29 research outputs found
Short-Term Very High Carbohydrate Diet and Gut-Training Have Minor Effects on Gastrointestinal Status and Performance in Highly Trained Endurance Athletes
We implemented a multi-pronged strategy (MAX) involving chronic (2 weeks high carbohydrate [CHO] diet + gut-training) and acute (CHO loading + 90 g·h(â1) CHO during exercise) strategies to promote endogenous and exogenous CHO availability, compared with strategies reflecting lower ranges of current guidelines (CON) in two groups of athletes. Nineteen elite male race walkers (MAX: 9; CON:10) undertook a 26 km race-walking session before and after the respective interventions to investigate gastrointestinal function (absorption capacity), integrity (epithelial injury), and symptoms (GIS). We observed considerable individual variability in responses, resulting in a statistically significant (p < 0.001) yet likely clinically insignificant increase (Î 736 pg·mL(â1)) in I-FABP after exercise across all trials, with no significant differences in breath H(2) across exercise (p = 0.970). MAX was associated with increased GIS in the second half of the exercise, especially in upper GIS (p < 0.01). Eighteen highly trained male and female distance runners (MAX: 10; CON: 8) then completed a 35 km run (28 km steady-state + 7 km time-trial) supported by either a slightly modified MAX or CON strategy. Inter-individual variability was observed, without major differences in epithelial cell intestinal fatty acid binding protein (I-FABP) or GIS, due to exercise, trial, or group, despite the 3-fold increase in exercise CHO intake in MAX post-intervention. The tight-junction (claudin-3) response decreased in both groups from pre- to post-intervention. Groups achieved a similar performance improvement from pre- to post-intervention (CON = 39 s [95 CI 15â63 s]; MAX = 36 s [13â59 s]; p = 0.002). Although this suggests that further increases in CHO availability above current guidelines do not confer additional advantages, limitations in our study execution (e.g., confounding loss of BM in several individuals despite a live-in training camp environment and significant increases in aerobic capacity due to intensified training) may have masked small differences. Therefore, athletes should meet the minimum CHO guidelines for training and competition goals, noting that, with practice, increased CHO intake can be tolerated, and may contribute to performance outcomes
Short-term very high carbohydrate diet and gut-training have minor effects on gastrointestinal status and performance in highly trained endurance athletes
We implemented a multi-pronged strategy (MAX) involving chronic (2 weeks high carbohydrate [CHO] diet + gut-training) and acute (CHO loading + 90 g·hâ1 CHO during exercise) strategies to promote endogenous and exogenous CHO availability, compared with strategies reflecting lower ranges of current guidelines (CON) in two groups of athletes. Nineteen elite male race walkers (MAX: 9; CON:10) undertook a 26 km race-walking session before and after the respective interventions to investigate gastrointestinal function (absorption capacity), integrity (epithelial injury), and symptoms (GIS). We observed considerable individual variability in responses, resulting in a statistically significant (p < 0.001) yet likely clinically insignificant increase (Î 736 pg·mLâ1) in I-FABP after exercise across all trials, with no significant differences in breath H2 across exercise (p = 0.970). MAX was associated with increased GIS in the second half of the exercise, especially in upper GIS (p < 0.01). Eighteen highly trained male and female distance runners (MAX: 10; CON: 8) then completed a 35 km run (28 km steady-state + 7 km time-trial) supported by either a slightly modified MAX or CON strategy. Inter-individual variability was observed, without major differences in epithelial cell intestinal fatty acid binding protein (I-FABP) or GIS, due to exercise, trial, or group, despite the 3-fold increase in exercise CHO intake in MAX post-intervention. The tight-junction (claudin-3) response decreased in both groups from pre- to post-intervention. Groups achieved a similar performance improvement from pre- to post-intervention (CON = 39 s [95 CI 15â63 s]; MAX = 36 s [13â59 s]; p = 0.002). Although this suggests that further increases in CHO availability above current guidelines do not confer additional advantages, limitations in our study execution (e.g., confounding loss of BM in several individuals despite a live-in training camp environment and significant increases in aerobic capacity due to intensified training) may have masked small differences. Therefore, athletes should meet the minimum CHO guidelines for training and competition goals, noting that, with practice, increased CHO intake can be tolerated, and may contribute to performance outcomes
Maternal Obesity, Overweight and Gestational Diabetes Affect the Offspring Neurodevelopment at 6 and 18 Months of Age â A Follow Up from the PREOBE Cohort
The study was registered at www.ClinicalTrials.gov, identifier:NCT01634464).Background:
Brain development in fetal life and early infancy is critical to determine lifelong performance in various neuropsychological domains. Metabolic pathologies such as overweight, obesity, and gestational diabetes in pregnant women are prevalent and increasing risk factors that may adversely affect long-term brain development in their offspring.Objective:
