Infantile Overnutrition in the First Year of Life: A Field Study in Dudley,Worcestershire

A survey of feeding patterns and nutrient intake in relation to the growth of 300 normal infants up to 1 year of age in Dudley, Worcestershire, highlights a problem of overnutrition in the group; 50 (16·7%) were found to be suffering from infantile obesity and a further 83 (27·7%) were overweight.During the first three months of life the daily energy intakes of 136 cal/kg body weight for boys and 149 for girls were markedly greater than the level of 120/kg recommended by the Department of Health and Social Security. This coincided with the early addition of solid foods to a full milk intake. 119 babies (39·7%) were offered solids before they were 4 weeks old and 280 (93·3%) before 13 weeks of age. Some babies had solids from the first week after birth. Protein intake was persistently high throughout the first year, and the mean intake of 32·7 g/day was much greater than the intake of 20 g for infants aged up to 1 year recommended by the Department of Health. Standards for fat and carbohydrate intake are not available but in comparison with the levels reported in breast-fed babies intake of fat and carbohydrate was high in the first three months and came closer to the desired level for the former and remained slightly high for the latter in the subsequent age quarters.The relation of childhood and subsequent adult obesity to infant feeding patterns is not yet clear, but there is a high correlation between obese parents and obese and overweight babies; had these babies not been overfed the condition might have been prevented.     

Plasma amino-acid concentrations during development in the rat

The plasma individual amino-acid concentrations in the rat during late foetal development and from the birth to the end of the weaning have been studied. Both the very low foetal amino-acid degrading capabilities in addition to the high amino-acid concentration ability of the placenta help to sustain considerably high plasma foetal amino-acid levels that favour considerably protein synthesis. There is a very important decrease in most amino-acid concentrations with birth, due to the cessation of placental transfer, relative immaturity of intake and assimilation processes and to the highly anabolic environment found in the pup. The changes in postnatal development plasma amino-acid patterns reflect directly the availability of amino acids in the diet, the maturation of the amino-acid metabolism pathways and transport systems and their use for protein synthesis (and other nitrogenous compounds). The main situation that affects individual amino-acid levels is the shift from high biological value milk protein to low biological value plant proteins in the rat chow pellets. The postnatal development is characterized by a high combined total amino-acids homeostasis with ample changes in individual amino-acid concentrations, that is maintained in spite of the deep changes in diet, size, metabolism, hormone environment, maturation, etc. observed in the rat from birth to weaning and adulthood.     

Continuous Intragastric Milk Feeds in Infants of Low Birth Weight

In a feeding trial 66 infants of low birth weight received continuous intragastric milk feeds from the fourth hour of life, starting with 60 ml/kg/24 hr and reaching a maximum of 300 ml/kg/24 hr on the ninth day. Each infant received only full-strength milk, which was either expressed human breast milk or SMA-S26 (a proprietary low-protein adapted cows'' milk) or half-cream Regal milk (partly-skimmed evaporated cows'' milk). For various reasons 10 babies had to be withdrawn, and the final assessment was made on the 56 who completed the trial successfully.Persistent vomiting was a problem in only four infants. In two of them the trial was continued after gastric lavage and in the other two vomiting stopped when the volume was reduced. Despite a careful search no evidence was found of aspiration of feeds in any infant. Continuous intragastric milk infusion was shown to be a safe method of feeding infants of low birth weight and SMA-S26 was almost as well tolerated as human milk. Because of the high-protein content of half-cream cows'' milk preparations and the resultant high plasma amino-acid levels when they are given in these large volumes they should be avoided for this type of feeding although they produce better weight gains in the first week of life.     

Implementation of Nutritional Strategies Decreases Postnatal Growth Restriction in Preterm Infants

Background

Prevention of postnatal growth restriction of very preterm infants still represents a challenge for neonatologists. As standard feeding regimens have proven to be inadequate. Improved feeding strategies are needed to promote growth. Aim of the present study was to evaluate whether a set of nutritional strategies could limit the postnatal growth restriction of a cohort of preterm infants.

