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Biomedical subjects

Robert A Gibson

Publications and source records attributed to Robert A Gibson.

At least 19 recordsLinked to original sources

Plasma phospholipid fatty acid composition as a biomarker of habitual dietary fat intake in an ethnically diverse cohort.

BACKGROUND AND AIM: As an evaluation of fatty acid intake measurement, our aim was to examine associations between diet and plasma phospholipid (PL) fatty acids, and whether these were modified by age, sex, country of birth, fasting status, use of cholesterol-lowering medication, body size, chronic disease and other lifestyle factors. METHODS AND RESULTS: Cross-sectional analysis of plasma PL fatty acid composition and dietary fatty acid intake over 12 months from a 121-item food frequency questionnaire (FFQ) in 4439 men and women aged 40-69 years, born in Australia, Greece or Italy. Crude correlation coefficients ranged from 0.18 to 0.40; and corrected correlation coefficients from 0.38 to 0.78 for total monounsaturated, polyunsaturated, n-6, n-3 fatty acids, oleic acid, linoleic acid, EPA and DHA. Weaker associations were observed for other fatty acids. The associations did not vary significantly by fasting status, use of lipid lowering medication or alcohol intake, but for some fatty acids did vary by sex, age, body mass index, country of birth, smoking and previous heart attack or diabetes. CONCLUSIONS: The FFQ provides useful information on intakes of mono- and polyunsaturated fatty acids. Correlations did not differ by fasting status, or use of lipid-lowering medication.

Adult↗

Interleukin-2 in human milk: a potential modulator of lymphocyte development in the breastfed infant.

Development of lymphocyte subpopulations and response to antigen exposure will be influenced by the limited ability of neonates to produce cytokines. In the case of cytokines such as interleukin (IL)-2 which are potent T lymphocyte regulators but poorly produced by newborn infants, the supply of cytokines through human milk could alleviate an immunological deficit and potentially aid the maturation of the immune system. We analysed human milk from 52 mothers (15-357 days postpartum) by ELISA to determine levels of aqueous IL-2, as well as production by human milk cells. IL-2 was detectable (>8 pg/mL) in the aqueous phase of 81% of all day 1 samples with no significant difference found in the mean concentration over 3 consecutive days. IL-2 was produced constitutively at detectable levels by 57% of milk cell samples and production was significantly increased by stimulation with Con A (380%). No correlation was found between aqueous and cellular IL-2, however there was a significant correlation between milk aqueous IL-2 and serum IL-2. This is the first report of IL-2 in the aqueous phase of human milk. A supply of exogenous IL-2 in human milk may provide the suckling infant with important immunological signals during a significant stage of T cell development.

Adult↗

Effect of iron supplementation during pregnancy on the intelligence quotient and behavior of children at 4 y of age: long-term follow-up of a randomized controlled trial.

BACKGROUND: Iron supplements are often prescribed during pregnancy despite the lack of intervention trials that have assessed the effects of supplementation in pregnancy on childhood development. OBJECTIVE: The objective was to determine whether iron supplementation during pregnancy influences childhood intelligence quotient (IQ) in an industrialized country. DESIGN: Pregnant women (n = 430) were randomly allocated to receive iron (20 mg/d) or placebo from 20 wk gestation until delivery, and the women and their children were followed up over the long term (4 y). Seventy percent of these families participated in the follow-up. The proportion of women with iron deficiency anemia at the end of pregnancy was 1% (2 of 146) in the iron group and 11% (15 of 141) in the placebo group. The primary outcome was the IQ of the children at 4 y of age, as assessed by the Stanford-Binet Intelligence Scale. Secondary outcomes included child behavior and the general health of the mothers. RESULTS: The mean IQ was not significantly different (P = 0.980) between the children of the iron-supplemented mothers (109 +/- 11; n = 153) and the children of the mothers in the placebo group (109 +/- 11; n = 149). However, the percentage of children with an abnormal behavior score was higher in the iron group (24 of 151, or 16%) than in the placebo group (12 of 149, or 8%); the relative risk was 1.97 (95% CI: 1.03, 3.80; P = 0.037). There was no significant difference in the health of the mothers between groups, as assessed by the SF-36 Health Survey. CONCLUSIONS: Prenatal iron supplementation that reduces the incidence of iron deficiency anemia from 11% to 1% has no effect on the IQ of the offspring at 4 y of age.

