Fat and cholesterol in the diet of infants and young children: implications for growth, development, and long-term health

Dietary exposure assessment of infant formula and baby foods' oxidized lipids in the US population

Baby Foods (BFs) and Infant formulas (IFs) are the main sources of nutrition for an infant throughout the 1st year of life. Various enriched products are commercially available for parents seeking to fulfill their baby's nutritional needs. Consequently, different bioactive lipids are present in BFs and IFs, including dietary oxysterols (DOxS), whose known toxicity has been associated with mutagenicity, cancer, and other chronic diseases. In this work, we performed an exposure assessment of 25 bioactive lipids on IFs (n = 30) and BFs (n = 13) commercially available in the US. To determine dietary exposure, we used EPA's SHEDS-HT probabilistic model. Even though β-Sitosterol was the most exposed bioactive lipid with 75,410 μg/day, cholesterol was the most absorbed compound during the entire first year (19.3 mg/day). Additionally, we found 7α-hydroxycholesterol (7α-OH) as a potential DOxS biomarker of the BFs manufacturing process. This is the first time an infant's exposure assessment (including DOxS) after BFs and IFs consumption is performed, enabling much-needed information regarding these hazardous compounds and their potential effects on infants' health.

A Nutritional Comparison of Cow's Milk and Alternative Milk Products

OBJECTIVE

Alternative milk products are becoming more visible and popular, but nutrient data to compare these products to traditional cow's milk are not easily accessible. By summarizing this nutritional information, this project aims to help primary care providers take better care of their patients by providing easy to access nutritional comparison between cow's milk and milk alternatives such as plant-based milks and goat's milk.

METHODS

This project uses data from the United States Department of Agriculture's Food Data Central database and publicly available nutrition label data to compare the nutritional content of selected milk.

RESULTS

Almond and oat milks provide less than half of the protein provided by soy, goat's, and cow's milk. Goat's milk contains the most fat of the products surveyed, while skim milk contains the lowest fat per serving. Soy milk, almond milk, and oat milk contain at least half the fat of cow's milk. Almond milk contained the most calcium of the milks surveyed. Quantities of folate and vitamin B12 were most notably decreased in goat's milk and almond milk while soy milk had almost double the amount of folate and vitamin B12 present in cow's milk.

CONCLUSION

Cow's milk still remains the best source of fats, protein, and micronutrients. For parents who prefer an alternative to cow's milk, the child's health should be considered. Parents may consider nutrition information when making decisions for their families, and primary care pediatricians should be able to provide current nutritional data on frequently advertised products.

The Lipid and Glyceride Profiles of Infant Formula Differ by Manufacturer, Region and Date Sold

We tested the hypothesis that the lipid composition of infant formula is consistent between manufacturers, countries and target demographic. We developed techniques to profile the lipid and glyceride fraction of milk and formula in a high throughput fashion. Formula from principal brands in the UK (2017-2019; bovine-, caprine-, soya-based), the Netherlands (2018; bovine-based) and South Africa (2018; bovine-based) were profiled along with fresh British animal and soya milk and skimmed milk powder. We found that the lipid and glyceride composition of infant formula differed by region, manufacturer and date of manufacture. The formulations within some brands, aimed at different target age ranges, differed considerably where others were similar across the range. Soya lecithin and milk lipids had characteristic phospholipid profiles. Particular sources of fat, such as coconut oil, were also easy to distinguish. Docosahexaenoic acid is typically found in triglycerides rather than phospholipids in formula. The variety by region, manufacturer, date of manufacture and sub-type for target demographics lead to an array of lipid profiles in formula. This makes it impossible to predict its molecular profile. Without detailed profile of the formula fed to infants, it is difficult to characterise the relationship between infant nutrition and their growth and development.

Oral administration of dibutyryl adenosine cyclophosphate improved growth performance in weaning piglets by enhancing lipid fatty acids metabolism

