Maternal Dietary Pattern with an Emphasis on Child Growth Pattern and Exclusive Breastfeeding Duration

Background: maternal nutrition and breast milk nutrient concentration are associated with infant's growth. Enhanced knowledge encourages mothers to breast feed for the sake of optimizing growth and development. Methods: the current study was performed longitudinally in some rural areas, south of Iran, from birth to six months. Out of 319 candidates with serial anthropometric measurements of an infant, including weight, height, and head circumference at four times (birth, two, four, and six months ), 195 were included in the multivariate regression model (total measurements, n=776) to construct the pattern of growth. Then, information regarding demographic background, lactation status and infant supplementation intake status, feeding practices, maternal anthropometric measurements, and food frequency questionnaire were collected from mothers and their children during six months in two rural health centers. Results: The most important association between dietary factors and infant anthropometrics (weight, height, and head circumference) involved Factor2 vegetables, including leafy vegetables, tomato, onion and garlic, (weight β=0.35 95%CI 0.27 - 0.44, length β=3.82 95%CI 3.42 - 4.22, head circumference β=2.55 95%CI 2.32 - 2.79) and Factor1 fruit, including orange, kiwi, cherries, watermelon, date, and grapes) (weight β=0.117 95%CI 0.04-0.189, length β=0.59 95%CI 0.257-0.929, head circumference β=0.307 95% CI 0.108-0.507), respectively. Generalized Estimation Equation model revealed that Factor2 dairy (including low fat milk, yogurt and dough) significantly contributed to weight growth velocity (β=-0.009 95% CI -0.016 - 0.001). Conclusion: a dietary habit of fruit and vegetables, which are rich in bioactive components by breast feed mother showed better growth for infants. As growth is multifactorial, maternal nutrition and breastfeeding duration is a simple modifiable factor which can affect the subsequent growth and development of the child during the first six months. Key words: exclusive breastfeeding, growth, anthropometric measures, maternal nutrition, and multivariate multiple regression

Early feeding and growth pattern in infants:Using a three-variate longitudinal model derived from Gaussian copula function

Background: The Gaussian copula model was used to generate joint distributions for continuous longitudinal variables on infant types of feeding and longitudinal measures of height, weight and head circumference  Methods: The study was performed longitudinally in rural areas of southern part of Iran, on children from birth to 9 months of age. Out of 319 infants with serial anthropometric measurements from birth, and 2, 4, 6, 7 and 9 months old, 120 were included. Infants were divided into three groups (breast fed, formula fed and both milk types). A three-variate longitudinal model including Copula function was used to estimate the effect of feeding on growth pattern. All the analyses were performed using SAS version 9.4 (Proc NLmix).  Results: Ninety infants (75%) were breastfed, sixteen (13.3%) were formula fed and fourteen (11.7%) had combined feeding. Copula model showed that, breast fed children had a better weight gain (β=0.627 95% CI 0.217-1.038 P = 0.003), height (β=2.603 95% CI 1.023-4.183 P = 0.001) and head circumference (β=0.8 95% CI 0.069- 1.531 P = 0.0) as compared to formula fed children. R2 for Copula model was (wt=0.52, ht=0.96, hc=0.84).  Conclusions: Implication of Copula model was easy to perform. Estimation of the parameters in copula model indicated that, breast milk consumption had a positive effect on the growth of infants

Early feeding and growth pattern in infants: Using a three-variate longitudinal model derived from Gaussian copula function

Background: The Gaussian copula model was used to generate joint distributions for continuous longitudinal variables on infant types of feeding and longitudinal measures of height, weight and head circumference  Methods: The study was performed longitudinally in rural areas of southern part of Iran, on children from birth to 9 months of age. Out of 319 infants with serial anthropometric measurements from birth, and 2, 4, 6, 7 and 9 months old, 120 were included. Infants were divided into three groups (breast fed, formula fed and both milk types). A three-variate longitudinal model including Copula function was used to estimate the effect of feeding on growth pattern. All the analyses were performed using SAS version 9.4 (Proc NLmix).  Results: Ninety infants (75%) were breastfed, sixteen (13.3%) were formula fed and fourteen (11.7%) had combined feeding. Copula model showed that, breast fed children had a better weight gain (β=0.627 95% CI 0.217-1.038 P = 0.003), height (β=2.603 95% CI 1.023-4.183 P = 0.001) and head circumference (β=0.8 95% CI 0.069- 1.531 P = 0.0) as compared to formula fed children. R2 for Copula model was (wt=0.52, ht=0.96, hc=0.84).  Conclusions: Implication of Copula model was easy to perform. Estimation of the parameters in copula model indicated that, breast milk consumption had a positive effect on the growth of infants.&nbsp

