Body composition assessment in 6-month-old infants: A comparison of two- and three-compartment models using data from the Baby-bod study

BACKGROUND/OBJECTIVES

An appreciation of infant body composition is helpful to understand the 'quality' of growth in early life. Air displacement plethysmography (ADP) using PEA POD and the deuterium dilution (DD) technique are commonly used body composition approaches in infants. We evaluated the comparability of body composition assessed using both techniques with two-compartment (2C) and three-compartment (3C) models in 6-month-old infants.

SUBJECTS/METHODS

Infant fat mass (FM) and percent fat mass (%FM) obtained from a 2C model using PEA POD (2C-PP) and a 2C model using the deuterium dilution technique (2C-DD) were compared to those derived from a 3C model, and to each other, using Bland-Altman analysis and Deming regression.

RESULTS

Measurements were available from 68 infants (93% Caucasian, 53% male). The mean biases were not significant between any of the method comparisons. However, significant constant and proportional biases were identified in 2C-DD vs 3C and 2C-PP vs 2C-DD, but not in the 2C-PP vs 3C comparison. Furthermore, we observed significant associations between the mean differences and infants' percent total body water (%TBW).

CONCLUSIONS

While no significant between-method mean differences were found in body composition estimates, some comparisons revealed significant constant and proportional biases and notable associations between the mean differences and %TBW were observed. Our results emphasise the importance of method choice, ensuring methodological uniformity in long-term studies, and carefully considering and regulating multiple pre-analytical variables, such as the hydration status of the participants.

Trends and associations between maternal characteristics and infant birthweight among Indigenous and non-Indigenous people in Tasmania, Australia: a population-based study

OBJECTIVE

This study aimed to investigate the trends and associations of maternal characteristics and birthweight among Indigenous and non-Indigenous infants.

STUDY DESIGN

This was a retrospective population-based study.

METHODS

Fourteen years (2005-2018) of birthweight and perinatal health data of live-born singletons and their mothers obtained from the Tasmanian Data Linkage Unit were used to assess the trends and associations between maternal characteristics and infant birthweight using regression modelling.

RESULTS

Compared with non-Indigenous mothers (n = 76,750), Indigenous mothers (n = 3805) had a significantly higher prevalence of risk factors during the 14-year period. Although the prevalence of prepregnancy obesity and gestational diabetes mellitus (GDM) markedly increased in both groups, the rate of increase was higher (P < 0.001) for Indigenous than non-Indigenous mothers. Smoking, alcohol consumption and illegal drug use during pregnancy reduced over the years, and there was no significant difference in the rate of reduction between the groups. Large-for-gestational-age (LGA) births increased while small-for-gestational-age (SGA) births decreased in both groups over time. In addition, high birthweight (HBW) births decreased while low birthweight (LBW) births increased. The rates of increase in LGA and LBW births and the rates of decrease in SGA and HBW births were significantly higher in Indigenous mothers compared with non-Indigenous mothers (P < 0.001 for all). The association between Indigenous ethnicity and LBW and SGA births weakened after adjusting for other confounding maternal and perinatal variables. LBW and SGA were positively associated with Indigenous ethnicity, age <18 years, smoking, alcohol consumption and illegal drug use, pre-eclampsia, underweight prepregnancy body mass index and low socio-economic status. Women with higher parity, pre-existing diabetes and prepregnancy overweight or obesity were more likely to give birth to an infant with HBW or LGA.

CONCLUSIONS

The prevalence of risk factors for abnormal birthweight is higher among Tasmanian Indigenous mothers, contributing to a gap in birthweight outcomes between Indigenous and non-Indigenous infants. The dramatic increase in prepregnancy obesity and GDM in both groups highlight the importance of screening and management of GDM during pregnancy. Comprehensive programmes co-designed and co-managed in consultation with Indigenous people are needed to support healthy lifestyle choices among Indigenous women to address the barriers to individuals adopting behaviour change and to help close the health outcomes-related gap between Indigenous and non-Indigenous mothers and infants.

Synbiotics as Supplemental Therapy for the Alleviation of Chemotherapy-Associated Symptoms in Patients with Solid Tumours

Chemotherapy is still the first line of treatment for most cancer patients. Patients receiving chemotherapy are generally prone to infections, which result in complications, such as sepsis, mucositis, colitis, and diarrhoea. Several nutritional approaches have been trialled to counter the chemotherapy-associated side effects in cancer patients, but none have yet been approved for routine clinical use. One of the approaches to reduce or avoid chemotherapy-associated complications is to restore the gut microbiota. Gut microbiota is essential for the healthy functioning of the immune system, metabolism, and the regulation of other molecular responses in the body. Chemotherapy erodes the mucosal layer of the gastrointestinal tract and results in the loss of gut microbiota. One of the ways to restore the gut microbiota is through the use of probiotics. Probiotics are the ‘good’ bacteria that may provide health benefits if consumed in appropriate amounts. Some studies have highlighted that the consumption of probiotics in combination with prebiotics, known as synbiotics, may provide better health benefits when compared to probiotics alone. This review discusses the different nutritional approaches that have been studied in an attempt to combat chemotherapy-associated side effects in cancer patients with a particular focus on the use of pre-, pro- and synbiotics.

