Postnatal Nutrition Research Articles

Community-Based Nutrition Education Improves Caregivers’ Knowledge of Complementary Feeding in Southern Ethiopia

Abstract Objectives Quality Diets for Better Health (QDBH) is a nutrition-sensitive agriculture project in southern Ethiopia that promotes vitamin A-rich orange-fleshed sweetpotato (OFSP) and community-based nutrition education to improve the quality of young child diets. The objective of this research is to examine the impact of the project and other predictors on caregiver knowledge of infant and young child feeding (IYCF) over time. Methods Communities were randomized to a control group and intervention groups receiving OFSP planting materials and community-based nutrition education. Households with infants <6 months completed a baseline survey in January 2018, and follow-up surveys 7 and 13 months later. Knowledge of IYCF recommendations and vitamin A was assessed at each visit; a knowledge score (range 0–100) was calculated by assigning points for accurate responses. If a caregiver was missing not more than two responses, we imputed her score with the community-mean to retain sample size and minimize bias. We used mixed effects modeling to examine the effect of QDBH and other factors, such as education and prenatal counseling, on knowledge scores over time, while controlling for covariates. Results Of the 605 households who completed the baseline survey, 548 (90.6%) and 523 (86.4%) completed the follow-up surveys. Baseline characteristics of the group lost to follow-up did not differ from those retained in the sample. Knowledge scores were highest at baseline (65.3 ± 14.4), and lower at 7 months (48.4 ± 13.8) and 13 months follow-up (46.9 ± 14.0). Baseline scores were higher among caregivers with higher education (P < 0.05) and who reported receiving prenatal IYCF counseling (P < 0.0001), but also declined faster among those who had prenatal counseling (β = −1.6, P = 0.04). Knowledge scores in intervention and control groups were similar at baseline (P = 0.49), but scores of those in the intervention group declined less rapidly than those in the control group (β = 4.0, P < 0.0001). Conclusions Caregivers’ knowledge of IYCF decreased in the postnatal period; decreases were fastest among those who received prenatal IYCF counseling and among those in the control group. Postnatal community-based nutrition education can help maintain knowledge of IYCF recommendations. Funding Sources This research is funded by the European Union in partnership with the International Potato Center.

Development and growth of mohair fleeces from birth and relationships between skin follicle populations, mohair physical properties, animal size and fleece value

Abstract Knowledge of associations between skin follicle development in Angora goats and development of mohair fleeces is limited. These associations were investigated using data from a controlled nutrition experiment which had 3 levels of mid pregnancy nutrition (MPN) × 2 levels of postnatal nutrition during lactation (PNN), with single and twin litters. Skin biopsies were taken (birth, 114, 180, 420 days of age). Mid-side fibre growth and physical properties were determined 6 times between birth and 180 days of age. Birth coats were visually scored (1, straight; 5 curly). Fibre diameter distribution histograms were analysed at these ages. Skin area was measured. Total number of follicles and fibre growth per day determined. Fleeces were harvested at 7, 13 and 19 months of age and tested. Average fleece-free live weight (AvFFLwt) during fleece growing periods was determined. Data were analysed for treatment effects, correlations between attributes and multiple linear regression analysis performed to determine relationships between mean fibre diameter (MFD) at different ages with variables. AvFFLwt over the study within shearing intervals ranged from 5.8 to 37.6 kg. Density of secondary follicles (Ds) at 180 days of ranged from 10.8 to 34.0 mm−2, ratio of secondary to primary skin follicles (S/P) at 420 ranged from 4.8 to 14.1. Total fibre growth/day was related to the surface area (size) of kids, as surface area increased proportionally with live weight0.73. Smaller kids (female, twin reared) grew respectively 15–23% less fibre than larger male and 13–16% less than single reared goats. MFD was 27.8 μm at birth, then declined before increasing after 2 months of age. PNN had small effects on fibre diameter CV which was high at birth before declining rapidly during the first three months of life. There were negative correlations between both Ds and S/P ratio with: MFD; and the incidence of medullated fibres (patch fibre growth and fleeces at 13 and 19 months). The magnitude of these correlations increased with age. Birth coat score was negatively associated with fleece value. Predictions of MFD at shearing were related to log10AvFFLwt during the growth period, either Ds or S/P ratio, sex of kid, and a covariate term for the dam MFD. Greater Ds and S/P ratios greater than 9 were associated with finer mohair and more valuable fleeces.

