Search

Objectives: The lecithin/sphingomyelin (L/S) ratio and the lamellar body count (LBC) can be used to predict respiratory distress syndrome (RDS).Design: We performed a retrospective cohort study among consecutive women who underwent amniotic fluid sampling for the assessment of fetal lung maturity. Logistic regression was used to construct models for the prediction of RDS in three gestational age categories, with models based on clinical characteristics only, clinical characteristics and the LBC, and on clinical characteristics and L/S ratio.Results: When amniotic fluid was collected <30 weeks, the specificity of the LBC was 30% and the sensitivity 100%. Addition of the L/S ratio increased the specifity to 60%, for a sensitivity of 100%. When amniocentesis was performed between 30 and 33 weeks, addition of the L/S ratio only marginally improved the performance of the LBC.Conclusions: At a gestational age <30 weeks, the L/S ratio has additional value over the LBC. Above 30 weeks of gestation, single use of the LBC seems sufficient. [ABSTRACT FROM AUTHOR]

Objective:Increased dietary fat intake is a precipitating factor for the development of obesity and associated metabolic disturbances. Physically active individuals generally have a reduced risk of developing these unhealthy states, but the underlying mechanisms are poorly understood. In the present study, we investigated the effects of feeding a high-fat diet (HFD) on obesity development and fuel homeostasis in male and female mice with a trait for increased physical activity and in their controls.Methods:Male and female mice selectively bred for a high level of wheel running behavior over 30 generations and nonselected controls (background strain Hsd:ICR) were maintained on a standard lab chow high-carbohydrate diet (HCD) or on an HFD (60% fat). Food intake, body weight, indirect calorimetry parameters, spontaneous locomotor activity and several hormones relevant to metabolism and energy balance were measured.Results:On HFD, mice reduced food intake and increased body fat mass and plasma leptin levels, with the notable exception of the selected females, which increased their ingested calories without any effects on body mass or plasma leptin levels. In addition, they had an elevated daily energy expenditure (DEE), increased spontaneous cage activity (∼700% relative to controls) and higher resting metabolic rate (RMR) on the HFD compared with feeding the HCD. The selected males also had a higher DEE compared with controls, but no interaction with diet was observed. On HCD, adiponectin levels were higher in selected male, but not female, mice relative to controls. A marked increase in the level of plasma adiponectin was observed on the HFD in selected females, an effect of diet that was not observed in selected males.Conclusion:Genetically based high locomotor activity renders female, but not male, mice resistant to HFD-induced obesity by alterations in behavioral, endocrine and metabolic traits that facilitate fat utilization rather than limiting HFD intake.International Journal of Obesity (2008) 32, 1566–1575; doi:10.1038/ijo.2008.136; published online 26 August 2008 [ABSTRACT FROM AUTHOR]

Aims/hypothesis: The aim of this study was to establish the value of maternal HbA1c levels and older sibling birthweight as predictors of birthweight and macrosomia in the offspring of women with type 1 diabetes. Subjects and methods: A total of 214 pregnancies of 107 women with type 1 diabetes were studied. Regression analysis was performed to test the predictive value of the birthweight of the first-born infant, HbA1c levels, maternal BMI, maternal age and time between subsequent births on the birthweight of the second-born infant. Birthweights were corrected for sex and gestational age. The percentages of first- and second-born infants with macrosomia (weight »90th centile)were calculated and compared. Results: Only the birthweight of earlier born infants was significantly related to that of second-born infants (p«0.001) and 40–50% of the variation in the birthweight of second-born infants could be explained by the birthweight of the firstborn infants. About 85% of the mothers who gave birth to a macrosomic infant had a macrosomic infant in a subsequent pregnancy. Conclusions/interpretation: Although it is clear that glycaemic control contributes to birthweight in women with type 1 diabetes, the birthweight of an earlier born infant appears to be a much better predictor of the birthweight of a subsequent infant than HbA1c levels during pregnancy. It may, therefore, be used to identify patients at risk of giving birth to a macrosomic infant. Daily home monitoring of glucose levels, rather than HbA1c levels, should be used for assessment of maternal glycaemia during pregnancy. [ABSTRACT FROM AUTHOR]

