Breast milk exposure is associated with cortical maturation in preterm infants

Breast milk exposure is associated with improved neurocognitive outcomes following preterm birth but the neural substrates linking nutrition with outcome are uncertain. By combining nutritional data with brain MRI, we tested the hypothesis that high versus low breast milk exposure in preterm infants during neonatal care results in a cortical morphology that more closely resembles that of infants born at term. We studied 135 preterm (mean gestational age 30+2 weeks, range 22+1 to 32+6) and 77 term-born infants (mean gestational age 39+4 weeks, range 36+3 to 42+1). Nutritional data was collected from birth until hospital discharge to identify the proportion of days preterm infants received exclusive breast milk. Structural and diffusion MRI were performed at term-equivalent age. Cortical indices (volume, thickness, surface area, gyrification index, sulcal depth, curvature) and water diffusion parameters (fractional anisotropy, mean diffusivity, radial diffusivity, axial diffusivity, neurite density index, orientation dispersion index) were compared between preterm infants who received exclusive breast milk for <75% of inpatient days (n=68), preterm infants who received exclusive breast milk for ≥75% of inpatient days (n=67) and term-born controls (n=77). High breast milk exposure was associated with reduced cortical gray matter volume (d=0.47, p=0.014), thickness (d=0.42, p=0.039) and radial diffusivity (d=0.38, p=0.039), and increased fractional anisotropy (d=0.38, p=0.037) after adjustment for age at MRI. High versus low breast milk exposure in the weeks following preterm birth is associated with a cortical imaging phenotype that more closely resembles the brain morphology of healthy infants born at term.

Labelling Assessment of Greek “Quality Label” Prepacked Cheeses as the Basis for a Branded Food Composition Database

A labelling assessment study of Greek prepacked “quality label” cheeses was conducted with a view to provide an overview of the whole category. In total, 158 prepacked products belonging to 19 “quality label” cheeses were identified in the Greek market. Among them, Feta had the highest share followed by Kasseri, Graviera Kritis, Kefalograviera and Ladotyri Mitilinis with 81, 16, 15, 11 and 9 products found in the market, respectively. For the rest of the 14 cheeses, the share was limited, ranging from 1 to 4. All labelling indications, nutritional information, claims and other labelling data were recorded and analysed in relation to their compliance against European food law requirements. The results of the analysis showed that for only 6 of the 19 cheeses, all products fully complied with EU labelling legislation. Among the 14 mandatory labelling requirements, the lowest overall compliance was observed for allergens declaration (65%). The analysis of the nutritional data showed a remarkable variability between cheeses and products. Differences in the nutritional characteristics were more pronounced among soft, semi-hard, hard and whey cheese. The above data were entered into an archival database. Application of global harmonisation and standardisation guidelines and tools lead to the initialisation of a branded food composition database (BFCD), conceptualising a specialised database for “quality label” foods.

Megaherbivores modify forest structure and increase carbon stocks through multiple pathways

Megaherbivores have pervasive ecological effects. In African rainforests, elephants can increase aboveground carbon, though the mechanisms are unclear. Here we combine a large unpublished dataset of forest elephant feeding with published browsing preferences totaling > 120,000 records covering 700 plant species, including nutritional data for 102 species. Elephants increase carbon stocks by: 1) promoting high wood density tree species via preferential browsing on leaves from low wood density species, which are more digestible; 2) dispersing seeds of trees that are relatively large and have the highest average wood density among tree guilds based on dispersal mode. Loss of forest elephants could cause a 5-12% decline in carbon stocks due to regeneration failure of elephant-dispersed trees and an increase in abundance of low wood density trees. These results show the major importance of megaherbivores in maintaining diverse, high-carbon tropical forests. Successful elephant conservation will contribute to climate mitigation at a scale of global relevance.

The ontology of fast food facts: conceptualization of nutritional fast food data for consumers and semantic web applications

Background Fast food with its abundance and availability to consumers may have health consequences due to the high calorie intake which is a major contributor to life threatening diseases. Providing nutritional information has some impact on consumer decisions to self regulate and promote healthier diets, and thus, government regulations have mandated the publishing of nutritional content to assist consumers, including for fast food. However, fast food nutritional information is fragmented, and we realize a benefit to collate nutritional data to synthesize knowledge for individuals. Methods We developed the ontology of fast food facts as an opportunity to standardize knowledge of fast food and link nutritional data that could be analyzed and aggregated for the information needs of consumers and experts. The ontology is based on metadata from 21 fast food establishment nutritional resources and authored in OWL2 using Protégé. Results Three evaluators reviewed the logical structure of the ontology through natural language translation of the axioms. While there is majority agreement (76.1% pairwise agreement) of the veracity of the ontology, we identified 103 out of the 430 statements that were erroneous. We revised the ontology and publicably published the initial release of the ontology. The ontology has 413 classes, 21 object properties, 13 data properties, and 494 logical axioms. Conclusion With the initial release of the ontology of fast food facts we discuss some future visions with the continued evolution of this knowledge base, and the challenges we plan to address, like the management and publication of voluminous amount of semantically linked fast food nutritional data.

