Difference In Mean Weight Gain Research Articles

Effect of topical emollient oil application on weight of preterm newborns: A systematic review and meta-analysis.

Synthesizing current evidence on interventions to improve survival outcomes in preterm infants is crucial for informing programs and policies. The objective of this study is to investigate the impact of topical emollient oil application on the weight of preterm infants. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. To identify relevant studies, comprehensive searches were conducted across multiple databases, including PubMed, Cochrane, Scopus, Clinical trials, ProQuest Central, Epistemonikos, and gray literature sources. The inclusion criteria were based on the PICO (Population, Intervention, Comparison, and Outcomes) format. Study quality was assessed using the Cochrane risk of bias tool for randomized trials (RoB 2.0). Data analysis was performed using StataCrop MP V.17 software, which included evaluating heterogeneity, conducting subgroup analysis, sensitivity analysis, and meta-regression. The findings were reported in accordance with the PRISMA checklist, and the review was registered with PROSPERO (CRD42023413770). Out of the initial pool of 2734 articles, a total of 18 studies involving 1454 preterm neonates were included in the final analysis. Fourteen of these studies provided data that contributed to the calculation of the pooled difference in mean weight gain in preterm neonates. The random effects meta-analysis revealed a significant pooled difference in mean weight gain of 52.15 grams (95% CI: 45.96, 58.35), albeit with high heterogeneity (I2 > 93.24%, p 0.000). Subgroup analyses were conducted, revealing that preterm infants who received massages three times daily with either sunflower oil or coconut oil exhibited greater mean differences in weight gain. Meta-regression analysis indicated that the type of emollient oil, duration of therapy, and frequency of application significantly contributed to the observed heterogeneity. A sensitivity analysis was performed, excluding two outlier studies, resulting in a pooled mean weight difference of 78.57grams (95% CI: 52.46, 104.68). Among the nine studies that reported adverse events, only two mentioned occurrences of rash and accidental slippage in the intervention groups. The available evidence suggests that the application of topical emollient oil in preterm neonates is likely to be effective in promoting weight gain, with a moderate-to-high level of certainty. Based on these findings, it is recommended that local policymakers and health planners prioritize the routine use of emollient oils in newborn care for preterm infants. By incorporating emollient oils into standard care protocols, healthcare providers can provide additional support to promote optimal growth and development in preterm infants.

Breast feeding in infants diagnosed with phenylketonuria (PKU): a scoping review

BackgroundPhenylketonuria (PKU) is the most common inherited disease of amino acid metabolism, characterised by elevated levels of phenylalanine (Phe). There is a lack of infant feeding guidance for those with...

On‐farm growth performance of different strains of tilapia, Oreochromis niloticus reared in earthen ponds

AbstractThe growth of aquaculture sector in Kenya has been anchored on farmed Nile tilapia Oreochromis niloticus. Different strains of the species exist in Kenya with unknown quality due to lack of stock improvement programmes coupled by variations in breeding and management practices in different hatcheries. The seeds supplied to farmers have not exhibited good performance and resilience to changing climate. There is need to validate the quality of strains supplied to fish farmers in Kenya. This study sought to compare the growth performance of three strains of farmed Nile tilapia; Sagana strain (SAG‐F8) produced through selective breeding, super YY strain (KAM‐YY) from Kamuthanga fish farm and the local strain (LOC‐T) obtained from Siaya County. The fish were stocked in fertilised earthen ponds measuring 300 m2 in triplicates at 3 fish/m2. The fish were fed on 35% crude protein diet for 180 days at Bukani Aquapark located in Busia County, Kenya. There was no significant difference in mean weight gain (MWG) between SAG‐F8 and LOC‐T strain exhibiting 159.786 ± 6.76 g and 158.623 ± 4.67 g, respectively. However, under similar conditions, the KAM‐YY strain had a significantly lower MWG (131.74 ± 4.75 g) compared to the two strains. Food conversion ratio (FCR), specific growth rate (SGR) did not demonstrate any significant difference among the different strains. The body protein content in the SAG‐F8 fish strain was higher (65.40 ± 0.20%) followed by LOC‐T strain (61.23 ± 2.34%) and lastly KAM‐YY strain had the lowest (60.37 ± 0.89%). In this study, the impact of genetic improvement has been demonstrated to influence growth and feed efficiency as well as body composition. These improved strains will substantially increase fish production and productivity, hence, a positive impact on the fish farmers' livelihoods when supplied to the farmers and seed multipliers.

