A multifaceted assessment of the nutritional status, diet and eating habits of midwives working on a shift schedule in Wroclaw, Poland: evaluation of macronutrients, vitamins and minerals in the diets of midwives participating in the study.

OBJECTIVES: The aim of the study was to assess the nutritional status and diet of midwives working on a shift schedule in public hospitals in Wroclaw, Poland, and to analyze the variation in their diet according to their working hours (day shift, night shift) and on a non-working day. MATERIAL AND METHODS: In the group of 50 midwives, employed in 4 public hospitals in Wroclaw weight and body composition, waist and hip circumference, waist-hip-ratio and BMI were assessed. The nutritional habits and quality of the study participants' diets were assessed by 3-days food dietary recall, including 1 day shift day, 1 night shift day, and 1 non-working day. RESULTS: More than half of the subjects were assessed as having excess body weight (BMI ≥25 kg/m2). Thirty percent of participants had BMI ≥25-<30 kg/m2 and 24% BMI ≥30 kg/m2, 70% had a body fat percentage >30%. Fifty-six percent of the diets had an energy value <90% of the subject's total daily energy expenditure. Significantly higher energy value of diets on the night shift day compared to the morning shift day (1959.05±596.09 kcal vs. 1715.36±654.55 kcal, p = 0.01) were observed. The same relationship applied to cholesterol content (349.50±155.33 mg vs. 261.39±190.59 mg, p = 0.002). A high intake of phosphorus and sodium, exceeding the recommended dietary intake, was noticed. CONCLUSIONS: The occurrence of a night shift in the shift work schedule is an element of that model that may have a significant impact on the nutritional and health value of shift workers' diets. Therefore, it seems reasonable to implement nutritional education programs promoting healthy eating choices and habits during night work. Int J Occup Med Environ Health. 2023;36(5):618-31.

Normal range and predictors of serum erythroferrone in infants.

BACKGROUND: Erythroferrone (ERFE) has been identified as a hepcidin-regulating hormone synthetized by erythroblasts correlating to the erythropoietic activity and the needs for iron substrate in bone marrow of adults. The present study aimed to assess the ERFE serum concentrations and its predictors in infants. METHODS: ERFE was explored at 4 time points during the first year of life in 45 healthy, breastfed, normal birth weight (NBW) infants, and 136 marginally low birth weight infants (LBW, 2000-2500 g) receiving iron (N = 58) or placebo (N = 78) between 6 weeks and 6 months of age. RESULTS: ERFE concentrations were low at birth, increasing gradually during the first year of life. In NBW infants, reference ranges (5th to 95th percentile) were at 6 weeks <0.005-0.99 ng/mL and at 12 months <0.005-33.7 ng/mL. ERFE was higher in LBW infants at 6 weeks but lower at 12 months compared to NBW and minimally affected by iron supplementation among LBW infants. Correlations of ERFE with erythropoietic and iron status markers were weak and inconsistent. CONCLUSIONS: The role of ERFE in the crosstalk of erythropoiesis and iron homeostasis remains unclear in infants and further studies on ERFE in infants and older children are warranted within the framework of the erythropoietin-ERFE-hepcidin axis. IMPACT: Normal range of erythroferrone in healthy infants is described for the first time. Erythroferrone in infants lacks correlation to iron status and markers of erythropoiesis. The findings indicate differences in infant regulation of iron homeostasis as compared to adults. The findings point to a need to study infant erythropoiesis separately from its adult counterpart. The findings may have clinical impact on management strategies of iron-loading anemia in infancy.

Evaluation of Supplement Use in Sport Climbers at Different Climbing Levels.

The lack of specific recommendations on the use of supplements for sport climbers may be the reason for their misuse by athletes of this discipline. This study aimed to evaluate choices of dietary supplementation, the reasons for taking them, and the source of information on supplementation among sport climbers at different levels. In addition, how climbers subjectively evaluated the impact of their diets in supporting selected aspects of climbing training was evaluated. We enrolled 110 regular sport climbers (40 women and 70 men) from Wroclaw, Poland, who completed a validated questionnaire, assessing their use of dietary supplements, attitudes towards the influence of diet on sports performance, and climbing level. Their anthropometric measurements were also collected. Participants regarded diet as an important element of sports performance. Sport climbers indicated the Internet to be the main source of information on supplements. Health maintenance and improvement of recovery were the most frequently chosen reasons for taking dietary supplements. The most common supplements were isolated protein, vitamin C, vitamin D, magnesium, and amino acid blends. However, participants rarely used supplements suggested as beneficial for sport climbing performance. Therefore, developing recommendations for supplementation in sport climbing and promoting this should be an elementary part of the preparation for climbing training.

Effects of prenatal and/or postnatal supplementation with iron, PUFA or folic acid on neurodevelopment: update.

