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| 2. |
- Björkström, Markus V, et al.
(författare)
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Intestinal flora in very low-birth weight infants
- 2009
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 98:11, s. 1762-1767
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To study the early faecal microbiota in very low-birth weight infants (VLBW, <1500 g), possible associations between faecal microbiota and faecal calprotectin (f-calprotectin) and to describe the faecal microbiota in cases with necrotizing enterocolitis (NEC) before diagnosis. METHODS: Stool samples from the first weeks of life were analysed in 48 VLBW infants. Bacterial cultures were performed and f-calprotectin concentrations were measured. In three NEC cases, cultures were performed on stool samples obtained before diagnosis. RESULTS: Bifidobacteria and lactobacilli were often identified in the first stool sample, 55% and 71% of cases, respectively within the first week of life. A positive correlation between lactic acid bacteria (LAB) and volume of enteral feed was found. Other bacteria often identified were Escherichia coli, Enterococcus and Staphyloccus sp. F-calprotectin was not associated with any bacterial species. All NEC cases had an early colonization of LAB. Prior to onset of disease, all cases had a high colonization of non-E. coli Gram-negative species. CONCLUSION: In contrast to the previous studies in VLBW infants, we found an early colonization with LAB. We speculate that this may be due to early feeding of non-pasteurized breast milk.
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| 3. |
- Domellöf, Magnus, et al.
(författare)
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Effects of mode of oral iron administration on serum ferritin and haemoglobin in infants
- 2008
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 97:8, s. 1055-1060
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate effects of iron-fortified foods (FFs) and medicinal iron drops (MD) on iron status in infants. Methods: Data from one MD and one FF study were compared. Infants were divided into groups depending on the predominant source and amount of dietary iron during 6–9 months of age: MD: Medicinal iron drops (1 mg/kg/day). FF: iron intake >1.3 mg/kg/day, predominantly from FF and no iron supplements. Low iron (LI) group: iron intake <1.3 mg/kg/day and no iron supplements. Results: Mean iron intake did not differ between MD (n = 30) and FF (n = 35) groups but was lower in the LI (n = 232) group. The FF group had significantly higher mean Hb at 9 months compared to the MD and LI groups (120 vs. 115 g/L and 120 vs. 116 g/L, respectively, p ≤ 0.005). The MD group had significantly higher mean SF at 9 months compared to the FF and the LI groups (46 vs. 23 μg/L and 46 vs. 26 μg/L, respectively, p < 0.001). Conclusions: Our results suggest that, in healthy, term, nonanaemic 6–9-month-old infants, iron given as medicinal iron drops is primarily deposited into iron stores while iron given as iron-fortified foods is primarily utilized for Hb synthesis.
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| 4. |
- Domellöf, Magnus
(författare)
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Iron requirements, absorption and metabolism in infancy and childhood.
- 2007
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Ingår i: Curr Opin Clin Nutr Metab Care. - 1363-1950. ; 10:3, s. 329-35
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- PURPOSE OF REVIEW: Iron deficiency is a significant public health problem in young children due to their high iron requirements, and iron supplements are therefore often recommended. During the time period in focus for this review (2005-2006), there have been additional advances in our understanding of the molecular mechanisms of iron absorption and metabolism. It has also been suggested that iron supplements may have adverse effects in children. RECENT FINDINGS: Recently discovered molecules, for example hepcidin, lactoferrin receptor and heme carrier protein may be important for iron metabolism in children. There are possible metabolic interactions between iron and several other minerals. Many studies show that iron deficiency in young children is associated with impaired neurodevelopment but it is not clear whether this can be prevented by iron supplementation. Oral iron supplements given to young children in malarious regions may lead to increased risk of death or severe infections, especially in those who are iron replete. SUMMARY: More research is needed to identify those children who will benefit from iron supplementation and to better determine iron requirements during early life. Clinical trials should include functional outcomes. Better knowledge about molecular mechanisms and nutrient interactions may lead to new diagnostic tests and preventive strategies.
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| 5. |
- Domellöf, Magnus, et al.
(författare)
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Iron supplementation does not affect copper and zinc absorption in breastfed infants.