Metabolic side effects in persons with schizophrenia during mid- to long-term treatment with antipsychotics: a network meta-analysis of randomized controlled trials.

Metabolic side effects of antipsychotic drugs can have serious health consequences and may increase mortality. Although persons with schizophrenia often take these drugs for a long time, their mid- to long-term metabolic effects have been studied little so far. This study aimed to evaluate the mid- to long-term metabolic side effects of 31 antipsychotics in persons with schizophrenia by applying a random-effects Bayesian network meta-analysis. We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials (up to April 27, 2020) and PubMed (up to June 14, 2021). We included published and unpublished, open and blinded randomized controlled trials with a study duration >13 weeks which compared any antipsychotic in any form of administration with another antipsychotic or with placebo in participants diagnosed with schizophrenia. The primary outcome was weight gain measured in kilograms. Secondary outcomes included "number of participants with weight gain", fasting glucose, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides. We identified 137 eligible trials (with 35,007 participants) on 31 antipsychotics, with a median follow-up of 45 weeks. Chlorpromazine produced the most weight gain (mean difference to placebo: 5.13 kg, 95% credible interval, CrI: 1.98 to 8.30), followed by clozapine (4.21 kg, 95% CrI: 3.03 to 5.42), olanzapine (3.82 kg, 95% CrI: 3.15 to 4.50), and zotepine (3.87 kg, 95% CrI: 2.14 to 5.58). The findings did not substantially change in sensitivity and network meta-regression analyses, although enriched design, drug company sponsorship, and the use of observed case instead of intention-to-treat data modified the mean difference in weight gain to some extent. Antipsychotics with more weight gain were often also among the drugs with worse outcome in fasting glucose and lipid parameters. The confidence in the evidence ranged from low to moderate. In conclusion, antipsychotic drugs differ in their propensity to induce metabolic side effects in mid- to long-term treatment. Given that schizophrenia is often a chronic disorder, these findings should be given more consideration than short-term data in drug choice.

Effectiveness of interventions to address obesity and health risk behaviours among people with severe mental illness in low- and middle-income countries (LMICs): a systematic review and meta analysis.

People with severe mental illness (SMI) are more likely to have obesity and engage in health risk behaviours than the general population. The aims of this study are (1) evaluate the effectiveness of interventions that focus on body weight, smoking cessation, improving sleeping patterns, and alcohol and illicit substance abuse; (2) Compare the number of interventions addressing body weight and health risk behaviours in low- and middle-income countries (LMICs) v. those reported in published systematic reviews focusing on high-income countries (HICs). Intervention studies published up to December 2020 were identified through a structured search in the following database; OVID MEDLINE (1946-December 2020), EMBASE (1974-December 2020), CINAHL (1975-2020), APA PsychoINFO (1806-2020). Two authors independently selected studies, extracted study characteristics and data and assessed the risk of bias. and risk of bias was assessed using the Cochrane risk of bias tool V2. We conducted a narrative synthesis and, in the studies evaluating the effectiveness of interventions to address body weight, we conducted random-effects meta-analysis of mean differences in weight gain. We did a systematic search of systematic reviews looking at cardiometabolic and health risk behaviours in people with SMI. We compared the number of available studies of LMICs with those of HICs. We assessed 15 657 records, of which 9 met the study inclusion criteria. Six focused on healthy weight management, one on sleeping patterns and two tested a physical activity intervention to improve quality of life. Interventions to reduce weight in people with SMI are effective, with a pooled mean difference of -4.2 kg (95% CI -6.25 to -2.18, 9 studies, 459 participants, I 2 = 37.8%). The quality and sample size of the studies was not optimal, most were small studies, with inadequate power to evaluate the primary outcome. Only two were assessed as high quality (i.e. scored 'low' in the overall risk of bias assessment). We found 5 reviews assessing the effectiveness of interventions to reduce weight, perform physical activity and address smoking in people with SMI. From the five systematic reviews, we identified 84 unique studies, of which only 6 were performed in LMICs. Pharmacological and activity-based interventions are effective to maintain and reduce body weight in people with SMI. There was a very limited number of interventions addressing sleep and physical activity and no interventions addressing smoking, alcohol or harmful drug use. There is a need to test the feasibility and cost-effectiveness of context-appropriate interventions to address health risk behaviours that might help reduce the mortality gap in people with SMI in LMICs.

