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Dos Reis Araujo T, Alves BL, Dos Santos LMB, Gonçalves LM, Carneiro EM. Association between protein undernutrition and diabetes: Molecular implications in the reduction of insulin secretion. Rev Endocr Metab Disord 2024; 25:259-278. [PMID: 38048021 DOI: 10.1007/s11154-023-09856-8] [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] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
Undernutrition is still a recurring nutritional problem in low and middle-income countries. It is directly associated with the social and economic sphere, but it can also negatively impact the health of the population. In this sense, it is believed that undernourished individuals may be more susceptible to the development of non-communicable diseases, such as diabetes mellitus, throughout life. This hypothesis was postulated and confirmed until today by several studies that demonstrate that experimental models submitted to protein undernutrition present alterations in glycemic homeostasis linked, in part, to the reduction of insulin secretion. Therefore, understanding the changes that lead to a reduction in the secretion of this hormone is essential to prevent the development of diabetes in undernourished individuals. This narrative review aims to describe the main molecular changes already characterized in pancreatic β cells that will contribute to the reduction of insulin secretion in protein undernutrition. So, it will provide new perspectives and targets for postulation and action of therapeutic strategies to improve glycemic homeostasis during this nutritional deficiency.
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Affiliation(s)
- Thiago Dos Reis Araujo
- Obesity and Comorbidities Research Center (OCRC), Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Carl Von Linnaeus Bloco Z, Campinas, SP, Cep: 13083-864, Brazil
| | - Bruna Lourençoni Alves
- Obesity and Comorbidities Research Center (OCRC), Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Carl Von Linnaeus Bloco Z, Campinas, SP, Cep: 13083-864, Brazil
| | - Lohanna Monali Barreto Dos Santos
- Obesity and Comorbidities Research Center (OCRC), Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Carl Von Linnaeus Bloco Z, Campinas, SP, Cep: 13083-864, Brazil
| | - Luciana Mateus Gonçalves
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Everardo Magalhães Carneiro
- Obesity and Comorbidities Research Center (OCRC), Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Carl Von Linnaeus Bloco Z, Campinas, SP, Cep: 13083-864, Brazil.
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Buklijas T, Al-Gailani S. A fetus in the world: Physiology, epidemiology, and the making of fetal origins of adult disease. HISTORY AND PHILOSOPHY OF THE LIFE SCIENCES 2023; 45:44. [PMID: 38091094 PMCID: PMC10719150 DOI: 10.1007/s40656-023-00598-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/25/2023] [Indexed: 12/17/2023]
Abstract
Since the late 1980s, the fetal origins of adult disease, from 2003 developmental origins of health and disease (DOHaD), has stimulated significant interest in and an efflorescence of research on the long-term effects of the intrauterine environment. From the start, this field has been interdisciplinary, using experimental animal, clinical and epidemiological tools. As the influence of DOHaD on public health and policy expanded, it has drawn criticism for reducing the complex social and physical world of early life to women's reproductive bodies as drivers of intergenerational ills. This paper explains this narrowing of focus in terms of a formative and consequential exchange between David Barker, the British epidemiologist whose work is credited with establishing the field, and the discipline of fetal physiology. We suggest that fetal physiologists were a crucial constituency of support for Barker's hypothesis about early life origins of disease. Their collaborations with Barker helped secure and sustain the theory amid considerable controversy. The trajectory of DOHaD and its focus on the maternal body can be understood, we argue, as a consequence of this alliance, which brought together two distinct conceptualizations of the intrauterine environment, one from epidemiology and the other from fetal physiology. Along the way, we trace the histories of these conceptualizations, both of which were products of mid-to-late twentieth century British science, and show how Barker's early emphasis on social and economic conditions was superseded by a narrower focus on physiological mechanisms acting upon the autonomous fetus.
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Affiliation(s)
- Tatjana Buklijas
- Koi Tū: Centre for Informed Futures & Global Studies, The University of Auckland, Auckland, New Zealand
| | - Salim Al-Gailani
- Department of History and Philosophy of Science, University of Cambridge, Cambridge, UK.
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3
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Sturgeon JP, Mufukari W, Tome J, Dumbura C, Majo FD, Ngosa D, Chandwe K, Kapoma C, Mutasa K, Nathoo KJ, Bourke CD, Ntozini R, Bwakura-Dangarembizi M, Amadi B, Kelly P, Prendergast AJ. Risk factors for inpatient mortality among children with severe acute malnutrition in Zimbabwe and Zambia. Eur J Clin Nutr 2023; 77:895-904. [PMID: 37553508 PMCID: PMC10473959 DOI: 10.1038/s41430-023-01320-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND/OBJECTIVES Malnutrition underlies 45% of deaths in children under-5 years annually. Children hospitalised with complicated severe acute malnutrition (SAM) have unacceptably high mortality. We aimed to identify variables from early hospital admission (baseline factors) independently associated with inpatient mortality in this cohort to identify those most at risk. SUBJECTS/METHODS Observational study of 745 children aged 0-59 months admitted with complicated SAM at three hospitals in Zimbabwe/Zambia. Children underwent anthropometry and clinical assessment by a study physician within 72 h of enrolment, and caregivers provided sociodemographic data. Children were followed-up daily until discharge/death. A multivariable survival analysis identified the baseline factors independently associated with mortality. RESULTS 70/745 (9.4%) children died in hospital. Age between 6-23 months [aHR 6.53, 95%CI 2.24-19.02], higher mid-upper arm circumference [aHR 0.73, 95%CI 0.59-0.89], presence of oedema [aHR 2.22, 95%CI 1.23-4.05], shock [aHR 8.18, 95%CI 3.79-17.65], sepsis [aHR 3.13, 95%CI 1.44-6.80], persistent diarrhoea [aHR 2.27, 95%CI 1.18-4.37], lack of a toilet at home [aHR 4.35, 95%CI 1.65-11.47], and recruitment at one Harare site [aHR 0.38, 95%CI 0.18-0.83] were all independently associated with inpatient mortality. Oedematous children had a significantly higher birthweight [2987 g vs 2757 g, p < 0.001] than those without oedema; higher birthweight was weakly associated with mortality [aHR 1.50 95%CI 0.97-2.31]. CONCLUSIONS Children with oedema, low MUAC, baseline infections, shock and lack of home sanitation had a significantly increased risk of inpatient mortality following hospitalisation for complicated SAM. Children with high-risk features may require additional care. A better understanding of the pathophysiology of SAM is needed to identify adjunctive interventions.
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Affiliation(s)
- Jonathan P Sturgeon
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe.
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, 4 Newark Street, London, E1 2AT, UK.
| | - Wadzanai Mufukari
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe
| | - Joice Tome
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe
| | - Cherlynn Dumbura
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe
| | - Florence D Majo
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe
| | - Deophine Ngosa
- Tropical Gastroenterology and Nutrition Group, University of Zambia, Lusaka, Zambia
| | - Kanta Chandwe
- Tropical Gastroenterology and Nutrition Group, University of Zambia, Lusaka, Zambia
| | - Chanda Kapoma
- Tropical Gastroenterology and Nutrition Group, University of Zambia, Lusaka, Zambia
| | - Kuda Mutasa
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe
| | - Kusum J Nathoo
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Claire D Bourke
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, 4 Newark Street, London, E1 2AT, UK
| | - Robert Ntozini
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe
| | - Mutsa Bwakura-Dangarembizi
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Beatrice Amadi
- Tropical Gastroenterology and Nutrition Group, University of Zambia, Lusaka, Zambia
| | - Paul Kelly
- Tropical Gastroenterology and Nutrition Group, University of Zambia, Lusaka, Zambia
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, 4 Newark Street, London, E1 2AT, UK
| | - Andrew J Prendergast
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, 4 Newark Street, London, E1 2AT, UK
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Lelijveld N, Cox S, Anujuo K, Amoah AS, Opondo C, Cole TJ, Wells JCK, Thompson D, McKenzie K, Abera M, Berhane M, Kerac M. Post-malnutrition growth and its associations with child survival and non-communicable disease risk: a secondary analysis of the Malawi 'ChroSAM' cohort. Public Health Nutr 2023; 26:1658-1670. [PMID: 36876519 PMCID: PMC10466107 DOI: 10.1017/s1368980023000411] [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: 04/07/2022] [Revised: 01/05/2023] [Accepted: 02/06/2023] [Indexed: 03/07/2023]
Abstract
OBJECTIVE To explore patterns of post-malnutrition growth (PMGr) during and after treatment for severe malnutrition and describe associations with survival and non-communicable disease (NCD) risk 7 years post-treatment. DESIGN Six indicators of PMGr were derived based on a variety of timepoints, weight, weight-for-age z-score and height-for-age z-score (HAZ). Three categorisation methods included no categorisation, quintiles and latent class analysis (LCA). Associations with mortality risk and seven NCD indicators were analysed. SETTING Secondary data from Blantyre, Malawi between 2006 and 2014. PARTICIPANTS A cohort of 1024 children treated for severe malnutrition (weight-for-length z-score < 70 % median and/or MUAC (mid-upper arm circumference) < 110 mm and/or bilateral oedema) at ages 5-168 months. RESULTS Faster weight gain during treatment (g/d) and after treatment (g/kg/day) was associated with lower risk of death (adjusted OR 0·99, 95 % CI 0·99, 1·00; and adjusted OR 0·91, 95 % CI 0·87, 0·94, respectively). In survivors (mean age 9 years), it was associated with greater hand grip strength (0·02, 95 % CI 0·00, 0·03) and larger HAZ (6·62, 95 % CI 1·31, 11·9), both indicators of better health. However, faster weight gain was also associated with increased waist:hip ratio (0·02, 95 % CI 0·01, 0·03), an indicator of later-life NCD risk. The clearest patterns of association were seen when defining PMGr based on weight gain in g/d during treatment and using the LCA method to describe growth patterns. Weight deficit at admission was a major confounder. CONCLUSIONS A complex pattern of benefits and risks is associated with faster PMGr. Both initial weight deficit and rate of weight gain have important implications for future health.
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Affiliation(s)
- Natasha Lelijveld
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, LondonWC1E 7HT, UK
- Emergency Nutrition Network (ENN), Oxford, UK
- Centre for Maternal, Adolescent & Reproductive Child Health (MARCH), London School of Hygiene & Tropical Medicine, London, UK
| | - Sioned Cox
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, LondonWC1E 7HT, UK
| | - Kenneth Anujuo
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, LondonWC1E 7HT, UK
| | - Abena S Amoah
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, LondonWC1E 7HT, UK
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Charles Opondo
- Department of Medical Statistics, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Tim J Cole
- Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Jonathan CK Wells
- Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Debbie Thompson
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Kimberley McKenzie
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | | | | | - Marko Kerac
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, LondonWC1E 7HT, UK
- Centre for Maternal, Adolescent & Reproductive Child Health (MARCH), London School of Hygiene & Tropical Medicine, London, UK
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Wang L, Tonsager AJ, Zheng W, Wang Y, Stessman D, Fang W, Stenback KE, Campbell A, Tanvir R, Zhang J, Cothron S, Wan D, Meng Y, Spalding MH, Nikolau BJ, Li L. Single-cell genetic models to evaluate orphan gene function: The case of QQS regulating carbon and nitrogen allocation. FRONTIERS IN PLANT SCIENCE 2023; 14:1126139. [PMID: 37051080 PMCID: PMC10084940 DOI: 10.3389/fpls.2023.1126139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
We demonstrate two synthetic single-cell systems that can be used to better understand how the acquisition of an orphan gene can affect complex phenotypes. The Arabidopsis orphan gene, Qua-Quine Starch (QQS) has been identified as a regulator of carbon (C) and nitrogen (N) partitioning across multiple plant species. QQS modulates this important biotechnological trait by replacing NF-YB (Nuclear Factor Y, subunit B) in its interaction with NF-YC. In this study, we expand on these prior findings by developing Chlamydomonas reinhardtii and Saccharomyces cerevisiae strains, to refactor the functional interactions between QQS and NF-Y subunits to affect modulations in C and N allocation. Expression of QQS in C. reinhardtii modulates C (i.e., starch) and N (i.e., protein) allocation by affecting interactions between NF-YC and NF-YB subunits. Studies in S. cerevisiae revealed similar functional interactions between QQS and the NF-YC homolog (HAP5), modulating C (i.e., glycogen) and N (i.e., protein) allocation. However, in S. cerevisiae both the NF-YA (HAP2) and NF-YB (HAP3) homologs appear to have redundant functions to enable QQS and HAP5 to affect C and N allocation. The genetically tractable systems that developed herein exhibit the plasticity to modulate highly complex phenotypes.
