Early Growth and Adult Health : Focus on Resting Metabolism, Non-alcoholic Fatty Liver Disease, Hypertension and Regional Differences in Birth Size

Background. A small birth size, an indicator of a suboptimal intrauterine environment, is a risk factor for several non-communicable diseases (NCDs), a risk that in many cases is modified by childhood growth patterns. Regional variation in NCD prevalence could partly have its origin in early development. Lifestyle factors further influence NCD prevalence. Aims. We aimed to explore the associations between early growth and adult resting metabolic rate (RMR), body composition, non-alcoholic fatty liver disease (NAFLD), and hypertension. We also studied the associations between fructose intake and NAFLD, and differences in birth size between Helsinki and the Åland Islands. Subjects and methods. The Helsinki Birth Cohort Study consists of 13345 individuals born in Helsinki in 1934‒44. Detailed records are available for all participants including information on maternal and birth characteristics and measurements of childhood body size. 2003 individuals participated in a clinical study in 2001‒04 and 1083 of these additionally participated in a follow-up study in 2006‒08. The Åland records include 1697 births for the years 1937‒44. Results. The association between birth weight and RMR was inverse among women and quadratic among men. A higher attained adult weight than expected, based on weight and height measurements before age 11 years and adult height, was associated with higher adult body fat content. The odds ratio (OR) for NAFLD was 18.5 (95% CI 10.1; 33.6) among those who belonged to the lowest BMI tertile at age 2 years and subsequently were obese as adults, compared to those who were still lean or normal weight as adults. NAFLD was most common among individuals with the lowest dietary fructose intake. Systolic blood pressure (SBP) and the presence of hypertension were inversely associated with linear (height) growth between ages 2 and 11 years. Relative weight gain after age 11 years was positively associated with SBP. Ålandic babies born 1937‒44 were 87 grams (95% CI 61; 111) heavier and 0.4 cm (95% CI 0.3; 0.5) longer than their Helsinki peers. Conclusions. A more pronounced increase in relative weight after age 11 years than would be expected from previous body size, was positively associated with body fat content, NAFLD, and hypertension. Conversely, several growth measurements before age 11 years were negatively associated with the outcomes studied. None of the studied individuals were obese in childhood. Instead, a larger relative childhood body size in this group most likely represents a more beneficial childhood environment. Contrary to previous findings, we found that individuals with the highest fructose intake were least likely to suffer from NAFLD. We found a small but significant difference in birth size between the Åland Islands and Helsinki for the years 1937‒44.Tausta. Pieni syntymäpaino on yhdistetty suurentuneeseen riskiin sairastua moneen kansantautiin. Tähän riskiin vaikuttaa lapsuuden kasvukuvio. Monien kansantautien esiintyvyys vaihtelee sekä maiden välillä että niiden sisällä. Muun muassa on hiljattain todettu, että Ahvenanmaan väestö on Suomen terveintä. Lisäksi sairastumisriskiin vaikuttavat elintavat. Muun muassa hedelmäsokerin nauttimisen on ehdotettu olevan riski alkoholin käytöstä riippumattoman rasvamaksan (NAFLD, non-alcoholic fatty liver disease) esiintymiseen. Tavoitteet. Päätarkoituksena oli tutkia yhteyksiä varhaisen kasvun ja kehonkoostumuksen, lepoaineenvaihdunnan, NAFLD:n ja verenpaineen välillä. Tavoitteena oli myös arvioida yhteyttä nautitun hedelmäsokerimäärän ja NAFLD:n välillä sekä lisäksi arvioida eroavaisuuksia syntymäkoossa vuosina 1937‒1944 Helsingin ja Ahvenanmaan välillä. Aineisto. Helsingin syntymäkohortti, joka koostuu 13345 Helsingissä vuosien 1934‒1944 välillä syntyneestä henkilöstä. Heistä on saatavilla yksityiskohtaiset tiedot, muun muassa syntymäpaino sekä lapsuuden paino- ja pituusmitat. 