Difference in mean weight gain and hospital stay in preterm babies receiving complete or partial kangaroo mother care compared to no kangaroo mother care: Experience from a tertiary care hospital

Background: Pakistan is a resource limited country with one of the highest neonatal mortality rate (NMR) in the world. Kangaroo Mother Care (KMC) helps in reducing the mortality and improving the care of preterm babies. The objective of this study was to identify the benefits of KMC in hospitalized newborns in terms of better weight gain and early discharge from hospital.
 Subjects and methods: A retrospective case-control study was conducted in the Neonatal Department of Services Hospital from 01.02.2019 to 31.01.2020. A total of 144 case notes, who met inclusion criteria were included. Subjects were divided in 2 Groups of 77 each. Group 1 did not receive KMC and Group 2 received KMC (partial or complete). Admission weight, gestational age at birth, duration of hospital stay and the average weight gain was noted for subjects in both groups. SPSS version 23 was used to analyze data. Independent samples t-test was applied. A p-value of ˂0.05 is taken as significant.
 Results: Mean weight gain in Group 1 was 5.521 g/kg/day (±6.664), whereas in Group 2 was 15.635 g/kg/day (±9.268). Mean hospital stay in Group 1 was 12.558 days (±10.856) and in Group 2 it was 8.208 days (±6.473). Weight gain and duration of hospital stay was significantly better in KMC Group with a p-value ˂0.05. This benefit was observed both for partial and complete KMC.
 Conclusion: KMC (partial or complete) leads to better weight gain and reduces the duration of hospital stay.

Enteral nutrition for maintenance of remission in Crohn's disease.

Enteral nutrition for maintenance of remission in Crohn's disease.

Effectiveness of a Locally Produced, Fish-Based Food Product on Weight Gain among Cambodian Children in the Treatment of Acute Malnutrition: A Randomized Controlled Trial.

Cambodia continues to have a high prevalence of acute malnutrition. Low acceptability has been found for standard ready-to-use-therapeutic-food (RUTF) products. Therefore, NumTrey, a locally-produced fish-based RUTF, was developed. The objective was to evaluate the effectiveness of NumTrey compared to an imported milk-based RUTF for weight gain among children aged 6–59 months in the home-treatment for acute malnutrition. Effectiveness was tested in a single-blinded randomized controlled trial with weight gain as the primary outcome. Anthropometry was assessed at baseline and bi-weekly follow-ups until endline at Week 8. In total, 121 patients were randomized into BP-100TM (n = 61) or NumTrey (n = 60). There was no statistical difference in mean weight gain between the groups (1.06 g/kg/day; 95% CI (0.72, 1.41) and 1.08 g/kg/day; 95% CI (0.75, 1.41) for BP-100™ and NumTrey, respectively). In addition, no statistically significant differences in secondary outcomes were found. Although the ability to draw conclusions was limited by lower weight gain than the desired 4 g/kg/day in both groups, no superiority was found for eitherRUTF. A locally produced RUTF is highly relevant to improve nutrition interventions in Cambodia. A locally produced fish-based RUTF is a relevant alternative to imported milk-based RUTF for the treatment of SAM in Cambodia.

A Double-Blind Randomized Controlled Trial of Maternal Postpartum Deworming to Improve Infant Weight Gain in the Peruvian Amazon.