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Affiliation(s)
- Lei Wang
- Department of Biological Sciences, Mississippi State University, Mississippi State, MS, United States
| | - Andrew J. Tonsager
- Roy J. Carver Department of Biochemistry, Biophysics, and Molecular Biology, Iowa State University, Ames, IA, United States
- Engineering Research Center for Biorenewable Chemicals, Iowa State University, Ames, IA, United States
- Center for Metabolic Biology, Iowa State University, Ames, IA, United States
| | - Wenguang Zheng
- Department of Genetics, Development and Cell Biology, Iowa State University, Ames, IA, United States
| | - Yingjun Wang
- Department of Genetics, Development and Cell Biology, Iowa State University, Ames, IA, United States
| | - Dan Stessman
- Department of Genetics, Development and Cell Biology, Iowa State University, Ames, IA, United States
| | - Wei Fang
- Department of Genetics, Development and Cell Biology, Iowa State University, Ames, IA, United States
| | - Kenna E. Stenback
- Roy J. Carver Department of Biochemistry, Biophysics, and Molecular Biology, Iowa State University, Ames, IA, United States
- Engineering Research Center for Biorenewable Chemicals, Iowa State University, Ames, IA, United States
- Center for Metabolic Biology, Iowa State University, Ames, IA, United States
| | - Alexis Campbell
- Roy J. Carver Department of Biochemistry, Biophysics, and Molecular Biology, Iowa State University, Ames, IA, United States
- Engineering Research Center for Biorenewable Chemicals, Iowa State University, Ames, IA, United States
- Center for Metabolic Biology, Iowa State University, Ames, IA, United States
| | - Rezwan Tanvir
- Department of Biological Sciences, Mississippi State University, Mississippi State, MS, United States
| | - Jinjiang Zhang
- Department of Biological Sciences, Mississippi State University, Mississippi State, MS, United States
- Mississippi School for Mathematics and Science, Columbus, MS, United States
| | - Samuel Cothron
- Department of Biological Sciences, Mississippi State University, Mississippi State, MS, United States
| | - Dongli Wan
- Institute of Grassland Research, Chinese Academy of Agricultural Sciences, Hohhot, China
| | - Yan Meng
- Department of Agriculture, Alcorn State University, Lorman, MS, United States
| | - Martin H. Spalding
- Department of Genetics, Development and Cell Biology, Iowa State University, Ames, IA, United States
| | - Basil J. Nikolau
- Roy J. Carver Department of Biochemistry, Biophysics, and Molecular Biology, Iowa State University, Ames, IA, United States
- Engineering Research Center for Biorenewable Chemicals, Iowa State University, Ames, IA, United States
- Center for Metabolic Biology, Iowa State University, Ames, IA, United States
| | - Ling Li
- Department of Biological Sciences, Mississippi State University, Mississippi State, MS, United States
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Thompson DS, Francis-Emmanuel PM, Barnett AT, Osmond C, Hanson MA, Byrne CD, Gluckman PD, Forrester TE, Boyne MS. The effect of wasting and stunting during severe acute malnutrition in infancy on insulin sensitivity and insulin clearance in adult life. J Dev Orig Health Dis 2022; 13:750-756. [PMID: 35229708 DOI: 10.1017/s2040174422000034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Adults who had non-edematous severe acute malnutrition (SAM) during infancy (i.e., marasmus) have worse glucose tolerance and beta-cell function than survivors of edematous SAM (i.e., kwashiorkor). We hypothesized that wasting and/or stunting in SAM is associated with lower glucose disposal rate (M) and insulin clearance (MCR) in adulthood.We recruited 40 nondiabetic adult SAM survivors (20 marasmus survivors (MS) and 20 kwashiorkor survivors (KS)) and 13 matched community controls. We performed 150-minute hyperinsulinaemic, euglycaemic clamps to estimate M and MCR. We also measured serum adiponectin, anthropometry, and body composition. Data on wasting (weight-for-height) and stunting (height-for-age) were abstracted from the hospital records.Children with marasmus had lower weight-for-height z-scores (WHZ) (-3.8 ± 0.9 vs. -2.2 ± 1.4; P < 0.001) and lower height-for-age z-scores (HAZ) (-4.6 ± 1.1 vs. -3.4 ± 1.5; P = 0.0092) than those with kwashiorkor. As adults, mean age (SD) of participants was 27.2 (8.1) years; BMI was 23.6 (5.0) kg/m2. SAM survivors and controls had similar body composition. MS and KS and controls had similar M (9.1 ± 3.2; 8.7 ± 4.6; 6.9 ± 2.5 mg.kg-1.min-1 respectively; P = 0.3) and MCR. WHZ and HAZ were not associated with M, MCR or adiponectin even after adjusting for body composition.Wasting and stunting during infancy are not associated with insulin sensitivity and insulin clearance in lean, young, adult survivors of SAM. These data are consistent with the finding that glucose intolerance in malnutrition survivors is mostly due to beta-cell dysfunction.
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Affiliation(s)
- Debbie S Thompson
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Jamaica
| | - Patrice M Francis-Emmanuel
- UWI Solutions for Developing Countries, The University of the West Indies, Mona, Jamaica
- Department of Medicine, The University of the West Indies, Mona, Jamaica
| | - Alan T Barnett
- Department of Surgery, Radiology, Anaesthesia and Intensive Care, The University of the West Indies, Mona, Jamaica
| | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Mark A Hanson
- Institute of Developmental Sciences and NIHR Biomedical Research Centre, University of Southampton and University Hospital Southampton, Southampton, UK
| | - Christopher D Byrne
- Institute of Developmental Sciences and NIHR Biomedical Research Centre, University of Southampton and University Hospital Southampton, Southampton, UK
- Nutrition and Metabolism Unit, School of Medicine, University of Southampton, Southampton, UK
| | - Peter D Gluckman
- UK Centre for Human Evolution, Adaptation and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Terrence E Forrester
- UWI Solutions for Developing Countries, The University of the West Indies, Mona, Jamaica
| | - Michael S Boyne
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Jamaica
- Department of Medicine, The University of the West Indies, Mona, Jamaica
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Feige-Diller J, Herrera-Rivero M, Witten A, Stoll M, Kaiser S, Richter SH, Sachser N. The Impact of Varying Food Availability on Gene Expression in the Liver: Testing the Match-Mismatch Hypothesis. Front Nutr 2022; 9:910762. [PMID: 35859757 PMCID: PMC9289739 DOI: 10.3389/fnut.2022.910762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/02/2022] [Indexed: 11/29/2022] Open
Abstract
Background During early phases of life, such as prenatal or early postnatal development and adolescence, an organism's phenotype can be shaped by the environmental conditions it experiences. According to the Match-Mismatch hypothesis (MMH), changes to this environment during later life stages can result in a mismatch between the individual's adaptations and the prevailing environmental conditions. Thus, negative consequences in welfare and health can occur. We aimed to test the MMH in the context of food availability, assuming adolescence as a sensitive period of adaptation. Methods We have previously reported a study of the physiological and behavioral effects of match and mismatch conditions of high (ad libitum) and low (90% of ad libitum intake) food availability from adolescence to early adulthood in female C57BL/6J mice (n = 62). Here, we performed RNA-sequencing of the livers of a subset of these animals (n = 16) to test the effects of match and mismatch feeding conditions on the liver transcriptome. Results In general, we found no effect of the match-mismatch situations. Contrarily, the amount of food available during early adulthood (low vs. high) drove the differences we observed in final body weight and gene expression in the liver, regardless of the amount of food available to the animals during adolescence. Many of the differentially expressed genes and the corresponding biological processes found to be overrepresented overlapped, implicating common changes in various domains. These included metabolism, homeostasis, cellular responses to diverse stimuli, transport of bile acids and other molecules, cell differentiation, major urinary proteins, and immunity and inflammation. Conclusions Our previous and present observations found no support for the MMH in the context of low vs high food availability from adolescence to early adulthood in female C57BL/6J mice. However, even small differences of approximately 10% in food availability during early adulthood resulted in physiological and molecular changes with potential beneficial implications for metabolic diseases.
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Affiliation(s)
- Janina Feige-Diller
- Department of Behavioral Biology, University of Münster, Münster, Germany
- DFG RTG EvoPAD, WWU Münster, Münster, Germany
- Janina Feige-Diller
| | - Marisol Herrera-Rivero
- Department of Genetic Epidemiology, Institute of Human Genetics, University of Münster, Münster, Germany
- *Correspondence: Marisol Herrera-Rivero ;
| | - Anika Witten
- Department of Genetic Epidemiology, Institute of Human Genetics, University of Münster, Münster, Germany
- Core Facility Genomics, Medical Faculty, University of Münster, Münster, Germany
| | - Monika Stoll
- DFG RTG EvoPAD, WWU Münster, Münster, Germany
- Department of Genetic Epidemiology, Institute of Human Genetics, University of Münster, Münster, Germany
| | - Sylvia Kaiser
- Department of Behavioral Biology, University of Münster, Münster, Germany
| | - S. Helene Richter
- Department of Behavioral Biology, University of Münster, Münster, Germany
- DFG RTG EvoPAD, WWU Münster, Münster, Germany
| | - Norbert Sachser
- Department of Behavioral Biology, University of Münster, Münster, Germany
- DFG RTG EvoPAD, WWU Münster, Münster, Germany
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8
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Nieder R, Benbi DK. Reactive nitrogen compounds and their influence on human health: an overview. REVIEWS ON ENVIRONMENTAL HEALTH 2022; 37:229-246. [PMID: 34022126 DOI: 10.1515/reveh-2021-0021] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
Nitrogen (N) is a critical component of food security, economy and planetary health. Human production of reactive nitrogen (Nr) via Haber-Bosch process and cultivation-induced biological N2 fixation (BNF) has doubled global N cycling over the last century. The most important beneficial effect of Nr is augmenting global food supplies due to increased crop yields. However, increased circulation of Nr in the environment is responsible for serious human health effects such as methemoglobinemia ("blue baby syndrome") and eutrophication of coastal and inland waters. Furthermore, ammonia (NH3) emission mainly from farming and animal husbandary impacts not only human health causing chronic lung disease, inflammation of human airways and irritation of eyes, sinuses and skin but is also involved in the formation of secondary particulate matter (PM) that plays a critical role in environment and human health. Nr also affects human health via global warming, depletion of stratospheric ozone layer resulting in greater intensity of ultra violet B rays (UVB) on the Earth's surface, and creation of ground-level ozone (through reaction of NO2 with O2). The consequential indirect human health effects of Nr include the spread of vector-borne pathogens, increased incidence of skin cancer, development of cataracts, and serious respiratory diseases, besides land degradation. Evidently, the strategies to reduce Nr and mitigate adverse environmental and human health impacts include plugging pathways of nitrogen transport and loss through runoff, leaching and emissions of NH3, nitrogen oxides (NO x ), and other N compounds; improving fertilizer N use efficiency; reducing regional disparity in access to N fertilizers; enhancing BNF to decrease dependence on chemical fertilizers; replacing animal-based proteins with plant-based proteins; adopting improved methods of livestock raising and manure management; reducing air pollution and secondary PM formation; and subjecting industrial and vehicular NO x emission to pollution control laws. Strategic implementation of all these presents a major challenge across the fields of agriculture, ecology and public health. Recent observations on the reduction of air pollution in the COVID-19 lockdown period in several world regions provide an insight into the achievability of long-term air quality improvement. In this review, we focus on complex relationships between Nr and human health, highlighting a wide range of beneficial and detrimental effects.
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Affiliation(s)
- Rolf Nieder
- Institute of Geoecology, Technische Universität Braunschweig, Braunschweig, Germany
| | - Dinesh K Benbi
- Department of Soil Science, Punjab Agricultural University, Ludhiana, India
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Mwene-Batu P, Bisimwa G, Donnen P, Bisimwa J, Tshongo C, Dramaix M, Hermans MP, Briend A. Risk of Chronic Disease after an Episode of Marasmus, Kwashiorkor or Mixed-Type Severe Acute Malnutrition in the Democratic Republic of Congo: The Lwiro Follow-Up Study. Nutrients 2022; 14:2465. [PMID: 35745195 PMCID: PMC9229924 DOI: 10.3390/nu14122465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/05/2022] [Accepted: 06/10/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Long-term impact of different forms of severe acute malnutrition (SAM) in childhood on the emergence of noncommunicable diseases (NCDs) is poorly known. Aim: To explore the association between subtypes of SAM during childhood, NCDs, and cardiovascular risk factors (CVRFs) in young adults 11 to 30 years after post-SAM nutritional rehabilitation. Methods: In this follow-up study, we investigated 524 adults (mean age 22 years) treated for SAM during childhood in eastern Democratic Republic of the Congo (DRC) between 1988 and 2007. Among them, 142 had a history of marasmus, 175 of kwashiorkor, and 207 had mixed-form SAM. These participants were compared to 407 aged- and sex-matched control adults living in the same community without a history of SAM. Our outcomes of interest were cardiometabolic risk markers for NCDs. Logistic and linear regressions models were sued to estimate the association between subtype of SAM in childhood and risk of NCDs. Results: Compared to unexposed, former mixed-type SAM participants had a higher adjusted ORs of metabolic syndrome [2.68 (1.18; 8.07)], central obesity [1.89 (1.11; 3.21)] and low HDL-C (High-density lipoprotein cholesterol) [1.52 (1.08; 2.62)]. However, there was no difference between groups in terms of diabetes, high blood pressure, elevated LDL-C (low-density lipoprotein cholesterol) and hyper TG (hypertriglyceridemia) and overweightness. Former mixed-type SAM participants had higher mean fasting glucose [3.38 mg/dL (0.92; 7.7)], reduced muscle strength [−3.47 kg (−5.82; −1.11)] and smaller hip circumference [−2.27 cm (−4.24; −0.31)] compared to non-exposed. Regardless of subtypes, SAM-exposed participants had higher HbA1c than unexposed (p < 0.001). Those with a history of kwashiorkor had cardiometabolic and nutritional parameters almost superimposable to those of unexposed. Conclusion: The association between childhood SAM, prevalence of NCDs and their CVRFs in adulthood varies according to SAM subtypes, those with mixed form being most at risk. Multicenter studies on larger cohorts of older participants are needed to elucidate the impact of SAM subtypes on NCDs risk.