MON-029 Polycystic Ovary Syndrome (PCOS) in Adolescent Girls:Toward a Simple On-Treatment Predictor of Post-Treatment Ovulation Rate

There is no approved treatment for adolescent girls with PCOS. The vast majority of these patients are guided into a trajectory that starts with oral contraceptive (OC) treatment, leads into oligo-anovulatory subfertility, then into the use of assisted reproductive techniques, and ultimately into pregnancies with a double-to-triple risk for complications (such as gestational diabetes, preeclampsia and preterm birth) potentially with lifelong sequelae in the offspring.Evidence is converging into the insight that adolescent PCOS is frequently driven by hepato-visceral fat excess (“central obesity”) ensuing from a mismatch between (rather restrictive) prenatal and (rather abundant) postnatal nutrition, on a background of genetic susceptibility (Trends Endocrinol Metab 2018;29:815). This insight has prompted the exploration of an alternative PCOS treatment that aims at reducing the central-fat excess (without causing weight loss in non-obese girls) in order to normalize the entire phenotype, including ovulation rate.So far, this alternative approach has been tested in two randomized controlled pilot studies that were performed in non-obese girls with PCOS and with no need for contraception (total N=62; age 16 yr; BMI 24 Kg/m2; treatment for 1 year; ovulation assessment during the post-treatment year). In these studies, the effects of an OC were compared to those of SPIOMET, which is a low-dose combination of spironolactone (= a mixed anti-androgen and -mineralocorticoid, also activating brown adipose tissue; Diab Ob Metab 2019;21:509), pioglitazone and metformin (= two insulin sensitizers acting through different mechanisms).Pooled results of the pilot studies confirm the first report (J Adolesc Health 2017;61:446) that SPIOMET has more normalizing effects than OC; there were approximately 3-fold more ovulations post-SPIOMET than post-OC; normovulation occurred only post-SPIOMET; anovulation was >10-fold more frequent post-OC.Pooled results also disclosed two new features of adolescent PCOS: low concentrations of circulating CXCL14 (= a brown adipokine, signaling activity in brown adipose tissue; Cell Metab 2018;28:750) and miR-451a (= an inhibitor of THRSP-mediated hepatic lipogenesis; Mol Cell Endocrinol 2018;474:260), both of which remain abnormally low on OC, but normalize on SPIOMET treatment. The on-treatment Z-scores of fasting insulin and miR-451a explained together approximately 50% of the variation in post-treatment ovulation rates. This simple duo, if validated in larger and more diverse PCOS populations, may become a first on-treatment predictor of post-treatment ovulation rate.

Improving use of maternal care services among married adolescent girls: an intervention study in rural India.

This study examined the effect of the Safe Adolescent Transition and Health Initiative (SATHI) programme on the use of maternal care services among rural, pregnant adolescents in India. This was an intensive community-based, multi-site intervention project conducted in Maharashtra state between 2008 and 2011. Its aims were to improve the reproductive health of married adolescent girls and avert the adverse consequences of early motherhood. It had a quasi-experimental, case-control, pre-post design to enable rigorous evaluation. This study used cross-sectional data from 644 married girls aged under 19 years at baseline and 802 at endline to assess the maternal care outcomes of antenatal care, delivery and postnatal services and nutrition during pregnancy. Difference-in-differences analysis showed that all outcomes improved significantly in the study sites between baseline and endline, and the improvement in study sites was significantly larger than in the control sites. Multivariate analysis showed a statistically significant dose-response effect of intervention participation for antenatal care, pregnancy nutrition and postnatal care. Study participation was not statistically significantly associated with higher rates of safe or institutional delivery. The analysis suggests that training and supporting community health workers to work with married adolescent girls using interpersonal communication and interacting frequently with them and their families and communities can significantly improve the use of maternal care services among this population. With almost a million community health workers and 200,000 auxiliary nurse midwives at the community level providing primary level care in India, this intervention offers a proven strategy to replicate and scale-up to reach large numbers of married adolescent girls who do not currently use maternal care services.

Plasma Metabolome Alterations Associated with Extrauterine Growth Restriction.

