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Special Issue "Early Life Nutrition: From Nutrients to Systems"

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (30 June 2018)

Special Issue Editor

Guest Editor
Assoc. Prof. Rebecca Golley

Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5001, Australia
Website | E-Mail
Interests: behavioural nutrition; diet quality; obesity prevention; children

Special Issue Information

Dear Colleagues,

The first five years of life is a period when dietary behaviours that promote optimal nutrition, growth and development are established or begin to track over the life course. The influence of early nutrition on health reflects the complex interplay between child and family factors with the broader social, physical, political and institutional environments in which children live, learn and eat. Nutrition promotion and health interventions, including obesity prevention, need to leverage a broad evidence-base spanning nutrition science, behavioural nutrition and public health nutrition policy and practice. This Special Issue of Nutrients, entitled; "Early Life Nutrition: From Nutrients to Systems" welcomes the submission of manuscripts describing either epidemiological, behavioural, methodological, qualitative, intervention or policy research.

Potential topics may include, but are not limited to:

  • Food intake and dietary behaviours of infants, toddlers and pre-school children
  • Parent feeding practices, particularly in vulnerable populations
  • Socio ecological predictors of early life nutrition
  • Early life nutrition interventions targeting diet quality, growth (e.g., obesity), health (e.g., dental caries) and development (e.g., cognitive development)
  • Measuring diet in young children
  • Early life nutrition service delivery: policy, economic and practice implications
Assoc. Prof. Rebecca Golley
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Dietary intake
  • Socio-ecological model
  • Infant, toddler and pre-schoolers
  • Obesity prevention

Published Papers (16 papers)

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Research

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Open AccessArticle Beverage Consumption Patterns among Infants and Young Children (0–47.9 Months): Data from the Feeding Infants and Toddlers Study, 2016
Nutrients 2018, 10(7), 825; https://doi.org/10.3390/nu10070825
Received: 30 May 2018 / Revised: 18 June 2018 / Accepted: 22 June 2018 / Published: 26 June 2018
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Abstract
(1) Background: Data about early life beverage intake patterns is sparse. We describe beverage patterns among infants and young children from the Feeding Infants and Toddlers Study (FITS) 2016. (2) Methods: FITS 2016 is a cross-sectional survey of U.S. parents/caregivers of children 0–47.9
[...] Read more.
(1) Background: Data about early life beverage intake patterns is sparse. We describe beverage patterns among infants and young children from the Feeding Infants and Toddlers Study (FITS) 2016. (2) Methods: FITS 2016 is a cross-sectional survey of U.S. parents/caregivers of children 0–47.9 months (n = 3235). Food and beverage intakes were collected by 24-h dietary recalls to describe beverage consumption patterns including: a) prevalence of consumption, per capita and per consumer intake, b) contribution to intake of calories and key nutrients, and c) prevalence according to eating occasions. (3) Results: Breast milk and infant formula were commonly consumed among <12-month-olds. Among 12–23.9-month-olds, the most commonly consumed beverage was whole milk (67% consuming), followed by 100% juice (50% consuming). Plain drinking water was consumed by 70% of 12–23.9-month-olds and 78% of 24–47.9-month-olds. Among 12–47.9-month-olds, milks provided more energy and key nutrients than all other beverages. Across eating occasions, sugar-sweetened beverage (SSB) consumption, especially in the form of fruit-flavored drinks, was higher among 24–47.9 compared to 12–23.9-month-olds. Only 23–32% of ≥12-month-olds consumed milk or water at lunch or dinner. (4) Conclusions: Opportunities exist to improve beverage patterns. Future interventions may benefit from focusing on timely introduction of age-appropriate beverages and reducing consumption of SSBs. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
Open AccessFeature PaperArticle Impact of a Modified Version of Baby-Led Weaning on Infant Food and Nutrient Intakes: The BLISS Randomized Controlled Trial
Nutrients 2018, 10(6), 740; https://doi.org/10.3390/nu10060740
Received: 6 May 2018 / Revised: 28 May 2018 / Accepted: 5 June 2018 / Published: 7 June 2018
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Abstract
Despite growing international interest in Baby-Led Weaning (BLW), we know almost nothing about food and nutrient intake in infants following baby-led approaches to infant feeding. The aim of this paper was to determine the impact of modified BLW (i.e., Baby-Led Introduction to SolidS;
[...] Read more.