The objective of this research was to investigate the influence of maternal metabolic pathologies on the neurodevelopment of the offspring at 6 and 18 months of life.Design:
This was a prospective case-control study of 331 mother- and child pairs from Granada, Spain. The mothers were included during pregnancy into four groups according to their pre-gestational body mass index and their gestational diabetes status; overweight (n:56), obese (n:64), gestational diabetic (n:79), and healthy normal weight controls (n:132). At 6 months and 18 months we assessed the children with the Bayley III scales of neurodevelopment.Results:
At 6 months (n=215), we found significant group differences in cognition composite language, and expressive language. Post hoc test revealed unexpectedly higher scores in the obese group compared to the normal weight group and a similar trend in overweight and diabetic group. The effects on language remained significant after adjusting for confounders with an adjusted odds ratio for a value above median in composite language score of 3.3 (95% CI: 1.1, 10.0; p=0.035) for children of obese mothers. At 18 month (n=197), the offspring born to obese mothers had lost five points in language composite scores and the previous differences in language and cognition was replaced by a suggestive trend of lower gross motor scores in the overweight, obese, and diabetic groups.Conclusions:
Infants of obese mothers had a temporary accelerated development of cognition and language, followed by a rapid deceleration until 18 months of age, particularly of language scores. This novel observation prompts further confirmative studies to explore possible placental and neurodevelopmental mechanisms involved.This study was funded by Spanish Ministry of Innovation and Science. Junta de AndalucĂa: Excellence Projects (P06-CTS-02341); Spanish Ministry of Education (Grant no. SB2010-0025); Spanish Ministry of Economy and Competitiveness (BFU2012-40254-C03-01); Further support was received by Abbott Laboratories, Granada, Spain
Different vulnerability indicators for psychosis and their neuropsychological characteristics in the Northern Finland 1986 Birth Cohor
This study is one of very few that has investigated the neuropsychological functioning of both familial and clinical high risk subjects for psychosis. Participants (N = 164) were members of the Northern Finland 1986 Birth Cohort in the following four groups: familial risk for psychosis (n = 62), clinical risk for psychosis (n = 20), psychosis (n = 13), and control subjects (n = 69). The neurocognitive performance of these groups was compared across 19 cognitive variables. The two risk groups did not differ significantly from controls, but differed from the psychosis group in fine motor function. Neuropsychological impairments were not evident in a non-help-seeking high-risk sample
Objectively assessed disease activity and drug persistence during ustekinumab treatment in a nationwide real-world Crohn's disease cohort
ObjectiveLong-term evidence on ustekinumab treatment response and persistence in patients with Crohn's disease in a real-world setting is scarce. We performed a retrospective nationwide chart review study of long-term clinical outcomes in Crohn's disease patients treated with ustekinumab.MethodsThe study was conducted in 17 Finnish hospitals and included adult Crohn's disease patients who received an initial intravenous dose of ustekinumab during 2017-2018. Disease activity data were collected at baseline, 16 weeks, and 1 year from health records.ResultsThe study included 155 patients. The disease was stricturing or penetrating in 69 and 59% had prior Crohn's disease-related surgeries, and 97% had a treatment history of at least one biologic agent. Of 93 patients with >= 1 year of follow-up, 77 (83%) were still on ustekinumab at 1 year. In patients with data available, from baseline to the 1-year follow-up the simple endoscopic score for Crohn's disease (SES-CD) decreased from 10 to 3 (P = 0.033), C-reactive protein from 7 to 5 mg/L, (P ConclusionsUstekinumab treatment in patients with highly refractory Crohn's disease resulted in high long-term treatment persistence and significantly reduced disease activity, assessed with objective markers for intestinal inflammatory activity.</div
Maternal prepregnancy body mass index and offspring white matter microstructure: results from three birth cohorts
Prepregnancy maternal obesity is a global health problem and has been associated with offspring
metabolic and mental ill-health. However, there is a knowledge gap in understanding potential neurobiological factors
related to these associations. This study explored the relation between maternal prepregnancy body mass index (BMI) and
offspring brain white matter microstructure at the age of 6, 10, and 26 years in three independent cohorts. Maternal BMI was associated with higher FA and lower MD in multiple brain tracts in offspring aged 10 and
26 years, but not at 6 years of age. Future studies should examine whether our observations can be replicated and explore the
potential causal nature of the findings.This work was supported by the European
Unionâs Horizon 2020 research and innovation program [grant
agreement no. 633595 DynaHEALTH] and no. 733206 LifeCycle], the
Netherlands Organization for Health Research and Development
[ZONMW Vici project 016.VICI.170.200]. The PREOBE cohort was
funded by Spanish Ministry of Innovation and Science. Junta de
AndalucĂa: Excellence Projects (P06-CTS-02341) and Spanish Ministry of Economy and Competitiveness (BFU2012-40254-C03-01).
