Urinary metabolic biomarkers of diet quality in European children are associated with metabolic health.

Urinary metabolic profiling is a promising powerful tool to reflect dietary intake and can help understand metabolic alterations in response to diet quality. Here, we used 1H NMR spectroscopy in a multicountry study in European children (1147 children from 6 different cohorts) and identified a common panel of 4 urinary metabolites (hippurate, N-methylnicotinic acid, urea, and sucrose) that was predictive of Mediterranean diet adherence (KIDMED) and ultra-processed food consumption and also had higher capacity in discriminating children's diet quality than that of established sociodemographic determinants. Further, we showed that the identified metabolite panel also reflected the associations of these diet quality indicators with C-peptide, a stable and accurate marker of insulin resistance and future risk of metabolic disease. This methodology enables objective assessment of dietary patterns in European child populations, complementary to traditional questionary methods, and can be used in future studies to evaluate diet quality. Moreover, this knowledge can provide mechanistic evidence of common biological pathways that characterize healthy and unhealthy dietary patterns, and diet-related molecular alterations that could associate to metabolic disease.

Diet quality and cardiometabolic health in childhood: the Generation R Study.

PURPOSE: Diet is an important determinant of cardiometabolic disease risk in adults. We aimed to study associations of diet quality with cardiometabolic health in school-age children. METHODS: This study was embedded in the Generation R Study a prospective population-based cohort in Rotterdam, the Netherlands and included 3991 children. Food intake was assessed with a Food-Frequency Questionnaire at age 8 years. A diet quality score (0-10) was calculated reflecting adherence to age-specific dietary guidelines. The following outcome variables were measured at age 10 years and used to create a continuous cardiometabolic risk factor score: body fat percentage, insulin, triglycerides, HDL cholesterol, and systolic and diastolic blood pressure. Outcomes were expressed in age- and sex-specific standard deviation scores (SDS). Multivariable linear regression models were used to assess associations between the diet quality score and the cardiometabolic risk factor score and with the individual cardiometabolic risk factors. RESULTS: In models adjusted for socioeconomic and lifestyle factors and BMI, a higher diet quality was associated with a lower cardiometabolic risk factor score [- 0.08 per point higher diet score, (95% CI - 0.15, - 0.001)]. This association was mainly driven by associations of higher diet quality with lower systolic [- 0.04 SD (95% CI - 0.06, - 0.01)] and diastolic blood pressure [- 0.05 SD, (95% CI - 0.07, - 0.02)]. No statistically significant associations were found for insulin, triglycerides, HDL cholesterol, or body fat percentage as individual factors. CONCLUSIONS: We found an association between higher diet quality and better cardiometabolic health in childhood, mainly driven by a lower blood pressure. Further research is needed to explore associations of diet quality in childhood with long-term cardiometabolic health.

Diet quality at age 5-6 and cardiovascular outcomes in preadolescents.

BACKGROUND & AIMS: Specific dietary components during childhood may affect risk factors for cardiovascular disease. Whether overall higher diet quality prevents children from adverse cardiovascular outcomes remains contradictive. We aimed to examine the associations between diet quality at age 5-6 years and cardiovascular outcomes after a 6-year follow-up. METHODS: We used data from the Amsterdam Born Children and their Development study, a multi-ethnic birth cohort. Dietary intake was assessed at age 5-6 using a semi-quantitative food frequency questionnaire and diet quality was ascertained with the Dietary Approaches to Stop Hypertension (DASH) score and the child diet quality score (CDQS), an index specifically developed for Dutch school-age children. Cardiovascular outcomes were examined after 6-years follow-up (age 11-12, N = 869). Outcomes were body mass index (BMI), waist circumference (WC), blood pressure (BP), lipid profile, fasting glucose and carotid intima-media thickness (CIMT). Multivariable linear and logistic regression models adjusted for baseline value were used to examine associations between diet quality and cardiovascular outcomes. RESULTS: Higher diet quality at age 5-6 was associated with lower BMI (DASH score: Δ quintile (Q) 5 and Q1: -0.35 kg/m2, p for trend = 0.016), lower WC (DASH score: Δ Q5 and Q1: -1.0 cm, p for trend = 0.028), lower systolic (DASH score: Δ Q5 and Q1: -2.7 mmHg, p for trend = 0.046) and diastolic BP (DASH score: Δ Q5 and Q1: -2.4, p for trend < 0.001) and with lower plasma triglycerides (DASH score: Δ Q5 and Q1: -0.20 mmol/L, p for trend = 0.032) after 6-years follow-up. Associations of the CDQS with these outcomes showed similar trends, but less pronounced. We found no statistically significant associations between diet quality and LDL-C, HDL-C, total cholesterol, fasting glucose or CIMT. CONCLUSIONS: Higher diet quality in childhood at age 5-6 years predicted better health on some cardiovascular outcomes in preadolescence.