BackgroundNutritional interventions targeting the critical growth and development period before two years of age can have the greatest impact on health trajectories over the life course. Compelling evidence has demonstrated that interventions investing in maternal health in the first 1000 days of life are beneficial for both mothers and their children. One such potential intervention is deworming integrated into maternal postpartum care in areas where soil-transmitted helminth (STH) infections are endemic.Methodology/Principal FindingsFrom February to August 2014, 1010 mother-infant pairs were recruited into a trial aimed at assessing the effectiveness of maternal postpartum deworming on infant and maternal health outcomes. Following delivery, mothers were randomly assigned to receive either single-dose 400 mg albendazole or placebo. Participants were followed-up at 1 and 6 months postpartum. There was no statistically significant difference in mean weight gain between infants in the experimental and control groups (mean difference: -0.02; 95% CI: -0.1, 0.08) at 6 months of age. Further, deworming had no effect on measured infant morbidity indicators. However, ad hoc analyses restricted to mothers who tested positive for STHs at baseline suggest that infants of mothers in the experimental group had greater mean length gain in cm (mean difference: 0.8; 95% CI: 0.1, 1.4) and length-for-age z-score (mean difference: 0.5; 95% CI: 0.2, 0.8) at 6 months of age.Conclusions/SignificanceIn a study population composed of both STH-infected and uninfected mothers, maternal postpartum deworming was insufficient to impact infant growth and morbidity indicators up to 6 months postpartum. Among STH-infected mothers, however, important improvements in infant length gain and length-for-age were observed. The benefits of maternal postpartum deworming should be further investigated in study populations having higher overall prevalences and intensities of STH infections and, in particular, where whipworm and hookworm infections are of public health concern.Trial registrationClinicalTrials.gov (NCT01748929).

Are early first trimester weights valid proxies for preconception weight?

BackgroundAn accurate estimate of preconception weight is necessary for providing a gestational weight gain range based on the Institute of Medicine’s guidelines; however, an accurate and proximal preconception weight is not available for most women. We examined the validity of first trimester weights for estimating preconception body mass index category.MethodsUnder identical measurement conditions, preconception weight and two first trimester weights (i.e., 4–10 and 12 weeks gestation) were obtained (n = 43).ResultsThe 4–10 week and the 12 week weight correctly classified 95 and 91% women, respectively. Mean weight changes were relatively small overall (M = 0.74 ± 1.99 kg at 4–10 weeks and M = 1.02 ± 2.46 at 12 weeks). There was a significant difference in mean weight gain by body mass index category at 4–10 weeks (−0.09 ± 1.86 kg for normal weight participants vs. 1.61 + 1.76 kg for overweight/obese participants, p = 0.01), but not at 12 weeks (0.53 ± 2.29 kg for normal weight participants vs. 1.54 ± 2.58 kg for overweight/obese participants).ConclusionsAssigning gestational weight gain guidelines based on an early first trimester weight resulted in 5–9% of women being misclassified depending on the gestational week the weight was obtained. Thus, most women are correctly classified based on a first trimester weight, particularly an early first trimester weight, although it is possible that modeling strategies could be developed to further improve estimates of preconception body mass index category.Trial registrationClinicaltrials.gov # NCT01131117, registered May 25, 2010.

Routine weighing to reduce excessive antenatal weight gain: a randomised controlled trial.

To assess whether routinely weighing women at each antenatal visit leads to a difference in gestational weight gain and weight gain within the Institute of Medicine (IOM) recommendation. A randomised controlled trial. Antenatal clinics in a tertiary obstetric hospital in Melbourne, Australia. Healthy women were enrolled during their antenatal booking visit if they were between 18 and 45 years of age, were <21 weeks' gestation with a singleton pregnancy. The intervention was weighing at each antenatal clinic appointment followed by counselling by their treating clinician according to IOM gestational weight gain guidelines. The control group had standard antenatal care comprising recording weight at booking and then at 36 weeks. Primary analysis was by intention-to-treat. The primary outcome was difference in mean weight gain between groups. An important secondary outcome was gestational weight gain within IOM recommendations. Secondary outcomes also included maternal or neonatal morbidity. Seven hundred and eighty two women consented to take part and 386 were randomised to the intervention group and 396 to the control group. There was no significant difference in weight gain between the intervention group (0.54 kg/week) compared with the control group (0.53 kg/week) (P = 0.63). A similar proportion of women gained more weight than the IOM recommended range: 75% in the intervention group and 71% in the control group (P = 0.21). There were no significant differences in secondary outcomes between the two groups. We found no evidence that regular weighing in antenatal clinics changed weight gain or was effective at reducing excessive gestational weight gain.