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Affiliation(s)
- Pacifique Mwene-Batu
- Ecole Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu P.O. Box 285, Democratic Republic of the Congo; (G.B.); (J.B.)
- Faculté de Médecine, Université de Kaziba, Kaziba P.O. Box 85, Democratic Republic of the Congo
- Hôpital Provincial General de Reference de Bukavu, Université Catholique de Bukavu, Bukavu P.O. Box 162, Democratic Republic of the Congo;
| | - Ghislain Bisimwa
- Ecole Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu P.O. Box 285, Democratic Republic of the Congo; (G.B.); (J.B.)
| | - Philippe Donnen
- Ecole de Santé Publique, Université Libre de Bruxelles, 1070 Brussels, Belgium; (P.D.); (M.D.)
| | - Jocelyne Bisimwa
- Ecole Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu P.O. Box 285, Democratic Republic of the Congo; (G.B.); (J.B.)
| | - Christian Tshongo
- Hôpital Provincial General de Reference de Bukavu, Université Catholique de Bukavu, Bukavu P.O. Box 162, Democratic Republic of the Congo;
| | - Michelle Dramaix
- Ecole de Santé Publique, Université Libre de Bruxelles, 1070 Brussels, Belgium; (P.D.); (M.D.)
| | - Michel P. Hermans
- Division of Endocrinology & Nutrition, Cliniques Universitaires St-Luc, Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - André Briend
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, DK-2200 Copenhagen, Denmark;
- Center for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland
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10
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Bauer KC, Littlejohn PT, Ayala V, Creus-Cuadros A, Finlay BB. Nonalcoholic Fatty Liver Disease and the Gut-Liver Axis: Exploring an Undernutrition Perspective. Gastroenterology 2022; 162:1858-1875.e2. [PMID: 35248539 DOI: 10.1053/j.gastro.2022.01.058] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 12/31/2021] [Accepted: 01/07/2022] [Indexed: 02/08/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a chronic condition affecting one quarter of the global population. Although primarily linked to obesity and metabolic syndrome, undernutrition and the altered (dysbiotic) gut microbiome influence NAFLD progression. Both undernutrition and NAFLD prevalence are predicted to considerably increase, but how the undernourished gut microbiome contributes to hepatic pathophysiology remains far less studied. Here, we present undernutrition conditions with fatty liver features, including kwashiorkor and micronutrient deficiency. We then review the gut microbiota-liver axis, highlighting key pathways linked to NAFLD progression within both overnutrition and undernutrition. To conclude, we identify challenges and collaborative possibilities of emerging multiomic research addressing the pathology and treatment of undernourished NAFLD.
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Affiliation(s)
- Kylynda C Bauer
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada; Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada; Thoracic and Gastrointestinal Malignancies Branch, National Institutes of Health, National Cancer Institute, Center for Cancer Research, Bethesda, Maryland
| | - Paula T Littlejohn
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada; Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Victoria Ayala
- Institut de Recerca Biomèdica de Lleida (IRB-Lleida), Lleida, Spain; Department of Experimental Medicine, Universitat de Lleida, Lleida, Spain
| | - Anna Creus-Cuadros
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
| | - B Brett Finlay
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada; Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada; Biochemistry and Molecular Biology Department, University of British Columbia, Vancouver, British Columbia, Canada.
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11
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Abstract
The association between severe acute malnutrition (SAM) in early childhood and liver fat in adults is unknown. We hypothesized that exposure to SAM, especially severe wasting, is associated with fatty liver later in life. In this observational study, abdominal CT was used to quantify mean liver attenuation (MLA) and liver:spleen attenuation ratio (L/S). Birth weight (BW), serum lipids, insulin resistance (homeostatic model assessment), anthropometry and intrabdominal fat were collected. Mean differences between diagnostic groups were tested and hierarchical regression analysis determined the best predictors of liver fat. We studied 88 adult SAM survivors and 84 community participants (CPs); age 29.0 ± 8.4 years, BMI 23.5 ± 5.0 kg/m2 (mean ± SDs). SAM survivors had less liver fat than CPs (using L/S) (p = 0.025). Severe wasting survivors (SWs) had lower BW (-0.51 kg; p = 0.02), were younger, thinner and had smaller waist circumference than oedematous malnutrition survivors (OMs). In the final regression model adjusting for age, sex, birth weight and SAM phenotype (i.e., oedematous malnutrition or severe wasting), SWs had more liver fat than OMs (using MLA) (B = 2.6 ± 1.3; p = 0.04) but similar liver fat using L/S (p = 0.07) and lower BW infants had less liver fat (MLA) (B = -1.8 ± 0.8; p = 0.03). Greater liver fat in SWs than OMs, despite having less body fat, supports our hypothesis of greater cardiometabolic risk in SWs. Other postnatal factors might influence greater liver fat in survivors of severe wasting, suggesting the need to monitor infants exposed to SAM beyond the acute episode.
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12
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May T, de la Haye B, Nord G, Klatt K, Stephenson K, Adams S, Bollinger L, Hanchard N, Arning E, Bottiglieri T, Maleta K, Manary M, Jahoor F. One-carbon metabolism in children with marasmus and kwashiorkor. EBioMedicine 2022; 75:103791. [PMID: 35030356 PMCID: PMC8761690 DOI: 10.1016/j.ebiom.2021.103791] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 11/24/2021] [Accepted: 12/16/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Kwashiorkor is a childhood syndrome of edematous malnutrition. Its precise nutritional precipitants remain uncertain despite nine decades of study. Remarkably, kwashiorkor's disturbances resemble the effects of experimental diets that are deficient in one-carbon nutrients. This similarity suggests that kwashiorkor may represent a nutritionally mediated syndrome of acute one-carbon metabolism dysfunction. Here we report findings from a cross-sectional exploration of serum one-carbon metabolites in Malawian children. METHODS Blood was collected from children aged 12-60 months before nutritional rehabilitation: kwashiorkor (N = 94), marasmic-kwashiorkor (N = 43) marasmus (N = 118), moderate acute malnutrition (N = 56) and controls (N = 46). Serum concentrations of 16 one-carbon metabolites were quantified using LC/MS techniques, and then compared across participant groups. FINDINGS Twelve of 16 measured one-carbon metabolites differed significantly between participant groups. Measured outputs of one-carbon metabolism, asymmetric dimethylarginine (ADMA) and cysteine, were lower in marasmic-kwashiorkor (median µmol/L (± SD): 0·549 (± 0·217) P = 0·00045 & 90 (± 40) P < 0·0001, respectively) and kwashiorkor (0·557 (± 0·195) P < 0·0001 & 115 (± 50) P < 0·0001), relative to marasmus (0·698 (± 0·212) & 153 (± 42)). ADMA and cysteine were well correlated with methionine in both kwashiorkor and marasmic-kwashiorkor. INTERPRETATION Kwashiorkor and marasmic-kwashiorkor were distinguished by evidence of one-carbon metabolism dysfunction. Correlative observations suggest that methionine deficiency drives this dysfunction, which is implicated in the syndrome's pathogenesis. The hypothesis that kwashiorkor can be prevented by fortifying low quality diets with methionine, along with nutrients that support efficient methionine use, such as choline, requires further investigation. FUNDING The Hickey Family Foundation, the American College of Gastroenterology, the NICHD, and the USDA/ARS.
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Affiliation(s)
- Thaddaeus May
- Children's Nutrition Research Center, Baylor College of Medicine, One Baylor Plaza, Houston TX, USA.
| | | | | | - Kevin Klatt
- Children's Nutrition Research Center, Baylor College of Medicine, One Baylor Plaza, Houston TX, USA,Center for Precision Environmental Health, Baylor College of Medicine
| | | | | | - Lucy Bollinger
- Washington University in St. Louis School of Medicine, USA
| | - Neil Hanchard
- National Institutes of Health, USA,National Human Genome Research Institute, Nationl Institutes of Health
| | - Erland Arning
- Center of Metabolomics, Institute of Metabolic Disease, Baylor Scott and White Research Institute
| | - Teodoro Bottiglieri
- Center of Metabolomics, Institute of Metabolic Disease, Baylor Scott and White Research Institute
| | | | - Mark Manary
- Children's Nutrition Research Center, Baylor College of Medicine, One Baylor Plaza, Houston TX, USA,The University of Malawi College of Medicine, Malawi,Washington University in St. Louis School of Medicine, USA
| | - Farook Jahoor
- Children's Nutrition Research Center, Baylor College of Medicine, One Baylor Plaza, Houston TX, USA
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13
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Saitou M, Resendez S, Pradhan AJ, Wu F, Lie NC, Hall NJ, Zhu Q, Reinholdt L, Satta Y, Speidel L, Nakagome S, Hanchard NA, Churchill G, Lee C, Atilla-Gokcumen GE, Mu X, Gokcumen O. Sex-specific phenotypic effects and evolutionary history of an ancient polymorphic deletion of the human growth hormone receptor. SCIENCE ADVANCES 2021; 7:eabi4476. [PMID: 34559564 PMCID: PMC8462886 DOI: 10.1126/sciadv.abi4476] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 08/04/2021] [Indexed: 06/13/2023]
Abstract
The common deletion of the third exon of the growth hormone receptor gene (GHRd3) in humans is associated with birth weight, growth after birth, and time of puberty. However, its evolutionary history and the molecular mechanisms through which it affects phenotypes remain unresolved. We present evidence that this deletion was nearly fixed in the ancestral population of anatomically modern humans and Neanderthals but underwent a recent adaptive reduction in frequency in East Asia. We documented that GHRd3 is associated with protection from severe malnutrition. Using a novel mouse model, we found that, under calorie restriction, Ghrd3 leads to the female-like gene expression in male livers and the disappearance of sexual dimorphism in weight. The sex- and diet-dependent effects of GHRd3 in our mouse model are consistent with a model in which the allele frequency of GHRd3 varies throughout human evolution as a response to fluctuations in resource availability.
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Affiliation(s)
- Marie Saitou
- Department of Biological Sciences, University at Buffalo, Buffalo, NY, USA
| | - Skyler Resendez
- Department of Biological Sciences, University at Buffalo, Buffalo, NY, USA
| | | | - Fuguo Wu
- Department of Ophthalmology, Ross Eye Institute, Jacobs School of Medicine and Biological Sciences, University at Buffalo, Buffalo, NY, USA
| | - Natasha C. Lie
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Nancy J. Hall
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Qihui Zhu
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | | | - Yoko Satta
- Department of Evolutionary Studies of Biosystems, SOKENDAI (Graduate University for Advanced Studies), Kanagawa Prefecture, Japan
| | - Leo Speidel
- University College London, Genetics Institute, London, UK
- The Francis Crick Institute, London, UK
| | | | - Neil A. Hanchard
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | | | - Charles Lee
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
- Precision Medicine Center, The First Affiliated Hospital of Xi’an Jiaotong University, Shaanxi, People’s Republic of China
| | | | - Xiuqian Mu
- Department of Ophthalmology, Ross Eye Institute, Jacobs School of Medicine and Biological Sciences, University at Buffalo, Buffalo, NY, USA
| | - Omer Gokcumen
- Department of Biological Sciences, University at Buffalo, Buffalo, NY, USA
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14
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Nasiri-Babadi P, Sadeghian M, Sadeghi O, Siassi F, Dorosty A, Esmaillzadeh A, Pouraram H. The association of serum levels of zinc and vitamin D with wasting among Iranian pre-school children. Eat Weight Disord 2021; 26:211-218. [PMID: 31900880 DOI: 10.1007/s40519-019-00834-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 12/10/2019] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Wasting is a main indicator of Child's undernutrition that is associated with several non-communicable diseases and child mortality. This is the first population-based study which evaluated the association of serum zinc and vitamin D levels with wasting in a Middle East region. We also reported the prevalence of vitamin D and zinc deficiencies among Iranian pre-school children aged 6 years. METHODS This was a multicenter cross-sectional study that included 425 children aged between 5 and 7 years (on average 6 years) with BMI-for-age Z-scores of < - 1 SD resident in urban and rural areas of Iran in the spring of 2012 as part of the National Integrated Micronutrient Survey 2 (NIMS-2). Anthropometric measurements and blood sampling were obtained. The prevalence of vitamin D and zinc deficiencies together with the correlations of these variables with the increase of BMI-for-age Z-scores were evaluated. RESULTS The prevalence of vitamin D and zinc deficiencies was 18.8% and 12.7%, respectively. In addition, 31.1% of children were wasted. Children in the second tertile of 25(OH)D levels were less likely to have wasting compared with those in the first tertile in both crude and adjusted models (OR 0.47, 95% CI 0.27-0.83). A significant inverse association was found between serum levels of zinc and wasting (OR 0.57, 95% CI 0.34-0.96); such that after adjusting for confounders, children in the highest tertile of serum zinc had 47% less odds of wasting compared with those in the first tertile (OR 0.53, 95% CI 0.31-0.91). CONCLUSION The prevalence of vitamin D and zinc deficiencies among Iranian pre-school children aged 6 years was 18.8 and 12.7%, respectively. Serum levels of vitamin D and zinc were inversely associated with wasting either before or after controlling for confounders. LEVEL OF EVIDENCE Level III, case-control analytic studies.