OBJECTIVE:: Firstly, to compare food, and macronutrient intake as obtained from a single 24-h recall and a frequency questionnaire (FQ) covering a 14-day period in breast-fed infants aged 4 months of age. Secondly, nonbreast milk water intake (NB-WI, ml/day) was used as an estimation of energy and macronutrient intake, and NB-WI as calculated from FQ (NB-WIFQ) was compared with NB-WI as measured using the dose-to-the-mother2H2O turnover method (NB-WIDO) covering the same 14-day period. DESIGN:: Cross-sectional. SETTING:: Community-based study in urban Pelotas, Southern Brazil. SUBJECTS:: In all, 67 breast-fed infants aged 4 months of age recruited at birth. MAIN OUTCOME MEASURES:: (1) Bias in estimations of food and macronutrient intake of the 24-h recall relative to FQ; (2) Bias in NB-WIFQ relative to NB-WIDO. RESULTS:: In infants with an energy intakeFQ from complementary foods above the 50th percentile (1.03?kcal/day), estimations of water, tea, juice, and milk intake were not different between 24-h recall and FQ (n=34). Nor were estimations of energy and macronutrient intake (protein, fat, and carbohydrates) different between the two methods, and bias was nonsignificant. NB-WIDO was divided into quintiles and compared with NB-WIFQ. The first two quintiles included negative values for NB-WIDO as a result of random errors of the2H2O turnover method. Subsequently, bias of NB-WIFQ relative to NB-WIDO was positive in the 1st (P=0.001) and 2nd quintile (P=0.638), respectively. Bias was negative for the three highest quintiles, and within this group, underestimation by FQ was significant for the 3rd and 4th quintile (-57.4%, P=0.019;-43.7%, P=0.019). CONCLUSIONS:: Firstly, at the age of 4 months FQ covering a 14-day period provides similar results on food and macronutrient intake as compared to a single 24-h recall for estimations of complementary liquid foods. Secondly, NB-WIFQ appeared to be a good proxy for macronutrient and energy intake in breast-fed infants receiving other liquids. In infants with NB-WIDO>0, the method provides a useful tool for the detection of bias from FQ, and results indicate an underestimation from FQ relative to the2H2O turnover method. This exercise could be applied wherever the2H2O turnover method is used in combination with conventional food consumption techniques for measuring intake of nonbreast milk liquids of breast-fed infants in whom solid foods have not yet been introduced. It would help interpreting estimations of macronutrient intake, and could be relevant to studies of dietary intake of infants and its relationship with growth and health. SPONSORSHIP:: International Atomic Energy Agency through RC 10981/R1.European Journal of Clinical Nutrition (2005) 59, 93-100. doi:10.1038/sj.ejcn.1602043 Published online 22 September 2004 [ABSTRACT FROM AUTHOR]

OBJECTIVE:: To investigate the extent to which breast milk is replaced by intake of other liquids or foods, and to estimate energy intake of infants defined as exclusively (EBF), predominantly (PBF) and partially breast-fed (PartBF). DESIGN:: Cross-sectional. SETTING:: Community-based study in urban Pelotas, Southern Brazil. SUBJECTS:: A total of 70 infants aged 4 months recruited at birth. MAIN OUTCOME MEASURES:: Breast milk intake measured using a ‘dose-to-the-mother’ deuterium-oxide turnover method; feeding pattern and macronutrient intake assessed using a frequency questionnaire. RESULTS:: Adjusted mean breast milk intakes were not different between EBF and PBF (EBF, 806?g/day vs PBF, 778?g/day, P=0.59). The difference between EBF and PartBF was significant (PartBF, 603?g/day, P=0.004). Mean intakes of water from supplements were 10?g/day (EBF), 134?g/day (PBF) and 395?g/day (PartBF). Compared to EBF these differences were significant (EBF vs PBF, P=0.005; EBF vs PartBF, P<0.001).The energy intake of infants receiving cow or formula milk (BF+CM/FM) in addition to breast milk tended to be 20% higher than the energy intake of EBF infants (EBF, 347?kJ/kg/day vs BF+CM/FM, 418?kJ/kg/day, P=0.11). CONCLUSIONS:: There was no evidence that breast milk was replaced by water, tea or juice in PBF compared to EBF infants. The energy intake in BF+CM/FM infants tended to be 20% above the latest recommendations (1996) for breast-fed and 9% above those for formula-fed infants. If high intakes are maintained, this may result in obesity later in life. SPONSORSHIP:: International Atomic Energy Agency through RC 10981/R1.European Journal of Clinical Nutrition (2003) 57, 1633-1642. doi:10.1038/sj.ejcn.1601735 [ABSTRACT FROM AUTHOR]

Aims/hypothesis. To investigate the incidence of foetal macrosomia (i.e. birth weight >90th percentile) in a non-selected nationwide cohort of women with Type I (insulin-dependent) diabetes mellitus in The Netherlands and to identify risk indicators predictive for macrosomia. Methods. We conducted a prospective nationwide cohort based survey regarding the outcome of Type I diabetic pregnancy in The Netherlands. Data of 289 women who gave birth to a live singleton infant without major congenital malformations at more than or equal to 28 weeks of gestation are shown. Results. The incidence of foetal macrosomia was very high (48.8%), with 26.6% of infants weighing more than 97.7th percentile. Glycaemic control during pregnancy was good (i.e. mean HbA1c ≤7.0%), in almost all (84%) women. Multiple logistic regression analysis resulted in a predictive model for macrosomia that incorporated five variables: third trimester HbA1c (Odds Ratio [95% Confidence Interval]: (1.6[1.1–2.4]), absence of third trimester severe hypoglycaemia (3.0[1.2–7.3]), the use of insulin lispro (3.1[0.9–10.4]), weight gain during pregnancy (1.1[1.0–1.2]) and non-smoking (2.8[0.9–9.3]). Third trimester HbA1c was the most powerful predictor for the occurrence of macrosomia, but its predictive capacity was weak (explained variance <5%). Conclusion/interpretation. Despite apparent good glycaemic control, the incidence of foetal macrosomia in this non-selected prospective nationwide cohort of 289 Type I diabetic women was very high. Third trimester HbA1c was the most powerful predictor, but its predictive capacity was weak. Thus, future research should focus on new more detailed glucose monitoring techniques (such as a continuous glucose monitoring system) as well as to alternative factors to reduce macrosomia. [ABSTRACT FROM AUTHOR]

