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Platelet-related cytokines among normal body mass index, overweight, and obese Malaysians

Background and Objectives: Recent studies have reported that obesity is associated with platelet activation and systemic inflammation. Malaysia has the highest prevalence of obesity, hence, this research is performed to evaluate the development of low-grade inflammation and platelet activation, measured using soluble CD40 ligand (sCD40L) and soluble P-selectin (sP-sel), and to determine their association with obesity. In addition, we assessed the mean platelet volume (MPV) and platelet count (PLT), which are novel parameters consistently associated with obesity. Methods and Study Design: A cross-sectional study was conducted on 112 healthy men and women from 3 main ethnic group (Malay, Chinese, and Indian) who were aged 18-60 years. The participants were categorized into normal body mass index (BMI), overweight and obese groups according to WHO criteria for BMI in Asian populations (18.5 kg/m^2＜BMI＜35 kg/m^2). Waist circumference (WC) was also measured and included in the analysis. Results: MPV, sCD40L, and sP-sel differed significantly among the normal BMI, overweight, and obese groups (p＜0.05). Contrastingly, the PLT did not vary significantly among the 3 groups. In addition, sP-sel levels correlated significantly with BMI (r=0.36, p=0.001) and WC (r=0.25, p=0.007) and MPV correlated significantly with BMI (r=0.2, p=0.001) and WC (r=0.2, p=0.003). Conclusions: Higher MPV and sP-sel levels in the obese participants than in the overweight and normal BMI participants indicated potentially higher activation of platelets in people with obesity. Moreover, we observed higher sCD40L levels in obese participants than in the overweight and normal BMI participants, suggesting a proinflammatory state in obese individuals.

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Exercise induced dehydration status and skinfold compressibility in athletes: an intervention study

Background and Objectives: Skinfold thickness assessment is a widely recognized technique for the estimation of body adiposity and fat free mass. This method assumes that skinfolds' compressibility is constant but there are some factors that could influence its compressibility. This study aims to evaluate whether the skinfolds' compressibility is influenced by hydration status. Methods and Study Design: An intervention study was conducted in a sample of 22 adult male amateur soccer players, who took part in a 90min simulated soccer match. Before and after the intervention skinfolds thicknesses were measured in eight anatomical sites. An electronic caliper, Lipotool, was used to collect and record 120 values during 2s of evaluation. To analyze skinfolds' compressibility, two methods were used: identification of lowest skinfold thickness measurement (SL) and SH = 110% x S_L, and the parameter TAU (τ) determination. Baseline hydration status was evaluated by total body water (TBW) through multifrequency bioimpedance analysis. Dehydration was assessed by the difference of body weight before and after the intervention. Results: The intervention resulted in a loss of 2.11% of participants' baseline weight. The skinfolds thicknesses, assessed by S_L and S_H, were significantly higher after exercise for all skinfolds except for skinfolds at iliac crest and abdominal. This intervention did not affect skinfolds' compressibility when assessed by τ. However, an association between dehydration and medial-calf skinfold' compressibility was found (r=0.48, p=0.042). Conclusions: Although an increase in the skinfolds thickness after the intervention was found, skinfolds' compressibility did not change.

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Prevalence and determinants of iron deficiency anemia among non-pregnant women of reproductive age in Pakistan

