Accuracy of Parent-Measured Weight and Height of Preschool Children at Home With Increasing Levels of Instruction

Background: The purpose of this study was to determine how accurately parents measure their preschool child's weight and height with increasing levels of instruction. Methods: Parents measured their child's (n = 30 dyads) weight (own weight scale) and height (soft tape measure) using three levels of instruction: instructional guide (level 1); guide, demonstration video (level 2); and guide, video, and virtual monitoring (level 3), which were compared to researcher measurements (electronic weight scale, Stadiometer). Paired t-tests were used to determine differences between researcher and parent measurements and between the three parent levels. Inaccurate classifications were calculated using parent-measured values for the four categories (underweight, healthy, overweight, obese). Results: Raw mean parent-measured weights (17.4 ± 2.3 kg) differed from researcher by 0.2 kg (level 1), 0.3 kg (level 2), and 0.1 kg (level 3). Raw mean parent-measured heights (104.0 ± 5.9 cm) differed from researcher by 0.9 cm (level 1, p = 0.005), 0.4 cm (level 2, NS), and 0.3 cm (level 3, NS). Across all levels, 48.9% and 65.5% parents overmeasured their children's weights and heights, respectively. Using parent-measured values, 29.4% of children were classified high while 70.5% were classified low. Parents were more likely to make errors if their children were on the borderline between any of the two weight categories. Conclusion: Findings indicate that an instructional guide with demonstration video is helpful in improving the parents' accuracy of their children's weights and heights. More research is needed to determine accuracy in population other than White parents with high education levels and children under overweight and obese category.

Dietary nitrate biochemistry and physiology. An update on clinical benefits and mechanisms of action

It is now more than 35 years since endothelium derived relaxing factor was identified as nitric oxide (NO). The last few decades have seen an explosion around nitric oxide biochemistry, physiology and clinical translation. The science reveals that all chronic disease is associated with decreased blood flow to the affected organ which results in increased inflammation, oxidative stress and immune dysfunction. This is true for cardiovascular disease, neurological disease, kidney, lung, liver disorders and every other major disorder. Since nitric oxide controls and regulates blood flow, oxygen and nutrient delivery to every cell, tissue and organ in the body and also mitigates inflammation, oxidative stress and immune dysfunction, a focus on restoring nitric oxide production is an obvious therapeutic strategy for a number of poorly managed chronic diseases. Since dietary nitrate is a major contributor to endogenous nitric oxide production, it should be considered as a means of therapy and restoration of nitric oxide. This review will update on the current state of the science and effects of inorganic nitrate administered through the diet on several chronic conditions and reveal how much is needed. It is clear now that antiseptic mouthwash and use of antacids disrupt nitrate metabolism to nitric oxide leading to clinical symptoms of nitric oxide deficiency. Based on the science, nitrate should be considered an indispensable nutrient that should be accounted for in dietary guidelines.

Dietary Nitrate Supplementation Alters Protein and Lipid Metabolism in Zebrafish (Danio rerio) Livers

Objectives

Dietary nitrate supplementation shows protective effects against cardio-metabolic disease, decreases pulmonary oxygen uptake, and improves exercise performance in animal models and humans. However, the biological effect of nitrate on energy metabolism in the liver is not well understood. The objective of this study was to elucidate changes in liver metabolism associated with nitrate treatment and exercise.

Methods

Fish were exposed to sodium nitrate (606.9 mg/L), or control water, for 21 days and analyzed at intervals during a strenuous exercise test. We utilized untargeted liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis to determine the effect of nitrate treatment and exercise on the liver metabolome. We measured gene expression of 31 genes linked to energy metabolism and redox signaling.

