Early Dietary Interventions Research Articles

Quantitative computed tomography analysis of body composition changes in paediatric patients with acute lymphoblastic leukaemia.

Children with acute lymphoblastic leukaemia (ALL) are at risk for obesity and cardiometabolic diseases. To gain insight into body composition changes among children with ALL, we assessed quantitative computed tomography (QCT) data for specific body compartments (subcutaneous adipose tissue [SAT], visceral adipose tissue [VAT], total adipose tissue [TAT], lean tissue [LT], LT/TAT and VAT/SAT at lumbar vertebrae L1 and L2) at diagnosis and at off-therapy for 189 children with ALL and evaluated associations between body mass index (BMI) Z-score and clinical characteristics. BMI Z-score correlated positively with SAT, VAT and TAT and negatively with LT/TAT and VAT/SAT. At off-therapy, BMI Z-score, SAT, VAT and TAT values were higher than at diagnosis, but LT, LT/TAT and VAT/SAT were lower. Patients aged ≥10 years at diagnosis had higher SAT, VAT and TAT and lower LT and LT/TAT than patients aged 2.0-9.9 years. Female patients had lower LT and LT/TAT than male patients. Black patients had less VAT than White patients. QCT analysis showed increases in adipose tissue and decreases in LT during ALL therapy when BMI Z-scores increased. Early dietary and physical therapy interventions should be considered, particularly for patients at risk for obesity.

Effect of Early Dietary Interventions on Energy Expenditure and Nutrient Oxidation in Newborn Intrauterine Restricted Piglets: A Pilot Study

Effect of Early Dietary Interventions on Energy Expenditure and Nutrient Oxidation in Newborn Intrauterine Restricted Piglets: A Pilot Study

Association between dietary inflammatory index and metabolic syndrome: Analysis of the NHANES 2005-2016.

ObjectiveMetabolic syndrome (MetS) is a global problem that increasingly violates human health and quality of life. We explored the relationship between dietary inflammatory potential represented by dietary inflammatory index (DII) and the occurrence of MetS to provid data support for the prevention of it through dietary structure intervention.MethodsThe data was come from National Health and Nutrition Examination Survey 2007–2018, including demographic, dietary, questionnaire variables and laboratory indicators. MetS was defined according to the criteria proposed by the American Endocrine Association (ACE) and the American Society of Clinical Endocrinology (ACCE). DII was calculated using the scoring method established by Shivappa. We divided DII scores into 4 quartiles, the chi-square test was used to compare the variable difference between DII quartiles groups. A logistic regression model was used to analyze the association between DII and MetS. We also performed subgroup analysis. A generalized linear regression model was used to explore the association of DII level and the levels of seven MetS related biochemical indicators.ResultsThe final sample size was 8,180, and the DII scores of the subjects were −5.50 to 5.22. The proportions of men, young people, non-Hispanic blacks, poor people, smokers, and MetS patients in the Q1–Q4 DII quantiles groups were gradually increased. The risk of MetS in the Q4 group which had highest dietary inflammatory degree was 1.592 (1.248, 2.030) times higher than that in the Q1 group, respectively (P < 0.001). After subgroup analysis, women, youth, non-smokers and alcohol drinkers were found to be more sensitive to the dietary inflammation. Then we found that the level of DII was significantly positively correlated with waist circumference (WC), body mass index (BMI), triglyceride (TG), systolic blood pressure (SBP) and diastolic blood pressure (DBP), but negatively correlated with high density lipoprotein cholesterol (HDL-C).ConclusionsIn the research subjects, the degree of dietary inflammation was associated with the occurrence of MetS and significantly affected WC, BMI, blood pressure, and blood lipid levels. It is necessary to conduct investigations and early dietary interventions for women and young people to prevent the occurrence of chronic metabolic diseases.