Methodology/Principal Findings

We performed a prospective non randomized interventional cohort study. Growth and body composition were assessed in 102 very low birth weight infants after the introduction of a set of nutritional practice changes. 69 very low birth weight infants who had received nutrition according to the standard nutritional feeding strategy served as a historical control group. Weight was assessed daily, length and head circumference weekly. Body composition at term corrected age was assessed using an air displacement plethysmography system. The cumulative parenteral energy and protein intakes during the first 7 days of life were higher in the intervention group than in the historical group (530±81 vs 300±93 kcal/kg, p<0.001 and 21±2.9 vs 15±3.2 g/kg, p<0.01). During weaning from parenteral nutrition, the intervention group received higher parental/enteral energy and protein intakes than the historical control group (1380±58 vs 1090±70 kcal/kg; 52.6±7 vs 42.3±10 g/kg, p<0.01). Enteral energy (kcal/kg/d) and protein (g/kg/d) intakes in the intervention group were higher than in the historical group (130±11 vs 100±13; 3.5±0.5 vs 2.2±0.6, p<0.01). The negative changes in z score from birth to discharge for weight and head circumference were significantly lower in the intervention group as compared to the historical group. No difference in fat mass percentage between the intervention and the historical groups was found.

Conclusions

The optimization and the individualization of nutritional intervention promote postnatal growth of preterm infants without any effect on percentage of fat mass.     

Glycine is a nutritionally essential amino acid for maximal growth of milk-fed young pigs

Analysis of amino acids in milk protein reveals a relatively low content of glycine. This study was conducted with young pigs to test the hypothesis that milk-fed neonates require dietary glycine supplementation for maximal growth. Fourteen-day-old piglets were allotted randomly into one of four treatments (15 piglets/treatment), representing supplementation with 0, 0.5, 1 or 2 % glycine (dry matter basis) to a liquid milk replacer. Food was provided to piglets every 8 h (3 times/day) for 2 weeks. Milk intake (32.0–32.5 g dry matter/kg body weight per day) did not differ between control and glycine-supplemented piglets. Compared with control piglets, dietary supplementation with 0.5, 1 and 2 % glycine increased (P < 0.05) plasma concentrations of glycine and serine, daily weight gain, and body weight without affecting body composition, while reducing plasma concentrations of ammonia, urea, and glutamine, in a dose-dependent manner. Dietary supplementation with 0.5, 1 and 2 % glycine enhanced (P < 0.05) small-intestinal villus height, glycine transport (measured using Ussing chambers), mRNA levels for GLYT1, and anti-oxidative capacity (indicated by increased concentrations of reduced glutathione and a decreased ratio of oxidized glutathione to reduced glutathione). These novel results indicate, for the first time, that glycine is a nutritionally essential amino acid for maximal protein accretion in milk-fed piglets. The findings not only enhance understanding of protein nutrition, but also have important implications for designing improved formulas to feed human infants, particularly low birth weight and preterm infants.     

Production and composition of Iberian sow's milk and use of milk nutrients by the suckling Iberian piglet

Sixteen purebred Iberian (IB) sows were used in two consecutive trials to determine the efficiency of conversion of sow's milk into piglet body weight (BW) gain and the relationship between milk protein and body protein retention and between milk energy yield and body energy retention in the nursing IB piglet. In each trial, four sows were selected in order to evaluate their milk production, litter growth and nutrient balance measurements, together with four additional sows for milk sampling. Litter size was equalized to six piglets. Daily milk yield (MY) was determined weekly by the weigh-suckle-weigh technique over a 34-day lactation period. Piglets were weighed individually at birth and then weekly from day 5 of lactation. Milk samples were collected on days 5, 12, 19, 26 and 34 post partum. The comparative slaughter procedure was used to determine piglet nutrient and energy retention. One piglet from each litter was slaughtered at birth and four on the morning of day 35. Total MY was on average 5.175 ± 0.157 kg/day. The average chemical composition (g/kg) of the milk was 179 ± 4 dry matter, 53.4 ± 1.0 CP, 58.5 ± 3.8 fat, 10.4 ± 0.3 ash and 56.9 ± 2.3 lactose. Milk gross energy (GE) was 4.626 ± 0.145 MJ/kg. Milk intake per piglet tended to increase in trial 2 (832 v. 893 g/day; P = 0.066). Piglet BW gain contained (g/kg) 172.1 ± 1.3 protein, 151.5 ± 3.5 fat, 41.4 ± 0.6 ash and 635 ± 3 water and 10.127 ± 0.126 MJ GE/kg. Throughout the 34-day nursing period, the piglets grew at an average rate of 168 ± 3 g/day. The ratio of daily piglet BW gain to daily MY was 0.195 ± 0.002 g/g and the gain per MJ milk GE intake was 41.9 ± 0.5 g/MJ. The overall efficiency of protein accretion (g CP gain/g CP milk intake) was low and declined in trial 2 (0.619 v. 0.571; P = 0.016). Nutrient and energy deposition between birth and weaning were 27.4 ± 0.5 g/day protein, 24.2 ± 0.8 g/day fat and 1615 ± 40 kJ/day energy. Piglet energy requirements for maintenance were 404 kJ metabolizable energy (ME)/kg BW0.75. ME was used for growth with a net efficiency of 0.584. These results suggest that poor efficiency in the use of sow's milk nutrients rather than a shortage in milk nutrient supply might explain the low growth rate of the suckling IB piglet.     

