Quality of complementary feeding and its effect on nutritional status in preterm infants: a cross-sectional study

BACKGROUND

The first 2 years of life represent a critical phase for growth and development, with the quality of the diet at this stage having repercussions throughout adulthood. The present study aimed to develop an Index for Measuring the Quality of Complementary Feeding (IMQCF) for infants, as well as to evaluate diet quality and its effects on the nutritional status of preterm infants.

METHODS

This cross-sectional study was conducted at a Brazilian University Hospital. The data were extracted by care protocol of outpatient preterm infants at 2 years of corrected age (CA). Dietary data were collected from 24-h recalls. The diet quality was assessed by the IMQCF composed of nine items based on a Brazilian Food Guide for children aged <2 years. Response options were scored 0-100, with scores closer to 100 representing a better quality diet. Association with growth indicators (Z-scores for weight- and length-for-age (WAZ and LAZ) were evaluated via tests of mean difference and multiple linear regression.

RESULTS

The median complementary feeding (CF) score was 72.2 (61.1-77.8) A shorter breastfeeding duration or infant formula use and the early introduction of wheat-based foods, ultra-processed foods and cow's milk in the preterm's diet were the main factors interfering in the adequacy of diet. There was an association between the quality of the diet score and WAZ (0.44; 95% confidence interval = 0.03-0.85; P = 0.03).

CONCLUSIONS

The introduction of poor quality food in the first 2 years of life interfered with the CF quality of preterm infants and can affect nutritional status at 2 years of CA, possibly in the long term.

Oral fish oil positively influences nutritional-inflammatory risk in patients with haematological malignancies during chemotherapy with an impact on long-term survival: a randomised clinical trial

BACKGROUND

Studies suggest that the ingestion of fish oil (FO), a source of the omega-3 polyunsaturated fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), can reduce the deleterious side-effects of chemotherapy. The aim of this randomised clinical trial was to evaluate the effect of supplementation with oral FO for 9 weeks on nutritional parameters and inflammatory nutritional risk in patients with haematological malignancies during the beginning of chemotherapy.

METHODS

Twenty-two patients with leukaemia or lymphoma were randomised to the unsupplemented group (UG) (n = 13) or supplemented group (SG) (n = 9). SG received 2 g/day of fish oil for 9 weeks. Nutritional status, serum acute-phase proteins and plasma fatty acids were evaluated before (T0) and after (T1) the intervention period. Data were analysed using two models; model 1, comprising data from all patients included in the study, and model 2, comprising data from UG patients with no increase in the proportions of EPA and DHA in plasma and data from SG patients showing an at least 100% increase in plasma EPA and DHA.

RESULTS

SG showed an increased plasma proportion of EPA and DHA in both models. In model 2, C-reactive protein (CRP) and CRP/albumin ratio showed larger reductions in the SG. Overall long-term survival in both models (465 days after the start of the chemotherapy) was higher in the group ingesting fish oil (P < 0.05).

CONCLUSIONS

These findings indicate an improved nutritional-inflammatory risk and potential effects on long-term survival in patients with haematological malignancies supplemented with FO during the beginning of chemotherapy.

Analysis of the motivation for hematopoietic stem cell donation

The Italian Bone Marrow Donor Register is the institutional organization for management of unrelated hematopoietic stem cell donors. The law requires only a donor's clinical history, but not a psychosocial profile for registration. We have studied the donor's motivation for enlistment on the donor registry and the medical staff's need for this information to interact correctly with the donor. For this purpose we distributed a questionnaire to new donors at the 20 centers in the Lombardy Region over a period of 1 year. The analysis of the responses revealed a prevalence of extrinsic motivations that would not ensure continued registration for donation. Therefore, it is necessary that the donor be well informed and better educated about all aspects of donation, in order to produce a shift to an intrinsic motivation. This objective can be facilitated via professional training of health workers in communication.

Abnormal neutrophil chemotaxis in bone marrow transplant patients correlates with impaired 31D8 monoclonal antibody binding

BACKGROUND

31D8 monoclonal antibody (mAb) has been shown to bind heterogeneously to human neutrophils, identifying subsets of cells which differ in their functional response to chemotactic stimuli. In this study we used 31D8 mAb to determine whether differences in neutrophil subpopulations might explain the long-lasting decreased chemotaxis observed in bone marrow transplant recipients.

METHODS

Thirty patients with self-sustaining hematopoiesis 1 to 5 years bone marrow transplantation (BMT) (15 allogeneic and 15 autologous) performed for acute lymphocytic leukemia (ALL, 10 patients) or acute myelogenous leukemia in complete remission (8 patients), Hodgkin's lymphoma (2 patients), chronic myeloid leukemia (8 patients) and severe aplastic anemia (2 patients) were included in the study. Neutrophil chemotaxis was evaluated using a modified Boyden chamber assay and 31D8 binding was determined by indirect immunofluorescence and cytofluorimetric analysis.

RESULTS

Neutrophil chemotaxis was significantly impaired in the BMT group with respect to controls. The chemotactic defect strikingly correlated with autologous BMT and, in particular, with ALL as the pre-existing disease. No differences between patients and controls were observed in the percentage of 31D8 bright and dull neutrophils. However, when mean fluorescence intensity (MFI) was analyzed as a relative measure of 31D8 antigen expression on the overall neutrophil population, a significant decrease was observed in neutrophils from BMT patients with respect to controls. As for chemotaxis, the impairment of 31D8 binding was more evident in autologous BMT and strikingly correlated with ALL as the pre-existing disease regardless of age, sex and time since BMT. Moreover, a significant positive correlation between impaired chemotaxis and decreased 31D8 binding was found in our patients.

CONCLUSIONS

These findings suggest that the decreased neutrophil chemotaxis observed in some BMT patients may be due in part to circulating 31D8 dull neutrophils, although the causes for the decreased 31D8 binding and for the quite pronounced neutrophil defect in ALL patients remain unknown.