Sources and Health Benefits of Functional Food Components

Functional foods are the foods claimed that have additional health benefits beyond their basic nutritional values, and functional food components are bioactive, potentially beneficial compounds that are found either naturally in foods or added to them as functional ingredients. Some important functional food components are carotenoids, isothiocyanates, soluble and insoluble dietary fiber, phenolic acids, fatty acids, plant stanols and sterols, flavonoids, polyols, soy protein, prebiotics and probiotics, phytoestrogens, vitamins, and minerals. Most of the functional food components occur mainly in plant foods (whole grains, fruits, and vegetables), however, few functional foods components, such as omega-3, -6, and -9 polyunsaturated fatty acids are also found in animal products (e.g. milk, fermented milk products, and cold-water fish). Evidence suggested that there is a relationship between functional food components and health benefits. Functional food components can be used for the treatment and prevention of different diseases. Biologically active functional food components can reduce the risk of certain non-communicable diseases, such as cancer, type II diabetes, cardiovascular diseases, osteoporosis, inflammation, and lowering of blood cholesterol. Thus, people should consume a wide variety of foods to assure the ingestion of functional food components in their body, such as fatty acids, fiber, carotenoids, flavonoids, prebiotics and probiotics, vitamins, and mineral

Prediction Equations for Body-fat Percentage in Indian Infants and Young Children Using Skinfold Thickness and Mid-arm Circumference

The objective of the study was to develop prediction equations for fat-mass percentage in infants in India based on skinfold thickness, mid-arm circumference, and age. Skinfold thicknesses and mid-arm circumference of 46 apparently-healthy infants (27 girls and 19 boys), aged 6–24 months, from among the urban poor attending a well baby clinic of a hospital in Kolkata were measured. Their body-fat percentage was measured using the D2O dilution technique as the reference method. Equations for body-fat percentage were developed using a stepwise forward regression model using skinfold thicknesses, mid-arm circumference, and age as independent variables, and the body-fat percentage was derived by D2O dilution as the dependent variable. The new prediction equations are: body-fat percentage=-69.26+5.76×B-0.33×T2+5.40×M+0.01×A2 for girls and body-fat percentage=-8.75+3.73×B+2.57×S for boys, where B=biceps skinfold thickness, T=triceps skinfold thickness, and S=suprailiac skinfold thickness all in mm, M=mid-arm circumference in cm, and A=age in month. Using the D2O dilution technique, the means (SD) of the calculated body-fat percentage were 17.11 (7.25) for girls and 16.93 (6.62) for boys and, using the new prediction equations, these were 17.11 (6.25) for girls and 16.93 (6.02) for boys. The mean of the differences of paired values in body-fat percentage was zero. The mean (SD) of the differences of paired values for body-fat percentage derived by the D2O technique and the new equations, applied on an independent sample of 23 infants (11 girls and 12 boys) were -0.93 (6.56) for girls and 1.14 (2.43) for boys; the 95% confidence limits of the differences of paired values for body-fat percentage were -2.03 to +3.89 for girls and -0.26 to +2.54 for boys. Given that the trajectories of growth during infancy and childhood are a major risk factor for a group of diseases in adulthood, including coronary heart disease and diabetes, these predictive equations should be useful in field studies

Prediction equations for body-fat percentage in Indian infants and young children using skinfold thickness and mid-arm circumference

The objective of the study was to develop prediction equations for fat-mass percentage in infants in In-dia based on skinfold thickness, mid-arm circumference, and age. Skinfold thicknesses and mid-arm cir-cumference of 46 apparently-healthy infants (27 girls and 19 boys), aged 6-24 months, from among the urban poor attending a well baby clinic of a hospital in Kolkata were measured. Their body-fat percent-age was measured using the D 2 O dilution technique as the reference method. Equations for body-fat per-centage were developed using a stepwise forward regression model using skinfold thicknesses, mid-arm circumference, and age as independent variables, and the body-fat percentage was derived by D 2 O dilu-tion as the dependent variable. The new prediction equations are: body-fat percentage=-69.26+5.76\u3a7B-0.33\u3a7T 2 +5.40\u3a7M+0.01\u3a7A 2 for girls and body-fat percentage=-8.75+3.73\u3a7B+2.57\u3a7S for boys, where B=biceps skinfold thickness, T=triceps skinfold thickness, and S=suprailiac skinfold thickness all in mm, M=mid-arm circumference in cm, and A=age in month. Using the D 2 O dilution technique, the means (SD) of the cal-culated body-fat percentage were 17.11 (7.25) for girls and 16.93 (6.62) for boys and, using the new predic-tion equations, these were 17.11 (6.25) for girls and 16.93 (6.02) for boys. The mean of the differences of paired values in body-fat percentage was zero. The mean (SD) of the differences of paired values for body-fat percentage derived by the D 2 O technique and the new equations, applied on an independent sample of 23 infants (11 girls and 12 boys) were -0.93 (6.56) for girls and 1.14 (2.43) for boys; the 95% confidence limits of the differences of paired values for body-fat percentage were -2.03 to +3.89 for girls and -0.26 to +2.54 for boys. Given that the trajectories of growth during infancy and childhood are a major risk factor for a group of diseases in adulthood, including coronary heart disease and diabetes, these predictive equations should be useful in field studies

