Systematic review of fatty acid composition of human milk from mothers of preterm compared to full-term infants

Background: Fatty acid composition of human milk serves as guidance for the composition of infant formulae. The aim of the study was to systematically review data on the fatty acid composition of human milk of mothers of preterm compared to full-term infants. Methods: An electronic literature search was performed in English (Medline and Medscape) and German (SpringerLink) databases and via the Google utility. Fatty acid compositional data for preterm and fullterm human milk were converted to differences between means and 95% confidence intervals. Results: We identified five relevant studies publishing direct comparison of fatty acid composition of preterm versus full-term human milk. There were no significant differences between the values of the principal saturated and monounsaturated fatty acids. In three independent studies covering three different time points of lactation, however, docosahexaenoic acid (DHA) values were significantly higher in milk of mothers of preterm as compared to those of full-term infants, with an extent of difference considered nutritionally relevant. Conclusion: Higher DHA values in preterm than in full-term human milk underlines the importance of using own mother's milk for feeding preterm babies and raises the question whether DHA contents in preterm formulae should be higher than in formulae for full-term infants. Copyright (c) 2008 S. Karger AG, Basel

Placental fatty acid transfer: a key factor in fetal growth

The functionality of the placenta may affect neonatal adiposity and fetal levels of key nutrients such as long-chain polyunsaturated fatty acids. Fetal macrosomia and its complications may occur even in adequately controlled gestational diabetic (GDM) mothers, suggesting that maternal glycemia is not the only determinant of fetal glycemic status and wellbeing. We studied in vivo the placental transfer of fatty acids (FA) labeled with stable isotopes administered to 11 control and 9 GDM pregnant women (6 treated with insulin). Subjects received orally &lt;sup&gt;13&lt;/sup&gt;C-palmitic, &lt;sup&gt;13&lt;/sup&gt;C-oleic, and &lt;sup&gt;13&lt;/sup&gt;C-linoleic acids and &lt;sup&gt;13&lt;/sup&gt;C-docosahexaenoic acid (&lt;sup&gt;13&lt;/sup&gt;C-DHA) 12 h before an elective caesarean section. FA were quantified by gas chromatography and &lt;sup&gt;13&lt;/sup&gt;C enrichments by gas chromatography-isotope ratio mass spectrometry. The &lt;sup&gt;13&lt;/sup&gt;C-FA concentration was higher in total lipids of maternal plasma in GDM patients versus controls, except for &lt;sup&gt;13&lt;/sup&gt;C-DHA. Moreover, &lt;sup&gt;13&lt;/sup&gt;C-DHA showed a lower placenta/maternal plasma ratio in GDM patients versus controls and a significantly lower cord/maternal plasma ratio. Other FA ratios studied were not different between GDM and controls. A disturbed &lt;sup&gt;13&lt;/sup&gt;C-DHA placental uptake occurred in GDM patients treated with diet or insulin, while the latter also had lower &lt;sup&gt;13&lt;/sup&gt;C-DHA levels in the venous cord. The tracer study pointed towards an impaired placental DHA uptake as a critical step, while the transfer of other &lt;sup&gt;13&lt;/sup&gt;C-FA was less affected. Patients with GDM treated with insulin could also have a greater fetal fat storage, which may have contributed to the reduced &lt;sup&gt;13&lt;/sup&gt;C-DHA in the venous cord observed. The DHA transfer to the fetus was reduced in GDM pregnancies compared to controls. This might have an influence on fetal neurodevelopment and long-term consequences for the child.</jats:p

Los primeros 1000 días: una oportunidad para reducir la carga de las enfermedades no transmisibles