Child Behavior↗

Diagnostic accuracy of coeliac serological tests: a prospective study.

OBJECTIVE: The best way to test serologically for coeliac disease (CD) remains controversial, with endomysial (EMA), transglutaminase (TTG), and gliadin antibodies (AGA) being assessed in various combinations with no apparent standardization. The objective of this study was to evaluate whether TTG-IgA+/-TTG-IgG could be used as a replacement for endomysial antibodies as a reliable screen for CD in patients presenting to a major Australian tertiary referral hospital for assessment of symptoms consistent with CD. METHODS: Individuals referred for gastroscopic assessment of possible CD were prospectively evaluated by duodenal biopsy assessment. The following diagnostic methods were compared: dual-isotype transglutaminase (TTG-dual), combined-isotype transglutaminase (TTG-IgA+G), TTG-IgA, combined-isotype gliadin antibodies (AGA-IgA+G), AGA-IgA, and endomysial antibody assays. Clinical performance characteristics (sensitivity, specificity, area under the curve for receiver-operating characteristic analysis; AUROC) were assessed for all kits. RESULTS: The correlation between transglutaminase kits was generally good, with the best transglutaminase kit demonstrating high correlation (r=0.86) with endomysial antibodies. A comparison of different types of endomysial antibody assays displayed variable diagnostic performance (sensitivity 61.90-68.42%; specificity 80.00-98.57%; AUROC 0.71-0.83). Sensitivity (90.48-92.31%), specificity (80.77-82.89%) and AUROC values (0.92-0.94) for dual-isotype transglutaminase kits displayed narrow ranges. AGA assays were less sensitive (AGA-IgA: 42.31-46.15%; AGA-IgG: 61.54%) and less specific (AGA-IgA: 85.09-87.73%; AGA-IgG: 82.46-84.09%). Dual-isotype transglutaminase testing was diagnostically equivalent to transglutaminase-IgA (AUROC 0.92 versus 0.91, P=0.33). CONCLUSIONS: Our study suggests that transglutaminase screening (using the IgA+/-IgG isotype) is a sensitive and specific alternative to endomysial antibody testing in the serological assessment of CD. On the basis of our findings, AGA antibody testing no longer appears to be an essential part of the diagnostic strategy for adult CD.

Adolescent↗

The effect of alpha-linolenic acid and linoleic acid on the growth and development of formula-fed infants: a systematic review and meta-analysis of randomized controlled trials.

This systematic review and meta-analysis aimed to evaluate the effect of modifying 18-carbon PUFA [18-C PUFA: alpha-linolenic acid (ALA, 18:3n-3) and linoleic acid (LA, 18:2n-6)] in the diets of term and preterm infants on DHA (22:6n-3) status, growth, and developmental outcomes. Only randomized controlled trials (RCT) involving formula-fed term and preterm infants, in which the 18-C PUFA composition of the formula was changed and growth or developmental outcomes were measured, were included. Differences were presented as control (standard formula) and treatment (18-C PUFA-supplemented formula). Primary analyses for term infants were 4 and 12 mon and for preterm infants 37-42 and 57 wk postmenstrual age. Five RCT involving term infants and three RCT involving preterm infants were included in the systematic review. Infants fed ALA-supplemented formula had significantly higher plasma and erythrocyte phospholipid DHA levels than control infants. There was no effect of ALA supplementation on the growth of preterm infants. In term infants, ALA supplementation was associated with increased weight and length at 12 mon, which was at least 4 mon after the end of dietary intervention. Developmental indices of term infants did not differ between groups. There was a transient improvement in the retinal function of preterm infants fed ALA-supplemented diets compared with controls. The findings suggest that ALA-supplemented diets improve the DHA status of infants. Further studies are needed to provide convincing evidence regarding the effects of ALA supplementation of formula on infant growth and development.

