Probiotics, prebiotics infant formula use in preterm or low birth weight infants: a systematic review

ABSTRACT: BACKGROUND: Previous reviews (2005 to 2009) on preterm infants given probiotics or prebiotics with breast milk or mixed feeds focused on prevention of Necrotizing Enterocolitis, sepsis and diarrhea. This review assessed if probiotics, prebiotics led to improved growth and clinical outcomes in formula fed preterm infants. METHODS: Cochrane methodology was followed using randomized controlled trials (RCTs) which compared preterm formula containing probiotic(s) or prebiotic(s) to conventional preterm formula in preterm infants. The mean difference (MD) and corresponding 95% confidence intervals (CI) were reported for continuous outcomes, risk ratio (RR) and corresponding 95% CI for dichotomous outcomes. Heterogeneity was assessed by visual inspection of forest plots and a chi2 test. An I2 test assessed inconsistencies across studies. I2> 50% represented substantial heterogeneity. RESULTS: Four probiotics studies (N=212), 4 prebiotics studies (N=126) were included. Probiotics: There were no significant differences in weight gain (MD 1.96, 95% CI: -2.64 to 6.56, 2 studies, n=34) or in maximal enteral feed (MD 35.20, 95% CI: -7.61 to 78.02, 2 studies, n=34), number of stools per day increased significantly in probiotic group (MD 1.60, 95% CI: 1.20 to 2.00, 1 study, n=20). Prebiotics: Galacto-oligosaccharide / Fructo-oligosaccharide (GOS/FOS) yielded no significant difference in weight gain (MD 0.04, 95% CI: -2.65 to 2.73, 2 studies, n=50), GOS/FOS yielded no significant differences in length gain (MD 0.01, 95% CI: -0.03 to 0.04, 2 studies, n=50). There were no significant differences in head growth (MD [MINUS SIGN]0.01, 95% CI: -0.02 to 0.00, 2 studies, n=76) or age at full enteral feed (MD [MINUS SIGN]0.79, 95% CI: -2.20 to 0.61, 2 studies, n=86). Stool frequency increased significantly in prebiotic group (MD 0.80, 95% CI: 0.48 to 1.1, 2 studies, n=86). GOS/FOS and FOS yielded higher bifidobacteria counts in prebiotics group (MD 2.10, 95% CI: 0.96 to 3.24, n=27) and (MD 0.48, 95% CI: 0.28 to 0.68, n=56). CONCLUSIONS: There is not enough evidence to state that supplementation with probiotics or prebiotics results in improved growth and clinical outcomes in exclusively formula fed preterm infants.     

Addition of long-chain polyunsaturated fatty acids to formula for very low birth weight infants

Thirty-four premature infants who were appropriate for gestational age and weighing less than 1500 g at birth were fed “preemie” SMA-24 formula, “preemie” SMA-24 formula manufactured to contain C₂₀ and C₂₂ ω6 and ω3 fatty acids (LCPE-SMA), or expressed milk (EBM). Blood samples were drawn from a small arm vein during the first week of life and after 28 days of feeding. The fatty acid content of plasma phospholipids was determined. Infants fed SMA-24 had a high content of 18∶2ω6 in plasma phospholipids. Feeding LCPE-SMA normalized plasma phospholipid levels of C₂₀ and C₂₂ ω6 and ω3 fatty acids to be similar to levels of C₂₀ and C₂₂ ω6 and ω3 fatty acids found in infants fed EBM, and significantly higher than characteristic levels for infants fed SMA-24. Feeding LCPE-SMA or EBM results in a balanced incorporation of C₂₀ and C₂₂ ω6 and ω3 fatty acids into phospholipids derived from the liver or perhaps the small intestine. Based on a paper presented at the Symposium on Milk Lipids held at the 1990 AOCS Annual Meeting, Baltimore, MD, April 1990.     

