scholarly journals Intestinal Permeability and Inflammation Mediate Dietary Intake Associated Risks of Micronutrient Deficiencies at 15 Months: Results from the MAL-ED Study (OR07-04-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Laura Caulfield ◽  
Benjamin McCormick ◽  
Laura Murray-Kolb ◽  
Gwenyth Lee ◽  
Kerry Schulze ◽  
...  
Keyword(s):  
Systemic Inflammation ◽  
Lower Risk ◽  
High Plasma ◽  
Micronutrient Deficiency ◽  
Micronutrient Deficiencies ◽  
Complementary Foods ◽  
Nutrient Density ◽  
Lm Tests ◽  
Increased Risk ◽  
Alpha 1 Antitrypsin

Abstract Objectives We tested whether environmental enteric dysfunction (EED) is associated with risk of micronutrient deficiencies adjusting for diet and systemic inflammation, and whether it mediates the relation between intake and micronutrient status. Methods Data from 1283 children in the MAL-ED birth cohort were examined to evaluate risk of anemia, low plasma retinol, zinc, and ferritin, and high plasma transferrin receptor (TfR) at 15 months. We characterized gut inflammation and permeability by myeloperoxidase, neopterin, and alpha-1-antitrypsin concentrations from monthly asymptomatic fecal samples averaged from 9–15 months, and urinary recovery of lactulose (L) and mannitol (M) from LM tests at 9 and 15 months, converted to a ratio z score (LMZ) and averaged. Nutrient intakes from complementary foods were quantified monthly from 9–15 months and densities were averaged. Plasma alpha-1 acid glycoprotein at 15 months characterized systemic inflammation. Relationships among variables were modelled using a direct acyclic graph. Results Greater risk of anemia was associated with permeability [LMZ: 1.15 (95% confidence interval: 1.01–1.31)] and inflammation [myeloperoxidase: 1.16 (1.01–1.34)]. Greater risk of low ferritin was associated with alpha-1-antitrypsin [1.19 (1.03–1.37)] and neopterin [1.22 (1.04–1.43)]. Greater risk of low retinol was associated with LMZ [1.25 (1.07–1.45)]. However, myeloperoxidase was associated with lower risk of high TfR [0.86 (0.74–0.98)], neopterin with lower risk of low retinol [0.75 (0.62–0.89)], and alpha-1-antripysin with lower risk of low plasma zinc [0.83 (0.70–0.99)]. Greater nutrient densities of vitamin A, B6, calcium, protein and zinc were negatively associated with EED. Inverse associations between nutrient densities and micronutrient deficiency largely disappeared after adjustment for EED, suggesting that EED mediates associations between intake and status. Conclusions EED is independently associated with increased risk of low ferritin, low retinol and anemia. Greater nutrient density from complementary foods may reduce EED, and control of micronutrient deficiency may require control of EED. Funding Sources The MAL-ED study was supported by the Bill & Melinda Gates Foundation, through awards to the Foundation for the NIH and NIH/FIC.

scholarly journals Intestinal permeability and inflammation mediate the association between nutrient density of complementary foods and biochemical measures of micronutrient status in young children: results from the MAL-ED study

2019 ◽  
Vol 110 (4) ◽  
pp. 1015-1025 ◽  
Author(s):  
Benjamin J J McCormick ◽  
Laura E Murray-Kolb ◽  
Gwenyth O Lee ◽  
Kerry J Schulze ◽  
A Catharine Ross ◽  
...  
Keyword(s):  
Systemic Inflammation ◽  
Transferrin Receptor ◽  
Lower Risk ◽  
Micronutrient Deficiency ◽  
Dietary Intakes ◽  
Micronutrient Deficiencies ◽  
Complementary Foods ◽  
Nutrient Density ◽  
Micronutrient Status ◽  
Increased Risk

