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Biomedical subjects

B Lönnerdal

Publications and source records attributed to B Lönnerdal.

At least 55 records · Page 3Linked to original sources

Are weaning foods causing impaired iron and zinc status in 1-year-old Swedish infants? A cohort study.

We analysed whether 12-month-old Swedish infants who have been fed iron-fortified and relatively zinc-rich foods, according to current recommendations, have adequate iron and zinc status. A cohort of 76 healthy, full term Swedish infants was followed regarding feeding habits and growth from birth to 12 months of age, when haemoglobin, iron and zinc status were evaluated. Twenty-six percent of the infants had low (<12 microg/l) s-ferritin values, indicative of iron depletion, and 36% of the infants had low s-zinc concentrations (<10.7 micromol/l). Only two infants had both low haemoglobin and low s-ferritin values. s-Zinc and s-iron were positively correlated, and s-zinc and s-transferrin receptor values were negatively correlated. Lower birthweight was associated with lower s-ferritin levels at 12 months in boys, and with increased s-transferrin receptor values in girls. Feeding habits during infancy were relatively homogeneous, dominated by breastfeeding, iron-fortified milk- and cereal-based follow-on formula. No clear association between feeding pattern and iron and zinc status was found. The results indicate that in a group of healthy, well growing 12-month-old Swedish infants one-quarter is iron-depleted, although iron deficiency anaemia is rare, and one-third may be zinc-depleted. The high cereal intake of Swedish infants from 6 months of age may have limited the bioavailability of both iron and zinc from the diet.

Age Distribution↗

Spot ferritin assay for serum samples dried on filter paper.

A spot method was developed for analyzing ferritin from 20-microL serum samples (n = 71) that were spotted and dried on filter paper and stored frozen (2 d). Spot samples were thawed, incubated in a buffer containing cellulase, and centrifuged and the supernate assayed for ferritin by a commercial radioimmunoassay. The geometric means (+/- 1 SD) for ferritin analyzed with the spot and traditional methods were 49.4 (range: 14.9-164.0) and 47.5 (range: 14.4-156.0) micrograms/L, respectively. The two methods correlated strongly (r = 0.98, P = 0.0001). Storage of spot samples (n = 31) under various conditions (at room temperature, refrigerated, or frozen for 2 wk, or at room temperature for 4 wk) in airtight bags before analysis yielded ferritin values that were not significantly different from those obtained by the traditional method. Ferritin values from spotted samples stored at room temperature for 4 wk before being analyzed were only 2.2 micrograms/L higher than those from samples analyzed by the traditional method. With iron depletion defined as a serum ferritin concentration < 15 micrograms/L, this method corresponded absolutely with the traditional method in classifying individuals as iron sufficient or deficient. Thus, the spot ferritin method (with samples stored at room temperature for 4 wk) offers a reliable, accurate, and practical tool for iron status assessment in field studies. Capillary blood can be sampled to avoid the costs and concerns associated with venipuncture and spotted serum samples can be stored at room temperature for > or = 4 wk, eliminating the need for freezing during storage and transportation.

Adolescent↗

Copper nutrition during infancy and childhood.

Full-term human infants are believed to possess adequate copper stores to last through weaning regardless of the copper content of the diet they are fed. This may not be generally true, however; a combination of low copper intake and low bioavailability from the diet may lead to copper deficiency. More information is needed on the bioavailability of copper from different infant diets, but it appears that copper is well absorbed from breast milk compared with infant formula. Several dietary factors that may affect copper absorption in infants, such as protein sources, amino acids, phytate, ascorbic acid, and other essential cations, need to be evaluated further. Studies in human infants evaluating these factors through use of stable isotope methods, as well as better indicators of copper status, are needed before the copper requirements of infants can be established. This is particularly important for premature infants who, born with inadequate copper stores, are prone to develop copper deficiency unless given higher provisions of copper. The possibility of copper excess also needs to be considered because there are limited opportunities to diagnose copper toxicity. Finally, the role of homeostatic regulation of copper metabolism in infants needs to be evaluated.

Animals↗

Stress during labor and delivery and early lactation performance.