Lactation in Relation to Long-Term Maternal Weight Gain in African-American Women.

We assessed the relationship of lactation to long-term maternal weight gain among African-American women, who have a lower prevalence of lactation and a higher prevalence of obesity than other US women. A pregnancy cohort of 3,147 African-American women from the Black Women's Health Study who gave birth for the first time between 1995 and 2003 was followed for 8 years postpartum. Participants provided data on weight, lactation, gestational weight gain, education, diet, and exercise. Mean differences in weight gain were estimated in multivariable models. Overall, lactation was not associated with mean weight gain. However, the association was modified by prepregnancy body mass index (BMI; weight (kg)/height (m)2) (P for interaction=0.03): Among women with BMI<30 prior to the pregnancy, mean weight gain decreased with increasing months of lactation (P for trend<0.01), whereas among obese women (BMI≥30), mean weight gain increased with increasing duration of lactation (P for trend=0.04). Adjusted mean differences for ≥12 months of lactation relative to no lactation were -1.56 kg (95% confidence interval: -2.50, -0.61) among nonobese women and 2.33 kg (95% confidence interval: -0.35, 5.01) among obese women. The differences in postpartum mean weight gain persisted over the 8-year study period. Residual confounding by factors more common in women who breastfeed longer may have influenced the results.

Effect of tactile kinesthetic stimulation on preterm infants' weight and length of hospital stay in Khartoum, Sudan.

Objectives:To determine the effect of 7 days tactile kinesthetic stimulation (TKS) on preterm infants’ weight and hospital stays in Khartoum State, Sudan.Methods:This is a quasi-experimental study, it was conducted in 4 hospitals between January and June 2013, Khartoum, Sudan, and it involved 160 preterm infants randomly assigned into the case and control groups (80 neonates in each). Preterm infants in the control group received routine nursing care, while preterm infants in the case group received TKS for 3 periods, 15 minute per day for 7 constitutive days, in addition to routine care. Data was collected using a structured self-designed and validated questionnaire, checklist, and weighting scale. Weight gain and hospital stay were compared between the 2 groups.Results:Over the constitutive 7 days, the case group gained significantly more weight (1071gm versus 1104gm) compared with the control group (1077gm versus 1084gm) (1084.55±90.74) who gained only 6.9gm within the same 7 days without TKS treatment. The mean difference in weight gain was significant (p=0.00). The hospital stay for preterm infants in the case group was significantly shorter (18.05±9.36 versus 25.47±10.25; p=0.00).Conclusion:Tactile kinesthetic stimulation for preterm infants has a beneficial effect on weight gain and earlier discharge from hospital, which are sequentially efficient and cost effective.

Growth and safety evaluation of infant formulae containing oligosaccharides derived from bovine milk: a randomized, double-blind, noninferiority trial.