Results

In the absence of exercise, nitrate treatment upregulated expression of genes central to nutrient sensing (pgc1a and sirt3), protein synthesis (mtor) and purine metabolism (pnp5a and ampd1) and downregulated expression of genes involved in mitochondrial fat oxidation (acaca, cpt2 and hadh). Upregulation of these genes was associated with an increased abundance of metabolites involved in endogenous nitric oxide metabolism, dopamine biosynthesis, branched chain amino acid metabolism, and lipid metabolism in nitrate-treated livers at rest, compared to rested controls. As expected, the availability of these metabolites was diminished in nitrate-treated livers relative to rested controls. We found no significant change in gene of metabolites directly linked to glycolysis.

Conclusions

The main novel finding of this study was that sub-chronic nitrate treatment altered dopamine biosynthesis, protein synthesis and lipid metabolism in zebrafish liver without exercise. This is significant because dietary nitrate is emerging as an interesting therapeutic modality for metabolic syndrome and non-alcoholic fatty liver disease by preventing lipid accumulation in the liver.

Funding Sources

Celia Strickland and G. Kenneth Austin III Endowment and National Institutes of Health.

Nitrate-Induced Improvements in Exercise Performance Is Coincident With Exuberant Changes in Metabolic Genes and the Metabolome in Zebrafish (Danio rerio) Skeletal Muscle

Objectives

Dietary nitrate (NO3−) supplementation improves exercise performance by reducing the oxygen cost of exercise and enhancing skeletal muscle function. However, the mechanisms underlying the beneficial effects on exercise performance are not well understood and may be supported by changes in metabolism within the skeletal muscle. The purpose of this study was to elucidate nitrate-induced changes in skeletal muscle energy metabolism associated with improvements in exercise performance that may reflect enhanced metabolic flexibility.

Methods

Fish were exposed to sodium nitrate (60.7 mg/L, 303.5 mg/L, and 606.9 mg/L), or control water, for 21 days and analyzed at intervals during a strenuous exercise test. Nitrate storage in muscle was measured using chemiluminescence. We utilized nuclear magnetic resonance spectroscopy (NMR), liquid-chromatography tandem mass spectrometry (LC-MS/MS) untargeted metabolomics and real-time quantitative polymerase chain reaction (RT-qPCR) to determine changes in muscle metabolism with nitrate and exercise.

Results

Nitrate treatment significantly increased muscle nitrate concentrations, while muscle nitrate levels declined with increasing exercise duration, and nitrate treatment was associated with a decrease in the oxygen cost of exercise. In skeletal muscle, nitrate treatment upregulated expression of genes central to nutrient sensing (mtor), glucose (hk2) and lipid metabolism (acaca), redox signaling (nrf2a) and muscle differentiation (sox6). Nitrate treatment caused rested skeletal muscle to have significantly increased metabolites directly linked to energy production (phosphocreatine (PCr), creatine (Cr), adenosine nucleosides, purines, glycolytic, fatty acid and tricarboxylic acid cycle (TCA) intermediates) and a concomitant decrease in these metabolites after exercise, compared to rested-control fish.

Conclusions

Our data suggest that nitrate exposure may improve exercise performance by changing the metabolic programming of muscle prior to exercise, thus increasing the availability of energy producing metabolites required for exercise such as ATP and phosphocreatine.

Funding Sources

Celia Strickland and G. Kenneth Austin III Endowment and National Institutes of Health.

Nitrate Treatment Alters Metabolite Abundance and Fuel Preference in Exercised Zebrafish

Objectives

Nitrate, found abundantly in green leafy vegetables, may improve exercise performance by increasing availability and utilization of metabolic fuels that require less oxygen for energy production. However, it is not known if the performance effect occurs at the peak exercise intensity. We hypothesize that supplemental nitrate treatment will promote the metabolism of specific fuels (carbohydrates versus fatty acids) during exercise that require less oxygen to produce ATP. Metabolic analysis will quantify if a net change in these fuels are linked to an improvement in exercise performance with nitrate treatment during submaximal exercise conditions.

