scholarly journals Nutritional Surveillance for the Best Start in Life, Promoting Health for Neonates, Infants and Children

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3386
Author(s):  
Valeria Calcaterra ◽  
Hellas Cena ◽  
Elvira Verduci ◽  
Alessandra Bosetti ◽  
Gloria Pelizzo ◽  
...  
Keyword(s):  
Early Life ◽  
Maternal Nutrition ◽  
Noncommunicable Diseases ◽  
Life Cycle Approach ◽  
Adult Health ◽  
Disease Manifestation ◽  
Increased Risk ◽  
Nutritional Surveillance

This Special Issue aims to examine the crucial role of nutritional status starting from pregnancy in modulating fetal, neonatal and infant growth and metabolic pathways, with potential long-term impacts on adult health. Poor maternal nutritional conditions in the earliest stages of life during fetal development and early life may induce both short-term and longer lasting effects; in particular, an increased risk of noncommunicable diseases (NCDs) and other chronic diseases such as obesity, which itself is a major risk factor for NCDs, is observed over the lifespan. Poor maternal nutrition affects the fetal developmental schedule, leading to irreversible changes and slowdown in growth. The fetus limits its size to conserve the little energy available for cardiac functions and neuronal development. The organism will retain memory of the early insult, and the adaptive response will result in pathology later on. Epigenetics may contribute to disease manifestation affecting developmental programming. After birth, even though there is a limited evidence base suggesting a relationship between breastfeeding, timing and type of foods used in weaning with disease later in life, nutritional surveillance is also mandatory in infants in the first year of life. We will explore the latest findings on nutrition in early life and term and preterm babies, as well as the role of malnutrition in the short- and long-term impact over the lifespan. Focusing on nutritional interventions represents part of an integrated life-cycle approach to prevent communicable and non-communicable diseases.

scholarly journals The Infant Gut Microbiota and Risk of Asthma: The Effect of Maternal Nutrition during Pregnancy and Lactation

2020 ◽  
Vol 8 (8) ◽  
pp. 1119 ◽  
Author(s):  
Naser A. Alsharairi
Keyword(s):  
Gut Microbiota ◽  
Early Life ◽  
Nutrient Intake ◽  
Maternal Nutrition ◽  
Current Knowledge ◽  
Increased Risk ◽  
Dietary Nutrient ◽  
Pregnancy And Lactation ◽  
Gut Microbiota Composition

Research has amply demonstrated that early life dysbiosis of the gut microbiota influences the propensity to develop asthma. The influence of maternal nutrition on infant gut microbiota is therefore of growing interest. However, a handful of prospective studies have examined the role of maternal dietary patterns during pregnancy in influencing the infant gut microbiota but did not assess whether this resulted in an increased risk of asthma later in life. The mechanisms involved in the process are also, thus far, poorly documented. There have also been few studies examining the effect of maternal dietary nutrient intake during lactation on the milk microbiota, the effect on the infant gut microbiota and, furthermore, the consequences for asthma development remain largely unknown. Therefore, the specific aim of this mini review is summarizing the current knowledge regarding the effect of maternal nutrition during pregnancy and lactation on the infant gut microbiota composition, and whether it has implications for asthma development.

scholarly journals Leptin partially mediates the association between early-life nutritional supplementation and long-term glycemic status among women in a Guatemalan longitudinal cohort

2020 ◽  
Vol 111 (4) ◽  
pp. 804-813 ◽  
Author(s):  
Siran He ◽  
Ngoc-Anh Le ◽  
Manuel Ramirez-Zea ◽  
Reynaldo Martorell ◽  
K M Venkat Narayan ◽  
...  
Keyword(s):  
Early Life ◽  
Cell Function ◽  
Fasting Glucose ◽  
Mediation Effect ◽  
Glycemic Status ◽  
Glucose Lowering ◽  
Obesity And Diabetes ◽  
Increased Risk

