Impact of adiposity, age, sex and maternal feeding practices on eating in the absence of hunger and caloric compensation in preschool children.

BACKGROUND/OBJECTIVES: Between the ages of 3 and 5 years, children may become less responsive to internal cues of satiation and more responsive to external cues, which may induce overeating and lead to weight gain. This study aimed to compare eating in the absence of hunger (EAH) and caloric compensation in 3- to 6-year-old children, and to relate the measurements with children's adiposity, age, sex and maternal feeding practices. METHODS: According to a within-subject three sequential condition design, food intake in children (n=236) was measured at lunch during three sessions, once a week. The same meal (565 kcal) was offered at each session. The first session (control) was only composed of the meal. Thirty minutes before the second meal, children were offered an energy preload (137 kcal; caloric compensation condition). Ten minutes after the third meal, children were exposed to a post-meal snack (430 kcal; EAH condition). Individual caloric compensation score (COMPX) and EAH score were calculated. Maternal characteristics were measured by questionnaire. Child anthropometrics were measured by a medical doctor. RESULTS: On average, children compensated 52±4% of the energy preload and ate 24±1% of the energy provided by their meal in the absence of hunger. COMPX and EAH score were not correlated and did not vary with children's adiposity or age. EAH score was higher in boys (P=0.006). Maternal use of food as reward was associated with higher EAH score (P=0.01) but greater COMPX (P=0.005). CONCLUSIONS: As early as the age of 3 years children did not fully compensate the energy brought by a snack and ate in the absence of hunger. Parents should be advised to avoid these situations where overeating may occur and to limit the use of food as reward.

[To which tastes are infants exposed during the first year of life?]. / A quelles saveurs les nourrissons sont-ils exposés dans la première année de vie ?

Food consumption in young children is guided by their food preferences, which are partly determined by their attraction to the different tastes (sweet, salty, sour, bitter, and umami tastes). Early food experiences might modulate this attraction. Yet, no study has previously described the tastes of infant foods during the first year of life. This is the objective of the present study. The diet of 76 infants was recorded by their parents 1 week per month during the first year of life. This record provided an inventory of 2902 foods a priori different from a sensory point of view. The taste intensity of these foods was estimated. For each infant, each month, and each taste, a variable of exposure to the taste was calculated. Foods consumed by infants from 1 to 12 months of age generally had low or relatively moderate taste intensity. During the milk-feeding period, infants were mainly exposed to sweet taste; this exposure increased during the first year. Beginning with weaning, the exposure to sour taste rose sharply without becoming as high as the exposure to sweet taste, the exposures to salty and umami tastes rose modestly, and the exposure to bitter taste rose slightly, then stagnated. Consequently, the proportion of bitter taste was reduced to approximately half the other tastes between the age of 7 and 12 months. Taking these observations into account would be helpful in establishing feeding recommendations for the pediatric population.

[Gustatory perceptions in children]. / Les perceptions gustatives chez l'enfant.

As soon as the end of gestation, the gustatory system is stimulated by the taste-active compounds carried by the amniotic fluid and its maturation continues until mid-childhood. Facial expressions and relative ingestion methods show that the newborn can discriminate the various taste qualities (bitter, salty, sour, sweet and umami). The range of individual responses is wide. Neonatal reactions to sweet and umami are generally considered to express pleasure. The bitter and sour stimulations lead to hedonically negative reactions. The response to salt taste is less characteristic. Overall, the attraction towards sweet and the rejection of bitter and sour tastes become more pronounced during childhood but tend to decrease in adult life. The early attraction to sweetness is reinforced by exposure to sweet stimulations. With age, the response to salt evolves towards attraction which intensity is dependent on the context and on postnatal exposures to salt. The link between gustatory sensitivity to sweet, salty and sour stimuli and food preferences is far from being clear; the sensitivity to bitter taste better explains the rejection of bitter foods, such as vegetables for instance. The development of gustatory perceptions partly depends upon experience. A better knowledge of the role of experience could help to improve the orientation and the efficacy of nutritionally-oriented food education strategies.

