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Objective: We aimed to investigate prospective associations between milk bioactives related to metabolic health (glucose, insulin, leptin, C reactive protein [CRP], and interleukin 6 [IL-6]) and incident formula initiation at 3 and 6 months postpartum. Design: This study included 363 mother–infant dyads who were fully breastfed at 1 month and participated in the prospective Mothers and Infants Linked for Healthy Growth study from pregnancy to 6 months postpartum. Associations between milk glucose, leptin, insulin, CRP, and IL-6 at 1 and 3 months and incident formula feeding (FF) at 3 and 6 months, respectively, were tested using multiple logistic regression, adjusting for numerous potential confounders such as maternal age and prepregnancy body mass index. Results: At 3 months postpartum, 1-month glucose (odds ratio [OR] 0.45 [95% confidence interval (CI): 0.27–0.75], p ≤ 0.01) and smaller decreases in glucose from 1 to 3 months (OR 0.51 [95% CI: 0.28–0.92], p = 0.03) were associated with lower odds of FF, whereas 1-month leptin (OR 2.30 [95% CI: 1.30–4.07], p

BACKGROUND: Our prior studies revealed that infant somatic growth is influenced by fructose in breast milk, and fructose in breast milk is increased in response to maternal sugar-sweetened beverage (SSB) intake in lactation. It is unknown whether infant neurodevelopmental outcomes are also influenced by maternal SSBs in lactation. OBJECTIVES: To determine whether infant cognitive development at 24 postnatal months was influenced by maternal fructose consumption during lactation, and whether this relation persisted after accounting for maternal SSB and juice (SSB + J) intake. METHODS: Hispanic mother–infant pairs (n = 88) were recruited across the spectrum of prepregnancy BMI. Mothers completed two 24-h dietary recalls at 1 and 6 postnatal months, and reported breastfeedings per day. The Bayley-III Scales of Infant Development were administered at 24 postnatal months to assess infant cognition. Linear regressions were used to examine associations, reported as unstandardized (B) coefficients, 95% CIs, and P values. RESULTS: Mothers consumed 1656 ± 470 kcal, 21.8 ± 12 g fructose, and 2.5 ± 2.6 servings SSBs + J, and reported 6.9 ± 2.1 breastfeedings per day at 1 postnatal month. Controlling for maternal age, prepregnancy BMI, education level, kilocalories, infant age, sex, and birthweight revealed that infant cognitive development scores at 24 postnatal months correlated inversely with maternal fructose consumption at 1 postnatal month (B = −0.08; 95% CI = −0.13, −0.03; P

Context Little is known about the specific breastmilk components responsible for protective effects on infant obesity. Whether 12,13-dihydroxy-9Z-octadecenoic acid (12,13-diHOME), an oxidized linoleic acid metabolite and activator of brown fat metabolism, is present in human milk, or linked to infant adiposity, is unknown. Objective To examine associations between concentrations of 12,13-diHOME in human milk and infant adiposity. Design Prospective cohort study from 2015 to 2019, following participants from birth to 6 months of age. Setting Academic medical centers. Participants Volunteer sample of 58 exclusively breastfeeding mother-infant pairs; exclusion criteria included smoking, gestational diabetes, and health conditions with the potential to influence maternal or infant weight gain. Main Outcome Measures Infant anthropometric measures including weight, length, body mass index (BMI), and body composition at birth and at 1, 3, and 6 months postpartum. Results We report for the first time that 12,13-diHOME is present in human milk. Higher milk 12,13-diHOME level was associated with increased weight-for-length Z-score at birth (β = 0.5742, P = 0.0008), lower infant fat mass at 1 month (P = 0.021), and reduced gain in BMI Z-score from 0 to 6 months (β = −0.3997, P = 0.025). We observed similar associations between infant adiposity and milk abundance of related oxidized linoleic acid metabolites 12,13-Epoxy-9(Z)-octadecenoic acid (12,13-epOME) and 9,10-Dihydroxy-12-octadecenoic acid (9,10-diHOME), and metabolites linked to thermogenesis including succinate and lyso-phosphatidylglycerol 18:0. Milk abundance of 12,13-diHOME was not associated with maternal BMI, but was positively associated with maternal height, milk glucose concentration, and was significantly increased after a bout of moderate exercise. Conclusions We report novel associations between milk abundance of 12,13-diHOME and adiposity during infancy.

Hydrogen peroxide (H2O2), a pesticide used in salmonid aquaculture, is released directly into the environment where nontarget organisms are at risk of exposure. We determined threshold concentrations for mortality of Calanus spp., the dominant zooplankton species in the North Atlantic, and assessed sublethal effects, focusing on the escape response and oxygen consumption rates (OCRs) as behavioral and physiological assays. One-hour exposure to 170 mg·L−1 (i.e., 10% of the recommended H2O2 treatment) was lethal to copepodite stage V (92% mortality) and adult females (100% mortality). The acute median lethal concentration (1h-LC50) was 214.1 (150.67–277.4) and 48.6 (44.9–52.2) mg·L−1 for copepodite V and adults, respectively. The 25-h LC50 was 77.1 (57.9–96.2) and 30.63 (25.4–35.8) mg·L−1 for copepodite V and adults, respectively. At concentrations of 0.5% and 1% of the recommended treatment level, Calanus spp. showed a decrease in escape performance and lower OCRs with increased concentration. At H2O2 concentrations of 5% of the recommended treatment levels (85 mg·L−1), exposed copepods showed no escape reaction response. These results suggest that sublethal concentrations of H2O2 will increase the risk of predation for Calanus spp. Furthermore, this study provides supporting evidence that theoretical “safe” values, traditionally used for predicting toxicity thresholds, underestimate the impact of H2O2 on the physiological condition of nontarget crustaceans.

The objective of this study was to investigate the associations of mode of feeding with infant anthropometric and body composition variables at 6 months of age. We studied 259 infants whose exclusive mode of feeding (breast or formula) to 1 month was confirmed. Standard anthropometric characteristics of the infants (weight, length and weight‐for‐length z scores) were obtained, and body composition (total fat mass, fat‐free mass, trunk fat mass and body fat percent) was measured using dual‐energy X‐ray absorptiometry (DXA) at 6 months (±12 days). General linear models were used to test the associations of mode of feeding with infant anthropometric and body composition variables at 6 months after adjustment for maternal and infant covariates. In this cohort of predominantly breastfed, White infants of highly educated mothers, fat‐free mass was lower (P = .002), and trunk fat mass (P = .032) and body fat percent (P < .001) were greater in breastfed infants than in formula‐fed infants at 6 months of age. After adjustment for covariates, total fat‐free mass was significantly lower (β = −372 g, [SE = 125, P = .003]), and body fat percent was significantly greater (β = 3.30, [SE = 0.91, P < .001]) in breastfed infants than in formula‐fed infants. No other significant associations were observed. These findings support those of previous studies reporting greater fat‐free mass in formula‐fed infants during the first 6 months of life. Additional research is warranted to explore whether differences in infant body composition by mode of feeding persist throughout the life course and to assess causality.