ABSTRACT Background Early-life exposure to improved nutrition is associated with decreased risk of diabetes but increased risk of obesity. Leptin positively correlates with adiposity and has glucose-lowering effects, thus it may mediate the association of early-life nutrition and long-term glycemic status. Objectives We aimed to investigate the role of leptin in the differential association between early-life nutrition and the risks of obesity and diabetes. Methods We analyzed data from a Guatemalan cohort who were randomly assigned at the village level to receive nutritional supplements as children. We conducted mediation analysis to examine the role of leptin in the associations of early-life nutrition and adult cardiometabolic outcomes. Results Among 1112 study participants aged (mean ± SD) 44.1 ± 4.2 y, 60.6% were women. Cardiometabolic conditions were common: 40.2% of women and 19.4% of men were obese, and 53.1% of women and 41.0% of men were hyperglycemic or diabetic. Median (IQR) leptin concentration was 15.2 ng/mL (10.2–17.3 ng/mL) in women and 2.7 ng/mL (1.3–5.3 ng/mL) in men. Leptin was positively correlated with BMI (Spearman's ρ was 0.6 in women, 0.7 in men). Women exposed to improved nutrition in early life had 2.8-ng/mL (95% CI: 0.3, 5.3 ng/mL) higher leptin and tended to have lower fasting glucose (–0.8 mmol/L; –1.8, 0.2 mmol/L, nonsignificant) than unexposed women. There were no significant differences in leptin (–0.7 ng/mL; –2.1, 0.8 ng/mL) or fasting glucose (0.2 mmol/L; –0.5, 0.9 mmol/L) in men exposed to improved nutrition in early life compared with unexposed men. Leptin mediated 34.9% of the pathway between early-life nutrition and fasting glucose in women. The mediation in women was driven by improved pancreatic β-cell function. We did not observe the mediation effect in men. Conclusions Leptin mediated the glucose-lowering effect of early-life nutrition in women but not in men.

scholarly journals Role of diuretics on long-term mortality may differ in volume status in patients with acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Kawai ◽  
D Nakatani ◽  
T Yamada ◽  
T Watanabe ◽  
T Morita ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Propensity Score ◽  
Plasma Volume ◽  
Cox Regression ◽  
Volume Status ◽  
Increased Risk ◽  
Long Term Mortality

Abstract Background Diuretics has been reported to have a potential for an activation of the renin-angiotensin-aldosterone system and the sympathetic nervous system, leading to a possibility of poor clinical outcome in patients with cardiovascular disease. However, few data are available on clinical impact of diuretics on long-term outcome in patients with acute myocardial infarction (AMI) based on plasma volume status. Methods To address the issue, a total of 3,416 survived patients with AMI who were registered to a large database of the Osaka Acute Coronary Insufficiency Study (OACIS) were studied. Plasma volume status was assessed with the estimated plasma volume status (ePVS) that was calculated at discharge as follows: actual PV = (1 − hematocrit) × [a + (b × body weight)] (a=1530 in males and a=864 in females, b=41.0 in males and b=47.9 in females); ideal PV = c × body weight (c=39 in males and c=40 in females), and ePVS = [(actual PV − ideal PV)/ideal PV] × 100 (%). Multivariable Cox regression analysis and propensity score matching were performed to account for imbalances in covariates. The endpoint was all-cause of death (ACD) within 5 years. Results During a median follow-up period of 855±656 days, 193 patients had ACD. In whole population, there was no significant difference in long-term mortality risk between patients with and without diuretics in both multivariate cox regression model and propensity score matching population. When patients were divided into 2 groups according to ePVS with a median value of 4.2%, 46 and 147 patients had ACD in groups with low ePVS and high ePVS, respectively. Multivariate Cox analysis showed that use of diuretics was independently associated with an increased risk of ACD in low ePVS group, (HR: 2.63, 95% confidence interval [CI]: 1.22–5.63, p=0.01), but not in high ePVS group (HR: 0.70, 95% CI: 0.44–1.10, p=0.12). These observations were consistent in the propensity-score matched cohorts; the 5-year mortality rate was significantly higher in patients with diuretics than those without among low ePVS group (4.7% vs 1.7%, p=0.041), but not among high ePVS group (8.0% vs 10.3%, p=0.247). Conclusion Prescription of diuretics at discharge was associated with increased risk of 5-year mortality in patients with AMI without PV expansion, but not with PV expansion. The role of diuretics on long-term mortality may differ in plasma volume status. Therefore, prescription of diuretics after AMI may be considered based on plasma volume status. Funding Acknowledgement Type of funding source: None

scholarly journals Prognostic role of neoplastic markers in Takotsubo syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Francesco Santoro ◽  
Tecla Zimotti ◽  
Adriana Mallardi ◽  
Alessandra Leopizzi ◽  
Enrica Vitale ◽  
...  
Keyword(s):  
Serum Levels ◽  
Takotsubo Syndrome ◽  
Ca 15.3 ◽  
Risk Of Death ◽  
Increased Risk ◽  
Ca 19.9 ◽  
Long Term Follow Up

