Lower intakes of protein, carbohydrate, and energy are associated with increased global DNA methylation in 2- to 3-year-old urban slum children in Bangladesh

Buccal DNA global methylation and cognitive performance in stunted children under 5 years of age

The prevalence of stunting in Indonesian children under five years of age is about 20%. Chronic maternal malnutrition contributes to the risk of stunting by affecting global DNA methylation. In the present study, we aimed to evaluate the levels of 5-methyl-cytosine (5mC), as a surrogate marker of global DNA methylation, in buccal swabs and its potential association with risk of stunting and cognitive performance. The levels of 5mC were measured using the enzyme-linked immunosorbent assay. The Wechsler Preschool and Primary Scale of Intelligence was used to measure cognitive functions. Buccal swab DNA samples and anthropometric data were collected from a total of 231 children aged zero to five years. In this cross-sectional cohort, the prevalence of stunting was 37% in 138 children aged zero to two years and 30% in 93 children aged > two years. The univariable analysis revealed that the levels of 5mC in buccal swab DNA were significantly lower in severely stunted children (median, 2.84; interquartile range [IQR], 2.39-4.62; P-value, 0.0314) and in children of a younger age (median, 2.81; IQR 2.53-4.62, P-value, 0.0001) than in normal (median, 3.75; IQR, 2.80-4.74) and older children (median, 4.01, IQR, 3.39-4.87), respectively. We also found that the average cognitive scores tended to be low in boys and stunted children, although the differences were not statistically significant. Furthermore, levels of 5mC found in buccal and mouthwash DNA were not associated with cognitive scores.

Nutrient Composition of Indonesian Specialty Cereals: Rice, Corn, and Sorghum as Alternatives to Combat Malnutrition

Stunted growth (stunting) caused by malnutrition is a growing concern in Indonesia. The nutritional composition of cereals is important information for improving people's nutrition. This research aimed to comparatively study the nutritional values of several Indonesian local cereal crops and provide a nutritional database for promoting local food with the aim of combating malnutrition. The cereals investigated included varieties of rice, corn, and sorghum. The nutritional analysis included ash, protein, fat, carbohydrates, dietary fiber, essential amino acids, vitamins, and minerals. A purposive sampling method was performed by collecting five lots from each sampling area and forming composite samples by combining 1∼2 kg of each sample, then mixed before laboratory analysis. The results showed that colored rice, colored corn and sorghum, contain richer essential nutrients, dietary fiber, and essential amino acids compared to white rice and corn. The highest protein content was found in sorghum (13.26%), followed by corn (9.18%), and rice (8.0%). The highest energy value was also found in sorghum (380.5 kcal/100 g), followed by corn (379.9 kcal/100 g), and rice (362.1 kcal/100 g). The same sequence was seen for the mineral contents, where the zinc and iron contents were 1.57 and 2.39 mg/100 g, respectively for sorghum; 1.36 and 0.79 mg/100 g for corn; and 0.93 and 0.58 mg/100 g for rice. Accordingly, it can be concluded that sorghum has the highest nutritional value and therefore potential for combating malnutrition, while corn and rice are also highly nutritious and can be grown locally in order to combat malnutrition.

Malnourished Microbes: Host-Microbiome Interactions in Child Undernutrition

Childhood undernutrition is a major global health burden that is only partially resolved by nutritional interventions. Both chronic and acute forms of child undernutrition are characterized by derangements in multiple biological systems including metabolism, immunity, and endocrine systems. A growing body of evidence supports a role of the gut microbiome in mediating these pathways influencing early life growth. Observational studies report alterations in the gut microbiome of undernourished children, while preclinical studies suggest that this can trigger intestinal enteropathy, alter host metabolism, and disrupt immune-mediated resistance against enteropathogens, each of which contribute to poor early life growth. Here, we compile evidence from preclinical and clinical studies and describe the emerging pathophysiological pathways by which the early life gut microbiome influences host metabolism, immunity, intestinal function, endocrine regulation, and other pathways contributing to child undernutrition. We discuss emerging microbiome-directed therapies and consider future research directions to identify and target microbiome-sensitive pathways in child undernutrition.

Globally elevated levels of histone H3 lysine 9 trimethylation in early infancy are associated with poor growth trajectory in Bangladeshi children

BACKGROUND

Stunting is a global health problem affecting hundreds of millions of children worldwide and contributing to 45% of deaths in children under the age of five. Current therapeutic interventions have limited efficacy. Understanding the epigenetic changes underlying stunting will elucidate molecular mechanisms and likely lead to new therapies.

