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Banjara SK, Challa SR, Augustine LF, Dasi T, Madhari R, Fernandez Rao S, Palika R, Pullakhandam R, Kalashikam RR, Kumar RN, Palepu DP, Chilumula M, Selvaraj K, Gopinath P, Davies-Kershaw H, Jobarteh ML, Haggarty P, Heffernan C, Ferguson E, Kulkarni B. Eggs for Improving Nutrition, cognitive development and reducing linear growth retardation among Infants and young Children (ENRICH): protocol of an egg supplementation trial among children aged 9-18 months in Hyderabad, India. BMJ Paediatr Open 2024; 8:e001892. [PMID: 38417922 PMCID: PMC10900354 DOI: 10.1136/bmjpo-2023-001892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 07/13/2023] [Indexed: 03/01/2024] Open
Abstract
INTRODUCTION Evidence on the impact of nutrient-rich animal source foods such as eggs for improving child growth and cognition is inconsistent. This study aims to examine the impact of an egg intervention in children, along with behaviour change communication (BCC) to the mother, on linear growth and cognition, and nutritional status in children aged 9-18 months. METHODS AND ANALYSIS A 9-month open-labelled randomised controlled trial will be conducted in three urban slums in Hyderabad, India, as a substudy of an observational cohort study (n=350) following pregnant women and their children until 18 months of age in a population at risk of stunting. The children born to women enrolled during the third trimester of pregnancy will be block randomised in a 1:4 ratio into the intervention (n=70) and control (n=280) groups. Children in the intervention group will be supplemented with one egg per day starting from 9 months until 18 months of age. BCC designed to enhance adherence to the intervention will be used. The control group will be a part of the observational cohort and will not receive any intervention from the study team. The primary outcome will be length-for-age z-scores, and the secondary outcomes will include cognition, blood biomarkers of nutritional status including fatty acid profile and epigenetic signatures linked with linear growth and cognition. Multivariate intention-to-treat analyses will be conducted to assess the effect of the intervention. ETHICS AND DISSEMINATION The study is approved by the Institutional ethics committees of ICMR-National Institute of Nutrition, Hyderabad, India and London School of Hygiene and Tropical Medicine, UK. The results will be published in peer-reviewed journals and disseminated to policy-makers. Findings will also be shared with study participants and community leaders. TRIAL REGISTRATION NUMBER CTRI/2021/11/038208.
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Affiliation(s)
| | - Sai Ram Challa
- ICMR - National Institute of Nutrition, Hyderabad, India
| | | | - Teena Dasi
- ICMR - National Institute of Nutrition, Hyderabad, India
| | | | | | | | | | | | | | | | | | | | | | | | - Modou Lamin Jobarteh
- Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Claire Heffernan
- Department of Pathobiology and Population Sciences, University of London, London, UK
- London International Development Centre (LIDC), London, UK
| | - Elaine Ferguson
- London School of Hygiene and Tropical Medicine (LSHTM), London, UK
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Hajihashemi P, Haghighatdoost F, Kassaian N, Rahim Khorasani M, Hoveida L, Nili H, Tamizifar B, Adibi P. Therapeutics effects of bovine colostrum applications on gastrointestinal diseases: a systematic review. Syst Rev 2024; 13:76. [PMID: 38409162 PMCID: PMC10898101 DOI: 10.1186/s13643-024-02489-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/15/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Evidence on the effects of bovine colostrum (BC) supplementation on gastrointestinal (GI) diseases is conflicting. OBJECTIVES This systematic review summarized the findings of clinical trials (CTs) on the effects of BC supplementation on GI diseases. METHODS A systematic search was conducted in online databases, including PubMed, ISI Web of Science, and Scopus, until March 2021 and updated until December 2023. CTs investigated BC's effect on any measurable symptomatic change in terms of GI health as the primary outcome variable or as one of the outcomes in any population eligible for this systematic review. RESULTS Out of 6881 records, 22 CTs (uncontrolled = 4, cross-over = 1, and parallel = 17) with 1427 patients were enrolled in the systematic review. Diarrhea, the most frequently evaluated symptom (20 interventional arms), was decreased in frequency with BC supplementation in 15 of these arms. However, most studies reported no change in its duration. BC supplementation consistently reduced stool frequency across all seven studies. Abdominal pain relief was noted in four interventional arms but showed no improvement in five others. Assessment of other GI symptoms was limited, yielding inconclusive results. CONCLUSIONS There is limited evidence on the effects of BC on GI diseases, with mixed findings. More well-designed controlled clinical trials are required to explore its effects.