The effect of a Mediterranean diet on the symptoms of depression in young males (the “AMMEND: A Mediterranean Diet in MEN with Depression” study): a randomized controlled trial

Depression is a common mental health condition that affects 1 in 8 males each year, especially young adults. Young adulthood offers an opportunity for early dietary interventions, with research suggesting that a Mediterranean diet (MD) could be beneficial in treating depression. This study aimed to determine if an MD can improve depressive symptoms in young males with clinical depression. A 12-wk, parallel-group, open-label, randomized controlled trial was conducted to assess the effect of an MD intervention in the treatment of moderate to severe depression in young males (18-25 y). Befriending therapy was chosen for the control group. Assessments were taken at baseline, week 6, and week 12. MD adherence was measured with the Mediterranean Diet Adherence Score (MEDAS). The primary outcome measure was the Beck Depression Inventory Scale-version II (BDI-II) and secondary outcome was quality of life (QoL). A total of 72 participants completed the study. After 12 wk, the MEDAS scores were significantly higher in the MD group compared with the befriending group (mean difference: 7.8; 95% CI: 7.23, 8.37; P<0.001). The mean change in BDI-II score was significantly higher in the MD group compared with the befriending group at week 12 (mean difference: 14.4; 95% CI: 11.41, 17.39; P<0.001). The mean change in QoL score was also significantly higher in the MD group compared with the befriending group at week 12 (mean difference: 12.7; 95% CI: 7.92, 17.48; P<0.001). Our results demonstrate that compared with befriending, an MD intervention leads to significant increases in MEDAS, decreases in BDI-II score, and increases in QoL scores. These results highlight the important role of nutrition for the treatment of depression and should inform advice given by clinicians to this specific demographic population.The trial was registered with Australia and New Zealand Clinical Trials Registry (trial ID ACTRN12619001545156) and has also been registered with the WHO International Clinical Trials Registry Platform (Universal Trial Number U1111-1242-5215).

Association Between the Children's Dietary Inflammatory Index (C-DII) and Markers of Inflammation and Oxidative Stress Among Children and Adolescents: NHANES 2015-2018.

ObjectivesTo explore the association of Children's Dietary Inflammatory Index (C-DII) scores with inflammation and markers of inflammatory factors in children and adolescents.MethodsData on dietary nutrient intake, markers of inflammation (ferritin, alkaline phosphatase, C-reactive protein (CRP), absolute neutrophil cell count and lymphocyte count) and oxidative stress (serum bilirubin, albumin, and iron) were available for participants aged 6–19 years (n = 1281). Each participant's C-DII score was calculated based on a 24-h diet and recall. Generalized linear models were applied to examine associations between C-DII and markers of inflammation and oxidative stress, while adjusting for covariates. Restricted cubic splines were used to explore the dose-response association of C-DII scores with indicators of inflammatory oxidative stress. Akaike's Information Criterionwas applied to compare the performance of linear and non-linear models.ResultsAfter adjusting for potential confounders, quantile regression results showed that when comparing C-DII quartile 4 (most pro-inflammatory) and quartile 1 (most anti-inflammatory), lymphocytes, ferritin, CRP were statistically significant differences in serum bilirubin, albumin and serum iron (P < 0.05). The C-DII score showed a non-linear relationship with inflammatory oxidative stress indicators. Overweight/obese children and adolescents who ate a high pro-inflammatory diet were more likely to have higher levels of inflammatory cytokines (P = 0.002).ConclusionsThe dietary inflammatory index in children is associated with markers of chronic inflammation and oxidative stress. A pro-inflammatory diet resulted in increased serum concentrations of these markers, implying that early dietary interventions have implications for reducing chronic inflammation and oxidative stress in children and adolescents.

Sex differences in cardiovascular risk factors of children and adolescents with type 1 diabetes mellitus: A role for diet?

