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Linear growth from birth to 2 years of children enrolled in the World Health Organization Multicentre Growth Reference Study was similar despite substantial parental height differences among the six study sites. Within-site variability in child length attributable to parental height was estimated by repeated measures analysis of variance using generalized linear models. This approach was also used to examine relationships among selected traits (e.g. breastfeeding duration and child morbidity) and linear growth between 6 and 24 months of age. Differences in intergenerational adult heights were evaluated within sites by comparing mid-parental heights (average of the mother's and father's heights) to the children's predicted adult height. Mid-parental height consistently accounted for greater proportions of observed variability in attained child length than did either paternal or maternal height alone. The proportion of variability explained by mid-parental height ranged from 11% in Ghana to 21% in India. The average proportion of between-child variability accounted for by mid-parental height was 16% and the analogous within-child estimate was 6%. In the Norwegian and US samples, no significant differences were observed between mid-parental and children's predicted adult heights. For the other sites, predicted adult heights exceeded mid-parental heights by 6.2-7.8 cm. To the extent that adult height is predicted by height at age 2 years, these results support the expectation that significant community-wide advances in stature are attainable within one generation when care and nutrition approximate international recommendations, notwithstanding adverse conditions likely experienced by the previous generation. [ABSTRACT FROM AUTHOR]

This summary covers the articles and attributed discussion in the present supplement, which resulted from the 24th Marabou Symposium titled 'Nutrition and the Human Microbiome', which was held in Stockholm in 2011 with the participation of about 40 global experts in microbiology, physiology, biology, and medicine. The individual articles address a number of topics related to the human microbiome; the attributed discussion, however, offers much more on the nature of the current scientific debate and provides insight into new opportunities for research as well as possible effects of the gut microbes, ranging from possible prenatal epigenetic effects to brain function and behavior. [ABSTRACT FROM AUTHOR]

The evaluation of child growth trajectories and the interventions designed to improve child health are highly dependent on the growth charts used. The U.S. CDC and the WHO, in May 2000 and April 2006, respectively, released new growth charts to replace the 1977 NCHS reference. The WHO charts are based for the first time on a prescriptive, prospective, international sample of infants selected to represent optimum growth. This article compares the WHO and CDC curves and evaluates the growth performance of healthy breast-fed infants according to both. As expected, there are important differences between the WHO and CDC charts that vary by age group, growth indicator, and specific Z-score curve. Differences are particularly important during infancy, which is likely due to differences in study design and characteristics of the sample, such as type of feeding. Overall, the CDC charts reflect a heavier, and somewhat shorter, sample than the WHO sample. This results in lower rates of undernutrition (except during the first 6 mo of life) and higher rates of overweight and obesity when based on the WHO standards. Healthy breast-fed infants track along the WHO standard's weight-for-age mean Z-score while appearing to falter on the CDC chart from 2 mo onwards. Shorter measurement intervals in the WHO standards result in a better tool for monitoring the rapid and changing rate of growth in early infancy. Their adoption would have important implications for the assessment of lactation performance and the adequacy of infant feeding and would bring coherence between the tools used to assess growth and U.S. national guidelines that recommend breast-feeding as the optimal source of nutrition during infancy. [ABSTRACT FROM AUTHOR]

The development of an international growth standard for the screening, surveillance, and monitoring of school-aged children and adolescents has been motivated by 2 contemporaneous events, the global surge in childhood obesity and the release of a new international growth standard for infants and preschool children by the WHO. If a prescriptive approach analogous to that taken by WHO for younger children is to be adopted for school-aged children and adolescents, several issues need to be addressed regarding the universality of growth potential across populations and the definition of optimal growth in children and adolescents. A working group of experts in growth and development and representatives from international organizations concluded that subpopulations exhibit similar patterns of growth when exposed to similar external conditioners of growth. However, based on available data, we cannot rule out that observed differences in linear growth across ethnic groups reflect true differences in genetic potential rather than environmental influences. Therefore, the sampling frame for the development of an international growth standard for children and adolescents must include multiethnic sampling strategies designed to capture the variation in human growth patterns. A single international growth standard for school-aged children and adolescents could be developed with careful consideration of the population and individual selection criteria, study design, sample size, measurements, and statistical modeling of primary growth and secondary ancillary data. The working group agreed that existing growth references for school-aged children and adolescents have shortcomings, particularly for assessing obesity, and that appropriate growth standards for these age groups should be developed for clinical and public health applications. [ABSTRACT FROM AUTHOR]