Very preterm infants (VPI, born at or before 32 weeks of gestation) are at risk of adverse health outcomes, from which they might be partially protected with appropriate postnatal nutrition and growth. Metabolic processes or biochemical markers associated to extrauterine growth restriction (EUGR) have not been identified. We applied untargeted metabolomics to plasma samples of VPI with adequate weight for gestational age at birth and with different growth trajectories (29 well-grown, 22 EUGR) at the time of hospital discharge. A multivariate analysis showed significantly higher levels of amino-acids in well-grown patients. Other metabolites were also identified as statistically significant in the comparison between groups. Relevant differences (with corrections for multiple comparison) were found in levels of glycerophospholipids, sphingolipids and other lipids. Levels of many of the biochemical species decreased progressively as the level of growth restriction increased in severity. In conclusion, an untargeted metabolomic approach uncovered previously unknown differences in the levels of a range of plasma metabolites between well grown and EUGR infants at the time of discharge. Our findings open speculation about pathways involved in growth failure in preterm infants and the long-term relevance of this metabolic differences, as well as helping in the definition of potential biomarkers.

Toward a Treatment Normalizing Ovulation Rate in Adolescent Girls With Polycystic Ovary Syndrome.

Adolescent polycystic ovary syndrome (PCOS) is characterized by androgen excess and oligomenorrhea, and commonly driven by hepato-visceral fat excess (“central obesity”) ensuing from a mismatch between prenatal and postnatal nutrition, on a background of genetic susceptibility. There is no approved treatment for adolescent PCOS.We report the pooled results of 2 pilot studies in nonobese girls with PCOS (N = 62, age 15.8 years) that compared the effects of randomized treatment for 1 year, either with an oral estro-progestogen contraceptive (OC), or with a low-dose combination of spironolactone-pioglitazone-metformin (SPIOMET, targeting the excess of ectopic fat).Auxological and endocrine-metabolic variables (including fasting insulin, androgens, high-molecular-weight adiponectin [HMW-adiponectin], and microRNA [miR]-451a), body composition (dual x-ray absorptiometry) and hepato-visceral fat (magnetic resonance imaging) were assessed on- and posttreatment. Data from menstrual diaries were combined with weekly salivary progesterone measurements to infer ovulation rates during the second and fourth quarter of the posttreatment year.OC and SPIOMET treatment reduced the androgen excess comparably, and had no differential effects on total-body lean or fat mass. However, SPIOMET was accompanied by more broadly normalizing effects, including on hepato-visceral fat and on circulating insulin, HMW-adiponectin, and miR-451a. On average, there were 3-fold more ovulations post-SPIOMET than post-OC; normovulation was only observed after SPIOMET; anovulation was >10-fold more prevalent post-OC.Pooled results of randomized studies in nonobese adolescent girls with PCOS indicate that SPIOMET treatment leads to an overall healthier, more insulin-sensitive condition—with less ectopic fat—than OC treatment, and to a more normal posttreatment ovulation rate.

Metabolism and Functions of Amino Acids in Sense Organs.

Sense organs (eyes, ears, nose, tongue, and skin) provide senses of sight, hearing, smell, taste, and touch, respectively, to aid the survival, development, learning, and adaptation of humans and other animals (including fish). Amino acids (AAs) play an important role in the growth, development, and functions of the sense organs. Recent work has identified receptor-mediated mechanisms responsible for the chemosensory transduction of five basic taste qualities (sweet, sour, bitter, umami and salty tastes). Abnormal metabolism of AAs result in a structural deformity of tissues and their dysfunction. To date, there is a large database for AA metabolism in the eye and skin under normal (e.g., developmental changes and physiological responses) and pathological (e.g., nutritional and metabolic diseases, nutrient deficiency, infections, and cancer) conditions. Important metabolites of AAs include nitric oxide and polyamines (from arginine), melanin and dopamine (from phenylalanine and tyrosine), and serotonin and melatonin (from tryptophan) in both the eye and the skin; γ-aminobutyrate (from glutamate) in the retina; and urocanic acid and histamine (from histidine) in the skin. At present, relatively little is known about the synthesis or catabolism of AAs in the ears, nose, and tongue. Future research should be directed to: (1) address this issue with regard to healthy ageing, nasal and sinus cancer, the regulation of food intake, and oral cavity health; and (2) understand how prenatal and postnatal nutrition and environmental pollution affect the growth, development and health of the sense organs, as well as their expression of genes (including epigenetics) and proteins in humans and other animals.