Dibutyryl adenosine cyclophosphate (dbcAMP-Ca), an analog of cyclic adenosine monophosphate (cAMP), plays greater roles in regulating physiological activities and energy metabolism than cAMP. The aim of this study was to investigate the effect of oral administration of dbcAMP-Ca on growth performance and fatty acids metabolism in weaning piglets. A total of 14 early weaning piglets (7 ± 1 d of age, 3.31 ± 0.09 kg, Landrace × Large White × Duroc) were randomly divided into 2 groups: control group and dbcAMP-Ca group, and the piglets received 7 mL of 0.9% NaCl or 1.5 mg dbcAMP-Ca dissolved in 7 mL of 0.9% NaCl per day for 10 d, respectively. The results showed that the average daily gain (ADG) increased by 109.17% (P < 0.05) in the dbcAMP-Ca group compared with the control group. Besides, dbcAMP-Ca significantly decreased blood high density lipoprotein cholesterol (HDLC) concentration (P < 0.05) and significantly increased blood low density lipoprotein cholesterol (LDLC) concentration (P ＜ 0.05) compared with the control group. Further, liver C18:2n6t content significantly increased in dbcAMP-Ca group (P < 0.05) compared with the control group. With the increase of C18:2n6t content, the mRNA expression levels of peroxisome proliferator-activated receptor α (PPARα) and hormone sensitive glycerol three lipase (HSL), of which genes are related to lipid metabolism, were also significantly increased (P < 0.05 or P < 0.01). All of the results indicated that dbcAMP-Ca improved the ADG, which was probably done by regulating fatty acids metabolism in the liver of weaning piglets.

Synthesis of long-chain fatty acid derivatives as a novel anti-Alzheimer's agent

In order to develop new drugs for Alzheimer's disease, we prepared 17 fatty acid derivatives with different chain lengths and different numbers and positions of double bonds by using Wittig reaction and stereospecific hydrogenation of triple bonds as key reactions. Among them, (4Z,15Z)-octadecadienoic acid (10) and (23Z,34Z)-heptatriacontadienoic acid (16) showed the most potent neurite outgrowth activities on Aβ(25-35)-treated rat cortical neurons, which activities were comparable to that of a positive control, NGF. Both fatty acids 10 and 16 possess two (Z)-double bonds at the n-3 and n-14 positions, which might be important for the neurite outgrowth activity.

Attitudes and practices of family paediatricians in Italy regarding infant feeding

AIM

  The aim of this study was to examine attitudes and practices of family paediatricians in Italy towards infant feeding.

METHODS

  A questionnaire was sent to 850 paediatricians across Italy, asking about attitudes and practices towards infant feeding with focus on the World Health Organization's criteria.

RESULTS

  The response rate was 91.2%. Breastfeeding is recommended for 6-11 months (70.6%) or longer (29.4%). A 95% of paediatricians recommend introducing complementary foods throughout 4-5.9 months. Among paediatricians who give indications about the minimum acceptable diet (61.7%), recommendations agree with WHO in 71.3% and 83.3% of cases for infants aged 6-8 or 9-11 months, respectively. A 95.6% of paediatricians recommend consumption of meat for infants aged 6 months or more, and 98.4% use of formula milk for infants having breastfeeding stopped in the first year of life. Paediatricians reported own experience (73.4%) and reading (54.2%) as main sources of information. A 70% of paediatricians know the WHO/Infant and Young Child Feeding Practices criteria regarding breastfeeding but <5% the complementary feeding indicators.

CONCLUSION

  Family paediatricians in Italy have positive disposition towards infant feeding but their knowledge and practices are suboptimal with respect to the WHO criteria, especially regarding complementary feeding.

Screening of selected food and medicinal plant extracts for pancreatic lipase inhibition

Lipids are important components in human nutrition; however, their increased intake contributes to the development of obesity and can lead to multiple long-term complications. Pancreatic lipase (triacylglycerol acylhydrolase, EC 3.1.1.3) is a key enzyme for the absorption of dietary triglycerides. Interference with fat hydrolysis results in the reduced utilization of ingested lipids, therefore inhibition of lipases decreases fat absorption. Extracts from 106 species of medicinal plants, vegetables and fruits were screened for potential lipase inhibitory activity. p-Nitrophenylpalmitate and 5-bromo-4-chloro-3-indoxylpalmitate were used as substrates in an in vitro test with crude porcine pancreatic lipase. Bearberry (Arctostaphylos uva-ursi), garden pea (Pisum sativum), Norway spruce (Picea abies) and large-leaved lime (Tilia platyphyllos) extracts were the most active. Additionally, the activity of selected extracts with removed polyphenols was measured. Extracts of bearberry, garden pea and large-leaved lime are a promising source for developing functional foods or isolating active compounds.

Food and nutrient intakes of 9-month-old infants in Adelaide, Australia

OBJECTIVE

To describe the food and nutrient intakes of 9-month-old infants.

DESIGN

A survey undertaken as part of a longitudinal study of child growth and development. Infant diet was characterised through a structured interview in which consumption frequency and portion size of foods were obtained. This method was compared with a 4 d diary and had adequate relative validity.

SETTING

Adelaide, Australia.