Breast-fed babies have been shown to grow at a substantially different rate from the current international reference curves, with greater growth rates in height but with smaller body weight increases and substantially less variability in the growth patterns of a group. On this basis, the World Health Organization concluded that there was a need to undertake new studies to establish on a global basis the appropriate growth curves for exclusively breast-fed babies, their growth curves then being potentially seen as optimum standard curves rather than an arbitrary set of reference charts. The Multi-Country Growth Reference Study was therefore carried out from July 1997 to December 2003 as a population-based study covering the cities of Davis, California, USA; Muscat, Oman; Oslo, Norway; and Pelotas, Brazil, together with selected affluent neighborhoods of Accra, Ghana and South Delhi, India. These centers were considered conducive to a study of babies and children under optimum breast-feeding and weaning and early feeding conditions. These studies, to be reported shortly, confirm previous observations on breast-fed children, but also show that the greatest differences are within each population group rather than being international differences. [ABSTRACT FROM AUTHOR]

Recent advances in understanding genome-nutrient and nutrient-network interactions, and the modifying effects of genetic variation on their function, have strengthened interests in acute and long-lasting diet/nutrition influences on health. Relationships between early and mid-gestational and perinatal conditions (including those related to maternal nutrition) and outcomes, and later-onset chronic diseases have received particular attention. Controlled animal experiments support views that responses with long-lasting effects to nutritional milieus are enabled by epigenetic and other metabolic adjustments during critical windows. Thus, underlying mechanisms are beginning to be understood. For example, chromatin remodeling during development can alter gene expression levels, fix or determine future set points critical to intra- and inter-organ communication networks, alter morphogenesis, initiate remodeling events, etc., all with life- long consequences. These also may affect DNA mutation rates and thereby influence adult cancer and other risks. There is increasing evidence that nutrient-based strategies will be of value to the prevention or delay of onset of chronic diseases and that these strategies may require initiation during embryonic or fetal stages of development to achieve maximal benefit. [ABSTRACT FROM AUTHOR]

This is a brief review of the effects of infection and other forms of stress on the energy needs of infants and young children. The results of studies estimating energy expenditure in infants and young children during illness and convalescence were evaluated. Expectations that energy expenditure is influenced by the severity of illness, nutritional status, the nature of the illness, the presence and intensity of 'catch-up growth,' and the stage of convalescence are generally supported by the literature. The qualitative or quantitative nature of responses, however, are not uniform for diverse illnesses in children in diverse planes of nutritional adequacy. [ABSTRACT FROM AUTHOR]

This is a brief review of the effects of infection and other forms of stress on the energy needs of infants and young children. The results of studies estimating energy expenditure in infants and young children during illness and convalescence were evaluated. Expectations that energy expenditure is influenced by the severity of illness, nutritional status, the nature of the illness, the presence and intensity of ‘catch-up growth,’ and the stage of convalescence are generally supported by the literature. The qualitative or quantitative nature of responses, however, are not uniform for diverse illnesses in children in diverse planes of nutritional adequacy. [ABSTRACT FROM AUTHOR]