Contrary to other non-photic cues, acute melatonin injection does not induce immediate changes of clock gene mRNA expression in the rat suprachiasmatic nuclei.

The suprachiasmatic nuclei (SCN) contain the main clock of the mammalian circadian system. The endogenous oscillation machinery involves interactive positive and negative transcriptional and posttranslational feedback loops involving the clock genes Per1, Per2, Per3, Clock, Bmal1, Cry1 and Cry2. The SCN endogenous oscillation is entrained to 24 h by the light/dark cycle. Light induced regulation of Per1 and Per2 mRNA expression have been suggested to take part in the clock resetting. However, other factors have chronobiotic and synchronizing effects on SCN activity. Especially, the nocturnal pineal gland hormone, melatonin, which is involved in the regulation of both circadian and seasonal rhythms, is known to feedback on the SCN. Melatonin applied on SCN slices immediately phase-shifts their neuronal electrical activity, while daily injections of melatonin to free running rodents resynchronize their locomotor activity to 24 h. To determine whether melatonin feedback control on SCN activity implicates transcriptional regulation of the clock genes, we monitored the expression pattern of Per 1, 2, 3, Bmal1, Cry1 and AVP mRNAs after a single melatonin injection at the end of the subjective day. Results showed that melatonin injection affected none of the mRNA expression pattern during the first circadian night. Per1, Per3, Bmal1 and AVP expression patterns were, however, significantly but differentially affected, during the second subjective night after the melatonin injection. The present results strongly suggest that the immediate phase shifting effect of melatonin on the SCN molecular loop implicates rather post-translational than transcriptional mechanisms.

Fos immunoreactivity in the suprachiasmatic nuclei of golden hamsters bearing an ectopic pituitary graft.

Young male golden hamsters, made hyperprolactinemic by a pituitary graft under the kidney capsule, were exposed to a light pulse (1,000 lx/30 min) at Zeitgeber time (ZT) 18. Controls included hamsters receiving a sham graft (muscle). Fos immunoreactive cells were counted in both suprachiasmatic nuclei (SCN) of each animal, using an image analyzer system. The Fos immunoreactivity (Fos-ir) of the ventrolateral and dorsomedial SCN regions was greater in the pituitary-grafted hamsters. Indeed, light induced the greatest response in grafted animals in both SCN regions. However, the SCN of pituitary-grafted hamsters in the absence of light showed the lowest Fos-ir in both regions. The results support the occurrence of a dual effect of hyperprolactinemia on Fos-ir in the SCN of hamsters at ZT 18, with inhibition of Fos expression in the absence of light and potentiation of early gene expression when animals were exposed to a light pulse.

Effect of unilateral superior cervical ganglionectomy on mandibular incisor eruption rate in rats.

To assess the effect of sympathectomy on rat tooth eruption, the effect of a unilateral superior cervical ganglionectomy (SCGx) on eruption rate of ipsi- and contralateral lower incisors was examined. Two experiments were performed. In a first experiment, the eruption rate of ipsilaterally denervated incisors was similar to that of contralaterally innervated incisors, when assessed for up to 28 days after surgery. In a second experiment, under conditions of unilateral unimpeded eruption of incisors performed ipsilaterally or contralaterally to a unilateral SCGx, a significantly lower eruption rate of denervated incisors at the impeded eruption side, and a significantly higher eruption rate of denervated incisors at the unimpeded side were observed, when computed every 2 days. Significant differences in individual Student's t tests at every time interval occurred mainly during the first and the last week of examination. When average daily eruption rate was computed in weekly intervals, a significant interaction between SCGx and the side of impeded or unimpeded eruption was found in a factorial ANOVA, that is, for each of the 4 weeks of examination, sympathetically denervated incisors showed lower eruption rates at the impeded eruption side, and higher eruption rates at the unimpeded side. These results indicate that incisor eruption is not modified by a local sympathetic denervation unless the contralateral lower rat incisor is cut out of occlusion.