SUBJECTS

Three hundred and forty-one infants for whom dietary data were plausible according to pre-specified criteria.

RESULTS

At 9 months of age, the median body weights for 161 girls and 180 boys were 8.8 and 9.6 kg, respectively. Differences in intakes between boys and girls largely reflected differences in size. Median daily energy intake was 3541 kJ and median contributions of protein, fat and carbohydrate to total energy were 13 %, 36 % and 50 %. Using published Estimated Average Requirements, Zn intake was inadequate for <1 % of children not breast-fed at this age while Fe intake was inadequate for 9 %. Infants who were still breast-fed (35 %) had more diversity in the foods that provided additional energy, compared with those not receiving breast milk, and were less likely to consume nutrient-displacing drinks such as juice or cordial. Cow's milk was the main drink for 5 % of infants.

CONCLUSIONS

In a group of Australian-born children, an important proportion had weaning diets that were low in Fe. Fat intake of many children was below current recommendations and cow's milk was the main milk source for a small minority.

Abnormal neurological responses in young adult offspring caused by excess omega-3 fatty acid (fish oil) consumption by the mother during pregnancy and lactation

Consuming omega-3 fatty acids (omega-3 FA) during pregnancy and lactation benefits fetal and infant brain development and might reduce the severity of preterm births by prolonging pregnancy. However, diets that are relatively rich in omega-3 FA can adversely affect fetal and infant development and the auditory brainstem response (ABR), a measure of brain development and sensory function. We previously examined the offspring of female rats fed excessive, adequate or deficient amounts of omega-3 FA during pregnancy and lactation. The 24-day-old offspring in the Excess group, compared to the Control group, had postnatal growth retardation and poor hearing acuity and prolonged neural transmission times as evidenced by the ABR. The Deficient group was intermediate. The current study followed these offspring to see if these poor outcomes persisted into young adulthood. Based on prior findings, we hypothesized that the Excess and Deficient offspring would "catch-up" to the Control offspring by young adulthood. Female Wistar rats received one of the three diet conditions from day 1 of pregnancy through lactation. The three diets were the Control omega-3 FA condition (omega-3/omega-6 ratio approximately 0.14), the Excess omega-3 FA condition (omega-3/omega-6 ratio approximately 14.0) and Deficient omega-3 FA condition (omega-3/omega-6 ratio approximately 0% ratio). The Control diet contained 7% soybean oil; whereas the Deficient and Excess omega-3 FA diets contained 7% safflower oil and 7% fish oil, respectively. One male and female offspring per litter were ABR-tested as young adults using tone pip stimuli of 2, 4, 8 and 16 kHz. The postnatal growth retardation and prolonged neural transmission times in the Excess and Deficient pups had dissipated by young adulthood. In contrast, the Excess group had elevated ABR thresholds (hearing loss) at all tone pip frequencies in comparison to the Control and Deficient groups. The Deficient group had worse ABR thresholds than the Control group in response to the 8 kHz tone pips only. The Excess group also had ABR amplitude-intensity profiles suggestive of hyperacusis. These results are consistent with the Barker hypothesis concerning the fetal and neonatal origins of adult diseases. Thus, consuming diets that are excessively rich or deficient in omega-3 FA during pregnancy and lactation seems inadvisable because of risks for long-lasting adverse effects on brain development and sensory function.

Excess and deficient omega-3 fatty acid during pregnancy and lactation cause impaired neural transmission in rat pups

Omega-3 fatty acids (omega-3 FA) consumption during pregnancy and lactation is beneficial to fetal and infant growth and may reduce the severity of preterm births. Thus, scientists and clinicians are recommending increasingly higher omega-3 FA doses for pregnant women and nursing babies for advancing the health of preterm, low birth weight, and normal babies. In contrast, some studies report that over-supplementation with omega-3 FA can have adverse effects on fetal and infant development by causing a form of nutritional toxicity. Our goal was to assess the effects of omega-3 FA excess and deficiency during pregnancy and lactation on the offspring's neural transmission as evidenced by their auditory brainstem responses (ABR). Female Wistar rats were given one of three diets from day 1 of pregnancy through lactation. The three diets were the Control omega-3 FA condition (omega-3/omega-6 ratio approximately 0.14), the Deficient omega-3 FA condition (omega-3/omega-6 ratio approximately 0%) and the Excess omega-3 FA condition (omega-3/omega-6 ratio approximately 14.0). The Control diet contained 7% soybean oil, whereas the Deficient diet contained 7% safflower oil and the Excess diet contained 7% fish oil. The offspring were ABR-tested on postnatal day 24. The rat pups in the Excess group had prolonged ABR latencies in comparison to the Control group, indicating slowed neural transmission times. The pups in the Excess group also showed postnatal growth restriction. The Deficient group showed adverse effects that were milder than those seen in the Excess group. Milk fatty acid profiles reflected the fatty acid profiles of the maternal diets. In conclusion, excess or deficient amounts of omega-3 FA during pregnancy and lactation adversely affected the offspring's neural transmission times and postnatal thriving. Consuming either large or inadequate amounts of omega-3 FA during pregnancy and lactation seems inadvisable because of the potential for adverse effects on infant development.

