{"title":"Changing Landscape from Nutrients to Dietary Patterns: Implications for Child Health.","authors":"Jossie M Rogacion","doi":"10.1159/000528990","DOIUrl":"https://doi.org/10.1159/000528990","url":null,"abstract":"<p><p>Dietary patterns (DPs) have shifted the focus in nutrition epidemiology away from being nutrient centered. Foods are consumed not as single nutrients but as a combination of dietary components interacting with each other. DPs are indicators of diet quality. Two approaches are used to derive them: the index-based and data-driven approaches, each with its own advantages and disadvantages. Studies on diet-disease relationships are now concentrated on DPs. Most available studies are in adults, which emphasize the role of DPs as contributors to certain chronic diseases like cardiovascular diseases, diabetes, and certain cancers. Only few studies were conducted among children, mostly using a data-driven approach and population specific. The available studies identify associations with some diseases like obesity, neurobehavioral disorders, asthma, and cardiometabolic markers. Tracking of DP consumption from early childhood to later life stages including adulthood has been shown from longitudinal studies to predict certain cardiometabolic risk factors and adiposity that may predispose to certain diseases later in life. The influences of sociodemographic factors, most especially maternal education, have predictive effects on adherence to certain DPs, whether the \"healthy\" or \"unhealthy\" type. More studies are needed to strongly elucidate this DP-disease outcome relationship in children.</p>","PeriodicalId":18986,"journal":{"name":"Nestle Nutrition Institute workshop series","volume":"97 ","pages":"72-81"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9761210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Strategies in Neonatal Care to Promote Optimized Growth and Development: Focus on Low Birth Weight Infants","authors":"","doi":"10.1159/isbn.978-3-318-07015-6","DOIUrl":"https://doi.org/10.1159/isbn.978-3-318-07015-6","url":null,"abstract":"","PeriodicalId":18986,"journal":{"name":"Nestle Nutrition Institute workshop series","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42686399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Importance of the Gut Microbiome in Preterm Infants.","authors":"C. Stewart","doi":"10.1159/000519396","DOIUrl":"https://doi.org/10.1159/000519396","url":null,"abstract":"Birth represents the start of an incredible journey for the individual and the microbes which reside within and upon them. This interaction between human and microbe is essential for healthy development. Term infants are colonized by bacteria at birth, and thereafter the diet is the most important factor shaping the gut microbiome, in particular receipt of human milk. Human milk contains viable bacteria and numerous components that modulate the bacterial community, including human milk oligosaccharides (HMOs) which promote the growth of Bifidobacteriumspecies. Notably, Bifidobacteriumspp. are the primary bacterium used in probiotic supplements, owing to their association with positive outcomes in cohort studies and range of beneficial properties in mechanistic experiments. Preterm infants born <32 weeks' gestation encounter an unnatural beginning to life, with housing in \"sterile\" incubators, higher rates of caesarean delivery and antibiotic use, and complex nutritional provision. This reduces Bifidobacteriumabundance and overall microbial diversity. However, this also presents an opportunity to use probiotics and prebiotics (e.g., HMOs) to restore \"normal\" development. Much work has focused in this area over the past two decades and, while more work is needed, there is promise in symbiotic intervention to modulate the microbiome and reduce disease in preterm infants.","PeriodicalId":18986,"journal":{"name":"Nestle Nutrition Institute workshop series","volume":"53 1","pages":"141-148"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86397732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Summary on the Role of Human Milk Oligosaccharides and the Microbiome in the Health of Very Low Birth Weight Infants.","authors":"L. Bode","doi":"10.1159/000519405","DOIUrl":"https://doi.org/10.1159/000519405","url":null,"abstract":"","PeriodicalId":18986,"journal":{"name":"Nestle Nutrition Institute workshop series","volume":"10 1","pages":"175-177"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90171549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Finn, B. Kineman, Laura A Czerkies, Ryan S Carvalho
