Proportion Of Weight Gain Research Articles

The updated nutrient profile underlying the Nutri-Score label and adult weight gain: A cohort study

Abstract Introduction Nutrient profiling systems are key tools in the development of nutrition-related policies. Their prospective associations with health outcomes are a crucial step in assessing their validity as public health measures. In 2023, the nutrient profiling system underlying the Nutri-Score -a nutrition front-of-pack label used in the European Union- was updated. The present study aims to investigate the updated nutrient profile’s association with weight gain, overweight and obesity. Methods The dietary and anthropometric data of 75,775 participants of the Nutrinet-Santé cohort study was retrieved for this study. Standardized dietary indices derived from both nutrient profiling systems (the 2015 NS-NPM DI (initial profile) and 2023 NS-NPM DI (updated profile)) were computed based on at least 3 24-hour dietary records upon the first two years of inclusion in the cohort. The associations between these indices and the risk of developing overweight and obesity were assessed using Cox proportional hazard models and weight gain using mixed models. Results Participants with a higher 2023 NS-NPM DI (i.e. a poorer nutritional quality of diet) were more likely to gain BMI over time (T3 vs. T1: +0.23% points of BMI/year, p < 0.0001), had a higher risk of developing overweight (HR T3 vs. T1: 1.33 [95% CI: 1.24-1.43]) and obesity (HR T3 vs. T1: 1.29 [95% CI: 1.14-1.45]). Overall, the 2015 NS-NPM DI displayed similar associations and effect sizes with the outcomes and the predictive ability of the two indices on overweight and obesity risk was not significantly different (p = 0.32 for overweight risk, p = 0.09 for obesity risk). Conclusions These results constitute a step in the validation of the recently updated nutrient profiling system and help support its use in public policies for non-communicable diseases prevention. Key messages • The 2023 updated nutrient profiling system underlying the Nutri-Score was associated with weight gain and obesity, two important risk factors in the development of non-communicable diseases. • The 2015 and 2023 NS-NPM DI showed similar prospective associations with overweight and obesity risk.

Effectiveness and cost-effectiveness of a 12-month automated text message intervention for weight management in postpartum women with overweight or obesity: protocol for the Supporting MumS (SMS) multisite, parallel-group, randomised controlled trial

IntroductionThe reproductive years can increase women’s weight-related risk. Evidence for effective postpartum weight management interventions is lacking and engaging women during this life stage is challenging. Following a promising pilot...

Plasma Clozapine and N -Desmethylclozapine (Norclozapine) Concentrations and the Clozapine/Norclozapine Ratio : Effect of Dose, Sex, and Cigarette Smoking.

Smoking enhances plasma clozapine clearance, but the magnitude of the effect across the dose and age ranges is unclear. We audited clozapine dose and predose plasma clozapine and N -desmethylclozapine (norclozapine) concentrations by sex and smoking habit in samples submitted for clozapine TDM, 1996-2017. There were 105,316/60,792 and 34,288/31,309 samples from male/female smokers/nonsmokers, respectively. There were distinct dose-median plasma concentration trajectories for male/female smokers/nonsmokers across the range <50 to >850 mg d -1 . For both sexes, the percentage difference in median plasma clozapine in nonsmokers versus smokers averaged 50% but was greatest for men (76%) and women (59%) in the 151 to 250 mg d -1 dose band. In men, the percentage difference declined steadily to 34% at doses of ≥850 mg d -1 . In women, the difference after falling initially remained relatively constant at 40% to 54%. The pattern in median plasma clozapine/norclozapine ratio by plasma clozapine concentration and dose groups was independent of sex and smoking habit, but increased with plasma clozapine concentration (higher ratio at higher concentrations) and also changed with dose. Median plasma clozapine concentration and median clozapine dose by sex and smoking habit were similar up to age 60 years. Proportional weight gain was similar over time in smokers and nonsmokers of either sex. These data explain the variations in the effect size of starting or stopping smoking on plasma clozapine concentration at constant dose reported in different studies. Changes in smoking habit in patients prescribed clozapine require prompt dose adjustment.

Acute malnutrition recovery energy requirements based on mid-upper arm circumference: Secondary analysis of feeding program data from 5 countries, Combined Protocol for Acute Malnutrition Study (ComPAS) Stage 1.

