scholarly journals The Association Between Glycemic Variability and Macronutrients in Young Children with T1D

2020 ◽  
Vol 45 (7) ◽  
pp. 749-758
Author(s):  
Alexandra D Monzon ◽  
Laura B Smith ◽  
Scott W Powers ◽  
Lawrence M Dolan ◽  
Susana R Patton
Keyword(s):  
Food Intake ◽  
Young Children ◽  
Multilevel Models ◽  
Glycemic Variability ◽  
Potential Effect ◽  
Group Level ◽  
Limited Information ◽  
Continuous Glucose Monitor ◽  
Diet Records ◽  
Glycemic Outcomes

Abstract Objective  There is limited information regarding the potential effect macronutrients have on postprandial glycemic variability in young children with type 1 diabetes (T1D). To date, studies examining nutrition and glycemic outcomes either assess these factors at a single timepoint, or aggregate large datasets for group level analyses. This study examined how inter- and intraindividual fluctuations in carbohydrate, fat, and protein intake impact glycemic variability in the postprandial period for young children with T1D. Methods  Thirty-nine young children, aged 2–6 years, wore a continuous glucose monitor for 72 hr, while their parents completed detailed diet records of all food intake. The analyses tested three multilevel models to examine intra- and interindividual differences between food intake and postprandial glycemic variability. Results  The results suggest carbohydrate intake, relates to greater postprandial glycemic variability. In contrast, the results reveal the inverse effect for protein, suggesting a tendency for young children who ate more protein at some meals to have lower postprandial glycemic variability, with the exception of lunch. There was no effect for fat on postprandial glycemic variability. Conclusion  These results suggest protein consumption may be an important consideration when aiming for optimal glycemic levels for some meals. When counseling parents of young children with T1D on common behaviors underlying glycemic excursion, pediatric psychologists may consider discussing the nutritional make up of children’s meals. Further, the results demonstrate retaining longitudinal data at the person level, versus aggregating individual data for group level analyses, may offer new information regarding macronutrient intake and glycemic outcomes.

A New Analysis Tool for Continuous Glucose Monitor Data

2021 ◽  
pp. 193229682110289
Author(s):  
Evan Olawsky ◽  
Yuan Zhang ◽  
Lynn E Eberly ◽  
Erika S Helgeson ◽  
Lisa S Chow
Keyword(s):  
Glucose Monitoring ◽  
Glycemic Variability ◽  
R Package ◽  
Analysis Tool ◽  
Continuous Glucose Monitor ◽  
Analysis Tools ◽  
R Shiny ◽  
Primary Driver ◽  
Rich Information ◽  
Web App

Background: With the development of continuous glucose monitoring systems (CGMS), detailed glycemic data are now available for analysis. Yet analysis of this data-rich information can be formidable. The power of CGMS-derived data lies in its characterization of glycemic variability. In contrast, many standard glycemic measures like hemoglobin A1c (HbA1c) and self-monitored blood glucose inadequately describe glycemic variability and run the risk of bias toward overreporting hyperglycemia. Methods that adjust for this bias are often overlooked in clinical research due to difficulty of computation and lack of accessible analysis tools. Methods: In response, we have developed a new R package rGV, which calculates a suite of 16 glycemic variability metrics when provided a single individual’s CGM data. rGV is versatile and robust; it is capable of handling data of many formats from many sensor types. We also created a companion R Shiny web app that provides these glycemic variability analysis tools without prior knowledge of R coding. We analyzed the statistical reliability of all the glycemic variability metrics included in rGV and illustrate the clinical utility of rGV by analyzing CGM data from three studies. Results: In subjects without diabetes, greater glycemic variability was associated with higher HbA1c values. In patients with type 2 diabetes mellitus (T2DM), we found that high glucose is the primary driver of glycemic variability. In patients with type 1 diabetes (T1DM), we found that naltrexone use may potentially reduce glycemic variability. Conclusions: We present a new R package and accompanying web app to facilitate quick and easy computation of a suite of glycemic variability metrics.

