Suboptimal Feeding Research Articles

PSXIII-19 Swine Health Health and Management Evaluation in American Samoa.

American Samoa is working to improve swine production genetics and management. Our objective was to identify health and management factors affecting swine performance. A1998 survey found six leptospirosis serovars and parvovirus and heavy parasites loads, but no brucellosis or pseudorabies. Our 2016 Artificial Insemination Training focused on improving genetics and resulted in 12 sows bred and 103 piglets born. Oour 2017 Swine Farm Evaluation surveyed 26 farms with an average of 9 sows per farm. Serological samples were tested for antibodies against Porcine Circovirus Type 2b (ELISA, 96% positive), Swine Influenza (ELISA, 31%), Senecavirus (IFA, 27%), Mycoplasma hyopneumoniae (ELISA, 15%), Porcine Epidemic Diarrhea (IFA, 15%), and Porcine Reproductive and Respiratory Syndrome (ELISA, 4%, 1 pig). o evidence was seen of Porcine Respiratory Coronavirus (ELISA), Transmissable Gastroenteritis (ELISA) or Pseudorabies (SN). Fecal samples contained Ascaris suum, Oesophagostomum dentatum, Stephanurus dentatus, and, less commonly, Strongyles nodular worm, Stronglyloides, Brachylaemus suis, Necator species, Trichuris suis, and Fasciolopsis buski. Ear scrapings and scratching behavior indicated the presence of sarcoptic mange (31% of farms). Most farms fed a 14% grain feed (88% of farms) and local feeds (coconut, vegetables, fruits, 69%); only one farm fed an 18% starter and one fed milk to young pigs. One or more thin pigs were seen on 46% of farms. Waste is managed either by wash down (85% of farms) or as dry litter (42%); some farms used both. Wastewater concerns led to water restriction on 12% of farms. In conclusion, parasites and suboptimal feeding are constraints on pig growth and performance. Management recommendations to improve production should address these, in addition to improving health and genetics.

The Human Microbiome and Child Growth - First 1000 Days and Beyond.

The assembly of microbial communities within the gastrointestinal tract during early life plays a critical role in immune, endocrine, metabolic, and other host developmental pathways. Environmental insults during this period, such as food insecurity and infections, can disrupt this optimal microbial succession, which may contribute to lifelong and intergenerational deficits in growth and development. Here, we review the human microbiome in the first 1000 days - referring to the period from conception to 2 years of age - and using a developmental model, we examine the role of early microbial succession in growth and development. We propose that an 'undernourished' microbiome is intergenerational, thereby perpetuating growth impairments into successive generations. We also identify and discuss the intertwining host-microbe-environment interactions occurring prenatally and during early infancy, which may impair the trajectories of healthy growth and development, and explore their potential as novel microbial targets for intervention.

Artemia feeds: a review of brine shrimp production in the Mekong Delta, Vietnam

AbstractSeasonal Artemia pond production has been practiced for several decades by rural salt producing communities in the Mekong Delta, Vietnam, with more success than elsewhere in the world. In spite of this success, yields have been stagnating for a long time due to suboptimal feeding conditions. As feeding is one of the most important factors affecting Artemia production, the aim of this article was to review the studies that have been done so far on the development and application of appropriate Artemia feeds and feeding protocols in this area. So far, there are three main approaches. Traditionally, phytoplankton blooming is stimulated by the use of fertilizers in so‐called fertilization ponds. This green water is supplemented by the use of cheap agriculture waste products and chicken manure, directly applied in Artemia ponds. As this technique, however, often results in suboptimal feeding levels and comes with high nutrient charges in pond effluents, recently a formulated feed has been developed specifically for Artemia pond production which allows further increasing production levels. Finally, also the biofloc technology can be applied in Artemia culture by adding tapioca flour or molasses as carbon source to obtain the ratio C/N ≥ 10 in order to stimulate biofloc development as feed for Artemia in ponds. The limitations of the above techniques are discussed. It is envisaged that the future success and further expansion of Artemia pond production, also outside Vietnam, will increasingly be determined by a flexible use of a combination of these techniques.

