The Effect of Breast and Bottle Feeding on Dental Caries in Preschool Children

Introduction: This study evaluates the effect of breast and bottle feeding on the severity and age of onset of early childhood caries (ECC). This prospective study conducted at the dental clinic of King Hussein Medical Center between March 2020 and July 2020. All preschool children who attended to the dental clinic suffering from dental caries were included in the study. Methodology: All preschool children who attended to the dental clinic suffering from dental caries were included in the study. A detailed history was obtained regarding age, gender, medical diseases, dental history, duration, frequency, and patterns of infant feeding. The patients were divided into 3 groups; the 1st group are those with exclusive breast feeding, the 2nd group are those with excusive bottle feeding and the 3rd group are those with mixed bottle and breast feeding. The age of onset of the caries was recorded. The severity of dental caries using DMFT index was explored in the groups. The obtained data was analyzed and compared with other studies. Results: 240 patients with aged between 3 and 6 years (mean 4.6±1.1) were enrolled in the study. A bout 55% of them was males. The commonest method of feeding for children was combined breast and bottle feeding (43%) followed by exclusive breast feeding (34%) and bottle feeding (23%). The highest DMFT score was found among patients with bottle feeding (4.9). The highest DMFT scores and earlier onset of caries were observed among patients who were breast fed (5.2, 3.2) or bottle fed (4.8,3.1) for more than 2 years respectively. Patients who were fed at night or those with frequent daily feeding at a rate of more than 6 times were associated with more sever forms of dental caries. Conclusion: Bottle feeding, nocturnal feeding and prolonged and frequent breast feeding were associated with more sever forms and earlier onset of dental caries in preschool children. Therefore, exclusive daily breast feeding at a rate not exceeding 6 times daily and for a duration not exceeding 12 months is recommended as a habit of feeding for infants. Key words: Breast feeding, Bottle feeding, Dental caries

Difference in Performance of EPI Pigs Fed Either Lipase-Predigested or Creon®-Supplemented Semielemental Diet

Pancreatic enzyme replacement therapy (PERT) and fat predigestion are key in ensuring the optimal growth of patients with cystic fibrosis. Our study attempted to highlight differences between fat predigestion and conventional PERT on body composition of young pigs with exocrine pancreatic insufficiency (EPI). EPI and healthy pigs were fed with high-fat diet for six weeks. During the last two weeks of the study, all pigs received additional nocturnal alimentation with Peptamen AF (PAF) and were divided into three groups: H—healthy pigs receiving PAF; P—EPI pigs receiving PAF+PERT; and L—EPI pigs receiving PAF predigested with an immobilized microbial lipase. Additional nocturnal alimentation increased the body weight gain of EPI pigs with better efficacy in P pigs. Humerus length and area in pigs in groups L and P were lower than that observed in pigs in group H ( p value 0.005-0.088). However, bone mineral density and strength were significantly higher in P and L as compared to that of H pigs ( p value 0.0026-0.0739). The gut structure was improved in P pigs. The levels of neurospecific proteins measured in the brain were mainly affected in P and less in L pigs as compared to H pigs. The beneficial effects of the nocturnal feeding with the semielemental diet in the prevention of EPI pigs’ growth/development retardation are differently modified by PERT or fat predigestion in terms of growth, bone properties, neurospecific protein distribution, and gut structure.

State of Satiation Partially Regulates the Dynamics of Vertical Migration

Vertical migrations into shallower waters at night are beneficial for migrators as they reduce predation risk and allow migrators to encounter a higher density of prey. Nevertheless, ocean acoustics data and trawl data have shown that a portion of some vertically migrating populations remain at depth and do not migrate. One hypothesis for this phenomenon is the Hunger-Satiation hypothesis, which in part states that the non-migrating portion of the migrating species-assemblage refrains from migrating if they have full or partially full stomachs from daytime or nocturnal feeding. However, stomach fullness of the non-migrating subpopulation compared to the migrating portion has rarely been studied, due to the difficulty in obtaining sufficient samples. The stomach fullness levels of numerically abundant crustacean and fish species with well-known depth distributions were quantified in the present study. Animals were captured during night trawls from discrete-depth intervals between 0 and 1,500 m. Stomach fullness indices were assigned from 0 to 5 and compared between migratory taxa caught in shallow and deep waters. Data from the crustaceansAcanthephyra purpurea, Gardinerosergia splendens, Plesionika richardi, andSystellaspsis debilis, as well as the fishesLampanyctus alatus, Lepidophanes guentheri, andNotolychnus valdiviae, provided support for the Hunger-Satiation hypothesis, while data from the crustaceansGennadas capensisandGennadas valensand the fishBenthosema suborbitaledid not. These findings suggest that stomach vacancy may be just one of several factors regulating the dynamics of vertical migration in those species whose behavioral plasticity suggests daily “choices” in whether or not to vertically migrate.