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Affiliation(s)
- Pegah Nasiri-Babadi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Mehdi Sadeghian
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Omid Sadeghi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereydoun Siassi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Ahmadreza Dorosty
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran.,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamed Pouraram
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran.
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15
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Abstract
Predictive adaptive responses (PARs) are a form of developmental plasticity in which the developmental response to an environmental cue experienced early in life is delayed and yet, at the same time, the induced phenotype anticipates (i.e., is completely developed before) exposure to the eventual environmental state predicted by the cue, in which the phenotype is adaptive. We model this sequence of events to discover, under various assumptions concerning the cost of development, what lengths of delay, developmental time, and anticipation are optimal. We find that in many scenarios modeled, development of the induced phenotype should be completed at the exact same time that the environmental exposure relevant to the induced phenotype begins: that is, in contrast to our observed cases of PARs, there should be no anticipation. Moreover, unless slow development is costly, development should commence immediately after the cue: there should be no delay. Thus, PARs, which normally have non-zero delays and/or anticipation, are highly unusual. Importantly, the exceptions to these predictions of zero delays and anticipation occurred when developmental time was fixed and delaying development was increasingly costly. We suggest, therefore, that PARs will only evolve under three kinds of circumstances: (i) there are strong timing constraints on the cue and the environmental status, (ii) delaying development is costly, and development time is either fixed or slow development is costly, or (iii) when the period between the cue and the eventual environmental change is variable and the cost of not completing development before the change is high. These predictions are empirically testable.
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16
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Pham TPT, Alou MT, Golden MH, Million M, Raoult D. Difference between kwashiorkor and marasmus: Comparative meta-analysis of pathogenic characteristics and implications for treatment. Microb Pathog 2021; 150:104702. [PMID: 33359074 DOI: 10.1016/j.micpath.2020.104702] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 12/04/2020] [Accepted: 12/08/2020] [Indexed: 12/11/2022]
Abstract
Kwashiorkor and marasmus are two clinical syndromes observed in severe acute malnutrition. In this review, we highlighted the differences between these two syndromes by reviewing the data comparing kwashiorkor and marasmus in literature, combined with recent microbiological findings and meta-analysis. Depletion of antioxidants, vitamins and minerals were more severe in kwashiorkor than marasmus. This was consistent with the severe and uncontrolled oxidative stress associated with the depletion of gut anaerobes and the relative proliferation of aerotolerant gut pathogens. This relative proliferation and invasion of gut microbes belonging to the aerotolerant Proteobacteria phylum and pathogens suggested a specific microbial process critical in the pathogenesis of kwashiorkor. Liver mitochondrial and peroxisomal dysfunction could be secondary to toxic microbial compounds produced in the gut such as ethanol, lipopolysaccharides and endotoxins produced by Proteobacteria, particularly Klebsiella pneumoniae, and aflatoxin produced by Aspergillus species. The gut-liver axis alteration is characterized by oedema and a fatty and enlarged liver and was associated with a dramatic depletion of methionine and glutathione, an excessive level of free circulating iron and frequent lethal bacteraemia by enteric pathogens. This was consistent with the fact that antibiotics improved survival only in children with kwashiorkor but not marasmus. The specific pathogenic characteristics of kwashiorkor identified in this review open new avenues to develop more targeted and effective treatments for both marasmus and/or kwashiorkor. Urgent correction of plasma glutathione depletion, alongside supply of specific essential amino acids, particularly methionine and cysteine, early detection of pathogens and an antibiotic more efficient than amoxicillin in supressing gut Proteobacteria including K. pneumoniae, and probiotics to restore the human gut anaerobic mature microbiota could save many more children with kwashiorkor.
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Affiliation(s)
- Thi-Phuong-Thao Pham
- Aix-Marseille Univ, IRD, APHM, MEPHI, Marseille, France; IHU Méditerranée Infection, Marseille, France
| | - Maryam Tidjani Alou
- Aix-Marseille Univ, IRD, APHM, MEPHI, Marseille, France; IHU Méditerranée Infection, Marseille, France
| | - Michael H Golden
- Department of Medicine and Therapeutics, University of Aberdeen, Aberdeen, Scotland, UK
| | - Matthieu Million
- Aix-Marseille Univ, IRD, APHM, MEPHI, Marseille, France; IHU Méditerranée Infection, Marseille, France
| | - Didier Raoult
- Aix-Marseille Univ, IRD, APHM, MEPHI, Marseille, France; IHU Méditerranée Infection, Marseille, France.
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17
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Thompson DS, Bourdon C, Massara P, Boyne MS, Forrester TE, Gonzales GB, Bandsma RHJ. Childhood severe acute malnutrition is associated with metabolic changes in adulthood. JCI Insight 2020; 5:141316. [PMID: 33201860 PMCID: PMC7819749 DOI: 10.1172/jci.insight.141316] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/11/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Severe acute malnutrition (SAM) is a major contributor to global mortality in children under 5 years. Mortality has decreased; however, the long-term cardiometabolic consequences of SAM and its subtypes, severe wasting (SW) and edematous malnutrition (EM), are not well understood. We evaluated the metabolic profiles of adult SAM survivors using targeted metabolomic analyses. METHODS This cohort study of 122 adult SAM survivors (SW = 69, EM = 53) and 90 age-, sex-, and BMI-matched community participants (CPs) quantified serum metabolites using direct flow injection mass spectrometry combined with reverse-phase liquid chromatography. Univariate and sparse partial least square discriminant analyses (sPLS-DAs) assessed differences in metabolic profiles and identified the most discriminative metabolites. RESULTS Seventy-seven metabolite variables were significant in distinguishing between SAM survivors (28.4 ± 8.8 years, 24.0 ± 6.1 kg/m2) and CPs (28.4 ± 8.9 years, 23.3 ± 4.4 kg/m2) (mean ± SDs) in univariate and sPLS-DA models. Compared with CPs, SAM survivors had less liver fat; higher branched-chain amino acids (BCAAs), urea cycle metabolites, and kynurenine/tryptophan (KT) ratio (P < 0.001); and lower β-hydroxybutyric acid and acylcarnitine/free carnitine ratio (P < 0.001), which were both associated with hepatic steatosis (P < 0.001). SW and EM survivors had similar metabolic profiles as did stunted and nonstunted SAM survivors. CONCLUSION Adult SAM survivors have distinct metabolic profiles that suggest reduced β-oxidation and greater risk of type 2 diabetes (BCAAs, KT ratio, urea cycle metabolites) compared with CPs. This indicates that early childhood SAM exposure has long-term metabolic consequences that may worsen with age and require targeted clinical management. FUNDING Health Research Council of New Zealand, Caribbean Public Health Agency, Centre for Global Child Health at the Hospital for Sick Children. DST is an Academic Fellow and a Restracomp Fellow at the Centre for Global Child Health. GBG is a postdoctoral fellow of the Research Foundation Flanders.
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Affiliation(s)
- Debbie S Thompson
- Translational Medicine Program, Hospital for Sick Children, Toronto, Canada.,Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada.,Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Celine Bourdon
- Translational Medicine Program, Hospital for Sick Children, Toronto, Canada.,The Childhood Acute Illness & Nutrition Network, Nairobi, Kenya
| | - Paraskevi Massara
- Translational Medicine Program, Hospital for Sick Children, Toronto, Canada.,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Michael S Boyne
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica.,Department of Medicine, The University of the West Indies, Kingston, Jamaica
| | - Terrence E Forrester
- University of the West Indies Solutions for Developing Countries, Kingston, Jamaica
| | - Gerard Bryan Gonzales
- Translational Medicine Program, Hospital for Sick Children, Toronto, Canada.,Gastroenterology, Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.,Nutrition, Metabolism and Genomics Group, Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Robert H J Bandsma
- Translational Medicine Program, Hospital for Sick Children, Toronto, Canada.,Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada.,The Childhood Acute Illness & Nutrition Network, Nairobi, Kenya.,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.,Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, Canada
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18
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Kumar D, Rao SK, Singh TB. Clinico-biochemical profile of sick children with severe acute malnutrition. J Family Med Prim Care 2020; 9:2269-2272. [PMID: 32754486 PMCID: PMC7380782 DOI: 10.4103/jfmpc.jfmpc_1236_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/11/2020] [Accepted: 03/26/2020] [Indexed: 11/04/2022] Open
Abstract
Objective Severe acute malnutrition (SAM) classified as edematous and marasmus, however, Kwashiorker represents the most severe phenotype of edematous malnutrition. The aim of this study was to describe the clinico-biochemical profile in sick children with severe acute malnutrition. Materials and Methods This is a descriptive cross-sectional study, which included children aged 6 to 60 months, fulfilling the World Health Organization (WHO) criteria of severe acute malnutrition. We collected data on demography, anthropometry, history, and clinical examination. Investigations included arterial blood gas analysis, serum electrolytes, calcium, serum albumin, and blood sugar. P value < 0.05 was considered significant. Results One hundred twenty-two children with SAM were recruited, out of which 65 (53.27%) had edematous malnutrition and 57 (46.7%) had nonedematous malnutrition. Out of total children, 90 (73.77%) were discharged from hospital, 18 (14.7%) died, and 14 (11.4%) were left against medical advice. Out of 122 children with SAM, edematous children were younger (25.7 vs. 34.5 months, P = 0.002). Children with edematous malnutrition were more likely to have pneumonia (P = 0.04), acute gastroenteritis (P < 0.001), hyponatremia (P = 0.04), metabolic acidosis (P = 0.005), and hypocalcemia (P = 0.006) when compared with nonedematous children. Edematous malnutrition has 1.3 and 1.4 times more risk of death and leave against medical advice (LAMA) respectively as compared to nonedematous malnutrition. Mortality was higher in edematous malnutrition (12, 66.6%) than nonedematous malnutrition (6, 33.3%). Conclusion Edematous malnutrition was commonly prevalent in 1 to 3 years of children and clinical and biochemical abnormalities frequently co-exist with edematous malnutrition.
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Affiliation(s)
- Dhilip Kumar
- Resident Pediatrics, IMS, BHU, Uttar Pradesh, India
| | | | - Tej Bali Singh
- Department of Biostatistics, IMS, BHU, Uttar Pradesh, India
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19
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King SE, Skinner MK. Epigenetic Transgenerational Inheritance of Obesity Susceptibility. Trends Endocrinol Metab 2020; 31:478-494. [PMID: 32521235 PMCID: PMC8260009 DOI: 10.1016/j.tem.2020.02.009] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/18/2020] [Accepted: 02/21/2020] [Indexed: 02/07/2023]
Abstract
The prevalence of obesity and associated diseases has reached pandemic levels. Obesity is often associated with overnutrition and a sedentary lifestyle, but clearly other factors also increase the susceptibility of metabolic disease states. Ancestral and direct exposures to environmental toxicants and altered nutrition have been shown to increase susceptibility for obesity and metabolic dysregulation. Environmental insults can reprogram the epigenome of the germline (sperm and eggs), which transmits the susceptibility for disease to future generations through epigenetic transgenerational inheritance. In this review, we discuss current evidence and molecular mechanisms for epigenetic transgenerational inheritance of obesity susceptibility. Understanding ancestral environmental insults and epigenetic transgenerational impacts on future generations will be critical to fully understand the etiology of obesity and to develop preventative therapy options.