The data generated from the human genome project offers unprecedented opportunities to elucidate the etiology of chronic diseases and developmental anomalies that arise from deleterious genome-diet interactions. Folate metabolism is an attractive system to explore such relationships. Folate is necessary for the synthesis of purine and thymidine deoxyribonucleotides and S-adenosylmethionine, a cofactor required for DNA methylation. Impaired folate metabolism results from primary folate deficiency, alcohol, gastrointestinal disorders that result in malabsorption, single nucleotide polymorphisms, increased folate catabolism and secondary nutrient deficiencies in vitamin B-6, vitamin B-12 and iron arising from a variety of pathologies. Any of these conditions singly or in combination influence DNA synthesis, DNA integrity, allelic-specific gene expression, chromatin structure and DNA mutation rates. Biochemical manifestations of impaired folate metabolism include increased uracil uptake into DNA, altered DNA methylation status and elevated homocysteine and S-adenosylhomocysteine in serum and tissues. These biochemical changes are associated with risk for cancer, cardiovascular disease, neural tube defects and some neuropathies and anemia, although direct causative mechanisms have not been established in all cases. Interactions between folate and the genome are reciprocal; polymorphisms in key genes influence folate nutritional requirements, indicating that dietary folate adequacy likely exerts selective pressure and thereby influences genetic variation. Other studies indicate that exposure to excess folate, perhaps at levels that occur at the upper end of the intake distribution curve, may have unintended consequences in promoting embryo viability. Therefore individualizing folic acid dietary recommendations necessitates a detailed understanding of all genetic and physiological variables that influence the interaction of folate with the genome and their relationship to the disease process. [ABSTRACT FROM AUTHOR]

An attenuated severity of infections is among the well-documented benefits of breast-feeding. The degree to which this attenuated severity extends to the amelioration of anorexia is understood incompletely, and possible underlying mechanisms have received limited evaluation. This study was designed to test whether breast-feeding attenuates reductions in energy intake associated with a mild immunologic stimulus and to assess poststimulus relationships among putative reductions in energy intake and serum interleukin (IL)-1beta, tumor necrosis factor (TNF)-alpha and leptin concentrations. A quasi-experimental, hospital-based study was conducted in 23 healthy fully breast- (BF) and formula-fed (FF) infants who received the quadruple diphtheria, pertussis, tetanus and hemophilus influenza (DPTH) immunization as an immunologic challenge. Only FF infants had decreased energy intakes (12 +/- 2%, P = 0.001) after immunization. Leptin concentrations increased after immunization only in FF infants (30 +/- 7%, P = 0.03). Correlations between postimmunization increases in IL-beta and reductions in energy intake were of borderline significance (r = -0.56, P = 0.08). These findings support the view that breast-feeding protects against anorectic responses to mild immunologic stimuli. Increases in leptin are associated with reductions in energy consumption in the postimmunization period in FF infants and postimmunization changes in IL-1beta concentrations likely are related to reductions in energy intake in response to immunologic stimuli. [ABSTRACT FROM AUTHOR]

Presents information on a study which assessed whether anorexia induced by an immunologic stimulus is attenuated in breast-fed infants compared with formula-fed infants and examined the relationships among changes in energy intake and serum interleukin-1*beta, tumor necrosis factor-α and leptin concentrations. Methodology of the study; Results and discussion on the study.

Human epidemiologic and experimental animal studies suggest strongly that prenatal and early postnatal nutrition influence adult susceptibility to diet-related chronic disease. To elucidate biologic mechanisms linking divergent early nutritional sufficiency to adult insulin axis function in an animal model of "metabolic imprinting," this research focused on the following two objectives: 1) identify a tissue responsible for effect persistence, and 2) identify genes showing sustained differential expression in that tissue. Newborn rats were assigned randomly to small (SL), control (C) or large litters (LL) until weaning. Glucose and insulin tolerance tests were conducted directly after weaning (age 26 d) and in adulthood (ages 110 and 255 d). Glucose-stimulated insulin secretion from isolated pancreatic islets was assessed at those ages. DNA microarrays were used to identify genes showing persistent between-group differential expression in isolated islets. Glucose and insulin tolerance tests suggested persistently reduced pancreatic glucose-responsiveness in SL and LL rats. Insulin tolerance tests showed no group differences in whole-body insulin-stimulated glucose uptake. These data support the hypothesis that the endocrine pancreas contributes to primary imprinting in this model. Persistent defects in glucose-stimulated insulin secretion from isolated islets also supported this hypothesis but only in SL rats. Of 13 named islet genes showing SL vs. C differential expression at age 26 d, 10 remained differentially expressed at age 110 d. These data indicate that the endocrine pancreas plays a primary role in the putative metabolic imprinting mechanism in SL rats. [ABSTRACT FROM AUTHOR]