BackgroundSevere and moderate acute malnutrition (SAM and MAM) are currently treated with different food products in separate treatment programs. The development of a unified and simplified treatment protocol using a single food product aims to increase treatment program efficiency and effectiveness. This study, the first stage of the ComPAS trial, sought to assess rate of growth and energy requirements among children recovering from acute malnutrition in order to design a simplified, MUAC-based dosage protocol.MethodsWe obtained secondary data from patient cards of children aged 6–59 months recovering from SAM in outpatient therapeutic feeding programs (TFPs) and from MAM in supplementary feeding programs (SFPs) in five countries in Africa and Asia. We used local polynomial smoothing to assess changes in MUAC and proportional weight gain between clinic visits and assessed their normalized differences for a non-zero linear trend. We estimated energy needs to meet or exceed the growth observed in 95% of visits.ResultsThis analysis used data from 5518 patients representing 33942 visits. Growth trends in MUAC and proportional weight gain were not significantly different, each lower at higher MUAC values: MUAC growth averaged 2mm/week at lower MUACs (100 to <110mm) and 1mm/week at higher MUACs (120mm to <125mm); and proportional weight gain declined from 3.9g/kg/day to 2.4g/kg/day across the same MUAC values. In 95% of visits by children with a MUAC 100mm to <125mm who were successfully treated, energy needs could be met or exceeded with 1,000 kilocalories a day.ConclusionTwo 92g sachets of Ready-to-Use Therapeutic Food (RUTF) (1,000kcal total) is proposed to meet the estimated total energy requirements of children with a MUAC 100mm to <115mm, and one 92g sachet of RUTF (500kcal) is proposed to meet half the energy requirements of children with a MUAC of 115 to <125mm. A simplified, combined protocol may enable a more holistic continuum of care, potentially contributing to increased coverage for children suffering from acute malnutrition.

Facilitation between invasive herbivores: hemlock woolly adelgid increases gypsy moth preference for and performance on eastern hemlock

1. Interactions between invertebrate herbivores with different feeding modes are common on long‐lived woody plants. In cases where one herbivore facilitates the success of another, the consequences for their shared host plant may be severe. Eastern hemlock (Tsuga canadensis), a canopy‐dominant conifer native to the eastern U.S., is currently threatened with extirpation by the invasive stylet‐feeding hemlock woolly adelgid (Adelges tsugae). The effect of adelgid on invasive hemlock‐feeding folivores remains unknown.2. This study evaluated the impact of feeding by hemlock woolly adelgid on gypsy moth (Lymantria dispar) larval preference for, and performance on, eastern hemlock. To assess preference, 245 field‐grown hemlocks were surveyed for gypsy moth herbivory damage and laboratory paired‐choice bioassays were conducted. To assess performance, gypsy moth larvae were reared to pupation on adelgid‐infested or uninfested hemlock foliage, and pupal weight, proportional weight gain, and larval period were analysed.3. Adelgid‐infested hemlocks experienced more gypsy moth herbivory than did uninfested control trees, and laboratory tests confirmed that gypsy moth larvae preferentially feed on adelgid‐infested hemlock foliage. Gypsy moth larvae reared to pupation on adelgid‐infested foliage gained more weight than larvae reared on uninfested control foliage.4. These results suggest that the synergistic effect of adelgid and gypsy moth poses an additional threat to eastern hemlock that may increase extirpation risk and ecological impact throughout most of its range.

Examining Response to Treatment of Severe Acute Malnutrition in Children 6–59 Months Old in Afghanistan, Chad, Mali, and Niger (P12-002-19)