Background and aimsCardiovascular disease is the leading cause of morbidity and mortality in individuals with type 1 diabetes mellitus (T1DM). Cardiovascular risk is higher in women with diabetes than in men. With this study, we wanted to determine whether female children and adolescents with T1DM are more prone to cardiovascular risk factors (CVRFs) and an atherogenic diet than boys. Methods and resultsFor this cross-sectional study, anthropometric, clinical, biochemical, and dietary intake data of 314 children with diabetes (3–18 years; 178 boys) were analysed according to age and sex. Linear and binary logistic regression was performed to test independent associations between sex, dietary intake, and CVRFs.Low-density lipoprotein -cholesterol (LDL-c), triglyceride (TG), fibre, monounsaturated fatty acid levels (all p < 0.01), and lipid (p = 0.022) intake were higher in the girls than in the boys. Multiple regression analysis showed that LDL was associated with sex, glycated haemoglobin (HbA1c), and lipid intake percentage (R (Kannel, 1979) [2] = 0.130; p = 0.0004) independent of age, pubertal stage, body mass index (BMI), duration of diabetes, energy, and fibre intake. Logistic regression analysis showed that high LDL-c levels were present more often in girls [odds ratio, OR; confidence interval, CI = 2.569 (1.178–5.604); p = 0.018] who had a higher dietary lipid intake percentage [OR (CI) = 1.089 (1.011–1.173); p = 0.025]. ConclusionsGirls with diabetes have higher LDL-c levels associated with higher dietary lipid intake. Our findings suggest that young people with diabetes, especially girls, may benefit from early dietary interventions to reduce their cardiovascular risk.

Abstract 10695: Early Overnutrition in Rats Induces Premature Cardiac Alterations Independently of Blood Pressure: Leptin-TRH Pathway Involvement

Animal models are an interesting tool to evaluate future consequences of early nutritional insults. We described in adult mice that: leptin induces cardiac cTRH, leading to cardiac damage regardless of blood pressure in hyperleptinemic Agouti. Conversely, cTRH in the ob/ob lacking leptin is similar to control and even do not have Left Ventricular Hypertrophy (LVH). Moreover, leptin restitution induces cTRH and later LVH. Also, in C57BL/6 a 3-week subanorexigenic leptin dose induced cTRH and sequent LVH. All this suggests that heart damage in obesity depends on the novel leptin-cTRH pathway. Plus, Leptin directly induces TRH in cell culture (Aisicovich 2019, AHA) To further investigate the impact of early dietary interventions in childhood, we studied rat litter size reduction, a model with a reported increase in body weight, fat, leptin, insulin and cholesterol levels (Stefanidis A, 2012) We hypothesize that leptin rise increases cTRH leading to cardiac damage, independently of hypertension. On postnatal day 4, Wistar rat litters of 11 pups at birth were adjusted to 4 male pups (overnourished ON) or 11 (control C). At weaning, we individualized rats with free access to water and standard diet up to 7 weeks old. The rise in body weight, food consumption, and fat in ON vs C (p&lt;0.02 n=10 ANOVA) confirmed the model. There weren’t any blood pressure differences between groups, still LVH index increased (heart weight/tibia length) (p&lt; 0.01 n=6) in ON vs C. As expected, in ON the higher leptin increased cTRH mRNA (p&lt; 0.01 n=6) as protein [WB (p=0.05 n=3) IHQ (p&lt;0.04 n=6)] vs C. According to cTRH actions, hypertrophic and fibrotic markers TGF-B and Collagens 1 and 3 mRNA increased (p&lt;0.01, n=6) confirmed by IHQ and Sirius red staining (p&lt; 0.01 n=6) Also, echocardiogram showed increases in LV end-diastolic (0.26±0.08 vs 0.61±0.07 ml p &lt;0.01) and end-systolic (0.02±0.02 vs 0.11±0.01 ml p &lt;0.01) volumes, and decreases in LV ejection fraction (94.5±2.2 vs 83.3±1.9 % p &lt;0.01) and SF (54.4±2.6 vs 45.0±2.3 % p &lt;0.02) This could be restored by cTRH inhibition as demonstrated in the cardiac infarct model (Schuman ML, 2021) Our results point out that early overnutrition induces evident cardiac damage already at 7 weeks, independently of blood pressure and mostly driven by the leptin-TRH pathway.