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Affiliation(s)
- Stephanie E King
- Center for Reproductive Biology, School of Biological Sciences, Washington State University, Pullman, WA, 99164-4236, USA
| | - Michael K Skinner
- Center for Reproductive Biology, School of Biological Sciences, Washington State University, Pullman, WA, 99164-4236, USA.
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20
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Lock M. Toxic Environments and the Embedded Psyche. Med Anthropol Q 2020; 34:21-40. [DOI: 10.1111/maq.12545] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 07/21/2019] [Accepted: 07/22/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Margaret Lock
- Department of Social Studies of Medicine McGill University
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21
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Wells JCK. Developmental plasticity as adaptation: adjusting to the external environment under the imprint of maternal capital. Philos Trans R Soc Lond B Biol Sci 2020; 374:20180122. [PMID: 30966888 DOI: 10.1098/rstb.2018.0122] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Plasticity is assumed to enable beneficial adjustment to the environment. In this context, developmental plasticity is generally approached within a two-stage framework, whereby adjustments to ecological cues in stage 1 are exposed to selection in stage 2. This conceptual approach may have limitations, because in species providing parental investment, particularly placental mammals such as humans, initial adjustments are not to the environment directly, but rather to the niche generated by parental phenotype (in mammals, primarily that of the mother). Only as maternal investment is withdrawn is the developing organism exposed directly to prevailing ecological conditions. A three-stage model may therefore be preferable, where developmental trajectory first adjusts to maternal investment, then to the external environment. Each offspring experiences a trade-off, benefitting from maternal investment during the most vulnerable stages of development, at the cost of exposure to investment strategies that maximize maternal fitness. Maternal life-history trade-offs impact the magnitude and schedule of her investment in her offspring, generating lifelong effects on traits related to health outcomes. Understanding the imprint of maternal capital on offspring is particularly important in species demonstrating social hierarchy. Interventions targeting maternal capital might offer new opportunities to improve health outcomes of both mother and offspring. This article is part of the theme issue 'Developing differences: early-life effects and evolutionary medicine'.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health , 30 Guilford Street, London WC 1N 1EH , UK
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22
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Garland CJ. Implications of accumulative stress burdens during critical periods of early postnatal life for mortality risk among Guale interred in a colonial era cemetery in Spanish Florida (ca. AD 1605-1680). AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2020; 172:621-637. [PMID: 32064605 DOI: 10.1002/ajpa.24020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/24/2020] [Accepted: 01/29/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Research situated within the Developmental Origins of Health and Disease demonstrates that stressors are correlated with future mortality risk, especially if experienced frequently and during early periods of postnatal life. This study examines if the developmental timing and frequency of early life stressors influenced mortality risk for Indigenous Guale in Spanish Florida during the 17th century. MATERIALS AND METHODS The present study examines internal enamel microgrowth disruptions (accentuated lines-AL) from Guale individuals (n = 52) interred at Mission Santa Catalina de Guale on St. Catherines Island, Georgia (AD 1605-1680). Teeth were thin-sectioned and microscopically analyzed to document AL variables as predictors of age-at-death. RESULTS Individuals with AL died earlier than those without AL. This difference, however, was not significant. Individuals who exhibit AL formed during their first year of life died on average three times earlier than those who did not. The frequency of AL and age-at-first-AL are significantly correlated with age-at-death, and Cox hazard analyses indicates that individuals with early forming and frequent AL had increased risks of early death. DISCUSSION This study emphasizes how the lived experiences of Guale children shaped demographic patterns during the 17th century. The survival of early life stressors resulted in life history trade-offs and increased risks for early death. Mortality risks were exacerbated for individuals who experienced frequent stressors during the earliest periods of life. This underscores a role for bioarchaeology in understanding of how accumulative stress burdens during the earliest years of postnatal life may influence mortality risk.
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Affiliation(s)
- Carey J Garland
- Department of Anthropology, University of Georgia, Athens, Georgia, USA
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23
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Lu A, Petrullo L, Carrera S, Feder J, Schneider-Crease I, Snyder-Mackler N. Developmental responses to early-life adversity: Evolutionary and mechanistic perspectives. Evol Anthropol 2019; 28:249-266. [PMID: 31498945 DOI: 10.1002/evan.21791] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 03/28/2019] [Accepted: 06/11/2019] [Indexed: 02/06/2023]
Abstract
Adverse ecological and social conditions during early life are known to influence development, with rippling effects that may explain variation in adult health and fitness. The adaptive function of such developmental plasticity, however, remains relatively untested in long-lived animals, resulting in much debate over which evolutionary models are most applicable. Furthermore, despite the promise of clinical interventions that might alleviate the health consequences of early-life adversity, research on the proximate mechanisms governing phenotypic responses to adversity have been largely limited to studies on glucocorticoids. Here, we synthesize the current state of research on developmental plasticity, discussing both ultimate and proximate mechanisms. First, we evaluate the utility of adaptive models proposed to explain developmental responses to early-life adversity, particularly for long-lived mammals such as humans. In doing so, we highlight how parent-offspring conflict complicates our understanding of whether mothers or offspring benefit from these responses. Second, we discuss the role of glucocorticoids and a second physiological system-the gut microbiome-that has emerged as an additional, clinically relevant mechanism by which early-life adversity can influence development. Finally, we suggest ways in which nonhuman primates can serve as models to study the effects of early-life adversity, both from evolutionary and clinical perspectives.
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Affiliation(s)
- Amy Lu
- Department of Anthropology, Stony Brook University, Stony Brook, New York
| | - Lauren Petrullo
- Interdepartmental Doctoral Program in Anthropological Sciences, Stony Brook University, Stony Brook, New York
| | - Sofia Carrera
- Department of Psychology, University of Michigan, Ann Arbor, Michigan
| | - Jacob Feder
- Interdepartmental Doctoral Program in Anthropological Sciences, Stony Brook University, Stony Brook, New York
| | - India Schneider-Crease
- Department of Anthropology, Stony Brook University, Stony Brook, New York.,Department of Psychology, University of Washington, Seattle, Washington
| | - Noah Snyder-Mackler
- Department of Psychology, University of Washington, Seattle, Washington.,Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington
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24
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Kulkarni B, Mamidi RS. Nutrition rehabilitation of children with severe acute malnutrition: Revisiting studies undertaken by the National Institute of Nutrition. Indian J Med Res 2019; 150:139-152. [PMID: 31670269 PMCID: PMC6829782 DOI: 10.4103/ijmr.ijmr_1905_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Indexed: 11/04/2022] Open
Abstract
Severe acute malnutrition (SAM) in children under five years is an important public health problem due to associated high mortality and long-term health consequences. Research on the dietary causes of SAM, especially the role and relative importance of dietary protein, in the aetiology of oedematous malnutrition, has led to considerable debates and controversies. The present article revisits some of the debates in this field, where the researchers at the National Institute of Nutrition (NIN), Hyderabad, India, with their pioneering work, have contributed to the global literature on the various facets of the disease. Highlighting the importance of energy as a bigger problem than protein malnutrition is a noteworthy contribution of NIN's research. It is, however, important to examine the protein quality of the diets in light of the new information on the lysine requirements. The article argues that the currently dominating hypothesis of free radical theory requires a critical review of the supporting evidence. Over the past few decades, the research has focused on low-cost diets using locally available foods. The article also argues that solutions based on local foods, being acceptable and sustainable, need to be strengthened for their effective delivery through the existing nutrition programmes. Recent evidence shows that the use of ready-to-use therapeutic foods (RUTF) with high micronutrient density may be linked with higher mortality possibly due to the high iron content, which could be counterproductive. There are several unaddressed concerns regarding the potential long-term impact of consumption of RUTF in children with SAM. More evidence and a cautious approach are, therefore, needed before implementing these solutions.
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Affiliation(s)
- Bharati Kulkarni
- Division of Maternal & Child Nutrition, ICMR-National Institute of Nutrition, Hyderabad, India
| | - Raja Sriswan Mamidi
- Division of Clinical Epidemiology, ICMR-National Institute of Nutrition, Hyderabad, India
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25
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Pinel C, Prainsack B, McKevitt C. Markers as mediators: A review and synthesis of epigenetics literature. BIOSOCIETIES 2019; 13:276-303. [PMID: 31105763 PMCID: PMC6520226 DOI: 10.1057/s41292-017-0068-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Epigenetics, the study of the processes that control gene expression without a change in DNA sequence, highlights the importance of environmental factors in gene regulation. This paper maps the terrain of epigenetics and identifies four main research subfields: gene expression; molecular epigenetics; clinical epigenetics and epigenetic epidemiology. Within and across these fields, we analyse of what is conceptualised as environment and demonstrate the variable ways authors understand epigenetics environments. Then, following an analysis of the discursive strategies employed by epigenetics researchers, we demonstrate how authors portray the interactions between genes, epigenetics, and environment as relationships linking the outside (where the environment is located) with the inside (where the genes are located). We argue that authors assign specific roles to each actor: the environment as the active player initiating the relationship, the genes as recipients, and epigenetics as mediators between environment and genes. Framed as mediators, epigenetic markers can be understood as enablers of communication between environment and genome, capable of processing and organising signals so as to regulate the interactions between the actors of epigenetic relationships. This finding complicates the observation by social science scholars that the interactions between environment and genes can be understood through the concept of signal.
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Affiliation(s)
- Clémence Pinel
- School of Population Sciences and Health Services Research, King’s College London, UK
| | - Barbara Prainsack
- Department of Political Science, University of Vienna, Austria
- Department of Global Health & Social Medicine, King’s College London, UK
| | - Christopher McKevitt
- School of Population Sciences and Health Services Research, King’s College London, UK
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26
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Gluckman PD, Hanson MA, Low FM. Evolutionary and developmental mismatches are consequences of adaptive developmental plasticity in humans and have implications for later disease risk. Philos Trans R Soc Lond B Biol Sci 2019; 374:20180109. [PMID: 30966891 PMCID: PMC6460082 DOI: 10.1098/rstb.2018.0109] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2018] [Indexed: 01/29/2023] Open
Abstract
A discrepancy between the phenotype of an individual and that which would confer optimal responses in terms of fitness in an environment is termed 'mismatch'. Phenotype results from developmental plasticity, conditioned partly by evolutionary history of the species and partly by aspects of the developmental environment. We discuss two categories of such mismatch with reference primarily to nutrition and in the context of evolutionary medicine. The categories operate over very different timescales. A developmental mismatch occurs when the phenotype induced during development encounters a different environment post-development. This may be the result of wider environmental changes, such as nutritional transition between generations, or because maternal malnutrition or placental dysfunction give inaccurate information about the organism's likely future environment. An evolutionary mismatch occurs when there is an evolutionarily novel environment. Developmental plasticity may involve immediate adaptive responses (IARs) to preserve survival if an environmental challenge is severe, and/or predictive adaptive responses (PARs) if the challenge does not threaten survival, but there is a fitness advantage in developing a phenotype that will be better adapted later. PARs can have long-term adverse health consequences if there is a developmental mismatch. For contemporary humans, maternal constraint of fetal growth makes PARs likely even if there is no obvious IAR, and this, coupled with the pervasive nutritionally dense modern environment, can explain the widespread observations of developmental mismatch, particularly in populations undergoing nutritional transition. Both developmental and evolutionary mismatch have important public health consequences and implications for where policy interventions may be most effective. This article is part of the theme issue 'Developing differences: early-life effects and evolutionary medicine'.
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Affiliation(s)
- Peter D. Gluckman
- Liggins Institute, University of Auckland, New Zealand
- Singapore Institute for Clinical Sciences, Singapore
| | - Mark A. Hanson
- Institute of Developmental Sciences, University of Southampton, Southampton SO17 1BJ, UK
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27
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Williams TC, Drake AJ. Preterm birth in evolutionary context: a predictive adaptive response? Philos Trans R Soc Lond B Biol Sci 2019; 374:20180121. [PMID: 30966892 PMCID: PMC6460087 DOI: 10.1098/rstb.2018.0121] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2018] [Indexed: 12/12/2022] Open
Abstract
Preterm birth is a significant public health problem worldwide, leading to substantial mortality in the newborn period, and a considerable burden of complications longer term, for affected infants and their carers. The fact that it is so common, and rates vary between different populations, raising the question of whether in some circumstances it might be an adaptive trait. In this review, we outline some of the evolutionary explanations put forward for preterm birth. We specifically address the hypothesis of the predictive adaptive response, setting it in the context of the Developmental Origins of Health and Disease, and explore the predictions that this hypothesis makes for the potential causes and consequences of preterm birth. We describe how preterm birth can be triggered by a range of adverse environmental factors, including nutrition, stress and relative socioeconomic status. Examining the literature for any associated longer-term phenotypic changes, we find no strong evidence for a marked temporal shift in the reproductive life-history trajectory, but more persuasive evidence for a re-programming of the cardiovascular and endocrine system, and a range of effects on neurodevelopment. Distinguishing between preterm birth as a predictive, rather than immediate adaptive response will depend on the demonstration of a positive effect of these alterations in developmental trajectories on reproductive fitness. This article is part of the theme issue 'Developing differences: early-life effects and evolutionary medicine'.
