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Varache M, Rizzo S, Sayers EJ, Newbury L, Mason A, Liao CT, Chiron E, Bourdiec N, Jones A, Fraser DJ, Taylor PR, Jones AT, Thomas DW, Ferguson EL. Dextrin conjugation to colistin inhibits its toxicity, cellular uptake and acute kidney injury in vivo. RSC Pharm 2024; 1:68-79. [PMID: 38646595 PMCID: PMC11024668 DOI: 10.1039/d3pm00014a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/04/2024] [Indexed: 04/23/2024]
Abstract
The acute kidney injury (AKI) and dose-limiting nephrotoxicity, which occurs in 20-60% of patients following systemic administration of colistin, represents a challenge in the effective treatment of multi-drug resistant Gram-negative infections. To reduce clinical toxicity of colistin and improve targeting to infected/inflamed tissues, we previously developed dextrin-colistin conjugates, whereby colistin is designed to be released by amylase-triggered degradation of dextrin in infected and inflamed tissues, after passive targeting by the enhanced permeability and retention effect. Whilst it was evident in vitro that polymer conjugation can reduce toxicity and prolong plasma half-life, without significant reduction in antimicrobial activity of colistin, it was unclear how dextrin conjugation would alter cellular uptake and localisation of colistin in renal tubular cells in vivo. We discovered that dextrin conjugation effectively reduced colistin's toxicity towards human kidney proximal tubular epithelial cells (HK-2) in vitro, which was mirrored by significantly less cellular uptake of Oregon Green (OG)-labelled dextrin-colistin conjugate, when compared to colistin. Using live-cell confocal imaging, we revealed localisation of both, free and dextrin-bound colistin in endolysosome compartments of HK-2 and NRK-52E cells. Using a murine AKI model, we demonstrated dextrin-colistin conjugation dramatically diminishes both proximal tubular injury and renal accumulation of colistin. These findings reveal new insight into the mechanism by which dextrin conjugation can overcome colistin's renal toxicity and show the potential of polymer conjugation to improve the side effect profile of nephrotoxic drugs.
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Affiliation(s)
- Mathieu Varache
- Advanced Therapies Group, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University Heath Park Cardiff CF14 4XY UK
| | - Siân Rizzo
- Advanced Therapies Group, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University Heath Park Cardiff CF14 4XY UK
| | - Edward J Sayers
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University CF10 3NB UK
| | - Lucy Newbury
- Wales Kidney Research Unit, Division of Infection and Immunity, School of Medicine, College of Biomedical and Life Sciences, Cardiff University Cardiff CF14 4XN UK
| | - Anna Mason
- Wales Kidney Research Unit, Division of Infection and Immunity, School of Medicine, College of Biomedical and Life Sciences, Cardiff University Cardiff CF14 4XN UK
| | - Chia-Te Liao
- Systems Immunity Research Institute, Division of Infection and Immunity, School of Medicine, Cardiff University Cardiff CF14 4XN UK
| | - Emilie Chiron
- Advanced Therapies Group, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University Heath Park Cardiff CF14 4XY UK
| | - Nathan Bourdiec
- Advanced Therapies Group, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University Heath Park Cardiff CF14 4XY UK
| | - Adam Jones
- Advanced Therapies Group, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University Heath Park Cardiff CF14 4XY UK
- Cellular Pathology Department, University Dental Hospital, Cardiff and Vale University Health Board Cardiff CF14 4XY UK
| | - Donald J Fraser
- Wales Kidney Research Unit, Division of Infection and Immunity, School of Medicine, College of Biomedical and Life Sciences, Cardiff University Cardiff CF14 4XN UK
| | - Philip R Taylor
- Systems Immunity Research Institute, Division of Infection and Immunity, School of Medicine, Cardiff University Cardiff CF14 4XN UK
- UK Dementia Research Institute at Cardiff Hadyn Ellis Building Maindy Road Cardiff CF24 4HQ UK
| | - Arwyn T Jones
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University CF10 3NB UK
| | - David W Thomas
- Advanced Therapies Group, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University Heath Park Cardiff CF14 4XY UK
- Systems Immunity Research Institute, Division of Infection and Immunity, School of Medicine, Cardiff University Cardiff CF14 4XN UK
| | - Elaine L Ferguson
- Advanced Therapies Group, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University Heath Park Cardiff CF14 4XY UK
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Arimond M, Wiesmann D, Grummer‐Strawn LM, Ferguson EL. Food pattern modeling to inform global guidance on complementary feeding of infants. Matern Child Nutr 2024; 20:e13590. [PMID: 38124469 PMCID: PMC10981476 DOI: 10.1111/mcn.13590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/02/2023] [Accepted: 10/26/2023] [Indexed: 12/23/2023]
Abstract
Nutrient needs are difficult to meet during infancy due to high nutrient requirements and the small quantities of food consumed. Guidelines to support food choice decisions are critical to promoting optimal infant health, growth and development and food pattern modeling can be used to inform guideline development. We employed the Optifood modeling system to determine if unfortified complementary foods could meet 13 nutrient targets for breastfed infants (6-11 months), and to describe food patterns that met, or came as close as possible to meeting targets. We also examined the impacts of eliminating food groups, increasing starchy staple foods or adding sentinel unhealthy foods. We collated a global food list from dietary studies in 37 countries and used this list to develop nutrient values for a set of 35 food subgroups. We analyzed infant dietary intakes from studies in eight countries to inform maximum quantities and frequencies of consumption for these subgroups in weekly food patterns. We found that unfortified foods could meet targets for most infants for 12 nutrients, but not for iron. For the smallest and youngest infants, with the lowest energy intakes, there were additional deficits for minerals. Best-case food patterns that met targets or came as close as possible to meeting targets included ample amounts of diverse vegetables, diverse plant- and animal-source protein foods, small amounts of whole grain foods and dairy and no refined grains or added fats or sugar. There were nutrient deficits if animal-source foods or vegetables were eliminated or if unhealthy foods were included.
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Affiliation(s)
| | | | | | - Elaine L. Ferguson
- Department of Population Health, Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUnited Kingdom
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Hailu K, Joy EJM, Ferguson EL, Bailey EH, Wilson L, Davis K, Broadley MR, Gashu D. Dietary selenium intake among Ethiopian children in areas known for selenium spatial variability. Front Nutr 2023; 10:1250002. [PMID: 37908299 PMCID: PMC10613729 DOI: 10.3389/fnut.2023.1250002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/18/2023] [Indexed: 11/02/2023] Open
Abstract
Introduction There is spatial variability of selenium (Se) in soil and crops in Ethiopia. We assessed the Se content of food items, breast milk, and urine among infants in Ethiopia from two areas with contrasting Se concentrations in soils. Methods Dietary Se intakes among children (6-23 months) were evaluated using a weighed food record on two non-consecutive days. Also, spot urine samples from children and breast milk samples from their mothers were collected to determine Se concentration. Selenium concentrations in the samples were analyzed using an inductively coupled plasma mass spectrometer (ICP-MS). Results Injera (prepared from teff and mixtures of other cereals) with a legume-based stew were the most frequently consumed foods by the children in both areas, followed by pasta. Overall, the Se concentration (mean ± SD) of food items, breast milk (12.2 ± 3.9 μg/L vs. 3.39 ± 1.5 μg/L), and urine samples (22.5 ± 11.5 μg/L vs. 3.0 ± 1.9 μg/L) from East Amhara were significantly higher than the corresponding samples from West Amhara (p < 0.001). The total Se intakes by the study children from East Amhara and West Amhara were 30.2 [IQ 25%, 14.2; IQ 75%, 54.1] and 7.4 [IQR 25%, 4.2; IQ 75%, 10.6] μg day-1, respectively; 31.5% of children from East Amhara and 92% of children from West Amhara were at risk of inadequate Se intakes. Urinary Se excretion accounted for 53 and 39% of daily dietary Se intake in East Amhara and West Amhara, respectively. Dietary Se intake was positively correlated with urinary Se excretion in East Amhara (r = 0.56; p < 0.001) but not among samples from West Amhara (r = 0.16; p ≥ 0.05), suggesting greater physiological Se conservation in a state of deficiency. Conclusion There is spatial variability of Se in foods, breast milk, and urine in Ethiopia, suggesting the need for implementation of targeted agronomic interventions that enhance Se concentrations in the edible portion of plant foods.
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Affiliation(s)
- Kaleab Hailu
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Food Science and Applied Nutrition, Addis Ababa Science and Technology University, Addis Ababa, Ethiopia
| | - Edward J. M. Joy
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- School of Biosciences, University of Nottingham, Loughborough, United Kingdom
| | - Elaine L. Ferguson
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Elizabeth H. Bailey
- Sustainable Soils and Crops Department, Rothamsted Research, Harpenden, United Kingdom
| | - Lolita Wilson
- Sustainable Soils and Crops Department, Rothamsted Research, Harpenden, United Kingdom
| | - Kenneth Davis
- Sustainable Soils and Crops Department, Rothamsted Research, Harpenden, United Kingdom
| | - Martin R. Broadley
- School of Biosciences, University of Nottingham, Loughborough, United Kingdom
- Sustainable Soils and Crops Department, Rothamsted Research, Harpenden, United Kingdom
| | - Dawd Gashu
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
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Knight F, Ferguson EL, Rana ZH, Belizan J, Gomes F, Bourassa MW, Dickin KL, Weaver CM, Cormick G. Including calcium-fortified water or flour in modeled diets based on local foods could improve calcium intake for women, adolescent girls, and young children in Bangladesh, Uganda, and Guatemala. Ann N Y Acad Sci 2023; 1526:84-98. [PMID: 37391187 DOI: 10.1111/nyas.15032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
Adequate calcium intake is essential for health, especially for infants, children, adolescents, and women, yet is difficult to achieve with local foods in many low- and middle-income countries. Previous analysis found it was not always possible to identify food-based recommendations (FBRs) that reached the calcium population recommended intake (PRI) for these groups in Bangladesh, Guatemala, and Uganda. We have modeled the potential contribution of calcium-fortified drinking water or wheat flour to FBR sets, to fill the remaining intake gaps. Optimized diets containing fortified products, with calcium-rich local foods, achieved the calcium PRI for all target groups. Combining fortified water or flour with FBRs met dietary intake targets for adolescent girls in all geographies and allowed a reduction from 3-4 to the more feasible 1-2 FBRs. Water with a calcium concentration of 100 mg/L with FBRs was sufficient to meet calcium targets in Uganda, but higher concentrations (400-500 mg/L) were mostly required in Guatemala and Bangladesh. Combining calcium-fortified wheat flour at 400 mg/100 g of flour and the FBR for small fish resulted in diets meeting the calcium PRI in Bangladesh. Calcium-fortified water or flour could improve calcium intake for vulnerable populations, especially when combined with FBRs based on locally available foods.
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Affiliation(s)
- Frances Knight
- London School of Hygiene and Tropical Medicine, London, UK
- Nutrition Division, United Nations World Food Programme, Rome, Italy
| | | | - Ziaul H Rana
- The New York Academy of Sciences, New York, New York, USA
| | - José Belizan
- Centro de Investigaciones en Epidemiología y Salud Pública (CIESP-IECS). CONICET, Ciudad de Buenos Aires, Argentina
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Ciudad de Buenos Aires, Argentina
| | - Filomena Gomes
- The New York Academy of Sciences, New York, New York, USA
- NOVA Medical School, Universidade NOVA de Lisboa, Lisboa, Portugal
| | | | - Katherine L Dickin
- Department of Public and Ecosystem Health, Cornell University, Ithaca, New York, USA
| | | | - Gabriela Cormick
- Centro de Investigaciones en Epidemiología y Salud Pública (CIESP-IECS). CONICET, Ciudad de Buenos Aires, Argentina
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Ciudad de Buenos Aires, Argentina
- Departamento de Salud, Universidad Nacional de La Matanza (UNLAM), San Justo, Argentina
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Knight F, Rana ZH, Cormick G, Belizan J, Gomes F, Bourassa MW, Dickin KL, Weaver CM, Ferguson EL. Could local foods achieve recommended calcium intakes for nutritionally vulnerable populations in Uganda, Guatemala, and Bangladesh? Ann N Y Acad Sci 2023; 1525:173-183. [PMID: 37230491 DOI: 10.1111/nyas.15008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Globally, dietary intake of calcium is often insufficient, and it is unclear if adequacy could be achieved by promoting calcium-rich local foods. This study used linear programming and household consumption data from Uganda, Bangladesh, and Guatemala to assess whether local foods could meet calcium population reference intakes (Ca PRIs). The most promising food-based approaches to promote dietary calcium adequacy were identified for 12- to 23-month-old breastfed children, 4- to 6-year-old children, 10- to 14-year-old girls, and nonpregnant and nonbreastfeeding (NPNB) women of reproductive age living in two regions of each country. Calcium-optimized diets achieved 75-253% of the Ca PRI, depending on the population, and were <100% for 4- to 6-year-olds in one region of each country and 10- to 14-year-old girls in Sylhet, Bangladesh. The best food sources of calcium were green leafy vegetables and milk, across geographic locations, and species of small fish, nixtamalized (lime-treated) maize products, sesame seeds, and bean varieties, where consumed. Food-based recommendations (FBRs) achieving the minimum calcium threshold were identified for 12- to 23-month-olds and NPNB women across geographic locations, and for 4- to 6-year-olds and 10-to 14-year-old girls in Uganda. However, for 4- to 6-year-olds and 10- to 14-year-old girls in Bangladesh and Guatemala, calcium-adequate FBRs could not be identified, indicating a need for alternative calcium sources or increased access to and consumption of local calcium-rich foods.