Background and Objectives: Iron deficiency Anemia (IDA) in women of reproductive age is a recognized public health concern that impairs health and well-being in women and is associated with adverse reproductive outcomes. In Pakistan there is a dearth of up-to-date information on the prevalence and predictors of IDA. This study sought to investigate IDA in Pakistani women. Methods and Study Design: Secondary analysis was performed using the National Nutrition Survey in Pakistan 2011- 2012. We used a pre-structured instrument to collect socio demographic, reproductive and nutritional data on women. We also collected anthropometric measurements and blood samples for micronutrient deficiencies. Univariate and multivariate logistic regression were used to analyse the data. Results: A total of 7491 non-pregnant women aged between 15-49 years were included in the analysis. The prevalence of IDA was 18.1%. In the multivariate regression analysis; not using iron folic acid supplementation during the last pregnancy adjusted odds ratio (AOR) (95% CI) 1.31 (1.05, 1.64), a history of four or more pregnancies AOR (95% CI) 1.30 (1.04, 1.60), birth interval of ＜24 months AOR (95% CI) 1.27 (1.06, 1.71), household food insecurity AOR (95% CI) 1.42 (1.23, 1.63) and presence of clinical anemia AOR (95% CI) 5.82 (4.82, 7.02) were significantly associated with increased odds of IDA while with obesity AOR (95% CI) 0.60 (0.4, 0.88) showed a protective effect on IDA. Conclusion: To reduce IDA in Pakistani women, the country needs a multifaceted approach that incorporates iron supplementation, food fortification, improved family planning services and efforts to reduce food insecurity.

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Comparisons of proteomic profiles of whey protein between donor human milk collected earlier than 3 months and 6 months after delivery

Background and Objectives: Human milk has nutritional, protective, and developmental advantages for premature infants. However, proteomic information of low abundant protein of donor milk is insufficient. The purpose of this study is to analyze and compare the proteome of low abundant protein of donor milk obtained at different postpartum ages other than the colostrum. Methods and Study Design: Donor breast milk from 12 healthy mothers was collected 15 days, 2 months and 6 months after delivery and stored by medically approved methods. The whey milk proteomes were analyzed by mass spectrometry and classified using bioinformatics analysis. Results: Human milk obtained 15 days and 2 months after delivery showed more abundant expression of whey proteins related to the generation of precursor metabolites and energy, metabolism, and catalytic activity, compared with milk collected at 3 months. Immune and transport-related proteins were abundant at all time points. Proteins involved in cellular movement, immune cell trafficking, and the carbohydrate metabolism network was more abundant in whey milk collected at 15 day and 2 months using a network analysis. Conclusions: We report proteomic information for human donor whey protein. As significant changes were found in whey proteome collected earlier than 2 months and 6 months after delivery, selecting human donor milk earlier than 2 months might be more helpful for early postnatal recipients.

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Association of energy intake and physical activity with overweight among Indonesian children 6-12 years of age

Background and Objectives: Indonesia is currently facing double burden malnutrition in children. As overweight and obesity are due to a disturbed energy balance, this study aimed to assess the association of total energy intake and physical activity with the prevalence of overweight among Indonesian children. Methods and Study Design: The data used for this analysis were from 1143 children, 6-12 years old, that participated in the South East Asian Nutrition Survey (SEANUTS). Physical activity (PA) was measured using pedometers for 2 consecutive days and was categorized low, moderate and high. Child nutritional status was categorized based on body mass index for age z-scores (BAZ) into normal weight (-2 SD ≤BAZ≤1 SD) or overweight (BAZ ＞1 SD). Energy intake was calculated from a one day 24 hour recall and compared to the Indonesian recommended dietary allowance (RDA) for energy. Results: Children with low PA had higher risk (ODDs 3.4, 95% CI: 2.0, 6.0) of being overweight compared to children who had high PA. Children with moderate PA and energy take ＞100% RDA had higher risk (ODDs 4.2, 95% CI 1.9, 9.3) of being overweight than children with high PA and energy intakes ≤100% RDA. Conclusions: Low physical activity independently or moderate physical activity and high energy intake are risk factors for Indonesian children to get overweight. Program intervention such as increasing physical activity at school and home is needed to reduce overweight among children.

