Effects of Sn-2-palmitate-enriched formula feeding on infants' growth, stool characteristics, stool fatty acid soap contents and bone mineral content: A systematic review and meta-analysis of randomized controlled trials.

This systematic review and meta-analysis was performed to assess the effects of Sn-2-palmitate-enriched formula feeding on infants' growth, stool characteristics, stool fatty acid (FA) soap contents and bone mineral content (BMC). We searched PubMed, MEDLINE, Embase and Web of Science for randomized controlled trials published up to April 2022. Sixteen studies involving 1,931 infants were included. From each included study, weighted mean differences (WMDs) and 95% confidence intervals (CIs) for each of the above mentioned outcomes were extracted and pooled with a fixed-effects model (I2 ≤ 50%) or a random-effects model (I2 > 50%). Infants fed Sn-2-palmitate-enriched formula exhibited greater weight gains (WMD: 0.81; 95% CI: 0.23, 1.39 g/d; I2 = 0.00%), lower contents of total stool FA soaps (WMD: -3.47; 95% CI: -5.08, -1.86 mg/100 mg; I2 = 0.00%) and higher BMC (WMD: 7.08; 95% CI: 4.05, 10.10; I2 = 0.00%) than infants fed standard formula. However, no difference was observed in these outcomes between infants fed Sn-2-palmitate-enriched formula and those fed human milk. This meta-analysis demonstrated that compared with standard formula feeding, Sn-2-palmitate-enriched formula feeding could effectively promote weight gains, bone mineral accumulation and stool FA soap reduction in infants.

Biomarkers of fatty acids and risk of type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies.

We aimed to quantify and generate comprehensive evidence on the associations of different fatty acids (FAs) with the risk of type 2 diabetes mellitus (T2DM). PubMed, MEDLINE, and Embase were searched for prospective cohort studies that examined the association between FA biomarkers and the risk of T2DM published before 18 May 2020. Random-effects meta-analyses of the effects of FA concentration on T2DM were performed. Thirty-three studies involving 95,810 adults (19,904 cases) were included. Divergent associations of different types of FAs with type 2 diabetes were observed. The pooled relative risk (RRs) of T2DM comparing the top versus the bottom tertile of saturated FAs (C14:0, C16:0, C18:0, total saturated FAs), monounsaturated FA (C16:1 n-7), polyunsaturated FA (C20:3 n-6, C22:4 n-6), and Δ-6-desaturase activities ranged from 1.19 to 1.80. Interestingly, unlike previous studies, we found a negative correlation between odd-chain saturated FAs (C15:0, C17:0), trans-FAs (trans-C16:1 n-7), total n-6, Δ-5-desaturase activities and risk of T2DM. The pooled RRs of T2DM comparing the top versus the bottom tertile of these FAs ranged from 0.62 to 0.78. No associations with T2DM were observed for the other FAs. Considerable heterogeneity was observed in our study, and no definitive conclusions can be made until further investigation has been carried out.

Optimal gestational weight gain in Chinese pregnant women by Chinese-specific BMI categories: a multicentre prospective cohort study.

OBJECTIVE: To establish optimal gestational weight gain (GWG) in Chinese pregnant women by Chinese-specific BMI categories and compare the new recommendations with the Institute of Medicine (IOM) 2009 guidelines. DESIGN: Multicentre, prospective cohort study. Unconditional logistic regression analysis was used to evaluate the OR, 95 % CI and the predicted probabilities of adverse pregnancy outcomes. The optimal GWG range was defined as the range that did not exceed a 1 % increase from the lowest predicted probability in each pre-pregnancy BMI group. SETTING: From nine cities in mainland China. PARTICIPANTS: A total of 3731 women with singleton pregnancy were recruited from April 2013 to December 2014. RESULTS: The optimal GWG (ranges) by Chinese-specific BMI was 15·0 (12·8-17·1), 14·2 (12·1-16·4) and 12·6 (10·4-14·9) kg for underweight, normal weight and overweight pregnant women, respectively. Inappropriate GWG was associated with several adverse pregnancy outcomes. Compared with women gaining weight within our proposed recommendations, women with excessive GWG had higher risk for macrosomia, large for gestational age and caesarean section, whereas those with inadequate GWG had higher risk for low birth weight, small for gestational age and preterm delivery. The comparison between our proposed recommendations and IOM 2009 guidelines showed that our recommendations were comparable with the IOM 2009 guidelines and could well predict the risk of several adverse pregnancy outcomes. CONCLUSIONS: Inappropriate GWG was associated with higher risk of several adverse pregnancy outcomes. Optimal GWG recommendations proposed in the present study could be applied to Chinese pregnant women.