Evaluation of the Diet Tracking Smartphone Application Keenoa™: A Qualitative Analysis

Keenoa™ is a novel Canadian diet application (app) currently used by Canadian dietitians to collect diet-related data from clients. The goal of this study was to evaluate Keenoa™ based on user feedback and compare it to a conventional pen and paper method. One hundred and two participants were recruited and randomly assigned to record their diets using this application for 3 nonconsecutive days. Following this, participants were invited to complete an online “exit” survey. Seventy-two subjects responded, with 50 completing an open-ended question asking for general feedback about the app. Data were reviewed and 3 main themes emerged: strengths, challenges, and future recommendations. Strengths associated with the app consisted of picture recognition software, the additional commentary feature, and the overall pleasant data collection process. Challenges that were identified included inconsistencies with the barcode scanning features, the limited food database, time to enter food details, and software issues. Future recommendations included using a larger food database, pairing dietary intake with physical activity monitoring, and having accessible nutritional data. Despite these limitations, participants preferred using mobile apps to record diet compared with traditional written food diaries.

Prevention of hypoparathyroidism with the use of calcium-rich foods in the total thyroidectomy pre-operative period

<p class="abstract"><strong>Background:</strong> Transient hypocalcemia after total thyroidectomy (TT) is a common surgical complication. Authors used calcium supplements in different doses and periods, mainly after TT to try to avoid hypocalcemia. Indistinct use has been challenged due to complications. Currently, the risk of hypocalcemia was assessed by measuring parathormone (PTH) after TT; however, without a consensus on the best time and amount to consider. The objectives of this study were to evaluate the incidence of hypoparathyroidism with the use of calcium-rich foods in the pre-operative period of TT, followed by a measurement of PTH performed 12 hours after such procedure</p><p class="abstract"><strong>Methods:</strong> A preliminary study with 31 patients earmarked for TT. Patients were divided into two groups: (A) without calcium-rich foods intake in the TT pre-operative period; and (B) with the intake of calcium-rich foods, in the TT pre-operative period. These foods composing different menus have been suggested, based on the need for daily calcium intake, according to the age group and nutritional data of the Dietary reference intake (DRI). Beginning of the use of these foods has been standardized as being seven days before surgery, due to the slower calcium intestinal absorption process. </p><p class="abstract"><strong>Results:</strong> Group B, when compared to A, showed a significant difference between PTH values, before and after surgery (p value &lt;0.001).</p><p class="abstract"><strong>Conclusions:</strong> Calcium-rich foods intake in the conditions reported may be associated with lower rates of hypoparathyroidism.</p>

The Impact of Morbid Obesity on the Health Outcomes of Hospital Inpatients: An Observational Study

Morbid obesity poses a significant burden on the health-care system. This study determined whether morbid obesity leads to worse health-outcomes in hospitalised patients. This retrospective-study examined nutritional data of all inpatients aged 18–79 years, with a body-mass-index (BMI) ≥ 18.5 kg/m2 admitted over a period of 4 years at two major hospitals in Australia. Patients were divided into 3 groups for comparison: normal/overweight (BMI 18.5–29.9 kg/m2), obese (BMI 30–39.9 kg/m2) and morbidly-obese (BMI ≥ 40 kg/m2). Outcome measures included length-of-hospital-stay (LOS), in-hospital mortality, and 30-day readmissions. Multilevel-mixed-effects regression was used to compare clinical outcomes between the groups after adjustment for potential confounders. Of 16,579 patients, 1004 (6.1%) were classified as morbidly-obese. Morbidly-obese patients had a significantly longer median (IQR) LOS than normal/overweight patients (5 (2, 12) vs. 5 (2, 11) days, p value = 0.012) and obese-patients (5 (2, 12) vs. 5 (2, 10) days, p value = 0.036). After adjusted-analysis, morbidly-obese patients had a higher incidence of a longer LOS than normal/overweight patients (IRR 1.04; 95% CI 1.02–1.07; p value < 0.001) and obese-patients (IRR 1.13; 95% CI 1.11–1.16; p value < 0.001). Other clinical outcomes were similar between the different groups. Morbid obesity leads to a longer LOS in hospitalised patients but does not adversely affect other clinical outcomes.

