Update on nutritional status,body composition and growth in paediatric inflammatory bowel disease

Growth and nutritional status are important issues in paediatric inflammatory bowel disease(IBD).While linear growth is easy to assess,nutritional status is more complicated,with reports often compromised by the use of simple measures,such as weight and the body mass index,to assess nutritional status rather than more appropriate and sophisticated techniques to measure body composition.This review is an update on what is currently known about nutritional status as determined by body composition in paediatric IBD.Further,this review will focus on the impact of biologics on growth in paediatric IBD.Significant lean mass deficits have been reported in children with IBD compared with controls,and there is evidence these deficits persist over time.Furthermore,data imply that gender differences exist in body composition,both at diagnosis and in response to treatment.With respect to growth improvements following treatment with biologics,there are conflicting data.While some studies report enhancement of growth,others do not.The relationship between disease severity,impaired growth and the requirement for biologics needs to be considered when interpreting these data.However,key features associated with improvements in growth appear to be successful clinical response to treatment,patients in early stages of puberty,and the presence of growth failure at the onset of treatment.

Double Burden of Malnutrition: Toxic Metals in Breast Milk May Limit the Amounts of Micronutrients Available to Infants through Breast Milk

Background: The amounts of micronutrients in the diets of infants, and the factors that influence them needs to be monitored at the population level in order to avert detrimental developmental defects that impose lifetime-limitations on an infant’s regulatory and defense systems. This study therefore, sought to evaluate if increasing levels of the toxic metals, Hg, Pb and Cd in breast milk will result in reducing amounts of the micronutrients Zn, Se and Cu in breast milk. Methods: Breast milk samples of 114 women living in two mining areas (57 women each) in Ghana, whose babies’ amounts of breast milk intake at three months postpartum, and amounts of toxic metals had previously been determined in a prospective study, were analyzed for micronutrients by a combination of acid and microwave digestion, and quantifications were by two different modes (hydrogen and helium) of Octapole Reaction System Inductively Coupled Plasma Mass Spectrometer (7500 ce. Agilent), equipped with an ASX-510 Auto-sampler (Cetac). Results: All the breast milk specimen collected contained detectable amounts of Cu, Zn, both at levels less than have been previously reported, and Se. For specimen that did not contain Pb the amount of Se ranged from about 110 to 245 ng/g of milk, however, as the amount of Pb increased, the corresponding highest detected amount of Se reduced steeply, resulting in a right-angle triangle-shaped scatter plot. Similar relationships were observed between other toxic metals and micronutrients studied. A curve fitting regression analysis showed significant quadratic and cubic relationships between the amounts of Hg and Se, as well as between Pb, As and Cu. Conclusion: The results clearly suggest a double burden of malnutrition in these mining areas, where high loads of maternal toxic metals in breast milk, related significantly with a progressive reduction in the amounts of the micronutrients Cu and Se in breast milk, potentially reducing in infants’ intake of these micronutrients.

To Blend or Not to Blend? Anxiety Buffering Effects of Essential Oil Aromas

Essential oils of pure lavender and lavender blends have been employed as potential anxiolytic aromas in aromatherapy, but a direct comparison of their effectiveness is lacking. The current study investigated the effects of aroma on induced anxiety in non-clinical adults, comparing pure lavender, a commercially available blend and a no aroma control. An experimental, quantitative, mixed factorial design with an opportunity sample of 60 participants was employed. Participants were randomly allocated to three equal groups, one tested in a room infused with lavender aroma, the second with the doTerra Peace® blend, and the third free from any aroma. Participants’ state anxiety scores were measured before and after a novel video-based anxiety induction procedure. Data analysis revealed that the anxiety induction was successful and that both aromas delivered small to medium-sized buffering effects compared to no aroma. The findings add to a small body of research in an area where the practice is global yet has limited scientific evaluation. Future studies utilising brain imaging and blood serum analysis to investigate the anxiolytic mechanism of aromas would be beneficial to further our understanding.