Common Eider (Somateria Mollissima) Body Condition and Parasitic Load during a Mortality Event in the Baltic Proper

During late spring of 2007 and 2015, we observed unusually high mortality of Common Eiders (Somateria mollissima) on Christiansø in the Baltic Proper. The number of dead birds (2007: 125; 2015: 110) composed 5–10% of the total colony. In 2015, we collected 15 (12 adult females, three subadult males) of the 110 recently deceased Common Eiders for detailed autopsy. The average body mass of the females was 1,040 g (920–1,160 g) which is ca 60% lower than what can be expected of healthy females during wintertime. Similarly, for the subadult males the average body mass of 1,203 g (1,070–1,300 g) comprised only 45% of what can be expected for healthy subadult males during winter. All 15 birds were thus severely emaciated and cachexic with general atrophy of muscles and internal organs. Hunger oedema, distended gall bladder, empty stomach, empty and dilated intestines and dilated cardiomyopathy were observed as well. In addition, all 15 Common Eiders were infected with high loads of the acanthocephalan parasite Polymorphus minutus. No gross morphological changes suggested toxicological, bacteriological or viral causes to the mortality. Taken together, our autopsy suggested starvation leading to secondary metabolic catabolism and eventually congestive heart failure. Five birds that were examined in 2007 showed the same symptoms. We suspect that the introduction of suboptimal feeding conditions in combination with a high parasite load over the last decade synergistically caused high physiological stress leading to population level effects manifested as high mortality.

The Grow parenting program: demonstrating proof of concept

PurposeParent-focused interventions (PFIs) are a promising method for supporting parents and promoting children’s well-being. Few PFIs in the USA, however, include physical health promotion content and are universal programs. The purpose of this paper is to describe a universal health-promoting PFI for parents of elementary school-aged children and demonstrate proof of concept.Design/methodology/approachThe program emphasizes positive parenting practices, stress management skills and physical health promotion strategies and recommendations, and is part of a larger initiative that includes a continuum of universal, developmentally appropriate, health-promoting PFIs for civilian and military parents. The program was implemented at two community sites in rural Pennsylvania with 20 civilian parents completing pretests and posttests. Study measures assessed parenting, stress and stress management and physical health promotion related outcomes.FindingsParents reported decreases in suboptimal discipline and feeding practices, stress and child internalizing behavior. They also reported increases in their sense of control in managing child behavior, coping socialization, child’s outdoor playtime and health recommendations met.Research limitations/implicationsWhile these preliminary findings may not be generalizable, they serve as proof of concept, which suggests that more rigorous research on the program is warranted.Practical implicationsImplementing a universal, health-promoting PFI within the USA is viable and has the potential to impact multiple short-term outcomes.Originality/valueParents are among their child’s earliest and most influential educators, and this study lends further support to their role as health educators. Given the significant public health benefits of holistically promoting child health, the time has come for universal PFIs to begin including physical health promotion content.

Anemia and associated factors among children aged 6\u201323\xa0months in Damot Sore District, Wolaita Zone, South Ethiopia

BackgroundAnemia affects a significant part of the population in nearly every country in the globe. Iron requirements are greatest at ages 6–23 months when growth is extremely rapid and critically essential in critical times of life. Even though infants and toddlers are highly at risk, they are not considered as separate populations in the estimation of anemia. Despite this, the prevalence of anemia among under 24 months of age is still at its highest point of severity to be a public health problem in Ethiopia. There is no study that documented the magnitude of the problem and associated factors in the study area. The main aim of this study was to assess the prevalence of anemia and to identify associated factors among children 6–23 months of age.MethodsA community-based cross-sectional study was carried out among 485 children of Damot Sore, South Ethiopia from March to April 2017. Data on socio-demographic, dietary, blood samples for hemoglobin level and malaria infection were collected. Both descriptive and bivariate analyses were done and all variables having a p-value of 0.25 were selected for multivariable analyses. A multivariable logistic regression model was used to isolate independent predictors of anemia at a p-value less than 0.05. A principal component analysis was used to generate household wealth score, dietary diversity score.ResultsOut of 522 sampled children, complete data were captured from 485 giving a response rate of 92.91%. For altitude and persons smoking in the house adjusted prevalence of anemia was 255(52.6%). The larger proportion, 128(26.4%) of children had moderate anemia. On multivariable logistic regression analyses, household food insecurity (AOR = 2.74(95% CI: 1.62–4.65)), poor dietary diversity (AOR = 2.86(95% CI: 1.73–4.7)), early or late initiation of complementary feeding (AOR = 2.0(95% CI: 1.23–3.60)), poor breastfeeding practice (AOR = 2.6(95% CI: 1.41–4.62)), and poor utilization of folic acid by mothers (AOR = 2.75(95% CI: 1.42–5.36)) were significantly associated with anemia.ConclusionPrevalence of anemia among children (6–23 months) was a severe public health problem in the study area. Most important predictors are suboptimal child feeding practices, household food insecurity, and poor diet. Multi-sectoral efforts are needed to improve health and interventions targeting nutrition security are recommended.

