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Guja H, Belgiu M, Baye K, Stein A. Prevalence and determinants of stunting and anaemia in children aged 6-23 months: A multilevel analysis from rural Ethiopia. MATERNAL & CHILD NUTRITION 2025; 21:e13736. [PMID: 39377551 DOI: 10.1111/mcn.13736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 08/26/2024] [Accepted: 09/08/2024] [Indexed: 10/09/2024]
Abstract
Low- and middle-income countries shoulder the greatest burden of stunting and anaemia in children. This calls for prompt and effective intervention measures, while the contributing factors are not fully understood. This study evaluates determinants spanning from individual-, household- and community levels including agroecology and antinutrients as unique sets of predictors. Primary data were collected from 660 rural households representing the midland (ML), highland, and upper highland (UHL) agroecological zones from northern Ethiopia. The study relates several predictors to stunting and anaemia in children aged 6-23 months. We found 49.1% and 49.7% of children were stunted and anaemic, respectively. Children living in the ML are approximately twice more likely to be stunted adjusted odds ratio (AOR: 1.869; 95% CI: 1.147-3.043) than in the UHL. The risk of stunting increases by 16.3% and 41.9% for every unit increase in phytate-to-zinc and phytate-to-iron molar ratios, respectively. A 10% increase in mean aggregated crop yield was observed to reduce the likelihood of stunting occurrence by 13.6%. Households lacking non-farm income-generating opportunities, travel longer time to access the marketplace and poor health service utilisation were associated with increased risk of stunting. Low diversity of child's diet, age of the child (18-23 months) and mothers at a younger age are significantly associated with stunting. Risk of anaemia in children is high amongst households with unimproved water, sanitation, and hygiene practices, younger age (6-11 months) and mostly occurs amongst boys. Children in the ML had a 55% reduced risk of being anaemic (AOR: 0.446; 95% CI: 0.273-0.728) as compared to the UHL. Therefore, the influence of these factors should be considered to tailor strategies for reducing undernutrition in children of 6-23 months in rural Ethiopia. Interventions should go beyond the administrative boundaries into targeting agroecological variation.
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Affiliation(s)
- Habtamu Guja
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands
- Center for Food Science and Nutrition, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mariana Belgiu
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands
| | - Kaleab Baye
- Center for Food Science and Nutrition, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alfred Stein
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands
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Samarathunga N, Spence A, Grimes C, Russell CG, Lacy KE. Comparing Australian children's dietary intakes with the Eat-Lancet Commission Planetary Health Diet targets and Australian Dietary Guidelines: a cross-sectional study. Eur J Nutr 2024; 64:56. [PMID: 39738888 DOI: 10.1007/s00394-024-03565-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 11/26/2024] [Indexed: 01/02/2025]
Abstract
PURPOSE As healthy eating recommendations shift to incorporate environmentally sustainable eating principles, it becomes crucial to understand whether children's dietary intakes align with global recommendations such as the EAT-Lancet Commission Planetary Health Diet (PHD), in addition to national health-promoting guidelines, including the Australian Dietary Guidelines (ADG). This cross-sectional study aimed to assess the alignment of young Australian children's food intakes with these recommendations. METHODS Dietary data from the 2011-2012 National Nutrition and Physical Activity Survey for children aged 2-8 years were used and compared with, energy-adjusted target amounts of the PHD and ADG Foundation Diet. Usual energy intakes were calculated for two age groups (2-3; 4-8 years) and used to proportionally adjust the adult PHD target amounts for children. Mean intake of each food group (g/day) was determined through one 24-h dietary recall. RESULTS For both age groups (2-3-years: n = 463; 4-8-years: n = 776), the daily mean consumption of wholegrains, starchy vegetables, other vegetables, eggs, fish, legumes, nuts, and unsaturated oils was below the PHD targets, while the consumption of red meat, dairy products, poultry, and added sugars was above the targets. The ADG Foundation Diet trends were similar to the PHD for wholegrains, vegetables, nuts, and legumes but the daily mean consumption of dairy products and red meat was below ADG Foundation Diet targets and above PHD targets. CONCLUSION Australian children's diets do not align with the PHD and ADG Foundation Diet. Substantial changes are required to improve dietary practices, emphasizing the gap between current consumption and recommended guidelines.
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Affiliation(s)
- Nuvini Samarathunga
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences (SENS), Deakin University, Geelong, Australia
| | - Alison Spence
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences (SENS), Deakin University, Geelong, Australia
| | - Carley Grimes
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences (SENS), Deakin University, Geelong, Australia
| | - Catherine G Russell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences (SENS), Deakin University, Geelong, Australia
| | - Kathleen E Lacy
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences (SENS), Deakin University, Geelong, Australia.
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Ahmadi H, Askari M, Suitor K, Bellissimo N, Azadbakht L. The association between different types of amino acid intake and physical growth among children. Clin Nutr ESPEN 2024; 60:165-172. [PMID: 38479905 DOI: 10.1016/j.clnesp.2023.12.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/07/2023] [Accepted: 12/20/2023] [Indexed: 04/13/2024]
Abstract
BACKGROUND & AIMS Restricted linear growth and abnormal weight status are commonly observed among children in low-income countries, possibly due to inadequate protein intake. Considering the role of protein intake and amino acid (AA) synthesis in growth and development, it has been suggested that there may be an association between AA intake and physical growth. We aimed to investigate the association between different types of AA intake and physical growth among children. METHODS A cross-sectional study including 780 six-year-old children referred to 10 health care centers for vaccination between October 2017 and March 2018 was conducted. Anthropometric data was collected using standard methods, and dietary intake was assessed using a validated food-frequency questionnaire (FFQ) in an interview by a trained technician. RESULTS Children in the highest tertile (3rd) of branched-chain amino acids (BCAA) intake had a higher weight-for-age z-score (WAZ) (P = 0.02) and body mass index-for-age z-score (BAZ) (P = 0.001) compared to those in the lowest tertile (1st). Interestingly, BAZ was significantly associated with the highest tertile of acidic AA intake (P = 0.04), while an inverse association was observed between the highest tertile of aromatic AA (phenylalanine and tyrosine) intake and BAZ (P = 0.01) . No significant associations were observed between the highest tertile of sulfuric, aliphatic, or neutral AA and BAZ, height-for-age z-score (HAZ) or WAZ. Further, underweight was associated with the 3rd tertile of aromatic, alcoholic, aliphatic or neutral AA and BCAA intake. Aliphatic and neutral AA intake was also increased the risk of overweight. Finally, stunted growth patterns were associated with the highest tertile of acidic, alcoholic. CONCLUSION Findings presented in this study showed that higher BAZ and WAZ are associated with 3rd tertiles of BCAA intake, but lower BAZ were associated with 3rd tertiles of aromatic AA (phenylalanine and tyrosine) intake. Future research in other populations are needed to confirm these findings.
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Affiliation(s)
- Hedieh Ahmadi
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadreza Askari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Katherine Suitor
- Faculty of Community Services, School of Nutrition, Toronto Metropolitan University, Toronto, Canada
| | - Nick Bellissimo
- Faculty of Community Services, School of Nutrition, Toronto Metropolitan University, Toronto, Canada
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Soczynska I, da Costa BR, O'Connor DL, Jenkins DJ, Birken CS, Keown-Stoneman CD, Maguire JL. Plant-Based Milk Consumption and Growth in Children 1-10 Years of Age. J Nutr 2024; 154:985-993. [PMID: 38219863 DOI: 10.1016/j.tjnut.2023.12.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 12/27/2023] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND The effects of plant-based milk consumption on the growth of children are unclear. OBJECTIVES We aimed to evaluate the relationship between plant-based milk consumption and BMI in childhood. Secondary objectives were to examine the association with height and whether these relationships are mediated by dairy milk intake and modified by age or the type of plant-based milk consumed. METHODS A prospective cohort study was conducted in healthy children aged 1-10 y through the TARGet Kids! primary care research network in Toronto, Canada. Linear mixed-effect modeling and logistic generalized estimating equations were used to evaluate the association between plant-based milk consumption (number of 250 mL cups/d) and BMI. A mediation analysis was conducted to examine whether dairy milk intake mediated these relationships. Effect modification by age and type of plant-based milk was explored. RESULTS Among 7195 children (mean age: 3.1 y; 52.3% male), higher plant-based milk consumption was associated with lower BMI (P = 0.0002) and height (P = 0.005). No association was found with BMI categories. Lower dairy milk intake partially mediated these relationships. A child aged 5 y who consumed 3 cups of plant-based milk compared with 3 cups of dairy milk had a lower weight of 0.5 kg and lower height of 0.8 cm. Associations did not change over time and were similar for children who consumed soy milk compared with other plant-based milks. CONCLUSIONS Plant-based milk consumption was associated with lower BMI and height, but both were within the normal range on average. Future longitudinal studies are needed to determine whether these associations persist over time.
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Affiliation(s)
- Izabela Soczynska
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Pediatrics, St. Michael's Hospital, Toronto, ON, Canada; Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, ON, Canada
| | - Bruno R da Costa
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Deborah L O'Connor
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, ON, Canada; Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; Translational Medicine, SickKids Research Institute, Toronto, ON, Canada
| | - David Ja Jenkins
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada
| | - Catherine S Birken
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Ontario; Child Health and Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada; Division of Paediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada
| | - Charles Dg Keown-Stoneman
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Applied Health Research Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Biostatistics, Dalla Lana School of Public Health, University of Toronto, ON, Canada
| | - Jonathon L Maguire
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Pediatrics, St. Michael's Hospital, Toronto, ON, Canada; Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Ontario; Child Health and Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada.
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George F, Rajeev LN, Bandyopadhyay S, Baby J, Sinha S, Sachdev HS, Kurpad AV, Thomas T. The role of dairy consumption in the relationship between wealth and early life physical growth in India: evidence from multiple national surveys. BMC Public Health 2024; 24:96. [PMID: 38183073 PMCID: PMC10768164 DOI: 10.1186/s12889-023-17520-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 12/18/2023] [Indexed: 01/07/2024] Open
Abstract
INTRODUCTION Prevalence of undernutrition continues to be high in India and low household wealth is consistently associated with undernutrition. This association could be modified through improved dietary intake, including dairy consumption in young children. The beneficial effect of dairy on child growth has not been explored at a national level in India. The present analyses aimed to evaluate the direct and indirect (modifying association of household level per adult female equivalent milk and milk product consumption) associations between household wealth index on height for age (HAZ) and weight for age (WAZ) in 6-59 months old Indian children using data from of nationally representative surveys. METHODS Two triangulated datasets of two rounds of National Family Health Survey, (NFHS-3 and 4) and food expenditure (National Sample Survey, NSS61 and 68) surveys, were produced by statistical matching of households using Non-Iterative Bayesian Approach to Statistical Matching technique. A Directed Acyclic Graph was constructed to map the pathways in the relationship of household wealth with HAZ and WAZ based on literature. The direct association of wealth index and its indirect association through per adult female equivalent dairy consumption on HAZ and WAZ were estimated using separate path models for each round of the surveys. RESULTS Wealth index was directly associated with HAZ and WAZ in both the rounds, but the association decreased from NFHS-3 (βHAZ: 0.145; 95% CI: 0.129, 0.16) to NFHS-4 (βHAZ: 0.102; 95%CI: 0.093, 0.11). Adult female equivalent milk intake (increase of 10gm/day) was associated with higher HAZ (β_NFHS-3=0.001;95% CI: 0, 0.002; β_NFHS-4=0.002;95% CI: 0.002, 0.003) but had no association with WAZ. The indirect association of wealth with HAZ through dairy consumption was 2-fold higher in NFHS-4 compared to NFHS-3. CONCLUSIONS The analysis of triangulated survey data shows that household level per- adult female equivalent dairy consumption positively modified the association between wealth index and HAZ, suggesting that regular inclusion of milk and milk products in the diets of children from households across all wealth quintiles could improve linear growth in this population.
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Affiliation(s)
- Franciosalgeo George
- Division of Epidemiology, Biostatistics, and Population Health, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India
| | - L Naga Rajeev
- Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India
| | - Sulagna Bandyopadhyay
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, India
| | - Jeswin Baby
- Division of Epidemiology, Biostatistics, and Population Health, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India
- Department of Statistical Sciences, Kannur University, Kerala, India
- Research and Development Cell, Caritas Hospital and Institute of Health Sciences, Kottayam, India
| | - Srishti Sinha
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, India
| | - Harshpal Singh Sachdev
- Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India
| | - Anura V Kurpad
- Department of Physiology, St John's Medical College, Bengaluru, India
| | - Tinku Thomas
- Department of Biostatistics, St John's Medical College, Bengaluru, India.
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Mehrab Bakhtiar M, Hoddinott J. Household dairy production, dairy intake, and anthropometric outcomes in rural Bangladesh. FOOD POLICY 2023; 121:102567. [PMID: 38130414 PMCID: PMC10731516 DOI: 10.1016/j.foodpol.2023.102567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/05/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023]
Abstract
We assess whether ownership of dairy cows is associated with a greater likelihood of consuming dairy products and with child anthropometric status in rural Bangladesh. Consistent with the assumption of imperfectly functioning markets for dairy products, ownership of dairy cows increases the likelihood that a child 6-59 months consumes milk by 7.7 percentage points with no difference in this association between boys and girls. This association nearly doubles in magnitude when we consider households that own a dairy cow that produced milk in the last year. This result is robust to the controls we use and the way in which we measure dairy cow ownership. Even when we saturate our model with child, maternal, household, wealth, as well as village fixed effects, we retain an association between dairy cow ownership and height-for-age z scores (HAZ) that is meaningful in magnitude - 0.13 standard deviations - and statistically significant at the one percent level. For children in the 12-23.9 month age group, ownership of a dairy cow is associated with a 0.37 SD increase in HAZ and a reduction of 11.3 percentage points in stunting. There is no statistically significant association with weight-for-height or wasting. These associations do not differ between boys and girls.
