Effect of Vitamin D Supplementation in Early Life on Children's Growth and Body Composition: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Vitamin D deficiency during pregnancy or infancy is associated with adverse growth in children. No systematic review has been conducted to summarize available evidence on the effect of vitamin D supplementation in pregnancy and infancy on growth and body composition in children. OBJECTIVE: We aim to summarize the available evidence on the effect of vitamin D supplementation in pregnancy and infancy on child growth and body composition. METHOD: A systematic review and meta-analysis were performed on the effects of vitamin D supplementation during early life on children's growth and body composition (bone, lean and fat). A literature search of randomized controlled trials (RCTs) was conducted to identify relevant studies on the effects of vitamin D supplementation during pregnancy and infancy on children's body composition (bone, lean and fat) in PubMed, EMBASE and Cochrane Library from inception to 31 December 2020. A Cochrane Risk Assessment Tool was used for quality assessment. The comparison was vitamin D supplementation vs. placebo or standard care. Random-effects and fixed-effect meta-analyses were conducted. The effects are presented as mean differences (MDs) or risk ratios (RRs) with 95% confidence intervals (CIs). RESULTS: A total of 3960 participants from eleven randomized controlled trials were eligible for inclusion. Vitamin D supplementation during pregnancy was associated with higher triceps skinfold thickness (mm) (MD 0.33, 95% CI, 0.12, 0.54; I2 = 34%) in neonates. Vitamin D supplementation during pregnancy or infancy was associated with significantly increased length for age z-score in infants at 1 year of age (MD 0.29, 95% CI, 0.03, 0.54; I2 = 0%), and was associated with lower body mass index (BMI) (kg/m2) (MD -0.19, 95% CI -0.34, -0.04; I2 = 0%) and body mass index z-score (BMIZ) (MD -0.12, 95% CI -0.21, -0.04; I2 = 0%) in offspring at 3-6 years of age. Vitamin D supplementation during early life was not observed to be associated with children's bone, lean or fat mass. CONCLUSION: Vitamin D supplementation during pregnancy or infancy may be associated with reduced adiposity in childhood. Further large clinical trials of the effects of vitamin D supplementation on childhood body composition are warranted.

ERα Signaling in GHRH/Kiss1 Dual-Phenotype Neurons Plays Sex-Specific Roles in Growth and Puberty.

Gonadal steroids modulate growth hormone (GH) secretion and the pubertal growth spurt via undefined central pathways. GH-releasing hormone (GHRH) neurons express estrogen receptor α (ERα) and androgen receptor (AR), suggesting changing levels of gonadal steroids during puberty directly modulate the somatotropic axis. We generated mice with deletion of ERα in GHRH cells (GHRHΔERα), which displayed reduced body length in both sexes. Timing of puberty onset was similar in both groups, but puberty completion was delayed in GHRHΔERα females. Lack of AR in GHRH cells (GHRHΔAR mice) induced no changes in body length, but puberty completion was also delayed in females. Using a mouse model with two reporter genes, we observed that, while GHRHtdTom neurons minimally colocalize with Kiss1hrGFP in prepubertal mice, ∼30% of GHRH neurons coexpressed both reporter genes in adult females, but not in males. Developmental analysis of Ghrh and Kiss1 expression suggested that a subpopulation of ERα neurons in the arcuate nucleus of female mice undergoes a shift in phenotype, from GHRH to Kiss1, during pubertal transition. Our findings demonstrate that direct actions of gonadal steroids in GHRH neurons modulate growth and puberty and indicate that GHRH/Kiss1 dual-phenotype neurons play a sex-specific role in the crosstalk between the somatotropic and gonadotropic axes during pubertal transition.SIGNIFICANCE STATEMENT Late maturing adolescents usually show delayed growth and bone age. At puberty, gonadal steroids have stimulatory effects on the activation of growth and reproductive axes, but the existence of gonadal steroid-sensitive neuronal crosstalk remains undefined. Moreover, the neural basis for the sex differences observed in the clinical arena is unknown. Lack of ERα in GHRH neurons disrupts growth in both sexes and causes pubertal delay in females. Deletion of androgen receptor in GHRH neurons only delayed female puberty. In adult females, not males, a subset of GHRH neurons shift phenotype to start producing Kiss1. Thus, direct estrogen action in GHRH/Kiss1 dual-phenotype neurons modulates growth and puberty and may orchestrate the sex differences in endocrine function observed during pubertal transition.