2003 henkilöä osallistui vuosien 2001‒2004 välillä kliiniseen tutkimukseen ja 1083 heistä osallistui vielä seurantatutkimukseen vuosien 2006‒2008 välillä. Ahvenanmaan aineistoon kuuluu 1697 vuosina 1937‒1944 syntynyttä henkilöä. Tulokset. Kun kehonkoostumus oli otettu huomioon, huomattiin korkein lepoaineenvaihdunta naisilla, joilla oli alhaisin syntymäpaino, sekä miehillä, joilla oli sekä alhaisin että toisaalta korkein syntymäpaino. NAFLD oli tavallisin yksilöillä, jotka olivat pieniä varhaislapsuudessa ja aikuisina obeeseja. NAFLD:n pienin esiintyvyys oli niillä, jotka nauttivat eniten hedelmäsokeria. Oletettua nopeampi kasvu 2. ja 11. ikävuoden välillä oli yhteydessä alhaisempaan verenpaineeseen, kun taas päinvastaista tulosta ennusti kasvu 11. ikävuoden jälkeen. Ahvenanmaalla vuosina 1937‒1944 syntyneet lapset olivat keskimäärin 87 grammaa painavampia ja 0,4 cm pidempiä kuin Helsingissä syntyneet. Päätelmät. Aikaisempaan kokoon nähden odotettua nopeampi kasvu 11. ikävuoden jälkeen oli yhteydessä lisääntyneeseen kehon rasvaprosenttiin, korkeaan verenpaineeseen ja sairastumiseen NAFLD:iin. Kasvu ennen 11. ikävuotta näytti vaikuttavan suotuisasti. Vaikka lapsuuslihavuus on tänä päivänä tavallista, sitä ei juuri esiintynyt tutkittavilla yksilöillä. NAFLD:a esiintyi vähiten yksilöillä, jotka nauttivat eniten hedelmäsokeria. Tämä johtui todennäköisesti siitä, että nautitun hedelmäsokerin määrä oli pienempi kuin aikaisemmissa tutkimuksissa ja että hedelmäsokerin lähteenä olivat hedelmät eivätkä virvoitusjuomat. Pieni ero huomattiin syntymäpainossa Ahvenanmaan ja Helsingin välillä.Bakgrund. En liten födelsestorlek är förknippad med en ökad risk att utveckla ett flertal folksjukdomar. Denna risk påverkas av barndomens tillväxtmönster. Förekomsten av många folksjukdomar varierar dessutom inom och mellan länder. Bland annat har befolkningen på Åland nyligen konstaterats vara Finlands friskaste. Vidare påverkas sjukdomsrisk av livsstilsfaktorer. Bland annat har intag av fruktsocker kopplats till förekomst av icke-alkoholorsakad fettlever (NAFLD, non-alcoholic fatty liver disease). Syfte. Huvudsyftet var att studera sambanden mellan tidig tillväxt och kroppssammansättning, viloämnesomsättning, NAFLD samt högt blodtryck. Dessutom studerades sambanden mellan intag av fruktsocker och förekomsten av NAFLD samt skillnader i födelsestorlek mellan Helsingfors och Åland under åren 1937‒44. Studiedeltagare. I Helsingfors födelsekohortstudie ingår 13345 personer födda 1934‒44. För samtliga deltagare finns omfattande uppgifter avseende bland annat födelsestorlek samt vikt- och längdmått under barndomen. 2003 personer ingick i en klinisk studie under åren 2001‒04 och 1083 av dessa deltog dessutom i en uppföljningsstudie 2006‒08. I vårt åländska material ingick 1697 födslar från åren 1937‒44. Resultat. Efter att hänsyn tagits för kroppssammansättning, sågs högst vilometabolism hos kvinnor med lägst födelsevikt samt hos män med lägst och högst födelsevikt. NAFLD var vanligast hos individer som var små i tidig barndom och sedermera obesa som vuxna. Lägst förekomst av NAFLD sågs hos de som hade högst kostintag av fruktsocker. En snabbare än förväntad tillväxt mellan 2 och 11 års ålder var förknippat med lägre blodtryck vid 66.4 års medelålder medan det motsatta sågs för tillväxt efter 11 års ålder. Barn födda på Åland under åren 1937‒44 var i genomsnitt 87 gram tyngre och 0.4 cm längre än de som föddes i Helsingfors. Slutsatser. Snabbare än förväntad vikttillväxt efter 11 års ålder är förknippad med förekomst av NAFLD, högt blodtryck samt med högre andel kroppsfett. Tillväxt innan 11 års ålder, å andra sidan, verkar ha haft ett gynnsamt inflytande. Emedan barnfetma idag är vanligt, förekom det inte bland de studerade individerna. NAFLD var minst vanligt bland individer med det högsta intaget av fruktsocker. Detta beror sannolikt delvis på att mängden intaget fruktsocker var lägre än i tidigare studier samt att källan i första hand var frukt, inte läskedrycker. En liten skillnad i födelsestorlek noterades mellan Åland och Helsingfors

