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1.
J Dairy Sci ; 2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-38908701

RESUMO

Because calves are born with low levels of antibodies, effective colostrum management is one of the most critical factors for successful calf rearing. A timely and adequate supply of sufficiently high-quality colostrum immediately after birth is essential to ensure the passive immunization of calves. Frozen colostrum reserves are recommended to fulfill the immunological and nutrient requirements of newborn calves, even in exceptional situations; however, the implementation rates on German dairy farms and challenges of realization remain unclear. A 33-question online survey, focused on frozen colostrum reserves, was developed to obtain an overview of colostrum management practices on German dairy farms. The questionnaire was divided into 3 sections: 1. personal data; 2. farm characteristics; 3. colostrum management. Of the 155 responses we received, 63.9% were from female farmers, and 35.5% were from male farmers. Conventional farming was practiced on 89.0% of farms, and organic farming was practiced on 7.1% of farms. Of the respondents, 89.0% froze colostrum. The main reasons for freezing colostrum were: 1. the dam does not produce enough colostrum; 2. the dam cannot be milked; or 3. in cases where the dam dies during birth. Farmers primarily froze colostrum from cows during their third to fifth lactation. Before freezing, 33.1% of the respondents measured indicators in the colostrum to estimate Ig concentrations, whereas 2.3% determined the colostrum quality after freezing. Reusable and disposable PET deposits (23.1%, 22.3%) and ColostroBags (20.0%) were the primary containers used to freeze colostrum. The main reasons for not freezing colostrum were the high labor intensity and the availability of fresh colostrum from other cows. Thawing methods included buckets (47.7%) and professional water baths (13.8%). The survey identified areas in which improved knowledge transfer could enhance colostrum management. Furthermore, there appeared to be a lack of specific, feasible instructions for employees concerning the practical implementation of colostrum management. Most importantly, the regular determination and documentation of Ig concentrations should be emphasized. The added value of stored colostrum, relative to a greater workload, should also be promoted, particularly on smaller farms.

2.
Matern Child Nutr ; : e13678, 2024 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-38853139

RESUMO

Healthcare professionals (HCPs) have vital roles in providing evidence-based care to promote healthy micronutrient nutrition in early life. Providing such care requires scalable training to strengthen knowledge and confident application of effective behaviour change skills. Among 33 public and private HCPs (primarily dietitians) in South Africa, we evaluated the behaviour change aspects of a technology-enabled National Qualification Sub-Framework level 6 programme, Improving Early Nutrition and Health in South Africa ('ImpENSA'). This programme comprises two self-directed micronutrient and behaviour change knowledge-based eLearning and one facilitated online practical skills modules to improve maternal and infant micronutrient nutrition. Using assessments, questionnaires and interviews, we collected data at baseline, after module completion and at 3-month follow-up after programme completion. Questionnaire and interview data showed major improvements in understanding of and attitudes towards person-centred behaviour change support immediately following the eLearning module on behaviour change. The assessment pass rate increased from 38% at baseline to 88% postmodule, demonstrating significant knowledge gain in behaviour change support. Intention to change practice towards a person-centred approach was high and many had already started implementing changes. Three months postprogramme, support was centred around patients' needs. Open relationships with patients, improved patient outcomes and increased job satisfaction were among reported outcomes. Many reported becoming better change facilitators and reflective practitioners. Additional improvements in understanding and attitudes to behaviour change support were evident, reinforced by making changes and experiencing positive outcomes. The findings suggest that technology-enabled learning can equip HCPs with knowledge and skills to effectively support behaviour change for healthy micronutrient nutrition during pregnancy and infancy.