The clinical effect of a new infant formula in term infants with constipation: a double-blind,randomized cross-over trial

Background  

Nutrilon Omneo (new formula; NF) contains high concentration of sn-2 palmitic acid, a mixture of prebiotic oligosaccharides and partially hydrolyzed whey protein. It is hypothesized that NF positively affects stool characteristics in constipated infants.     

Modification of stool's water content in constipated infants: management with an adapted infant formula

Background

There is increasing global acceptance that viscous soluble fibers lower serum LDL cholesterol (LDL-C), but most evidence for this comes from studies in Caucasians. To see if oat β-glucan lowers LDL-C in Caucasians and non-Caucasians we conducted a post-hoc analysis of the results of a randomized, controlled, double-blind, multi-center clinical trial whose primary aim was to determine if molecular-weight (MW) influenced the LDL-C-lowering effect of oat β-glucan.

Results

Caucasian and non-Caucasian subjects with LDL-C-C ≥ 3.0 and ≤ 5.0 mmol/L (n = 786 screened, n = 400 ineligible, n = 19 refused, n = 367 randomized, n = 345 completed, n = 1 excluded for missing ethnicity) were randomly assigned to consume cereal containing wheat-fiber (Control, n = 74:13 Caucasian:non-Caucasian) or 3 g high-MW (3H, 2,250,000 g/mol, n = 67:19), 4 g medium-MW (4 M, 850,000 g/mol, n = 50:17), 3 g medium-MW (3M, 530,000 g/mol, n = 54:9) or 4 g low-MW (4 L, 210,000 g/mol, n = 51:12) oat β-glucan daily for 4 weeks. LDL-C after 4 weeks was influenced by baseline LDL-C (p < 0.001) and treatment (p = 0.003), but not ethnicity (p = 0.74). In all subjects, compared to control, 3 H, 4 M and 3 M reduced LDL-C significantly by 4.8 to 6.5%, but 4 L had no effect. Compared to control, the bioactive oat β-glucan treatments (3H, 4M and 3M) reduced LDL-C by a combined mean (95% CI) of 0.18 (0.06, 0.31) mmol/L (4.8%, n = 171, p = 0.004) in Caucasians, a value not significantly different from the 0.37 (0.09, 0.65) mmol/L (10.3%, n = 45, p = 0.008) reduction in non-Caucasians.

Conclusion

We conclude that oat β-glucan reduces LDL-C in both Caucasians and non-Caucasians; there was insufficient power to determine if the magnitude of LDL-C-lowering differed by ethnicity.

Trial Registration

ClinicalTrials.gov: NCT00981981     

Tolerance of a standard intact protein formula versus a partially hydrolyzed formula in healthy, term infants

Background  

Parents who perceive common infant behaviors as formula intolerance-related often switch formulas without consulting a health professional. Up to one-half of formula-fed infants experience a formula change during the first six months of life.     

Comparison of a low carbohydrate and low fat diet for weight maintenance in overweight or obese adults enrolled in a clinical weight management program

Background  

Recent evidence suggests that a low carbohydrate (LC) diet may be equally or more effective for short-term weight loss than a traditional low fat (LF) diet; however, less is known about how they compare for weight maintenance. The purpose of this study was to compare body weight (BW) for participants in a clinical weight management program, consuming a LC or LF weight maintenance diet for 6 months following weight loss.     

Effectivity in the use of protein supplements in resistance training: systematic review

To increase strength and lean body mass, protein has become one of the most popular supplements among athletes. The aim of this study was to analyze the effect of protein supplementation on body composition. A systematic review of the randomized controlled trials (RCT), published in MEDLINE/PubMed and SciELO up to April 10, 2009, was conducted. All RCT conducted in healthy subjects with interventions of six or more weeks were included. Nine studies fulfilled the inclusion criteria, and three of them had level 3 of evidence. Among these studies, the increase of lean mass ranged from 0.8 to 1.9 kg. However, the study with the longest term had duration of 12 weeks. Therefore, the evidence does not support the recommendation for the consumption of protein supplements among healthy individuals.     

