Complementary feeding practices are related to the risk of food allergy in the ELFE cohort.

BACKGROUND: Conflicting results have been obtained when analyzing the relationship between complementary feeding (CF) practices and allergic diseases in childhood. This study aims to further explore the association between allergic diseases in early childhood (10.1016/j.jaci.2012.02.036) and the age at CF introduction (10.1016/S0140-6736(15)00149-X), food diversity in the first year of life (10.1016/j.ijporl.2019.109759) and the delayed introduction of major allergenic foods. METHODS: This analysis focused on 6662 children from the French nationwide ELFE cohort. Data on feeding practices were collected monthly from 3 to 10 months old. Their age at CF introduction was calculated alongside a diversity score, and the number of major allergenic foods (out of eggs, fish, wheat, and dairy products) not introduced at 8 and 10 months. Their associations with parent-reported allergy-related health events between 1 and 5.5 years were assessed using logistic regressions adjusted for confounding factors. A sensitivity analysis excluding early allergic cases (occurring between 2 months and 1 or 2 years) was conducted. RESULTS: Late CF (>6 months) was related to a higher risk of food allergy (OR [95% CI] = 1.35 [1.02; 1.78]), a low diversity score at 8 months to a higher risk of asthma (OR [95% CI] = 1.22 [1.01; 1.48]), and two allergenic foods or more not being introduced at 10 months to a higher risk of rhinoconjunctivitis (OR [95% CI] = 1.20 [1.00; 1.44]) and food allergy (OR [95% CI] = 2.46 [1.77; 3.42]). Only this last association remained significant after the exclusion of early cases. CONCLUSION: The delayed introduction of major allergenic foods is related to a higher risk of food allergy, which supports the updated guidelines for allergy prevention.

Incisional Negative Pressure Wound Therapy Is Protective Against Postoperative Cardiothoracic Wound Infection.

BACKGROUND: Sternal wound infections are a rare but life-threatening complication of cardiothoracic surgery. Prior literature has supported the use of negative pressure wound therapy to decrease sternal wound infections and promote healing. This study sought to determine whether closed incision negative pressure therapy reduced wound infection and improved outcomes in cardiothoracic surgery. METHODS: A retrospective cohort study was performed including all adult patients who underwent nontraumatic cardiothoracic surgery at a single institution between 2016 and 2018 (n = 1199). Patient characteristics, clinical variables, and surgical outcomes were compared between those who did and did not receive incisional negative pressure wound therapy intraoperatively. Multivariable logistic regression analysis determined factors predictive or protective of the development of complications. RESULTS: Incisional negative pressure wound therapy was used in 58.9% of patients. Patients who received this therapy were older with statistically higher rates of hyperlipidemia, statin, and antihypertensive use. The use of negative pressure wound therapy was found to significantly reduce rates of both wound infection (3.0% vs 6.3%, P = 0.01) and readmission for wound infection (0.7% vs 2.6%, P = 0.01). After controlling for confounding variables, negative pressure wound therapy was found to be a protective factor of surgical wound infection (odds ratio, 0.497; 95% confidence interval, 0.262-0.945). CONCLUSIONS: In the largest population studied to date, this study supported the expanded use of negative pressure therapy on sternal wound incisions to decrease infection rates.

Fostering infant food texture acceptance: A pilot intervention promoting food texture introduction between 8 and 15 months.

Healthy infant feeding practices form the basis of healthy eating behaviour later in life. The effect of providing parents with recommendations on textured food introduction between 8 and 15 months on children's experience with and acceptance of textured foods was studied. Sixty parent/child dyads were randomly assigned to a control group (CG) receiving current French recommendations and an intervention group (IG) receiving a brochure with supplementary advice, tips and monthly counselling on food texture introduction. After the intervention, parents completed self-report measures about the introduction of 188 food items, including purees, soft/small pieces, hard/large pieces and double textures. Children's acceptance of eight textured foods was assessed in a laboratory setting. Parents in the IG introduced more soft/small food pieces (P = 0.004) but not more complex textures (P = 0.15). There was no group difference in children acceptance for any of the textured foods offered in the laboratory. Independent of their study group, children's exposure to texture was associated with birth order, self-feeding with fingers, low gagging frequency and seldom use of commercial baby foods. Higher acceptance was associated with higher exposure to food pieces but not to pureed foods (either smooth or rough) and with children's eating behavioural traits (high food enjoyment, high food responsiveness and low food fussiness). This pilot intervention demonstrated that providing information can be effective in promoting the introduction of small and soft food pieces, but the most effective way to influence the introduction of more challenging textures (hard pieces and double texture) is uncertain. Further research should focus on the identification of barriers to complex texture introduction and on how building on this knowledge for a population-based public health intervention.