Dietary reference intakes (DRIs) are quantitative, nutrient intake-based standards used for assessing the diets and specific nutrient intakes of healthy individuals and populations and for informing national nutrition policy and nutrition programs. Because nutrition needs vary by age, sex, and physiological state, DRIs are often specified for healthy subgroups within a population. Diet is known to be the leading modifiable risk factor for chronic disease, and the prevalence of chronic disease is growing in all populations globally and across all subgroups, but especially in older adults. It is known that nutrient needs can change in some chronic disease and other clinical states. Disease states and/or disease treatment can cause whole-body or tissue-specific nutrient depletion or excess, resulting in the need for altered nutrient intakes. In other cases, disease-related biochemical dysfunction can result in a requirement for a nonessential nutrient, rendering it as conditionally essential, or result in toxicity for a food component at levels usually tolerated by healthy people, as seen in inborn errors of metabolism. Here we summarize examples from a growing body of literature of disease-altering nutrient requirements, supporting the need to give more consideration to special nutrient requirements in disease states. [ABSTRACT FROM AUTHOR]

The article discusses maternal consequences in formulating HIV-related breast-feeding recommendations based on several reports by L. Kuhn and Z. Stein. The authors proposed that their reports accurately reflect the vulnerability of infants and the knowledge base that supports the scholarly consideration of conditions that lessen, or exacerbate, that vulnerability. Alterations in postpartum maternal immune and nutritional status can affect the risk of HIV transmission to the infant by human milk.

Information about several papers discussed at the 16th Marabou International Symposium on Early Nutrition and Lifelong Health held in Stockholm, Sweden is presented. Participating researchers and medical practitioners tackled on the plethora of the essential functional effects on children and adults and highlighted the necessity to conduct further studies to attain full understanding in the issue. The symposium featured Anita Aperia, Claude Bouchard and Michael Kramer.

The article discusses various reports published within the issue including the comparison of the new growth standard of the World Health Organization with the Centers for Disease Control and Prevention 2000 reference.

Focuses on the childhood growth charts released by the U.S. Centers for Disease Control and Prevention in 2000. Details of its development; Information on the growth charts being developed by the World Health Organization targeted for release in 2004 or 2005; Importance of growth charts.

A foreword to the 24th Marabou Symposium titled "Nutrition and the Human Microbiome," which was held in Stockholm in 2011 is presented.

The potential for new functional foods and substantial modification of traditional foods presents unprecedented opportunities and new challenges to the public health community. The technical advances that enable these possibilities presumably present an efficient, cost-effective, and sustainable means of improving human health and preventing nutrition-related diseases. Directed manipulation of the food supply, however, presents risks that also must be considered and monitored carefully to avoid known adverse consequences associated with elevated nutrient intakes. Additionally, more research is necessary to understand the subtle effects and long-term consequences that result from elevated individual nutrient intakes on human health and disease risk through changes in gene expression and genome stability. Growing awareness that genetic variation influences both nutrient requirements and upper levels of safe intake require that the risks and benefits associated with manipulation of the food supply be considered at the individual and population levels. In the present report current approaches and limitations to the precise manipulation of the food supply are considered in light of recent efforts to prevent neural tube defects by increasing the population's dietary folic acid intake. [ABSTRACT FROM AUTHOR]