Enteral Vitamin D Supplementation in Preterm or Low Birth Weight Infants: A Systematic Review and Meta-analysis

BACKGROUND AND OBJECTIVES Many preterm and low birth weight (LBW) infants have low vitamin D stores. The objective of this study was to assess effects of enteral vitamin D supplementation compared with no vitamin D supplementation in human milk fed preterm or LBW infants. METHODS Data sources include Cochrane Central Register of Controlled Trials, Medline, and Embase from inception to March 16, 2021. The study selection included randomized trials. Data were extracted and pooled with fixed and random-effects models. RESULTS We found 3 trials (2479 participants) that compared vitamin D to no vitamin D. At 6 months, there was increase in weight-for-age z-scores (mean difference 0.12, 95% confidence interval [CI] 0.01 to 0.22, 1 trial, 1273 participants), height-for-age z-scores (mean difference 0.12, 95% CI 0.02 to 0.21, 1 trial, 1258 participants); at 3 months there was decrease in vitamin D deficiency (risk ratio 0.58, 95% CI 0.49 to 0.68, I2=58%, 2 trials, 504 participants) in vitamin D supplementation groups. However, there was little or no effect on mortality, any serious morbidity, hospitalization, head circumference, growth to 6 years and neurodevelopment. The certainty of evidence ranged from very low to moderate. Fourteen trials (1969 participants) assessed dose and reported no effect on mortality, morbidity, growth, or neurodevelopment, except on parathyroid hormone and vitamin D status. No studies assessed timing. Limitations include heterogeneity and small sample size in included studies. CONCLUSIONS Enteral vitamin D supplementation improves growth and vitamin D status in preterm and LBW infants.publishedVersio

Bioelectrical Impedance among Rural Bangladeshi Women during Pregnancy and in the Postpartum Period

Properties of bioelectrical impedance analysis (BIA) reflect body-composition and may serve as stand-alone indicators of maternal health. Despite these potential roles, BIA properties during pregnancy and lactation in rural South Asian women have not been described previously, although pregnancy and infant health outcomes are often compromised. This paper reports the BIA properties among a large sample of pregnant and postpartum women of rural Bangladesh, aged 12-46 years, participating in a substudy of a community-based, placebo-controlled trial of vitamin A or beta-carotene supplementation. Anthropometry and single frequency (50 kHz) BIA were assessed in 1,435 women during the first trimester (≤12 weeks gestation), in 1,237 women during the third trimester (32-36 weeks gestation), and in 1,141 women at 12-18 weeks postpartum. Resistance and reactance were recorded, and impedance and phase angle were calculated. Data were examined cross-sectionally to maximize sample-size at each timepoint, and the factors relating to BIA properties were explored. Women were typically young, primiparous and lacking formal education (22.2±6.3 years old, 42.2% primiparous, and 39.7% unschooled among the first trimester participants). Weight (kg), resistance (Ω), and reactance (Ω) were 42.1±5.7, 688±77, and 73±12 in the first trimester; 47.7±5.9, 646±77, and 64±12 in the third trimester; and 42.7±5.6, 699±79, and 72±12 postpartum respectively. Resistance declined with age and increased with body mass index. Resistance was higher than that observed in other, non-Asian pregnant populations, likely reflecting considerably smaller body-volume among Bangladeshi women. Resistance and reactance decreased in advanced stage of pregnancy as the rate of gain in weight increased, returning to the first trimester values by the three months postpartum. Normative distributions of BIA properties are presented for rural Bangladeshi women across a reproductive cycle that may be related to pregnancy outcomes and ultimately be used for assessing body-composition in this population

Impact of an Integrated Health, Nutrition, and Early Child Stimulation and Responsive Care Intervention Package Delivered to Preterm or Term Small for Gestational Age Babies During Infancy on Growth and Neurodevelopment: Study Protocol of an Individually Randomized Controlled Trial in India (Small Babies Trial)