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Affiliation(s)
- Frances Knight
- London School of Hygiene and Tropical Medicine, London, UK
- Nutrition Division, United Nations World Food Programme, Rome, Italy
| | - Ziaul H Rana
- The New York Academy of Sciences, New York, New York, USA
| | - Gabriela Cormick
- Centro de Investigaciones Epidemiológicas y Salud Pública (CIESP-IECS). CONICET, Ciudad de Buenos Aires, Argentina
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Ciudad de Buenos Aires, Argentina
- Departamento de Salud, Universidad Nacional de La Matanza (UNLAM), San Justo, Argentina
| | - José Belizan
- Centro de Investigaciones Epidemiológicas y Salud Pública (CIESP-IECS). CONICET, Ciudad de Buenos Aires, Argentina
- Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Ciudad de Buenos Aires, Argentina
| | - Filomena Gomes
- The New York Academy of Sciences, New York, New York, USA
- NOVA Medical School, Universidade NOVA de Lisboa, Lisboa, Portugal
| | | | - Katherine L Dickin
- Department of Public and Ecosystem Health, Cornell University, Ithaca, New York, USA
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Vanderkooy A, Ferguson EL, Sy NY, Kane R, Diagne M, Mbodji A, Pries AM. High unhealthy food and beverage consumption is associated with poor diet quality among 12-35-month-olds in Guédiawaye Department, Senegal. Front Nutr 2023; 10:1125827. [PMID: 37404859 PMCID: PMC10315617 DOI: 10.3389/fnut.2023.1125827] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 05/19/2023] [Indexed: 07/06/2023] Open
Abstract
Background High consumption of unhealthy foods and beverages (UFB) during early childhood is cause for concern, with growing evidence from low- and middle-income countries finding associations with poor diet quality and malnutrition. Research from sub-Saharan Africa remains limited, with no studies quantifying the contribution of UFB to total energy intakes among young children or exploring the relationship between such intakes and diet quality or anthropometric outcomes. Objectives Assess UFB consumption patterns and their contribution to total energy intake from non-breastmilk foods/beverages (TEI-NBF), assess the association between high UFB consumption and dietary/nutrition outcomes, and explore drivers of unhealthy food choice among young children in Guédiawaye Department, Senegal. Methods We conducted a cross-sectional study of a representative sample of 724 primary caregivers and their 12-35.9-month-old children. The study included a questionnaire, a quantitative four-pass 24-h dietary recall, and anthropometric measurements. The contribution of UFB to TEI-NBF was calculated and terciles generated. Logistic and linear models were used to compare outcomes of high versus low UFB consumption terciles. Results UFB contributed on average 22.2% of TEI-NBF, averaging 5.9% for the lowest tercile and 39.9% for the highest. Diets of high UFB consumers, as compared to low, were significantly less dense in protein, fiber, and seven of the 11 micronutrients assessed and significantly denser in total fat, saturated fat, and total sugar. No associations were found with anthropometric outcomes. High UFB consumers were older and more likely to be living in food insecurity. The most common drivers of commercial UFB consumption were related to child preference, the use of these products as behavior management tools, treats, or gifts, and the sharing of these products by someone else eating them. Conclusion High UFB consumption is associated with poor diet quality among 12-35-month-olds in Guédiawaye Department, Senegal. Addressing high UFB consumption during this critical developmental period should be prioritized in young child nutrition research, programming, and policy development.
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Affiliation(s)
| | - Elaine L. Ferguson
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - Maty Diagne
- Direction de la Santé de la Mère et de l’Enfant, Division Alimentaire et Nutrition, Ministère de la Santé et de l’Action Sociale, Dakar, Senegal
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Hinnouho G, Ferguson EL, MacDougall A, Kroeun H, Sophonneary P, Chea M, Pries AM. High consumption of unhealthy commercial foods and beverages tracks across the complementary feeding period in rural/peri-urban Cambodia. Matern Child Nutr 2023; 19:e13485. [PMID: 36751966 PMCID: PMC10019055 DOI: 10.1111/mcn.13485] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 12/02/2022] [Accepted: 01/23/2023] [Indexed: 02/09/2023]
Abstract
Consumption of unhealthy commercial foods and beverages (UCFB) is common among infants and young children living in low- and middle-income countries. Such foods can displace other nutritious foods, however, there is limited evidence on how this consumption tracks across time. This study assessed and tracked UCFB consumption of children living in rural/peri-urban Cambodia during the complementary feeding period, identified UCFB consumption patterns of these children, and explored the association between UCFB consumption and growth. A 6-month longitudinal cohort study was implemented among 567 caregivers of children aged 10-14 months at recruitment. UCFB consumption was estimated each month via a telephone-administered 7-day food frequency questionnaire, and UCFB consumption patterns were identified based on changes in this frequency of consumption over time. The majority of children either maintained (45.7%, n = 246) or developed (43.5%, n = 234) an unhealthy consumption pattern and only 10.8% (n = 58) of children maintained/transitioned into a healthy consumption pattern. High consumers of UCFB at 10-14 months had a 4.7 (CI: 4.7 [3.1-7.2]) times odds of being high consumers of UCFB at 15-19 months (p < 0.001). There was a trend of lower length-for-age z-scores (LAZ) among children maintaining or developing an unhealthy consumption pattern (~-0. SD LAZ) compared to children maintaining/transitioning into a healthy consumption pattern, however, this association was not statistically significant. Findings indicate that high UCFB consumption begins during infancy and tracks into early childhood. National policies and programmes centred on early interventions addressing the use of UCFB for infant and young child feeding are needed.
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Affiliation(s)
| | | | | | - Hou Kroeun
- Helen Keller InternationalNew York CityNew YorkUSA
| | | | - Mary Chea
- Ministry of HealthPhnom PenhCambodia
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Bulungu ALS, Palla L, Nambooze J, Priebe J, Forsythe L, Katic P, Varley G, Galinda BD, Sarah N, Wellard K, Ferguson EL. Automated wearable cameras for improving recall of diet and time use in Uganda: a cross-sectional feasibility study. Nutr J 2023; 22:7. [PMID: 36635676 PMCID: PMC9835269 DOI: 10.1186/s12937-022-00828-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/28/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Traditional recall approaches of data collection for assessing dietary intake and time use are prone to recall bias. Studies in high- and middle-income countries show that automated wearable cameras are a promising method for collecting objective health behavior data and may improve study participants' recall of foods consumed and daily activities performed. This study aimed to evaluate the feasibility of using automated wearable cameras in rural Eastern Ugandan to collect dietary and time use data. METHODS Mothers of young children (n = 211) wore an automated wearable camera on 2 non-consecutive days while continuing their usual activities. The day after wearing the camera, participants' dietary diversity and time use was assessed using an image-assisted recall. Their experiences of the method were assessed via a questionnaire. RESULTS Most study participants reported their experiences with the automated wearable camera and image-assisted recall to be good (36%) or very good (56%) and would participate in a similar study in the future (97%). None of the eight study withdrawals could be definitively attributed to the camera. Fifteen percent of data was lost due to device malfunction, and twelve percent of the images were "uncodable" due to insufficient lighting. Processing and analyzing the images were labor-intensive, time-consuming, and prone to human error. Half (53%) of participants had difficulty interpreting the images captured by the camera. CONCLUSIONS Using an automated wearable camera in rural Eastern Uganda was feasible, although improvements are needed to overcome the challenges common to rural, low-income country contexts and reduce the burdens posed on both participants and researchers. To improve the quality of data obtained, future automated wearable camera-based image assisted recall studies should use a structured data format to reduce image coding time; electronically code the data in the field, as an output of the image review process, to eliminate ex post facto data entry; and, ideally, use computer-assisted personal interviews software to ensure completion and reduce errors. In-depth formative work in partnership with key local stakeholders (e.g., researchers from low-income countries, representatives from government and/or other institutional review boards, and community representatives and local leaders) is also needed to identify practical approaches to ensuring that the ethical rights of automated wearable camera study participants in low-income countries are adequately protected.
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Affiliation(s)
- Andrea L. S. Bulungu
- grid.8991.90000 0004 0425 469XDepartment of Population Health, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT UK
| | - Luigi Palla
- grid.7841.aDepartment of Public Health and Infectious Diseases, University of Roma La Sapienza, 00185 Rome, Italy ,grid.8991.90000 0004 0425 469XDepartment of Medical Statistics, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK ,grid.444715.70000 0000 8673 4005School of Tropical Medicine and Global Health, University of Nagasaki, Nagasaki, 852-8102 Japan
| | - Joweria Nambooze
- grid.450043.6Africa Innovations Institute (AfrII), P.O Box 34981, Kampala, Uganda ,grid.442642.20000 0001 0179 6299Department of Nutritional Sciences and Dietetics, Kyambogo University, Kyambogo, P.O. Box 1, Kampala, Uganda
| | - Jan Priebe
- grid.36316.310000 0001 0806 5472Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, Kent, ME4 4TB UK
| | - Lora Forsythe
- grid.36316.310000 0001 0806 5472Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, Kent, ME4 4TB UK
| | - Pamela Katic
- grid.36316.310000 0001 0806 5472Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, Kent, ME4 4TB UK
| | - Gwen Varley
- grid.36316.310000 0001 0806 5472Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, Kent, ME4 4TB UK
| | - Bernice D. Galinda
- grid.8991.90000 0004 0425 469XDepartment of Population Health, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT UK
| | - Nakimuli Sarah
- grid.8991.90000 0004 0425 469XDepartment of Population Health, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT UK
| | - Kate Wellard
- grid.36316.310000 0001 0806 5472Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, Kent, ME4 4TB UK
| | - Elaine L. Ferguson
- grid.8991.90000 0004 0425 469XDepartment of Population Health, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT UK
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Aniceto AS, Ferguson EL, Pedersen G, Tarroux A, Primicerio R. Temporal patterns in the soundscape of a Norwegian gateway to the Arctic. Sci Rep 2022; 12:7655. [PMID: 35538135 PMCID: PMC9090731 DOI: 10.1038/s41598-022-11183-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 04/19/2022] [Indexed: 11/16/2022] Open
Abstract
As an Arctic gateway, the Norwegian Sea sustains a rich diversity of seasonal and resident species of soniferous animals, vulnerable to the effects of climate change and anthropogenic activities. We show the occurrence of seasonal patterns of acoustic signals in a small canyon off Northern Norway, and investigate cetacean vocal behavior, human-made noise, and climatic contributions to underwater sound between January and May 2018. Mostly median sound levels ranged between 68.3 and 96.31 dB re 1 μPa2 across 1/3 octave bands (13 Hz-16 kHz), with peaks in February and March. Frequencies under 2 kHz were dominated by sounds from baleen whales with highest rates of occurrence during winter and early spring. During late-spring non-biological sounds were predominant at higher frequencies that were linked mainly to ship traffic. Seismic pulses were also recorded during spring. We observed a significant effect of wind speed and ship sailing time on received sound levels across multiple distance ranges. Our results provide a new assessment of high-latitude continental soundscapes in the East Atlantic Ocean, useful for management strategies in areas where anthropogenic pressure is increasing. Based on the current status of the local soundscape, we propose considerations for acoustic monitoring to be included in future management plans.
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Affiliation(s)
- A S Aniceto
- Department of Fisheries and Bioeconomics, Arctic University of Norway, Tromsø, Norway.
| | | | - G Pedersen
- Department of Marine Ecosystem Acoustics, Institute of Marine Research, 1870, Bergen, Norway
| | - A Tarroux
- Fram Centre - High North Research Centre for Climate and Environment, Norwegian Institute for Nature Research, 9296, Tromsø, Norway
| | - R Primicerio
- Department of Fisheries and Bioeconomics, Arctic University of Norway, Tromsø, Norway
- Fram Centre - High North Research Centre for Climate and Environment, Institute of Marine Research, 9296, Tromsø, Norway
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Bulungu ALS, Palla L, Priebe J, Forsythe L, Katic P, Varley G, Galinda BD, Sarah N, Nambooze J, Wellard K, Ferguson EL. Validation of an Automated Wearable Camera-Based Image-Assisted Recall Method and the 24-h Recall Method for Assessing Women's Time Allocation in a Nutritionally Vulnerable Population: The Case of Rural Uganda. Nutrients 2022; 14:nu14091833. [PMID: 35565802 PMCID: PMC9101468 DOI: 10.3390/nu14091833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/24/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022] Open
Abstract
Accurate data are essential for investigating relationships between maternal time-use patterns and nutritional outcomes. The 24 h recall (24HR) has traditionally been used to collect time-use data, however, automated wearable cameras (AWCs) with an image-assisted recall (IAR) may reduce recall bias. This study aimed to evaluate their concurrent criterion validity for assessing women’s time use in rural Eastern Ugandan. Women’s (n = 211) time allocations estimated via the AWC-IAR and 24HR methods were compared with direct observation (criterion method) using the Bland–Altman limits of agreement (LOA) method of analysis and Cronbach’s coefficient alpha (time allocation) or Cohen’s κ (concurrent activities). Systematic bias varied from 1 min (domestic chores) to 226 min (caregiving) for 24HR and 1 min (own production) to 109 min (socializing) for AWC-IAR. The LOAs were within 2 h for employment, own production, and self-care for 24HR and AWC-IAR but exceeded 11 h (24HR) and 9 h (AWC-IAR) for caregiving and socializing. The LOAs were within four concurrent activities for 24HR (−1.1 to 3.7) and AWC-IAR (−3.2 to 3.2). Cronbach’s alpha for time allocation ranged from 0.1728 (socializing) to 0.8056 (own production) for 24HR and 0.2270 (socializing) to 0.7938 (own production) for AWC-IAR. For assessing women’s time allocations at the population level, the 24HR and AWC-IAR methods are accurate and reliable for employment, own production, and domestic chores but poor for caregiving and socializing. The results of this study suggest the need to revisit previously published research investigating the associations between women’s time allocations and nutrition outcomes.
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Affiliation(s)
- Andrea L. S. Bulungu
- Department of Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (B.D.G.); (N.S.); (E.L.F.)