The first phase of the Generation R Study is made possible by financial
support from the Erasmus Medical Centre, the Erasmus University,
and the Netherlands Organization for Health Research and Development (ZonMW, grant ZonMW Geestkracht 10.000.1003). The
Northern Finland Birth Cohort 1986 is funded by University of Oulu,
University Hospital of Oulu, Academy of Finland (EGEA), Sigrid
Juselius Foundation, European Commission (EURO-BLCS, Framework 5 award QLG1-CT-2000-01643), NIH/NIMH
(5R01MH63706:02
Association between maternal nutritional status in pregnancy and offspring cognitive function in childhood and adolescence; a systematic review
Background
The mother is the only source of nutrition for fetal growth including brain development. Maternal nutritional status (anthropometry, macro- and micro-nutrients) before and/or during pregnancy is therefore a potential predictor of offspring cognitive function. The relationship of maternal nutrition to offspring cognitive function is unclear. This review aims to assess existing evidence linking maternal nutritional status with offspring cognitive function.
Methods
Exposures considered were maternal BMI, height and weight, micronutrient status (vitamins D, B12, folate and iron) and macronutrient intakes (carbohydrate, protein and fat). The outcome was any measure of cognitive function in children aged <18 years. We considered observational studies and trials with allocation groups that differed by single nutrients. We searched Medline/PubMed and the Cochrane Library databases and reference lists of retrieved literature. Two reviewers independently extracted data from relevant articles. We used methods recommended by the Centre for Reviews and Dissemination, University of York and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
Results
Of 16,143 articles identified, 38 met inclusion criteria. Most studies were observational, and from high-income settings. There were few randomized controlled trials. There was consistent evidence linking maternal obesity with lower cognitive function in children; low maternal BMI has been inadequately studied. Among three studies of maternal vitamin D status, two showed lower cognitive function in children of deficient mothers. One trial of folic acid supplementation showed no effects on the childrenâs cognitive function and evidence from 13 observational studies was mixed. Among seven studies of maternal vitamin B12 status, most showed no association, though two studies in highly deficient populations suggested a possible effect. Four out of six observational studies and two trials (including one in an Iron deficient population) found no association of maternal iron status with offspring cognitive function. One trial of maternal carbohydrate/protein supplementation showed no effects on offspring cognitive function.
Conclusions
Current evidence that maternal nutritional status during pregnancy as defined by BMI, single micronutrient studies, or macronutrient intakes influences offspring cognitive function is inconclusive. There is a need for more trials especially in populations with high rates of maternal undernutrition.
Systematic review registration
Registered in PROSPERO CRD42013005702
Intellectual disability in the Northern Finland Birth Cohort 1986
Abstract
The objective of this study was to investigate intellectual disability (ID) in children, with focus on occurrence, associated biomedical and sociodemographic factors, probable psychiatric problems and temporal variations in the occurrence of ID and the associated factors in an interval of 20 years.