Positive relationship between consumption of specific fish type and n-3 PUFA in milk of Hong Kong lactating mothers.

Residents of Hong Kong have undergone a dietary transition from a traditional Chinese diet that is high in seafood to a more Western diet. This may have affected the nutritional composition of breast milk of Hong Kong mothers. The present study aims to investigate the relationship between the dietary pattern and the fatty acid profile of the breast milk of lactating women in Hong Kong. Seventy-three volunteering healthy Hong Kong lactating mothers participated in the study. Their dietary intakes were assessed by using a 3-d dietary record and FFQ. The mean n-3 fatty acid levels were approximately 0·4 % (EPA) and 0·9 % (DHA) of total fatty acids in the breast milk of lactating mothers who had exclusively breastfed their infants aged 2-6 months. Maternal dietary intakes of n-3 fatty acids were positively associated with their levels in the breast milk. The levels of maternal intakes of freshwater and saltwater fish, especially the consumption of salmon, croaker and mandarin, were significantly correlated with the content of DHA in breast milk. The present study is among the very few in the literature to determine the fatty acid profile of breast milk in Hong Kong populations and verify certain dietary factors that influence this profile. High levels of n-3 PUFA, especially DHA, were observed in the breast milk of Hong Kong lactating women. The findings may serve as a dietary reference for lactating mothers to optimise the fatty acid profile of their breast milk.

Composition requirements of follow-up formula for 6-12-month-old infants: recommendations of a Chinese expert group.

BACKGROUND AND OBJECTIVES: The Chinese national standard of formula for 6-12-month-old infants (GB 10767- 2010) requires review and revision because it does not correspond to current scientific knowledge and data. The aim of this paper was to summarize the formula composition recommended for 6-12-month-old infants by a Chinese expert group. METHODS AND STUDY DESIGN: Formula composition recommendations for 6-12-month-old infants were devised by a Chinese expert group based on a detailed systematic review, which included nutrient intake, nutrient content of Chinese women's breast milk, and the latest adequate intake and tolerable upper intake levels, also referencing the Codex Alimentarius recommendations and those of other countries and considering the practice in products on the market. RESULTS: Compared with current standards, it was recommended that most compositional requirements be modified, including decreasing the maximum energy density from 85 to 75 kcal/100 mL, decreasing the protein content in milk-based formula from 2.9-5.0 g/100 kcal to 1.8-3.5 g/100 kcal, increasing the minimum content of lipids from 2.9 g/100 kcal to 3.5 g/100 kcal, providing the maximum amount of vitamins and minerals (including vitamin E, vitamin K, thiamin, riboflavin, vitamin B-6, vitamin B-12, niacin, folic acid, pantothenic acid, vitamin C, biotin, magnesium, calcium, phosphorus, and iodine), and changing the content of optional components such as taurine, docosahexaenoic acid, and arachidonic acid. CONCLUSIONS: These nutrient standard modifications based on recent evidence are expected to enhance feeding practices and further guarantee the health of 6-12-month-old infants in China.

Biomarkers of dairy fat intake and risk of cardiovascular disease: A systematic review and meta analysis of prospective studies.