Nursing of malnourished children with emphasis on polyunsaturated fatty acids

Omega-3 (Omega-3) and omega-6 (Omega-6) fatty acids (FAs) are essential FAs needed for brain and retina development and maintenance of red blood cell (RBC) membranes. This study investigated the association between the profile of FAs in the membranes of RBCs and malnutrition in children. Demographic, anthropometric, and breast-feeding data and blood samples for analysis of FAs were obtained from malnourished and well-nourished children. The results indicate significant between-group differences in the profile of FAs. These findings support the need for adequate intake of Omega-3 FAs in promoting optimal growth and development processes and emphasize the role of nurses as providers of nutritional and anticipatory guidance for parents and caretakers.

O papel da amamentação ineficaz na gênese da obesidade infantil: um aspecto para a investigação de enfermagem

OBJETIVO: Verificar a amamentação ineficaz como um fator que possibilitaria a gênese da obesidade infantil. MÉTODOS: Foram avaliadas 90 crianças entre dois e cinco anos de idade numa creche de Fortaleza. RESULTADOS: Essa avaliação revelou a seguinte condição nutricional: 57,7% (eutróficas), 14,4% (com sobrepeso), 13,3% (obesas), 11,1% (com baixo peso) e 3,3% (desnutridas). O cenário que envolvia as crianças com sobrepeso ou obesidade foi o seguinte: 60% tiveram um padrão de amamentação ineficaz (< 6 meses e não mamou); 60% viviam em famílias com uma renda mensal de menos de um salário mínimo. CONCLUSÃO: O estudo possibilitou visualizar o aleitamento materno como uma ação importante no cenário da prevenção da obesidade infantil.

Reduced auditory acuity in rat pups from excess and deficient omega-3 fatty acid consumption by the mother

Consumption of the nutrients omega-3 fatty acids (omega-3 FA) during pregnancy and lactation is considered beneficial to fetal and infant development. It may also reduce the incidence and severity of preterm births by prolonging gestational length. However several recent human and animal studies have reported that over-supplementation with omega-3 FA, especially in the form of fish oil, can have adverse effects on fetal and infant development and the auditory brainstem response (ABR). Our goal was to assess further the effects of omega-3 FA excess and deficiency during pregnancy and lactation on the offspring's auditory acuity as evidenced by their ABR thresholds. Female Wistar rats were given diets that were either deficient, adequate (control) or excess in omega-3 FA from day 1 of pregnancy through lactation. The offspring were ABR-tested at the postnatal age of 24 days. The rat pups in the Excess treatment condition had significantly elevated (worse) ABR thresholds, postnatal growth restriction, and a trend for increased postnatal mortality in comparison to the Control group. The Deficient group was intermediate. In conclusion, excess or deficient amounts of omega-3 FA during pregnancy and lactation in the laboratory rat adversely affected the offspring's auditory acuity. Postnatal thriving was also adversely affected. Consuming or administering large or inadequate amounts of omega-3 FA during pregnancy and lactation seems inadvisable because of the potential for adverse effects on infant development.

Polyunsaturated fatty acids and anthropometric indices of children in rural China

OBJECTIVE

To define fatty acid and macronutrient intakes in a rural Chinese preschool population, and relate these intakes to anthropometric indices.

DESIGN

Cross-sectional survey of anthropometry and diet (three 24-h recalls). National Centers for Health Statistics/World Health Organization growth reference charts were used to determine the prevalence of malnutrition (z-scores less than -2 standard deviation (s.d.) below the mean): height-for-age (stunted), weight-for-age (underweight), weight-for-height (wasted) and mid-upper-arm-circumference-for-age (low fat/muscle).

SUBJECTS AND SETTING

A total of 196 children aged 1-5 years old were volunteered by their families to participate in the survey, located in Heqing County, Yunnan Province, China.