3.
Crit Care ; 27(1): 7, 2023 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-36611211

RESUMO

BACKGROUND: Current guidelines suggest the introduction of early nutrition support within the first 48 h of admission to the intensive care unit (ICU) for patients who cannot eat. In that context, we aimed to describe nutrition practices in the ICU and study the association between the introduction of early nutrition support (< 48 h) in the ICU and patient mortality at day 28 (D28) using data from a multicentre prospective cohort. METHODS: The 'French-Speaking ICU Nutritional Survey' (FRANS) study was conducted in 26 ICUs in France and Belgium over 3 months in 2015. Adult patients with a predicted ICU length of stay > 3 days were consecutively included and followed for 10 days. Their mortality was assessed at D28. We investigated the association between early nutrition (< 48 h) and mortality at D28 using univariate and multivariate propensity-score-weighted logistic regression analyses. RESULTS: During the study period, 1206 patients were included. Early nutrition support was administered to 718 patients (59.5%), with 504 patients receiving enteral nutrition and 214 parenteral nutrition. Early nutrition was more frequently prescribed in the presence of multiple organ failure and less frequently in overweight and obese patients. Early nutrition was significantly associated with D28 mortality in the univariate analysis (crude odds ratio (OR) 1.69, 95% confidence interval (CI) 1.23-2.34) and propensity-weighted multivariate analysis (adjusted OR (aOR) 1.05, 95% CI 1.00-1.10). In subgroup analyses, this association was stronger in patients ≤ 65 years and with SOFA scores ≤ 8. Compared with no early nutrition, a significant association was found of D28 mortality with early enteral (aOR 1.06, 95% CI 1.01-1.11) but not early parenteral nutrition (aOR 1.04, 95% CI 0.98-1.11). CONCLUSIONS: In this prospective cohort study, early nutrition support in the ICU was significantly associated with increased mortality at D28, particularly in younger patients with less severe disease. Compared to no early nutrition, only early enteral nutrition appeared to be associated with increased mortality. Such findings are in contrast with current guidelines on the provision of early nutrition support in the ICU and may challenge our current practices, particularly concerning patients at low nutrition risk. Trial registration ClinicalTrials.gov Identifier: NCT02599948. Retrospectively registered on November 5th 2015.


Assuntos
Estado Terminal , Apoio Nutricional , Adulto , Humanos , Estudos Prospectivos , Estado Terminal/terapia , Estudos de Coortes , Estado Nutricional , Unidades de Terapia Intensiva , Tempo de Internação
4.
Zhongguo Dang Dai Er Ke Za Zhi ; 25(4): 362-367, 2023 Apr 15.
Artigo em Zh | MEDLINE | ID: mdl-37073840

RESUMO

OBJECTIVES: To study the relationship between early parenteral nutrient intake and the development of bronchopulmonary dysplasia (BPD) in preterm infants with gestational age less than 32 weeks who could not receive enteral nutrition within one week after birth. METHODS: A retrospective study was conducted on preterm infants born between October 2017 and August 2022 with gestational age less than 32 weeks who were admitted to the Neonatal Intensive Care Unit in Children's Hospital of Soochow University within 24 hours after birth and relied solely on parenteral nutrition within the first week of life. The study population included 79 infants with BPD and 73 infants without BPD. Clinical data during hospitalization were compared between the two groups. RESULTS: The proportions of infants with weight loss of more than 10% after birth, extrauterine growth retardation, and parenteral nutrition-associated cholestasis in the BPD group were higher than in the non-BPD group (P<0.05). The time to regain birth weight, time to achieve full enteral feeding, and corrected gestational age at discharge were longer in the BPD group than in the non-BPD group. The Z-scores of physical growth at corrected gestational age of 36 weeks were lower in the BPD group than in the non-BPD group (P<0.05). The BPD group had a higher fluid intake and a lower calories intake in the first week than the non-BPD group (P<0.05). The starting dose and total amount of amino acids, glucose, and lipids in the first week were lower in the BPD group than in the non-BPD group (P<0.05). The BPD group had a higher glucose-to-lipid ratio on the third day and higher energy-to-nitrogen and glucose-to-lipid ratios on the seventh day after birth than the non-BPD group (P<0.05). CONCLUSIONS: Preterm infants with BPD had lower intake of amino acids and lipids and a lower proportion of calories provided by amino acids and lipids in the first week of life, which suggests an association between early parenteral nutrition intake and the development of BPD.


Assuntos
Displasia Broncopulmonar , Recém-Nascido Prematuro , Lactente , Criança , Recém-Nascido , Humanos , Displasia Broncopulmonar/terapia , Estudos Retrospectivos , Idade Gestacional , Aminoácidos , Nutrição Parenteral/efeitos adversos , Glucose , Lipídeos
5.
Acta Paediatr ; 111(5): 927-934, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35038770

RESUMO

Exposure to nutritional imbalance during early life can influence disease risk lifelong and across generations. In this long-term conditioning, epigenetics constitutes a key mechanism. They bridge environmental cues and the expression of genes involved in the setting of long-standing biological regulations in numerous organs and species. Epigenetic marks are proposed as innovative diagnostic biomarkers and potential targets in the prevention of diseases. However, a number of uncertainties make them difficult to use in clinical approaches in the context of early exposure to nutritional challenge. In conclusion, active investigations in this field are still needed before clinical applications are considered.