Except for the management of severe malnutrition, there has been little research specifically conducted to support emergency food and nutrition programs. Lacking empirically based guidance regarding how accurately to identify problems and select the most effective means to achieve desired objectives, programming decisions have been based on extrapolations, anecdotal evidence and intuition, with hopes of doing the right thing. Consequently, donors, implementers and affected governments, who often hold contradictory opinions, expend time and resources on controversies about when and how to act. These controversies reveal inadequate knowledge for which research is urgently needed. Two past controversies are presented as illustrations: one related to ration energy requirements and the other to sales of food aid. Appropriate action depends on context and research to support emergency programming must encompass a broad range of sectors and disciplines. Furthermore, emergency contexts are characterized by extremes and dynamic change and investigations in such contexts demand special approaches and caution. Institutional structures need to be changed so that they can adequately support emergency nutrition research. [ABSTRACT FROM AUTHOR]

Abstract. Milk volume, day of initiation of pumping, duration and frequency of milk expression, and length of night rest interval were evaluated for the first month postpartum in 32 healthy, nonsmoking women (ages 20 to 38 years) who delivered at 28 to 30 weeks' gestation. Early milk volumes were related negatively to the delay between delivery and the initiation of milk expression (r = -.48, P < .02). Average milk volumes at 2 weeks and 4 weeks postpartum were 493 +/- 330 and 606 +/- 369 mL/d (mean +/- SD), respectively, and were not related to the absolute frequency or duration of pumping or to night rest interval. Volume changes between weeks 2 and 4 postpartum were correlated with the absolute frequency (r = .49, P < .01) and duration of pump use (r = .42, P < .05) during this interval and with changes in frequency (r = 0.56, P .002) or duration (r = 0.49, P < .05) between the first 2 and the second 2 weeks postpartum. Optimal milk production was associated with five or more milk expressions per day and pumping durations that exceeded 100 min/d. [ABSTRACT FROM AUTHOR]

Background: Gestational hypertensive and acute hypotensive disorders are associated with maternal morbidity and mortality worldwide. However, physiological blood pressure changes in pregnancy are insufficiently defined. We describe blood pressure changes across healthy pregnancies from the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) Fetal Growth Longitudinal Study (FGLS) to produce international, gestational age-specific, smoothed centiles (third, 10th, 50th, 90th, and 97th) for blood pressure.Methods and Findings: Secondary analysis of a prospective, longitudinal, observational cohort study (2009 to 2016) was conducted across 8 diverse urban areas in Brazil, China, India, Italy, Kenya, Oman, the United Kingdom, and the United States of America. We enrolled healthy women at low risk of pregnancy complications. We measured blood pressure using standardised methodology and validated equipment at enrolment at <14 weeks, then every 5 ± 1 weeks until delivery. We enrolled 4,607 (35%) women of 13,108 screened. The mean maternal age was 28·4 (standard deviation [SD] 3.9) years; 97% (4,204/4,321) of women were married or living with a partner, and 68% (2,955/4,321) were nulliparous. Their mean body mass index (BMI) was 23.3 (SD 3.0) kg/m2. Systolic blood pressure was lowest at 12 weeks: Median was 111.5 (95% CI 111.3 to 111.8) mmHg, rising to a median maximum of 119.6 (95% CI 118.9 to 120.3) mmHg at 40 weeks' gestation, a difference of 8.1 (95% CI 7.4 to 8.8) mmHg. Median diastolic blood pressure decreased from 12 weeks: 69.1 (95% CI 68.9 to 69.3) mmHg to a minimum of 68.5 (95% CI 68.3 to 68.7) mmHg at 19+5 weeks' gestation, a change of -0·6 (95% CI -0.8 to -0.4) mmHg. Diastolic blood pressure subsequently increased to a maximum of 76.3 (95% CI 75.9 to 76.8) mmHg at 40 weeks' gestation. Systolic blood pressure fell by >14 mmHg or diastolic blood pressure by >11 mmHg in fewer than 10% of women at any gestational age. Fewer than 10% of women increased their systolic blood pressure by >24 mmHg or diastolic blood pressure by >18 mmHg at any gestational age. The study's main limitations were the unavailability of prepregnancy blood pressure values and inability to explore circadian effects because time of day was not recorded for the blood pressure measurements.Conclusions: Our findings provide international, gestational age-specific centiles and limits of acceptable change to facilitate earlier recognition of deteriorating health in pregnant women. These centiles challenge the idea of a clinically significant midpregnancy drop in blood pressure. [ABSTRACT FROM AUTHOR]