Associations of family feeding and mealtime practices with children's overall diet quality: Results from a prospective population-based cohort.

Food parenting practices are considered to have a key influence on children's dietary habits, with potential long term effects. In this study, we explored the associations of parental feeding practices and family mealtime practices in early childhood with children's overall diet quality at school age among 3626 parents and their children in a population-based cohort study in Rotterdam, the Netherlands. Parental feeding practices (monitoring, pressure to eat, and restriction) and family mealtime practices (meal skipping behaviors and family meal frequency) at age 4 years were assessed by parental questionnaires. Children's dietary intake was assessed at age 8 years using a food-frequency questionnaire, from which diet quality scores (range 0-10) were calculated, reflecting adherence to age-specific dietary guidelines. Using multivariable linear regression models, we found that monitoring was associated with higher diet quality of children (ß = 0.12; 95%CI: 0.08, 0.16), whereas pressure to eat was associated with lower diet quality (ß = -0.08; 95%CI: -0.12, -0.04)), both independent of child BMI. Restriction was associated with a higher child diet quality, but this association was explained by child BMI. As compared to children who did not skip meals, children who skipped meals had a lower diet quality (e.g. breakfast skipping: ß = -0.32; 95%CI: -0.48, -0.17). Similarly, children who had less frequent family meals had a lower diet quality compared with those who had family meals every day (e.g. family dinner ≤2 days/week: ß = -0.37; 95%CI: -0.60, -0.14). These associations were not driven by single food groups. In conclusion, parental monitoring and family mealtime routines in early childhood may provide a supportive food environment that promotes children's overall diet quality. Longitudinal studies with repeated measurements are needed to replicate our findings.

Dietary taste patterns in early childhood: the Generation R Study.

BACKGROUND: Taste preference is an important determinant of dietary intake and is influenced by taste exposure in early life. However, data on dietary taste patterns in early childhood are scarce. OBJECTIVES: We aimed to evaluate dietary taste patterns in early childhood, to examine their tracking between the ages of 1 and 2 y, and to examine their associations with socioeconomic and lifestyle factors. METHODS: Dietary intake of children participating in a population-based cohort was assessed with a 211-item age-specific FFQ at the ages of 1 y ( n = 3629) and 2 y (n = 844) (2003-2007). Taste intensity values of FFQ food items were calculated based on a food taste database that had been previously constructed and evaluated using a trained adult sensory panel. Cluster analysis based on taste values identified 5 taste clusters that we named: "neutral," "sweet and sour," "sweet and fat," "fat," and "salt, umami and fat." Linear regression models were used to examine associations of percentage energy (E%) intake from these taste clusters with socioeconomic and lifestyle factors. RESULTS: At the age of 1 y, 64% ± 13% (mean ± SD) of energy intake was obtained from the "neutral" cluster, whereas at age 2 y, this was 42% ± 8%. At age 2 y, children had higher energy intakes from the "sweet and fat" (18% ± 7%), "fat" (11% ± 4%), and "salt, umami, and fat" (18% ± 6%) clusters than at age 1 y (7% ± 6%, 6% ± 4%, and 11% ± 6%, respectively). In multivariable models, older maternal age, longer breastfeeding duration, and later introduction of complementary feeding were associated with more energy from the "neutral" cluster (e.g., ß: 0.31 E%; 95% CI: 0.19, 0.43 E% per 1 mo longer breastfeeding). Higher child BMI was associated with more energy from the "salt, umami, and fat" cluster (ß: 0.22 E%; 95% CI: 0.06, 0.38 E% per BMI standard deviation score). CONCLUSIONS: Dietary taste patterns in this Dutch cohort were more varied and intense in taste at age 2 y than at 1 y, reaching a level similar to that previously observed in Dutch adults. Important factors related to dietary taste patterns of young children are maternal sociodemographic factors and feeding practices.This trial was registered at trialregister.nl as NL6484.

