Comparison of food and nutrient intake in infants aged 6-12 months, following baby-led or traditional weaning: A cross-sectional study.

BACKGROUND: A baby-led approach to weaning (BLW) encompasses self-feeding and self-selecting graspable foods, offering an alternative to traditional weaning (TW). This cross-sectional study explored adherence to characteristics of BLW and differences in food group exposure and nutrient intake between babies following either TW or BLW. METHODS: Nutritional data were collected via multiple-pass 24-h recall, following parental completion of an online survey. RESULTS: Infants were grouped according to age (6-8 months; TW [n = 36] and BLW [n = 24]) and (9-12 months; TW [n = 24] and BLW [n = 12]). BLW babies were more likely to be breast fed (p = 0.002), consumed a higher percentage of foods also consumed by their mother (p = 0.008) and were fed less purees (p < 0.001) at 6-8 months. TW babies were spoon fed more (p ≤ 0.001) at all ages. Amongst babies aged 6-8 months, total intake (from complementary food plus milk) of iron (p = 0.021), zinc (p = 0.048), iodine (p = 0.031), vitamin B12 (p = 0.002) and vitamin D (p = 0.042) and both vitamin B12 (p = 0.027) and vitamin D (p = 0.035) from complementary food alone was higher in babies following TW. Compared to TW, BLW babies aged 6-8 months had a higher percentage energy intake from fat (p = 0.043) and saturated fat (p = 0.026) from their milk. No differences in nutrient intake were observed amongst infants aged 9-12 months. Few differences were observed between groups in their number of exposures to specific food groups. CONCLUSIONS: TW infants had higher intakes of key micronutrients at 6-8 months, although there were few differences in nutritional intake at 9-12 months or food group exposure between babies following TW or BLW. BLW appears to be socially desirable. Guidance for parents is required, along with larger, longer-term studies, which explore the potential impact of BLW in later childhood.

Can selenium deficiency in Malawi be alleviated through consumption of agro-biofortified maize flour? Study protocol for a randomised, double-blind, controlled trial.

BACKGROUND: Micronutrient deficiencies including selenium (Se) are widespread in Malawi and potentially underlie a substantial disease burden, particularly among poorer and marginalised populations. Concentrations of Se in staple cereal crops can be increased through application of Se fertilisers - a process known as agronomic biofortification (agro-biofortification) - and this may contribute to alleviating deficiencies. The Addressing Hidden Hunger with Agronomy (AHHA) trial aims to establish the efficacy of this approach for improving Se status in rural Malawi. METHODS: A double-blind, randomised, controlled trial will be conducted in a rural community in Kasungu District, Central Region, Malawi. The hypothesis is that consumption of maize flour agro-biofortified with Se will increase serum Se concentration. We will recruit 180 women of reproductive age (WRA) (20-45 years) and 180 school-age children (SAC) (5-10 years) randomly assigned in a 1:1 ratio to receive either maize flour enriched through agro-biofortification with Se or a control flour not enriched with Se. Households will receive flour (330 g per capita per day) for 12 weeks. The primary outcome is Se concentration in serum (µg/L). Serum will be extracted from venous blood samples drawn at baseline (prior to flour distribution) and end-line. Selenium concentration will be measured by using inductively coupled plasma mass spectrometry. DISCUSSION: Findings will be communicated to policy stakeholders and participating communities and reported in peer-reviewed journals. TRIAL REGISTRATION: The Addressing Hidden Hunger with Agronomy (Malawi) trial is registered (5th March 2019; ISCRTN85899451).

Fetal and neonatal exposure to trans-fatty acids impacts on susceptibility to atherosclerosis in apo E*3 Leiden mice.

Nutrition during pregnancy can impact on the susceptibility of the offspring to CVD. Postnatal consumption of trans-fatty acids (TFA), associated with partially hydrogenated vegetable oil (PHVO), increases the risk of atherosclerosis, whereas evidence for those TFA associated with ruminant-derived dairy products and meat remain equivocal. In this study, we investigate the impact of maternal consumption of dietary PHVO (P) and ruminant milk fat (R) on the development of atherosclerosis in their offspring, using the transgenic apoE*3 Leiden mouse. Dams were fed either chow (C) or one of three high-fat diets: a diet reflecting the SFA content of a 'Western' diet (W) or one enriched with either P or R. Diets were fed during either pregnancy alone or pregnancy and lactation. Weaned offspring were then transferred to an atherogenic diet for 12 weeks. Atherosclerosis was assessed as lipid staining in cross-sections of the aorta. There was a significant effect of maternal diet during pregnancy on development of atherosclerosis (P=0·013) in the offspring with those born of mothers fed R or P during pregnancy displaying smaller lesions that those fed C or W. This was not associated with changes in total or lipoprotein cholesterol. Continuing to feed P during lactation increased atherosclerosis compared with that seen in offspring of dams fed P only during pregnancy (P<0·001). No such effect was seen in those from mothers fed R (P=0·596) or W (P=901). We conclude that dietary TFA have differing effects on cardiovascular risk at different stages of the lifecycle.

Supplementation of a maternal low-protein diet in rat pregnancy with folic acid ameliorates programming effects upon feeding behaviour in the absence of disturbances to the methionine-homocysteine cycle.

