Sexually dimorphic response to feeding mode in the growth of infants

BACKGROUND: The relation between infant feeding and growth has been extensively evaluated, but studies examining sex differences in the influence of infant milk feeding on growth are limited.OBJECTIVE: We examined the interaction of infant feeding and sex in relation to infant growth and compared growth trajectories in breastfed and formula-fed boys and girls.DESIGN: In 932 infants in a Singapore mother-offspring cohort, feeding practices in the first 6 mo were classified into the breastfeeding group (BF), mixed feeding group (MF), and formula feeding group (FF). Infant weight and length were measured and converted to WHO standards for weight-for-age z scores (WAZs) and length-for-age z scores (LAZs). Differences in WAZ and LAZ from birth to 6 mo, 6 to 12 mo, and 12 to 24 mo of age were calculated. Three-way interactions were examined between feeding mode, sex, and age intervals for WAZ and LAZ changes, with adjustment for confounders.RESULTS: The interaction between feeding mode, sex, and age intervals was significant for LAZ changes (P = 0.003) but not WAZ changes (P = 0.103) after adjustment for potential confounders. Compared with BF girls, BF boys showed similar LAZ gain (+0.28 compared with +0.39, P = 0.544) from 0 to 6 mo of age but greater LAZ gain from 6 to 12 mo of age (+0.39 compared with -0.10, P = 0.008). From 0 to 6 mo of age, FF boys and girls showed greater LAZ gains than their BF counterparts; from 6 to 12 mo of age, FF girls showed higher LAZ gain (+0.25 compared with -0.10, P = 0.031) than BF girls, which was not seen in boys.CONCLUSIONS: During infancy, there is a sexually dimorphic growth response to the mode of infant milk feeding, raising questions about whether formula feeding ought to remain sex neutral. However, further investigations on sex-specific feeding and infant growth are warranted before a conclusive message can be drawn based on our current findings. This trial was registered at www.clinicaltrials.gov as NCT01174875

Demographic characteristics, health behaviors before and pregnancy, and pregnancy and birth outcomes in mothers with different pregnancy planning status

Studies on pregnancy intentions and their consequences have yielded mixed results. Here, we comprehensively analyzed the maternal characteristics, health behaviors before and during pregnancy, as well as pregnancy and birth outcomes, across three different pregnancy planning status in 861 women participating in an ongoing Asian mother-offspring cohort study. At 26-28 weeks’ gestation, the women’s intention and enthusiasm towards their pregnancy were used to classify their pregnancy into planned or unplanned, and unplanned pregnancy was further subdivided into mistimed or unintended. Data on maternal characteristics, health behaviors, and pregnancy outcomes up to that stage, were recorded. After delivery, birth outcomes of the offspring were recorded. Linear and logistic regression analyses were performed. Overall, 56% had a planned pregnancy, 39% mistimed, and 5% unintended. Compared to women who planned their pregnancy, women with mistimed pregnancy had higher body mass index, and were more likely to have cigarette smoke exposure and less likely to have folic acid supplementation. At 26-28 weeks’ gestation, unintended pregnancy was associated with increased anxiety. Neonates of mistimed pregnancy had shorter birth length compared to those of planned pregnancy, even after adjustment for maternal baseline demographics. These findings suggest that mothers who did not plan their pregnancy had less desirable characteristics or health behaviors before and during pregnancy, and poorer pregnancy and birth outcomes. Shorter birth length in mistimed pregnancy may be attributed to maternal behaviors before or in the early stages of pregnancy, therefore highlighting the importance of preconception health promotion and screening for women of child-bearing age

Predominantly nighttime feeding and weight outcomes in infants

10.3945/ajcn.116.130765American Journal of Clinical Nutrition1042380 - 388AJCNAGUSTO (Growing up towards Healthy Outcomes

Predominantly night-time feeding and weight outcomes in infants

Background: The influence of circadian feeding patterns on weight outcomes has been demonstrated in animal and human studies but not in very young children. Objective: We aimed to examine the association of infant circadian feeding patterns at 12 months with subsequent growth and weight status after one year. Design: Mothers from a Singapore birth cohort (n=349) reported food given to their infant and the feeding time at 12 months of age. Predominantly day-time (pDT, 0700-1859h, n=282) and predominantly night-time (pNT, 1900-0659h, n=67) feeding infants were defined by whether daytime energy intake was &gt;50% or &lt;50% of total energy intake assessed by 24-hour recall. Body Mass Index Z-scores (BAZ) were computed using World Health Organization Child Growth Standards 2006 to determine changes in BAZ from 12 to 24 months and weight status at 24 months. Multivariable linear and logistic regression analyses were performed.Results: Compared to pDT feeding, pNT feeding was associated with higher BAZ gain from 12-24 months (adjusted ?=0.38, 95% CI=0.11 to 0.65, p=0.006) and an increased risk of becoming overweight at 24 months (adjusted OR=2.78, 95% CI=1.11 to 6.97, p=0.029), with adjustments for maternal age, education, ethnicity, monthly household income, parity, infant BAZ at 12 months, feeding mode in the first six months of life and total daily energy intake.Conclusion: Our study suggests that the role of daily distribution of energy consumption in weight regulation begins in infancy. Feeding infants predominantly during night-time hours was associated with adiposity gain and risk of overweight in early childhood. Including advice on appropriate feeding time may be considered when implementing strategies to combat childhood obesity. <br/