Assuntos
Epigênese Genética , Estado Nutricional , Humanos
6.
Eur J Pediatr ; 180(6): 1665-1673, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33517483

RESUMO

Preterm-born children are at risk for later neurodevelopmental problems and cardiometabolic diseases; early-life growth restriction and suboptimal neonatal nutrition have been recognized as risk factors. Prevention of these long-term sequelae has been the focus of intervention studies. High supplies of protein and energy during the first weeks of life (i.e., energy > 100 kcal kg-1 day-1 and a protein-to-energy ratio > 3 g/100 kcal) were found to improve both early growth and later neurodevelopmental outcome. Discontinuation of this high-energy diet is advised beyond 32-34 weeks postconceptional age to prevent excess fat mass and possible later cardiometabolic diseases. After discharge, nutrition with a higher protein-to-energy ratio (i.e., > 2.5-3.0 g/100 kcal) may improve growth and body composition in the short term.Conclusion: Preterm infants in their first weeks of life require a high-protein high-energy diet, starting shortly after birth. Subsequent adjustments in nutritional composition, aimed at achieving optimal body composition and minimizing the long-term cardiometabolic risks without jeopardizing the developing brain, should be guided by the growth pattern. The long-term impact of this strategy needs to be studied. What is Known: • Preterm infants are at risk for nutritional deficiencies and extrauterine growth restriction. • Extrauterine growth restriction and suboptimal nutrition are risk factors for neurodevelopmental problems and cardiometabolic disease in later life. What is New: • Postnatally, a shorter duration of high-energy nutrition may prevent excess fat mass accretion and its associated cardiometabolic risks and an early switch to a protein-enriched diet should be considered from 32-34 weeks postconceptional age. • In case of formula feeding, re-evaluate the need for the continuation of a protein-enriched diet, based on the infant's growth pattern.


Assuntos
Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido Prematuro , Criança , Alimentos Formulados , Humanos , Lactente , Recém-Nascido , Estado Nutricional , Avaliação de Resultados em Cuidados de Saúde
7.
Am Nat ; 196(5): 577-596, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33064590

RESUMO

AbstractSome species show high rates of reproductive failure, which is puzzling because natural selection works against such failure in every generation. Hatching failure is common in both captive and wild zebra finches (Taeniopygia guttata), yet little is known about its proximate causes. Here we analyze data on reproductive performance (the fate of >23,000 eggs) based on up to 14 years of breeding of four captive zebra finch populations. We find that virtually all aspects of reproductive performance are negatively affected by inbreeding (mean r=-0.117); by an early-starting, age-related decline (mean r=-0.132); and by poor early-life nutrition (mean r=-0.058). However, these effects together explain only about 3% of the variance in infertility, offspring mortality, fecundity, and fitness. In contrast, individual repeatability of different fitness components varied between 15% and 50%. As expected, we found relatively low heritability in fitness components (median: 7% of phenotypic variation and 29% of individually repeatable variation). Yet some of the heritable variation in fitness appears to be maintained by antagonistic pleiotropy (negative genetic correlations) between male fitness traits and female and offspring fitness traits. The large amount of unexplained variation suggests a potentially important role of local dominance and epistasis, including the possibility of segregating genetic incompatibilities.


Assuntos
Tentilhões/fisiologia , Infertilidade/genética , Envelhecimento , Fenômenos Fisiológicos da Nutrição Animal , Animais , Feminino , Tentilhões/embriologia , Tentilhões/genética , Endogamia , Masculino , Reprodução/genética , Reprodução/fisiologia
8.
J Nutr ; 150(12): 3114-3122, 2020 12 10.
Artigo em Inglês | MEDLINE | ID: mdl-33097931

RESUMO

BACKGROUND: In recent years, lactose-free infant formulas have been increasingly used. Digestible maltodextrins are commonly used as a substitute for lactose in these formulas, but the effects on energy metabolism are unknown. OBJECTIVE: We aimed to evaluate the differences in energy metabolism and substrate oxidation in piglets fed milk replacers containing lactose compared with maltodextrin as the only source of carbohydrates. METHODS: Piglets (Tempo × Topigs 20) from 8 litters were fed milk replacers containing lactose or maltodextrin (28% w/w, milk powder basis) from 1 to 9 wk of age (n =  4 litters/milk replacer). At 5 wk of age, 4 females and 4 entire males (mean ± SEM bodyweight, 10 ± 0.3 kg) were selected per litter, and housed in 16 groups of 4 littermates, with 2 females and 2 males per pen (n = 8 groups/milk replacer). Between 7 and 9 wk of age, groups were housed for 72 h in climate respiration chambers, and fed their experimental milk replacer in 2 meals per day, at 08:30 and 16:30. Heat production data were calculated from the continuous measurement of gaseous exchanges and analyzed using general linear models in SAS. RESULTS: Resting metabolic rate was 6% less in maltodextrin- than in lactose-fed piglets, notably before the morning meal. The postprandial respiratory quotient was 13% greater in maltodextrin- than in lactose-fed piglets after both meals. Net rates of carbohydrate oxidation were on average 5% greater in maltodextrin- than in lactose-fed piglets, particularly after the afternoon meal, whereas net rates of fat oxidation were 9% less in maltodextrin- than in lactose-fed piglets, particularly after the morning meal. CONCLUSIONS: Compared with lactose, maltodextrin in milk replacers reduced resting metabolic rate in the fasting state, and induced a shift in postprandial substrate oxidation profiles in pigs. Further research is warranted to evaluate the consequences of these metabolic changes for body composition.


