Longitudinal changes in body weight of breastfeeding mothers in the first year after delivery and its relationship with human milk composition:a combined longitudinal and cross-sectional cohort study

Objective:Postpartum weight retention(PPWR)is a common problem among women after childbirth.The main objectives of this study are to understand the changes in body weight of breastfeeding mothers during long-term follow-up and preliminarily explore the relationship between maternal body weight and human milk composition,including macronutrients,leptin,and adiponectin.Methods:The study included a longitudinal cohort(122 mothers),and a cross-sectional cohort(37 mothers).The human milk,maternal weight,and dietary surveys were collected in the longitudinal cohort at different follow-up time points(1-14 days postpartum,2-4 months postpartum,5-7 months postpartum,and 12-17 months postpartum).The maternal body weight was analyzed using the responses in the survey questionnaires.A milk analyzer based on the mid-infrared spectroscopy(MIRS)was used to determine milk composition,and nutrition analysis software evaluated dietary intakes.In the cross-sectional cohort,participating mothers were asked to provide blood and human milk samples and pertinent information related to maternal body composition.Maternal body composition was measured by bioelectrical impedance analysis(BIA),while ELISA analyzed leptin and adiponectin in milk and serum.Results:At 5-7 months postpartum,the PPWR of breastfeeding mothers was(2.46±3.59)kg.At 12-17 months postpartum,the PPWR was(0.98±4.06)kg.PPWR was found to be negatively correlated with milk fat content within 14 days postpartum and positively correlated at 2-4 months postpartum.In addition,the maternal weight and body muscle mass were positively correlated with leptin and adiponectin in milk.Plasma leptin was positively correlated with the mother’s body weight,body mass index(BMI),FAT percentage,and body fat mass,while plasma adiponectin did not correlate with any parameter.The results also indicate that the PPWR did not correlate with leptin and adiponectin in plasma or milk.Conclusions:Breastfeeding mothers may retain considerable weight gain one year after delivery.Human milk composition may be related to changes in maternal body weight.Leptin and adiponectin in breast milk and leptin in plasma are associated with the maternal body composition.This study supports the notion that maternal nutritional status may affect offspring health through lactation,and future research should focus on exploring weight management of postpartum mothers.

Analysis of the Effects of Maternal Body Mass Index and Gestational Weight Gain on Maternal and Neonatal Outcomes in Twin Pregnancy

Objective:To investigate the effects of maternal body mass index(BMI)and gestational weight gain on maternal and neonatal outcomes in twin pregnancies.Methods:Five hundred cases of twin pregnancies were divided into a low body weight group(68 cases),a normal weight group(355 cases),an overweight group(65 cases),and an obesity group(12 cases)according to the World Health Organization(WHO)Body Mass Index(BMI)classification guidelines Results:Comparison of weight gain during different pregnancies revealed that pregnant women were mainly of low weight and average weight.The higher the BMI before pregnancy,the higher the incidence of excessive weight gain during pregnancy.The incidences of gestational diabetes mellitus(GDM)and premature rupture of membranes in women with low weight gain were significantly higher than those in women with average weight gain and high weight gain(P<0.05).The incidences of gestational hypertension,preeclampsia,and anemia in women with high weight gain were significantly higher than those in women with low weight gain and average weight gain(P<0.05).The incidence of neonatal birth weight,fetal distress,and macrosomia in the high weight gain group was significantly higher than those in the low weight gain and average weight gain groups(P<0.05).The birth weight of newborns in low-weight gain mothers was significantly lower than that of normal-weight gain mothers(P<0.05).Conclusion:Poor maternal and infant outcomes were common in women with insufficient or excessive weight gain during pregnancy.Therefore,for women with twin pregnancies,weight management is crucial to ensure maternal and infant health.