The amount of stress experienced by both the mother and fetus during labor and delivery varies considerably and is likely to be different in primiparous and multiparous women. In this study we explored relations between the birth experience and lactation performance of 40 women. Stress hormones were measured in serum or plasma during pregnancy, parturition (cord and maternal blood), and lactation. Milk samples were obtained and breast-feeding frequency was recorded each day during the first 2 wk postpartum. Four outcomes were used as markers of lactogenesis: the time when the subject first felt fullness in the breasts, 24-h milk volume on day 5 postpartum, milk lactose concentration on day 5, and the day of appearance of casein in the milk as determined by gel electrophoresis. There were significant intercorrelations among the outcome variables, except for milk lactose. Compared with multiparous women, primiparous mothers experienced a delay in breast fullness and lower milk volume on day 5. In multiple regression analyses excluding subjects who had cesarean deliveries (n = 5), markers of both fetal and maternal stress during labor and delivery (cord glucose concentration and maternal exhaustion score) were associated with delayed breast fullness and casein appearance; delayed casein appearance was also associated independently with a longer duration of labor. Milk volume on day 5 was lower in women with higher exhaustion scores, and, in multiparous women, those who breast-fed less frequently on day 2. The milk lactose concentration was inversely related to pregnancy weight gain. These results indicate that primiparity, long labor, stress to the mother and fetus during labor and delivery, and elevated cord glucose concentrations are risk factors for delayed lactogenesis.

Adult↗

Effects of feeding ultrahigh-temperature (UHT)-treated infant formula with different protein concentrations or powdered formula, as compared with breast-feeding, on plasma amino acids, hematology, and trace element status.

The appropriate amount of protein to use in infant formula is still under discussion. We found earlier that protein digestibility is higher from ultrahigh-temperature (UHT)-treated formula than from conventionally heat-treated formula. In this study, we evaluated the nutritional, hematologic, and biochemical effects of feeding infants whey-predominant UHT-treated formula with 13 (UHT-13) or 15 (UHT-15) g protein/L as compared with a conventional, powdered, whey-predominant formula (PF) with 13 g protein/L from 6 wk to 6 mo of age. Breast-fed infants served as control subjects. Growth was assessed at monthly intervals and venous blood samples were drawn at entry into the study and at 6 mo of age. At 6 mo, there were no significant differences in weight gain or linear growth, or hemoglobin, serum ferritin, zinc, or copper concentrations among the groups. Blood urea nitrogen concentrations were lowest for breast-fed infants; among the formula-fed groups the UHT-13 group had the lowest values. All formula-fed groups had higher plasma threonine concentrations than breast-fed infants. Infants fed the UHT-13 formula had threonine values closest to those of breast-fed infants. Concentrations of branched-chain amino acids were similar in breast-fed infants and those fed UHT-13 formula, whereas the other groups had higher values. Plasma tryptophan concentrations were significantly higher in the UHT-treated formula groups than in the other groups. Thus, infants fed UHT-13 formula had metabolic measures similar to those of breast-fed infants, possibly because of high protein digestibility, or a difference in the protein source used. Iron, zinc, and copper status was satisfactory in all groups. Selenium status, as indicated by serum glutathione peroxidase activity, varied with dietary selenium intake.

Amino Acids↗

Effect of genetically modified, low-phytic acid maize on absorption of iron from tortillas.

BACKGROUND: Genetically modified, low-phytic acid strains of maize were developed to enhance mineral absorption, but have not been tested previously in humans. OBJECTIVES: We evaluated the mineral and phytic acid contents of a low-phytic acid "flint" maize (LPM, the lpa-1-1 mutant) and its parent, wild-type strain (WTM) and measured iron absorption from tortillas prepared with each type of maize and from a reference dose of ferrous ascorbate. DESIGN: Proximate composition and mineral and phytic acid contents were measured by standard techniques. Iron absorption from tortillas was evaluated by using the extrinsic tag method and was measured as the incorporation of radiolabeled iron into the red blood cells of 14 nonanemic men 2 wk after intake. RESULTS: The phytic acid content of LPM was 3.48 mg/g, approximately 35% of the phytic acid content of WTM; concentrations of macronutrients and most minerals were not significantly different between strains. Iron absorption results were adjusted to 40% absorption of ferrous ascorbate. Iron absorption was 49% greater from LPM (8.2% of intake) than from WTM (5.5% of intake) tortillas (P < 0.001, repeated-measures analysis of variance). CONCLUSION: Consumption of genetically modified, low-phytic acid strains of maize may improve iron absorption in human populations that consume maize-based diets.

Adult↗

Zinc supplementation improves the growth of stunted rural Guatemalan infants.

