Influence of the Type of Breastfeeding and Human Milk Polyamines on Infant Anthropometric Parameters

Feeding choices in the early months of life are key determinants of growth during infancy. Polyamines participate in cell proliferation and differentiation, and it has also been suggested that polyamine metabolism plays a role in adipogenesis. As the main exogenous source of polyamines in the infant is human milk, the aim of this work was to study if the type of breastfeeding received and the polyamine intake from human milk has an influence on infant anthropometric parameters. A cohort of 78 full-term healthy newborns was followed up until 4 months of age; 55 were fully and 23 partially breastfed. Anthropometric measurements were taken at 2 and 4 months, when human milk samples were also collected for analysis of polyamine content by UHPLC-FL. Fully breastfed infants had a better anthropometric profile than those partially breastfed (p < 0.05). Furthermore, polyamine intake in partially breastfed infants was significantly lower compared to those fully breastfed. However, only two of the 15 anthropometric indicators evaluated (triceps skinfold and mean upper arm circumference) showed a significant inverse association with polyamine content in human milk and intake (p < 0.05). Infant growth and body composition differ according to the type of breastfeeding received. Based on the weak associations between polyamines and anthropometric indicators, it is not possible to conclude the influence of polyamines in infant growth and body composition.

Body Composition and Diabetes

Representative body composition related to metabolic diseases in our body include fats and muscles, and accumulation of abdominal fats and loss of muscles caused by aging are the main causes of type 2 diabetes mellitus. Such changes in body composition vary according to sex and age; in particular, women exhibit significant changes, especially during menopause. Therefore it is necessary to determine new anthropometric indicators that reflect differences in muscles and fats mass changes caused by aging, as well as their distributions, and to establish diagnostic criteria for stratifying the risks of metabolic diseases in both men and women. This article summarizes the underlying mechanisms and recent epidemiological findings that support how muscles decrease and visceral fats increase the risk of type 2 diabetes mellitus.

Child nutritional status as screening tool for identifying undernourished mothers: an observational study of mother–child dyads in Mogadishu, Somalia, from November 2019 to March 2020

BackgroundActive screening of only pregnant and lactating mothers (PLMs) excludes other mothers of reproductive age susceptible to undernutrition. Our analysis evaluated if mothers presenting with wasted children were more likely to be undernourished themselves.MethodsThe observational study enrolled mother and child dyads presenting to an outpatient facility in Mogadishu, Somalia, between November 2019 and March 2020. Trained nurses recorded lower extremity oedema for children aged 6–59 months, parity and gestational status for women aged 19–50 years and age, access to care, height/length, mid-upper arm circumference (MUAC) and weight for both. Weight-for-height z-score (WHZ) for children and body mass index (BMI) for mothers were calculated using standard procedures. Wasting was defined as WHZ <−2, MUAC <12.5 cm and/or presence of oedema for children. Undernutrition was defined as MUAC <23 cm for PLMs and BMI <18.5 kg/m2 for neither pregnant nor lactating mothers (non-PLMs). Four multivariable linear regression models were fit to evaluate maternal anthropometric indicators (BMI or MUAC) given child anthropometric indicators (MUAC or WHZ), adjusting for maternal age, parity and gestational status.ResultsA total of 93.6% (2142/2288) of enrolled dyads met inclusion criteria. Wasting was observed among 57.5% of children; 20.2% of pregnant mothers, 20.0% of lactating mothers and 7.95% of non-PLMs were undernourished. Models suggest significant, positive associations between child and maternal anthropometrics; a one-unit increase in WHZ and a 1 cm increase in child MUAC were associated with 0.22 kg/m2 (95% CI 0.22 to 0.24) and 0.19 kg/m2 (95% CI 0.16 to 0.21) increases in maternal BMI, respectively, and 0.20 cm (95% CI 0.18 to 0.22) and 0.24 cm (95% CI 0.23 to 0.25) increases in maternal MUAC, respectively. Adjusted R2 values were low (range 0.06–0.10).ConclusionsUndernutrition among non-PLMs illustrates the importance of expanding screening. However, while significant, the strength of association between mother and child anthropometrics does not support child nutritional status as a screening tool for identifying at-risk mothers.