Intoxication Induced by Urea Containing Diets in Broiler Chickens: Effect on Weight Gain, Feed Conversion Ratio, Hematological and Biochemical Profiles

Urea as a source of cheap non-protein nitrogen is used to adulterate fish and meat meals which are basic components of broiler diets. The present study was carried out to elucidate the effects of urea on weight gain, and hematological and biochemical profiles. A total of 48 broiler chicks were randomly allotted into 4 groups, designated Groups 1, 2, 3 and 4 of 12 birds each. Birds in Groups 2, 3 and 4 were fed on diets containing urea at the levels of 1%, 2.5% and 4%, respectively. Birds in Group 1 served as control and were not exposed to urea. Experimentation period was for 3 weeks and experiment was terminated when birds were 42 days of age. Body weight of all intoxicated birds at the various intervals was significantly decreased in comparison with that of the untreated control. Compared with control, all intoxicated broilers manifested significant (P ≤ 0.05) decrease in all hematological parameters involving erythrocytic and total leucocytic counts, Hemoglobin (Hb) and Packed Cell Volume (PCV) on a dose- and time-pattern. In comparison with the control levels, biochemical profile of the intoxicated birds disclosed significant decrease in blood glucose level and significant increase in serum uric acid, urea, Alkaline Phosphatase (ALP) and Lactate Dehydrogenase (LDH) levels. Based upon the present data, it was concluded that the addition of urea to broiler diets bears serious sequences concerning the general health condition, performance, weight gain, and hematological and biochemical profiles.

Composition,function,and timing:exploring the early‑life gut microbiota in piglets for probiotic interventions

Background The establishment of a robust gut microbiota in piglets during their early developmental stage holds the potential for long-term advantageous effects.However,the optimal timeframe for introducing probiotics to achieve this outcome remains uncertain.Results In the context of this investigation,we conducted a longitudinal assessment of the fecal microbiota of 63 piglets at three distinct pre-weaning time points.Simultaneously,we gathered vaginal and fecal samples from 23 sows.Employing 16S rRNA gene and metagenomic sequencing methodologies,we conducted a comprehensive analysis of the fluctuation patterns in microbial composition,functional capacity,interaction networks,and colonization resistance within the gut microbiota of piglets.As the piglets progressed in age,discernible modifications in intestinal microbial diversity,composition,and function were observed.A source-tracking analysis unveiled the pivotal role of fecal and vaginal microbiota derived from sows in populating the gut microbiota of neonatal piglets.By D21,the microbial interaction network displayed a more concise and efficient configuration,accompanied by enhanced colonization resistance relative to the other two time points.Moreover,we identified three strains of Ruminococcus sp.at D10 as potential candidates for improving piglets’weight gain during the weaning phase.Conclusions The findings of this study propose that D10 represents the most opportune juncture for the introduction of external probiotic interventions during the early stages of piglet development.This investigation augments our comprehension of the microbiota dynamics in early-life of piglets and offers valuable insights for guiding forthcoming probiotic interventions.

Effects of Molasses-Urea Supplementation on Weight Gain,Ruminal Fermentation and Major Microbe Populations of Winter-Grazing Sheep in Inner Mongolia

The present experiment was conducted to determine the effects of Molasses-Urea Supplementation （MUS） on weight gain, ruminal fermentation and major microbial populations in sheep on a winter grazing regime in Inner Mongolia. Total 40 sheep, allowed free consumption of MUS after grazing, served as a treatment group, while 30 sheep, fed only by pasture grazing, served as a control group. Ruminal fermentation parameters, consisted of pH, Bacterial Crude Protein （BCP） and ammonia nitrogen （NH3-N） were measured. In addition, numbers of five symbiotic bacteria were investigated. The results showed as follows： the average daily weight gain, concentration of NH3-N and numbers of protozoa were significantly higher （p〈0.05） in the treatment group than those in the control group. Contrastingly, no significant difference was found in BCP concentration and pH between the two groups. At the end of the experiment, the populations of Selenomonas ruminantium, Anaerovibrio lipolytica, Fibrobacter succinogenes, Ruminococcus flaveciens and Ruminococcus albus in the treatment group were significantly higher than those of the control group （p〈0.05）. These results demonstrated that greater weight gain could be induced during winter in Inner Mongolia by improved nutritional status through promotion of microbial populations using urea and sugar.