AbstractTakotsubo syndrome (TTS) is an acute heart failure syndrome with significant rates of in and out-of-hospital mayor cardiac adverse events (MACE). To evaluate the possible role of neoplastic biomarkers [CA-15.3, CA-19.9 and Carcinoembryonic Antigen (CEA)] as prognostic marker at short- and long-term follow-up in subjects with TTS. Ninety consecutive subjects with TTS were enrolled and followed for a median of 3 years. Circulating levels of CA-15.3, CA-19.9 and CEA were evaluated at admission, after 72 h and at discharge. Incidence of MACE during hospitalization and follow-up were recorded. Forty-three (46%) patients experienced MACE during hospitalization. These patients had increased admission levels of CEA (4.3 ± 6.2 vs. 2.2 ± 1.5 ng/mL, p = 0.03). CEA levels were higher in subjects with in-hospital MACE. At long term follow-up, CEA and CA-19.9 levels were associated with increased risk of death (log rank p < 0.01, HR = 5.3, 95% CI 1.9–14.8, HR = 7.8 95% CI 2.4–25.1, respectively, p < 0.01). At multivariable analysis levels higher than median of CEA, CA-19.9 or both were independent predictors of death at long term (Log-Rank p < 0.01). Having both CEA and CA-19.9 levels above median (> 2 ng/mL, > 8 UI/mL respectively) was associated with an increased risk of mortality of 11.8 (95% CI 2.6–52.5, p = 0.001) at follow up. Increased CEA and CA-19.9 serum levels are associated with higher risk of death at long-term follow up in patients with TTS. CEA serum levels are correlated with in-hospital MACE.

scholarly journals Precision Medicine, Developmental Plasticity and Prevention of Non-Communicable Disease

2020 ◽  
Author(s):  
Carol Wang ◽  
John Attia ◽  
Stephen Lye ◽  
Wendy Oddy ◽  
Lawrence Beilin ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Early Life ◽  
Developmental Plasticity ◽  
Communicable Disease ◽  
Adult Health ◽  
Lower Systolic Blood Pressure ◽  
Adult Disease ◽  
Healthy Nutrition ◽  
Non Communicable Disease

Abstract Background: It is well established that genetics, environment, and interplay between them play crucial roles in adult disease. We aimed to evaluate the role of genetics, early life nutrition, and interaction between them, on optimal adult health. Methods: As part of a large international consortium (n~154,000), we identified 60 SNPs associated with both birthweight and adult disease. Utilising the Raine Study, we developed a birthweight polygenic score (BW-PGS) based the 60 SNPs and examined relationships between BW-PGS and adulthood cardiovascular risk factors, specifically evaluating interactions with early life nutrition. Findings: Healthy nutrition was beneficial for all individuals; longer duration of any breastfeeding was associated with lower BMI and lower Systolic Blood Pressure in those with higher BW-PGS. Interpretation: Optimal breastfeeding offers the greatest benefit to reduce adult obesity and hypertension in those genetically predisposed to high birthweight. This provides an example of how precision medicine in early life can improve adult health.

scholarly journals Race, Adolescent Socioeconomic Status, and Lifetime Non-Medical Use of Prescription Painkillers: Evidence from the National Longitudinal Study of Adolescent to Adult Health

2021 ◽  
Vol 18 (23) ◽  
pp. 12289
Author(s):  
Amy Ehntholt ◽  
Roman Pabayo ◽  
Lisa Berkman ◽  
Ichiro Kawachi
Keyword(s):  
Socioeconomic Status ◽  
Longitudinal Study ◽  
Ethnic Differences ◽  
Early Life ◽  
Family Income ◽  
Opioid Overdose ◽  
Adult Health ◽  
National Longitudinal Study ◽  
Increased Risk ◽  
Racial Ethnic

