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Biomedical subjects

Kim Fleischer Michaelsen

Publications and source records attributed to Kim Fleischer Michaelsen.

At least 37 records · Page 2Linked to original sources
PubMed2004

Effect of probiotics on gastrointestinal symptoms and small intestinal permeability in children with atopic dermatitis.

OBJECTIVE: To determine whether probiotic lactobacilli may alleviate small intestinal inflammation and strengthen the intestinal barrier function in children with atopic dermatitis. STUDY DESIGN: In a double-blinded, placebo-controlled, cross-over study, probiotic lactobacilli (Lactobacillus rhamnosus 19070-2 and L reuteri DSM 12246) were administered for 6 weeks to 41 children with moderate and severe atopic dermatitis. Gastrointestinal symptoms were registered before and during treatment and small intestinal permeability was measured by the lactulose-mannitol test. RESULTS: During Lactobacillus supplementation, there was a significant decrease in the frequency of gastrointestinal symptoms (39% during the placebo period versus 10% during active treatment, P=.002). There was a positive association between the lactulose to mannitol ratio and the severity of the eczema (r=0.61, P=.02 after placebo and r=0.53, P=.05 after active treatment). After probiotic treatment, the lactulose to mannitol ratio was lower (0.073) than after placebo (0.110, P=.001). CONCLUSIONS: Impairment of the intestinal mucosal barrier appears to be involved in the pathogenesis of atopic dermatitis. The study suggests that probiotic supplementation may stabilize the intestinal barrier function and decrease gastrointestinal symptoms in children with atopic dermatitis.

Adolescent↗
PubMed2004

Energy and nutrient dietary reference values for children in Europe: methodological approaches and current nutritional recommendations.

The Expert Group on the Methodological Approaches and Current Nutritional Recommendations in Children and Adolescents was convened to consider the current situation across Europe with regard to dietary recommendations and reference values for children aged 2-18 years. Information was obtained for twenty-nine of the thirty-nine countries in Europe and a comprehensive compilation was made of the dietary recommendations current up to September 2002. This report presents a review of the concepts of dietary reference values and a comparison of the methodological approaches used in each country. Attention is drawn to the special considerations that are needed for establishing dietary reference values for children and adolescents. Tables are provided of the current dietary reference values for energy and for the macronutrients, vitamins, minerals, trace elements and water. Brief critiques are included to indicate the scientific foundations of the reference values for children and to offer, where possible, an explanation for the wide differences that exist between countries. This compilation demonstrated that there are considerable disparities in the perceived nutritional requirements of European children and adolescents. Although some of this diversity can be attributed to real physiological and environmental differences, most is due to differences in philosophy about the best methodological approach to use and in the way the theoretical approaches are applied. The report highlights the main methodological and technological issues that will need to be resolved before harmonization can be fully considered. Solving these issues may help to improve the quality and consistency of dietary reference values across Europe. However, there are also considerable scientific and political barriers that will need to be overcome and the question of whether harmonization of dietary reference values for children and adolescents is a desirable or achievable goal for Europe requires further consideration.

Adolescent↗
PubMed2004

Maternal body composition, HIV infection and other predictors of gestation length and birth size in Zimbabwe.

The role of maternal infections, nutritional status and obstetric history in low birth weight is not clear. Thus, the objective of the present study was to assess the effects of maternal HIV infection, nutritional status and obstetric history, and season of birth on gestation length and birth size. The study population was 1669 antenatal care attendees in Harare, Zimbabwe. A prospective cohort study was conducted as part of a randomised, controlled trial. Maternal anthropometry, age, gravidity, and HIV status and load were assessed in 22nd-35th weeks gestation. Outcomes were gestation length and birth size. Birth data were available from 1106 (66.3%) women, of which 360 (32.5%) had HIV infection. Mean gestation length was 39.1 weeks with 16.6% <37 weeks, mean birth weight was 3030 g with 10.5% <2500 g. Gestation length increased with age in primigravidae, but not multigravidae (interaction, P=0.005), and birth in the early dry season, low arm fat area, multiple pregnancies and maternal HIV load were negative predictors. Birth weight increased with maternal height, and birth in the late rainy and early dry season; primi-secundigravidity, low arm fat area, HIV load, multiple pregnancies and female sex were negative predictors. In conclusion, gestation length and birth weight decline with increasing maternal HIV load. In addition, season of birth, gravidity, maternal height and body fat mass, and infant sex are predictors of birth weight.