The impact of zinc supplementation on the growth and body composition of Guatemalan infants was assessed in a community-based, double-blind intervention trial. Infants aged 6-9 mo were assigned randomly to receive 4 mL of a beverage containing 10 mg of zinc as zinc sulfate (n = 45) or a placebo (n = 44) daily (7 d/wk) for an average of 6.9 mo. The children's weight, length, mid-upper arm and head circumferences, and triceps skinfolds were measured at baseline and at 1-2 mo intervals until the end of supplementation. Midarm muscle area (MMA) was derived from the mid-upper arm circumference and triceps skinfolds measurements. Maternal anthropometry and family socioeconomic and demographic characteristics also were obtained. Zinc supplementation was associated with an overall increase of 0.61 cm2 in MMA (P = 0.02). Children who received zinc supplements had a mean length increment that was 0.75 cm greater than those who did not (P = 0.12). However, there was a significant interaction between treatment group and initial length-for-age status (P = 0.04), such that supplemented children who were stunted at baseline (length-for-age Z score less than -2) gained 1.40 cm more than stunted children who received the placebo. We conclude that zinc supplementation of these rural Guatemalan infants during 6. 9 mo increased accretion of fat-free mass and enhanced the linear growth of those who were stunted at baseline. Further research is required to determine whether zinc supplementation during longer periods of time may achieve larger and more generalized effects on physical growth.

Body Composition↗

Copper in infant nutrition: safety of World Health Organization provisional guideline value for copper content of drinking water.

BACKGROUND: Copper is an essential nutrient for humans. Recently, a limit of 31.48 micromol/l (2 mg/l) was proposed by the World Health Organization as the provisional guideline value for copper content of drinking water. The objective of the study was to determine the tolerance of chronic exposure to drinking water with low or high copper content in infants. METHODS: Healthy infants (n = 128) were randomly assigned to receive drinking water with less than 1.57 micromol/l (<0.1 mg/l) (n = 48) or 31.48 micromol/l (2 mg/l) of copper (n = 80) from 3 to 12 months of age. At 6, 9, and 12 months of age, serum concentrations of copper, ceruloplasmin, and superoxide dismutase; erythrocyte metallothionein; bilirubin; transaminases; and gamma-glutamyl transferase were measured. RESULTS: Small differences in biochemical indexes of copper nutrition were observed between the groups, but there was no evidence of adverse or toxic effects. These findings may be explained by an adaptive response to the higher copper intake, limiting copper absorption, and increasing biliary secretion, as well as by an increase in copper storage. It is also possible that the sensitivity of the biochemical indicators employed to detect differences in copper status is limited. CONCLUSION: No acute or chronic adverse consequences of consuming water with copper content of 31.48 micromol/l (2 mg/l) were detected in infants during the first year of life. The results support the safety of the World Health Organization's provisional guideline value for copper in drinking water during infancy.

Alanine Transaminase↗

In vitro digestion of proteins in human milk fortifiers and in preterm formula.

BACKGROUND: Knowledge about the digestibility of the proteins in new products designed for feeding preterm infants is limited. The purpose of this study was to observe in vitro the hydrolysis of the bovine and human whey proteins in such products. METHODS: Proteins in human milk, in human milk fortifiers (Presemp [Semper AB, Stockholm, Sweden] and Enfamil [Mead Johnson, Evansville, IN, U.S.A.] human milk fortifiers), in preterm formulas (Similac Special Care [Ross, Columbus, OH, U.S.A.] and Enfalac [Mead Johnson]), and whey protein concentrates with varying degrees of denaturation were digested by duodenal juice from healthy preterm infants, from a 3-year-old child, and from adults. Digestion was studied in vitro using polyacrylamide gradient gel electrophoresis, electroimmunoassay, and nonprotein nitrogen analysis. RESULTS: Casein was the protein most rapidly degraded in all products. Human and bovine whey proteins were more slowly digested; as much as 68% of human lactoferrin was still immunoreactive after 40 minutes of digestion. The corresponding figure for bovine serum albumin was 24-69%; for B-lactoglobulin, 20-40%; for bovine alpha-lactalbumin, 20-51%; and for human alpha-lactalbumin, 41%. Contrary to common belief, digestibility of bovine whey proteins decreased with a high degree of denaturation of the proteins. CONCLUSIONS: Bovine whey proteins in human milk fortifiers and in preterm formulas are relatively slowly digested in vitro by normal duodenal juice. The results may have implications for the design of products for feeding preterm infants.

