Human Milk Research, More to Learn?

Human milk is the recommended sole source of nutrition for infants during the first 6 months of age, thanks to its composition rich in nutritious and bioactive components. Progress in analytics has allowed for a detailed description of its components and their variability within and among mothers. This is especially valid for the human milk oligosaccharides (HMOs) that represent one of the major human milk compound groups.

Impact of preconception and antenatal supplementation with myo-inositol, probiotics, and micronutrients on offspring BMI and weight gain over the first 2 years.

Background: Nutritional intervention preconception and throughout pregnancy has been proposed as an approach to promoting healthy postnatal weight gain in the offspring but few randomised trials have examined this.

Methods: Measurements of weight and length were obtained at multiple time points from birth to 2 years among 576 offspring of women randomised to receive preconception and antenatally either a supplement containing myo-inositol, probiotics, and additional micronutrients (intervention) or a standard micronutrient supplement (control). We examined the influence on age- and sex-standardised BMI at 2 years (WHO standards, adjusting for study site, sex, maternal parity, smoking and pre-pregnancy BMI, and gestational age), together with the change in weight, length, BMI from birth, and weight gain trajectories using latent class growth analysis.

Prediction of fat-free mass in young children using bioelectrical impedance spectroscopy.

Background: Bioimpedance devices are practical for measuring body composition in preschool children, but their application is limited by the lack of validated equations.

Objectives: To develop and validate fat-free mass (FFM) bioimpedance prediction equations among New Zealand 3.5-year olds, with dual-energy X-ray absorptiometry (DXA) as the reference method.

Glucose variability in 6-12-month-old healthy infants.

Background: Metabolic programming of glucose homeostasis in the first 1,000 days of life may impact lifelong metabolic and cardiovascular health. Continuous glucose monitoring (CGM) devices may help measure the impact of dietary intake on glucose rhythms and metabolism in infants during the complementary feeding period.

Objectives: Demonstrate the feasibility of CGM to measure and quantify glucose variability in response to infant feeding and to evaluate associations between macronutrient meal composition and glucose variability.

The effect of a preconception and antenatal nutritional supplement on children's BMI and weight gain over the first 2 years of life: findings from the NiPPeR randomised controlled trial.

Background: Nutritional intervention before and throughout pregnancy might promote healthy infant weight gain; however, clinical evidence is scarce. Therefore, we examined whether preconception and antenatal supplementation would affect the body size and growth of children in the first 2 years of life.

Methods: Women were recruited from the community before conception in the UK, Singapore, and New Zealand, and randomly allocated to either the intervention (myo-inositol, probiotics, and additional micronutrients) or control group (standard micronutrient supplement) with stratification by site and ethnicity.

Prediction of fat-free mass in a multi-ethnic cohort of infants using bioelectrical impedance: Validation against the PEA POD.

Background: Bioelectrical impedance analysis (BIA) is widely used to measure body composition but has not been adequately evaluated in infancy. Prior studies have largely been of poor quality, and few included healthy term-born offspring, so it is unclear if BIA can accurately predict body composition at this age.

Aim: This study evaluated impedance technology to predict fat-free mass (FFM) among a large multi-ethnic cohort of infants from the United Kingdom, Singapore, and New Zealand at ages 6 weeks and 6 months ( = 292 and 212, respectively).

Nutritional Composition of Infant Cereal Prototypes Can Precisely Predict Their Glycemic Index.

Designing cereal-based products with appropriate metabolic responses is of high interest to the food industry in view of the potential health impact of the product. The objective of this study was to test whether a model that used the nutrient composition of breakfast cereals to predict their glycemic index (GI) and glycemic load (GL) could also accurately predict the GI and GL for complete (containing protein, reconstituted in water) infant cereal prototypes. Four independent studies measured the postprandial glucose response of 20 complete infant cereal prototypes (51−76 g/100 g glycemic carbohydrates) in healthy adults.

Total Fat and Fatty Acid Intake among 1-7-Year-Old Children from 33 Countries: Comparison with International Recommendations.

This work reviews available data on dietary intakes of total fat, saturated fatty acids (SFA) and individual polyunsaturated fatty acids (PUFA) in children in different countries worldwide and for the first time, compares them with recent international recommendations. Studies published before June 2021 reporting total fat, total SFA and individual PUFA intakes in children aged 1-7 y were included. Observed intakes were evaluated against FAO/WHO and EFSA recommendations.