Association of Gut Microbiome Dysbiosis with Neurodegeneration: Can Gut Microbe-Modifying Diet Prevent or Alleviate the Symptoms of Neurodegenerative Diseases?

The central nervous system was classically perceived as anatomically and functionally independent from the other visceral organs. But in recent decades, compelling evidence has led the scientific community to place a greater emphasis on the role of gut microbes on the brain. Pathological observations and early gastrointestinal symptoms highlighted that gut dysbiosis likely precedes the onset of cognitive deficits in Alzheimer’s disease (AD) and Parkinson’s disease (PD) patients. The delicate balance in the number and functions of pathogenic microbes and alternative probiotic populations is critical in the modulation of systemic inflammation and neuronal health. However, there is limited success in restoring healthy microbial biodiversity in AD and PD patients with general probiotics interventions and fecal microbial therapies. Fortunately, the gut microflora is susceptible to long-term extrinsic influences such as lifestyle and dietary choices, providing opportunities for treatment through comparatively individual-specific control of human behavior. In this review, we examine the impact of restrictive diets on the gut microbiome populations associated with AD and PD. The overall evidence presented supports that gut dysbiosis is a plausible prelude to disease onset, and early dietary interventions are likely beneficial for the prevention and treatment of progressive neurodegenerative diseases.

Abstract 26: Polygenic Risk Score for Obesity Modifies Associations of Proinflammatory Diets With Obesity, Long-term Weight Gain, and Cardiovascular Disease Risk: The Utilization of Polygenic Prediction in 3 US Prospective Cohorts

Background: Individuals predisposed to higher genetic risk of obesity may need early dietary interventions to prevent obesity and its comorbidities. Hypothesis: Proinflammatory diets may interact with genetic background to modify risks of obesity, long-term weight gain, and cardiovascular disease (CVD). Methods: We prospectively followed 16 281 and 11 832 women in the Nurses’ Health Study I and II, and 10 172 men in Health Professionals Follow-up Study, with available genetic data, for up to 28 years. Diet and weight were assessed every 4 years. Dietary inflammatory potential was assessed by an empirical dietary inflammatory pattern (EDIP) score pre-defined based on associations of foods with inflammatory markers. Polygenic risk scores (PRS) of body mass index (BMI), waist-hip ratio, and body fat mass, developed based on genome-wide association data of 9 million variants in 389 972 UK Biobank participants using LDpred, were applied to characterize genetic predispositions to obesity, central obesity, and adiposity. Results: All 3 PRS were highly predictive for BMI ( Fig. A ). In pooled multivariable analyses, higher EDIP scores were associated with a higher BMI, with the association 2-3 folds stronger comparing participants in the highest 10% to the lowest 10% of genetic risk of obesity/adiposity ( P interaction ≤0.001; Fig. B ). The positive association between EDIP and CVD incidence was 1.6-fold stronger in participants at a higher genetic risk of central obesity ( P interaction =0.04; Fig. C ). In addition, an increase in EDIP scores was associated with a greater long-term weight gain, while a reduction in EDIP was associated with a greater weight loss, comparing participants in the highest 10% of genetic risk to those at lower risks, among participants aged &lt;65 years but not above ( P interaction &lt;0.005; Fig. D ). Conclusions: Polygenic background modifies associations of proinflammatory diets with obesity, long-term weight change, and CVD risk. PRS may be useful tools to identify individuals in need for early dietary interventions.

The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction of Allergenic Complementary Foods.