- Correspondence: (A.L.S.B.); (L.P.)
| | - Luigi Palla
- Department of Public Health and Infectious Diseases, University of Roma La Sapienza, 00185 Rome, Italy
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
- School of Tropical Medicine and Global Health, University of Nagasaki, Nagasaki 852-8102, Japan
- Correspondence: (A.L.S.B.); (L.P.)
| | - Jan Priebe
- Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, Kent ME4 4TB, UK; (J.P.); (L.F.); (P.K.); (G.V.); (K.W.)
| | - Lora Forsythe
- Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, Kent ME4 4TB, UK; (J.P.); (L.F.); (P.K.); (G.V.); (K.W.)
| | - Pamela Katic
- Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, Kent ME4 4TB, UK; (J.P.); (L.F.); (P.K.); (G.V.); (K.W.)
| | - Gwen Varley
- Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, Kent ME4 4TB, UK; (J.P.); (L.F.); (P.K.); (G.V.); (K.W.)
| | - Bernice D. Galinda
- Department of Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (B.D.G.); (N.S.); (E.L.F.)
| | - Nakimuli Sarah
- Department of Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (B.D.G.); (N.S.); (E.L.F.)
| | - Joweria Nambooze
- Africa Innovations Institute (AfrII), Kampala P.O. Box 34981, Uganda;
- Department of Nutritional Sciences and Dietetics, Kyambogo University, Kyambogo, Kampala P.O. Box 1, Uganda
| | - Kate Wellard
- Natural Resources Institute (NRI), University of Greenwich, Chatham Maritime, Kent ME4 4TB, UK; (J.P.); (L.F.); (P.K.); (G.V.); (K.W.)
| | - Elaine L. Ferguson
- Department of Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (B.D.G.); (N.S.); (E.L.F.)
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11
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Tang K, Adams KP, Ferguson EL, Woldt M, Yourkavitch J, Pedersen S, Broadley MR, Dary O, Ander EL, Joy EJM. Systematic review of metrics used to characterise dietary nutrient supply from household consumption and expenditure surveys. Public Health Nutr 2022; 25:1-13. [PMID: 35022103 PMCID: PMC9991734 DOI: 10.1017/s1368980022000118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 11/22/2021] [Accepted: 01/10/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To review existing publications using Household Consumption and Expenditure Survey (HCES) data to estimate household dietary nutrient supply to (1) describe scope of available literature, (2) identify the metrics reported and parameters used to construct these metrics, (3) summarise comparisons between estimates derived from HCES and individual dietary assessment data and (4) explore the demographic and socio-economic sub-groups used to characterise risks of nutrient inadequacy. DESIGN This study is a systematic review of publications identified from online databases published between 2000 to 2019 that used HCES food consumption data to estimate household dietary nutrient supply. Further publications were identified by 'snowballing' the references of included database-identified publications. SETTING Publications using data from low- and lower-middle income countries. RESULTS In total, fifty-eight publications were included. Three metrics were reported that characterised household dietary nutrient supply: apparent nutrient intake per adult-male equivalent per day (n 35), apparent nutrient intake per capita per day (n 24) and nutrient density (n 5). Nutrient intakes were generally overestimated using HCES food consumption data, with several studies finding sizeable discrepancies compared with intake estimates based on individual dietary assessment methods. Sub-group analyses predominantly focused on measuring variation in household dietary nutrient supply according to socio-economic position and geography. CONCLUSION HCES data are increasingly being used to assess diets across populations. More research is needed to inform the development of a framework to guide the use of and qualified interpretation of dietary assessments based on these data.
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Affiliation(s)
- Kevin Tang
- Department of Population Health, London School of Hygiene & Tropical Medicine, LondonWC1E 7HT, UK
- USAID Advancing Nutrition, 4th Floor, 2733 Crystal Drive, Arlington, VA22202, USA
| | - Katherine P Adams
- Institute for Global Nutrition, University of California, Davis, Davis, CA, USA
| | - Elaine L Ferguson
- Department of Population Health, London School of Hygiene & Tropical Medicine, LondonWC1E 7HT, UK
| | - Monica Woldt
- USAID Advancing Nutrition, 4th Floor, 2733 Crystal Drive, Arlington, VA22202, USA
- Helen Keller International, Washington, DC, USA
| | - Jennifer Yourkavitch
- USAID Advancing Nutrition, 4th Floor, 2733 Crystal Drive, Arlington, VA22202, USA
- Results for Development, Washington, DC, USA
| | - Sarah Pedersen
- USAID, Bureau for Resilience and Food Security, Washington, DC, USA
| | - Martin R Broadley
- School of Biosciences, University of Nottingham, Sutton Bonington, Loughborough, UK
| | - Omar Dary
- USAID, Bureau for Global Health, Washington, DC, USA
| | - E Louise Ander
- School of Biosciences, University of Nottingham, Sutton Bonington, Loughborough, UK
- Centre for Environmental Geochemistry, British Geological Survey, Keyworth, Nottingham, UK
| | - Edward JM Joy
- Department of Population Health, London School of Hygiene & Tropical Medicine, LondonWC1E 7HT, UK
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12
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Joy EJM, Kalimbira AA, Sturgess J, Banda L, Chiutsi-Phiri G, Manase H, Gondwe J, Ferguson EL, Kalumikiza Z, Bailey EH, Young SD, Matandika L, Mfutso-Bengo J, Millar K, Niksic M, Segovia de la Revilla L, Likoswe BH, Phuka JC, Phiri FP, Lark RM, Gashu D, Langley-Evans SC, Ander EL, Lowe NM, Dangour AD, Nalivata PC, Broadley MR, Allen E. Biofortified Maize Improves Selenium Status of Women and Children in a Rural Community in Malawi: Results of the Addressing Hidden Hunger With Agronomy Randomized Controlled Trial. Front Nutr 2022; 8:788096. [PMID: 35071297 PMCID: PMC8770811 DOI: 10.3389/fnut.2021.788096] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/07/2021] [Indexed: 01/18/2023] Open
Abstract
Background: Selenium deficiency is widespread in the Malawi population. The selenium concentration in maize, the staple food crop of Malawi, can be increased by applying selenium-enriched fertilizers. It is unknown whether this strategy, called agronomic biofortification, is effective at alleviating selenium deficiency. Objectives: The aim of the Addressing Hidden Hunger with Agronomy (AHHA) trial was to determine whether consumption of maize flour, agronomically-biofortified with selenium, affected the serum selenium concentrations of women, and children in a rural community setting. Design: An individually-randomized, double-blind placebo-controlled trial was conducted in rural Malawi. Participants were randomly allocated in a 1:1 ratio to receive either intervention maize flour biofortified with selenium through application of selenium fertilizer, or control maize flour not biofortified with selenium. Participant households received enough flour to meet the typical consumption of all household members (330 g capita -1 day-1) for a period of 8 weeks. Baseline and endline serum selenium concentration (the primary outcome) was measured by inductively coupled plasma mass spectrometry (ICP-MS). Results: One woman of reproductive age (WRA) and one school-aged child (SAC) from each of 180 households were recruited and households were randomized to each group. The baseline demographic and socioeconomic status of participants were well-balanced between arms. No serious adverse events were reported. In the intervention arm, mean (standard deviation) serum selenium concentration increased over the intervention period from 57.6 (17.0) μg L-1 (n = 88) to 107.9 (16.4) μg L-1 (n = 88) among WRA and from 46.4 (14.8) μg L-1 (n = 86) to 97.1 (16.0) μg L-1 (n = 88) among SAC. There was no evidence of change in serum selenium concentration in the control groups. Conclusion: Consumption of maize flour biofortified through application of selenium-enriched fertilizer increased selenium status in this community providing strong proof of principle that agronomic biofortification could be an effective approach to address selenium deficiency in Malawi and similar settings. Clinical Trial Registration: http://www.isrctn.com/ISRCTN85899451, identifier: ISRCTN85899451.
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Affiliation(s)
- Edward J M Joy
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Alexander A Kalimbira
- Bunda College, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Joanna Sturgess
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Leonard Banda
- Bunda College, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Gabriella Chiutsi-Phiri
- Natural Resources College, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Hastings Manase
- Bunda College, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Jellita Gondwe
- National Nutrition Reference Lab, Community Health Sciences Unit, Public Health Institute of Malawi, Lilongwe, Malawi
| | - Elaine L Ferguson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Zione Kalumikiza
- Bunda College, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Elizabeth H Bailey
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, United Kingdom
| | - Scott D Young
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, United Kingdom
| | - Limbanazo Matandika
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Joseph Mfutso-Bengo
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Kate Millar
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, United Kingdom
| | - Maja Niksic
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Lucia Segovia de la Revilla
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Blessings H Likoswe
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - John C Phuka
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Felix P Phiri
- Department of Nutrition, HIV and AIDS, Ministry of Health, Lilongwe, Malawi
| | - R Murray Lark
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, United Kingdom
| | - Dawd Gashu
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
| | - Simon C Langley-Evans
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, United Kingdom
| | - E Louise Ander
- Inorganic Geochemistry, Centre for Environmental Geochemistry, British Geological Survey, Nottingham, United Kingdom
| | - Nicola M Lowe
- UCLan Research Centre for Global Development, University of Central Lancashire, Preston, United Kingdom
| | - Alan D Dangour
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Patson C Nalivata
- Bunda College, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Martin R Broadley
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, United Kingdom
- Rothamsted Research, Harpenden, United Kingdom
| | - Elizabeth Allen
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
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13
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Tang K, Adams KP, Ferguson EL, Woldt M, Kalimbira AA, Likoswe B, Yourkavitch J, Chrisinger B, Pedersen S, Segovia De La Revilla L, Dary O, Ander EL, Joy EJM. Modeling food fortification contributions to micronutrient requirements in Malawi using Household Consumption and Expenditure Surveys. Ann N Y Acad Sci 2021; 1508:105-122. [PMID: 34580873 PMCID: PMC9291765 DOI: 10.1111/nyas.14697] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/20/2021] [Accepted: 08/29/2021] [Indexed: 01/20/2023]
Abstract
Large-scale food fortification may be a cost-effective intervention to increase micronutrient supplies in the food system when implemented under appropriate conditions, yet it is unclear if current strategies can equitably benefit populations with the greatest micronutrient needs. This study developed a mathematical modeling framework for comparing fortification scenarios across different contexts. It was applied to model the potential contributions of three fortification vehicles (oil, sugar, and wheat flour) toward meeting dietary micronutrient requirements in Malawi through secondary data analyses of a Household Consumption and Expenditure Survey. We estimated fortification vehicle coverage, micronutrient density of the diet, and apparent intake of nonpregnant, nonlactating women for nine different micronutrients, under three food fortification scenarios and stratified by subpopulations across seasons. Oil and sugar had high coverage and apparent consumption that, when combined, were predicted to improve the vitamin A adequacy of the diet. Wheat flour contributed little to estimated dietary micronutrient supplies due to low apparent consumption. Potential contributions of all fortification vehicles were low in rural populations of the lowest socioeconomic position. While the model predicted large-scale food fortification would contribute to reducing vitamin A inadequacies, other interventions are necessary to meet other micronutrient requirements, especially for the rural poor.
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Affiliation(s)
- Kevin Tang
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.,USAID Advancing Nutrition, Arlington, Virginia
| | - Katherine P Adams
- Institute for Global Nutrition, University of California, Davis, Davis, California
| | - Elaine L Ferguson
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Monica Woldt
- USAID Advancing Nutrition, Arlington, Virginia.,Helen Keller International, Washington, DC
| | - Alexander A Kalimbira
- Department of Human Nutrition and Health, Faculty of Food and Human Sciences, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Blessings Likoswe
- Department of Public Health, School of Public Health and Family Medicine, University of Malawi, Chichiri, Malawi
| | - Jennifer Yourkavitch
- USAID Advancing Nutrition, Arlington, Virginia.,Results for Development, Washington, DC
| | - Benjamin Chrisinger
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Sarah Pedersen
- USAID, Bureau for Resilience and Food Security, Washington, DC
| | | | - Omar Dary
- USAID, Bureau for Global Health, Washington, DC
| | - E Louise Ander
- School of Biosciences, University of Nottingham, Loughborough, United Kingdom.,Centre for Environmental Geochemistry, British Geological Survey, Keyworth, United Kingdom
| | - Edward J M Joy
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
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14
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Chiron E, Varache M, Stokniene J, Thomas DW, Ferguson EL. A physicochemical assessment of the thermal stability of dextrin-colistin conjugates. Sci Rep 2021; 11:10600. [PMID: 34011987 PMCID: PMC8134461 DOI: 10.1038/s41598-021-89946-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/04/2021] [Indexed: 11/25/2022] Open
Abstract
Attachment of polysaccharide carriers is increasingly being used to achieve precision delivery and improved effectiveness of protein and peptide drugs. Although it is clear that their clinical effectiveness relies on the purity and integrity of the conjugate in storage, as well as following administration, instability of polysaccharide-based conjugates can reduce the protective efficacy of the polymer, which may adversely affect the bioactive's potency. As a model, these studies used dextrin-colistin conjugates, with varying degrees of polymer modification (1, 2.5 and 7.5 mol% succinoylation) to assess the effect of storage temperature (- 20, 4, 21 and 37 °C) and duration (up to 12 months) on saccharide and colistin release and antimicrobial activity. Estimation of the proportion of saccharide release (by comparison of area under the curve from size exclusion chromatograms) was more pronounced at higher temperatures (up to 3 and 35% at - 20 °C and 37 °C, respectively after 12 months), however, repeated freeze-thaw did not produce any measurable release of saccharides, while addition of amylase (20, 100, 500 IU/L) caused rapid release of saccharides (> 70% total within 24 h). At all temperatures, conjugates containing the lowest degree of succinoylation released the highest proportion of free colistin, which increased with storage temperature, however no trend in saccharide release was observed. Despite the clear physical effects of prolonged storage, antimicrobial activity of all samples was only altered after storage at 37 °C for 12 months (> threefold decreased activity). These results demonstrate significant release of saccharides from dextrin-colistin conjugates during prolonged storage in buffered solution, especially at elevated temperature, which, in most cases, did not affect antimicrobial activity. These findings provide vital information about the structure-activity relationship of dextrin-colistin conjugates, prior to full-scale commercial development, which can subsequently be applied to other polysaccharide-protein and -peptide conjugates.