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Affiliation(s)
- Thomas C. Williams
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Amanda J. Drake
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh EH16 4TJ, UK
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28
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Nutrition, the visceral immune system, and the evolutionary origins of pathogenic obesity. Proc Natl Acad Sci U S A 2018; 116:723-731. [PMID: 30598443 PMCID: PMC6338860 DOI: 10.1073/pnas.1809046116] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The global obesity epidemic is the subject of an immense, diversely specialized research effort. An evolutionary analysis reveals connections among disparate findings, starting with two well-documented facts: Obesity-associated illnesses (e.g., type-2 diabetes and cardiovascular disease), are especially common in: (i) adults with abdominal obesity, especially enlargement of visceral adipose tissue (VAT), a tissue with important immune functions; and (ii) individuals with poor fetal nutrition whose nutritional input increases later in life. I hypothesize that selection favored the evolution of increased lifelong investment in VAT in individuals likely to suffer lifelong malnutrition because of its importance in fighting intraabdominal infections. Then, when increased nutrition violates the adaptive fetal prediction of lifelong nutritional deficit, preferential VAT investment could contribute to abdominal obesity and chronic inflammatory disease. VAT prioritization may help explain several patterns of nutrition-related disease: the paradoxical increase of chronic disease with increased food availability in recently urbanized and migrant populations; correlations between poor fetal nutrition, improved childhood (catch-up) growth, and adult metabolic syndrome; and survival differences between children with marasmus and kwashiorkor malnutrition. Fats and sugars can aggravate chronic inflammation via effects on intestinal bacteria regulating gut permeability to visceral pathogens. The extremes in a nutrition-sensitive trade-off between visceral (immune-function) vs. subcutaneous (body shape) adiposity may have been favored by selection in highly stratified premedicine societies. Altered adipose allocation in populations with long histories of social stratification and malnutrition may be the result of genetic accommodation of developmental responses to poor maternal/fetal conditions, increasing their vulnerability to inflammatory disease.
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29
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Temple DH. Bioarchaeological evidence for adaptive plasticity and constraint: Exploring life‐history trade‐offs in the human past. Evol Anthropol 2018; 28:34-46. [DOI: 10.1002/evan.21754] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 06/26/2018] [Accepted: 09/28/2018] [Indexed: 01/09/2023]
Affiliation(s)
- Daniel H. Temple
- Department of Sociology and Anthropology George Mason University Fairfax Virginia
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30
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Lock M. Mutable environments and permeable human bodies★. JOURNAL OF THE ROYAL ANTHROPOLOGICAL INSTITUTE 2018. [DOI: 10.1111/1467-9655.12855] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Margaret Lock
- Department of Social Studies of Medicine; McGill University; 3647 Peel Street Montréal, Québéc H3A 1X1 Canada
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31
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Abstract
The Anthropocene has been officially declared as a new geological epoch owing to the lasting impact made by humans on environments, negatively affecting the health and even survival of human populations. Furthermore, over the past decade, molecular science has shown that the human genome is reactive to environments that are external and internal to the body. Hence, environments impact directly on individual bodies by bringing about epigenetic changes in the genome. Following a discussion of human exceptionalism and its limitations, I argue that an anthropology of embodiment should be situated in time and space, and recognition given to local biologies as a subcategory of situated biologies evident globally. Examples are then given of the intergenerational transmission of epigenetic effects due to environmental toxic exposures with a concluding call for anthropologists to engage with the worldwide challenge.
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Affiliation(s)
- Margaret Lock
- Social Studies of Medicine, McGill University, Montreal, Quebec H3A 1X1, Canada
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32
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Bernardi JR, Goldani MZ, Pinheiro TV, Guimarães LSP, Bettiol H, da Silva AAM, Barbieri MA. Gender and social mobility modify the effect of birth weight on total and central obesity. Nutr J 2017. [PMID: 28651584 PMCID: PMC5485694 DOI: 10.1186/s12937-017-0260-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Little is known about the interaction between gender and low birth weight (LBW) and lifelong social mobility as an explanation of the etiology of obesity. The aim of the present study was to evaluate total and central obesity according to gender, LBW and social mobility, within the context of the epidemiological transition in middle-income countries. We hypothesize that there are more pronounced metabolic consequences of social mobility for women born with LBW. METHODS We used data from a birth cohort study conducted in Ribeirão Preto, São Paulo, Brazil. Data regarding anthropometric measurements, schooling and smoking status were collected at 23-25 years of age. Social mobility was determined based on maternal and adult offspring schooling and categorized as Low-Low, Low-High and High-High. Analysis of covariance was performed to assess the association between social mobility and body mass index (BMI) or waist circumference (WC) in adulthood, stratified by LBW and gender. RESULTS Data on 6827 singleton pregnancies were collected at birth in 1978/79 and a sample was followed up in 2002/04. A total of 2063 subjects were included in the study. Mean age was 23.9 ± 0.7 years, 51.8% (n = 1068) were female and the LBW was 6.2% (n = 128). There was a triple interaction between social mobility, LBW and gender. Among women born without LBW, BMI and WC were higher in the Low-Low group compared to High-High schooling group. Among LBW women, BMI and WC were higher in the Low-Low group compared to the Low-High group. CONCLUSIONS Women born with LBW belonging to the low schooling group in early adulthood had high BMI and WC, compared to the Low-High social mobility group.
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Affiliation(s)
- Juliana Rombaldi Bernardi
- Departamento de Nutrição, Universidade Federal do Rio Grande do Sul, Av. Jerônimo de Ornelas, 721 - Santana, 90040-341, Porto Alegre, Rio Grande do Sul, Brazil. .,Departamento de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Santana, 90035-003, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Marcelo Zubaran Goldani
- Departamento de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Santana, 90035-003, Porto Alegre, Rio Grande do Sul, Brazil
| | - Tanara Vogel Pinheiro
- Departamento de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Santana, 90035-003, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luciano Santos Pinto Guimarães
- Unidade de Bioestatística, Grupo de Pesquisa e Pós-graduação, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Santa Cecilia, 90035-903, Porto Alegre, Rio Grande do Sul, Brazil
| | - Heloisa Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900 - Monte Alegre, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Antônio Augusto Moura da Silva
- Departamento de Saúde Pública, Universidade Federal do Maranhão, Av. dos Portugueses, 1966 - Vila Bacanga, MA, 65085-580, São Luís, Maranhão, Brazil
| | - Marco Antônio Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900 - Monte Alegre, Ribeirão Preto, São Paulo, 14049-900, Brazil
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Sheppard A, Ngo S, Li X, Boyne M, Thompson D, Pleasants A, Gluckman P, Forrester T. Molecular Evidence for Differential Long-term Outcomes of Early Life Severe Acute Malnutrition. EBioMedicine 2017; 18:274-280. [PMID: 28330812 PMCID: PMC5405153 DOI: 10.1016/j.ebiom.2017.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/14/2017] [Accepted: 03/01/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Severe acute malnutrition (SAM) in infants may present as one of two distinct syndromic forms: non-edematous (marasmus), with severe wasting and no nutritional edema; or edematous (kwashiorkor) with moderately severe wasting. These differences may be related to developmental changes prior to the exposure to SAM and phenotypic changes appear to persist into adulthood with differences between the two groups. We examined whether the different response to SAM and subsequent trajectories may be explained by developmentally-induced epigenetic differences. METHODS We extracted genomic DNA from muscle biopsies obtained from adult survivors of kwashiorkor (n=21) or marasmus (n=23) and compared epigenetic profiles (CpG methylation) between the two groups using the Infinium® 450K BeadChip array. FINDINGS We found significant differences in methylation of CpG sites from 63 genes in skeletal muscle DNA. Gene ontology studies showed significant differential methylation of genes in immune, body composition, metabolic, musculoskeletal growth, neuronal function and cardiovascular pathways, pathways compatible with the differences in the pathophysiology of adult survivors of SAM. INTERPRETATION These findings suggest persistent developmental influences on adult physiology in survivors of SAM. Since children who develop marasmus have lower birth weights and after rehabilitation have different intermediary metabolism, these studies provide further support for persistent developmentally-induced phenomena mediated by epigenetic processes affecting both the infant response to acute malnutrition and later life consequences. FUNDING Supported by a Grant from the Bill and Melinda Gates Foundation (Global Health OPP1066846), Grand Challenge "Discover New Ways to Achieve Healthy Growth." EVIDENCE BEFORE THIS STUDY Previous research has shown that infants who develop either kwashiorkor or marasmus in response to SAM differ in birth weight and subsequently have different metabolic patterns in both infancy and adulthood. ADDED VALUE OF THIS STUDY This study demonstrates epigenetic differences in the skeletal muscle of adult survivors of marasmus versus kwashiorkor and these differences are in genes that may underlie the longer-term consequences. IMPLICATIONS OF ALL THE AVAILABLE EVIDENCE These data are compatible with the different clinical responses to SAM arising from developmentally-induced epigenetic changes laid down largely before birth and provide evidence for the predictive adaptive response model operating in human development.
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Affiliation(s)
- Allan Sheppard
- The Liggins Institute, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand
| | - Sherry Ngo
- The Liggins Institute, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand
| | - Xiaoling Li
- The Liggins Institute, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand
| | - Michael Boyne
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston 7, Jamaica
| | - Debbie Thompson
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston 7, Jamaica
| | - Anthony Pleasants
- The Liggins Institute, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand
| | - Peter Gluckman
- The Liggins Institute, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand
| | - Terrence Forrester
- The Liggins Institute, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand; UWI Solutions for Developing Countries, The University of the West Indies, Mona, Kingston 7, Jamaica.
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Campbell CP, Raubenheimer D, Badaloo AV, Gluckman PD, Martinez C, Gosby A, Simpson SJ, Osmond C, Boyne MS, Forrester TE. Developmental contributions to macronutrient selection: a randomized controlled trial in adult survivors of malnutrition. EVOLUTION MEDICINE AND PUBLIC HEALTH 2016; 2016:158-69. [PMID: 26817484 PMCID: PMC4871598 DOI: 10.1093/emph/eov030] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 10/14/2015] [Indexed: 11/13/2022]
Abstract
Background and objectives: Birthweight differences between kwashiorkor and marasmus suggest that intrauterine factors influence the development of these syndromes of malnutrition and may modulate risk of obesity through dietary intake. We tested the hypotheses that the target protein intake in adulthood is associated with birthweight, and that protein leveraging to maintain this target protein intake would influence energy intake (EI) and body weight in adult survivors of malnutrition. Methodology: Sixty-three adult survivors of marasmus and kwashiorkor could freely compose a diet from foods containing 10, 15 and 25 percentage energy from protein (percentage of energy derived from protein (PEP); Phase 1) for 3 days. Participants were then randomized in Phase 2 (5 days) to diets with PEP fixed at 10%, 15% or 25%. Results: Self-selected PEP was similar in both groups. In the groups combined, selected PEP was 14.7, which differed significantly (P < 0.0001) from the null expectation (16.7%) of no selection. Self-selected PEP was inversely related to birthweight, the effect disappearing after adjusting for sex and current body weight. In Phase 2, PEP correlated inversely with EI (P = 0.002) and weight change from Phase 1 to 2 (P = 0.002). Protein intake increased with increasing PEP, but to a lesser extent than energy increased with decreasing PEP. Conclusions and implications: Macronutrient intakes were not independently related to birthweight or diagnosis. In a free-choice situation (Phase 1), subjects selected a dietary PEP significantly lower than random. Lower PEP diets induce increased energy and decreased protein intake, and are associated with weight gain.