FEATURES OF NUTRITIONAL STATUS IN CHILDREN WITH SPASTIC CEREBRAL PALSY

Children with spastic cerebral palsy (CP) are at risk of undernutrition, which increases with the severity of movement disorders. Objective of the study: to assess and compare anthropometric indicators and body composition in children with cerebral palsy, depending on the level of impairment of gross motor function classification system (GMFCS). Materials and methods of research: 102 children were included in a prospective open-label comparative single-center non-randomized study: 58 (56.8%) boys and 44 (43.1%) girls with cerebral palsy aged 2 years to 16 years and 9 months who were undergoing rehabilitation in the National Medical Research Center of Children's Health in the period from 2019 to 2021. Anthropometric measurements (body weight, length, knee height, triceps and subscapular skinfold thicknesses) were performed on admission. Body fat percentage (%FM) was calculated by CP-modified (Gurka) equations and compared with results obtained using bioelectrical impedance analysis. A survey on the EDACS scale was performed to determine the ability to eat and drink. Results: patients were divided into 2 groups: the main group – 53 children (52%) with GMFCS levels IV–V and a comparison group – 49 children (48%) with GMFCS levels I–III. The groups did not differ statistically significantly in terms of gender (p=0.956) and age (p=0.207). The median age in the main group was 7.1 years, in the comparison group – 5.3 years. Children of the main group had statistically significantly lower growth indicators (HAZ1 –1.5 [–2.6; –0.74] and HAZ2 –0.58 [–1.59; 0.44], p=0.003), BMI (BAZ1 –2.43 [–3.67; –0.93]; BAZ2 –0.91 [–1.942; 0.28], p<0.001), higher frequency of oromotor dysfunction (42% and 4%, p< 0.001), the percentage of severe wasting (59% and 16%, p<0.001; OR 7.2 (95% CI 2.8–18.4) (p<0.001). There was no significant difference in %FM between children of main and comparison groups. Patients even with moderate and severe undernutrition according to WHO criteria had normal or excess %FM. A moderate positive correlation was found between %FM calculated using the Gurka equations and those obtained by bioelectrical impedance analysis (r=0.565, p=0.002). Conclusions: anthropometric indicators in children with CP deteriorate with an increase in the degree of neurological deficit. The use of BMI as the only marker of nutritional status is insufficient to properly diagnose of undernutrition and identify patients needed in nutritional interventions. For an adequate analysis of the nutritional status of children with CP, it is necessary to assess the body composition (measurement of the skinfold thicknesses or bioelectrical impedance analysis).

ANALYSING ASSOCIATION BETWEEN ANTHROPOMETRIC INDICATORS OF INSULIN RESISTANCE AND INSULIN-LIKE GROWTH FACTOR-1 IN PATIENTS WITH NODULAR GOITER

Publications suggesting that thyroid nodule might be associated with insulin resistance (IR) and metabolic syndrome are quite interesting. In a very recent report, increased thyroid volume and nodule prevalence were also reported in patients with IR in an iodine-sufficient area []. The purpose of the work is to analyze the association between anthropometric indicators IR and IGF-1 in patients with nodular goiter. Materials and methods. During the study the authors examined 73 patients with euthyroid single-node (n = 34) and multinodular goiter (n = 39) aged 17 to 74 years (mean - (51.0 ± 10.6) years), determining WC, WC / HC, BMI, WHtR, ABSI, BFD, BRI, CI, AVI, BAI, IGF-1, TSH, fT4, fT3. Thyroid volume, its structure, number, size and location of foci was assessed by an ultrasonic complex Aloka SSD-1100 (Japan), using a linear sensor 7.5 MHz. Results and their discussion. In the total number of patients with nodular goiter IGF-1 is nonlinearly negatively associated with BMI (r = -0.30; P = 0.016), WC (r = -0.26; P = 0.036), WHtR (r = -0.30) ; P = 0.020), AVI (r = -0.27; P = 0.03), ABSI (r = -0.31; P = 0.015), nonlinear positive with BFD (r = 0.27; P = 0.033) ), BRI (r = 0.29; P = 0.02) and linearly positive with BAI (r = 0.36; P = 0.004); thyroid volume is linearly positively associated with age (r = 0.35; P = 0.009), nonlinearly positively with WC / HC (r = 0.43; P = 0.001), BFD (r = 0.26; P = 0.06 ) and CI (r = 0.31; P = 0.02). In patients with nodular goiter with BMI≥35 kg / m2 thyroid volume is linearly positively associated with BMI (r = 0.71; P = 0.049). In patients with nodular goiter with IRF-1 above the sex-age norm, thyroid volume is nonlinearly positively associated with WC / HC (r = 0.71; P = 0.01), BAI (r = 0.66; P = 0.03 ) and nonlinearly negative with BFD (r = -0.52; P = 0.01). It has been found that BAI explains 82.37% of the variance of IGF-1 in the general group and more than 90% of the variance of its level in groups of patients with nodular goiter with high IGF-1 with / without obesity. In patients with nodular goiter with high IGF-1 and obesity, the predictor of increased thyroid volume is BRI, which explains 81.14% of the variance of its volume. Conclusions: Patients with nodular goiter with IGF-1 level in blood above the sex-age norm have significantly higher values ​​of anthropometric indicators IR (WHtR, ABSI, BFD and BAI) compared with patients with a normal level of this indicator; in patients with nodular goiter with II degree obesity and above, thyroid volume is significantly associated with BMI; BAI (R2 = 82.37%) is a predictor of increased levels of IGF-1 in blood of patients with nodular goiter, regardless of the obesity; BRI (R2 = 81.14%) is a predictor of increased thyroid volume in patients with nodular goiter with IGF -1 high level and obesity. Key words: nodular goiter, anthropometric indicators, insulin resistance