RESULTS

The respective prevalence of stunting, underweight, wasting and low fat/muscle was: 38, 21, 2 and 8%. Daily intakes of linoleic acid (LA; 18:2n-6), alpha-linolenic acid (LNA; 18:3n-3), arachidonic acid (AA; 20:4n-6) and docosahexaenoic acid (DHA; 22:6n-3), averaged for all children, were 2 100+/-1200, 300+/-250, 55+/-35 and 30+/-140 mg/day, respectively. As percent of total fat intake, LA contributed 11.9%, LNA 1.8%, AA 0.3% and DHA 0.2%. Height-for-age and weight-for-age z-scores were negatively correlated with g/kg/day intake of LA and AA (P<0.05). Weight-for-height z-score was negatively correlated with AA g/kg/day intake (P<0.05).

CONCLUSIONS

This study provided polyunsaturated fatty acids (PUFA) intakes in rural preschool children in a developing country. The associations of PUFA intake with early childhood growth suggest that growth in preschool-aged children could be significantly and specifically related to n-6 fatty acid intakes.

Attenuation of serum lipid abnormalities and cardiac oxidative stress by eicosapentaenoate-lipoate (EPA-LA) derivative in experimental hypercholesterolemia

BACKGROUND

Dietary cholesterol plays an important role in development of atherogenesis and cardiovascular disease. We explored the lipemic-oxidative injury in the hypercholesterolemic atherogenic animals. The effects of eicosapentaenoic acid (EPA), dl-alpha-lipoic acid (LA) and eicosapentaenoate-lipoate derivative (EPA-LA) were tested for their efficacy in controlling the atherogenic disturbances.

METHODS

Four groups of male Wistar rats were fed with a high cholesterol diet (rat chow supplemented with 4% cholesterol and 1% cholic acid; HCD) for 30 days. Of these groups, 3 groups of rats were treated with either EPA (oral gavage, 35 mg/kg body weight/day), LA (oral gavage, 20 mg/kg body weight/day) or EPA-LA derivative (oral gavage, 50 mg/kg body weight/day) from 16th day to 30th day of the experimental period.

RESULTS

HCD induced abnormal increase in lipid peroxidation and serum cholesterol, triglyceride, LDL and VLDL, and a decreased HDL concentration. Altered activity of cardiac and serum creatine kinase, accompanied by a depressed cardiac enzymatic and nonenzymatic antioxidants defense system were observed in HCD fed rats. These changes were partially restored in the EPA and LA treated groups, however, their combined derivative EPA-LA more effectively restored the altered parameters near to that of control (P<0.05).

CONCLUSION

Lipid abnormalities and oxidative injury were induced by a hypercholesterolemic diet. Administration of the combination treatment of EPA-LA afforded protection against the lipemic-oxidative injury.

APOE4 protects the cognitive development in children with heavy diarrhea burdens in Northeast Brazil

Polymorphisms in the apolipoprotein E (APOE) have constituted the major rationale to identify potential risk groups for developing late-onset Alzheimer's disease and help to predict recovery of cognitive function after brain injury. However, the APOE impact on cognitive development in children living in poor areas of the developing world, where we have discovered profound significant associations of early childhood diarrhea (at 0-2 y) with lasting impairments of growth, cognition, and school performance, is not known. Therefore, we conducted APOE genotyping in 72 Brazilian shantytown children under active surveillance since birth, using purified DNA extracted from buccal cell samples. We found a high frequency of APOE4 alleles (18% versus 9-11% expected) in children with lower diarrhea burdens. When we examined the children who experienced the heavier diarrhea burdens (greater than or equal to the median of seven illnesses in the first 2 y of life), those with APOE4 did significantly better in the coding subtest (p=0.01) when compared with APOE4-negative children with similar diarrhea burdens. Positive correlations between the APOE4 occurrence and coding scores remained, even after adjusting for family income, maternal education, and breast-feeding. Moreover, the APOE4-positive group, under heavy burdens of diarrhea, had preserved semantic fluency and the mean difference in fluency scores, p=0.025, a standardized coefficient for disproportional verbal fluency impairment. Our findings show that APOE4 is relatively common in favela children and suggest a protective role of the APOE4 allele in children with a history of heavy burdens of diarrhea in their first 2 y of life.

Feeding infants and toddlers study: improvements needed in meeting infant feeding recommendations

OBJECTIVE

To assess adherence to infant feeding recommendations among a sample of infants and toddlers four to 24 months of age in the United States.

DESIGN

Descriptive analysis of data collected in the 2002 Feeding Infants and Toddlers Study (FITS) based on telephone interviews and 24-hour dietary recalls collected with the Nutrition Data System for Research of the University of Minnesota.