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Affiliation(s)
- Claudia P Campbell
- UWI Solutions for Developing Countries, University of the West Indies, Mona, Kingston, Jamaica
| | - David Raubenheimer
- Liggins Institute and National Research Centre for Growth and Development, University of Auckland, Auckland, New Zealand Charles Perkins Centre and School of Biological Sciences, The University of Sydney, Sydney, NSW, Australia Faculty of Veterinary Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Asha V Badaloo
- Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica
| | - Peter D Gluckman
- Liggins Institute and National Research Centre for Growth and Development, University of Auckland, Auckland, New Zealand
| | - Claudia Martinez
- Liggins Institute and National Research Centre for Growth and Development, University of Auckland, Auckland, New Zealand
| | - Alison Gosby
- Charles Perkins Centre and School of Biological Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Stephen J Simpson
- Charles Perkins Centre and School of Biological Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Michael S Boyne
- Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica
| | - Terrence E Forrester
- UWI Solutions for Developing Countries, University of the West Indies, Mona, Kingston, Jamaica
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Li L, Zheng W, Zhu Y, Ye H, Tang B, Arendsee ZW, Jones D, Li R, Ortiz D, Zhao X, Du C, Nettleton D, Scott MP, Salas-Fernandez MG, Yin Y, Wurtele ES. QQS orphan gene regulates carbon and nitrogen partitioning across species via NF-YC interactions. Proc Natl Acad Sci U S A 2015; 112:14734-9. [PMID: 26554020 PMCID: PMC4664325 DOI: 10.1073/pnas.1514670112] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The allocation of carbon and nitrogen resources to the synthesis of plant proteins, carbohydrates, and lipids is complex and under the control of many genes; much remains to be understood about this process. QQS (Qua-Quine Starch; At3g30720), an orphan gene unique to Arabidopsis thaliana, regulates metabolic processes affecting carbon and nitrogen partitioning among proteins and carbohydrates, modulating leaf and seed composition in Arabidopsis and soybean. Here the universality of QQS function in modulating carbon and nitrogen allocation is exemplified by a series of transgenic experiments. We show that ectopic expression of QQS increases soybean protein independent of the genetic background and original protein content of the cultivar. Furthermore, transgenic QQS expression increases the protein content of maize, a C4 species (a species that uses 4-carbon photosynthesis), and rice, a protein-poor agronomic crop, both highly divergent from Arabidopsis. We determine that QQS protein binds to the transcriptional regulator AtNF-YC4 (Arabidopsis nuclear factor Y, subunit C4). Overexpression of AtNF-YC4 in Arabidopsis mimics the QQS-overexpression phenotype, increasing protein and decreasing starch levels. NF-YC, a component of the NF-Y complex, is conserved across eukaryotes. The NF-YC4 homologs of soybean, rice, and maize also bind to QQS, which provides an explanation of how QQS can act in species where it does not occur endogenously. These findings are, to our knowledge, the first insight into the mechanism of action of QQS in modulating carbon and nitrogen allocation across species. They have major implications for the emergence and function of orphan genes, and identify a nontransgenic strategy for modulating protein levels in crop species, a trait of great agronomic significance.
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Affiliation(s)
- Ling Li
- Department of Genetics, Development and Cell Biology, Iowa State University, Ames, IA 50011; Center for Metabolic Biology, Iowa State University, Ames, IA 50011;
| | - Wenguang Zheng
- Department of Genetics, Development and Cell Biology, Iowa State University, Ames, IA 50011; Center for Metabolic Biology, Iowa State University, Ames, IA 50011
| | - Yanbing Zhu
- Department of Genetics, Development and Cell Biology, Iowa State University, Ames, IA 50011
| | - Huaxun Ye
- Department of Genetics, Development and Cell Biology, Iowa State University, Ames, IA 50011
| | - Buyun Tang
- Department of Genetics, Development and Cell Biology, Iowa State University, Ames, IA 50011
| | - Zebulun W Arendsee
- Department of Genetics, Development and Cell Biology, Iowa State University, Ames, IA 50011
| | - Dallas Jones
- Department of Genetics, Development and Cell Biology, Iowa State University, Ames, IA 50011
| | - Ruoran Li
- Department of Genetics, Development and Cell Biology, Iowa State University, Ames, IA 50011
| | - Diego Ortiz
- Department of Agronomy, Iowa State University, Ames, IA 50011
| | - Xuefeng Zhao
- Department of Biochemistry, Biophysics and Molecular Biology, Iowa State University, Ames, IA 50011
| | - Chuanlong Du
- Department of Statistics, Iowa State University, Ames, IA 50011
| | - Dan Nettleton
- Department of Statistics, Iowa State University, Ames, IA 50011
| | - M Paul Scott
- Department of Agronomy, Iowa State University, Ames, IA 50011; Corn Insects and Crop Genetics Research Unit, Agricultural Research Service, US Department of Agriculture, Ames, IA 50011
| | | | - Yanhai Yin
- Department of Genetics, Development and Cell Biology, Iowa State University, Ames, IA 50011
| | - Eve Syrkin Wurtele
- Department of Genetics, Development and Cell Biology, Iowa State University, Ames, IA 50011; Center for Metabolic Biology, Iowa State University, Ames, IA 50011;
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Rytter MJH, Namusoke H, Babirekere-Iriso E, Kæstel P, Girma T, Christensen VB, Michaelsen KF, Friis H. Social, dietary and clinical correlates of oedema in children with severe acute malnutrition: a cross-sectional study. BMC Pediatr 2015; 15:25. [PMID: 25885808 PMCID: PMC4383214 DOI: 10.1186/s12887-015-0341-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 03/04/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Severe acute malnutrition is a serious public health problem, and a challenge to clinicians. Why some children with malnutrition develop oedema (kwashiorkor) is not well understood. The objective of this study was to investigate socio-demographic, dietary and clinical correlates of oedema, in children hospitalised with severe acute malnutrition. METHODS We recruited children with severe acute malnutrition admitted to Mulago Hospital, Uganda. Data was collected using questionnaires, clinical examination and measurement of blood haemoglobin, plasma c-reactive protein and α1-acid glycoprotein. Correlates of oedema were identified using multiple logistic regression analysis. RESULTS Of 120 children included, 77 (64%) presented with oedematous malnutrition. Oedematous children were slightly older (17.7 vs. 15.0 months, p = 0.006). After adjustment for age and sex, oedematous children were less likely to be breastfed (odds ratio (OR): 0.19, 95%-confidence interval (CI): 0.06; 0.59), to be HIV-infected (OR: 0.10, CI: 0.03; 0.41), to report cough (OR: 0.33, CI: 0.13; 0.82) and fever (OR: 0.22, CI: 0.09; 0.51), and to have axillary temperature > 37.5 °C (OR: 0.28 CI: 0.11; 0.68). Household dietary diversity score was lower in children with oedema (OR: 0.58, CI: 0.40; 85). No association was found with plasma levels of acute phase proteins, household food insecurity or birth weight. CONCLUSION Children with oedematous malnutrition were less likely to be breastfed, less likely to have HIV infection and had fewer symptoms of other infections. Dietary diversity was lower in households of children who presented with oedema. Future research may confirm whether a causal relationship exists between these factors and nutritional oedema.
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Affiliation(s)
- Maren Johanne Heilskov Rytter
- Department of Paediatrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. .,Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, 1958, Frederiksberg C, Denmark.
| | - Hanifa Namusoke
- Mwanamugimu Nutrition Unit, Department of Paediatrics, Mulago Hospital, Kampala, Uganda.
| | - Esther Babirekere-Iriso
- Mwanamugimu Nutrition Unit, Department of Paediatrics, Mulago Hospital, Kampala, Uganda. .,Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, 1958, Frederiksberg C, Denmark.
| | - Pernille Kæstel
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, 1958, Frederiksberg C, Denmark.
| | - Tsinuel Girma
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, 1958, Frederiksberg C, Denmark. .,Department of Paediatrics and Child Health, Jimma University Specialized Hospital, Jimma, Ethiopia.
| | - Vibeke Brix Christensen
- Department of Paediatrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, 1958, Frederiksberg C, Denmark.
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, 1958, Frederiksberg C, Denmark.
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Bateson P, Gluckman P, Hanson M. The biology of developmental plasticity and the Predictive Adaptive Response hypothesis. J Physiol 2015; 592:2357-68. [PMID: 24882817 DOI: 10.1113/jphysiol.2014.271460] [Citation(s) in RCA: 312] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Many forms of developmental plasticity have been observed and these are usually beneficial to the organism. The Predictive Adaptive Response (PAR) hypothesis refers to a form of developmental plasticity in which cues received in early life influence the development of a phenotype that is normally adapted to the environmental conditions of later life. When the predicted and actual environments differ, the mismatch between the individual's phenotype and the conditions in which it finds itself can have adverse consequences for Darwinian fitness and, later, for health. Numerous examples exist of the long-term effects of cues indicating a threatening environment affecting the subsequent phenotype of the individual organism. Other examples consist of the long-term effects of variations in environment within a normal range, particularly in the individual's nutritional environment. In mammals the cues to developing offspring are often provided by the mother's plane of nutrition, her body composition or stress levels. This hypothetical effect in humans is thought to be important by some scientists and controversial by others. In resolving the conflict, distinctions should be drawn between PARs induced by normative variations in the developmental environment and the ill effects on development of extremes in environment such as a very poor or very rich nutritional environment. Tests to distinguish between different developmental processes impacting on adult characteristics are proposed. Many of the mechanisms underlying developmental plasticity involve molecular epigenetic processes, and their elucidation in the context of PARs and more widely has implications for the revision of classical evolutionary theory.
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Affiliation(s)
- Patrick Bateson
- Department of Zoology, University of Cambridge, Cambridge, UK
| | - Peter Gluckman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Mark Hanson
- Institute of Developmental Sciences, Faculty of Medicine, University of Southampton and NIHR Nutrition Biomedical Research Centre, Universazity Hospital Southampton, Southampton, UK
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The importance of early life in childhood obesity and related diseases: a report from the 2014 Gravida Strategic Summit. J Dev Orig Health Dis 2014; 5:398-407. [PMID: 25308169 PMCID: PMC4255318 DOI: 10.1017/s2040174414000488] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Obesity and its related non-communicable diseases (NCDs), such as type 2 diabetes, heart disease and cancer, impose huge burdens on society, particularly the healthcare system. Until recently, public health and policy were primarily focused on secondary prevention and treatment of NCDs. However, epidemiological and experimental evidence indicates that early-life exposures influence the risk of childhood obesity and related diseases later in life, and has now focused attention on the health of both mother and child. During pregnancy and the early neonatal period, individuals respond to their environment by establishing anatomical, physiological and biochemical trajectories that shape their future health. This period of developmental plasticity provides an early window of opportunity to mitigate the environmental insults that may increase an individual’s sensitivity to, or risk of, developing obesity or related diseases later in life. Although much investigation has already occurred in the area of Developmental Origins of Health and Disease research, the science itself is still in its infancy. It remains for researchers to tackle the important outstanding questions and translate their knowledge into workable solutions for the public good. The challenge, however, is to decide which areas to focus on. With these opportunities and challenges in mind, the 2014 Gravida Summit convened to examine how its early-life research program can determine which areas of research into mechanisms, biomarkers and interventions could contribute to the international research strategy to fight childhood obesity and its related diseases.
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Hanson MA, Gluckman PD. Early developmental conditioning of later health and disease: physiology or pathophysiology? Physiol Rev 2014; 94:1027-76. [PMID: 25287859 PMCID: PMC4187033 DOI: 10.1152/physrev.00029.2013] [Citation(s) in RCA: 717] [Impact Index Per Article: 71.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Extensive experimental animal studies and epidemiological observations have shown that environmental influences during early development affect the risk of later pathophysiological processes associated with chronic, especially noncommunicable, disease (NCD). This field is recognized as the developmental origins of health and disease (DOHaD). We discuss the extent to which DOHaD represents the result of the physiological processes of developmental plasticity, which may have potential adverse consequences in terms of NCD risk later, or whether it is the manifestation of pathophysiological processes acting in early life but only becoming apparent as disease later. We argue that the evidence suggests the former, through the operation of conditioning processes induced across the normal range of developmental environments, and we summarize current knowledge of the physiological processes involved. The adaptive pathway to later risk accords with current concepts in evolutionary developmental biology, especially those concerning parental effects. Outside the normal range, effects on development can result in nonadaptive processes, and we review their underlying mechanisms and consequences. New concepts concerning the underlying epigenetic and other mechanisms involved in both disruptive and nondisruptive pathways to disease are reviewed, including the evidence for transgenerational passage of risk from both maternal and paternal lines. These concepts have wider implications for understanding the causes and possible prevention of NCDs such as type 2 diabetes and cardiovascular disease, for broader social policy and for the increasing attention paid in public health to the lifecourse approach to NCD prevention.
