Associations between human milk oligosaccharides and growth in infancy and early childhood

Background: Breastfeeding modulates infant growth and protects against the development of obesity. However, whether or not maternal variation in human milk components, such as human milk oligosaccharides (HMOs), is associated with programming of child growth remains unknown.Objective: Our objective was to determine the association between maternal HMO composition and child growth during the first 5 y of life. In addition, the association between maternal prepregnancy BMI and HMO composition was assessed.Methods: Human milk samples from 802 mothers were obtained from a prospective population-based birth cohort study, Steps to healthy development of Children (STEPS), conducted in Turku, Finland. HMO composition in these milk samples was analyzed by HPLC. Child growth data from 3 mo to 5 y were collected from municipal well-baby clinics and linked to maternal HMO composition data to test for associations.Results: Maternal HMO composition 3 mo after delivery was associated with height and weight during the first 5 y of life in children of secretor mothers. Specifically, HMO diversity and the concentration of lacto-N-neo-tetraose (LNnT) were inversely associated and that of 2'-fucosyllactose (2'FL) was directly associated with child height and weight z scores in a model adjusted for maternal prepregnancy BMI, mode of delivery, birthweight z score, sex, and time. Maternal prepregnancy BMI was associated with HMO composition.Conclusions: The association between maternal HMO composition and childhood growth may imply a causal relation, which warrants additional testing in preclinical and clinical studies, especially since 2'FL and LNnT are among the HMOs now being added to infant formula. Furthermore, altered HMO composition may mediate the impact of maternal prepregnancy BMI on childhood obesity, which warrants further investigation to establish the cause-and-effect relation.</p

Neighborhood Socioeconomic Disadvantage and Childhood Body Mass Index Trajectories From Birth to 7 Years of Age

Background: The epidemic of increasing childhood overweight and obesity is a major global health concern, with local contextual factors identified as possible contributors. Robust research is needed to establish an evidence base supporting health policy decisions to reverse the trend. We aimed to examine the association between neighborhood socioeconomic disadvantage and trajectories of body mass index (BMI) from birth to age 7.Methods: The present study included 11,023 children born within the Southwest Finland Birth Cohort who were free of severe conditions affecting growth with adequate exposure and growth data. We obtained child growth data until school age from municipal follow-up clinics. We based cumulative childhood neighborhood socioeconomic disadvantage on the average annual income, unemployment, and level of education in a residential area defined using a geographic grid at a spatial resolution of 250 m by 250 m.Results: Cumulative neighborhood socioeconomic disadvantage was associated with distinct childhood BMI z score trajectories from birth to age 7. Despite being born in the lowest BMI z scores, children growing up in disadvantaged neighborhoods subsequently exhibited a trajectory of increasing BMI z scores starting at 4 years of age, ending up with a higher risk of overweight at the end of the follow-up (30%) as compared with children living in more affluent neighborhoods (22%). The corresponding risk of obesity was 5 % for those in affluent neighborhoods and 9 % and those in disadvantaged neighborhoods.Conclusion: Cumulative exposure to neighborhood socioeconomic disadvantage is independently associated with unfavorable BMI development and obesity in childhood.</p

Neonatal antibiotic exposure impairs child growth during the first six years of life by perturbing intestinal microbial colonization

Exposure to antibiotics in the first days of life is thought to affect various physiological aspects of neonatal development. Here, we investigate the long-term impact of antibiotic treatment in the neonatal period and early childhood on child growth in an unselected birth cohort of 12,422 children born at full term. We find significant attenuation of weight and height gain during the first 6 years of life after neonatal antibiotic exposure in boys, but not in girls, after adjusting for potential confounders. In contrast, antibiotic use after the neonatal period but during the first 6 years of life is associated with significantly higher body mass index throughout the study period in both boys and girls. Neonatal antibiotic exposure is associated with significant differences in the gut microbiome, particularly in decreased abundance and diversity of fecal Bifidobacteria until 2 years of age. Finally, we demonstrate that fecal microbiota transplant from antibiotic-exposed children to germ-free male, but not female, mice results in significant growth impairment. Thus, we conclude that neonatal antibiotic exposure is associated with a long-term gut microbiome perturbation and may result in reduced growth in boys during the first six years of life while antibiotic use later in childhood is associated with increased body mass index. In this study, Omry Koren, Samuli Rautava and colleagues report a sex-specific association between neonatal antibiotic exposure and weight and height gain during the first six years of life and showing that boys but not girls exposed to neonatal antibiotics exhibit impaired weight and height development

Differences in selling B2B and B2C markets : sales psychology and customer experience