Methods

Adult zebrafish were exposed to sodium nitrate (606.9 mg NaNO3/L water) or control water for 21 days (n = 54). Fish were sampled at three conditions during a graded exercise test: 1) rested, 2) peak speed, and 3) post-exercise. Whole fish tissue was homogenized and analyzed using high-pressure liquid chromatography Triple Q-ToF mass spectrometry based untargeted metabolomics.

Results

Metabolomics analysis resulted in the detection of 12,135 and 10,604 features in positive and negative ion mode respectively. Preliminary results show succinate levels significantly increased in nitrate-treated rested fish as compared to control rested fish. Likewise, a significant increase in methylmalonate, which serves as a vital intermediate in the catabolism of lipids and protein, was detected in nitrate-treated fish at rest relative to rested controls. Nitrate treatment both at rest and at peak exercise intensity, significantly increased the abundance of various acyl carnitines relative to control fish at the same exercise intensity, and these metabolites function to transfer long-chain fatty acids to mitochondria for β-oxidation, relative to control fish at the same exercise intensity. Work is ongoing to further identify metabolites that significantly changed with nitrate treatment at various exercise intensities.

Conclusions

Our data are consistent with the hypothesis that nitrate treatment may alter lipid and carbohydrate metabolism of zebrafish.

Funding Sources

Celia Strickland and G. Kenneth Austin III Endowment, the Oregon Agricultural Experimental Station, and National Institutes of Health.

Nitrate and Nitrite Treatment Affect Zebrafish Behavior and Brain Metabolomic Profile

Objectives

Dietary nitrate contributes to optimal cardiovascular health, exercise performance, and has been hypothesized to improve cognitive performance and affect cerebral blood flow in specific brain regions. While the mechanisms responsible are not fully understood, we tested the hypothesis that nitrate and nitrite treatment would improve indicators of learning and cognitive performance in a zebrafish (Danio rerio) model. We also explored the extent to which treatment caused changes in the brain metabolome.

Methods

Fish were exposed to sodium nitrate (606.9 mg/L), sodium nitrite (19.5 mg/L), or control water for 2–4 weeks and free swim, startle response, innate predator avoidance, social cohesion, and shuttle box assays were performed.

Results

Nitrate and nitrite treatment did not change fish weight, length, predator avoidance, or distance and velocity traveled in an unstressed environment. All treatment groups habituated to a repetitive startle, but nitrate-treated fish moved 10% less distance. Data from the shuttle box learning assay is consistent with a decrease in associative learning or executive function with nitrate and nitrite treatment but, over multiple trials, all treatment groups demonstrated behaviors associated with learning. Nitrate and nitrite-treatment also significantly increased anxiety-like behavior, but did not alter epinephrine, norepinephrine or dopamine levels. Targeted LC-MS/MS analysis revealed no significant increase in brain nitrate or nitrite concentrations with treatment. An untargeted metabolomics analysis found 47 metabolites whose abundance was significantly altered in the brain with nitrate and nitrite treatment including an 18–19% reduction in the neurotransmitter gamma-aminobutyric acid, and 17–22% reduction in its precursor glutamine, which may contribute to the increase anxiety-like behavior in the fish.

Conclusions

Nitrate and nitrite treatment did not adversely affect multiple parameters of health but was associated with mild anxiety-like behavior, changes in brain metabolome, and caused a decrease in executive function or associative learning.

Funding Sources

Celia Strickland and G. Kenneth Austin III Endowment, the Oregon Agricultural Experimental Station, and National Institutes of Health.

Nitrate and Nitrite Treatment Modulate Performance and Available Fuel Sources In Zebrafish Muscle and Liver

Objectives

Treatment with nitrate, but not nitrite, improves exercise performance but the mechanisms responsible are not fully understood. Thus, we tested the hypothesis that nitrate and nitrite treatment alter exercise performance through regulation of genes related to glucose and lipid metabolism in skeletal muscle and liver. Furthermore, we tested the hypothesis that nitrate treatment caused increased abundance and utilization of metabolic fuels in muscle that require less oxygen for energy production.