Adipose Tissue↗
PubMed2004

Protein intake at 9 mo of age is associated with body size but not with body fat in 10-y-old Danish children.

BACKGROUND: During the complementary feeding period, infants shift from a daily protein intake (PI) of approximately 1 g/kg body wt to an intake 3-4 times as high. A high PI probably has both endocrine and physiologic effects and may increase the risk of obesity. OBJECTIVE: We examined the associations between PI in infancy and body size and composition in late childhood. DESIGN: We conducted an observational cohort study of 142 Danish healthy term infants (63 boys) born during 1987-1988. At 9 mo of age, diet, weight, length, skinfold thicknesses, insulin-like growth factor I, and serum urea nitrogen were determined. At 10 y of age, 105 children (51 boys) participated in a follow-up study. Diet, weight, height, skinfold thicknesses, percentage of body fat (dual-energy X-ray absorptiometry), insulin-like growth factor I, and serum urea nitrogen were determined. RESULTS: At 9 mo of age, PI (in g/d and percentage of energy) was strongly correlated with body size (length and weight) but not with measures of adiposity. PI at 9 mo of age was positively associated with height and weight but not with percentage of body fat at 10 y of age. Inclusion of parental body size in the models did not change the associations, but the significant associations were attenuated when body size at 9 mo of age was included. CONCLUSIONS: PI in infancy seems to stimulate early growth. This might explain part of the association between early PI and body size at 10 y of age, but a continuous effect of protein on growth during childhood cannot be excluded. PI in infancy was not associated with any measure of body fat at 10 y of age.

Adipose Tissue↗
PubMed2004

Animal protein intake, serum insulin-like growth factor I, and growth in healthy 2.5-y-old Danish children.

BACKGROUND: Studies from developing countries indicate that intake of animal protein, especially of milk, is associated with greater velocity of linear growth in childhood. Whether the same association exists in industrialized countries, where protein intake is high, is not clear. OBJECTIVE: Our objective was to examine associations between protein intake, serum insulin-like growth factor I (sIGF-I) concentrations, and height in healthy children. DESIGN: We analyzed the associations between protein intake, sIGF-I concentrations, and height in 2.5-y-old children. Diet (7-d record) and sIGF-I (radioimmunoassay) data were available from 90 children (54 boys). RESULTS: The 10th, 50th, and 90th percentiles of protein intake were 2.4, 2.9, and 4.0 g. kg(-1). d(-1), respectively; 63% was animal protein. In multiple linear regressions with adjustment for sex and weight, height (cm) was positively associated with intakes of animal protein (g/d) [0.10 +/- 0.038 (b +/- SE); P = 0.01] and milk (0.0047 +/- 0.002; P = 0.007), but not with those of vegetable protein or meat. The sIGF-I concentration was significantly associated with intakes of animal protein (1.4 +/- 0.53; P = 0.01) and milk (0.049 +/- 0.024; P = 0.045), but not with those of vegetable protein or meat. sIGF-I concentrations were positively associated with height (0.019 +/- 0.008; P = 0.02). CONCLUSION: Milk intake was positively associated with sIGF-I concentrations and height. An increase in milk intake from 200 to 600 mL/d corresponded to a 30% increase in circulating IGF-I. This suggests that milk compounds have a stimulating effect on sIGF-I concentrations and, thereby, on growth.

Animals↗
PubMed2003

[Breast feeding and intelligence].

