Dietary patterns of infants and toddlers are associated with nutrient intakes

Dietary patterns are a useful summary measure of diet. Few studies have examined the nutrient profiles underpinning the dietary patterns of young children. The study aim is to determine whether dietary patterns at 6 and 15 months of age are associated with nutrient intakes at 8 and 18 months, respectively. Participants were children from the Avon Longitudinal Study of Parents and Children who had complete dietary pattern and nutrient intake data (n = 725 at 6–8 months, n = 535 at 15–18 months). The association between tertiles of dietary pattern scores and nutrient intake was examined using a non-parametric test for trend. Scores on the home-made traditional pattern (6–8 months) were positively associated with median energy intake. Each dietary pattern had different associations with energy-adjusted intakes of macro- and micro-nutrients. At both times, the discretionary pattern was positively and the ready-prepared baby foods pattern was negatively associated with sodium intake. At 6–8 months, calcium and iron intakes decreased across scores on the home-made traditional and breastfeeding patterns, but increased across the ready-prepared baby food patterns. These findings highlight that dietary patterns in infants and toddlers vary in their underlying energy and nutrient composition.Lisa G. Smithers, Rebecca K. Golley, Laima Brazionis, Pauline Emmett, Kate Northstone and John W. Lync

Associations with sight-threatening diabetic macular oedema among Indigenous adults with type 2 diabetes attending an Indigenous primary care clinic in remote Australia: a Centre of Research Excellence in Diabetic Retinopathy and Telehealth Eye and Associated Medical Services Network study

Objective To identify factors associated with sight-threatening diabetic macular oedema (STDM) in Indigenous Australians attending an Indigenous primary care clinic in remote Australia. Methods and analysis A cross-sectional study design of retinopathy screening data and routinely-collected clinical data among 236 adult Indigenous participants with type 2 diabetes (35.6% men) set in one Indigenous primary care clinic in remote Australia. The primary outcome variable was STDM assessed from retinal images. Results Age (median (range)) was 48 (21–86) years, and known diabetes duration (median (range)) was 8.0 (0–24) years. Prevalence of STDM was high (14.8%) and similar in men and women. STDM was associated with longer diabetes duration (11.7 vs 7.9 years, respectively; p300 mg/mmol) (20.6 vs 5.7%, respectively; p=0.014) and chronic kidney disease (25.7 vs 12.2%, respectively; p=0.035). Some clinical factors differed by sex: anaemia was more prevalent in women. A higher proportion of men were smokers, prescribed statins and had increased albuminuria. Men had higher blood pressure, but lower glycated Haemoglobin A1c (HbA1c) levels and body mass index, than women. Conclusion STDM prevalence was high and similar in men and women. Markers of renal impairment and longer diabetes duration were associated with STDM in this Indigenous primary care population. Embedded teleretinal screening, known diabetes duration-based risk stratification and targeted interventions may lower the prevalence of STDM in remote Indigenous primary care services.Trial registration number Australia and New Zealand Clinical Trials Register: ACTRN 12616000370404.Laima Brazioni, Anthony Keech, Christopher Ryan, Alex Brown, David O'Neal, John Boffa, Sven-Erik Bursell, Alicia Jenkin

Neurodegenerative influence of oxidative stress in the retina of a murine model of diabetes

Aims/hypothesis: Diabetic retinopathy is a progressive neuro-degenerative disease, but the underlying mechanism is still obscure. Here, we focused on oxidative stress in the retina, and analysed its influence on retinal neurodegeneration, using an antioxidant, lutein. Methods: C57BL/6 mice with streptozotocin-induced diabetes were constantly fed either a lutein-supplemented diet or a control diet from the onset of diabetes, and their metabolic data were recorded. In 1-month-diabetic mice, reactive oxygen species (ROS) in the retina were measured using dihydroethidium and visual function was evaluated by electroretinograms. Levels of activated extracellular signal-regulated kinase (ERK), synaptophysin and brain-derived neurotrophic factor (BDNF) were also measured by immunoblotting in the retina of 1-month-diabetic mice. In the retinal sections of 4-month-diabetic mice, histological changes, cleaved caspase-3 and TUNEL staining were analysed. Results: Lutein did not affect the metabolic status of the diabetic mice, but it prevented ROS generation in the retina and the visual impairment induced by diabetes. ERK activation, the subsequent synaptophysin reduction, and the BDNF depletion in the diabetic retina were all prevented by lutein. Later, in 4-month-diabetic mice, a decrease in the thickness of the inner plexiform and nuclear layers, and ganglion cell number, together with increase in cleaved caspase-3- and TUNEL-positive cells, were avoided in the retina of lutein-fed mice. Conclusions/interpretation: The results indicated that local oxidative stress that has a neurodegenerative influence in the diabetic retina is prevented by constant intake of a lutein-supplemented diet. The antioxidant, lutein may be a potential therapeutic approach to protect visual function in diabetes

Disease Gene Interaction Pathways: A Potential Framework for How Disease Genes Associate by Disease-Risk Modules

