Effectiveness of the National Program of Complementary Feeding for older adults in Chile on vitamin B12 status in older adults; secondary outcome analysis from the CENEX Study (ISRCTN48153354).

BACKGROUND: Older people are at increased risk of vitamin B12 deficiency and the provision of fortified foods may be an effective way to ensure good vitamin B12 status in later life. AIM: To evaluate the effectiveness of a vitamin B12 fortified food provided by a national program of complementary food for older people on plasma vitamin B12 levels. SUBJECTS AND METHODS: A random sub-sample of 351 subjects aged 65-67 y from a large cluster randomised controlled trial provided blood samples at baseline and after 24 months of intervention. The intervention arm (10 clusters 186 participants) received a vitamin B12 fortified food designed to deliver 1.4 μg/day, while the control arm did not receive complementary food (10 clusters, 165 participants). Serum vitamin B12 and folate levels determined by radioimmunoassay were used to estimate the effect of intervention on vitamin B12 levels, adjusting for baseline levels and sex. RESULTS: Attrition at 24 months was 16.7% and 23.6% in the intervention and control arms respectively (p = 0.07). Over 24 months of intervention, mean (95% CI) serum vitamin B12 decreased from 392 (359-425) pmol/dL to 357 (300-414) pmol/dL (p < 0.07) in the intervention arm and from 395 (350-440) pmol/dL to 351 (308-395) pmol/dL in the control arm. There was no significant effect of the intervention on folate status. DISCUSSION: Our findings suggest that foods fortified with 1.4 μg/daily vitamin B12 as provided by Chile's national programme for older people are insufficient to ensure adequate vitamin B12 levels in this population. Chile has a long and successful experience with nutrition intervention programs; however, the country's changing demographic and nutritional profiles require a constant adjustment of the programs

History of modern nutrition science-implications for current research, dietary guidelines, and food policy.

NIH, NHLBI R01 HL13073

Maternal attitudes and child-feeding practices: relationship with the BMI of Chilean children

<p>Abstract</p> <p>Background</p> <p>Chile has experienced the nutritional transition due to both social and economic progress. As a consequence, higher rates of overweight and obesity have been observed in children. In western countries, researchers have tried to determine pathways by which parents influence their children's eating behavior; up to now findings have been inconsistent. The objective of this study was to evaluate the cross-sectional and retrospective relationship between maternal attitudes and child-feeding practices and children's weight status in children who had been subject of an obesity prevention intervention for two years.</p> <p>Methods</p> <p>In 2006, for a cross-sectional study, a random sample of 232 children (125 girls, mean age 11.91 ± 1.56 y and 107 boys mean age 11.98 ± 1.51 y) was selected from three primary schools from a small city called Casablanca. Weight and height were determined to assess their nutritional status, using body mass index (BMI) <it>z </it>scores. Child-feeding practices and attitudes were determined cross-sectionally in 2006, using the Child Feeding Questionnaire (CFQ). To analyze the relationship between trends in weight change and child-feeding practices and attitudes, BMI <it>z </it>scores of all the 232 children in 2003 were used.</p> <p>Results</p> <p>Cross-sectionally, mothers of overweight children were significantly more concerned (P < 0.01) about their child's weight. Mothers of normal weight sons used significantly more pressure to eat (P < 0.05). Only in boys, the BMI <it>z </it>score was positively correlated with concern for child's weight (r = 0.28, P < 0.05) and negatively with pressure to eat (r = -0.21, P < 0.05). Retrospectively, the change in BMI <it>z </it>score between age 9 and 12 was positively correlated with concern for child's weight, but only in boys (r = 0.21, P < 0.05). Perceived child weight and concern for child's weight, explained 37% in boys and 45% in girls of the variance in BMI <it>z </it>score at age 12.</p> <p>Conclusion</p> <p>Mothers of overweight children were more concerned with their children's weight; this indicated the Western negative attitude towards childhood overweight. None of the child-feeding practices were significantly correlated with a change in BMI <it>z </it>score.</p