BACKGROUND: Circulating biomarkers of dairy fat provide objective measures of dairy fat intake and facilitate conclusions relevant to populations with different diets and susceptibility to cardiovascular diseases (CVD). OBJECTIVE: To assess the relationship between circulating pentadecanoic acid (15:0), heptadecanoic acid (17:0) and trans-palmitoleic acid (trans-16:1n-7) and the risk of CVD. METHODS: Pubmed, Medline and Embase were searched for prospective cohort studies of the relationship between biomarkers of dairy fat and CVD risk, which included coronary heart disease (CHD), stroke, heart failure and CVD mortality, supplemented by bibliographies of retrieved articles and previous reviews. For each study, relative risks (RR) and 95% confidence intervals (CI) were extracted and pooled with the random effect model. RESULTS: Thirteen studies involving 7,680 CVD cases were included. The pooled RRs of the risk of CVD for the top third vs. bottom third 15:0, 17:0 and trans-16:1n-7 level were 0.94 (95%CI: 0.77-1.15), 0.82 (95% CI: 0.68-0.99) and 0.82 (95% CI: 0.67-1.02), respectively. Subgroup analysis indicated that there were no associations between the concentration of 15:0 with CHD and stroke, but a negative relationship with heart failure (RR = 0.72, 95% CI: 0.55-0.95). Null association was observed between circulating 17:0 and trans-16:1n-7 level and subtypes of CVD except for only one study which reported a negative relationship between 17:0 and heart failure. CONCLUSION: Higher dairy fat exposure is not associated with an increased risk of CVD.

Effects of chocolate-based products intake on blood glucose, insulin and ghrelin levels and on satiety in young people: a cross-over experimental study.

This cross-over experimental study aimed to examine the effects of filled chocolate consumption on blood glucose, insulin and ghrelin levels in 20 volunteers. After a one-week run-in period, study participants consumed two chocolate-based products, the tested biscuit or water for 21 days as a morning snack. After a two-week wash-out period, participants consumed another tested food for another 21 days. Each participant consumed all four test foods within an 18-week period. The participants' blood insulin increased slowly after two chocolate-based products intakes on the first day and satiety levels after eating chocolate-based products and the tested biscuit were the same. Chocolate consumption for three weeks had no adverse effects on blood glucose, insulin or ghrelin levels. In conclusion, compared to eating the tested biscuit, 21-day consumption of the tested chocolate-based products had no adverse effects on the blood glucose, insulin and ghrelin levels. This trial is registered with chictr.org.cn: ChiCTR-IOR-16009525.

The effects of different levels of calcium supplementation on the bone mineral status of postpartum lactating Chinese women: a 12-month randomised, double-blinded, controlled trial.

Increasing dietary Ca intake may prevent the excessive mobilisation of bone mineral in nursing mothers. We aimed to investigate whether higher Ca intake could positively modulate the bone mineral changes in Chinese postpartum lactating women. The study was a 12-month randomised, double-blinded, parallel group trial conducted over 12 months. A total of 150 postpartum women were randomly selected to receive either 40 g of milk powder containing 300 mg of Ca and 5 µg of vitamin D (Low-Ca group) or same milk powder additionally fortified with 300 mg of Ca (Mid-Ca group) or 600 mg of Ca (High-Ca group). Bone mineral density (BMD) for the whole body, the lumbar spine, the total left hip and its sub-regions was measured using dual-energy X-ray absorptiometry. A total of 102 subjects completed the whole trial. The duration of total lactating time was 7·9 (SD 2·8) months on average. The intention-to-treat analysis yielded the following mean percentage changes in BMD for the whole body, the lumbar spine and the total left hip, respectively: -0·93 (SD 1·97), 2·11 (SD 4·90) and -1·60 (SD 2·65)% for the Low-Ca group; -0·56 (SD 1·89), 2·21 (SD 3·77) and -1·43 (SD 2·30)% for the Mid-Ca group; and -0·44 (SD 1·67), 2·32 (SD 4·66) and -0·95 (SD 4·08)% for the High-Ca group. The differences between the groups were not statistically significant (P: 0·5-0·9). The results of the complete case analysis were similar. In sum, we found no significant differences in the bone mineral changes from baseline to 12 months in postpartum lactating women consuming milk powder fortified with different levels of Ca.