SUBJECTS

A national random sample of 3,022 infants and toddlers age four to 24 months, including 2,024 infants age four to 11 months.

MAIN OUTCOME MEASURES

Breastfeeding, timing of introduction of complementary foods, and adherence to infant feeding recommendations.

STATISTICAL ANALYSES

Means and standard errors, percentile distributions, and percentages by age group (four to six months, seven to eight months, and nine to 11 months).

RESULTS

About 76% of infants and toddlers were fully or partly breastfed at birth. This percentage declined to 30% at six months and 16% at 12 months-short of Healthy People 2010 goals of 50% and 25%, respectively. The average duration of breastfeeding was 5.5 months for all who initiated breastfeeding. About two-thirds of infants had been introduced to complementary foods between four and six months-the period recommended by the American Academy of Pediatrics (AAP); 17% consumed juice before the AAP recommended age of six months or later. Twenty-two percent of infants nine to 11 months consumed cow's milk on a daily basis before the recommended age of 12 months or later, and one in 10 consumed french fries and/or sweetened beverages on any given day.

APPLICATIONS/CONCLUSIONS

More parents and caregivers can benefit from guidance about the introduction of developmentally appropriate, micronutrient-rich first solid foods such as iron-rich infant cereals, iron-fortified grain products, meats, soft fruits, and cooked vegetables and the importance of breastfeeding through the first year of life. A smaller proportion of parents and caregivers require guidance on delaying the introduction of juices until six months of age and cow's milk other than formula until one year of age.

Influence of dietary cholesterol on vitamin d metabolism in formula-fed preterm neonates

OBJECTIVES

Supplementation of preterm formulas with cholesterol could help to mimic the fat composition of human milk. However, this could possibly influence vitamin D 25-hydroxylation because this reaction is catalyzed in part by the mitochondrial cytochrome P-450, the enzyme responsible for the 27-hydroxylation of cholesterol. The purpose of this study was to verify whether the addition of cholesterol to preterm formulas could interfere with vitamin D metabolism in preterm neonates.

METHODS

In a prospective study, 30 preterm neonates were randomly assigned to a low (< 0.03 g/L), medium (0.15 g/L), or high (0.30 g/L) cholesterol-content preterm formula until theoretical term (i.e., 40 weeks post-conceptional age). Anthropometric data and serum hydroxy-vitamin D and 1,25 dihydroxy-vitamin D concentrations were measured at study entry and theoretical term. In a subgroup of 14 subjects, serum cholesterol and lymphocyte 3-hydroxy-3-methylglutaryl coenzyme A reductase mRNA were also assessed.

RESULTS

(median [25, 75 centiles]): At theoretical term, there were no significant differences in serum hydroxy-vitamin D concentrations among the three groups, even after adjustment for confounding variables (65 [50, 78] nmol/L, 79 [59, 86] nmol/L, and 67 [43, 103] nmol/L, respectively, = 0.65) or 1,25 dihydroxy-vitamin D ( = 0.88). Furthermore, there were no significant differences in 3-hydroxy-3-methylglutaryl coenzyme A reductase mRNA copy numbers.

CONCLUSIONS

In preterm neonates fed formulas with a cholesterol content similar to or higher than that of human milk, we did not observe deleterious effects on vitamin D metabolism. However, long-term effects of cholesterol supplementation require further studies.

Mitigation of free radical toxicity in hyperoxaluric condition by a novel derivative eicosapentaenoate-lipoate

Lipoic acid (LA) and eicosapentaenoic acid (EPA) have been shown to ameliorate the changes associated with hyperoxaluria. This prompted us to study the effect of EPA-LA, a new derivative, in experimental urolithiatic condition. Foreign body implantation method followed by supplementation of ammonium oxalate was adopted to induce stone formation in the bladder. Significant depletion in the antioxidant status was observed in the kidney and bladder of stone-forming animals, associated with increased lipid peroxidation. The present observations provide supporting evidence to the hypothesis that free radicals might be involved in causing toxicity in hyperoxaluric condition. The three drugs, namely LA, EPA and EPA-LA had reversed the above changes, but the effect was more pronounced in EPA-LA-treated stone formers. These features highlight the beneficial effect of EPA-LA wherein the potency of two drugs has been combined. The practical outcome of these findings is that the cellular antioxidant defence can be increased by the supplementation of lipoate and its derivative EPA-LA.