Carbohydrate Intake in Early Childhood and Body Composition and Metabolic Health: Results from the Generation R Study.

High sugar intake in childhood has been linked to obesity. However, the role of macronutrient substitutions and associations with metabolic health remain unclear. We examined associations of carbohydrate intake and its subtypes with body composition and metabolic health among 3573 children participating in a population-based cohort in the Netherlands. Intake of total carbohydrate, monosaccharides and disaccharides, and polysaccharides at age 1 year was assessed with a food-frequency questionnaire. We repeatedly measured children's height and weight to calculate BMI between their ages of 1 and 10 years. At ages 6 and 10 years, fat and fat-free mass were measured with dual-energy X-ray-absorptiometry and blood concentrations of triglycerides, cholesterol, and insulin were obtained. For all outcomes, we calculated age and sexspecific SD-scores. In multivariable-adjusted linear mixed models, we found no associations of intake of carbohydrates or its subtypes with children's BMI or body composition. A higher intake of monosaccharides and disaccharides was associated with higher triglyceride concentrations (0.02 SDS per 10 g/d, 95% CI: 0.01, 0.04). Higher monosaccharide and disaccharide intake was also associated with lower HDL-cholesterol (-0.03 SDS, 95% CI: -0.04; -0.01), especially when it replaced polysaccharides. Overall, our findings suggest associations of higher monosaccharide and disaccharide intake in early childhood with higher triglyceride and lower HDL-cholesterol concentrations, but do not support associations with body composition.

Sensory and Chemical Drivers of Wine Consumers' Preference for a New Shiraz Wine Product Containing Ganoderma lucidum Extract as a Novel Ingredient.

This study explored wine consumers' preferences towards a novel Australian Shiraz wine product containing Ganoderma lucidum (GL). Wine consumers (n = 124) were asked to complete a questionnaire and participate in a blind tasting of six GL wine products (differing in the amount and timing of GL extract additions). Based on individual liking scores for each GL wine product that was tasted, four hedonic clusters C1 (n = 44, preferred control and low levels of GL additions), C2 (n = 28, preferred control only), C3 (n = 26, generally preferred all GL additions) and C4 (n = 26, preferred 1 g/L additions and 4 g/L post-fermentation) were identified. Sensory attributes of the GL wine products were also profiled with rate-all-that-apply (n = 65) and the 31 sensory attributes that significantly differentiated the wines underwent principal component analysis with the hedonic clusters overlaid to explain consumers' preferences. There was a clear separation between hedonic clusters. Sensory attributes and volatile flavor compounds that significantly differentiated the wines were subjected to partial least squares regression, which indicated the important positive drivers of liking among the hedonic clusters. Pepper and jammy aroma, 3-methylbutanoic acid (linked to fruity notes) and non-fruit aftertaste positively drove C2's preference, whereas spice flavor and hexanoic acid (known for leafy and woody descriptors) drove C3's liking. There were no positive drivers for C1's liking but bitter taste, cooked vegetable, and toasty aromas drove this cluster' dislike. C4 preferred brown appearance, tobacco aroma, and jammy and cooked vegetable flavors. These findings provide the wine industry with deeper insights into consumers' liking towards new GL wine products targeted at the Australasian market.

Diet quality in early and mid-childhood in relation to trajectories of growth and body composition.