Assuntos
Metabolismo Energético/efeitos dos fármacos , Lactose/metabolismo , Substitutos do Leite/química , Polissacarídeos/metabolismo , Suínos/fisiologia , Animais , Calorimetria , Feminino , Lactose/química , Masculino , Oxirredução , Polissacarídeos/química
9.
Am J Physiol Endocrinol Metab ; 317(4): E617-E630, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31361544

RESUMO

Disturbances of diet during pregnancy and early postnatal life may impact colonization of gut microbiota during early life, which could influence infant health, leading to potential long-lasting consequences later in life. This is a nonsystematic review that explores the recent scientific literature to provide a general perspective of this broad topic. Several studies have shown that gut microbiota composition is related to changes in metabolism, energy balance, and immune system disturbances through interaction between microbiota metabolites and host receptors by the gut-brain axis. Moreover, recent clinical studies suggest that an intestinal dysbiosis in gut microbiota may result in cognitive disorders and behavioral problems. Furthermore, recent research in the field of brain imaging focused on the study of the relationship between gut microbial ecology and large-scale brain networks, which will help to decipher the influence of the microbiome on brain function and potentially will serve to identify multiple mediators of the gut-brain axis. Thus, knowledge about optimal nutrition by modulating gut microbiota-brain axis activity will allow a better understanding of the molecular mechanisms involved in the crosstalk between gut microbiota and the developing brain during critical windows. In addition, this knowledge will open new avenues for developing novel microbiota-modulating based diet interventions during pregnancy and early life to prevent metabolic disorders, as well as neurodevelopmental deficits and brain functional disorders.


Assuntos
Bactérias/metabolismo , Encéfalo/fisiologia , Microbioma Gastrointestinal/fisiologia , Sistema Imunitário/fisiologia , Fígado/fisiologia , Sistema Nervoso/crescimento & desenvolvimento , Animais , Humanos
10.
Ann Nutr Metab ; 74(4): 269-278, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30939482

RESUMO

BACKGROUND: Nutrition status prior to conception and during pregnancy and infancy seems to have an influence on the disease risk in adulthood (early nutrition/developmental programming). We aimed to review the current knowledge on the role of micronutrients in early nutrition programming and its implications for healthcare. SUMMARY OF FINDINGS: Globally and even in high-income countries where a balanced diet is generally accessible, an inadequate maternal micronutrient status is common. This may induce health problems in the mother and foetus/newborn both immediately and in later life. Pregnant women and those who may become pregnant should aim to achieve a satisfactory micronutrient status from a well-balanced diet, and where necessary from additional supplements. Key Messages: We emphasise the need for a call to action for healthcare providers and policymakers to better educate women of child-bearing age regarding the short- and long-term benefits of an appropriate micronutrient status. The role of micronutrient status in early nutrition programming needs to be emphasized more to address the still limited awareness of the potential long-term health repercussions of suboptimal micronutrient supply during pregnancy.


Assuntos
Micronutrientes/administração & dosagem , Gravidez/fisiologia , Cuidado Pré-Natal , Suplementos Nutricionais , Feminino , Humanos , Estado Nutricional
11.
Ann Nutr Metab ; 74(2): 93-106, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30673669

RESUMO

BACKGROUND: A considerable body of evidence accumulated especially during the last decade, demonstrating that early nutrition and lifestyle have long-term effects on later health and disease ("developmental or metabolic programming"). METHODS: Researchers involved in the European Union funded international EarlyNutrition research project consolidated the scientific evidence base and existing recommendations to formulate consensus recommendations on nutrition and lifestyle before and during pregnancy, during infancy and early childhood that take long-term health impact into account. Systematic reviews were performed on published dietary guidelines, standards and recommendations, with special attention to long-term health consequences. In addition, systematic reviews of published systematic reviews on nutritional interventions or exposures in pregnancy and in infants and young children aged up to 3 years that describe effects on subsequent overweight, obesity and body composition were performed. Experts developed consensus recommendations incorporating the wide-ranging expertise from additional 33 stakeholders. FINDINGS: Most current recommendations for pregnant women, particularly obese women, and for young children do not take long-term health consequences of early nutrition into account, although the available evidence for relevant consequences of lifestyle, diet and growth patterns in early life on later health and disease risk is strong. INTERPRETATION: We present updated recommendations for optimized nutrition before and during pregnancy, during lactation, infancy and toddlerhood, with special reference to later health outcomes. These recommendations are developed for affluent populations, such as women and children in Europe, and should contribute to the primary prevention of obesity and associated non-communicable diseases.


