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Introduction Women and infants are among the most vulnerable groups for micronutrient deficiencies. Pregnancy micronutrient status can affect birth outcomes and subsequent infants' growth. Methods We determined the relationship between maternal iron and vitamin A status at delivery using several biomarkers (ferritin, soluble transferrin receptor [sTFR], body iron stores [BIS], hemoglobin and retinol binding protein [RBP]) and birth outcomes (body weight, Z-scores, head circumference, small-for-gestational-age and preterm birth) in rural Uganda. We investigated women who had serum results at the point of delivery and paired them to their infants at birth (n = 1244). We employed multivariable linear and logistic regression, adjusting for clustering at the subcounty level to determine the relationship between maternal micronutrients and birth outcomes. Results After adjusting for relevant factors, we found that maternal iron status (ferritin and BIS) and anemia (hemoglobin) were not significantly associated with the assessed birth outcomes. However, there was a significant association between serum sTFR and preterm births (AOR: 0.67; 95% CI 0.48-0.94). For Vitamin A, we observed a significant positive association between RBP and length-for-age (LAZ) at birth ([beta] = 0.12, p < 0.030). Discussion These findings indicate that the relationship between maternal iron status and birth outcomes needs to be further investigated, because depending on the biomarker used the associations were either in favor of an adverse birth outcome or not significant. Additionally, they confirm that higher maternal RBP levels could be beneficial for birth outcomes. Clinicaltrials.gov as NCT04233944., Author(s): Julieta Mezzano [sup.1] , Grace Namirembe [sup.1] , Lynne M. Ausman [sup.1] , Elizabeth Marino-Costello [sup.1] , Robin Shrestha [sup.1] , Juergen Erhardt [sup.2] , Patrick Webb [sup.1] , [...]

Recommendations for decreasing the risk of developing cardiovascular disease include increasing the intake of plant sterols and fish oil. The cholesterol-lowering action of plant sterols, when provided in a fish-oil fatty acids vehicle, remains to be investigated in humans. A randomized, crossover-feeding, single-blind trial was conducted in 30 subjects with mild-to-moderate hypercholesterolemia to study the effects on plasma lipids of 2 novel forms of plant sterols: those combined with, or esterified to, fish-oil fatty acids. The treatments were margarine (control), free plant sterols, plant sterols esterified to fatty acids from sunflower oil, plant sterols esterified to very long-chained fatty acids from fish oil, and plant sterols combined with the same amount of very long-chained fatty acids from fish oil. Each sterolcontaining food (1.0-1.8 g plant sterols/d) was consumed for 29 d as a single dose with breakfast under staff supervision. Compared with the control treatment, none of the plant sterol preparations reduced plasma total cholesterol or LDL cholesterol, triacylglycerol, apolipoprotein A-I, apolipoprotein B, lipoprotein (a), or C-reactive protein concentration. Relative to the control phase, all plant sterols treatment increased the plasma HDL cholesterol concentration (P < 0.05) by ~8%. In conclusion, because standard forms of plant sterols did not reduce plasma cholesterol concentrations, the efficacy of the new formulation of plant sterols cannot be confirmed from the 3resent study design, where plant sterols were given as a single morning dose. KEY WORDS: * plant sterols * fish oil * plant sterol--fish-oil ester * single dose