Despite growing international interest in Baby-Led Weaning (BLW), we know almost nothing about food and nutrient intake in infants following baby-led approaches to infant feeding. The aim of this paper was to determine the impact of modified BLW (i.e., Baby-Led Introduction to SolidS; BLISS) on food and nutrient intake at 7–24 months of age. Two hundred and six women recruited in late pregnancy were randomized to Control (n = 101) or BLISS (n = 105) groups. All participants received standard well-child care. BLISS participants also received lactation consultant support to six months, and educational sessions about BLISS (5.5, 7, and 9 months). Three-day weighed diet records were collected for the infants (7, 12, and 24 months). Compared to the Control group, BLISS infants consumed more sodium (percent difference, 95% CI: 35%, 19% to 54%) and fat (6%, 1% to 11%) at 7 months, and less saturated fat (−7%, −14% to −0.4%) at 12 months. No differences were apparent at 24 months of age but the majority of infants from both groups had excessive intakes of sodium (68% of children) and added sugars (75% of children). Overall, BLISS appears to result in a diet that is as nutritionally adequate as traditional spoon-feeding, and may address some concerns about the nutritional adequacy of unmodified BLW. However, BLISS and Control infants both had high intakes of sodium and added sugars by 24 months that are concerning. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
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Open AccessArticle A Phosphatidylserine Source of Docosahexanoic Acid Improves Neurodevelopment and Survival of Preterm Pigs
Nutrients 2018, 10(5), 637; https://doi.org/10.3390/nu10050637
Received: 29 March 2018 / Revised: 2 May 2018 / Accepted: 14 May 2018 / Published: 18 May 2018
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Abstract
The amount, composition, and sources of nutrition support provided to preterm infants is critical for normal growth and development, and particularly for structural and functional neurodevelopment. Although omega-3 long chain polyunsaturated fatty acids (LC-PUFA), and particularly docosahexanoic acid (DHA), are considered of particular
[...] Read more.
The amount, composition, and sources of nutrition support provided to preterm infants is critical for normal growth and development, and particularly for structural and functional neurodevelopment. Although omega-3 long chain polyunsaturated fatty acids (LC-PUFA), and particularly docosahexanoic acid (DHA), are considered of particular importance, results from clinical trials with preterm infants have been inconclusive because of ethical limitations and confounding variables. A translational large animal model is needed to understand the structural and functional responses to DHA. Neurodevelopment of preterm pigs was evaluated in response to feeding formulas to term-equivalent age supplemented with DHA attached to phosphatidylserine (PS-DHA) or sunflower oil as the placebo. Newborn term pigs were used as a control for normal in utero neurodevelopment. Supplementing formula with PS-DHA increased weight of the brain, and particularly the cerebellum, at term-equivalent age compared with placebo preterm pigs (P’s < 0.10 and 0.05 respectively), with a higher degree of myelination in all regions of the brain examined (all p < 0.06). Brains of pigs provided PS-DHA were similar in weight to newborn term pigs. Event-related brain potentials and performance in a novel object recognition test indicated the PS-DHA supplement accelerated development of sensory pathways and recognition memory compared with placebo preterm pigs. The PS-DHA did not increase weight gain, but was associated with higher survival. The benefits of PS-DHA include improving neurodevelopment and possibly improvement of survival, and justify further studies to define dose-response relations, compare benefits associated with other sources of DHA, and understand the mechanisms underlying the benefits and influences on the development of other tissues and organ systems. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
Open AccessArticle Growth Responses of Preterm Pigs Fed Formulas with Different Protein Levels and Supplemented with Leucine or β-Hydroxyl β-Methylbutyrate
Nutrients 2018, 10(5), 636; https://doi.org/10.3390/nu10050636
Received: 31 March 2018 / Revised: 9 May 2018 / Accepted: 16 May 2018 / Published: 18 May 2018
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Abstract
Growth after preterm birth is an important determinant of long-term outcomes. Yet, many preterm infants suffer ex utero growth retardation. We evaluated effects of leucine and the metabolite, β-hydroxy β-methylbutyrate (HMB) on growth of preterm pigs, a previously-validated translational model for preterm infants.