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Affiliation(s)
| | - John Hoddinott
- International Food Policy Research Institute, USA
- Cornell University, USA
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Feyisa BB, Dabu GT. Determinant of under nutrition among under five children in Ambo town during covid 19 pandemic in 2020. A community-based cross-sectional study. BMC Nutr 2023; 9:103. [PMID: 37715228 PMCID: PMC10504691 DOI: 10.1186/s40795-023-00762-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/03/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND About 8 to 44% of all child mortality in Africa is associated with undernutrition. To alleviate this problem, it is necessary to determine the magnitude and determinants of undernutrition during Covid 19 pandemic. However, there is scarce evidence in an urban setting like Ambo town. Therefore, this study assessed the magnitude and factors associated with undernutrition among under-five children in Ambo town, west Ethiopia. METHODS AND PATIENTS A community-based cross-sectional study was conducted in Ambo town from March 01-30, 2020. The child and mother/caregiver socio-demographic characteristics, child illness and health care utilization, and child feeding practice-related data were collected using the standardized tool adopted from similar studies conducted in Ethiopia. Anthropometric measurements of the child were made using a calibrated scale. A systematic sampling technique was employed to select 363 mothers/caregivers of the child as a source of data. Nutritional status indices were generated using ENASMART software. After testing for collinearity, variables with a p-value < 0.25 in binary logistic regression were interred to backward multiple logistic regressions at a level of significance of p < 0.05. RESULTS A total of 363 participants were included in this study providing a 100% response rate and providing the following result. The mean (+ SD) age of children was 28.85 (+ 14.17) months and that of mothers/caregivers was 28.12 + 48 years. This study found 16.00%, 25.30%, and 19.00% of the study participants were underweight, wasted, and stunted respectively. Decisions making on major food purchases, who usually care for the child, the age at which the child starts complimentary food, late introduction of complementary food were positively associated with wasting. Diarrhea, birth weight, child age, age at which the child starts complimentary food, consumption of milk and milk product, and who usually care for the child were significantly associated with being underweight. Consumption of milk and milk products, household food security level, and birth weight were independent determinants of stunting. CONCLUSION This study identified a high prevalence of undernutrition, especially wasting. Childbirth weight, age, diarrhea, feeding practice, household (HH) food security, Decision making on major food purchases, late introduction of complementary food were found to be the potential determinants of undernutrition. Thus there should be an effort to improve the nutritional status of children in the study area by focusing on these factors.
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Affiliation(s)
- Beshadu Bedada Feyisa
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, PO box 19, Ambo, Ethiopia.
| | - Getu Taresa Dabu
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, PO box 19, Ambo, Ethiopia
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Goldfarb G, Sela Y. The Ideal Diet for Humans to Sustainably Feed the Growing Population - Review, Meta-Analyses, and Policies for Change. F1000Res 2023; 10:1135. [PMID: 37928317 PMCID: PMC10623543 DOI: 10.12688/f1000research.73470.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 11/07/2023] Open
Abstract
INTRODUCTION As of now, no study has combined research from different sciences to determine the most suitable diet for humans. This issue is urgent due to the predicted population growth, the effect of this on the environment, and the deterioration of human health and associated costs. METHODS A literature review determined whether an optimal diet for humans exists and what such a diet is, followed by six meta-analyses. The standard criteria for conducting meta-analyses of observational studies were followed. A review of literature reporting Hazard Ratios with a 95% confidence interval for red meat intake, dairy intake, plant-based diet, fiber intake, and serum IGF-1 levels were extracted to calculate effect sizes. RESULTS Results calculated using NCSS software show that high meat consumption increases mortality probability by 18% on average and increases diabetes risk by 50%. Plant-based and high-fiber diets decrease mortality by 15% and 20% respectively ( p < .001). Plant-based diets decreased diabetes risk by 27%, and dairy consumption (measured by increased IGF-1 levels) increased cancer probability by 48% ( p < 0.01). A vegetarian or Mediterranean diet was not found to decrease the probability of heart disease. A vegetarian diet can be healthy or not, depending on the foods consumed. A Mediterranean diet with high quantities of meat and dairy products will not produce the health effects desired. The main limitations of the study were that observational studies were heterogeneous and limited by potential confounders. DISCUSSION The literature and meta-analyses point to an optimal diet for humans that has followed our species from the beginnings of humankind. The optimal diet is a whole food, high fiber, low-fat, 90+% plant-based diet. This diet allowed humans to become the most developed species on Earth. To ensure people's nutritional needs are met healthily and sustainably, governmental dietary interventions are necessary.
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Affiliation(s)
- Galit Goldfarb
- Nutrition, OUS University, The Royal Academy of Economics and Technology, Zürich, Switzerland
| | - Yaron Sela
- Nutrition, OUS University, The Royal Academy of Economics and Technology, Zürich, Switzerland
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Mbabazi J, Pesu H, Mutumba R, Filteau S, Lewis JI, Wells JC, Olsen MF, Briend A, Michaelsen KF, Mølgaard C, Ritz C, Nabukeera-Barungi N, Mupere E, Friis H, Grenov B. Effect of milk protein and whey permeate in large quantity lipid-based nutrient supplement on linear growth and body composition among stunted children: A randomized 2 × 2 factorial trial in Uganda. PLoS Med 2023; 20:e1004227. [PMID: 37220111 DOI: 10.1371/journal.pmed.1004227] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/29/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Despite possible benefits for growth, milk is costly to include in foods for undernourished children. Furthermore, the relative effects of different milk components, milk protein (MP), and whey permeate (WP) are unclear. We aimed to assess the effects of MP and WP in lipid-based nutrient supplement (LNS), and of LNS itself, on linear growth and body composition among stunted children. METHODS AND FINDINGS We performed a randomized, double-blind, 2 × 2 factorial trial among 12 to 59 months old stunted children in Uganda. Children were randomized to 4 formulations of LNS with MP or soy protein isolate and WP or maltodextrin (100 g/day for 12 weeks) or no supplementation. Investigators and outcome assessors were blinded; however, participants were only blinded to the ingredients in LNS. Data were analyzed based on intention-to-treat (ITT) using linear mixed-effects models adjusted for age, sex, season, and site. Primary outcomes were change in height and knee-heel length, and secondary outcomes included body composition by bioimpedance analysis (ISRCTN13093195). Between February and September 2020, we enrolled 750 children with a median age of 30 (interquartile range 23 to 41) months, with mean (± standard deviation) height-for-age z-score (HAZ) -3.02 ± 0.74 and 12.7% (95) were breastfed. The 750 children were randomized to LNS (n = 600) with or without MP (n = 299 versus n = 301) and WP (n = 301 versus n = 299), or no supplementation (n = 150); 736 (98.1%), evenly distributed between groups, completed 12-week follow-up. Eleven serious adverse events occurred in 10 (1.3%) children, mainly hospitalization with malaria and anemia, all deemed unrelated to the intervention. Unsupplemented children had 0.06 (95% confidence interval, CI [0.02, 0.10]; p = 0.015) decline in HAZ, accompanied by 0.29 (95% CI [0.20, 0.39]; p < 0.001) kg/m2 increase in fat mass index (FMI), but 0.06 (95% CI [-0.002; 0.12]; p = 0.057) kg/m2 decline in fat-free mass index (FFMI). There were no interactions between MP and WP. The main effects of MP were 0.03 (95% CI [-0.10, 0.16]; p = 0.662) cm in height and 0.2 (95% CI [-0.3, 0.7]; p = 0.389) mm in knee-heel length. The main effects of WP were -0.08 (95% CI [-0.21, 0.05]; p = 220) cm and -0.2 (95% CI [-0.7; 0.3]; p = 403) mm, respectively. Interactions were found between WP and breastfeeding with respect to linear growth (p < 0.02), due to positive effects among breastfed and negative effects among non-breastfed children. Overall, LNS resulted in 0.56 (95% CI [0.42, 0.70]; p < 0.001) cm height increase, corresponding to 0.17 (95% CI [0.13, 0.21]; p < 0.001) HAZ increase, and 0.21 (95% CI [0.14, 0.28]; p < 0.001) kg weight increase, of which 76.5% (95% CI [61.9; 91.1]) was fat-free mass. Using height-adjusted indicators, LNS increased FFMI (0.07 kg/m2, 95% CI [0.0001; 0.13]; p = 0.049), but not FMI (0.01 kg/m2, 95% CI [-0.10, 0.12]; p = 0.800). Main limitations were lack of blinding of caregivers and short study duration. CONCLUSIONS Adding dairy to LNS has no additional effects on linear growth or body composition in stunted children aged 12 to 59 months. However, supplementation with LNS, irrespective of milk, supports linear catch-up growth and accretion of fat-free mass, but not fat mass. If left untreated, children already on a stunting trajectory gain fat at the expense of fat-free mass, thus nutrition programs to treat such children should be considered. TRIAL REGISTRATION ISRCTN13093195.
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Affiliation(s)
- Joseph Mbabazi
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
- Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda
| | - Hannah Pesu
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Rolland Mutumba
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
- Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda
| | - Suzanne Filteau
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jack I Lewis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Jonathan C Wells
- Childhood Nutrition Research Centre, Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Mette F Olsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - André Briend
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
- Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Christian Mølgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Christian Ritz
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Ezekiel Mupere
- Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Benedikte Grenov
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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10
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Vlaardingerbroek H, Joustra SD, Oostdijk W, de Bruin C, Wit JM. Assessment of Nutritional Status in the Diagnostic Evaluation of the Child with Growth Failure. Horm Res Paediatr 2023; 97:11-21. [PMID: 37054683 DOI: 10.1159/000530644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/23/2023] [Indexed: 04/15/2023] Open
Abstract
Current clinical guidelines provide information about the diagnostic workup of children with growth failure. This mini-review focuses on the nutritional assessment, which has received relatively little attention in such guidelines. The past medical history, in particular a low birth size and early feeding problems, can provide information that can increase the likelihood of nutritional deficits or several genetic causes. The current medical history should include a dietary history and can thereby reveal a poorly planned or severely restricted diet, which can be associated with nutritional deficiencies. Children on a vegan diet should receive various nutritional supplements, but insufficient compliance has been reported in one-third of cases. While proper use of nutritional supplements in children consuming a vegan diet appears to be associated with normal growth and development, insufficient intake of supplements may impede growth and bone formation. Physical examination and analysis of height and weight over time can help differentiating between endocrine causes, gastrointestinal disorders, psychosocial problems, or underlying genetic conditions that prevent adequate nutritional intake. Laboratory screening should be part of the workup in every child with short stature, and further laboratory tests can be indicated if warranted by the dietary history, especially in children on a poorly planned vegan diet.
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Affiliation(s)
- Hester Vlaardingerbroek
- Division of Paediatric Endocrinology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands
| | - Sjoerd D Joustra
- Division of Paediatric Endocrinology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands
| | - Wilma Oostdijk
- Division of Paediatric Endocrinology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands
| | - Christiaan de Bruin
- Division of Paediatric Endocrinology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jan M Wit
- Division of Paediatric Endocrinology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands
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11
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Melnik BC, John SM, Carrera-Bastos P, Cordain L, Leitzmann C, Weiskirchen R, Schmitz G. The Role of Cow's Milk Consumption in Breast Cancer Initiation and Progression. Curr Nutr Rep 2023; 12:122-140. [PMID: 36729355 PMCID: PMC9974716 DOI: 10.1007/s13668-023-00457-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE OF REVIEW This review evaluates cow milk's impact on breast carcinogenesis by linking recent epidemiological evidence and new insights into the molecular signaling of milk and its constituents in breast cancer (BCa) pathogenesis. RECENT FINDINGS Recent prospective cohort studies support the association between cow's milk consumption and the risk of estrogen receptor-α-positive (ER+) BCa. Milk is a complex biological fluid that increases systemic insulin-like growth factor 1 (IGF-1), insulin and estrogen signaling, and interacting hormonal promoters of BCa. Further potential oncogenic components of commercial milk include exosomal microRNAs (miR-148a-3p, miR-21-5p), bovine meat and milk factors, aflatoxin M1, bisphenol A, pesticides, and micro- and nanoplastics. Individuals with BRCA1 loss-of-function mutations and FTO and IGF1 gain-of-function polymorphisms enhancing IGF-1/mTORC1 signaling may be at increased risk for milk-induced ER+ BCa. Recent prospective epidemiological and pathobiochemical studies identify commercial milk consumption as a critical risk factor of ER+ BCa. Large meta-analyses gathering individuals of different ethnic origins with milk derived from dairy cows of varying genetic backgrounds and diverse feeding procedures as well as missing data on thermal processing of milk (pasteurization versus ultra-heat treatment) make multi-national meta-analyses unsuitable for BCa risk estimations in susceptible populations. Future studies are required that consider all vulnerable periods of breast carcinogenesis to cow's milk exposure, beginning during the perinatal period and puberty, since these are the most critical periods of mammary gland morphogenesis. Notwithstanding the need for better studies including detailed information on milk processing and vulnerable periods of human breast carcinogenesis, the available evidence suggests that dietary guidelines on milk consumption may have to be reconsidered.