ObjectivesIdentify the most significant factors affecting the trajectory of recovery from severe acute malnutrition (SAM), as measured by average daily weight gain in each child 6–59 months of age who were diagnosed and treated for SAM and treated, adjusting for covariates including: breastfeeding status, number of children in household, illness, and distance to health center.Hypothesis 1a:Children 6–59 months enrolled in SAM treatment have slower times to recovery and slower weight gain if they are admitted for treatment at a lower anthropometric cut-off admission (weight for height z-score < –4) than children admitted for treatment at a higher anthropometric cut-off (weight for height z-score ≥ –4).Hypothesis 1b: Older children (24–59 months) recover more quickly than younger children (6–23 months) controlling for ration size. MethodsA retrospective panel data analysis on children 6–59 months enrolled in standard outpatient treatment for severe acute malnutrition (SAM) between 2014 and 2016 was conducted. The study period was between September-December 2018. Children were exhaustively sampled. Children with edema, children with implausible z-scores for W/H (<–5 and >5) and H/A (<–6 and >6), children who were referred for inpatient therapeutic feeding to a stabilization center, and children from the same household, except in the case of twins, were eliminated from the analysis. There was one database per country. A total of 1384 children between 6–59 months were included in the analysis. ResultsThe most significant factors affecting the proportional weight gain include age at enrollment (P = 0.001, 95%CI = –0.00—0.00) and Weight for height z-score (WHZ) (P = 0.00, 95%CI = 0.04—0.05) in each child 6–59 months of age who were diagnosed with SAM and treated, adjusting for covariates including: breastfeeding status, number of children in household, illness, and distance to health center. Sex of child did not significantly affect proportional weight gain (P = 0.404, 95%CI = –0.012–0.005). ConclusionsThe existing protocol to treat severe acute malnutrition should be modified to treat younger children and children who are admitted with a lower weight for height z-score due to different vulnerabilities. Funding SourcesThe research was conducted as part of a dissertation at The Friedman School of Nutrition Science and Policy at Tufts University. Data were obtained from World Vision.

MUAC as the sole discharge criterion from community-based management of severe acute malnutrition in Burkina Faso.

The use of mid upper arm circumference (MUAC) measurement to screen and determine eligibility for admission to therapeutic feeding programs has been established, but evidence and programmatic experience to inform guidance on the use of MUAC as a discharge criterion is limited. We present results from a large‐scale nutritional program using MUAC for admission and discharge and compare program outcomes and response to treatment when determining eligibility for discharge by proportional weight gain versus discharge by MUAC. The study population included all children admitted to the Ministry of Health therapeutic feeding program supported by Médecins Sans Frontières in northern Burkina Faso from September 2007 to December 2011 (n = 50,841). Recovery was high overall using both discharge criteria, with low risks of death, nonresponse, and transfer to inpatient care and high daily gains in weight, MUAC, weight‐for‐height Z score, and height. When discharge was made by MUAC only, recovery increased, while all adverse program outcomes and length of stay decreased, with increasing MUAC on admission. MUAC‐based programming, where MUAC is integrated into program screening, admission, and discharge, is one of several new approaches that can be used to target resources to the most at‐risk malnourished children and improve program efficiency and coherency. This analysis provides additional programmatic experience on the use of MUAC‐based discharge criterion, but more work may be needed to inform optimal discharge thresholds across settings.

Birth weight variants are associated with variable fetal intrauterine growth from 20 weeks of gestation

Fetal intrauterine growth is influenced by complex interactions between the maternal genes, environment and fetal genes. The aim of this study was to assess the effect of GWAS-identified genetic variants associated with birth weight on intrauterine fetal growth in 665 children. Fetal growth was estimated by two-dimensional ultrasound scans at 20, 25 and 32 weeks of gestation and growth trajectories were modeled using mixed linear regression. A genetic risk score (GRS) of birth weight-raising variants was associated with intrauterine growth showing an attenuating effect on the unconditional daily reduction in proportional weight gain of 8.92 × 10−6 percentage points/allele/day (p = 2.0 × 10−4), corresponding to a mean difference of 410 g at 40 weeks of gestation between a child with lowest and highest GRS. Eight variants were independently associated with intrauterine growth throughout the pregnancy, while four variants were associated with fetal growth in the periods 20–25 or 25–32 weeks of gestation, indicating that some variants may act in specific time windows during pregnancy. Four of the intrauterine growth variants were associated with type 2 diabetes, hypertension or BMI in the UK Biobank, which may provide basis for further understanding of the link between intrauterine growth and later risk of metabolic disease.

Impact of Excessive Weight Gain on Cardiovascular Outcomes in Type 1 Diabetes: Results From the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study.