Adult↗

Digestion of proteins in human milk, human milk fortifier, and preterm formula in infant rhesus monkeys.

BACKGROUND: There is limited information in the literature on the capacity of the preterm infant to digest human and bovine milk proteins. We therefore studied in vivo the luminal phase of the hydrolysis of proteins in human milk, human milk fortifier, and preterm formula in preterm rhesus monkeys and in infant rhesus monkeys at 6 weeks and 7 months of age. METHODS: Protein hydrolysis was followed by polyacrylamide gradient gel electrophoresis and electroimmunoassay. The serum level of absorbed unhydrolyzed human alpha-lactalbumin was measured by a radioimmunoassay method. Trypsin and elastase activities in duodenal contents were measured before and after the meal. RESULTS: In 6-week-old monkeys, the enzyme activities decreased by 50% postprandially, whereas they increased in 7-month-old monkeys. In preterm and in 6-week-old monkeys, hydrolysis of human and bovine whey proteins was slow, and in 6-week-old monkeys, 30-50% of the proteins could still be detected immunochemically in duodenal contents after 60 min. At these ages, serum level of absorbed alpha-lactalbumin were high. At 7 months of age, no or small (lactoferrin and bovine serum albumin) amounts of the proteins could be detected in duodenal contents after 15 min. At this age alpha-lactalbumin was not measurable in serum. CONCLUSIONS: The low capacity to digest whey proteins in suckling monkeys may depend upon an immaturity of the exocrine pancreas to respond to secretogogues.

Age Factors↗

Effects of milk and milk components on calcium, magnesium, and trace element absorption during infancy.

During early life, infants usually consume a diet that is heavily dominated by milk. It is generally believed that breast-fed infants absorb adequate quantities of minerals and trace elements, whereas there is some concern about how well infants can utilize these nutrients from cow's milk formula and other infant diets. Therefore, most infant formulas contain much higher concentrations of minerals and trace elements than those of breast milk. Our knowledge of how infants can utilize these nutrients from different diets is very limited. This paper critically reviews the effects of various components in breast milk, cow's milk, and infant formula and how they either facilitate or inhibit the absorption of minerals and trace elements. Particular emphasis is put on milk proteins such as lactoferrin, casein, and whey proteins, but phytate in soy formula is also discussed. Competition among minerals for absorptive pathways as well as other nutrient-nutrient interactions are considered in the context of infant nutrition. The difficulties involved in assessing mineral and trace element status in infants, as well as the potential consequences of suboptimal and excessive intakes of calcium, magnesium, iron, zinc, copper, manganese, and selenium are also discussed, particularly in the light of infant requirements.

Absorption↗

Impact of zinc supplementation on morbidity from diarrhea and respiratory infections among rural Guatemalan children.

OBJECTIVE: A community-based, randomized, double-blind intervention trial was conducted to measure the impact of zinc supplementation on young Guatemalan children's morbidity from diarrhea and respiratory infections. METHODS: Children aged 6 to 9 months were randomly assigned to receive 4 mL of a beverage containing 10 mg of zinc (as zinc sulfate) daily (7 d/wk) for 7 months (n = 45) or a placebo (n = 44). Morbidity data were collected daily. Diagnoses of diarrhea, fever, and anorexia were based on mothers' definitions. Respiratory infections were defined as the presence of at least two of the following symptoms: runny nose, cough, wheezing, difficulty breathing, or fever. RESULTS: High rates of diarrhea and respiratory infections were reported. Children from the placebo group had a 20% episodic prevalence of diarrhea, with 8 episodes/100 d, and a 7% episodic prevalence of respiratory infections, with 3 episodes/100 d. The median incidence of diarrhea among children who received zinc supplementation was reduced by 22% (Wilcoxon rank test), with larger reductions among boys and among children with weight-for-length at baseline lower than the median of the sample (39% reductions in both subgroups). Zinc supplementation also produced a 67% reduction in the percentage of children who had one or more episodes of persistent diarrhea (chi2 test). No significant effects were found on the episodic prevalence of diarrhea, the number of days per episode, or the episodic prevalence or incidence of respiratory infections. CONCLUSIONS: The large impact of zinc supplementation on diarrhea incidence suggests that young, rural Guatemalan children may be zinc deficient and that zinc supplementation may be an effective intervention to improve their health and growth.