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Fruit and vegetable intake of Korean children and adolescents according to cooking location and daily meal: study based on 2010 and 2011 Korea National Health and Nutrition Examination Survey data

Background and Objectives: This study analyzed the intake of fruits and vegetables by cooking location and daily meals for Korean children and adolescents. Methods and Study Design: For this study, 2,538 Korean children and adolescents aged 7-18 years, who participated in the 2010 and 2011 Korea National Health and Nutrition Examination Survey dietary intake survey (24-hour recall methods), were sampled. Results: The total unsalted fruit and vegetable intake for all subjects was 300 g (aged 7-12 years, 280 g; aged 13-18 years, 316 g). Regarding meal serving location, the combined unsalted fruit and vegetable intake was 159 g at home, 206 g at commercial locations, and 104 g at institutions. The combined unsalted fruit and vegetable intake in snack form was 128 g, which was higher than that during daily meals. In total, 24.9% of subjects satisfied the recommended fruit and vegetable intake (≥400 g), according to the guidelines created by the World Health Organization/World Cancer Research Fund. Logistic regression analysis results revealed that the fruit and vegetable intake of girls was 1.4 times higher than that of boys, and the number of people who ate more than 400 g of fruits and vegetables was 1.7 times higher in the group with higher education. Conclusions: Based on the above results, in-depth measures to continuously increase intake of fruits and vegetables in children and adolescents are needed. This study can be used as basic data for the development of educational programs for dietary improvements.

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Vitamin D status and cardiometabolic risk factors in young adults in Hong Kong: associations and implications

Background and Objectives: Vitamin D deficiency is reportedly common, but we lack data from young adults. Such data are of interest because epidemiological data support vitamin D as a possible risk modulator for diabetes and cardiovascular ('cardiometabolic') disease. Our objectives were to assess vitamin D status (as plasma 25(OH)D concentration) and investigate associations between this and biomarkers of cardiometabolic disease risk in a group of still-healthy young adults in Hong Kong. Methods and Study Design: In this observational study, fasting venous blood was collected from 196 (63 males, 133 females), young (18-26 years) non-smoking, nonobese, consenting adults in good general health. Plasma 25(OH)D was measured by LC-MS/MS. A panel of established cardiometabolic risk factors (HbA1c, plasma glucose, lipid profile, hsCRP) and blood pressure were also measured. Results: Mean (SD) plasma 25(OH)D concentration was 42.1 (13.0), with range 15.7-86.8 nmol/L; 141/196 subjects (72%) had vitamin D deficiency (25(OH)D ＜50 nmol/L); 13/184 (6.6%) were severely deficient (＜25 nmol/L). Inverse association was seen between 25(OH)D and fasting glucose (r=-0.18; p＜0.05). Higher HbA1c and TC:HDL-C ratio and lower HDL-C were seen in those with plasma 25(OH)D ＜25 nmol/L (p＜0.05). Conclusions: Vitamin D deficiency was highly prevalent and associated with poorer cardiometabolic risk profile in these young adults. Public health strategies for addressing vitamin D deficiency are needed urgently. These new data provide support for further study on vitamin D deficiency as a modifiable risk factor for cardiometabolic disease and the ameliorative effects of increased vitamin D intake on cardiometabolic disease risk profile of vitamin D-deficient young adults.

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Dietary patterns change over two years in early adolescent girls in Hawai'i

Background and Objectives: In investigating diet-disease relationships, examination of dietary patterns allows for conclusions to be drawn based on overall intake. This study characterized dietary patterns of early adolescent girls over a two-year period and examined the relationship between dietary patterns and body mass index (BMI). Methods and Study Design: Cross-sectional analyses were performed using longitudinal data from food records of early adolescent girls (n=148) 9 to 14 years in Hawai'i from the Female Adolescent Maturation (FAM) study. Dietary patterns were identified using principal component analysis (PCA). Pearson's correlations between BMI percentile and z-score and dietary pattern factor scores at Times 1 (2001-2002) and 2 (2002-2003) were calculated. For each dietary pattern, participants were divided into low, intermediate, and high scorers. Mean BMI percentiles and z-scores were compared between groups using analysis of covariance. Results: At Time 1, three patterns were identified, characterized by: (1) whole grains, nuts and seeds, added sugar; (2) non-whole grain, tomatoes, discretionary fat; and (3) deep yellow vegetables, other starchy vegetables, cooked dry beans/peas. At Time 2, three different dietary patterns emerged: (1) non-whole grains, meat, discretionary fat; (2) other vegetables, fish, eggs; and (3) whole grain, tomatoes, other vegetables. BMI percentile and z-score differed between high and low scorers on Time 1-Pattern 1 and Time 2-Pattern 3. Conclusion: Results revealed changes in dietary patterns over time and an association between intake and BMI. Findings demonstrate the importance of frequent nutrition assessment to monitor changes in intake that may be improved to prevent obesity.