Nutrition and growth in children.

The well-balanced nourishment during "the first 1000 days," the period between conception (day 18) and the age of two years, is quite important for two main reasons. Firstly, the nutritive requirement is high due to the rapid physiological growth and functional development. Then, this period is characterized by extreme susceptibility to external stimuli such as inadequate maternal and infant nutritional status which they can interfere with the different stages of the development process leading to short and long-term consequences for health. Linear growth and brain development are particularly impaired from not sufficient nutrition. In consideration of the irreversible damage of malnutrition, especially on developing brain, an adequate nutrition during the first 1000 days of life is paramount. The aim of this review was to overview the latest scientific evidences on the relationship between nutrition and growth, focusing on nutritional requirements during the first 1000 days, and the impact of inadequate nutrition on brain development and linear growth.

Effect of Nopal (Opuntia ficus indica) Consumption at Different Maturity Stages as an Only Calcium Source on Bone Mineral Metabolism in Growing Rats.

This work determines the effect nopal consumption at different maturity stages (60, 200, 400, and 600 g) as the only calcium source in bone metabolism. The apparent mineral absorption, the biomarkers of bone metabolism, the bone mineral density at different femoral regions, and crystal properties of the bone were evaluated during the growth stage. The Ca absorption was increased with the rat age in most of the experimental groups, while Mg supplementation decreased intestinal absorption probably due to a saturation process. Intestinal Ca and Mg absorption showed an opposite trend; this result suggests that both ions can compete for vitamin D absorption sites. The percentage of absorption of K was lower in the groups fed with Nopal; nevertheless, due to supplementation, the net absorption was higher than the control group. In all groups, osteocalcin levels decreased with the rat age. Nopal consumption increased osteocalcin levels during the adolescence stage in comparison to the control group. Amino N-terminal propeptide of type I procollagen levels increased in puberty and adolescence in all groups compared to the control group. Bone mineral density in different femoral regions was lower in the groups fed with nopal at early maturity stages (N-60 and N-200) than the groups fed with nopal at late maturity stages (N-400 and N-600). The crystal size of hydroxyapatite exhibited changes for all the groups, indicating the inclusion of mono and divalent ions in calcium replacement. On this basis, the nopal at late maturity stage contributed to bone formation.

Effect on Facial Growth of the Management of Cleft Lip and Palate.

Treatment of cleft lip and palate ordinarily requires multiple interventions spanning the time of birth to adulthood. Restriction of facial growth, a common occurrence in affected children, is due to multiple factors. There are multiple surgical and therapeutic options, which may have influence on facial growth in these patients. As restriction to facial development can have significant implications to form, function, and psychological well-being, practitioners should have an appreciation for the effects of the different cleft therapies to facial growth. We have outlined and thoroughly reviewed in chronological order all of the interventions from birth to adulthood necessary in the comprehensive care of the patient with cleft lip and palate, along with the effects they may or may not have on facial growth.

Which dietary components modulate longitudinal growth?

PURPOSE OF REVIEW: Linear growth in children is sensitive to nutritional status; the growth of the human skeleton requires many different nutritional factors for energy and building blocks: proteins, lipids, carbohydrates and micronutrients. However, what are the specific nutritional factors that are required for proper growth and what is the composition that will be most beneficial is still not known. RECENT FINDINGS: Recent findings indicate that macro and micronutrients are required as building blocks and as cofactors for important enzymes. In addition, they stimulate linear growth by acting as regulatory factors and also affect gut microbiome. Some interesting studies regarding the effect of proteins and amino acids are presented. SUMMARY: Most studies investigated the effect of replacing a single micronutrient that was deficient; however, in real life, deficiency of one nutritional element is commonly associated with other deficiencies. Therefore, it is a reasonable clinical approach, both in developing and developed countries, to use a mixture of both macro and micronutrients to support growth. How much of each of the components and what is the best composition are still open questions that require more research.

Dietary protein intake and quality in early life: impact on growth and obesity.