BackgroundA limited number of nondigestible oligosaccharides are available for use in infant formula. This study evaluated growth and safety in infants fed formula supplemented with a mixture of bovine milk-derived oligosaccharides (BMOS). This mixture, which was generated from whey permeate, contains galactooligosaccharides and other oligosaccharides from bovine milk, such as 3′- and 6′-sialyllactose. We hypothesized that growth in infants fed BMOS-supplemented formula would be noninferior to that in infants fed standard formula.MethodsHealthy term infants ≤14 days old were randomly assigned to standard formula (control; n = 84); standard formula with BMOS (IF-BMOS; n = 99); or standard formula with BMOS and probiotics (Bifidobacterium longum, Lactobacillus rhamnosus) (IF-BMOS + Pro; n = 98). A breastfed reference group was also enrolled (n = 30). The primary outcome was mean weight gain/day from enrollment to age 4 months (noninferiority margin: −3.0 g/day).Results189 (67.3%) formula-fed infants were included in the primary analysis. Mean differences in weight gain between the control and IF-BMOS and IF-BMOS + Pro groups were <1 g/day, with 97.5% confidence intervals above −3.0 g/day, indicating noninferior weight gain in the BMOS formula groups. Compared with control, infants in the BMOS groups had more frequent (p < 0.0001) and less hard (p = 0.0003) stools. No significant differences were observed between the control and BMOS groups in caregivers’ reports of flatulence, vomiting, spitting up, crying, fussing, and colic. When based on clinical evaluation by the investigator, the incidence of colic was higher (p = 0.01) in IF-BMOS than in control; the incidence of investigator-diagnosed colic was not significantly different in control and IF-BMOS + Pro (p = 0.15). Stool bifidobacteria and lactobacilli counts were higher with IF-BMOS + Pro compared with control (p < 0.05), whereas Clostridia counts were lower (p < 0.05) in both BMOS groups compared with control.ConclusionsInfant formula containing BMOS either with or without probiotics provides adequate nutrition for normal growth in healthy term infants. Further studies are needed to fully explore the digestive tolerance of BMOS formula.Trial registrationClinicalTrials.gov NCT01886898. Registered 24 June 2013.

Maternal Exercise and Growth in Breastfed Infants: A Meta-analysis of Randomized Controlled Trials

Studies have revealed that women who breastfeed their infants may be reluctant to exercise due to concerns that to do so would adversely affect their breast milk and consequently the growth of their infants. In this review, we seek to systematically review and statistically synthesize evidence from randomized controlled trials (RCTs) that have assessed the effects of maternal exercise on breastfed infant growth (weight gain and gain in length). Searches of the following electronic bibliographic databases were performed to identify RCTs: Cochrane Library (CENTRAL), Medline/PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and SPORT Discus. RCTs that compared any type of exercise intervention with other treatments or no treatment in women exclusively or predominately breastfeeding were eligible for inclusion, as were trials involving exercise as a cointervention. Two authors extracted data from studies independently. Four RCTs (5 comparisons) were included in the meta-analysis of infant weight gain that incorporated 170 participants. In breastfed infants, maternal exercise did not significantly affect infant weight gain (difference in mean weight gain = 18.6 g [95% confidence interval: -113.52 to 150.80, P = .73]). Only 1 trial assessed infant gain in length; no difference between the exercise and control groups was reported. Trials were classified as moderate or good methodological quality (moderate risk of bias). It appears that mothers can exercise and breastfeed without detriment to the growth of their infants, but this is based on limited evidence, and more research is required before this finding is confirmed.

Weight gain, physical activity and dietary changes during the seven months of first-year university life in Malawi

Objective: The objective of the study was to assess weight gain, physical activity and dietary changes during the first year of university life in Malawi.Setting: The setting was Bunda College of Agriculture, University of Malawi.Subjects: The subjects were first-year students (n = 47) enrolled for the 2008/2009 academic year.Method: A prospective cohort study was carried out, with repeated measures (November 2008 and June 2009). It included residential and nonresidential students. Data were collected using self-administered structured questionnaires. Weight, height and mid-upper-arm circumference were measured.Results: There was a significant difference in mean weight gain between female (7.1 ± 3.2 kg, n = 26) and male students (9.6 ± 3.5 kg, n = 21) (p-value = 0.013). Overall, within the first year of university life, the students gained 8.5 ± 3.6 kg (p-value < 0.001), and a modest but significant height of 0.2 cm (p-value = 0.04). Body mass index (kg/m2) increased from 20.7 ± 3.2 to 23.9 ± 3.2 (p-value < 0.001). At the baseline, in general, the students lived sedentary lives, with 6.6 hours spent resting, 2.1 hours engaged in light activities, and 0.9 hours engaged in heavy activities. No significant changes were observed at the end of the study. Daily consumption of wheat products, meat and meat products, sugar, milk and milk products and margarine increased, while that of other foods such as fish, and fruits and vegetables declined.Conclusion: Unprecedented freshman weight gain was observed in this study. Transition to university life in Malawi might be the beginning of poor dietary and lifestyle changes. If not restrained, these could elevate the risk of lifestyle diseases in people who have attained tertiary education and who are important to national development.