Butyrate, a metabolite of intestinal bacteria, enhances sleep.

Emerging evidence suggests that the intestinal microbiota is a source of sleep-promoting signals. Bacterial metabolites and components of the bacterial cell wall are likely to provide important links between the intestinal commensal flora and sleep-generating mechanisms in the brain. Butyrate is a short-chain fatty acid produced by the intestinal bacteria by the fermentation of nondigestible polysaccharides. We tested the hypothesis that butyrate may serve as a bacterial-derived sleep-promoting signal. Oral gavage administration of tributyrin, a butyrate pro-drug, elicited an almost 50% increase in non-rapid-eye movement sleep (NREMS) in mice for 4 hours after the treatment. Similarly, intraportal injection of butyrate led to prompt and robust increases in NREMS in rats. In the first 6 hours after the butyrate injection, NREMS increased by 70%. Both the oral and intraportal administration of butyrate led to a significant drop in body temperature. Systemic subcutaneous or intraperitoneal injection of butyrate did not have any significant effect on sleep or body temperature. The results suggest that the sleep-inducing effects of butyrate are mediated by a sensory mechanism located in the liver and/or in the portal vein wall. Hepatoportal butyrate-sensitive mechanisms may play a role in sleep modulation by the intestinal microbiota.

Development of a new in-home testing method to assess infant food liking.

The objective of this study was to develop a new elaborate method to evaluate infants' liking of foods that could be applied at home and to compare the results of this elaborate method with those of a basic method. Mothers of infants aged 4 to 7 (n = 44) and 12-15 months (n = 46) participated in this study. For the basic method, mothers were asked to assess their infant's global liking at the end of a meal. Then, for the elaborate method, mothers received detailed instructions on how to feed their infant, how infants might express like/dislike and when to stop the meal. During the first nine spoons, they were asked to report the presence/absence of positive and negative behaviours after each spoon, and the infant's initial liking was reported after each triplet of spoons. They also assessed their infant's global liking at the end of the meal. Both methods were applied using three commercial familiar baby foods adapted to each age range. In 4-7-month-olds, the elaborate method showed a significant difference across products for liking, whereas the basic method did not show any difference. In 12-15-month-olds, the elaborate method showed more differences across products for liking than the basic method. In both age groups, negative behaviours, despite being less frequently reported, provided better liking discrimination than positive behaviours. In conclusion, the elaborate method produced better product liking discrimination than the basic method by focusing maternal attention on infants' eating behaviours since the first spoons.

Early factors related to carbohydrate and fat intake at 8 and 12 months: results from the EDEN mother-child cohort.

BACKGROUND/OBJECTIVES: Few studies have examined the factors explaining the variability in fat and carbohydrate intake during infancy. We aimed to describe infants' fat and carbohydrate intake and analyse the associations with infant and maternal characteristics and feeding practices. SUBJECTS/METHODS: This study included 1275 infants aged 8 months from the French EDEN mother-child cohort. Carbohydrate intake, fat intake, added fat (vegetable oils and animal fats) and added sugar (honey, white sugar, brown sugar, jam and sweetened beverages) consumption were calculated at 8 and 12 months. Associations between these variables and infant and maternal characteristics as well as maternal dietary patterns during pregnancy, breast-feeding duration and age at complementary feeding introduction were analysed using multivariable linear and logistic regressions. RESULTS: Less than 5% of non-breast-fed infants reached the recommendation of consuming at least 40% of total energy from fat, whereas more than 95% of them reached 45% of energy from carbohydrates. Overall, infant and maternal characteristics and maternal diet during pregnancy were marginally associated with both carbohydrate/added sugar and fat/added fat intake. Nevertheless, age at complementary feeding introduction was associated with all outcomes. CONCLUSIONS: Our results suggest that only a small proportion of non-breast-fed infants at 8 and 12 months reached the recommendations for fat intake, whereas a majority of them reached the recommendations for carbohydrate intake. As subgroups of infants with a higher risk of inadequate diet were not identified, the present results call for an improved dissemination of information regarding infant-specific dietary fat needs in the entire population.

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.

Salivary protein profiles are linked to bitter taste acceptance in infants.