El crecimiento y desarrollo de un individuo está determinado desde la etapa embrionaria por su genética y los factores ambientales con los que interactúa. Los riesgos para la salud infantil y adulta pueden programarse durante las etapas fetal-neonatal y esta programación metabólica precoz puede afectar al desarrollo posterior de enfermedades como la obesidad y otras enfermedades no transmisibles (ENT) asociadas. La vida temprana, por la gran plasticidad que la caracteriza, constituye el momento ideal para intervenir y prevenir el riesgo de ENT (ventana de oportunidad). Una nutrición óptima durante los primeros 1000 días, que comprende desde la concepción hasta los dos años, es clave para la salud a lo largo de la vida. El rápido crecimiento y desarrollo del organismo y sus funciones durante el embarazo, la lactancia y el niño de corta edad conlleva requisitos nutricionales específicos en cada una de estas etapas. La microbiota del tracto gastrointestinal desempeña una labor fundamental en la función y el desarrollo del sistema inmune. Las interacciones entre el hospedador y su microbiota intestinal se consideran factores potenciales en la programación temprana de las funciones intestinales, con una evidencia creciente de que las alteraciones de la colonización bacteriana en el neonato se asocian con un mayor riesgo de enfermedad, incluidas las enfermedades alérgicas. La evidencia científica acumulada muestra que los primeros 1000 días son cruciales para alcanzar el mejor desarrollo y salud a largo plazo, y constituyen un periodo estratégico en términos de prevención y salud pública. Growth and development are determined by genetic and environmental factors since the very early embryonic life. Long-term health risks, as obesity and other non-communicable diseases (NCD), could be programmed since these early stages. Early life, characterized by plasticity, is the ideal time to intervene and to prevent the risk of suffering a NCD (window of opportunity). Optimal nutrition during the first 1, 000 days, since conception to the end of the second year of life, has a determinant role for long-term health. Pregnancy, infancy and toddler periods have specific nutritional requirements. Intestinal microbiota enhances maturation and functioning of the immune system. The interactions between host and intestinal microbiota are potential factors influencing early programming of the intestinal function. Alterations in intestinal colonization are associated to a higher risk of allergic diseases in childhood. Scientific evidence supports the fact that the first 1,000 days are crucial to achieve a better long-term health and represents a strategic period to intervene under the perspective of prevention and public health

Trans Fat Consumption and Aggression

Background: Dietary trans fatty acids (dTFA) are primarily synthetic compounds that have been introduced only recently; little is known about their behavioral effects. dTFA inhibit production of omega-3 fatty acids, which experimentally have been shown to reduce aggression. Potential behavioral effects of dTFA merit investigation. We sought to determine whether dTFA are associated with aggression/irritability. Methodolgy/Prinicpal Findings: We capitalized on baseline dietary and behavioral assessments in an existing clinical trial to analyze the relationship of dTFA to aggression. Of 1,018 broadly sampled baseline subjects, the 945 adult men and women who brought a completed dietary survey to their baseline visit are the target of this analysis. Subjects (seen 1999– 2004) were not on lipid medications, and were without LDL-cholesterol extremes, diabetes, HIV, cancer or heart disease. Outcomes assessed adverse behaviors with impact on others: Overt Aggression Scale Modified-aggression subscale (primary behavioral endpoint); Life History of Aggression; Conflict Tactics Scale; and self-rated impatience and irritability. The association of dTFA to aggression was analyzed via regression and ordinal logit, unadjusted and adjusted for potential confounders (sex, age, education, alcohol, and smoking). Additional analyses stratified on sex, age, and ethnicity, and examined the prospective association. Greater dTFA were strongly significantly associated with greater aggression, with dTFA more consistently predictive than other assessed aggression predictors. The relationship was upheld wit

Mutational status of nevus-associated melanomas.

Introduction Melanoma origin has always been a debated subject, as well as the role of adjacent melanocytic nevi. Epidemiological and histopathological studies point to melanomas arising either de novo or from a nevus. Methods Sixty-one melanomas found in association with a preexisting nevus were microdissected, after careful selection of cell subpopulations and submitted to Sanger sequencing of the BRAF, NRAS, C-KIT, PPP6C, STK19 and RAC1 genes. Each gene was evaluated twice in all samples by sequencing or by sequencing and another confirmation method, allele-specific fluorescent polymerase chain reaction (PCR) and capillary electrophoresis detection, or by SNaPshot Analysis. Only mutations confirmed via two different molecular methods or twice by sequencing were considered positive. Results The majority of cases presented concordance of mutational status between melanoma and the associated nevus for all 6 genes (40/60; 66.7%). Nine cases presented concomitant BRAF and NRAS mutations, including one case, in which both the melanoma and the adjacent nevus harbored V600E and Q61K double mutations. In two cases, both melanoma and associated nevus, located on acral sites were BRAF mutated, including an acral lentiginous melanoma. Conclusions This is the largest nevus-associated melanoma series molecularly evaluated to our knowledge. The majority of melanomas and adjacent nevi in our sample share the same mutational profile, corroborating the theory that the adjacent nevus and melanoma are clonally related and that melanoma originated within a nevus