Capsaicin and Zinc Signalling Pathways as Promising Targets for Managing Insulin Resistance and Type 2 Diabetes

The global burden of type 2 diabetes (T2DM) has led to significant interest in finding novel and effective therapeutic targets for this chronic disorder. Bioactive food components have effectively improved abnormal glucose metabolism associated with this disease. Capsaicin and zinc are food components that have shown the potential to improve glucose metabolism by activating signalling events in the target cells. Capsaicin and zinc stimulate glucose uptake through the activation of distinct pathways (AMPK and AKT, respectively); however, calcium signal transduction seems to be the common pathway between the two. The investigation of molecular pathways that are activated by capsaicin and zinc has the potential to lead to the discovery of new therapeutic targets for T2DM. Therefore, this literature review aims to provide a summary of the main signalling pathways triggered by capsaicin and zinc in glucose metabolism.

Capsaicin and Zinc Promote Glucose Uptake in C2C12 Skeletal Muscle Cells through a Common Calcium Signalling Pathway

Capsaicin and zinc have recently been highlighted as potential treatments for glucose metabolism disorders; however, the effect of these two natural compounds on signalling pathways involved in glucose metabolism is still uncertain. In this study, we assessed the capsaicin- or zinc- induced activation of signalling molecules including calcium/calmodulin-dependent protein kinase 2 (CAMKK2), cAMP-response element-binding protein (CREB), and target of rapamycin kinase complex 1 (TORC1). Moreover, the expression status of genes associated with the control of glucose metabolism was measured in treated cells. The activation of cell signalling proteins was then evaluated in capsaicin- or zinc treated cells in the presence or absence of cell-permeant calcium chelator (BAPTA-AM) and the CAMKK inhibitor (STO-609). Finally, capsaicin- and zinc-induced glucose uptake was measured in the cells pre-treated with or without BAPTA-AM. Our results indicate that calcium flux induced by capsaicin or zinc led to activation of calcium signalling molecules and promoting glucose uptake in skeletal muscle cells. Pharmacological inhibition of CAMKK diminished activation of signalling molecules. Moreover, we observed an increase in intracellular cAMP levels in the cells after treatment with capsaicin and zinc. Our data show that capsaicin and zinc mediate glucose uptake in C2C12 skeletal muscle cells through the activation of calcium signalling.

TRPV1 Activation by Capsaicin Mediates Glucose Oxidation and ATP Production Independent of Insulin Signalling in Mouse Skeletal Muscle Cells

BACKGROUND

Insulin resistance (IR), a key characteristic of type 2 diabetes (T2DM), is manifested by decreased insulin-stimulated glucose transport in target tissues. Emerging research has highlighted transient receptor potential cation channel subfamily V member (TRPV1) activation by capsaicin as a potential therapeutic target for these conditions. However, there are limited data on the effects of capsaicin on cell signalling molecules involved in glucose uptake.

METHODS

C2C12 cells were cultured and differentiated to acquire the myotube phenotype. The activation status of signalling molecules involved in glucose metabolism, including 5' adenosine monophosphate-activated protein kinase (AMPK), calcium/calmodulin-dependent protein kinase 2 (CAMKK2), extracellular signal-regulated protein kinases 1 and 2 (ERK1/2), protein kinase B (AKT), and src homology phosphatase 2 (SHP2), was examined. Finally, activation of CAMKK2 and AMPK, and glucose oxidation and ATP levels were measured in capsaicin-treated cells in the presence or absence of TRPV1 antagonist (SB-452533).

RESULTS

Capsaicin activated cell signalling molecules including CAMKK2 and AMPK leading to increased glucose oxidation and ATP generation independent of insulin in the differentiated C2C12 cells. Pharmacological inhibition of TRPV1 diminished the activation of CAMKK2 and AMPK as well as glucose oxidation and ATP production. Moreover, we observed an inhibitory effect of capsaicin in the phosphorylation of ERK1/2 in the mouse myotubes.