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Affiliation(s)
- Parisa Hajihashemi
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nazila Kassaian
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marzieh Rahim Khorasani
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, 8174673461, Iran.
| | - Laleh Hoveida
- Department of Microbiology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
| | - Hassan Nili
- Zeitoon Isfahan Vaccine Innovators Company, Isfahan Scince and Technology Town, Isfahan, Iran
| | - Babak Tamizifar
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Larson EA, Zhao Z, Bader-Larsen KS, Magkos F. Egg consumption and growth in children: a meta-analysis of interventional trials. Front Nutr 2024; 10:1278753. [PMID: 38249601 PMCID: PMC10796599 DOI: 10.3389/fnut.2023.1278753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/06/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Stunting and wasting are prevalent in low- and middle-income countries, putting children at risk for disease and disability. Eggs are a nutrient-rich food that can potentially facilitate growth. Purpose The aim of this meta-analysis was to evaluate the potential beneficial effect of egg supplementation on growth in children. Methods Following the PRISMA guidelines, PubMed and Healthline (Ovid) were systematically searched for interventional studies on egg supplementation for growth in children aged 6 months to 18 years, with no restrictions on date. Studies were evaluated for quality using Cochrane's GRADE technique. Data were pooled and reported as means and 95% confidence intervals. Results Seven studies reporting on 9 unique interventions in 3,575 male and female participants were included in the meta-analysis. Participants in the intervention groups experienced significantly greater increases in height/length (by 0.47 [0.13, 0.80] cm, p < 0.01) and weight (by 0.07 [0.01, 0.13] kg, p = 0.03) when compared to those in the control groups. Conclusion Eggs are an affordable, nutritious option for improving growth in children, though more studies with longer interventions are warranted.Systematic review registration: PROSPERO (CRD42021289609: https://www.crd.york.ac.uk/prospero/).
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Affiliation(s)
- Elisabeth A. Larson
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - Zaixin Zhao
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Karlen S. Bader-Larsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Malique A, Sun S, Chandwe K, Amadi B, Haritunians T, Jain U, Muegge BD, Frein J, Sasaki Y, Foster A, Storer CE, Mengesha E, Kern J, McGovern DPB, Head RD, Kelly P, Liu TC. NAD + precursors and bile acid sequestration treat preclinical refractory environmental enteric dysfunction. Sci Transl Med 2024; 16:eabq4145. [PMID: 38170788 DOI: 10.1126/scitranslmed.abq4145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 12/04/2023] [Indexed: 01/05/2024]
Abstract
Environmental enteric dysfunction (EED) is a diffuse small bowel disorder associated with poor growth, inadequate responses to oral vaccines, and nutrient malabsorption in millions of children worldwide. We identify loss of the small intestinal Paneth and goblet cells that are critical for innate immunity, reduced villous height, increased bile acids, and dysregulated nicotinamide adenine dinucleotide (NAD+) synthesis signaling as potential mechanisms underlying EED and which also correlated with diminished length-for-age z score. Isocaloric low-protein diet (LPD) consumption in mice recapitulated EED histopathology and transcriptomic changes in a microbiota-independent manner, as well as increases in serum and fecal bile acids. Children with refractory EED harbor single-nucleotide polymorphisms in key enzymes involved in NAD+ synthesis. In mice, deletion of Nampt, the gene encoding the rate-limiting enzyme in the NAD+ salvage pathway, from intestinal epithelium also reduced Paneth cell function, a deficiency that was further aggravated by LPD. Separate supplementation with NAD+ precursors or bile acid sequestrant partially restored LPD-associated Paneth cell defects and, when combined, fully restored all histopathology defects in LPD-fed mice. Therapeutic regimens that increase protein and NAD+ contents while reducing excessive bile acids may benefit children with refractory EED.