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Affiliation(s)
- Bodo C Melnik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, D-49076, Osnabrück, Germany.
| | - Swen Malte John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, D-49076, Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Lower-Saxonian Institute of Occupational Dermatology (NIB), Osnabrück, Germany
| | - Pedro Carrera-Bastos
- Center for Primary Health Care Research, Lund University/Region Skåne, Skåne University Hospital, 205 02, Malmö, Sweden
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670, Madrid, Spain
- Centro de Estudios Avanzados en Nutrición (CEAN), 11007, Cádiz, Spain
| | | | - Claus Leitzmann
- Institute of Nutrition, University of Giessen, 35390, Giessen, Germany
| | - Ralf Weiskirchen
- Institute of Molecular Pathobiochemistry, Experimental Gene Therapy and Clinical Chemistry (IFMPEGKC), RWTH University Hospital Aachen, D-52074, Aachen, Germany
| | - Gerd Schmitz
- Institute for Clinical Chemistry and Laboratory Medicine, University Hospital of Regensburg, University of Regensburg, D-93053, Regensburg, Germany
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12
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Ara G, Sanin KI, Khanam M, Sarker MSA, Tofail F, Nahar B, Chowdhury IA, Boitchi AB, Gibson S, Afsana K, Askari S, Ahmed T. A comprehensive intervention package improves the linear growth of children under 2-years-old in rural Bangladesh: a community-based cluster randomized controlled trial. Sci Rep 2022; 12:21962. [PMID: 36536016 PMCID: PMC9763408 DOI: 10.1038/s41598-022-26269-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
Approximately one-third of children under the age of five are stunted in developing countries and many of them are micronutrient-deficient. We designed a comprehensive intervention package including egg/milk-based snacks to improve linear growth and dietary diversity among 6 to 12-month-old children in rural Bangladesh. In this 1-year community-based cluster randomized controlled longitudinal experiment, 412 mother-infant pairs were randomly assigned to receive either monthly food vouchers (for eggs, milk, semolina, sugar, and oil) to prepare egg and milk-based snacks for their children, along with multiple micronutrient powder (MNP), counseling on child feeding and handwashing, or regular government health communication alone (control; n = 206, treatment; n = 206). The trial was conducted in 12 clusters (small administrative units of sub-district). The primary inclusion criteria were ultra-poor households with limited resources and having children under 2-years-old. The primary and secondary outcomes were differences in children's length gain and dietary diversity. The effect of intervention on child growth was examined using a mixed effect linear regression model. Mean weight and length of the children did not significantly differ between groups at baseline. Around 90% of the children in both groups were breastfed. After receiving intervention for 12 months, LAZ score increased by 0.37 (CI 0.24, 0.51, p < 0.001) and risk of stunting reduced by 73% (OR: 0.27, CI 0.13, 0.58, p = 0.001). This comprehensive intervention package improved the growth and dietary diversity of children in extremely poor Bangladeshi households. A scaling-up of this intervention in contexts with limited resources should be taken into consideration.Trial registration: This trial registered retrospectively at ClinicalTrials.gov as NCT03641001, 21/8/2018.
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Affiliation(s)
- Gulshan Ara
- grid.414142.60000 0004 0600 7174International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Kazi Istiaque Sanin
- grid.414142.60000 0004 0600 7174International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Mansura Khanam
- grid.414142.60000 0004 0600 7174International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Md. Shafiqul Alam Sarker
- grid.414142.60000 0004 0600 7174International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Fahmida Tofail
- grid.414142.60000 0004 0600 7174International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Baitun Nahar
- grid.414142.60000 0004 0600 7174International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212 Bangladesh
| | | | - Anika Bushra Boitchi
- grid.414142.60000 0004 0600 7174International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Sarah Gibson
- grid.490985.90000 0004 0450 2163The Children’s Investment Fund Foundation, 7 Clifford Street, London, W1S 2FT UK
| | - Kaosar Afsana
- grid.52681.380000 0001 0746 8691BRAC James P Grant School of Public Health, BRAC University, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Sufia Askari
- grid.490985.90000 0004 0450 2163The Children’s Investment Fund Foundation, 7 Clifford Street, London, W1S 2FT UK
| | - Tahmeed Ahmed
- grid.414142.60000 0004 0600 7174International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212 Bangladesh
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13
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Ngume L, Katalambula L, Muyogwa M, Mongi R, Lyeme H. Formulation and nutritional properties of qualea-bird-meat-based complementary foods for children (6–23 months) in Tanzania using a linear programming technique. NFS JOURNAL 2022. [DOI: 10.1016/j.nfs.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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14
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Melnik BC, Schmitz G. Milk Exosomal microRNAs: Postnatal Promoters of β Cell Proliferation but Potential Inducers of β Cell De-Differentiation in Adult Life. Int J Mol Sci 2022; 23:ijms231911503. [PMID: 36232796 PMCID: PMC9569743 DOI: 10.3390/ijms231911503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/15/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
Pancreatic β cell expansion and functional maturation during the birth-to-weaning period is driven by epigenetic programs primarily triggered by growth factors, hormones, and nutrients provided by human milk. As shown recently, exosomes derived from various origins interact with β cells. This review elucidates the potential role of milk-derived exosomes (MEX) and their microRNAs (miRs) on pancreatic β cell programming during the postnatal period of lactation as well as during continuous cow milk exposure of adult humans to bovine MEX. Mechanistic evidence suggests that MEX miRs stimulate mTORC1/c-MYC-dependent postnatal β cell proliferation and glycolysis, but attenuate β cell differentiation, mitochondrial function, and insulin synthesis and secretion. MEX miR content is negatively affected by maternal obesity, gestational diabetes, psychological stress, caesarean delivery, and is completely absent in infant formula. Weaning-related disappearance of MEX miRs may be the critical event switching β cells from proliferation to TGF-β/AMPK-mediated cell differentiation, whereas continued exposure of adult humans to bovine MEX miRs via intake of pasteurized cow milk may reverse β cell differentiation, promoting β cell de-differentiation. Whereas MEX miR signaling supports postnatal β cell proliferation (diabetes prevention), persistent bovine MEX exposure after the lactation period may de-differentiate β cells back to the postnatal phenotype (diabetes induction).
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Affiliation(s)
- Bodo C. Melnik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, D-49076 Osnabrück, Germany
- Correspondence: ; Tel.: +49-52-4198-8060
| | - Gerd Schmitz
- Institute for Clinical Chemistry and Laboratory Medicine, University Hospital of Regensburg, University of Regensburg, D-93053 Regensburg, Germany
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15
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Birhanu H, Gonete KA, Hunegnaw MT, Aragaw FM. Minimum acceptable diet and associated factors among children aged 6-23 months during fasting days of orthodox Christian mothers in Gondar city, North West Ethiopia. BMC Nutr 2022; 8:76. [PMID: 35948943 PMCID: PMC9364522 DOI: 10.1186/s40795-022-00558-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 07/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background Nutritional improvement through appropriate feeding practices is critical for young children's healthy growth and development. Even if children are exempted from fasting, their diets are influenced by the widespread fasting practices of their Orthodox Christian mothers. However, scientific evidence on a minimum acceptable diet (MAD) among children aged 6–23 months during the fasting period was limited. Therefore, this study aimed to assess the minimum acceptable diet and associated factors among children aged 6–23 months during the fasting period among Orthodox Christian mothers in Gondar city, Northwest Ethiopia. Method A community-based cross-sectional study was conducted during the fasting season (Lent) from March 8, 20,121 to April 8, 2021. A total of 738 Orthodox Christian mothers with their children were selected by multistage sampling. A structured questionnaire was used to collect data among mothers to assess children’s MAD status. The degree of association between independent and dependent variables was assessed by using an odds ratio with a 95% confidence interval. Those variables with a p-value of less than 0.05 in the multivariable analysis were considered as a significant factor for MAD among children aged 6–23 months. Data were presented using texts, tables and figures. Results The overall prevalence of MAD among children aged 6–23 months was 19.4% (95% CI: 16.40%-22.20). Having household wealth index of rich and middle (AOR = 4.39, 95% CI: 2.26,8.50) and (AOR = 3.25, 95% CI: 1.69,6.22), respectively, children aged from 12–17 months (AOR = 2.66, 95% CI: 1.43,4.92) and 18–23 months (AOR = 5.39, 95% CI: 2.93,9.95) respectively, Children who lived with a family member who consumed any time without keeping the fasting time(AOR = 1.79, 95% CI: 1.13,2.83) and mothers of young children who were married (AOR = 4.13, 95% CI: 1.29,13.23) have significant association with MAD. Conclusion The practice of minimum acceptable diet was inadequate. Age of child, wealth status, marital status, and presence of family member who fed without keeping fasting time were significantly associated factors for MAD among children aged 6–23 months. Advocacy for appropriate feeding practice and meeting the MAD for children aged 6–23 months during the fasting period should also be strengthened targeting the unmarried women and those with poor households and giving awareness for mothers in collaboration with the respective religious leaders is highly recommended. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00558-z.
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Affiliation(s)
| | - Kedir Abdela Gonete
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melkamu Tamir Hunegnaw
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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16
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Zeng X, Cai L, Gui Z, Shen T, Yang W, Chen Q, Chen Y. Association Between Dairy Intake and Executive Function in Chinese Children Aged 6–12 Years. Front Nutr 2022; 9:879363. [PMID: 35898711 PMCID: PMC9309784 DOI: 10.3389/fnut.2022.879363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 06/10/2022] [Indexed: 11/13/2022] Open
Abstract
Association between dairy intake and executive function remains controversial, especially among children, a population with fast-developing executive functions. This study aimed to explore this topic. Additionally, we further distinguished the role of dairy intake types (full- or low-fat milk or yogurt) in this relationship. This survey included 5,138 children aged 6–12 years. Dairy intakes were assessed by validated questionnaires. Executive function was measured by the behavior rating inventory of executive function (BRIEF; Parent Version), and lower T-scores of BRIEF indices indicated superior executive function performance. Results showed that children with higher dairy intake had statistically better performance in Shift (46.58 ± 7.48 vs. 45.85 ± 7.10), Initiate (48.02 ± 8.58 vs. 47.14 ± 8.33), and Working Memory (50.69 ± 8.82 vs. 49.89 ± 8.73). In the analysis of multivariate linear regression, we found that for every one unit increase in full-fat dairy intake, T-scores for Shift (β = −0.350 (95% confidence interval [CI]: (−0.660, −0.039) and Initiate (β = −0.486 (95% CI: (−0.845, −0.127) were decreased and for every one unit increase in low-fat dairy intake, T-score for Organizations of Materials (β = −0.940 (95% CI: (−1.690, −0.189) was decreased. After distinguishing dairy into milk and yogurt, we observed that only milk intake, not yogurt, was significantly associated with better executive function performance in Shift (β = −0.390 (95% CI (−0.745, −0.035) and Initiate (β = −0.509 (95% CI (−0.917, −0.101) after adjusting for potential confounding factors. This study shows that a higher intake of dairy, irrespective of fat content, is related to better executive function performance among children aged 6–12. In addition, a significantly positive relationship between dairy intake and executive function’s indices of Shift and Initiate only was observed in milk, not in yogurt.
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Affiliation(s)
- Xia Zeng
- Department of Child and Adolescent Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, Guangdong Pharmaceutical University, Guangzhou, China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhaohuan Gui
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Tianran Shen
- Department of Child and Adolescent Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, Guangdong Pharmaceutical University, Guangzhou, China
| | - Wenhan Yang
- Department of Child and Adolescent Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, Guangdong Pharmaceutical University, Guangzhou, China
| | - Qingsong Chen
- Department of Child and Adolescent Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, Guangdong Pharmaceutical University, Guangzhou, China
- *Correspondence: Qingsong Chen,
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Yajun Chen,
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Senbanjo IO, Owolabi AJ, Oshikoya KA, Hageman JHJ, Adeniyi Y, Samuel F, Melse-Boonstra A, Schaafsma A. Effect of a Fortified Dairy-Based Drink on Micronutrient Status, Growth, and Cognitive Development of Nigerian Toddlers- A Dose-Response Study. Front Nutr 2022; 9:864856. [PMID: 35571933 PMCID: PMC9097016 DOI: 10.3389/fnut.2022.864856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/31/2022] [Indexed: 11/24/2022] Open
Abstract
Malnutrition results in a high prevalence of stunting, underweight, and micronutrient deficiencies. This study investigated the effect of a multi-nutrient fortified dairy-based drink on micronutrient status, growth, and cognitive development in malnourished [height-for-age z-score (HAZ) and/or weight-for-age z-score (WAZ) < -1 SD and >-3 SD] Nigerian toddlers (n = 184, 1-3 years). The product was provided in different daily amounts (200, 400, or 600 ml) for 6 months. At baseline and endline, venous blood and urine samples were collected to determine micronutrient status. Bodyweight, height, waist, and head circumference were measured, and corresponding Z-scores were calculated. The Bayley-III Screening Test was used to classify the cognitive development of the children. In a modified per-protocol (PP) population, the highest prevalence's of micronutrient deficiencies were found for vitamin A (35.5%) and selenium (17.9%). At endline, there were no significant improvements in iodine, zinc, vitamin B12, and folate status in any of the three groups. Regarding vitamin D status (25OHD), consumption of 600 and 400 ml resulted in an improved status as compared to baseline, and in a difference between the 600- and 200-ml groups. Consumption of 600 ml also increased vitamin A and selenium status as compared to baseline, but no differences were found between groups. Within the groups, WAZ, weight-for-height z-score (WHZ), and BMI-for-age z-score (BAZ) improved, but without differences between the groups. For HAZ, only the 600 ml group showed improvement within the group, but it was not different between groups. For the absolute weight, height, and head circumference only trends for differences between groups were indicated. Cognition results did not differ between the groups. Within groups, all showed a decline in the per cent of competent children for receptive language. To study the effects of a nutritional intervention on linear growth and cognition, a longer study duration might be necessary. Regarding the improvement of micronutrient status, 600 ml of fortified dairy-based drink seems most effective. Clinical Trial Registration https://clinicaltrials.gov/ct2/show/NCT03411590?term=NCT03411590.&draw=2&rank=1, identifier: NCT03411590.