The misuse of prescription painkillers is a major contributor to the ongoing drug overdose epidemic. This study investigated variability in non-medical use of prescription painkillers (NMUPP) by race and early-life socioeconomic status (SES) in a sample now at increased risk for opioid overdose. Data from two waves of the National Longitudinal Study of Adolescent to Adult Health (n = 11,602) were used to calculate prevalence of reported NMUPP by Wave 4 (2008; mean age 28), and to assess variation by race and by equivalized household family income at Wave 1 (1994/5). Predicted values for prevalence of NMUPP were modelled, adjusting for age, sex, parental education, and region. Race and SES in adolescence were associated with later reported NMUPP. A gradient was seen in prevalence by SES (adjusted: family income quartile 1 = 13.3%; quartile 2 = 13.8%; quartile 3 = 14.8%; quartile 4 = 16.0%; trend p-value = 0.007). Prevalence was higher among males. Racial/ethnic differences in prevalence were seen (non-Hispanic white (NHW) = 18.5%; non-Hispanic black (NHB) = 5.8%; Hispanic = 10.5%; Other = 10.0%). SES differences were less pronounced upon stratification, with trend tests significant only among females (p = 0.004), and marginally significant among Hispanic males (p = 0.06). Early-life SES was associated with reported lifetime NMUPP: the higher the family income in adolescence, the greater the likelihood of NMUPP by young adulthood. Variations in NMUPP by income paled in comparison with racial/ethnic differences. Results point to a possible long-enduring association between SES and NMUPP, and a need to examine underlying mechanisms.

Abstract 13619: Major Electrocardiographic Abnormalities in Brazilian Adults: Prognostic Value and Potential Use in Primary Prevention (from the Elsa-Brasil Cohort Study)

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Marcelo M Pinto Filho ◽  
Luisa C Brant ◽  
Sandhi M Barreto ◽  
JOSE GERALDO MILL ◽  
Paulo A Andrade Lotufo ◽  
...  
Keyword(s):  
Primary Prevention ◽  
Cardiovascular Mortality ◽  
Risk Model ◽  
Independent Predictor ◽  
Cardiovascular Death ◽  
Noncommunicable Diseases ◽  
Adult Health ◽  
Increased Risk ◽  
Electrocardiographic Abnormality ◽  
Electrocardiogram Ecg

Introduction: Cardiovascular diseases (CVD) are the most preventable noncommunicable diseases. Accurate risk stratification is paramount for identifying patients for whom interventions should be offered. The electrocardiogram (ECG) is a potential tool for CVD primary prevention. Our aim is to evaluate the ECG role as an independent predictor of all-cause and cardiovascular mortality Methods: Participants from the Longitudinal Study of Adult Health (ELSA-Brasil), who were free of known CVD at baseline were included. A 12-lead ECG was obtained at baseline (2008-2010).Participants were followed up to 2018 by annual interviews.Deaths and hospitalizations were independently reviewed. Cox and Fine and Gray competitive risk regressions were applied to evaluate if the presence of any major electrocardiographic abnormality (MEA) at baseline, defined according to de Minnesota Code system (MC), would predict total and cardiovascular deaths in multivariable models Results: The 13,437 participants (mean age 51.8 years, 55% women) were followed for 8±1 years. Baseline prevalence of MEA was 7.2% for men, 5.8% for women. All-cause and cardiovascular mortality occurred in 5.7% and 1.2% of men, and 3.1% and 1.2% of women, respectively. Prevalent MEA was an independent predictor of overall mortality after adjustments for age, race, education and traditional cardiovascular risk factors (HR:2.2; 95%CI 1.6-2.9 for men and HR:2.3; 95%CI 1.6-3.4 for women). [LB1] In the competitive risk model for cardiovascular death, the increased risk attributable to MEA was even higher (HR4.1, 95%CI 2.47-6.81 in men and 5.37, 95%CI 2.54-11.36 in women). Conclusions: Presence of MEA was a strong and independent predictor of overall and cardiovascular death for both sexes. ECG may have a role in improving risk assessment for death in primary care

scholarly journals Fetal endocrinology and development--manipulation and adaptation to long-term nutritional and environmental challenges

Reproduction ◽  
2001 ◽  
pp. 853-862 ◽  
Author(s):  
ME Symonds ◽  
H Budge ◽  
T Stephenson ◽  
IC McMillen
Keyword(s):  
Adipose Tissue ◽  
Maternal Nutrition ◽  
Uncoupling Protein ◽  
Prolactin Receptor ◽  
Endocrine System ◽  
Adult Obesity ◽  
Maternal Undernutrition ◽  
Increased Risk ◽  
Long Form