Background: Linear growth faltering in the first 2 y contributes greatly to a high stunting burden, and prevention is hampered by the limited capacity in primary health care for timely screening and intervention.Objective: This study aimed to determine an approach to predicting long-term stunting from consecutive 1-mo weight increments in the first year of life.Methods: By using the reference sample of the WHO velocity standards, the analysis explored patterns of consecutive monthly weight increments among healthy infants. Four candidate screening thresholds of successive increments that could predict stunting were considered, and one was selected for further testing. The selected threshold was applied in a cohort of Bangladeshi infants to assess its predictive value for stunting at ages 12 and 24 mo.Results: Between birth and age 12 mo, 72.6% of infants in the WHO sample tracked within 1 SD of their weight and length. The selected screening criterion ("event") was 2 consecutive monthly increments below the 15th percentile. Bangladeshi infants were born relatively small and, on average, tracked downward from approximately age 6 to <24 mo (51% stunted). The population-attributable risk of stunting associated with the event was 14% at 12 mo and 9% at 24 mo. Assuming the screening strategy is effective, the estimated preventable proportion in the group who experienced the event would be 34% at 12 mo and 24% at 24 mo.Conclusions: This analysis offers an approach for frontline workers to identify children at risk of stunting, allowing for timely initiation of preventive measures. It opens avenues for further investigation into evidence-informed application of the WHO growth velocity standards. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between complementary feeding indicators and attained linear growth at 6-23 months.Design: Secondary analysis of Phase V Demographic and Health Surveys data (2003-2008). Country-specific ANOVA models were used to estimate effects of three complementary feeding indicators (minimum meal frequency, minimum dietary diversity and minimum adequate diet) on length-for-age, adjusted for covariates and interactions of interest.Setting: Twenty-one countries (four Asian, twelve African, four from the Americas and one European).Subjects: Sample sizes ranging from 608 to 13 676.Results: Less than half the countries met minimum meal frequency and minimum dietary diversity, and only Peru had a majority of the sample receiving a minimum adequate diet. Minimum dietary diversity was the indicator most consistently associated with attained length, having significant positive effect estimates (ranging from 0·16 to 1·40 for length-for-age Z-score) in twelve out of twenty-one countries. Length-for-age declined with age in all countries, and the greatest declines in its Z-score were seen in countries (Niger, -1·9; Mali, -1·6; Democratic Republic of Congo, -1·4; Ethiopia, -1·3) where dietary diversity was persistently low or increased very little with age.Conclusions: There is growing recognition that poor complementary feeding contributes to the characteristic negative growth trends observed in developing countries and therefore needs focused attention and its own tailored interventions. Dietary diversity has the potential to improve linear growth. Using four food groups to define minimum dietary diversity appears to capture enough information in a simplified, standard format for multi-country comparisons of the quality of complementary diets. [ABSTRACT FROM AUTHOR]