- 2009
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Ingår i: American Journal of Clinical Nutrition. - : Elsevier BV. - 0002-9165 .- 1938-3207. ; 89:1, s. 185-190
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Iron supplements are commonly recommended for infants but were suggested to inhibit zinc and copper absorption. OBJECTIVE: The objective of this study was to investigate potential effects of iron supplementation, infant age, and mineral status on zinc and copper absorption in infants at 6 and 9 mo of age. DESIGN: Twenty-five healthy breastfed term infants were recruited from a larger randomized iron supplementation trial. Six of these infants received iron supplements (1 mg . kg(-1) . d(-1)) from 4 to 9 mo, 8 were supplemented from 6 to 9 mo, and 11 received placebo only. Zinc and copper absorption was measured at 6 and 9 mo of age, using orally administered (70)Zn and (65)Cu and fecal monitoring of recovered stable isotopes. RESULTS: Mean (+/-SD) zinc absorption was 51.9 +/- 17.9%, and mean copper absorption was 79.0 +/- 13.5%. No significant difference was observed in zinc or copper absorption between 6 and 9 mo of age. When combining all measurements, no significant effect of prior iron supplementation was observed on zinc or copper absorption. No significant correlation was observed between plasma zinc and zinc absorption or between plasma copper and copper absorption. No significant correlation was observed between erythrocyte copper-zinc-dependent superoxide dismutase activity and copper absorption. CONCLUSIONS: The study does not support the contention that iron supplements inhibit the absorption of zinc or copper in healthy breastfed infants at 6-9 mo of age. In addition, we did not find any age-related changes in zinc or copper absorption between 6 and 9 mo of age.
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| 6. |
- Domellöf, Magnus, et al.
(författare)
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Iron supplements reduce erythrocyte copper-zinc superoxide dismutase activity in term, breastfed infants.
- 2005
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Ingår i: Acta Paediatr. - 0803-5253. ; 94:11, s. 1578-82
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate whether iron supplements compromise copper status in infants. METHODS: 214 healthy, term, breastfed Swedish and Honduran infants were randomized to (1) iron supplements (1 mg/kg/d) from 4-9 mo of age, (2) iron supplements from 6-9 mo, or (3) placebo. Blood samples were obtained at 4, 6, and 9 mo and analyzed for plasma copper (p-Cu) and, at 9 mo, for copper/zinc-dependent superoxide dismutase (CuZn-SOD) activity. RESULTS: P-Cu increased with infant age. At 9 mo, Honduran infants had significantly higher p-Cu (1.40+/-0.29 vs 1.09+/-0.22 mg/l, p<0.001) and CuZn-SOD activity (1.09+/-0.29 vs 0.93+/-0.21 U/mg Hb, p<0.001) than Swedish infants. Infants receiving iron supplements from 4-9 mo had significantly lower CuZn-SOD at 9 mo of age (0.95+/-0.27 vs 1.08+/-0.24 U/mg Hb, p=0.023) than those receiving placebo.CONCLUSION: There is a physiologic increase in p-Cu during the first 9 mo of life. Differences in copper status between Swedish and Honduran infants may be due to genetic or nutritional differences. Iron supplementation decreases CuZn-SOD activity, probably due to a negative effect on copper status. Possible clinical implications remain to be elucidated.
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| 7. |
- Domellöf, Magnus, et al.
(författare)
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Processed infant cereals as vehicles of functional components.
- 2007
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Ingår i: Nestle Nutr Workshop Ser Pediatr Program.. ; 60, s. 107-21
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Cereals are the most common complementary foods all over the world and there is now a novel possibility to add functional components to target health problems that are not caused by a simple nutritional deficiency. So far there have been very few published trials on the addition of functional components to infant cereals. A single trial has suggested that infant cereals containing a combination of probiotics, prebiotics and zinc are an effective adjunct to oral rehydration solution in the treatment of acute gastroenteritis. Up to now there has been no evidence that infant cereals supplemented with probiotics or prebiotics have a preventive effect on diarrhea but a recent study has suggested that a milk fat globule membrane (MFGM) protein fraction added to an infant cereal reduces the risk of diarrhea in a developing country. There are some promising results suggesting that infant cereals supplemented with probiotics or prebiotics may prevent atopic eczema. The addition of prebiotic oligosaccharides to infant cereals may lead to softer stools, likely to benefit those infants who are suffering from constipation. More studies are needed to verify these results and to assess the effects of other functional components - especially probiotics, prebiotics, nucleotides, novel protein fractions and recombinant human milk proteins - added to infant cereals.
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| 8. |
- Josefsson, Stina, et al.
(författare)
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Fecal calprotectin in very low birth weight infants.