Association of magnesium in serum and urine with carotid intima-media thickness and serum lipids in middle-aged and elderly Chinese: a community-based cross-sectional study.

OBJECTIVE: Previous studies suggested that magnesium (Mg) might protect against atherosclerosis, but data were scarce in an Asian population. We examined the association of Mg levels in serum and urine with carotid intima-media thickness (cIMT) and serum lipids in Chinese adults. METHODS: This community-based cross-sectional study recruited 2,837 participants aged 40-75 years in Guangzhou, China. General information, lifestyle factors, serum and urinary concentrations of Mg and cardiometabolic factors were determined. The cIMTs of the common carotid artery (CCA) and the carotid bifurcation (BIF) were measured ultrasonographically. RESULTS: The mean (SD) concentration of serum Mg was 0.85 (0.07) mmol/L and median (IQR) for urinary Mg excretion was 2.29 (1.56-3.51) mmol/L. After adjustment for potential covariates, both serum and the urinary concentrations of Mg were inversely associated with CCA-IMT, but not with BIF-IMT. The regression coefficients (standard errors) were -100 (29) µm (total), -86 (34) µm (women) and -117 (52) µm (men) CCA-IMT per 1 mmol/L of serum Mg, and -41 (8) µm (total), -41 (10) µm (women) and -44 (15) µm (men) CCA-IMT per 1 unit of urinary Mg/creatinine (log mmol/mmol) (all p < 0.05), respectively. Higher serum Mg levels were associated with higher total cholesterol, HDLc, LDLc and triglyceride, but lower non-HDLc/HDLc in total population (all p < 0.05). Similar relationships of urinary Mg with lipoproteins were also found in total population (all p < 0.05). CONCLUSION: Higher levels of serum and urinary Mg are associated with lower CCA-IMTs, and the role of Mg in lipid metabolism needs further investigation.

Association between n-3 polyunsaturated fatty acids in erythrocytes and metabolic syndrome in Chinese men and women.

PURPOSE: Evidence of an association between n-3 polyunsaturated fatty acids (PUFAs) and metabolic syndrome (MS) is limited and inconsistent. We investigated the association between n-3 PUFAs in erythrocytes and the presence of MS in Chinese adults. METHODS: The levels of α-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) in erythrocytes were measured using gas chromatography in 3072 participants (900 men and 2172 women) aged 30-75 years from Guangzhou, China. Cardiometabolic factors were determined, and MS was defined using the updated Adult Treatment Panel III criteria. Other covariates were collected via interviewer-administered questionnaires. RESULTS: After adjusting for age and other confounders, higher levels of marine-derived n-3 PUFAs, including EPA, DPA, and DHA, were associated with a lower presence of metabolic syndrome in both men and women. The odds ratios (95 % confidence interval) for MS obtained by comparing extreme quartiles were 0.55 (0.35-0.88) (EPA), 0.54 (0.34-0.87) (DPA), 0.45 (0.27-0.73) (DHA), and 0.52 (0.32-0.84) (total n-3 PUFAs) in men (p trend <0.05 for all results); and 0.74 (0.56-0.99) (EPA), 0.73 (0.55-0.98) (DPA), 0.75 (0.56-1.02) (DHA), and 0.71 (0.53-0.96) (total n-3 PUFAs) in women, respectively. No significant association of ALA with MS was observed (p trend > 0.05). CONCLUSION: Higher levels of total n-3 PUFAs, EPA, DPA, and DHA, but not of ALA, in erythrocyte membranes are associated with a lower presence of metabolic syndrome in Chinese adults.

The validity of the body adiposity index in predicting percentage body fat and cardiovascular risk factors among Chinese.