scholarly journals Methods to Assess Fat Mass in Infants and Young Children: A Comparative Study Using Skinfold Thickness and Air-Displacement Plethysmography

Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 75
Author(s):  
Stefanie M. P. Kouwenhoven ◽  
Nadja Antl ◽  
Jos W. R. Twisk ◽  
Berthold V. Koletzko ◽  
Martijn J. J. Finken ◽  
...  
Keyword(s):  
Young Children ◽  
Fat Mass ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Correlation Coefficients ◽  
Skinfold Thickness ◽  
Limited Information ◽  
Air Displacement Plethysmography ◽  
Mixed Model Analysis ◽  
Infants And Young Children

Background: Traditionally, fat mass is estimated using anthropometric models. Air-displacement plethysmography (ADP) is a relatively new technique for determining fat mass. There is limited information on the agreement between these methods in infants and young children. Therefore we aimed to longitudinally compare fat mass percentage values predicted from skinfold thicknesses (SFTs) and ADP in healthy infants and young children. Methods: Anthropometry and body composition were determined at the ages of 1, 4, and 6 months and 2 years. We quantified the agreement between the two methods using the Bland–Altman procedure, linear mixed-model analysis, and intra-class correlation coefficients (ICC). Results: During the first 6 months of life, fat mass% predicted with SFT was significantly different from that measured with ADP in healthy, term-born infants (n = 245). ICCs ranged from 0.33 (at 2 years of age) and 0.47 (at 4 months of age). Although the mean difference (bias) between the methods was low, the Bland–Altman plots showed proportional differences at all ages with wide limits of agreement. Conclusions: There is poor agreement between ADP and SFTs for estimating fat mass in infancy or early childhood. The amount of body fat was found to influence the agreement between the methods.

scholarly journals Effects of Bacterial CLPB Protein Fragments on Food Intake and PYY Secretion

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2223
Author(s):  
Manon Dominique ◽  
Nicolas Lucas ◽  
Romain Legrand ◽  
Illona-Marie Bouleté ◽  
Christine Bôle-Feysot ◽  
...  
Keyword(s):  
Food Intake ◽  
Peptide Yy ◽  
Molecular Mimicry ◽  
Potential Effect ◽  
In Vivo Studies ◽  
Sprague Dawley ◽  
E Coli ◽  
In Vivo Effects

CLPB (Caseinolytic peptidase B) protein is a conformational mimetic of α-MSH, an anorectic hormone. Previous in vivo studies have already shown the potential effect of CLPB protein on food intake and on the production of peptide YY (PYY) by injection of E. coli wild type (WT) or E. coli ΔClpB. However, until now, no study has shown its direct effect on food intake. Furthermore, this protein can fragment naturally. Therefore, the aim of this study was (i) to evaluate the in vitro effects of CLPB fragments on PYY production; and (ii) to test the in vivo effects of a CLPB fragment sharing molecular mimicry with α-MSH (CLPB25) compared to natural fragments of the CLPB protein (CLPB96). To do that, a primary culture of intestinal mucosal cells from male Sprague–Dawley rats was incubated with proteins extracted from E. coli WT and ΔCLPB after fragmentation with trypsin or after a heat treatment of the CLPB protein. PYY secretion was measured by ELISA. CLPB fragments were analyzed by Western Blot using anti-α-MSH antibodies. In vivo effects of the CLPB protein on food intake were evaluated by intraperitoneal injections in male C57Bl/6 and ob/ob mice using the BioDAQ® system. The natural CLPB96 fragmentation increased PYY production in vitro and significantly decreased cumulative food intake from 2 h in C57Bl/6 and ob/ob mice on the contrary to CLPB25. Therefore, the anorexigenic effect of CLPB is likely the consequence of enhanced PYY secretion.

scholarly journals High-risk environments for eating foods surplus to requirements: a multilevel analysis of adolescents’ non-core food intake in the National Diet and Nutrition Survey (NDNS)