Intensive treatment (INT) of type 1 diabetes reduces the incidence of cardiovascular disease (CVD) events compared with conventional treatment (CONV), but it also results in more weight gain. Our objective was to examine whether excessive weight gain from INT of type 1 diabetes is independently associated with subsequent CVD events. Quartiles (Q) of weight gain in 1,213 participants aged 18 years and older at enrollment in the Diabetes Control and Complications Trial (DCCT) were determined within randomized treatment groups (INT vs. CONV) using change in BMI from baseline to the closeout DCCT visits. Effects of this weight gain on CVD risk factors and outcomes during an additional 20 years of observational follow-up were then determined. The Q4 INT group experienced greater proportional weight gain (median change in BMI, 6.08 kg/m2), increases in CVD risk factors, and need for medications for hypertension and lipids compared with the Q1-3 INT and comparable CONV groups. Over a mean of 26 years of follow-up, the numbers of major and total CVD events were not statistically different in Q4 compared with Q1-3 of either the INT or CONV group. By year 14, however, the incident CVD event curve became significantly higher in the Q4 INT group than in the Q1-3 INT groups (P = 0.024) and was similar to that for the CONV group. For the first 13 years after DCCT, INT for type 1 diabetes reduced macrovascular events compared with CONV, even when excessive weight gain occurred. After this, total CVD events significantly increased in the Q4 INT group, becoming equivalent to those in the CONV group. Longer follow-up is needed to determine whether this trend continues and results in more major CVD events.

Safety and practicability of using mid-upper arm circumference as a discharge criterion in community based management of severe acute malnutrition in children aged 6 to 59 months programmes.

BackgroundThe use of proportional weight gain as a discharge criterion for MUAC admissions to programs treating severe acute malnutrition (SAM) is no longer recommended by WHO. The critical limitation with the proportional weight gain criterion was that children who are most severely malnourished tended to receive shorter treatment compared to less severely malnourished children. Studies have shown that using a discharge criterion of MUAC ≥ 125 mm eliminates this problem but concerns remain over the duration of treatment required to reach this criterion and whether this discharge criterion is safe. This study assessed the safety and practicability of using MUAC ≥ 125 mm as a discharge criterion for community based management of SAM in children aged 6 to 59 months.MethodsA standards-based trial was undertaken in health facilities for the outpatient treatment of SAM in Lilongwe District, Malawi. 258 children aged 6 to 51 months were enrolled with uncomplicated SAM as defined by a MUAC equal or less than 115 mm without serious medical complications. Children were discharged from treatment as ‘cured’ when they achieved a MUAC of 125 mm or greater for two consecutive visits. After discharge, children were followed-up at home every two weeks for three months.ResultsThis study confirms that a MUAC discharge criterion of 125 mm or greater is a safe discharge criterion and is associated with low levels of relapse to SAM (1.9 %) and mortality (1.3 %) with long durations of treatment seen only in the most severe SAM cases. The proportion of children experiencing a negative outcome was 3.2 % and significantly below the 10 % standard (p = 0.0013) established for the study. All children with negative outcomes had achieved weight-for-height z-score (WHZ) above −1 z-scores at discharge. Children admitted with lower MUAC had higher proportional weight gains (p < 0.001) and longer lengths of stay (p < 0.0001). MUAC at admission and attendance were both independently associated with cure (p < 0.0001). There was no association with negative outcomes at three months post discharge for children with heights at admission below 65 cm than for taller children (p = 0.5798).ConclusionsThese results are consistent with MUAC ≥ 125 mm for two consecutive visits being a safe and practicable discharge criterion. Use of a MUAC threshold of 125 mm for discharge achieves reasonable lengths of stay and was also found to be appropriate for children aged six months or older who are less than 65 cm in height at admission. Early detection and recruitment of SAM cases using MUAC in the community and compliance with the CMAM treatment protocols should reduce lengths of stay and associated treatment costs.

Association between postnatal weight gain and severe retinopathy of prematurity in preterm babies with very low birth weight