OBJECTIVE: Recent research has suggested that body adiposity index (BAI) correlates more closely with percentage body fat (PBF) than body mass index (BMI). Here, we aimed to evaluate BAI's predictive power for PBF and for obesity-associated risk factors in the Chinese population. SUBJECTS: A total of 1707 women and 680 men aged 51-77 years were analysed in this community-based cross-sectional study. MEASUREMENTS: Body weight, height, waist circumference (WC) and hip circumference (HC) were measured, and BMI and BAI were calculated. Percentage body fat was determined by dual-energy X-ray absorptiometry (DXA). Blood pressure, fasting lipid profiles, glucose and Carotid ultrasound examination determined intima-media thickness (IMT) at the common carotid arteries (CCA) were also measured. RESULTS: The Pearson correlation analysis indicated a stronger correlation between BAI and PBF when women and men were pooled together, but this effect disappeared in sex-stratified analysis. Bland-Altman plots suggested that BAI underestimated 5·8% of PBF in women and slightly overestimated 0·28% of PBF in men, but the magnitudes of these biases showed a fat mass-dependent manner. Both the logistic regression and the receiver operating characteristic curve (ROC) analysis indicated that BAI has an inferior predictive power for the presence of hypertension, dyslipidaemia, metabolic syndrome and CCA-intima-media thickening, compared with BMI and WC. CONCLUSION: We concluded that BAI was neither a better predictor for PBF nor for cardiovascular risks in Chinese population compared with BMI and WC.

Calcium supplementation and bone mineral accretion in Chinese adolescents aged 12-14 years: a 12-month, dose-response, randomised intervention trial.

A 12-month, dose-response, randomised, intervention trial was conducted to determine adequate Ca intake levels for Chinese adolescents by investigating the effect of Ca supplementation on bone mineral accretion. A total of 220 Han adolescents (111 girls and 109 boys) aged 12-14 years were recruited. All subjects were randomly divided into three groups. The bone mineral content (BMC) and bone mineral density (BMD) of the whole body, lumbar spine (L1-L4), left hip and femoral neck were measured by dual-energy X-ray absorptiometry. Girls in the high-Ca group (actual Ca intake: 1243 (sd 193) mg/d) exhibited greater increases in the femoral neck BMC compared with those in the low-Ca group (9·7 v. 6·4 %, P =0·04) over the 1-year intervention period. The increases in femoral neck BMC were greater in boys in the high-Ca and medium-Ca groups (actual Ca intake: 985 (sd 168) mg/d) than in those in the low-Ca group (15·7 v. 11·7 %, P =0·03; 15·8 v. 11·7 %, P =0·03). Ca supplementation had significant effects on the whole-body BMC and BMD in subjects with physical activity levels>34·86 metabolic equivalents and on the spine BMD and BMC and BMD of most sites in subjects with Tanner stage < 3. Increasing Ca intake levels with Ca supplementation enhanced femoral neck mineral acquisition in Chinese adolescents. Furthermore, high physical activity levels and low Tanner stage appeared to significantly contribute to the effect of Ca supplementation on bone mass. Whether this is a lasting beneficial effect leading to the optimisation of peak bone mass needs to be determined in other long-term prospective studies.

Current information and Asian perspectives on long-chain polyunsaturated fatty acids in pregnancy, lactation, and infancy: systematic review and practice recommendations from an early nutrition academy workshop.

The Early Nutrition Academy supported a systematic review of human studies on the roles of pre- and postnatal long-chain polyunsaturated fatty acids (LC-PUFA) published from 2008 to 2013 and an expert workshop that reviewed the information and developed recommendations, considering particularly Asian populations. An increased supply of n-3 LC-PUFA during pregnancy reduces the risk of preterm birth before 34 weeks of gestation. Pregnant women should achieve an additional supply ≥200 mg docosahexaenic acid (DHA)/day, usually achieving a total intake ≥300 mg DHA/day. Higher intakes (600-800 mg DHA/day) may provide greater protection against early preterm birth. Some studies indicate beneficial effects of pre- and postnatal DHA supply on child neurodevelopment and allergy risk. Breast-feeding is the best choice for infants. Breast-feeding women should get ≥200 mg DHA/day to achieve a human milk DHA content of ∼0.3% fatty acids. Infant formula for term infants should contain DHA and arachidonic acid (AA) to provide 100 mg DHA/day and 140 mg AA/day. A supply of 100 mg DHA/day should continue during the second half of infancy. We do not provide quantitative advice on AA levels in follow-on formula fed after the introduction of complimentary feeding due to a lack of sufficient data and considerable variation in the AA amounts provided by complimentary foods. Reasonable intakes for very-low-birth weight infants are 18-60 mg/kg/day DHA and 18-45 mg/kg/day AA, while higher intakes (55-60 mg/kg/day DHA, ∼1% fatty acids; 35-45 mg/kg/day AA, ∼0.6-0.75%) appear preferable. Research on the requirements and effects of LC-PUFA during pregnancy, lactation, and early childhood should continue. © 2014 S. Karger AG, Basel.