Bone mineral density in very low birthweight adults-A sibling study

Background Children and adults born very low birthweight (VLBW,Peer reviewe

Effect of maternal weight during pregnancy on offspring muscle strength response to resistance training in late adulthood

Purpose: Maternal obesity can unfavorably influence offspring body composition, muscle strength, and possibly muscle's adaptability to training, but the human studies are scarce. Therefore, we aimed to investigate the effect of maternal obesity on offspring muscle strength responses to resistance training intervention in elderly frail women. Materials/methods: Recruited participants were elderly frail women offspring of lean/normal weight mothers (n = 19, mean body mass index (BMI): 22.8 kg/m2, range: 19.9-24.5) or overweight/obese mothers (n = 16, mean BMI: 29.7 kg/m2, range: 28.2-34.2). Information on maternal BMI immediately prior to delivery was collected from the birth registers. All women participated in a 4-month supervised progressive resistance training intervention three times a week for 60 min. Predicted 1-RM of abdominal crunch, hip abduction, leg curl, leg press, seated row, and total strength were measured at baseline and after each month of training. Results: According to rANOVA, strength increased significantly in both groups (p for time 0.072). On average, muscle strength of the women offspring of overweight/obese mothers tended to be lower than in women offspring of lean/normal weight mothers, but the only significant difference was found in leg curl (p = 0.006). No significant differences between the groups were found in relative strength changes from baseline to 4-months. Conclusions: Muscle strength response to supervised resistance training is not modulated by maternal adiposity in late pregnancy in elderly frail female offspring.Peer reviewe

Resistance Training Increases White Matter Density in Frail Elderly Women

We aimed to investigate the effects of maternal obesity on brain structure and metabolism in frail women, and their reversibility in response to exercise. We recruited 37 frail elderly women (20 offspring of lean/normal-weight mothers (OLM) and 17 offspring of obese/overweight mothers (OOM)) and nine non-frail controls to undergo magnetic resonance and diffusion tensor imaging (DTI), positron emission tomography with Fluorine-18-fluorodeoxyglucose (PET), and cognitive function tests (CERAD). Frail women were studied before and after a 4-month resistance training, and controls were studied once. White matter (WM) density (voxel-based morphometry) was higher in OLM than in OOM subjects. Exercise increased WM density in both OLM and OOM in the cerebellum in superior parietal regions in OLM and in cuneal and precuneal regions in OOM. OLM gained more WM density than OOM in response to intervention. No significant results were found from the Freesurfer analysis, nor from PET or DTI images. Exercise has an impact on brain morphology and cognition in elderly frail women

Abdominal adipose tissue and liver fat imaging in very low birth weight adults born preterm : birth cohort with sibling-controls