- 2007
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Ingår i: J Pediatr Gastroenterol Nutr. - 1536-4801. ; 44:4, s. 407-13
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To measure concentrations of fecal calprotectin (f-calprotectin) in infants with very low birth weight (VLBW; <1500 g) longitudinally and to describe changes in f-calprotectin in infants who develop severe abdominal disease. PATIENTS AND METHODS: The study included 59 VLBW infants. Seven patients (disease group) developed severe abdominal disease defined as necrotizing enterocolitis (NEC) or a condition leading to laparotomy. The remainder (n = 52) were considered reference infants and had a mean (+/-SD) gestational age of 27.2 +/- 2.6 weeks and a birth weight of 939 +/- 273 g. F-calprotectin was analyzed in meconium and weekly during postnatal weeks 1 to 8. In disease cases, more frequent samples were analyzed around the time of abdominal disease diagnosis. RESULTS: In reference infants the median (range) f-calprotectin level in meconium was 332 (12-9386) microg/g and correlated negatively to Apgar score. F-calprotectin in postmeconium samples was 253 (9-1867) microg/g and correlated positively to delivery by cesarean section, postnatal age, and volume of enteral feeds, and negatively to treatment with antibiotics and corticosteroids. In reference infants no postmeconium sample had f-calprotectin levels >2000 microg/g. In disease cases f-calprotectin was increased to >2000 microg/g in 3 cases of NEC and 1 case of covered perforation with microscopic bowel inflammation. In 1 case of NEC without microscopic bowel inflammation and 2 cases of focal intestinal perforation, f-calprotectin levels never exceeded 2000 microg/g. CONCLUSIONS: F-calprotectin concentrations in VLBW infants are similar to previously reported levels in healthy term and moderately preterm infants. An f-calprotectin level >2000 microg/g is a useful but not an early marker of NEC and other severe intestinal inflammatory conditions in VLBW infants.
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| 9. |
- Stattin, Eva-Lena, 1960-, et al.
(författare)
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Familial osteochondritis dissecans associated with early osteoarthritis and disproportionate short stature
- 2008
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Ingår i: Osteoarthritis and Cartilage. - London : Elsevier BV. - 1063-4584 .- 1522-9653. ; 16:8, s. 890-6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Familial osteochondritis dissecans (OCD) is a rare disorder characterised by disturbed chondro-skeletal development, disproportionate growth and deformation of the skeleton. DESIGN: We identified a five-generation family with 15 living affected members from Northern Sweden. The disorder was diagnosed with a case definition of OCD in at least one joint. RESULTS: Main clinical findings consisted of OCD in knees and/or hips and/or elbows, disproportionate short stature and early osteoarthritis (OA). There were no radiological indications of epiphyseal dysplasia. Anthropometric measurements of affected individuals showed short stature, a high ratio between sitting height and total height, a relatively normal arm span and head circumference. In 12 of 15 cases, onset was during late childhood or adolescence and OA had developed in seven of those patients. CONCLUSIONS: Our observation suggests that OA is a frequent complication in familial OCD even though the lesions appear before closure of physis.
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| 10. |
- Yang, Zhenyu, et al.
(författare)
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Comparison of plasma ferritin concentration with the ratio of plasma transferrin receptor to ferritin in estimating body iron stores : results of 4 intervention trials
- 2008
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Ingår i: American Journal of Clinical Nutrition. - Bethseda, Md. : American Society for Nutrition. - 0002-9165 .- 1938-3207. ; 87:6, s. 1892-1898
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Efforts to develop global programs for the control of iron deficiency require simple, low-cost, and accurate indicators of iron status. Objective: We aimed to compare estimates of body iron (BI) stores, as calculated from either plasma ferritin concentration alone (BI-ferritin) or the ratio of plasma transferrin receptor (TfR) to ferritin (BI-TfR/ferritin). Design: Data were analyzed from 4 previously completed, randomized intervention trials that enrolled infants, schoolchildren, or pregnant women (totaln = 1189, after excluding subjects with elevated C-reactive protein). Results: The correlation coefficients between BI-ferritin and BI-TfR/ferritin were >0.95 for all studies. The kappa index ranged from 0.5 to 1.0. All of the sensitivities of BI-ferritin for identifying persons with low iron stores (defined as BI-TfR/ferritin < 0 mg/kg body wt) were >0.90. All of the specificities were >0.90 except the study of pregnant women (specificity = 0.66). The effect sizes of iron intervention trials were significantly greater for change in iron reserves estimated by BI-TfR/ferritin than by BI-ferritin in 2 studies with larger effect sizes (1.11 compared with 1.00 and 1.56 compared with 1.44, respectively; P < 0.05) and 1 study with medium effect size (0.70 compared with 0.57; P < 0.05). However, there were no significant differences between estimates of these effect sizes for 1 study with a medium effect size and 1 study with a smaller effect size (0.78 compared with 0.83 and 0.37 compared with 0.35, respectively; P > 0.2). Conclusion: Plasma ferritin concentration alone provides a good approximation of total BI reserves, as estimated by BI-TfR/ferritin, on the basis of high correlation, sensitivity, and specificity among nonpregnant persons with unelevated C-reactive protein.
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