PURPOSE OF REVIEW: Obesity is an increasing problem and high-protein intake early in life seems to increase later risk of obesity. This review summarizes recent publications in the area including observational and intervention studies and publications on underlying mechanisms. RECENT FINDINGS: Recent observational and randomized controlled trials confirmed that high-protein intake in early life seems to increase early weight gain and the risk of later overweight and obesity. Recent studies have looked at the effect of different sources of protein, and especially high-animal protein intake seems to have an effect on obesity. Specific amino acids, such as leucine, have also been implicated in increasing later obesity risk maybe via specific actions on insulin-like growth factor I. Furthermore, additional underlying mechanisms including epigenetics have been linked to long-term obesogenic programming. Finally, infants with catch-up growth or specific genotypes might be particularly vulnerable to high-protein intake. SUMMARY: Recent studies confirm the associations between high-protein intake during the first 2 years and later obesity. Furthermore, knowledge of the mechanisms involved and the role of different dietary protein sources and amino acids has increased, but intervention studies are needed to confirm the mechanisms. Avoiding high-protein intake in early life holds promise as a preventive strategy for childhood obesity.

Age of introduction of first complementary feeding for infants: a systematic review.

BACKGROUND: Despite a World Health Organization recommendation for exclusive breastfeeding of all full-term infants to 6 months of age, it is not clear what the health implications may be. Breast milk alone may not meet the nutrition needs for all growing infants, leaving them at risk for deficiencies. The objective of this study was to investigate the relationship between moderate (4 months) versus late (6 months) introduction of complementary foods to the full-term breastfed infant on iron status and growth. METHODS: An electronic search of peer-reviewed and gray-literature was conducted for randomized control trials (RCTs) and observational studies related to the timing of introduction of complementary foods. Iron status and growth data from the relevant RCTs were analyzed using RevMan 5.2.11. RESULTS: Three RCTs and one observational study met the inclusion criteria. Meta-analysis showed significantly higher hemoglobin levels in infants fed solids at 4 months versus those fed solids at 6 months in developing countries [mean difference [MD]: 5.0 g/L; 95% CI: 1.5, 8.5 g/L; P = 0.005]. Meta-analysis also showed higher serum ferritin levels in the 4-month group in both developed and developing countries [MD: 26.0 µg/L; 95% CI: -0.1, 52.1 µg/L, P = 0.050], [MD: 18.9 µg/L; 95% CI: 0.7, 37.1 µg/L, P = 0.040]. Short follow-up periods and small sample sizes of the included studies were the major limitations. CONCLUSIONS: RCT evidence suggests the rate of iron deficiency anemia in breastfed infants could be positively altered by introduction of solids at 4 months.

Effect of integrated responsive stimulation and nutrition interventions in the Lady Health Worker programme in Pakistan on child development, growth, and health outcomes: a cluster-randomised factorial effectiveness trial.

BACKGROUND: Stimulation and nutrition delivered through health programmes at a large scale could potentially benefit more than 200 million young children worldwide who are not meeting their developmental potential. We investigated the feasibility and effectiveness of the integration of interventions to enhance child development and growth outcomes in the Lady Health Worker (LHW) programme in Sindh, Pakistan. METHODS: We implemented a community-based cluster-randomised effectiveness trial through the LHW programme in rural Sindh, Pakistan, with a 2 × 2 factorial design. We randomly allocated 80 clusters (LHW catchments) of children to receive routine health and nutrition services (controls; n=368), nutrition education and multiple micronutrient powders (enhanced nutrition; n=364), responsive stimulation (responsive stimulation; n=383), or a combination of both enriched interventions (n=374). The allocation ratio was 1:20 (ie, 20 clusters per intervention group). The data collection team were masked to the allocated intervention. All children born in the study area between April, 2009, and March, 2010, were eligible for enrolment if they were up to 2·5 months old without signs of severe impairments. Interventions were delivered by LHWs to families with children up to 24 months of age in routine monthly group sessions and home visits. The primary endpoints were child development at 12 and 24 months of age (assessed with the Bayley Scales of Infant and Toddler Development, Third Edition) and growth at 24 months of age. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT007159636. FINDINGS: 1489 mother-infant dyads were enrolled into the study, of whom 1411 (93%) were followed up until the children were 24 months old. Children who received responsive stimulation had significantly higher development scores on the cognitive, language, and motor scales at 12 and 24 months of age, and on the social-emotional scale at 12 months of age, than did those who did not receive the intervention. Children who received enhanced nutrition had significantly higher development scores on the cognitive, language, and social-emotional scales at 12 months of age than those who did not receive this intervention, but at 24 months of age only the language scores remained significantly higher. We did not record any additive benefits when responsive stimulation was combined with nutrition interventions. Responsive stimulation effect sizes (Cohen's d) were 0·6 for cognition, 0·7 for language, and 0·5 for motor development at 24 months of age; these effect sizes were slightly smaller for the combined intervention group and were low to moderate for the enhanced nutrition intervention alone. Children exposed to enhanced nutrition had significantly better height-for-age Z scores at 6 months (p<0·0001) and 18 months (p=0·02) than did children not exposed to enhanced nutrition. Longitudinal analysis showed a small benefit to linear growth from enrolment to 24 months (p=0·026) in the children who received the enhanced nutrition intervention. INTERPRETATION: The responsive stimulation intervention can be delivered effectively by LHWs and positively affects development outcomes. The absence of a major effect of the enhanced nutrition intervention on growth shows the need for further analysis of mediating variables (eg, household food security status) that will help to optimise future nutrition implementation design. FUNDING: UNICEF.