Among all the body fluids, breast milk is one of the richest sources of microRNAs (miRNAs). MiRNAs packaged within the milk exosomes are bioavailable to breastfeeding infants. The role of miRNAs in determining infant growth and the impact of maternal overweight/obesity on human milk (HM) miRNAs is poorly understood. The objectives of this study were to examine the impact of maternal overweight/obesity on select miRNAs (miR-148a, miR-30b, miR-29a, miR-29b, miR-let-7a and miR-32) involved in adipogenesis and glucose metabolism and to examine the relationship of these miRNAs with measures of infant body composition in the first 6 months of life. Milk samples were collected from a cohort of 60 mothers (30 normal-weight [NW] and 30 overweight [OW]/obese [OB]) at 1-month and a subset of 48 of these at 3 months of lactation. Relative abundance of miRNA was determined using real-time PCR. The associations between the miRNAs of interest and infant weight and body composition at one, three, and six months were examined after adjusting for infant gestational age, birth weight, and sex. The abundance of miR-148a and miR-30b was lower by 30% and 42%, respectively, in the OW/OB group than in the NW group at 1 month. miR-148a was negatively associated with infant weight, fat mass, and fat free mass, while miR-30b was positively associated with infant weight, percent body fat, and fat mass at 1 month. Maternal obesity is negatively associated with the content of select miRNAs in human milk. An association of specific miRNAs with infant body composition was observed during the first month of life, suggesting a potential role in the infant’s adaptation to enteral nutrition.

Background Whether current dietary guidelines are appropriate for pregnancy and lactation has not been well studied. Many women of reproductive age are not meeting recommendations for dietary components such as fat, added sugar, and fiber. Objectives To assess associations between maternal dietary components during pregnancy and lactation and infant growth and adiposity at 6 mo of age. Methods Mother-infant dyads (n = 349) from the prospective, observational Mothers and Infants Linked for Healthy Growth study were included (100% fully breastfed for 1 mo; 75% to 6 mo). Daily intake of fat, fiber, and added sugar was obtained using the National Cancer Institute Diet History Questionnaire II during the third trimester of pregnancy and at 1 and 3 mo postpartum. Furthermore, intakes were categorized as meeting/exceeding 2015-2020 Dietary Guidelines for Americans. Multiple linear regression models adjusted for numerous potential confounders tested relations between dietary components and infant adiposity (via DXA) and growth parameters. Regression coefficients (β) for continuous variables were expressed per SD to allow for comparison of effect sizes. Results Maternal intake of total fat and saturated fat was positively associated with infant percent body fat (%BF) (β: 0.84 per SD, P = 0.04; β: 0.96 per SD, P = 0.01, respectively). Added sugar intake was positively associated with infant weight-for-length z score (β: 0.16 per SD, P = 0.02), and excessive added sugar intake was positively associated with %BF at 6 mo (β: 0.75 per SD, P = 0.05). Conclusions In a predominantly fully breastfeeding cohort of women, maternal intake of fat and added sugar during pregnancy and lactation were associated with small increases in infant adiposity and relative weight at 6 mo. Additional research is needed to determine if these relations persist later in infancy and if such elevations in adiposity are important for long-term obesity risk.

Background Insulin, leptin, and adiponectin regulate energy balance and may influence infant growth via their presence in human milk. Maternal body mass index has been associated with human milk insulin, leptin, and adiponectin concentrations, but results are inconsistent. Maternal serum hormone concentrations and fat mass may better characterize human phenotype and be more appropriate predictors of human milk insulin, leptin, and adiponectin. Research aim To examine the associations of human milk insulin, leptin, and adiponectin with their concentrations in maternal circulation and with maternal fat mass. Methods Insulin, leptin, and adiponectin were measured in serum and human milk at 1 month postpartum in 25 women. Total body fat mass and fat-free mass were measured using bioelectrical impedance analysis. Linear regression modeling was used to examine associations of serum hormone concentrations or fat mass with human milk insulin, leptin, and adiponectin after adjusting for covariates. Results Serum insulin ( p = .007), leptin ( p < .001), and adiponectin ( p < .001) were each associated with their respective concentrations in human milk. Fat mass was positively associated with insulin ( p = .005) and leptin ( p < .001), but not with adiponectin ( p = .65), in human milk. Conclusions Human milk insulin, leptin, and adiponectin were positively associated with their concentrations in serum, and human milk insulin and leptin were associated with maternal fat mass. Future research is needed to elucidate the role of human milk hormones in infant energy balance and growth.

OBJECTIVES: Our prior studies have shown that maternal sugar-sweetened beverage and juice (SSBJ) consumption influenced breast milk fructose, and higher breast milk fructose was associated with greater infant growth. It is unknown whether maternal SSBJ consumption in lactation also influences infant neurodevelopment. The aim of this study was to determine whether maternal SSBJ consumption in lactation was associated with infant cognitive, language, and motor development at 24 postnatal months. Associations of maternal fructose, added, and total sugar consumption with infant neurodevelopmental outcomes were also examined. METHODS: Hispanic mother-infant pairs (N = 89) were recruited across the spectrum of pre-pregnancy BMI. Mothers completed two 24-hour dietary recalls at 1 and 6 postnatal months. The Bayley-III Scales were administered to all infants at 24 postnatal months to assess cognitive, language, and motor development. Multiple linear regressions were used to assess the correlations of maternal diet with infant Bayley-III outcomes, adjusting for maternal age, BMI, education level, energy intake, infant age, sex, and birthweight. RESULTS: At 1 postnatal month, mothers consumed 2.7 ± 3.1 servings SSBJ, 22 ± 12 g fructose, 59 ± 35 g added sugar, and 98 ± 47 g total sugar per day, and all were inversely associated with infant Bayley-III outcomes. Every 1 serving increase in SSBJs was associated with a 0.24 decrease in cognitive, 0.50 decrease in language, and 0.43 decrease in motor development scores (all P's ≤0.01). At 6 postnatal months, maternal SSBJ consumption remained inversely associated with infant motor development scores (B = −0.24, P = 0.03), but maternal fructose, added, and total sugar consumption were not associated with infant Bayley-III outcomes. CONCLUSIONS: Our findings suggest that maternal SSBJ consumption in early lactation is an adverse influence of infant neurodevelopmental outcomes at 24 postnatal months. FUNDING SOURCES: National Institute of Diabetes and Digestive and Kidney Diseases (NIH R01 DK110793); The Gerber Foundation (15PN-013).

Objective: The aim of this study was to determine sucralose and acesulfame-potassium (ace-K) pharmacokinetics in breast milk following maternal ingestion of a diet soda. Methods: Thirty-four exclusively breast-feeding women (14 normal-weight, 20 obese) consumed 12 ounces of Diet Rite Cola, sweetened with 68-mg sucralose and 41-mg ace-K, before a standardized breakfast meal. Habitual non-nutritional sweeteners intake was assessed via a diet questionnaire. Breast milk was collected from the same breast before beverage ingestion and hourly for 6 hours. Results: Owing to one mother having extremely high concentrations, peak sucralose and acesulfame-potassium concentrations following ingestion of diet soda ranged from 4.0 to 7387.9 ng/mL (median peak 8.1 ng/mL) and 299.0 to 4764.2 ng/mL (median peak 945.3 ng/mL), respectively. Conclusions: Ace-K and sucralose transfer into breast milk following ingestion of a diet soda. Future research should measure concentrations after repeated exposure and determine whether chronic ingestion of sucralose and acesulfame-potassium via the breast milk has clinically relevant health consequences.