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Affiliation(s)
- Idowu Odunayo Senbanjo
- Department of Paediatrics and Child Health, Paediatric Gastroenterology, Hepatology and Nutrition Unit, Lagos State University College of Medicine, Lagos, Nigeria
| | - Adedotun J. Owolabi
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Kazeem Adeola Oshikoya
- Department of Pharmacology, Therapeutic and Toxicology, Lagos State University College of Medicine, Lagos, Nigeria
| | | | - Yetunde Adeniyi
- Department of Child and Adolescent Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Folake Samuel
- Department of Human Nutrition, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Alida Melse-Boonstra
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
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Wen J, Ma H, Yu Y, Zhang X, Guo D, Yin X, Yu X, Yin N, Wang J, Zhao Y. Sugar Content of Market Beverages and Children's Sugar Intake from Beverages in Beijing, China. Nutrients 2021; 13:nu13124297. [PMID: 34959849 PMCID: PMC8708007 DOI: 10.3390/nu13124297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/25/2021] [Accepted: 11/26/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: This study aims to find the sugar content of market beverages and estimate the sugar intake from beverages among students in Beijing. (2) Methods: Using snapshotting, we collected the sugar content of beverages through their packages or nutrition labels. Combined with the statistic of student beverage consumption, we estimated students' sugar intake. (3) Results: The median sugar content of total beverages was 9.0 g/100 mL, among which the fruits/vegetable juices and beverages had the highest sugar content (10.0 g/100 mL). Sugar content in most beverages in Beijing was generally higher than the recommendations, and fruit/vegetable juices and beverages exceeded the most. The median of sugar intake from beverages among students was 5.3 g/d, and the main sources were fruit/vegetable juices and beverages, protein beverages and carbonated beverages. Sugar intake from beverages differed according to gender, age and living area. Higher sugar intake was found among boys, older students and rural students. (4) Conclusions: Sugar content in market beverages in Beijing were high. Gender, age and residence were the influencing factors of sugar intake. Targeted measures should be taken to decrease the sugar content in beverages, especially the fruit/vegetable juices and beverages and the sugar intake among students.
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Affiliation(s)
- Jing Wen
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (J.W.); (H.M.); (X.Z.); (X.Y.); (N.Y.)
| | - Huijuan Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (J.W.); (H.M.); (X.Z.); (X.Y.); (N.Y.)
| | - Yingjie Yu
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China; (Y.Y.); (D.G.); (X.Y.)
| | - Xiaoxuan Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (J.W.); (H.M.); (X.Z.); (X.Y.); (N.Y.)
| | - Dandan Guo
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China; (Y.Y.); (D.G.); (X.Y.)
| | - Xueqian Yin
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (J.W.); (H.M.); (X.Z.); (X.Y.); (N.Y.)
| | - Xiaohui Yu
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China; (Y.Y.); (D.G.); (X.Y.)
| | - Ning Yin
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (J.W.); (H.M.); (X.Z.); (X.Y.); (N.Y.)
| | - Junbo Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (J.W.); (H.M.); (X.Z.); (X.Y.); (N.Y.)
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing 100191, China
- Correspondence: (J.W.); (Y.Z.); Tel.: +86-10-8280-1575 (J.W.); +86-1368-158-3701 (Y.Z.)
| | - Yao Zhao
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China; (Y.Y.); (D.G.); (X.Y.)
- Correspondence: (J.W.); (Y.Z.); Tel.: +86-10-8280-1575 (J.W.); +86-1368-158-3701 (Y.Z.)
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Grenov B, Larnkjær A, Ritz C, Michaelsen KF, Damsgaard CT, Mølgaard C. The effect of milk and rapeseed protein on growth factors in 7-8 year-old healthy children - A randomized controlled trial. Growth Horm IGF Res 2021; 60-61:101418. [PMID: 34333391 DOI: 10.1016/j.ghir.2021.101418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Milk protein may stimulate linear growth through insulin-like growth factor-1 (IGF-1). However, the effect of plant proteins on growth factors is largely unknown. This study assesses the effect of combinations of milk and rapeseed protein versus milk protein alone on growth factors in children. DESIGN An exploratory 3-armed randomized, double-blind, controlled trial was conducted in 129 healthy 7-8 year-old Danish children. Children received 35 g milk and rapeseed protein (ratio 54:46 or 30:70) or 35 g milk protein per day for 4 weeks. The primary outcome was difference in IGF-1 changes between intervention groups after 4 weeks. Secondary outcomes included changes in IGF-1 after 1 week and changes in insulin-like growth factor binding protein-3 (IGFBP-3), IGF-1/IGFBP-3, insulin, height, weight and body composition after 1 and 4 weeks. Results were analysed by multiple linear mixed-effect models. RESULTS There were no differences in changes of plasma IGF-1, insulin-like growth factor binding protein-3 (IGFBP-3), IGF-1/IGFBP-3 ratio or insulin between groups after 1 or 4 weeks based on 89 complete cases (P > 0.10). IGF-1 increased by 13.7 (95% CI 9.7;17.7) ng/mL and 18.0 (14.0;22.0) ng/mL from baseline to week 1 and 4, respectively, a 16% increase during the intervention. Similarly, insulin increased by 31% (14; 50) and 33% (16; 53) from baseline to week 1 and 4. Fat-free mass index (FFMI) increments were higher with milk alone than rapeseed blends (P < 0.05), coinciding with a trend towards a lower height increment. Body mass index increased within all groups (P < 0.05), mainly due to an increase in FFMI (P < 0.01). CONCLUSION There were no differences in changes of growth factors between the combinations of milk and rapeseed protein and milk protein alone in healthy, well-nourished children with a habitual intake of milk. Within groups, growth factors increased considerably. Future studies are needed to investigate how intakes of plant and animal proteins affect childhood growth.
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Affiliation(s)
- Benedikte Grenov
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark.
| | - Anni Larnkjær
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark.
| | - Christian Ritz
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark.
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark.
| | - Camilla T Damsgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark.
| | - Christian Mølgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark.
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20
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Effects of dietary and health factors on nutritional status of children in pastoral settings in Borana, southern Ethiopia, August-October 2015. ACTA ACUST UNITED AC 2021; 79:169. [PMID: 34551821 PMCID: PMC8456605 DOI: 10.1186/s13690-021-00692-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/10/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Childhood undernourishment is a major public health problem globally, and being responsible for higher mortalities in children and enormous health costs in sub-Saharan Africa. However, scarcity of data on the magnitude of malnutrition and its underlying causes, especially in the pastoral system, limits the effectiveness of potential interventions. This study addresses the nutritional status and factors associated with malnutrition among children in Borana pastoral system, southern Ethiopia. METHODS A community based cross-sectional study, using multistage cluster sampling, was conducted from August to October 2015. Dietary diversity score (DDS), milk and meal frequencies, anthropometric measurements, and socio-economic variables were recorded for 538 children aged 6-59 months. Multivariable generalized linear model (GLM) with log link function was applied to ascertain determinants of malnutrition. The strength of association was assessed based on prevalence ratio (PR). RESULTS Prevalence of underweight, stunting, and wasting were 28.3 % (95 % CI: 24.4-32.1), 41.1 % (95 % CI: 36.7-45.1), and 9.8 % (95 % CI: 7.3, 12.4), respectively. Children who consumed more diverse foods were at a lower risk of being underweight (PR = 0.72, 95 % CL: 0.59-0.88), stunted (PR = 0.80, 95 % CL: 0.68-0.93) and wasted (PR = 0.42, 95 % CL: 0.27-0.66). Intake of increased milk frequency was also associated with lower risk of underweight (PR = 0.86, 95 %CL: 0.76-0.97), stunting (PR = 0.83, 95 %CL: 0.75-0.91) and wasting (PR = 0.73, 95 %CL: 0.56-0.96). The risk of underweight (PR = 1.02, 95 %CL: 1.01-1.03), stunting (PR = 1.01, 95 %CL: 1.00-1.02) and wasting (PR = 1.01, 95 %CL: 1.00-1.04) had increased with age, and no difference was observed between boys and girls. Children who lived far away from health care facilities were 1.2 and 2.4 times more likely to be stunted and wasted, respectively than those residing near a health care facility. Ownership of toilet and living close to market were associated with reduced stunting, whereas illness was associated with increased risk of underweight. CONCLUSIONS The high prevalence of stunting among pastoral children is a serious public health concern and calls for urgent action. Association of nutritional status of children with dietary intake, and health status, access to health services and toilet availability underlines the need for improved nutrition practices, health care facilities and sanitary conditions in the study area.
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21
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Muleta A, Hailu D, Stoecker BJ, Belachew T. Camel milk consumption is associated with less childhood stunting and underweight than bovine milk in rural pastoral districts of Somali, Ethiopia: a cross-sectional study. J Nutr Sci 2021; 10:e78. [PMID: 34616549 PMCID: PMC8477347 DOI: 10.1017/jns.2021.75] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 07/18/2021] [Accepted: 08/24/2021] [Indexed: 11/06/2022] Open
Abstract
Undernutrition is a major global health problem. Various types of animal milk are used for feeding children at early ages; however, associations of camel milk (CaM) and bovine milk (BM) with the nutritional status of children have not been explored. A comparative community-based cross-sectional study was conducted among pre-schoolers in rural pastoral districts of Somali, Ethiopia. Children were selected from households with lactating camels or cows. Anthropometric measurements followed standard procedures for height-for-age, weight-for-age and weight-for-height scores. Independent sample t-tests identified significant differences in anthropometric indices based on the type of milk consumed. Multivariable logistic regression was used to examine associations between milk consumption and other predictors of growth failures. The prevalence of stunting was 24⋅1 % [95 % confidence interval (CI) 20⋅5, 28⋅3] of pre-schoolers, 34⋅8 % (95 % CI 29⋅9, 39⋅6) were wasted and 34⋅7 % (95 % CI 30⋅1, 39⋅9) were underweight. Higher proportions of BM-fed children were severely stunted, wasted and underweight compared with CaM consumers. Using logistic regression models, children who consumed BM [adjusted odds ratio (AOR): 2⋅10; 95 % CI 1⋅22, 3⋅61] and who were anaemic (AOR: 4⋅22; 95 % CI 2⋅23, 7⋅98) were more likely to be stunted than their counterparts, while girls were less likely to be stunted than boys (AOR: 0⋅57; 95 % CI 0⋅34, 0⋅94). Similarly, children who consumed BM (AOR: 1⋅97; 95 % CI 1⋅20, 3⋅24), who were anaemic (AOR: 2⋅27; 95 % CI 1⋅38, 3⋅72) and who drank unsafe water (AOR: 1⋅91; 95 % CI 1⋅19, 3⋅07) were more likely to be underweight than their counterparts. In conclusion, CaM consumption was associated with lower prevalence of stunting and underweight than BM. Promoting CaM in pastoralist areas may help to curb the high level of undernutrition.
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Affiliation(s)
- Anbissa Muleta
- Department of Food Science and Nutrition, Jigjiga University, Jigjiga, Ethiopia
- School of Nutrition, Food Science and Technology, Hawassa University, Hawassa, Ethiopia
| | - Dejene Hailu
- Department of Public and Environmental Health, College of Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Barbara J. Stoecker
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
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22
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Wells JCK, Pomeroy E, Stock JT. Evolution of Lactase Persistence: Turbo-Charging Adaptation in Growth Under the Selective Pressure of Maternal Mortality? Front Physiol 2021; 12:696516. [PMID: 34497534 PMCID: PMC8419441 DOI: 10.3389/fphys.2021.696516] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/30/2021] [Indexed: 11/13/2022] Open
Abstract
The emergence of the capacity to digest milk in some populations represents a landmark in human evolution, linking genetic change with a component of niche construction, namely dairying. Alleles promoting continued activity of the enzyme lactase through the life-course (lactase persistence) evolved in several global regions within the last 7,000 years. In some European regions, these alleles underwent rapid selection and must have profoundly affected fertility or mortality. Elsewhere, alleles spread more locally. However, the functional benefits underlying the rapid spread of lactase persistence remain unclear. Here, we set out the hypothesis that lactase persistence promoted skeletal growth, thereby offering a generic rapid solution to childbirth complications arising from exposure to ecological change, or to new environments through migration. Since reduced maternal growth and greater neonatal size both increase the risk of obstructed labour, any ecological exposure impacting these traits may increase maternal mortality risk. Over many generations, maternal skeletal dimensions could adapt to new ecological conditions through genetic change. However, this adaptive strategy would fail if ecological change was rapid, including through migration into new niches. We propose that the combination of consuming milk and lactase persistence could have reduced maternal mortality by promoting growth of the pelvis after weaning, while high calcium intake would reduce risk of pelvic deformities. Our conceptual framework provides locally relevant hypotheses to explain selection for lactase persistence in different global regions. For any given diet and individual genotype, the combination of lactase persistence and milk consumption would divert more energy to skeletal growth, either increasing pelvic dimensions or buffering them from worsening ecological conditions. The emergence of lactase persistence among dairying populations could have helped early European farmers adapt rapidly to northern latitudes, East African pastoralists adapt to sudden climate shifts to drier environments, and Near Eastern populations counteract secular declines in height associated with early agriculture. In each case, we assume that lactase persistence accelerated the timescale over which maternal skeletal dimensions could change, thus promoting both maternal and offspring survival. Where lactase persistence did not emerge, birth weight was constrained at lower levels, and this contributes to contemporary variability in diabetes risk.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Emma Pomeroy
- Department of Archaeology, University of Cambridge, Cambridge, United Kingdom
| | - Jay T Stock
- Department of Anthropology, University of Western Ontario, London, ON, Canada.,Department of Archaeology, Max Planck Institute for the Science of Human History, Jena, Germany
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23
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Dor C, Stark AH, Dichtiar R, Keinan-Boker L, Shimony T, Sinai T. Milk and dairy consumption is positively associated with height in adolescents: results from the Israeli National Youth Health and Nutrition Survey. Eur J Nutr 2021; 61:429-438. [PMID: 34406484 DOI: 10.1007/s00394-021-02661-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 08/10/2021] [Indexed: 01/17/2023]
Abstract
PURPOSE Milk consumption is associated with increased height primarily in early childhood. However, in adolescents, data are scarce with inconsistent results. Since height is a proxy for overall health and well-being, this study evaluated the association of dairy intake with height in adolescents. METHODS Students in 7th-12th grades, participating in the 2015-2016 Israeli Health and Nutrition Youth Survey, a school-based cross-sectional study, completed self-administered questionnaires, including a semi-quantitative food frequency questionnaire (n = 3529, 48% males, 15.2 ± 1.6 years). Anthropometric measurements were also performed. Dairy servings were calculated as the calcium equivalent of 1 cup of milk, and consumption was divided into four categories from very low (< 1 serving/day) to high (3 + servings/day). BMI- and Height-for-age z scores (HAZs) were calculated according to WHO growth standard; relatively short stature (RSS) was defined as HAZ < - 0.7 SD (< 25th percentile). Multivariable linear and logistic regression analyses were performed to evaluate the association of dairy intake with HAZ and prevalence of RSS, respectively. RESULTS Median consumption of dairy products was 2 servings/day, 1.4 from unsweetened products (milk, cheese and yogurt). Controlling for age, sex, BMI-z-score and socioeconomic status, each increment of unsweetened dairy intake was associated with on average 0.04 higher HAZ (equivalent to 0.3-0.4 cm, p < 0.05), and with reduced risk for RSS: OR 0.90, 95%CI: 0.84, 0.97, p < 0.01. No such associations were found with sweetened dairy products. CONCLUSION Consumption of unsweetened dairy products (3-4 servings/day) appears to contribute to achieving growth potential in adolescents. Intervention studies are necessary to determine the causal relationship between dairy intake and linear growth.