RESULTS

We profiled the repressive mark histone H3 lysine 9 trimethylation (H3K9me3) genome-wide in peripheral blood mononuclear cells (PBMCs) from 18-week-old infants (n = 15) and mothers (n = 14) enrolled in the PROVIDE study established in an urban slum in Bangladesh. We associated H3K9me3 levels within individual loci as well as genome-wide with anthropometric measurements and other biomarkers of stunting and performed functional annotation of differentially affected regions. Despite the relatively small number of samples from this vulnerable population, we observed globally elevated H3K9me3 levels were associated with poor linear growth between birth and one year of age. A large proportion of the differentially methylated genes code for proteins targeting viral mRNA and highly significant regions were enriched in transposon elements with potential regulatory roles in immune system activation and cytokine production. Maternal data show a similar trend with child's anthropometry; however, these trends lack statistical significance to infer an intergenerational relationship.

CONCLUSIONS

We speculate that high H3K9me3 levels may result in poor linear growth by repressing genes involved in immune system activation. Importantly, changes to H3K9me3 were detectable before the overt manifestation of stunting and therefore may be valuable as new biomarkers of stunting.

Association of zinc level with DNA methylation and its consequences: A systematic review

Background

Objectives

Method

Results

Conclusion

DNA methylation profile of a rural cohort exposed to early-adversity and malnutrition: An exploratory analysis

Barker's hypothesis affirms that undernourishment in early-life induces metabolic reprogramming that compromises organism functions later in life, leading to age-related diseases. We are exposed to environmental and social conditions that impact our life trajectories, leading to ageing phenotypes as we grow. Epigenetic mechanisms constitute the link between both external stimuli and genetic programming. Studies have focused on describing the effect of early adverse events such as trauma, famines, or childhood labor on epigenetic markers in adulthood and the elderly. However, we lack information on epigenetic programming in individuals born in rural communities from underdeveloped countries, exposed to negative influences during fetal and postnatal development, particularly chronic malnutrition. Hence, in this exploratory analysis, we characterize the epigenome of individuals and some parents from Tlaltizapan (a rural community in Mexico originally studied almost 50 years ago) and collect anthropometric data on growth and development, as well on the living conditions of the families. Our results help build a biological hypothesis indicating that most of the epigenetic age measures of the subjects are significantly different among them. Interestingly, the most affected methylated regions correspond to pathways involved in neuronal system development, reproductive behaviour, learning and memory regulation.

Association of DNA methylation and genetic variations of the APOE gene with the risk of diabetic dyslipidemia

Apolipoprotein E (APOE) is a key regulator of lipoprotein metabolism, and consequently, affects the plasma and tissue lipid contents. The aim of the present study was to investigate the parallel effects of APOE genetic variants and promoter methylation levels of six CpGs on the risk of diabetic dyslipidemia. A total of 204 Palestinian type 2 diabetes (T2D) patients (mean age ± SD: 62.7±10.2) were enrolled in the present study (n=96 with dyslipidemia and n=108 without dyslipidemia). Next generation sequencing was performed to analyze five single nucleotide polymorphisms: Two variants rs7412 and rs429358 that determine APOE ε alleles, and three variants in the promoter region (rs769446, rs449647, and rs405509). For all subjects, the most common genotype was ε3/ε3 (79.4%). No statistical differences were observed in the APOE ε polymorphisms and the three promoter variants among T2D patients with and without dyslipidemia (P>0.05). A comparison of lipid parameters between ε3/ε3 subjects and ε4 carriers in both groups revealed no significant differences in the mean values of LDL-C, HDL-C, TG, and TC levels (P>0.05). Six CpG sites in the APOE promoter on chromosome 19:44905755-44906078 were identified, and differential DNA methylation in these CpGs were observed between the study groups. Logistic regression analysis revealed a significant association of DNA methylation level at the six CpGs with an increased risk of diabetic dyslipidemia (odds ratio, 1.038; 95% confidence interval, 1.012-1.064; P=0.004). In conclusion, the present study revealed that DNA methylation levels in six CpGs in the APOE promoter region was associated with the risk of diabetic dyslipidemia independently of the APOE ε4 variant which could be a potential therapeutic target to reverse the methylation of the APOE promoter.