BACKGROUND: A balanced diet in childhood is important for growth and development. We aimed to examine associations of overall diet quality in both early and mid-childhood with trajectories of growth and body composition until age 10 years. METHODS: We included 3991 children from the Generation R Study, a population-based, prospective cohort in Rotterdam, the Netherlands. At child's ages of 1 and 8 years, dietary intake was assessed using food-frequency questionnaires to calculate diet quality scores (0-10), which measure adherence to age-specific dietary guidelines. Height and weight were measured repeatedly between ages 1 and 10 years. Body composition was assessed using dual-energy X-ray absorptiometry at ages 6 and 10 years. We calculated sex- and age-specific SD-scores for body mass index (BMI), fat mass index (FMI), fat-free mass index (FFMI), and body fat percentage (BF%). RESULTS: After adjustment for socioeconomic and lifestyle factors, results from linear mixed models showed that higher diet quality at 1 year was associated with higher height, weight, and BMI up to age 10 years. Using linear regression analyses, similar associations were observed for diet quality at 8 years. For diet quality at both time points, positive associations with BMI were fully driven by a higher FFMI (ß = 0.07 SDS, 95%CI: 0.05, 0.10 for diet quality at 8 years), and not FMI or BF%. Most of the observed associations were independent of diet quality at the other time point. CONCLUSION: We observed that better diet quality in both early and mid-childhood was associated with higher height, weight, and FFMI, but not with body fatness up to age 10 years. This was independent of diet quality at an earlier or later time point. Our findings suggest that dietary intake according to dietary guidelines may have a beneficial impact on growth and body composition throughout childhood.

Volatile Composition and Sensory Profiles of a Shiraz Wine Product Made with Pre- and Post-Fermentation Additions of Ganoderma lucidum Extract.

Novel Shiraz red wine products enriched with Ganoderma lucidum (GL) extract, a traditional Asian medicinal mushroom, were developed and characterized. GL extract was added at different levels prior to and after primary fermentation to investigate its impact on the juice fermentation kinetics, and the chemical composition and sensory properties of the resulting wines. The fermentation kinetics of red grape juice were not significantly different between ferments. Basic chemical analyses plus headspace solid-phase micro-extraction (HS-SPME), gas chromatography‒mass spectrometry (GC-MS), and a rate-all-that-apply (RATA) (n = 65) sensory panel were used to investigate the influence of GL extract additions on wine composition and sensory characteristics. Of the 54 sensory attributes assessed, 39 significantly differentiated the wines. A clear separation between GL wine treatments was evident with PLS regression, where specific volatiles were correlated with relevant sensory attributes that dominated the wines. These products could be promising for emerging wine markets.

Children's Attention-Deficit/Hyperactivity Disorder Symptoms Predict Lower Diet Quality but Not Vice Versa: Results from Bidirectional Analyses in a Population-Based Cohort.

BACKGROUND: As an adjuvant for medication, dietary changes focused on specific nutrients have been proposed to prevent or reduce attention-deficit/hyperactivity disorder (ADHD) symptoms. However, whether an overall healthy dietary pattern is associated with ADHD symptom severity during childhood remains unclear. Furthermore, it is not clear what the direction of this association is. OBJECTIVES: We aimed to examine the association between dietary patterns and ADHD symptoms in school-aged children. In addition, we aimed to identify the temporal direction of this association-that is, whether dietary patterns predict ADHD symptoms or vice versa. METHODS: We analyzed data from 3680 children participating in the Generation R Study, a prospective cohort in Rotterdam, Netherlands. ADHD symptoms were assessed with parent-report questionnaires at ages 6 and 10 y using the Child Behavior Checklist. Dietary intake was assessed at the age of 8 y with a validated food-frequency questionnaire. We computed a diet quality score reflecting adherence to dietary guidelines. We examined bidirectional associations of diet quality with ADHD symptom scores using multivariable linear regression analysis and cross-lagged modeling. RESULTS: Linear regressions showed that more ADHD symptoms at age 6 y were associated with a lower diet quality score at age 8 y (SD score = -0.08; 95% CI: -0.11, -0.05) but that diet quality at age 8 y was not associated with ADHD symptoms at age 10 y. Cross-lagged models confirmed a unidirectional relation from ADHD symptoms to diet quality but not vice versa. Associations did not differ by overweight status or between boys and girls. CONCLUSION: Our study suggests that children with more ADHD symptoms may be at higher risk of an unhealthy diet but that overall diet quality does not affect ADHD risk.