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Affiliation(s)
- M A Hanson
- Academic Unit of Human Development and Health, University of Southampton, and NIHR Nutrition Biomedical Research Centre, University Hospital, Southampton, United Kingdom; and Liggins Institute and Gravida (National Centre for Growth and Development), University of Auckland, Auckland, New Zealand
| | - P D Gluckman
- Academic Unit of Human Development and Health, University of Southampton, and NIHR Nutrition Biomedical Research Centre, University Hospital, Southampton, United Kingdom; and Liggins Institute and Gravida (National Centre for Growth and Development), University of Auckland, Auckland, New Zealand
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Weisstaub G, Aguilar AM, Uauy R. Treatment and prevention of malnutrition in Latin America: focus on Chile and Bolivia. Food Nutr Bull 2014; 35:S39-46. [PMID: 25069292 DOI: 10.1177/15648265140352s106] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Seven million children under 5 years of age died worldwide in 2011, and one-third had malnutrition. Latin America and Caribbean countries stand out for the notable improvement of their health and nutrition situation, particularly in pregnant women and young children. Nutrition-sensitive interventions such as promoting food security, women's empowerment, social safety nets, clean water, and sanitation, among others, are critical for success. In Bolivia, the program Desnutrición Cero (Malnutrition Zero) was able to reduce mortality from severe malnutrition after 5 years from 25% to less than 5%, based on widespread implementation of the World Health Organization 10-steps protocol for hospitalized care and the application of community management. The Economic Commission for Latin America estimated the cost of malnutrition for Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama, and the Dominican Republic as US $6,658 million. Approximately 1 million children have dropped out of school because of malnutrition, and as a result, malnourished children have 2 years less schooling, which brings social and economic losses not only to those affected but to society at large. National and international nutrition and food programs developed over the past 50 years have been implemented as integral components of broader strategies of primary healthcare and education, oriented toward preventing deaths and improving the quality of life of low-socioeconomic-status groups. Treating hundreds or thousands of affected children will not solve the global public health problem of malnutrition. Access to adequate amounts of quality foods represents a basic human right and is a necessary precondition for health. In turn, good nutrition and health are prerequisites for human, social, and economic development.
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Tennant IA, Barnett AT, Thompson DS, Kips J, Boyne MS, Chung EE, Chung AP, Osmond C, Hanson MA, Gluckman PD, Segers P, Cruickshank JK, Forrester TE. Impaired cardiovascular structure and function in adult survivors of severe acute malnutrition. Hypertension 2014; 64:664-71. [PMID: 24980666 DOI: 10.1161/hypertensionaha.114.03230] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Malnutrition below 5 years remains a global health issue. Severe acute malnutrition (SAM) presents in childhood as oedematous (kwashiorkor) or nonoedematous (marasmic) forms, with unknown long-term cardiovascular consequences. We hypothesized that cardiovascular structure and function would be poorer in SAM survivors than unexposed controls. We studied 116 adult SAM survivors, 54 after marasmus, 62 kwashiorkor, and 45 age/sex/body mass index-matched community controls who had standardized anthropometry, blood pressure, echocardiography, and arterial tonometry performed. Left ventricular indices and outflow tract diameter, carotid parameters, and pulse wave velocity were measured, with systemic vascular resistance calculated. All were expressed as SD scores. Mean (SD) age was 28.8±7.8 years (55% men). Adjusting for age, sex, height, and weight, SAM survivors had mean (SE) reductions for left ventricular outflow tract diameter of 0.67 (0.16; P<0.001), stroke volume 0.44 (0.17; P=0.009), cardiac output 0.5 (0.16; P=0.001), and pulse wave velocity 0.32 (0.15; P=0.03) compared with controls but higher diastolic blood pressures (by 4.3; 1.2-7.3 mm Hg; P=0.007). Systemic vascular resistance was higher in marasmus and kwashiorkor survivors (30.2 [1.2] and 30.8 [1.1], respectively) than controls 25.3 (0.8), overall difference 5.5 (95% confidence interval, 2.8-8.4 mm Hg min/L; P<0.0001). No evidence of large vessel or cardiac remodeling was found, except closer relationships between these indices in former marasmic survivors. Other parameters did not differ between SAM survivor groups. We conclude that adult SAM survivors had smaller outflow tracts and cardiac output when compared with controls, yet markedly elevated peripheral resistance. Malnutrition survivors are thus likely to develop excess hypertension in later life, especially when exposed to obesity.
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Affiliation(s)
- Ingrid A Tennant
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Alan T Barnett
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Debbie S Thompson
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Jan Kips
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Michael S Boyne
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Edward E Chung
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Andrene P Chung
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Clive Osmond
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Mark A Hanson
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Peter D Gluckman
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Patrick Segers
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - J Kennedy Cruickshank
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.)
| | - Terrence E Forrester
- From the Tropical Medicine Research Institute (D.S.T., M.S.B.), Departments of Surgery, Radiology, Anaesthesia, and Intensive Care (I.A.T., A.T.B.), Medicine (Cardiology) (E.E.C., A.P.C.), and UWI Solutions for Developing Countries (T.E.F.), University of the West Indies, Mona, Kingston, Jamaica; Institute Biomedical Technology, Ghent University, Gent, Belgium (J.K., P.S.); MRC Lifecourse Epidemiology Unit (C.O.) and DOHAD Division (M.A.H.), University of Southampton, Southampton, United Kingdom; Centre for Human Evolution, Adaptation, and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand (P.D.G.); and Division of Diabetes, Cardiovascular Medicine, and Nutrition, King's College and King's Health Partners, London, United Kingdom (J.K.C.).
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Francis-Emmanuel PM, Thompson DS, Barnett AT, Osmond C, Byrne CD, Hanson MA, Gluckman PD, Forrester TE, Boyne MS. Glucose metabolism in adult survivors of severe acute malnutrition. J Clin Endocrinol Metab 2014; 99:2233-40. [PMID: 24517147 DOI: 10.1210/jc.2013-3511] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT AND OBJECTIVES The clinical syndromes of severe acute malnutrition may have early life origins because children with marasmus have lower birth weight than those with kwashiorkor. We hypothesized that resultant metabolic effects may persist into adulthood. We investigated whether marasmus survivors (MS) are more insulin resistant and glucose intolerant than kwashiorkor survivors (KS). RESEARCH DESIGN AND SETTING This was a case-control study in Jamaican adults. SUBJECTS We performed oral glucose tolerance tests on 191 adults (aged 17-50 y; 52% male; body mass index 24.2 ± 5.5 kg/m(2)). There were 43 MS; 38 KS; 70 age-, sex-, and body mass index-matched community controls; and 40 age- and birth weight-matched controls. MEASUREMENTS We measured insulin sensitivity with the whole-body insulin sensitivity index, and β-cell function with the insulinogenic index and the oral disposition index. RESULTS Fasting glucose was comparable across groups, but glucose intolerance was significantly more common in MS (19%) than in KS (3%), community controls (11%), and birth weight-matched controls (10%). The whole-body insulin sensitivity index was lower in MS than KS (P = .06) but similar between MS and controls. The insulinogenic index and oral disposition index were lower in MS compared with all three groups (P < .01). CONCLUSIONS Marasmus survivors tend to be less insulin sensitive, but have significantly lower insulin secretion and are more glucose intolerant compared with kwashiorkor survivors and controls. This suggests that poor nutrition in early life causes β-cell dysfunction, which may predispose to the development of diabetes.
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Affiliation(s)
- Patrice M Francis-Emmanuel
- Tropical Medicine Research Institute (P.M.F.-E., D.S.T., A.T.B., T.E.F., M.S.B.) and Department of Surgery, Radiology, Anaesthesia, and Intensive Care (A.T.B.), The University of the West Indies, Mona, Kingston 7, Jamaica, West Indies; Medical Research Council Lifecourse Epidemiology Unit (C.O.), Institute of Developmental Sciences (M.A.H.) and Nutrition and Metabolism Unit (C.D.B.), School of Medicine, University of Southampton, Southampton SO16 6YD, United Kingdom; and Centre for Human Evolution, Adaptation, and Disease (P.D.G.), Liggins Institute, University of Auckland, Auckland 1142, New Zealand
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Obesity at conception programs the opioid system in the offspring brain. Neuropsychopharmacology 2014; 39:801-10. [PMID: 23924601 PMCID: PMC3924512 DOI: 10.1038/npp.2013.193] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 07/29/2013] [Accepted: 07/29/2013] [Indexed: 02/05/2023]
Abstract
Maternal obesity during pregnancy increases the risk for offspring obesity, in part through effects on the developing brain. Previous research has shown that perinatal consumption of highly palatable foods by the mother can influence the development of offspring taste preferences and alter gene expression within the central nervous system (CNS) reward system. Opioids stimulate consumption of both fats and carbohydrates, and overconsumption of these energy dense foods increases the risk for obesity. What has remained unclear is whether this risk can be transmitted to the offspring before gestation or if it is wholly the gestational exposure that affects offspring brain development. Utilizing an embryo transfer experimental design, 2-cell embryos were obtained from obese or control dams, and transferred to obese or control gestational carriers. Expression of the mu-opioid receptor (MOR), preproenkephalin (PENK), and the dopamine transporter was evaluated in the hypothalamus and reward circuitry (ventral tegmental area, prefrontal cortex, and nucleus accumbens) in adult and late embryonic brains. Obesity before pregnancy altered expression levels of both MOR and PENK, with males relatively more affected than females. These data are the first to demonstrate that obesity at conception, in addition to during gestation, can program the brain reward system.
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Girma T, Kæstel P, Mølgaard C, Michaelsen KF, Hother AL, Friis H. Predictors of oedema among children hospitalized with severe acute malnutrition in Jimma University Hospital, Ethiopia: a cross sectional study. BMC Pediatr 2013; 13:204. [PMID: 24314329 PMCID: PMC3866507 DOI: 10.1186/1471-2431-13-204] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 11/27/2013] [Indexed: 11/29/2022] Open
Abstract
Background Severe acute malnutrition has two main clinical manifestations, i.e., oedematous and non-oedematous. However, factors associated with oedema are not well established. Methods Children 0.5-14 years of age with SAM (MUAC < 11.0 cm or weight-for-height < 70 % of median and/or nutritional oedema) admitted to the nutrition unit were included. Information on infections before and during admission was collected together with anthropometry. Predictors of oedema was analysed separately for younger (< 60 months) and older children (≥ 60 months). Results 351 children were recruited (median age: 36 months (interquartile range 24 to 60); 43.3% females). Oedema was detected in 61.1%. The prevalence of oedema increased with age, peaked at 37–59 months (75%) and declined thereafter. Infection was more common in the younger group (33% vs. 8.9%, p < 0.001) and in this group children with oedema had less infections (25.2% vs. 45.1%, p = 0.001). In the older group the prevalence of infections was not different between oedematous and non-oedematous children (5.5% v. 14.3%, p = 0.17). In the younger group oedema was less common in children with TB (OR = 0.20, 95% CI: 0.06, 0.70) or diarrhea (OR = 0.40, 95% CI: 0.21, 0.73). Conclusions The proportion of oedema in SAM peaked at three to five years of age and a considerable proportion was above 5 years. Furthermore, the prevalence of infection seemed to be lower among children with oedema. Further studies are needed to better understand the role of infection-immunity interaction.
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Affiliation(s)
- Tsinuel Girma
- Department of Pediatrics and Child Health, Jimma University Specialized Hospital, Jimma, Ethiopia.
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Benyshek DC. The “early life” origins of obesity-related health disorders: New discoveries regarding the intergenerational transmission of developmentally programmed traits in the global cardiometabolic health crisis. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2013; 152 Suppl 57:79-93. [DOI: 10.1002/ajpa.22393] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 09/17/2013] [Indexed: 12/21/2022]
Affiliation(s)
- Daniel C. Benyshek
- Department of Anthropology, University of Nevada; Las Vegas Las Vegas, NV 89154-5003
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Hayward AD, Rickard IJ, Lummaa V. Influence of early-life nutrition on mortality and reproductive success during a subsequent famine in a preindustrial population. Proc Natl Acad Sci U S A 2013; 110:13886-91. [PMID: 23918366 PMCID: PMC3752237 DOI: 10.1073/pnas.1301817110] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Individuals with insufficient nutrition during development often experience poorer later-life health and evolutionary fitness. The Predictive Adaptive Response (PAR) hypothesis proposes that poor early-life nutrition induces physiological changes that maximize fitness in similar environments in adulthood and that metabolic diseases result when individuals experiencing poor nutrition during development subsequently encounter good nutrition in adulthood. However, although cohort studies have shown that famine exposure in utero reduces health in favorable later-life conditions, no study on humans has demonstrated the predicted fitness benefit under low later-life nutrition, leaving the evolutionary origins of such plasticity unexplored. Taking advantage of a well-documented famine and unique datasets of individual life histories and crop yields from two preindustrial Finnish populations, we provide a test of key predictions of the PAR hypothesis. Known individuals from fifty cohorts were followed from birth until the famine, where we analyzed their survival and reproductive success in relation to the crop yields around birth. We were also able to test whether the long-term effects of early-life nutrition differed between individuals of varying socioeconomic status. We found that, contrary to predictions of the PAR hypothesis, individuals experiencing low early-life crop yields showed lower survival and fertility during the famine than individuals experiencing high early-life crop yields. These effects were more pronounced among young individuals and those of low socioeconomic status. Our results do not support the hypothesis that PARs should have been favored by natural selection and suggest that alternative models may need to be invoked to explain the epidemiology of metabolic diseases.
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Affiliation(s)
- Adam D Hayward
- Department of Animal and Plant Sciences, University of Sheffield, Western Bank, Sheffield S10 2TN, United Kingdom.
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