Frontline health workers and exclusive breastfeeding guidelines in an HIV endemic South African community: a qualitative exploration of policy translation

BackgroundMothers rely heavily on health worker advice to make infant feeding decisions. Confusing or misleading advice can lead to suboptimal feeding practices. From 2001, HIV positive mothers in South Africa were counseled to choose either exclusive breastfeeding or exclusive formula feeding to minimize vertical HIV transmission. On the basis of revised World Health Organization guidelines, the government amended this policy in 2011, by promoting exclusive breastfeeding and discontinuing the provision of free formula. We explored how health workers experienced this new policy in an HIV endemic community in 2015–16, with attention to their knowledge of the policy, counselling practices, and observations of any changes.MethodsWe interviewed eleven health workers, from four community health clinics, who had counseled mothers before and after the policy change. The transcribed interviews were analyzed thematically, using a hybrid coding approach.ResultsThe scientific rationale of the policy was not explained to most health workers, who mostly thought that the discontinuation of the formula program was cost-related. The content of their counseling reflected knowledge about promoting breastfeeding for all women, and accordingly they mentioned the nutritional and developmental benefits of breastfeeding. The importance of exclusive breastfeeding for all infants was not emphasized, instead counseling focused on HIV prevention, even for uninfected mothers. The health workers noted an increased incidence of breastfeeding, but some worried that to avoid HIV disclosure, HIV positive mothers were mixed feeding rather than exclusively breastfeeding.ConclusionsCausal links between the policy, counseling content and feeding practices were unclear. Some participants believed that breastfeeding practices were driven by finance or family pressures rather than the health information they provided. Health workers generally lacked training on the policy’s evidence base, particularly the health benefits of exclusive breastfeeding for non-exposed infants. They wanted clarity on their counseling role, based on individual risk or to promote exclusive breastfeeding as a single option. If the latter, they needed training on how to assist mothers with community-based barriers. Infant feeding messages from health workers are likely to remain confusing until their uncertainties are addressed. Their insights should inform future guideline development as key actors.

Risk of postneonatal mortality, hospitalisation and suboptimal breast feeding practices in low birthweight infants from rural Haryana, India: findings from a secondary data analysis

ObjectivesLow birth weight (LBW) is a risk factor for neonatal mortality and morbidity. It is important to examine whether this risk persists beyond neonatal period. The current secondary data analysis...

The experiences of mothers and caregivers on feeding practices of children under the age of five years with undernutrition in Oshikoto region, Namibia

Background: Undernutrition in children under the age of five years is prevalent in the developing countries which increase the risk of morbidity and mortality among such age group. Lack of information related to nutrition and feeding practices as well as other factors such as employment and pressure from family and community members cause mothers and caregivers of children under the age of five years to use inappropriate methods of feeding which contribute to undernutrition.Purpose: The aim of this article is to relate the experiences of mothers and caregivers on feeding practices of children under the age of five years in Oshikoto region, Namibia.Methods: A qualitative study design was utilized to explore and describe the experiences of mothers and caregivers on feeding practices of children under the age of five years. The study population comprised of mothers and caregivers of children diagnosed with undernutrition either severe or moderate, admitted in pediatric units or registered on Nutritional Assessment Counseling and Support programme. A purposive sampling was used to select participants and a total number of fifteen mothers/caregivers were interviewed. The data were transcribed verbatim and analysed using Tesch steps.Results: The study revealed that mothers and caregivers experienced lack of information related to nutrition and feeding practices and other contextual constraints which resulted in the utilization of suboptimal feeding practices of children under the age of five years.Conclusions: Due to challenges experienced by mothers and caregivers, they need to be empowered with knowledge on nutrition and feeding practices of children under the age of five years.