Isolation of a yeast,Trichosporon cutaneum,able to use low molecular weight phenolic compounds: application to olive mill waste water treatment

This study deals with the degradation of phenolic compounds in olive oil mill waste; a highly polluting material in olive oil‐producing countries because of its abundance and the toxicity of its phenolic compound content. This investigation confirms the ability of an isolated yeast, identified as Trichosporon cutaneum, to degrade phenolic compounds extracted from olive mill waste water (OMW). The yeast was adapted to the OMW by an enrichment culture. The results of this biotransformation were a decrease in the phenolic content and hence a reduction in the phytotoxic effects of the effluent after the yeast treatment. The kinetic growth of the isolated yeast on phenol over a range of concentrations (0.3–3.0 g dm^?3) was studied. The ability of the strain to assimilate simple monomeric phenols and alkyl phenols, at a concentration of 1 g dm^?3, in a synthetic liquid medium used as the sole carbon source was investigated in a batch culture. The aromatic ring cleavage pathway occurred in the yeast through catechol oxidation. Using various concentrations of ethyl acetate extract from OMW as the sole carbon source, the yeast exhibited growth on the substrate up to 7 g dm^?3 equivalent of phenols. A significant reduction of COD after the treatment of the OMW extract by the yeast isolate was noticed. The removal of phenol and COD exceeded 80% of the original loading after 8 days of treatment, for extracts containing initial COD in the range 19 to 72 g dm^?3. Copyright © 2004 Society of Chemical Industry     

A health facility based case-control study on determinants of low birth weight in Dassie town,Northeast Ethiopia: the role of nutritional factors

Background

Low birth weight remains a major public health problem affecting developing countries. Evidence shows that low birth weight has long lasting negative health consequences through its contribution to stunting, mental impairment and non-communicable chronic diseases in later life. Thus, it is worth investigating the role of nutritional factors as determinants of low birth weight to suggest nutritional interventions to curb its negative health outcomes. This study aimed to investigate the determinants of low birth weight with main focus on the role of nutritional factors in Ethiopia.

Methods

A facility-based case-control study was conducted from 3 February to 29 April, 2017. The data were collected using structured, pretested interviewer-administered questionnaire in all public health facilities of Dessie Town. Anthropometric measurements were made following standard procedures for both mothers and their newborns. Consecutive live births of <?2500 g and two succeeding normal weight babies were selected as cases and controls, respectively. Data were entered in to Epi-data software version 3.1, and exported to SPSS version 21, and analyzed using frequency, mean and percentage. Factors with p?<?0.25 during bivariate analyses were entered into a multivariable logistic regression model to determine significant determinants of LBW. Statistical significance was considered at p?<?0.05. Results were reported with odds ratio and 95% CI.

Results

Mean?±?SD of birth weight (g) was 2138?±?207 for cases and 3145?±?415 for controls. After adjusting for potential confounders using multivariable logistic regression analysis, the absence of iron and folate supplementation, receiving no nutritional counseling and consuming no additional meal, maternal undernutrition, maternal anemia and inadequate dietary diversity during the current pregnancy were found to be significant determinants of low birth weight in our study.

Conclusion

Lack of nutritional counseling, absence of additional meal intake and iron and folate supplementation during pregnancy, and maternal undernutrition, maternal anemia and inadequate maternal dietary diversity were significant determinants of low birth weight. The importance of nutritional counseling, improving iron and folate supplementation during pregnancy, and nutritional status of pregnant women need to be strengthened to reduce the incidence of LBW in Ethiopia. In addition, behavioral change communications targeting pregnant women to improve women dietary diversity and their extra meal intake practice need to be enhanced in Ethiopia.