ObjectiveTo examine the association between complementary feeding indicators and attained linear growth at 6–23 months.DesignSecondary analysis of Phase V Demographic and Health Surveys data (2003–2008). Country-specific ANOVA models were used to estimate effects of three complementary feeding indicators (minimum meal frequency, minimum dietary diversity and minimum adequate diet) on length-for-age, adjusted for covariates and interactions of interest.SettingTwenty-one countries (four Asian, twelve African, four from the Americas and one European).SubjectsSample sizes ranging from 608 to 13 676.ResultsLess than half the countries met minimum meal frequency and minimum dietary diversity, and only Peru had a majority of the sample receiving a minimum adequate diet. Minimum dietary diversity was the indicator most consistently associated with attained length, having significant positive effect estimates (ranging from 0·16 to 1·40 for length-for-age Z-score) in twelve out of twenty-one countries. Length-for-age declined with age in all countries, and the greatest declines in its Z-score were seen in countries (Niger, −1·9; Mali, −1·6; Democratic Republic of Congo, −1·4; Ethiopia, −1·3) where dietary diversity was persistently low or increased very little with age.ConclusionsThere is growing recognition that poor complementary feeding contributes to the characteristic negative growth trends observed in developing countries and therefore needs focused attention and its own tailored interventions. Dietary diversity has the potential to improve linear growth. Using four food groups to define minimum dietary diversity appears to capture enough information in a simplified, standard format for multi-country comparisons of the quality of complementary diets. [ABSTRACT FROM AUTHOR]

The interplay of factors that affect post-partum loss or retention of weight gained during pregnancy is not fully understood. The objective of this paper is to describe patterns of weight change in the six sites of the World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) and explore variables that explain variation in weight change within and between sites. Mothers of 1743 breastfed children enrolled in the MGRS had weights measured at days 7, 14, 28 and 42 post-partum, monthly from 2 to 12 months and bimonthly thereafter until 24 months post-partum. Height, maternal age, parity and employment status were recorded and breastfeeding was monitored throughout the follow-up. Weight change patterns varied significantly among sites. Ghanaian and Omani mothers lost little or gained weight post-partum. In Brazil, India, Norway and USA, mothers on average lost weight during the first year followed by stabilization in the second year. Lactation intensity and duration explained little of the variation in weight change patterns. In most sites, obese mothers tended to lose less weight than normal-weight mothers. In Brazil and Oman, primiparous mothers lost about 1 kg more than multiparous mothers in the first 6 months. In India and Ghana, multiparous mothers lost about 0.6 kg more than primiparas in the second 6 months. Culturally defined mother-care practices probably play a role in weight change patterns among lactating women. This hypothesis should stimulate investigation into gestational weight gain and post-partum losses in different ethnocultural contexts. [ABSTRACT FROM AUTHOR]

Iron deficiency and anemia remain among the most important global public health problems facing school children. Helminth infections often peak at school age and aggravate nutritional risks. We conducted a 12-wk randomized controlled trial in 406 Malian anemic shoolchildren infected with Schistosoma hematobium to examine the effects of 2 doses of praziquantel (P) (40 mg/kg body weight), P + 60 mg/d iron (Fe), and/or a multiple micronutrient supplement (MM) that included 18 mg/d Fe. Supplements were administered to the children each school day (5 d/wk) throughout the study. Changes in hemoglobin (Hb), serum ferritin (SF), and serum transferrin receptors (s-TfR) were followed. We also examined interactions between Fe and MM than th effects of P alone and MM with or without added Fe at 6 and 12 wk (P<0.001). In all groups, s-TfR decreased at 6 and 12 wk compared with baseline. The decrease was most pronounced in the P + Fe group compared with the other 3 groups at wk 6(P=0.05). Fe and MM interacted negatively at wk 6 and 12 to affect Hb (β = -0.43, 95% CI= -0.77, -0.09; P=0.01 and β = -0.47, 95% CI = -0.83, -0.11; P=0.01, respectively) and SF (β = -0.42, 95% CI= -25.60, 12.31; P<0.001, and β = -0.37, 95% CI= -0.63, -0.12; P=0.004, respectively). Malaria incidence was higher in the groups treated with added Fe(relative risk; 1.66; 95% CI: 0.75, 3.67). In this context, MM with added iron were not more effective that Fe without MM. Fe supplementation of schoolchildren with 60 mg/d for anemia control should be considered carefully. [ABSTRACT FROM AUTHOR]