[...] Read more.
Growth after preterm birth is an important determinant of long-term outcomes. Yet, many preterm infants suffer ex utero growth retardation. We evaluated effects of leucine and the metabolite, β-hydroxy β-methylbutyrate (HMB) on growth of preterm pigs, a previously-validated translational model for preterm infants. After 48 h of parenteral nutrition preterm pigs were fed for 6 to 7 days isocaloric formulas with different levels of protein (50 or 100 g/L) with leucine (10 g/L, 76 mM) or HMB (at 1.1 g/L, 4 mM) added to stimulate protein synthesis or with alanine (6.8 g/L; 76 mM) as the control. Rates of growth of pigs fed the low protein formula with alanine (3.4 ± 0.2% gain per day) or leucine (3.7 ± 0.2) exceeded that of pigs fed the high protein formula (2.8 ± 0.2, p = 0.02 for comparison with both low protein formulas; p = 0.01 compared with low protein + leucine). Supplementing the high protein formula with leucine or HMB did not increase growth relative to alanine (2.72 ± 0.20, 2.74 ± 0.27, and 2.52 ± 0.20, respectively). Small pigs (<700 g birth weight) grew slower during parenteral nutrition and had a more pronounced response to leucine. Females fed the high protein formulas grew faster than males, and particularly for small pigs (p < 0.05). Blood urea nitrogen values were lower for pigs fed the low versus the high protein formulas (p < 0.05). Leucine and HMB improved growth of preterm pigs fed low, but not high protein formulas, even after controlling for birth weight and sex, which independently correlated with growth rates. They offer an option to improve growth without increasing the amino acid load, with its attendant metabolic disadvantages. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
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Open AccessArticle The Effect of Increasing the Protein Content of Human Milk Fortifier to 1.8 g/100 mL on Growth in Preterm Infants: A Randomised Controlled Trial
Nutrients 2018, 10(5), 634; https://doi.org/10.3390/nu10050634
Received: 26 April 2018 / Revised: 11 May 2018 / Accepted: 15 May 2018 / Published: 17 May 2018
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Abstract
The aim of this study was to assess the effect of feeding high protein human milk fortifier (HMF) on growth in preterm infants. In this single-centre randomised trial, 60 infants born 28–32 weeks’ gestation were randomised to receive a higher protein HMF providing
[...] Read more.
The aim of this study was to assess the effect of feeding high protein human milk fortifier (HMF) on growth in preterm infants. In this single-centre randomised trial, 60 infants born 28–32 weeks’ gestation were randomised to receive a higher protein HMF providing 1.8 g protein (n = 31) or standard HMF providing 1 g protein per 100 mL expressed breast milk (EBM) (n = 29). The primary outcome was rate of weight gain. Baseline characteristics were similar between groups. There was no difference between high and standard HMF groups for weight gain (mean difference (MD) −14 g/week; 95% CI −32, 4; p = 0.12), length gain (MD −0.01 cm/week; 95% CI −0.06, 0.03; p = 0.45) or head circumference gain (MD 0.007 cm/week; 95% CI −0.05, 0.06; p = 0.79), despite achieving a 0.7 g/kg/day increase in protein intake in the high protein group. Infants in the high protein group had a higher proportion of lean body mass at trial entry; however, there was no group by time effect on lean mass gains over the study. Increasing HMF protein content to 1.8 g per 100 mL EBM does not improve growth in preterm infants born 28–32 weeks’ gestation. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
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Open AccessArticle The Relative Validity of the Menzies Remote Short-Item Dietary Assessment Tool (MRSDAT) in Aboriginal Australian Children Aged 6–36 Months
Nutrients 2018, 10(5), 590; https://doi.org/10.3390/nu10050590
Received: 26 March 2018 / Revised: 7 May 2018 / Accepted: 8 May 2018 / Published: 10 May 2018
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Abstract
The Menzies Remote Short-item Dietary Assessment Tool (MRSDAT) can be used to derive a dietary index score, which measures the degree of compliance with the Australian Dietary Guidelines. This study aimed to determine the relative validity of a dietary index score for children
[...] Read more.
