scholarly journals Neurocognitive Benefits of Maternal Thiamine Supplementation for Breastfed Cambodian Infants

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 931-931
Author(s):  
Kyly Whitfield ◽  
Dare A Baldwin ◽  
Mary Chea ◽  
Tim Green ◽  
Frank Wieringa ◽  
...  
Keyword(s):  
At Risk ◽  
Language Development ◽  
Thiamine Deficiency ◽  
Controlled Trial ◽  
Newborn Infants ◽  
Cognitive Test ◽  
York Academy ◽  
Double Blind ◽  
Significant Drop ◽  
The Impact

Abstract Objectives Women reliant on rice-heavy diets can have inadequate thiamine intakes, placing breastfed infants at risk of thiamine deficiency and, in turn, neurocognitive impairments. We investigated the impact of maternal thiamine supplementation doses on infants’ cognitive, motor, and language development across the first year. Methods In this double-blind, four-parallel arm, randomized controlled trial, healthy mothers of exclusively breastfed newborn infants were recruited in Kampong Thom, Cambodia. At 2-weeks postnatal, women (n = 335) were randomized to one of four treatment groups to consume one capsule/day with varying amounts of thiamine for 22 weeks: 0 mg, 1.2 mg, 2.4 mg, and 10 mg. At 2-, 12-, 24- and 52-weeks of age, infants were assessed with the Mullen Scales of Early Learning (MSEL). Results Mixed effects modeling suggest that by 6 months of age, the highest maternal thiamine dose (10 mg/day) held significant benefits for infants’ language development, F's (3,659) > 33.2, P's < 0.001, but generally not for motor or visual reception development. Despite having achieved standardized scores on the MSEL that approximated US norms by 6 months, infants showed a significant drop in all cognitive domains following trial completion, indicating that nutritional interventions beyond 6 months may be necessary. Conclusions Findings provide the first experimental evidence that thiamine supplementation among lactating mothers at risk of thiamine deficiency protects their infants’ neurocognitive development, with particular benefit to developing language capacities. Results are consistent with studies that report a widening gap in cognitive test scores over time between children from high vs. low-risk contexts. Important questions remain, particularly with respect to the appropriate duration of thiamine supplementation and/or alternate interventions such as mandatory fortification, with potential to build protective stores of thiamine in preconception or pregnancy. Funding Sources Bill & Melinda Gates Foundation and the New York Academy of Sciences (Opportunity ID OPP1176128).

scholarly journals Fortified Iodine Milk Improves Iodine Status and Cognitive Abilities in Schoolchildren Aged 7–9 Years Living in a Rural Mountainous Area of Morocco

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Fatima Ezzahra Zahrou ◽  
Mehdi Azlaf ◽  
Imane El Menchawy ◽  
Mohamed El Mzibri ◽  
Khalid El Kari ◽  
...  
Keyword(s):  
Cognitive Abilities ◽  
Controlled Trial ◽  
Urinary Iodine ◽  
Cognitive Test ◽  
Favorable Effect ◽  
Mountainous Area ◽  
Double Blind ◽  
Iodine Status ◽  
Fortified Milk ◽  
The Impact

Iodine is required for the production of the thyroid hormones essential for the growth and development of the brain. All forms of iodine deficiency (ID) affect the mental development of the child. Our study aims to assess the impact of ID on the intellectual development of Moroccan schoolchildren and to evaluate the effect of consumption of fortified milk on reducing ID. In a double-blind controlled trial conducted on schoolchildren, children were divided into two groups to receive fortified milk (30% of cover of RDI iodine) or nonfortified milk for 9 months. Urinary iodine was analyzed using the Sandell-Kolthoff reaction, a dynamic cognitive test using Raven’s Standard Progressive Matrices to assess learning potential was performed at baseline and end line, and anthropometric assessment was done only at baseline. The study included schoolchildren who were severely iodine deficient. The prevalence of malnutrition was high in both groups; in this study, we found improvements in iodine status and in cognitive abilities among Moroccan schoolchildren. Our study showed that the consumption of fortified milk led to a clear improvement in iodine status and also appeared to have a favorable effect on the cognitive ability of Moroccan schoolchildren in a rural mountainous region.

