Fat intake and breast milk fatty acid composition in farming and nonfarming women and allergy development in the offspring.

BACKGROUND: Children growing up on small family farms are at much lower risk of developing allergy than other children. We hypothesized that low intake of margarine and polyunsaturated fats among farming families could contribute to this protection. METHODS: Twenty-eight mother-infant pairs living on small dairy farms and 37 nonfarm rural resident pairs were recruited in the FARMFLORA birth cohort. Food items expected to affect dietary fat composition were recorded by food frequency questionnaires during pregnancy and by 24-h recalls followed by 24-h food diaries during lactation. Allergy was diagnosed by doctors, using strict predefined criteria. Maternal diet and breast milk fat composition were compared between farming and nonfarming mothers and related to children's allergy at age 3 y. RESULTS: Farming mothers consumed more butter, whole milk, saturated fat, and total fat than nonfarming mothers, who consumed more margarine, oils, and low-fat milk. Farming mothers' breast milk contained higher proportions of saturated and lower proportions of polyunsaturated fat. Allergy was eight times more common in nonfarm children. Mothers of allergic children consumed more margarine and oils than mothers of nonallergic children. CONCLUSION: Low maternal consumption of margarine and vegetable oils might contribute to the allergy-preventive effect of growing up on small dairy farms.

High proportion of CD5+ B cells in infants predicts development of allergic disease.

Delayed maturation of the immune system has been proposed to be a risk factor for development of allergy, but B cell maturation in relation to allergic disease has not been examined. B cells lose CD5 and acquire CD27 during maturation from immature via mature/naive to Ig-secreting cells and memory cells. We sought to investigate B cell maturation in relation to development of allergic disease and sensitization in the FARMFLORA birth cohort including 65 Swedish children. Total B cell numbers, proportions of CD5(+) and CD27(+) B cells, and levels of IgM, IgG, IgA, and IgE were measured in blood on repeated occasions from birth to 36 mo of age, and related to allergic disease and sensitization at 18 and 36 mo of age with multivariate discriminant analysis. We also compared the expression of CD24 and CD38 within CD5(+) and CD5(neg) B cells in children and in adults. We found that infants with a high proportion of CD5(+) B cells at birth and at 1 mo of age had an increased risk for having allergic disease at 18 and 36 mo of life. Further, the proportions of CD5(+) B cells at 1 mo of age were inversely correlated with total IgG levels at 18 and 36 mo of age. The majority of the CD5(+) B cells were of a CD24(hi/+)CD38(hi/+) immature/naive phenotype at birth (97%), 7 y of age (95%), and in adults (86%). These results suggest that development of allergic disease is preceded by an immaturity in neonatal B cell phenotype.

Infant B cell memory differentiation and early gut bacterial colonization.

Germ-free animal models have demonstrated that commensal bacterial colonization of the intestine induces B cell differentiation and activation. Whether colonization with particular bacterial species or groups is associated with B cell development during early childhood is not known. In a prospective newborn/infant cohort including 65 Swedish children, we examined the numbers and proportions of CD20(+), CD5(+), and CD27(+) B cells in blood samples obtained at several time points during the first 3 y of life using flow cytometry. Fecal samples were collected and cultured quantitatively for major facultative and anaerobic bacteria at 1, 2, 4, and 8 wk of life. We found that the numbers of CD20(+) B cells and CD5(+)CD20(+) B cells reached their highest levels at 4 mo, whereas CD20(+) B cells expressing the memory marker CD27 were most numerous at 18 and 36 mo of age. Using multivariate analysis, we show that early colonization with Escherichia coli and bifidobacteria were associated with higher numbers of CD20(+) B cells that expressed the memory marker CD27 at 4 and 18 mo of age. In contrast, we were unable to demonstrate any relation between bacterial colonization pattern and numbers of CD20(+) or CD5(+)CD20(+) B cells. These results suggest that the intestinal bacterial colonization pattern may affect the B cell maturation also in humans, and that an early gut microbiota including E. coli and bifidobacteria might promote this maturation.

Motivation for choice and healthiness perception of calorie-reduced dairy products. a cross-cultural study.