ABSTRACTBackgroundEnvironmental enteric dysfunction (EED) is thought to increase the risk of micronutrient deficiencies, but few studies adjust for dietary intakes and systemic inflammation.ObjectiveWe tested whether EED is associated with micronutrient deficiency risk independent of diet and systemic inflammation, and whether it mediates the relation between intake and micronutrient status.MethodsUsing data from 1283 children in the MAL-ED (Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health) birth cohort we evaluated the risk of anemia, low retinol, zinc, and ferritin, and high transferrin receptor (TfR) at 15 mo. We characterized gut inflammation and permeability by myeloperoxidase (MPO), neopterin (NEO), and α-1-antitrypsin (AAT) concentrations from asymptomatic fecal samples averaged from 9 to 15 mo, and averaged the lactulose:mannitol ratio z-score (LMZ) at 9 and 15 mo. Nutrient intakes from complementary foods were quantified monthly from 9 to 15 mo and densities were averaged for analyses. α-1-Acid glycoprotein at 15 mo characterized systemic inflammation. Relations between variables were modeled using a Bayesian network.ResultsA greater risk of anemia was associated with LMZ [1.15 (95% CI: 1.01, 1.31)] and MPO [1.16 (1.01, 1.34)]. A greater risk of low ferritin was associated with AAT [1.19 (1.03, 1.37)] and NEO [1.22 (1.04, 1.44)]. A greater risk of low retinol was associated with LMZ [1.24 (1.08, 1.45)]. However, MPO was associated with a lower risk of high transferrin receptor [0.86 (0.74, 0.98)], NEO with a lower risk of low retinol [0.75 (0.62, 0.89)], and AAT with a lower risk of low plasma zinc [0.83 (0.70, 0.99)]. Greater nutrient intake densities (vitamins A and B6, calcium, protein, and zinc) were negatively associated with EED. Inverse associations between nutrient densities and micronutrient deficiency largely disappeared after adjustment for EED, suggesting that EED mediates these associations.ConclusionsEED is independently associated with an increased risk of low ferritin, low retinol, and anemia. Greater nutrient density from complementary foods may reduce EED, and the control of micronutrient deficiencies may require control of EED.

scholarly journals Complementary Foods and Milk-Based Formulas Provide Excess Protein but Suboptimal Key Micronutrients and Essential Fatty Acids in the Intakes of Infants and Toddlers from Urban Settings in Malaysia

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2354
Author(s):  
Geok Lin Khor ◽  
Siew Siew Lee
Keyword(s):  
Fatty Acids ◽  
Fast Food ◽  
Protein Intake ◽  
Essential Fatty Acids ◽  
Dietary Intakes ◽  
Micronutrient Deficiencies ◽  
Care Providers ◽  
Complementary Foods ◽  
Rapid Weight Gain ◽  
Increased Risk

This study determined the intakes of complementary foods (CFs) and milk-based formulas (MFs) by a total of 119 subjects aged 6–23.9 months from urban day care centers. Dietary intakes were assessed using two-day weighed food records. Intake adequacy of energy and nutrients was compared to the Recommended Nutrient Intakes (RNI) for Malaysia. The most commonly consumed CFs were cereals (rice, noodles, bread). The subjects derived approximately half of their energy requirements (kcals) from CFs (57 ± 35%) and MFs (56 ± 31%). Protein intake was in excess of their RNI requirements, from both CFs (145 ± 72%) and MFs (133 ± 88%). Main sources of protein included meat, dairy products, and western fast food. Intake of CFs provided less than the RNI requirements for vitamin A, thiamine, riboflavin, folate, vitamin C, calcium, iron, and zinc. Neither CF nor MF intake met the Adequate Intake (AI) requirements for essential fatty acids. These findings indicate imbalances in the dietary intake of the subjects that may have adverse health implications, including increased risk of rapid weight gain from excess protein intake, and linear growth faltering and intellectual impairment from multiple micronutrient deficiencies. Interventions are needed to improve child feeding knowledge and practices among parents and child care providers.

scholarly journals Helicobacter pylori infection and micronutrient deficiency in pregnant women: a systematic review and meta-analysis

2020 ◽  
Vol 7 (1) ◽  
pp. e000490
Author(s):  
Md. Nure Alam Afsar ◽  
Zannatun Nahar Jhinu ◽  
Md. Aminul Islam Bhuiyan ◽  
Zhahirul Islam ◽  
Towfida Jahan Siddiqua
Keyword(s):  
Systematic Review ◽  
Helicobacter Pylori ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Fixed Effect Model ◽  
Micronutrient Deficiency ◽  
Micronutrient Deficiencies ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
H Pylori