     

The use of carbon nanomaterials in membrane distillation membranes: a review

Membrane distillation (MD) is a thermal-based separation technique with the potential to treat a wide range of water types for various applications and industries. Certain challenges remain however, which prevent it from becoming commercially widespread including moderate permeate flux, decline in separation performance over time due to pore wetting and high thermal energy requirements. Nevertheless, its attractive characteristics such as high rejection (ca. 100%) of non-volatile species, its ability to treat highly saline solutions under low operating pressures (typically atmospheric) as well as its ability to operate at low temperatures, enabling waste-heat integration, continue to drive research interests globally. Of particular interest is the class of carbon-based nanomaterials which includes graphene and carbon nanotubes, whose wide range of properties have been exploited in an attempt to overcome the technical challenges that MD faces. These low dimensional materials exhibit properties such as high specific surface area, high strength, tuneable hydrophobicity, enhanced vapour transport, high thermal and electrical conductivity and others. Their use in MD has resulted in improved membrane performance characteristics like increased permeability and reduced fouling propensity. They have also enabled novel membrane capabilities such as in-situ fouling detection and localised heat generation. In this review we provide a brief introduction to MD and describe key membrane characteristics and fabrication methods. We then give an account of the various uses of carbon nanomaterials for MD applications, focussing on polymeric membrane systems. Future research directions based on the findings are also suggested.     

Validity of claims made in weight management research: a narrative review of dietetic articles

Background  

The best available evidence demonstrates that conventional weight management has a high long-term failure rate. The ethical implications of continued reliance on an energy deficit approach to weight management are under-explored.     

The use of bioelectrochemical systems in environmental remediation of xenobiotics: a review

Remediation of anthropogenic pollutants in our environment has become an imperative of the 21st century in order to sustain human activity and all life on the planet. With the current limitations of the existing technologies for this purpose, the need for innovative bioremediation technologies has become vitally important. Hitherto, electrochemically active microorganisms have only been a scientific curiosity and a platform for sustainable power production from waste material. However, recent research utilizing these electrochemically active microorganisms in bioelectrochemical systems (BES) has revealed their promising potential for bioremediation applications. The primary research focus of BES applications up-to now has been to optimize and increase their power output. The possibility of utilizing these systems for bioremediation applications has been a new facet of this field of work. This review provides a comprehensive outlook on the utilization of BES based technologies for remediation of xenobiotic environmental pollutants. © 2018 Society of Chemical Industry     

Factors related to birth weight: a comparison of related factors between newborns of Spanish and Colombian immigrant women in Spain

The objective of this study is to establish differentials in birth weight (BW) and related factors, in term newborns (NB) of Spanish (SP) and Colombian (CO) immigrant mothers living in Spain, between 2001-2005. Data on the NB population of SP and CO mothers was retrieved from the National Statistical Bulletin of Birth in Spain. We analysed the association with BW (Low birth weight -LBW- insufficient weight -IW- macrosomia), by the nationality of the mother; taking into account variables such as the intergenesic interval, maternal age, number of live children, maternal occupation and sex of NB. The analysis was based on frequencies and the estimation of simple and adjusted odds ratios (OR) by means of logistic regression with 95% confidence intervals (95% CI). A higher prevalence of LBW was found in SP mothers (3.4%) than in their CO counterparts (2.1%). In SP mothers a higher risk of LBW (aOR 1.89, 950% CI 1.65- 2.16) and IW (aOR 1.49, 95% CI 1.51- 1.57) was observed. In CO mothers a higher percentage of macrosomia was found (8.0%). Also, a higher percentage of LBW was observed in female new borns (SP4.1%; CO 2.7%) as well as IW (PI (SP 25.6%; CO 19.6%) (p < 0.001). Mothers aged > 40 years and having 4 or more children were associated with LBW in both nationalities. As a conclusion, NB of Colombian mothers presented a lower prevalence of LBW and IW, which could be explained by the healthy migrant effect.     

Walnut consumption in a weight reduction intervention: effects on body weight,biological measures,blood pressure and satiety

Background

Dietary strategies that help patients adhere to a weight reduction diet may increase the likelihood of weight loss maintenance and improved long-term health outcomes. Regular nut consumption has been associated with better weight management and less adiposity. The objective of this study was to compare the effects of a walnut-enriched reduced-energy diet to a standard reduced-energy-density diet on weight, cardiovascular disease risk factors, and satiety.