Understanding consumers' motives for selecting calorie-reduced dairy products are important to provide targeted communication to different consumer segments. The aim of this study was to identify motives for consumption of calorie-reduced dairy products among young consumers, and to identify how these consumers perceive the healthiness of such products compared to other food products. Consumers, aged 18-30 years, from Norway (n=118), Denmark (n=125), and California (n=127) participated in this cross-cultural study. The respondents sorted 24 statements referring to motives for choosing calorie-reduced yoghurt and cheese. The study also assessed the aspect of perceived healthiness of these products in comparison with a selection of other food products using a two-step ranking procedure. The data were analysed using chi-square analysis, Friedman's test and Principal Component Analysis (PCA). The results show that fat content, healthiness and taste were the most important motivators for choice of the calorie-reduced dairy products. In all three countries salmon was perceived as the healthiest among the products presented. The calorie-reduced dairy products were ranked as relatively healthy, with yoghurt ranked as healthier than cheese. Although cross-cultural differences existed in motives for choice and perceived healthiness of the products, the similarities between the countries were evident in this study.

Cord Blood Levels of EPA, a Marker of Fish Intake, Correlate with Infants' T- and B-Lymphocyte Phenotypes and Risk for Allergic Disease.

Maternal fish intake during pregnancy has been associated with reduced allergy development in the offspring and here, we hypothesized that components of fish stimulate fetal immune maturation. The aim of this study was to investigate how maternal fish intake during pregnancy and levels of n-3 long-chain polyunsaturated fatty acids (LCPUFAs) in the infant's cord serum correlated with different subsets of B- and T-cells in cord blood and B-cell activating factor (BAFF) in cord plasma, and with doctor-diagnosed allergy at 3 and 8 years of age in the FARMFLORA birth-cohort consisting of 65 families. Principal component analysis showed that infant allergies at 3 or 8 years of age were negatively associated with the proportions of n-3 LCPUFAs (eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid) in infant cord serum, which, in turn correlated positively with maternal fish intake during pregnancy. Both maternal fish intake and cord serum n-3 LCPUFAs correlated negatively to CD5+ B cells and the FOXP3+CD25high of the CD4+ T cell subsets in cord blood, but not to BAFF in cord plasma. Our observational study suggests that fish might contain components that promote maturation of the infant's immune system in a manner that protects against allergy development.

Differentiating between ADHD sub-types on CCPT measures of sustained attention and vigilance.

The aim of the study was to test whether sustained attention and vigilance, often considered as the same phenomenon, dissociate on the Conners' Continuous Performance Test, and whether subjects with ADHD-Inattentive type and ADHD-Combined type differ with regard to these measures. Sixty-five healthy controls and 67 subjects with ADHD between 9 and 16 years of age participated in the study. The ADHD-I group performed below control children on Hit Reaction Time Block Change, considered to measure sustained attention and the ADHD-C group scored below controls on Hit Reaction Time Inter-Stimulus-Interval, considered to measure vigilance. Comparing the two clinical groups showed a test by group interaction, with ADHD-I subjects performing below ADHD-C subjects with regard to sustained attention and above ADHD-C subjects with regard to vigilance. Sustained attention on the CCPT correlated specifically with parent and teacher ratings of inattention, but not with ratings of hyperactivity-impulsivity, while vigilance correlated with all symptom ratings.

Multi-frequency bioelectrical impedance analysis (BIA) compared to magnetic resonance imaging (MRI) for estimation of fat-free mass in colorectal cancer patients treated with chemotherapy.