This clinical report updates and replaces a 2008 clinical report from the American Academy of Pediatrics, which addressed the roles of maternal and early infant diet on the prevention of atopic disease, including atopic dermatitis, asthma, and food allergy. As with the previous report, the available data still limit the ability to draw firm conclusions about various aspects of atopy prevention through early dietary interventions. Current evidence does not support a role for maternal dietary restrictions during pregnancy or lactation. Although there is evidence that exclusive breastfeeding for 3 to 4 months decreases the incidence of eczema in the first 2 years of life, there are no short- or long-term advantages for exclusive breastfeeding beyond 3 to 4 months for prevention of atopic disease. The evidence now suggests that any duration of breastfeeding ≥3 to 4 months is protective against wheezing in the first 2 years of life, and some evidence suggests that longer duration of any breastfeeding protects against asthma even after 5 years of age. No conclusions can be made about the role of breastfeeding in either preventing or delaying the onset of specific food allergies. There is a lack of evidence that partially or extensively hydrolyzed formula prevents atopic disease. There is no evidence that delaying the introduction of allergenic foods, including peanuts, eggs, and fish, beyond 4 to 6 months prevents atopic disease. There is now evidence that early introduction of peanuts may prevent peanut allergy.

Implications of Epigenetic Drift in Colorectal Neoplasia.

Many normal tissues undergo age-related drift in DNA methylation, providing a quantitative measure of tissue age. Here, we identify and validate 781 CpG islands (CGI) that undergo significant methylomic drift in 232 normal colorectal tissues and show that these CGI continue to drift in neoplasia while retaining significant correlations across samples. However, compared with normal colon, this drift advanced (∼3-4-fold) faster in neoplasia, consistent with increased cell proliferation during neoplastic progression. The observed drift patterns were broadly consistent with modeled adenoma-to-carcinoma sojourn time distributions from colorectal cancer incidence data. These results support the hypothesis that, beginning with the founder premalignant cell, cancer precursors frequently sojourn for decades before turning into cancer, implying that the founder cell typically arises early in life. At least 77% to 89% of the observed drift variance in distal and rectal tumors was explained by stochastic variability associated with neoplastic progression, whereas only 55% of the variance was explained for proximal tumors. However, gene-CGI pairs in the proximal colon that underwent drift were significantly and primarily negatively correlated with cancer gene expression, suggesting that methylomic drift participates in the clonal evolution of colorectal cancer. Methylomic drift advanced in colorectal neoplasia, consistent with extended sojourn time distributions, which accounts for a significant fraction of epigenetic heterogeneity in colorectal cancer. Importantly, these estimated long-duration premalignant sojourn times suggest that early dietary and lifestyle interventions may be more effective than later changes in reducing colorectal cancer incidence. SIGNIFICANCE: These findings present age-related methylomic drift in colorectal neoplasia as evidence that premalignant cells can persist for decades before becoming cancerous.See related commentary by Sapienza, p. 437.

The bully-victim overlap and nutrition among school-aged youth in North America and Europe

Bullying behavior and its consequences is a public health issue of significant concern, due to the wide range of deleterious health, mental health, behavioral, and psychosocial problems identified among adolescent bully victims. Even so, the role of dietary behaviors in bullying and bully victimization remains unclear. Our objective was to examine the associations between dietary patterns among youth, bully perpetration, and bully victimization. We employed a cross-national study of approximately 150,000 youths, aged 10–16, from 40 different countries with complete information about bully victimization, perpetration, and a number of dietary items reflecting three different nutritional dimensions – health food consumption, junk food consumption, and meal deprivation. The findings indicate that health food consumption, junk food consumption, and meal deprivation were significantly associated with bully perpetration, regardless of whether bullying co-occurred with victimization (low health food consumption: OR = 1.24, CI = 1.19–1.30; high junk food consumption: OR = 1.66, CI = 1.60–1.73; frequent meal deprivation: OR = 1.48, CI = 1.42–1.54). Even so, none of the three dietary dimensions were associated with significant changes in the odds of bully victimization in the absence of perpetration. Ultimately, the predicted probability of being a bully more than doubles among youths reporting all three dimensions of nutritional risk, relative to youths reporting none. We propose that early dietary interventions among youth that diminish hunger and improve eating behaviors among at-risk populations may help to reduce the prevalence of bullying and its negative sequelae.