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Premorbid dietary intake of protein is associated with early outcomes but not with severity of ischemic stroke

Background and Objectives: Dietary protein intake has been associated with reduced risk of stroke. This study aimed to examine the relationship between premorbid dietary intake of protein and both stroke severity and neurological outcomes in patients with acute ischemic stroke. Methods and Study Design: Consecutive patients with first-ever ischemic stroke in Jinling Hospital were screened for eligibility of participation. A validated food-frequency questionnaire (FFQ) was performed to collect necessary data for calculating pre-stroke dietary intakes. Stroke severity was assessed by the National Institutes of Health Stroke Scale (NIHSS) at baseline. Neurological outcomes were assessed by the modified Rankin scale (mRS) 90 days after stroke onset. Multivariable logistical regression was applied to analyze the impacts of dietary protein intake on stroke severity or neurological outcomes. Results: Of the 201 enrolled patients, 110 (54.7%) were classified as minor (NIHSS ≤5) and 91 (45.3%) as major stroke (NIHSS ≥6). After adjusting for potential confounders, multivariable logistic regression did not detect significant association between total (odds ratio (OR)=0.98, p=0.15), animal (OR=1.01, p=0.87) or plant protein intake (OR=0.96, p=0.07) and stroke severity. According to the 90-day mRS, 127 patients (63.2%) were determined with good (mRS ≤2), and 74 (36.8%) with poor outcomes (mR 3-6). Multivariable logistic regression detected that premorbid dietary intake of total protein was positively associated with good neurological outcomes (OR=1.05, p=0.04). Conclusions: Higher level of premorbid protein intake may be associated with favorable neurological outcomes independent of stroke severity.

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Low maternal folate concentrations and maternal MTHFR C677T polymorphism are associated with an increased risk for neural tube defects in offspring: a case-control study among Pakistani case and control mothers

Background and Objectives: There is considerable evidence that periconceptional maternal folate deficiency and coding variants in maternal genes coding for critical enzymes in the folate pathway are associated with neural tube defects (NTDs) in offspring. In a case-control study we investigated C677T polymorphism in the 5,10- methylenetetrahydrofolate reductase (MTHFR) gene in case and control mothers of Pakistani origin, and compared these with the respective maternal folate concentrations measured at the time of delivery. Methods and Study Design: A case-control study was conducted among 109 case and 100 control mothers identified through the Holy Family Hospital Rawalpindi, Quaid-i-Azam University, Islamabad, Pakistan. Red blood cell (RBC) and serum folate concentrations and MTHFRC677T polymorphism were compared between case and control mothers. Results: Mean RBC folate and serum folate concentrations were significantly lower in cases compared with control mothers (p＜0.0001). Maternal MTHFR 677CT and 677TT genotypes were more common among cases compared with control mothers (CC vs TT p＜0.0393 and CC/CT vs TT p＜0.021). T-allele frequency was higher in cases compared with control mothers (C vs T p＜0.017). Case mothers with 677CT or 677TT genotypes had significantly lower serum (p＜0.0001) and RBC folate concentrations (p＜0.0001) compared with control mothers. Conclusions: The present study provides further evidence that maternal folate deficiency and MTHFRC677T polymorphism might be associated with an increased risk for NTDs in offspring. Our results are limited by the fact that maternal folate concentrations were not obtained during the periconceptional period, but at delivery. Further analyses, including maternal folate levels during the periconceptional period, are warranted.