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GASTRIC CASEIN COAGULATION AND POSTPRANDIAL AMINO ACID ABSORPTION OF MILK IS AFFECTED BY MINERAL COMPOSITION: A RANDOMIZED CROSSOVER TRIAL
Abstract
Background and Aims
In vitro studies suggest that gastric casein coagulation and digestion of milk formula under simulated infant conditions is affected by casein micelle mineralisation. Casein micelle mineralisation may thus also impact overall digestion and absorption kinetics in vivo. This study therefore aimed to determine the effect of milk casein micelle mineralisation on milk protein digestion and absorption.
Methods
In a randomized cross-over study healthy males (n =15, age 30.9±13.8 years) were fed low or high casein micelle mineralization milk and underwent gastric magnetic resonance imaging (MRI) scans to determine gastric emptying and the degree of casein coagulation. Blood samples were taken at baseline and up to 5 hours postprandially to determine amino acid absorption kinetics and changes in plasma insulin and glucose.
Results
MRI analyses showed that gastric volume over time did not differ between treatments. However, the degree of casein coagulation was lower for low mineralization milk. Postprandial plasma amino acid kinetics showed that casein-dominant amino acids, such as proline, differed significantly between treatments whereas whey-dominant amino acids, such as leucine, did not. Plasma insulin responses were in line with an initial higher level of branched-chain amino acids in the low mineralization condition although only valine was significantly different.
Conclusions
Mineral composition of milk can influence gastric coagulation with coherent effects on post prandial plasma amino acid kinetics and plasma insulin responses without impacting overall gastric emptying.
BLENDERIZED TUBE FEEDING FOR CHILDREN: A SYSTEMATIC REVIEW OF THE IMPACT ON UPPER GASTRO-INTESTINAL SYMPTOMS
Abstract
Background and Aims
Blenderized tube feeding (BTF) is on the rise among children who require enteral nutrition but the impact on health benefits is not clearly defined. Therefore, we aimed to perform a systematic review on the evidence of BTF on health outcomes. The primary aim was to determine the effect of BTF on upper gastro-intestinal (UGI) symptoms in pediatric patients.
Methods
A systematic review was performed by searching 4 databases (MEDLINE, EMBASE, Cochrane trials and LILACS) for randomised controlled trials (RCT), prospective and retrospective cohort studies and cross-sectional studies reporting on health outcomes in children on BTF (PROSPERO CRD42022306237). No language restrictions were used. Quality assessment was done using the ROBINS-I tool.
Results
A total of 2573 studies were screened on title and abstract. In total, 8 studies (422 patients) fulfilled the inclusion criteria and reported on health outcomes while on BTF. Overall the risk of bias was high. No RCT met the inclusion criteria. All cohort studies reported an improvement in UGI symptoms. An increased oral intake was observed in four studies (40 patients). Three studies reported a decline in the use of acid reduction medication.
Conclusions
There is a lack of high quality research on the health outcomes of BTF. The current available evidence shows that BTF might improve GI symptoms and oral intake.
MICRONUTRIENT INTAKE COMPLIANCE, DIETARY HABITS, AND FOOD TABOOS AMONG PREGNANT WOMEN IN NSUKKA: A DESCRIPTIVE CROSS-SECTIONAL STUDY
Abstract
Background and Aims
Micronutrients are recommended for pregnant women to routinely take during pregnancy to supplement the ones supplied by diet as well as prevent the negative consequences micronutrient deficiency. This study assessed the dietary habit, food taboos, and compliance to micronutrient intake among pregnant women attending ante-natal clinic in Nsukka Local Government.
Methods
The study design was facility-based cross-sectional survey. The population used for the study were pregnant women attending ante-natal care. Seven health care centers in Nsukka Local Government were selected for the study. A structured and validated questionnaire was used to elicit information from 340 participants. The socio-demographic, dietary habit, food taboos, and compliance to micronutrient were assessed. The data was analyzed using descriptive statistics.
Results
The result of the study showed that the respondents who craved specific food substances were 36.5% and those that had no cravings were 63.5%. Food taboos among respondents were 13.5% and those without food taboos were 86.5%. All 340 respondents take routine micronutrient supplements, 69.1% comply to those drugs while 30.9% do not comply. Pregnant women with low dietary diversity were 32% and 2.6% high dietary diversity.