OBJECTIVES: Our prior studies revealed that human milk oligosaccharides (HMOs) have numerous health benefits for nursing infants, and can also change dynamically over 24 months of lactation. However, the extent to which HMOs vary over days of time and also in response to acute factors such as maternal diet has not been established. The aims of this study were to determine the stability of HMO concentrations over 7-days, and in response to a standardized meal and sugar-sweetened beverage (SSB) over 6-hours. METHODS: Lactating mothers were enrolled at 6 weeks. Participants received in-person instructions and materials to complete procedures at home. In the first experiment (N = 11), mothers pumped a fasted sample of human milk at 7:00 AM for 7-consecutive days. In the second experiment (N = 33), mothers pumped a fasted sample of human milk at 6:00 AM. Mothers then consumed a standardized meal plus SSB provided by the study team. Thereafter, mothers pumped a non-fasted sample every hour for 6-consecutive hours. Samples were analyzed for nineteen HMOs. One-factor repeated-measures ANOVA was used to test changes in HMOs. RESULTS: There were no significant changes in any of the HMOs over 7-consecutive days, including 2’-fucosyllactose (2’FL) (interaction, P = 0.99), lacto-N-fucopentaose I (LNFPI) (interaction, P = 0.36), disialyl-lacto-N-tetraose (DSLNT) (interaction, P = 0.99), and lacto-N-neotetraose (LNnT) (interaction, P = 0.90). Further, there were no significant changes in any of the HMOs following a standardized meal plus SSB, as 2’FL (interaction, P = 0.12), LNFPI (interaction, P = 0.95), DSLNT (interaction, P = 0.66), and LNnT (interaction, P = 0.67) did not change in response to the diet intervention over 6-consecutive hours. CONCLUSIONS: Our findings reveal that HMOs are stable over one-week during early lactation, and are not acutely affected by maternal food and SSB consumption. FUNDING SOURCES: National Institutes of Health (HD098288, HD080444, and DK056341); Harold Hamm Diabetes Center at the University of Oklahoma Health Sciences Center.

Objective The goal of this study was to examine the associations of maternal weight status before, during, and after pregnancy with breast milk C-reactive protein (CRP) and interleukin 6 (IL-6), two bioactive markers of inflammation, measured at 1 and 3 months post partum. Methods Participants were 134 exclusively breastfeeding mother-infant dyads taking part in the Mothers and Infants Linked for Health (MILK) study, who provided breast milk samples. Pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) were assessed by chart abstraction; postpartum weight loss was measured at the 1- and 3-month study visits. Linear regression was used to examine the associations of maternal weight status with repeated measures of breast milk CRP and IL-6 at 1 and 3 months, after adjustment for potential confounders. Results Pre-pregnancy BMI and excessive GWG, but not total GWG or postpartum weight loss, were independently associated with breast milk CRP after adjustment (β = 0.49, P

SummaryBackground Much is to be learnt about human breast milk (HBM). Objectives The purpose of this study is to extend our knowledge of HBM by investigating the role of maternal body mass index (BMI), sex and stage of lactation (month 1 vs. 6) on HBM insulin, glucose, leptin, IL-6 and TNF-α and their associations with infant body composition. Methods Thirty-seven exclusively breastfeeding infants (n = 37; 16♀, 21♂), and their mothers (19–47 kg m−2) were studied at 1 and 6 months of lactation. Infants had body composition measured (using dual-energy X-ray absorptiometry) and HBM collected. Results A significant interaction between maternal BMI and infant sex on insulin levels (p = 0.0322) was observed such that insulin was 229% higher in obese mothers nursing female infants than in normal weight mothers nursing female infants and 179% higher than obese mothers nursing male infants. For leptin, a significant association with BMI category was observed (p

The copepod Lepeophtheirus salmonis is an obligate ectoparasite of salmonids. Salmon lice are major pests in salmon aquaculture and due to its economic impact Lepeophtheirus salmonis is one of the most well studied species of marine parasite. However, there is limited understanding of how increased concentration of pCO2 associated with ocean acidification will impact host-parasite relationships. We investigated the effects of increased pCO2 on growth and metabolic rates in the planktonic stages, rearing L. salmonis from eggs to 12 days post hatch copepodids under three treatment levels: Control (416 µatm), Mid (747 µatm), and High (942 µatm). The pCO2 treatment had a significant effect on oxygen consumption rate with the High treatment animals exhibiting the greatest respiration. The treatments did not have a significant effect on the other biological endpoints measured (carbon, nitrogen, lipid volume, and fatty acid content). The results indicate that L. salmonis have mechanisms to compensate for increased concentration of pCO2and that populations will be tolerant of projected future ocean acidification scenarios. The work reported here also describes catabolism during the lecithotrophic development of L. salmonis, information that is not currently available to parameterize models of dispersal and viability of the planktonic free-living stages.

BACKGROUND Maternal obesity is a risk factor for childhood obesity; this is a major public health concern given that ∼40% of pregnant women are either overweight or obese. Whether differences in milk composition in lean compared with obese women contribute to childhood obesity is unclear. OBJECTIVES We aimed to analyze relationships between maternal obesity and human milk metabolites, infant body composition, and postnatal weight gain. METHODS This was a prospective study in which mothers intending to breastfeed exclusively, and their newborn infants, were enrolled at delivery (n = 35 mother-infant pairs). We excluded mothers with diabetes, other medical conditions, or pregnancy complications. Participants were grouped by maternal prepregnancy BMI

Overweight and obese women with gestational diabetes mellitus are at increased risk for adverse perinatal outcomes, and they are also more likely to have suboptimal glycemic control. However, there is a paucity of data evaluating whether lower glycemic targets could improve outcomes.To evaluate the feasibility of intensive glycemic control in overweight and obese women with gestational diabetes mellitus.We randomized 60 overweight or obese women with gestational diabetes mellitus, diagnosed between 12 and 32 weeks' gestation to either intensive (fasting90 mg/dL, 1 hour postprandial120 mg/dL) or standard (fasting95 mg/dL, 1 ho postprandial140 mg/dL) glycemic targets. Maternal glucose was assessed in 2 ways: blinded continuous glucose monitors, worn for 5 days at 2 time points (at 12-32 weeks and again at 32-36 weeks), and self-monitored glucose measurement 4 times per day. All women underwent standardized dietary counseling, and medical therapy was prescribed as needed to achieve glycemic control.Between December 2015 and December 2017, we randomized 60 women to either intensive (n = 30) or standard (n = 30) glycemic control. Baseline characteristics including maternal age, body mass index, and gestational age at diagnosis were similar between the intensive and standard groups. Medical therapy was more common in women in the intensive group than those in the standard group (83 vs 57%, P = .02). Women in the intensive glycemic control group had lower glucose values as assessed by continuous glucose monitors at including 24-hour mean (-8.1; 95% confidence interval, -12.0 to -4.3 mg/dL; P .0001) and 1-h postprandial (-11.8; 95% confidence interval, -19.7 to -3.9 mg/dL, P = .004) values. Hypoglycemia60 mg/dL was uncommon and did not differ between groups.Intensive glycemic targets can be used in overweight and obese women with minimal hypoglycemia, and this approach results in improved glycemic control when compared to standard glycemic targets. Further studies are needed to determine whether intensive glycemic targets can improve maternal and neonatal outcomes in high-risk women with gestational diabetes mellitus.NCT02530866; clinicaltrials.gov.

Objective: Postpartum weight retention increases the risk of future obesity and cardiovascular disease. Although exclusive breastfeeding (EBF) has been promoted as an effective means to lose gestational weight gain, previous studies report mixed findings for the relationship between duration of EBF and maternal postpartum weight loss (PPWL). This study evaluates whether meeting the recommended 6-months of EBF is associated with greater PPWL by 6-months than a shorter duration of EBF. Methods: The Mothers and Infants LinKed for Health (MILK) study is an ongoing prospective cohort of non-diabetic, non-smoking mother-infant dyads, all of whom were exclusively breastfeeding at 1-month postpartum. Breastfeeding exclusivity was subsequently self-reported by mothers at 3 and 6-months postpartum. Maternal pre-pregnancy weight and weight at delivery were abstracted from medical records. PPWL was calculated as maternal weight measured at 1, 3 and 6-months minus maternal weight at delivery. Mixed effects linear regression models were used to test the association of duration of EBF with repeated measures of PPWL after adjustment for covariates including maternal pre-pregnancy weight, gestational weight gain, parity, physical activity and infant sex. Results: Among 315 mothers who were exclusively breastfeeding at 1-month, 93% and 75% continued EBF to 3 and 6-months, respectively. By 6-months postpartum, weight loss (least square means ± standard error) was -8.55 ± 1.31 kg among EBF to 1-month, -10.60 ± 0.82 kg among EBF to 3-months and -11.73 ± 0.37 kg among EBF to 6-months (Figure). EBF to 6-months was associated with greater PPWL by 6-months postpartum than EBF to 1 or 3-months (p Conclusion: EBF to 6-months postpartum was associated with greater maternal PPWL than shorter EBF durations. Interventions may promote prolonged EBF as a means of increasing maternal weight loss by 6-months postpartum, but additional research is needed to explore whether these differences persist after weaning.