Omega-3多不饱和脂肪酸与早产儿

近 10多年来 ,关于Omega - 3多不饱和脂肪酸在早产儿神经及视功能发育中的研究已经有了相当的进展。早产儿随机临床试验对这一领域的发展做了较为详尽的阐述。发现Omega - 3多不饱和脂肪酸的添加有益于早产儿神经及视功能的发育 ,但也发现它对早产儿的生长发育有一定的副作用 ,而同时添加AA减少了不利影响。某些混淆因素如出生前早产儿母亲皮质激素的注射可能影响研究结果。在提倡早产儿饮食中添加Omega - 3多不饱和脂肪酸之前我们还需要更多的研究 ,以追踪及评估婴幼儿的长期预后。

Diet,ageing and genetic factors in the pathogenesis of diverticular disease

Diverticular disease(DD) is an age-related disorder of the large bowel which may affect half of the population over the age of 65 in the UK.This high prevalence ranks it as one of the most common bowel disorders in western nations.The majority of patients remain asymptomatic but there are associated life-threatening co-morbidities, which, given the large numbers of people with DD, translates into a considerable number of deaths per annum.Despite this public health burden, relatively little seems to be known about either the mechanisms of development or causality.In the 1970s, a model of DD formulated the concept that diverticula occur as a consequence of pressureinduced damage to the colon wall amongst those with a low intake of dietary fiber.In this review, we have examined the evidence regarding the influence of ageing, diet, inflammation and genetics on DD development.We argue that the evidence supporting the barotrauma hypothesis is largely anecdotal.We have also identified several gaps in the knowledge base which need to be filled before we can complete a model for the etiology of diverticular disease.

Metabolomics as a diagnostic tool in gastroenterology

Metabolomics has increasingly been applied in addition to other "omic" approaches in the study of the pathophysiology of different gastrointestinal diseases.Metabolites represent molecular readouts of the cell status reflecting a physiological phenotype.In addition,changes in metabolite concentrations induced by exogenous factors such as environmental and dietary factors which do not affect the genome,are taken into account.Metabolic reactions initiated by the host or gut microbiota can lead to "marker" metabolites present in different biological fluids that allow differentiation between health and disease.Several lines of evidence implicated the involvement of intestinal microbiota in the pathogenesis of inflammatory bowel disease(IBD).Also in irritable bowel syndrome(IBS),a role of an abnormal microbiota composition,so-called dysbiosis,is supported by experimental data.These compositional alterations could play a role in the aetiology of both diseases by altering the metabolic activities of the gut bacteria.Several studies have applied a metabolomic approach to identify these metabolite signatures.However,before translating a potential metabolite biomarker into clinical use,additional validation studies are required.This review summarizes contributions that metabolomics has made in IBD and IBS and presents potential future directions within the field.

Identification of a Native Novel Oncolytic Immunoglobulin on Exfoliated Colon Epithelial Cells: A Bispecific Heterodimeric Chimera of IgA/IgG*

Understanding the nature of cell surface markers on exfoliated colonic cells is a crucial step in establishing criteria for a normally functioning mucosa. We have found that colonic cells isolated from stool samples (SCSR-010 Fecal Cell Isolation Kit, NonInvasive Technologies, Elkridge, MD), preserved at room temperature for up to one week, with viability of >85% and low levels of apoptosis (8% - 10%) exhibit two distinct cell size subpopulations, in the 2.5 μM - 5.0 μM and 5.0 μM - 8.0 μM range. In addition to IgA, about 60% of the cells expressed a novel heterodimeric IgA/IgG immunoglobulin that conferred a broad-spectrum cell mediated cytotoxicity against tumor cells. In a cohort of 58 subjects the exclusive absence of this immunoglobulin in two African-Americans was suggestive of a germline deletion. Serial cultures in stem cell medium retained the expression of this heterodimer. Since a majority of the cystic cells expressed the stem cell markers Lgr5 and Musashi-1 we termed these cells as gastrointestinal progenitor stem cells (GIP-C**). CXCR-4, the cytokine co-receptor for HIV was markedly expressed. These cells also expressed CD20, IgA, IgG, CD45, and COX-2. We assume that they originated from mature columnar epithelium by dedifferentiation. Our observations indicate that we have a robust noninvasive method to study mucosal pathophysiology and a direct method to create a database for applications in regenerative medicine.

The Effect of Antiretroviral Therapy (ART) on Body Composition and Clinical Markers of Lipodystrophy in HIV-Infected Children Assessed in Follow-Up Study