The study population consisted of two birth cohorts of children born in northern Finland, the Northern Finland Birth Cohort 1986 (NFBC 1986, N = 9,432 live-born children) and the Northern Finland Birth Cohort 1966 (NFBC 1966, N = 12,058 live-born children). Temporal changes in ID were studied by comparing NFBC 1986 with NFBC 1966. The same definition of intellectual disability (intelligence quotient â€70), time of follow-up (up to 11.5 years), case ascertainment methods and data sources were used. Data were collected from questionnaires, registers and records.
In NFBC 1986 the incidence of ID was 12.62/1,000 by age 11.5 years and prevalence 11.23/1,000 live-born at age 11.5 years. Associated biomedical aetiology could be found in two thirds of the cases. Genetic disorders were the largest aetiological category (36.1%) associated with ID. Maternal disadvantage (unskilled worker, basic education only) had the largest impact on the incidence of ID, while among single independent factors, maternal prepregnancy obesity (body mass index â„30) showed the highest risk for ID (OR 2.8, 95% CI 1.5, 5.3) in the offspring. According to the assessments by the teachers at school children with ID had 4.9 times more likely probable behavioural problems than their peers not having ID.
In an interval of 20 years, there was no change in the incidence or in the prevalence of ID between NFBC 1986 and NFBC 1966. However, a shift occurred from more severe levels of ID towards mild ID, so that both the incidence and prevalence of mild ID increased by 50% whereas more severe ID decreased by 50%. Temporal changes appeared in the proportions of aetiological categories (NFBC 1986 vs. NFBC 1966) with a statistically significant decrease of Down syndrome and paranatally originating causes (traumas/asphyxia). The proportion of chromosomal disorders other than Down syndrome increased, as did malformations of the central nervous system. Among sociodemographic factors associated with ID, indicators of socio-economic disadvantage retained their status as having the largest impact on the incidence of ID. Over the 20 years, the mother being single, living in a remote area and mother's older age at time of delivery had lost their association with ID. Only one new maternal sociodemographic factor, prepregnancy obesity, had emerged as having an association with ID with a statistically significant difference between NFBC 1986 and NFBC 1966.
In conclusion, these results indicate that although the occurrence of ID remained the same in northern Finland over a period of 20 years, temporal changes have taken place in the biomedical and sociodemographic factors contributing to the incidence and prevalence of ID. There are also factors that have retained their status as associated disadvantageous factors. Studies like this with repeatedly collected data in the same geographical area, describing the occurrence of ID, and analysing associated biomedical and sociodemographic factors, are valuable for evaluating developments in the health care and service system. They are also of value for future planning of services for individuals with ID.TiivistelmÀ
TÀmÀn tutkimuksen tavoitteena oli selvittÀÀ kehitysvammaisuuden esiintyvyyttÀ lapsilla, siihen liittyviÀ lÀÀketieteellisiÀ etiologisia ja sosiodemografisia tekijöitÀ, mahdollisia psykiatrisia ongelmia sekÀ kehitysvammaisuuden esiintyvyydessÀ ja siihen liittyvissÀ tekijöissÀ tapahtuneita muutoksia 20 vuoden aikana.
Tutkimusjoukko muodostui kahden syntymĂ€kohortin lapsista, jotka olivat syntyneet Pohjois-Suomessa, Pohjois-Suomen syntymĂ€kohortti 1986 (NFBC 1986, N = 9432 elĂ€vĂ€nĂ€ syntynyttĂ€ lasta) ja Pohjois-Suomen syntymĂ€kohortti 1966 (NFBC 1966, N = 12058 elĂ€vĂ€nĂ€ syntynyttĂ€ lasta). Kehitysvammaisuudessa tapahtuneita ajallisia muutoksia tutkittiin vertaamalla Pohjois-Suomen syntymĂ€kohortti 1986:ta Pohjois-Suomen syntymĂ€kohortti 1966:een. Tutkimuksessa kĂ€ytettiin samaa kehitysvammaisuuden mÀÀritelmÀÀ (Ă€lykkyysosamÀÀrĂ€ â€70, seuranta-aika 11.5 vuoteen saakka), tiedonkeruun menetelmiĂ€ ja tietolĂ€hteitĂ€. Tiedot kerĂ€ttiin kyselylomakkeista, rekistereistĂ€ ja asiakirjoista.