The Doubly Labeled Water (DLW) method was validated against respiration gas analysis in growing Japanese Quail chicks (between 1 week and 3 weeks of age) as well as in birds after having achieved sexual maturity (7 weeks of age). A comparison was made between a strain selected for high growth rates (P-strain, n=18), and a non-selected strain (C-strain, n=18). Relative growth rates of individual chicks during the measurement ranged from -13.8% day-1 to 23.1% day-1. When employing a single-pool model (eq. 34, Lifson and McClintock 1966), it was found that the relative error of the DLW method was sensitive to assumptions concerning fractional evaporative water loss. The best fit was obtained after taking a fractional evaporative water loss value of 0.33. When applying this value for all chicks, it was found that neither strain, relative growth rate of the chick during measurement, nor age significantly contributed to the explained variance. When employing two-pool models, it was found that the DLW method significantly underestimated the true rates of CO2 production at all assumed levels of fractional evaporative water loss. Based on an evaluation of DLW validation studies in growing shorebirds, terns, and quail we recommend Speakman's Eq. 7.17 (Speakman 1997) for general use in young birds. [ABSTRACT FROM AUTHOR]

To study zebra finch allocation of energy to day and night at two different workloads, we assessed the daily energy turnover from: (1) metabolizable energy of the food, and (2) doubly-labeled water. In both experiments we imposed two levels of activity on captive zebra finches ( Taeniopygia guttata), by applying different computer-controlled workload schedules. A low workload required 20 hops, and a high workload 40 hops to obtain 10 s access to food. In experiment 1, we further measured nocturnal energy expenditure by overnight oxygen consumption. From experiment 2 we derived an estimate of the costs of hopping activity, from inter-individual association of daily amount of hopping and daily energy expenditure. Surprisingly, the daily energy budget was, on average, reduced slightly when birds were subjected to a high workload. Since hopping activity was 50% higher during the high workload than during the low workload, the birds apparently compensated, even over-compensated, for the increased energetic demands of activity. Nocturnal energy expenditure was indeed reduced for the high workload, which was largely due to a reduction in resting metabolic rate. Economizing on energy was more than could have been accomplished by a reduction in mass alone, and we discuss the occurrence and potential mechanisms of physiological compensation. The amount of energy saved during the night did account for part of the total amount of energy saved. We surmise that the strategy of energetic compensation observed during the night was extended into the inactive hours of the day. [ABSTRACT FROM AUTHOR]

The assessment of energy expenditure is valuable for the management of children with various conditions such as obesity and failure to thrive. Total daily energy expenditure (TDEE) includes resting energy expenditure (REE), energy expenditure during physical activity, dietary thermogenesis and growth. TDEE can be assessed by using the double-labelled water technique, but it has complex pitfalls and potential sources of errors and is impractical for everyday use. As REE is a substantial part of TDEE (65%-70%) and computerised indirect calorimeters have become recently available, this non-invasive, relatively cheap and easy to use technique is valuable for the assessment of short-term changes in energy metabolism. This can be used to assess REE of children with inborn errors of metabolism, whilst well and during episodes of metabolic decompensation and therefore to accurately determine energy intake. [ABSTRACT FROM AUTHOR]

Objective: There is increasing evidence that in healthy populations, breast-fed infants are leaner than formula-fed infants. It is of interest to know the effects of breast-feeding on infant weight in case of maternal diabetes, given the high incidence of fetal macrosomia and risk of childhood obesity in this population. Design and Subjects: As part of a nation-wide study in the Netherlands on diabetes and pregnancy, 229 women with Type 1 diabetes were sent a questionnaire on weight and height of their infant, the type of nutrition given during the first 6 weeks of life, the duration of lactation and intercurrent diseases during the first year of life. Results and conclusion: Our data show no significant difference between breast- ,formula- , and mixed-fed infants in weight and body mass index (BMI) at 1 y of age, which is not in accordance with the findings in nondiabetic populations. Sponsorship: Novo Nordisk Farma BV, Alphen aan de Rijn, the Netherlands and the Cornelis Visser Foundation. [ABSTRACT FROM AUTHOR]