Comprehensive nutritional and metabolic assessment in patients with spinal muscular atrophy: Opportunity for an individualized approach

Optimal nutrition support is recommended for patients with spinal muscular atrophy (SMA). In a prospective study, we performed comprehensive nutritional assessments with the aim to guide best nutritional strategies for patients with SMA types II and III. We recorded a) anthropometry; b) macro- and micronutrient intakes; c) measured resting energy expenditure by indirect calorimetry; and d) body composition including dual X-ray absorptiometry. We enrolled a cohort of 21 patients aged 3 to 36 years of which 13 were female; 19 had SMA type II and 2 had SMA type III. The body mass index z-score ranged from −3 to 2.4. Forty-five percent of the cohort was either underfed or overfed, based on the difference between actual energy intake and measured resting energy expenditure. Vitamin D, E, K, folate and calcium intakes were low in a majority of the cohort. Forty-five percent of the cohort was either hypometabolic or hypermetabolic. Fat mass index (kg/m2) was significantly higher and lean body mass index (kg/m2) was significantly lower in the study cohort compared to population normalized values. Bone mineral density was low in 13 of 17 patients. In summary, we have described the prevalence of malnutrition, suboptimal feeding and alterations in body composition in children with SMA. A comprehensive nutritional assessment could guide individualized nutrition therapy in this vulnerable population.

Retraction Note: Determinants of suboptimal breastfeeding practice in Debre Berhan town, Ethiopia: a cross sectional study

The authors are retracting this article [1] because there is significant overlap of both text and data with the Master’s Thesis of Hilina Ketma, “Assessment of prevalence and determinants of suboptimal breast feeding among mothers of children aged less than two years in Dire Dawa City Administration, Ethiopia, June 2013”, which was defended at the School of Graduate Studies, Addis Ababa University, in June 2013.

Sub-Optimal Breastfeeding and Its Associated Factors in Rural Communities of Hula District, Southern Ethiopia: A Cross-Sectional Study.

Sub-optimal breast feeding contributed a significant number of infants' death. Although breast feeding is universal in Ethiopia, the practice is not optimal. Hence, this study assessed the prevalence of sub-optimal breast feeding practice and its associated factors in rural communities of Hula District, Southern Ethiopia. A community based cross-sectional study was conducted among 634 women with infants aged 6 to 12 months. Multistage sampling technique was employed to select study subjects. Interviewer administered structured questionnaire was used for data collection. Data were entered and analyzed by using SPSS version 20.0. Bivariate and multivariate logistic regression was used to identify predictors of delayed initiation of breastfeeding and non-exclusive breastfeeding. The prevalence of suboptimal breast feeding of infants was found to be 56.9%. Nearly half (49.4%) of the mothers delayed initiation of breast feeding, and 13.4% of the infants were fed breast non-exclusively. Having formal education [AOR: 1.74; 95% CI (1.17, 2.59)], family size < 5 [AOR=1.59; 95% CI (1.03, 2.45)], having one under five child [AOR=1.88; 95% CI (1.29, 2.75)], lower number of antenatal care visits [AOR= 2.40; 95% CI (1.68, 3.43)] and lack of counseling on breastfeeding [AOR= 1.69; 95% CI (1.19, 2.41)] were negatively associated with delayed initiation of breast feeding. Similarly, not attending formal education, low birth order and lack of knowledge about exclusive breastfeeding were also negatively associated with exclusive breastfeeding practice. In this study, sub-optimal breast feeding was found to be high. Delayed initiation and non-exclusive breastfeeding practices were major contributors to sub-optimal breast feeding.

