Subjective hunger sensations and prospective food intake in obese and overweight subjects: influence of ethnicity

The thesis assessed the potential impact of ethnicity on subjective sensations of hunger and food intake. In a cross-sectional design, 18 Asians and 26 Europid overweight/ obese Australians had hunger/satiety sensations tracked before and for 2h after an oral glucose load. Prospective food intake was recorded at a buffet meal and over 24h. There were no differences in hunger/satiety sensations and food intake between ethnic groups but history of weight stability interacted with ethnicity to influence outcomes

Gestational Diabetes Mellitus Is Associated with Age-Specific Alterations in Markers of Adiposity in Offspring:A Narrative Review

Maternal hyperglycemia alters an offspring's metabolic health outcomes, as demonstrated by the increased risk for obesity, impaired glucose handling and diabetes from early childhood onwards. Infant growth patterns are associated with childhood adiposity and metabolic health outcomes and, as such, can be used as potential markers to detect suboptimal metabolic development at an early age. Hence, we aimed to assess whether gestational diabetes mellitus (GDM) has an impact on offspring growth trajectories. Outcomes included weight gain (WG), body mass index (BMI), and skin fold thickness (SFT) measured at least at two time points from birth to later childhood. In addition, we explored the role of early life pre- and post-natal nutritional modifiable factors on longitudinal growth in infants of mother with GDM (GDM-F1). Despite the large heterogeneity of the studies, we can still conclude that GDM seems to be associated with altered growth outcomes in the offspring. More specifically, these alterations in growth outcomes seem to be rather time-specific. Increased SFT were reported particularly at birth, with limited information on reporting SFT between 2-5 y, and increased adiposity, measured via SFT and BMI, appeared mainly in later childhood (5-10 y). Studies evaluating longitudinal growth outcomes suggested a potential role of early life nutritional modifiable factors including maternal nutrition and breastfeeding. These may impact the cycle of adverse metabolic health by attenuating growth outcome alterations among GDM-F1. Conclusions: Timely diagnoses of growth deviations in infancy are crucial for early identification of GDM-F1 who are at risk for childhood overweight and metabolic disease development

Early detection of childhood obesity through extended routine growth monitoring of children below two years of age in Asia Pacific region

Introduction: Increased body fat deposition during early life predisposes to higher obesity and metabolicdisorder risks in later life. This is particularly relevant in the Asia Pacific region where historically prevalentunder-nutrition is now been paralleled or even overruled by over-nutrition over the last few decades. Thisoverview aims to evaluate the potential of early detection of obesity (risk) among experts through additionof specific growth monitoring assessments in children during the first two years of life.Methods: A discussionamong experts from Malaysia, Singapore, Sri Lanka and Australia on infant growth and a qualitativeevaluation of current practice highlighted the need to measure body composition to assess the quality ofgrowth. Current tools are mainly directed towards simple anthropometric measures such as body weight,length and head circumference which do not adequately reflect concurrent changes in body composition todetect early life adiposity development. Recent findings have shown benefits of measurement such as thesum of four skinfold thickness (S4SFT) during the first two years of life for risk assessment of lateroverweight/obesity. We recommend this assessment for routine practice as a proxy for fat deposition inyoung children. Further studies to understand implementation hurdles and cost-effectiveness of S4SFT andhealth outcomes in young children in the Asia Pacific region are necessary.Conclusion: Inclusion of fourskinfold thickness measurements as part of routine growth monitoring assessment, in addition to weight andheight, could be recommended to assess adiposity development in early life allowing identification of infantsat risk for obesity

Macronutrient Composition and Food Form Affect Glucose and Insulin Responses in Humans

Glycaemic index (GI) is used as an indicator to guide consumers in making healthier food choices. We compared the GI, insulin index (II), and the area under the curve for blood glucose and insulin as glucose (GR) and insulin responses (IR) of a newly developed liquid nutritional formula with one commercially available liquid product with different types of carbohydrates. We then evaluated the glucose and insulin responses of two test foods with comparable energy density and protein percentage but presented in different food forms (liquid vs. solid). Fourteen healthy women participated in the study. GI, II, GR, and IR were assessed after (independent) consumption of two liquid products and a solid breakfast meal. The two liquid foods showed comparable GI, whilst the liquid form appeared to produce lower median GI (25 vs. 54), and II (52 vs. 98) values compared to the solid breakfast (p < 0.02). The median GR and IR for solid breakfast were respectively 44% and 45% higher compared to the liquid product (p < 0.02). Liquid formulas with different carbohydrate qualities produced comparable glucose responses, while foods with comparable energy density and protein percentage but different food form elicited differential effects on GI, II, GR, and IR. Nutrient quality and food form need to be taken into consideration when developing low GI products to manage glycaemic responses