Assuntos
Fenômenos Fisiológicos da Nutrição do Lactente , Lactação , Gravidez , Fenômenos Fisiológicos da Nutrição Pré-Natal , Aleitamento Materno , Saúde da Criança , Pré-Escolar , Feminino , Humanos , Lactente , Estilo de Vida , Saúde Materna , Política Nutricional , Obesidade/prevenção & controle , Revisões Sistemáticas como Assunto
12.
BMC Pediatr ; 19(1): 140, 2019 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-31053102

RESUMO

BACKGROUND: Early microbial colonization is a relevant aspect in human health. Altered microbial colonization patterns have been linked to an increased risk of non-communicable diseases (NCDs). Advances in understanding host-microbe interactions highlight the pivotal role of maternal microbiota on infant health programming. This birth cohort is aimed to characterize the maternal microbes transferred to neonates during the first 1000 days of life, as well as to identify the potential host and environmental factors, such as gestational age, mode of delivery, maternal/infant diet, and exposure to antibiotics, which affect early microbial colonization. METHODS: MAMI is a prospective mother-infant birth cohort in the Spanish-Mediterranean area. Mothers were enrolled at the end of pregnancy and families were follow-up during the first years of life. Maternal-infant biological samples were collected at several time points from birth to 24 months of life. Clinical and anthropometric characteristics and dietary information is available. Specific qPCR and 16S rRNA gene sequencing as well as short chain fatty acid (SCFAs) profile would be obtained. Multivariable models will be used to identy associations between microbiota and clinical and anthropometric data controlling for confounders. MAMI would contribute to a better understanding of the interaction between diet, microbiota and host response in early life health programming, enabling new applications in the field of personalized nutrition and medicine. TRIAL REGISTRATION: The study is registered on the ClinicalTrial.gov platform NCT03552939. (June 12, 2018).


Assuntos
Aleitamento Materno , Dieta , Saúde do Lactente , Monitorização Fisiológica/métodos , Adulto , Fatores Etários , Desenvolvimento Infantil , Estudos de Coortes , DNA/genética , Feminino , Microbioma Gastrointestinal , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Masculino , Relações Mãe-Filho , Análise Multivariada , Reação em Cadeia da Polimerase/métodos , Estudos Prospectivos , Fatores Sexuais , Espanha
13.
FASEB J ; 31(5): 2037-2049, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28167496

RESUMO

A suboptimal early nutritional environment (i.e., excess of energy, sugar, and fat intake) can increase susceptibility to diseases and neurocognitive disorders. The purpose of this study was to investigate in nonobese Yucatan minipigs (Sus scrofa) the impact of maternal diet [standard diet (SD) vs. Western diet (WD)] during gestation and 25 d of lactation on milk composition, blood metabolism, and microbiota activity of sows (n = 17) and their piglets (n = 65), and on spatial cognition (n = 51), hippocampal plasticity (n = 17), and food preferences/motivation (n = 51) in the progeny. Milk dry matter and lipid content, as well as plasma total cholesterol and free fatty acid (FFA) concentrations (P < 0.05) were higher in WD than in SD sows. Microbiota activity decreased in both WD sows and 100-d-old piglets (P < 0.05 or P < 0.10, depending on short-chain FAs [SCFAs]). At weaning [postnatal day (PND) 25], WD piglets had increased blood triglyceride and FFA levels (P < 0.01). Both SD and WD piglets consumed more of a known SD than an unknown high-fat and -sucrose (HFS) diet (P < 0.0001), but were quicker to obtain HFS rewards compared with SD rewards (P < 0.01). WD piglets had higher working memory (P = 0.015) and reference memory (P < 0.001) scores, which may reflect better cognitive abilities in the task context and a higher motivation for the food rewards. WD piglets had a smaller hippocampal granular cell layer (P = 0.03) and decreased neurogenesis (P < 0.005), but increased cell proliferation (P < 0.001). A maternal WD during gestation and lactation, even in the absence of obesity, has significant consequences for piglets' blood lipid levels, microbiota activity, gut-brain axis, and neurocognitive abilities after weaning.-Val-Laillet, D., Besson, M., Guérin, S., Coquery, N., Randuineau, G., Kanzari, A., Quesnel, H., Bonhomme, N., Bolhuis, J. E., Kemp, B., Blat, S., Le Huërou-Luron, I., Clouard, C. A maternal Western diet during gestation and lactation modifies offspring's microbiota activity, blood lipid levels, cognitive responses, and hippocampal neurogenesis in Yucatan pigs.