Nutritional adequacy of a novel human milk fortifier from donkey milk in feeding preterm infants: study protocol of a randomized controlled clinical trial

BackgroundFortification of human milk is a standard practice for feeding very low birth weight infants. However, preterm infants often still experience suboptimal growth and feeding intolerance. New fortification strategies and different commercially available fortifiers have been developed. Commercially available fortifiers are constituted by a blend of ingredients from different sources, including plant oils and bovine milk proteins, thus presenting remarkable differences in the quality of macronutrients with respect to human milk. Based on the consideration that donkey milk has been suggested as a valid alternative for children allergic to cow’s milk proteins, due to its biochemical similarity to human milk, we hypothesized that donkey milk could be a suitable ingredient for developing an innovative human milk fortifier.The aim of the study is to evaluate feeding tolerance, growth and clinical short and long-term outcomes in a population of preterm infants fed with a novel multi-component fortifier and a protein concentrate derived from donkey milk, in comparison to an analogous population fed with traditional fortifier and protein supplement containing bovine milk proteins.MethodsThe study has been designed as a randomized, controlled, single-blind clinical trial. Infants born <1500 g and <32 weeks of gestational age were randomized to receive for 21 days either a combination of control bovine milk-based multicomponent fortifier and protein supplement, or a combination of a novel multicomponent fortifier and protein supplement derived from donkey milk. The fortification protocol followed is the same for the two groups, and the two diets were designed to be isoproteic and isocaloric. Weight, length and head circumference are measured; feeding tolerance is assessed by a standardized protocol. The occurrence of sepsis, necrotizing enterocolitis and adverse effects are monitored.DiscussionThis is the first clinical study investigating the use of a human milk fortifier derived from donkey milk for the nutrition of preterm infants. If donkey milk derived products will be shown to improve the feeding tolerance or either of the clinical, metabolic, neurological or auxological outcomes of preterm infants, it would be an absolute innovation in the field of feeding practices for preterm infants.Trial registrationISRCTN -ISRCTN70022881.

Malnutrition, Mortality and Breastfeeding Practices in the Eastern Mediterranean Region: A Review of the Current Status

Background: Countries in the Eastern Mediterranean region (EMR) are facing many challenges that hinder progress in reduction of mortality rates (MRs) and nutritional status of children under-five years of age (CU5). Hence there is a need to identify breastfeeding practices that can influence malnutrition and MRs in the region. Aim: To analyze regional data of malnutrition, mortality and breastfeeding practices in mothers and CU5 in the EMR countries. Methods: Data from regional surveys of WHO and UNICEF for nutritional status and MRs in the EMR countries were analyzed in total and by income group and correlated to breastfeeding practices including timely first suckle (TFS), exclusive breastfeeding (EBF), breastfeeding rates at 12 (BR12) and 24 months (BR24) and percent designated Baby-friendly hospitals (DBFH). MRs included neonatal mortality rates (NMR), infant mortality rates (IMR), under-five mortality rates (U5MR), maternal mortality ratio (MMR). Selected indicators for development included illiteracy rates and total fertility rates (TFR). Results: Practices of early initiation (TFS), EBF, and continuity of breastfeeding are low in the region. MRs correlated with percent DBFH, TFS, EBF. Also BF12 and BF24 months correlated with stunting, wasting in the CU5, U5MR and overweight and obesity in adults. MRs correlated highly with stunting and wasting and poorly with overweight or obesity in CU5. Other variables as illiteracy, TFR, obesity and overweight in adults correlated significantly with MRs and with breastfeeding duration. At country level the low trends of shortened breastfeeding duration were associated with the high MRs and malnutrition rates. Conclusion: Suboptimal early feeding practices, low EBF and declines in breastfeeding duration impact child growth and survival and are associated with high stunting, wasting, overweight and mortality in CU5. Indices of development as improving literacy, birth spacing and can also help improve survival of children and mothers in the region.