Maternal protein restriction in rat pregnancy is associated with altered feeding behaviour in later life. When allowed to self-select their diet, rats subject to prenatal undernutrition show an increased preference for fatty foods. The main aim of the present study was to evaluate the contribution of folic acid in the maternal diet to programming of appetite, since disturbances of the folate and methionine-homocysteine cycles have been suggested to impact upon epigenetic regulation of gene expression and hence programme long-term physiology and metabolism. Pregnant rats were fed diets containing either 9 or 18 % casein by weight, with folate provided at either 1 or 5 mg/kg diet. Adult male animals exposed to low protein (LP) in fetal life exhibited increased preference for high-fat food. Providing the higher level of folate in the maternal diet prevented this effect of LP, but offspring of rats fed 18 % casein diet with additional folate behaved in a similar manner to LP-exposed animals. Among day 20 gestation fetuses, it was apparent that both protein restriction and maternal folate supplementation could have adverse effects upon placental growth. Examination of methionine-homocysteine and folate cycle intermediates, tissue glutathione concentrations and expression of mRNA for methionine synthase, DNA methyltransferase 1 and methyltetrahydrofolate reductase revealed no gross disturbances of folate and one-carbon metabolism in either maternal or fetal tissue. The present findings indicated that any role for DNA methylation in programming of physiology is not related to major perturbations of folate metabolism, and is likely to be gene-specific rather than genome-wide.

Prenatal exposure to undernutrition and programming of responses to high-fat feeding in the rat.

Fetal undernutrition programmes risk of later metabolic disorders. Postnatal factors modify the programmed phenotype. This study aimed to assess the effects of a postnatal high-fat (HF) challenge on body weight gain, adiposity and gene expression following prenatal undernutrition. Pregnant rats were fed either a control diet or a low-protein (LP) diet, targeted at days 0-7 (LPE), days 8-14 (LPM), or days 15-22 (LPL) gestation. At 12 weeks of age offspring were either fed standard laboratory chow diet (4.13 % fat), or a 39.5 % fat diet, for 10 weeks. LP exposure had no effect on weight gain or abdominal fat in males. Females exposed to LP diet in utero exhibited a similar weight gain on HF diet as on the chow diet. Programming of fat deposition was noted in LPE females and males of the LPM and LPL groups (P = 0.019). Hypothalamic expression of galanin mRNA was similar in all groups, but expression of the galanin-2 receptor was modified by LP exposure in female offspring. Hepatic expression of sterol response element binding protein (SREBP-1c) was decreased by LP at both the mRNA (P = 0.008) and protein (P < 0.001) level. HF feeding increased expression of SREBP-1c mRNA three-fold in controls, with little response noted in the LP groups. Interactions of factors such as postnatal diet, age and sex act together with prenatal factors to determine metabolic function and responsiveness at any stage of postnatal life. This study further establishes a role for prenatal nutrition in programming the genes involved in lipid metabolism and appetite regulation.

Increased systolic blood pressure in rats induced by a maternal low-protein diet is reversed by dietary supplementation with glycine.

When rat dams consume a diet low in protein during pregnancy, their offspring develop high blood pressure. On a low-protein diet, the endogenous formation of the amino acid glycine is thought to become constrained. Glycine may become conditionally essential, as its rate of endogenous formation is inadequate to meet metabolic needs, and may be limiting for the normal development of the fetus. In the present study, five groups of Wistar rats were provided during pregnancy with one of five diets: a control diet containing 18% (w/w) casein (CON), a low-protein diet containing 9% casein (MLP), or the low-protein diet supplemented with 3% glycine (MLPG), alanine (MLPA) or urea (MLPU). The offspring were weaned on to standard laboratory chow, and blood pressure was measured at 4 weeks of age. Blood pressure was significantly increased in the MLP, MLPA and MLPU groups compared with the CON group, but for the MLPG group blood pressure was not significantly different from CON. Compared with the CON group, body weight was significantly reduced for the MLP, MLPA and MLPG groups, but for the MLPU group body weight was not different from CON. These data show that different forms of non-essential dietary nitrogen, when consumed during pregnancy, exert different effects upon the growth and function of the offspring. The availability of glycine appears to be of critical importance for normal cardiovascular development.

Use of folic acid supplements in the first trimester of pregnancy.

Folic acid supplementation in the periconceptual period is known to reduce the risk of neural tube defects. High dose supplementation prevents a high proportion of recurrent defects, whilst low doses reduce the risk of first occurrences. The Department of Health advises all women considering pregnancy to take folate supplements for 12 weeks prior to conception and in the first trimester of pregnancy. Surveys of the British population indicate that the uptake of this advice is poor. The aim of the present study was to evaluate the uptake of advice in a group of Northampton women between January and June 2001. A total of 301 Caucasian women were recruited through an antenatal dating scan clinic. The women were aged between 16 and 42 years and completed a questionnaire concerning nutritional supplements prior to and during pregnancy and a five-day food diary, which was used to estimate dietary folate intakes. Of the women 67% consumed folate-containing supplements in the first trimester of pregnancy and 43% reported taking folate before becoming pregnant. Women under the age of 21 years were less likely to take folate supplements than women over the age of 21 years (p = 0.007), as were smokers (p < 0.001) and women from lower social classes. Mean folate intakes, including supplements, were 511 +/- 17 micrograms per day and unsupplemented dietary intakes were 237 +/- 5 micrograms per day. Of the women interviewed, 24.5% had folate intakes below the reference nutrient intake for pregnancy (300 micrograms per day). The data supports the assertion that neural tube defects are more likely to be prevented through the fortification of staple foods than through supplementation, but highlights the fact that young women from poor social backgrounds may still require close monitoring and support.