An Electronic Questionnaire Survey Evaluating the Perceived Prevalence and Practices of Lactose Intolerance in 1 to 5 Year Old Children in South East Asia

Purpose: Lactose intolerance (LI) is perceived to be frequent in Asia and has been reported to have considerable impact on dietary intake, nutritional status and the quality of life. We aimed to gather information from healthcare professionals on the perceived incidence, diagnosis and management of LI in 1 to 5 year old children in Southeast Asia. Methods: An anonymous electronic survey was sent randomly among healthcare professionals registered in the database of the pediatric societies in Thailand, Indonesia, and Singapore between June and October 2016. Results: In total, 259 health care professionals responded of which 45.5% (n=118) were from Thailand, 37.4% (n=97) from Indonesia and 16.9% (n=44) from Singapore. Of the participants who responded (n=248), primary LI prevalence among children 1 to 3 years of age was estimated to be less than 5% by 56.8%. However, about 18.9% (n=47) answered they did not know/unsure. Regarding secondary LI, 61.6% of respondents (n=153) estimated the prevalence to be less than 15%. But again, 10.8% (n=27) answered they did not know or unsure. Rotavirus gastroenteritis was ranked as the top cause for secondary LI. There was considerable heterogeneity in the diagnostic methods used. The majority of respondents (75%) recommended lactose-free milk to manage primary and secondary LI. Conclusion: More education/training of pediatricians on this topic and further epidemiological studies using a more systematic approach are required

Strategies and Future Opportunities for the Prevention, Diagnosis, and Management of Cow Milk Allergy

The prevalence of food allergy has increased over the last 20-30 years, including cow milk allergy (CMA) which is one of the most common causes of infant food allergy. International allergy experts met in 2019 to discuss broad topics in allergy prevention and management of CMA including current challenges and future opportunities. The highlights of the meeting combined with recently published developments are presented here. Primary prevention of CMA should start from pre-pregnancy with a focus on a healthy lifestyle and food diversity to ensure adequate transfer of inhibitory IgG- allergen immune complexes across the placenta especially in mothers with a history of allergic diseases and planned c-section delivery. For non-breastfed infants, there is controversy about the preventive role of partially hydrolyzed formulae (pHF) despite some evidence of health economic benefits among those with a family history of allergy. Clinical management of CMA consists of secondary prevention with a focus on the development of early oral tolerance. The use of extensive Hydrolysate Formulae (eHF) is the nutrition of choice for the majority of non-breastfed infants with CMA; potentially with pre-, probiotics and LCPUFA to support early oral tolerance induction. Future opportunities are, among others, pre- and probiotics supplementation for mothers and high-risk infants for the primary prevention of CMA. A controlled prospective study implementing a step-down milk formulae ladder with various degrees of hydrolysate is proposed for food challenges and early development of oral tolerance. This provides a more precise gradation of milk protein exposure than those currently recommended

Six Strategies for Optimizing Linear Growth through Improving Awareness of Breastfeeding, Dietary Diversity in Complementary Feeding, and Growth Monitoring during Early Life

Only one-fourth of the countries under the Sustainable Development Goal are ‘on track’ to reduce the burden of malnutrition as of 2020. A deficit in linear growth during the first 5 years of life is mainly due to growth faltering in the first 1000 days. This deficit has been consistently reported to be linked to suboptimal cognitive neurodevelopment, while its improvement in early childhood has been reported to offer an opportunity for rescuing neurocognitive potential. This paper describes the perspectives of multidisciplinary experts, representing a range of disciplines related to child growth and nutrition, from Nigeria, Indonesia, and Malaysia, who convened virtually to review and discuss measures aimed at preventing a further increase in growth faltering, including stunting, among children aged 0-3 years under the current prevailing circumstances. Based on the latest evidence of practices and knowledge, the expert panel proposed six strategies to support linear growth in early life which consists of 2 new initiatives: 1) increasing peer-to-peer knowledge transfer among HCP via digital engagement; 2) increasing knowledge transfer from HCPs to caregivers via social media; while maintaining the existing strategies: 1) stimulating initiatives to support breastfeeding during the first 6 months of life; 2) improving quality of complementary feeding; 3) strengthening growth monitoring to detect suboptimal growth in early childhood; 4) optimizing public-private engagement. The recommended solutions presented herein are the culmination of the collective insights of the expert panel. These recommendations offer invaluable approaches on addressing the critical public health issue of malnutrition, specifically growth faltering, and can benefit not only the three countries concerned but also other low and middle-income countries facing similar nutritional challenges