Attenuation of oxalate-induced nephrotoxicity by eicosapentaenoate-lipoate (EPA-LA) derivative in experimental rat model

Hyperoxaluria is one of the major risk factors for the formation of urinary calcium oxalate stones. Calcium oxalate crystals and their deposition have been implicated in inducing renal tubular damage. Lipoic acid (LA) and eicosapentaenoic acid (EPA) have been shown to ameliorate the changes associated with hyperoxaluria. This prompted us to investigate the nephroprotectant role of EPA-LA, a new derivative, in vivo in hyperoxaluric rats. Elevation in the levels of calcium, oxalate and phosphorus, the stone-forming constituents, were observed in calculogenic rats as a manifestation of crystal deposition. Tubular damage to the renal tissue was assessed byassaying the excretion of marker enzymes in the urine. Damage to the tubules was indicated by increased excretion of alkaline phosphatase (ALP), lactate dehydrogenase (LDH), gamma-glutamyl transferase (gamma-GT), beta-Glucuronidase (beta-GLU) and N-Acetyl beta-D glucosaminidase (NAG). Fibrinolytic activity was found to be reduced. Administration of EPA, LA and EPA-LA reduced the tubular damage and decreased the markers of crystal deposition markedly, which was substantiated by the reduction in weight of bladder stone formed. Our results highlight that EPA-LA is the most effective drug in inhibiting stone formation and mitigating renal damage caused by oxalate toxicity, thus confirming it as a nephroprotectant. Further work in this direction is warranted to establish the therapeutic effectiveness of this new derivative.

Nutrition and the life cycle 2: infancy and weaning

The first article in this nutrition and the life cycle series discussed nutrition in pregnancy (Vol 9 (17): 1133-8). This second article will concentrate on infancy and weaning. Weaning infants is an area that causes concern for parents. Health professionals need to be well informed about this aspect of childcare, as practices have changed recently. Babies should usually begin weaning between 4 and 6 months of age. Infant diets need to be high in lipid for energy, and for essential long-chain fatty acids and fat-soluble vitamins. Their diets should also be rich in the micronutrients; infants are particularly at risk of deficiency for iron and zinc. Infants should be introduced to as many tastes and textures as reasonably possible, but foods likely to cause an allergic reaction should be avoided for as long as possible. Finally, all the family should enjoy mealtimes, and the pattern laid down for a life of healthy eating. The next article in this series will review nutrition in the school-age child.

Macronutrient and energy intakes in young children fed milk products containing different quantities and qualities of fat and protein

BACKGROUND

Milk is the major source of protein and saturated fats in the diet after infancy. In the present study, the effects of different fat and protein quantity as well as fat quality in milk and dairy products on nutrient intake and growth in young children were determined.

METHODS

Thirty-eight healthy children were randomly assigned to one of four feeding groups at 12 months of age: 1) Low-fat milk (1.0 g fat/dl, 3.3 g protein/dl); 2) standard-fat milk (3.5 g fat/dl, 3.3 g protein/dl); 3) partially vegetable fat and protein-reduced milk (3.5 g fat/dl, 50% vegetable; 2.2 g protein/dl); and 4) full-vegetable-fat milk (3.5 g fat/dl, 100% vegetable; 3.0 g protein/dl). Nutrient intake and growth were measured at 12, 15, and 18 months.

RESULTS

The protein intake was significantly reduced with the protein-reduced milks. The intake of saturated fat was significantly lower with low-fat milk (11% of energy) or milks containing vegetable fat (13%) than in standard-fat milk (19.6%). However, the total fat intake was below 30% of energy in low-fat milk, whereas the total fat intake remained more than 30% in the other groups. Energy intake and growth were similar in all groups.

CONCLUSIONS

A modified milk with reduced protein content for young children results in protein intakes closer to recommendations. A modified milk with either 50% or 100% vegetable fat and dairy products with low milk fat and high vegetable fat content results in intakes of total and saturated fats closer to international recommendations, compared with standard or low-fat milk and dairy products.