Assuntos
Cognição/fisiologia , Dieta Ocidental , Hipocampo/metabolismo , Lactação/fisiologia , Lipídeos/sangue , Microbiota/fisiologia , Fenômenos Fisiológicos da Nutrição Animal/fisiologia , Animais , Animais Lactentes , Suplementos Nutricionais , Feminino , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Leite/metabolismo , Suínos
14.
BMC Pediatr ; 18(1): 233, 2018 07 18.
Artigo em Inglês | MEDLINE | ID: mdl-30021541

RESUMO

BACKGROUND: Nutrition and environmental factors are essential for the education of the neonatal immune system. Epidemiological evidence has shown that malnutrition and allergic diseases that occur during early childhood share similar protective and risk factors. This paper describes the protocol of the Mother and Infant Cohort Study (MICOS), which aims to determine the contribution of early nutrition to the development of malnutrition and allergic diseases in infants' first year of life. METHODS: MICOS is a prospective cohort study conducted at selected government health clinics in two states, namely Selangor and Wilayah Persekutuan Kuala Lumpur, Malaysia. Women in their third trimester of pregnancy are recruited into the study and their infants will be followed-up at 3, 6, and 12 months of age. Information on prenatal factors including socio-demographic characteristics, obstetric history, pre-pregnancy body mass index, gestational weight gain, smoking, family history of allergic diseases, maternal dietary intake and sunlight exposure during pregnancy are obtained through face-to-face interviews. Postnatal factors including dietary intake, sun exposure, and anthropometric measurements of the mothers, as well as feeding practices, dietary intake, anthropometric measurements, and development of allergic diseases of the infants are assessed at each follow-up. Blood samples are collected from the mothers in the third trimester to determine 25-hydroxyvitamin D levels as well as from the infants at age 12 months to determine atopic sensitisation. DISCUSSION: The concept of developmental origins of health and disease (DOHaD) which emphasises on the role of early life environments in shaping future health and disease susceptibility in adulthood has gained a huge interest in recent years. The DOHaD paradigm has influenced many fields of research including malnutrition and allergic diseases. While findings from the developed countries remain controversial, such studies are scarce in developing countries including Malaysia. The present study will determine the cause and effect relationship between early nutrition and the development of malnutrition and allergic diseases in infants' first year of life.


Assuntos
Países em Desenvolvimento , Hipersensibilidade/epidemiologia , Hipersensibilidade/fisiopatologia , Fenômenos Fisiológicos da Nutrição do Lactente , Desnutrição/epidemiologia , Desnutrição/fisiopatologia , Estado Nutricional , Dieta , Humanos , Incidência , Lactente , Malásia/epidemiologia , Mães , Estudos Prospectivos , Fatores Socioeconômicos
15.
BMC Pediatr ; 18(1): 220, 2018 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-29981569

RESUMO

BACKGROUND: Babies born at moderate-late preterm gestations account for > 80% of all preterm births. Although survival is excellent, these babies are at increased risk of adverse neurodevelopmental outcomes. They also are at increased risk of adverse long-term health outcomes, such as cardiovascular disease, obesity and diabetes. There is little evidence guiding optimal nutritional practices in these babies; practice, therefore, varies widely. This factorial design clinical trial will address the role of parenteral nutrition, milk supplementation and exposure of the preterm infant to taste and smell with each feed on time to tolerance of full feeds, adiposity, and neurodevelopment at 2 years. METHODS/DESIGN: The DIAMOND trial is a multi-centre, factorial, randomised, controlled clinical trial. A total of 528 babies born between 32+ 0 and 35+ 6 weeks' gestation receiving intravenous fluids and whose mothers intend to breastfeed will be randomised to one of eight treatment conditions that include a combination of each of the three interventions: (i) intravenous amino acid solution vs. intravenous dextrose solution until full milk feeds established; (ii) milk supplement vs. exclusive breastmilk, and (iii) taste/smell given or not given before gastric tube feeds. Babies will be excluded if a particular mode of nutrition is clinically indicated or there is a congenital abnormality. Primary study outcome: For parenteral nutrition and milk supplement interventions, body composition at 4 months' corrected age. For taste/smell intervention, time to full enteral feeds defined as 150 ml.kg- 1.day- 1 or exclusive breastfeeding. SECONDARY OUTCOMES: Days to full sucking feeds; days in hospital; body composition at discharge; growth to 2 years' corrected age; development at 2 years' corrected age; breastfeeding rates. DISCUSSION: This trial will provide the first direct evidence to inform feeding practices in moderate- to late-preterm infants that will optimise their growth, metabolic and developmental outcomes. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry - ACTRN12616001199404 . This trial is endorsed by the IMPACT clinical trials network ( https://impact.psanz.com.au ).