UNLABELLED: Based on recent studies in adult subjects, saliva composition is increasingly considered as a physiological factor contributing to taste sensitivity or acceptance. In order to evaluate a possible link between salivary protein composition and taste acceptance in infants, 73 infants participated longitudinally in taste acceptance tests and donated saliva at the age at 3 and 6 months. Intake ratios, reflecting acceptance of a taste solution relative to water were calculated for the five basic tastes. Salivary proteins were separated by one-dimensional electrophoresis and bands were semi-quantified by image analysis. Partial least square (PLS) regression analyses were performed for each taste at both ages to explain intake ratios by band intensities. Bitterness acceptance in the younger infants was unique in the sense that salivary protein profiles could partly predict bitter taste acceptance. At that age, infants were on average indifferent to the 0.18-M urea solution, but great variability in acceptance was observed. The six bands considered as the best predictors for bitterness acceptance were identified by MALDI-TOF mass spectrometry. Higher abundance of bands containing secretory component, zinc-α-2-glycoprotein and carbonic anhydrase 6 was associated to a lower bitterness acceptance, while higher abundance of bands containing lactoperoxidase, prolactin-inducible protein and S-type cystatins was associated to a higher bitterness acceptance. In a second stage, S-type cystatin abundance was measured by Western blotting in order to tentatively confirm this particular finding in an independent group of 22 infants. Although not reaching statistical significance, probably due to a relatively small sample size, it was again observed that cystatin abundance was higher in infants accepting more readily the bitter solution over water. CONCLUSION: saliva protein composition may contribute to bitter taste acceptance in the younger infants.

Complementary feeding and "donner les bases du goût" (providing the foundation of taste). A qualitative approach to understand weaning practices, attitudes and experiences by French mothers.

Complementary feeding (CF) practices vary within and across cultures but have been investigated only to a very limited extent. It is however important to understand CF practices and how they differ, as CF sets the foundation for children's later food choices. The present study was set out to examine practices, attitudes and experiences of CF including the introduction of vegetables amongst French mothers (n=18, 25-39 years). Thematic analysis of transcribed focus groups and interviews revealed the perceived importance of the weaning period, as a critical milestone for infants' development but with a sense of "now or never" for introducing new tastes including vegetables. Flavour exposure and taste discovery during weaning were identified as the beginning of a "taste journey", in which educating the palate with a variety of different foods was considered important for children's later eating habits. Weaning was described as emotional and complex, a transition period in which the baby makes progress away from milk towards the family diet and which goes beyond mere nutrition. Advice was sought from official sources, but adapted to the needs of infants. In agreement with earlier observations of French adults, pleasure and taste development were considered of primary importance. In particular, French mothers believed complementary feeding lay the foundations of taste early in life.

Saliva electrophoretic protein profiles in infants: changes with age and impact of teeth eruption and diet transition.

OBJECTIVE: The objective of this study was to describe the changes in salivary protein profiles in infants between the ages of 3 and 6 months, and to evaluate the impact of teeth eruption and introduction of solid foods on such profiles. DESIGN: 73 infants were followed longitudinally at 3 and 6 months of age. Their whole saliva proteins were separated by SDS-PAGE electrophoresis and semi-quantified by image analysis. Amylase activity was also measured on a sub-sample of the population (n=42 infants). Bands which abundance was significantly different between the two ages according to paired comparisons were identified by mass spectrometry techniques. RESULTS: Out of 21 bands, 13 were significantly different between 3 and 6 months of age. Two short variants of amylase increased in abundance with age, as did amylase activity. Other changes possibly translated developmental physiological events, for example maturation of the adaptive immune system. The balance between S-type cystatins and cystatins A and B was modified, in favour of S-type cystatins at 6 months of age. Teeth eruption resulted in an increase in albumin abundance, whilst introduction of solid foods was associated with higher levels of ß-2 microglobulin and S-type cystatins. CONCLUSIONS: Salivary profiles were modified substantially between the ages of 3 and 6 months. Both teeth eruption and diet had an impact on abundance changes for some proteins, revealing dynamic interactions between saliva proteome, oral physiology and diet.

[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.

tert-Butyl 2-benzoyl-2-methyl-propanoate.

The title compound, C(15)H(20)O(3), is bent with a dihedral angle of 67.28 (9)° between the mean planes of the phenyl ring and a group encompassing the ester functionality (O=C-O-C). In the crystal, mol-ecules related by inversion symmetry are connected by weak C-H⋯O inter-actions into infinite chains. On one side of the mol-ecule there are two adjacent inter-actions between neighbouring mol-ecules involving the H atoms of methyl groups from the dimethyl groups and the O atoms of the ketone; on the other side, there are also two inter-actions to another adjacent mol-ecule involving the H atoms on the phenyl rings and the carbonyl O atoms of the ester functionality.

Development of olfactory ability in children: sensitivity and identification.

This study assessed the influence of school level and gender on odor sensitivity and identification, and the role of verbal capacity on odor identification in children (4-12 years) by using a revised version of an olfactory test designed for adults [Rouby et al. (1997). Connaissance et reconnaissance d'une série olfactive chez l'enfant préscolaire. Enfance, 1, 152-171]. We found that odor sensitivity and identification scores increased with school level, and that identification performance was better in girls than in boys. However, when we controlled verbal ability, the gender differences disappeared and the school level differences remained. This result indicates that the effect of gender on identification was probably due to the greater verbal ability of girls rather than to their greater olfactory ability per se. In addition, we found that general verbal ability is independent of olfactory fluency and that their influence on olfactory perception is different. Thus, this study illuminates the role of cognitive/verbal factors in the development of odor perception and knowledge.