Body Size↗

Dietary nucleotides do not alter erythrocyte long-chain polyunsaturated fatty acids in formula-fed term infants.

There have been conflicting reports regarding the effectiveness of dietary nucleotides (NT) to regulate tissue desaturases and hence stimulate accumulation of both n-6 and n-3 long-chain polyunsaturated fatty acids (LCPUFA). The aim of this study was to examine the effect of NT-supplemented cow's milk-based formula on erythrocyte phospholipid FA status in a large randomized controlled trial involving a well-nourished infant population born at term. Formula-fed infants were allocated to control formula with an innate level of NT at 10 mg/L (n = 102), or formula fortified with NT at 34 mg/L (n = 98). A parallel group of breastfed infants was included as a reference. Peripheral blood samples were collected by venipuncture at 7 mon of age and erythrocyte phospholipid FA determined by capillary GC. Erythrocyte LCPUFA levels did not differ between the NT-supplemented and control formula groups and were reduced in both groups compared with breastfed infants. We conclude that there is no induction of LCPUFA accumulation in erythrocyte phospholipids of term, formula-fed infants following 7 mon of NT supplementation.

Breast Feeding↗

Paradoxical effect of n-3-containing vegetable oils on long-chain n-3 fatty acids in rat heart.

Flaxseed, echium, and canola oils contain alpha-linolenic acid (18:3n-3, ALA) in a range of concentrations. To examine their effect on elevating cardiac levels of long-chain n-3 FA, diets based on these n-3-containing vegetable oils were fed to rats for 4 wk. Sunflower oil, which contains little ALA, was a comparator. Despite canola oil having the lowest ALA content of the three n-3-containing vegetable oils, it was the most potent for elevating DHA (22:6n-3) levels in rat hearts and plasma. However, the relative potencies of the dietary oils for elevation of EPA (20:5n-3) in heart and plasma followed the same rank order as their ALA content, i.e., flaxseed > echium > canola > sunflower oil. This paradox may be explained by lower ALA intake leading to decreased competition for Delta6 desaturase activity between ALA and the 24:5n-3 FA precursor to DHA formation.

Animals↗

Supplementation of infant formula with long-chain polyunsaturated fatty acids does not influence the growth of term infants.

BACKGROUND: Adequate growth is an important indicator of health and well-being in infants. OBJECTIVE: Our objective was to determine the effect of supplementing infant formula with long-chain polyunsaturated fatty acids (LCPUFAs) on the growth of term infants. DESIGN: Using the methodology outlined by the Cochrane Collaboration, we reviewed all known randomized controlled trials that involved LCPUFA supplementation of infant formula fed to term infants. Outcome measures were weight, length, and head circumference. Original data obtained from the investigators of published trials were used. Outcomes were analyzed with fixed-effects or random-effects model meta-analyses and were reported as weighted mean differences with 95% CIs. RESULTS: We identified 14 eligible trials that had data available for meta-analysis (1846 infants). Trial quality was generally high. Meta-analysis showed no significant effect of LCPUFA supplementation on infant weight, length, or head circumference at any assessment age. Similarly, subgroup analyses showed that supplementation with only n-3 LCPUFAs (no arachidonic acid) had no significant effect on infant weight, length, or head circumference. The source of LCPUFA supplementation (phospholipid or triacylglycerol) also did not significantly affect infant growth. CONCLUSION: We found no evidence that LCPUFA supplementation of infant formula influences the growth of term infants in either a positive or a negative way.

Fatty Acids, Unsaturated↗

A biomarker of n-3 compliance in patients taking fish oil for rheumatoid arthritis.