Neurodevelopment has been linked, among other factors, to maternal and early infant diets. The objective of this review, which is part of the NUTRIMENTHE research project 'The effect of diet on the mental performance of children' (www.nutrimenthe.com), was to update current evidence on the effects of nutritional interventions such as iron, folic acid or n-3 long-chain polyunsaturated fatty acid (LCPUFA) supplementation during pregnancy and/or in early life on the mental performance and psychomotor development of children. In May 2014, we searched MEDLINE and The Cochrane Database of Systematic Reviews for relevant studies published since 2009. The limited updated evidence suggests that iron supplementation of infants may positively influence the psychomotor development of children, although it does not seem to alter their mental development or behaviour. The use of multivitamin-containing folic acid supplements during pregnancy did not benefit the mental performance of the offspring. Evidence from randomised controlled trials (RCT) did not show a clear and consistent benefit of n-3 LCPUFA supplementation during pregnancy and/or lactation on childhood cognitive and visual development. Caution is needed when interpreting current evidence, as many of the included trials had methodological limitations such as small sample sizes, high attrition rates, and no intention-to-treat analyses. Taken together, the evidence is still inconclusive. Large, high-quality RCT to assess the effects of supplementation with iron, LCPUFA or folic acid are still needed to further clarify the effects of these, and other nutrients, on neurodevelopment. Recent recommendations from scientific societies are briefly presented.

Role of iodine-containing multivitamins during pregnancy for children's brain function: protocol of an ongoing randomised controlled trial: the SWIDDICH study.

INTRODUCTION: Iodine is essential for normal brain development. Moderate and severe fetal iodine deficiency results in substantial to serious developmental delay in children. Mild iodine deficiency in pregnancy is associated with neurodevelopmental deficits in the offspring, but evidence from randomised trials is lacking. The aim of the Swedish Iodine in Pregnancy and Development in Children study is to determine the effect of daily supplementation with 150 µg iodine during pregnancy on the offspring's neuropsychological development up to 14 years of age. METHODS AND ANALYSIS: Thyroid healthy pregnant women (n=1275: age range 18-40 years) at ≤12 weeks gestation will be randomly assigned to receive multivitamin supplements containing 150 µg iodine or non-iodine-containing multivitamin daily throughout pregnancy. As a primary outcome, IQ will be measured in the offspring at 7 years (Wechsler Intelligence Scale for Children-V). As secondary outcomes, IQ will be measured at 3.5 and 14 years, psychomotor development at 18 months and 7 years, and behaviour at 3.5, 7 and 14 years. Iodine status (urinary iodine concentration) will be measured during pregnancy and in the offspring at 3.5, 7 and 14 years. Thyroid function (thyroid hormones, thyroglobulin), and deiodinase type 2 polymorphisms will be measured during pregnancy and in the offspring at 7 and 14 years. Structural MRI or other relevant structural or functional brain imaging procedures will be performed in a subgroup of children at 7 and 14 years. Background and socioeconomic information will be collected at all follow-up times. ETHICS AND DISSEMINATION: This study is approved by the Ethics Committee in Göteborg, Sweden (Diary numbers: 431-12 approved 18 June 2012 (pregnancy part) and 1089-16 approved 8 February 2017 (children follow-up)). According to Swedish regulations, dietary supplements are governed by the National Food Agency and not by the Medical Product Agency. Therefore, there is no requirement for a monitoring committee and the National Food Agency does not perform any audits of trial conduct. The trial will be conducted in accordance with the Declaration of Helsinki. The participating sites will be contacted regarding important protocol changes, both orally and in writing, and the trial registry database will be updated accordingly. Study results will be presented at relevant conferences, and submitted to peer-reviewed journals with open access in the fields of endocrinology, paediatrics and nutrition. After the appropriate embargo period, the results will be communicated to participants, healthcare professionals at the maternal healthcare centres, the public and other relevant groups, such as the national guideline group for thyroid and pregnancy and the National Food Agency. TRIAL REGISTRATION NUMBER: NCT02378246; Pre-results.

Effects of iron supplementation of low-birth-weight infants on cognition and behavior at 7 years: a randomized controlled trial.

BackgroundLow-birth-weight infants (LBW) are at an increased risk of iron deficiency that has been associated with impaired neurodevelopment. We hypothesized that iron supplementation of LBW infants improves cognitive scores and reduces behavioral problems until school age.MethodsWe randomized 285 marginally LBW (2,000-2,500 g) infants to receive 0, 1, or 2 mg/kg/day of iron supplements from 6 weeks to 6 months of age. At 7 years of age, 205 participants were assessed regarding cognition using Wechsler Intelligence Scale for Children (WISC-IV) and behavior using the parental questionnaires Child Behavior Checklist (CBCL) and Five to Fifteen (FTF).ResultsThere were no significant differences between the intervention groups in WISC-IV or FTF. However, the CBCL scores for externalizing problems were significantly different, in favor of supplemented children (P=0.045). When combining the supplemented groups, they had significantly lower scores for externalizing behavior compared with placebo (median (interquartile range): 44 [34;51] vs. 48.5 [41;56] P=0.013), and their risk ratio (95% confidence interval) for a total behavioral score above the cutoff for clinical problems was 0.31 (0.09-1.0), P=0.054.ConclusionLower scores of externalizing behavior in supplemented children support our previous findings at 3 years, and suggest that iron supplementation may have long-lasting effects on behavioral functions.