Striae distensae: a comprehensive review and evidence-based evaluation of prophylaxis and treatment.

Striae distensae are an extremely common, therapeutically challenging form of dermal scarring. Risk factors have been reported but much remains to be understood about their epidemiology, diagnosis and treatment. Up-to-date knowledge of the scientific research and the evidence behind both preventative and therapeutic agents are vital in order to understand striae and to offer patients the best therapeutic alternatives. We present a clinical review of the current literature concerning striae distensae and their prevention and treatment. A systematic review of the literature was undertaken using Medline, Embase and Google Scholar. Articles in English, Spanish, Portuguese, Turkish and French were included. Striae distensae occur in pregnancy, puberty and obesity as well as in numerous medical conditions and following therapeutic interventions. Proposed aetiological mechanisms relate to hormones, physical stretch and structural alterations to the integument. Assessment methods include subjective visual scoring and various imaging modalities. Treatments that we have evaluated include topical agents, used prophylactically or therapeutically, as well as light and laser therapies, which have shown improvements in the appearance of striae. Few high level evidence based medicine randomized controlled trials evaluating treatments for striae distensae exist. Topical therapeutic agents appear to lack efficacy in the prevention of striae distensae.

Maternal obesity impairs brain glucose metabolism and neural response to hyperglycemia in male rat offspring.

Hypothalamic appetite regulators neuropeptide Y (NPY) and pro-opiomelanocortin (POMC) are modulated by glucose. This study investigated how maternal obesity disturbs glucose regulation of NPY and POMC, and whether this deregulation is linked to abnormal hypothalamic glucose uptake-lactate conversion. As post-natal high-fat diet (HFD) can exaggerate the effects of maternal obesity, its additional impact was also investigated. Female Sprague Dawley rats were fed a HFD (20 kJ/g) to model maternal obesity. At weaning, male pups were fed chow or HFD. At 9 weeks, in vivo hypothalamic NPY and POMC mRNA responses to acute hyperglycemia were measured; while hypothalami were glucose challenged in vitro to assess glucose uptake-lactate release and related gene expression. Maternal obesity dampened in vivo hypothalamic NPY response to acute hyperglycemia, and lowered in vitro hypothalamic glucose uptake and lactate release. When challenged with 20 mM glucose, hypothalamic glucose transporter 1, monocarboxylate transporters, lactate dehydrogenase-b, NPY and POMC mRNA expression were down-regulated in offspring exposed to maternal obesity. Post-natal HFD consumption reduced in vitro lactate release and monocarboxylate transporter 2 mRNA, but increased POMC mRNA levels when challenged with 20 mM glucose. Overall, maternal obesity produced stronger effects than post-natal HFD consumption to impair hypothalamic glucose metabolism. However, they both disturbed NPY response to hyperglycemia, potentially leading to hyperphagia.