Methods

Overweight and obese men and women (n =?100) were randomly assigned to a standard reduced-energy-density diet or a walnut-enriched (15% of energy) reduced-energy diet in the context of a behavioral weight loss intervention. Measurements were obtained at baseline and 3- and 6-month clinic visits. Participants rated hunger, fullness and anticipated prospective consumption at 3 time points during the intervention. Body measurements, blood pressure, physical activity, lipids, tocopherols and fatty acids were analyzed using repeated measures mixed models.

Results

Both study groups reduced body weight, body mass index and waist circumference (time effect p <?0.001 for each). Change in weight was ?9.4 (0.9)% vs. -8.9 (0.7)% (mean [SE]), for the standard vs. walnut-enriched diet groups, respectively. Systolic blood pressure decreased in both groups at 3 months, but only the walnut-enriched diet group maintained a lower systolic blood pressure at 6 months. The walnut-enriched diet group, but not the standard reduced-energy-density diet group, reduced total cholesterol and low-density lipoprotein cholesterol (LDL-C) at 6 months, from 203 to 194 mg/dL and 121 to 112 mg/dL, respectively (p <?0.05). Self-reported satiety was similar in the groups.

Conclusions

These findings provide further evidence that a walnut-enriched reduced-energy diet can promote weight loss that is comparable to a standard reduced-energy-density diet in the context of a behavioral weight loss intervention. Although weight loss in response to both dietary strategies was associated with improvements in cardiovascular disease risk factors, the walnut-enriched diet promoted more favorable effects on LDL-C and systolic blood pressure.

Trial registration

The trial is registered at (NCT02501889).

     

Visible light-induced photocurable (forming a film) low molecular weight chitosan derivatives for biomedical applications: Synthesis,characterization and in vitro biocompatibility

In this work, visible light-induced photocurable low molecular weight chitosan derivatives (F-LMC: furfuryl-low molecular weight chitosan) were prepared by nitrous acid decomposition followed by modification with furfuryl glycidyl ether. The structure of the decomposition products (LMC: low molecular weight chitosan) was characterized by FT-IR analysis. The structure and molecular weight of F-LMC, prepared from the decomposition products by modification with furfuryl glycidyl ether, were characterized by ¹H NMR and GPC analysis, respectively. F-LMC was initially water-soluble, but after the exposure to visible light, it became water-insoluble, indicating that F-LMC undergoes visible light-induced inter- and intra-molecular cross-linking. The cross-linking was determined by concentration of F-LMC and time of exposure to visible light. The cytotoxicity test using fibroblast 3T3 showed no toxicity of F-LMC. Cross-linked F-LMC surface inhibited cell adherence.     

The potential for use of gold in automotive pollution control technologies: a short review

Topics in Catalysis - Recent studies relevant to the future use of gold catalysts in the automotive industry are summarized. Gold catalysts have been examined for their potential in low temperature...     

Lack of efficacy of pomegranate supplementation for glucose management,insulin levels and sensitivity: evidence from a systematic review and meta-analysis

Background

The potential glucose-lowering effects of pomegranate have been reported in animal and observational studies, but intervention studies in humans have generated mixed results. In this paper, we aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the precise effects of pomegranate supplementation on measures of glucose control, insulin levels and insulin sensitivity in humans.

Methods

Comprehensive electronic searches were conducted in PubMed, Embase, and the Cochrane Library. Studies included were RCTs that evaluated the changes in diabetes biomarkers among adults (≥18 years) following pomegranate interventions. The predefined outcomes included fasting blood glucose (FBG), fasting blood insulin (FBI), glycated haemoglobin (HbA1c), and homeostatic model assessment of insulin resistance (HOMA-IR). Endpoints were calculated as weighted mean differences (WMDs) with 95% confidence intervals (CIs) by using a random-effects model. Publication bias, subgroup analyses, sensitivity analysis and random-effects meta-regression were also performed to explore the influence of covariates on the net changes in fasting glucose and insulin concentrations.

