Howard Wey

Differences in fatty acid composition of human milk in vegetarian and nonvegetarian women: long-term effect of diet

The purpose of the current study was to determine whether there were differences in the fatty acid composition of milk from vegetarian mothers compared to nonvegetarian mothers and whether fatty acid composition was related to length of time on a vegetarian diet. Median time on a vegetarian diet was 81 months (range 36-132 months). Milk fat and fatty acids produced de novo in the mammary gland did not differ between diet groups. Milk from vegetarian women (n = 12) contained higher percentages of the precursors of arachidonic acid compared to nonvegetarian women (n = 7). Although there was no difference between diet group in the amount of arachidonic acid present (percent of total), a lower percentage was observed in women the longer they were on a vegetarian diet (r = -0.724, p = 0.008), with a corresponding higher percentage of the sum of precursors of arachidonic acid (r = 0.563, p = 0.056). The percentage of docosahexenoic acid was similar in the milk of vegetarian women compared to nonvegetarian women. The length of time on a vegetarian diet had no effect on these two fatty acids. In summary, differences in fatty acid content were apparent between the two dietary groups and changes with time on a vegetarian diet suggest that not only does current maternal diet affect fatty acid milk composition, but long-term dietary habits may as well.

Cross-sectional versus longitudinal associations of lean and fat mass with pQCT bone outcomes in children.

CONTEXT Cross-sectional associations for lean mass (LM) and fat mass (FM) with bone may not reflect longitudinal associations. OBJECTIVE Cross-sectional and longitudinal associations of LM and FM with radial bone measurements in children were compared. DESIGN AND PARTICIPANTS We conducted a longitudinal study on 370 (232 females) children, 8-18 yr of age. MAIN OUTCOME MEASURES LM and FM were measured by dual-energy absorptiometry. Peripheral quantitative computed tomography at the 4% radius (4R) and 20% radius (20R) measured bone mineral content (BMC), volumetric bone mineral density (vBMD), area, and strength [polar stress strain index (pSSI)]. RESULTS Males at 20R had negative FM cross-sectional and longitudinal associations with cortical area and BMC and pSSI (P < 0.02); negative cross-sectional association with total area (P < 0.001); and negative longitudinal association with cortical thickness (P < 0.001). Females at 20R had FM cross-sectional association with total area, cortical BMC, and pSSI and longitudinal associations with cortical BMC and area, vBMD, and pSSI that went from positive to negative with age and, in some cases, varied with menarche. Both sexes at 4R had a negative FM cross-sectional association with BMC and area (P < 0.001) but negative longitudinal association with vBMD (P < 0.05). LM associations with bone outcomes were generally positive, except for negative longitudinal associations with cortical BMC and vBMD in young females (P < 0.01). LM associations were greater magnitude than FM associations and often depended on age. CONCLUSIONS For males and older females, cross-sectional associations indicated a reduced bone size with higher FM, whereas longitudinal associations showed a decrease in cortical area without changes in bone size. LM was positively associated with BMC and area.

Effect of perchloroethylene, smoking, and race on oxidative DNA damage in female dry cleaners.

Perchloroethylene (PERC) is used widely as an industrial dry cleaning solvent and metal degreaser. PERC is an animal carcinogen that produces increased incidence of renal adenomas, adenocarcinomas, mononuclear cell leukemia, and hepatocellular tumors. Oxidative DNA damage and lipid peroxidation were assessed in 38 women with (dry cleaners) or without (launderers) occupational exposure to PERC. PERC exposure was assessed by collecting breathing zone samples on two consecutive days of a typical work week. PERC levels were measured in blood drawn on the morning of the second day of breathing zone sample collection in dry cleaners and before a typical workday in launderers. Blood PERC levels were two orders of magnitude higher in dry cleaners compared to launderers. A significant correlation was noted between time weighted average (TWA) PERC and blood PERC in dry cleaners (r=0.7355, P<0.002). 8-Hydroxydeoxyguanosine (8-OHdG), ng/mg deoxyguanosine (dG) in leukocyte nuclear DNA was used as an index of steady-state oxidative DNA damage. Urinary 8-OHdG, microg/g creatinine was used as an index of oxidative DNA damage repair. Urinary 8-epi-prostaglandin F(2alpha) (8-epi-PGF), ng/g creatinine was used as an index of lipid peroxidation. The mean+/-S.D. leukocyte 8-OHdG in launderers was 16.0+/-7.3 and was significantly greater than the 8.1+/-3.6 value for dry cleaners. Urinary 8-OHdG and 8-epi-PGF were not significantly different between dry cleaners and launderers. Unadjusted Pearson correlation analysis of log transformed PERC exposure indices and biomarkers of oxidative stress indicated a significant association in launderers between blood PERC and day 1 urinary 8-OHdG (r=0.4661, P<0.044). No significant associations between exposure indices and biomarkers were evident in linear models adjusted for age, body mass index, race, smoking (urinary cotinine, mg/g creatinine) and blood levels of the antioxidants Vitamin E and beta-carotene. The mean+/-S.D. leukocyte 8-OHdG value in control white women was 17.8+/-7.4 and was significantly greater than the 11.8+/-5.9 in control black women. No significant differences by race were evident for the other biomarkers. Smoking status was not significantly associated with any of the oxidative damage indices. Results indicate a reduction in oxidative DNA damage in PERC exposed dry cleaners relative to launderers, but PERC could not clearly be defined as the source of the effect.