Fruit and vegetable intake and bone mass in Chinese adolescents, young and postmenopausal women.

OBJECTIVE: Previous studies showed an inconsistent association of fruit and vegetable consumption with bone health. We assessed the associations in Chinese adolescents, young and postmenopausal women. DESIGN: A cross-sectional study conducted in China during July 2009 to May 2010. SETTING: Bone mineral density (BMD) and content (BMC) at the whole body, lumbar spine and left hip were measured with dual-energy X-ray absorptiometry. Dietary intakes were assessed using an FFQ. All these values were separately standardized into Z-scores in each population subgroup. SUBJECTS: One hundred and ten boys and 112 girls (11-14 years), 371 young women (20-34 years, postpartum within 2 weeks) and 333 postmenopausal women (50-70 years). RESULTS: After adjustment for potential covariates, analysis of covariance showed a significantly positive association between fruit intake and BMD and BMC in all participants combined (P-trend: < 0.001 to 0.002). BMD Z-score increased by 0.25 (or 2.1 % of the mean), 0.22 (3.5 %), 0.23 (3.0 %) and 0.25 (3.5 %), and BMC Z-score increased by 0.33 (5.7 %), 0.25 (5.8 %), 0.34 (5.9 %) and 0.29 (4.7 %), at the total body, lumbar spine, total hip and femoral neck in participants belonging to the top tertile compared with the bottom tertile of fruit intake (all P < 0.05), respectively. There was no significant association between vegetable intake and bone mass at all bone sites studied except for total body BMD (P = 0.030). Relatively more pronounced effects were observed in boys and postmenopausal women. CONCLUSION: Our findings add to the existing evidence that fruits and vegetables may have a bone sparing effect.

Soya isoflavone consumption in relation to carotid intima-media thickness in Chinese equol excretors aged 40-65 years.

Previous studies have suggested that the daidzein metabolite equol rather than daidzein itself contributes to the beneficial effect of soya foods in the prevention of CVD. The aim of the present study is to examine the proportion of equol excretion in Chinese adults and compare plasma lipids and carotid artery intima-media thickness (IMT) between equol excretors and non-excretors, and to evaluate the effect of soya isoflavone intakes on serum lipids and IMT in either equol excretors or non-excretors. Subjects (n 572; women n 362, men n 210) were recruited for the present study. An overnight urine sample was provided by each subject on their usual diet to quantify urinary concentrations of daidzein and equol. Far-wall IMT was determined by B-mode ultrasound in the right carotid at two sites, carotid bulb (CB-IMT) and common carotid artery (CCA-IMT), and fasting serum lipids were measured. Habitual dietary intakes were estimated with a FFQ, and soya isoflavone intake derived from the FFQ was assessed. Of the 572 subjects, the proportion of equol excretors on their usual diet was 25·0 % (n 143). Compared with non-excretors, equol excretors showed significantly lower serum TAG (-38·2 (95 % CI -70·4, -5·9) %, P = 0·012) and CCA-IMT (-4·9 (95 % CI -9·7, -0·3) %, P = 0·033). Equol excretors with higher daily isoflavone intakes (-5·4 mg/d) had significantly lower IMT (-16·2 %, P = 0·035) and tended to have higher HDL-cholesterol (P = 0·055) than did those with lower daily isoflavone intakes (1·5 mg/d), while no association was observed between soya isoflavone intakes and serum lipids or IMT in non-excretors. In conclusion, the benefits of soya isoflavones in preventing CVD may be apparent among equol excretors only.