Diversidad alimentaria y su asociación con el retraso del crecimiento en niños de 6-23 meses. Perú, 2008-2010 / Dietary diversity and its association with growth retardation in children aged 6-23 months. Peru, 2008-2010

Objetivo. Analizar la situación de la diversidad alimentaria (DA) en niños de 6-23 meses en Perú, ysu relación con el crecimiento infantil y factores sociodemográficos asociados. Material ymétodos. La presente tesis constituye un análisis secundario del Monitoreo Nacional deIndicadores Nutricionales (MONIN) 2008-2010. Se construyeron puntajes de DiversidadAlimentaria (DA) según lo propuesto por la Organización Mundial de la Salud. Se describió lasituación de la DA según características de la madre, el niño y los hogares. Asimismo, se empleó unmodelo de regresión logística para estimar la asociación entre el retraso de crecimiento y la DA,ajustado por potenciales variables de confusión. (...) Conclusiones. La alimentación del niño de 6-23 meses en Perú esmonótona, con un bajo consumo generalizado de alimentos de origen animal. Mejorar la ingesta demicronutrientes y las prácticas de alimentación complementaria, especialmente a través de ladiversificación de la dieta son aspectos cruciales para prevenir el retraso de crecimiento. Debendesarrollarse estudios para definir cuestiones metodológicas, y examinar la relación entre DA yaspectos como seguridad alimentaria, adecuación nutricional y exceso de peso, que permitan su usoen diferentes condiciones y contextos.

Objective. To analyze the dietary diversity (DD) situation in Peruvian children aged 6-23months, and its relationship to child growth and associated socio-demographic factors.Material and methods. This thesis is a secondary analysis of the National Surveillance ofNutritional Indicators (MONIN) 2008-2010. Dietary diversity (DD) score was constructedaccording to suggested by the World Health Organization. The status of DD was described bycharacteristics of the mother, child and households. Also, it was used a logistic regressionmodel to estimate the association between stunting and DD, model was adjusted by potentialconfounding variables. (...) Conclusions. Diet of Peruvian children 6-23 months is monotonous, generally poorin animal source foods. Improve micronutrient intake and complementary feeding practices,especially through diet diversification are crucial to prevent stunting. Studies to definemethodological aspects and examine the relationship between DD and issues such as foodsecurity, nutritional adequacy and excess weight, appropriate to be used in different contexts,should be developed.

Efecto del zinc sobre el crecimiento lineal en menores de cinco años de Latinoamérica; revisión sistemática / Efficacy of zinc on lineal growth on latin american children younger than 5 y; systematic review

Antecedentes: En la mayoría de los países latinoamericanos existe una deficiencia de micronutrientes, retraso en el crecimiento, y altas tasas de morbilidad y mortalidad infantil. En la actualidad se ha asociado la deficiencia de zinc con el retraso del crecimiento infantil. El propósito de esta revisión, fue analizar artículos sobre estudios aleatorizados que evaluaron el efecto de la suplementación con zinc y el crecimiento infantil. Metodología: Se realizó una búsqueda electrónica de la literatura en la base de datos de PubMed con las palabras claves “Micronutrient supplementation and growth”, publicados de enero de 2005 a abril de 2013. Se identificaron 34 estudios aleatorizados controlados (EAC) realizados en Latinoamérica, de los cuales cinco reunieron los criterios de inclusión. Se añadió un estudio referido por otros autores. Resultados: Los estudios se realizaron en Brasil, Cuba, Perú, Ecuador, y Guatemala. En ningún estudio se observó el efecto positivo del zinc sobre el crecimiento lineal. Conclusión: La revisión realizada sugiere que la suplementación con zinc no tiene un efecto significativo sobre el crecimiento lineal; sin embargo, podría tener beneficios sobre el crecimiento en niños con deficiencia de zinc si se añaden otros nutrientes en deficiencia (AU)

BACKGROUND: In most Latin American countries, the prevalence of micronutrient deficiencies, growth stunting, morbidity and mortality are highly present in children. Single micronutrient deficiencies such as zinc have been associated to growth retardation. The purpose of this study was to conduct a systematic review of randomized control trials that examined the association between zinc supplementation and children s growth in Latin America.METHODOLOGY: An electronic literature search was conducted with the keywords "Micronutrients supplementation and growth" in the PubMed databases, of RCT, published from January 2005 to April 2013. There were 279 RCT found assessing the effect of zinc supplementation on linear growth; 34 were conducted in Latin American countries, of which five met the inclusion criteria. A study referred by other authors was also included.RESULTS: Six studies were analyzed. The studies were conducted in Brazil, Cuba, Peru, Ecuador, and Guatemala. None of the studies analyzed observed the positive effect of zinc on lineal growth.CONCLUSIONS: The conducted review suggests that zinc supplementation has not a significant effect on linear growth; however, zinc supplementation might be beneficial over lineal growth to zinc-deficient children, if other deficient nutrients are added (AU)

Early growth and postprandial appetite regulatory hormone responses.