The evolution of genomic imprinting: Epigenetic control of mammary gland development and postnatal resource control.

Genomic imprinting is an epigenetically regulated process leading to gene expression according to its parental origin. Imprinting is essential for prenatal growth and development, regulating nutritional resources to offspring, and contributing to a favored theory about the evolution of imprinting being due to a conflict between maternal and paternal genomes for the control of prenatal resources-the so-called kinship hypothesis. Genomic imprinting has been mainly studied during embryonic and placental development; however, maternal nutrient provisioning is not restricted to the prenatal period. In this context, the mammary gland acts at the maternal-offspring interface providing milk to the newborn. Maternal care including lactation supports the offspring, delivering nutrients and bioactive molecules protecting against infections and contributing to healthy organ development and immune maturation. The normal developmental cycle of the mammary gland-pregnancy, lactation, involution-is vital for this process, raising the question of whether genomic imprinting might also play a role in postnatal nutrient transfer by controlling mammary gland development. Characterizing the function and epigenetic regulation of imprinted genes in the mammary gland cycle may therefore provide novel insights into the evolution of imprinting since the offspring's paternal genome is absent from the mammary gland, in addition to increasing our knowledge of postnatal nutrition and its relation to life-long health. This article is categorized under: Developmental Biology > Developmental Processes in Health and Disease.

374 Effects of maternal nutrition on secretion of leptin in the neonatal heifer and interaction of maternal and postnatal nutrition on age at puberty and postpubertal secretion of luteinizing hormone

Abstract Nutrition during gestation and early postnatally can program developmental changes in the offspring that persist until adult life. Here we tested the hypotheses that maternal nutritional during the second and third trimesters of gestation 1) affects neonatal secretion of leptin in heifer offspring, and 2) interacts with dietary energy intake during the juvenile period to affect age at puberty and postpubertal pulsatile secretion of luteinizing hormone (LH) in heifers. Bos indicus-influenced beef cows (n = 108) in 3 replicates bearing heifer fetuses were assigned randomly to receive low (L), moderate (M), or high energy (H) diets to achieve body condition scores (BCS) of 3–3.5 (thin; n = 36), 5.5–6 (moderate; n = 36), or 7.5–8 (obese; n = 36) by the second trimester of gestation until calving. Heifer offspring were weaned at 3–3.5 months of age and assigned randomly to either a high- (H; 1 kg/day) or low-gain (L; 0.5 kg/day) diet for 5 months. Blood samples from a subgroup of 30 heifers (Exp. 1) from cows in each maternal treatment (n = 10/treatment) were collected once every 2–3 days for 2 weeks after birth. In Exp. 2, 18 heifers representing 3 of the maternal × postnatal groups (HH, MH and LL) were ovariectomized and received estradiol replacement (OVX+E) after puberty. Pulsatile secretion of LH was evaluated for 5.5 hours. Maternal nutrition did not affect postnatal circulating leptin. Based on two replicates (n = 61), postnatal diets had the greatest effect on age at puberty (L > H; P < 0.001), with a lesser maternal diet effect (P < 0.10), although LL > HH by 99 days. None of the characteristics of pulsatile LH secretion differed among treatments in OVX + E heifers. Dietary effects on age at puberty were not associated with hormonal characteristics evaluated in these initial studies.

Epigenetics: Linking Early Postnatal Nutrition to Obesity Programming?

Despite constant research and public policy efforts, the obesity epidemic continues to be a major public health threat, and new approaches are urgently needed. It has been shown that nutrient imbalance in early life, from conception to infancy, influences later obesity risk, suggesting that obesity could result from “developmental programming”. In this review, we evaluate the possibility that early postnatal nutrition programs obesity risk via epigenetic mechanisms, especially DNA methylation, focusing on four main topics: (1) the dynamics of epigenetic processes in key metabolic organs during the early postnatal period; (2) the epigenetic effects of alterations in early postnatal nutrition in animal models or breastfeeding in humans; (3) current limitations and remaining outstanding questions in the field of epigenetic programming; (4) candidate pathways by which early postnatal nutrition could epigenetically program adult body weight set point. A particular focus will be given to the potential roles of breast milk fatty acids, neonatal metabolic and hormonal milieu, and gut microbiota. Understanding the mechanisms by which early postnatal nutrition can promote lifelong metabolic modifications is essential to design adequate recommendations and interventions to “de-program” the obesity epidemic.