Milk and Protein Intake by Pregnant Women Affects Growth of Foetus

The study assessed the effects of the daily intake of milk and protein by pregnant women on foetal growth and determined the growth pattern and velocity of growth. A total of 504 ultrasound observations from 156 respondents were collected following a cross-sectional design in the last trimester of pregnancy; majority of them were in the last month of pregnancy. De facto and purposive sampling was done, and direct interviews of affluent pregnant women were conducted. Kruskal-Wallis test shows that majority of the respondents had tendency to consume 155.65 to 465.17 mL of milk per day, resulting in better and higher foetal growth. Most respondents consumed about 50-70 g of protein per day, and the foetal growth measurements, such as abdomen-circumference, femur length, biparietal diameter, and head-circumference, on an average, were higher in the same group. Quadratic regression model exhibited that all the traits of growth pattern in Model 1 (low milk and protein intake) appeared to have more mode of decline, in contrast to Model 2 (more milk and protein intake), which shows better growth. In addition, velocity of growth pattern was obtained through the first derivative of quadratic regression of growth pattern. Moreover, 95% confidence interval calculated for regression line slope of Model 1 and Model 2 showed that the estimation point (2 B2) of Model 1 does not lay into 95% CI of Model 2; so, statistical significance assorted and also the same trend conversely hold for Model 2. The rate of growth was highly influenced by maternal milk and protein intake. These findings suggest that contribution of common nutrients or other nutritional factors present in milk and protein promote the growth of foetus

J-shaped relationship between cardiovascular risk and efficacy of intensive blood pressure reduction: A post-hoc analysis of the SPRINT trial.

BackgroundIn the 2017 ACC/AHA hypertension guidelines, a 10-year risk of more than 10% is considered for initiation of intensive blood pressure reduction. The current study aimed to determine which cut off limit of cardiovascular risk for starting intensive blood pressure reduction is beneficial.DesignA Secondary Analysis of Systolic Blood Pressure Intervention Trial (SPRINT).MethodsData from the SPRINT Trial was obtained from the NHLBI Data Repository Center. In the SPRINT, non-diabetic participants with SBP of ≥ 130 mmHg were randomly assigned to intensive and standard treatment arms with SBP targets of ResultsIn the analysis, 4292 patients were enrolled. The results demonstrated a clear J-shaped relationship between the effect of intensive blood pressure control and the risk of CVD events and 10-year Framingham cardiovascular risk levels at a cut-off limit of approximately ConclusionsThis post-hoc secondary analyses of the SPRINT trial showed that a cut off value of more than 7% may be useful in selecting patients suitable for initiation of blood pressure reduction

Milk and Protein Intake by Pregnant Women Affects Growth of Foetus

The study assessed the effects of the daily intake of milk and protein by pregnant women on foetal growth and determined the growth pattern and velocity of growth. A total of 504 ultrasound observations from 156 respondents were collected following a cross-sectional design in the last trimester of pregnancy; majority of them were in the last month of pregnancy. De facto and purposive sampling was done, and direct interviews of affluent pregnant women were conducted. Kruskal-Wallis test shows that majority of the respondents had tendency to consume 155.65 to 465.17 mL of milk per day, resulting in better and higher foetal growth. Most respondents consumed about 50-70 g of protein per day, and the foetal growth measurements, such as abdomen-circumference, femur length, biparietal diameter, and head-circumference, on an average, were higher in the same group. Quadratic regression model exhibited that all the traits of growth pattern in Model 1 (low milk and protein intake) appeared to have more mode of decline, in contrast to Model 2 (more milk and protein intake), which shows better growth. In addition, velocity of growth pattern was obtained through the first derivative of quadratic regression of growth pattern. Moreover, 95% confidence interval calculated for regression line slope of Model 1 and Model 2 showed that the estimation point (2 B2) of Model 1 does not lay into 95% CI of Model 2; so, statistical significance assorted and also the same trend conversely hold for Model 2. The rate of growth was highly influenced by maternal milk and protein intake. These findings suggest that contribution of common nutrients or other nutritional factors present in milk and protein promote the growth of foetus

Dietary insulin index, dietary insulin load and dietary patterns and the risk of metabolic syndrome in Hoveyzeh Cohort Study