2018 ◽  
Vol 22 (1) ◽  
pp. 74-84 ◽  
Author(s):  
Zoi Toumpakari ◽  
Kate Tilling ◽  
Anne M Haase ◽  
Laura Johnson
Keyword(s):  
Food Intake ◽  
Energy Intake ◽  
Multilevel Models ◽  
Time Of Day ◽  
Individual Characteristics ◽  
Nutrition Survey ◽  
Cross Sectional ◽  
Individual Level ◽  
Risk Environments ◽  
Core Energy

AbstractObjectiveInterventions to reduce adolescents’ non-core food intake (i.e. foods high in fat and sugar) could target specific people or specific environments, but the relative importance of environmental contexts v. individual characteristics is unknown.DesignCross-sectional.SettingData from 4d food diaries in the UK National Diet and Nutrition Survey (NDNS) 2008–2012 were analysed. NDNS food items were classified as ‘non-core’ based on fat and sugar cut-off points per 100g of food. Linear multilevel models investigated associations between ‘where’ (home, school, etc.) and ‘with whom’ (parents, friends, etc.) eating contexts and non-core food energy (kcal) per eating occasion (EO), adjusting for variables at the EO (e.g. time of day) and adolescent level (e.g. gender).ParticipantsAdolescents (n 884) aged 11–18 years.ResultsOnly 11 % of variation in non-core energy intake was attributed to differences between adolescents. In adjusted models, non-core food intake was 151 % higher (ratio; 95 % CI) in EO at ‘Eateries’ (2·51; 2·14, 2·95) and 88 % higher at ‘School’ (1·88; 1·65, 2·13) compared with ‘Home’. EO with ‘Friends’ (1·16; CI 1·03, 1·31) and ‘Family & friends’ (1·21; 1·07, 1·37) contained 16–21 % more non-core food compared with eating ‘Alone’. At the individual level, total energy intake and BMI, but not social class, gender or age, were weakly associated with more non-core energy intake.ConclusionsRegardless of individual characteristics, adolescents’ non-core food consumption was higher outside the home, especially at eateries. Targeting specific eating contexts, not individuals, may contribute to more effective public health interventions.

Vitamin Intake of 3- to 36-Month-Old German Infants and Children – Results of the DONALD-Study

1999 ◽  
Vol 69 (4) ◽  
pp. 285-291 ◽  
Author(s):  
Alexy ◽  
Kersting ◽  
Sichert-Hellert ◽  
Manz ◽  
Schöch
Keyword(s):  
Young Children ◽  
Reference Values ◽  
Age Groups ◽  
Infants And Children ◽  
Infant Food ◽  
Diet Records ◽  
Lack Of Information ◽  
Vitamin Intake ◽  
First Year Of Life ◽  
Infants And Young Children

Infants and young children are a vulnerable group with regard to nutrition. However, there is a lack of information about the dietary composition of healthy German infants and children. Therefore, the intake of vitamins (A, C, E, B1, B2, B6, folate, niacin) was assessed in 354 healthy German infants and children aged 3 to 36 months from 3-day-weighed diet records and compared with German, European and US reference values. Intake of all B-vitamins (B1, B2, B6, folate, niacin) increased during the first 3 years of life, whereas intake of vitamin E decreased. Intake of vitamin A and C varied between age groups. The highest levels of the nutrient densities of most vitamins were found at the end of the first year of life. Depending on the reference values chosen, the vitamin supply of the study population ranged between sufficient and very good. The reported satisfactory intake of vitamins in infants and young children in this study gives rise to the question of whether the current extent of fortification of commercial infant food in Germany is necessary.

scholarly journals Parent–child cooking meal together may relate to parental concerns about the diets of their toddlers and preschoolers: a cross-sectional analysis in Japan

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Midori Ishikawa ◽  
Kumi Eto ◽  
Miki Miyoshi ◽  
Tetsuji Yokoyama ◽  
Mayu Haraikawa ◽  
...  
Keyword(s):  
Food Intake ◽  
Young Children ◽  
Dietary Habits ◽  
Nutrition Survey ◽  
Cross Sectional ◽  
Picky Eating ◽  
Sweetened Beverages ◽  
Cooking Practices ◽  
Sectional Analysis ◽  
Parent Child

