. Some parents had poor knowledge of appropriate weaning time, use of fruit juice and introduction of cow's milk as the main drink. Additional information and education is required in these areas. Further investigation is required in relation to use of cow's milk and ethnicity.
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Affiliation(s)
- V A Graham
- Department of Human Services, Western Metropolitan Region, Melbourne, Australia
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Engelmann MD, Davidsson L, Sandström B, Walczyk T, Hurrell RF, Michaelsen KF. The influence of meat on nonheme iron absorption in infants. Pediatr Res 1998; 43:768-73. [PMID: 9621986 DOI: 10.1203/00006450-199806000-00009] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
During weaning the infant has a high iron requirement, and highly available dietary iron is needed to ensure optimal iron status. Muscle tissue has been identified as an enhancer of nonheme iron absorption in adults, although the influence of meat on nonheme iron absorption in infants has not been previously reported. The effect of the addition of 25 g of meat (lean beef) on nonheme iron absorption from a home-prepared vegetable purée meal (80 g of vegetables) was investigated in infants in the present study. The meals did not differ in their contents of other known enhancers or inhibitors of nonheme iron absorption. Incorporation of stable isotopes of iron (57Fe and 58Fe) into red blood cells 14 d after intake was used to measure iron absorption, using a cross-over design in eight healthy infants 43-49 wk of age. Nonheme iron absorption was significantly increased (p = 0.002) from the vegetable purée with added meat (geometric mean 15.0%) compared with the puréed vegetables (geometric mean 9.9%). These results thus suggest that meat is also an enhancer of nonheme iron absorption in infants and that nonheme iron absorption from weaning foods can be increased by the addition of meat.
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Affiliation(s)
- M D Engelmann
- Research Department of Human Nutrition, LMC Centre for Advanced Food Studies, The Royal Veterinary and Agricultural University, Frederiksberg, Denmark
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Outwater JL, Nicholson A, Barnard N. Dairy products and breast cancer: the IGF-I, estrogen, and bGH hypothesis. Med Hypotheses 1997; 48:453-61. [PMID: 9247884 DOI: 10.1016/s0306-9877(97)90110-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Research on the role of dietary factors in breast cancer causation has focused predominantly on fat intake. While some studies have examined associations between breast cancer rates and consumption of whole milk, there has been less attention given to dairy products in general. Dairy products contain both hormones and growth factors, in addition to fat and various chemical contaminants, that have been implicated in the proliferation of human breast cancer cells. This literature review evaluates the epidemiological and mechanistic evidence linking dairy consumption with breast cancer risk.
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Affiliation(s)
- J L Outwater
- A. B. Princeton University 1996, Physicians Committee For Responsible Medicine, Washington, DC 20016, USA
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46
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Maxson RT, Johnson DD, Jackson RJ, Smith SD. The protective role of enteral IgA supplementation in neonatal gut-origin sepsis. Ann N Y Acad Sci 1996; 778:405-7. [PMID: 8611004 DOI: 10.1111/j.1749-6632.1996.tb21157.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- R T Maxson
- Department of Surgery, University of Arkansas, Little Rock 77202-3591, USA
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47
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Maxson RT, Jackson RJ, Smith SD. The protective role of enteral IgA supplementation in neonatal gut origin sepsis. J Pediatr Surg 1995; 30:231-3; discussion 233-4. [PMID: 7738744 DOI: 10.1016/0022-3468(95)90566-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Preterm infants and infants unable to breast feed are particularly susceptible to gut origin sepsis. Many studies have shown the benefits of breast milk in decreasing the incidence of bacterial infections in neonates. Little in vivo work has focused on prevention of neonatal gut origin sepsis with breast milk components. The aim of this study was to determine whether supplementation of a standard neonatal formula with exogenous, luminally administered, human secretory IgA protects against gut origin sepsis in a newborn rabbit model. Sixty New Zealand white rabbit pups were delivered by cesarean section 1 day preterm and divided into two groups--the IgA group (n = 26) and the non-IgA group (n = 34). Animals were gavage-fed a standard artificial formula (KMR) twice daily. The IgA group was supplemented on days 3 and 4 with 6.25 mg/kg of human secretory IgA. The non-IgA group received an equal volume of saline. On the evening of day 3, the animals were orally challenged with Escherichia coli K100. The quantity of bacteria that colonized the cecum was similar in the two groups. The quantity of bacteria that translocated to the mesenteric lymph node, liver, and spleen was significantly lower in the IgA group (P < .05). The incidence of translocation to the organs was also significantly lower in the IgA group (P < .05). The exogenous secretory IgA showed specificity to E coli K100 by ELISA. These data show that neonatal formula supplemented with human secretory IgA decreases the incidence and quantity of bacterial translocation of E coli K100 in a neonatal rabbit model.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- R T Maxson
- Division of Pediatric Surgery, University of Arkansas for Medical Sciences, Little Rock, USA
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48
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Buus-Frank ME, Adams DA. Introduction of Early Subnutritional Feedings in the Very Low Birth Weight Infant. Worldviews Evid Based Nurs 1994. [DOI: 10.1111/j.1524-475x.1994.00061.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mehta DI, Lebenthal E, Blecker U. New strategies for the use of short polymers of glucose in diarrhea. Clin Pediatr (Phila) 1994; 33:675-82. [PMID: 7859427 DOI: 10.1177/000992289403301107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- D I Mehta
- International Institute for Infant Nutrition and Gastrointestinal Disease, Philadelphia, Pennsylvania
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Coppa GV, Gabrielli O, Pierani P, Zampini L, Giorgi PL. Characterization of carbohydrates in commercial infant formulae. ACTA PAEDIATRICA (OSLO, NORWAY : 1992). SUPPLEMENT 1994; 402:31-6. [PMID: 7841617 DOI: 10.1111/j.1651-2227.1994.tb13357.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- G V Coppa
- Department of Pediatrics, University of Ancona, Italy
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