This thesis handles the differences between selling in the business market and the consumer market in general and from the aspect of sales psychology. Selling has changed radically in the recent years and salespeople must develop their actions all the time to meet the needs of the customers. The goal was to find out whether the sales representatives acknowledge their use of sales psychology and if there are significant differences between the actions of the salespeople and the sales psychology used in these different markets. This thesis was an assignment to Helsinki Sales Academy. First, in the theory part, the differences between the business markets and the consumer markets are explained. As the markets are different, so are the buyers and different types of buying behavior are depicted next and also the factors that affect buyer decision-making process. Buyers are affected in various ways and it is important for the seller to understand what goes on in the customer’s mind. The sales representative usually is the link between the company and the customers and it is important for the company to constantly train and educate their sales force. People working on sales have to master different skills and the use of sales psychology is fairly new to the sales representatives especially in Finland. Sales psychology is also closely linked with the customer experience and this is explained in the theory part. As a part of this thesis, a survey was conducted which consisted of personal interviews with sales representatives in the business market and of an e-mail survey which was sent to sellers working in the consumer market. The results indicated that both groups are using sales psychology in their own way but in general they do not acknowledge psychological factors in their use. Psychology however is present almost all the time in the actions of the seller because the buyer is affected by everything that the sales representative does. Results showed also that the sales representatives working on these two markets emphasize different things to the buyers depending on the market they are in.Tämä opinnäytetyö käsittelee yritysmarkkinoiden ja kuluttajamarkkinoiden eroja käytännön tasolla ja erityisesti myynnin ja myyntipsykologian näkökulmasta. Myynnissä on viime aikoina tapahtunut merkittäviä muutoksia ja myyntihenkilöstön tulee kehittää omaa toimintaansa vastaamaan ostajien muuttuvia tarpeita. Tavoitteena oli ottaa selvää, tiedostavatko myyjät käyttävänsä myyntipsykologisia keinoja ja mikäli kuluttajamyynnin ja yritysmyynnin välillä on suuria eroja myyntihenkilöstön toiminnassa ja myyntipsykologian käytössä. Teoriaosa erottelee ensin kuluttajamarkkinat ja yritysmarkkinat toisistaan sekä käsittelee ostajien käyttäytymistä ja siihen vaikuttavia tekijöitä näillä markkinoilla. Erilaisiin ihmisiin vaikuttavat erilaiset asiat ja psykologiset tekijät ja myyjän on elintärkeää tietää, mitä ostaja ajattelee ja millaiset hänen tarpeensa ovat. Myyjä on useimmiten linkki myyjäyrityksen ja ostajan välillä ja siksi yrityksille onkin tärkeää kouluttaa ja kehittää myyntihenkilöstöään jatkuvasti. Myyjien tulee osata suuri määrä erilaisia taitoja ja myyntipsykologian käyttö on suhteellisen uutta myyjille erityisesti Suomessa. Myyntipsykologia on läheisessä yhteydessä asiakaskokemukseen ja myös tätä käydään teoriaosassa läpi. Opinnäytetyötä varten suoritettiin tutkimus, joka koostui yritysmyyjille tehdyistä henkilökohtaisista haastatteluista ja kuluttajamyyjille suunnatusta sähköpostikyselystä. Tulosten perusteella molemmat ryhmät käyttävät jonkin verran myyntipsykologisia keinoja, vaikka he eivät aina niitä itse tiedostakaan. Psykologiset tekijät ovat kuitenkin läsnä lähes kaikissa myyjän teoissa. Tulokset osoittivat myös että myyjät painottavat eri asioita ostajille riippuen siitä, toimitaanko kuluttaja- vai yritysmyynnin parissa

Early life exposures and development of allergic disease in infants with familial risk: results from ongoing probiotic intervention trials

Aim: We search revision of risk determinants of the ongoing allergy epidemic.Methods: 433 children born to mothers with allergic disease or sensitization were selected from the three ongoing probiotic intervention trials for this case-control study. Children who developed atopic eczema or food allergy, had positive skin prick test results or had been prescribed inhaled corticosteroids by the age of two years were identified as cases (n=231) while children without allergic manifestations were the healthy controls (n=202). The data on early environmental exposures were collected from prospectively documented study records. The statistical analyses were adjusted for potential confounders.Results: Determinants associated with the increased risk of atopic eczema were lower maternal prepregnancy BMI (aOR 0.15, 95% CI: 0.037 – 0.54) and maternal intrapartum antibiotic treatment (aOR 2.21, 95% CI 1.20 – 4.10), the latter also linked to obstructive respiratory symptoms (aOR 3.87, 95% CI 1.07 – 14.06). The risk of allergic sensitization was associated with lower maternal prepegnancy BMI (aOR 0.18, 95% CI 0.43 – 0.79) and intrapartum antibiotic treatment (aOR 2.13, 95% CI 1.07 – 4.22).Conclusion: Based on our demonstrations, interventions such as personalized diets, can be optimized for specific subgroups and definite risk periods.</p