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Affiliation(s)
- Chen Dor
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, 7610001, Rehovot, Israel
| | - Aliza Hannah Stark
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, 7610001, Rehovot, Israel
| | - Rita Dichtiar
- Israel Center for Disease Control, Israel Ministry of Health, 5262100, Ramat Gan, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, 5262100, Ramat Gan, Israel
- School of Public Health, University of Haifa, 3498838, Haifa, Israel
| | - Tal Shimony
- Israel Center for Disease Control, Israel Ministry of Health, 5262100, Ramat Gan, Israel
| | - Tali Sinai
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, 7610001, Rehovot, Israel.
- Israel Center for Disease Control, Israel Ministry of Health, 5262100, Ramat Gan, Israel.
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24
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Nutrient status and growth in vegan children. Nutr Res 2021; 91:13-25. [PMID: 34130207 DOI: 10.1016/j.nutres.2021.04.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/24/2021] [Accepted: 04/19/2021] [Indexed: 11/23/2022]
Abstract
Vegan diets have risen in popularity over the past 9 years. However, few studies have examined nutrient status and the effect of a vegan diet on the growth of children. This study analysed the existing literature on the health impact and growth impact of selected nutrients in vegan children. We assessed the intake of calories and protein, as well as the nutrients iron, calcium, vitamin D, cobalamin and folate. With a small percentage of outliers, vegan children showed normal growth and were less often obese. We found limited evidence that children on a vegan diet can obtain all the examined nutrients. Furthermore, as proper planning and supplementation by caregivers is needed, it is currently unknown how often vegan children follow well-planned diets. Deficiencies in cobalamin, calcium, and vitamin D seem to be the biggest risks associated with a poorly planned vegan diet. For a more definitive assessment, data on the intake and nutrient status of omega-3 fatty acids, zinc, iodine, and selenium in vegan children are needed. Future research should account for demographic shifts in those following a vegan diet, and should discriminate between vegan sub-populations that are open or closed towards scientific approaches, towards health in general, and toward supplementation. Studies should assess the modes and dosages of supplementation and the use of fortified foods or drinks, as well as adherence to the diet itself. Plant ferritin as a source of iron and endogenous cobalamin synthesis warrants further scientific inquiry. In summary, the current literature suggests that a well-planned vegan diet using supplementation is likely to provide the recommended amounts of critical nutrients to provide for normal progression of height and weight in children, and can be beneficial in some aspects. However, data on 5 critical nutrients are still missing, hampering a more definitive conclusion.
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25
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Nutritional Adequacy and Diet Quality Are Associated with Standardized Height-for-Age among U.S. Children. Nutrients 2021; 13:nu13051689. [PMID: 34065650 PMCID: PMC8156872 DOI: 10.3390/nu13051689] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/04/2021] [Accepted: 05/13/2021] [Indexed: 12/01/2022] Open
Abstract
Nutritional status affects linear growth and development. However, studies on the associations between nutritional status, diet quality, and age-standardized height in children are limited. The aim of this study was to assess the relationship between macro- and micronutrient intake and food consumption and height-for-age Z score (HAZ) among US children in the National Health and Nutrition Examination Survey (NHANES). This cross-sectional population-based study included 6116 US children aged 2–18 years. The usual dietary intake of nutrients and food groups was estimated by the multiple source method (MSM) using two-day food consumption data from NHANES 2007–2014. After adjusting for covariates, HAZ was positively associated with intakes of energy, protein, carbohydrate, fat, vitamins A, D, E, B6, and B12, thiamin, riboflavin, niacin, calcium, and iron. Children in the highest tertile of HAZ were less likely to consume lower than the EAR for vitamin E and calcium. Major foods consumed by children with lower HAZ were soft drinks, high-fat milk products, cakes, cookies, pastries, and pies, whereas children with higher HAZ tended to consume low-fat milk products, tea, and low-calorie fruit juice. These findings suggest that adequate nutritional intake, diet quality, and nutrient-dense food are important factors for height in children.
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26
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Melnik BC, Schmitz G. Pasteurized non-fermented cow's milk but not fermented milk is a promoter of mTORC1-driven aging and increased mortality. Ageing Res Rev 2021; 67:101270. [PMID: 33571703 DOI: 10.1016/j.arr.2021.101270] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/16/2021] [Accepted: 02/03/2021] [Indexed: 02/07/2023]
Abstract
Recent epidemiological studies in Sweden, a country with traditionally high milk consumption, revealed that the intake of non-fermented pasteurized milk increased all-cause mortality in a dose-dependent manner. In contrast, the majority of epidemiological and clinical studies report beneficial health effects of fermented milk products, especially of yogurt. It is the intention of this review to delineate potential molecular aging mechanisms related to the intake of non-fermented milk versus yogurt on the basis of mechanistic target of rapamycin complex 1 (mTORC1) signaling. Non-fermented pasteurized milk via its high bioavailability of insulinotropic branched-chain amino acids (BCAAs), abundance of lactose (glucosyl-galactose) and bioactive exosomal microRNAs (miRs) enhances mTORC1 signaling, which shortens lifespan and increases all-cause mortality. In contrast, fermentation-associated lactic acid bacteria metabolize BCAAs and degrade galactose and milk exosomes including their mTORC1-activating microRNAs. The Industrial Revolution, with the introduction of pasteurization and refrigeration of milk, restricted the action of beneficial milk-fermenting bacteria, which degrade milk's BCAAs, galactose and bioactive miRs that synergistically activate mTORC1. This unrecognized behavior change in humans after the Neolithic revolution increased aging-related over-activation of mTORC1 signaling in humans, who persistently consume large quantities of non-fermented pasteurized cow's milk, a potential risk factor for aging and all-cause mortality.
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27
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Pesu H, Mutumba R, Mbabazi J, Olsen MF, Mølgaard C, Michaelsen KF, Ritz C, Filteau S, Briend A, Mupere E, Friis H, Grenov B. The Role of Milk Protein and Whey Permeate in Lipid-based Nutrient Supplements on the Growth and Development of Stunted Children in Uganda: A Randomized Trial Protocol (MAGNUS). Curr Dev Nutr 2021; 5:nzab067. [PMID: 34027295 PMCID: PMC8128719 DOI: 10.1093/cdn/nzab067] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/25/2021] [Accepted: 04/16/2021] [Indexed: 11/13/2022] Open
Abstract
Stunting is associated with cognitive impairment and later chronic disease. Previous trials to prevent stunting have had little effect, and no trials seem to have provided larger amounts of energy and high-quality proteins to already stunted children. We aimed to assess the effects of milk protein (MP) and whey permeate (WP) in large-quantity lipid-based nutrient supplements (LNS-LQ), among stunted children, on linear growth and child development. This was a randomized, double-blind, 2-by-2 factorial trial. Stunted children aged 12-59 mo from eastern Uganda (n = 750) were randomly assigned to receive 100 g LNS-LQ with or without MP and WP (n = 4 × 150) or no supplement (n = 150) for 3 mo. The primary outcomes were change in knee-heel and total length. Secondary outcomes included child development, body composition, anthropometry, and hemoglobin. Micronutrient status, intestinal function, and microbiota were also assessed. Our findings will contribute to an understanding of the role of milk ingredients and LNS in linear catch-up growth. This trial was registered at www.isrctn.com as ISRCTN13093195.
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Affiliation(s)
- Hannah Pesu
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Rolland Mutumba
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
- Department of Paediatrics and Child Health, School of Medicine College of Health Sciences, Makerere University, Kampala, Uganda
| | - Joseph Mbabazi
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
- Department of Paediatrics and Child Health, School of Medicine College of Health Sciences, Makerere University, Kampala, Uganda
| | - Mette F Olsen
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Christian Mølgaard
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Kim F Michaelsen
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Christian Ritz
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Suzanne Filteau
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - André Briend
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
- Tampere Centre for Child Health Research, Tampere University, Tampere, Finland
| | - Ezekiel Mupere
- Department of Paediatrics and Child Health, School of Medicine College of Health Sciences, Makerere University, Kampala, Uganda
| | - Henrik Friis
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Benedikte Grenov
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
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28
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Zaharia S, Ghosh S, Shrestha R, Manohar S, Thorne-Lyman AL, Bashaasha B, Kabunga N, Gurung S, Namirembe G, Appel KH, Liang L, Webb P. Sustained intake of animal-sourced foods is associated with less stunting in young children. NATURE FOOD 2021; 2:246-254. [PMID: 37118465 DOI: 10.1038/s43016-021-00259-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 03/11/2021] [Indexed: 04/30/2023]
Abstract
The value of animal-sourced foods (ASFs) in providing key nutrients, particularly for child growth and where diets are of low quality, is understood mainly from cross-sectional assessment of current consumption. Longitudinal panel data from Nepal, Bangladesh and Uganda were used here to assess associations among previous (lagged) and contemporaneous ASF intake with linear growth of children aged 6-24 months. Lagged ASF consumption was significantly correlated with a 10% decline in stunting in Nepali children who consumed any ASF in the previous year, while current intake was associated with a 9% decline in stunting in Uganda. Previous consumption of two or more ASFs showed a stronger association, ranging from a 10% decline in stunting in Bangladesh to a 16% decline in Nepal. This novel lagged analysis emphasizes the need for regular and appropriate levels of ASF intake by young children to support healthy growth in resource-constrained settings.
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Affiliation(s)
- Sonia Zaharia
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
- Feed the Future Innovation Lab for Nutrition, Boston, MA, USA.
| | - Shibani Ghosh
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Feed the Future Innovation Lab for Nutrition, Boston, MA, USA
| | - Robin Shrestha
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Feed the Future Innovation Lab for Nutrition, Boston, MA, USA
| | - Swetha Manohar
- Feed the Future Innovation Lab for Nutrition, Boston, MA, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrew L Thorne-Lyman
- Feed the Future Innovation Lab for Nutrition, Boston, MA, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bernard Bashaasha
- Feed the Future Innovation Lab for Nutrition, Boston, MA, USA
- Makerere University, Kampala, Uganda
| | - Nassul Kabunga
- Feed the Future Innovation Lab for Nutrition, Boston, MA, USA
| | - Sabi Gurung
- Feed the Future Innovation Lab for Nutrition, Boston, MA, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Grace Namirembe
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Feed the Future Innovation Lab for Nutrition, Boston, MA, USA
| | - Katherine H Appel
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Feed the Future Innovation Lab for Nutrition, Boston, MA, USA
| | - Lichen Liang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Feed the Future Innovation Lab for Nutrition, Boston, MA, USA
| | - Patrick Webb
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Feed the Future Innovation Lab for Nutrition, Boston, MA, USA
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29
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Melnik BC. Lifetime Impact of Cow's Milk on Overactivation of mTORC1: From Fetal to Childhood Overgrowth, Acne, Diabetes, Cancers, and Neurodegeneration. Biomolecules 2021; 11:404. [PMID: 33803410 PMCID: PMC8000710 DOI: 10.3390/biom11030404] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/04/2021] [Accepted: 03/04/2021] [Indexed: 02/07/2023] Open
Abstract
The consumption of cow's milk is a part of the basic nutritional habits of Western industrialized countries. Recent epidemiological studies associate the intake of cow's milk with an increased risk of diseases, which are associated with overactivated mechanistic target of rapamycin complex 1 (mTORC1) signaling. This review presents current epidemiological and translational evidence linking milk consumption to the regulation of mTORC1, the master-switch for eukaryotic cell growth. Epidemiological studies confirm a correlation between cow's milk consumption and birthweight, body mass index, onset of menarche, linear growth during childhood, acne vulgaris, type 2 diabetes mellitus, prostate cancer, breast cancer, hepatocellular carcinoma, diffuse large B-cell lymphoma, neurodegenerative diseases, and all-cause mortality. Thus, long-term persistent consumption of cow's milk increases the risk of mTORC1-driven diseases of civilization. Milk is a highly conserved, lactation genome-controlled signaling system that functions as a maternal-neonatal relay for optimized species-specific activation of mTORC1, the nexus for regulation of eukaryotic cell growth, and control of autophagy. A deeper understanding of milk´s impact on mTORC1 signaling is of critical importance for the prevention of common diseases of civilization.