Maternal Cadmium Levels during Pregnancy Associated with Lower Birth Weight in Infants in a North Carolina Cohort

Cadmium (Cd) is a ubiquitous environmental contaminant, a known carcinogen, and understudied as a developmental toxicant. In the present study, we examined the relationships between Cd levels during pregnancy and infant birth outcomes in a prospective pregnancy cohort in Durham, North Carolina. The study participants (n = 1027) had a mean Cd level of 0.46 µg/L with a range of <0.08 to 2.52 µg/L. Multivariable models were used to establish relationships between blood Cd tertiles and fetal growth parameters, namely birth weight, low birth weight, birth weight percentile by gestational age, small for gestational age, pre-term birth, length, and head circumference. In multivariable models, high maternal blood Cd levels (≥0.50 µg/L) during pregnancy were inversely associated with birth weight percentile by gestational age (p = 0.007) and associated with increased odds of infants being born small for gestational age (p<0.001). These observed effects were independent of cotinine-defined smoking status. The results from this study provide further evidence of health risks associated with early life exposure to Cd among a large pregnancy cohort.     

Plasma Osmolality and Feeding Practices of Healthy Infants in First Three Months of Life

Plasma osmolality was measured in 60 healthy infants aged 1 to 3 months. The mean plasma osmolality in the 14 breast-fed infants (group A) was 284·3 mOsm/1. Nine infants fed artificial milk formulae alone (group B) had a mean value of 293·8 mOsm/1.; 37 infants already receiving solid foods in addition to artificial milk formulae (group C) had a mean value of 297·1 mOsm/1. The number of individual observations in the hyperosmolar range (more than 300 mOsm/1.) in groups A, B, and C were 0, 1, and 15, accounting respectively for 0%, 11·1%, and 40·5% of the total number of observations in each group.These results suggest that the early introduction to solid foods and the widespread use of artificial milk formulae at the expense of breast-feeding during the first three months of life result in an excessive dietary solute intake. This considerably stretches the ability of the immature kidney to maintain normal plasma tonicity. Minimal loss of water could precipitate a dangerous situation for babies with hyperosmolar plasma.     

Prolonged Adaptation to a Low or High Protein Diet Does Not Modulate Basal Muscle Protein Synthesis Rates – A Substudy

Background

Based on controlled 36 h experiments a higher dietary protein intake causes a positive protein balance and a negative fat balance. A positive net protein balance may support fat free mass accrual. However, few data are available on the impact of more prolonged changes in habitual protein intake on whole-body protein metabolism and basal muscle protein synthesis rates.

Objective

To assess changes in whole-body protein turnover and basal muscle protein synthesis rates following 12 weeks of adaptation to a low versus high dietary protein intake.

Methods

A randomized parallel study was performed in 40 subjects who followed either a high protein (2.4 g protein/kg/d) or low protein (0.4 g protein/kg/d) energy-balanced diet (30/35/35% or 5/60/35% energy from protein/carbohydrate/fat) for a period of 12 weeks. A subgroup of 7 men and 8 women (body mass index: 22.8±2.3 kg/m², age: 24.3±4.9 y) were selected to evaluate the impact of prolonged adaptation to either a high or low protein intake on whole body protein metabolism and basal muscle protein synthesis rates. After the diet, subjects received continuous infusions with L-[ring-²H₅]phenylalanine and L-[ring-²H₂]tyrosine in an overnight fasted state, with blood samples and muscle biopsies being collected to assess post-absorptive whole-body protein turnover and muscle protein synthesis rates in vivo in humans.