The Menzies Remote Short-item Dietary Assessment Tool (MRSDAT) can be used to derive a dietary index score, which measures the degree of compliance with the Australian Dietary Guidelines. This study aimed to determine the relative validity of a dietary index score for children aged 6–24 months, living in a Remote Aboriginal Community (RAC), derived using MRSDAT. This validation study compared dietary index scores derived using MRSDAT with those derived from the average of three 24-h recalls. Participants were aged 6–36 months at the first dietary assessment and were living in a RAC. The level of agreement between the two methods was explored using Lin’s concordance correlation coefficient (CCC), Bland-Altman plots, weighted Cohen’s kappa, and Fischer’s exact and paired t-tests. Forty participants were recruited. The CCC was poor between methods (R = 0.35, 95% CI 0.06, 0.58), with MRSDAT estimating higher dietary intake scores for all food groups except fruit, and higher dietary quality scores by an average of 4.78 points/100. Community-based Aboriginal researchers were central to this validation study. MRSDAT was within the performance range of other short-item dietary assessment tools developed for young children, and shows promise for use with very young children in RACs. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
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Open AccessArticle Parental Translation into Practice of Healthy Eating and Active Play Messages and the Impact on Childhood Obesity: A Mixed Methods Study
Nutrients 2018, 10(5), 545; https://doi.org/10.3390/nu10050545
Received: 28 March 2018 / Revised: 20 April 2018 / Accepted: 24 April 2018 / Published: 27 April 2018
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Abstract
Childhood obesity is a significant health issue worldwide. Modifiable risk factors in early childhood relate to child healthy eating and active play, and are influenced by parents. The aim of the study was two-fold. Firstly, to determine the weight status of children aged
[...] Read more.
Childhood obesity is a significant health issue worldwide. Modifiable risk factors in early childhood relate to child healthy eating and active play, and are influenced by parents. The aim of the study was two-fold. Firstly, to determine the weight status of children aged between birth and 3.5 years in a rural and remote area of Australia. Secondly, to explore the relationship between child weight status and translation of advice on healthy eating and active play provided to parents by local, nurse-led, Maternal Child Health (MCH) services. Measured anthropometric data (n = 438) were provided by MCH services. Semi-structured interviews were conducted with two MCH nurses and 15 parents. Prevalence of overweight/obesity was calculated. Local childhood overweight/obesity prevalence was lower than the national average at age 3.5 years (11.38%; 20%). Parents identified the MCH service as a key source of healthy eating and active play advice and reported mostly following recommendations but struggling with screen time and fussy eating recommendations. We observed a relaxation in parent attitudes towards healthy child behaviours which coincided with a trend towards obesity from 12 months (p < 0.001). MCH services provide useful and effective advice to parents but ongoing support is required to prevent obesity later in childhood. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
Open AccessArticle Factors Influencing Parental Engagement in an Early Childhood Obesity Prevention Program Implemented at Scale: The Infant Program
Nutrients 2018, 10(4), 509; https://doi.org/10.3390/nu10040509
Received: 29 March 2018 / Revised: 12 April 2018 / Accepted: 16 April 2018 / Published: 19 April 2018
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Abstract
The ‘early years’ is a crucial period for the prevention of childhood obesity. Health services are well placed to deliver preventive programs to families, however, they usually rely on voluntary attendance, which is challenging given low parental engagement. This study explored factors influencing
[...] Read more.