INTRODUCTION: In several studies a positive association between breastfeeding and intellectual development in childhood has been suggested. However, the association between breastfeeding and adult intelligence is unknown, and the purpose of the present study was to investigate the relationship between duration of breastfeeding and intelligence in young adulthood. MATERIAL AND METHODS: A prospective longitudinal study based on the Copenhagen Perinatal Cohort. A mixed-sex sample comprising 973 individuals with a mean age of 27.2 years was assessed with a clinical intelligence test (WAIS) and an all-male sample comprising 2280 individuals was assessed with a military intelligence test (BPP) at the mean age of 18.7 years. Based upon duration of breastfeeding, the samples were divided into five categories. Thirteen potential confounders were included as covariates: Parental social status and education, single mother status, mother's height, age, weight gain during pregnancy, and cigarette consumption during the third trimester, number of pregnancies, estimated gestational age, birth weight, birth length, and indexes of pregnancy and delivery complications. RESULTS: Duration of breastfeeding was associated with significantly higher scores on both the verbal and performance parts of the WAIS. With regression adjustment for potential confounding factors, the full scale IQs were 99.4, 101.7, 102.3, 106.0, and 104.0 for breastfeeding durations of < or = 1 month, 2-3 months, 4-6 months, 7-9 months, and > 9 months (p = 0.003). The corresponding mean scores for the BPP were 38.0, 39.2, 39.9, 40.1, and 40.1 (p = 0.01). Thus, the mean test scores suggested a dose-response relationship for breastfeeding during the first nine months of life and adult intelligence. DISCUSSION: Independent of a wide range of possible confounding factors, a significant positive association between duration of breastfeeding and intelligence was observed in two independent samples of young adults, assessed with two different intelligence tests. Although duration of breastfeeding may correlate with maternal intelligence and with the quality of mother-child interaction, these findings suggest that nutrients in breastmilk may have long-term positive effects on cognitive and intellectual development.

Adult↗
PubMed2003

Degree of fatness after treatment of malignant lymphoma in childhood.

BACKGROUND: Sex hormone deficiency or growth hormone deficiency may cause excess fatness after treatment for childhood malignant lymphoma. Previous studies of the body composition after treatment for childhood cancer included few survivors of malignant lymphoma who were not analysed separately. PROCEDURE: We measured the whole-body percent fat by dual energy X-ray absorptiometry (DXA) and the body-mass index (weight/height(2) (kg/m(2)), BMI) in survivors of childhood Hodgkin disease (n = 23) or non-Hodgkin lymphoma (n = 21) a median of 11 years after diagnosis (range 2-25). Results were compared with local data on 463 healthy controls. RESULTS: Adjusted for sex and age, the mean BMI did not differ from that of local controls, but the mean whole-body percent fat was significantly increased (0.8 SD above predicted, P = 0.0001). Sixteen of 44 participants had a percent fat above the 90 percentile of the reference values, which indicates excess fatness. Adjusted for sex and age, percent fat was significantly higher in persons treated for non-Hodgkin lymphoma. Controlled for this, the whole-body percent fat was not significantly related to sex, age at diagnosis, length of follow-up, sex hormone therapy at follow-up or the cumulative dose of corticosteroids or doxorubicin. CONCLUSIONS: Eleven years after diagnosis of childhood Hodgkin disease or non-Hodgkin lymphoma, the whole-body percent fat was increased whereas the BMI was like that of the controls. This indicates a reduced lean body mass.

Adolescent↗
PubMed2003

Effect of probiotic Lactobacillus strains in children with atopic dermatitis.