Cortical Visual Evoked Potentials and Growth in Infants Fed with Bioactive Compounds-Enriched Infant Formula: Results from COGNIS Randomized Clinical Trial.

Postnatal nutrition is essential for growth and neurodevelopment. We analyzed the influence of a new enriched-infant formula with bioactive compounds on growth, neurodevelopment, and visual function (VF) in healthy infants during their first 18 months of life. A total of 170 infants were randomized in the COGNIS randomized clinical trial (RCT) to receive a standard infant formula (SF = 85) or a new experimental infant formula supplemented with functional nutrients (EF = 85). As a control, 50 breastfed infants (BF) were enrolled. Growth patterns were evaluated up to 18 months of life; neurodevelopment was assessed by general movements at 2, 3, and 4 months; VF was measured by cortical visual evoked potentials at 3 and 12 months. No differences in growth and neurodevelopment were found between groups. Regarding VF, SF and EF infants presented prolonged latencies and lower amplitudes in the P100 wave than BF infants. In the EF group, a higher percentage of infants presented response at 7½′ of arc at 12 months compared to 3 months of age; a similar proportion of BF and EF infants presented responses at 7½′ of arc at 12 months of age. Early nutritional intervention with bioactive compounds could narrow the gap in growth and neurodevelopment between breastfed and formula-fed infants.

Nutritional Models of Type 2 Diabetes Mellitus.

In order to better understand the events that precede and precipitate the onset of type 2 diabetes (T2DM), several nutritional animal models have been developed. These models are generated by manipulating the diet of either the animal itself, or its mother during her pregnancy, and in comparison to traditional genetic and knock out models, have the advantage that they more accurately reflect the etiology of human T2DM. This chapter will discuss some of the most widely used nutritional models of T2DM: Diet-induced obesity (DIO) in adult rodents, and studies of offspring of mothers fed a low-protein, high-fat and/or high-sugar diet during pregnancy and/or lactation. Several common mechanisms have been identified through which these nutritional manipulations can lead to metabolic disease, including pancreatic beta-cell dysfunction, impaired insulin signaling in skeletal muscle, and the excess accumulation of visceral adipose tissue and consequent deposition of nonesterified fatty acids in peripheral tissues. In addition, there is an emerging concept that obesity/poor quality diets result in increased production and release of pro-inflammatory cytokines from adipose tissue leading to a state of chronic low-grade inflammation, and that this is likely to represent an important link between obesity/diet and metabolic dysfunction. The following chapter will discuss the most common nutritional models of T2DM in experimental animals, their application, and relationship to human etiology, and will highlight the important insights these models have provided into the pathogenesis of T2DM.

Exposure to placental insufficiency alters postnatal growth trajectory in extremely low birth weight infants.

Growth in the immediate postnatal period for extremely low birth weight (ELBW, birth weight < 1000 g) infants is an important topic in neonatal medicine. The goal is to ensure adequate postnatal growth and to minimize complications resulting from suboptimal growth. Past efforts have focused on postnatal nutrition as well as on minimizing comorbidities. It has not been systematically assessed whether antenatal factors play a role in postnatal growth. In this report, we conducted a retrospective study on 91 maternal-neonatal pairs. We prospectively collected maternal and neonatal demographic data, neonatal nutrition in the first 7 days of life and after enteral nutrition is fully established, comorbidity data, as well as weight data from birth to 50 weeks corrected gestational age. We developed a linear mixed-effects model to examine the role of placental insufficiency, as defined by fetal Doppler studies, in postnatal weight z-score trajectory over time in the ELBW population. We relied on Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) for model selection. Interestingly, the selected model included a quadratic term of time and a placental insufficiency-by-time interaction term. In a covariate analysis, AIC and BIC both favored a model that included calories intake in the first 7 days of life and the total duration of antibiotics as fixed-effects, but not their interaction terms with time. Overall, we demonstrated for the first time that placental insufficiency, an antenatal factor, is a major determinant of postnatal weight trajectory in the ELBW population. Prospective studies are warranted to confirm our findings.

Is Foetal Programming by Mismatched Pre- and Postnatal Nutrition Contributing to the Prevalence of Obesity in Nepal?