The ‘early years’ is a crucial period for the prevention of childhood obesity. Health services are well placed to deliver preventive programs to families, however, they usually rely on voluntary attendance, which is challenging given low parental engagement. This study explored factors influencing engagement in the Infant Program: a group-based obesity prevention program facilitated by maternal and child health nurses within first-time parent groups. Six 1.5 h sessions were delivered at three-month intervals when the infants were 3–18 months. A multi-site qualitative exploratory approach was used, and program service providers and parents were interviewed. Numerous interrelated factors were identified, linked to two themes: the transition to parenthood, and program processes. Personal factors enabling engagement included parents’ heightened need for knowledge, affirmation and social connections. Adjusting to the baby’s routine and increased parental self-efficacy were associated with diminished engagement. Organisational factors that challenged embedding program delivery into routine practice included aspects of program promotion, referral and scheduling and workforce resources. Program factors encompassed program content, format, resources and facilitators, with the program being described as meeting parental expectations, although some messages were perceived as difficult to implement. The study findings provide insight into potential strategies to address modifiable barriers to parental engagement in early-year interventions. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
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Open AccessArticle Postnatal Growth Disadvantage of the Small for Gestational Age Preterm Twins
Nutrients 2018, 10(4), 476; https://doi.org/10.3390/nu10040476
Received: 29 January 2018 / Revised: 4 April 2018 / Accepted: 10 April 2018 / Published: 12 April 2018
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Abstract
In this study, we examined early growth characteristics among small-for-gestational-age (SGA) preterm twins compared to their appropriate-for-gestational-age (AGA) counterparts. A retrospective study evaluated all consecutive twins born between 2008 and 2015 at a tertiary referral center whose gestational age ranged from 30.0 to
[...] Read more.
In this study, we examined early growth characteristics among small-for-gestational-age (SGA) preterm twins compared to their appropriate-for-gestational-age (AGA) counterparts. A retrospective study evaluated all consecutive twins born between 2008 and 2015 at a tertiary referral center whose gestational age ranged from 30.0 to 34.86 weeks. Included were twins in which one twin was AGA and the other SGA at birth. Changes of ≥2, 1–1.99, and 0–0.99 in z-score between births and 36 weeks post menstrual age (PMA) were respectively defined as severe, moderate, and mild postnatal growth failure (PNGF) in weight or head circumference (HC). Early neonatal morbidities were documented. Multiple logistic regression analysis was applied to determine conditions associated with PNGF and its severity. Out of 666 sets of twins, 83 met the inclusion criteria. Weight PNGF was similar and mild among the SGA and the AGA groups (0.9 ± 0.46 vs. 0.96 ± 0.44 z-score, respectively, p = 0.24). At 36 weeks PMA, a significantly larger proportion of SGAs were below −2 z-scores in weight (84.3%) compared to birth (31.3%) or to the AGAs (8.4%). In both groups, weight PNGF correlated with the time needed to regain birth weight. HC PNGF was mild among both groups, yet significantly more prominent among the AGAs (0.39 ± 0.72 z-score) vs. SGAs (0.75 ± 0.65 z-score, p = 0.001). We suggest that among preterm SGA infants, the absolute z-score should be used to assess the severity of weight PNGF. Individual nutritional strategies to decrease time to regain birth weight may mitigate severe malnutrition among SGAs. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
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Open AccessArticle Influence of Mothers’ Nutrition Knowledge and Attitudes on Their Purchase Intention for Infant Cereal with No Added Sugar Claim
Nutrients 2018, 10(4), 435; https://doi.org/10.3390/nu10040435
Received: 5 February 2018 / Revised: 15 March 2018 / Accepted: 28 March 2018 / Published: 30 March 2018
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Abstract
A higher sugar intake in infancy might result in a predisposition to a higher sugar intake in later childhood. In Taiwan, many commercial infant and toddler foods with nutrition claims have high sugar content. This study explored the influence of mothers’ knowledge and
[...] Read more.