Could heart rate variability predict outcome in patients with severe head injury? A pilot study.

Despite major improvements in the resuscitation of patients with head injury, the outcome of patients with head trauma often remains poor and difficult to establish. Heart rate variability (HRV) analysis is a noninvasive tool used to measure autonomic nervous system (ANS) activity. The aim of this prospective study was to investigate whether HRV analysis might be a useful adjunct for predicting outcome in patients with severe head injury. Twenty patients with severe head trauma (Glasgow Coma Scale [GCS] or= 10) to HRV in patients characterized by a worsened neurologic state (GCS < 10). Statistical analysis used the Kruskal-Wallis test, P < .05. To assess whether HRV could predict evolution to brain death, receiver operating characteristic (ROC) curves were generated the day after trauma for Total Power, natural logarithm of high-frequency component of spectral analysis (LnHF), natural logarithm of low-frequency component of spectral analysis (LnLF), and root mean square for successive interval differences (rMSSD). Seven patients died between Day 1 and Day 5 after trauma. Six of those had progressed to brain death. In these six patients, at Day 1, Global HRV and parasympathetic tone were significantly higher. Referring to the area under the rMSSD ROC curve, HRV might provide useful information in predicting early evolution of patients with severe head trauma. During the awakening period, global HRV and the parasympathetic tone were significantly lower in the worsened neurologic state group. In conclusion, HRV could be helpful as a predictor of imminent brain death and a useful adjunct for predicting the outcome of patients with severe head injury.

Effect of melatonin on bone metabolism in ovariectomized rats.

To assess the effect of pharmacological dose of melatonin on bone metabolism in ovariectomized rats, urinary deoxypyridinoline (a marker of bone resorption) and calcium excretion, circulating levels of calcium, phosphorus and bone alkaline phosphatase activity (a marker of bone formation), and bone mineral density (BMD), mineral content (BMC) and bone area (BA) of total body, were measured in adult rats for up to 60 days after surgery. Rats received melatonin in the drinking water (25 microg/ml water) or drinking water alone. Urinary deoxypyridinoline increased significantly after ovariectomy by 51% (30 days after surgery) and by 47% (60 days after surgery). The increase in urinary deoxypyridinoline found 30 days after ovariectomy was not observed in melatonin-treated rats. Urinary calcium concentration was similar in the 4 experimental groups studied, as was the circulating calcium concentration at every time interval examined. Fifteen days after surgery, a significant increase in serum phosphorus and bone alkaline phosphatase levels occurred in ovariectomized rats receiving melatonin as compared to their controls. Sixty days after surgery BMD, BMC and BA decreased significantly in ovariectomized rats, an effect not modified by melatonin. Serum estradiol decreased significantly by 30 days after ovariectomy to attain values close to the limit of detection of the assay by 60 days after ovariectomy. The results support the conclusion that a pharmacological amount of melatonin modifies bone remodeling after ovariectomy and that the effect may need adequate concentrations of estradiol.

Could heart rate variability analysis become an early predictor of imminent brain death? A pilot study.