B Vitamins Can Reduce Body Weight Gain by Increasing Metabolism-related Enzyme Activities in Rats Fed on a High-Fat Diet

B vitamins are enzyme cofactors that play an important role in energy metabolism.The aim of this study was to elucidate whether B vitamin administration can reduce body weight(BW)gain by improving energy metabolism-related enzyme activities in rats fed on a highfat diet.Fifty rats were randomly assigned to one of the following five groups:control group(C),including rats fed on standard rat chow;four treatment groups(H0,H1,H2,and H3),in which rats were fed on a high-fat diet.Rats in the H1 group were treated daily with 100 mg/kg BW thiamine(VB1),100 mg/kg BW riboflavin(VB2),and 250 mg/kg BW niacin(VPP);rats in the H2 group were treated daily with 100 mg/kg BW pyridoxine(VB6),100 mg/kg BW cobalamin(VB12),and 5 mg/kg BW folate(FA);and rats in the H3 group were treated daily with all of the B vitamins administered to the H1 and H2 groups.After 12 weeks,the BW gains from the initial value were 154.5±58.4 g and 159.1±53.0 g in the H1 and C groups,respectively,which were significantly less than the changes in the H0 group(285.2±14.8 g,P〈0.05).In the H0 group,the plasma total cholesterol(CHO)and triglyceride(TG)levels were 1.59±0.30 mmol/L and 1.55±0.40 mmol/L,respectively,which were significantly greater than those in the H1 group(1.19±0.18 mmol/L and 0.76±0.34 mmol/L,respectively,P〈0.05).The activities of transketolase(TK),glutathione reductase,and Na^+/K^+adenosine triphosphatase were significantly increased in the B vitamin-treated groups and were significantly greater than those in the H0 group(P〈0.05).Furthermore,the glucose-6-phosphate dehydrogenase,pyruvic acid kinase,and succinate dehydrogenase activities also were increased after treatment with B vitamins.Supplementation with B vitamins could effectively reduce BW gain and plasma levels of lipids by improving energy metabolism-related enzyme activities in rats,thus possibly providing potential benefits to humans.

Associations of Gestational Diabetes Mellitus and Excessive Gestational Weight Gain with Offspring Obesity Risk

Objective Gestational diabetes mellitus(GDM)and gestational weight gain(GWG)are important risk factors that are known to affect offspring growth,but these outcomes are inconsistent and it remains unknown if both risk factors have a synergetic effect on early childhood growth.The present study aimed to conduct offspring body mass index-for-age Z-scores(BMIZ)trajectories and to evaluate the independent and interactive effect of the status of GDM and excessive GWG on the risks of overweight/obesity from birth to 24 months of age.Methods A total of 7949 mother-child pairs were enrolled in this study.The weight and length of children were measured at birth,6,12,and 24 months of age to calculate BMIZ.Results The status of GDM was positively associated with offspring BMIZ and risk of macrosomia at birth but was not associated with offspring BMIZ or the risks of overweight/obesity at 6,12,and 24 months of age.In contrast,excessive GWG was positively linked to offspring BMIZ,the stable high BMIZ trajectory pattern,and risks of overweight/obesity in the first 24 months of age.These two risk factors also had a significant synergistic effect on macrosomia at birth,but the interactive effect was only significant in boys during the follow-up years in the sex-stratified analyses.Conclusion The maternal GWG was a more pronounced predictor than GDM with relation to BMIZ and risk of overweight/obesity in early childhood.The interactive effect between these risk factors on offspring overweight/obesity may vary by sex.

Association between pre-pregnancy body mass index and gestational weight gain and the risk of preeclampsia:A systematic review and meta-analysis

Objective:To analyze the relationship between body mass index(BMI)before pregnancy and gestational weight gain throughout pregnancy with the incidence of preeclampsia.Methods:This was a systematic review-meta analysis of literature collected from three e-databases:Scopus,PubMed,and Science Direct.Quality assessment was measured with the Effective Public Health Practice Project methods.Meta-analysis was done by calculating the fixed and random-effects of odds ratio(OR)for each BMI category and gestational weight gain as compared with the incidence of preeclampsia.Results:Overweight was associated with a significantly increased risk of preeclampsia(OR=2.152,95%CI 1.363-3.400;P=0.001).Obesity was also associated with a noticeably increased risk of preeclampsia(OR=2.856,95%CI 1.755-4.649;P<0.001).Meanwhile,underweight was associated with a significantly reduced risk of preeclampsia(OR=0.639,95%CI 0.500-0.817;P<0.001)when compared with normal BMI.Pregnant women who gained weight below the standard throughout pregnancy was a protective factor from preeclampsia(OR=0.813,95%CI 0.610-1.083;P=0.157)whereas pregnant women who gained weight above the standard had almost doubled risk of preeclampsia(OR=1.850,95%CI 1.377-2.485;P<0.001).Conclusions:The result of this study affirms the role of overweight-obesity pre-pregnancy,and gestational weight gain above the standard during pregnancy as significant risk factors for developing preeclampsia.