BackgroundOver the last few years, epidemiological studies have shown that infection with Helicobacter pylori has a major effect on micronutrient deficiency as well as on adverse pregnancy outcomes. Importantly, there are gaps in understanding the linkage of H. pylori infection with micronutrients deficiency in pregnant women.ObjectiveWe conducted a systematic review and meta-analysis to estimate the association between H. pylori infection and micronutrient deficiencies in pregnant women.MethodsA systematic literature search was conducted for relevant articles using PubMed, Web of Science, and Scopus database from inception to March 2020. The OR with 95% CIs was determined by meta-analysis of data extracted from the selected studies.ResultsFrom 2384 primary articles, 6 studies were selected for systematic reviews and 4 studies distinctively (with 1274 participants: 553 cases and 721 controls) were selected for meta-analysis. The meta-analysed fixed effect model estimated the odds of having H. pylori infection was not significantly higher among pregnant women with micronutrient deficiencies than those without deficiencies (OR=1.12, 95% CI 0.88 to 1.42, p=0.37). In the subgroup analysis, no correlation was found between H. pylori infection and vitamin B12 (OR=0.74, 95% CI 0.45 to 1.21, p=0.22), folate (OR=1.07, 95% CI 0.73 to 1.58, p=0.73), and ferritin (OR=0.81, 95% CI 0.51 to 1.31, p=0.4). However, a positive correlation was found between iron-deficiency anaemia (IDA) and H. pylori infection (OR=16.23, 95% CI 4.19 to 62.93, p<0.0001) during pregnancy.ConclusionH. pylori infection is associated with increased risk of IDA but not with deficiency of other micronutrients in pregnancy.PROSPERO registration numberCRD42019135683.

scholarly journals Self-Rated Health and Psychological Distress among Emerging Adults in Italy: A Comparison between Data on University Students, Young Workers and Working Students Collected through the 2005 and 2013 National Health Surveys

2021 ◽  
Vol 18 (12) ◽  
pp. 6403
Author(s):  
Isabella Giulia Franzoi ◽  
Fabrizio D’Ovidio ◽  
Giuseppe Costa ◽  
Angelo d’Errico ◽  
Antonella Granieri
Keyword(s):  
Mental Health ◽  
University Students ◽  
Physical Health ◽  
Emerging Adults ◽  
Lower Risk ◽  
Health Surveys ◽  
Poor General Health ◽  
Working Students ◽  
Increased Risk ◽  
National Health Surveys

Background. The present study aimed at comparing self-reported physical health and mental health among university students, workers, and working students aged between 19 years and 29 years. Method. Using data from National Health Surveys held in 2005 and 2013, a cross-sectional study was conducted on 18,612 Italian emerging adults grouped into three groups: university students, workers, and working students. The odds ratios of self-reported anxiety or depression, poor general health, and poor mental health and physical health (as assessed through SF-12) were estimated through logistic regression models adjusted for potential confounders. Results. Compared with workers, students showed an increased risk of anxiety or depression and a lower risk of poor general health. Students and working students showed an increased risk of reporting weak mental health compared with that in workers, while students displayed a lower risk of poor physical health. Significant differences were not found between the 2005 and 2013 surveys. Conclusions. These results are of considerable importance for psychologists as well as educational and occupation-based institutions for planning prevention programs and clinical interventions.

Women with high plasma levels of PBDE-47 are at increased risk of preterm birth

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Morgan R. Peltier ◽  
Michael J. Fassett ◽  
Yuko Arita ◽  
Vicki Y. Chiu ◽  
Jiaxiao M. Shi ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Los Angeles ◽  
Polybrominated Diphenyl Ethers ◽  
Flame Retardants ◽  
Plasma Concentrations ◽  
First Trimester ◽  
High Plasma ◽  
Thyroid Stimulating Hormone ◽  
Spontaneous Preterm Birth ◽  
Increased Risk