A cross-cultural examination of Australian, Chinese and Vietnamese consumers' attitudes towards a new Australian wine product containing Ganoderma lucidum extract.

Ganoderma lucidum (GL) is a woody mushroom that has been widely used for many centuries in traditional Chinese medicine. Its bioactive-compounds are believed to promote longevity and prevent diseases in humans. With the close proximity of emerging Asian markets, Australian winemakers are beginning to adopt consumer-centric wine product development as a strategy to generate wines with profiles that meet the specific demands of these consumers. This cross-cultural study recruited 412 wine consumers (Chinese, Vietnamese and Australian) to participate in a survey to understand wine consumers' potential acceptance and self-reported intent towards new wine products produced with GL extracts and the relationship of their responses with wine neophobicity across cultures. Findings revealed that all consumer groups accepted the notion that GL wine products would be worth tasting and they would try them at social events, with Vietnamese consumers being particularly interested. Using the wine neophobia scale (WNS), three segments containing wine neophiles (n = 110), neutrals (n = 190) and wine neophobes (n = 112) were identified. The results revealed that Australian and Chinese participants were significantly more wine neophilic, compared to Vietnamese. As expected, neophiles were more prepared to taste and purchase GL wine products compared to neophobes across all three countries, although no gender differences were observed. The study provides the wine industry insights about consumers' attitudes towards a new GL wine product targeted to Australian and Asian markets that could help develop new niche wine categories and enhance consumers' satisfaction.

Diet quality in childhood: the Generation R Study.

PURPOSE: We aimed to evaluate diet quality of 8-year-old children in the Netherlands, to identify sociodemographic and lifestyle correlates of child diet quality, and to examine tracking of diet quality from early to mid-childhood. METHODS: For 4733 children participating in a population-based cohort, we assessed dietary intake using a validated food-frequency questionnaire at a median age of 8.1 years (interquartile range 8.0-8.2) (2011-2014). Based on dietary guidelines, we developed and validated a food-based diet quality score for children consisting of ten components (score 0-10): sufficient intake of vegetables; fruit; whole grains; fish; legumes; nuts; dairy; oils and soft fats; and low intake of sugar-containing-beverages; and high-fat and processed meat. RESULTS: We observed a mean (± SD) diet quality score of 4.5 (± 1.2) out of a maximum of 10. On average, intake of legumes, nuts, and oils or soft fats was below recommendations, whereas intake of sugar-containing beverages and high-fat or processed meat was higher than recommended. The main factors associated with higher diet quality were higher maternal educational level (ß = 0.29, 95% CI 0.21, 0.37 versus low education), higher household income (ß = 0.15, 95% CI 0.05, 0.25 versus low income), no maternal smoking (ß = 0.13, 95% CI 0.02, 0.25 versus current smoking), and less screen time (ß = 0.31, 95% CI 0.24, 0.38)-all independent of each other. For children with available dietary data at age 1 year (n = 2608), we observed only weak tracking of diet quality from early to mid-childhood (Pearson's r = 0.19, k = 0.11 for extreme quartiles). CONCLUSION: Overall diet quality of 8-year-old children did not conform to dietary guidelines, especially for children having more screen time, children of lower educated or smoking mothers, or from lower-income households.

Longitudinal association of dietary protein intake in infancy and adiposity throughout childhood.