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Affiliation(s)
- Bodo C Melnik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, D-49076 Osnabrück, Germany
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Millward DJ. Interactions between Growth of Muscle and Stature: Mechanisms Involved and Their Nutritional Sensitivity to Dietary Protein: The Protein-Stat Revisited. Nutrients 2021; 13:729. [PMID: 33668846 PMCID: PMC7996181 DOI: 10.3390/nu13030729] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/15/2021] [Accepted: 02/22/2021] [Indexed: 02/07/2023] Open
Abstract
Childhood growth and its sensitivity to dietary protein is reviewed within a Protein-Stat model of growth regulation. The coordination of growth of muscle and stature is a combination of genetic programming, and of two-way mechanical interactions involving the mechanotransduction of muscle growth through stretching by bone length growth, the core Protein-Stat feature, and the strengthening of bone through muscle contraction via the mechanostat. Thus, growth in bone length is the initiating event and this is always observed. Endocrine and cellular mechanisms of growth in stature are reviewed in terms of the growth hormone-insulin like growth factor-1 (GH-IGF-1) and thyroid axes and the sex hormones, which together mediate endochondral ossification in the growth plate and bone lengthening. Cellular mechanisms of muscle growth during development are then reviewed identifying (a) the difficulties posed by the need to maintain its ultrastructure during myofibre hypertrophy within the extracellular matrix and the concept of muscle as concentric "bags" allowing growth to be conceived as bag enlargement and filling, (b) the cellular and molecular mechanisms involved in the mechanotransduction of satellite and mesenchymal stromal cells, to enable both connective tissue remodelling and provision of new myonuclei to aid myofibre hypertrophy and (c) the implications of myofibre hypertrophy for protein turnover within the myonuclear domain. Experimental data from rodent and avian animal models illustrate likely changes in DNA domain size and protein turnover during developmental and stretch-induced muscle growth and between different muscle fibre types. Growth of muscle in male rats during adulthood suggests that "bag enlargement" is achieved mainly through the action of mesenchymal stromal cells. Current understanding of the nutritional regulation of protein deposition in muscle, deriving from experimental studies in animals and human adults, is reviewed, identifying regulation by amino acids, insulin and myofibre volume changes acting to increase both ribosomal capacity and efficiency of muscle protein synthesis via the mechanistic target of rapamycin complex 1 (mTORC1) and the phenomenon of a "bag-full" inhibitory signal has been identified in human skeletal muscle. The final section deals with the nutritional sensitivity of growth of muscle and stature to dietary protein in children. Growth in length/height as a function of dietary protein intake is described in the context of the breastfed child as the normative growth model, and the "Early Protein Hypothesis" linking high protein intakes in infancy to later adiposity. The extensive paediatric studies on serum IGF-1 and child growth are reviewed but their clinical relevance is of limited value for understanding growth regulation; a role in energy metabolism and homeostasis, acting with insulin to mediate adiposity, is probably more important. Information on the influence of dietary protein on muscle mass per se as opposed to lean body mass is limited but suggests that increased protein intake in children is unable to promote muscle growth in excess of that linked to genotypic growth in length/height. One possible exception is milk protein intake, which cohort and cross-cultural studies suggest can increase height and associated muscle growth, although such effects have yet to be demonstrated by randomised controlled trials.
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Affiliation(s)
- D Joe Millward
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
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Beitane I, Kruma Z, Kince T, Sabovics M, Iriste S, Muizniece-Brasava S, Bujaka J, Strode S, Ciprovica I. Case Study: Free Lunch Meals Provision during the Remote Learning Conditions. Nutrients 2021; 13:nu13020605. [PMID: 33673240 PMCID: PMC7918421 DOI: 10.3390/nu13020605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/26/2021] [Accepted: 02/08/2021] [Indexed: 02/04/2023] Open
Abstract
School meals for grade 1 to 4 pupils in Latvia are financed by the government, but with the onset of the COVID-19 pandemic in March 2020, and following the remote learning process, there were problems related to the delivery of these meals for pupils. The current situation in Latvia has been exacerbated again due to the spread of the pandemic; there is a great necessity to find well-thought-out solutions to ensure school lunches outside the school. The aim of this study was to develop recommendation-based one-week food packs for grade 1 to 4 pupils, providing the necessary amount of nutrients and energy. Four food packs were designed to provide five-day lunch meals for pupils, preparing a warm lunch at home. Protein, fat, saturated fatty acids, carbohydrates, sugar, dietary fiber, sodium, salt and calcium content of meals were analyzed according to standard methods. During the project, the most appropriate solution for food packs was explored. The four designed food packs will provide support to municipalities, because the composition of food packs complies with the nutrition and energy value regulation and does not exceed the planned budget. Parents will receive the developed recipe book in addition to a one-week food pack.
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Affiliation(s)
- Ilze Beitane
- Department of Nutrition, Faculty of Food Technology, Latvia University of Life Sciences and Technologies, Jelgava LV-3004, Latvia; (S.I.); (J.B.)
- Correspondence:
| | - Zanda Kruma
- Department of Food Technology, Faculty of Food Technology, Latvia University of Life Sciences and Technologies, Jelgava LV-3004, Latvia; (Z.K.); (T.K.); (M.S.); (S.M.-B.); (S.S.); (I.C.)
| | - Tatjana Kince
- Department of Food Technology, Faculty of Food Technology, Latvia University of Life Sciences and Technologies, Jelgava LV-3004, Latvia; (Z.K.); (T.K.); (M.S.); (S.M.-B.); (S.S.); (I.C.)
| | - Martins Sabovics
- Department of Food Technology, Faculty of Food Technology, Latvia University of Life Sciences and Technologies, Jelgava LV-3004, Latvia; (Z.K.); (T.K.); (M.S.); (S.M.-B.); (S.S.); (I.C.)
| | - Sandra Iriste
- Department of Nutrition, Faculty of Food Technology, Latvia University of Life Sciences and Technologies, Jelgava LV-3004, Latvia; (S.I.); (J.B.)
| | - Sandra Muizniece-Brasava
- Department of Food Technology, Faculty of Food Technology, Latvia University of Life Sciences and Technologies, Jelgava LV-3004, Latvia; (Z.K.); (T.K.); (M.S.); (S.M.-B.); (S.S.); (I.C.)
| | - Jekaterina Bujaka
- Department of Nutrition, Faculty of Food Technology, Latvia University of Life Sciences and Technologies, Jelgava LV-3004, Latvia; (S.I.); (J.B.)
| | - Sintija Strode
- Department of Food Technology, Faculty of Food Technology, Latvia University of Life Sciences and Technologies, Jelgava LV-3004, Latvia; (Z.K.); (T.K.); (M.S.); (S.M.-B.); (S.S.); (I.C.)
| | - Inga Ciprovica
- Department of Food Technology, Faculty of Food Technology, Latvia University of Life Sciences and Technologies, Jelgava LV-3004, Latvia; (Z.K.); (T.K.); (M.S.); (S.M.-B.); (S.S.); (I.C.)
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Drewnowski A. Adjusting for protein quality by food source may affect nutrient density metrics. Nutr Rev 2020; 79:1134-1144. [PMID: 33331638 DOI: 10.1093/nutrit/nuaa117] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Methods to assess nutrient density of foods, commonly known as nutrient profiling (NP), typically include protein as a component. In this study, the goal was to apply a correction for protein quality by food source to selected NP algorithms. Analyses of 378 component foods of the Fred Hutch food frequency questionnaire showed that animal-source foods (ie, meat, eggs, and dairy) along with some soy products and nuts were the only foods that provided > 20% of the daily value (DV) of protein per 100 g or per 100 kcal. Most beans, pulses, legumes, grains, and vegetables provided <10% DV of protein per 100 g or per 100 kcal. Adjusting for protein quality using a simplified Protein Digestibility Corrected Amino Acid Score (PDCAAS) had consequences for point-based NP models (namely, Nutri-Score) and for continuous nutrient density scores (namely, Nutrient Rich Foods). Quantitative methods that use protein content to capture nutrient density may require a protein-quality adjustment, especially when adapted for use in low- and middle-income countries where protein quality is an issue of public health concern.
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Affiliation(s)
- Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
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Clark DC, Cifelli CJ, Pikosky MA. Growth and Development of Preschool Children (12-60 Months): A Review of the Effect of Dairy Intake. Nutrients 2020; 12:E3556. [PMID: 33233555 PMCID: PMC7699766 DOI: 10.3390/nu12113556] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/10/2020] [Accepted: 11/18/2020] [Indexed: 12/15/2022] Open
Abstract
Undernutrition in young children is a global health issue. The ability to meet energy and nutrient needs during this critical stage of development is necessary, not only to achieve physical and mental potential but also socio-economic achievement later in life. Given ongoing discussions regarding optimization of dietary patterns to support achievement of the Sustainable Development Goals established by the United Nations, it is important to identify foods/food groups that have shown efficacy in reducing the negative impacts of undernutrition in young children. This narrative review addresses the impact of dairy intake, with a focus on linear growth, cognitive development and weight gain in early childhood (12-60 months). The impact of country economic status is also examined, to help elucidate regional specific recommendations and/or future research needs. Overall, the body of research addressing this age group is somewhat limited. Based on the data available, there is a positive association between dairy intake and linear growth. The impact of milk or dairy products on cognitive development is less clear due to a lack of evidence and is a gap in the literature that should be addressed. Regarding the impact on body weight, the majority of evidence suggests there is either no association or an inverse association between milk intake by preschool children on overweight and obesity later in life. This evidence is exclusively in high income countries, however, so additional work in lower income countries may be warranted.
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Affiliation(s)
- David C. Clark
- Bovina Mountain Consulting LLC, Englewood, FL 34223, USA;
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Vanderhout SM, Corsi DJ. Milk consumption and childhood anthropometric failure in India: Analysis of a national survey. MATERNAL & CHILD NUTRITION 2020; 17:e13090. [PMID: 33000532 PMCID: PMC7988841 DOI: 10.1111/mcn.13090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 09/08/2020] [Accepted: 09/11/2020] [Indexed: 11/29/2022]
Abstract
Dairy milk has been shown to contribute to child growth in many countries, but the relationship between milk intake and anthropometric outcomes among Indian children has not been studied. The objectives were to describe children aged 6–59 months who consume dairy milk in India and determine if dairy milk consumption was associated with lower odds of stunting, underweight and anthropometric failure among Indian children. This was a cross‐sectional study based on the fourth Indian National Family Health Survey (NFHS‐4), which was a national survey conducted between 2015 and 2016 by the Ministry of Health and Family Welfare. The primary exposure was the consumption of dairy milk within the past day or night. The primary outcomes were stunting (height‐for‐age z score < −2), underweight (weight‐for‐age z score < −2) and the composite index of anthropometric failure (CIAF), which is a combination of weight‐for‐age, weight‐for‐height and height‐for‐age. Multivariable logistic regression models and coarsened exact matching (CEM) were used to determine the relationship between dairy milk and odds ratios of each outcome. Setting was in India. Participants were children (N = 107,639) aged 6–59 months. Children who consumed dairy milk in the past day or night had an odds ratio of 0.95 for underweight (95% CI 0.92–0.98, P = .0005), 0.93 for stunting (95% CI 0.90–0.96, P < .0001) and 0.96 for CIAF (95% CI 0.93–0.99, P = .004), compared with children who did not consume dairy milk after adjusting for relevant covariates. When CEM was used among a subset (n = 28,207), evidence for relationships between dairy milk and anthropometric outcomes was consistent but slightly weaker. Widespread, equitable access to dairy milk among childhood may be part of an effort to lower the risk of anthropometric failure among children in India.
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Affiliation(s)
- Shelley M Vanderhout
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Daniel J Corsi
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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Technical opinion of the Asociación Mexicana de Gastroenterología on soy plant-based beverages. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2020. [DOI: 10.1016/j.rgmxen.2020.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Byberg L, Warensjö Lemming E. Milk Consumption for the Prevention of Fragility Fractures. Nutrients 2020; 12:E2720. [PMID: 32899514 PMCID: PMC7551481 DOI: 10.3390/nu12092720] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 12/17/2022] Open
Abstract
Results indicating that a high milk intake is associated with both higher and lower risks of fragility fractures, or that indicate no association, can all be presented in the same meta-analysis, depending on how it is performed. In this narrative review, we discuss the available studies examining milk intake in relation to fragility fractures, highlight potential problems with meta-analyses of such studies, and discuss potential mechanisms and biases underlying the different results. We conclude that studies examining milk and dairy intakes in relation to fragility fracture risk need to study the different milk products separately. Meta-analyses should consider the doses in the individual studies. Additional studies in populations with a large range of intake of fermented milk are warranted.