The Role of Nutrients and MCV on Stunting: A Case Study on Indonesian Early Teenagers

BACKGROUND: Many teenagers experience many nutritional problems, including anemia and stunting. The correlation between energy intake, protein, iron, and stunting with MCV levels in stunting adolescents in Jatinangor is not yet known. AIM: This study aims to analyze the correlation of energy intake, protein, iron, and stunting and MCV levels in stunting adolescents in Jatinangor. METHODS: This study was conducted with a cross-sectional design involving early adolescents aged 10-14 years in Jatinangor District as many as 41 people. Analysis of MCV levels was done by taking blood through veins. Stunting data were obtained based on WHO criteria with a value of z-score TB / U<- 2 SD and nutritional intake data including energy, protein, and iron obtained through 24-hour recall. To determine the intake of nutrients is done by interviewing with the method of 24 hours recall and FFQ. The data were analyzed with the Pearson Correlation Test. RESULTS: The correlation between energy intake and MCV levels was p=0.022 (r=0.356). Furthermore, the correlation of protein intake and MCV levels was p=0.257, and iron intake with MCV levels was p=0.301. Eventually, the stunting correlation test to MCV levels was p=0.006 (r=0.419). CONCLUSIONS: This study concludes that there is a correlation between energy intake and the value of the z-score TB / U index with MCV levels. There is no significant correlation between protein intake and iron intake with MCV levels in stunting adolescents in Jatinangor. There is a correlation between MCV and stunting levels, and there is no correlation between nutrient intake and stunting.

Methodological Aspects of Diet Quality Indicators in Childhood: A Mapping Review

Diet quality indicators (DQIns) are tools that aim to assess an individual's overall diet quality. Previous reviews focused mainly on health-related outcomes but did not provide detailed information about components, assessment variables, or important methodological issues for the development and application of DQIns in the pediatric age. The current mapping review aims to provide comprehensive guidance regarding DQIns developed through a priori methodology in children aged ≤14 y that have been applied worldwide. A mapping review was conducted, whereby 1665 original articles describing the development, modifications, and updates of DQIns, published up to June 26, 2020, in English and Spanish, were retrieved. A total of 139 articles were identified and classified into 13 subgroups. There were 10 overall DQIns: Healthy Eating Indexes (n = 25), Dietary Diversity Scores (n = 20), Diet Quality Indexes (n = 16), Food Variety Scores (n = 11), Healthy and Unhealthy Scores (n = 11), Feeding and Eating Indexes (n = 10), Diet Quality Scores (n = 5), Nutritional Adequacy and Micronutrients Indexes (n = 5), Dietary Guidelines Indexes (n = 5), and Other Healthy Diet Indexes (n = 13). Three additional subgroups of dietary and lifestyle indicators found were Mediterranean Diet Indexes (n = 10), Diet-Lifestyle Indexes (n = 5), and Breakfast Quality Indexes (n = 3). This compilation of DQIns will help researchers select the most appropriate tool for future epidemiological studies by considering a careful selection of information about the assessment components, scoring methods, and key methodological issues. The main limitations of this review are that, due to its nature, a risk-of-bias assessment was not performed and the article screening was completed in 2 databases (PubMed/MEDLINE and Scopus). More research is needed to identify health-related outcomes associated with DQIns in the pediatric population, using clearer and more standardized methodological criteria.

The relationship between dietary intake and stunting among pre-school children in Upper Egypt

OBJECTIVE

Linear growth is controlled by several factors, malnutrition is one of the leading causes of stunted child growth. The objective of this study was to determine the dietary intakes associated with stunting among pre-school children in rural Upper Egypt.

DESIGN

Community-based cross-sectional study.

SETTING

Data were collected by interviewing the children's caregivers in the rural household setting.

PARTICIPANTS

The study included 497 pre-school children aged 2-5 years in rural Upper Egypt. Food intake data were estimated using 24-h recall method. Anthropometric measurements of children were taken and then converted to z-scores for weight-for-age Z-score, height-for-age Z-score and weight-for-height Z-score.

RESULTS

The study included 497 children of which 19·1 % were stunted, 76·3 % did not meet recommended energetic intake and 13·7 % did not meet recommended protein intake and this was significantly higher than non-stunted children. Children who were stunted significantly consumed poultry, eggs and fruits less often than non-stunted children, by regression; male sex (adjusted odds ratio (aOR) = 1·91), mother's age (0·93), lower socio-economic status (SES); and not meeting recommended protein intake (aOR = 2·26) were found to be associated with stunting.

CONCLUSION

Male sex, younger mothers, lower SES and not meeting recommended energy and protein were statistically associated with stunting. Nutrition education messages encouraging adequate and healthy eating are recommended.