scholarly journals Thiamine Status of Supplemented, Lactating Mothers in Rural Cambodia: A Randomized Controlled Trial

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 830-830
Author(s):  
Kyly Whitfield ◽  
Rem Ngik ◽  
Jelisa Gallant ◽  
Kathleen Chan ◽  
Lisa N Yelland ◽  
...  
Keyword(s):  
New York ◽  
Human Milk ◽  
Controlled Trial ◽  
York Academy ◽  
Blood Biomarkers ◽  
Double Blind ◽  
Randomized Controlled ◽  
Lactating Mothers ◽  
Gates Foundation ◽  
The Impact

Abstract Objectives Thiamine deficiency is a cause of infant morbidity and mortality throughout Southeast and South Asia. Maternal intake influences human milk thiamine concentrations, thus mother's intake must be improved to combat infant deficiency. However, the dose of supplemental thiamine required by lactating mothers is unknown. We aimed to estimate the maternal oral thiamine dose required to optimize milk thiamine concentrations, and to investigate the impact of various doses on thiamine status biomarkers. Methods This was a double-blind, four-parallel arm randomized controlled dose-response trial. At 2 weeks postpartum, healthy mothers were randomized to consume one capsule daily for 22 weeks, containing either 0 mg (placebo, n = 83), 1.2 mg (estimated average requirement, n = 86), 2.4 mg (n = 81), or 10 mg (n = 85) thiamine. Human milk total thiamine, whole blood thiamine diphosphate, and erythrocyte transketolase activity coefficient (ETKac) were assessed. An Emax curve, estimated using a non-linear least squares model, was plotted for human milk. Linear mixed-effects models were used to test for differences between treatment groups for milk and blood biomarkers. Results A maternal supplemental dose of 2.35 (95% CI 0.58, 7.01) mg/d was estimated to reach 90% of the maximum average human milk total thiamine concentration of 191 µg/L. The mean (SD) milk thiamine concentration was significantly higher in all intervention groups (183 (91), 190 (105), and 206 (89) µg/L, for 1.2, 2.4, and 10 mg, respectively) compared to placebo (153 (85) µg/L; p < 0.0001), and did not differ from each other. Blood biomarkers followed similar group trends, except for infant ETKac, where only the 10 mg (mean [SD]: 1.18 [0.10]) and placebo (1.12 [0.06]) groups differed significantly (p = 0.003). Conclusions While an estimated maternal dose of 2.35 (0.58, 7.01) mg/d was required to reach a milk thiamine concentration of 191 µg/L in Emax dose analyses, group comparisons suggest a daily dose of 1.2 mg/d is sufficient to improve maternal biomarkers to levels similar to higher doses (2.4 and 10 mg/d) and consistent with thiamine-replete populations. However, a higher maternal dose of 10 mg/d was required to improve infant ETKac status compared to other dose groups. Funding Sources Bill & Melinda Gates Foundation, The New York Academy of Sciences.

scholarly journals A Three-Month Consumption of Eggs Enriched with ω-3, ω-5 and ω-7 Polyunsaturated Fatty Acids Significantly Decreases the Waist Circumference of Subjects at Risk of Developing Metabolic Syndrome: A Double-Blind Randomized Controlled Trial

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 663
Author(s):  
Monique T. Ngo Njembe ◽  
Barbara Pachikian ◽  
Irina Lobysheva ◽  
Nancy Van Overstraeten ◽  
Louis Dejonghe ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
At Risk ◽  
Randomized Controlled Trial ◽  
Waist Circumference ◽  
Controlled Trial ◽  
Density Lipoprotein ◽  
Test Group ◽  
Double Blind ◽  
Randomized Controlled ◽  
The Metabolic Syndrome