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Affiliation(s)
- Liisa Byberg
- Department of Surgical Sciences, Orthopaedics, Uppsala University, SE-751 85 Uppsala, Sweden;
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Vázquez-Frias R, Icaza-Chávez ME, Ruiz-Castillo MA, Amieva-Balmori M, Argüello-Arévalo GA, Carmona-Sánchez RI, Flores-Bello MV, Hernández-Rosiles V, Hernández-Vez G, Medina-Vera I, Montijo-Barrios E, Núñez-Barrera I, Pinzón-Navarro BA, Sánchez-Ramírez CA. Technical opinion of the Asociación Mexicana de Gastroenterología on soy plant-based beverages. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2020; 85:461-471. [PMID: 32863095 DOI: 10.1016/j.rgmx.2020.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 06/15/2020] [Accepted: 07/07/2020] [Indexed: 12/19/2022]
Abstract
There has been a recent increase in the consumption of cow's milk substitutes, specifically plant-based beverages, which have erroneously been named "plant milks". Plant-based beverages do not have a standard of identity, and so their nutritional composition can vary from one brand to another, even within the same category. The aim of the present narrative review was to produce a technical opinion to serve as a frame of reference for sustaining the recommendation of soy plant-based beverages. Nutrition and gastroenterology experts that belong to the Asociación Mexicana de Gastroenterología jointly commented on and analyzed themes on plant-based beverages, and on soy drinks in particular, including their nutritional characteristics, consumption in children, and potential growth and development alterations, as well as soy drink consumption in adults and its association with gastrointestinal alterations and other conditions. Plant-based beverages, including those made from soy, are not a replacement for breastmilk or breastmilk substitutes. Soy beverages are considered safe and can enrich the varied diet of its consumers, as long as they are considered an additional liquid portion of the diet. They can be ingested by adults and children above two years of age that present with cow's milk protein allergy or lactose intolerance.
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Affiliation(s)
- R Vázquez-Frias
- Departamento de Gastroenterología y Nutrición, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, México.
| | | | - M A Ruiz-Castillo
- Servicio de Gastroenterología Pediátrica, Hospital del Niño DIF Hidalgo, Pachuca, Hidalgo, México
| | - M Amieva-Balmori
- Instituto de Investigaciones Médico Biológicas, Universidad Veracruzana, Veracruz, México
| | - G A Argüello-Arévalo
- Departamento de Gastroenterología y Nutrición Pediátrica, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - R I Carmona-Sánchez
- Unidad de Medicina Ambulatoria, Christus Muguerza, San Luis Potosí, San Luis Potosí, México
| | - M V Flores-Bello
- Instituto Tecnológico y de Estudios Superiores de Monterrey, Campus Ciudad de México, Ciudad de México, México
| | - V Hernández-Rosiles
- Departamento de Gastroenterología y Nutrición, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, México
| | | | - I Medina-Vera
- Departamento de Metodología de la Investigación, Instituto Nacional de Pediatría, Ciudad de México, México
| | - E Montijo-Barrios
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Pediatría, Ciudad de México, México
| | - I Núñez-Barrera
- Departamento de Gastroenterología y Nutrición, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, México
| | - B A Pinzón-Navarro
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Pediatría, Ciudad de México, México
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Association between Dairy Intake and Linear Growth in Chinese Pre-School Children. Nutrients 2020; 12:nu12092576. [PMID: 32854304 PMCID: PMC7551188 DOI: 10.3390/nu12092576] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/19/2020] [Accepted: 08/21/2020] [Indexed: 12/17/2022] Open
Abstract
Stunting remains a major public health issue for pre-school children globally. Dairy product consumption is suboptimal in China. The aim of this study was to investigate the relationship between dairy intake and linear growth in Chinese pre-school children. A national representative survey (Chinese Nutrition and Health Surveillance) of children aged under 6 years was done in 2013. Stratified multistage cluster sampling was used to select study participants. A food frequency questionnaire was used to collect dietary information. We calculated height-for-age Z-scores (HAZs) and estimated stunting using the 2006 WHO growth standard. In total, 12,153 children aged two to four years old (24 to <60 months) were studied from 55 counties in 30 provinces in China. Approximately 39.2% (4759/12,153) of those children consumed dairy at least once per day, 11.9% (1450/12,153) consumed dairy at least once in the last week, and nearly half (48.9%, 5944/12,153) did not have any dairy in the last week. The HAZ was −0.15 ± 1.22 and the prevalence of stunting was 6.5% (785/12,153). The HAZ for children who consumed dairy at least once per day or per week was 0.11 points or 0.13 points higher than the children without dairy intake. The risk of stunting for children who consumed dairy at least once per day was 28% lower than the children without dairy intake in the last week, and the risk was similar between weekly dairy consumption and no dairy consumption (AOR: 1.03, 95% CI: 0.74–1.42) after adjusting for potential confounders, including socioeconomic characteristics, lifestyle, health status, and the intake frequency of other foods. Dairy intake was significantly associated with a higher HAZ and a lower risk of stunting for children aged 2–4 years old in China. The proportion of dairy intake was still low in Chinese pre-school children. The promotion of dairy consumption might be an effective and feasible measurement for improving linear growth in Chinese pre-school children.
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Abstract
OBJECTIVE To evaluate the association between the age of cow milk introduction and childhood growth. DESIGN A secondary analysis of a prospective cohort study. SETTING Toronto, Canada. PARTICIPANTS Healthy children <5 years of age enrolled in the TARGet Kids! practice-based research network. The primary exposure was the age of cow milk introduction. The primary outcome was height-for-age z-score. Secondary outcomes were volume of cow milk consumed (cups/d) and BMI z-score. Outcomes were measured at the last visit before 5 years of age. Multiple linear regression was used to examine these relationships. RESULTS Among 1981 children, introduction of cow milk at a younger age was associated with greater height by 3-5 years of age (P < 0·001). Each month earlier that cow milk was introduced was associated with 0·03 higher height-for-age z-score unit (95 % CI -0·05, -0·02) or 0·1 cm (95 % CI -0·15, -0·12 cm). At 4 years of age, the height difference between a child introduced to cow milk at 9 v. 12 months was 0·4 cm (95 % CI -0·45, -0·35 cm). There was no association between the timing of cow milk introduction and volume of cow milk consumed per day or BMI z-score. CONCLUSIONS Earlier introduction of cow milk was associated with greater height but not with weight status in children aged 3-5 years. Further research is needed to understand the casual relationship between earlier cow milk consumption and childhood height. These findings may be important for paediatricians and parents when considering when to introduce cow milk.
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MicroRNA-21-Enriched Exosomes as Epigenetic Regulators in Melanomagenesis and Melanoma Progression: The Impact of Western Lifestyle Factors. Cancers (Basel) 2020; 12:cancers12082111. [PMID: 32751207 PMCID: PMC7464294 DOI: 10.3390/cancers12082111] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/16/2020] [Accepted: 07/24/2020] [Indexed: 02/06/2023] Open
Abstract
DNA mutation-induced activation of RAS-BRAF-MEK-ERK signaling associated with intermittent or chronic ultraviolet (UV) irradiation cannot exclusively explain the excessive increase of malignant melanoma (MM) incidence since the 1950s. Malignant conversion of a melanocyte to an MM cell and metastatic MM is associated with a steady increase in microRNA-21 (miR-21). At the epigenetic level, miR-21 inhibits key tumor suppressors of the RAS-BRAF signaling pathway enhancing proliferation and MM progression. Increased MM cell levels of miR-21 either result from endogenous upregulation of melanocytic miR-21 expression or by uptake of miR-21-enriched exogenous exosomes. Based on epidemiological data and translational evidence, this review provides deeper insights into environmentally and metabolically induced exosomal miR-21 trafficking beyond UV-irradiation in melanomagenesis and MM progression. Sources of miR-21-enriched exosomes include UV-irradiated keratinocytes, adipocyte-derived exosomes in obesity, airway epithelium-derived exosomes generated by smoking and pollution, diet-related exosomes and inflammation-induced exosomes, which may synergistically increase the exosomal miR-21 burden of the melanocyte, the transformed MM cell and its tumor environment. Several therapeutic agents that suppress MM cell growth and proliferation attenuate miR-21 expression. These include miR-21 antagonists, metformin, kinase inhibitors, beta-blockers, vitamin D, and plant-derived bioactive compounds, which may represent new options for the prevention and treatment of MM.
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de Vries-ten Have J, Owolabi A, Steijns J, Kudla U, Melse-Boonstra A. Protein intake adequacy among Nigerian infants, children, adolescents and women and protein quality of commonly consumed foods. Nutr Res Rev 2020; 33:102-120. [PMID: 31997732 PMCID: PMC7282859 DOI: 10.1017/s0954422419000222] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 09/11/2019] [Accepted: 09/18/2019] [Indexed: 02/07/2023]
Abstract
Protein is important for growth, maintenance and protection of the body. Both adequacy of protein quantity and protein quality in the diet are important to guarantee obtaining all the essential amino acids. Protein-energy malnutrition is widely present in developing countries such as Nigeria and might result in stunting and wasting. Needs for protein differ depending on age and physiological status and are higher during growth, pregnancy and lactation. The present review assessed protein quantity and quality in diets of Nigerian infants, children, adolescents, and pregnant and lactating women. Literature reviews and calculations were performed to assess adequacy of Nigerian protein intake and to examine the Nigerian diet. The digestible indispensable amino acid score was used to calculate protein quality of nine Nigerian staple foods and of a mixture of foods. The Nigerian population had mostly adequate protein intake when compared with the most recent protein recommendations by the FAO (2013) and WHO/FAO/UNU (2007). An important exception was the protein intake of adolescent girls and pregnant and lactating women. Most of the assessed Nigerian plant-based staple foods were of low protein quality and predominantly lacked the amino acid lysine. The addition of animal-source foods can bridge the protein quality gap created by predominance of plant-based foods in the Nigerian diet. The methodology of this review can be applied to other low- and middle-income countries where diets are often plant-based and lack variety, which might influence protein intake adequacy.
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Affiliation(s)
- Judith de Vries-ten Have
- Division of Human Nutrition and Health, Wageningen University and Research, PO Box 9101, 6700 HBWageningen, The Netherlands
| | | | - Jan Steijns
- FrieslandCampina, 3818 LEAmersfoort, The Netherlands
| | - Urszula Kudla
- FrieslandCampina, 3818 LEAmersfoort, The Netherlands
| | - Alida Melse-Boonstra
- Division of Human Nutrition and Health, Wageningen University and Research, PO Box 9101, 6700 HBWageningen, The Netherlands
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Grenov B, Larnkjær A, Lee R, Serena A, Mølgaard C, Michaelsen KF, Manary MJ. Circulating Insulin-Like Growth Factor-1 Is Positively Associated with Growth and Cognition in 6- to 9-Year-Old Schoolchildren from Ghana. J Nutr 2020; 150:1405-1412. [PMID: 32211798 DOI: 10.1093/jn/nxaa075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/08/2019] [Accepted: 03/02/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Milk intake stimulates linear growth and improves cognition in children from low-income countries. These effects may be mediated through insulin-like growth factor-1 (IGF-1). OBJECTIVE The objective was to assess the effect of milk supplement on circulating IGF-1 and to assess IGF-1 as a correlate of growth and cognition in children. METHODS Secondary data on blood spot IGF-1 from a randomized, double-blind, controlled trial in 6-9-y-old children from rural Ghana were analyzed. Intervention groups received porridge with non-energy-balanced supplements: 8.8 g milk protein/d, 100 kcal/d (Milk8); 4.4 g milk and 4.4 g rice protein/d, 100 kcal/d (Milk/rice); 4.4 g milk protein/d, 48 kcal/d (Milk4); or a control (no protein, 10 kcal/d). IGF-1, length, body composition, and Cambridge Neuropsychological Test Automated Battery (CANTAB) were measured at 3.5 or 8.5 mo. Linear regressions were used to assess the effect of milk interventions on IGF-1 and IGF-1 as a correlate of growth and cognition. RESULTS The increase in IGF-1 was 15.3 (95% CI: 3.3, 27.3) ng/mL higher in children receiving Milk8 compared with the control. The IGF-1 increases in the isonitrogenous, isoenergetic Milk/rice or the Milk4 groups were not different from the control (P ≥ 0.49). The increase in IGF-1 was associated with improvements in 4 out of 5 CANTAB domains. The strongest associations included reductions in "mean correct latency" from Pattern Recognition Memory and "pre-extradimensional (pre-ED) shift errors" from Intra/Extradimensional Set Shift (P ≤ 0.005). In addition, change in IGF-1 was positively associated with changes in height, weight, and fat-free mass (P ≤ 0.001). CONCLUSIONS Intake of skimmed milk powder corresponding to one, but not half a glass of milk on school days stimulates IGF-1 in 6-9-y-old Ghanian children. IGF-1 seems to mediate the effect of milk intake on growth and cognition. The association between IGF-1 and cognition in relation to milk intake is novel and opens possibilities for dietary interventions to improve cognition.