Effects of Pleurotus eryngii Residue on Weight Gain of Chick and Duck

In the present study, Pleurotus eryngii residue was added into conventional feed of Chai chicks and meat-type ducks at different ratios to measure its effects on the production performance of chicks and ducks. The results revealed that the growth performance of chicks and ducks was the best when 20% Pleurotus eryngii residue was added into the feed. Under such condition, the daily weight gain of 8 - 11 and 12 - 15-week-old Chai chicks was increased by 6.8% and 13.5%, and that of 8 - 11 and 12 - 15-week-old ducks was increased by 11.5% and 19.3%, respectively.

The Potential of Duck Hepatitis Virus(DHV-1) Stimulating the Body Weight Gain and the Effects of Silymarin on It in Duckling

To evaluate the effects of duck hepatitis virus-1 （DHV-1） on the body weight gain in duck and the effects of silymarin on it in vivo, 100 10-d-old ducks, both male and female, were collected to be subjected to the test. The experiments were conducted in 8 groups： in group 1-3, the animals were inoculated with 1：105 diluted duck hepatitis virus （DHV-1） infected allantoic fluid and given 0, 30, and 50 mg kg^-1 BW d^-1 silymarin orally, respectively. In group 4-6, the animals were inoculated with 1：5 × 105 diluted DHV-1 infected allantoic fluid and given 0, 10, and 30 mg kg^-1 BW d^-1 silymarin orally, respectively. In group 7, the animals were given 10 mg kg^-1 BW d^-1 silymafin only. Group 8 was the control one treated by injecting sterillized saline into the leg muscles. All the silymarin was given from 0 to 4 d after inoculation of the virus. By the 5th d after inoculation, the vein blood was drawn from the dorsal foot vein and the plasma samples were collected and stored at -20℃. The body weight gain （BWG） was measured from 0 to 10 d after inoculation. The plasma IGF-I, T3, and T4 concentrations were measured by radioimmunoassay （RIA）. At the virus dose of 1：5 ×105 diluted virus infected allantoic fluid, the inoculation of the virus enhanced the BWG significantly compared with that of the control （P〈 0.01）, while 10-50 mg kg^-1 BW d^-1 silymarin could counteract the effects of the virus on the BWG dose-dependently. The plasma IGF-I levels showed no correlation with the BWG, but the T3 levels showed a same tropism with the body weight gain. The present results indicated that sublethal DHV-1 enhanced the body weight gain of ducklings significantly, and the silymarin could counteract this effect in vivo.

Postnatal weight gain in very low birth weight infants in Beijing and the risk of retinopathy of prematurity

AIMTo analyze the low weight gain (WG) from birth to 4 and 6wk of life to predict the development of retinopathy of prematurity (ROP) among very low birth weight (VLBW) preterm babies.METHODSThree hundred and three newborns with VLBW were analyzed. Body weight measurements were recorded weekly. In all patients, the proportion of the WG was defined as the preterm weight measured at the 4th and 6th weeks of life minus the birth weight (BW) divided by the BW. Other risk factors for ROP were also analyzed.RESULTSMean gestational age and mean BW of the whole cohort were 29.56±1.44wk and 1270.58±176.18g respectively. WG proportion at 4wk postnatal age (18.89%±13.58%) were significantly lower in infants with ROP (P=0.003). WG proportion at 6wk was not different between ROP and no ROP group (42.48%±20.36% vs 46.43%±15.65% P=0.118). When all the other risk factors significant for ROP were included in the logistic regression poor WG did not arise as an independent risk factor. Area under the ROC curve was 0.591 (95%CI: 0.515-0.666; P=0.016). For ROP, the best discriminative cutoff of 18.06% of the proportional WG at the 4th week over the BW, sensitivity and specificity values were 67.3% and 50.0% respectively.CONCLUSIONLow WG proportion in the first 4wk of life is maybe an additional predictor of ROP in very low BW infants. Preterm babies with low BW and low WG proportion should be followed closely for ROP.