Strong epidemiological evidence suggests that slow prenatal or postnatal growth is associated with an increased risk of CVD and other metabolic diseases. However, little is known whether early growth affects postprandial metabolism and, especially, the appetite regulatory hormone system. Therefore, we investigated the impact of early growth on postprandial appetite regulatory hormone responses to two high-protein and two high-fat content meals. Healthy, 65-75-year-old volunteers from the Helsinki Birth Cohort Study were recruited; twelve with a slow increase in BMI during the first year of life (SGI group) and twelve controls. Subjects ate a test meal (whey meal, casein meal, SFA meal and PUFA meal) once in a random order. Plasma glucose, insulin, TAG, NEFA, ghrelin, peptide tyrosine-tyrosine (PYY), glucose-dependent insulinotropic peptide, glucagon-like peptide-1 and a satiety profile were measured in the fasting state and for 4 h after each test meal. Compared with the controls, the SGI group had about 1·5-fold higher insulin responses after the whey meal (P= 0·037), casein meal (P= 0·023) and PUFA meal (P= 0·002). TAG responses were 34-69 % higher for the SGI group, but only the PUFA-meal responses differed significantly between the groups. The PYY response of the SGI group was 44 % higher after the whey meal (P= 0·046) and 115 % higher after the casein meal (P= 0·025) compared with the controls. No other statistically significant differences were seen between the groups. In conclusion, early growth may have a role in programming appetite regulatory hormone secretion in later life. Slow early growth is also associated with higher postprandial insulin and TAG responses but not with incretin levels.

Effect of dietary vitamin E and selenium supplementation on growth, body composition, and antioxidant defense mechanism in juvenile largemouth bass (Micropterus salmoides) fed oxidized fish oil.

Six oxidized fish oil contained diets were formulated to investigate the effect of graded levels of vitamin E (V(E)) (α-tocopherol acetate: 160, 280, and 400 mg kg(-1)) associated with either 1.2 or 1.8 mg kg(-1) selenium (Se) on growth, body composition, and antioxidant defense mechanism of juvenile largemouth bass. Another control diet containing fresh fish oil with 160 mg kg(-1) V(E) and 1.2 mg kg(-1) Se was also prepared. Over a 12-week feeding trial, about 5 % of Micropterus salmoide fed diet OxSe1.2/V(E)160 showed inflammation and hemorrhage symptoms at the base of dorsal, pectoral, and tail fin. Fish in all treatments survived well (above 90 %). Feed intakes (88.42-89.58 g fish(-1)) of all treatments were comparable. Growth performances (weight gain and specific growth rate) and feed utilization (feed and protein efficiency ratio) were significantly impaired by dietary oil oxidation, and they did not benefit from neither V(E) nor Se supplementation. Regardless of dietary V(E) and Se supplementation, oxidized oil ingestion resulted in markedly decreased hepatosomatic index and intraperitoneal fat ratio. Oxidized oil ingestion also induced markedly lower liver and muscle lipid contents, and these effects could be alleviated by dietary Se supplementation. Dietary oil oxidation stimulated hepatic catalase activities relative to the control, and supplementation of V(E) abrogated this effect. Hepatic reduced glutathione content in the control was markedly higher than that of treatment OxSe1.2/V(E)160, without any significant differences comparing with the other oxidized oil receiving groups. Hepatic glutathione peroxidase activity and liver Se concentration reflected dietary Se profile, whereas liver V(E) level reflected dietary V(E) profile. Compared with the control, fish fed diet OxSe1.2/V(E)160 obtained markedly higher serum, liver and muscle malondialdehyde contents, which droppe significantly with increasing either V(E) or Se supplementation. In conclusion, the overall results in this study suggested that both V(E) and Se inclusion could protect largemouth bass from the oxidative damage challenged by dietary oil oxidation.

Macronutrient-induced differences in food intake relate with hepatic oxidative metabolism and hypothalamic regulatory neuropeptides in rainbow trout (Oncorhynchus mykiss).