Abstract Objectives Nearly 100% of North American women have detectable levels of flame retardants such as polybrominated diphenyl ethers (PBDEs) in their plasma. These molecules have structural homology to thyroid hormones and may function as endocrine disruptors. Thyroid dysfunction has previously been associated with increased risk for preterm birth. Therefore, we conducted a multi-center, case-cohort study to evaluate if high plasma concentrations of a common PBDE congener in the first trimester increases the risk of preterm birth and its subtypes. Methods Pregnant women were recruited at the onset of initiation of prenatal care at Kaiser-Permanente Southern California (KPSC)-West Los Angeles and KPSC-San Diego medical centers. Plasma samples from women whose pregnancies ended preterm and random subset of those delivering at term were assayed for PBDE-47 and thyroid-stimulating hormone (TSH) by immunoassay. Quartile cutoffs were calculated for the patients at term and used to determine if women with exposures in the 4th quartile are at increased risk for preterm birth using logistic regression. Results We found that high concentrations of PBDE-47 in the first trimester significantly increased the odds of both indicated (adjusted odds ratio, adjOR=2.35, 95% confidence interval [CI]: 1.31, 4.21) and spontaneous (adjOR=1.76, 95% CI: 1.02, 3.03) preterm birth. Regardless of pregnancy outcome, TSH concentrations did not differ between women with high and low concentrations of PBDE-47. Conclusions These results suggest that high plasma concentrations of PBDE-47 in the first trimester, increases the risk of indicated and spontaneous preterm birth.

scholarly journals Perceived Social Status and Suicidal Ideation in Maltreated Children and Adolescents

2021 ◽  
Author(s):  
Kelli L. Dickerson ◽  
Helen M. Milojevich ◽  
Jodi A. Quas
Keyword(s):  
Risk Factor ◽  
Suicidal Ideation ◽  
Children And Adolescents ◽  
Social Status ◽  
Lower Risk ◽  
Developmental Patterns ◽  
Factors Associated ◽  
Established Risk Factor ◽  
Increased Risk ◽  
Perceived Social Status

AbstractRecent decades have seen an alarming increase in rates of suicide among young people, including children and adolescents (“youth”). Although child maltreatment constitutes a well-established risk factor for suicidal ideation in youth, few efforts have focused on identifying factors associated with maltreated youths’ increased risk for suicidal ideation, especially across development. The present study examined the relations between maltreated youths' (N = 279, M = 12.06 years, 52% female, 53% Latinx) perceptions of their social status and suicidal ideation and compared those relations between pre-adolescents and adolescents. Findings revealed unique developmental patterns: Perceived social status was associated with suicidal ideation, but only in adolescents, who showed greater risk for suicidal ideation if they viewed themselves as lower ranked in society and lower risk for suicidal ideation if they viewed themselves as higher ranked in society. Findings have implications for scientific and practical efforts aimed at better understanding and preventing suicide in a high-risk developmental population.

scholarly journals Ketogenic Diet as a Preventive and Supportive Care for COVID-19 Patients

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1004
Author(s):  
Elena Gangitano ◽  
Rossella Tozzi ◽  
Orietta Gandini ◽  
Mikiko Watanabe ◽  
Sabrina Basciani ◽  
...  
Keyword(s):  
Ketogenic Diet ◽  
Systemic Inflammation ◽  
Viral Infections ◽  
Invasive Mechanical Ventilation ◽  
Preventive Measure ◽  
Respiratory Compromise ◽  
Obese People ◽  
Increased Risk ◽  
Severely Obese ◽  
Respiratory Conditions

Severe obesity is associated with an increased risk of admission to intensive care units and need for invasive mechanical ventilation in patients with COVID-19. The association of obesity and COVID-19 prognosis may be related to many different factors, such as chronic systemic inflammation, the predisposition to severe respiratory conditions and viral infections. The ketogenic diet is an approach that can be extremely effective in reducing body weight and visceral fat in the short term, preserving the lean mass and reducing systemic inflammation. Therefore, it is a precious preventive measure for severely obese people and may be considered as an adjuvant therapy for patients with respiratory compromise.