Predominantly night-time feeding and maternal glycaemic levels during pregnancy

Little is known about the influence of meal timing and energy consumption patterns throughout the day on glucose regulation during pregnancy. We examined the association of maternal feeding patterns with glycaemic levels among lean and overweight pregnant women. In a prospective cohort study in Singapore, maternal 24-h dietary recalls, fasting glucose (FG) and 2-h postprandial glucose (2HPPG) concentrations were measured at 26-28 weeks of gestation. Women (n 985) were classified into lean (BMI&lt;23 kg/m2) or overweight (BMI?23 kg/m2) groups. They were further categorised as predominantly daytime (pDT) or predominantly night-time (pNT) feeders according to consumption of greater proportion of energy content from 07.00 to 18.59 hours or from 19.00 to 06.59 hours, respectively. On stratification by weight status, lean pNT feeders were found to have higher FG than lean pDT feeders (4·36 (sd 0·38) v. 4·22 (sd 0·35) mmol/l; P=0·002); however, such differences were not observed between overweight pDT and pNT feeders (4·49 (sd 0·60) v. 4·46 (sd 0·45) mmol/l; P=0·717). Using multiple linear regression with confounder adjustment, pNT feeding was associated with higher FG in the lean group (?=0·16 mmol/l; 95 % CI 0·05, 0·26; P=0·003) but not in the overweight group (?=0·02 mmol/l; 95 % CI -0·17, 0·20; P=0·879). No significant association was found between maternal feeding pattern and 2HPPG in both the lean and the overweight groups. In conclusion, pNT feeding was associated with higher FG concentration in lean but not in overweight pregnant women, suggesting that there may be an adiposity-dependent effect of maternal feeding patterns on glucose tolerance during pregnancy

Immunohistochemical differentiation between primary adenocarcinomas of the ovary and ovarian metastases of colonic and breast origin. Comparison between a statistical and an intuitive approach.

AIM: To discriminate between adenocarcinomas that are primary to the ovary and metastatic to the ovary, especially of colonic and breast origin, by immunohistochemistry, using stepwise discriminant analysis or a decision tree. METHODS: 312 routinely processed, formalin fixed tissue specimens were used. The tumours were divided into a learning set (n = 159), composed of primary tumours of ovary, breast, and colon, and a test set, comprising 134 metastases from these sites and an additional 19 primary ovarian carcinomas. The immunohistochemical panel was composed of antibodies against cytokeratin 7 (CK7) and 20 (CK20), CA125, vimentin, carcinoembryonic antigen (CEA), gross cystic disease fluid protein-15 (GCDFP-15), and the oestrogen receptor (ER). The staining results of the tumours were expressed as the product of the staining intensity and the percentage of positive tumour cells. Analyses were first performed on the learning set and then evaluated on the test set. RESULTS: Although the immunostaining patterns showed a considerable overlap between the three types of adenocarcinoma, the breast carcinomas were typically positive for GCDFP-15 and often for ER, and negative for vimentin. Ovarian carcinomas were always positive for CK7 and to a lesser extent for CA125. Colonic carcinomas showed prominent positivity for CEA and CK20, while no staining was seen for ER and vimentin. In discriminant analysis, six antibodies (alpha CK7, alpha CK20, alpha CA125, alpha CEA, alpha ER, and alpha GCDFP-15) appeared to be necessary for optimal classification: 89% of the learning set and 82% of the test set were classified correctly. In the decision tree, only four antibodies (alpha CK7, alpha CEA, alpha ER, and alpha GCDFP-15) were used to obtain a correct classification score of 89% for the learning set and 84% for the test set. CONCLUSIONS: Using a semiquantitative assessment of the immunostaining results by a restricted panel of six antibodies with stepwise discriminant analysis, 80-90% of the adenocarcinomas of colon, breast, and ovary can be correctly classified. Discriminant analysis is computer aided and therefore an easy method and for each case a probability value of the classification result is obtained. The intuitive decision tree method provides a slightly better result, requires only four antibodies, and offers a more practical method for the surgical pathologist

Recent advances in immunohistochemistry in the diagnosis of ovarian neoplasms

This leader reviews recent advances in immunohistochemistry that are useful in the diagnosis of ovarian neoplasms. These include the value of different anticytokeratin antibodies in the distinction between a primary ovarian adenocarcinoma and a metastatic adenocarcinoma, especially of colorectal origin. These antibodies have also helped to clarify the origin of the peritoneal disease in most cases of pseudomyxoma peritonei. The value of antibodies against so called tumour specific antigens, such as CA125 and HAM56, in determining the ovarian origin of an adenocarcinoma is also reviewed. In recent years, several studies have investigated the value of a variety of monoclonal antibodies in the diagnosis of ovarian sex cord stromal tumours and in the distinction between these neoplasms and their histological mimics. These antibodies include those directed against inhibin, CD99, Mullerian inhibiting substance, relaxin like factor, melan A, and calretinin. Of these, anti-α inhibin appears to be of most diagnostic value. It is stressed that these antibodies should always be used as part of a larger panel and not in isolation.J Clin Pathol(J Clin Pathol 2000;53:327–334) Key Words: ovarian neoplasms • diagnosis • immunohistochemistr