Children\u2019s, parents\u2019 and other stakeholders\u2019 perspectives on early dietary self-management to delay disease progression of chronic disease in children: a protocol for a mixed studies systematic review with a narrative synthesis

BackgroundChronic disease of childhood may be delayed by early dietary intervention. The purpose of this systematic review is to provide decision-makers with a perspective on the role of early dietary intervention, as a form of self-management, to delay disease progression in children with early chronic disease, as described by children, parents and other stakeholders.MethodsThe study will systematically review empirical research (qualitative, quantitative and mixed method designs), including grey literature, using a narrative synthesis. A four-stage search process will be conducted involving a scoping search, the Scottish Intercollegiate Guidelines Network (SIGN) Patient Issues search filter on MEDLINE, the search of seven databases using a chronic disease and chronic kidney disease (CKD) search strategy, and hand searching the reference lists of identified papers for additional studies. All studies retrieved during the search process will undergo a screening and selection process against the inclusion/exclusion criteria. Methodological quality of relevant studies will be assessed using a validated Mixed Studies Review scoring system, before inclusion in the review. Relevant grey literature will be assessed for methodological quality and relative importance using McGrath et al.’s framework and the Academy Health advisory committee categories, respectively. Data extraction will be guided by the Centre for Review and Dissemination guidance and Popay et al.’s work. The narrative synthesis of the findings will use elements of Popay et al.’s methodology of narrative synthesis, applying recognised tools for each of the four elements: (1) developing a theory of how the intervention works, why and for whom; (2) developing a preliminary synthesis of findings of included studies; (3) exploring relationships in the data; and (4) assessing the robustness of the synthesis.DiscussionThis mixed studies systematic review with a narrative synthesis seeks to elucidate the gaps in current knowledge and generate a fresh explanation of research findings on early dietary self-management in chronic disease, with particular application to CKD, from the stakeholders’ perspective. The review will provide an important platform to inform future research, identifying the facilitators and barriers to implementing early dietary interventions. Ultimately, the review will contribute vital information to inform future improvements in chronic disease. The lead author has a particular interest in CKD paediatric service delivery.Systematic review registrationThe review has been registered with PROSPERO (CRD42017078130).

Multi-Omic Biogeography of the Gastrointestinal Microbiota of a Pre-Weaned Lamb.

The digestive functions of the pre-weaned lamb gastrointestinal tracts (GITs) have been the subject of much research in recent years, but the microbial and host functions underlying these complex processes remain largely unknown. Here, we undertook a proof-of-principle metaproteogenomic investigation on luminal and mucosal samples collected from 10 GITs of a 30-day-old pre-weaned lamb. We demonstrate that the analysis of the diverse ecological niches along the GITs can reveal microbiota composition and metabolic functions, although low amounts of microbial proteins could be identified in the small intestinal and mucosal samples. Our data suggest that a 30-day lamb has already developed mature microbial functions in the forestomachs, while the effect of the milky diet appears to be more evident in the remaining GITs. We also report the distribution and the relative abundance of the host functions, active at the GIT level, with a special focus on those involved in digestive processes. In conclusion, this pilot study supports the suitability of a metaproteogenomic approach to the characterization of microbial and host functions of the lamb GITs, opening the way to further studies aimed at investigating the impact of early dietary interventions on the GIT microbiota of small ruminants.