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Affiliation(s)
- Emilie Chiron
- Advanced Therapies Group, Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff, CF14 4XY, UK
| | - Mathieu Varache
- Advanced Therapies Group, Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff, CF14 4XY, UK
- CNRS, Ingénierie Des Matériaux Polymères, IMP UMR CNRS 5223, Université de Lyon, Université Claude Bernard Lyon 1, 15 bd A. Latarjet, 69622, Villeurbanne, France
| | - Joana Stokniene
- Advanced Therapies Group, Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff, CF14 4XY, UK
| | - David W Thomas
- Advanced Therapies Group, Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff, CF14 4XY, UK
| | - Elaine L Ferguson
- Advanced Therapies Group, Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff, CF14 4XY, UK.
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15
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Pries AM, Filteau S, Ferguson EL. Snack food and beverage consumption and young child nutrition in low- and middle-income countries: A systematic review. Matern Child Nutr 2020; 15 Suppl 4:e12729. [PMID: 31225715 PMCID: PMC6618154 DOI: 10.1111/mcn.12729] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/13/2018] [Accepted: 08/23/2018] [Indexed: 12/30/2022]
Abstract
Although snacks can provide important nutrients for young children during the complementary feeding period, the increasing availability of snack foods and sugar‐sweetened beverages (SSB), often energy‐dense and nutrient‐poor, in low‐ and middle‐income countries (LMIC) is a concern. Such foods may displace consumption of nutritious foods in contexts where diets are often nutritionally inadequate and the burden of childhood malnutrition is high. This systematic review summarizes literature on the contribution of snack food/SSB consumption to total energy intakes (TEI) of children below 23 months of age in LMIC and associations between this consumption and nutritional outcomes. It also identifies areas where further research is needed. A systematic search of Embase, Global Health, and MEDLINE for literature published in January 1990–July 2018 was conducted. This search yielded 8,299 studies, 13 of which met inclusion criteria: Nine studies assessed % TEI from snack foods/SSB, and four studies assessed associations between snack food/SSB consumption and nutritional outcomes. Average % TEI from snack foods/SSB ranged from 13% to 38%. Findings regarding associations with growth were inconclusive, and no studies assessed associations with nutrient intakes. Variation in measurement of consumption and definitions of snack foods and SSB limited study comparisons. Further research is needed to understand how consumption of energy‐dense, nutrient‐poor snack foods and SSB influences undernutrition and overnutrition among young children during the complementary feeding period in settings that are experiencing dietary transitions and the double burden of malnutrition.
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Affiliation(s)
- Alissa M Pries
- Helen Keller International, New York, New York.,Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Suzanne Filteau
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Elaine L Ferguson
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
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16
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Sharma N, Ferguson EL, Upadhyay A, Zehner E, Filteau S, Pries AM. Perceptions of commercial snack food and beverages for infant and young child feeding: A mixed-methods study among caregivers in Kathmandu Valley, Nepal. Matern Child Nutr 2020; 15 Suppl 4:e12711. [PMID: 31225712 PMCID: PMC7198114 DOI: 10.1111/mcn.12711] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 09/18/2018] [Accepted: 09/20/2018] [Indexed: 12/30/2022]
Abstract
Ensuring nutritious complementary feeding is vital for child nutrition. Prior research in Kathmandu Valley found high consumption rates of commercially produced snack foods among young children, which are often energy‐dense/nutrient poor. This mixed‐methods study was conducted to elicit Nepali caregivers' perceptions of commercial snack foods and beverages and factors influencing their use for young child feeding. Seven facilitated focus group discussions (FGD) were conducted with Kathmandu Valley caregivers of children 12–23 months, and a survey of 745 primary caregivers of children 12–23 months of age was then conducted. During the FGD, caregivers reported commonly providing commercial food and beverage products to their children as snacks, and 98.6% of caregivers participating in the survey reported feeding their child such a food in the previous week. Because of processing and packaging, snack foods were not trusted by many FGD participants and considered as “junk foods” and not healthy for children. However, commercial snack foods were consistently ranked highly on convenience, both because of minimal preparation and ease of feeding; 48.5% of all surveyed caregivers reported providing a snack food because of convenience. Other family members' diets or provision of snack foods as treats also influenced children's consumption of these snack foods and beverages. This study indicates that caregivers of young children prefer snack options that are nutrient rich; however, this may conflict with preferences for foods that require minimal preparation and are appealing to young children. Such findings carry programmatic implications for interventions aiming to address children's diet quality in urban Nepal.
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Affiliation(s)
| | - Elaine L Ferguson
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Suzanne Filteau
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Alissa M Pries
- Helen Keller International, New York, New York.,Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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17
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Joy EJM, Kalimbira AA, Gashu D, Ferguson EL, Sturgess J, Dangour AD, Banda L, Chiutsi-Phiri G, Bailey EH, Langley-Evans SC, Lark RM, Millar K, Young SD, Matandika L, Mfutso-Bengo J, Phuka JC, Phiri FP, Gondwe J, Ander EL, Lowe NM, Nalivata PC, Broadley MR, Allen E. Can selenium deficiency in Malawi be alleviated through consumption of agro-biofortified maize flour? Study protocol for a randomised, double-blind, controlled trial. Trials 2019; 20:795. [PMID: 31888766 PMCID: PMC6937860 DOI: 10.1186/s13063-019-3894-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 11/08/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Micronutrient deficiencies including selenium (Se) are widespread in Malawi and potentially underlie a substantial disease burden, particularly among poorer and marginalised populations. Concentrations of Se in staple cereal crops can be increased through application of Se fertilisers - a process known as agronomic biofortification (agro-biofortification) - and this may contribute to alleviating deficiencies. The Addressing Hidden Hunger with Agronomy (AHHA) trial aims to establish the efficacy of this approach for improving Se status in rural Malawi. METHODS A double-blind, randomised, controlled trial will be conducted in a rural community in Kasungu District, Central Region, Malawi. The hypothesis is that consumption of maize flour agro-biofortified with Se will increase serum Se concentration. We will recruit 180 women of reproductive age (WRA) (20-45 years) and 180 school-age children (SAC) (5-10 years) randomly assigned in a 1:1 ratio to receive either maize flour enriched through agro-biofortification with Se or a control flour not enriched with Se. Households will receive flour (330 g per capita per day) for 12 weeks. The primary outcome is Se concentration in serum (μg/L). Serum will be extracted from venous blood samples drawn at baseline (prior to flour distribution) and end-line. Selenium concentration will be measured by using inductively coupled plasma mass spectrometry. DISCUSSION Findings will be communicated to policy stakeholders and participating communities and reported in peer-reviewed journals. TRIAL REGISTRATION The Addressing Hidden Hunger with Agronomy (Malawi) trial is registered (5th March 2019; ISCRTN85899451).
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Affiliation(s)
- Edward J M Joy
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
- London Centre for Integrative Research on Agriculture and Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Alexander A Kalimbira
- Lilongwe University of Agriculture and Natural Resources, PO BOX 219, Bunda College, Lilongwe, Malawi
| | - Dawd Gashu
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
| | - Elaine L Ferguson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- London Centre for Integrative Research on Agriculture and Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Joanna Sturgess
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Alan D Dangour
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- London Centre for Integrative Research on Agriculture and Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Leonard Banda
- Lilongwe University of Agriculture and Natural Resources, PO BOX 219, Bunda College, Lilongwe, Malawi
| | - Gabriella Chiutsi-Phiri
- Lilongwe University of Agriculture and Natural Resources, PO BOX 143, Natural Resources College, Lilongwe, Malawi
| | - Elizabeth H Bailey
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK
| | - Simon C Langley-Evans
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK
| | - R Murray Lark
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK
| | - Kate Millar
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK
| | - Scott D Young
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK
| | - Limbanazo Matandika
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Joseph Mfutso-Bengo
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - John C Phuka
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Felix P Phiri
- Lilongwe University of Agriculture and Natural Resources, PO BOX 219, Bunda College, Lilongwe, Malawi
- Department of Nutrition, HIV and AIDS, Ministry of Health, Lilongwe, Malawi
| | - Jellita Gondwe
- Public Health Institute of Malawi, Community Health Sciences Unit, National Nutrition Reference Lab, Lilongwe, Malawi
| | - E Louise Ander
- Inorganic Geochemistry, Centre for Environmental Geochemistry, British Geological Survey, Nottingham, NG12 5GG, UK
| | - Nicola M Lowe
- UCLan Research Centre for Global Development, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Patson C Nalivata
- Lilongwe University of Agriculture and Natural Resources, PO BOX 219, Bunda College, Lilongwe, Malawi
| | - Martin R Broadley
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK
| | - Elizabeth Allen
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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18
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Pries AM, Rehman AM, Filteau S, Sharma N, Upadhyay A, Ferguson EL. Unhealthy Snack Food and Beverage Consumption Is Associated with Lower Dietary Adequacy and Length-for-Age z-Scores among 12-23-Month-Olds in Kathmandu Valley, Nepal. J Nutr 2019; 149:1843-1851. [PMID: 31309223 PMCID: PMC6768809 DOI: 10.1093/jn/nxz140] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/01/2019] [Accepted: 05/31/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Consumption of unhealthy snack foods and beverages (USFBs) in low- and middle-income countries (LMICs) is rising, with global awareness increasing about risks of overnutrition. However, little is known about the relation between USFB consumption and young children's diet/nutritional outcomes in contexts where nutrient density of complementary foods is often low. OBJECTIVES This study assessed the association of high USFB consumption, compared with low consumption, with nutrient intakes, dietary adequacy, iron status, and growth in young children in Kathmandu Valley, Nepal. METHODS A cross-sectional survey was conducted in a representative sample of 745 primary caregivers of children aged 12-23 mo. Food consumption was measured through quantitative 24-h recalls, and child anthropometric measurements and capillary blood samples were collected. Using adjusted linear/logistic regression models, nutrient intakes, dietary adequacy, length-for-age and weight-for-length z-scores (LAZ and WLZ, respectively), and iron status were compared between lowest and highest tertiles of consumption based on the contribution of USFBs to total energy intakes (TEIs). Mediation of the relation between USFB consumption and LAZ via lowered dietary adequacy was explored using structural equations modeling. RESULTS On average, USFBs contributed 46.9% of TEI among the highest tertile of consumers, compared with 5.2% of TEI among the lowest. Compared with low-USFB consumers, high-USFB consumers had lower nutrient intakes and a greater proportion were at risk of inadequate intakes for 8 nutrients. Mean LAZ was nearly 0.3 SD lower among high-USFB consumers than low consumers (P = 0.003), with this relationship partially mediated through dietary adequacy. No associations were found with stunting prevalence or iron status. Prevalence of overweight/obesity was low. CONCLUSIONS In this LMIC context, high USFB consumption among young children was associated with inadequate micronutrient intakes, which can contribute to poor growth outcomes. Addressing increased availability of USFBs in LMIC food systems should be a priority for policies and programs aiming to safeguard child nutrition.
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Affiliation(s)
- Alissa M Pries
- Helen Keller International, Washington, DC, USA,Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom,Address correspondence to AMP (e-mail: )
| | - Andrea M Rehman
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Suzanne Filteau
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - Elaine L Ferguson
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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19
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Pries AM, Sharma N, Upadhyay A, Rehman AM, Filteau S, Ferguson EL. Energy intake from unhealthy snack food/beverage among 12-23-month-old children in urban Nepal. Matern Child Nutr 2019; 15 Suppl 4:e12775. [PMID: 31225707 PMCID: PMC6617731 DOI: 10.1111/mcn.12775] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/12/2018] [Accepted: 12/18/2018] [Indexed: 01/06/2023]
Abstract
Unhealthy snack food and beverage (USFB) consumption among young children has been noted in many low‐income and middle‐income countries (LMIC), however, there is a lack of information on the contribution of these foods to children's diets in these contexts. This study describes the nutrient profiles and costs of snacks consumed by young children in Kathmandu Valley, Nepal, and assesses the proportion of total energy intake from nonbreastmilk foods (%TEI‐NBF) contributed by USFB and factors associated with high USFB consumption. A cross‐sectional survey was conducted among 745 randomly sampled primary caregivers of children aged 12–23 months. Of 239 unique snack foods and beverages consumed, 180 (75.3%) were classified as unhealthy based on nutrient profiling, with 158 of these being commercially branded. Median cost/100 kcal of USFB was lower as compared with healthy snacks. Ninety‐one percent of children had consumed a USFB in the previous 24 hr, with these foods contributing a mean %TEI‐NBF of 24.5 ± 0.7 among all children. Biscuits (10.8%), candy/chocolate (3.5%), and savoury snacks (3.4%) provided the largest %TEI‐NBF. Children who were older, female, or from the poorest households had significantly higher odds of high USFB consumption, whereas children whose caregivers were of upper caste/ethnicity or had achieved tertiary education had lower odds of consumption than other children. To reduce USFB consumption, interventions should seek to further understand social/cultural drivers of feeding practices, target disadvantaged populations, and ensure caregivers are fully aware of the nutritional quality of food products they choose for their children.
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Affiliation(s)
- Alissa M Pries
- Helen Keller International, New York, New York.,Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Andrea M Rehman
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Suzanne Filteau
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Elaine L Ferguson
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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20
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Varache M, Powell LC, Aarstad OA, Williams TL, Wenzel MN, Thomas DW, Ferguson EL. Polymer Masked-Unmasked Protein Therapy: Identification of the Active Species after Amylase Activation of Dextrin-Colistin Conjugates. Mol Pharm 2019; 16:3199-3207. [PMID: 31125239 PMCID: PMC6779022 DOI: 10.1021/acs.molpharmaceut.9b00393] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
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Polymer
masked–unmasked protein therapy (PUMPT) uses conjugation
of a biodegradable polymer, such as dextrin, hyaluronic acid, or poly(l-glutamic acid), to mask a protein or peptide’s activity;
subsequent locally triggered degradation of the polymer at the target
site regenerates bioactivity in a controllable fashion. Although the
concept of PUMPT is well established, the relationship between protein
unmasking and reinstatement of bioactivity is unclear. Here, we used
dextrin–colistin conjugates to study the relationship between
the molecular structure (degree of unmasking) and biological activity.