Deficiency Diseases↗

Effects of coffee consumption on iron, zinc and copper status in nonpregnant and pregnant Sprague-Dawley rats.

To investigate the influence of coffee consumption on iron, zinc and copper status, 64 Sprague-Dawley female rats were assigned to four treatment groups: nonpregnant-given coffee, nonpregnant-given water, pregnant-given coffee and pregnant-given water. The coffee groups received a freeze-dried coffee solution (1.1% w/v) as the sole source of liquids during the 18-day study period; all groups were provided a purified diet marginal in iron ad libitum. On day 18 (of gestation in the pregnant rats), rats were intubated with 0.033 MBq59Fe after an 8 h fast and killed 4, 8, 12 or 24 h post-gavage. Fluid intake was significantly lower in the coffee groups. Coffee did not affect food consumption, weight gain, hemoglobin or hematocrit in either pregnant or nonpregnant rats. In nonpregnant rats, the percentage of 59Fe was lower in plasma and higher in the spleen and erythrocytes in the coffee group than in controls; in pregnant rats the coffee group had a higher percentage of 59Fe in the stomach (at 4 h only), blood, spleen and bone than controls. There were no significant effects of coffee on tissue concentrations of Fe, Zn or Cu in the nonpregnant group, but pregnant rats given coffee had high concentrations of Fe in the liver, bone and placenta, and low placenta Zn concentrations compared to controls. In fetuses, there were trends towards lower weight, length and percentage 59Fe, but higher liver Fe, in the coffee group than in the controls. The results suggest that coffee intake leads to (a) increased attempts at erythropoeisis, an indication of iron deficiency, in both nonpregnant and pregnant rats, and (b) impaired placental Fe transport.

Animals↗

Changes in nutrient and protein composition of cat milk during lactation.

OBJECTIVE: To evaluate changes in the nutrient and protein composition of cat milk during lactation. ANIMALS: 12 lactating domestic shorthair cats. PROCEDURE: Milk samples collected on days 1, 3, 7, 14, 28, and 42 after parturition were analyzed for concentrations of nitrogen, nonprotein nitrogen, casein, whey proteins, amino acids, total lipids, lactose, citrate, minerals, and trace elements. Individual milk proteins (caseins and whey proteins) were analyzed by use of polyacrylamide gradient gel electrophoresis. RESULTS: True protein concentration ranged from 6.3 to 8.6% and was as high in mature milk as in colostrum. Nonprotein nitrogen as a portion of total N was constant (approx 8%), as was the whey-to-casein ratio (approx 50:50). Total lipid concentration was high (9.3%) in colostrum, rapidly decreased, then increased to 9% in mature milk. Lactose concentration was constant at 4%. Milk calcium, iron, and copper concentrations increased markedly during lactation, and magnesium and zinc values remained constant. Colostrum and early milk had a low Ca-to-P ratio of 0.4:0.9. Although calcium concentration increased with time, phosphate concentration also increased so that the Ca-to-P ratio remained constant in mature milk at 1.0: 1.2. The major whey proteins had molecular weights of approximately 14,000, 19,000, 40,000 and 80,000. The 80,000 protein (possibly lactoferrin) decreased in concentration during lactation. Two major casein subunits of approximately 28,000 and 33,000 were found, and both increased during early lactation. CONCLUSIONS: Nutrient composition of cat milk and, thus, provision of nutrients to nursing kittens changes over time.

Amino Acids↗

Recombinant human milk proteins - an opportunity and a challenge.

Several human milk proteins have physiologic functions in infants. These proteins are involved in defense against infectious agents and in the optimization of nutrient uptake from milk. Therefore, interest in producing recombinant human milk proteins to use in infant formula has been growing. Microorganisms and transgenic animals can now be used for the production of bioactive proteins. However, the benefits of each protein must be evaluated in cells, animal models, and infants before claims can be made that adding them to formula improves the health or nutrition of infants. Once benefits are shown, proper manufacturing conditions must be developed for introducing the protein or proteins into formula. Processing conditions must be evaluated to ensure that biologic activity is maintained. Dry blending, aseptic processing, sterile filtration, and other techniques will likely be necessary for introducing proteins that require specific tertiary structure for activity. The importance of posttranslational modifications must also be considered: some proteins may require proper glycosylation or phosphorylation for physiologic activity.

Animals↗