A higher sugar intake in infancy might result in a predisposition to a higher sugar intake in later childhood. In Taiwan, many commercial infant and toddler foods with nutrition claims have high sugar content. This study explored the influence of mothers’ knowledge and attitudes on their purchase intention for infant food with nutrition claims. This study was a cross-sectional survey. An online survey was distributed to 940 mothers who had a child aged between 4 months and 3 years; 40% of mothers tend to misunderstand that “no added sugar” (NAS) indicates no sugar or less sugar content and, thus, that NAS infant cereal is healthy. Approximately 50–70% of mothers believe that NAS infant cereal is more natural, healthier, and contains less sugar. Attitude toward the NAS claim was found to be a mediating variable between sugar-related knowledge and purchase intention. The lower the level of sugar-related knowledge was, the more positive the attitude toward NAS infant cereal and the higher the purchase intention for NAS infant cereal were. In the future, regulation of no added sugar is needed to avoid the misleading information and mothers’ sugar-related knowledge need to be improved through nutrition education. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
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Open AccessArticle Differential Long-Chain Polyunsaturated Fatty Acids Status and Placental Transport in Adolescent Pregnancies
Nutrients 2018, 10(2), 220; https://doi.org/10.3390/nu10020220
Received: 7 December 2017 / Revised: 22 January 2018 / Accepted: 12 February 2018 / Published: 15 February 2018
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Abstract
Adolescent pregnancy increases risk of adverse perinatal outcomes. Placental delivery of long-chain polyunsaturated fatty acids (LCPUFA) is essential for fetal growth and development. In this pilot study, we aimed to assess maternal and fetal status of fatty acids (FA) measured at birth and
[...] Read more.
Adolescent pregnancy increases risk of adverse perinatal outcomes. Placental delivery of long-chain polyunsaturated fatty acids (LCPUFA) is essential for fetal growth and development. In this pilot study, we aimed to assess maternal and fetal status of fatty acids (FA) measured at birth and the expression of key genes involved in FA uptake, transport and metabolism in the placenta of fifteen adolescents and fifteen adults. FA were quantified by gas-liquid chromatography. Placental expression of FA transporters was assessed by quantitative real-time polymerase chain reaction (qRT-PCR) and peroxisome proliferator-activated receptor gamma (PPARγ) was quantified by Western Blot. Adolescents had lower docosahexaenoic acid (DHA, 22:6 n-3) and total n-3 FA levels in maternal erythrocytes and placenta, but these were not different in fetal erythrocytes. Arachidonic acid (AA, 20:4 n-6) concentration was increased in placenta but lower in fetal circulation. Plasma membrane fatty acid binding protein (FABPpm) and fatty acid transport protein (FATP) 4 mRNA expressions were not different, however FATP1, fatty acid translocase (FAT/CD36) and fatty acid binding protein 3 (FABP3) mRNA and PPARγ protein levels were decreased in placenta of adolescents. Despite significant downregulation of FATP1, CD36 and FABP3, there was only a modest decrease in LCPUFA (10%) and AA (12%) and no difference in DHA content in cord blood, suggesting that FA transfer to the fetus was partially protected by other factors in adolescents from this cohort. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
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Open AccessArticle Relative Validity of a 24-h Recall in Assessing Intake of Key Nutrients in a Cohort of Australian Toddlers
Nutrients 2018, 10(1), 80; https://doi.org/10.3390/nu10010080
Received: 30 November 2017 / Revised: 9 January 2018 / Accepted: 11 January 2018 / Published: 12 January 2018
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Abstract
There is limited information concerning the dietary intake of toddlers in Australia. Consequently, there is a need for studies investigating toddler intake that use dietary assessment measures that are valid and place a low participant burden on caregivers. The aim of this study
[...] Read more.