Effect of iron supplementation on psychomotor development of non-anaemic, exclusively or predominantly breastfed infants: a randomised, controlled trial.

INTRODUCTION: Uncertainty exists regarding the effects of iron supplementation during infancy on neurodevelopmental outcomes in the absence of anaemia. The aim of the study is to establish whether psychomotor and mental development is influenced by early iron supplementation in healthy, non-anaemic, exclusively or predominantly breastfed infants. METHODS AND ANALYSIS: Healthy term infants will be recruited. If exclusively or predominantly breast fed (>50% of daily feedings) and not anaemic at 4 months, they will be randomised to receive either iron pyrophosphate (approximately 1 mg/kg) or placebo daily until 9 months of age. The primary outcome measure is neurodevelopment assessed with the Bayley Scales of Infant and Toddler Development (Bayley-III) at 12 months, and repeated at 24 and 36 months of age. Haematological parameters of iron metabolism also will be measured. ETHICS AND DISSEMINATION: The Bioethics Committee of the Medical University of Warsaw approved the study protocol before recruitment started. Study results will be submitted to peer-reviewed journals in the fields of paediatrics and nutrition, and presented at relevant conferences. TRIAL REGISTRATION NUMBER: NCT02242188.

The effect of glucomannan on body weight in overweight or obese children and adults: a systematic review of randomized controlled trials.

OBJECTIVE: Glucomannan (GM), a soluble fiber derived from the plant Amorphophallus konjac, is marketed as being helpful in reducing body weight. However, the data supporting this claim are scarce. The aim of this review was to systematically evaluate the effects of GM on body weight (BW) and body mass index (BMI) in otherwise healthy obese or overweight children and adults. METHODS: MEDLINE, EMBASE, CENTRAL, and Google Scholar databases were systematically searched up to June 2014 for randomized controlled trials (RCTs) assessing the effectiveness of GM versus placebo. The primary outcome measures were BW and BMI. RESULTS: Six eligible RCTs, only one of which performed in children, were included. In adults, three RCTs reported a significant reduction in BW in the GM group compared with the control group at the following different points during the intervention: At week 2 (mean difference [MD], 0.21 kg; 95% confidence interval [CI], 0.13-0.29); at week 4 (MD, 2.04; 95% CI, 0.52-3.56); at week 5 (MD, 1.3; 95% CI, 0.89-1.71); and at week 8 (MD, 3.17; 95% CI, 1.29-5.05). Only one RCT reported a beneficial effect at more than one point. None of the RCTs reported a favorable effect of GM on BMI. CONCLUSIONS: In otherwise healthy overweight or obese adults, there is some evidence that in the short term GM may help to reduce BW, but not BMI. Data in children are too limited to draw any conclusions.

Effects of iron supplementation in nonanemic pregnant women, infants, and young children on the mental performance and psychomotor development of children: a systematic review of randomized controlled trials.

BACKGROUND: Uncertainty exists regarding the effects of iron supplementation on neurodevelopmental outcomes in the absence of anemia. OBJECTIVE: Our objective was to evaluate the effects of iron supplementation in nonanemic pregnant women and in nonanemic healthy children aged <3 y on the mental performance and psychomotor development of children. DESIGN: In this systematic review, MEDLINE, EMBASE, and The Cochrane Library were searched through December 2009 for randomized controlled trials (RCTs). RESULTS: None of 5 RCTs individually showed a beneficial effect of iron supplementation during early life on the Mental Developmental Index of the Bayley Scales of Infant Development at different ages throughout the first 18 mo. Meta-analysis of 3 RCTs (n = 561) showed that, compared with placebo, supplementation with iron had no significant effect on children's Mental Developmental Index at approximately 12 mo of age (weighted mean difference: 1.66; 95% CI: -0.14, 3.47). Three of 5 RCTs showed a beneficial effect of iron supplementation on the Psychomotor Development Index at some time points, whereas 2 did not. Meta-analysis of 3 RCTs (n = 561) showed significant improvement on the Psychomotor Development Index at approximately 12 mo of age in the iron-supplemented group compared with the control group (weighted mean difference: 4.21; 95% CI: 2.31, 6.12). Two RCTs showed no effect of iron supplementation on behavior. Neither of the 2 RCTs that addressed the influence of prenatal iron supplementation showed an effect of iron on either the intelligence quotient or behavioral status of the children. CONCLUSION: Limited available evidence suggests that iron supplementation in infants may positively influence children's psychomotor development, whereas it does not seem to alter their mental development or behavior.