BACKGROUND: Preterm and term small for gestational age (SGA) babies are at high risk of experiencing malnutrition and impaired neurodevelopment. Standalone interventions have modest and sometimes inconsistent effects on growth and neurodevelopment in these babies. For greater impact, intervention may be needed in multiple domains-health, nutrition, and psychosocial care and support. Therefore, the combined effects of an integrated intervention package for preterm and term SGA on growth and neurodevelopment are worth investigating. METHODS: An individually randomized controlled trial is being conducted in urban and peri-urban low to middle-socioeconomic neighborhoods in South Delhi, India. Infants are randomized (1:1) into two strata of 1300 preterm and 1300 term SGA infants each to receive the intervention package or routine care. Infants will be followed until 12 months of age. Outcome data will be collected by an independent outcome ascertainment team at infant ages 1, 3, 6, 9, and 12 months and at 2, 6, and 12 months after delivery for mothers. DISCUSSION: The findings of this study will indicate whether providing an intervention that addresses factors known to limit growth and neurodevelopment can offer substantial benefits to preterm or term SGA infants. The results from this study will increase our understanding of growth and development and guide the design of public health programs in low- and middle-income settings for vulnerable infants. TRIAL REGISTRATION: The trial has been registered prospectively in Clinical Trial Registry - India # CTRI/2021/11/037881, Registered on 08 November 2021

Impact of an integrated health, nutrition, and early child stimulation and responsive care intervention package delivered to preterm or term small for gestational age babies during infancy on growth and neurodevelopment: study protocol of an individually randomized controlled trial in India (Small Babies Trial)

Background: Preterm and term small for gestational age (SGA) babies are at high risk of experiencing malnutrition and impaired neurodevelopment. Standalone interventions have modest and sometimes inconsistent effects on growth and neurodevelopment in these babies. For greater impact, intervention may be needed in multiple domains-health, nutrition, and psychosocial care and support. Therefore, the combined effects of an integrated intervention package for preterm and term SGA on growth and neurodevelopment are worth investigating. Methods: An individually randomized controlled trial is being conducted in urban and peri-urban low to middle-socioeconomic neighborhoods in South Delhi, India. Infants are randomized (1:1) into two strata of 1300 preterm and 1300 term SGA infants each to receive the intervention package or routine care. Infants will be followed until 12 months of age. Outcome data will be collected by an independent outcome ascertainment team at infant ages 1, 3, 6, 9, and 12 months and at 2, 6, and 12 months after delivery for mothers. Discussion: The findings of this study will indicate whether providing an intervention that addresses factors known to limit growth and neurodevelopment can offer substantial benefits to preterm or term SGA infants. The results from this study will increase our understanding of growth and development and guide the design of public health programs in low- and middle-income settings for vulnerable infants. Trial registration: The trial has been registered prospectively in Clinical Trial Registry - India # CTRI/2021/11/037881, Registered on 08 November 2021. Keywords: Child health; Early child stimulation; Growth failure; Intrauterine growth restriction; Responsive stimulation; Small for gestational age; Small vulnerable newborns; preterm. © 2024. The Author(s).The study was funded by Centre for Intervention Science in Maternal and Child Health at the University of Bergen (Bergen, Norway). The funding agency did not play any role in the design of the study and is neither involved in nor has any influence over the collection of analysis or interpretation of data.publishedVersio

Bioelectrical Impedance among Rural Bangladeshi Women during Pregnancy and in the Postpartum Period

Properties of bioelectrical impedance analysis (BIA) reflect body-composition and may serve as stand-alone indicators of maternal health. Despite these potential roles, BIA properties during pregnancy and lactation in rural South Asian women have not been described previously, although pregnancy and infant health outcomes are often compromised. This paper reports the BIA properties among a large sample of pregnant and postpartum women of rural Bangladesh, aged 12-46 years, participating in a substudy of a communitybased, placebo-controlled trial of vitamin A or beta-carotene supplementation. Anthropometry and single frequency (50 kHz) BIA were assessed in 1,435 women during the first trimester ( 6412 weeks gestation), in 1,237 women during the third trimester (32-36 weeks gestation), and in 1,141 women at 12-18 weeks postpartum. Resistance and reactance were recorded, and impedance and phase angle were calculated. Data were examined cross-sectionally to maximize sample-size at each timepoint, and the factors relating to BIA properties were explored. Women were typically young, primiparous and lacking formal education (22.2\ub16.3 years old, 42.2% primiparous, and 39.7% unschooled among the first trimester participants). Weight (kg), resistance (\u3a9), and reactance (\u3a9) were 42.1\ub15.7, 688\ub177, and 73\ub112 in the first trimester; 47.7\ub15.9, 646\ub177, and 64\ub112 in the third trimester; and 42.7\ub15.6, 699\ub179, and 72\ub112 postpartum respectively. Resistance declined with age and increased with body mass index. Resistance was higher than that observed in other, non-Asian pregnant populations, likely reflecting considerably smaller body-volume among Bangladeshi women. Resistance and reactance decreased in advanced stage of pregnancy as the rate of gain in weight increased, returning to the first trimester values by the three months postpartum. Normative distributions of BIA properties are presented for rural Bangladeshi women across a reproductive cycle that may be related to pregnancy outcomes and ultimately be used for assessing body-composition in this population