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Affiliation(s)
- Atika Malique
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Shengxiang Sun
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Kanta Chandwe
- Tropical Gastroenterology and Nutrition Group, Department of Medicine, University of Zambia School of Medicine, P.O. Box 50398, Lusaka, Zambia
| | - Beatrice Amadi
- Tropical Gastroenterology and Nutrition Group, Department of Medicine, University of Zambia School of Medicine, P.O. Box 50398, Lusaka, Zambia
| | - Talin Haritunians
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Umang Jain
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Brian D Muegge
- Department of Medicine, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Jennifer Frein
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Yo Sasaki
- Department of Genetics, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Amanda Foster
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Chad E Storer
- Department of Genetics, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Emebet Mengesha
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Justin Kern
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Dermot P B McGovern
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Richard D Head
- Department of Genetics, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Paul Kelly
- Tropical Gastroenterology and Nutrition Group, Department of Medicine, University of Zambia School of Medicine, P.O. Box 50398, Lusaka, Zambia
- Blizard Institute, Barts & the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK
| | - Ta-Chiang Liu
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
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Muema J, Mutono N, Kisaka S, Ogoti B, Oyugi J, Bukania Z, Daniel T, Njuguna J, Kimani I, Makori A, Omulo S, Boyd E, Osman AM, Gwenaelle L, Jost C, Thumbi SM. The impact of livestock interventions on nutritional outcomes of children younger than 5 years old and women in Africa: a systematic review and meta-analysis. Front Nutr 2023; 10:1166495. [PMID: 37485389 PMCID: PMC10358768 DOI: 10.3389/fnut.2023.1166495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Background Nutrition-sensitive livestock interventions have the potential to improve the nutrition of communities that are dependent on livestock for their livelihoods by increasing the availability and access to animal-source foods. These interventions can also boost household income, improving purchasing power for other foods, as well as enhance determinants of health. However, there is a lack of synthesized empirical evidence of the impact and effect of livestock interventions on diets and human nutritional status in Africa. Objective To review evidence of the effectiveness of nutrition-sensitive livestock interventions in improving diets and nutritional status in children younger than 5 years old and in pregnant and lactating women. Methods Following PRISMA guidelines, we conducted a systematic review and meta-analysis of published studies reporting on the effect of livestock interventions on maternal and child nutrition in Africa. Data were extracted, synthesized, and summarized qualitatively. Key outcomes were presented in summary tables alongside a narrative summary. Estimation of pooled effects was undertaken for experimental studies with nutritional outcomes of consumption of animal-source foods (ASFs) and minimum dietary diversity (MDD). Fixed effects regression models and pooled effect sizes were computed and reported as odds ratios (ORs) together with their 95% confidence intervals (CI). Results After the screening, 29 research papers were included in the review, and of these, only 4 were included in the meta-analysis. We found that nutrition-sensitive livestock interventions have a significant positive impact on the consumption of ASFs for children < 5 years (OR = 5.39; 95% CI: 4.43-6.56) and on the likelihood of meeting minimum dietary diversity (OR = 1.89; 95% CI: 1.51-2.37). Additionally, the impact of livestock interventions on stunting, wasting, and being underweight varied depending on the type of intervention and duration of the program/intervention implementation. Therefore, because of this heterogeneity in reporting metrics, the pooled estimates could not be computed. Conclusion Nutrition-sensitive livestock interventions showed a positive effect in increasing the consumption of ASFs, leading to improved dietary diversity. However, the quality of the evidence is low, and therefore, more randomized controlled studies with consistent and similar reporting metrics are needed to increase the evidence base on how nutrition-sensitive livestock interventions affect child growth outcomes.