BACKGROUND & AIMS: Protein intake in infancy promotes growth, but excessive intake may lead to adiposity in children. However, whether this increased adiposity persists throughout childhood and is independent of diet in later life remains unclear. Therefore, we studied the associations of total protein intake and protein from different sources at age 1 year with repeatedly measured growth and body composition up to age 10 years. Additionally, we examined whether these associations are independent of protein intake and overall diet quality at age 8 years. METHODS: We included 3573 children from the Generation R study, a population-based prospective cohort in the Netherlands. Dietary intakes were assessed with food-frequency questionnaires at ages 1 and 8 years and macronutrient intakes were expressed as energy percentages (E%). Height and weight were measured at eight time points between ages 1 and 10 years. Fat and fat-free masses were measured at ages 6 and 10 years with dual-energy X-ray-absorptiometry. We calculated body mass index (BMI), fat mass index (FMI) and fat-free mass index (FFMI). Outcomes were standardized for sex and age and expressed as standard deviation scores (SDS). Associations of protein intake with growth and body composition trajectories were examined with multivariable linear mixed models. RESULTS: After adjustment for confounders, 5E% additional protein intake at age 1 year was associated with a 0.10 SDS higher weight (95% CI 0.04, 0.16), 0.10 SDS higher BMI (95% CI 0.04, 0.16), and 0.07 SDS higher FMI (95% CI 0.01, 0.13) up to age 10 years. These associations were explained by protein from animal sources and not plant sources. Associations were independent of protein intake and overall diet quality at age 8 years, and were independent of whether higher protein was consumed at the expense of carbohydrates or fat in the diet. CONCLUSIONS: Our study suggests that high protein intake in infancy, particularly from animal food sources, is persistently associated with adiposity up to age 10 years. Restricting protein intake in this critical period of development may aid in the early prevention of adiposity in childhood.

Predictors and outcomes of patients switching from maintenance haemodialysis to peritoneal dialysis in Australia and New Zealand: Strengthening the argument for 'peritoneal dialysis first' policy.

AIMS: (1) To determine incidence and reasons for transfer from maintenance haemodialysis (HD) to peritoneal dialysis (PD); (2) To compare mortality of HD patients transferred to PD with those who initiated and remained on PD. METHODS: A 1:2 matched cohort of ANZDATA included patients dialyzing over 3 months dividing into 2 groups. Group A (HD to PD) was compared to group B (initiated and remained on PD) and matched PD group (Group C). We compared mortality by total time on dialysis regardless of modality. RESULTS: Of 20 882 patients, there were 911 in group A. The transfer rate from HD to PD was 5%, 6.7% and 7.4% at 1,4 and 8 years, respectively. Median time before switching of patients in Group A was 5.9 (4.0-10.9) months. The commonest reported reason for transfer was patient preference (63.8%). Mortality was significantly worse in Group A if dialysis vintage was ≤6 months and from 12-24 months (P < 0.05), whereas there was no difference in mortality if dialysis vintage was 6-12 months or ≥ 24 months (P = 0.073 and P = 0.153, respectively). Overall, mortality of patients in group A was higher than that in group B after adjusting for age, race, chronic lung disease, peripheral vascular disease, cerebrovascular disease, diabetes, haemoglobin and phosphate (hazard ratio = 1.335, 95% confidence interval = 1.172-1.520). CONCLUSION: Haemodialysis patients transferred to PD had higher mortality than those initiated on PD, strengthening the case for PD first policy.

Rabies Vaccine Hesitancy and Deaths Among Pregnant and Breastfeeding Women - Vietnam, 2015-2016.

Human rabies deaths are preventable through prompt administration of postexposure prophylaxis (PEP) with rabies immune globulin and rabies vaccine after exposure to a rabid animal (1); there are no known contraindications to receiving PEP (1,2). Despite widespread availability of PEP in Vietnam, in 2015 the Ministry of Health (MoH) received reports of pregnant and breastfeeding women with clinically diagnosed rabies. MoH investigated factors associated with these rabies cases. MoH found that, during 2015-2016, among 169 cases reported in Vietnam, two probable cases of rabies were reported in breastfeeding mothers and four in pregnant women, all of whom had been bitten by dogs. All six patients died. Three of the four pregnant women had cesarean deliveries. One of the three newborns died from complications believed to be unrelated to rabies; the fourth pregnant woman contracted rabies too early in pregnancy for the fetus to be viable. Two of the patients sought care from a medical provider or traditional healer; however, none sought PEP after being bitten. In each case, families reported the patient's fear of risk to the fetus or breastfed child as the primary barrier to receiving PEP. These findings highlight the need for public health messaging about the safety and effectiveness of PEP in preventing rabies among all persons with exposures, including pregnant and breastfeeding women.

Diet Quality throughout Early Life in Relation to Allergic Sensitization and Atopic Diseases in Childhood.