Neighborhood Socioeconomic Disadvantage and Childhood Body Mass Index Trajectories From Birth to 7 Years of Age

Background: The epidemic of increasing childhood overweight and obesity is a major global health concern, with local contextual factors identified as possible contributors. Robust research is needed to establish an evidence base supporting health policy decisions to reverse the trend. We aimed to examine the association between neighborhood socioeconomic disadvantage and trajectories of body mass index (BMI) from birth to age 7. Methods: The present study included 11,023 children born within the Southwest Finland Birth Cohort who were free of severe conditions affecting growth with adequate exposure and growth data. We obtained child growth data until school age from municipal follow-up clinics. We based cumulative childhood neighborhood socioeconomic disadvantage on the average annual income, unemployment, and level of education in a residential area defined using a geographic grid at a spatial resolution of 250 m by 250 m. Results: Cumulative neighborhood socioeconomic disadvantage was associated with distinct childhood BMI z score trajectories from birth to age 7. Despite being born in the lowest BMI z scores, children growing up in disadvantaged neighborhoods subsequently exhibited a trajectory of increasing BMI z scores starting at 4 years of age, ending up with a higher risk of overweight at the end of the follow-up (30%) as compared with children living in more affluent neighborhoods (22%). The corresponding risk of obesity was 5 % for those in affluent neighborhoods and 9 % and those in disadvantaged neighborhoods. Conclusion: Cumulative exposure to neighborhood socioeconomic disadvantage is independently associated with unfavorable BMI development and obesity in childhood.Peer reviewe

Neonatal antibiotic exposure impairs child growth during the first six years of life by perturbing intestinal microbial colonization

Exposure to antibiotics in the first days of life is thought to affect various physiological aspects of neonatal development. Here, we investigate the long-term impact of antibiotic treatment in the neonatal period and early childhood on child growth in an unselected birth cohort of 12,422 children born at full term. We find significant attenuation of weight and height gain during the first 6 years of life after neonatal antibiotic exposure in boys, but not in girls, after adjusting for potential confounders. In contrast, antibiotic use after the neonatal period but during the first 6 years of life is associated with significantly higher body mass index throughout the study period in both boys and girls. Neonatal antibiotic exposure is associated with significant differences in the gut microbiome, particularly in decreased abundance and diversity of fecal Bifidobacteria until 2 years of age. Finally, we demonstrate that fecal microbiota transplant from antibiotic-exposed children to germ-free male, but not female, mice results in significant growth impairment. Thus, we conclude that neonatal antibiotic exposure is associated with a long-term gut microbiome perturbation and may result in reduced growth in boys during the first six years of life while antibiotic use later in childhood is associated with increased body mass index. In this study, Omry Koren, Samuli Rautava and colleagues report a sex-specific association between neonatal antibiotic exposure and weight and height gain during the first six years of life and showing that boys but not girls exposed to neonatal antibiotics exhibit impaired weight and height development.Peer reviewe

Relationship between obstructive coronary artery disease and abnormal stress testing in patients with paroxysmal or persistent atrial fibrillation

Atrial fibrillation (AF) has been linked to the presence of underlying coronary artery disease (CAD). However, whether the higher burden of CAD observed in AF patients translates into higher burden of myocardial ischemia is unknown. In 87 patients (71% male, mean age 61 ± 10 years) with paroxysmal or persistent AF and without history of CAD, MSCT coronary angiography and stress testing (exercise ECG test or myocardial perfusion imaging) were performed. CAD was classified as obstructive (≥50% luminal narrowing) or not. Stress tests were classified as normal or abnormal. A population of 122 patients without history of AF, similar to the AF group as to age, gender, symptomatic status and pre-test likelihood, served as a control group. Based on MSCT, 17% of AF patients were classified as having no CAD, whereas 43% showed non-obstructive CAD and the remaining 40% had obstructive CAD. A positive stress test was observed in 49% of AF patients with obstructive CAD. Among non-AF patients, 34% were classified as having no CAD, while 41% showed non-obstructive CAD and 25% had obstructive CAD (P = 0.013 compared to AF patients). A positive stress test was observed in 48% of non-AF patients with obstructive CAD. In conclusion, the higher burden of CAD observed in AF patients is not associated to higher burden of myocardial ischemia