In-depth Analysis of Mortality in Relation to Malnutrition in Children Under-five of Age in the Eastern Mediterranean Region

Background: The Eastern Mediterranean region (EMR) countries are facing many challenges that influence the nutritional status of children under-five years of age (CU5) and increase early mortality rates (MRs). Few studies have considered using global data to analyze the protective effect of breastfeeding on reducing MRs in the EMR. Aim: To analyze regional mortality rates in relation to socio-demographic, nutritional indices and early feeding practices in CU5 in the EMR countries. Methods: Data from the WHO global data bank for nutritional status and MRs in the 22 countries in EMR were analyzed MRs included neonatal mortality rates (NMR), infant mortality rates (IMR), under-five mortality rates (U5MR), maternal mortality ratio (MMR). Data was analyzed by income group and correlated to obesity and underweight, early feeding practices including early initiation of breastfeeding (EIBF), exclusive breastfeeding (EBF), breastfeeding rates at 12 (BR12) and 24 months (BR24) and selected indicators for development included illiteracy rates and total fertility rates (TFR). Results: MRs correlated with global data for country rates EIBF, EBF. Also BF12 and BF24 months correlated with stunting, wasting in the CU5, U5MR and overweight and obesity in adults. MRs correlated highly with stunting and wasting and poorly with overweight or obesity in CU5. Other variables as illiteracy, TFR, obesity and overweight in adults correlated significantly with MRs and with breastfeeding duration. At country level the low trends of shortened breastfeeding duration were associated with the high MRs and rate for obesity and stunting. Conclusions: Suboptimal early feeding practices leading to the double burden of malnutrition influence MR in the under-five mortality rates in children. Improving early initiation rates and prolonging the duration of intense breastfeeding can reduce early mortality. This cannot be attained without improving social indicators of literacy and birth spacing i.e. a comprehensive developmental approach to child survival.

Trends and predictors of appropriate complementary feeding practices in Nepal: An analysis of national household survey data collected between 2001 and 2014.

There is evidence that suboptimal complementary feeding contributes to poor child growth. However, little is known about time trends and determinants of complementary feeding in Nepal, where the prevalence of child undernutrition remains unacceptably high. The objective of the study was to examine the trends and predictors of suboptimal complementary feeding in Nepali children aged 6–23 months using nationally representative data collected from 2001 to 2014. Data from the 2001, 2006, and 2011 Nepal Demographic and Health Surveys and the 2014 Multiple Indicator Cluster Survey were used to estimate the prevalence, trends and predictors of four WHO‐UNICEF complementary feeding indicators: timely introduction of complementary foods (INTRO), minimum meal frequency (MMF), minimum dietary diversity (MDD), and minimum acceptable diet (MAD). We used multilevel logistic regression models to identify independent factors associated with these indicators at the individual, household and community levels. In 2014, the weighted proportion of children meeting INTRO, MMF, MDD, and MAD criteria were 72%, 82%, 36% and 35%, respectively, with modest average annual rate of increase ranging from 1% to 2%. Increasing child age, maternal education, antenatal visits, and community‐level access to health care services independently predicted increasing odds of achieving MMF, MDD, and MAD. Practices also varied by ecological zone and sociocultural group. Complementary feeding practices in Nepal have improved slowly in the past 15 years. Inequities in the risk of inappropriate complementary feeding are evident, calling for programme design and implementation to address poor feeding and malnutrition among the most vulnerable Nepali children.

Invited review: Practical feeding management recommendations to mitigate the risk of subacute ruminal acidosis in dairy cattle

Rumen health is of vital importance in ensuring healthy and efficient dairy cattle production. Current feeding programs for cattle recommend concentrate-rich diets to meet the high nutritional needs of cows during lactation and enhance cost-efficiency. These diets, however, can impair rumen health. The term "subacute ruminal acidosis" (SARA) is often used as a synonym for poor rumen health. In this review, we first describe the physiological demands of cattle for dietary physically effective fiber. We also provide background information on the importance of enhancing salivary secretions and short-chain fatty acid absorption across the stratified squamous epithelium of the rumen; thus, preventing the disruption of the ruminal acid-base balance, a process that paves the way for acidification of the rumen. On-farm evaluation of dietary fiber adequacy is challenging for both nutritionists and veterinarians; therefore, this review provides practical recommendations on how to evaluate the physical effectiveness of the diet based on differences in particle size distribution, fiber content, and the type of concentrate fed, both when the latter is part of total mixed ration and when it is supplemented in partial mixed rations. Besides considering the absolute amount of physically effective fiber and starch types in the diet, we highlight the role of several feeding management factors that affect rumen health and should be considered to control and mitigate SARA. Most importantly, transitional feeding to ensure gradual adaptation of the ruminal epithelium and microbiota; monitoring and careful management of particle size distribution; controlling feed sorting, meal size, and meal frequency; and paying special attention to primiparous cows are some of the feeding management tools that can help in sustaining rumen health in high-producing dairy herds. Supplementation of feed additives including yeast products, phytogenic compounds, and buffers may help attenuate SARA, especially during stress periods when the risk of a deficiency of physically effective fiber in the diet is high, such as during early lactation. However, the usage of feed additives cannot fully compensate for suboptimal feeding management.