Nepal and many developing countries are currently suffering from increased prevalence of obesity, type 2 diabetes, and other metabolic disorders. Unhealthy dietary habits and physical inactivity are traditionally considered as responsible factors for these disorders. The relatively new concept of foetal programming suggests that development of metabolic diseases later in life may be associated with poor nutritional status in utero, and such phenomenon could be amplified by subsequent exposure to unhealthy diets after birth. We suggest that foetal programming and mismatched nutritional situations during foetal and postnatal life are important causative factors for increased prevalence of obesity and metabolic disorders in Nepal. Issues highlighted in this paper may also be relevant to other developing countries with similar socioeconomic status. Undernutrition in foetal life can predispose for visceral fat deposition and may alter dietary preferences towards unhealthy diets, amplifying the risk of nutritional mismatch after birth; this can lead to metabolic disturbances in a number of pathways including glucose and lipid metabolism. Providing attention to early life nutrition could therefore be an important tool to reduce the prevalence of lifestyle diseases in Nepal. Future national health policies should thus include changes in research and intervention activities towards preventing averse early life nutritional programming. Availability of free-of-cost and mandatory nutritional education and medical services to pregnant women and their families and better management of national health care systems including digitalization of national health data could be viable strategies to achieve these goals.

The Microbiota and Malnutrition: Impact of Nutritional Status During Early Life.

According to the developmental origins of health and disease hypothesis, our health is determined by events experienced in utero and during early infancy. Indeed, both our prenatal and postnatal nutrition conditions have an impact on the initial architecture and activity of our microbiota. Recent evidence has underlined the importance of the composition of the early gut microbiota in relation to malnutrition, whether it be undernutrition or overnutrition, that is, in terms of both stunted and overweight development. It remains unclear how early microbial contact is linked to the risk of disease, as well as whether alterations in the microbiome underlie the pathogenesis of malnutrition or are merely the end result of it, which indicates that thequestion of causality must urgently be answered. This review provides information on the complex interaction between the microbiota and nutrition during the first 1,000 days of life, taking into account the impact of both undernutrition and overnutrition on the microbiota and on infants' health outcomes in the short- and long-term.

Nutrition, epigenetics and health

Nutrition, epigenetics and health

Low birth weight causes insulin resistance and aberrant intestinal lipid metabolism independent of microbiota abundance in Landrace-Large White pigs.

Low birth weight (LBW) and postnatal nutrition are risk factors for adult metabolic diseases. However, the interactions between LBW, diet, and intestinal lipid absorption and secretion leading to adult metabolic disease remain unclear. The current study determined the impact of LBW on intestinal lipid and carbohydrate metabolism under both control and Western diet (high fat, high fructose, and cholesterol) conditions in 5-wk-old LBW and normal birth weight (NBW) Landrace-Large White × Duroc pigs. A 2-step modified oral glucose and fat challenge test was performed. Mesenteric lymph, jejunal mucosal scrapings, and cecal digesta samples were also collected. LBW offspring were lower in weight and gained less weight per day. LBW pigs on either control or Western diets displayed increased triglyceride (TG) secretion into lymph (P = 0.0135). Western diet-fed LBW pigs developed fasting (P = 0.03) and postprandial (P < 0.05) hypertriglyceridemia, muscle steatosis (P = 0.0072), had higher insulin excursion (P < 0.01), increased jejunal stearoyl-CoA desaturase 1 mRNA and increased hepatic fibrosis (P = 0.0017) compared with NBW piglets. Gut microbiota showed significant dysbiosis on Western diet independent of birth weight. In conclusion, LBW pigs fed a Western diet specifically up-regulate TG absorption and secretion, develop dyslipidemia, muscular steatosis, and display early signs of insulin resistance. Interestingly, this study does not provide evidence of altered intestinal microbiome in LBW pigs contributing to increased severity of metabolic diseases.-Fontaine, M. A., Diane, A., Singh, V. P., Mangat, R., Krysa, J. A., Nelson, R., Willing, B. P., Proctor, S. D. Low birth weight causes insulin resistance and aberrant intestinal lipid metabolism independent of microbiota abundance in Landrace-Large White pigs.

