Childhood obesity--the diagnosis and management.

We do not, at present, understand the cause of obesity in children. Realising this, we should not pretend to be able to 'cure' obesity, rather we should promote a management programme that provides 'benefit' for the obese child. The value of triiodothyronine (T3) appears to be related to its role in promoting carbohydrate utilisation for energy production. The current hypothesis endorses this action and thus it might provide us with a better understanding of the nature of childhood obesity. There is no place for dietary restriction in the treatment of an obese child as it is a further damaging event in the unhappy life of such a child.

Effects of time of dose in relation to food on the bioavailability of Theo-Dur Sprinkle at steady state in asthmatic children.

The effects of administration of Theo-Dur Sprinkle in the fasting state (phase A), 10 minutes before food (phase B), and immediately after food (phase C) were investigated in 12 children with asthma aged 5 to 9 years at steady state. The AUC during the dosing interval was significantly reduced in phases B and C compared with phase A, and bioavailability relative to the fasting state was reduced to 77% +/- 15% (range 61% to 104%) in phase B and 70% +/- 16% (range 40% to 103%) in phase C. The average plasma theophylline concentration during the dosing interval and Cmax were also significantly reduced in phases B and C compared with phase A. The morning predose plasma theophylline concentration in phase B was 22% lower than the predose concentration with Theo-Dur tablets taken 10 minutes before breakfast. The diurnal variation in predose plasma theophylline concentrations was increased from 28% in phase A to 63% in phase C. There was no significant difference in any parameter between administration 10 minutes before food and immediately after food.

Fatty acid composition of breast milk from three racial groups from Penang, Malaysia.

The fatty acid composition of samples of breast milk obtained from 51 mothers (26 Malay, 15 Chinese, 10 Indian) residing in Penang, Malaysia was determined by gas chromatography. Despite living in close physical proximity the mothers from the three racial groups showed distinct cultural differences in dietary intake. These differences were reflected in differences in the fatty acid composition of breast milk samples. The milk of Chinese mothers was generally less saturated (41%) than that of Malay and Indian mothers (52 and 50% respectively). The milk of Chinese mothers was also richer in linoleic acid (17%) than that of Malay and Indian mothers (9% and 11% respectively). Overall the level of individual fatty acids fell within the range of values reported for Western mothers on well nourished diets and pointed to breast milk of high standard despite large variations in the diet of Malaysian mothers.

Homeostatic control of membrane fatty acid composition in the rat after dietary lipid treatment.

Diets in which both the lipid content and composition (polyunsaturated to saturated fatty acid ratio) were varied were fed to rats for 20 weeks, and the effects on the tissue lipid profiles were determined. The fatty acid profile of the plasma lipids, and the phospholipid fatty acids of the mitochondrial and microsomal fractions of liver, heart, kidney and brain, as well as erythrocyte membranes were determined. Despite large differences in the level and type of lipid present in the experimental diets and in the proportion of saturated fatty acids in the plasma lipids in response to the various diets, there was little effect on the proportion of saturated to unsaturated fatty acids in the phospholipids of the various membranes examined. The major effect of altering the dietary level of polyunsaturated to saturated fatty acids was on the ratio of the omega 6/omega 3 series of unsaturated fatty acids in the membrane lipids. This change occurred in all tissues except the brain, in which only a small response to altered dietary lipid intake was observed. The omega 6/omega 3 ratio was elevated upon feeding a diet rich in omega 6 polyunsaturated fatty acids, but decreased when a diet rich in saturated fatty acids was fed. The failure to significantly alter membrane lipid saturation/unsaturation in the tissues examined would suggest that a homeostatic mechanism is operative in biological membranes and may act to buffer membranes from the effects of changes in the nature of the dietary lipid intake.

A lack of correlation between linoleate and arachidonate in human breast milk.

The levels of arachidonic acid and linoleic acid found in the lipid fraction of human milk samples were compared. No correlation was found between the level of precursor linoleate and product arachidonate in 80 samples of colostrum (day 3-5) or 60 samples of mature breast milk. We attempted to test the hypothesis that the absence of a precursor-product relationship was caused by a constant level of arachidonate being secreted in the phospholipids (PL) of breast milk cells. Examination of the fatty acid (FA) composition of the PL and triglyceride fractions revealed arachidonate in high concentration in PL but that most of the total arachidonate existed in triglycerides.

Comparative levels of arachidonic acid and eicosapentaenoic acid in Malaysian fish.

Total lipids were extracted from 22 species of Malaysian fish and the constituent fatty acids were analysed by gas chromatography. Malaysian fish generally contained high levels of saturated fatty acids (range 36-55% total fatty acids) and contained variable amounts of monounsaturates, chiefly palmitic and stearic acids, but only trace levels of 20:1 and 22:1. Unlike fish caught in colder northern hemisphere waters, Malaysian fish were found to contain arachidonic acid (20:4 omega 6, range 2-12%) in addition to the expected eicosapentaenoic acid (20:5 omega 3, range 1-13%) and docosahexaenoic acid (22:6 omega 3, range 6.6-40.4%).

Fatty acid composition of human colostrum and mature breast milk.

The fatty acid composition of human milk obtained on individual samples from 120 mothers early (day 3 to 5) and later (day 40 to 45) in lactation were determined by argentation thin-layer and gas chromatographic procedures. In comparison with mature milk, human colostrum was characterized by a lower percentage of saturated fatty acids including medium chain length acids, a higher percentage of monounsaturates, and a lower level of linoleic and linolenic acids, but a higher percentage of their long chain polyunsaturated derivatives. It is concluded that in view of their levels in breast milk, the polyenoic derivatives of linoleic and linolenic acids must be taken into account when assessing infant foods.

Effect of sampling on fatty acid composition of human colostrum.

Samples of colostrum were taken from 19 subjects before and after infant feeding, 3 and 5 days post partum. Milk samples were analyzed by argentation and gas chromatography for 30 fatty acids contained in the lipid fraction. Although small differences were observed between day 3 and day 5 samples, the fatty acid composition of the milk did not vary on either of the days between samples taken before and after nursing. It is concluded that a single sample taken any time during the feeding is representative of the entire nursing.