Dietary fat consumption and health

Dietary Guidelines have emerged over the past 30 years recommending that Americans limit their consumption of total fat and saturated fat as one way to reduce the risk of a range of chronic diseases. However, a low-fat diet is not a no-fat diet. Dietary fat clearly serves a number of essential functions. For example, maternal energy deficiency, possible exacerbated by very low-fat intakes (< 15% of energy), is one key determinant in the etiology of low birth weight. The debate continues over recommendations for limiting total fat and saturated fatty acid intake in children. Recent evidence indicates that diets with adequate energy providing less than 30% of energy from fat are sufficient to promote normal growth and normal sexual maturation. More attention needs to be devoted to the effect of dietary fat reduction on the nutrient density of children's diets. The association between dietary fat and CHD has been extensively studied. Diets high in saturated fatty acids and trans fatty acids increase LDL cholesterol levels, and in turn, the risk of heart disease. The relationship between high-carbohydrate/low-fat diets and CHD is more ambiguous because high-carbohydrate diets induce dyslipidemia in certain individuals. Obesity among adults and children is now of epidemic proportions in the United States. High-fat diets leading to excessive energy intakes are strongly linked to the increasing obesity in the United States. However, the prevalence of obesity has increased during the same time period that dietary fat intake (both in absolute terms and as a percentage of total dietary energy) has decreased. These trends suggest that a concomitant decrease in total dietary energy and modifications of other lifestyle factors, such as physical activity, also need to be emphasized. Obesity is also an independent risk factor for the development of diabetes. The current availability of fat-modified foods offers the potential for dietary fat reduction and treatment of the comorbidities associated with diabetes. However, to date, few studies have documented the effectiveness of fat-modified foods as part of a weight loss regimen or in reduction in CHD risks among individuals with diabetes mellitus. The association between total dietary fat and cancer is still under debate. While there is some evidence demonstrating associations between dietary fat intake and cancers of the breast, prostate, and colon, there are serious methodologic issues, including the difficulty in differentiating the effects of dietary fat independent of total energy intake. Reported total fat and saturated fatty acid intakes as a percentage of total energy have been declining over the past 30 years in the United States. Despite this encouraging trend, the majority of individuals--regardless of age--do not report consuming a diet that meets the levels of fat and saturated fatty acids recommended by the Dietary Guidelines for Americans. On a relative basis, saturated fat intake has gone down less than has total fat intake. Individuals of all ages who report consuming a diet with < or = 30% of energy from fat consistently have lower energy intakes. Given the increasing rates of obesity in the United States at an earlier and earlier age, dietary fat reduction may be an effective part of an overall strategy to balance energy consumption with energy needs. In each of the age/gender groups reporting consumption of < or = 30% of energy from fat and less than 10% of energy from saturated fatty acids, fat-modified foods play a more important role in their diets than for people who are consuming higher levels of fat and saturated fat. The data are clear than fat-modified foods make a more significant contribution to diets of consumers with low-fat intakes. While one cannot argue cause and effect from the results presented, the patterns of fat-modified foods/low-fat intakes are consistent. The focus on overall diet quality is often lost in the national obsession with lowering fat inta

Longitudinal study of nutrient and food intakes of infants aged 2 to 24 months

OBJECTIVE

To determine the nutrient and food intakes of healthy, white infants from families of middle and upper socioeconomic status and to compare intakes to current recommendations.

DESIGN

Using an incomplete random block design, we interviewed 98 mother-infant pairs longitudinally when infants were 2, 3, 4, 6, 8, 10, 12, 16, 20, and 24 months old. Data obtained included 24-hour dietary recalls, usual food intake, and food likes and dislikes.

SETTING

Interviews were conducted in the mother's home by registered dietitians. Subjects resided in two urban areas of Tennessee.

SUBJECTS

Of the original 98 subjects, 94 completed the 2-year study.

RESULTS

Mean energy and nutrient intakes generally met or exceeded the Recommended Dietary Allowance (RDA). Exceptions were zinc and vitamin D, which were each below 100% of the RDA at 9 of the 10 data points, and vitamin E, which was below the RDA in the infants' second year. Fat intake decreased from more than 40% of energy in the first 6 months to 30% to 32% from 10 to 24 months. One third of the infants drank reduced-fat milks at 12 months and more than half drank them at 24 months. Although infants ate a variety of foods, vegetables often were the least favorite foods. A variety of dairy products provided calcium for the infant but lacked vitamin D.

CONCLUSIONS

Several nutritional issues about infant feeding before 2 years of age arose. Low intakes of zinc, vitamin D, and vitamin E were observed. In the second year, low fat intake, use of reduced-fat milks, and dislike of vegetables were areas of concern.

The lipids in human milk

The summary will be limited to the areas that should be intensively investigated. The first is: determination of fatty acid profiles using modern methods on a world wide basis. We have no more than five or six papers in which my criterion was applied, one from Canada and the remainder from Europe with some data from Africa. Obviously, milk cannot be used as the gold standard on this meager data base. The second area is analysis of TG structure. These analyses are difficult, but structure is one of the factors controlling digestion. Data on the effects of maternal diet on structure would be useful. The third area is the role of primary or derived milk lipids as microbicidal agents. The fourth area is examination of globule parameters, i.e. number, size, volume, surface, and how they are affected by diet. There are many others which may interest the reader.