BACKGROUND: Recent studies suggest that oral bacteriotherapy with probiotics might be useful in the management of atopic dermatitis (AD). OBJECTIVE: The purpose of this investigation was to evaluate the clinical and anti-inflammatory effect of probiotic supplementation in children with AD. METHODS: In a double-blind, placebo-controlled, crossover study, 2 probiotic Lactobacillus strains (lyophilized Lactobacillus rhamnosus 19070-2 and Lactobacillus reuteri DSM 122460) were given in combination for 6 weeks to 1- to 13-year-old children with AD. The patients' evaluations were registered after each intervention (ie, better, unchanged, or worse). The clinical severity of the eczema was evaluated by using the scoring atopic dermatitis (SCORAD) score. As inflammatory markers, eosinophil cationic protein in serum and cytokine production by PBMCs were measured. RESULTS: After active treatment, 56% of the patients experienced improvement of the eczema, whereas only 15% believed their symptoms had improved after placebo (P =.001). The total SCORAD index, however, did not change significantly. The extent of the eczema decreased during active treatment from a mean of 18.2% to 13.7% (P =.02). The treatment response was more pronounced in allergic patients (at least one positive skin prick test response and elevated IgE levels), and in this group the SCORAD score decreased (P =.02 compared with nonallergic patients). During active treatment, serum eosinophil cationic protein levels decreased (P =.03). No significant changes in the production of the cytokines IL-2, IL-4, IL-10, or IFN-gamma were found. CONCLUSIONS: A combination of L rhamnosus 19070-2 and L reuteri DSM 122460 was beneficial in the management of AD. The effect was more pronounced in patients with a positive skin prick test response and increased IgE levels.

Administration, Topical↗
PubMed2003

Vitamin D and bone health in early life.

Prolonged vitamin D deficiency resulting in rickets is seen mainly during rapid growth. A distinct age distribution has been observed in the Copenhagen area where all registered hospital cases of rickets were either infants and toddlers or adolescents from immigrant families. Growth retardation was only present in the infant and toddler group. A state of deficiency occurs months before rickets is obvious on physical examination. Growth failure, lethargy and irritability may be early signs of vitamin D deficiency. Mothers with low vitamin D status give birth to children with low vitamin D status and increased risk of rickets. Reports showing increasing rates of rickets due to insufficient sunlight exposure and inadequate vitamin D intake are cause for serious concern. Many countries (including the USA from 2003) recommend vitamin D supplementation during infancy to avoid rickets resulting from the low vitamin D content of human milk. Without fortification only certain foods such as fatty fish contain more than low amounts of vitamin D, and many children will depend entirely on sun exposure to obtain sufficient vitamin D. The skin has a high capacity to synthesize vitamin D, but if sun exposure is low vitamin D production is insufficient, especially in dark-skinned infants. The use of serum 25-hydroxyvitamin D to evaluate vitamin D status before development of rickets would be helpful; however, there is no agreement on cut-off levels for deficiency and insufficiency. Furthermore, it is not known how marginal vitamin D insufficiency affects children's bones in the long term.

Adolescent↗
PubMed2003

Does breast feeding influence liver biochemistry?

OBJECTIVE: It is assumed that early feeding can affect liver biochemistry because breast-fed infants have a higher risk of hyperbilirubinemia than formula-fed infants. The authors sought to determine how feeding mode affected liver biochemistry in healthy term infants. METHODS: Healthy term infants were followed up during infancy with a monthly questionnaire about feeding mode. Blood samples were obtained at 2, 6, and 9 months. Liver biochemistry (serum albumin, alkaline phosphatase, lactic dehydrogenase, aspartate aminotransferase [AST], and bilirubin), total insulin-like growth factor 1 (IGF-I), and insulin growth factor binding protein 3 (IGFBP-3) were determined at all ages. RESULTS: Mean AST and bilirubin were significantly higher in breast-fed infants at 2 and 6 months. In addition, mean albumin levels were higher in breast-fed infants at 2 months. Alkaline phosphatase, IGF-I, IGFBP-3, and lactic dehydrogenase levels did not differ between the feeding groups. AST levels did not correlate significantly with bilirubin, albumin, alkaline phosphatase, or lactic dehydrogenase values. There was a strong positive association between AST and IGF-I at 2 months (r = 0.47, P = 0.004). CONCLUSION: Cytomegalovirus infection, vitamin K deficiency, and macromolecular forms of AST could be an explanation for a higher AST level among breast-fed infants. However, no other clinical or paraclinical sign of liver disease was seen, all infants were given oral vitamin K, and the AST did not rise to levels comparable to those seen in individuals with macromolecular AST. The authors speculate the most likely explanation of the elevated AST is induction of hepatocytes by factors in human milk. This is supported by the higher albumin levels in breast-fed infants and the positive association between AST and IGF-I.