Olanzapine-Induced Weight Gain in Patients With Bipolar I Disorder

The weight impact produced by the atypical antipsychotic olanzapine has been explored in meta-analyses focusing on patients with schizophrenia. However, outcomes identified for schizophrenia patients cannot always be generalized to patients with bipolar disorder. This study aims to quantitatively estimate the impact of olanzapine on the weight of patients with bipolar disorder. EMBASE, Medline, and PsycINFO were searched using the keywords olanzapine AND (bipolar OR acute mania) in conjunction with (weight gain OR weight increase) (last search: October 2010, with no restrictions on dates of publication). English language was used as a restriction. The search identified 110 articles for review. The inclusion criteria for the chosen studies were a diagnosis of bipolar disorder, the presence of an olanzapine monotherapy group, a comparator placebo or monotherapy group, and mean weight gain and/or incidences of weight gain data. This process identified 13 studies for inclusion. The primary outcome measure was the mean weight change between olanzapine monotherapy and comparator monotherapy, reported in kilograms. Standard deviation was extracted directly from studies when possible and imputed for 3 studies. The secondary outcome measure was the reported incidences of ≥ 7% weight gain. The mean difference in weight gain was calculated for the continuous data of the primary outcome. Olanzapine monotherapy was associated with more weight gain when compared to placebo (mean difference = 2.10 kg; 95% CI, 1.16-3.05; P < .001) and other bipolar monotherapy (mean difference = 1.34 kg; 95% CI, 0.95-1.72; P < .001). Odds ratio analysis of the dichotomous secondary outcome also showed more weight gain with olanzapine monotherapy compared to placebo (odds ratio [OR] = 10.12; 95% CI, 1.93-53.14; P = .006) and other bipolar monotherapy (OR = 2.09; 95% CI, 1.27-3.44; P = .004). Currently available data suggest that olanzapine is associated with significant weight gain in bipolar patients. Issues related to side effect profiles and their impact on treatment compliance and physical health outcomes need to be considered when selecting pharmacotherapy.

The Effect of Bifidobacterium lactis on the Growth of Infants: A Pooled Analysis of Randomized Controlled Studies

Background/Aims: Breast milk is the best source of nutrition for the growth of the newborn infant. It is therefore essential that mothers who cannot breastfeed or choose not to are provided with alternatives that closely match the composition and functionality of breast milk. This study aimed to investigate the growth effects of probiotic-supplemented formulas on both healthy and vulnerable populations of infants. Methods: A meta-analysis of data from 5 randomized controlled clinical trials that included infants fed formulas containing a probiotic Bifidobacterium lactis CNCM I-3446 was performed (n = 525). A sub-analysis was performed among infants of HIV-positive mothers (n = 120). Growth measurements (gain in weight and body mass index, BMI, from enrollment to 120 days) were compared between infants fed a formula containing B. lactis and those fed a control formula. Changes in length and Z-scores were also compared. Results: Formula with B.lactis was demonstrated to be at least as good as formula without B. lactis in the meta-analysis of 5 studies. The lower boundary of the 95% confidence interval (CI) of the differences in mean weight gain (95% CI 0.09–2.93 g/day) was above the predefined non-inferiority margin of –3.0 g/day. Moreover, among infants with HIV-positive mothers, weight gain of those taking B. lactis was significantly higher than of those not taking B. lactis, by 3.1 g/day (95% CI 0.4–5.8 g/day, p = 0.0226) and the BMI gains were significantly higher, by 6.4 g/m²/day (95% CI 0.0.3–12.5 g/m²/day, p = 0.0400). The corresponding weight for age and BMI Z-scores were also significantly higher, by 0.37 (95% CI 0.03–0.71, p = 0.0308) and by 0.42 (95% CI 0.02–0.83, p = 0.0377), respectively, whereas differences in length gain or length-for-age Z-score were not significant. Among infants in the non-HIV mothers group, there were no significant differences between infants fed formulas with or without B. lactis, for any of the growth parameters. Conclusions: The analysis suggests that B. lactis may have a positive effect on growth in vulnerable populations, specifically in infants born to mothers with HIV.