There is limited information concerning the dietary intake of toddlers in Australia. Consequently, there is a need for studies investigating toddler intake that use dietary assessment measures that are valid and place a low participant burden on caregivers. The aim of this study was to determine the relative validity of a single 24-h dietary recall (24HR) in measuring the intake of five nutrients in a cohort of Australian toddlers compared to a combined 24HR and 2-day estimated food record (2DFR). A single 24HR and a 2DFR were collected from a cohort of Australian toddlers (n = 699) at approximately 12 months of age as part of the Study of Mothers’ and Infants’ Life Events affecting oral health (SMILE) project. Relative validity of one day of dietary data (24HR) in assessing intake of energy, protein, calcium, iron, and added sugars was tested against three days of dietary data (24HR + 2DFR) using paired t-tests, Bland–Altman analysis, cross-classification, and weighted Kappa statistic. Classification analysis found good agreement between the 24HR and 24HR + 2DFR for all nutrients with the percentage classified in the same tertile at 57.9% and above. The weighted Kappa statistic found acceptable agreement for all nutrients. This study suggests that a 24HR is a valid assessment tool for estimating the relative intake of energy, protein, calcium, iron, and added sugars among Australian toddlers at the individual level. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
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Review

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Open AccessReview Attenuating Pregnancy Weight Gain—What Works and Why: A Systematic Review and Meta-Analysis
Nutrients 2018, 10(7), 944; https://doi.org/10.3390/nu10070944
Received: 20 June 2018 / Revised: 18 July 2018 / Accepted: 20 July 2018 / Published: 22 July 2018
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Abstract
Excessive maternal gestational weight gain (GWG) contributes to generational obesity. Our aim was to explore efficacy and intervention characteristics (trimester, duration, frequency, intensity, and delivery method) of interventions to prevent excessive GWG. CINAHL, Cochrane, EMBASE, LILACS, MEDLINE, PsycINFO, and Scopus were searched up
[...] Read more.
Excessive maternal gestational weight gain (GWG) contributes to generational obesity. Our aim was to explore efficacy and intervention characteristics (trimester, duration, frequency, intensity, and delivery method) of interventions to prevent excessive GWG. CINAHL, Cochrane, EMBASE, LILACS, MEDLINE, PsycINFO, and Scopus were searched up to May 2018 (no date or language restrictions). Keywords and MeSH terms for diet, GWG, intervention, lifestyle, maternal, physical activity, and pregnancy were used to locate randomized-controlled trials (RCTs). The Cochrane Collaboration tool for assessing risk of bias was applied. Eighty-nine RCTs were included. Meta-analysis (60 trials) estimated that women in diet only (WMD: −3.27; 95% CI: −4.96, −1.58, p < 0.01), physical activity (PA) (WMD: −1.02; 95% CI: −1.56, −0.49, p < 0.01), and lifestyle interventions (combining diet and PA) (WMD: −0.84; 95% CI: −1.29, −0.39, p < 0.01) gained significantly less weight than controls. The three eHealth interventions favored neither intervention nor control (WMD: −1.06; 95% CI: −4.13, 2.00, p = 0.50). Meta-regression demonstrated no optimal duration, frequency, intensity, setting, or diet type. Traditional face to face delivery of weight management interventions during pregnancy can be successful. Delivery via eHealth has potential to extend its reach to younger women but needs further evaluation of its success. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
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Open AccessReview A Systematic Review and Meta-Analysis of Human Milk Feeding and Morbidity in Very Low Birth Weight Infants
Nutrients 2018, 10(6), 707; https://doi.org/10.3390/nu10060707
Received: 24 April 2018 / Revised: 25 May 2018 / Accepted: 29 May 2018 / Published: 31 May 2018
Cited by 1 | PDF Full-text (1804 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
This systematic review and meta-analysis synthesised the post-1990 literature examining the effect of human milk on morbidity, specifically necrotising enterocolitis (NEC), late onset sepsis (LOS), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD) and neurodevelopment in infants born ≤28 weeks’ gestation and/or publications with
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This systematic review and meta-analysis synthesised the post-1990 literature examining the effect of human milk on morbidity, specifically necrotising enterocolitis (NEC), late onset sepsis (LOS), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD) and neurodevelopment in infants born ≤28 weeks’ gestation and/or publications with reported infant mean birth weight of ≤1500 g. Online databases including Medline, PubMed, CINAHL, Scopus, and the Cochrane Central Register of Controlled Trials were searched, and comparisons were grouped as follows: exclusive human milk (EHM) versus exclusive preterm formula (EPTF), any human milk (HM) versus EPTF, higher versus lower dose HM, and unpasteurised versus pasteurised HM. Experimental and observational studies were pooled separately in meta-analyses. Risk of bias was assessed for each individual study and the GRADE system used to judge the certainty of the findings. Forty-nine studies (with 56 reports) were included, of which 44 could be included in meta-analyses. HM provided a clear protective effect against NEC, with an approximate 4% reduction in incidence. HM also provided a possible reduction in LOS, severe ROP and severe NEC. Particularly for NEC, any volume of HM is better than EPTF, and the higher the dose the greater the protection. Evidence regarding pasteurisation is inconclusive, but it appears to have no effect on some outcomes. Improving the intake of mother’s own milk (MOM) and/or donor HM results in small improvements in morbidity in this population. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