Pohjois-Suomen syntymĂ€kohortti 1986:ssa kehitysvammaisuuden ilmaantuvuus oli 12.62/1000 11.5 vuoden ikÀÀn mennessĂ€ ja vallitsevuus 11.23/1000 11.5 vuoden iĂ€ssĂ€. Kehitysvammaisuuteen liittyvĂ€ lÀÀketieteellinen etiologia pystyttiin selvittĂ€mÀÀn kahdessa kolmasosassa tapauksia. Geneettiset hĂ€iriöt muodostivat suurimman etiologisen luokan (36.1%). Ă€itiin liittyvillĂ€ epĂ€edullisilla sosiaalisilla tekijöillĂ€ (kouluttamaton työntekijĂ€, vain peruskoulutus) oli suurin vaikutus kehitysvammaisuuden ilmaantuvuuteen, kun taas yksittĂ€isistĂ€ sosiodemografisista tekijöistĂ€ korkein riski (vaarasuhde 2.8, luottamusvĂ€li 1.5, 5.3) oli Ă€idin lihavuudella (painoindeksi â„30) raskauden alussa. Koulussa opettajien arvioiden mukaan kehitysvammaisilla lapsilla esiintyi mahdollisia kĂ€ytöshĂ€iriöitĂ€ 4.9 kertaa useammin kuin ei-kehitysvammaisilla lapsilla.
20 vuoden aikana Pohjois-Suomen syntymÀkohorttien 1986 ja 1966 vÀlillÀ ei ollut tapahtunut muutoksia kehitysvammaisuuden kokonaisilmaantuvuudessa eikÀ -vallitsevuudessa. Kuitenkin tuli esiin siirtymÀ vaikeammasta lievempÀÀn asteeseen siten, etta lievÀn kehitysvammaisuuden ilmaantuvuus ja vallitsevuus lisÀÀntyivÀt noin 50%, kun taas vaikeamman vÀheni 50%. LÀÀketieteellisten etiologisten luokkien osuuksissa tuli esiin ajallisia muutoksia (Pohjois-Suomen syntymÀkohortti 1986 vs. Pohjois-Suomen syntymÀkohortti 1966) siten, ettÀ Downin syndrooman sekÀ syntymÀn aikaan ajoittuvan vamman ja hapenpuutteen osuudet vÀhenivÀt tilastollisesti merkitsevÀsti. Keskushermoston epÀmuodostumien sekÀ muiden kromosomihÀiriöiden kuin Downin syndrooman osuudet kasvoivat. Kehitysvammaisuuteen liittyvistÀ sosiodemografisista tekijöistÀ sosioekonomisen huono-osaisuuden osoittimet sÀilyttivÀt asemansa suurimpana ryhmÀnÀ. 20 vuoden aikana Àidin naimattomuus, asuminen syrjÀseudulla sekÀ korkeampi ikÀ lapsen syntymÀn aikaan olivat menettÀneet yhteytensÀ kehitysvammaisuuteen. Pohjois-Suomen syntymÀkohortti 1986:n ja Pohjois-Suomen syntymÀkohortti 1966:n vÀlillÀ tuli esiin vain yksi uusi kehitysvammaisuuteen tilastollisesti merkitsevÀsti liittyvÀ sosiodemografinen tekijÀ, Àidin lihavuus raskauden alussa.
Yhteevetona voidaan todeta, etta vaikka kehitysvammaisuuden kokonaisesiintyvyys oli pysynyt samana Pohjois-Suomessa 20 vuoden aikana niin esiintyvyyteen liittyvÀt etiologiset ja sosiodemografiset tekijÀt olivat osittain muuttuneet. TÀmÀnkaltaiset tutkimukset, joissa perÀkkÀisinÀ ajanjaksoina kerÀtÀÀn tietoja samalla maantieteellisellÀ alueella ja jotka kuvaavat kehitysvammaisuuden esiintyvyyttÀ sekÀ analysoivat siihen liittyviÀ lÀÀketieteellisiÀ ja sosiodemografisia tekijoitÀ, ovat hyödyllisiÀ arvioitaessa terveydenhoidossa ja palvelujÀrjestelmÀssÀ tapahtunutta kehitystÀ. NiitÀ voidaan hyödyntÀÀ myös suunniteltaessa tulevaisuudessa palveluja kehitysvammaisille henkilöille