Size exclusion chromatography was employed to collect fractions of
differentially degraded conjugates and ultraperformance liquid chromatography–mass
spectrometry (UPLC–MS) employed to characterize the corresponding
structures. Antimicrobial activity was studied using a minimum inhibitory
concentration (MIC) assay and confocal laser scanning microscopy of
LIVE/DEAD-stained biofilms with COMSTAT analysis. In vitro toxicity
of the degraded conjugate was assessed using an 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl
tetrazolium bromide assay. UPLC–MS revealed that the fully
“unmasked” dextrin–colistin conjugate composed
of colistin bound to at least one linker, whereas larger species were
composed of colistin with varying lengths of glucose units attached.
Increasing the degree of dextrin modification by succinoylation typically
led to a greater number of linkers bound to colistin. Greater antimicrobial
and antibiofilm activity were observed for the fully “unmasked”
conjugate compared to the partially degraded species (MIC = 0.25 and
2–8 μg/mL, respectively), whereas dextrin conjugation
reduced colistin’s in vitro toxicity toward kidney cells, even
after complete unmasking. This study highlights the importance of
defining the structure–antimicrobial activity relationship
for novel antibiotic derivatives and demonstrates the suitability
of LC–MS to aid the design of biodegradable polymer–antibiotic
conjugates.
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Affiliation(s)
- Mathieu Varache
- Advanced Therapies Group, Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences , Cardiff University , Heath Park , Cardiff CF14 4XY , U.K
| | - Lydia C Powell
- Advanced Therapies Group, Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences , Cardiff University , Heath Park , Cardiff CF14 4XY , U.K
| | - Olav A Aarstad
- Department of Biotechnology and Food Sciences , Norwegian University of Science and Technology , Trondheim 7491 , Norway
| | - Thomas L Williams
- School of Chemistry , Cardiff University , Main Building, Park Place , Cardiff CF10 3AT , U.K
| | - Margot N Wenzel
- School of Chemistry , Cardiff University , Main Building, Park Place , Cardiff CF10 3AT , U.K
| | - David W Thomas
- Advanced Therapies Group, Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences , Cardiff University , Heath Park , Cardiff CF14 4XY , U.K
| | - Elaine L Ferguson
- Advanced Therapies Group, Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences , Cardiff University , Heath Park , Cardiff CF14 4XY , U.K
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21
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Wessells KR, Young RR, Ferguson EL, Ouédraogo CT, Faye MT, Hess SY. Assessment of Dietary Intake and Nutrient Gaps, and Development of Food-Based Recommendations, among Pregnant and Lactating Women in Zinder, Niger: An Optifood Linear Programming Analysis. Nutrients 2019; 11:E72. [PMID: 30609695 PMCID: PMC6357040 DOI: 10.3390/nu11010072] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 12/18/2018] [Accepted: 12/20/2018] [Indexed: 12/14/2022] Open
Abstract
Pregnant and lactating women in rural Niger are at high risk for inadequate intakes of multiple micronutrients. Thus, 24 h dietary recalls were conducted and analyzed for dietary intakes in this population (n = 202). Using linear programming analyses, micronutrient gaps in women's diets were identified, food-based recommendations (FBR) to improve dietary micronutrient adequacy were developed, and various supplementation strategies were modelled. Energy intakes were below estimated requirements, and, for most micronutrients, >50% of women were at risk of inadequate intakes. Linear programming analyses indicated it would be difficult to select a diet that achieved recommended dietary allowances for all but three (vitamin B₆, iron and zinc) of 11 modeled micronutrients. Consumption of one additional meal per day, and adherence to the selected FBR (daily consumption of dark green leafy vegetables, fermented milk, millet, pulses, and vitamin A fortified oil), would result in a low percentage of women at risk of inadequate intakes for eight modeled micronutrients (vitamin A, riboflavin, thiamin, B6, folate, iron, zinc, and calcium). Because the promotion of realistic FBRs likely will not ensure that a low percentage of women are at risk of inadequate intakes for all modeled micronutrients, multiple micronutrient supplementation or provision of nutrient-dense foods should be prioritized.
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Affiliation(s)
- K Ryan Wessells
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA 95616, USA.
| | - Rebecca R Young
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA 95616, USA.
| | - Elaine L Ferguson
- Department of Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
| | - Césaire T Ouédraogo
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA 95616, USA.
| | | | - Sonja Y Hess
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA 95616, USA.
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22
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Ferguson EL, Naseer S, Powell LC, Hardwicke J, Young FI, Zhu B, Liu Q, Song B, Thomas DW. Controlled release of dextrin-conjugated growth factors to support growth and differentiation of neural stem cells. Stem Cell Res 2018; 33:69-78. [PMID: 30321831 PMCID: PMC6288241 DOI: 10.1016/j.scr.2018.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/06/2018] [Accepted: 10/03/2018] [Indexed: 12/16/2022] Open
Abstract
An essential aspect of stem cell in vitro culture and in vivo therapy is achieving sustained levels of growth factors to support stem cell survival and expansion, while maintaining their multipotency and differentiation potential. This study investigated the ability of dextrin (~74,000 g/mol; 27.8 mol% succinoylation) conjugated to epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF; or FGF-2) (3.9 and 6.7% w/w protein loading, respectively) to support the expansion and differentiation of stem cells in vitro via sustained, controllable growth factor release. Supplementation of mouse neural stem cells (mNSCs) with dextrin-growth factor conjugates led to greater and prolonged proliferation compared to unbound EGF/bFGF controls, with no detectable apoptosis after 7 days of treatment. Immunocytochemical detection of neural precursor (nestin) and differentiation (Olig2, MAP2, GFAP) markers verified that controlled release of dextrin-conjugated growth factors preserves stem cell properties of mNSCs for up to 7 days. These results show the potential of dextrin-growth factor conjugates for localized delivery of bioactive therapeutic agents to support stem cell expansion and differentiation, and as an adjunct to direct neuronal repair.
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Affiliation(s)
- Elaine L Ferguson
- Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff CF14 4XY, UK; Cardiff Institute of Tissue Engineering and Repair, Cardiff University, 10 Museum Place, Cardiff, South Glamorgan, CF10 3BG, UK.
| | - Sameza Naseer
- Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff CF14 4XY, UK
| | - Lydia C Powell
- Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff CF14 4XY, UK; Cardiff Institute of Tissue Engineering and Repair, Cardiff University, 10 Museum Place, Cardiff, South Glamorgan, CF10 3BG, UK
| | - Joseph Hardwicke
- Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff CF14 4XY, UK; Cardiff Institute of Tissue Engineering and Repair, Cardiff University, 10 Museum Place, Cardiff, South Glamorgan, CF10 3BG, UK
| | - Fraser I Young
- Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff CF14 4XY, UK; Cardiff Institute of Tissue Engineering and Repair, Cardiff University, 10 Museum Place, Cardiff, South Glamorgan, CF10 3BG, UK
| | - Bangfu Zhu
- Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff CF14 4XY, UK
| | - Qian Liu
- Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff CF14 4XY, UK
| | - Bing Song
- Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff CF14 4XY, UK; Cardiff Institute of Tissue Engineering and Repair, Cardiff University, 10 Museum Place, Cardiff, South Glamorgan, CF10 3BG, UK
| | - David W Thomas
- Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff CF14 4XY, UK; Cardiff Institute of Tissue Engineering and Repair, Cardiff University, 10 Museum Place, Cardiff, South Glamorgan, CF10 3BG, UK
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23
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Ferguson EL, Watson L, Berger J, Chea M, Chittchang U, Fahmida U, Khov K, Kounnavong S, Le BM, Rojroongwasinkul N, Santika O, Sok S, Sok D, Do TT, Thi LT, Vonglokham M, Wieringa F, Wasantwisut E, Winichagoon P. Realistic Food-Based Approaches Alone May Not Ensure Dietary Adequacy for Women and Young Children in South-East Asia. Matern Child Health J 2018; 23:55-66. [DOI: 10.1007/s10995-018-2638-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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24
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Powell LC, Pritchard MF, Ferguson EL, Powell KA, Patel SU, Rye PD, Sakellakou SM, Buurma NJ, Brilliant CD, Copping JM, Menzies GE, Lewis PD, Hill KE, Thomas DW. Targeted disruption of the extracellular polymeric network of Pseudomonas aeruginosa biofilms by alginate oligosaccharides. NPJ Biofilms Microbiomes 2018; 4:13. [PMID: 29977590 PMCID: PMC6026129 DOI: 10.1038/s41522-018-0056-3] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 05/20/2018] [Accepted: 06/06/2018] [Indexed: 11/29/2022] Open
Abstract
Acquisition of a mucoid phenotype by Pseudomonas sp. in the lungs of cystic fibrosis (CF) patients, with subsequent over-production of extracellular polymeric substance (EPS), plays an important role in mediating the persistence of multi-drug resistant (MDR) infections. The ability of a low molecular weight (Mn = 3200 g mol−1) alginate oligomer (OligoG CF-5/20) to modify biofilm structure of mucoid Pseudomonas aeruginosa (NH57388A) was studied in vitro using scanning electron microscopy (SEM), confocal laser scanning microscopy (CLSM) with Texas Red (TxRd®)-labelled OligoG and EPS histochemical staining. Structural changes in treated biofilms were quantified using COMSTAT image-analysis software of CLSM z-stack images, and nanoparticle diffusion. Interactions between the oligomers, Ca2+ and DNA were studied using molecular dynamics (MD) simulations, Fourier transform infrared spectroscopy (FTIR) and isothermal titration calorimetry (ITC). Imaging demonstrated that OligoG treatment (≥0.5%) inhibited biofilm formation, revealing a significant reduction in both biomass and biofilm height (P < 0.05). TxRd®-labelled oligomers readily diffused into established (24 h) biofilms. OligoG treatment (≥2%) induced alterations in the EPS of established biofilms; significantly reducing the structural quantities of EPS polysaccharides, and extracellular (e)DNA (P < 0.05) with a corresponding increase in nanoparticle diffusion (P < 0.05) and antibiotic efficacy against established biofilms. ITC demonstrated an absence of rapid complex formation between DNA and OligoG and confirmed the interactions of OligoG with Ca2+ evident in FTIR and MD modelling. The ability of OligoG to diffuse into biofilms, potentiate antibiotic activity, disrupt DNA-Ca2+-DNA bridges and biofilm EPS matrix highlights its potential for the treatment of biofilm-related infections. Small carbohydrate molecules derived from marine algae show potential for inhibiting biofilm formation in multi-drug resistant infections. A research team led by Lydia Powell at Cardiff University, UK, investigated the action of carbohydrates called alginate oligosaccharides, composed of a small number of linked sugar molecules. The oligosaccharides modified and disrupted the structure of cultured biofilms of Pseudomonas aeruginosa, the cause of many serious drug resistant infections. This effect significantly inhibited the formation and maintenance of the biofilm state, which is known to be a crucial factor allowing the bacteria to resist drug treatment. Antibiotics proved more effective following the oligosaccharide intervention. The researchers uncovered key molecular details involved in the ability of the oligosaccharides to diffuse into and disrupt biofilms. The therapeutic potential of these small carbohydrates is currently being investigated in clinical trials.
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Affiliation(s)
- Lydia C Powell
- 1Advanced Therapies Group, Cardiff University School of Dentistry, Heath Park, Cardiff, CF14 4XY UK
| | - Manon F Pritchard
- 1Advanced Therapies Group, Cardiff University School of Dentistry, Heath Park, Cardiff, CF14 4XY UK
| | - Elaine L Ferguson
- 1Advanced Therapies Group, Cardiff University School of Dentistry, Heath Park, Cardiff, CF14 4XY UK
| | - Kate A Powell
- 1Advanced Therapies Group, Cardiff University School of Dentistry, Heath Park, Cardiff, CF14 4XY UK
| | - Shree U Patel
- 1Advanced Therapies Group, Cardiff University School of Dentistry, Heath Park, Cardiff, CF14 4XY UK
| | | | | | - Niklaas J Buurma
- 3Physical Organic Chemistry Centre, School of Chemistry, Cardiff University, Cardiff, UK
| | | | - Jack M Copping
- 4Respiratory Diagnostics Group, Swansea University, Swansea, UK
| | | | - Paul D Lewis
- 4Respiratory Diagnostics Group, Swansea University, Swansea, UK
| | - Katja E Hill
- 1Advanced Therapies Group, Cardiff University School of Dentistry, Heath Park, Cardiff, CF14 4XY UK
| | - David W Thomas
- 1Advanced Therapies Group, Cardiff University School of Dentistry, Heath Park, Cardiff, CF14 4XY UK
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25
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Scomparin A, Florindo HF, Tiram G, Ferguson EL, Satchi-Fainaro R. Two-step polymer- and liposome-enzyme prodrug therapies for cancer: PDEPT and PELT concepts and future perspectives. Adv Drug Deliv Rev 2017; 118:52-64. [PMID: 28916497 DOI: 10.1016/j.addr.2017.09.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/17/2017] [Accepted: 09/07/2017] [Indexed: 12/14/2022]
Abstract
Polymer-directed enzyme prodrug therapy (PDEPT) and polymer enzyme liposome therapy (PELT) are two-step therapies developed to provide anticancer drugs site-selective intratumoral accumulation and release. Nanomedicines, such as polymer-drug conjugates and liposomal drugs, accumulate in the tumor site due to extravasation-dependent mechanism (enhanced permeability and retention - EPR - effect), and further need to cross the cellular membrane and release their payload in the intracellular compartment. The subsequent administration of a polymer-enzyme conjugate able to accumulate in the tumor tissue and to trigger the extracellular release of the active drug showed promising preclinical results. The development of polymer-enzyme, polymer-drug conjugates and liposomal drugs had undergone a vast advancement over the past decades. Several examples of enzyme mimics for in vivo therapy can be found in the literature. Moreover, polymer therapeutics often present an enzyme-sensitive mechanism of drug release. These nanomedicines can thus be optimal substrates for PDEPT and this review aims to provide new insights and stimuli toward the future perspectives of this promising combination.