Methods

Adult zebrafish fish were exposed to sodium nitrate (606.9 mg NaNO3/L water), sodium nitrite (19.5 mg NaNO2/L of water), or control water for 21 days (n = 9–12/treatment). Liver and muscle gene expression were analyzed by quantitative real-time PCR and liver and muscle metabolomes were assessed by 1H-NMR untargeted metabolomics.

Results

Nitrite treatment significantly increased carnitine palmitoyl transferase 1b (cpt1b) expression in the liver and significantly decreased acetyl-CoA carboxylase (acaca) expression in skeletal muscle. Nitrate treatment significantly increased expression of peroxisome proliferator activated receptor-γ (pparg) muscle while acaca significantly decreased in skeletal muscle. Nitrate treatment also induced significant increases in metabolic fuels, such as ATP and creatine phosphate, and fuel sources including β-hydroxybutyrate and glycolytic intermediates in rested skeletal muscle. After a graded exercise test, these metabolites decreased in skeletal muscle of nitrate-treated fish while they increased with exercise in the skeletal muscle of control-treated zebrafish.

Conclusions

Our data are consistent with the hypothesis that nitrate treatment altered lipid and carbohydrate metabolism of zebrafish, in part, through a pparg mediated mechanism in the liver, and may improve exercise performance through utilization of fuel sources that require less oxygen during exercise. In contrast, our data indicate that nitrite may attenuate exercise performance, in part, by promoting dependence on fatty acid oxidation in the liver of zebrafish. These mechanisms may mediate improved exercise tolerance in populations with cardiovascular disease.

Funding Sources

Celia Strickland and G. Kenneth Austin III Endowment and National Institutes of Health.

Aging and serum MCP-1 are associated with gut microbiome composition in a murine model

Introduction. Age is the primary risk factor for major human chronic diseases, including cardiovascular disorders, cancer, type 2 diabetes, and neurodegenerative diseases. Chronic, low-grade, systemic inflammation is associated with aging and the progression of immunosenescence. Immunosenescence may play an important role in the development of age-related chronic disease and the widely observed phenomenon of increased production of inflammatory mediators that accompany this process, referred to as “inflammaging.” While it has been demonstrated that the gut microbiome and immune system interact, the relationship between the gut microbiome and age remains to be clearly defined, particularly in the context of inflammation. The aim of our study was to clarify the associations between age, the gut microbiome, and pro-inflammatory marker serum MCP-1 in a C57BL/6 murine model.

Results. We used 16S rRNA gene sequencing to profile the composition of fecal microbiota associated with young and aged mice. Our analysis identified an association between microbiome structure and mouse age and revealed specific groups of taxa whose abundances stratify young and aged mice. This includes the Ruminococcaceae, Clostridiaceae, and Enterobacteriaceae. We also profiled pro-inflammatory serum MCP-1 levels of each mouse and found that aged mice exhibited elevated serum MCP-1, a phenotype consistent with inflammaging. Robust correlation tests identified several taxa whose abundance in the microbiome associates with serum MCP-1 status, indicating that they may interact with the mouse immune system. We find that taxonomically similar organisms can exhibit differing, even opposite, patterns of association with the host immune system. We also find that many of the OTUs that associate with serum MCP-1 stratify individuals by age.

Discussion. Our results demonstrate that gut microbiome composition is associated with age and the pro-inflammatory marker, serum MCP-1. The correlation between age, relative abundance of specific taxa in the gut microbiome, and serum MCP-1 status in mice indicates that the gut microbiome may play a modulating role in age-related inflammatory processes. These findings warrant further investigation of taxa associated with the inflammaging phenotype and the role of gut microbiome in the health status and immune function of aged individuals.