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Affiliation(s)
- Josphat Muema
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
- Washington State University Global Health Program–Kenya, Nairobi, Kenya
- Feed the Future Innovation Lab for Animal Health, Washington State University, Pullman, WA, United States
| | - Nyamai Mutono
- Washington State University Global Health Program–Kenya, Nairobi, Kenya
- Feed the Future Innovation Lab for Animal Health, Washington State University, Pullman, WA, United States
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | - Stevens Kisaka
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | - Brian Ogoti
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | - Julius Oyugi
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Zipporah Bukania
- Centre for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Joseph Njuguna
- Food and Agriculture Organization of the United Nations, Nairobi, Kenya
| | - Irene Kimani
- Food and Agriculture Organization of the United Nations, Nairobi, Kenya
| | - Anita Makori
- Washington State University Global Health Program–Kenya, Nairobi, Kenya
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | - Sylvia Omulo
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
- Washington State University Global Health Program–Kenya, Nairobi, Kenya
- Feed the Future Innovation Lab for Animal Health, Washington State University, Pullman, WA, United States
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA, United States
| | - Erin Boyd
- United States Agency for International Development’s Bureau for Humanitarian Assistance, Washington, DC, United States
| | - Abdal Monium Osman
- Emergency and Resilience Division, Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Luc Gwenaelle
- Emergency and Resilience Division, Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Christine Jost
- United States Agency for International Development’s Bureau for Humanitarian Assistance, Washington, DC, United States
- Global Health Support Initiative III, Social Solutions International, Washington, DC, United States
| | - SM Thumbi
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
- Feed the Future Innovation Lab for Animal Health, Washington State University, Pullman, WA, United States
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA, United States
- South African Center for Epidemiological Modelling and Analysis, Stellenbosch, South Africa
- Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, United Kingdom
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Perez-Plazola M, Diaz J, Stewart CP, Arnold CD, Caswell BL, Lutter CK, Werner ER, Maleta K, Turner J, Prathibha P, Liu X, Gyimah E, Iannotti L. Plasma mineral status after a six-month intervention providing one egg per day to young Malawian children: a randomized controlled trial. Sci Rep 2023; 13:6698. [PMID: 37095119 PMCID: PMC10125967 DOI: 10.1038/s41598-023-33114-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 04/07/2023] [Indexed: 04/26/2023] Open
Abstract
Mineral deficiencies are common in children living in low-resource areas. Eggs are a rich source of essential nutrients and have been shown to improve growth in young children, although little is known about their impact on mineral status. Children aged 6-9 months (n = 660) were randomized to receive either one egg/day for 6-months or no intervention. Anthropometric data, dietary recalls, and venous blood were collected at baseline and 6-months follow-up. Quantification of plasma minerals (n = 387) was done using inductively coupled plasma-mass spectroscopy. Difference-in-difference mean plasma mineral concentrations was determined from baseline and follow-up values and assessed between groups by intention-to-treat using ANCOVA regression models. Prevalence of zinc deficiency was 57.4% at baseline and 60.5% at follow-up. Mean difference (MD) of plasma magnesium, selenium, copper, and zinc levels were not different between groups. Plasma iron concentrations were significantly lower in the intervention compared to the control group (MD = - 9.29; 95% CI: - 15.95, - 2.64). Zinc deficiency was widely prevalent in this population. Mineral deficiencies were not addressed with the egg intervention. Further interventions are needed to improve the mineral status of young children.
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Affiliation(s)
| | - Jenna Diaz
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, Campus, Box 8208, St. Louis, MO, 63110, USA.
| | - Christine P Stewart
- Institute for Global Nutrition, Department of Nutrition, University of California Davis, Davis, USA
| | - Charles D Arnold
- Institute for Global Nutrition, Department of Nutrition, University of California Davis, Davis, USA
| | - Bess L Caswell
- Institute for Global Nutrition, Department of Nutrition, University of California Davis, Davis, USA
- Western Human Nutrition Research Center, U.S. Department of Agriculture, Agricultural Research Service,, Davis, USA
| | - Chessa K Lutter
- International Development Group, RTI International US, Triangle Park, USA
| | - E Rochelle Werner
- Institute for Global Nutrition, Department of Nutrition, University of California Davis, Davis, USA
| | - Kenneth Maleta
- School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Jay Turner
- Division of Engineering Education Energy, Environmental Energy and Chemical Engineering, Washington University in St. Louis, St. Louis, USA
| | - Pradeep Prathibha
- Division of Engineering Education Energy, Environmental Energy and Chemical Engineering, Washington University in St. Louis, St. Louis, USA
| | - Xuan Liu
- Division of Engineering Education Energy, Environmental Energy and Chemical Engineering, Washington University in St. Louis, St. Louis, USA
| | - Emmanuel Gyimah
- Institute for Public Health, Washington University in St. Louis, St. Louis, USA
| | - Lora Iannotti
- Institute for Public Health, Washington University in St. Louis, St. Louis, USA
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Artym J, Zimecki M. Colostrum and Lactoferrin Protect against Side Effects of Therapy with Antibiotics, Anti-inflammatory Drugs and Steroids, and Psychophysical Stress: A Comprehensive Review. Biomedicines 2023; 11:biomedicines11041015. [PMID: 37189633 DOI: 10.3390/biomedicines11041015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/17/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
In this article, we review the benefits of applying bovine colostrum (BC) and lactoferrin (LF) in animal models and clinical trials that include corticosteroid application and psychic stress, treatment with non-steroid anti-inflammatory drugs (NSAIDs) and antibiotics. A majority of the reported investigations were performed with native bovine or recombinant human LF, applied alone or in combination with probiotics, as nutraceutics and diet supplements. Apart from reducing adverse side effects of the applied therapeutics, BC and LF augmented their efficacy and improved the wellness of patients. In conclusion, LF and complete native colostrum, preferably administered with probiotic bacteria, are highly recommended for inclusion in therapeutic protocols in NSAIDs and corticosteroid anti-inflammatory, as well as antibiotic, therapies. These colostrum-based products can also be of value for individuals subjected to prolonged psychophysical stress (mediated by endogenous corticosteroids), especially at high ambient temperatures (soldiers and emergency services), as well as physically active people and training athletes. They are also recommended for patients during recovery from trauma and surgery, which are always associated with severe psychophysical stress.