Abstract Postprandial insulin secretion has been associated with metabolic disorders such as hyperlipidemia and type 2 diabetes. Therefore, we aimed to explore the relationship between dietary insulin indices and dietary pattern with the risk of Metabolic Syndrome (MetS). The participants of the present cross-sectional study were included among the individuals who participated in the Hoveyzeh Cohort Study (HCS). A total of 3905 Iranian adults, aged 35–70 years, are included in the current analysis. The Food Frequency Questionnaire (FFQ) is used to calculate the dietary Insulin Index (DII), Insulin Load (DIL), and dietary pattern. Dietary pattern was derived using Reduced-Rank Regression (RRR) based on intake of protein (g/day), fiber (g/day), fat (g/day), magnesium (mg/day), and dietary insulin index were considered as response variables. The Generalized Linear Model was used to obtain the odds ratio (OR) and 95% confidence interval (CI) for MetS based on gender, while considering quartiles of DIL, DII scores, and dietary pattern, adjusted for potential confounders. The mean ± SD of age and BMI of the participants in the top quartile of DIL were 45.72 ± 8.05 years and 28.25 ± 5.02 kg/m2, respectively. The mean ± SD of DII was 40.53 ± 4.06 and the mean ± SD of DIL was 117,986.1 ± 30,714.06. A significant positive association was observed between DIL and MetS in women after adjusting for confounding factors (OR: 1.51; 95% CI 1.16; 1.96). No significant association was seen between DIL, DII, and MetS among men. A derived dietary pattern characterized by high intakes of fruits, sugar, sweet deserts, Whole Grains, and dairy was associated with an increased risk of MetS in adjusted model2 among women (OR: 1.41; 95% CI 1.13; 1.75) and men in the same model (OR: 2.09; 95% CI 1.35; 3.21).However, the final model was significant just for men (OR: 2.08; 95% CI 1.35; 3.21) and not for women (OR: 1.24; 95% CI 0.96; 1.60). Our findings showed that adherence to a diet with a high insulin load can increase the risk of MetS in women. In addition, a derived dietary pattern by RRR indicated that a diet rich in fruits, sugar, sweet deserts, whole Grains, and dairy is related to increased risk of MetS in both men and women

The dietary patterns derived by reduced-rank regression in association with Framingham risk score and lower DASH score in Hoveyzeh cohort study

Abstract The relationship between dietary patterns (DPs) and cardiovascular disease (CVD) has been the subject of much research, but given the significance of this disease, studying the factors affecting it through different methodological considerations is of utmost importance. This study aimed to investigate the association between the four dietary patterns (DPs) derived from reduced-rank regression (RRR) and the risk of CVD predicted by the Framingham Risk Score (FRS) in the Arab residence of Khuzestan, Iran. Furthermore, the predefined Dietary Approaches to Stop Hypertension (DASH) would be used as a comparative model to assess the validity of the extracted DPs. In this cross-sectional study, 5799 individuals aged 35–70 without a CVD diagnosis were selected among the participants of the Hoveyzeh cohort study (HCS). The Risk of CVD was assessed using the FRS model. A semi-quantitative food frequency questionnaire evaluated dietary intake. Four DPs were derived using RRR with 28 food groups as predictors and total protein (g/d), fiber(g/d), fat(g/d), and magnesium intake (mg/d) as response variables. Multinomial and binary logistic regression were used to assess the relationship of DPs with intermediate (10–20%) and high (> 20%) levels of FRS and lower DASH scores ( 20%) across quartiles of four identified DPs. After adjustment for potential confounders, higher tendency to 1st and 2nd DPs in Model 1, OR = 4.67 (95% CI 3.65; 6.01), OR = 1.42 (95% CI 1.13; 1.79) were presented accordingly. The 1st DP, characterized by higher intake of refined grains and lower intake of vegetables oil, sugar, mayonnaise and artificial juices, the 2nd DP characterized by higher intake of hydrogenated fat and lower consumption of tomato sauce and soft drink was associated with greater odds of CVD with the intermediate level of FRS. However, higher adherence to the 3rd DP, characterized by higher intake of fruits, vegetables and legumes and lower intake of fish, egg, red meat, processed meat, mayonnaise, sugar and artificial juices, the 4th DP characterized by higher intake of coffee, nuts and lower intake of sugar, mayonnaise and artificial juices was associated with a lower risk of FRS. Moreover, lower DASH score considered in binary logistic regression across quartiles of four identified dietary patterns. 1st and 2nd DPs were directly related to lower DASH scores, while 3rd and 4th DPs had high comparability with the DASH diet and inversely contributed to the lower DASH score. Total DASH score was significantly correlated to four derived DPs. Our findings confirm the current knowledge regarding the beneficial effects of healthy plant-based DPs and the avoidance of high-fat and processed foods to prevent CVD

Grafting Amino Drugs to Poly(styrene-alt-maleic Anhydride) as a Potential Method for Drug Release

Drug delivery systems based on polymer-drug conjugates give an improved treatment with lower toxicity or side effects and be used for the treatment of different diseases. Conjugates of biodegradable poly(styrene-alt-maleic anhydride) (PSMA), with a therapeutic agents such as amantadine hydrochloride, amlodipine, gabapentin, zonisamide and mesalamine, were afforded by the formation of the amide bonds of the amino drugs that reacted with the PSMA anhydride groups. The amounts of covalently conjugated drugs were determined by a¹ H NMR spectroscopic method, and the in vitro release rate in buffer solution (pH 1.3) was studied at body temperature 37 ºC. In kinetic studies, different dissolution models were examined to obtain drug release data and the collected data were well-fitted to the Korsmeyer-Peppas equation, revealing a dominant Fickian diffusion mechanism for drug release under the in vitro conditions