Abstract: Glycoalkaloids are naturally occurring toxins in potatoes, which at high levels may induce toxic effects in humans, mainly on the gastrointestinal tract by cell membrane disruption. In order to better understand the molecular mechanisms underlying glycoalkaloid toxicity, we examined the effects of α-chaconine on gene expression in the Caco-2 intestinal epithelial cell line using DNA microarrays. Caco-2 cells were exposed for 6h to 10μM α-chaconine in three independent experiments (randomized block design). The most prominent finding from our gene expression and pathway analyses was the upregulation of expression of several genes involved in cholesterol biosynthesis. This to some extent is in line with the literature-described mechanism of cell membrane disruption by glycoalkaloids. In addition, various growth factor signaling pathways were found to be significantly upregulated. This study is useful in understanding the mechanism(s) of α-chaconine toxicity, which may be extended to other potato glycoalkaloids more generally. [Copyright &y& Elsevier]

Objectives: To compare growth patterns and estimates of malnutrition based on the World Health Organization (WHO) Child Growth Standards ('the WHO standards') and the National Center for Health Statistics (NCHS)/WHO international growth reference ('the NCHS reference'), and discuss implications for child health programmes.Design: Secondary analysis of longitudinal data to compare growth patterns (birth to 12 months) and data from two cross-sectional surveys to compare estimates of malnutrition among under-fives.Settings: Bangladesh, Dominican Republic and a pooled sample of infants from North America and Northern Europe.Subjects: Respectively 4787, 10 381 and 226 infants and children.Results: Healthy breast-fed infants tracked along the WHO standard's weight-for-age mean Z-score while appearing to falter on the NCHS reference from 2 months onwards. Underweight rates increased during the first six months and thereafter decreased when based on the WHO standards. For all age groups stunting rates were higher according to the WHO standards. Wasting and severe wasting were substantially higher during the first half of infancy. Thereafter, the prevalence of severe wasting continued to be 1.5 to 2.5 times that of the NCHS reference. The increase in overweight rates based on the WHO standards varied by age group, with an overall relative increase of 34%.Conclusions: The WHO standards provide a better tool to monitor the rapid and changing rate of growth in early infancy. Their adoption will have important implications for child health with respect to the assessment of lactation performance and the adequacy of infant feeding. Population estimates of malnutrition will vary by age, growth indicator and the nutritional status of index populations. [ABSTRACT FROM AUTHOR]

Abstract. The volume of milk produced by mothers who smoked cigarettes (n = 11) and control subjects who did not smoke (n = 29) was compared after the delivery of their preterm infants (28 to 32 weeks gestation). Milk production was significantly less among those who smoked, with or without adjusting for age, race, parity, gravidity, weight-for-height, prior nursing experience, customary alcohol and caffeine intake, infant birth weight, and pumping frequency. Each mother maintained her milk production using an electrical breast pump and without the stimulus of her infant suckling at the breast. Daily frequency and duration of breast pump usage were similar in the two groups. At 2 weeks postpartum, 24-hour milk volumes were 406 = 262 mL for mothers who smoked and 514 +/- 338 mL for control subjects. Between 2 to 4 weeks postpartum, the mean change in 24-hour milk volume (milliliters per 24 hours) of control subjects increased (+113 +/- 179 mL, P < .005), whereas milk volume of mothers who smoked cigarettes remained unchanged (-47 +/- 122 mL, P = .25). The percentage change in milk volume between 2 and 4 weeks for the combined groups was significantly related to four factors: pumping frequency, change in daily pumping frequency, day of initiation of pumping, and smoking status. Total and protein nitrogen, lactose, calcium, and phosphorous concentrations did not differ in milks from mothers who smoked cigarettes and mothers who did not smoke. Fat concentrations were lower in the milk from mothers who smoked cigarettes. Reduced milk volume and fat concentrations may explain the reported early weaning of breast-fed infants by women who smoke cigarettes. [ABSTRACT FROM AUTHOR]