Assuntos
Composição Corporal , Aleitamento Materno , Desenvolvimento Infantil/fisiologia , Fórmulas Infantis , Recém-Nascido Prematuro/fisiologia , Nutrição Parenteral/métodos , Olfato , Paladar , Humanos , Lactente , Recém-Nascido , Leite Humano
16.
J Anim Physiol Anim Nutr (Berl) ; 102(4): 1053-1061, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29654618

RESUMO

Carryover effect of prior fibre consumption on metabolic markers was investigated. Treatments were arranged in 2 × 2 factorial with 2 fibre sources, 4% inulin or cellulose (Solka-Floc®) and fat levels (5 or 15%) for the low-fat diet (LFD) and high-fat diet (HFD) respectively. Pigs were fed the two fibre diets for the first 56d (nursery phase), and thereafter fed either the LFD or HFD containing no added fibre source from d56 to 140 (growing phase). Pigs on the HFD were heavier (p = .05) than those on LF (64.61 vs. 68.38 kg), regardless of prior fibre type consumed. Pigs that were fed cellulose during the nursery and later fed the HFD had the highest ADG (p < .05). Feeding the HFD resulted in higher back fat (BF) (13.41 and 18.18 ± 0.12 mm for LFD and HFD, respectively; p < .01). The HFD resulted in higher (p < .01) insulin (0.014 and 0.016 ± 0.001 mg/L for LF and HF respectively) and glucose (100.89 and 125.03 ± 4.39 mg/dl for LF and HF respectively) concentrations in the serum. Inulin increased (p ≤ .02) jejunal expression of SREBP-1c and CL-4, but reduced (p < .05) TNFɑ and IL-6 expression in the ileum. Alpha-diversity was significantly different (p < .05) between the inulin and cellulose fed pigs at the end of the nursery and finishing phases. Therefore, inulin feeding before a HFD may lead to reduction in ADG and inflammatory markers in the small intestine of pigs, and thus prevent future metabolic disorders.


Assuntos
Dieta Hiperlipídica/veterinária , Fibras na Dieta/administração & dosagem , Suínos/crescimento & desenvolvimento , Suínos/metabolismo , Ração Animal , Animais , Dieta , Íleo/metabolismo , Inulina
17.
Crit Rev Food Sci Nutr ; 57(3): 489-500, 2017 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-25751102

RESUMO

BACKGROUND: EarlyNutrition ( www.project-earlynutrition.eu ) is an international research project investigating the effects of early nutrition on metabolic programming. OBJECTIVE: To summarize, by performing a systematic review, current standards, recommendations, guidelines, and regulations (hereafter, referred to as documents) on the nutrition of children up to three years of age. Special emphasis was placed on long-term effects of early nutrition, such as the risk of cardiovascular disease, hypertension, overweight, obesity, metabolic syndrome, diabetes, or glucose intolerance. METHODS: MEDLINE, selected databases, and websites were searched for documents published between 2008 and January 2013. RESULTS: Forty two documents met the inclusion criteria. The strongest and most consistent evidence for a protective, long-term effect was documented for breastfeeding. Also, limiting the intake of sodium and rapidly absorbed carbohydrates, use of a specific meal pattern, reducing the consumption of saturated fatty acids by replacing them with polyunsaturated fatty acids, and lowering the intake of trans fatty acids, seems beneficial. Many documents did not evaluate long-term outcomes of interest to us, or reported insufficient or imprecise data. Inconsistency in recommendations for some outcomes and research gaps were identified. CONCLUSIONS: Our findings may serve as a helpful tool in planning further research, preventive actions against important diet-related diseases, and guidelines improvement.


Assuntos
Fenômenos Fisiológicos da Nutrição do Lactente/normas , Política Nutricional , Aleitamento Materno , Doenças Cardiovasculares/prevenção & controle , Pré-Escolar , Diabetes Mellitus Tipo 2/prevenção & controle , Ingestão de Energia , Ácidos Graxos Insaturados/administração & dosagem , Ácidos Graxos Insaturados/análise , Humanos , Hipertensão/prevenção & controle , Lactente , Síndrome Metabólica/prevenção & controle , Obesidade/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Sódio na Dieta/administração & dosagem , Sódio na Dieta/análise
18.
Biogerontology ; 18(6): 893-900, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28357523

RESUMO

Ageing, a complex process that results in progressive decline in intrinsic physiological function leading to an increase in mortality rate, has been shown to be affected by early life nutrition. Accumulating data from animal and epidemiological studies indicate that exposure to a suboptimal nutritional environment during fetal life can have long-term effects on adult health. In this paper, we discuss the impact of early life nutrition on the development of age-associated diseases and life span. Special emphasis is given to studies that have investigated the molecular mechanisms underlying these effects. These include permanent structural and cellular changes including epigenetics modifications, oxidative stress, DNA damage and telomere shortening. Potential strategies targeting these mechanisms, in order to prevent or alleviate the detrimental effects of suboptimal early nutrition on lifespan and age-related diseases, are also discussed. Although recent reports have already identified effective therapeutic interventions, such as antioxidant supplementation, further understanding of the extent and nature of how early nutrition influences the ageing process will enable the development of novel and more effective approaches to improve health and extend human lifespan in the future.