CONCLUSION

Our data show that capsaicin-mediated stimulation of TRPV1 in differentiated C2C12 cells leads to activation of CAMKK2 and AMPK, and increased glucose oxidation which is concomitant with an elevation in intracellular ATP level. Further studies of the effect of TRPV1 channel activation by capsaicin on glucose metabolism could provide novel therapeutic utility for the management of IR and T2DM.

Exclusivity of breastfeeding and body composition: learnings from the Baby-bod study

Background

This report evaluated the breastfeeding status in a Tasmanian cohort and its effects on infant and maternal anthropometry and body composition.

Methods

An observational-cohort analysis of self-reported feeding data from 175 Tasmanian mother-baby dyads (recruited via in-person contact between September 2017 and October 2019), was executed. Only mothers who were ≥ 18 years of age, who had a singleton pregnancy and were able to speak and understand English, were included in the study. Infants outside a gestational age range between 37^+ 0 and 41^+ 6 weeks were excluded. Infant (using Air Displacement Plethysmography) and maternal body composition was assessed at 0, 3 and 6 months. Analysis of variance with relevant statistical corrections were utilised for cross-sectional and longitudinal comparisons between non-exclusively breastfed (neBF) and exclusively breastfed (eBF) groups.

Results

Fat-free mass was significantly higher [t = 2.27, df = 98, P = 0.03, confidence interval (CI) 0.03, 0.48] in neBF infants at 6 months (5.59 ± 0.59 vs 5.33 ± 0.50 kg) despite a higher mean fat-free mass in eBF infants at birth (2.89 ± 0.34 vs 3.01 ± 0.35 kg). Weak evidence for different fat mass index trajectories was observed for eBF and neBF infants in the first 6 months of life (ANOVA, F = 2.42, df = 1.9, P = 0.09) with an inversion in fat mass index levels between 3 and 6 months. Body Mass Index (BMI) trajectories were significantly different in eBF and neBF mothers through pregnancy and the first 6 months postpartum (ANOVA, F = 5.56, df = 30.14, P = 0.01). Compared with eBF mothers, neBF mothers retained significantly less weight (t = − 2.754, df = 158, P = 0.02, CI -6.64, − 1.09) at 3 months (0.68 ± 11.69 vs 4.55 ± 6.08 kg) postpartum. Prevalence for neBF was incrementally higher in mothers with a normal BMI compared to mothers with obesity, and mothers who underwent surgical or medical intervention during birth were less likely to exclusively breastfeed.

Conclusions

Infants with different feeding patterns may display varying growth patterns in early life and sustained breastfeeding can contribute to greater postpartum maternal weight loss.

Determinants of Infant Adiposity across the First 6 Months of Life: Evidence from the Baby-bod study

Excess adiposity in infancy may predispose individuals to obesity later in life. The literature on determinants of adiposity in infants is equivocal. In this longitudinal cohort study, we investigated pre-pregnancy, prenatal and postnatal determinants of different adiposity indices in infants, i.e., fat mass (FM), percent FM (%FM), fat mass index (FMI) and log-log index (FM/FFM^p), from birth to 6 months, using linear mixed-effects regression. Body composition was measured in 322, 174 and 109 infants at birth and 3 and 6 months afterwards, respectively, utilising air displacement plethysmography. Positive associations were observed between gestation length and infant FM, maternal self-reported pre-pregnancy body mass index and infant %FM, and parity and infant %FM and FMI at birth. Surprisingly, maternal intake of iron supplements during pregnancy was associated with infant FM, %FM and FMI at 3 months and FM/FFM^p at 6 months. Male infant sex and formula feeding were negatively associated with all adiposity indices at 6 months. In conclusion, pre-pregnancy and pregnancy factors influence adiposity during early life, and any unfavourable impacts may be modulated postnatally via infant feeding practices. Moreover, as these associations are dependent on the adiposity indices used, it is crucial that researchers use conceptually and statistically robust approaches such as FM/FFM^p.

Gestational Diabetes Mellitus and Infant Adiposity at Birth: A Systematic Review and Meta-Analysis of Therapeutic Interventions

Exposure to untreated gestational diabetes mellitus (GDM) in utero increases the risk of obesity and type 2 diabetes in adulthood, and increased adiposity in GDM-exposed infants is suggested as a plausible mediator of this increased risk of later-life metabolic disorders. Evidence is equivocal regarding the impact of good glycaemic control in GDM mothers on infant adiposity at birth. We systematically reviewed studies reporting fat mass (FM), percent fat mass (%FM) and skinfold thicknesses (SFT) at birth in infants of mothers with GDM controlled with therapeutic interventions (IGDMtr). While treating GDM lowered FM in newborns compared to no treatment, there was no difference in FM and SFT according to the type of treatment (insulin, metformin, glyburide). IGDMtr had higher overall adiposity (mean difference, 95% confidence interval) measured with FM (68.46 g, 29.91 to 107.01) and %FM (1.98%, 0.54 to 3.42) but similar subcutaneous adiposity measured with SFT, compared to infants exposed to normal glucose tolerance (INGT). This suggests that IGDMtr may be characterised by excess fat accrual in internal adipose tissue. Given that intra-abdominal adiposity is a major risk factor for metabolic disorders, future studies should distinguish adipose tissue distribution of IGDMtr and INGT.