{"title":"Human Milk Bioactives: Future Perspective.","authors":"K. Finn, B. Kineman, Laura A Czerkies, Ryan S Carvalho","doi":"10.1159/000519401","DOIUrl":"https://doi.org/10.1159/000519401","url":null,"abstract":"Human milk is a dynamic, complex fluid that offers much more than nutrition to infants. The macronutrient content of human milk has been well characterized and described. However, human milk is not a simple matrix of protein, carbohydrate, fat, and micronutrients. The National Institutes of Health have defined bioactives in food as elements that \"affect biological processes or substrates and hence have an impact on body function or condition and ultimately health.\" Bioactives are cells, anti-infectious and anti-inflammatory agents, growth factors, and prebiotics that are naturally present in human milk. They may explain the differences in health outcomes observed between breastfed and non-breastfed infants. They influence the development of the immune and gastrointestinal systems, gut microbiota, neurodevelopment, metabolic health, and protection against infection. Human milk oligosaccharides are one bioactive that have been an increasingly popular area of research. This review provides a broad overview of some bioactive components that positively affect the immune system and touches on certain well-known growth factors present in human milk. Future research will look at the interplay of the multitude of bioactive components in human milk as a biological system and beyond singular compounds.","PeriodicalId":18986,"journal":{"name":"Nestle Nutrition Institute workshop series","volume":"17 1","pages":"166-174"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78614668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Postdischarge Nutrition of Preterm Infants: Breastfeeding, Complementary Foods, Eating Behavior and Feeding Problems.","authors":"N. Haiden","doi":"10.1159/000519399","DOIUrl":"https://doi.org/10.1159/000519399","url":null,"abstract":"In preterm infants, the key goals of nutrition are to establish adequate growth and to contribute to appropriate neurodevelopmental outcome. In this context, the postdischarge period is crucial to establish catch-up growth and avoid wrong metabolic programming caused by overfeeding. Breastfeeding is strongly recommended, and for preterm infants the European Society for Gastroenterology, Hepatology, and Nutrition (ESPGHAN) suggests fortifying breastmilk after discharge up to term in appropriate growing infants and up to 3 months in growth-retarded infants. If breastfeeding is not possible, postdischarge formula should be fed at least up to term. However, the effects of a higher nutrient density and energy administered by breastmilk fortification or postdischarge formula on growth and neurodevelopmental outcome are limited or missing but might have a positive impact on lung function and vision later in life. Moreover, little is known on the optimal timepoint to introduce solids in preterm infants. Data from observational studies have shown that preterm infants are weaned early in life around 13-15 weeks of corrected age. The degree of prematurity and use of formula are major determinants for early complementary feeding introduction. It is emphasized that there should be a strong focus on the infant's anatomical, physiological, and oral-motor readiness to receive foods other than breast milk or formula. Feeding problems and preterm's eating difficulties are common, and especially in the very immature population approximately 30% show oro-motor dysfunction or avoidant behavior at 3 months. An individualized approach according to the infant's neurological ability and nutritional status seems to be the best practice when introducing complementary feeding in preterm infants especially in the absence of evidence-based guidelines.","PeriodicalId":18986,"journal":{"name":"Nestle Nutrition Institute workshop series","volume":"64 1","pages":"34-44"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90903275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Strategies in Neonatal Care to Promote Growth and Neurodevelopment of the Preterm Infant.","authors":"F. Bloomfield, B. Cormack","doi":"10.1159/000519391","DOIUrl":"https://doi.org/10.1159/000519391","url":null,"abstract":"Recommendations for nutrition of very preterm and very low birth weight infants have developed over time with our understanding of the requirements of preterm babies and the awareness of widespread poor postnatal growth. In general, the trend has been towards enhancing nutrition, but more recent recommendations have begun to raise questions with respect to the potential for high and early nutritional intakes, particularly of protein, to carry risks such as refeeding syndrome. However, large gaps in our knowledge remain for both macro- and micronutrient requirements to support optimal growth and how nutrition and growth relate to important long-term outcomes. Closing these knowledge gaps has been hampered by inconsistent reporting of nutrition intakes and growth parameters, small trials with short-term outcomes and the use of a variety of different methods of monitoring growth. The challenge now is for future research to address these issues through consensus building around the important questions that need to be answered, how to report data from neonatal nutritional trials and whether large trials answering important questions can take place through development of consortia that undertake similar trials in multiple jurisdictions with agreements to share data.","PeriodicalId":18986,"journal":{"name":"Nestle Nutrition Institute workshop series","volume":"50 1","pages":"13-22"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80813127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nutritional Interventions to Improve Brain Outcomes in Preterm Infants.","authors":"N. Embleton, Claire L. Granger, Kristina