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Affiliation(s)
- Anna Scomparin
- Department of Physiology and Pharmacology, Sackler School of Medicine, Room 607, Tel Aviv University, Tel Aviv 69978, Israel
| | - Helena F Florindo
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisbon, Portugal
| | - Galia Tiram
- Department of Physiology and Pharmacology, Sackler School of Medicine, Room 607, Tel Aviv University, Tel Aviv 69978, Israel
| | - Elaine L Ferguson
- Advanced Therapies Group, Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff CF14 4XY, UK
| | - Ronit Satchi-Fainaro
- Department of Physiology and Pharmacology, Sackler School of Medicine, Room 607, Tel Aviv University, Tel Aviv 69978, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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26
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Ferguson EL, Scomparin A, Hailu H, Satchi-Fainaro R. HPMA copolymer-phospholipase C and dextrin-phospholipase A2 as model triggers for polymer enzyme liposome therapy (PELT). J Drug Target 2017; 25:818-828. [PMID: 28728446 DOI: 10.1080/1061186x.2017.1358726] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
'Polymer Enzyme Liposome Therapy' (PELT) is a two-step anticancer approach in which a liposomal drug and polymer-phospholipase conjugate are administered sequentially to target the tumour interstitium by the enhanced permeability and retention effect, and trigger rapid, local, drug release. To date, however, the concept has only been described theoretically. We synthesised two polymer conjugates of phospholipase C (PLC) and A2 (PLA2) and evaluated their ability to trigger anthracycline release from the clinically used liposomes, Caelyx® and DaunoXome®. N-(2-Hydroxypropyl)methacrylamide (HPMA) copolymer-PLC and a dextrin-PLA2 were synthesised and their enzymatic activity characterised. Doxorubicin release from polyethyleneglycol-coated (PEGylated) Caelyx® was relatively slow (<20%, 60 min), whereas daunomycin was rapidly released from non-PEGylated DaunoXome® (∼87%) by both enzymes. Incubation with dextrin-PLA2 triggered significantly less daunomycin release than HPMA copolymer-PLC, but when dextrin-PLA2 was pre-incubated with α-amylase, the rate of daunomycin release increased. DaunoXome®'s diameter increased in the presence of PLA2, while Caelyx®'s diameter was unaffected by free or conjugated PLA2. Dextrin-PLA2 potentiated the cytotoxicity of DaunoXome® to MCF-7 cells to a greater extent than free PLA2, while combining dextrin-PLA2 with Caelyx® resulted in antagonism, even in the presence of α-amylase, presumably due to steric hindrance by PEG. Our findings suggest that in vivo studies to evaluate PELT combinations should be further evaluated.
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Affiliation(s)
- Elaine L Ferguson
- a Centre for Polymer Therapeutics, Welsh School of Pharmacy , Cardiff University , Cardiff , UK.,b Advanced Therapies Group, Oral and Biomedical Sciences, School of Dentistry, College of Biomedical and Life Sciences , Cardiff University , Cardiff , UK
| | - Anna Scomparin
- c Department of Physiology and Pharmacology, Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Hanna Hailu
- a Centre for Polymer Therapeutics, Welsh School of Pharmacy , Cardiff University , Cardiff , UK
| | - Ronit Satchi-Fainaro
- c Department of Physiology and Pharmacology, Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
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Hemsworth J, Kumwenda C, Arimond M, Maleta K, Phuka J, Rehman AM, Vosti SA, Ashorn U, Filteau S, Dewey KG, Ashorn P, Ferguson EL. Lipid-Based Nutrient Supplements Increase Energy and Macronutrient Intakes from Complementary Food among Malawian Infants. J Nutr 2016; 146:326-34. [PMID: 26740684 DOI: 10.3945/jn.115.215327] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 11/30/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Low intakes of good-quality complementary foods (CFs) contribute to undernutrition and consequently negatively affect health, growth, and development. Lipid-based nutrient supplements (LNSs) are designed to ensure dietary adequacy in micronutrients and essential fatty acids and to provide some energy and high-quality protein. In populations in which acute energy deficiency is rare, the dose-dependent effect of LNSs on CF intakes is unknown. OBJECTIVE The objective of this study was to evaluate the difference in energy and macronutrient intakes from CF between a control (no supplement) group and 3 groups that received 10, 20, or 40 g LNS/d. METHODS We collected repeated interactive 24-h dietary recalls from caregivers of rural Malawian 9- to 10-mo-old infants (n = 748) to estimate dietary intakes (LNS and all non-breast-milk foods) of energy and macronutrients and their dietary patterns. All infants were participating in a 12-mo randomized controlled trial to investigate the efficacy of various doses of LNS for preventing undernutrition. RESULTS Dietary energy intakes were significantly higher among infants in the LNS intervention groups than in the control group (396, 406, and 388 kcal/d in the 10-, 20-, and 40-g LNS/d groups, respectively, compared with 345 kcal/d; each pairwise P < 0.05), but no significant differences were found in energy intakes between groups who were administered the different LNS doses (10 g LNS/d compared with 20 g LNS/d: P = 0.72; 10 g LNS/d compared with 40 g LNS/d: P ≥ 0.67; 20 g LNS/d compared with 40 g LNS/d: P = 0.94). Intakes of protein and fat were significantly higher in the LNS intervention groups than in the control group. No significant intergroup differences were found in median intakes of energy from non-LNS CFs (357, 347, and 296 kcal/d in the 10-, 20-, and 40-g LNS/d groups, respectively, compared with 345 kcal/d in the control group; P = 0.11). CONCLUSION LNSs in doses of 10-40 g/d increase intakes of energy and macronutrients among 9- to 10-mo-old Malawian infants, without displacing locally available CFs. This trial was registered at clinicaltrials.gov as NCT00945698.
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Affiliation(s)
| | - Chiza Kumwenda
- Department for International Health, School of Medicine, and
| | - Mary Arimond
- Program in International and Community Nutrition, and
| | - Kenneth Maleta
- College of Medicine, University of Blantyre, Blantyre, Malawi
| | - John Phuka
- College of Medicine, University of Blantyre, Blantyre, Malawi
| | - Andrea M Rehman
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stephen A Vosti
- Department of Agricultural and Resource Economics, University of California, Davis, CA; and
| | - Ulla Ashorn
- Department for International Health, School of Medicine, and
| | | | | | - Per Ashorn
- Department for International Health, School of Medicine, and Department of Pediatrics, Tampere University Hospital, Tampere, Finland
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Roberts JL, Cattoz B, Schweins R, Beck K, Thomas DW, Griffiths PC, Ferguson EL. In Vitro Evaluation of the Interaction of Dextrin–Colistin Conjugates with Bacterial Lipopolysaccharide. J Med Chem 2016; 59:647-54. [DOI: 10.1021/acs.jmedchem.5b01521] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jessica L. Roberts
- Advanced
Therapies Group, School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, U.K
| | - Beatrice Cattoz
- Department
of Pharmaceutical, Chemical and Environmental Sciences, Faculty of
Engineering and Science, University of Greenwich, Medway Campus, Central Avenue, Chatham Maritime ME4 4TB, U.K
| | - Ralf Schweins
- Institut Laue-Langevin, DS/LSS group, 6, rue Jules Horowitz, 38042 Cedex 9 Grenoble, France
| | - Konrad Beck
- Advanced
Therapies Group, School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, U.K
| | - David W. Thomas
- Advanced
Therapies Group, School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, U.K
| | - Peter C. Griffiths
- Department
of Pharmaceutical, Chemical and Environmental Sciences, Faculty of
Engineering and Science, University of Greenwich, Medway Campus, Central Avenue, Chatham Maritime ME4 4TB, U.K
| | - Elaine L. Ferguson
- Advanced
Therapies Group, School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, U.K
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Menon KC, Ferguson EL, Thomson CD, Gray AR, Zodpey S, Saraf A, Das PK, Skeaff SA. Effects of anemia at different stages of gestation on infant outcomes. Nutrition 2015; 32:61-5. [PMID: 26643748 DOI: 10.1016/j.nut.2015.07.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 07/13/2015] [Accepted: 07/16/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Maternal anemia is a public health challenge worldwide. The present study aims to explore the effects of maternal anemia at different stages of gestation on postnatal growth and neurobehavioral development in infants. METHODS A cohort of pregnant Indian women were followed from 13 to 22 wk gestation (i.e., second trimester; n = 211), 29 to 42 wk gestation (i.e., third trimester; n = 178); their infants were followed to ∼3 wk (n = 147) postpartum. Data collected included information on sociodemographic and health-related factors, including anemia (i.e., low hemoglobin status), maternal and infant anthropometric data, and infant neurobehavioral data. A mixed logistic regression model was used to examine the impact of anemia during pregnancy on maternal and infant outcomes (i.e., anthropometric growth parameters and infant neurobehavioral development). RESULTS The prevalence of maternal anemia was 41% and 55% (P < 0.001), and iron deficiency anemia was 3.6% and 5.6%, respectively, in the second trimester and third trimester. Infants of pregnant women who were not anemic in the second trimester were 0.26 standard deviations (SD) heavier (P = 0.029), 0.50 SD taller (P = 0.001), and had 0.26 SD larger head circumference (P = 0.029) compared with infants of anemic pregnant women. Infants of pregnant women who were not anemic in the third trimester had orientation scores 3.88 higher (P = 0.004) than infants of women who were anemic. CONCLUSIONS Our findings indicate that maternal anemia in the second trimester of gestation influences postnatal infant growth and underscores the necessity of alleviating anemia in young women in the early stages of gestation.
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Affiliation(s)
- Kavitha C Menon
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
| | - Elaine L Ferguson
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Andrew R Gray
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | | | - Abhay Saraf
- Symbiosis School of Biomedical Sciences, Symbiosis International University, Pune, India
| | | | - Sheila A Skeaff
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
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Ferguson EL, Azzopardi E, Roberts JL, Walsh TR, Thomas DW. Dextrin-colistin conjugates as a model bioresponsive treatment for multidrug resistant bacterial infections. Mol Pharm 2014; 11:4437-47. [PMID: 25360900 DOI: 10.1021/mp500584u] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Polymer therapeutics offer potential benefits in the treatment of multidrug resistant (MDR) infections; affording targeted delivery of biologically active agents to the site of inflammation, potential decreases in systemic toxicity, and the retention of antimicrobial activity at the target site. As a prototype model, these studies developed and characterized a library of dextrin-colistin conjugates (dextrin molecular weight: 7500-48,000 g/mol) as a means of targeting the delivery of colistin. Optimum colistin release kinetics (following dextrin degradation by physiological concentrations of amylase (100 IU/L)) were observed in conjugates containing low molecular weight (∼7500 g/mol) dextrin with ∼1 mol % succinoylation (∼80% drug release within 48 h, compared to ∼33% from sodium colistin methanesulfonate (CMS, Colomycin)). These conjugates exhibited comparable antimicrobial activity to CMS in conventional MIC assays against a range of Gram-negative pathogens, but with significantly reduced in vitro toxicity toward kidney (IC₅₀ = CMS, 15.4 μg/mL; dextrin-colistin, 63.9 μg/mL) and macrophage (IC₅₀ = CMS, 111.3 μg/mL; dextrin-colistin, 303.9 μg/mL) cells. In vivo dose-escalation studies in rats demonstrated improved pharmacokinetics of the conjugates, with prolonged plasma levels of colistin (t₁/₂ 135-1271 min vs 53 min) and decreased toxicity, compared to colistin sulfate. These studies highlight the potential utility of "nanoantibiotic" polymer therapeutics to aid the safe, effective, and targeted delivery of colistin in the management of MDR infections.
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Affiliation(s)
- Elaine L Ferguson
- Advanced Therapies Group, Tissue Engineering and Reparative Dentistry, School of Dentistry, ‡Microbiology and Infection Translational Research Group (MITReG), §Department of Infection, Immunity and Biochemistry, School of Medicine, Cardiff University , Heath Park, Cardiff CF14 4XY, U.K
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Herbst CA, Menon KC, Ferguson EL, Thomson CD, Bailey K, Gray AR, Zodpey S, Saraf A, Das PK, Skeaff SA. Dietary and non-dietary factors associated with serum zinc in Indian women. Biol Trace Elem Res 2014; 161:38-47. [PMID: 25080861 DOI: 10.1007/s12011-014-0090-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 07/22/2014] [Indexed: 10/25/2022]
Abstract
Women in low-income settings, common in India, are at risk of inadequate zinc intake due to poor diet quality and low consumption of flesh foods rich in zinc. The aims of this study were to assess the prevalence of zinc status of non-pregnant rural and tribal women living in central India and to identify dietary and non-dietary factors associated with the biochemical zinc status of these women. Rural and tribal non-pregnant women 18-30 years of age were selected using proportion to population sampling near Nagpur, Maharashtra, India. Sociodemographic, biochemical (serum zinc), clinical, and dietary data (1-day interactive 24-h recall) were collected. The mean age of women (n = 109; rural = 52; tribal = 56) was 23.2 years and mean BMI was 17.9 kg/m(2). The majority of the participants identified as being non-vegetarian (72 %). The mean ± SD serum zinc concentration was 10.8 ± 1.6 μmol/L, and 52 % of participants had a low serum zinc concentration according to the International Zinc Nutrition Consultative Group (IZiNCG). The median (first and third quartile) energy, zinc intake, and phytate/zinc molar ratio was 5.4 (4.2, 6.7) MJ/day, 5.3 (3.8, 7.0) mg/day, and 26 (22, 28), respectively. Zinc intakes were well below IZiNCG recommendations for dietary zinc of 9 mg/day for non-pregnant women aged 14-18 years and 7 mg/day for non-pregnant women aged ≥ 19 years. Using linear regression analysis to identify non-dietary and dietary factors associated with serum zinc, a significant association was only found for current lactation (p = 0.012) and energy intake (p < 0.001). Diets low in energy with poor bioavailability of dietary zinc are likely to be the primary cause of the high proportion of Indian women with zinc deficiency.