Results

After 12 weeks of intervention, whole-body protein balance in the fasted state was more negative in the high protein treatment when compared with the low protein treatment (-4.1±0.5 vs -2.7±0.6 μmol phenylalanine/kg/h;P<0.001). Whole-body protein breakdown (43.0±4.4 vs 37.8±3.8 μmol phenylalanine/kg/h;P<0.03), synthesis (38.9±4.2 vs 35.1±3.6 μmol phenylalanine/kg/h;P<0.01) and phenylalanine hydroxylation rates (4.1±0.6 vs 2.7±0.6 μmol phenylalanine/kg/h;P<0.001) were significantly higher in the high vs low protein group. Basal muscle protein synthesis rates were maintained on a low vs high protein diet (0.042±0.01 vs 0.045±0.01%/h;P = 0.620).

Conclusions

In the overnight fasted state, adaptation to a low-protein intake (0.4 g/kg/d) does not result in a more negative whole-body protein balance and does not lower basal muscle protein synthesis rates when compared to a high-protein intake.

Trial Registration

Clinicaltrials.gov NCT01551238.     

Longitudinal study of the dietary selenium intake of exclusively breast-fed infants during early lactation in Korea and Japan.

213 samples of human breast milk were collected from 51 healthy Korean women. Selenium content of the samples was determined by atomic absorption spectrometry with hydride generation. The selenium content of Korean milk decreased with increase of days after birth: The arithmetic mean of selenium content was higher in colostrum (< 4 days) 34 micrograms/kg (SD +/- 11, n = 44) than in transitional milk 21 micrograms/kg (SD +/- 8, n = 78) or in mature milk (> 10 days) 13 micrograms/kg (SD +/- 6, n = 91). The daily dietary selenium intake of 0-1 month aged Korean infants fed on breast milk is estimated to be around 10 micrograms per day (3 micrograms/kg body weight) regardless of days postpartum, resulting from the calculation of our selenium data and daily milk intake during early lactation. The same result on selenium intake for Japanese newborns, as well as Korean infants, is also estimated to be around 10 micrograms per day (3 micrograms/kg body weight) regardless of days postpartum.     

Hypothalamus integrity and appetite regulation in low birth weight rats reared artificially on a high-protein milk formula

High-protein (HP) milk formulas are routinely used in infants born with a low birth weight (LBW) to enhance growth and ensure a better verbal IQ development. Indirect evidence points to a link between an HP intake during early life and the prevalence of obesity in later life. We hypothesized that HP milk supplementation to LBW pups during early postnatal life would impact hypothalamic appetite neuronal pathways development with consequences, at adulthood, on energy homeostasis regulation. Rat pups born with a LBW were equipped with gastrostomy tubes on the fifth day of life. They received a milk formula with either normal protein (NP, 8.7 g protein/dl) or high protein content (HP; 13.0 g protein/dl) and were subsequently weaned to a standard, solid diet at postnatal day 21. Rats that had been fed HP content milk gained more weight at adulthood associated with an increase of plasma insulin, leptin and triglycerides concentrations compared to NP rats. Screening performed on hypothalamus in development from the two groups of rats identified higher gene expression for cell proliferation and neurotrophin markers in HP rats. Despite these molecular differences, appetite neuronal projections emanating from the arcuate nucleus did not differ between the groups. Concerning feeding behavior at adulthood, rats that had been fed HP or NP milk exhibited differences in the satiety period, resting postprandial duration and nocturnal meal pattern. The consequences of HP milk supplementation after LBW will be discussed in regard to neural development and metabolic anomalies.     

Energy intake and weight gain of very low birthweight babies fed raw expressed breast milk.

The energy intake and weight gain of low birthweight infants (under 1500 g) fed expressed breast milk were measured. Between the second and fourth weeks of life the mean energy intake was 577 kJ (138 kcals)/kg/day and the mean weekly increase in weight 119 g/week. Feeding energy-rich hind milk to two babies increased their energy intake but had little effect on their rate of weight gain. There appeared to be no correlation between energy intake and weight gain, probably owing to variation in the absorption of nutrients from expressed breast milk. This study forms a basis for a comparison of weight gain in babies fed alternative regimens of artificial milks.     