[Physical activity and bone mineral density in postmenopausal women].

OBJECTIVE: To test the association of total and physical activity (PA) intensity levels with bone mineral density (BMD) and bone mineral content (BMC) in postmenopausal women. METHODS: 315 postmenopausal women (50-70 y) were recruited for this cross-sectional study from community residents in Guangzhou, China. PA and related covariates including general characteristics and dietary intakes were assessed using a face-to-face interview. BMD and BMC were determined by a dual energy x-ray absorptiometry, at the whole body, lumbar spine (L1-AL4), total hip and its sub-sites. RESULTS: The participants were tertiled according to metabolic equivalent (MET) of PA. Analysis of covariance showed that greater PA tended to correlated to better BMD and BMC at various sites. Mean (S) BMDs at the whole body were (1.045 +/- 0.008), (1.043 +/- 0.008), (1.068 +/- 0.008) g/cm2 in the tertile I, II and III of total PA. BMD was significantly higher in the tertile III than those in the tertile I (P = 0. 049) and II (P = 0.028). No significant difference was observed at other sites. Mean BMC was significantly higher in the of highest total PA group than those in the other two groups at total femur, femoral neck, shaft femur and ward's triangle (P = 0. 004-0. 042). The association was differed by PA intensity levels. BMD tended to be increased with less light-intensity PA, more moderate-intensity PA and moderate vigorous-intensity PA. CONCLUSION: Greater total PA and moderate-intensity PA, and moderate vigorous-intensity PA might improve bone mass in postmenopausal women.

Human Milk Lipid Profiles around the World: A Systematic Review and Meta-Analysis.

Reported breast milk lipid concentrations may vary with geographical region, postnatal age, and year of sample collection. In this review, we summarized data on the concentrations of total fat, total phospholipids, cholesterol, and fatty acids in human milk worldwide and their variation according to lactation stage, study area, and sample collection year. A systematic literature search was performed using the PubMed, Embase, Web of Science, and Medline databases for English-language papers and Wanfang and China National Knowledge Infrastructure databases for Chinese-language papers. A total of 186 studies evaluating the human milk lipid profiles were included. According to random-effects models based on worldwide data, the summarized means (95% CIs) as percentages of total fat were 42.2% (41.1%, 43.3%) for SFAs, 36.6% (35.6%, 37.5%) for MUFAs, and 21.0% (19.3%, 22.7%) for PUFAs. However, the study heterogeneity was high for most types of fatty acids (I2 > 99%). Human milk from Western countries had higher concentrations of MUFAs and 18:1n-9 (ω-9), but lower concentrations of PUFAs, 18:2n-6, 20:4n-6, 18:3n-3, 20:5n-3, 22:6n-3, and total n-6 PUFA compared with those from non-Western countries (P < 0.001-0.011). Significant lactation stage differences were observed for total fat and some individual fatty acids. The concentrations of SFAs and 16:0 were significantly negatively correlated with sampling year (P < 0.001-0.028). In contrast, a significant positive correlation between the concentrations of 18:2n-6 and 18:3n-3 and sampling year was observed (P < 0.001-0.035). Our results suggest that the pooling of data on human milk lipid profiles in different studies should be done with caution due to the high between-study heterogeneity. The concentration of lipids, including total fat, cholesterol, and specific fatty acids, differs in human milk according to lactation stage, geographical region, and year of sample collection.

Effect of milk and calcium supplementation on bone density and bone turnover in pregnant Chinese women: a randomized controlled trail.