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Hendrixson DT, Naskidashvili N, Stephenson KB, Laury ML, Koroma AS, Manary MJ. An Alternative Oat-Containing, Ready-To-Use, Therapeutic Food Does Not Alter Intestinal Permeability or the 16S Ribosomal RNA Fecal Microbiome Configuration Among Children With Severe Malnutrition in Sierra Leone: A Randomized Controlled Trial. J Nutr 2023; 152:2744-2753. [PMID: 36055798 DOI: 10.1093/jn/nxac207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/20/2022] [Accepted: 08/29/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Previously, a novel oat ready-to-use therapeutic food (o-RUTF) resulted in improved recovery from severe acute malnutrition (SAM) when compared to a standard RUTF (s-RUTF). The o-RUTF contained 18% oat, while the s-RUTF has no cereal ingredients. OBJECTIVES We determined the effects of o-RUTF on intestinal permeability, as measured by lactulose permeability, and the 16S ribosomal RNA (rRNA) fecal microbiome configuration of children with SAM. METHODS This was a prospective, randomized, double-blinded, controlled clinical trial. Sierra Leonean children aged 6-59 mo with SAM, defined by a midupper arm circumference < 11.5 cm, were randomized to receive o-RUTF or s-RUTF. All children received 7 d of amoxicillin per guidelines. Lactulose permeability testing and fecal 16S rRNA sequencing were performed at baseline and after 4 wk of therapy. The change in lactulose permeability was the primary outcome, while the fecal 16S rRNA configuration at 4 wk was a secondary outcome. RESULTS Of the 129 children enrolled, lactulose permeability testing was completed by 100 at baseline and 82 at week 4. After 4 wk of therapeutic feeding, there were no differences in lactulose permeability between the o-RUTF and s-RUTF groups (P = 0.84), and over half of children had increased lactulose permeability (50% s-RUTF compared with 58% o-RUTF, mean difference = -7.5%; 95% CI: -29.2, 15.2; P = 0.50). After 4 wk of feeding, there were no differences in the 16S rRNA configurations between the o-RUTF and s-RUTF groups (Permanova, 999 permutations; P = 0.648; pseudo-F = 0.581), nor were there differences in α or β diversity. CONCLUSIONS Despite remarkably different compositions of o-RUTF and s-RUTF, no differences were identified in lactulose permeability or the fecal 16S rRNA configuration among children with SAM receiving these foods. These results suggest that the o-RUTF exerts its beneficial effects through mechanisms other than reducing intestinal permeability or altering the fecal 16S configuration. This trial was registered at clinicaltrials.gov as NCT04334538.