Alpha-linolenic acid (ALA), docosahexaenoic acid (DHA), rumenic acid (RmA), and punicic acid (PunA) are claimed to influence several physiological functions including insulin sensitivity, lipid metabolism and inflammatory processes. In this double-blind randomized controlled trial, we investigated the combined effect of ALA, DHA, RmA and PunA on subjects at risk of developing metabolic syndrome. Twenty-four women and men were randomly assigned to two groups. Each day, they consumed two eggs enriched with oleic acid (control group) or enriched with ALA, DHA, RmA, and PunA (test group) for 3 months. The waist circumference decreased significantly (−3.17 cm; p < 0.001) in the test group. There were no major changes in plasma insulin and blood glucose in the two groups. The dietary treatments had no significant effect on endothelial function as measured by peripheral arterial tonometry, although erythrocyte nitrosylated hemoglobin concentrations tended to decrease. The high consumption of eggs induced significant elevations in plasma low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol (p < 0.001), which did not result in any change in the LDL/HDL ratio in both groups. These results indicate that consumption of eggs enriched with ALA, DHA, RmA and PunA resulted in favorable changes in abdominal obesity without affecting other factors of the metabolic syndrome.

scholarly journals Ropivacaine 75mg versus placebo in perineal infiltration for analgesic efficacy at mid- and long-term for episiotomy repair in postpartum women- The ROPISIO study: a two-center, randomized, double-blind, placebo-controlled trial.

2020 ◽  
Author(s):  
Claire CARDAILLAC ◽  
Stéphane Ploteau ◽  
Aurélie Le Thuaut ◽  
Vincent Dochez ◽  
Norbert Winer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Controlled Trial ◽  
Analgesic Efficacy ◽  
Perineal Pain ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Mediolateral Episiotomy ◽  
The Impact

Abstract Background Perineal pain due to episiotomy is commonly reported and can be severe enough to disturb the mother-infant dyad during the postpartum period. Its incidence at day 7 postpartum varies from 63% to 74%. Recent studies have already investigated the analgesic efficacy of perineal infiltration of ropivacaine after episiotomy, but have only focused on the immediate postpartum period (at 24 and 48 hours after birth). Large, adequately powered, multicenter, randomized controlled trials are required to evaluate the impact of ropivacaine infiltration on perineal pain and mid- and long-term quality of life before the widespread use of ropivacaine to prevent perineal pain after episiotomy can be recommended. Methods The ROPISIO study is a two-center, randomized, double-blind, placebo-controlled trial in La Roche sur Yon and Nantes, France. It will involve 272 women with vaginal singleton delivery and mediolateral episiotomy at term (≥ 37 weeks). Perineal infiltration (ropivacaine 75mg or placebo) will be administrated just after vaginal birth and before episiotomy repair. The primary outcome will be the analgesic efficacy at day 7 postpartum (mid-term), defined by the numerical rating scale of pain (ENS NRS) strictly superior to 3/10 on the perineal repair area. Secondary outcomes will be the analgesic efficacy (ENS NRS), the impact of pain on daily behavior, on the quality of life (36-Item Short Form Health Survey), on the occurrence of symptoms of postpartum depression (Edinburgh Postnatal Depression Scale) and on sexuality (Female Sexual Function Index) at 3 and 6 months (long-term) using validated online questionnaires. This study will have 90% power to show approximately 30% relative risk reduction in the incidence of perineal pain at day 7, from 70.0% to 50.0%. Discussion Ropivacaine is a promising candidate drug, inexpensive, easy to administer, and would be suitable to include in the routine management of deliveries in labor ward. This study will investigate if perineal ropivacaine infiltration just after birth can reduce mid- and long-term postpartum pain and increase quality of life in women with mediolateral episiotomy.

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