WHO Child Growth Standards in context: The Baby-bod Project - Observational study in Tasmania

OBJECTIVE

This research evaluated (1) differences in body size and composition of Tasmanian infants at birth and 3 and 6 months postpartum compared with WHO child growth standards and (2) body composition changes in Tasmanian infants at the extremes of the weight-for-length (WFL) spectrum.

DESIGN

Observational study.

SETTING

A hospital in Northern Tasmania, Australia.

PATIENTS

315 healthy infants (~90% Caucasian) born between 2017 and 2019 in Tasmania.

INTERVENTIONS

Body composition and anthropometric measures at 0, 3 and 6 months.

MAIN OUTCOME MEASURES

Growth characteristics at birth and growth trajectories from 0 to 6 months were compared against WHO child growth standards for 0-2 years.

RESULTS

Overall, growth of Tasmanian infants in the first 6 months of life was similar to the global prescriptive standards. Trajectories of fat mass (FM) and fat-free mass (FFM) accrual in infants from the extremes of the size spectrum appear to converge at the 6-month time point. Infants in the lower extremity demonstrated the most precipitous accrual in percentage FM (and the steepest decline in percentage FFM), compared with all other infants.

CONCLUSION

No significant deviations of growth were observed in Tasmanian infants from 0 to 6 months in comparison to the WHO prescriptive growth standards. Infants below the third percentile WFL showed the most precipitous increase in FM accretion. Periodic comparisons local infants with global standards will enable identification of significant deviations from optimal growth patterns.

Diet and Multiple Sclerosis: Scoping Review of Web-Based Recommendations

Background

There is currently no scientific evidence supporting the use of specific diets in the management of multiple sclerosis (MS); the strongest dietary associations are observed with vitamin D and omega-3 fatty acid supplementation. Despite this, there are many websites that provide advice or suggestions about using various dietary approaches to control symptoms or disease progression.

Objective

The objective of this study was to assess the dietary advice for the symptomatic management of MS available on the internet.

Methods

This study was a systematic review of webpages that provided dietary advice for the management of MS. Webpages were selected from an internet search conducted in November 2016 using Google, Yahoo, and Bing search engines and the search term “MS diet.” The first two pages of results from each search engine were included for the initial assessment. Duplicates were removed. Data extracted from websites included specific advice relating to diet and its rationale and the citation of supporting scientific literature. Authorship and credential information were reviewed to assess webpage quality.

Results

We included 32 webpages in the final assessment. The webpages made a wide variety of specific recommendations regarding dietary patterns and individual foods to help manage MS. The most common dietary pattern advised on these webpages was the low-fat, high-fiber balanced diet, followed by the low-saturated fat diet, near-vegetarian Swank diet, and the Paleo diet. The main categories of individual foods or nutrients suggested for addition to the diet were: supplements (especially omega-3 and vitamin D), fruits, vegetables, and lean protein. In contrast, the most commonly recommended for removal were saturated fats, dairy, gluten-containing grains, and refined sugar. These recommendations were often accompanied by rationale relating to how the particular food or nutrient may affect the development, prevalence and symptoms of MS; however, very little of this information is supported by the current scientific evidence between diet and MS. Only 9 webpages provided full authorship including credential information.

Conclusions

There is a wide variety of Web-based dietary advice, which in some cases is contradictory. In most cases, this advice is the result of peoples’ individual experiences and has not been scientifically tested. How people living with MS use this information is not known. These findings highlight the important role health professionals can play in assisting people living with MS in their health information-seeking behaviors.

Online dietary advice for the symptomatic management of multiple sclerosis: a scoping review protocol

The objective of this scoping review is to identify, map and assess the range of dietary advice provided on websites for the symptomatic management of multiple sclerosis (MS), specifically in relation to the types of diets, relationship between specific food/diet/supplement and specific symptoms, citation of scientific literature to support claims and advice to consult a health professional (doctor/nutritionist/dietitian).Specifically the review question is: What dietary advice is available on websites for the symptomatic management of MS?