Linking rates of metabolism and growth in marine fish larvae

The intricate relationship between metabolism and growth is still largely unexplored in early life stages of fish. In the present study, two experiments were conducted to explore how standard metabolic rate (SMR) of Atlantic herring (Clupea harengus) larvae was related to differences in body size, growth rate and feeding environment. In two of the three trials of the first experiment, larval SMR decreased (up to 37%) after larvae experienced 3 days of sub-optimal feeding conditions. Inter-individual differences in SMR and nutritional condition (RNA–DNA ratio) were unrelated. In a second experiment, inter-individual differences in SMR were not explained by differences in short-term (otolith marginal increment width) or long-term (size-at-age, otolith diameter-at-age) growth indicators in well (ad libitum) fed larvae. Nevertheless, a negative relationship between SMR and otolith core diameter (formed between hatching and first feeding) was observed. In well-fed larvae, the relationship between SMR, temperature (T, 5–15 °C) and dry mass (DM, 60–3000 µm, 10–24 mm body length) was equal to: SMR = 0.0528 (± 0.0047) * DM 0.8859 (± 0.0127) * e T * 0.1046 (± 0.0034) [mean (± SE), adj R 2 = 0.9302, n = 384]. This is the first study to report the effects of DM on SMR in Atlantic herring larvae over a wide range of T. The present results suggest that metabolic flexibility can exist, particularly when larvae experience contrasting feeding environments, which needs to be taken into account when evaluating factors affecting larval growth and survival in the sea.

Feeding adequacy among Critically Ill Patients in the Intensive Care Unit and Its Association with Clinical Outcomes: A Narrative Review

The Intensive Care Unit (ICU) is one of the disciplines in the hospital that provides close monitoring to the seriously ill or injured patients, also known as the critically ill patients. Critically ill patients in the ICU are usually unable to maintain volitional oral nutrition intake and therefore require nutritional therapy. Nutritional therapy can be delivered via the enteral or parenteral route. Optimal nutrition adequacy (i.e. neither underfeeding nor overfeeding) is very important for better clinical outcome. However, the problem of suboptimal feeding adequacy continues to be reported over the years. This article attempts to give an overview of the literature on feeding adequacy and the relationship of feeding adequacy with clinical outcomes among the critically ill patients in the ICU.Bangladesh Crit Care J September 2017; 5(2): 113-121

Tools to improve planning, implementation, monitoring, and evaluation of complementary feeding programmes.

Adequate nutrient intake is a prerequisite for achieving good nutrition status. Suboptimal complementary feeding practices are a main risk factor for stunting. The need for systematic and user-friendly tools to guide the planning, implementation, monitoring, and evaluation of dietary interventions for children aged 6-23months has been recognized. This paper describes five tools, namely, ProPAN, Optifood, Cost of the Diet, Fill the Nutrient Gap, and Monitoring Results for Equity System that can be used in different combinations to improve situation analysis, planning, implementation, monitoring, or evaluation approaches for complementary feeding in a particular context. ProPAN helps with development of strategies and activities designed to change the behaviours of the target population. Optifood provides guidance for developing food-based recommendations. The Cost of the Diet can provide insight on economic barriers to accessing a nutritious and balanced diet. The Fill the Nutrient Gap facilitates formulation of context-specific policies and programmatic approaches to improve nutrient intake, through a multistakeholder process that uses insights from linear programming and secondary data. The Monitoring Results for Equity System helps with analysis of gaps, constraints, and determinants of complementary feeding interventions and adoption of recommended practices especially in the most vulnerable and deprived populations. These tools, and support for their use, are readily available and can be used either alone and/or complementarily throughout the programme cycle to improve infant and young child-feeding programmes at subnational and national levels.