Risiken und Nutzen von Kupfer im Licht neuer Erkenntnisse zur Kupferhomöostase

ZusammenfassungDas essentielle Spurenelement Kupfer ist an einer Vielzahl biologischer Prozesse beteiligt, die für die Erhaltung des Lebens unverzichtbar sind. Im Überschuss kann es jedoch auch toxisch sein, wobei der häufigste chronische Effekt in einer Schädigung der Leber besteht. Die Resorption von Kupfer im Verdauungstrakt sowie seine Ausscheidung über die Galle werden durch wirkungsvolle Regulationsmechanismen kontrolliert. Beim Menschen wird Kupfer, abhängig von der Kupferzufuhr, dem Vorliegen weiterer Faktoren in der Nahrung, die seine Resorption fördern oder hemmen können, und dem Kupferstatus, zu 12 bis 60 % resorbiert. Aktuelle Daten lassen vermuten, dass Kupfermangel mit höherer Prävalenz vorkommen könnte als bisher angenommen wurde, wohingegen Kupfertoxizität unter normalen Lebensumständen eher selten ist. Das Menkes-Syndrom und die Wilson-Krankheit sind genetische Störungen, die mit schwerem Kupfermangel bzw. mit Kupfertoxizität assoziiert sind.Die Auswirkungen eines milden Kupfermangels oder -überschusses sind bisher noch nicht ausreichend beschrieben, was hauptsächlich auf das Fehlen sensitiver und spezifischer Indikatoren zurückzuführen ist. Die am häufigsten verwendeten Indikatoren sind die Kupferkonzentration und die Ceruloplasminspiegel im Serum, jedoch lassen sich mit ihnen nur vergleichsweise starke Änderungen des Kupferstatus nachweisen. Von den vielen Proteinen, die als potenzielle Marker für den Kupferstatus untersucht werden, hat das Chaperon der Cu/Zn-Superoxiddismutase (CCS1) vielversprechende Ergebnisse geliefert. Um seine Eignung als Indikator für Kupfermangel im Frühstadium zu bestätigen, sind jedoch noch weitere Daten zu seinem Verhalten unter verschiedenen Bedingungen erforderlich. Die Bestimmung des Kupferbedarfs sowie einer Obergrenze für die unbedenkliche Zufuhr (Tolerable Upper Intake Level, UL) ist ein komplexer Prozess, da Kupfermangel und Kupferüberschuss gleichermaßen zu Gesundheitsschäden führen (U-förmige Kurve). Im Regelwerk für die Risikobewertung essentieller Spurenelemente, das im Rahmen des Internationalen Programms für Chemikaliensicherheit (International Programms on Chemical Safety, IPCS) geschaffen wurde, wird ein homöostatisches Modell zur Ermittlung des adäquaten Bereichs für die orale Zufuhr (Adequate Range of Oral Intake, AROI) essentieller Spurenelemente vorgeschlagen. Der Tiefstpunkt der sich ergebenden U-Kurve dient zur Definition des AROI. In diesem Bereich wird durch physiologische Mechanismen eine normale Homöostase aufrechterhalten und es sind im Grunde keine gesundheitsschädlichen Auswirkungen nachweisbar. Derzeit werden Werte für die empfohlene tägliche Zufuhr mit der Nahrung (RDI) und die ausreichende Zufuhrmenge (AI) herangezogen, um Empfehlungen für die Kupferzufuhr in verschiedenen Lebensphasen und -umständen zu formulieren. Die hier vorgelegten Daten, die am Menschen und an nicht-menschlichen Primaten erhoben wurden, weisen darauf hin, dass der aktuelle UL-Wert für Kupfer überprüft werden sollte. Die Entwicklung einer wissenschaftlichen Grundlage für den UL-Wert für Kupfer und die Bewertung der Relevanz des Kupfermangels im globalen Rahmen sind die zentrale Herausforderung bei zukünftigen Forschungsarbeiten zum Thema Kupfer

The association of excessive growth with development of general and central obesity at 7 years of age in every period after birth in Chilean children

AbstractObjectiveTo determine whether overweight or obesity between 0 and 6 y increases the probability of developing general/central obesity at 7 y.MethodsWeight, height, and waist circumference were assessed between 0 and 6 y in 628 Chilean children. Body mass index, incidence of overweight (IOW), incidence of obesity (IOB), and prevalence at birth and 0 to 6, 6 to 24, 24 to 48, and 48 to 72 mo and odds ratio (OR) and 95% confidence interval (95% CI) for developing obesity/central obesity at 84 mo were calculated by sex.ResultsIOW was highest at 6 to 24 mo (20.3% and 21.1% for girls and boys, respectively); IOB was highest at 6 to 24 and 24 to 48 mo (11% and 10%, respectively). OR for developing obesity at 7 y was significant if overweight was present 24 to 48 mo in girls and 6 to 24 mo in boys OR 2.47 [95% CI, 1.5–4] and OR 2.26 [95% CI, 1.30–3.92], respectively, and much higher for children who were obese, OR 6.1 (95% CI, 3.03–12.21) for girls 6 to 24 mo and OR 6.57 (95% CI, 2.55–16.86) for boys 0 to 6 mo. IOW or IOB was not associated with obesity at 84 mo, except for the previous period. Overweight also increased the risk of central obesity very early on, after 6 mo in girls and after birth in boys OR 3.8 [95% CI, 2.3–6.2] and OR 2.5 [95% CI, 2.04–3] at 6 to 24 and 0 to 6 mo, respectively, whereas obesity in all periods was associated with a significantly higher OR of presenting central obesity at 7 y.ConclusionThere is tracking not only of obesity but also of overweight after birth for developing general or central obesity at 7 y. Prevention should begin very early on