BACKGROUND: Disease genes that interact cooperatively play crucial roles in the process of complex diseases, yet how to analyze and represent their associations is still an open problem. Traditional methods have failed to represent direct biological evidences that disease genes associate with each other in the pathogenesis of complex diseases. Molecular networks, assumed as 'a form of biological systems', consist of a set of interacting biological modules (functional modules or pathways) and this notion could provide a promising insight into deciphering this topic. METHODOLOGY/PRINCIPAL FINDINGS: In this paper, we hypothesized that disease genes might associate by virtue of the associations between biological modules in molecular networks. Then we introduced a novel disease gene interaction pathway representation and analysis paradigm, and managed to identify the disease gene interaction pathway for 61 known disease genes of coronary artery disease (CAD), which contained 46 disease-risk modules and 182 interaction relationships. As demonstrated, disease genes associate through prescribed communication protocols of common biological functions and pathways. CONCLUSIONS/SIGNIFICANCE: Our analysis was proved to be coincident with our primary hypothesis that disease genes of complex diseases interact with their neighbors in a cooperative manner, associate with each other through shared biological functions and pathways of disease-risk modules, and finally cause dysfunctions of a series of biological processes in molecular networks. We hope our paradigm could be a promising method to identify disease gene interaction pathways for other types of complex diseases, affording additional clues in the pathogenesis of complex diseases

A preference based measure of complementary feeding quality: Application to the Avon Longitudinal Study of Parents and Children

This paper presents the development of the Complementary Feeding Utility Index (CFUI), a composite index aimed to measure adherence to infant feeding guidelines. Through an axiomatic characterization this paper shows the advantages in using the CFUI are the following: it avoids the use of arbitrary cut-offs, and by converting observed diet preferences into utilities, summing the score is meaningful. In addition, as the CFUI is designed to be scored continuously, it allows the transition from intake of beneficial foods (in low quantities) and intake of detrimental foods (in high quantities) to be more subtle. The paper first describes the rationale being the development of the CFUI and then elaborates on the methodology used to develop the CFUI, including the process of selecting the components. The methodology is applied to data collected from the Avon Longitudinal Study of Parents and Children to show the advantages of the CFUI over traditional diet index approaches. Unlike traditional approaches, the distribution of the CFUI does not peak towards mean value but distributes evenly towards the tails of the distribution.Murthy N. Mittinty, Rebecca K. Golley, Lisa G. Smithers, Laima Brazionis, John W. Lync

Homocysteine and diabetic retinopathy

Objective— Homocysteine is an emerging risk factor for cardiovascular and nondiabetic ocular vaso-occlusive diseases. However, studies of the relationship between homocysteine and diabetic retinopathy have reported inconsistent results. The purpose of this study was to evaluate the relationship between plasma total homocysteine concentration and diabetic retinopathy. Research Design And Methods— We assessed the homocysteine-retinopathy relationship in 168 men and women with type 2 diabetes in a community-based, cross-sectional study. We photodocumented diabetic retinopathy status and measured plasma total homocysteine concentration using a commercial fluorescence polarization immunoassay enzymatic kit. Data for selected clinical/demographic variables and established risk factors for diabetic retinopathy were obtained from fasting blood samples and an interviewer-assisted lifestyle questionnaire. Results— A higher mean plasma total homocysteine concentration was observed in diabetic individuals with retinopathy than in those without retinopathy (11.5 _mol/l [95% CI 10.4 –12.5] vs. 9.6 _mol/l [9.1–10.2], P _ 0.001). Furthermore, the relationship between homocysteine and diabetic retinopathy was not explained by renal dysfunction and was independent of the other major risk factors for diabetic retinopathy (duration of diabetes, A1C, and systolic blood pressure) and determinants of higher homocysteine concentrations (age, sex, and red cell folate) (odds ratio 1.20 [95% CI 1.023–1.41], P _ 0.024). Conclusions— Plasma total homocysteine concentration may be a useful biomarker and/or a novel risk factor for increased risk of diabetic retinopathy in people with type 2 diabetes.Laima Brazionis, Kevin Rowley, Catherine Itsiopoulos, Colin Alexander Harper and Kerin O’de

Is risk of diabetic retinopathy lower in Australia's Greek-born migrants?

L. Brazionis, K. Rowley, C. Itsiopoulos, and K. O'De

Diet spanning infancy and toddlerhood is associated with child blood pressure at age 7.5 y

BackgroundDiet in the first 2 y of life may be a pivotal period regarding effects on future blood pressure (BP). However, data on early-life diet and BP in childhood are sparse.ObjectiveWe prospectively assessed associations between types of diet spanning infancy and toddlerhood (ie, transition diets across the complementary feeding period) and BP at age 7.5 y.DesignIn a birth cohort study (Avon Longitudinal Study of Parents and Children; United Kingdom), a total of 1229 children had complete dietary intake data at 6, 15, and 24 mo; BP data at 7.5 y of age; and all 18 covariables.ResultsOf the 2 transition diets that were extracted by using principal components analysis, the less-healthy diet was associated with an increase in systolic BP of 0.62 mm Hg (95% CI: 0.00, 1.24 mm Hg) and an increase in diastolic BP of 0.55 mm Hg (95% CI: 0.10, 1.00 mm Hg) for every one-unit (SD) increase in the less-healthy-diet score after adjustment for 15 potential confounders, including maternal characteristics and sociodemographic factors, birth variables, and breastfeeding duration. In contrast with systolic BP, the positive association between the less-healthy transition-diet score and diastolic BP persisted after additional adjustment for child body-size factors [height, body mass index (BMI), and waist circumference] at 7.5 y.ConclusionsA less-healthy transition diet by age 2 y was associated with higher BP at 7.5 y. The BMI-related reduction in effect size reinforces the importance of BMI on the diet-BP relation.Laima Brazionis, Rebecca K Golley, Murthy N Mittinty, Lisa G Smithers, Pauline Emmett, Kate Northstone, and John W Lync