This article reviews the fetal endocrine system in sheep, a species that has a long gestation and primarily produces a singleton fetus. Attention is focused on information that is applicable to humans. The endocrinology of metabolic homeostasis in sheep fetuses is well adapted to respond to a range of metabolic challenges, including placental restriction and maternal undernutrition. A small placenta results in hypoxaemia, hypoglycaemia, reduced abundance of anabolic hormones, and fetal growth restriction. Fetuses with restricted growth are characterized by tissue-specific reductions in hormone receptor mRNA, for example mRNA for the long form of prolactin receptor is reduced in adipose tissue. In contrast, the adipose tissue of fetuses with accelerated growth, stimulated by increasing maternal nutrition in the second half of gestation, has more protein for the long form of the prolactin receptor and more uncoupling protein 1, by which large amounts of heat are generated at birth. Maternal undernutrition in early gestation, coinciding with the period of rapid placental growth, initially restricts placental growth, but when mothers are fed to requirements, a longer fetus results with a disproportionately large placenta. This nutritional manipulation replicates, in part, epidemiological findings from the Dutch famine of 1944-1945, for which the offspring are at increased risk of adult obesity.

Increased risk of many early-life diseases after surgical removal of adenoids and tonsils in childhood

2017 ◽  
Author(s):  
Sean G. Byars ◽  
Stephen C. Stearns ◽  
Jacobus J. Boomsma
Keyword(s):  
Absolute Risk ◽  
Surgical Removal ◽  
Adult Health ◽  
Immune Development ◽  
Relative Risks ◽  
Increased Risk ◽  
Disease Risks ◽  
Perioperative Risks ◽  
Lymphatic Organs

AbstractBACKGROUNDSurgical removal of the adenoids and tonsils are common pediatric procedures, with conventional wisdom suggesting their absence has little impact on health or disease. However, little is known about long-term health consequences beyond the perioperative risks. Such ignorance is significant, for these lymphatic organs play important roles in both the development and the function of the immune system.METHODSWe tested the long-term consequences of surgery in the population of Denmark by examining risk for 28 diseases with ̴1 million individuals followed from birth up to 30 years of age depending on whether any of three common surgeries (adenoidectomy, tonsillectomy, adenotonsillectomy) occurred in the first 9 years of life. To weigh costs and benefits, we also compared the absolute risks for these diseases to the risks for the conditions that these surgeries aimed to treat. We obtained robust results by using stratified Cox regressions with statistically well-powered samples of cases (with surgery) and controls (without surgery) whose general health was no different prior to surgery. We adjusted our estimates of risk for diseases occurring before surgery, stratified for sex (and other effects) and for 18 covariates, including parental disease history and birth metrics.RESULTSWe found significantly elevated relative risks for many diseases, with effects on respiratory, allergic and infectious disorders after removal of adenoids and tonsils being most pronounced. For some of these diseases, absolute risk increases were considerable. In comparison, many risks for conditions that surgeries aimed to treat were either not significantly different or significantly higher following surgery up to 30 years of age. This suggests that any immediate benefits of these surgeries may not continue longer-term, while resulting in slightly compromised early adult health due to significantly increased risk of many non-target diseases.CONCLUSIONSOur results indicate that surgical removal of tonsils and adenoids early in life are associated with longer-term health risks. They underline the importance of these organs and tissues for normal immune functioning and early immune development, and suggest that these longer-term disease risks may outweigh the short-term benefits of these surgeries.

scholarly journals The Long and Short of It: The Role of Telomeres in Fetal Origins of Adult Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Stephanie E. Hallows ◽  
Timothy R. H. Regnault ◽  
Dean H. Betts
Keyword(s):  
Intrauterine Growth Restriction ◽  
The Body ◽  
Premature Aging ◽  
Fetal Origins ◽  
Maternal Malnutrition ◽  
Adult Disease ◽  
Increased Risk

Placental insufficiency, maternal malnutrition, and other causes of intrauterine growth restriction (IUGR) can significantly affect short-term growth and long-term health. Following IUGR, there is an increased risk for cardiovascular disease and Type 2 Diabetes. The etiology of these diseases is beginning to be elucidated, and premature aging or cellular senescence through increased oxidative stress and DNA damage to telomeric ends may be initiators of these disease processes. This paper will explore the areas where telomere and telomerase biology can have significant effects on various tissues in the body in IUGR outcomes.

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