BACKGROUND: Changes in body composition in cancer patients during chemotherapy are associated with treatment related toxicities or mortalities. Thus, it is relevant to identify accessible, relatively inexpensive, portable and reliable tools for evaluation of body composition in cancer patients during the course of their treatments. OBJECTIVE: To examine relationships between single cross-sectional thighs magnetic resonance imaging (MRI), skeletal muscle mass (SM) as reference and multi-frequency bioelectrical impedance analysis (BIA) fat free mass (FFM) in patients with colorectal cancer undergoing chemotherapy. DESIGN: In an observational, prospective study we examine the relationships between single cross-sectional thighs MRI (T1-weighted (1.5 T) SM compared to FFM BIA (8-electrodes multi-frequency Tanita MC780MA)) and FFM skin-fold thickness (ST) (4-points (Harpenden, Skinfold Caliper)) and SM equation for non-obese persons from Lee et al. 2000 (L2000) (based on age, height, weight, sex and race). FFM and SM (kg) were calculated based on either area (MRI) or weight. RESULTS: 18 CRC patients (10 males and 8 females) with mean (SD) age 67 yr (6) were measured at baseline, and 13 were available for follow-up. BIA overestimated FFM kg for all 31 measurements with mean (SD) 18.0 kg (6.0) compared to the MRI. ST overestimated FFM kg with mean 12.4 kg (6.2) and L2000 underestimated SM kg in 18 measurements and overestimated in 13 with a total mean of -4.3 kg (6.8). CONCLUSIONS: BIA and ST were the best alternatives to MRI as they showed constant and thereby correctable errors. The equation, L2000, carried the smallest average measurement error but it was non-constant.

Counteracting Age-related Loss of Skeletal Muscle Mass: a clinical and ethnological trial on the role of protein supplementation and training load (CALM Intervention Study): study protocol for a randomized controlled trial.

BACKGROUND: Aging is associated with decreased muscle mass and functional capacity, which in turn decrease quality of life. The number of citizens over the age of 65 years in the Western world will increase by 50 % over the next four decades, and this demographic shift brings forth new challenges at both societal and individual levels. Only a few longitudinal studies have been reported, but whey protein supplementation seems to improve muscle mass and function, and its combination with heavy strength training appears even more effective. However, heavy resistance training may reduce adherence to training, thereby attenuating the overall benefits of training. We hypothesize that light load resistance training is more efficient when both adherence and physical improvement are considered longitudinally. We launched the interdisciplinary project on Counteracting Age-related Loss of Skeletal Muscle Mass (CALM) to investigate the impact of lifestyle changes on physical and functional outcomes as well as everyday practices and habits in a qualitative context. METHODS: We will randomize 205 participants older than 65 years to be given 1 year of two daily nutrient supplements with 10 g of sucrose and 20 g of either collagen protein, carbohydrates, or whey. Further, two groups will perform either heavy progressive resistance training or light load training on top of the whey supplement. DISCUSSION: The primary outcome of the CALM Intervention Study is the change in thigh cross-sectional area. Moreover, we will evaluate changes in physical performance, muscle fiber type and acute anabolic response to whey protein ingestion, sensory adaptation, gut microbiome, and a range of other measures, combined with questionnaires on life quality and qualitative interviews with selected subjects. The CALM Intervention Study will generate scientific evidence and recommendations to counteract age-related loss of skeletal muscle mass in elderly individuals. TRIAL REGISTRATION: ClinicalTrials.gov NCT02034760 . Registered on 10 January 2014. ClinicalTrials.gov NCT02115698 . Registered on 14 April 2014. Danish regional committee of the Capital Region H-4-2013-070. Registered on 4 July 2013. Danish Data Protection Agency 2012-58-0004 - BBH-2015-001 I-Suite 03432. Registered on 9 January 2015.

[The effect of psychosocial rehabilitation after acute myocardial infarction. A randomized controlled trial]. / Effekt af psykosocial rehabilitering efter akut myokardieinfarkt. En randomiseret undersøgelse.

INTRODUCTION: The aim of the study was to examine the effect of group based psychosocial rehabilitation following discharge compared to usual care. MATERIAL AND METHODS: A randomised clinical trial was performed in the setting of a coronary unit at Herlev University Hospital. The study sample included 200 patients admitted to the unit with a diagnosis of acute myocardial infarction. All patients received usual care. Besides, the intervention group was offered two group based outpatient counselling sessions with focus on reduction of risk factors and psychosocial adjustment after myocardial infarction. Coping strategies, anxiety and depression, general health, physical function and number of readmissions were measured on the basis of the questionnaires HAD and mini-MAC. Participants completed questionnaires before discharge and again six weeks and four months after discharge. RESULTS: The intervention did not significantly affect coping strategies, general health or physical function. The readmission rate was significantly lower in the intervention group compared to the control group. The mortality rate in the intervention group was lower after four months, one year and four years. DISCUSSION: Possible explanations for the lack of effect in psychosocial parameters are the complex target group with no restrictions in gender and age and no intervention targeted the relatives. The lower mortality rate in the intervention group might be due to the intervention. However, it could also be due to variables not available in this study, such as the type of infarction and changes in lifestyle.