Maternal pregnancy nutrition influences fetal growth. Evidence is limited, however, on the relationship of maternal diet during pregnancy and lactation on infant postnatal growth and adiposity. Our purpose was to examine associations between maternal diet quality during pregnancy and lactation with offspring growth and body composition from birth to six months. Maternal diet quality was serially assessed in pregnancy and at one and three months postpartum, using the Healthy Eating Index&ndash, 2015 in a cohort of 354 fully breastfeeding mother&ndash, infant dyads. Infant length-for-age (LAZ), weight-for-age (WAZ), and weight-for-length (WLZ) Z-scores were assessed at birth, one, three, and six months. Infant body fat percent (BF%), fat mass (FM), and fat-free mass (FFM) were measured at six months using dual-energy X-ray absorptiometry. Higher maternal diet quality from pregnancy through three months postpartum was associated with lower infant WLZ from birth to six months (p = 0.02) and BF% at six months (p &le, 0.05). Higher maternal diet quality at one and three months postpartum was also associated with lower infant FM at six months (p &lt, 0.01). In summary, maternal diet quality during pregnancy and lactation was inversely associated with infant relative weight and adiposity in early postnatal life. Additional research is needed to explore whether associations persist across the life course.

Objective This narrative review examines six important non-nutritive substances in breast milk, many of which were thought to have little to no biological significance. The overall objective is to provide background on key bioactive factors in breast milk believed to have an effect on infant outcomes (growth and body composition). Methods The evidence for the effects of the following six bioactive compounds in breast milk on infant growth outcomes are reviewed: insulin, leptin, adiponectin, ghrelin, interleukin-6, and tumor necrosis factor-α. Results The existing literature on the effects of breast milk insulin, ghrelin, interleukin-6, and tumor necrosis factor-α and their associations with infant growth and adiposity is sparse. Of the bioactive compounds reviewed, leptin and adiponectin are the most researched. Data reveal that breast milk adiponectin has negative associations with growth in infancy. Conclusions There is a need for innovative, well-designed studies to improve causal inference and advance our understanding in the effects of breast milk and its components on offspring growth and body composition. The recommendations provided, along with careful consideration of both known and unknown factors that affect breast milk composition, will help improve, standardize, and ultimately advance this emergent field.

Background: Evidence linking breastfeeding to reduced risk of developing childhood obesity is inconclusive, yet previous studies have not considered variation in specific components of breast milk that may affect early development. Objective: We examined whether differences in the composition of human milk oligosaccharides (HMOs) correlate with infant growth and body composition at 1 and 6 mo of age. Design: Twenty-five mother-infant dyads were recruited from the University Hospital at the University of Oklahoma Health Sciences Center. Infants were breastfed for 6 mo. Breast-milk and infant measures were obtained at 1 and 6 mo of infant age. HMO composition was analyzed by high-pressure liquid chromatography, and infant growth (length and weight) and body composition (percentage fat, total fat, lean mass) were measured by dual-energy X-ray absorptiometry. Relations between HMOs and infant growth and body composition were examined by using multiple linear regression. A priori covariates included maternal prepregnancy body mass index, pregnancy weight gain, and infant age and sex. Results: Higher HMO diversity and evenness at 1 mo were associated with lower total and percentage fat mass at 1 mo. At 1 mo, each 1-μg/mL increase in lacto-N-fucopentaose (LNFP) I was associated with a 0.40-kg lower infant weight (P = 0.03). At 6 mo, each 1-μg/mL increase in LNFPI was associated with a 1.11-kg lower weight (P = 0.03) and a 0.85-g lower lean mass (P = 0.01). At 6 mo, each 1-μg/mL increase in LNFPI was associated with a 0.79-g lower fat mass (P = 0.02), whereas disialyl-lacto-N-tetraose and LNFPII were associated with a 1.92-g (P = 0.02) and 0.42-g (P = 0.02) greater fat mass, respectively. At 6 mo, each 1-μg/mL increase in fucosyl-disialyl-lacto-N-hexaose and lacto-N-neotetraose was associated with 0.04% higher (P = 0.03) and 0.03% lower (P < 0.01) body fat, respectively. Conclusion: These findings support the hypothesis that differences in HMO composition in mother’s milk are associated with infant growth and body composition. This trial was registered at clinicaltrials.gov as NCT02535637.

Objective To examine the associations of maternal weight status before, during, and after pregnancy with breast milk C-Reactive Protein (CRP) and Interleukin-6 (IL-6), two bioactive markers of inflammation, measured at one and three months postpartum. Methods Participants were 134 exclusively breastfeeding mother-infant dyads taking part in the Mothers and Infants LinKed for Health (MILK) study, who provided breast milk samples. Pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) were assessed by chart abstraction; postpartum weight loss was measured at the one and three month study visits. Linear regression was used to examine the associations of maternal weight status with repeated measures of breast milk CRP and IL-6 at one and three months, after adjustment for potential confounders. Results Pre-pregnancy BMI and excessive GWG, but not total GWG or postpartum weight loss, were independently associated with breast milk CRP after adjustment (β=0.49, p

Background: Air-displacement plethysmography is a good candidate for monitoring body composition in new-borns and young infants, but reference centile curves are lacking that allow for assessment at birth and across the first six months of life. Objective: Using pooled data from four studies, we aimed to produce new charts for assessment according to gestational age at birth (30+1 to 41+6 weeks) and postnatal age at measurement (1 to 27 weeks). Design: The sample comprised 222 preterm infants born in the United States of America (USA) who were measured at birth; 1029 term infants born in Ireland who were measured at birth; 149 term infants born in the USA and 57 term infants born in Italy who were measured at birth, 1 & 2 weeks and 1, 2, 3, 4, 5, & 6 months of age. Infants whose birth weights were 97th centile of the INTERGROWTH-21st standard were excluded, thereby ensuring that the charts depict body composition of infants whose birth weights did not indicate suboptimal fetal growth. Sex-specific centiles for fat mass (kg), fat-free mass (kg), and percentage body fat were estimated using the lambda-mu-sigma (LMS) method. Results: For each sex and measure (e.g., fat mass), the new charts comprise two panels. The first shows centiles according to gestational age, allowing term infants to be assessed at birth and preterm infants to be monitored until they reach term. The second shows centiles according to postnatal age, allowing all infants to be monitored to age 27 weeks. The LMS values underlying these charts are presented, enabling researchers and clinicians to convert measurements to centiles and Z-scores. Conclusions: These charts provide a single tool for the assessment of body composition, according to air-displacement plethysmography, in infants across the first six months of life and will help enhance early-life nutritional management.