Comparison of the acute metabolic effect of different infant formulas and human milk in healthy adults: a randomized trial.

Background/objectives: Different infant formulas, varying in protein type and quantity, are available for infants who are not breastfed or are partially breastfed. Postprandial insulinemic and glycemic responses to intact vs partially hydrolyzed protein in infant formula are unclear. To compare the effect of different forms (partially hydrolyzed vs non-hydrolyzed) and levels of protein in infant formula compared with a human milk reference subgroup on insulin response in adults.

Polyunsaturated fatty acids as modulators of fat mass and lean mass in human body composition regulation and cardiometabolic health.

It is now recognized that the amount and type of dietary fat consumed play an important role in metabolic health. In humans, high intake of polyunsaturated fatty acids (PUFAs) has been associated with reductions in cardiovascular disease risk, improvements in glucose homeostasis, and changes in body composition that involve reductions in central adiposity and, more recently, increases in lean body mass. There is also emerging evidence, which suggests that high intakes of the plant-based essential fatty acids (ePUFAs)-n-6 linoleic acid (LA) and n-3 α-linolenic acid (ALA)-have a greater impact on body composition (fat mass and lean mass) and on glucose homeostasis than the marine-derived long-chain n-3 PUFA-eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

Whey Versus Casein as a Protein Source during the Weaning Period: Impact on Growth and Later Adiposity and Glucose Homeostasis in a Rat Model of Intrauterine Growth Restriction.

The impact of early life protein source (whey vs. casein) on short- and long-term glucose homeostasis and adiposity is unknown and was investigated in this study. At the end of the suckling period, non-IUGR (intrauterine growth restriction) and IUGR pups were separated from dams and were randomized into four groups.

Effect of Incorporating Genetic Testing Results into Nutrition Counseling and Care on Health Outcomes: An Evidence Analysis Center Systematic Review-Part II.

In recent years, literature examining implementation of nutritional genomics into clinical practice has increased, including publication of several randomized controlled trials (RCTs). This systematic review addressed the following question: In children and adults, what is the effect of incorporating results of genetic testing into nutrition counseling and care compared with an alternative intervention or control group, on nutrition-related health outcomes? A literature search of MEDLINE, Embase, PsycINFO, CINAHL, and other databases was conducted for peer-reviewed RCTs published from January 2008 until December 2018. An international workgroup consisting of registered dietitian nutritionists, systematic review methodologists, and evidence analysts screened and reviewed articles, summarized data, conducted meta-analyses, and graded conclusion statements.

Consensus Report of the Academy of Nutrition and Dietetics: Incorporating Genetic Testing into Nutrition Care.

Personalization of nutrition advice is a process already familiar to registered dietitian nutritionists, but it is not yet clear whether incorporating genetic results as an added layer of precision improves nutrition-related outcomes. Therefore, an independent workgroup of experts, supported by the Academy's Evidence Analysis Center staff, conducted a systematic review to examine the level of evidence measuring the effect of incorporating genetic testing results into nutrition counseling and care, compared to an alternative intervention or control group, on nutrition-related outcomes. This systematic review revealed that only weak quality evidence is available in the scientific literature and observed that this field is still maturing.

Effect of Incorporating Genetic Testing Results into Nutrition Counseling and Care on Dietary Intake: An Evidence Analysis Center Systematic Review-Part I.

Consumer interest in personalized nutrition based on nutrigenetic testing is growing. Recently, multiple, randomized controlled trials have sought to understand whether incorporating genetic information into dietary counseling alters dietary outcomes. The objective of this systematic review was to examine how incorporating genetic information into nutrition counseling and care, compared to an alternative intervention or control group, impacts dietary outcomes.

Body composition-derived BMI cut-offs for overweight and obesity in ethnic Indian and Creole urban children of Mauritius.