Alkaline Phosphatase↗
PubMed2002

[Lactic bacteria and other probiotics in infections and inflammatory diseases in children. What do we believe? - What do we know?].

Probiotics are microorganisms which, when ingested, may have a positive effect in the prevention or treatment of a specific pathologic condition. Probiotics are used for a number of gastrointestinal and certain systemic infectious and inflammatory diseases. The efficacy of selected probiotics to promote recovery from acute viral gastroenteritis in young children is well-documented. However, the role of probiotics in systemic diseases, e.g. atopic dermatitis, need to be confirmed in larger randomised controlled trials. This paper describes the theoretical background for the use of probiotics and reviews results from randomised controlled trials describing the effect of probiotics, particularly in paediatric diseases.

Child↗
PubMed2002

[Body mass index. Reference values for 0-45-year-old Danes].

INTRODUCTION: Our aim was to establish body mass index (weight/height2 [kg/m2], BMI) reference values for 0- to 45-year-old Danes. MATERIAL AND METHODS: A national sample that was used to generate the current Danish height and weight reference (29,106 measurements in 1965-1977; age 0-21 years; sample I). Four samples from Copenhagen (3391 measurements in 1981-1985; age 7-45 years; samples II and III and 2608 measurements in 1991-1994; age 6-45 years; samples IV and V). With the LMS method for smoothing the curves, Danish BMI reference values by age and sex were constructed from samples I and II. BMI values from two recently examined, but smaller, Danish cohorts (samples IV and V) were compared with the reference values to assess the secular trend in BMI. RESULTS: The Danish BMI reference values are presented graphically. Graphs can be downloaded from http://www.paediatri.dk. In the more recently examined samples, the mean BMI was significantly increased in children and adolescents (SD score 0.19, P = 0.0007), but unchanged in young adults (SD score 0.01, P = 0.49). DISCUSSION: For clinical purposes, we recommend comparison of the BMI of Danish children and adolescents with the present Danish reference values and new internationally based cut-off values. The BMI of Danish adults should be compared with the WHO cut-off values. Cut-off values or national or internationally used BMI reference values can be used for research, depending on the purpose.

Adolescent↗
PubMed2002

The association between duration of breastfeeding and adult intelligence.

CONTEXT: A number of studies suggest a positive association between breastfeeding and cognitive development in early and middle childhood. However, the only previous study that investigated the relationship between breastfeeding and intelligence in adults had several methodological shortcomings. OBJECTIVE: To determine the association between duration of infant breastfeeding and intelligence in young adulthood. DESIGN, SETTING, AND PARTICIPANTS: Prospective longitudinal birth cohort study conducted in a sample of 973 men and women and a sample of 2280 men, all of whom were born in Copenhagen, Denmark, between October 1959 and December 1961. The samples were divided into 5 categories based on duration of breastfeeding, as assessed by physician interview with mothers at a 1-year examination. MAIN OUTCOME MEASURES: Intelligence, assessed using the Wechsler Adult Intelligence Scale (WAIS) at a mean age of 27.2 years in the mixed-sex sample and the Børge Priens Prøve (BPP) test at a mean age of 18.7 years in the all-male sample. Thirteen potential confounders were included as covariates: parental social status and education; single mother status; mother's height, age, and weight gain during pregnancy and cigarette consumption during the third trimester; number of pregnancies; estimated gestational age; birth weight; birth length; and indexes of pregnancy and delivery complications. RESULTS: Duration of breastfeeding was associated with significantly higher scores on the Verbal, Performance, and Full Scale WAIS IQs. With regression adjustment for potential confounding factors, the mean Full Scale WAIS IQs were 99.4, 101.7, 102.3, 106.0, and 104.0 for breastfeeding durations of less than 1 month, 2 to 3 months, 4 to 6 months, 7 to 9 months, and more than 9 months, respectively (P =.003 for overall F test). The corresponding mean scores on the BPP were 38.0, 39.2, 39.9, 40.1, and 40.1 (P =.01 for overall F test). CONCLUSION: Independent of a wide range of possible confounding factors, a significant positive association between duration of breastfeeding and intelligence was observed in 2 independent samples of young adults, assessed with 2 different intelligence tests.