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Affiliation(s)
| | | | - Kevin B Stephenson
- Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Marie L Laury
- Genome Technology Access Center, Washington University in St Louis, St. Louis, MO, USA
| | - Aminata Shamit Koroma
- Ministry of Health and Sanitation, The Republic of Sierra Leone, Freetown, Sierra Leone
| | - Mark J Manary
- Project Peanut Butter, Freetown, Sierra Leone.,Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA.,USDA Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
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Mathews T, Hayer SS, Dinkel D, Hanish A, Poppert Cordts KM, Rasmussen H, Moore T. Maternal-Child Microbiome and Impact on Growth and Neurodevelopment in Infants and Children: A Scoping Review. Biol Res Nurs 2023:10998004221151179. [PMID: 36607703 DOI: 10.1177/10998004221151179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Pathologic changes in the microbiome (dysbiosis) have been implicated in affecting the growth and neurodevelopment of infants and children. There is evidence to suggest that prenatal and postnatal stressors may be a factor in dysbiosis and there is also a growing body of evidence to suggest that interventions may reduce this negative impact. A scoping review was undertaken to identify association between maternal and/or child microbiome with child growth and neurodevelopment. Additionally, intervention studies such as use of nutritional supplementation and its impact on the microbiome, growth and neurodevelopment were reviewed. METHODS An exhaustive literature search identified 654 relevant citations. After review of abstracts, 557 were eliminated, and 97 remained for full text review. We identified and reported on 42 articles which met inclusion criteria. RESULTS Seven studies examined associations between microbiome and neurodevelopment and 36 studies evaluated anthropometric measurements, most commonly weight, and microbiota relationships. One study evaluated both growth and neurodevelopment and microbiota. Fourteen studies evaluated supplemental nutrients. Preterm, low birth weight (LBW), and very low birth weight (VLBW) infants were most studied. Findings were inconclusive for consistent associations between microbiota and growth and neurodevelopment. Further, there were no consistent conclusive changes with prescribed treatment interventions. DISCUSSION There is a need for high-quality longitudinal studies evaluating repeated developmental assessment measures using consistent microbial analysis techniques to inform conclusions regarding the association between microbiome and infant and child growth and neurodevelopment. Additional intervention studies that may mitigate dysbiosis are warranted.
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Affiliation(s)
- Therese Mathews
- College of Nursing, 12284University of Nebraska Medical Center, Omaha, NE, USA
| | - Shivdeep S Hayer
- Department of Biology, College of Arts and Sciences, 169231University of Nebraska at Omaha, Omaha, NE, USA
| | - Danae Dinkel
- School of Health and Kinesiology, 14720University of Nebraska at Omaha, Omaha, NE, USA
| | - Alyson Hanish
- College of Nursing, 12284University of Nebraska Medical Center, Omaha, NE, USA
| | - Katrina M Poppert Cordts
- College of Medicine, Department of Psychiatry, 12284University of Nebraska Medical Center, Omaha, NE, USA
| | - Heather Rasmussen
- College of Education & Human Sciences, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Tiffany Moore
- College of Nursing, 12284University of Nebraska Medical Center, Omaha, NE, USA
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Artym J, Zimecki M. Colostrum Proteins in Protection against Therapy-Induced Injuries in Cancer Chemo- and Radiotherapy: A Comprehensive Review. Biomedicines 2023; 11:biomedicines11010114. [PMID: 36672622 PMCID: PMC9856106 DOI: 10.3390/biomedicines11010114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 01/05/2023] Open
Abstract
In this article, we review the benefits of application of colostrum and colostrum-derived proteins in animal models and clinical trials that include chemotherapy with antimetabolic drugs, radiotherapy and surgical interventions. A majority of the reported investigations was performed with bovine colostrum (BC) and native bovine or recombinant human lactoferrin (LF), applied alone, in nutraceutics or in combination with probiotics. Apart from reducing side effects of the applied therapeutics, radiation and surgical procedures, BC and LF augmented their efficacy and improved the wellness of patients. In conclusion, colostrum and colostrum proteins, preferably administered with probiotic bacteria, are highly recommended for inclusion to therapeutic protocols in cancer chemo- and radiotherapy as well as during the surgical treatment of cancer patients.
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11
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Mehra R, Kumar S, Singh R, Kumar N, Rathore D, Nayik GA, Alabdallah NM, Monteiro A, Guiné RF, Kumar H. Biochemical, dielectric and surface characteristics of freeze-dried bovine colostrum whey powder. Food Chem X 2022; 15:100364. [PMID: 35761882 PMCID: PMC9233230 DOI: 10.1016/j.fochx.2022.100364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 05/18/2022] [Accepted: 06/12/2022] [Indexed: 11/03/2022] Open
Abstract
Whey powder prepared by freeze-drying of bovine colostrum obtained from high altitude cow breed Himachali Pahari. Freeze-dried BCWP contained a considerable amount of amino acids, minerals and IgG. BCWP has a resistance of ∼57 M-ohm (Ω) which decreases with frequency and temperature. BCWP can find utilization as a functional food ingredient in health and infants’ formula.