UNLABELLED: Physiology of brain death is characterized by major disturbances of autonomic nervous system (ANS) activity which can lead to graft dysfunction. These findings exhibit the importance of early diagnosis of brain death to improve transplantation outcome. The aim of this prospective study was to assess whether heart rate variability (HRV) analysis, a noninvasive method to investigate ANS activity in comatose patients, could achieve this goal. A total of 14 brain-injured patients were included in the study as soon as they exhibited the clinical signs of imminent brain death. The electrocardiogram was then recorded from two leads with a Holter digital monitor. The clinical diagnosis of brain death was considered after an autonomic storm had occurred. HRV was assessed from 6 h before to 6 h after brain death in both time domain and spectral analysis, estimating either global ANS activity (index of variability, total power), parasympathetic activity (percentage of delta of R-R interval >50 ms, root mean square for successive interval differences, LnHF) or sympathetic activity (LnLF). Hourly averages of these variables were compared by using one-way analysis of variance. To assess whether HRV could per se diagnose brain death, receiver operating characteristic curves were generated for total power, root mean square for successive interval differences, and LnHF. We observed, for 6 h before brain death, a progressive extinction of the influence of the ANS on cardiovascular regulation. There was no activity in the two components of the ANS as soon as brain death occurred. HRV analysis appeared to be a very sensitive but a less specific method of diagnosing brain death. IMPLICATIONS: A total of 14 brain-injured patients with the clinical criteria of imminent brain death were enrolled for electrocardiogram recording and heart rate variability analysis (a noninvasive method to investigate autonomic nervous system activity). For 6 h before brain death, we observed a progressive extinction of autonomic nervous system activity which was not present as soon as brain death was clinically evoked.

Effect of unilateral superior cervical ganglionectomy on bone mineral content and density of rat's mandible.

To assess the effect of a local sympathectomy on bone metabolism, the effect of a unilateral superior cervical ganglionectomy (Gx) on growth and bone mineral content and density of the ipsi- and contralateral mandibles was examined in female rats. A significant increase in the hemi-mandibular bone ipsilateral to Gx was found as compared to the contralateral, sham-operated side 30 days, but not 15 days, after surgery. Bone mineral content of the hemi-mandibular bones was significantly lower in the side ipsilateral to Gx in the group of rats killed on the 30th day after surgery. Since no difference in areas between innervated and denervated hemi-mandibles was found, bone mineral density was also significantly lower in the hemi-mandible ipsilateral to Gx. The results further support that a regional sympathectomy causes qualitative alterations in bone modeling and remodeling, leading to bone resorption.

[Food consumption of infants and young children in France in 1997]. / Consommation alimentaire des nourrissons et des enfants en bas âge en France en 1997.

BACKGROUND: In 1981 and 1989, two French nationwide food consumption surveys reported the dietary intakes of infants and toddlers. In 1997, another survey was conducted. POPULATION AND METHODS: Six-hundred and sixty, 1 to 30-month-old infants and children were recruited. Food records were completed by their parents during a 3-day period. Energy, proteins, carbohydrates, total lipids, minerals, vitamins, linoleic acid contents were calculated. Energy contribution of various food groups and the pattern of the distribution of the different meals were indicated. RESULTS: Between 1989 and 1997, the contribution of milk-based infant formulas increased at 4, 5, 7 and 8-9 months. From the age of 5 months, approximately 75% of the children had a protein intake twice as high as the official recommendations. Mean iron intakes were higher than those calculated in 1989 at the age of 7, 8-9 and 10-12 months. The average daily intake of linoleic acid was lower than the recommended daily allowance from the age of 6 months. CONCLUSION: Trends in dietary intakes between 1989 and 1997 indicated that the nutritional needs of French infants and toddlers are better covered as recommended by scientific committees. More effective efforts are needed for improvement of their nutritional status particularly for iron and essential fatty acids. For example, weaning foods should be introduced later and toddler's formulas should be used more systematically and longer.

Vitamin status of healthy subjects in Burgundy (France).