Effects of Dietary Carbohydrate Sources on Daily Weight Gain and Digestive Enzyme Activities of Juvenile Peanut Worm(Sipunculus nudus)

In the study,glucose,sucrose,dextrin,tapioca starch,potato starch,corn starch and gelatinized corn starch were selected to make the diets with same nitrogen and lipid,and Juvenile peanut worms( Sipunculus nudus) were fed with the diets came from different carbohydrate sources,effects of diets with different carbohydrate sources on daily weight gain and digestive enzyme activities of S. nudus were studied. Results showed that diets with different carbohydrate sources had significant influences on daily weight gain and digestive enzyme activities of S. nudus( P < 0. 05). Daily weight gain in gelatinized corn starch group was significantly higher than that in other groups( P < 0. 05); daily weight gain in glucose group was significantly lower than that in other groups( P < 0. 05); daily weight gain in the three ungelatinized starch groups was significantly higher than that in glucose,sucrose and dextrin groups( P < 0. 05). Analysis of digestive enzyme activities showed that dietary carbohydrate sources had significant influences on digestive enzyme activities of S. nudus( P < 0. 05). Protease activities and amylase activities of S. nudus in sucrose group were the highest,which were significantly higher than that in the other groups( P < 0. 05); lipase activities of S. nudus in glucose group were the lowest,which were significantly lower than that in other groups( P < 0. 05). In conclusion,growth-promoting effects of macromolecules carbohydrates( starch) were better than that of disaccharide( sucrose) and monosaccharide( glucose),which of gelatinized starch were better than that of ungelatinized starch.

Design and application of weight gain graphs based on Bandura’s self-efficacy theory for patients on maintenance haemodialysis

Purpose:To design interdialytic and daily weight gain graphs for patients on maintenance haemodialysis and to evaluate their effect on patient adherence to restricted fluid intake.Methods:Forty-five patients on maintenance haemodialysis were recruited from August to October 2012.The graphs were applied for 12 weeks based on Bandura’s self-efficacy theory.Adherence to restricted fluid intake,dialysis adequacy,and satisfaction were compared before and after the graphs were applied.Results:Adherence to restricted fluid intake increased from 53.3%to 91.1%;the mean rate of urea clearance(Kt/V)decreased from 1.197 to 1.311,and the qualified rate increased from 42.5%to 70%.The rate of adherence was 86.77%;acceptance and satisfaction rates were 100%.Conclusion:It is acceptable to apply the graphs clinically for subsequent effective improvement of adherence to restricted fluid intake,promoting dialysis adequacy,and increasing patient satisfaction.Therefore,clinical application of the graphs is worthwhile.

Effect of High Digestible Essential Amino Acids on Weight Gains and Carcass Compositions of Laying Hens

The objective of this study was to evaluate the effect of high digestible essential amino acids （DEAA） on weight gains and carcass compositions of laying hens. Three hundred and sixty lsa Brown hens in five replications per treatment （12 birds/replicate） were used. Six experimental diets which contained of treatment 1 （negative control） as the conventional layer diet are recommended by NRC （1994） while another dietary treatments; treatments 2 （positive control）, 3, 4, 5 and 6 were formulated to meet 100%, 110%, 120%, 130% and 140% of Standard Ileal Digestible Lysine Levels （SIDLL） without crude protein minimum, while methionine （Met）, threonine （Thre） and tryptophan （Tryp） as related by Ideal Protein Concept （IPC） which suggested by NRC （1994） and INRA （2004）. However, metabolizable energy （ME）, calcium and available phosphorus （Avai P） levels of all experimental diets were meet requirement as recommended by NRC （1994）. The experiment was assigned in CRD and laying hens fed dietary treatments from 28 to 44 weeks of age and cage was the experimental unit （3 hens/cage）. The result shown that percentages of thigh （TP）, feet （FP）, drumstick （DP）, heart （HP）, liver （LP） and gizzard （GP） were not affected by dietary treatment. However, weight gains （WG） and percentage of dressed weight （DWP）, eviscerate weight （EWP） and breast （BP） were increased （P 〈 0.05） and abdominal fat was reduced （P 〈 0.05） when birds fad diets containing 130% of SIDLL as compared with control group and another dietary treatments, when increasing the DEAA levels upper to 130% of SIDLL. The result indicated that diets formulated without crude protein minimum and increased DEAA resulted in increasing the efficiency of converting metabolizable energy （ME） to net energy （NE） for increasing weight gain and improved meat products while fat deposition in carcass composition was reduced.