Understanding the gut microbiome of dairy calves: Opportunities to improve early-life gut health

Early gut microbiota plays a vital role in the long-term health of the host. However, understanding of these microbiota is very limited in livestock species, especially in dairy calves. Neonatal calves are highly susceptible to enteric infections, one of the major causes of calf death, so approaches to improving gut health and overall calf health are needed. An increasing number of studies are exploring the microbial composition of the gut, the mucosal immune system, and early dietary interventions to improve the health of dairy calves, revealing possibilities for effectively reducing the susceptibility of calves to enteric infections while promoting growth. Still, comprehensive understanding of the effect of dietary interventions on gut microbiota-one of the key aspects of gut health-is lacking. Such knowledge may provide in-depth understanding of the mechanisms behind functional changes in response to dietary interventions. Understanding of host-microbial interactions with dietary interventions and the role of the gut microbiota during pathogenesis at the site of infection in early life is vital for designing effective tools and techniques to improve calf gut health.

Early Low-Fat Diet Enriched With Linolenic Acid Reduces Liver Endocannabinoid Tone and Improves Late Glycemic Control After a High-Fat Diet Challenge in Mice.

Evidence suggests that alterations of glucose and lipid homeostasis induced by obesity are associated with the elevation of endocannabinoid tone. The biosynthesis of the two main endocannabinoids, N-arachidonoylethanolamine and 2-arachidonoyl-glycerol, which derive from arachidonic acid, is influenced by dietary fatty acids (FAs). We investigated whether exposure to n-3 FA at a young age may decrease tissue endocannabinoid levels and prevent metabolic disorders induced by a later high-fat diet (HFD) challenge. Three-week-old mice received a 5% lipid diet containing lard, lard plus safflower oil, or lard plus linseed oil for 10 weeks. Then, mice were challenged with a 30% lard diet for 10 additional weeks. A low n-6/n-3 FA ratio in the early diet induces a marked decrease in liver endocannabinoid levels. A similar reduction was observed in transgenic Fat-1 mice, which exhibit high tissue levels of n-3 FA compared with wild-type mice. Hepatic expression of key enzymes involved in carbohydrate and lipid metabolism was concomitantly changed. Interestingly, some gene modifications persisted after HFD challenge and were associated with improved glycemic control. These findings indicate that early dietary interventions based on n-3 FA may represent an alternative strategy to drugs for reducing endocannabinoid tone and improving metabolic parameters in the metabolic syndrome.

Delayed growth, motor function and learning in preterm pigs during early postnatal life.

Preterm birth interrupts normal fetal growth with consequences for postnatal growth and organ development. In preterm infants, many physiological deficits adapt and disappear with advancing postnatal age, but some may persist into childhood. We hypothesized that preterm birth would induce impaired organ growth and function during the first postnatal week in pigs, while motor abilities and behavioral characteristics would show more persistent developmental delay. Cesarean-delivered preterm (n = 112, 90% gestation) or term (n = 56, 100% gestation) piglets were reared under identical conditions and euthanized for blood and organ collection on postnatal days 0, 5, or 26. Body weight gain remained lower in preterm vs. term pigs up to day 26 (25.5 ± 1.5 vs. 31.0 ± 0.5 g·kg(-1)·day(-1), P < 0.01) when relative weights were higher for brain and kidneys and reduced for liver and spleen. Neonatal preterm pigs had reduced values for blood pH, Po2, glucose, lactate, hematocrit, and cortisol, but at day 26, most values were normalized, although plasma serotonin and IGF 1 levels remained reduced. Preterm pigs showed delayed neonatal arousal and impaired physical activity, coordination, exploration, and learning, relative to term pigs (all P < 0.05). Supplementation of parenteral nutrition during the first 5 days with an enteral milk diet did not affect later outcomes. In preterm pigs, many physiological characteristics of immaturity disappeared by 4 wk, while some neurodevelopmental deficits remained. The preterm pig is a relevant animal model to study early dietary and pharmacological interventions that support postnatal maturation and neurodevelopment in preterm infants.