Preterm birth at very low birth weight (VLBW, < 1500 g) is associated with an accumulation of cardiovascular and metabolic risk factors from childhood at least to middle age. Small-scale studies suggest that this could partly be explained by increased visceral or ectopic fat. We performed magnetic resonance imaging on 78 adults born preterm at VLBW in Finland between 1978 and 1990 and 72 term same-sex siblings as controls, with a mean age of 29 years. We collected T1-weighted images from the abdomen, and magnetic resonance spectra from the liver, subcutaneous abdominal adipose tissue, and tibia. The adipose tissue volumes of VLBW adults did not differ from their term siblings when adjusting for age, sex, and maternal and perinatal factors. The mean differences were as follows: subcutaneous - 0.48% (95% CI - 14.8%, 16.3%), visceral 7.96% (95% CI - 10.4%, 30.1%), and total abdominal fat quantity 1.05% (95% CI - 13.7%, 18.4%). Hepatic triglyceride content was also similar. VLBW individuals displayed less unsaturation in subcutaneous adipose tissue (- 4.74%, 95% CI - 9.2%, - 0.1%) but not in tibial bone marrow (1.68%, 95% CI - 1.86%, 5.35%). VLBW adults displayed similar adipose tissue volumes and hepatic triglyceride content as their term siblings. Previously reported differences could thus partly be due to genetic or environmental characteristics shared between siblings. The VLBW group displayed less unsaturation in subcutaneous abdominal adipose tissue, suggesting differences in its metabolic activity and energy storage.Peer reviewe

Effect of Vitamin D3Supplementation in the First 2 Years of Life on Psychiatric Symptoms at Ages 6 to 8 Years : A Randomized Clinical Trial

Importance: Vitamin D is associated with neurodevelopment, but causality, critical windows, and potentials for modification remain unknown. Objective: To determine the impact of high-dose (1200 IU) vs standard-dose (400 IU) vitamin D3supplementation during the first 2 years on psychiatric symptoms at ages 6 to 8 years and whether the impact is different in children with lower vs higher maternal vitamin D3levels; lower vs higher levels were defined as 25-hydroxyvitamin D (25[OH]D) less than 30 ng/mL vs 30 ng/mL or greater. Design, Setting, and Participants: This study was a long-term follow-up of the double-blind randomized clinical trial (RCT) Vitamin D Intervention in Infants (VIDI) conducted at a single center in Helsinki, Finland, at 60 degrees north latitude. Recruitment for VIDI took place in 2013 to 2014. Follow-up data for secondary data analysis were collected 2020 to 2021. VIDI originally included 987 term-born infants; 546 of these individuals participated in the follow-up at ages 6 to 8 years, among whom 346 individuals had data on parent-reported psychiatric symptoms. Data were analyzed from June 2022 to March 2023. Interventions: There were 169 infants randomized to receive 400-IU and 177 infants randomized to receive 1200-IU oral vitamin D3supplementation daily from ages 2 weeks to 24 months. Main Outcomes and Measures: Primary outcomes were internalizing, externalizing, and total problems scores, with clinically significant problems defined as T scores of 64 or greater in the Child Behavior Checklist questionnaire. Results: Among 346 participants (164 females [47.4%]; mean [SD] age, 7.1 [0.4] years), the vitamin D3dose was 400 IU for 169 participants and 1200 IU for 177 participants. Clinically significant internalizing problems occurred in 10 participants in the 1200-IU group (5.6% prevalence) compared with 20 participants (11.8%) in the 400-IU group (odds ratio, 0.40; 95% CI, 0.17-0.94; P =.04) after adjustment for sex, birth season, maternal depressive symptoms at birth, and parental single status at follow-up. In a post hoc subgroup analysis, 48 children in the 400-IU group with maternal 25(OH)D concentrations less than 30 ng/mL had higher internalizing problems scores compared with children in the 1200-IU group, including 44 children with maternal 25(OH)D concentrations below 30 ng/mL (adjusted mean difference, 0.49; 95% CI, 0.09-0.89; P =.02) and 91 children with maternal concentrations above 30 ng/mL (adjusted mean difference, 0.37; 95% CI, 0.03-0.72; P =.04). Groups did not differ in externalizing or total problems. Conclusions and Relevance: This randomized clinical trial found that higher-than-standard vitamin D3supplementation in the first 2 years decreased risk of internalizing problems at ages 6 to 8 years. Trial Registration: ClinicalTrials.gov Identifiers: NCT01723852 (VIDI) and NCT04302987 (VIDI2).Peer reviewe

Femoral Bone Marrow Insulin Sensitivity Is Increased by Resistance Training in Elderly Female Offspring of Overweight and Obese Mothers