Bronchopulmonary Dysplasia in Premature Infants with Very Low Birth Weight: A Single Centre Retrospective Study in China

To investigate bronchopulmonary dysplasia (BPD) and its treatment with dexamethasone (DEX) in premature infants with birth weight (BW) < 1500 g. We retrospectively reviewed the records of preterm infants admitted to the Division of Neonatology, the Second Xiangya Hospital, Central South University between September 2011 and December 2014. Patients were excluded if they needed oxygen therapy but were lost to follow-up at ≤36 weeks post-menstrual age (PMA) or <56 days after birth, or they had severe congenital anomalies. The incidence of BPD was 18% (37/212). Gestational age (GA) was <32 weeks in all BPD patients. GA, BW, and Apgar scores were lower and hospitalization duration and pulmonary surfactant (PS) use were higher in the BPD group than in the non-BPD group (P < 0.05). Risk factors for BPD included neonatal respiratory distress syndrome, neonatal pneumonia, positive sputum culture, pulmonary hemorrhage, respiratory failure. Multivariate logistic regression revealed that GA (odds ratio [OR]: 0.479, P = 0.004) and neonatal respiratory distress syndrome (OR: 6.146, P = 0.043) were independent risk factors for BPD. DEX was administered to 26 patients after the diagnosis of BPD. After one and two weeks of DEX treatment, the oxygen requirement had significantly reduced compared to the week prior to treatment (P < 0.05), while during treatment, the weight gain rate and weight gain efficiency slower significantly than that during either of the two preceding weeks (P < 0.001). These results suggest that low GA was the most important risk factor for BPD, DEX reduced oxygen dependency but decreased weight gain.

Analysis on Family History of Diabetes, Weight Gain during Pregnancy and Pre-pregnancy Body Mass Index on 82 Pregnant Women with Gestational Diabetes Mellitus

Objective:To investigate the effects of family history of diabetes mellitus,Gestational Weight Gain(GWG)and Body Mass Index(BMI)before pregnancy on Gestational Diabetes Mellitus(GDM).Method:82 pregnant women with GDM who were hospitalized and delivered in the obstetrics department of our hospital from September 2017 to September 2019 were selected as the observation group,and 60 pregnant women with normal glucose tolerance test in the same period were selected as the control group;The relationship between family history of diabetes,weight gain during pregnancy and pre-pregnancy Body Mass Index and GDM were analyzed.Results:The age,pre-pregnancy weight and weight gain during pregnancy were significantly higher in the observation group than in the control group(P<0.05),and the family history of diabetes and pre-pregnancy Body Mass Index were higher in the observation group than in the control group(P<0.05),and the differences were statistically significant.Conclusion:It is suggested that family history of diabetes is related to gestational diabetes mellitus.Excessive GWG growth during pregnancy and high Body Mass Index before pregnancy may increase the risk of gestational diabetes mellitus in pregnant women.

Effect of individualized nutrition interventions on clinical outcomes of pregnant women with gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)can lead to excessive pregnancy weight gain(PWG),abnormal glucolipid metabolism,and delayed lactation.Therefore,it is necessary to provide appropriate and effective interventions for pregnant women with GDM.AIM To clarify the effects of individualized nutrition interventions on PWG,glucolipid metabolism,and lactation in pregnant women with GDM.METHODS The study population consisted of 410 pregnant women with GDM who received treatment at the Northern Jiangsu People's Hospital of Jiangsu Provinceand Yangzhou Maternal and Child Health Hospital between December 2020 and December 2022,including 200 who received routine in-terventions[control(Con)group]and 210 who received individualized nutrition interventions[research(Res)group].Data on PWG,glucolipid metabolism[total cholesterol,(TC);triglycerides(TGs);fasting blood glucose(FPG);glycosylated hemoglobin(HbA1c)],lactation time,perinatal complications(cesarean section,premature rupture of membranes,postpartum hemorrhage,and pregnancy-induced hypertension),and neonatal adverse events(premature infants,fetal macrosomia,hypo-glycemia,and respiratory distress syndrome)were collected for comparative analysis.RESULTS The data revealed markedly lower PWG in the Res group vs the Con group,as well as markedly reduced TG,TC,FPG and HbA1c levels after the intervention that were lower than those in the Con group.In addition,obviously earlier lactation and statistically lower incidences of perinatal complications and neonatal adverse events were observed in the Res group.CONCLUSION Individualized nutrition interventions can reduce PWG in pregnant women with GDM,improve their glucolipid metabolism,and promote early lactation,which deserves clinical promotion.