Conclusions
Nutrition in the first one thousand days starts from conception until the child is two years. This study showed that majority of the pregnant women did not have high dietary diversity, and many does not comply with micronutrient intake.
DIETARY DIVERSITY AMONG HIV-EXPOSED AND UNINFECTED COMPARED TO HIV-UNEXPOSED AND UNINFECTED CHILDREN AGED 32-59 MONTHS IN GAUTENG, SOUTH AFRICA.
Abstract
Background and Aims
Little is known about HIV-exposed uninfected (HEU) feeding practices compared to HIV-unexposed and uninfected (HUU) children. We assessed factors associated with dietary diversity among HEU and HUU children in Gauteng, South Africa.
Methods
We tracked 124 mother-baby pairs (62.1% HEU) between 07/2020–02/2021 from a sub-set of 1150 enrolled in the PEAD-Link trial one week after delivery from 10/2016–02/2018. Household dietary diversity (HDD) and child dietary diversity (CDD) were determined by summing unique food groups consumed in the preceding 24 hours. We categorized CDD into inadequate (CDD <4) and adequate (CDD ≥4) based on the minimum acceptable dietary diversity recommended by the WHO. HDD was categorized as inadequate (HDD <6) and adequate (HDD ≥6). Modified Poisson regression, reporting crude prevalence ratios (PR), was used to evaluate CDD and HDD predictors.
Results
Overall, 9.7% of children had inadequate CDD, 8.5% HUU and 10.4% HEU; and 23.4% resided in households with inadequate HDD (31.9% HUU vs 18.2% HEU). Predictors of inadequate CDD were low maternal literacy (PR 2.9, 95%CI: 1.0-8.3), inadequate HDD (PR 9.8, 95%CI: 2.8-34.1), ≥3 children in the household (PR 3.1 vs 1-2 Children, 95 %CI: 1.0-9.1). Predictors of inadequate HDD were low maternal literacy (PR 2.0, 95%CI: 1.1-3.8), living in a secondary home (PR 2.0 vs primary home, 95 %CI: 1.0-3.8), and ≥2 adults in the household (PR 0.2 vs 1 adult, 95 %CI: 0.1-0.4).
Conclusions
Nutrition education programs should be tailored to mothers' literacy levels. Child dietary diversity may be most impacted by interventions to improve household nutritional status.
NUTRITIONAL INEQUALITIES AMONG UNDER-FIVE CHILDREN: A GEOSPATIAL ANALYSIS OF HOTSPOTS AND COLD SPOTS IN 73 LOW- AND MIDDLE-INCOME COUNTRIES
Abstract
Background and Aims
Child undernutrition is a severe health problem in the developing world, which affects children’s development in the long term. This study analyses the extent and patterns of under-five child undernutrition using Demographic and Health Surveys (DHS) for 73 low- and middle-income countries (LMICs).
Methods
First, we mapped the prevalence of undernutrition in the developing world. Second, using the LISA (a local indicator of spatial association) technique, we analyzed the geographical patterns in undernutrition to highlight the localized hotspots (regions with high undernutrition prevalence surrounded by similar other regions), cold spots (regions with low undernutrition prevalence surrounded by similar other regions).
Results
South Asia has the highest under-five child undernutrition rates. The intra-country nutritional inequalities are highest in Burundi (stunting), Kenya (wasting), and Madagascar (underweight). The local indicator of spatial association (LISA) analysis suggests that South Asia, Middle East and North Africa (MENA) region, and Sub-Saharan Africa are undernutrition hotspots and Europe and Central Asia and Latin America, and the Caribbean are undernutrition cold spots (regions with low undernutrition surrounded by similar other regions). Getis Ord-Gi* estimates generally support LISA analysis. Moran’s I and Geary’s C gave similar results about the global patterns of undernutrition. Geographically weighted regressions suggest that several socioeconomic indicators significantly explain child undernutrition.
Conclusions
We found a significant within and across country variation in stunting, wasting and underweight rates among the under-five children’s population. The geospatial analysis also suggested that stunting, wasting, and underweight patterns exhibit clear regional patterns, underscoring the need for coordinated interventions at the regional level.