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Open AccessReview Biological and Psychosocial Processes in the Development of Children’s Appetitive Traits: Insights from Developmental Theory and Research
Nutrients 2018, 10(6), 692; https://doi.org/10.3390/nu10060692
Received: 13 April 2018 / Revised: 25 May 2018 / Accepted: 28 May 2018 / Published: 29 May 2018
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Abstract
There has been increasing concern expressed about children’s food intakes and dietary patterns. These are closely linked to children’s appetitive traits (such as disinhibited eating and food fussiness/neophobia). Research has examined both biological and psychosocial correlates or predictors of these traits. There has
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There has been increasing concern expressed about children’s food intakes and dietary patterns. These are closely linked to children’s appetitive traits (such as disinhibited eating and food fussiness/neophobia). Research has examined both biological and psychosocial correlates or predictors of these traits. There has been less focus on possible processes or mechanisms associated with children’s development of these traits and research that links biological and psychosocial factors. There is an absence of research that links biological and psychosocial factors. In the present article, we outline a model intended to facilitate theory and research on the development of appetitive traits. It is based on scholarship from developmental theory and research and incorporates biological factors such as genetic predispositions and temperament as well as psychosocial factors in terms of parent cognitions, feeding styles and feeding practices. Particular attention is directed to aspects such as emotional eating and feeding, self-regulation of energy intake, and non-shared family environments. We highlight the opportunity for longitudinal research that examines bidirectional, transactional and cascade processes and uses a developmental framework. The model provides a basis for connecting the biological foundations of appetitive traits to system-level analysis in the family. Knowledge generated through the application of the model should lead to more effective prevention and intervention initiatives. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
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Open AccessReview Comparison of Growth of Healthy Term Infants Fed Extensively Hydrolyzed Protein- and Amino Acid-Based Infant Formulas
Nutrients 2018, 10(3), 289; https://doi.org/10.3390/nu10030289
Received: 27 December 2017 / Revised: 23 February 2018 / Accepted: 26 February 2018 / Published: 1 March 2018
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Abstract
The aim of this narrative review was to assess published growth data for healthy, term, infants consuming extensively hydrolyzed protein-based (EHF), or amino acid-based formulas (AAF). These data may be of use to clinicians managing infants with medical conditions consuming these products. A
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The aim of this narrative review was to assess published growth data for healthy, term, infants consuming extensively hydrolyzed protein-based (EHF), or amino acid-based formulas (AAF). These data may be of use to clinicians managing infants with medical conditions consuming these products. A search was conducted using key terms: amino acid-based, hydrolysate, hydrolyzed, hydrolysed, infant formula, infant formulae or formulas, baby formula, or formulae or formulas, infant, infants, infantile, and growth. Seven controlled, randomized, prospective growth trials of healthy term infants fed EHFs or AAFs at similar time points during the first four months of age met these and other criteria, including that the trial was published in a peer-reviewed journal, subjects were enrolled by ≤14 days of age and were exclusively formula-fed at entry and throughout the duration of the trial, and infants were assessed at regular intervals with weight measures available ideally at 14 days, one, two, three, and four months of age. Results suggested that healthy infants receiving commonly available EHFs and AAFs do not appear to experience accelerated growth as reported for infants fed many standard formulas. Differences in growth patterns were observed with some formulas supporting normative growth patterns during the first four months but others appearing to support markedly lower growth patterns. These observations should be confirmed in well-designed prospective randomized trials. Until that time, it is recommended that EHFs and AAFs be chosen carefully with individual patient needs considered. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
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