Impact of targeted food supplementation on pregnancy weight gain and birth weight in rural Bangladesh: an assessment of the Bangladesh Integrated Nutrition Program (BINP)

To assess whether the Bangladesh Integrated Nutrition Programme (BINP) correctly identified which pregnant women should be enrolled in the food supplementation programme, whether supplementation commenced on time and was taken on a regular basis. A second objective was to determine whether food supplementation led to enhanced pregnancy weight gain and reduction in the prevalence of low birth weight. A one-year community-based longitudinal study. A rural union of Bhaluka Upazila, Mymensingh, located 110 km north-west of Dhaka City, the capital of Bangladesh.ParticipantsA total of 1104 normotensive, non-smoking pregnant women who attended Community Nutrition Centres were studied from first presentation at the centre until child delivery. Pregnant women who had a BMI of <18.5 kg/m(2) on first presentation should have been selected for supplementary feeding (2512 kJ (600 kcal)/d for six days per week) starting at month 4 (16 weeks) of pregnancy. However, of the 526 women who had BMI < 18.5 kg/m(2), only 335 received supplementation; so the failure rate was 36.3 %. In addition, of those receiving supplementation, only 193 women (36.7 % of 526 women) commenced supplementation at the correct time, of whom thirty-two (9.6 % of 335 women) received supplementation for the correct number of days (100 % days). There were no significant differences in mean weight gain between BMI < 18.5 kg/m(2) supplemented or non-supplemented groups or between the equivalent groups with BMI > or = 18.5 kg/m(2). Weight gain was inversely related to initial weight, so lighter women gained relatively more weight during their pregnancy than heavier women. The mean birth weight in the supplemented and non-supplemented groups was 2.63 kg and 2.72 kg, respectively. Mothers with BMI < 18.5 kg/m(2) who were or were not supplemented had almost equal percentages of low-birth-weight babies (21 % and 22 %, respectively). The study raises doubt about the efficiency of the BINP to correctly target food supplementation to pregnant women. It also shows that food supplementation does not lead to enhanced pregnancy weight gain nor does it provide any evidence of a reduction in prevalence of low birth weight.

A proof of concept randomised placebo controlled factorial trial to examine the efficacy of St John's wort for smoking cessation and chromium to prevent weight gain on smoking cessation

Background St John's wort is an effective antidepressant that can reduce tobacco withdrawal symptoms, but it is not known whether it assists cessation. Chromium assists weight loss and might limit post cessation weight gain. Methods In a factorial design, we randomised smokers stopping smoking to 900 mg St John's wort (SJW) active or placebo and also randomised them to 400 μm chromium or placebo daily. Treatment started 2 weeks prior to quit day and continued for 14 weeks. Participants and researchers were blind to treatment allocation. All participants received weekly behavioural support. The primary endpoints were biochemically confirmed prolonged abstinence and mean weight gain in abstinent smokers 4 weeks after quitting. Results 6/71 (8.5%) participants on active SJW and 9/72 (12.5%) on placebo achieved prolonged abstinence at 4 weeks, an odds ratio (OR) (95% confidence interval) of 0.65 (0.22–1.92). At 6 months, 3 (4.2%) SJW active and 6 (8.3%) SJW placebo participants were still abstinent, an OR of 0.49 (0.12–2.02). Among these participants, the mean difference in weight gain between active chromium and placebo was −0.81 kg (−3.79 to 2.18) at 4 weeks and −3.88 kg (−12.13 to 4.38) at 6 months. Conclusions Taking together the absolute quit rates, the small difference between active and placebo, and lack of effects on withdrawal shows that SJW is ineffective for smoking cessation. Insufficient people stopped smoking to properly test the efficacy of chromium in preventing weight gain, but the point estimate indicates a potentially worthwhile benefit.