Validation of an interviewer-administered seven-day semi-quantitative food frequency questionnaire for the dietary assessment of preschool children in rural Bangladesh

A validation study of an interviewer-administered, seven-day semi-quantitative food frequency questionnaire (7-d SQFFQ) was conducted in Bangladeshi rural preschool age children. Using a cross-sectional study design, 105 children from 103 households were randomly selected. For the SQFFQ, a list of commonly consumed foods was adapted from the Bangladesh national micronutrient survey 2011–12. The data on the actual number of times and the amount of the children's consumption of the foods in the preceding 1 week were collected by interviewing the mothers. The intake was compared with two non-consecutive days 24-h dietary recalls conducted within 2 weeks after the SQFFQ. Validity was assessed by the standard statistical tests. After adjusting for the energy intake and de-attenuation for within-subject variation, the food groups (cereals, animal source foods, milk and the processed foods) had ‘good’ correlations between the methods (rho 0⋅65–0⋅93; P < 0⋅001). Similarly, the macronutrients (carbohydrate, protein and fats) had ‘good’ correlations (rho 0⋅50–0⋅75; P < 0⋅001) and the key micronutrients (iron, zinc, calcium, vitamin A, etc.) demonstrated ‘good’ correlations (rho 0⋅46–0⋅85; P < 0⋅001). The variation in classifying the two extreme quintiles by the SQFFQ and the 24-h recalls was <10 %. The results from Lin's concordance coefficients showed a ‘moderate’ to ‘excellent’ absolute agreement between the two methods for food groups, and nutrients (0⋅21–0⋅90; P < 0⋅001). This interviewer-administered, 7-d SQFFQ with an open-ended intake frequency demonstrated adequate validity to assess the dietary intake for most nutrients and suitable for dietary assessments of young children in Bangladesh.

The regulation mechanisms and the Lamarckian inheritance property of DNA methylation in animals

DNA methylation is a stable and heritable epigenetic mechanism, of which the main functions are stabilizing the transcription of genes and promoting genetic conservation. In animals, the direct molecular inducers of DNA methylation mainly include histone covalent modification and non-coding RNA, whereas the fundamental regulators of DNA methylation are genetic and environmental factors. As is well known, competition is present everywhere in life systems, and will finally strike a balance that is optimal for the animal's survival and reproduction. The same goes for the regulation of DNA methylation. Genetic and environmental factors, respectively, are responsible for the programmed and plasticity changes of DNA methylation, and keen competition exists between genetically influenced procedural remodeling and environmentally influenced plastic alteration. In this process, genetic and environmental factors collaboratively decide the methylation patterns of corresponding loci. DNA methylation alterations induced by environmental factors can be transgenerationally inherited, and exhibit the characteristic of Lamarckian inheritance. Further research on regulatory mechanisms and the environmental plasticity of DNA methylation will provide strong support for understanding the biological function and evolutionary effects of DNA methylation.

Lower intakes of protein, carbohydrate, and energy are associated with increased global DNA methylation in 2- to 3-year-old urban slum children in Bangladesh

Stunting in children is a global public health concern. We investigated how global DNA methylation relates to food intakes, dietary diversity, and development of stunting among 324 children aged 24-36 months in a slum community in Dhaka, Bangladesh. Stunted children (height-for-age z score ˂-2; n = 162) and their age- and sex-matched nonstunted counterparts (height-for-age z score ˃-1; n = 162) were selected by active community surveillance. We studied global DNA methylation, measured as 5-mC% content in whole blood. Dietary intake, anthropometric measurement, and sociodemographic information were obtained. In the multiple linear regression model, increased global DNA methylation level in children was significantly associated with consumption of lower amount of energy, coef: .034 (95% CI [.014, .053]); P = .001, protein, coef: .038 (95% CI [.019, .057]); P = .000, carbohydrate, coef: .027 (95% CI [.008, .047]); P = .006, zinc, coef: .020 (95% CI [.001, .039]); P = .043, total dietary intakes, coef: .020 (95% CI [.001, .039]); P = .043, and intake from plant sources, coef: .028 (95% CI [.009, .047]); P = .005, after adjusting for other covariates. Moreover, higher fruits and vegetables consumption was significantly associated with lower 5-mC% level, coef: -.022 (95% CI [-.041, -.002]); P = .028. Our findings suggest a significant association between low dietary intakes and increased global DNA methylation. We also found increased global DNA methylation in stunted children. To establish the relationship among the macronutrient intakes, global DNA methylation, and stunting, future prospective studies are warranted in resource-poor settings.