Objective To analyze the association of postnatal weight gain proportion of very low birth weight (BW) preterm babies and the onset of severe retinopathy of prematurity, and investigate the optimal cut-off points and predictive ability of postnatal weight gain (WG) proportion for the onset of retinopathy of prematurity (ROP). Methods A retrospective cohort study. 257 preterm infants underwent screening whose weight was less than 1500 g were enrolled in this study. Risk factors include BW, gestational age (GA), history of oxygen inhalation, need for blood transfusions, Apgar score in 1 to 10 minutes, embryo number, delivery mode, in vitro fertilization infants, and WG proportion within 6 weeks after birth and other systemic diseases were recorded. Their correlation with severe ROP is analyzed. Clinical outcomes were divided into severe ROP group (patients who suffered from ROP and required treatment) and mild and no ROP group (patients who suffered from ROP but do not require treatment and patient without ROP). The severe ROP group included 18 patients and mild and no ROP group included 239 patients. Multiple logistic regression and receiver operating characteristic (ROC) curve were used to determine if the WG proportion was independently related to severe ROP development and if it was capable of predicting severe ROP. This study determines the predict value by comparing the area under the ROC curve (AUC) of independent risk factors. Results GA (t=-4.835, P<0.001), BW(t=-5.192, P<0.001), history of oxygen inhalation (χ2=6.001, P=0.009), proportion of infants who had oxygen inhalation for more than 10 days(χ2=10.019, P=0.002), postnatal WG proportion at 1 week(t=-3.663, P<0.001), postnatal WG proportion at 2 weeks(t=-3.425, P=0.001) had significant difference between two groups. Multiple logistic regression analysis revealed that GA(β=-0.858, P=0.008), BW(β=-0.005, P=0.010), postnatal WG proportion at 2 weeks (β=-8.745, P=0.035)were correlated to severe ROP significantly. And their area under the ROC were 0.836[95% confidence interval (CI): 0.752 - 0.920], 0.826 (95%CI: 0.947 - 0.903), 0.744 (95%CI: 0.598 - 0.891) respectively. The optimal cut-off points of GA, BW, and postnatal WG proportion at 2 weeks were 28.41 weeks, 1241.96 g, 12.80% respectively. Conclusion Low WG proportion at 2 weeks of very low BW preterm babies is an important and independent risk factor for severe ROP and has certain predictive value of the onset of severe ROP. Key words: Retinopathy of prematurity/etiology; Birth weight/growth and development; Weight gain/growth and development; Forecasting

Postnatal weight gain in very low birth weight infants in Beijing and the risk of retinopathy of prematurity.

To analyze the low weight gain (WG) from birth to 4 and 6wk of life to predict the development of retinopathy of prematurity (ROP) among very low birth weight (VLBW) preterm babies. Three hundred and three newborns with VLBW were analyzed. Body weight measurements were recorded weekly. In all patients, the proportion of the WG was defined as the preterm weight measured at the 4(th) and 6(th) weeks of life minus the birth weight (BW) divided by the BW. Other risk factors for ROP were also analyzed. Mean gestational age and mean BW of the whole cohort were 29.56±1.44wk and 1270.58±176.18g respectively. WG proportion at 4wk postnatal age (18.89%±13.58%) were significantly lower in infants with ROP (P=0.003). WG proportion at 6wk was not different between ROP and no ROP group (42.48%±20.36% vs 46.43%±15.65% P=0.118). When all the other risk factors significant for ROP were included in the logistic regression poor WG did not arise as an independent risk factor. Area under the ROC curve was 0.591 (95%CI: 0.515-0.666; P=0.016). For ROP, the best discriminative cutoff of 18.06% of the proportional WG at the 4(th) week over the BW, sensitivity and specificity values were 67.3% and 50.0% respectively. Low WG proportion in the first 4wk of life is maybe an additional predictor of ROP in very low BW infants. Preterm babies with low BW and low WG proportion should be followed closely for ROP.

Enhanced flavor–nutrient conditioning in obese rats on a high-fat, high-carbohydrate choice diet

Through flavor–nutrient conditioning rats learn to prefer and increase their intake of flavors paired with rewarding, postingestive nutritional consequences. Since obesity is linked to altered experience of food reward and to perturbations of nutrient sensing, we investigated flavor–nutrient learning in rats made obese using a high fat/high carbohydrate (HFHC) choice model of diet-induced obesity (ad libitum lard and maltodextrin solution plus standard rodent chow). Forty rats were maintained on HFHC to induce substantial weight gain, and 20 were maintained on chow only (CON). Among HFHC rats, individual differences in propensity to weight gain were studied by comparing those with the highest proportional weight gain (obesity prone, OP) to those with the lowest (obesity resistant, OR). Sensitivity to postingestive food reward was tested in a flavor–nutrient conditioning protocol. To measure initial, within-meal stimulation of flavor acceptance by post-oral nutrient sensing, first, in sessions 1–3, baseline licking was measured while rats consumed grape- or cherry-flavored saccharin accompanied by intragastric (IG) water infusion. Then, in the next three test sessions they received the opposite flavor paired with 5ml of IG 12% glucose. Finally, after additional sessions alternating between the two flavor-infusion contingencies, preference was measured in a two-bottle choice between the flavors without IG infusions. HFHC-OP rats showed stronger initial enhancement of intake in the first glucose infusion sessions than CON or HFHC-OR rats. OP rats also most strongly preferred the glucose-paired flavor in the two-bottle choice. These differences between OP versus OR and CON rats suggest that obesity is linked to responsiveness to postoral nutrient reward, consistent with the view that flavor–nutrient learning perpetuates overeating in obesity.