This study examines how dietary macronutrient-induced changes in voluntary food intake (FI) relate to changes in markers of hepatic oxidative metabolism and in the expression of FI regulatory neuropeptides in a teleost model, the rainbow trout. Rainbow trout were fed for 6weeks with one of four iso-energetic diets (2×2 factorial design), containing either a high (HP, ~500 g·kg(-1) DM) or a low (LP, ~250 g·kg(-1) DM) protein level (PL) with, at each PL, fat (diets HP-F and LP-F) being substituted by an iso-energetic amount of gelatinized corn starch (diets HP-St and LP-St) as non-protein energy source (ES). Irrespective of the dietary PL, FI (g·kg(-0.8)·d(-1)) and digestible energy intake (DEI, kJ·kg(-0.8)·d(-1)) were significantly (P<0.05) reduced by the iso-energetic replacement of fat by starch as non-protein ES. Interestingly, trout fed these St-diets had higher gene expression of markers of hepatic oxidative phosphorylation (OxPhos), i.e., ubiquinol-cytochrome c reductase subunit 2 (UCR2) and cytochrome oxidase subunit 4 (COX4) and of aerobic oxidative capacity (CS, citrate synthase), which paralleled glucokinase (GK) transcription. This positive relation suggests that glucose phosphorylation and markers of mitochondrial OxPhos are linked at the hepatic level and possibly triggered the observed reduction in FI. Moreover, trout displaying the reduced FI had higher cocaine amphetamine regulator transcript (CART) mRNA in hypothalamus, whereas neuropeptide Y (NPY) mRNA did not follow the macronutrient-induced changes in FI. Further studies are needed to unravel the mechanisms by which diet-induced changes in hepatic metabolism inform central feeding centers involved in the regulation of FI in fish.

Protein and micronutrient supplementation in complementing pubertal growth.

For several reasons, adolescence is considered as a nutritionally critical period of life. The dramatic increase in physical growth and development puts greater pressure on the need for nutrients, as it is during this period when adolescents experience a weight gain equivalent to 65% of their weight at the beginning of the period or 40% of their final weight, and a height gain equivalent to 15% of their adult height. The requirement of some of the nutrients is as high as, or higher in adolescents than in any other age groups. Moreover, adolescence is a time where the life-style and food habits are influenced by socio-cultural factors resulting in an imbalance in nutrient intake and nutrient inadequacy can result in delayed sexual maturation and can arrest or slow linear growth. With the increasing prevalence of hidden malnutrition among Indian children, adolescence can be the second opportunity to catch up growth and cover the deficits suffered during childhood and to meet the demands of physical and cognitive growth and development, provide adequate stores of energy for illnesses and pregnancy, and prevent adult onset of nutrition-related diseases. Adolescents should be recognized as a priority target group as an integral part of health promotion and optimal nutrition through balanced diet and nutrient supplementation should be promoted in conjunction with healthy eating habits and physical activity.

Does vitamin D during pregnancy impact offspring growth and bone?

During pregnancy, maternal and fetal Ca demands are met through increased intestinal Ca absorption. Increased Ca absorption may be more dependent on oestrogen's up-regulation of Ca transport genes than on vitamin D status. Numerous studies, however, have found that severe vitamin D deficiency with secondary hyperparathyroidism during pregnancy leads to abnormal Ca homoeostasis in the neonate. Some, but not all, studies of maternal vitamin D supplementation during pregnancy find a greater birth weight among infants of mothers with adequate vitamin D status. Observational studies find a higher incidence of small-for-gestational age (SGA) infants among mothers who are vitamin D deficient, but this effect may be modified by genetics. In addition, the effect of vitamin D status on SGA may not be linear, with increased occurrence of SGA at high maternal 25-hydroxyvitamin D (25-OHD) concentrations. Some studies, but not all, also have found that maternal vitamin D status is associated with growth trajectory during the first year of life, although the findings are contradictory. There are recent studies that suggest maternal 25-OHD, or surrogates of vitamin D status, are associated with growth and bone mass later in childhood. These results are not consistent, and blinded randomised trials of vitamin D supplementation during pregnancy with long-term follow-up are needed to determine the benefits, and possible risks, of maternal vitamin D status on offspring growth and bone development. The possibility of adverse outcomes with higher maternal 25-OHD concentrations should be considered and investigated in all ongoing and future studies.