Differentiating morpho-functional patterns of the five most common deep-sea benthic anglerfishes (Lophiiformes) from Andaman and Nicobar Islands (eastern Indian Ocean)

Anglerfishes are widely distributed from shallow to deep-water habitats occupying different ecological niches. To explain this adaptability, we performed a morpho-functional study on common benthic anglerfishes inhabiting the Indian deep-sea waters. Sensory capabilities of species were examined using the morphology and morphometry of sagitta otoliths (related to detection sound and hearing) and eye size (related to visual communication). We also performed an analysis of the degree of functional niche overlap using fish body traits to understand the coexistence of species. Otoliths showed a morphological pattern similar to that of other anglerfishes: an archaesulcoid sulcus acusticus and variability in the irregularity of the dorsal margin. This last feature affected the allometric relationships between the otolith morphometry and fish length, as well as the otolith relative sizes of each species. The findings suggested that bigger otoliths are associated with the increase of depth distribution of species up to 1000 m, from which it decreases. Our hypothesis is that anglerfishes with irregular otolith shapes could be linked to more nocturnal feeding behaviour because they were characterized by greater eye sizes. The results also indicated interspecific significant differences in functional traits providing a low niche overlap. Therefore, our study supports the hypothesis of an environmental and ecological specialization of benthic anglerfishes.

Nocturnal whey protein ingestion impairs post-prandial glucose tolerance at breakfast

Poor post-prandial glucose control is a risk factor for multiple health conditions. The second-meal effect refers to the progressively improved glycaemic control with repeated feedings, an effect which is achievable with protein ingestion at the initial eating occasion. The most pronounced glycaemic response each day therefore typically occurs following breakfast, so the present study investigated whether ingesting protein during the night could improve glucose control at the first meal of the day. In a randomised crossover design, fifteen adults (seven males, eight females; age, 22 (sd 3) years; BMI, 24·0 (sd 2·8) kg/m2; fasting blood glucose, 4·9 (sd 0·5) mmol/l) woke at 04.00 (sd 1) hours to ingest 300 ml water with or without 63 g whey protein. Participants then completed a mixed-macronutrient meal tolerance test (1 g carbohydrate/kg body mass, 2356 (sd 435) kJ), 5 h 39 min following the nocturnal feeding. Nocturnal protein ingestion increased the glycaemic response (incremental AUC) to breakfast by 43·5 (sd 55·5) mmol × 120 min/l (P = 0·009, d = 0·94). Consistent with this effect, individual peak blood glucose concentrations were 0·6 (sd 1·0) mmol/l higher following breakfast when protein had been ingested (P = 0·049, d = 0·50). Immediately prior to breakfast, rates of lipid oxidation were 0·02 (sd 0·03) g/min higher (P = 0·045) in the protein condition, followed by an elevated post-prandial energy expenditure (0·38 (sd 0·50) kJ/min, P = 0·018). Post-prandial appetite and energy intake were similar between conditions. The present study reveals a paradoxical second-meal phenomenon whereby nocturnal whey protein feeding impaired subsequent glucose tolerance, whilst increasing post-prandial energy expenditure.

Circadian misalignment imposed by nocturnal feeding tends to increase fat deposition in pigs

Misalignment of day/night and feeding rhythms has been shown to increase fat deposition and the risk for metabolic disorders in humans and rodents. In most studies, however, food intake and intake patterns are not controlled. We studied the effects of circadian misalignment on energy expenditure in pigs while controlling for food intake as well as intake patterns. Twelve groups of five male pigs were housed in respiration chambers and fed either during the day (10.00–18.00 hours; DF) or night (22.00–06.00 hours; NF), bihourly the same sequential meals, representing 15, 10, 25, 30 and 20 % of the daily allowance. Paired feeding was applied to ensure equal gross energy intake between treatments. Apparent total tract digestibility, energy balances and heat partitioning were measured and analysed using a mixed linear model. Apparent total tract energy and DM digestibility tended to be lower for NF-pigs than DF-pigs (P < 0·10). Heat production was 3 % lower for NF-pigs than DF-pigs (P < 0·026), increasing fat retention by 7 % in NF-pigs (P = 0·050). NF-pigs were less active than DF-pigs during the feeding period, but more active during the fasting period. RMR was greater for DF-pigs than NF-pigs during the fasting period. Methane production was 30 % greater in NF-pigs than DF-pigs (P < 0·001). In conclusion, circadian misalignment has little effect on nutrient digestion, but alters nutrient partitioning, ultimately increasing fat deposition. The causality of the association between circadian misalignment and methane production rates remains to be investigated.

Malnutrition in Cirrhosis and Its Management

The World Health Organization defines malnutrition as a term referring to deficiencies, excesses, or imbalances in a person’s intake or energy and/or nutrients. Malnutrition is a nearly universal complication of end-stage liver disease, with a prevalence of up to 90%. Given their hepatic synthetic dysfunction, patients with cirrhosis are at a particularly high risk for protein-calorie depletion, which has been reported in over half of patients with cirrhosis and worsens with disease severity. Undernutrition is a potent predictor of adverse outcomes in cirrhotic patients, including lower survival rates, hepatic decompensation, longer length of days in the hospital and intensive care unit (ICU), increased number of infection episodes, and higher resource utilization. On the other hand, excess energy intake, or overnutrition, is increasingly being recognized as an important determinant of long-term outcomes in this population, particularly those with nonalcoholic steatohepatitis. Nearly one quarter of patients with cirrhosis are overnourished and up to 72% show excessive daily intake of energy and protein. In this review, we will consider the full spectrum of malnutrition in patients with end-stage liver disease and highlight key areas in need of further investigation. This review contains 4 figures, 4 tables, and 54 references. Key Words: frailty, inflammation, nocturnal feeding, nutritional assessment, nutritional risk, nutritional screening, protein-energy malnutrition, sarcopenia