It is increasingly recognised that the use of BMI cut-off points for diagnosing obesity (OB) and proxy measures for body fatness in a given population needs to take into account the potential impact of ethnicity on the BMI-fat % relationship in order to avoid adiposity status misclassification. This relationship was studied here in 377 Mauritian schoolchildren (200 boys and 177 girls, aged 7-13 years) belonging to the two main ethnic groups: Indian (South Asian descent) and Creole (African/Malagasy descent), with body composition assessed using an isotopic 2H dilution technique as reference. The results indicate that for the same BMI, Indians have more body fat (and less lean mass) than Creoles among both boys and girls: linear regression analysis revealed significantly higher body fat % by 4-5 units (P < 0·001) in Indians than in Creoles across a wide range of BMI (11·6-34·2 kg/m2) and body fat % (5-52 %).

Cardiovascular responses to a glucose drink in young male individuals with overweight/obesity and mild alterations in glucose metabolism, but without impaired glucose tolerance.

Purpose: Little is known about whether mild aberrations in glucose metabolism, which are seen in overweight/obese subjects (OW/OB) without impaired glucose tolerance, affect regulator control elements for blood pressure homeostasis.

Methods: Hence, we measured in age-matched male subjects with normal weight (n = 16; BMI = 22.4 kg m) and OW/OB (n = 11; BMI = 28.

Perspective: Cardiovascular Responses to Sugar-Sweetened Beverages in Humans: A Narrative Review with Potential Hemodynamic Mechanisms.

Cardiovascular diseases are still the primary cause of mortality worldwide, with high blood pressure and type 2 diabetes as major promoters. Over the past 3 decades, almost in parallel with the rise in cardiovascular disease incidence, the consumption of sugar-sweetened beverages (SSBs) has increased. In this context, SSBs are potential contributors to weight gain and increase the risk for elevations in blood pressure, type 2 diabetes, coronary heart disease, and stroke.

Water ingestion decreases cardiac workload time-dependent in healthy adults with no effect of gender.

Ingestion of water entails a variety of cardiovascular responses. However, the precise effect remains elusive. We aimed to determine in healthy adults the effect of water on cardiac workload and to investigate potential gender differences.

Substantial Inter-Subject Variability in Blood Pressure Responses to Glucose in a Healthy, Non-obese Population.

A large inter-subject variability in the blood pressure (BP) response to glucose drinks has been reported. However, the underlying factors remain elusive and we hypothesized that accompanying changes in glucose metabolism affect these BP responses. Cardiovascular and glycemic changes in response to a standard 75 g oral-glucose-tolerance-test were investigated in 30 healthy, non-obese males.

Issues in Continuous 24-h Core Body Temperature Monitoring in Humans Using an Ingestible Capsule Telemetric Sensor.

Background: There is increasing interest in the use of pill-sized ingestible capsule telemetric sensors for assessing core body temperature (Tc) as a potential indicator of variability in metabolic efficiency and thrifty metabolic traits. The aim of this study was to investigate the feasibility and accuracy of measuring Tc using the CorTemp system.

Methods: Tc was measured over an average of 20 h in 27 human subjects, with measurements of energy expenditure made in the overnight fasted state at rest, during standardized low-intensity physical activity and after a 600 kcal mixed meal.

Reliability of low-power cycling efficiency in energy expenditure phenotyping of inactive men and women.

Standardized approaches to assess human energy expenditure (EE) are well defined at rest and at moderate to high-intensity exercise, but not at light intensity physical activities energetically comparable with those of daily life (i.e., 1.

Energy Cost of Standing in a Multi-Ethnic Cohort: Are Energy-Savers a Minority or the Majority?

Background: The disease risks associated with sedentary behavior are now firmly established, and consequently there is much interest in methods of increasing low-intensity physical activity. In this context, it is a widely held belief that altering posture allocation can modify energy expenditure (EE) to impact upon body weight regulation and health. However, we recently showed the existence of two distinct phenotypes pertaining to the energy cost of standing-with the majority of a Caucasian cohort showing no sustained increase in EE during standing relative to sitting.

Cerebro- and Cardio-vascular Responses to Energy Drink in Young Adults: Is there a Gender Effect?

Background And Purpose: Energy drinks (EDs) are suspected to induce potential adverse cardiovascular effects and have recently been shown to reduce cerebral blood flow velocity (CBFV) in young, healthy subjects. Gender differences in CBFV in response to EDs have not previously been investigated, despite the fact that women are more prone to cardiovascular disturbances such as neurocardiogenic syncope than men. Therefore, the aim of this study was to explore gender differences in cerebrovascular and cardiovascular responses to EDs.