Dietary fish oil supplements have been shown to have benefits in rheumatoid arthritis (RA), other inflammatory diseases, and in cardiovascular disease. As with any medical advice, variability will exist with regard to adherence and consequent biochemical or pharmacophysiologic effects. The aim was to explore the utility of plasma phospholipid EPA as a measure of n-3 PUFA intake and response to standardized therapeutic advice given in an outpatient or office practice setting, to increase dietary n-3 PUFA, including a fish oil supplement. Patients with early RA were given verbal and written advice to alter their dietary n-3 PUFA intake, including ingestion of 20 mL of bottled fish oil on juice daily. The advice included instructions to increase n-3 PUFA and to avoid foods rich in n-6 PUFA. Every 3 mon, blood samples were obtained for analysis of plasma phospholipid FA. Plasma phospholipid EPA was used as the primary index of n-3 PUFA intake. A diverse response was seen, with about one-third of patients achieving a substantial elevation of plasma phospholipid EPA over the 12-mon study period. A third had little change, with the remainder achieving intermediate levels. Data obtained longitudinally from individual patients indicated that substantial elevations of EPA (> 5% total plasma phospholipid FA) could be maintained for more than 3 yr. Plasma phospholipid EPA is a convenient measure of adherence to advice to take a dietary n-3 PUFA-rich fish oil supplement This measure may prove a useful adjunct to intention to treat analyses in determining the effect of dietary fish oil supplements on long-term outcomes in arthritis and other chronic inflammatory diseases. It may also provide a guide to the effectiveness of therapeutic and preventive messages designed to increase n-3 PUFA intake.

Arachidonic Acid↗

Efficacy and tolerability of low-dose iron supplements during pregnancy: a randomized controlled trial.

BACKGROUND: Iron deficiency anemia (IDA) is common in pregnant women, but previous trials aimed at preventing IDA used high-dose iron supplements that are known to cause gastrointestinal side effects. OBJECTIVE: The objective was to assess the effect on maternal IDA and iron deficiency (ID, without anemia) of supplementing pregnant women with a low dosage (20 mg/d) of iron. Effects on iron status were assessed at the time of delivery and at 6 mo postpartum. Gastrointestinal side effects were assessed at 24 and 36 wk of gestation. DESIGN: This was a randomized, double-blind, placebo-controlled trial of a 20-mg daily iron supplement (ferrous sulfate) given from 20 wk of gestation until delivery. RESULTS: A total of 430 women were enrolled, and 386 (89.7%) completed the follow-up to 6 mo postpartum. At delivery, fewer women from the iron-supplemented group than from the placebo group had IDA [6/198, or 3%, compared with 20/185, or 11%; relative risk (RR): 0.28; 95% CI: 0.12, 0.68; P < 0.005], and fewer women from the iron-supplemented group had ID (65/186, or 35%, compared with 102/176, or 58%; RR: 0.60; 95% CI: 0.48, 0.76; P < 0.001). There was no significant difference in gastrointestinal side effects between groups. At 6 mo postpartum, fewer women from the iron-supplemented group had ID (31/190, or 16%, compared with 51/177, or 29%; RR: 0.57; 95% CI: 0.38, 0.84; P < 0.005). The rate of IDA between the groups did not differ significantly at 6 mo postpartum. CONCLUSION: Supplementing the diet of women with 20 mg Fe/d from week 20 of pregnancy until delivery is an effective strategy for preventing IDA and ID without side effects.

Adult↗

The role of fats in the lifecycle stages: pregnancy and the first year of life.

Fish oil supplementation during pregnancy has been tested in several trials, with small positive effects on length of gestation; there have been no beneficial or harmful effects on cognitive development or growth of infants as a result of fish oil supplementation in pregnancy. The strongest evidence for good developmental outcomes for infants supports breastfeeding for at least six months. Preterm infants are at the greatest risk of DHA deficiency and there is strong evidence for the positive effects of DHA on visual and cognitive outcomes that has resulted in all Australian preterm formulas being supplemented with DHA. Debate continues about the importance of DHA supplementation for term infants; the current consensus is that the benefits of DHA supplementation in term infants are smaller than for preterm infants.

Breast Feeding↗

Variations in transforming growth factor beta in human milk are not related to levels in plasma.