[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.

[Clinical experience with percutaneus large-core needle biopsies of the breast and evaluation of cytopathological and histopathological results]. / Klinische Erfahrungen mit einer kombinierten imprintzytologischen und histopathologischen und Begutachtung von perkutanen Stanzbiopsien der Mamma.

OBJECTIVE: Core needle biopsy (CNB) allows a microinvasive diagnosis of breast lesions. We investigated whether imprint cytology of CNB specimens is a useful method of rapidly obtaining additional diagnostic information. MATERIAL AND METHOD: During five years 46 218 breast examinations for 23 300 patients were performed. 563 patients were examined by CNB. The results of imprint cytology were compared with the histopathological results. Statistical analysis was done for all patients who underwent subsequent surgery. RESULTS: 195 of 563 patients were treated surgically. 155 patients exhibited malign lesions. 40 patients showed benign breast lesions. Four patients with malign findings in imprint cytology and histopathology of CNB were treated conservatively. Imprint cytology had a sensitivity of 0.89, specificity of 0.88, positive predictive value of 0.96 and negative predictive value of 0.67. Histopathology revealed a sensitivity of 0.90, specificity of 0.95, positive predictive value of 0.98 and negative predictive value of 0.70. 364 patients with benign findings in imprint cytology and histopathology were controlled subsequently. One of these patients developed five month later an invasive ductal tumor. CONCLUSION: Imprint cytology of CNB is a reliable method to obtain additional diagnostic information. Inadequate and suspicious cases should be evaluated based on complementary diagnostic procedures for breast lesions.

Evolution of the taste of a bitter Camembert cheese during ripening: characterization of a matrix effect.

The objective of this study was to characterize the effect of ripening on the taste of a typically bitter Camembert cheese. The first step was to select a typically bitter cheese among several products obtained by different processes supposed to enhance this taste defect. Second, the evolution of cheese taste during ripening was characterized from a sensory point of view. Finally, the relative impact of fat, proteins, and water-soluble molecules on cheese taste was determined by using omission tests performed on a reconstituted cheese. These omission tests showed that cheese taste resulted mainly from the gustatory properties of water-soluble molecules but was modulated by a matrix effect due to fat, proteins, and cheese structure. The evolution of this matrix effect during ripening was discussed for each taste characteristic.

Taste active compounds in a goat cheese water-soluble extract. 1. Development and sensory validation of a model water-soluble extract.

The aim of this study was to evaluate the impact of the components of a goat cheese water-soluble extract (WSE) on its flavor by both physicochemical and sensory techniques with special emphasis on taste. After characterization of the organoleptic properties of the cheese, the WSE was extracted with pure water and submitted to successive tangential ultrafiltrations and nanofiltration. The physicochemical assessment of these fractions led to the constitution of a model mixture (MWSE) compared by sensory evaluation to the crude WSE, using a panel of 16 trained members. The results of both sensory profile and triangular tests indicate no significant difference, therefore proving that the reconstitution of the WSE was correct, thereby showing the sensory neutrality of lipids and peptides smaller than 500 Da, which had not been included in the MWSE. Moreover, the cheese gustatory characteristics are comparable to those of the WSE despite weaker levels of sharpness and astringency in the extract, the respective origins of which are discussed.

Taste active compounds in a goat cheese water-soluble extract. 2. Determination of the relative impact of water-soluble extract components on its taste using omission tests.

The aim of this work was to determine the relative impact of water-soluble compounds on the gustatory properties of a goat cheese water-soluble extract (WSE). Using a semisynthetic model mixture (MWSE) previously elaborated in physicochemical and gustatory accordance with the cheese WSE (see part 1, Engel et al. J. Agric. Food Chem. 2000, 48, 4252-4259), omission tests were performed. Among the main taste characteristics of the WSE (salty, sour, and bitter), saltiness was explained by an additive contribution of sodium, potassium, calcium, and magnesium cations, whereas sourness was mainly due to a synergistic effect involving sodium chloride, phosphates, and lactic acid and bitterness was found to result from calcium and magnesium chlorides, the impact of which was partially masked by sodium chloride. In contrast, amino acids, lactose, and peptides did not have any significant impact on WSE taste properties. To quantify the contribution of the taste active compounds to bitterness and saltiness, stepwise multiple linear regressions were performed. Those contributions were expressed as a percentage of the considered taste characteristic intensity in the WSE. The model obtained allowed up to 97.4% of the perceived saltiness to be described and approximately 85% of the bitterness.