Central processing energetic factors mediate impaired motor control in ADHD combined subtype but not in ADHD inattentive subtype.

Participants with attention-deficit/hyperactivity disorder (ADHD) are often impaired in visuomotor tasks. However, little is known about the contribution of modal impairment in motor function relative to central processing deficits or whether different processes underlie the impairment in ADHD combined (ADHD-C) versus ADHD inattentive (ADHD-I) subtype. The present study analyzes performance on the Visual Motor Integration Test relative to less effortful motor tests as well as on measures of energetics. Both ADHD groups showed evidence of impaired motor function on both visual-motor integration (VMI) and the less effortful motor tests. The ADHD-C group performed below the ADHD-I group on VMI, but their performance correlated highly with the measures of the energetic pools of arousal and effort. Different mechanisms may underlie impaired fine motor skills in ADHD. Central processing deficits contribute significantly to the deficit of ADHD-C but do not explain the motor impairment in ADHD-I.

Do low-effort learning strategies mediate impaired memory in ADHD?

As a group, participants with attention-deficit/hyperactivity disorder (ADHD) are impaired in academic performance and learning. This may be due to a mild intellectual impairment, impaired attention, or inability to allocate sufficient effort. If the latter is the case, this should be evident in the learning strategies applied. Four indices of learning strategy, considered to measure degree of effort, were analyzed from 67 participants with ADHD and 67 age-matched normal controls between 9 and 16 years of age. The participants with ADHD were impaired with regard to semantic clustering, retroactive interference, and percentage items reported from the middle section of the list even when controlling for IQ and comorbid conduct or oppositional defiant disorders symptoms. In addition, participants with combined ADHD (ADHD-C) did not display the normal proactive interference effect. The four effort indices explained 39% and 35% of the variance in free recall among participants with inattentive ADHD (ADHD-I) and ADHD-C, respectively. IQ was still significant when the effect of strategy measures were accounted for, whereas diagnosis was no longer significant when entered into the regression analysis after the effort indices. The study shows that participants with ADHD employ less effortful learning strategies than healthy controls and that low effort to a large degree can account for diagnosis related variance in memory performance.

[Smoking cessation among patients with acute heart disease. A randomised intervention project]. / Rygestop hos akutte hjertepatienter. Et randomiseret interventionsprojekt.

INTRODUCTION: Our goal was to investigate whether ambulatory smoking cessation among patients in a cardiologic department would (1) reduce the number of smokers by at least 25% after 12 months compared to a control group and (2) influence whether the individual patient was readmitted to hospital. We used a randomised, controlled, prospective intervention project design. MATERIALS AND METHODS: Everyone hospitalised during the project period was screened. Those who fulfilled the criteria for inclusion were randomised for inclusion in either the intervention group or the control group. Both groups were given the department's smoking cessation information. In addition, the intervention group attended five ambulatory smoking cessation intervention sessions. Each patient's smoking status was registered after 12 months. chi2-test and logistic regression analysis were used to test differences, associations and control of confounders. RESULTS: In all, 3,982 patients were screened, 29.5% of whom were smokers. The study included 105 patients: 54 in the intervention group and 51 in the control group. After 12 months, 52% of those in the intervention group compared to 39% in the control group had become non-smokers, which was non-significant (p = 0,14). Ischemic heart disease (IHS) was significantly associated with smoking cessation. After adjustment for this confounder, the result was enhanced (p = 0,06). Readmission to hospital was not affected by smoking cessation (p = 0,73). DISCUSSION: Ambulatory smoking cessation intervention had no significant effect on smoking cessation on an unselected group of patients in a cardiologic hospital department. The project does indicate that ambulatory smoking cessation interventions could have an effect on patients with IHS.