Epigenética y obesidad

ResumenLa evidencia indica que la exposición a diversas condiciones ambientales en etapas tempranas de la vida puede inducir alteraciones persistentes en el epigenoma. Los estudios epigenómicos en sujetos obesos han permitido evaluar el papel de los mecanismos epigenéticos en el origen y desarrollo de la obesidad. La presente revisión aborda estudios que dan cuenta de la asociación entre la obesidad y metilación global del genoma (ADN), analizando el potencial impacto de intervenciones previas y posteriores al nacimiento que afectan la metilación del ADN y la obesidad en etapas más avanzadas de la vida. Estudios realizados principalmente en leucocitos, han logrado identificar sitios del ADN diferencialmente metilados asociados con obesidad. Estudios hasta la fecha no han demostrado que dichos cambios en metilación sean revertidos luego de bajar de peso. Esto contrasta con resultados iniciales en este campo, que sugieren que existirían marcadores epigenéticos presentes desde el nacimiento que permitirían definir el riesgo de obesidad durante el curso de la vida. La evidencia actual sugiere que algunas marcas epigenéticas son modificables, basándonos en la exposición en la vida intrauterina y también por los hábitos dietarios y de actividad fisica durante las etapas del crecimiento y en la adultez. Esto sugiere que existe la oportunidad de intervenir durante la gestación o en la vida posnatal temprana, que modificaría los perfiles epigenéticos desfavorables e idealmente contribuiría a prevenir la obesidad en los sujetos o poblaciones susceptibles.AbstractCurrent evidence supports the notion that exposure to various environmental conditions in early life may induce permanent changes in the epigenome that persist throughout the life-course. This article focuses on early changes associated with obesity in adult life. A review is presented on the factors that induce changes in whole genome (DNA) methylation in early life that are associated with adult onset obesity and related disorders. In contrast, reversal of epigenetic changes associated with weight loss in obese subjects has not been demonstrated. This contrasts with well-established associations found between obesity related DNA methylation patterns at birth and adult onset obesity and diabetes. Epigenetic markers may serve to screen indivuals at risk for obesity and assess the effects of interventions in early life that may delay or prevent obesity in early life. This might contribute to lower the obesity-related burden of death and disability at the population level. The available evidence indicates that epigenetic marks are in fact modifiable, based on modifications in the intrauterine environment and changes in food intake, physical activity and dietary patterns patterns during pregnancy and early years of adult life. This offers the opportunity to intervene before conception, during pregnancy, infancy, childhood, and also in later life. There must be documentation on the best preventive actions in terms of diet and physical activity that will modify or revert the adverse epigenetic markers, thus preventing obesity and diabetes in suceptible individuals and populations

[Evolution of the nutritional status of six years old Chilean children (1987-2003)].

BACKGROUND: As a consequence of the epidemiological transition in Chile, the nutritional status of the population has changed notoriously. AIM: To study the changes in the nutritional status of six years-old Chilean children from 1987 to 2003. MATERIAL AND METHODS: The computer data base of a government institution in charge of the School Lunch Program (JUNAEB) was used. It contains data on weight, height, sex and date of birth of six years old children, in the years 1987, 1990, 1993, 1996, 2000, 2001, 2002 and 2003. RESULTS: The data of approximately 80,000 children was analyzed. Both weight and height increased over the study years. There was a significant reduction in the number of children with weight deficit but also an increase in the proportion of children with obesity. Stunting was also reduced. The proportion of children with HAZ over 2 SD increased from 0.76 in 1987 to 2.2% in 2003. The prevalence of obesity has not increased since the year 2000. CONCLUSION: The stabilization in the prevalence of obesity is a positive finding, considering its adverse consequences for health