Treatment of advanced glioma with an energy restricted ketogenic diet: Case report and literature summary

e13047

Background: We initiated a pilot study to evaluate an energy restricted ketogenic diet (ERKD) as treatment for patients with glioblastoma multiforme (GBM) whose brain tumor had progressed with standard therapy. Methods: This reports documents our experience using an ERKD with an IRB approved, clinical trials #NCTO1535911 registered treatment protocol and briefly summarizes the 5 published case reports that document favorable responses with ERKD. Results: Our patient, a 55-year-old white male, presented with a left sided visual field cut, decreased analytical mental skills, a slow methodical wide based gait and a right posterior brain mass with a histological diagnosis of GBM. After documented progression following surgery, radiation therapy and TMZ the patient was treated with ERKD. He was hospitalized to induce a decrease in glucose and an increase in ketones using Ketocal 20-25 Cal/Kg. Adherence and efficacy to the diet was monitored using AM and PM measurements of blood glucose and ketones. Initial treatment with Ketocal decreased his blood glucose so that his PM glucose was <80mg/dl and increased his PM ketones to >3mm(our protocol’s target concentrations). However, his AM glucose was still >80mg/dl and his AM ketones decreased to >2mM. Because of the low palatability of the Ketocal, the patient was switched to a ketogenic regular food diet with a 3:1 ratio of fat to proteins and carbohydrates. Out of the hospital and on this diet his PM ketones remained > 3mM and his AM > 2mM, but his AM and PM blood glucose increased to > 80mg/dl. After 4 weeks of treatment with the ERKD, the patient’s disease advanced; his vision, mobility and cognition decreased and MRI demonstrated tumor growth and he withdrew from the study. Five patients with advanced brain tumors and favorable responses to ERKD have been reported. The best response was a C.R. 5 years after diagnosis. In 4 of the 5 patients ERKD was combined with one of the standard modalities of treatment. At last report 3 of the 5 patients were C.R. and 2 had documented disease progression after stopping the ERKD. Conclusions: Investigation of ERKD in patients with malignant brain tumors using an approved, registered protocol under the guidance of a dietician is feasible.

Localization and characterization of the 86- and 84-kDa heat shock proteins in Hepa 1c1c7 cells

The 90-kDa heat shock protein (hsp90) is present in cells at high levels in the cytoplasm and is composed of two separate gene products, hsp86 and hsp84. Rabbit polyclonal antibodies to the murine N-terminal sequences of the 86- and 84-kDa heat shock proteins were isolated from serum by peptide affinity chromatography. Antibodies against each form of hsp90 are capable of immunoprecipitating hsp90. Each antibody preparation is specific against either hsp86 or hsp84 when tested on a protein blot of Hepa 1c1c7 cytosol. The over-all ratio of hsp84/hsp86 in Hepa 1 cytosol was estimated to be 2 to 1. Each antibody preparation was used to immunoprecipitate hsp84 or hsp86 from Hepa 1 cytosol to test whether hsp86/84 exists as a homo- and/or heterodimer. After electrophoresis, silver staining revealed that anti-hsp86 antibodies immunoprecipitated both hsp86 and hsp84. This result would suggest that hsp86 forms heterodimers with hsp84. In contrast, the anti-hsp84 antibodies immunoprecipitated almost entirely hsp84, suggesting that hsp84 exists largely as homodimers. Both anti-hsp86 and hsp84 antibodies were able to immunoprecipitate the 2-azido-3-[125I]iodo-7,8-dibromodibenzo-p-dixoin-labeled Ah receptor from Hepa 1 cytosol, indicating that these antibodies are able to bind to hsp90 when it is complexed with other proteins. Both antibody preparations recognize hsp90 in mouse, rat, and human cell lines. Immunofluorescence and confocal microscopy were performed using both antibody preparations, and the results indicated that both hsp86 and hsp84 were located in the cytoplasm and nucleus of Hepa 1 cells. Hsp86 was found to localize unevenly in the cytoplasm, while hsp84 was found evenly dispersed throughout the cytoplasm. Hsp86 also appeared to be localized to a greater degree than hsp84 in the vicinity of the nuclear envelope.