A predictive score for retinopathy of prematurity in very low birth weight preterm infants

This study describes the development of a score based on cumulative risk factors for the prediction of severe retinopathy of prematurity (ROP) comparing the performance of the score against the birth weight (BW) and gestational age (GA) in order to predict the onset of ROP. A prospective cohort of preterm infants with BW≤ 1500 g and/or GA≤ 32 weeks was studied. The score was developed based on BW, GA, proportional weight gain from birth to the 6th week of life, use of oxygen in mechanical ventilation, and need for blood transfusions from birth to the 6th week of life. The score was established after linear regression, considering the impact of each variable on the occurrences of any stage and severe ROP. Receiver operating characteristic (ROC) curves were used to determine the best sensitivity and specificity values for the score. All variables were entered into an Excel spreadsheet (Microsoft) for practical use by ophthalmologists during screening sessions. The sample included 474 patients. The area under the ROC curve for the score was 0.77 and 0.88 to predict any stage and severe ROP, respectively. These values were significantly higher for the score than for BW (0.71) and GA (0.69) when measured separately. ROPScore is an excellent index of neonatal risk factors for ROP, which is easy to record and more accurate than BW and GA to predict any stage ROP or severe ROP in preterm infants. The scoring system is simple enough to be routinely used by ophthalmologists during screening examination for detection of ROP.

Sugar in moderation: sugar diets affect short-term parasitoid behaviour

The biological control potential of parasitic wasps in the field is expected to increase with the provisioning of sugar sources, which increase longevity and replenish carbohydrate reserves. Apanteles aristoteliae is an important parasitoid of Argyrotaenia franciscana, the orange tortrix, an economic pest in fruit crops. In the present study, the effect of sugar diet on the physiological status of A. aristoteliae is investigated in the laboratory, as well as the effects of nutritional status on short-term olfactory orientation and parasitism behaviour, and the association between olfactory orientation and immediate parasitism activity. Levels of glycogen, fructose, total sugars, proportional weight gain and volume consumed are higher among females fed 25% sucrose solution than 10% sucrose solution, and lowest for those fed water. Sugar feeding also affects behaviour: wasps with higher levels of fructose or weight gain have a lower probability of making a choice in the olfactometer. Wasps with intermediate fructose levels or weight gain have a higher probability of orienting towards hosts than wasps with low or high levels. Among wasps that make a choice in the olfactometer, wasps fed 10% or 25% sucrose significantly prefer host versus food cues, whereas starved wasps are just as likely to select food cues as host cues.

Estimating the changes in energy flux that characterize the rise in obesity prevalence

Background: The daily energy imbalance gap associated with the current population weight gain in the obesity epidemic is relatively small. However, the substantially higher body weights of populations that have accumulated over several years are associated with a substantially higher total energy expenditure (TEE) and total energy intake (TEI), or energy flux (EnFlux = TEE = TEI).Objective: The objective was to develop an equation relating EnFlux to body weight in adults for estimating the rise in EnFlux associated with the obesity epidemic.Design: Multicenter, cross-sectional data for TEE from doubly labeled water studies in 1399 adults aged 5.9 ± 18.8 y (mean ± SD) were analyzed in linear regression models with natural log (ln) weight as the dependent variable and ln EnFlux as the independent variable, adjusted for height, age, and sex. These equations were compared with those for children and applied to population trends in weight gain.Results: ln EnFlux was positively related to ln weight (β = 0.71; 95% CI: 0.66, 0.76; R2 = 0.52), adjusted for height, age, and sex. This slope was significantly steeper than that previously described for children (β = 0.45; 95% CI: 0.38, 0.51).Conclusions: This relation suggests that substantial increases in TEI have driven the increases in body weight over the past 3 decades. Adults have a higher proportional weight gain than children for the same proportional increase in energy intake, mostly because of a higher fat content of the weight being gained. The obesity epidemic will not be reversed without large reductions in energy intake, increases in physical activity, or both.