A nutrition survey was conducted in Burgundy (France) with a population sample of 337 middle-aged and healthy subjects (157 males and 180 females) recruited at a health examination center in 1985-1986. The status of beta-carotene, thiamin, riboflavin, folate, vitamin B6, B12, C, A, D, and E was assessed by means of 7-day food records and biochemical studies. Results were compared with two other recent nutritional surveys conducted in France: ESVITAF (control group only) and Val de Marne surveys. The dietary information collected for each subject was compared to the 1992 French Recommended Dietary Allowances (FRDA). Dietary vitamin intakes were higher in males than in females. Low vitamin intakes (< 1/2 FRDA) were found in 5% of males and 7% of females for thiamin, in 11% of males and 28% of females for vitamin B6, in 6% of males and 3% of females for vitamin C, in 87% of males and 91% of females for vitamin D, and in 8% of males and 13% of females for vitamin E. No subject had a vitamin intake < 1/2 FRDA for riboflavin, folate, vitamins A and B12. ESVITAF and Val de Marne studies also show low vitamin intakes for vitamin B6, thiamin, riboflavin, vitamins D and E. Biochemical status was examined using erythrocyte enzyme function and blood vitamin levels. The percent of subjects with deficient biochemical values was high for vitamin B6 (15% of all males and 20% of all females), and vitamin D (13% of all males, and 15% of all females). With regard to thiamin, riboflavin, vitamin C, folate, vitamin B12, vitamin A, and vitamin E, < 5% of subjects had values in the range of major vitamin deficiency. However, in both genders, except for vitamin C and vitamin A (only for females), low values corresponding to a moderate risk of vitamin deficiency was high for most vitamins. The incidence of a severe deficient vitamin status for thiamin and riboflavin was higher in Val de Marne than in Burgundy, or ESVITAF. In Val de Marne, the probability of a moderate risk of vitamin deficiency was high for thiamin, riboflavin, vitamin B6, vitamin A and vitamin E. Our results (as other studies performed in France and in other industrialized countries) raise the issue of the health significance of marginally deficient vitamin status.

Effects of electromyostimulation and strength training on muscle soreness, muscle damage and sympathetic activation.

Electromyostimulation (EMS) is known to develop muscular strength and hypertrophy. The aim of this study was to compare EMS exercise-induced damage with concentric (CONC) exercise-induced damage. Twelve male athletes were randomly assigned to concentric exercise (five sets of 6 voluntary contractions) or to EMS (30 contractions of 6 s duration, 20 s rest between contractions) on day 0 (D0). The load was 80% of the maximal isometric force. Criterion measures of plasma creatine kinase (CK) activity and lactate dehydrogenase (LDH) activity, and subjective ratings of muscle soreness and urinary catecholamines, were assessed 1 day before and for 3 days after exercise. Among the members of the EMS group, there were significant increases in catecholamine urinary excretion, especially adrenaline (on days D+2 and D+3), plasma CK activity (on day D+2) and plasma LDH activity (on days D+1 and D+2). The changes among the members of the CONC group were smaller and no significant difference was noted. Muscular soreness was greatest in the EMS group, with the peak occurring on day D+2. Comparisons of enzyme release, muscular soreness and urinary catecholamines suggest that EMS induces myofibre membrane damage and a significant increase in sympathetic nervous activity.

[Evolution of the application of nutrition in French nursing infants. Comparison of two national investigations performed in 1981 and 1989]. / Evolution des apports nutritionnels chez les nourrissons français. Comparaison de deux enquêtes nationales realisées en 1981 et 1989.

A national dietary survey was carried out in 1981 among a representative sample of 499 French infants 1 to 18 months of age. When compared with the French Recommended Dietary Allowances, the diets were found to be well supplied in energy, protein and calcium, and inadequately supplied in iron and linoleic acid, mainly for infants aged 4-10 months. A comparative dietary survey conducted by using the same methodology (food consumption was measured by means of a 3-day food record) in 1989 showed that linoleic acid intake was higher in the 6-month-old group. Similarly, iron intakes were higher in 1989 for infants aged 1-7 months. The mean daily iron intake increased between 1981 and 1989 from 5.0 +/- 1.9 mg to 7.3 +/- 2.6 mg in the 6-month-old group and was similar for the older infants. The data suggest that educational programs were partially efficient but it is clear that more effective efforts are needed.

[Simultaneous recording of pH in the distal and proximal esophagus]. / Enregistrements simultanés du pH de l'oesophage distal et proximal.