Objective: To assess whether body mass index (BMI) provides a better assessment of measured adiposity at age 1 month compared with weight-for-length (WFL). Study design: Participants were healthy term-born infants in the Infant Growth and Microbiome (n = 146) and the Baby Peas (n = 147) studies. Length, weight, and body composition by air displacement plethysmography were measured at 1 month. World Health Organization-based WFL and BMI z-scores were calculated. Within-cohort z-scores of percent fat-Z, fat mass-Z, fat mass/length 2 -Z, fat mass/length 3 -Z, fat-free mass-Z, and fat-free mass/length 2 -Z were calculated. Correlation and multiple linear regression (adjusted for birth weight) analyses tested the associations between body composition outcomes and BMI-Z vs WFL-Z. Quantile regression was used to test the stability of these associations across the distribution of body compositions. Results: The sample was 52% female and 56% African American. Accounting for birth weight, both BMI-Z and WFL-Z were strongly associated with fat mass-Z (coefficients 0.56 and 0.35, respectively), FM/L 2 -Z (0.73 and 0.51), and FM/L 3 -Z (0.79 and 0.58), with stronger associations for BMI-Z compared with WFL-Z (P

OBJECTIVE The aim of this study was to test associations of prepregnancy BMI, gestational weight gain, oral glucose challenge test results, and postpartum weight loss as predictors of breast milk leptin, insulin, and adiponectin concentrations and whether these relationships vary over time. METHODS Milk was collected at 1 and 3 months from 135 exclusively breastfeeding women from the longitudinal Mothers and Infants Linked for Healthy Growth (MILk) study. Hormones were assayed in skimmed samples using ELISA. Mixed-effects linear regression models were employed to assess main effects and effect-by-time interactions on hormone concentrations. RESULTS In adjusted models, BMI was positively associated with milk leptin (P

Aim To determine the effect of childhood obesity and insulin resistance on bone health. Methods We conducted a cross sectional study in pubertal adolescents and young adults 13-20 years old who were either overweight/obese or normal weight. Participants were Tanner 3 or above for pubertal stage, and had fasting blood work done to measure glucose, insulin, C-reactive protein and lipid levels. Homeostatic model of insulin resistance (HOMA-IR) was calculated using the formula (Fasting Blood Glucose *Insulin/405). Body composition and bone mineral density were measured using dual energy X-ray absorptiometry (DXA; Hologic QDR 4500, Waltham, MA, United Kingdom). Results Percent trunk fat was associated inversely with whole body bone mineral content (BMC), whereas HOMA-IR was associated positively with whole body BMC. Conclusion Our results suggest that abdominal adiposity may have an adverse effect on whole body bone parameters and that this effect is not mediated by insulin resistance.

Structural steel-reinforced concrete (SRC) coupling beams are an alternative to conventional and diagonal rebar-reinforced concrete coupling beams. To address gaps in previous testing that was used to develop design recommendations, four large-scale, flexure-yielding, cantilever SRC coupling beams were embedded, without inclusion of auxiliary transfer bars and bearing plates, into reinforced concrete structural walls. Beams were tested by applying quasi-static, reversed-cyclic shear loading to the coupling beam, and moment and shear to the top of the wall to create cyclic tension and compression fields across the embedment region. The primary test variables were the structural steel section embedment length, beam span length (aspect ratio), quantities of wall boundary longitudinal and transverse reinforcement, and applied wall loading (moment, shear, and axial load). Favorable performance, characterized by minimal pinching and asymmetry in the load-deformation response and concentration of damage ...

Using test results presented in previous studies, design and modeling recommendations for steel-reinforced concrete (SRC) coupling beams are provided for both code-based (prescriptive) design approaches and performance-based design approaches. Procedures for computing both nominal and expected (upper bound) moment and shear strengths are described. For embedment, a capacity design approach is recommended in which the provided embedment strength exceeds the expected beam strength. Two approaches are recommended for determination of effective stiffness, one based on using a rigid beam (for flexure and shear) along with an interface rotational spring, since test results from the literature indicate that the majority of the coupling-beam deformations were associated with interface slip/extension, and an alternative approach where the effective stiffness is based on the beam aspect ratio or beam length. Additional parameters are provided to define deformation capacity at significant strength loss (to c...

Practice management guidelines for screening and treatment of patients with blunt cerebrovascular injury (BCVI) have been associated with a decreased risk of ischemic stroke.of patients with BCVI and multisystem injuries that delays immediate antithrombotic therapy remains controversial. The purpose of this study was to determine the timing of BCVI treatment initiation, the incidence of stroke, and bleeding complications as a result of antithrombotic therapy in patients with isolated BCVI in comparison to those with BCVI complicated by multisystem injuries.This study was a retrospective review of all adult blunt trauma patients admitted to a level 1 trauma center from 2009 to 2014 with a diagnosis of BCVI.A total of 28,305 blunt trauma patients were admitted during the study period. Of these, 323 (1.1%) had 481 BCEVIs and were separated into two groups. Isolated BCVI was reported in 111 (34.4%) patients and 212 (65.6%) patients had accompanying multisystem injuries (traumatic brain injury (TBI), solid organ injury, or spinal cord injury) that contraindicated immediate antithrombotic therapy.started in patients with isolated BCVI at a median time of 30.3 (15, 52) hours after injury in contrast to 62.4 (38, 97) hours for those with multisystem injuries (p0.001). The incidence of stroke was identical (9.9%) between groups and no bleeding complications related to antithrombotic therapy were identified.The lack of bleeding complications and equivalent stroke rates between groups suggests that the presence of TBI, solid organ injury, and spinal cord injury are not contraindications to anti-thrombotic therapy for stroke prevention in patients with BCVI.

Dietary sugars have been shown to promote excess adiposity among children and adults; however, no study has examined fructose in human milk and its effects on body composition during infancy. Twenty-five mother–infant dyads attended clinical visits to the Oklahoma Health Sciences Center at 1 and 6 months of infant age. Infants were exclusively breastfed for 6 months and sugars in breast milk (i.e., fructose, glucose, lactose) were measured by Liquid chromatography-mass spectrometry (LC-MS/MS) and glucose oxidase. Infant body composition was assessed using dual-energy X-ray absorptiometry at 1 and 6 months. Multiple linear regression was used to examine associations between breast milk sugars and infant body composition at 6 months of age. Fructose, glucose, and lactose were present in breast milk and stable across visits (means = 6.7 μg/mL, 255.2 μg/mL, and 7.6 g/dL, respectively). Despite its very low concentration, fructose was the only sugar significantly associated with infant body composition. A 1-μg/mL higher breast milk fructose was associated with a 257 g higher body weight (p = 0.02), 170 g higher lean mass (p = 0.01), 131 g higher fat mass (p = 0.05), and 5 g higher bone mineral content (p = 0.03). In conclusion, fructose is detectable in human breast milk and is positively associated with all components of body composition at 6 months of age.

Objectives The correct assessment of energy expenditure in very active individuals is important to ensure that dietary energy intake is sufficient. We aimed to validate a combined heart rate (HR) and motion sensor in estimating total (TEE) and activity energy expenditure (AEE) in males and females with high physical activity levels. Design Cross-sectional. Methods Doubly-labelled water (DLW) was used to assess 7-day TEE in 12 male and female elite junior basketball players, aged 16–17 years. Resting energy expenditure (REE) was assessed with indirect calorimetry and AEE was calculated (AEE = TEE-RMR-0.1 × TEE). Simultaneously, TEE and AEE were measured by combined HR and motion sensing. Individual HR calibration was performed with step-test. TEE and AEE were estimated from accelerometry and HR with individual (ACC + HR step ) and group calibration (ACC + HR group ). Results No mean differences were found between TEE and AEE from the ACC + HR step and ACC + HR group with DLW. TEE values (kJ/day) from ACC + HR group and ACC + HR step explained TEE from DLW by ∼60% and 53%, respectively whereas AEE (kJ/day) estimated by ACC + HR group and ACC + HR step explained 53% and 41% of the variability of AEE from the reference method. Concordance correlation coefficients for TEE and AEE using ACC + HR group were 0.74 and 0.69, correspondingly while for ACC + HR step values of 0.69 and 0.45 were found. Large limits of agreement were found for TEE and AEE using both ACC + HR group and ACC + HR step . Conclusions ACC + HR models are a valid alternative to estimate TEE but not AEE in a group of highly active individuals however the considerable rate of equipment failure (∼50%) limits its usefulness.