Results

Sixteen eligible trials with 538 subjects were included. The pooled estimates suggested that pomegranate did not significantly affect the measures of FBG (WMD, ?0.6 mg/dL; 95% CI, ?2.79 to 1.58; P=0.59), FBI (WMD, 0.29 μIU/mL; 95% CI, ?1.16 to 1.75; P=0.70), HOMA-IR (WMD, ?0.04; 95% CI, ?0.53 to 0.46; P=0.88) or HbA1c (WMD, ?0.11%; 95% CI, ?0.39 to ?0.18; P=0.46). Overall, significant heterogeneity was detected for FBI and HOMA-IR, but subgroup analysis could not identify factors significantly influencing these parameters. These results were robust in sensitivity analysis, and no significant publication bias was found in the current meta-analysis.

Conclusion

Pomegranate intake did not show a notably favourable effect on improvements in glucose and insulin metabolism. The current evidence suggests that daily pomegranate supplementation is not recommended as a potential therapeutic strategy in glycemic management. Further large-scale RCTs with longer duration are required to confirm these results.

     

The effects of oral iron supplementation on cognition in older children and adults: a systematic review and meta-analysis

Background  

In observational studies anaemia and iron deficiency are associated with cognitive deficits, suggesting that iron supplementation may improve cognitive function. However, due to the potential for confounding by socio-economic status in observational studies, this needs to be verified in data from randomised controlled trials (RCTs).     

A generalized correlation for the viscosity of dextrans in aqueous solutions as a function of temperature,concentration, and molecular weight at low shear rates

An expression relating the viscosity of dextran solutions to polymer concentration (c), molecular weight (M), and temperature (T) has been derived from experimental data in the following ranges: 5 < c < 25% (wt/wt), 298.2 < T < 363.2 K, and 71,500 < M < 531,000 g/mol. The experimental work was based on capillary viscosimeters. Thermodynamic data (entropy and energy of activation for the viscous flow of a Newtonian fluid) are also presented as a function of polymer concentration for the three molecular weights studied. This thermodynamic analysis suggests that dextrans in aqueous solutions behave as flexible polymers. Application of our expression to existing viscosity data for ethylene/vinylacetate copolymers in paraffin has resulted in improved goodness of fit with respect to established correlations.     

Diffusion of low molecular weight substances into a laminar film. I: Rigorous solution of the diffusion equation in a composite film of multiple layers

A rigorous solution of the diffusion of penetrant into a laminar film comprised of multilayers of m components is presented by an orthogonal-expansion method. As the simplest practical cases of m ? 2 and m ? 3, with stepwise distribution of both diffusion coefficients and solubility coefficients at the boundary between respective layers, the diffusion properties in the transient state are analyzed in detail. That is, changes in the penetrant concentration distribution within the laminar film and the total amount of penetrant sorbed within the film both with time after exposing the film to an atmosphere of fixed penetrant concentration are calculated for A–B as well as A–B–A type layer arrangements. The calculation is performed while keeping (L₂/L₁) at a constant value of 2.0 but varying the diffusion coefficient ratio of (D₁/D₂) from 10² to 10^?2, and/or varying the solubility coefficient ratio of (S₁/S₂) from 1 to 10, where L₁ and (L₂ ? L₁) are the thickness D₁ and D₂ are the diffusion coefficients of penetrant, and S₁ and S₂ are the solubility coefficients in the A-component and B-component, respectively. The sorption curves deviate considerably from those of Fickian curves of homogeneous film with (D₁/D₂) ? 1 in their respective ways. The results obtained here can be applied to the diffusion in a single component polymer film having a surface layer with different diffusion properties from that of the inner side of the film caused by differing distributions in molecular orientation or degrees of crystallinity.