Abstract Background Parents often have concerns about the food habits of their young children. Cooking is a frequent behavior related to dietary activities at home. We hypothesized that “a parent cooking meals together with young children might alleviate dietary concerns.” The aim of this study was to identify the relationship between parental cooking practices (e.g., cooking meals together with the child) and diet-related concerns. Methods Data were extracted from the “National nutrition survey on preschool children” conducted among nation-wide households with toddlers and preschoolers in 2015 by the Ministry of Health, Labour and Welfare of Japan. Parents were classified into two groups comprising those who cooked meals together with their children and those who did not. The following variables were compared: taking too much time to eat (slow eaters), “picky” eating (eating only certain foods), inconsistent food intake (eating too much or too little), playing with food/utensils while eating, preferring sweetened beverages and snacks over meals, eating too fast to chew well, not swallowing food, disinterested in eating, and spitting out food. The associations between parent–child cooking meals together and the concerns pertaining to the child’s dietary habits and food intake were analyzed and compared between the two groups. Results The concerns of “picky eating” and “playing with food/utensils while eating” were lower, while “eating too much” was higher in the parent-cooking together group. The intake frequency of fish, soybeans/soy products, vegetables, and milk among children were higher in the “cooking together” group than among those in the “not cooking together” group. Children in the “cooking together” group consumed a significantly greater variety of foods than those in the “not cooking together” group. Conclusions Cooking a meal together with a child may be related to the parent’s lower concerns about the dietary habits of the child, including “picky eating” and “playing with food/utensils while eating,” but may also be related to the higher concerns of “eating too much.”

scholarly journals In a Free-Living Setting, Obesity Is Associated With Greater Food Intake in Response to a Similar Premeal Glucose Nadir

2019 ◽  
Vol 104 (9) ◽  
pp. 3911-3919
Author(s):  
Janice Kim ◽  
Wai Lam ◽  
Qinxin Wang ◽  
Lisa Parikh ◽  
Ahmed Elshafie ◽  
...  
Keyword(s):  
Food Intake ◽  
Hemoglobin A1c ◽  
Normal Weight ◽  
Free Living ◽  
Continuous Glucose Monitor ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Interstitial Glucose ◽  
Glucose Profiles ◽  
Low Glucose

Abstract Purpose Changes in blood glucose levels have been shown to influence eating in healthy individuals; however, less is known about effects of glucose on food intake in individuals who are obese (OB). The goal of this study was to determine the predictive effect of circulating glucose levels on eating in free-living OB and normal weight (NW) individuals. Methods Interstitial glucose levels, measured with a continuous glucose monitor (CGM) system, were obtained from 15 OB and 16 NW volunteers (age: 40 ± 14 and 37 ± 12 years; weight: 91 ± 13 and 68 ± 12 kg; hemoglobin A1c: 5.1% ± 0.7% and 5.2% ± 0.4%, respectively). While wearing the CGM, participants filled out a food log (mealtime, hunger rating, and amount of food). Glucose profiles were measured in relation to their meals [macro program (CGM peak and nadir analysis) using Microsoft® Excel]. Results OB and NW individuals showed comparable CGM glucose levels: mean [OB = 100 ± 8 mg/dL; NW = 99 ± 13 mg/dL; P = nonsignificant (NS)] and SD (OB = 18 ± 5 mg/dL, NW = 18 ± 4 mg/dL; P = NS). Obesity was associated with slower postprandial rate of changing glucose levels (P = 0.04). Preprandial nadir glucose levels predicted hunger and food intake in both groups (P < 0.0001), although hunger was associated with greater food intake in OB individuals than in NW individuals (P = 0.008 for group interaction). Conclusions Premeal glucose nadir predicted hunger and food intake in a group of free-living, healthy, nondiabetic NW and OB individuals; however for a similar low glucose level stimulus, hunger-induced food intake was greater in OB than NW individuals.

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