Chmelova","doi":"10.1159/000519389","DOIUrl":"https://doi.org/10.1159/000519389","url":null,"abstract":"The last 20 years have seen dramatic improvements in survival for preterm infants in both high- and low-income settings. Survival rates of over 50% in infants born 16 weeks early (24 weeks' gestation) are now commonplace in well-resourced neonatal intensive care units. However, ensuring adequate nutrient intakes especially in the first few days and weeks is challenging, and many infants show poor growth and nutritional status. Good nutritional management should be seen as the cornerstone of good neonatal care and is key to improving a range of important outcomes including reduced rates of retinopathy of prematurity, chronic lung disease, necrotizing enterocolitis (NEC), and sepsis. Equally importantly, is that good nutritional status is essential to optimize brain growth and differentiation. There are multiple potential mechanisms that link nutrition to brain outcomes in preterm infants including needs for tissue accretion, energy supply, signaling roles, functional components in human milk, epigenetic regulation, prevention of NEC and disease, and impacts on the gut brain axes. This article will review data in support of different mechanistic links for the impact of nutrition on brain outcomes in preterm infants.","PeriodicalId":18986,"journal":{"name":"Nestle Nutrition Institute workshop series","volume":"26 1","pages":"23-33"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76025328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Microbiota and Human Milk Oligosaccharides in Premature Infants.","authors":"J. Hascoët, Yipu Chen","doi":"10.1159/000519390","DOIUrl":"https://doi.org/10.1159/000519390","url":null,"abstract":"Gut microbiota plays an important role in infants' health. The prevalence of bifidobacteria in the gastrointestinal tract of term breastfed infants has been associated with reduced infection rates compared with formula-fed infants. However, few studies evaluated microbiota in premature infants. In an observational study of 577 preterm newborns born below 32 weeks gestation, gut microbiota was not driven by bifidobacteria but could be classified into six different clusters with regard to the most abundant bacteria present. Clusters were related to infants' maturity, perinatal determinants, and were associated with short- and long-term outcome. In another study, the effects of caesarean birth on infant gut microbiota could be alleviated by human milk oligosaccharides (HMOs) in mothers' milk. In addition, 58 infants fed with a formula enriched with 2 HMOs had microbiota closer to breastfed infants than 63 infants receiving the same formula without HMOs. The question then arose of the benefit of HMO supplementation for microbiota in premature infants. Thus, a multicenter randomized controlled intervention study of the effect of a liquid supplement containing 2 HMOs was set up. Ongoing data analysis will evaluate gastrointestinal tolerance parameters, intake of HMOs from human milk, long-term growth outcomes, fecal microbiota, and fecal biomarkers of gut maturation and immunity.","PeriodicalId":18986,"journal":{"name":"Nestle Nutrition Institute workshop series","volume":"21 1","pages":"160-165"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85046909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Juncker, B. V. van Keulen, M. Finken, S. D. de Rooij, J. V. van Goudoever, A. Korosi
{"title":"The Potential Role of Nutrition in Modulating the Long-Term Consequences of Early-Life Stress.","authors":"H. Juncker, B. V. van Keulen, M. Finken, S. D. de Rooij, J. V. van Goudoever, A. Korosi","doi":"10.1159/000519383","DOIUrl":"https://doi.org/10.1159/000519383","url":null,"abstract":"Stress exposure during sensitive developmental periods lastingly affects brain function and cognition and increases vulnerability to psychopathology later in life, as established in various preclinical and clinical studies. Interestingly, similar patterns are seen in children who suffer from perinatal malnutrition. Stress and malnutrition can act closely aligned and stress and nutrition interact. There is emerging evidence that specific nutritional supplementation during various time windows may ameliorate the long-lasting effects of early-life stress, although possible mechanistic insights in this process are sparsely reported. Understanding how stress exposure in early-life influences brain development, and understanding the role of nutrition in this process, is essential for the development of effective (nutritional) therapies to improve long-term health in children exposed to early-life stress. This is especially important in the situation of preterm birth where both stress exposure and malnutrition are common. Here, we will discuss the programming effects of early-life stress, the possible underlying mechanisms, how nutrients impact on this process, and the promising role of nutrition in modulating (some of) the lasting consequences of early-life stress on brain function and health in adulthood.","PeriodicalId":18986,"journal":{"name":"Nestle Nutrition Institute workshop series","volume":"108 1","pages":"116-129"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81668127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}