Knowledge Central

Robert Pendergrast, MD, a pediatrician trained in Western Medicine with a master's degree in public health, has written an informative and easy-to-read book. Pendergrast also completed a fellowship at the University of Arizona Center for Integrative Medicine, founded by the well-known physician Andrew Weil, MD. Breast Cancer: Reduce Your Risk With Foods You Love lives up to its title by focusing on disease prevention and health promotion. The text is written in clear, lay language and covers all aspects of how a woman can reduce her risk of developing breast cancer. References to scholarly articles supporting Pendgergrast's recommendations and suggestions for further reading are included. The text emphasizes early dietary interventions to be made even before a woman reaches puberty and makes recommendations to be maintained throughout life.

Choline supplementation following third-trimester-equivalent alcohol exposure attenuates behavioral alterations in rats.

Despite the known adverse consequences of prenatal alcohol exposure, some pregnant women continue to drink alcohol, making it imperative to identify treatments for children with fetal alcohol spectrum disorders. The authors recently reported that perinatal choline supplementation can reduce some fetal alcohol effects (J. D. Thomas, M. Garrison, & T. M. O'Neill, 2004), and the present study examined whether choline supplementation is effective when administered after third-trimester-equivalent ethanol treatment. Rat pups were exposed to 6.0 g/kg/day ethanol during the neonatal brain growth spurt (Postnatal Days [PD] 4-9) and treated with choline chloride (0, 10, 50, or 100 mg/kg) from PD 10-30. Behavioral testing occurred after choline treatment had ceased. Female subjects exposed to ethanol were overactive and exhibited spatial learning deficits, effects that were attenuated with all doses of choline supplementation. These data indicate that choline supplementation can alter brain development following a developmental insult. Moreover, the data suggest that early dietary interventions may reduce the severity of some fetal alcohol effects, even when administered after birth.

Double‐blind, Placebo‐controlled Trial Comparing Effects of Supplementation of Two Micronutrient Sprinkles on Fatty Acid Status in Cambodian Infants

Infants in developing countries require early dietary interventions to prevent nutritional deficiencies, above all protein, energy, iron and zinc. To what extent these interventions may affect the fatty acid (FA) status is still unknown. To examine and compare the effects of 2 micronutrient "sprinkles" supplementations (iron 12.5 mg + folic acid 150 microg, iron/folate and iron 12.5 mg + folic acid 150 microg + zinc 5 mg + vitamins A, C and D3, mineral/micronutrient [MMN]) versus placebo on the FA status of Cambodian infants. A total of 204 infants age 6 mo and living in Kompong Chhnang Province, Cambodia, were randomly assigned to receive daily supplementation of MMN (n = 68) and iron/folate (n = 68) or placebo (n = 68) for a 12-mo period in powder form as sprinkles. At the end of the intervention period, FAs in the range of 16 to 24 C were determined in blood drops absorbed on a strip collected from 182 subjects, and values among the 3 intervention subgroups and those of 21 Italian 18-mo-old, normal-growing infants as the reference group were compared. At the end of the supplementation trial, higher levels of the 2 essential FAs (EFAs) (linoleic acid, 18:2n-6, and alpha-linolenic acid, 18:3n-3) were found in the MMN group. No differences occurred for the major longer chain derivatives of both EFAs arachidonic acid (20:4n-6) and docosahexaenoic acid (22:6n-3). In MMN supplemented Cambodians, blood levels of linoleic acid approached those of Italian infants, and in addition their alpha-linolenic acid levels were improved. Cambodian infants, mostly still breast-fed through the second year of life, showed significantly higher levels of long-chain derivatives of both the n-6 and the n-3 series compared with Italians. Supplementation with iron, folic acid, zinc and vitamins was associated with an increase of linoleic acid and alpha-linolenic acid levels in Cambodian infants versus placebo, without significant changes in the concentrations of their longer chain derivatives, resulting in a FA status closer to Italian counterparts for the essential polyunsaturated FA levels. The iron/folate-treated infants showed no differences compared with the other 2 groups. Studies are needed to differentiate the potential effects of the supplemented micronutrients on the FA status.