Differences in Dietary Patterns of Adolescent Patients with IBD

Inflammatory bowel disease (IBD) includes Crohn’s disease (CD) and ulcerative colitis (UC). The prevalence of both in pediatric populations has been constantly increasing. This study aimed to analyze the diet of adolescent patients with IBD in comparison to healthy controls and the current dietary standards for the Polish population to further their optimal supplementation regimen. The study group consisted of 53 patients (21 girls and 32 boys) with IBD (CD: n = 27; UC: n = 26) at a mean age of 15.4 ± 2.4 and 14.7 ± 2.2, years for girls and boys, respectively. The control group (CG) consisted of 20 patients, and 72 h of recall diaries on nutrition were collected. The nutritional data were analyzed in the Dieta 6D dietary program. When compared to Polish dietary standards, the largest differences girls with IBD and boys with IBD were found for the intake of energy (61.9 and 71.9%), iodine (61.9 and 62.6%), folates (76.2 and 87.5%), vitamin D (100 and 96.9%), potassium (61.9 and 59.4%), and calcium (85.7 and 93.8%). The overconsumption of saturated fatty acids (SFA) (61.9 and 56.3%) and sodium (76.2 and 90.6%) in girls and boys, respectively, was noted. In relation to girls with CG, girls with IBD showed a significantly higher intake of energy (1751. 3 vs. 1558.6 p = 0.0224), total protein (71.3 vs. 56.2 p = 0.0217), animal protein (47.8 vs. 34.5 p = 0.0183), total carbohydrates (237.3 vs. 196.1 p = 0.0442), and assimilable carbohydrates (219.8 vs. 180.5 p = 0.7921). Boys in the CG consumed significantly more calcium (851.8 vs. 432 p = 0.0006), phosphorus (1024.3 vs. 1357.5 p = 0.0431), lactose (11.6 vs. 6.1 p = 0.0016), and riboflavin (1.7 vs. 1.3 p = 0.0123) compared to boys with IBD. Dietician care should therefore be mandatorily provided alongside outpatient care. Based on our results, we suggest that supplementation with the selected components be considered.

Nutrition surveillance in the Sudan: a community-based approach

In 1992, a pilot project for collecting information on the socioeconomic and nutritional status of children and their mothers as part of the early warning system was implemented in two villages in Kassala Province, Sudan. The objectives were to test the feasibility of local participation in socioeconomic and nutritional data collection, analysis and utilization;and to incorporate socioeconomic data into the food and nutrition information system, and examine its usefulness in early warning. The pilot project also included the introduction of new parameters such as adult anthropometry, i. e. body mass index of the mothers of the children seen, to monitor the nutritional status of both children and their mothers at the same time. This led to very interesting results which played a major role in determining the type of intervention needed

Rehabilitation of intubated COVID-19 patients in a Singapore regional hospital with early intensive care unit and sustained post-intensive care unit rehabilitation

Background A proportion of patients with COVID-19 become critically ill, but few studies describe the functional outcomes and rehabilitation process of these patients. Objective To describe the complications encountered and functional outcomes of critically ill COVID-19 patients requiring intubation and subsequent intensive care unit (ICU) management and rehabilitation. Methods Retrospective case note review was conducted on all patients requiring intubation and ICU admission and subsequently discharged from our hospital from February 15, 2020 to May 1, 2020. Demographics, preexisting medical conditions, complications encountered in ICU, ICU and General Ward Length of Stay, number of therapy sessions delivered, nutritional data, and functional outcomes on discharge were collected from electronic medical records and entered in a deidentified database. Results Most patients developed significant breathlessness affecting post-ICU rehabilitation, a few patients developed ICU associated delirium while no patient developed ICU-associated weakness. All patients survived and could walk 20 m within 12 days post-extubation. Conclusion Early ICU and sustained post-ICU rehabilitation of critically ill, intubated COVID-19 patients is feasible. Further studies could look into the outcomes of this group of patients, in particular the effect of nutrition and pulmonary training on functional outcomes. We strongly recommend an interdisciplinary rehabilitation team approach in managing critically ill COVID-19 patients.