Objectives: Antiretroviral therapy (ART) has been associated with lipodystrophy in children. We evaluated changes in various anthropometric measurements for the assessment of lipodystrophy and assessed whether there was an association with use of protease inhibitors (PI), non-PI containing ART and/or stavudine (d4T). Methods: Eighty-five HIV-infected children attending the HIV clinic at Great Ormond Street Hospital (GOSH) were included. The average follow-up was 8.4 months (range 3 - 12 months). Body fat redistribution was assessed by anthropometric measurements including skinfold thickness and circumferences of upper and lower limbs. Measurements were converted to age- and sex-adjusted z-scores through development stages including puberty. Results: Sixty children had taken ART;37 received PI-containing;38 received d4T;25 had never been treated. In the studied population, clinically important changes with decreases in biceps (BSF), subscapular skinfolds and total body fat (4SFT) over period of 12 months were observed. Some increase was noticed in triceps skinfolds (TSF). Limbs circumferences remained at the same level. Further we looked at 4 months basis changes in anthropometric measurements stratified by baseline ART. Generally z-scores of anthropometric measurements were lower in therapy naive children when compared to ART groups. PI-based ART regimens resulted in significant increases in BSF with a trend towards increases in TSF, suprailiac and 4SFT. Mid-arm and thigh circumferences were higher in PI compared to naive group. Similarly, significant changes in BSF z-scores were associated with d4T use. Increases were seen in TSF and mid-arm circumference and decreases were observed in subscapular skinfolds and calf circumference z-scores. Conclusions: Body fat redistribution in HIV-infected children with sub-clinical lipodystrophy could be detected by anthropometric measurements, particularly when PI or d4T is included in ART. Over time, changes with increase in arm and trunk fat, and no change or decrease in leg fat were more pronounced among ART-receiving children.

A Pilot Study of the Acute Ingestion of No. 1 Rosemary Water: Evidence of Cognitive, Physiological and Subjective Effects in Healthy Adults

This study investigated the potential impact of the acute ingestion of No. 1 Rosemary water—a commercially available carbonated water containing an extract of Rosemary (Rosmarinus officinalis). Twenty healthy adults were randomly allocated to consume either 330 ml of No. 1 Rosemary water or plain carbonated water. They then completed a series of subjective measures and cognitive tasks including a fifteen-minute session on a stress inducing multi-tasking framework, followed by a second completion of the subjective measures. Heart rate and blood pressure were monitored throughout the procedure. Given the pilot nature of the study, analysis of the data eschewed significance testing for the calculation of Cohen’s d measure of effect sizes. These revealed a number of small enhancement effects on cognition, consistent with those found previously for the inhalation of the aroma of Rosemary essential oil, and oral administration of dried herb. Of particular interest here are the reduced subjective evaluations of stress, and the blunted physiological reactivity noted for heart rate and blood pressure, which represent novel findings in this area. Taken together the data suggest further investigation of this product is warranted with regard to its potential beneficial properties.

Aromas of <i>Salvia</i>Species Enhance Everyday Prospective Memory Performance in Healthy Young Adults

Research has previously demonstrated that aromas of both Salvia officinalis and Salvia lavandulaefolia are capable of modulating aspects of retrospective memory, attention and mood. This study is the first to report the potential for these aromas to enhance everyday prospective memory performance in healthy young adults. In an independent groups design, three conditions, Salvia officinalis aroma, Saliva lavandulaefolia aroma and no aroma were employed with 45 healthy volunteers in each condition. Prospective memory performance was assessed using the Prospective Remembering Video Procedure. Data analysis revealed that the Salvia officinalis aroma group performed significantly better than the control group on both event and action subscales of the prospective memory task. Saliva lavandulaefolia aroma only led to enhancement for the event measure when compared to controls. No differences were found between the aroma conditions. These findings offer support for those previously reported for the effects of the aromas of Salvia sp. on cognition and again demonstrate differential effects of the two aromas. The results are considered in terms of pharmacological mechanisms.

婴幼儿身体总水量的预测

Background: In paediatric clinical practice treatment is often adjusted in rel ation to body size, for example the calculation of pharmacological and dialysis dosages. In addition to use of body weight, for some purposes total body water ( TBW) and surface area are estimated from anthropometry using equations developed several decades previously. Whether such equations remain valid in contemporary populations is not known. Methods: Total body water was measured using deuteriu m dilution in 672 subjects (265 infants aged < 1 year; 407 children and adolesce nts aged 1-19 years) during the period 1990-2003. TBW was predicted (a) using published equations, and (b) directly from data on age, sex, weight, and height. Results: Previously published equations, based on data obtained before 1970, si gnificantly overestimated TBW, with average biases ranging from 4%to 11%. For all equations, the overestimation of TBW was greatest in infancy. New equations were generated. The best equation, incorporating log weight, log height, age, an d sex, had a standard error of the estimate of 7.8%. Conclusions: Secular trend s in the nutritional status of infants and children are altering the relation be tween age or weight and TBW. Equations developed in previous decades significant ly overestimate TBW in all age groups, especially infancy; however, the relation between TBW and weight may continue to change. This scenario is predicted to ap ply more generally to many aspects of paediatric clinical practice in which dosa ges are calculated on the basis of anthropometric data collected in previous dec ades.