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Affiliation(s)
- Benedikte Grenov
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Frederiksberg C, Denmark
| | - Anni Larnkjær
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Frederiksberg C, Denmark
| | - Reginald Lee
- Department of Pediatrics, Washington University, St Louis, MO, USA
| | - Anja Serena
- Global Nutrition, Arla Foods amba, Skejby, Denmark
| | - Christian Mølgaard
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Frederiksberg C, Denmark
| | - Kim F Michaelsen
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Frederiksberg C, Denmark
| | - Mark J Manary
- Department of Pediatrics, Washington University, St Louis, MO, USA
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
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Hoke MK. A biocultural examination of home food production and child growth in highland Peru. Am J Hum Biol 2020; 32:e23438. [PMID: 32459029 DOI: 10.1002/ajhb.23438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/06/2020] [Accepted: 05/07/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Chronic malnutrition remains a persistent global health issue. This mixed methods investigation in rural Peru examines the role of home food production (HFP) in reducing child malnutrition by testing the following hypotheses: (a) higher HFP will be associated with higher infant z-scores than those with less HFP and (b) infants with higher HFP will exhibit improved longitudinal growth outcomes across 6 months. METHODS Ethnographic methods include semi-structured interviews and participant observation. A household survey and anthropometric data were collected twice, from 86 infants under of 24 months old. A HFP index (HFI) was generated based on reports of animals for meat consumption, eggs, milk, and agricultural products for home consumption. Kruskal-Wallis tests were used to examine patterns of HFI and infant anthropometrics. Multivariate regressions were used to examine the relationships between HFP and infant height for age (HAZ), weight for age (WAZ), and triceps skinfold for age (TSAZ) in both rounds and 6-month change between rounds (6MΔ). RESULTS There were no relationships between HFI and infant z-scores in round one, however, HFI was significantly positively related to HAZ (B = 0.091, P < .039) in round two and with 6MΔ in HAZ (B = 0.09, P < .047). HFI did not predict WAZ or TSAZ in either round. CONCLUSIONS HFP represents an important influence of infant growth in Nuñoa, likely through nutritional improvement due to increased availability of animal-sourced foods and through contribution to household economy and maternal empowerment.
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Affiliation(s)
- Morgan K Hoke
- Department of Anthropology & Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Sanwlani R, Fonseka P, Chitti SV, Mathivanan S. Milk-Derived Extracellular Vesicles in Inter-Organism, Cross-Species Communication and Drug Delivery. Proteomes 2020; 8:11. [PMID: 32414045 PMCID: PMC7356197 DOI: 10.3390/proteomes8020011] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 12/13/2022] Open
Abstract
Milk is considered as more than a source of nutrition for infants and is a vector involved in the transfer of bioactive compounds and cells. Milk contains abundant quantities of extracellular vesicles (EVs) that may originate from multiple cellular sources. These nanosized vesicles have been well characterized and are known to carry a diverse cargo of proteins, nucleic acids, lipids and other biomolecules. Milk-derived EVs have been demonstrated to survive harsh and degrading conditions in gut, taken up by various cell types, cross biological barriers and reach peripheral tissues. The cargo carried by these dietary EVs has been suggested to have a role in cell growth, development, immune modulation and regulation. Hence, there is considerable interest in understanding the role of milk-derived EVs in mediating inter-organismal and cross-species communication. Furthermore, various attributes such as it being a natural source, as well as its abundance, scalability, economic viability and lack of unwarranted immunologic reactions, has generated significant interest in deploying milk-derived EVs for clinical applications such as drug delivery and disease therapy. In this review, the role of milk-derived EVs in inter-organismal, cross-species communication and in drug delivery is discussed.
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Affiliation(s)
| | | | | | - Suresh Mathivanan
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, VIC 3083, Australia; (R.S.); (P.F.); (S.V.C.)
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Association between milk consumption and child growth for children aged 6-59 months. Sci Rep 2020; 10:6730. [PMID: 32317668 PMCID: PMC7174323 DOI: 10.1038/s41598-020-63647-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/30/2020] [Indexed: 11/29/2022] Open
Abstract
Apart from high levels of energy, proteins, micro- and macronutrients, milk contains calcium and the insulin-like growth factor-1 that are of major relevance for children’s development and growth. Using Demographic and Health Survey data between 1990 and 2017 with information on milk consumption and anthropometric measurements from all low- and middle-income countries available, we investigate whether milk consumption in childhood is associated with stunting, wasting, and underweight. We specify logistic regression models and adjust for a range of covariates and fixed effects on the primary sampling unit level. We analyze heterogeneity in the association by wealth quintiles and age groups and present country-specific estimates. The final samples for wasting, underweight and stunting include 668.463, 693.376, and 673.177 observations of children aged 6 to 59 months, respectively. Our results suggest that milk consumption is associated with a reduced probability of being underweight of 1.4 percentage points (95% confidence interval −0.02, −0.01) and a reduced probability of being stunted of 1.9 percentage points (95% confidence interval −0.02, −0.01). The association for wasting is not robust. The association is stronger for children from wealthier households, which might indicate that milk consumption is a proxy for better overall nutrition or socio-economic status.
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Geiker NRW, Mølgaard C, Iuliano S, Rizzoli R, Manios Y, van Loon LJC, Lecerf JM, Moschonis G, Reginster JY, Givens I, Astrup A. Impact of whole dairy matrix on musculoskeletal health and aging-current knowledge and research gaps. Osteoporos Int 2020; 31:601-615. [PMID: 31728607 PMCID: PMC7075832 DOI: 10.1007/s00198-019-05229-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 11/06/2019] [Indexed: 12/31/2022]
Abstract
Dairy products are included in dietary guidelines worldwide, as milk, yoghurt, and cheese are good sources of calcium and protein, vital nutrients for bones and muscle mass maintenance. Bone growth and mineralization occur during infancy and childhood, peak bone mass being attained after early adulthood. A low peak bone mass has consequences later in life, including increased risk of osteoporosis and fractures. Currently, more than 200 million people worldwide suffer from osteoporosis, with approximately 9 million fractures yearly. This poses a tremendous economic burden on health care. Between 5% and 10% of the elderly suffer from sarcopenia, the loss of muscle mass and strength, further increasing the risk of fractures due to falls. Evidence from interventional and observational studies support that fermented dairy products in particular exert beneficial effects on bone growth and mineralization, attenuation of bone loss, and reduce fracture risk. The effect cannot be explained by single nutrients in dairy, which suggests that a combined or matrix effect may be responsible similar to the matrix effects of foods on cardiometabolic health. Recently, several plant-based beverages and products have become available and marketed as substitutes for dairy products, even though their nutrient content differs substantially from dairy. Some of these products have been fortified, in efforts to mimic the nutritional profile of milk, but it is unknown whether the additives have the same bioavailability and beneficial effect as dairy. We conclude that the dairy matrix exerts an effect on bone and muscle health that is more than the sum of its nutrients, and we suggest that whole foods, not only single nutrients, need to be assessed in future observational and intervention studies of health outcomes. Furthermore, the importance of the matrix effect on health outcomes argues in favor of making future dietary guidelines food based.
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Affiliation(s)
- N R W Geiker
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, DK-1958, Frederiksberg C, Denmark.
| | - C Mølgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, DK-1958, Frederiksberg C, Denmark
| | - S Iuliano
- Department of Endocrinology, University of Melbourne, Austin Health, Melbourne, Australia
| | - R Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Y Manios
- Department of Nutrition & Dietetics, Harokopio University, Athens, Greece
| | - L J C van Loon
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - J-M Lecerf
- Department of Nutrition and Physical Activity, Institut Pasteur de Lille, Lille, France
| | - G Moschonis
- Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, Australia
| | - J-Y Reginster
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium
| | - I Givens
- Institute for Food, Nutrition and Health, University of Reading, Reading, United Kingdom
| | - A Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, DK-1958, Frederiksberg C, Denmark
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Carter SA, Parsons CM, Robinson SM, Harvey NC, Ward KA, Cooper C, Dennison EM. Infant milk feeding and bone health in later life: findings from the Hertfordshire cohort study. Osteoporos Int 2020; 31:709-714. [PMID: 32062688 DOI: 10.1007/s00198-020-05296-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 01/09/2020] [Indexed: 10/25/2022]
Abstract
UNLABELLED Using data from the Hertfordshire cohort study, this study examined the effect of breastfeeding and bottle feeding on adult lumbar spine and femoral neck bone mineral content (BMC) and bone mineral density (BMD). The type of infant milk feeding was significantly associated with lumbar spine BMD in males. INTRODUCTION Using data from the Hertfordshire cohort study (HCS), this study aims to examine the effect of infant milk feeding on bone health in later life by comparing the effect of breastfeeding and bottle feeding on lumbar spine and femoral neck BMC and BMD. METHODS Information about infant milk feeding, birth weight (kg) and weight at 1 (kg) was collected by health visitors between 1931 and 1939 in Hertfordshire. BMC and BMD measurements were taken by DXA scan between 1998 and 2004. Linear regression models adjusted for conditional weight at 1, age at DXA scan, sex, adult BMI, smoking behaviour, alcohol consumption, physical activity, dietary calcium, and prudent diet score. RESULTS Infant milk feeding was significantly associated with lumbar spine BMD (b = - 0.028; 95% CI, - 0.055; - 0.000; p value, 0.047) in males. On average, males who consumed breastmilk alternatives in infancy had lower lumbar spine BMD measurements than those who were fed only breastmilk. These associations remained significant in fully adjusted models. There were no significant associations between infant milk feeding and bone health for females. CONCLUSIONS Significant associations between infant milk feeding and lumbar spine BMD in males indicate that breastmilk may be protective for the bone health of male babies. The evidence presented here underscores the potential lifelong benefits of breastfeeding and may highlight the differences between osteoporotic risk factors for males and females.
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Affiliation(s)
- S A Carter
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - C M Parsons
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - S M Robinson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- AGE Research Group, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, UK
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - K A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- MRC Nutrition and Bone Health Research Group, Cambridge, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
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Shao Y, Chen G, Li R, Liu F. Government regulation and consumer evaluation after dairy products scandal in China. ACTA ALIMENTARIA 2020. [DOI: 10.1556/066.2020.49.1.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
With the continuous expansion of the global dairy trade market, the quality and safety of the Chinese dairy market have a wide and far-reaching impact on the world. Based on the development of the dairy scandal in the past few years in China, this study illustrates the serious damage of melamine on human health and the negative impact on the dairy industry in China.
This study shows that the lack of effective government regulations is a key reason for dairy market failure. Consumers are lacking confidence in the quality of Chinese dairy products and the government's market regulations. The Chinese dairy market will continue to rely on imported dairy products. By analyzing the typical cases of the dairy market in China, this study aims to provide a guide for dairy industries in other countries.
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Affiliation(s)
- Y. Shao
- aChina Institute of Regulation Research, Zhejiang University of Finance and Economics, Xueyuan street, Hangzhou 310018. China
| | - G. Chen
- bSchool of Economics, Zhejiang University of Finance and Economics, Xueyuan street, Hangzhou 310018. China
| | - R. Li
- cSchool of Accounting, Zhejiang University of Finance and Economics, Xueyuan street, Hangzhou 310018. China
| | - F. Liu
- cSchool of Accounting, Zhejiang University of Finance and Economics, Xueyuan street, Hangzhou 310018. China
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Mahfuz M, Alam MA, Das S, Fahim SM, Hossain MS, Petri WA, Ashorn P, Ashorn U, Ahmed T. Daily Supplementation With Egg, Cow Milk, and Multiple Micronutrients Increases Linear Growth of Young Children with Short Stature. J Nutr 2020; 150:394-403. [PMID: 31665385 DOI: 10.1093/jn/nxz253] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 08/15/2019] [Accepted: 09/19/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Childhood stunting is the most prevalent public health nutrition problem in low- and middle-income countries. OBJECTIVE This study aimed to determine whether daily supplementation in 12-18-mo-old undernourished Bangladeshi children with egg, cow milk, and multiple micronutrients improves linear growth. METHODS In the Bangladesh Environmental Enteric Dysfunction (BEED) study, a community-based intervention study, 12-18-mo-old children with length-for-age z score (LAZ) <1 were supplemented daily with an egg and 150 mL of milk for 90 feeding days, and 1 sachet of multiple micronutrient powder was provided daily for 60 feeding days. The change in LAZ over this period was compared with that in children of the same age and same baseline LAZ who were enrolled in the recently completed Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health (MAL-ED) Dhaka birth cohort study conducted in the same community where no nutrition intervention was provided. Difference-in-difference (DID) analysis was done and the effect size was adjusted for other possible covariates using a generalized estimating equation in a regression model. RESULTS A total of 472 children with LAZ <1 completed the intervention and data were available for 174 children in the comparison group. Compared with the comparison group, adjusted DID analysis revealed a change in LAZ in the intervention group of +0.23 (95% CI: 0.18, 0.29; P < 0.05). In a subgroup analysis, the changes were +0.27 (95% CI: 0.18, 0.35; P < 0.05) in stunted (LAZ <2) children and +0.19 (95% CI: 0.12, 0.27; P < 0.05) in children at risk of stunting (LAZ -1 to -2). No allergic reactions or other adverse events related to milk and egg consumption were observed. CONCLUSIONS Daily directly observed milk, egg, and multiple micronutrient supplementation may improve linear growth of stunted children. A randomized controlled trial with longer duration of supplementation coupled with an additional intervention aimed at reducing pathogen burden is warranted to confirm these results. This trial was registered at clinicaltrials.gov as NCT02812615.
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Affiliation(s)
- Mustafa Mahfuz
- icddr,b, Dhaka, Bangladesh.,Faculty of Medicine and Life Sciences, University of Tampere, Finland
| | | | | | | | | | | | - Per Ashorn
- Faculty of Medicine and Life Sciences, University of Tampere, Finland
| | - Ulla Ashorn
- Faculty of Medicine and Life Sciences, University of Tampere, Finland
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Akpinar Kara Y, Ozdemir D. Evaluation of food consumption in patients with acne vulgaris and its relationship with acne severity. J Cosmet Dermatol 2019; 19:2109-2113. [DOI: 10.1111/jocd.13255] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 11/26/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Yesim Akpinar Kara
- Department of Dermatology Yüksek Ihtisas UniversityKoru Hospital Ankara Turkey
| | - Deniz Ozdemir
- Department of Nutrition and Dietetics Liv Hospital Ankara Turkey
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