IgM-Antibodies against Phosphorylcholine in Mothers and Normal or Low Birth Weight Term Newborn Infants

Objective

To determine levels of athero-protective IgM antibodies against phosphorylcholine in mothers and term-born normal or low birth weight infants.

Approach

Twenty three mother-infant pairs were studied, of whom 16 infants were within the normal weight range for gestational age (NGA; 3652[504] g) and 7 were small for gestational age (SGA; birth weight: 2715[255] g), the latter <2SD below the Swedish reference data mean for normal fetal growth. All infants were born at term (mean±SD 40.5±1.1 weeks). Serum was available from 6 mothers with SGA and 14 with NGA infants. Participating mothers were aged 34.0±3.9 years (no difference between groups). Fourteen neonates were boys and seven were girls. Levels of anti-PC IgM were determined by ELISA.

Results

Neonatal IgM anti-PC levels were low (undetectable in 8 infants out of which 3 were SGA) with a median of 76[range 0–2.51] U/ml. Maternal IgM anti-PC levels were significantly higher (median 7198[range: 25.32–656.0]) U/ml) and the proportion of mothers in highest quartile (>75th percentile) was larger in mothers of NGA-infants (43%) vs. those of SGA-infants (0%, p = 0.032).

Conclusions

IgM anti-PC levels are low at birth, which suggests that these antibodies do not play a “housekeeping” role in immune function during fetal life/development, but arise predominately on exposure to external antigens after birth. Furthermore, low maternal IgM anti-PC levels may play a role in placental insufficiency, contributing to poor fetal growth and a small-for-date baby. This preliminary observation may have implications for the future risk of atherosclerosis/cardiovascular disease development in pregnant women and their offspring.     

Comparison of Effect on Tobacco Consumption and Carbon Monoxide Absorption of Changing to High and Low Nicotine Cigarettes

In 10 sedentary workers, smoking as they felt inclined over a five-hour period in the middle of a typical working day, changing to low nicotine cigarettes (<0·3 mg) caused an increase in the number and weight of cigarettes smoked, while changing to high nicotine cigarettes (3·2 mg) caused a decrease (P < 0·01). The average number and weight smoked in five hours for usual, low, and high nicotine brands were respectively 10·6 (6·00 g), 12·5 (6·52 g), and 6·7 (4·19 g). When smoking the usual brand the average blood carboxyhaemoglobin (COHb) increased 1·78% (from 6·38% to 8·16%). But on changing to either high or low nicotine cigarettes the COHb levels instead of increasing, tended to fall (P < 0·01). The average fall of 0·34% while smoking low nicotine cigarettes was due to the low carbon monoxide (CO) yield of these cigarettes, while the fall of 1·04% when smoking high nicotine cigarettes was attributable to reduced consumption. The findings support the view that smoking behaviour is modified to regulate nicotine intake. Besides having low tar and CO yields, the least harmful cigarettes for heavy smokers may be those with a high, rather than low, nicotine yield.     

Nutritional and ecological evaluation of dairy farming systems based on concentrate feeding regimes in semi-arid environments of Jordan