Resistant starch type 4-enriched diet lowered blood cholesterols and improved body composition in a double blind controlled cross-over intervention.

A metabolic health crisis is evident as cardiovascular diseases (CVD) remain the leading cause of mortality in the United States. Effects of resistant starch type 4 (RS4), a prebiotic fiber, in comprehensive management of metabolic syndrome (MetS) remain unknown. This study examined the effects of a blinded exchange of RS4-enriched flour (30% v/v) with regular/control flour (CF) diet on multiple MetS comorbidities. In a double blind (participants-investigators), placebo-controlled, cluster cross-over intervention (n = 86, age≥18, 2-12 week interventions, 2-week washout) in the United States, individuals were classified as having MetS (With-MetS) or not (No-MetS) following International Diabetes Federation (IDF)-criteria. RS4 consumption compared with CF resulted in 7.2% (p = 0.002) lower mean total cholesterol, 5.5% (p = 0.04) lower non-HDL, and a 12.8% (p < 0.001) lower HDL cholesterol in the With-MetS group. No-MetS individuals had a 2.6% (p = 0.02) smaller waist circumference and 1.5% (p = 0.03) lower percent body fat following RS4 intervention compared to CF. A small but significant 1% increase in fat-free mass was observed in all participants combined (p = 0.02). No significant effect of RS4 was observed for glycemic variables and blood pressures. RS4 consumption improved dyslipidemia and body composition. Incorporation of RS4 in routine diets could offer an effective strategy for public cardio-metabolic health promotion.

Cessation Among State Quitline Participants with a Mental Health Condition

INTRODUCTION Telephone quitlines are an effective treatment option for tobacco cessation in the general population. Many participants who use quitline services have mental health conditions (MHC), yet few published studies have examined the use of quitline services in this population. This study examined the prevalence of MHC among state quitline participants and compared cessation outcomes among those with and without MHC. METHODS Demographic and tobacco use data were collected at enrollment and 7 months post-enrollment using standardized assessments for 10,720 eligible participants who enrolled in a state quitline between September, 2010 and August, 2012. RESULTS The prevalence of self-reported MHC was 19.8% (2,086/10,720 callers). The intent to treat quit rate for participants with a MHC was 16.4% compared to 21.5% for those without a MHC (p < .001), and the responder quit rate was 36.9% for those with a MHC compared to 44.4% for those without (p < .001). The adjusted odds ratio describing the association of MHC status and tobacco cessation was identical for both the intent-to-treat and responder populations, and indicated that participants with MHC were 23% less likely to quit (p < .05). CONCLUSIONS This study identified that participants with MHC accessed a state quitline, but were less likely to quit. The finding was independent of other factors influencing tobacco cessation, such as gender, race, and education. These findings indicate that although quitline services are an option for tobacco cessation among persons with MHC, further research is needed to determine why cessation rates are lower.

Longitudinal effects of fat and lean mass on bone accrual in infants

There are conflicting reports on the influence of lean and fat mass on bone accrual during childhood. No infants studies have been reported that describe the influence of changes in body composition with changes in bone accrual during the first year of life. The objective of this research was to test the hypothesis that greater gains in lean mass will have a positive effect on bone mineral content (BMC) accrual, while greater gains in fat mass will have a negative effect on BMC accrual in infants. Longitudinal data from 3 previous infant studies were used. Linear mixed models, adjusting for age, sex, dietary calcium, and length were used to investigate longitudinal and cross-sectional associations between total body BMC and lean and fat mass in the individual studies and in a combined analysis. In both individual and combined analyses, we found that lean and fat mass were positively associated with whole body BMC accrual (all, P<0.001). The cross-sectional association of BMC and dietary calcium was negative in one study (P<0.05). No differences in BMC change between sexes were observed in three studies. Our results showed positive cross-sectional and longitudinal associations between total body BMC and lean mass in infants. In contradiction to our hypothesis for fat mass, we found a positive cross-sectional and longitudinal association between total body BMC and fat mass in infants.