Importance of adapted digestion conditions to simulate in vitro lipid digestion of broilers in different life stages

In vitro digestion studies demonstrate large potential to gain more and quicker insights into the underlying mechanisms of feed additives,allowing the optimization of feed design.Unfortunately,current in vitro digestion models relevant for broiler chickens lack sufficient description in terms of protocols and standardisation used.Furthermore,no distinction is made between the different life phases of these animals(starter,grower,and finisher).Hence,our research aimed to establish adapted in vitro digestion conditions,corresponding to the 3 life phases in broilers,with specific focus on lipid digestion.The effect of 3 different bile salt concentrations of 2,10,and 20 mM,and 3 different lipase activities of 5,20,and 100 U/mL,on in vitro lipid digestion kinetics were evaluated using a full factorial design.These values were selected to represent starter,grower,and finisher birds,respectively.Our findings showed that the extent of lipid digestion was mainly influenced by lipase activity.The rate of lipid digestion was affected by an interplay between bile salt concentration and lipase activity,due to possible lipase inhibition at certain bile salt concentrations.Overall,this work resulted in 3 in vitro lipid digestion models representative for starter,grower,and finisher birds.In conclusion,this research showed the impact of adapted in vitro digestion conditions on lipid digestion kinetics and thus the need for these conditions relevant for each life phase of broilers.

Negative Feedback Regulation of Auxin Signaling by ATHB8/ACL5-BUD2 Transcription Module

The role of auxin as main regulator of vascular differentiation is well established, and a direct correlation between the rate of xylem differentiation and the amount of auxin reaching the （pro）cambial cells has been proposed. It has been suggested that thermospermine produced by ACAULIS5 （ACL5） and BUSHY AND DWARF2 （BUD2） is one of the factors downstream to auxin contributing to the regulation of this process in Arabidopsis. Here, we provide an in-depth characterization of the mechanism through which ACL5 modulates xylem differentiation. We show that an increased level of ACL5 slows down xylem differentiation by negatively affecting the expression of homeodomain-leucine zipper （HD- ZIP） III and key auxin signaling genes. This mechanism involves the positive regulation of thermospermine biosynthesis by the HD-ZIP III protein ARABIDOPSIS THALIANA HOMEOBOX8 tightly controlling the expression of ACL5 and BUD2. In addition, we show that the HD-ZIP III protein REVOLUTA contributes to the increased leaf vascularization and long hypocotyl phenotype of acl5 likely by a direct regulation of auxin signaling genes such as LIKE AUXIN RESISTANT2 （LAX2） and LAX3. We propose that proper formation and differentiation of xylem depend on a balance between positive and negative feedback loops operating through HD-ZIP III genes.

Gastric and small intestinal lipid digestion kinetics as affected by the gradual addition of lipases and bile salts

We studied the effect of evolving from static in vitro digestion conditions towards the gradual addition of essential digestive compounds for lipid digestion.Two oil-in-water emulsions were considered:a low(5%w/w)and high(20%w/w)triolein-based emulsion with identical surfactant-to-oil ratio(0.2).Emulsions were subjected to in vitro static digestion conditions or gradual gastric lipase addition,gradual pancreatic lipase addition,and/or gradual bile salt addition.For these three latter cases,similar amounts of gastric/pancreatic lipase and/or bile salts were provided as in the static case,however divided over 4 doses added during the first 30 min of each digestive phase.For the low-lipid emulsion,gradually adding lipases and bile salts did not significantly affect lipolysis kinetics.This can be related to the sufficient amounts of digestive compounds present even in the smallest initial dose.For the high-lipid emulsion,the gradual addition of bile salts significantly reduced the lipolysis rate.Bile salts are essential to remove lipid digestion products from the interface and thus allow the continuation of the lipid digestion process at the interface.Oppositely,the lipolysis extent after 2 h of small intestinal phase was not significantly influenced by the digestion approach.This is again explained by the simple nature of the emulsions studied and the excess of lipase even in the smallest initial dose.Overall,this work showed that evolving towards more(semi-)dynamic digestion conditions can impact(lipid)digestion kinetics,even for relatively simple food compositions,and is of interest to obtain more physiological relevant digestion kinetics.

个体化营养与健康

Jose Ordovas及其同事认为,根据个体特征和行为进行个体化营养干预具有前景,但在实施之前还需要做更多的工作。膳食因素公认是导致心脏病、卒中、2型糖尿病、癌症等常见疾病的主要因素之一1-3。尽管已知疾病与膳食模式相关联.试图改变膳食习惯进而影响公众健康和福祉的干预措施仍收效甚微。对于能够影响健康结果的行为,将干预措施个体化可能更凑效4-5,在本文中我们考量了个体化营养的相关证据。