Objective Describe the level of registered dietitian (RD) involvement in neonatal intensive care units (NICUs) and associations with NICU nutrition practices. Design Questionnaires were mailed to 820 NICUs in the United States with two follow-up mailings to nonresponders. Abbreviated phone surveys were conducted with a random sample of 10% of nonresponders. A nutrition care score was devised based on a sum of 10 survey questions (range 0 to 10) to summarize the intensity of reported practices. Subjects/setting Directors of NICUs in the United States and RDs associated with them. Statistical analyses [chi square], analysis of variance, Bonferroni and Duncan multiple range tests, regression. Results Respondents from 417 (54%) of the 772 NICUs eligible for the study provided completed questionnaires. Among NICUs responding, 76% involved RDs in care (41% employed full- or part-time RDs, 35% employed consult RDs), and 24% had no RD. NICUs with full- or part-time RDs provided fewer kilocalories and more protein parenterally, and more kilocalories and protein enterally. NICUs with less RD involvement were more likely to provide full-term infant feedings (eg, unfortified breast milk, full-term formula) to very-low-birth-weight infants. Mean nutrition care score varied with RD involvement from 4.6[+ or -]1.7 (mean[+ or -]standard deviation) for NICUs with a consult RD and 4.7 [+ or -] 1.4 for NICUs employing no RD to 5.6[+ or -]1.7 for NICUs with a full- or part-time RD (overall P<.001). Conclusions More involvement of RDs in NICUs increased the intensity of important aspects of nutrition care that may improve outcomes of very-low-birth-weight infants in NICUs. These findings highlight the importance of RDs as NICU team members. J Am Diet Assoc. 2005;105:1224-1230.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2005.05.012 Byline: Irene E. Olsen, Douglas K. Richardson, Christopher H. Schmid, Lynne M. Ausman, Johanna T. Dwyer Abstract: Describe the level of registered dietitian (RD) involvement in neonatal intensive care units (NICUs) and associations with NICU nutrition practices.

We assessed the independent effect of soy protein relative to animal protein and of isoflavones on various electrophoretic characteristics of LDL particles. LDL particles were characterized by polyacrylamide gradient gel electrophoresis in 36 moderately hypercholesterolemic men and women (LDL cholesterol > 3.36 mmol/L). All subjects consumed in random order each of the four diets (soy protein depleted of isoflavones, soy protein enriched in isoflavones, animal protein with no added isoflavones, and animal protein with added isoflavones) for 6 wk. Consumption of soy protein was associated with a larger LDL peak particle size relative to animal protein (P < 0.01). Soy protein also decreased the cholesterol levels in LDL < 25.5 nm by 12.3% (P < 0.001) and increased cholesterol levels in LDL > 26.0 nm by 14.3% (P < 0.05) relative to animal protein. Isoflavones did not affect these LDL particle characteristics. Soy protein shifted LDL particle distribution to a less atherogenic pattern and this effect is independent of soy's isoflavone component. KEY WORDS: * soy protein * isoflavones * lipoproteins * lipids * LDL size

Objective. To explain differences in weight growth velocity of extremely premature infants among 6 level III neonatal intensive care units (NICUs). Methods. In 6 NICUs, we studied 564 infants, stratified by gestational age (GA), who were first admissions, survivors, Results. Weight growth velocities varied significantly among the 6 NICUs. Adjustment for case mix and medical factors explained little of this variability, but additional control for calorie and especially protein intake accounted for much of the intersite variability. For the average infant, adjusted growth velocity ranged from 10.4 to 14.3 g/kg/d among the sites studied. The final predictive model, including case mix and medical and nutritional factors, explained 53% of the overall variance in growth velocity. Prolonged ([greater than or equal to]15 days) exposure to postnatal steroids and greater severity of illness both decreased growth velocity. The model predicted that adding 1 g/kg/d protein to the mean intake for our sample would increase growth by 4.1 g/kg/d. Conclusions. Variation in nutrition explained much of the difference in growth among the NICUs studied. Mean intake of calories and protein failed to meet recommended levels, and the average growth in only 1 NICU approximated intrauterine growth standards. Increasing nutritional intake into the recommended ranges, in particular of protein, may increase growth of extremely premature infants up to or above intrauterine rates. Pediatrics 2002;110:1125-1132; premature infants, growth, transfer bias, case mix, nutrition, protein, steroids, SNAP., ABBREVIATIONS. NICU, neonatal intensive care unit; NEC, necrotizing enterocolitis; GA, gestational age; VLBW, very low birth weight; SNAP, Score for Neonatal Acute Physiology; CI, confidence interval. It is difficult to [...]