Rural vs. non-rural differences and longitudinal bone changes by DXA and pQCT in men aged 20-66 years: A population-based study

The purpose of this research was to determine whether there were differences in estimated means and rates of change in BMC, bone area, BMD and measures of bone geometry among men (n=544) from three distinct populations (Hutterite [rural], rural non-Hutterite, non-rural), and whether activity levels or calcium intake explain these population differences. Men were enrolled in the South Dakota Rural Bone Health Study and followed for 7.5 years to estimate means and rates of change in bone mass, density, size and geometry. Femoral neck (FN) and spine measurements were obtained every 18 months by DXA and distal radius (4% and 20%) measurements by pQCT. Activity measurements and calcium intake were obtained quarterly for the first 3 years and at 54, 72, and 90 months. Rural men had greater percent time in moderate plus vigorous activity (mean ± SD: 22 ± 10 vs. 15 ± 8%, p<0.001) and greater lean mass (69 ± 9 vs. 66 ± 10 kg, p=0.05) than non-rural men. Both rural populations (Hutterite and rural men) had larger femoral neck (FN) bone area and greater 20% radius cross-sectional area than non-rural men ([least square means ± SE] FN area: 5.90 ± 0.02 and 5.86 ± 0.02 vs. 5.76 ± 0.03 cm(2), p<0.001 and p=0.03 respectively and cross-sectional area: 171.0 ±1.3 and 165.5 ± 1.5 vs. 150.3 ± 1.6mm(2), both p<0.001). Despite lower cortical vBMD in Hutterite and rural men compared to non-rural men (1182 ± 2 and 1187 ± 2 vs. 1192 ± 2 mm(2), p<0.001 and p=0.06 respectively), bone strength (pSSI) was greater (429 ± 5 and 422 ± 5 vs. 376 ± 6 mm(3), both p<0.001). The rates of change in femoral neck BMC and aBMD and trabecular vBMD also differed by rural lifestyle, with greater losses among non-rural men in their 20s and 60s compared to both Hutterite and rural populations (time-by-age-by-group interactions, both p<0.01). Physical activity was not found to be a potential mediator of population differences. Baseline calcium intake was associated with FN aBMD (p=0.04), and increases in calcium intake were associated with spine BMC (p=0.04) and inversely associated with cortical area (p=0.02). There was some evidence for mediation by either baseline calcium intake or changes in calcium intake over the study period, but the influence on population differences were negligible. We speculate that rural-non-rural differences in bone occur earlier in life or are a result of factors that have not yet been identified.

Are former late-preterm children at risk for child vulnerability and overprotection?

BACKGROUND Parent perception of child vulnerability (PPCV) and parent overprotection (POP) are believed to have serious implications for age appropriate cognitive and psychosocial development in very low birth weight preterm children. AIM With recent concerns about suboptimal developmental outcomes in late-preterm children, this study was aimed at examining the relationship between history of late-preterm birth (34-36 6/7 weeks gestation), and PPCV, POP, and healthcare utilization (HCU). STUDY DESIGN This was a cross-sectional observational design. PARTICIPANTS Study participants were mothers of 54 healthy singleton children recruited from community centers including Women and Children Clinics (WIC), primary care clinics and daycare centers in the upper Midwest region. OUTCOME MEASURES Outcome measures included Forsyth Child Vulnerability Scale (CVS), Thomasgard Parent Protection Scale (PPS) scores, and healthcare utilization (HCU). Potential covariates included history of life-threatening illness, child and maternal demographics, and maternal stress and depression using the Center for Epidemiologic Studies Depression Scale (CESD). RESULTS HCU (p=0.02) and the PPS subscales of supervision (p=0.003) and separation (p=0.03) were significant predictors of PPCV in mothers of 3-8 years old children with late-preterm history. Age of the child (p=0.008) and CVS scores (p=0.005) were significant predictors of POP. Maternal age (p=0.04), stress (p=0.04), and CVS scores (p=0.003) were significant predictors of HCU. Dependence, a subscale of the PPS, correlated with the childs age and gender even after controlling for age. CONCLUSION History of late-preterm did not predict MPCV, MOP, or HCU in healthy children. Future research is needed in larger more diverse samples to better understand causal relationships and develop strategies to lessen risks of MPCV and MOP.

Precision of the XCT 3000 and Comparison of Densitometric Measurements in Distal Radius Scans Between XCT 3000 and XCT 2000 Peripheral Quantitative Computed Tomography Scanners

Researchers conducting longitudinal studies face challenges as technology evolves and data collection equipment is upgraded from older to newer models. In this study, we report precision error and associations from correlation, regression equations, and Bland-Altman plots that compare results of distal radius images from the XCT 2000 and XCT 3000 peripheral quantitative computed tomography densitometers at the 4% and 20% distal radius site. The mean difference expressed as a percent of the measurements mean was approximately 5% for cortical thickness, periosteal and endosteal circumferences, and total bone size at the 20% site, and less than 2% for all other measures. There were strong associations between bone parameter measures from the XCT 3000 and XCT 2000 with correlation coefficients ranging from 0.92 to 1.0. Strong associations between the 2 machines allow for the comparison of results with minor adjustments.

Estimation of length or height in infants and young children using ulnar and lower leg length with dual-energy X-ray absorptiometry validation.

We compared the accuracy and reproducibility of using ulnar and lower leg length measurements to predict length and height in infants and children aged 0 to 6 years.