Combined effects of plasma von Willebrand factor and platelet measures on the risk of incident venous thromboembolism

Blood ◽  
2021 ◽  
Author(s):  
Magnus Sandvik Edvardsen ◽  
Ellen-Sofie Hansen ◽  
Kristian Hindberg ◽  
Vânia Maris Morelli ◽  
Thor Ueland ◽  
...  
Keyword(s):  
Platelet Count ◽  
Venous Thromboembolism ◽  
Von Willebrand Factor ◽  
Platelet Reactivity ◽  
High Plasma ◽  
Combined Effects ◽  
Exposure Group ◽  
Increased Risk ◽  
Von Willebrand ◽  
Willebrand Factor

Plasma von Willebrand factor (VWF) and platelet reactivity are both risk factors for venous thromboembolism (VTE), and VWF can promote hemostasis by interaction with platelets. In this study, we explored the combined effects of plasma VWF and platelet measures on the risk of incident VTE. A population-based nested case-control study with 403 cases and 816 controls was derived from the Tromsø Study. VWF, platelet count and mean platelet volume (MPV) were measured in blood samples drawn at baseline. Odds ratios (ORs) with 95% confidence intervals (CIs) for VTE were estimated across VWF tertiles, within predefined MPV (&lt;8.5, 8.5-9.5, ≥9.5 fL) and platelet count (&lt;230, 230-299, ≥300·109 L-1) strata. Here, participants with VWF levels in the highest tertile and MPV ≥9.5 fL had an OR of 1.98 (95% CI 1.17-3.36) for VTE compared with those in the lowest VWF tertile and with MPV &lt;8.5 fL in the age- and sex-adjusted model. In the joint exposure group, 48% (95% CI 15% to 96%) of VTEs were attributable to the biological interaction between VWF and MPV. Similarly, individuals with VWF in the highest tertile and platelet count ≥300·109 L-1 had an OR of 2.91 (95% CI 1.49-5.67) compared with those with VWF in the lowest tertile and platelet count &lt;230, and 39% (95% CI -2% to 97%) of VTEs in the joint exposure group were explained by the interaction. Our results suggest that both platelet reactivity and platelet count interact biologically with high plasma VWF, resulting in an increased risk of incident VTE.

Alpha-1 antitrypsin deficiency: clarifying the role of the putative protective threshold

2021 ◽  
pp. 2101410
Author(s):  
Alessandro N. Franciosi ◽  
Daniel Fraughen ◽  
Tomás P. Carroll ◽  
Noel G. McElvaney
Keyword(s):  
Risk Estimation ◽  
Specific Treatment ◽  
Weekly Administration ◽  
Risk Assessment Models ◽  
Increased Risk ◽  
Antitrypsin Deficiency ◽  
Dosing Regimens ◽  
Alpha 1 Antitrypsin Deficiency ◽  
Alpha 1 Antitrypsin ◽  
Protective Threshold

AATD is the only readily identifiable monogenic cause of COPD. To date the only condition-specific treatment for AATD-associated COPD is weekly administration of intravenous purified pooled human AAT (IV-AAT). Uncertainties regarding which AATD genotypes should benefit from IV-AAT persist. IV-AAT is costly and involves weekly administration of a plasma product. Much of the risk stratification has been centred around the long-accepted hypothesis of a “putative protective threshold” of 11 µM (0.57 g·L−1) in serum. This hypothesis has become central to the paradigm of AATD care, though its derivation and accuracy for defining risk of disease remain unclear.We review the literature and examine the association between the 11 µM threshold and clinical outcomes to provide context and insight into the issues surrounding this topic.We found no data which demonstrates an increased risk of COPD dependent on the 11 µM threshold. Moreover, an abundance of recent clinical data examining this threshold refutes the hypothesis. Conversely, the use of 11 µM as a treatment target in appropriate ZZ individuals is supported by clinical evidence, although more refined dosing regimens are being explored.Continued use of the 11 µM threshold as a determinant of clinical risk is questionable, perpetuates inappropriate AAT-augmentation practices, may drive increased healthcare expenditure and should not be used as an indicator for commencing treatment.Genotype represents a more proven indicator of risk, with ZZ and rare ZZ-equivalent genotypes independently associated with COPD. New and better risk assessment models are needed to provide individuals diagnosed with AATD with reliable risk estimation and optimised treatment goals.

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