Changes in Taste Threshold, Perceived Intensity, Liking, and Preference in Pregnant Women:a Literature Review

Introduction Studies of changes in taste threshold, perceived intensity, liking, and preference during pregnancy were reviewed, because such changes have the potential to negatively impact nutrient intake in pregnant women. Methods Medline and Web of Science were searched; eligibility was based on inclusion, exclusion, and quality criteria. Results Fourteen articles were included: 5 reported taste thresholds, 8 taste intensity, and 13 liking/preferences. Articles addressed sweet, salty, sour, and bitter, not umami. Results of self-reported changes suggested that many women experienced some sort of alteration in taste during pregnancy. Studies with real stimuli demonstrated that the only consistent finding for taste thresholds was that pregnant women showed higher thresholds for bitterness in their first trimester. For taste intensity, no consistent differences between pregnant women and controls were observed. However, over the course of pregnancy, salty intensity seemed to decrease, the intensity of other tastes did not change. During pregnancy, higher saltiness was liked more and salty snacks were consumed more, particularly in the second and/or third trimester. Drinks with lower sweetness were preferred and intake of sweet snacks was highest in the second trimester. Preference for sour and bitter did not seem to be affected. Conclusion Self-reports suggested that many women experienced some taste changes during pregnancy, while changes based on studies with real stimuli were limited. Implications Many women experienced a higher threshold for bitter perception in the first trimester, a preference for sweet snacks in the second trimester, and higher saltiness appetite in the second and third trimester of pregnancy, which may have nutritional consequences

Systematic Literature Review of the Nutrient Status, Intake, and Diet Quality of Chinese Children across Different Age Groups

There is a lack of comprehensive reports on nutrient deficiencies and dietary intake among various age groups of children in China. The objective of this review is to provide an overview of the nutrient status, intake, and diet adequacy of Chinese children (0–18 years old). PubMed and Scopus were searched for literature published between January 2010 and July 2022. A systematic review approach with a quality assessment was performed to analyze 2986 identified articles in English and Chinese. Eighty-three articles were included in the analysis. In younger children, anemia and iron and Vitamin A deficiencies remain severe public health problems, despite high Vitamin A and adequate iron intake. In older children, a high prevalence of selenium; Vitamin A and D deficiencies; and inadequate intakes of Vitamins A, D, B, C, selenium, and calcium were reported. Intakes of dairy, soybeans, fruits, and vegetables were below recommended levels. High intakes of iodine, total and saturated fat, and sodium and low dietary diversity scores were also reported. As nutritional concerns vary with age and region, future nutrition interventions should be tailored accordingly

Relative validity of a semi-quantitative food frequency questionnaire for Singaporean toddlers aged 15–36 months

Abstract Background There is presently no simple tool for use in large epidemiological studies to understand the food and nutrient intakes of Asian toddlers. This study aimed to assess the relative validity of a semi-quantitative food frequency questionnaire (sqFFQ) developed for multi-ethnic Singaporean toddlers aged 15–36 months. Methods Ninety-one parents completed the sqFFQ and a 2-day weighed food record as the reference method. Intake of energy and 25 nutrients were determined for each method and compared using Pearson correlations corrected for attenuation, Bland-Altman plots, and weighted kappa according to quartiles; sqFFQ calibration was performed using multivariable linear regression. Results Deattenuated correlations for energy and all nutrients were acceptable (r = ≥0.30, p < 0.001). The sqFFQ was highly reproducible, but significantly overestimated intake of energy and all nutrients except vitamin A. Bland-Altman plots showed wide limits of agreement for energy and all nutrients. Weighted kappa ranged from 0.12 (slight) to 0.53 (moderate). After calibration, deattenuated correlations improved for energy and 10/25 nutrients, with no change or a slight decline for the remainder, including one falling to r = 0.27. Limits of agreement narrowed for energy and all nutrients, and except for DHA, median intakes were not significantly different except for vitamin A, enabling population estimates of absolute intakes. Weighted kappa improved overall; energy and 16 nutrients now had moderate agreement (0.41–0.60), while 9 nutrients had fair agreement (0.21–0.40). Conclusions The Singaporean toddler semi-quantitative food frequency questionnaire is suitable for ranking nutrient intakes of Singaporean toddlers in larger epidemiological studies. However, for population estimates of absolute nutrient intakes, it is recommended that a subsample within a cohort complete weighed food records for calibration purposes. Trial registration This study was registered retrospectively on clinicaltrials.gov on 3rd May 2017 (identifier code: NCT03138330)