Full breastfeeding (FBF) is promoted as effective for losing pregnancy weight during the postpartum period. This study evaluated whether longer FBF is associated with lower maternal postpartum weight retention (PPWR) as compared to a shorter FBF duration. The MILK (Mothers and Infants Linked for Healthy Growth) study is an ongoing prospective cohort of 370 mother&ndash, infant dyads, all of whom fully breastfed their infants for at least 1 month. Breastfeeding status was subsequently self-reported by mothers at 3 and 6 months postpartum. Maternal PPWR was calculated as maternal weight measured at 1, 3, and 6 months postpartum minus maternal prepregnancy weight. Using linear mixed effects models, by 6 months postpartum, adjusted means &plusmn, standard errors for weight retention among mothers who fully breastfed for 1&ndash, 3 (3.40 &plusmn, 1.16 kg), 3&ndash, 6 (1.41 &plusmn, 0.69 kg), and &ge, 6 months (0.97 &plusmn, 0.32 kg) were estimated. Compared to mothers who reported FBF for 1&ndash, 3 months, those who reported FBF for 3&ndash, 6 months and &ge, 6 months both had lower PPWR over the period from 1 to 6 months postpartum (p = 0.04 and p &lt, 0.01, respectively). However, PPWR from 3 to 6 months was not significantly different among those who reported FBF for 3&ndash, 6 versus &ge, 6 months (p &gt, 0.05). Interventions to promote FBF past 3 months may increase the likelihood of postpartum return to prepregnancy weight.

SummaryBackground Detailed measures of infant body composition are needed for understanding the impact of genes and environment on growth early in life. Objective The purpose of this study was to compare the accuracy and bias of body composition in infants. Methods Dual energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI) were used to determine body composition and the trunk depot. The depots measured were total fat mass (FM), total fat-free mass (FFM) and trunk FM and FFM using DXA and MRI in 14 infants. Results None of the regression lines between DXA and MRI significantly deviate from the line of identity for any of the depots studied. However, Bland–Altman analyses revealed bias for trunk FM and trunk FFM. Conclusion Our data showed DXA to be accurate (regression not significantly deviating from the line of identity), with high agreement (indicated by high R2) and without bias (non-significant Bland–Altman) when estimating total FM and FFM. This could not be said for trunk estimates.

No study of coping with climate change is complete without considering geoengineering. Leveraging Tsiolkovsky's and Tsander's 1920s idea to use mirrors for space propulsion, Fuller's 1940s Dymaxion Grid, Glaser's 1970s study of solar power satellites, and Forward's 1970–90s concepts of “statites” and “Starwisps”, we propose placing one or more large (Σarea=700 K km2) lightsail(s) in a radiation-levitated non-Keplerian orbit(s) just sunward of the Sun–Earth Lagrange-1 point. The purpose of this syncretic concept is twofold: (I) As a parasol, it would reduce insolation on Earth by at least one-quarter of a percent, same as that which caused 1.8 °C drop during the “Little Ice Age” (∼1550–1850), and same as the IPCC Third Report's mid-range value for global warming by 2050. Lowering temperature will reduce the atmosphere's water vapor content, which should reverse the increasing frequency and severity of storms, likewise reducing the damage accompanying climate change. It transforms the “solar constant” to a controlled solar variable. The sail would utilize the very photons it diverts from us to maintain its position without expensive fuel. (II) As a ∼100+ K km2 photovoltaic power station, the parasol could displace over 300 EJ/a (∼100 trillion kWh/yr) of fossil-fired electricity for its creators, roughly the entire global demand forecast by 2050, in turn displacing most carbon burners from the terrestrial grid, providing US$trillions in revenue from clean energy sales to amortize the scheme. This approach to geoengineering is not precluded by international treaty, but it is not a panacea either because it does not fix the other consequences of exponentially growing combustion of fossil fuels. However, it would buy time because it is self-funding (“pay-as-you-go”); furthermore it is linear, scalable, minimally intrusive, and above all, reversible. If Tellurian spacefaring civilization bootstraps its exponential growth with lightsails, there might eventually be enough of them to have a detectable effect on Sol's apparent luminosity as seen from far away, similar to the eponymous Dyson Sphere. So we tagged our concept with the moniker “Dyson Dot”.

Simple methods to assess both fat (FM) and fat-free mass (FFM) are required in paediatric populations. Several bioelectrical impedance instruments (BIAs) and anthropometric equations have been developed using different criterion methods (multicomponent models) for assessing FM and FFM. Through childhood, FFM density increases while FFM hydration decreases until reaching adult values. Therefore, multicomponent models should be used as the gold standard method for developing simple techniques because two-compartment models (2C model) rely on the assumed adult values of FFM density and hydration (1.1 g/cm3and 73.2%, respectively). This study will review BIA and/or anthropometric-based equations for assessing body composition in paediatric populations. We reviewed English language articles from MEDLINE (1985–2012) with the selection of predictive equations developed for assessing FM and FFM using three-compartment (3C) and 4C models as criterion. Search terms included children, adolescent, childhood, adolescence, 4C model, 3C model, multicomponent model, equation, prediction, DXA, BIA, resistance, anthropometry, skinfold, FM, and FFM. A total of 14 studies (33 equations) were selected with the majority developed using DXA as the criterion method with a limited number of studies providing cross-validation results. Overall, the selected equations are useful for epidemiological studies, but some concerns still arise on an individual basis.

Excess weight gain during both pre- and postnatal life increases risk for obesity in later life. Although a number of gestational and early life contributors to this effect have been identified, there is a dearth of research to examine whether gestational factors and weight gain velocity in infancy exert independent effects on subsequent body composition and fat distribution. Objective: To test the hypothesis that birth weight, as a proxy of prenatal weight gain, and rate of weight gain before 6 months would be associated with total and truncal adiposity at 12 months of age. Design and Methods: Healthy, term infants (N = 47) were enrolled in the study and rate of weight gain (g/day) was assessed at 0-3 months, 3-6 months, and 6-12 months. Results: Total and regional body composition were measured by dual-energy X-ray absorptiometry (DXA) at 12 months. Stepwise linear regression modeling indicated that lean mass at 12 months, after adjusting for child length, was predicted by rate of weight gain during each discrete period of infancy (P < 0.05), and by maternal pre-pregnancy BMI (P < 0.05). Total fat mass at 12 months was predicted by rate of weight gain during each discrete period (P < 0.01), and by older maternal age at delivery (P < 0.05). Trunk fat mass at 12 months, after adjusting for leg fat mass, was predicted by rate of weight gain from 0-3 months and 3-6 months (P < 0.05). Conclusion: Results suggest that growth during early infancy may be a critical predictor of subsequent body composition and truncal fat distribution.

The objective of this study was to determine the accuracy, precision, bias, and reliability of percent fat (%fat) determined by air-displacement plethysmography (ADP) with the pediatric option against the four-compartment model in 31 children (4.1 ± 1.2 years, 103.3 ± 10.2 cm, 17.5 ± 3.4 kg). %Fat was determined by (BOD POD Body Composition System; COSMED USA, Concord, CA) with the pediatric option. Total body water (TBW) was determined by isotope dilution (2H2O; 0.2 g/kg) while bone mineral was determined by dual-energy X-ray absorptiometry (DXA) (Lunar iDXA v13.31; GE, Fairfield, CT and analyzed using enCore 2010 software). The four-compartment model by Lohman was used as the criterion measure of %fat. The regression for %fat by ADP vs. %fat by the four-compartment model did not deviate from the line of identity where: y = 0.849(x) + 4.291. ADP explained 75.2% of the variance in %fat by the four-compartment model while the standard error of the estimate (SEE) was 2.09 %fat. The Bland—Altman analysis showed %fat by ADP did not exhibit any bias across the range of fatness (r = 0.04; P = 0.81). The reliability of ADP was assessed by the coefficient of variation (CV), within-subject SD, and Cronbach's α. The CV was 3.5%, within-subject SD was 0.9%, and Cronbach's α was 0.95. In conclusion, ADP with the pediatric option is accurate, precise, reliable, and without bias in estimating %fat in children 2–6 years old.