Omega-3 dietary Fatty Acid status of healthy older adults in Tasmania, Australia: an observational study

OBJECTIVES

To determine the dietary and supplement intake of omega-3 (n-3) polyunsaturated fatty acids (PUFA) of older Tasmanian adults; their plasma n-3 PUFA status and the relationship between n-3 PUFA intake and plasma status.

DESIGN

Cross-sectional study.

SETTING

Launceston and surrounding regions, Tasmania, Australia.

PARTICIPANTS

Seventy-three community-dwelling older adults: 23 men aged 70 ± 6.1 years and 50 women aged 70 ± 6.7 years.

MEASUREMENTS

A validated, semi-quantitative food frequency questionnaire estimated dietary PUFA intake. The plasma phospholipid fraction of venous blood samples was analysed for fatty acid content. Anthropometric data was recorded.

RESULTS

Thirty-five participants (48%) regularly ingested a fish oil supplement. Their plasma n-3 PUFA profile contained significantly more eicosapentaenoic acid (EPA) (odds ratio 3.14; 95% CI 1.37% to 7.30%; p<0.05) and docosahexaenoic acid (DHA) (odds ratio 2.64; 95% CI 1.16% to 6.01%; p<0.05) than non-supplement users. Fish and meat were the main dietary sources of n-3 PUFAs. Participants most commonly consumed fish 3-4 times per week. Significant associations of dietary α-linolenic acid (ALA), EPA, docosapentaenoic acid (DPA) and DHA with plasma n-3 PUFAs were noted but not always between dietary and plasma counterparts.

CONCLUSION

Without the use of fish oil supplements, most study participants were unable to meet the recommended daily intake of 0.5g EPA and DHA combined; however, the plasma n-3 PUFA profile of non-supplement-users was still robust compared to other Australian and overseas studies.

Effect of hereditary haemochromatosis genotypes and iron overload on other trace elements

PURPOSE

Hereditary haemochromatosis is a common genetic disorder involving dysregulation of iron absorption. There is some evidence to suggest that abnormal iron absorption and metabolism may influence the status of other important trace elements. In this study, the effect of abnormal HFE genotypes and associated iron overload on the status of other trace elements was examined.

METHODS

Dietary data and blood samples were collected from 199 subjects (mean age = 55.4 years; range = 21-81 years). Dietary intakes, serum selenium, copper and zinc concentrations and related antioxidant enzymes (glutathione peroxidase and superoxide dismutase) in subjects with normal HFE genotype (n = 118) were compared to those with abnormal HFE genotype, with both normal iron status (n = 42) and iron overload (n = 39).

RESULTS

For most dietary and biochemical variables measured, there were no significant differences between study groups. Red cell GPx was significantly higher in male subjects with normal genotypes and normal iron status compared to those with abnormal genotypes and normal iron status (P = 0.03) or iron overload (P = 0.001). Red cell GPx was also highest in normal women and significantly lower in the abnormal genotype and normal iron group (P = 0.016), but not in the iron overload group (P = 0.078).

CONCLUSION

Although it may not be possible to exclude a small effect between the genotype groups on RBC GPx, overall, haemochromatosis genotypes or iron overload did not appear to have a significant effect on selenium, copper or zinc status.

Evaluation of the Randox colorimetric serum copper and zinc assays against atomic absorption spectroscopy

BACKGROUND

Analysis of copper and zinc in serum is commonly performed using atomic absorption spectrometry (AAS); however, these methods are often not readily available in smaller laboratories. Randox colorimetric assays for copper and zinc in serum were evaluated on the Thermo Electron Data Pro analyser against flame AAS methods.

METHODS

Copper and zinc were measured in 48 serum samples using the Randox colorimetric copper (CU2340) and zinc (ZN2341) assays on the Data Pro analyser and the results compared with those from a Varian Spectra 880 atomic absorption spectrometer. A smaller set of samples (n = 15) were also analysed colorimetrically for zinc on the Roche Cobas Mira.

RESULTS

Linear regression analyses of Bland and Altman plots from the Data Pro - AAS comparison gave the following results for copper: correlation r = 0.6669 (P < 0.01), slope = -0.2499 (P < 0.01), intercept = 3.219 (P < 0.01). For zinc, results were as follows: correlation r = 0.1976, slope = 0.1807, intercept = -1.922. For the smaller set of samples, the Cobas Mira - AAS comparison for zinc gave correlation r = 0.4379, slope = 0.5294, intercept = -4.074. The results indicated significant systematic and fixed bias between the colorimetric copper and the AAS method.

CONCLUSION

Performances in comparison to AAS methods indicated the colorimetric methods, as used, are unsuitable for the accurate determination of copper and zinc in human serum.