The objective of this study was to evaluate the nutritional and ecological aspects of feeding systems practiced under semi-arid environments in Jordan. Nine dairy farms representing the different dairy farming systems were selected for this study. Feed samples (n = 58), fecal samples (n = 108), and milk samples (n = 78) were collected from the farms and analysed for chemical composition. Feed samples were also analysed for metabolisable energy (ME) contents and in vitro organic matter digestibility according to Hohenheim-Feed-Test. Furthermore, fecal nitrogen concentration was determined to estimate in vivo organic matter digestibility. ME and nutrient intakes were calculated based on the farmer’s estimate of dry matter intake and the analysed composition of the feed ingredients. ME and nutrient intakes were compared to recommended standard values for adequate supply of ME, utilizable crude protein, rumen undegradable crude protein (RUCP), phosphorus (P), and calcium (Ca). Technology Impact Policy Impact Calculation model complemented with a partial life cycle assessment model was used to estimate greenhouse gas emissions of milk production at farm gate. The model predicts CH₄, N₂O and CO₂ gases emitted either directly or indirectly. Average daily energy corrected milk yield (ECM) was 19 kg and ranged between 11 and 27 kg. The mean of ME intake of all farms was 184 MJ/d with a range between 115 and 225 MJ/d. Intake of RUCP was lower than the standard requirements in six farms ranging between 19 and 137 g/d, was higher (32 and 93 g/d) in two farms, and matched the requirements in one farm. P intake was higher than the requirements in all farms (mean oversupply = 19 g/d) and ranged between 3 and 30 g/d. Ca intake was significantly below the requirements in small scale farms. Milk nitrogen efficiency N-_eff (milk N/intake N) varied between 19% and 28% and was mainly driven by the level of milk yield. Total CO₂ equivalent (CO₂ equ) emission ranged between 0.90 and 1.88 kg CO₂/kg ECM milk, where the enteric and manure CH₄ contributed to 52% of the total CO₂ equ emissions, followed by the indirect emissions of N₂O and the direct emissions of CO₂ gases which comprises 17% and 15%, respectively, from total CO₂ equ emissions. Emissions per kg of milk were significantly driven by the level of milk production (r² = 0.93) and of eDMI (r² = 0.88), while the total emissions were not influenced by diet composition. A difference of 16 kg ECM/d in milk yield, 9% in N-_eff and of 0.9 kg CO₂ equ/kg in ECM milk observed between low and high yielding animals. To improve the nutritional status of the animals, protein requirements have to be met. Furthermore, low price by-products with a low carbon credit should be included in the diets to replace the high proportion of imported concentrate feeds and consequently improve the economic situation of dairy farms and mitigate CO₂ equ emissions.     

Urinary 3-methylhistidine derivative as indicator of nutrients intake in low-birth-weight infants

Urinary excretion levels of N-methylhistidine derivatives and N-methylhistidine/creatinine ratios were studied in a group of 20 small for date newborns, 10 premature infants and 8 normal infants, at birth and at one week of life. All infants were fed with an adapted milk formula supplying 2.8 g protein/kg body weight. 1-methyl and 3-methylhistidine urinary excretion were increased in all groups of infants from birth to the 7th day of life. Creatinine and N-methyl derivatives/creatinine ratios were also significantly increased at one week of life. The two ratios showed a higher level in small for date and premature infants than in normal infants at birth which continued relatively increased at one week of life. 3-methyl-histidine/creatinine ratio appears as a useful indicator of the turnover rate of muscular proteins in low-birth-weight infants.     

Albumin synthesis in preterm infants on the first day of life studied with [1-13C]leucine

Albumin is the major binding protein in the human neonate. Low production of albumin will lower its transport and binding capacity. This is especially important in preterm infants, in whom albumin binds to potentially toxic products such as bilirubin and antibiotics. To study the metabolism of plasma albumin in preterm infants, we administered a 24-h constant infusion of [1-(13)C]leucine to 24 very low birth weight (VLBW) infants (28.4 +/- 0.4 wk, 1,080 +/- 75 g) on the first day of life. The caloric intake consisted of glucose only, and therefore amino acids for albumin synthesis were derived from proteolysis. The fractional synthesis rate (FSR) of plasma albumin was 13.9 +/- 1.5%/day, and the absolute synthesis rate was 148 +/- 17 mg x kg(-1) x day(-1). Synthesis rates were significantly lower (P<0.03) in infants showing intrauterine growth retardation. Albumin synthesis increased with increasing SD scores for gestation and weight (P<0.05). The FSR of albumin tended to increase by 37% after administration of antenatal corticosteroids to improve postnatal lung function (P=0.09). We conclude that liver synthetic capacity is well developed in VLBW infants and that prenatal corticosteroids tend to increase albumin synthesis. Decreased weight gain rates in utero have effects on protein synthesis postnatally.     

Effect of Dietary Aflatoxin Concentration on the Assessment of Genetic Variability of Response in a Randombred Population of Chickens