Colostrum samples of recently registered cow breed “Himachali Pahari” were assorted from high altitude zone (901–2200 m). Prepared bovine colostrum whey powder (BCWP) was analysed for chemical composition, amino acids, minerals, surface morphology (SEM-EDS), FTIR and dielectric properties. Results showed that freeze-dried BCWP contained a considerable amount of nutritional parameters viz IgG (18.55 g/100 g), protein (71.72 g/100 g) and total amino acids (69.64 g/100 g). Additionally, the concentration of essential minerals was found to be adequate, and there was no presence of heavy metals. The BCWP exhibits good dielectric properties (resistance ∼57 M-Ω). SEM-EDS showed the broken up-wards layer structure with the uniform distribution of minerals on the surface. The FTIR spectra confirmed the presence of a higher proportion of β-sheets and β-turn structures in BCWP. Thus, on account of good functional and nutritive properties, BCWP could be foreseen as the future of functional food.
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12
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Insights into the Research Trends on Bovine Colostrum: Beneficial Health Perspectives with Special Reference to Manufacturing of Functional Foods and Feed Supplements. Nutrients 2022; 14:nu14030659. [PMID: 35277018 PMCID: PMC8840100 DOI: 10.3390/nu14030659] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/28/2022] [Accepted: 02/02/2022] [Indexed: 01/27/2023] Open
Abstract
Bovine colostrum (BC) is the initial mammary secretion after parturition, which is nature’s bountiful source consisting of nutritional and bioactive components present in a highly concentrated low-volume format. All mammalian newborns require colostrum to enhance physiological processes such as lifelong immunity, gastrointestinal development, and resistance to microbial infections. The genetic, environmental, and processing methods can all have an impact on the biochemical contents of BC and its supplements. BC and its derivatives have been intensively researched for their potential use in functional foods, medicines, and animal feed. Evidence from clinical studies suggests that BC products are well-tolerated, nontoxic, and safe for human ingestion. Functional foods, feed, and pharmaceutical formulations based on bovine colostrum are playing noteworthy roles in the development of innovative products for promoting health and the prevention of chronic illnesses. This systematic review sheds light on recent research on (a) the effects of processing techniques on BC components, (b) emerging techniques used in the isolation and identification of novel components, (c) BC-based functional foods for human consumption and animal feed supplements, and (d) the role of BC in current drug delivery, as well as future recommendations.
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Chandwe K, Kelly P. Colostrum Therapy for Human Gastrointestinal Health and Disease. Nutrients 2021; 13:1956. [PMID: 34200282 PMCID: PMC8228205 DOI: 10.3390/nu13061956] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/12/2021] [Accepted: 06/01/2021] [Indexed: 12/12/2022] Open
Abstract
There is increasing awareness that a broad range of gastrointestinal diseases, and some systemic diseases, are characterized by failure of the mucosal barrier. Bovine colostrum is a complex biological fluid replete with growth factors, nutrients, hormones, and paracrine factors which have a range of properties likely to contribute to mucosal healing in a wide range of infective, inflammatory, and injury conditions. In this review, we describe the anatomy and physiology of the intestinal barrier and how it may fail. We survey selected diseases in which disordered barrier function contributes to disease pathogenesis or progression, and review the evidence for or against efficacy of bovine colostrum in management. These disorders include enteropathy due to non-steroidal anti-inflammatory drugs (NSAIDs), inflammatory bowel disease (IBD), necrotizing enterocolitis, infectious diarrhea, intestinal failure, and damage due to cancer therapy. In animal models, bovine colostrum benefits NSAID enteropathy, IBD, and intestinal failure. In human trials, there is substantial evidence of efficacy of bovine colostrum in inflammatory bowel disease and in infectious diarrhea. Given the robust scientific rationale for using bovine colostrum as a promoter of mucosal healing, further work is needed to define its role in therapy.