Background Cardiovascular disease is seen at a younger age and at a higher prevalence in patients with type 1 diabetes than in the general population. It is well described that women with type 1 diabetes have a higher relative risk of cardiovascular disease than men with type 1 diabetes, unlike that seen in the general population. The pathophysiology behind this is unknown. Objective We performed a cross-sectional study to examine sex differences in cardiovascular disease risk factors in adolescents with type 1 diabetes between ages 13 and 20 years, compared with children of a similar age without type 1 diabetes. Methods All patients underwent a dual energy x-ray absorptiometry scan to measure body composition and a pulse wave test measure of arterial elasticity. Fasting serum lipid levels, apolipoprotein B, and apolipoprotein C-III levels were measured in each patient. Twenty-nine children with type 1 diabetes (10 girls, 19 boys) and 37 healthy children (18 girls, 19 boys) participated. Results Although no sex differences for body mass index ( P = 0.91) and glycosylated hemoglobin ( P = 0.69) were seen, girls with type 1 diabetes had a significantly higher percent trunk fat compared with boys ( P = 0.004). No sex differences were found ( P > 0.05) for percent trunk fat in adolescents without diabetes. There was no sex difference among any other cardiovascular risk factors in either children with or without diabetes. Conclusions Female adolescents with type 1 diabetes have more centrally distributed fat, which may contribute to their relatively higher cardiovascular disease risk. Attenuation of the central distribution of fat through exercise and dietary modifications may help ameliorate their subsequent cardiovascular disease burden.

Numerous appetite, growth, obesity-related hormones and inflammatory factors are found in human breast-milk, but there is little evidence on their relationship with infant body composition. The purpose of the present cross-sectional pilot study was to assess the cross-sectional associations of appetite-regulating hormones and growth factors (leptin, insulin, glucose) and inflammatory factors (IL-6 and TNF-α) in human breast-milk with infant size, adiposity, and lean tissue at 1-month of age in healthy term infants. Human breast-milk was collected from nineteen exclusively breast-feeding mothers using one full breast expression between 8:00 and 10:00 am. The milk was then mixed, aliquoted, stored at −80°C and then centrifuged to remove the milk fat, prior to analyses using commercially available immunoassay kits; milk analytes were natural log transformed prior to analysis. Infant body composition was assessed using a Lunar iDXA v11-30.062 scanner (Infant whole body analysis enCore 2007 software, GE, Fairfield, CT). Maternal pre-pregnancy BMI was positively associated with milk leptin concentration (p=0.0027), and so maternal-BMI-adjusted Spearman correlations were examined between breast-milk analytes and infant growth and body composition variables. As previously reported, greater milk leptin was associated with lower BMIZ (r= −0.54, p=0.03). Glucose was positively associated with relateive weight (r = 0.6, p=0.01), and both fat and lean mass (0.43 – 0.44, p

Obesity is a topic on which many views are strongly held in the absence of scientific evidence to support those views, and some views are strongly held despite evidence to contradict those views. We refer to the former as "presumptions" and the latter as "myths." Here, we present nine myths and 10 presumptions surrounding the effects of rapid weight loss; setting realistic goals in weight loss therapy; stage of change or readiness to lose weight; physical education classes; breastfeeding; daily self-weighing; genetic contribution to obesity; the "Freshman 15"; food deserts; regularly eating (versus skipping) breakfast; eating close to bedtime; eating more fruits and vegetables; weight cycling (i.e., yo-yo dieting); snacking; built environment; reducing screen time in childhood obesity; portion size; participation in family mealtime; and drinking water as a means of weight loss. For each of these, we describe the belief and present evidence that the belief is widely held or stated, reasons to support the conjecture that the belief might be true, evidence to directly support or refute the belief, and findings from randomized controlled trials, if available. We conclude with a discussion of the implications of these determinations, conjecture on why so many myths and presumptions exist, and suggestions for limiting the spread of these and other unsubstantiated beliefs about the obesity domain.

Type 1 diabetes (T1D) is a risk factor for cardiovascular disease. However, it is unclear whether increased body weight amplifies that risk in T1D patients. This is a cross-sectional study examining the presence of cardiovascular risk factors in normal and overweight children, both with and without T1D. Sixty-six children (aged 16±2.2 years) were included in one of the following groups: (T1D and normal weight, T1D and overweight, healthy and normal weight, and healthy and overweight). A fasting blood sample was analyzed for lipid profile (triglyceride, cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol), apolipoprotein B (apoB), and apolipoprotein C-III (apoC-III) levels. Body composition was determined by dual energy x-ray absorptiometry and vascular elasticity by HDI/Pulsewave CR-2000 (Hypertension Diagnostics, Eagan, MN). Statistical analyses examined the effect of T1D and body weight status and their interactions on cardiovascular risk parameters. In this study, the authors were unable to demonstrate an additive effect of body weight status and T1D on cardiovascular risk profile. However, subgroup analysis of patients with T1D revealed higher apoC-III levels in overweight patients with T1D (P=.0453) compared with normal-weight diabetic children. Most notably, there was a direct relationship of small artery elasticity to body weight status. This seemingly paradoxical observation supports recent data and warrants further investigation. J Clin Hypertens (Greenwich). 2011;13:351–356. ©2010 Wiley Periodicals, Inc.

Early development of the percentage of fat and muscle is rarely considered, but is important because excessive fat is related to the development of diabetes and other morbidities later in life. In pediatric medicine, there are few to no data comparing sex differences in body composition in the first months of life despite the fact that males are typically longer and weigh more than girls at birth.The purpose of this study was to determine whether observed sex differences in body composition at birth persist through the first 6 months of life.Participants were healthy, full-term, male and female newborns. Children throughout the Oklahoma City, Oklahoma, metropolitan area were enrolled. The inclusion criteria were: mothers aged 18 to 45 years at the time of delivery; a term pregnancy lastingor=37 weeks of gestation (determined by mother's physician); weight adequate for gestational age; and a hospital stay for the infant of3 days following delivery. The exclusion criteria were: maternal tobacco use or alcohol consumption (1 drink per week) during pregnancy; gestational diabetes; preeclampsia; and infants with presumed or known congenital birth defects. Baseline assessment at birth included length and weight. Newborns had their body composition (percent fat [%fat], total fat, and fat-free mass) determined at approximately 1 month of age using whole body plethysmography. Mothers were invited to have their children take part in a 5-month extension that conducted additional body composition measurements at 3 and 6 months of age.Sixty-four girls (mean [SD] age at time of testing, 20.9 [7.9] days; birth weight, 3500 [388] g; birth length, 49.9 [2.4] cm; white race, 73.4%) and 53 boys (mean age at time of testing, 20.2 [7.3] days; birth weight, 3353 [413] g; birth length, 51.0 [2.4] cm; white race, 69.8%) were assessed and included in the study. At birth, girls were significantly shorter and weighed more than boys (both, P0.05). At ~1 month of age, body composition revealed that girls had significantly greater %fat (15.1% vs 12.7%; P0.05) and less fat-free mass (3182 [303] vs 3454 [361] g; P0.001) than did boys. At 3 months of age, girls continued to have significantly less fat-free mass (4379 [347] vs 4787 [310] g; P0.01) than did boys; however, by 6 months of age, no significant sex difference was observed in any body composition variable studied.In this small sample of healthy, full-term newborns, at ~1 month of age, statistically significant differences in %fat and fat-free mass existed between girls and boys; however, by 6 months of age, these differences no longer existed.