Dietary calories and lipids synergistically shape adipose tissue cellularity during postnatal growth

ObjectiveThe susceptibility to abdominal obesity and the metabolic syndrome is determined to a substantial extent during childhood and adolescence, when key adipose tissue characteristics are established. Although the general impact of postnatal nutrition is well known, it is not clear how specific dietary components drive adipose tissue growth and how this relates to the risk of metabolic dysfunction in adulthood. MethodsAdipose tissue growth including cell proliferation was analyzed in juvenile mice upon dietary manipulation with in vivo nucleotide labeling. The proliferative response of progenitors to specific fatty acids was assayed in primary cultures. Long-term metabolic consequences were assessed through transient dietary manipulation post-weaning with a second obesogenic challenge in adulthood. ResultsDietary lipids stimulated adipose tissue progenitor cell proliferation in juvenile mice independently of excess caloric intake and calorie-dependent adipocyte hypertrophy. Excess calories increased mitogenic IGF-1 levels systemically, whereas palmitoleic acid was able to enhance the sensitivity of progenitors to IGF-1, resulting in synergistic stimulation of proliferation. Early transient consumption of excess lipids promoted hyperplastic adipose tissue expansion in response to a second dietary challenge in adulthood and this correlated with abdominal obesity and hyperinsulinemia. ConclusionsDietary lipids and calories differentially and synergistically drive adipose tissue proliferative growth and the programming of the metabolic syndrome in childhood.

Effects of intrauterine growth restriction and postnatal nutrition on pediatric asthma in Bangladesh.

Numerous studies have investigated the risk of developing asthma due to early-life experiences and environmental exposures. However, the influence of intrauterine growth restriction and postnatal undernutrition on childhood wheezing/asthma remains unclear. Thus, we examined the effects of both small for gestational age (SGA) and postnatal stunted growth on ever asthma among children in the rural areas in Bangladesh.Multiple follow-up studies were conducted in a cohort of randomized clinical trial of nutrition interventions during pregnancy (the MINIMat trial). Overall, 1208 and 1697 children were followed-up for asthma at 4.5 and 10 years, respectively. Anthropometric measurements were obtained at various intervals from birth to 10 years of age. Ever asthma was identified using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire.Results showed that SGA was significantly associated with increased risk of ever asthma at 4.5 and 10 years after adjusting for sex, body mass index, socioeconomic status, family history of asthma, gestational age at birth, mother's parity, mother's age at birth and intervention trial arm [odds ratio (OR)=1.97 (95% confidence interval (CI): 1.34-2.90) and 1.86 (95% CI: 1.18-2.72)]. For the postnatal effect of undernutrition, stunting at 1 and 2 years was significantly associated with ever asthma at 4.5 and 10 years [1 year: OR=1.77 (95% CI: 1.22-2.57) and OR=1.72 (95% CI: 1.16-2.56), 2 years: OR=1.49 (95% CI: 1.06-2.10) and OR=1.41 (95% CI: 1.02-1.96)].In conclusion, SGA and undernutrition during infancy has an influence on childhood asthma among children in Bangladesh, indicating the need for nutritional interventions early in life.

Extreme Premature Small for Gestational Age Infants Have Appropriate Catch-up Growth at Term Equivalence Compared with Extreme Premature Appropriate for Gestational Age Infants

Recent studies have shown that small for gestational age (SGA) term infants undergo catch-up growth during infancy but there is limited studies on early growth outcomes of extreme premature SGA infants. The aim of this study was to compare factors associated during birth in extremely premature infants less than 28 weeks’ gestation who were born SGA (<10th percentile for gestational age) with those who were born appropriate-for-gestational age (AGA) (10th-89th percentile) and to determine whether there was catch-up growth at term equivalence. One hundred fifty-three extreme premature infants (89 males) born below 28 weeks’ gestation were prospectively recruited. All infants had auxological measurements undertaken and prospective data on pregnancy, maternal factors, perinatal and postnatal data obtained. SGA infants at birth had significantly higher Clinical Risk Index for Babies scores and mortality, lower birth weight, smaller head circumference, smaller mid arm circumference and shorter leg length at time of birth compared with AGA infants. However, at term equivalence, weight and leg length of were not significant between AGA and SGA infants born at extreme prematurity. Our study shows that extreme premature SGA infants have appropriate catch-up growth by the time they reach term equivalence suggesting that postnatal nutrition and care are important determinants of catch-up growth in SGA infants.