Assuntos
Envelhecimento/fisiologia , Estado Nutricional , Animais , Humanos
19.
Ann Nutr Metab ; 70(3): 161-169, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28683464

RESUMO

The Power of Programming conference 2016 at Ludwig-Maximilians-Universität Munich brought together about 600 researchers and other stakeholders from around the world who reviewed the recent evidence on the lasting health impact of environment and nutrition during early life, from pre-pregnancy to early childhood. The conference was hosted by the Early Nutrition Project, a multidisciplinary research collaboration funded by the European Commission with collaborating researchers from 35 institutions in 15 countries in Europe, the United States and Australia. The project explores the early origins of obesity, adiposity and associated non-communicable diseases, underlying mechanisms and opportunities for prevention. The project also proactively supports translational application of research findings. In fact, some existing evidence has already been rapidly adopted into policy, regulatory standards and practice. Further, broad dissemination of findings is achieved through the established digital eLearning platform of the Early Nutrition eAcademy, video clip-based learning and graphically supported messaging to consumers. The project demonstrated powerful effects of early metabolic programming on later health. Compared to other common prevention strategies, modifying risk trajectories in early life can achieve a much larger risk reduction and be more cost-effective. While some effective prevention strategies have been promptly implemented in policy and guidelines, legislation and practice, in other areas, the uptake is limited by a paucity of quality human intervention trials and insufficient evaluation of the feasibility of implementation and econometric impact. This needs to be strengthened by future collaborative research work.


Assuntos
Fenômenos Fisiológicos da Nutrição do Lactente , Fenômenos Fisiológicos da Nutrição Materna , Obesidade/prevenção & controle , Efeitos Tardios da Exposição Pré-Natal/prevenção & controle , Pesquisa Translacional Biomédica/normas , Austrália , Pré-Escolar , Meio Ambiente , Europa (Continente) , Feminino , Política de Saúde , Humanos , Lactente , Recém-Nascido , Cooperação Internacional , Masculino , Obesidade/etiologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/etiologia , Estados Unidos
20.
BMC Pediatr ; 17(1): 115, 2017 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-28454516

RESUMO

BACKGROUND: Childhood obesity is one of the most serious public health issues of the twenty-first century affecting even low- and middle-income countries. Overweight and obese children are more likely to stay obese into adulthood. Due to the paucity of data on local practices, our study aimed to assess the knowledge and practices of physicians from the Middle East and North Africa region with respect to early-onset obesity. METHODS: A specific questionnaire investigating the perception and knowledge on early-onset obesity was circulated to healthcare providers (general physicians, pediatricians, pediatric gastroenterologist, neonatologists) practicing in 17 Middle East and North African countries. RESULTS: A total of 999/1051 completed forms (95% response) were evaluated. Of all respondents, 28.9% did not consistently use growth charts to monitor growth during every visit and only 25.2% and 46.6% of respondents were aware of the correct cut-off criterion for overweight and obesity, respectively. Of those surveyed, 22.3, 14.0, 36.1, 48.2, and 49.1% of respondents did not consider hypertension, type 2 diabetes, coronary heart disease, fatty liver disease, and decreased life span, respectively, to be a long-term complication of early childhood obesity. Furthermore, only 0.7% of respondents correctly answered all survey questions pertaining to knowledge of early childhood overweight and obesity. CONCLUSION: The survey highlights the low use of growth charts in the evaluation of early childhood growth in Middle East and North Africa region, and demonstrated poor knowledge of healthcare providers on the short- and long-term complications of early-onset obesity. This suggests a need for both continued professional education and development, and implementation of guidelines for the prevention and management of early childhood overweight and obesity.


Assuntos
Competência Clínica/estatística & dados numéricos , Obesidade Infantil , Padrões de Prática Médica/estatística & dados numéricos , Adulto , África do Norte , Pré-Escolar , Feminino , Gráficos de Crescimento , Pesquisas sobre Atenção à Saúde , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Oriente Médio , Obesidade Infantil/complicações , Obesidade Infantil/diagnóstico , Obesidade Infantil/terapia
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