There is considerable variability in the concentrations of transforming growth factor beta (TGFbeta) in human milk from individual women which is not readily explained by maternal factors such as smoking or illness. A potential correlate is the maternal plasma level of TGFbeta since changes in plasma concentration of TGFbeta in response to a number of pathological conditions have been well documented. The purpose of this study was to investigate the relationship between the concentration of TGFbeta1 and TGFbeta2 in a single sample of human milk and plasma obtained on the same day from 80 lactating mothers at 5 weeks postpartum. The concentration of TGFbeta1 and TGFbeta2 in the aqueous fraction of human milk ranged from 228 to 3542 pg/ml (647, 438-799; median, 25th-75th percentiles) and 98 to 13 855 pg/ml (955, 535-1999) respectively and in paired samples of plasma from 440 to 19 460 (4026, 3245-6656) and 92 to 1739 (620, 391-925) respectively. Thus, in milk the median ratio of TGFbeta1 to TGFbeta2 was 1:1.6 whereas the corresponding median ratio in plasma was 7:1. There was no correlation between the concentration of either isoform of TGFbeta in milk and the corresponding TGFbeta in plasma.

Adult↗

Visual acuity and retinal function in infant monkeys fed long-chain PUFA.

Previous randomized clinical trials suggest that supplementation of the human infant diet with up to 0.35% DHA may benefit visual development. The aim of the current study was to assess the impact of including arachidonic acid (AA) and a higher level of DHA in the postnatal monkey diet on visual development. Infant rhesus monkeys were fed either a control diet (2.0% alpha-linolenic acid as the sole n-3 FA) or a supplemented diet (1.0% DHA and 1.0% AA) from birth. Visual evoked potential acuity was measured at 3 mon of age. Rod and cone function were assessed in terms of parameters describing phototransduction. Electroretinogram (ERG) amplitudes and implicit times were recorded over a wide intensity range (-2.2 to 4.0 log scot td-sec) and assessed in terms of intensity response functions. Plasma DHA and AA were significantly increased (P < 0.001) in the diet-supplemented monkeys compared with the control monkeys. There was an approximately equal effect of diet for the rod phototransduction parameters, sensitivity, and capacitance but in the opposite directions. Diet-supplemented monkeys had significantly shorter b-wave implicit times at low retinal illuminances (<-0.6 log scot td-sec). There were no significant effects of diet for visual acuity or the other 23 ERG parameters measured. The results suggest that supplementation of the infant monkey diet with 1.0% DHA and 1.0% AA neither harms nor provides substantial benefit to the development of visual acuity or retinal function in the first four postnatal months.

Animals↗

Cytokine production by human milk cells and peripheral blood mononuclear cells from the same mothers.

Samples of milk (n = 80) and venous blood were collected at 5 weeks postpartum from 82 lactating mothers. Human milk cells and peripheral blood mononuclear cells were isolated and the production of interleukin-1beta, interleukin-6, and tumor necrosis factor-a in the absence and presence of lipopolysaccharide was determined by enzyme-linked immunosorbent assay. Human milk cells spontaneously produced significantly less interleukin-1beta, interleukin-6, and tumor necrosis factor-alpha than peripheral blood mononuclear cells in the absence of stimulation. In vitro stimulation of human milk cells with lipopolysaccharide (500 ng/ml) for 24 hr increased cytokine production by approximately 40-50%, whereas peripheral blood mononuclear cells responded to lipopolysaccharide (200 ng/ml) with increased cytokine production of up to 350%. These observations suggest that cells in milk are capable of active involvement in the production of the interleukin-1beta, interleukin-6, and tumor necrosis factor-a in the mammary gland and have the capacity to respond to further stimulation after leaving the breast.

Adult↗

A randomized trial of supplementation with docosahexaenoic acid-rich tuna oil and its effects on the human milk cytokines interleukin 1 beta, interleukin 6, and tumor necrosis factor alpha.