Early-life nutrition is an important modifiable determinant in the development of a child's immune system, and may thereby influence the risk of allergic sensitization and atopic diseases. However, associations between overall dietary patterns and atopic diseases in childhood remain unclear. We examined associations of diet quality in early life with allergic sensitization, self-reported physician-diagnosed inhalant and food allergies, eczema, and asthma among 5225 children participating in a population-based cohort in the Netherlands. Diet was assessed during pregnancy, infancy, and childhood using validated food-frequency questionnaires. We calculated food-based diet quality scores (0-10 or 0-15), reflecting adherence to dietary guidelines. At age 10 years, allergic sensitization was assessed with skin prick tests. Information on physician-diagnosed inhalant and food allergies, eczema, and asthma was obtained with questionnaires. We observed no associations between diet quality during pregnancy and allergic sensitization (odds ratio (OR) = 1.05 per point in the diet score, 95% confidence interval (CI): 0.99, 1.13), allergies (0.96, 95% CI: 0.88, 1.04), eczema (0.99, 95% CI: 0.93, 1.06), or asthma (0.93, 95% CI: 0.85, 1.03) in childhood. Also, diet quality in infancy or childhood were not associated with atopic outcomes in childhood. Our findings do not support our hypothesis that a healthy dietary pattern in early life is associated with a lower risk of allergic sensitization or atopic diseases in childhood.

Maternal history of eating disorders: Diet quality during pregnancy and infant feeding.

We studied associations of maternal history of eating disorders (EDs) with diet quality of pregnant women and their infants, and breastfeeding practices. We included 6196 mother-child pairs from Generation R, a population-based cohort in the Netherlands. Maternal history of lifetime EDs was assessed during pregnancy with a questionnaire. Dietary intake during pregnancy and in infancy was assessed with food-frequency questionnaires and diet quality scores were calculated, reflecting adherence to dietary guidelines. Breastfeeding practices were assessed with questionnaires at 2, 6, and 12 months. We observed that, after adjustment for socioeconomic and lifestyle factors, women with a history of EDs had a higher diet quality than women without a history of EDs (B = 0.24 SD, 95%CI: 0.15; 0.33). Mothers with a history of EDs were less likely to breastfeed (unadjusted OR = 0.68, 95%CI: 0.51; 0.93), although no longer statistically significant after adjustment (OR = 0.75, 95%CI: 0.55; 1.03). These findings suggest that mothers with a history of EDs seem slightly less likely to initiate breastfeeding, however, this warrants further investigation. At the age of 1 year, infants of mothers with a history of EDs had a higher diet quality (B = 0.15 SD, 95%CI: 0.02; 0.27). We conclude that mothers with a history of EDs and their infants have a relative good diet quality, although follow-up studies are needed to assess long-term associations with diet in later childhood and adolescence.

Evaluation of intravenous midazolam limited sampling models to determine area under the concentration time curve during cytochrome P450 3A baseline, inhibition and induction or activation.

OBJECTIVE: This study evaluated if previously published limited sampling models (LSMs) accurately predict midazolam area under the concentration time curve (AUC) during cytochrome P450 (CYP) 3A baseline, inhibition and induction/activation. MATERIALS AND METHODS: Plasma midazolam concentrations (n = 108) were obtained where intravenous midazolam was co-administered alone or concomitantly with ketoconazole, itraconazole, aprepitant, rifampin, or pleconaril. Observed AUC was calculated using noncompartmental analysis. Predicted AUC was calculated from the LSMs. Bias and precision were determined by percent mean prediction error (%MPE), percent mean absolute error (%MAE), and percent root mean squared error (%RMSE). RESULTS: Contrasting results were observed for LSMs in predicting CYP3A baseline activity, with the majority of studies resulting in unacceptable bias and precision. During CYP3A inhibition, unacceptable bias and precision were observed from single- and 2-time point LSMs. %MAE and %RMSE values exceeded acceptable limits during CYP3A induction with rifampin. Contrasting results were observed with pleconaril. CONCLUSION: The contrasting results during CYP3A baseline and induction/activation, as well as the unacceptable bias and precision during CYP3A inhibition, limits the widespread use of the previously published LSMs.