Weight gain measured at 6 weeks after birth as a predictor for severe retinopathy of prematurity: study with 317 very low birth weight preterm babies

Recent studies suggest that postnatal weight gain can play an important role in the development of retinopathy of prematurity (ROP). To analyze the low weight gain (WG) from birth to 6 weeks of life to predict the development of severe retinopathy of prematurity (ROP) among very low birth weight preterm babies (VLBW). A prospective cohort study included 317 newborns with birth weight (BW) <or=1,500 g and gestational age (GA) <or=32 weeks. The main outcome was the development of severe ROP (defined as threshold ROP and higher stages of ROP). In all patients, the proportion of the WG was defined as the preterm weight measured at 6 weeks of life minus the BW divided by the BW. Seventeen risk factors for ROP were studied by univariate analysis. Chi-square test and Student's t-test were used to compare no-ROP/mild ROP patients and severe ROP patients. Logistic regression and receiver operating characteristic (ROC) curve were used to determine if the WG proportion was independently related to severe ROP development and if it was capable of predicting severe ROP. Ophthalmological examinations started between the fourth and sixth week of life, and were repeated until the 45th week of postmenstrual age. Weight gain proportion was always calculated at completed 6 weeks of life. Mean GA and mean BW of the whole cohort were 29.6 weeks (+/-1.9) and 1,124 grams (+/-239.5) respectively. After logistic regression, the low WG proportion under 51.2% from the BW, measured at 6 weeks of life, showed OR 3.007 (95%CI: 1.195-7.566; P = 0.019), for severe ROP, when adjusted for BW and for any stage intraventricular hemorrhage. Area under the ROC curve was 0.63 (95%CI: 0.495-0.761; P = 0.037). For the discriminative cutoff of 51.2% of the WG proportion, sensitivity and specificity values were 66.3% and 62.6% respectively. Positive and negative predictive values were 10.2% and 94.7% respectively. Low WG by six weeks of life is an important and independent risk factor for severe ROP and is capable to predict the development of severe ROP in most patients that needed treatment.

Comparison of performance of two size groups of farmed cod (Gadus morhua L.) juveniles following transfer to sea cages

AbstractIn order to investigate the biologically and economically optimum size for sea transfer of cultured cod, replicated trials were undertaken using experimental cages (1.5 m × 1 m × 1 m) stocked with two size grades of cod juveniles previously “untested” for on-growing at sea in Shetland: “small grade” (SG), 9.3-g mean weight (±2.08 s.d.) and “large grade” (LG), 19.4-g mean weight (±4.48 s.d.). Survival was high in both grades tested, with no significant difference in overall mortality (7.3% (SG) and 8.4% (LG)). A significant difference was observed in the overall percentage growth per day (%SGR) (p = 0.02), with SG and LG exhibiting values of 1.3 and 1.08, respectively. Regression analysis of body weight gain over time between the two grades revealed a significantly higher proportional weight gain in SG (p = 0.01). Cost analysis revealed an initial saving of 8.5% by selecting SG juveniles. This saving was reduced to 2.9% when the cost of feeding these fish was taken into account. However, food wastage was higher in this study than would be expected in a commercial operation, suggesting that the actual saving for the on-grower could be greater than 2.9%. Selecting smaller sized juveniles for transfer will increase the growout period. However, this may be offset by the fact they may be transferred earlier, at a significantly lower price.

Iron status in 6-y-old children: associations with growth and earlier iron status

To investigate the iron status of 6-y-old children and its association with growth and earlier iron status. In a cross-sectional study, children's body size measurements were recorded and blood samples taken near their sixth birthday. A sample of 188 children, randomly selected in two previous studies, was contacted, and 139(74%) agreed to participate. No children had iron deficiency anaemia, one was iron-deficient (serum ferritin (SF) <15 microg/l and mean corpuscular volume (MCV) <76 fl but 16% had depleted iron stores (SF<15 microg/l). Iron status indices were generally higher than at 1 and 2 y, but correlation was seen between iron status indices at 6 y and earlier values. Haemoglobin concentration at 6 y was negatively associated with length gain from birth to 1 y (B+/-s.e.=-1.269+/-0.452; P=0.007; adj. R2=0.119) (n=52), and proportional weight gain from birth to 1 y was higher among children with SF<15 microg/l at 6 y (295+/-33%; n=10) than those with SF> or =15 microg/l (258+/-31%; n=49) (P=0.001). MCV at 2 y predicted weight gain from 2 to 6 y (B+/-s.e.=1.721+/-0.581; P=0.005; adj. R2=0.153) (n=44); also, children with SF<15 microg/l at 6 y (n=9) gained 7.8+/-1.2 kg from 2 to 6 y, while children with SF> or =15 microg/l (n=35) gained 9.6+/-2.8 kg (P=0.007), furthermore a difference was seen in proportional weight gain from 2 to 6 y between children with depleted iron stores at 2 y and not, or 156+/-13 vs 169+/-18% (P=0.038). The results suggest that low iron status at 1 and 2 y might lead to slower growth up to 6 y of age. Low iron status at 1 and 2 y and/or slower growth from 1 and 2 y up to 6 y might contribute to worse iron status at 6 y, while faster growth in early childhood is related to lower iron status.