Adult↗
PubMed2002

[Children, fat and cardiovascular diseases].

Children do not normally develop atherosclerosis. However, they do develop fatty streaks in the aorta. These are reversible. During the first years of life dietary fat has an influence on blood lipids, and other traditional risk factors influence vascular function, but the consequences are unknown. As saturated fat has no positive effects, the Danish Nutrition Council recommends that the intake of saturated fat is reduced to 10 energy per cent from the age of 12 months. This can be accomplished with semi-skimmed milk (1.5% fat) instead of full-cream milk. During the first year of life, it is recommended that a teaspoon of fat is added to each serving of home made mashed food or porridge to prevent the diet from being so hypocaloric that it has a negative effect on growth.

Adult↗
PubMed2002

Effect of probiotic Lactobacillus strains in young children hospitalized with acute diarrhea.

BACKGROUND: Oral bacteriotherapy promotes recovery from acute childhood diarrhea, but few strains have been shown to have therapeutic potentials. We examined the effect of two newly identified probiotic Lactobacillus strains in acute childhood diarrhea. METHODS: Sixty-nine children were randomized during hospitalization for acute diarrhea to receive a mixture of Lactobacillus rhamnosus 19070-2 and Lactobacillus reuteri DSM 12246, 10(10) colony-forming units of each strain or placebo twice daily for 5 days. Before selection of these stains their potential probiotic characteristics were demonstrated in vitro and in healthy volunteers. RESULTS: In patients receiving probiotics, the diarrheal phase was reduced by 20%. The duration of diarrhea was 82 h in the treatment group vs. 101 h in the control group (not significant, P = 0.07). However, 3 of 30 patients from the treatment group vs. 13 of 39 from the control group still had loose stools at the end of the study period (P = 0.03). In patients with diarrhea for <60 h before start of treatment (early intervention), a clear effect of the probiotics was demonstrated (80 h in the treatment group vs. 130 h in the control group, P = 0.003). After early intervention, the length of hospitalization was reduced by 48% (3.5 vs. 1.7 days, P = 0.03). At the end of the intervention, rotavirus antigen was found in 12% of patients from the treatment group vs. 46% from the control group (P = 0.02). CONCLUSIONS: The two probiotics, L. rhamnosus 19070-2 and L. reuteri DSM 12246, ameliorated acute diarrhea in hospitalized children and reduced the period of rotavirus excretion. Oral bacteriotherapy was associated with a reduced length of hospital stay. The beneficial effects were most prominent in children treated early in the diarrheal phase.

Acute Disease↗
PubMed2002

Effect of probiotic Lactobacillus strains on acute diarrhea in a cohort of nonhospitalized children attending day-care centers.

BACKGROUND: Certain strains of lactobacilli have been shown to promote recovery from rotavirus enteritis in hospitalized children. Few studies have examined the effect of probiotics in nonhospitalized children with mild diarrhea. METHODS: We studied in a randomized placebo-controlled trial the effect of lyophilized Lactobacillus rhamnosus 19070-2 and Lactobacillus reuteri DSM 12246, 10(10) colony-forming units of each strain twice daily for 5 days, on acute diarrhea in children in a cohort of children recruited from local day-care centers. The duration of diarrhea and assessment of stool consistency were recorded by the parents. RESULTS: In patients treated with the selected Lactobacillus strains, the mean duration of diarrhea after intervention was reduced (76 h in patients treated with probiotics vs. 116 h in the placebo group; P = 0.05). In patients with diarrhea for <60 h before start of treatment (early intervention), a more pronounced effect of probiotics was found. The time to recovery after early treatment was 79 h vs. 139 h in the placebo group (P = 0.02); 1 of 17 patients treated early vs. 6 of 13 in the control group still had loose stools 120 h after start of treatment (P = 0.03). CONCLUSIONS: In children from day-care centers with mild gastroenteritis, the combination of L. rhamnosus 19070-2 and L. reuteri DSM 12246 was effective in reducing the duration of diarrhea.

Acute Disease↗