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Affiliation(s)
- Kanta Chandwe
- Tropical Gastroenterology & Nutrition Group, University of Zambia School of Medicine, Lusaka 10101, Zambia;
| | - Paul Kelly
- Tropical Gastroenterology & Nutrition Group, University of Zambia School of Medicine, Lusaka 10101, Zambia;
- Blizard Institute, Barts & The London School of Medicine, Queen Mary University of London, London E1 2AT, UK
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14
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Playford RJ, Weiser MJ. Bovine Colostrum: Its Constituents and Uses. Nutrients 2021; 13:265. [PMID: 33477653 PMCID: PMC7831509 DOI: 10.3390/nu13010265] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 02/07/2023] Open
Abstract
Colostrum is the milk produced during the first few days after birth and contains high levels of immunoglobulins, antimicrobial peptides, and growth factors. Colostrum is important for supporting the growth, development, and immunologic defence of neonates. Colostrum is naturally packaged in a combination that helps prevent its destruction and maintain bioactivity until it reaches more distal gut regions and enables synergistic responses between protective and reparative agents present within it. Bovine colostrum been used for hundreds of years as a traditional or complementary therapy for a wide variety of ailments and in veterinary practice. Partly due to concerns about the side effects of standard Western medicines, there is interest in the use of natural-based products of which colostrum is a prime example. Numerous preclinical and clinical studies have demonstrated therapeutic benefits of bovine colostrum for a wide range of indications, including maintenance of wellbeing, treatment of medical conditions and for animal husbandry. Articles within this Special Issue of Nutrients cover the effects and use bovine colostrum and in this introductory article, we describe the main constituents, quality control and an overview of the use of bovine colostrum in health and disease.
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Affiliation(s)
- Raymond John Playford
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK
- Department of R&D, PanTheryx Inc., Boulder, CO 80301, USA;
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Selimoglu MA, Kansu A, Aydogdu S, Sarioglu AA, Erdogan S, Dalgic B, Yuce A, Cullu Cokugras F. Nutritional Support in Malnourished Children With Compromised Gastrointestinal Function: Utility of Peptide-Based Enteral Therapy. Front Pediatr 2021; 9:610275. [PMID: 34164352 PMCID: PMC8215107 DOI: 10.3389/fped.2021.610275] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 05/07/2021] [Indexed: 12/20/2022] Open
Abstract
This review focuses on nutritional support in malnourished children with compromised gastrointestinal function addressing the interplay between malnutrition and gastrointestinal dysfunction, and the specific role of peptide-based enteral therapy in pediatric malnutrition. Malnutrition is associated with impaired gut functions such as increased intestinal permeability, malabsorption, and diarrhea, while pre-existing functional gastrointestinal disorders may also lead to malnutrition. Presence of compromised gastrointestinal function in malnourished children is critical given that alterations such as malabsorption and increased intestinal permeability directly interfere with efficacy of nutritional support and recovery from malnutrition. Appropriate nutritional intervention is the key step in the management of malnutrition, while alterations in gastrointestinal functions in malnourished children are likely even in those with mild degree malnutrition. Therefore, nutritional therapy in children with compromised gastrointestinal function is considered to involve gut-protective interventions that address the overlapping and interacting effects of diarrhea, enteropathy and malnutrition to improve child survival and developmental potential in the long-term. Peptide-based enteral formulas seem to have clinical applications in malnourished children with compromised gastrointestinal function, given their association with improved gastrointestinal tolerance and absorption, better nitrogen retention/ balance, reduced diarrhea and bacterial translocation, enhanced fat absorption, and maintained/restored gut integrity as compared with free amino acid or whole-protein formulas.
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Affiliation(s)
- Mukadder Ayse Selimoglu
- Department of Pediatric Gastroenterology, Atasehir and Bahcelievler Memorial Hospitals, Istanbul, Turkey
| | - Aydan Kansu
- Department of Pediatric Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
| | - Sema Aydogdu
- Department of Pediatric Gastroenterology, Ege University Faculty of Medicine, Izmir, Turkey
| | | | | | - Buket Dalgic
- Department of Pediatric Gastroenterology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Aysel Yuce
- Department of Pediatric Gastroenterology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Fugen Cullu Cokugras
- Department of Pediatric Gastroenterology, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey
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