Abstract-Bone marrow insulin sensitivity may be an important factor for bone health in addition to bone mineral density especially in insulin resistant conditions. First we aimed to study if prenatal maternal obesity plays a role in determining bone marrow insulin sensitivity in elderly female offspring. Secondly we studied if a four-month individualized resistance training intervention increases bone marrow insulin sensitivity in elderly female offspring and whether this possible positive outcome is regulated by the offspring’s mother’s obesity status. 37 frail elderly females (mean age 71.9 ± 3.1 years) of which 20 were offspring of lean/normal-weight mothers (OLM, maternal BMI ≤ 26.3 kg/m2) and 17 were offspring of obese/overweight mothers (OOM, maternal BMI ≥ 28.1 kg/m2) were studied before and after a four-month individualized resistance training intervention. Nine age- and sex-matched non-frail controls (maternal BMI ≤ 26.3 kg/m2) were studied at baseline. Femoral bone marrow (FBM) and vertebral bone marrow (VBM) insulin sensitivity were measured using [18F]fluoro-2-deoxy-D-glucose positron emission tomography with computer tomography under hyperinsulinemic euglycemic clamp. We found that bone marrow insulin sensitivity was not related to maternal obesity status but FBM insulin sensitivity correlated with whole body insulin sensitivity (R = 0.487, p = 0.001). A four-month resistance training intervention increased FBM insulin sensitivity by 47% (p = 0.006) only in OOM, while VBM insulin sensitivity remained unchanged regardless of the maternal obesity status. In conclusion, FBM and VBM glucose metabolism reacts differently to a four-month resistance training intervention in elderly women according to their maternal obesity status.</p

Femoral Bone Marrow Insulin Sensitivity Is Increased by Resistance Training in Elderly Female Offspring of Overweight and Obese Mothers

Bone marrow insulin sensitivity may be an important factor for bone health in addition to bone mineral density especially in insulin resistant conditions. First we aimed to study if prenatal maternal obesity plays a role in determining bone marrow insulin sensitivity in elderly female offspring. Secondly we studied if a four-month individualized resistance training intervention increases bone marrow insulin sensitivity in elderly female offspring and whether this possible positive outcome is regulated by the offspring's mother's obesity status. 37 frail elderly females (mean age 71.9 +/- 3.1 years) of which 20 were offspring of lean/normal-weight mothers (OLM, maternal BMI = 28.1 kg/m(2)) were studied before and after a four-month individualized resistance training intervention. Nine age-and sex-matched non-frail controls (maternal BMIPeer reviewe

STABILIZED FINITE ELEMENT METHOD FOR SOLIDS WITH LARGE GRADIENT MECHANICAL PROPERTIES

ABSTRACT Many polymers exhibit mechanical properties that vary greatly with temperature. The stress-strain relationships may include a tensile modulus that for certain temperature ranges decreases drastically. For instance, linear amorphous polymers have glassy-transition-rubbery-flow regions where the Young&apos;s modulus is nearly constant in the glassy and rubbery plateau, but decreases rapidly with temperature in the transition and flow regions. To predict displacement of solids the finite element method (FEM) is often used. However, for structural problem with large variations of material properties the stability of the solution is affected negatively. In this work we formulate a sub-scale finite element formulation for thermal plasticity problems based on differential inclusions of elliptic and parabolic type

Stabilized Finite Element Method for Solids with Large Gradient Mechanical Properties

Many polymers exhibit mechanical properties that vary greatly with temperature. The stress-strain relationships may include a tensile modulus that for certain temperature ranges decreases drastically. For instance, linear amorphous polymers have glassy-transition-rubbery-flow regions where the Young\u27s modulus is nearly constant in the glassy and rubbery plateau, but decreases rapidly with temperature in the transition and flow regions. To predict displacement of solids the finite element method (FEM) is often used. However, for structural problem with large variations of material properties the stability of the solution is affected negatively. In this work we formulate a sub-scale finite element formulation for thermal plasticity problems based on differential inclusions of elliptic and parabolic typ