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Affiliation(s)
- Catherine A Herbst
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
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Skau JKH, Bunthang T, Chamnan C, Wieringa FT, Dijkhuizen MA, Roos N, Ferguson EL. The use of linear programming to determine whether a formulated complementary food product can ensure adequate nutrients for 6- to 11-month-old Cambodian infants. Am J Clin Nutr 2014; 99:130-8. [PMID: 24153341 DOI: 10.3945/ajcn.113.073700] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A new software tool, Optifood, developed by the WHO and based on linear programming (LP) analysis, has been developed to formulate food-based recommendations. OBJECTIVE This study discusses the use of Optifood for predicting whether formulated complementary food (CF) products can ensure dietary adequacy for target populations in Cambodia. DESIGN Dietary data were collected by 24-h recall in a cross-sectional survey of 6- to 11-mo-old infants (n = 78). LP model parameters were derived from these data, including a list of foods, median serving sizes, and dietary patterns. Five series of LP analyses were carried out to model the target population's baseline diet and 4 formulated CF products [WinFood (WF), WinFood-Lite (WF-L), Corn-Soy-Blend Plus (CSB+), and Corn-Soy-Blend Plus Plus (CSB++)], which were added to the diet in portions of 33 g/d dry weight (DW) for infants aged 6-8 mo and 40 g/d DW for infants aged 9-11 mo. In each series of analyses, the nutritionally optimal diet and theoretical range, in diet nutrient contents, were determined. RESULTS The LP analysis showed that baseline diets could not achieve the Recommended Nutrient Intake (RNI) for thiamin, riboflavin, niacin, folate, vitamin B-12, calcium, iron, and zinc (range: 14-91% of RNI in the optimal diets) and that none of the formulated CF products could cover the nutrient gaps for thiamin, niacin, iron, and folate (range: 22-86% of the RNI). Iron was the key limiting nutrient, for all modeled diets, achieving a maximum of only 48% of the RNI when CSB++ was included in the diet. Only WF and WF-L filled the nutrient gap for calcium. WF-L, CSB+, and CSB++ filled the nutrient gap for zinc (9- to 11-mo-olds). CONCLUSIONS The formulated CF products improved the nutrient adequacy of complementary feeding diets but could not entirely cover the nutrient gaps. These results emphasize the value of using LP to evaluate special CF products during the intervention planning phase. The WF study was registered at controlled-trials.com as ISRCTN19918531.
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Affiliation(s)
- Jutta K H Skau
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark (JKHS, MAD, and NR); the Department of Fisheries Post-harvest Technologies and Quality Control, Fishery Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia (TB and CC); Institut de Recherche pour le Développement, Montpellier, France (FTW); and the Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom (ELF)
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Azzopardi EA, Camilleri L, Moseley R, Thomas DW, Ferguson EL. Statistical Characterization of Succinoylated Dextrin Degradation Behavior in Human α-Amylase. J Carbohydr Chem 2013. [DOI: 10.1080/07328303.2013.831434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Azzopardi EA, Ferguson EL, Thomas DW. The enhanced permeability retention effect: a new paradigm for drug targeting in infection. J Antimicrob Chemother 2012; 68:257-74. [PMID: 23054997 DOI: 10.1093/jac/dks379] [Citation(s) in RCA: 191] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Multidrug-resistant, Gram-negative infection is a major global determinant of morbidity, mortality and cost of care. The advent of nanomedicine has enabled tailored engineering of macromolecular constructs, permitting increasingly selective targeting, alteration of volume of distribution and activity/toxicity. Macromolecules tend to passively and preferentially accumulate at sites of enhanced vascular permeability and are then retained. This enhanced permeability and retention (EPR) effect, whilst recognized as a major breakthrough in anti-tumoral targeting, has not yet been fully exploited in infection. Shared pathophysiological pathways in both cancer and infection are evident and a number of novel nanomedicines have shown promise in selective, passive, size-mediated targeting to infection. This review describes the similarities and parallels in pathophysiological pathways at molecular, cellular and circulatory levels between inflammation/infection and cancer therapy, where use of this principle has been established.
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Affiliation(s)
- Ernest A Azzopardi
- School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, Wales, UK.
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Menon KC, Skeaff SA, Thomson CD, Gray AR, Ferguson EL, Zodpey S, Saraf A, Das PK, Pandav CS. The effect of maternal iodine status on infant outcomes in an iodine-deficient Indian population. Thyroid 2011; 21:1373-80. [PMID: 22029720 DOI: 10.1089/thy.2011.0130] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND An adequate intake of iodine during pregnancy is essential for the synthesis of maternal thyroid hormones needed to support normal fetal development. This study aimed to assess the iodine status of pregnant tribal Indian women and their infants and to determine the impact of maternal iodine status on infant growth and behavior. METHODS A prospective, observational study was undertaken to assess the iodine status of tribal pregnant Indian women living in Ramtek, northeast of Nagpur, India. Pregnant women were recruited at 13-22 weeks gestation (n=220), visited a second time at 33-37 weeks gestation (n=183), and again visited at 2-4 weeks postpartum with their infants. Sociodemographic, anthropometric, and biochemical data, including household salt, blood, and urine samples were obtained from pregnant women. Urine samples, anthropometric, and neonatal behavioral data were collected from infants. RESULTS The median urinary iodine concentration (MUIC) at recruitment (mean gestation=17.5 weeks) of mothers was 106 μg/L, which declined to 71 μg/L at the second visit (mean gestation=34.5 weeks) similar to the postpartum MUIC of 69 μg/L, indicating that these women were iodine deficient. Infant (mean age=2.5 weeks) MUIC was 168 μg/L. Median maternal thyroid stimulating hormone (TSH) and free thyroxine (FT(4)) concentrations at first and second visits were 1.71 and 1.79 mIU/L and 14.4 and 15.4 pmol/L, respectively; 20.0% of women at first visit had TSH >97.5th percentile and 1.4% had FT(4) <2.5th percentile. Salt iodine concentration was a significant predictor of maternal UIC (p<0.001), and postpartum maternal UIC was a significant predictor of infant UIC (p<0.001). For every pmol/L increase in maternal FT(4) concentration at first visit, both infant weight-for-age Z-score and length-for-age Z-score increased by 0.05 units. There was no relationship between maternal UIC, FT(4), or TSH at first visit and neonatal behavior. CONCLUSIONS Despite three quarters of the women in this study having access to adequately iodized salt (i.e., >15 ppm), these pregnant tribal Indian women were iodine deficient. Increasing the iodine content of salt deemed adequately iodized and iodine supplementation are two strategies that might improve the iodine status of these pregnant women and, consequently, the growth of their infants.
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Affiliation(s)
- Kavitha C Menon
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
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Houghton LA, Gray AR, Szymlek-Gay EA, Heath ALM, Ferguson EL. Vitamin D-fortified milk achieves the targeted serum 25-hydroxyvitamin D concentration without affecting that of parathyroid hormone in New Zealand toddlers. J Nutr 2011; 141:1840-6. [PMID: 21832027 DOI: 10.3945/jn.111.145052] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
For young children, the level of vitamin D required to ensure that most achieve targeted serum 25-hydroxyvitamin D [25(OH)D] ≥50 nmol/L has not been studied. We aimed to investigate the effect of vitamin D-fortified milk on serum 25(OH)D and parathyroid hormone (PTH) concentrations and to examine the dose-response relationship between vitamin D intake from study milks and serum 25(OH)D concentrations in healthy toddlers aged 12-20 mo living in Dunedin, New Zealand (latitude 46°S). Data from a 20-wk, partially blinded, randomized trial that investigated the effect of providing red meat or fortified toddler milk on the iron, zinc, iodine, and vitamin D status in young New Zealand children (n = 181; mean age 17 mo) were used. Adherence to the intervention was assessed by 7-d weighed diaries at wk 2, 7, 11, 15, and 19. Serum 25(OH)D concentration was measured at baseline and wk 20. Mean vitamin D intake provided by fortified milk was 3.7 μg/d (range, 0-10.4 μg/d). After 20 wk, serum 25(OH)D concentrations but not PTH were significantly different in the milk groups. The prevalence of having a serum 25(OH)D <50 nmol/L remained relatively unchanged at 43% in the meat group, whereas it significantly decreased to between 11 and 15% in those consuming fortified study milk. In New Zealand, vitamin D intake in young children is minimal. Our findings indicate that habitual consumption of vitamin D-fortified milk providing a mean intake of nearly 4 μg/d was effective in achieving adequate year-round serum 25(OH)D for most children.
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Affiliation(s)
- Lisa A Houghton
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
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Izzo L, Griffiths PC, Nilmini R, King SM, Wallom KL, Ferguson EL, Duncan R. Impact of polymer tacticity on the physico-chemical behaviour of polymers proposed as therapeutics. Int J Pharm 2011; 408:213-22. [DOI: 10.1016/j.ijpharm.2011.02.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 01/28/2011] [Accepted: 02/04/2011] [Indexed: 11/15/2022]
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Morgan EJ, Heath ALM, Szymlek-Gay EA, Gibson RS, Gray AR, Bailey KB, Ferguson EL. Red meat and a fortified manufactured toddler milk drink increase dietary zinc intakes without affecting zinc status of New Zealand toddlers. J Nutr 2010; 140:2221-6. [PMID: 20980643 DOI: 10.3945/jn.109.120717] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Evidence suggests that New Zealand (NZ) children are mildly zinc deficient and may respond to dietary change. A 20-wk randomized intervention trial was therefore conducted to determine whether an increased intake of red meat or consumption of a fortified manufactured toddler milk drink (FTMD, fortified with zinc and other micronutrients) would increase dietary zinc intakes and improve the biochemical zinc status of 12- to 20-mo-old NZ toddlers. Toddlers were randomized to a red meat intervention (n = 90), FTMD intervention (n = 45), or nonfortified milk placebo (n = 90). Study foods were provided. Adherence was assessed via monthly 7-d meat or milk recording diaries. Hair and serum zinc concentrations, and length and weight were measured at baseline and postintervention. Nutrient intakes were assessed via 3-d weighed food records at baseline, wk 4, and wk 18. At baseline, 38% of participants had low serum zinc concentrations despite seemingly adequate dietary zinc intakes (<4% below the Estimated Average Requirement). Dietary zinc intakes significantly increased by 0.8 mg/d (95% CI: 0.5, 1.1) in the meat group and 0.7 mg/d (95% CI: 0.2, 1.1) in the FTMD group compared with a decrease of -0.5 (95% CI: -0.8, -0.2) mg/d in the placebo group. No corresponding increases in serum or hair zinc concentrations were observed. Dietary zinc intakes achievable via interventions based on red meat or a FTMD are unlikely to improve biochemical zinc status in NZ toddlers. These results also question cutoffs used to define zinc deficiency in toddlers.
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Affiliation(s)
- Emily J Morgan
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
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Torheim LE, Ferguson EL, Penrose K, Arimond M. Women in resource-poor settings are at risk of inadequate intakes of multiple micronutrients. J Nutr 2010; 140:2051S-8S. [PMID: 20881075 DOI: 10.3945/jn.110.123463] [Citation(s) in RCA: 118] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A systematic review was conducted to identify all studies that were published between 1988 and 2008 reporting micronutrient intakes of women in resource-poor settings. Inclusion criteria were study location (resource-poor), dietary assessment method (24-h recall, estimated/weighed record, or locally validated FFQ), energy and 1 or more micronutrient intakes reported (vitamin A, vitamin B-6, vitamin B-12, vitamin C, thiamin, riboflavin, niacin, folate, iron, or zinc), age range (15-50 y), sample size (≥30), and sex (female). Of the 1560 papers identified, 52 papers were included. Results showed that, except for vitamin A (29%), vitamin C (34%), and niacin (34%), the reported mean/median intakes in over 50% of studies were below the Estimated Average Requirement (EAR). Folate intake was most often below EAR (91% of studies). Regional differences were apparent for intakes of vitamins A, C, and B-6 and riboflavin; mean/median intakes in Latin America exceeded the EAR, whereas in Asia, reported mean/median intakes of vitamin C, vitamin A, and riboflavin were below the EAR in 47, 50, and 77% of the studies, respectively, as was the case for vitamin B-6 in 75% of the studies in Africa. These results suggest that inadequate intakes of multiple micronutrients are common among women living in resource-poor settings and emphasize the need for increased attention to the quality of women's diets. There is a need for more high-quality studies of women's micronutrient intakes.
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Affiliation(s)
- Liv Elin Torheim
- Fafo Institute for Applied International Studies, NO-0608 Oslo, Norway.
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Mulrine HM, Skeaff SA, Ferguson EL, Gray AR, Valeix P. Breast-milk iodine concentration declines over the first 6 mo postpartum in iodine-deficient women. Am J Clin Nutr 2010; 92:849-56. [PMID: 20702609 DOI: 10.3945/ajcn.2010.29630] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Little is known about the iodine status of lactating mothers and their infants during the first 6 mo postpartum or, if deficient, the amount of supplemental iodine required to improve status. OBJECTIVE The objective was to determine maternal and infant iodine status and the breast-milk iodine concentration (BMIC) over the first 6 mo of breastfeeding. DESIGN A randomized, double-blind, placebo-controlled supplementation trial was conducted in lactating women who received placebo (n = 56), 75 μg I/d (n = 27), or 150 μg I/d (n = 26) after their infants' birth until 24 wk postpartum. Maternal and infant urine samples and breast-milk samples were collected at 1, 2, 4, 8, 12, 16, 20, and 24 wk. Maternal serum thyrotropin and free thyroxine concentrations were measured at 24 wk. RESULTS Over 24 wk, the median urinary iodine concentration (UIC) of unsupplemented women and their infants ranged from 20 to 41 μg/L and 34 to 49 μg/L, respectively, which indicated iodine deficiency (ie, UIC < 100 μg/L). Mean maternal UIC was 2.1-2.4 times higher in supplemented than in unsupplemented women (P < 0.001) but did not differ significantly between the 2 supplemented groups. BMIC in the placebo group decreased by 40% over 24 wk (P < 0.001) and was 1.3 times and 1.7 times higher in women supplemented with 75 μg I/d (P = 0.030) and 150 μg I/d (P < 0.001), respectively, than in unsupplemented women. Thyrotropin and free thyroxine did not differ significantly between groups. CONCLUSION BMIC decreased in the first 6 mo in these iodine-deficient lactating women; supplementation with 75 or 150 μg I/d increased the BMIC but was insufficient to ensure adequate iodine status in women or their infants. The study was registered with the Australian New Zealand Clinical Trials Registry as ACTRN12605000345684.