Psychosocial and Lifestyle Factors Associated with Insufficient and Excessive Maternal Weight gain during Pregnancy

Helping women attain recommended weight gain during pregnancy is an important challenge for clinicians. It is well documented that both insufficient and excessive maternal weight gain are associated with adverse pregnancy outcomes ( (1) Subcommittee on the Nutritional Status and Weight Gain During Pregnancy, Institute of Medicine, National Academy of Sciences. Nutrition During Pregnancy, Weight Gain, Nutrient Supplements. National Academy Press, Washington, DC1990 Google Scholar , (2) Johnson J.W. Yancey M.K. A critical review of the new recommendations for weight gain in pregnancy. Am J Obstet Gynecol. 1996; 174: 254-258 Google Scholar , (3) The Federal-Provincial Subcommittee on Nutrition.Nutrition in Pregnancy. Minister of National Health and Welfare, Ottawa, Ontario, Canada1987 Google Scholar , (4) Bianco A.T. Smilen S.W. Davis Y. Lopez S. Lapinski R. Lockwood C.J. Pregnancy outcome and weight gain recommendations for the morbidly obese woman. Obstet Gynecol. 1998; 91: 97-102 Google Scholar , (5) Edwards L.E. Hellerstedt W.L. Alton I.R. Story M. Himes J.H. Pregnancy complications and birth outcomes in obese and normal-weight women effects of gestational weight change. Obstet Gynecol. 1996; 87: 389-394 Google Scholar , (6) Abrams B. Carmichael S. Selvin A. Factors associated with the pattern of maternal weight gain during pregnancy. Obstet Gynecol. 1995; 86: 170-176 Google Scholar , (7) Abrams B. Selvin S. Maternal weight gain patterns and birth weight. Obstet Gynecol. 1995; 86: 163-169 Google Scholar , (8) Seiga-Riz A.M. Adair L.S. Hobel C.J. Institute of Medicine maternal weight gain recommendations and pregnancy outcome in a predominantly Hispanic population. Obstet Gynecol. 1994; 84: 565-573 Google Scholar , (9) Shepard M.J. Hellenbrand K.G. Bracken M.B. Proportional weight gain and complications of pregnancy, labor, and delivery in healthy women of normal weight prepregnancy stature. Am J Obstet Gynecol. 1986; 155: 947-954 Google Scholar , (10) Garbaciak J.A. Richter M. Miller S. Barton J.J. Maternal weight gain and pregnancy complications. Am J Obstet Gynecol. 1985; 1525: 238-245 Google Scholar , (11) Brown J.E. Jacobson N.H. Askue L.H. Peick M.G. Influences of pregnancy weight gain on the size of infants born to underweight women. Obstet Gynecol. 1981; 57: 13-17 Google Scholar , (12) Abrams B. Laros R.K. Prepregnancy weight, weight gain and birth weight. Am J Obstet Gynecol. 1979; 154: 503-509 Google Scholar , (13) Edwards L.E. Alton I.R. Barrada I.M. Hakanson E.Y. Pregnancy in the underweight woman. Am J Obstet Gynecol. 1979; 135: 297-301 Google Scholar , (14) Naeye R.L. Weight gain and the outcome of pregnancy. Am J Obstet Gynecol. 1979; 135: 39 Google Scholar ). Insufficient gain is linked to low infant birth weight and perinatal mortality, whereas excessive gain is associated with high infant birth weight and mortality, cesarean section, and prolonged second stage of labor. This work was supported by the Fonds de Développement of the University of Montreal, the Interdisciplinary Health Research Group of the University of Montreal, the Fonds de recherche en sauté du Québec, and the Research Center of the Centre Hospitalier de I’Université de Montréal, Notre-Dame Hospital. Part of this work was the topic of C. Chabot's master's degree thesis at the University of Montreal.