Background: Few studies have examined physical activity during the transition from high school to college. Purpose: To examine changes in physical activity and physical activity patterns among females during the transition from high school to college. Methods: Sixty-nine females (age 18.2±0.4 years; body mass index 21.8±2.6 kg/m2; 84% Caucasian) at a large university in the south central United States participated in this prospective longitudinal study. They completed a questionnaire at the beginning of their freshman and sophomore years of college, recalling their participation in physical activity during the previous 12 months. Results: Weekly time spent in moderate, vigorous, and moderateto-vigorous physical activity declined between high school and college (p

Background:Women’s understanding of “moderate-intensity” physical activity (MPA) as presented in the media is not well-understood. This study assessed whether women who are presented a mass-media message about MPA can demonstrate a moderate-intensity walking pace without practicing this pace first.Methods:Insufficiently active women (n = 75, age 40 ± 12 years, 76% White) were shown a mass-media description of a MPA recommendation. Forty-one were randomized to also practice a moderate-intensity (55%−70% of maximum heart rate) walk. One month later, participants were asked to demonstrate a 10-minute moderate-intensity walk. Groups were compared on the proportion of participants who walked ≥10 minutes at a moderate intensity.Results:At posttest, more participants who received practice at baseline walked at a moderate-intensity ≥10 minutes than those who received no practice (P < .05).Conclusion:To understand MPA, it is not enough to simply hear and read a description of MPA. It is essential to practice MPA.

College students and young adults are experiencing the greatest increases in rates of obesity, and 20% of college students are classified as obese. The objective of this study was to compare changes and rates of change in body weight and body composition between the freshman academic year and the summer after the freshman year among female college students.Participants were recruited early in their freshman year of college to participate in a prospective longitudinal study examining changes in body weight and composition over the college years. Height and weight were measured, and body composition was assessed using dual energy x-ray absorptiometry (DEXA) at the beginning and end of the freshman year. Upon return from the summer for their sophomore year, participants returned to have all measurements repeated. Sixty-nine female participants completed all three visits.Body weight increased 1.3 kg during the academic period and an additional 0.1 kg during the summer period. Body mass index (BMI) increased between the first two visits but did not change between the last two visits. However, percent fat increased at each visit. Fat-free mass significantly increased 0.5 kg over the academic year but decreased by 1.1 kg over the summer (p0.05). Greater rates of change were detected in percent fat, fat-free mass, and BMI during the summer compared with the academic year (p0.05).Differences in body composition between the academic and summer periods may reflect changes in living situations between these periods. Unfavorable changes during the summer suggest the need to promote healthy lifestyles to freshman women before they leave campus for the summer.

This study was designed to compare measured and predicted thoracic gas volume (V (TG)) after weight loss and to analyze the effect of body composition confounders such as waist circumference (WC) on measured V (TG) changes.Prospective intervention study.Outpatient University Laboratory, Lisbon, Portugal.Eighty-five overweight and obese women (body mass index = 30.0+/-3.5 kg/m(2); age = 39.0+/-5.7 years) participating in a 16-month university-based weight control program designed to increase physical activity and improve diet.Body weight (Wb), body volume (Vb), body density (Db), fat mass (FM), percent fat mass (%FM) and fat-free mass (FFM) were assessed by air-displacement plethysmography (ADP) at baseline and at post-intervention (16 months). The ADP assessment included a protocol to measure V (TG) and a software-based predicted V (TG). Dual-energy X-ray absorptiometry (DXA) (Hologic QDR 1500) was also used to estimate FM, %FM and FFM. Maximal oxygen uptake (VO(2) max) was assessed with a modified Balke cardiopulmonary exercise testing protocol with a breath-by-breath gas analysis.Significant differences between the baseline and post-weight loss intervention were observed for body weight and composition (Vb, Db, %FM, FM and FFM), and measures of V (TG) (measured: Delta=0.2 l, P0.001; predicted: Delta=0.01 l, P0.010) variables. Measured V (TG) change was negatively associated with the change in the WC (P=0.008), controlling for VO(2) max and age (P=0.007, P=0.511 and P=0.331). Linear regression analysis results indicated that %FM and FM using the measured and predicted V (TG) explained 72 and 76%, and 86 and 90% respectively, of the variance in %FM and FM changes using dual-energy x-ray absorptiometry.After weight loss, measured V (TG) increased significantly, which was partially attributed to changes is an indicator of body fat distribution such as WC. Consequently, measured and predicted V (TG) should not be used interchangeably when tracking changes in body composition. The mechanisms relating the reduction of an upper body fat distribution with an increase measured V (TG) are worthy of future investigation.

The aim of the study was to evaluate air-displacement plethysmography (ADP) thoracic gas volume (TGV) prediction equations in children representing a wide range of body mass index (BMI).254 children (5 to 17 years) were recruited from two centres (England and the United States). Subjects were stratified into three BMI categories according to the International Obesity TaskForce (IOTF) criteria: lean (48 male, 42 female), overweight (15 male, 29 female), and obese (52 male, 68 female). As part of the normal ADP procedure, TGV was measured (TGV(Meas)), predicted using child specific equations developed by Fields (TGV(Fields)) and adult derived equations by Crapo (TGV(Crapo)) with percentage body fat (PF) estimates subsequently calculated (PF(Meas), PF(Fields), PF(Crapo)).Compared with the mean TGV(Meas), the TGV(Fields) estimates were within+/-0.2 L in all groups, except obese males (+0.5 L), while the mean TGV(Crapo) estimates were greater than+/-0.3 L in all groups except lean males (+0.1 L). When converted to PF, the mean PF(Fields) estimates were within+/-1% of the measured value in all groups, except obese males (+1.1%), while the mean PF(Crapo) estimates were greater than+/-1% in all groups, except lean males (+0.5%). Using either prediction equation, Bland-Altman analysis revealed that the greatest PF+/-95% limits of agreement were in the lean and overweight groups and lowest in the obese groups.The Fields child-specific TGV prediction equations provide accurate mean PF estimates and appear better than using the Crapo equations if a measured TGV cannot be achieved in children of a wide range of BMI. However, individual predictions may result in large PF errors especially in lean children.

Infant formulas provide more protein than breast milk. High protein intakes may place infants at risk of later obesity. The present study tested whether a formula with protein content below the regulatory level supports normal growth from age 3 months.Randomized double-blind trial enrolled healthy infants less than age 3 months. At 3 months, formula-fed infants were assigned to experimental (EXPL, 1.61 g protein/100 kcal; modified bovine whey proteins with caseinoglycomacropeptide removed) or control (CTRL 2.15 g protein/100 kcal; unmodified bovine milk protein with a whey/casein ratio of 60/40) formula; breast-fed (BF) infants were enrolled in a reference group. Complementary foods were allowed in small amounts from 4 to 6 months and unrestricted after 6 months.Weight gain (g/day) from 3 to 6 months was similar in the EXPL and CTRL groups (EXPL-CTRL -0.84 g/day; 95% confidence interval -2.25 to 0.57) and faster in the EXPL and CTRL groups than in the BF group. Weight analyzed longitudinally from 4 to 12 months was lower in the EXPL group than in the CTRL group (P = 0.031) but higher than in the BF group (P 0.0001). Longitudinal analysis of odds ratios from 4 to 12 months indicated fewer infants with weight85th percentile in the EXPL group than in the CTRL group (P = 0.015). Length z scores were lower than, and body mass index z scores were similar to, World Health Organization Standards in all of the groups. Serum biochemical parameters in the EXPL group reflected lower protein intake and were closer to parameters in the BF infants than in the CTRL group.A formula with 1.61 g of protein/100 kcal supports normal growth of infants after age 3 months. This protein content is adequate if provided from a high-quality source.