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Affiliation(s)
- Hannah M Mulrine
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
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Gibson RS, Bailey KB, Gibbs M, Ferguson EL. A review of phytate, iron, zinc, and calcium concentrations in plant-based complementary foods used in low-income countries and implications for bioavailability. Food Nutr Bull 2010; 31:S134-46. [PMID: 20715598 DOI: 10.1177/15648265100312s206] [Citation(s) in RCA: 237] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Plant-based complementary foods often contain high levels of phytate, a potent inhibitor of iron, zinc, and calcium absorption. This review summarizes the concentrations of phytate (as hexa- and penta-inositol phosphate), iron, zinc, and calcium and the corresponding phytate:mineral molar ratios in 26 indigenous and 27 commercially processed plant-based complementary foods sold in low-income countries. Phytate concentrations were highest in complementary foods based on unrefined cereals and legumes (approximately 600 mg/100 g dry weight), followed by refined cereals (approximately 100 mg/100 g dry weight) and then starchy roots and tubers (< 20 mg/100 g dry weight); mineral concentrations followed the same trend. Sixty-two percent (16/26) of the indigenous and 37% (10/27) of the processed complementary foods had at least two phytate:mineral molar ratios (used to estimate relative mineral bioavailability) that exceeded suggested desirable levels for mineral absorption (i.e., phytate:iron < 1, phytate:zinc < 18, phytate:calcium < 0.17). Desirable molar ratios for phytate:iron, phytate:zinc, and phytate:calcium were achieved for 25%, 70%, and 57%, respectively, of the complementary foods presented, often through enrichment with animal-source foods and/or fortification with minerals. Dephytinization, either in the household or commercially, can potentially enhance mineral absorption in high-phytate complementary foods, although probably not enough to overcome the shortfalls in iron, zinc, and calcium content of plant-based complementary foods used in low-income countries. Instead, to ensure the World Health Organization estimated needs for these minerals from plant-based complementary foods for breastfed infants are met, dephytinization must be combined with enrichment with animal-source foods and/or fortification with appropriate levels and forms of mineral fortificants.
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Affiliation(s)
- Rosalind S Gibson
- Department of Human Nutrition, University of Otago, Union Street, PO Box 56, Dunedin 9015, New Zealand.
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Ferguson EL, Gibson RS, Opare‐Obisaw C, Ounpuu S, Lamba C. Dietary strategies for improving the zinc Nutriture of rural, southern Malawian and Ghanaian children. Ecol Food Nutr 2010. [DOI: 10.1080/03670244.1995.9991445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ferguson EL, De Luca E, Heenan RK, King SM, Griffiths PC. Time-Resolved Small-Angle Neutron Scattering as a Tool for Studying Controlled Release from Liposomes using Polymer-Enzyme Conjugates. Macromol Rapid Commun 2010; 31:1685-90. [DOI: 10.1002/marc.201000241] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 06/06/2010] [Indexed: 11/05/2022]
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Houghton LA, Szymlek-Gay EA, Gray AR, Ferguson EL, Deng X, Heath ALM. Predictors of vitamin D status and its association with parathyroid hormone in young New Zealand children. Am J Clin Nutr 2010; 92:69-76. [PMID: 20484452 DOI: 10.3945/ajcn.2009.29055] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Despite increased awareness of the adverse health effects of low vitamin D status, few studies have evaluated 25-hydroxyvitamin D [25(OH)D] status in young children. OBJECTIVES We aimed to assess vitamin D status on the basis of 25(OH)D and its relation with parathyroid hormone (PTH) and to identify possible predictors of 25(OH)D status in young children living in a country with minimal vitamin D fortification. DESIGN Serum 25(OH)D and PTH concentrations were measured in a cross-sectional sample of children aged 12-22 mo [n = 193 for 25(OH)D, n = 144 for PTH] living in Dunedin, New Zealand (latitude: 45 degrees S). Anthropometric, dietary, and sociodemographic data were collected. RESULTS The majority of children sampled in the summer (94%; 47 of 50) had 25(OH)D >50 nmol/L; however, nearly 80% of children sampled in the winter (43 of 55) had serum concentrations < or =50 nmol/L. In season-adjusted multivariate analysis, breastfeeding and higher levels of education were independently associated with lower 25(OH)D concentrations, whereas male sex and cigarette-smoke exposure were positively associated with 25(OH)D (all P < 0.05). Fractional polynomial regression was used to describe the nonlinear relation between serum PTH and 25(OH)D (P < 0.001). When 25(OH)D concentrations were >60-65 nmol/L, a plateau in PTH was evident. CONCLUSIONS Seasonal variation in 25(OH)D concentration implies that postsummer vitamin D stores were insufficient to maintain status >50 nmol/L year-round. Examination of the predictors of 25(OH)D in our model shows few modifiable risk factors, and thus effective dietary strategies may be required if future research determines that children with 25(OH)D concentrations <50 nmol/L are at significant health risk. This trial was registered at www.actr.org.au as ACTRN12605000487617.
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Affiliation(s)
- Lisa A Houghton
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
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Menon KC, Skeaff SA, Thomson CD, Gray AR, Ferguson EL, Zodpey S, Saraf A, Das PK, Toteja GS, Pandav CS. Concurrent micronutrient deficiencies are prevalent in nonpregnant rural and tribal women from central India. Nutrition 2010; 27:496-502. [PMID: 20558038 DOI: 10.1016/j.nut.2010.02.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Revised: 02/25/2010] [Accepted: 02/25/2010] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The existence of concurrent micronutrient deficiencies in Indian women of reproductive age has received little attention. This study aimed to comprehensively assess the micronutrient status of nonpregnant rural and tribal women 18-30 y from central India. METHODS Participants (n = 109) were randomly selected using a stratified (rural-tribal) proportionate-to-population size cluster sampling method from 12 subcenters in Ramtek block, Nagpur. Sociodemographic, anthropometric, dietary, and biochemical data, including blood and urine samples, were obtained. RESULTS Tribal and rural women had similar sociodemographic characteristics and anthropometric status; 63% of women had a body mass index <18.5 kg/m(2). The median urinary iodine concentration was 215 μg/L (IQR: 127, 319). The mean (SD) concentration of hemoglobin, serum zinc, retinol, and folate was 112 (13) g/L, 10.8 (1.6) μmol/L, 1.2 (0.3) μmol/L, 18.4 (8.4) nmol/L, respectively, with a geometric mean serum vitamin B(12) concentration of 186 pmol/L. The percentage of women with low values for hemoglobin (<120 g/L), serum zinc (<10.7 μmol/L), vitamin B(12) (<148 pmol/L), retinol (<0.7 μmol/L), and folate (<6.8 nmol/L) was 66%, 52%, 34%, 4%, and 2%, respectively. Tribal women had a higher prevalence of zinc deficiency (58% versus 39%, P = 0.054) and concurrent deficiency of any two micronutrients (46% versus 26%; P = 0.034), including zinc and anemia (38% versus 21%, P = 0.024). CONCLUSION Zinc, vitamin B(12), and iron constitute the principal micronutrient deficiencies in these women. Existing supplementation programs should be extended to include 18- to 30-y-old nonpregnant women as the majority of childbearing occurs within this timeframe.
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Affiliation(s)
- Kavitha C Menon
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
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Ferguson EL, Richardson SCW, Duncan R. Studies on the Mechanism of Action of Dextrin−Phospholipase A2 and Its Suitability for Use in Combination Therapy. Mol Pharm 2010; 7:510-21. [DOI: 10.1021/mp900232a] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Elaine L. Ferguson
- Centre for Polymer Therapeutics, Welsh School of Pharmacy, Cardiff University, King Edward VII Avenue, Cardiff, CF10 3XF, U.K
| | - Simon C. W. Richardson
- Centre for Polymer Therapeutics, Welsh School of Pharmacy, Cardiff University, King Edward VII Avenue, Cardiff, CF10 3XF, U.K
| | - Ruth Duncan
- Centre for Polymer Therapeutics, Welsh School of Pharmacy, Cardiff University, King Edward VII Avenue, Cardiff, CF10 3XF, U.K
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Szymlek-Gay EA, Ferguson EL, Heath ALM, Gray AR, Gibson RS. Food-based strategies improve iron status in toddlers: a randomized controlled trial12. Am J Clin Nutr 2009; 90:1541-51. [PMID: 19828711 DOI: 10.3945/ajcn.2009.27588] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Nonanemic iron deficiency is common in toddlers in developed countries. Food-based strategies are safe methods to control and prevent mild micronutrient deficiencies. OBJECTIVE Our objective was to determine the efficacy of an increased intake of red meat, or the consumption of iron-fortified milk, in improvement of iron status in toddlers at a population level. DESIGN In this 20-wk randomized placebo-controlled trial, 225 healthy nonanemic 12-20-mo-old children were assigned to 1 of 3 groups: red meat (toddlers encouraged to consume approximately 2.6 mg iron from red meat dishes daily), fortified milk [toddlers' regular milk replaced with iron-fortified (1.5 mg iron/100 g prepared milk) cow milk], or control [toddlers' regular milk replaced with nonfortified (0.01 mg iron/100 g prepared milk) cow milk]. Blood samples were collected at baseline and at 20 wk for hemoglobin, serum ferritin, serum transferrin receptor, and C-reactive protein. The prevalence of suboptimal iron status (ie, depleted iron stores, iron-deficient erythropoiesis, and iron deficiency anemia) was determined, and body iron was calculated. RESULTS No intervention effects were shown on the prevalence of suboptimal iron status. Serum ferritin increased by 44% (95% CI: 14%, 82%; P = 0.002) in the fortified milk group, did not change (+10%) in the red meat group (95% CI: -7%, 30%; P = 0.241), and tended to decrease (-14%) in the control group (95% CI: -27%, 1%; P = 0.063). By 20 wk, in comparison with the control group, serum ferritin and body iron were significantly higher in the fortified milk group (both P < 0.001), and serum ferritin was significantly higher in the red meat group (P = 0.033). CONCLUSIONS Consumption of iron-fortified milk can increase iron stores in healthy nonanemic toddlers, whereas increased intakes of red meat can prevent their decline. This trial was registered at actr.org.au as ACTRN12605000487617.
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Affiliation(s)
- Ewa A Szymlek-Gay
- Departments of Human Nutrition and Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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Affiliation(s)
- Elaine L. Ferguson
- Centre for Polymer Therapeutics, Welsh School of Pharmacy, Cardiff University, King Edward VII Avenue, Cardiff, CF10 3XF, United Kingdom
| | - Ruth Duncan
- Centre for Polymer Therapeutics, Welsh School of Pharmacy, Cardiff University, King Edward VII Avenue, Cardiff, CF10 3XF, United Kingdom
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Houghton LA, Deng X, Bailey KB, Heath AM, Ferguson EL, Szymlek‐Gay EA, Skeaff CM. Assessment of serum 25‐hydroxyvitamin D [25(OH)D] status and its predictors in healthy toddlers aged 12‐20 months. FASEB J 2009. [DOI: 10.1096/fasebj.23.1_supplement.112.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Lisa A Houghton
- Department of Human NutritionUniversity of OtagoDunedinNew Zealand
| | - Xiaolan Deng
- Department of Human NutritionUniversity of OtagoDunedinNew Zealand
| | - Karl B Bailey
- Department of Human NutritionUniversity of OtagoDunedinNew Zealand
| | | | - Elaine L Ferguson
- Department of Human NutritionUniversity of OtagoDunedinNew Zealand
- Nutrition and Public Health Intervention Research UnitLondon School of Hygiene and Tropical MedicineLondonUnited Kingdom
| | | | - C Murray Skeaff
- Department of Human NutritionUniversity of OtagoDunedinNew Zealand
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Cross AJ, Heath ALM, Ferguson EL, Gray AR, Szymlek-Gay EA. Rates of common communicable illnesses in non-anaemic 12-24 month old South Island, New Zealand children. N Z Med J 2009; 122:24-35. [PMID: 19319166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIMS To describe the incidence of parentally reported illness in otherwise healthy South Island toddlers; characterise the predictors of illness; and determine whether there was a relationship between teething and illness in this population. METHODS A 20-week randomised controlled trial was conducted on 1-year-old children (n=225) from Otago and Southland between February 2004 and December 2005. Information on symptoms of morbidity, occurrence of teething, and childcare attendance were recorded daily throughout the intervention period. Morbidity symptoms were categorised into respiratory illness (RI), gastrointestinal illness (GII), ear infection, and total illness, and the number and duration of events were determined. RESULTS The mean (SD) number of total illnesses was 3.4 (2.3) per 20 weeks, with an average duration of 4.5 days. Episodes of RI were most common (50% of total illness events), and tended to be the longest in duration (mean of 3.7 days). Having siblings aged less than 5 years (23% increase, 95%CI 6%-42%, p=0.007) and attending childcare (72% increase, 95%CI 38%-113%, p<0.001)), were positively associated with the number of total illness events but not duration. In addition, teething was positively associated with total events (OR 1.94, 95%CI 1.45-2.60, p<0.001), RI events (OR 2.03, 95%CI 1.41-2.93, p<0.001) and GII events (OR 1.90, 95%CI 1.36-2.67, p<0.001). CONCLUSION This study has shown that illness (particularly RI) is common in the second year of life. It has also confirmed that attending childcare and having siblings aged under 5 years increases the number of illness events. An association between teething and the occurrence of illness was also seen but the exact nature of this relationship requires verification.
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Affiliation(s)
- Andrea J Cross
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
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