The effect of graded levels of dietary aflatoxin on the assessment of genetic variability of body weight and gain and plasma protein response was tested utilizing the Athens-Canadian randombred population of chickens. Dietary aflatoxin was administered at levels of either 0, 1.25, 2.50 or 5.0 µg/g of diet ad libitum from 7 to 21 days of age to progeny from 58 sire families. Twenty-one-day body weights, gain and plasma protein concentration were used to assess the variation in response.—The administration of increasing levels of aflatoxin resulted in a dose-related decrease of gains and plasma protein concentrations. Plasma protein concentrations were significantly higher among males than females within the control group; however, this difference was reversed as the severity of the aflatoxin challenge increased. Heritability estimates for all responses increased as the level of aflatoxin administered increased. This change was most notable for total plasma protein concentration. Phenotypic correlations for plasma protein concentration and growth measurements tended to diminish with increasing levels of aflatoxin. A similar trend was noted for the genetic correlations; however, a moderate correlation between growth responses and plasma protein response was detected in the 5.0-µg/g aflatoxin treatment group. Genetic correlations were calculated for the same characters between the different levels of aflatoxin. Regardless of which aflatoxin challenges were compared, a very high genetic correlation for 21-day body weight and 7- to 21-day gain was estimated. This variation in growth potential in the toxic environment paralleled that observed in the control environment but at a lower plane. Genetic correlations for plasma protein response across aflatoxin levels diminished as the difference between the levels of aflatoxin administered increased. Plasma protein concentration in the control environment was positively correlated with plasma protein response in groups fed a low level of aflatoxin, but negatively correlated when an aflatoxin challenge of 2.5 µg/g or more was given, suggesting that selection for aflatoxin resistance using plasma protein response as a selection criterion should be made under an aflatoxin stress environment.     

Effects of Step-Wise Increases in Dietary Carbohydrate on Circulating Saturated Fatty Acids and Palmitoleic Acid in Adults with Metabolic Syndrome

Recent meta-analyses have found no association between heart disease and dietary saturated fat; however, higher proportions of plasma saturated fatty acids (SFA) predict greater risk for developing type-2 diabetes and heart disease. These observations suggest a disconnect between dietary saturated fat and plasma SFA, but few controlled feeding studies have specifically examined how varying saturated fat intake across a broad range affects circulating SFA levels. Sixteen adults with metabolic syndrome (age 44.9±9.9 yr, BMI 37.9±6.3 kg/m²) were fed six 3-wk diets that progressively increased carbohydrate (from 47 to 346 g/day) with concomitant decreases in total and saturated fat. Despite a distinct increase in saturated fat intake from baseline to the low-carbohydrate diet (46 to 84 g/day), and then a gradual decrease in saturated fat to 32 g/day at the highest carbohydrate phase, there were no significant changes in the proportion of total SFA in any plasma lipid fractions. Whereas plasma saturated fat remained relatively stable, the proportion of palmitoleic acid in plasma triglyceride and cholesteryl ester was significantly and uniformly reduced as carbohydrate intake decreased, and then gradually increased as dietary carbohydrate was re-introduced. The results show that dietary and plasma saturated fat are not related, and that increasing dietary carbohydrate across a range of intakes promotes incremental increases in plasma palmitoleic acid, a biomarker consistently associated with adverse health outcomes.     

Quantitative Shear-Wave Elastography of the Liver in Preterm Neonates with Intra-Uterine Growth Restriction

The feasibility and reproducibility of liver stiffness measurements using Supersonic Shear-wave Imaging (SSI) in preterm neonate have not been reported. Our aim was to determine if liver stiffness differs between intra-uterine growth restriction (IUGR) and appropriate for gestational age (AGA) preterm infants with/without cholestasis. We measured liver stiffness (in kPa) in 45 AGA and 18 IUGR preterm infants, and assessed reproducibility in 26 preterms using Intraclass Correlation Coefficients (ICC) and Bland-Altman tests. Liver stiffness values were compared between AGA and IUGR with and without cholestasis and correlated with birth weight. Measurements showed high reproducibility (ICC = 0.94–0.98 for intra-operator, 0.86 for inter-operator) with good agreement (95% limits: -1.24 to 1.24 kPa). During the first postnatal week, liver stiffness was higher in IUGR (7.50 ±1.53 kPa) than in AGA infants (5.11 ±0.80 kPa, p<0.001). After day 8, liver stiffness remained unchanged in AGA but increased progressively in IUGR infants (15.57 ±6.49 kPa after day 21). Liver stiffness was higher in IUGR neonates with cholestasis (19.35 ± 9.80 kPa) than without cholestasis (7.72 ± 1.27 kPa, p<0.001). In conclusion, quantitative liver SSI in preterms is feasible and reproducible. IUGR preterms who will develop cholestasis present high liver stiffness even at birth, before biological cholestasis occurs.