Longitudinal Assessment of Prenatal, Perinatal, and Early-Life Aflatoxin B1 Exposure in 828 Mother–Child Dyads from Bangladesh and Malawi

Background: In utero or early-life exposure to aflatoxin, which contaminates staple crops in disadvantaged settings, may compromise pregnancy and infant outcomes, but investigations into the extent, persistence, and determinants of aflatoxin exposure at these life stages have lacked longitudinal data collection and broad geographic representation. Objectives: Aflatoxin exposure and selected determinants thereof were characterized in mother–child dyads with serial plasma/serum samples in prenatal, perinatal, and early life in Malawi and Bangladesh. Methods: Circulating aflatoxin B1 (AFB1)–lysine albumin adducts were measured in dyads from Bangladesh (n = 573; maternal first and third trimester, 3 mo postpartum, cord blood, infant 24 mo) and Malawi (n = 255; maternal second and third trimester, 6 mo postpartum, infant 6 and 18 mo) with isotope dilution mass spectrometry. We examined AFB1-lysine adduct magnitude, persistence, seasonality, and associations with infant feeding, and estimated daily AFB1 intake. Results: Maternal AFB1-lysine was higher in Malawi (98% detectable; median: 0.469, IQR: 0.225–1.027 pg/μL) than in Bangladesh (59%; 0.030, nondetectable [nd]–0.077 pg/μL). Although estimated dietary exposure in Malawi was temporally stable (648 ng AFB1/day), estimated intake in Bangladesh was reduced by 94% between rainy and winter seasons (98 to 6 ng/day). AFB1-lysine was low in cord blood from Bangladesh (15% detectable; 0.045, 0.031–0.088 pg/μL among detectable) and in Malawian infants at 6 mo of age (0.072, nd–0.236 pg/μL), but reached maternal concentrations by 18 or 24 mo (Bangladesh: 0.034, nd–0.063 pg/μL; Malawi: 0.370, 0.195–0.964 pg/μL). In Malawian infants, exclusive breastfeeding at 3 mo was associated with 58% lower AFB1-lysine concentrations at 6 mo compared with other feeding modes (P = 0.010). Conclusions: Among pregnant women, aflatoxin exposure was persistently high in Malawi, while lower and seasonal in Bangladesh. Infants were partially protected from exposure in utero and with exclusive breastfeeding, but exposures reached adult levels by 18–24 mo of age. The Bangladesh and Malawi trials are registered at clinicaltrials.gov as NCT00860470 and NCT01239693. Curr Dev Nutr 2022;6:nzab153.publishedVersionPeer reviewe

Why small-quantity lipid-based nutrient supplements should be integrated into comprehensive strategies to prevent child undernutrition in nutritionally vulnerable populations : response to Gupta et al.’s commentary

We write in response to the commentary by Gupta et al. (2023) on small-quantity lipid-based nutrient supplements (SQ-LNS) for infants and young children 6 to 24 months of age, which was prompted by the recent brief guidance note from UNICEF (2023) explaining when, why and how SQ-LNS are being prioritized as part of their package of preventive actions to combat early childhood malnutrition. The UNICEF document was disseminated shortly after publication of a correspondence in Nature Food (Aguayo et al. 2023), authored by nutrition leaders from several organizations, that summarized the evidence on the benefits of SQ-LNS and called for this intervention to be scaled up and integrated into programs for populations in which child undernutrition is prevalent and dietary quality is very poor. We agree with Gupta et al. that child malnutrition is the result of many factors and there is no single “quick fix” or “magic bullet”. In fact, the above-cited documents state clearly and frequently that provision of SQ-LNS is not a stand-alone intervention and must be integrated into comprehensive strategies to improve infant and young child feeding (IYCF), including the promotion of dietary diversity, as well as other actions needed to prevent malnutrition. SQ-LNS are intended for vulnerable populations who lack access to an affordable, nutritionally adequate complementary feeding diet and have high rates of stunting, wasting and mortality. In such populations, we agree with Gupta et al. that IYCF messages alone are not enough. This is precisely why SQ-LNS were originally developed