Maternal weight and its association with risk of overweight in offspring:a trajectory analysis from a birth cohort in China

Background Most studies on the association of maternal pregnancy weight with offspring weight trajectory have a short follow-up time.This study aimed to explore the associations of maternal prepregnancy body mass index(BMI)and gestational weight gain(GWG)with childhood weight trajectories in a 7-year birth cohort.Methods A total of 946 mother–child pairs(467 boys and 479 girls)from a longitudinal birth cohort in Tianjin City,China,were included in this study,ranging from pregnancy to offspring at 7 years.The outcome variable was defined as overweight or not overweight in offspring at the last round.A group-based trajectory model was applied to identify childhood BMI trajectory groups.Results Five discrete BMI trajectory groups were identified and characterized as constant underweight(25.2%),constant normal weight(42.8%),and high or increasing trajectory[at risk of overweight(16.9%),progressive overweight(11.0%)and progressive obesity(4.1%)].Maternal prepregnancy overweight was associated with 1.72(95%CI 1.14–2.60,P=0.01)to 4.02(95%CI 1.94–8.36,P<0.001)times the risk of all high or increasing trajectory groups,and excessive GWG was related to groups at risk of overweight[relative risk ratio(RRR)2.09,95%CI 1.27–3.46,P=0.004]and progressive obesity(RRR 3.33,95%CI 1.13–9.79,P=0.029).Children in all high or increasing trajectory groups were associated with greater overweight risk at the last round[risk ratios(RRs)ranged from 3.54(95%CI 2.53–4.95,P<0.001)to 6.18(95%CI 4.05–9.42,P<0.001)].Conclusion Maternal prepregnancy overweight and excessive gestational weight gain were associated with increasing or high-level childhood body mass index trajectories as well as a greater risk of overweight at 7 years.

Role of a probiotic (Saccharomyces boulardii) in management and prevention of diarrhoea

AIM： To assess the efficacy and safety of Saccharomyces boulardii （S. boulardii） in acute watery diarrhoea and its role in reducing the frequency of episodes of diarrhoea in subsequent two months. METHODS： Children from 2 mo to 12 years of age, with acute diarrhoea were selected according to inclusion criteria and randomised in S. boulardii group （treated with ORS, nutritional support and S. boulardii, 250 mg bid） and in control group （treated with ORS and nutritional support only）. Active treatment phase was 5 d and each child was followed for two months afterwards. Frequency and consistency of stools as well as safety of drug was assessed on every visit. A comparison of two groups was done in terms of number of diarrhoeal episode in subsequent two months. RESULTS： There were fifty patients in each group. Baseline characteristics such as mean age and the average frequency of stools were comparable in S. boulardii and control group at the time of inclusion in the trial. By d 3 it reduced to 2.7 and 4.2 stools per d respectively and by d 6 it reduced to 1.6 （5. boulardii Group） and 3.3 （control group）. The duration of diarrhoea was 3.6 d in S. boulardii group whereas it was 4.8 d in control group （P = 0.001）. In the following two months, S. boulardii group had a significantly lower frequency of 0.54 episodes as compared to 1.08 episodes in control group. The drug was well accepted and tolerated. There were no reports of the side effects during treatment period CONCLUSION： S. boulardii significantly reduces the frequency and duration of acute diarrhoea. The consistency of stool also improves. The drug is well-tolerated.

The effect of an early oral stimulation program on oral feeding of preterm infants

Purpose:To evaluate the effect of an oral stimulation program on preterm infants.Methods:Preterm infants(n=72)were randomly assigned to experimental and control groups.Controls(n=36)received routine care while the experimental group(n=36)received oral stimulation in addition to routine care.Postmenstrual age,total intake volume,body weight,the transition time from initiation of oral feeding to full oral feeding and feeding efficiency were calculated.Results:Postmenstrual age and full oral feeding weight were significantly lower in the experimental group(p<0.05).The time from initiation of oral feeding to full oral feeding was significantly shorter in the experimental group(p<0.05)while feeding efficiency was higher in the experimental group(p<0.05)compared to controls.No significant differences existed in hospital stay length or weight gain rate.Conclusions:An early oral stimulation program is beneficial in preterm infants.