A 24 hour esophageal pH recording was performed in 46 infants (age: 10 +/- 12 months). Two probes were placed in the proximal and distal esophageal sites respectively. A significant correlation was shown between the upper and lower part of the esophagus for the numbers of acid (pH fall below 4 for at least 15 s) and weakly acid (fall in pH of more than one unit, irrespective of whether or not the pH fell below 4) gastroesophageal reflux (GER), the reflux index and the number of acid GER longer than 5 min. The number of acid GER and the time spent at pH less than 4 at the proximal esophagus were significantly greated in group 1 (reflux index greater than 5% in the distal esophagus, n = 10), than in group 2 (reflux index less than 5% in the distal esophagus, n = 36). The proportion of distal acid and weakly acid reflux reaching the upper esophagus presented with marked variation coefficients. These findings indicate that data obtained in the distal esophagus are poorly predictive of the results in the proximal esophagus, even if infants present high reflux index at the lower esophagus. Weakly acid GER reached the upper esophagus more frequently than acid GER.

Gastro-oesophageal reflux in mechanically ventilated preterm infants.

Long duration oesophageal pH recordings were performed on 42 mechanically ventilated and parenterally fed preterm infants for a mean (SD) of 94 (28) hours. Their mean (SD) gestational age was 31.5 (2.6) weeks and birth weight 1514 (448) g. Their mean postnatal age was 19 (10) hours at the onset of pH recording, which was performed with the babies supine. The mean hourly values for the total number of episodes of gastro-oesophageal reflux (GOR) was 2.3 (2.7), for acid GOR 1.2 (1.4), and for acid GOR longer than 5 minutes 0.08 (0.09). The time the pH was greater than 4 (the reflux index) was 3.5 (3.3)% and the mean airway pressure was 6.6 (5.1) cm H2O. Fifteen infants had a reflux index above 5%. GOR patterns were not significantly correlated to birth weight, gestational age, postconceptional age, ventilatory patterns, and duration of mechanical ventilation. We concluded that the reproducibility of the reflux index was low because the median of the absolute differences was 1% when two consecutive 12 hour periods were compared and reached 2.5% when the two periods were separated by 96 hours. A second 24 hour pH recording was performed in 30 of the 42 patients after weaning from the ventilator and at a time when patients were asymptomatic and enterally fed. Compared with the late postprandial period of the second pH recording, the first recording showed an increase in the number of episodes of GOR and a decrease in reflux index, without any difference in the number of episodes of acid GOR.

Vitamin status of young athletes including the effects of supplementation.

Vitamin B1, B2, B6, C, A, and E status was assessed by combining determination of dietary intake with biochemical indices in 55 young male athletes. When compared with 20 matched sedentary controls, a similar number of individuals with biochemical deficiency was found in both groups for vitamins B1, B6, and E despite a higher mean dietary intake of these three vitamins in young athletes. Markedly reduced levels of pyridoxal 5'-phosphate, the biologically active form of the vitamin B6 compounds, were found in both populations. Supplementation administered for one month improved the vitamin status of the control subjects but not entirely those of the young athletes.

Smectite reduces gastroesophageal reflux in newborn infants.

We assessed the efficacy of a natural clay (smectite) on the frequency and the duration of acid (pH less than 4) and very acid (pH less than 3) gastroesophageal reflux (GER) measured by 24-hour continuous pH recording (CPR). Twenty newborn infants were enrolled in this double-blind controlled study owing to pathological CPR in supine position. After inclusion, all the patients were maintained in the 30-degree elevated prone position and received either smectite (3 g/day; n = 10) or placebo (n = 10) for 7 days. On the 8th day, a second 24-hour CPR was performed in supine position. The postural therapy alone (placebo group) was followed by a significant decrease in the numbers of acid GER (p less than 0.05) during the second CPR. The combination of postural therapy and smectite treatment was followed by a decrease in the number of acid (p less than 0.05) and very acid GER (p = 0.01), the percentages of time spent at pH below 4 (p less than 0.05) and 3 (p less than 0.01) and the maximal duration of acid GER (p less than 0.05).