OBJECTIVE: Calcium demand is increased during pregnancy. However, few randomized controlled trials examined the effects of calcium supplementation on bone mass during pregnancy. This study determined effects of calcium and milk supplementation on maternal bone mineral density (BMD) and bone turnover in pregnant Chinese women with habitual low calcium intake. METHODS: In this randomized controlled trial, 36 Chinese pregnant women (24-31 years, 18 gestational weeks) were randomly assigned to the following three arms (12 each): I, usual diet; II, "I" + 45 g milk powder (containing 350 mg calcium); or III, "II" + 600 mg calcium/day from gestational age of 20 weeks to 6 weeks post-partum (PP). BMD was measured post-treatment using dual-energy X-ray absorptiometry. Dietary intakes, 24-h urinary calcium, bone resorption (urinary hydroxyproline) and formation (serum osteocalcin) biomarkers were examined at the gestational age of 20 and 34 weeks, and 6 weeks PP. RESULTS: A dose-dependent relationship was observed between calcium intake and BMDs. The BMD values were significantly higher in subjects with calcium and milk supplementation than those in the controls at the whole body and spine (p < 0.05) but not at the hip sites. We found significant decreases in changes of urinary hydroxyproline, and significant increases in serum osteocalcin during the intervention period in the calcium/milk intervention groups than those in the control group (all p < 0.05). CONCLUSION: Calcium/milk supplementation during pregnancy is associated with greater BMD at the spine and whole body and suppresses bone resorption in Chinese women with habitual low calcium intake.

The relationships between erythrocyte membrane n-6 to n-3 polyunsaturated fatty acids ratio and blood lipids and C-reactive protein in Chinese adults: an observational study.

OBJECTIVE: To investigate the relationships between erythrocyte membrane n-6:n-3 PUFAs ratio and blood lipids and high sensitivity C-reactive protein (hs-CRP). METHODS: The observational study consisted of a population-based cross-sectional study of 456 Chinese and a subsequent 1-year follow-up study of 171 subjects with the fasting plasma total cholesterol of 5.13-8.00 mmol/L. RESULTS: In the cross-sectional analysis, plasma low-density lipoprotein cholesterol (LDL-c) had a significant and negative association with the erythrocyte membrane n-6:n-3 PUFAs ratio (P for trend=0.019) after adjusting for sex, age and total PUFA percentage. In the follow-up study, 171 subjects were categorized into quartiles by the changes of n-6:n-3 ratio in erythrocyte membrane (Δ=month 12-month 0). In the top quartile whose ratios of n-6:n-3 increased by an average of 1.25 during the follow-up, the LDL-c-lowering extent was 3.3 times of that in the lowest quartile whose ratios of n-6:n-3 decreased by an average of 1.13 (-1.07 mmol/L v.s. -0.32 mmol/L). The hsCRP decreased by 0.11 mg/dL in the lowest quartile while increasing by 0.10 mg/dL in the top quartile (P for difference=0.052). CONCLUSION: Our results suggested that the balance between n-6 and n-3 fatty acids may optimize the cardiovascular benefits from dietary PUFAs.

[Relationship of dietary iron intake, body iron overload and the risk of metabolic syndrome].

OBJECTIVE: To investigate the relationship among dietary iron intake, body iron overload and risk of metabolic syndrome. METHODS: 87 MS patients and 102 matched healthy adults were recruited. Fasting blood samples were collected and assayed for serum ferritin (SF), serum iron (SI), total iron-binding capacity (TIBC), fasting insulin (FIN), fasting blood glucose (FBG), MDA, SOD and NF-kappaB. The data of dietary intake were collected by using a 24-hour dietary recall method for 7 consecutive days by trained interviewers. RESULTS: Total dietary iron intake, iron intake from animal source, serum MDA and NF-kappaB in MS group was significantly higher than that in the control group. SF, SI, siderophilin saturation and serum SOD in MS group was lower than that in the control group. There is a positive correlation between serum iron and insulin resistance index and blood glucose. When the total dietary iron intake greater than 15 mg/d was defined as iron over intake, the risk of suffering from MS was high (OR = 7.12) in those subjects with over intake of total iron. When the animal source iron intake greater than 7.5 mg/d was defined as iron over intake, the risk of suffering from MS was high (OR = 7.73) in those subjects with over intake of animal source iron. Fat and iron intake are influencing factors for MS according to Logistic multiple factor regression analysis. CONCLUSION: Iron overload induced by higher meat-based iron intake might be associated with higher risk of MS.