BACKGROUND: Increased consumption of n-3 long-chain polyunsaturated fatty acids (PUFAs) has been recommended during pregnancy and lactation. The production of proinflammatory cytokines by human peripheral blood mononuclear cells (PBMCs) can be modified by dietary n-3 PUFAs. OBJECTIVE: We sought to determine whether dietary supplementation of lactating women with docosahexaenoic acid (DHA) can modulate the concentration of cytokines in the aqueous phase of human milk and the production of cytokines by human milk cells (HMCs) and PBMCs. DESIGN: In this double-blind, prospective, randomized trial, mothers of healthy full-term infants were asked to consume daily a nutritional supplement of 2000 mg oil containing either placebo (n = 40), 300 mg DHA + 70 mg eicosapentaenoic acid (EPA; n = 40), or 600 mg DHA + 140 mg EPA (n = 40). The fatty acid composition of plasma, PBMCs, milk, and HMCs from lactating mothers at 4 wk postpartum was measured by gas chromatography. The concentration of interleukin 6 and tumor necrosis factor alpha in milk and the production of interleukin 1beta, tumor necrosis factor alpha, and interleukin 6 by PBMCs and HMCs after stimulation with lipopolysaccharide was measured by enzyme-linked immunosorbent assay. RESULTS: At 4 wk postpartum, 82 mothers were still breast-feeding their infants. DHA increases in maternal plasma, PBMCs, milk, and HMCs were proportional to dietary DHA. There was no relation between tissue DHA status and cytokine concentrations. CONCLUSIONS: Consumption of < or = 600 mg DHA and 140 mg EPA/d for 4 wk increased n-3 PUFA concentrations in relevant tissues but did not cause perturbations in cytokine concentrations in human milk.

Adult↗

Nutritional effect of including egg yolk in the weaning diet of breast-fed and formula-fed infants: a randomized controlled trial.

BACKGROUND: Egg yolks can be a source of docosahexaenoic acid (DHA) and iron but are often associated with adverse consequences on plasma cholesterol. OBJECTIVE: Our goal was to investigate the effect of consumption of 4 egg yolks/wk on infant DHA status and hemoglobin, ferritin, and plasma cholesterol concentrations. Secondary outcomes included plasma iron, transferrin, and transferrin saturation. DESIGN: This was a randomized controlled trial comparing no dietary intervention, consumption of 4 regular egg yolks/wk, and consumption of 4 n-3 fatty acid-enriched egg yolks/wk in breast-fed and formula-fed infants from 6 to 12 mo of age. Erythrocyte DHA concentrations, cholesterol, and iron status were assessed at 6 and 12 mo of age. RESULTS: Of the 82 breast-fed infants recruited, 23 of 28 (no intervention), 23 of 27 (regular eggs), and 24 of 27 (n-3 eggs) completed the trial. Of the 79 formula-fed infants enrolled, 23 of 27 (no intervention), 24 of 26 (regular eggs), and 20 of 26 (n-3 eggs) completed the trial. Erythrocyte DHA concentrations were 30-40% higher after the n-3 egg intervention than after treatment with regular eggs or no eggs in both breast-fed and formula-fed infants. Egg treatment had no significant effect on plasma cholesterol, hemoglobin, ferritin, and transferrin but did result in improvements in plasma iron and transferrin saturation compared with no egg treatment. CONCLUSIONS: n-3 Fatty acid-enriched eggs may provide a means of increasing dietary DHA during the second 6 mo of life. Egg yolks may also be a useful source of iron during the weaning period and can be safely included in the weaning diet with no perturbations in plasma cholesterol.

Aging↗

Optimizing DHA levels in piglets by lowering the linoleic acid to alpha-linolenic acid ratio.

We examined the effect of altering the linoleic acid (LA, 18:2n-6) to alpha-linolenic acid (ALA, 18:3n-3) ratio in the dietary fats of 3 day old piglets fed formula for 3 weeks. The LA-ALA ratios of the experimental formulas were 0.5:1, 1:1, 2:1, 4:1, and 10:1. The level of LA was held constant at 13% of total fats while the level of ALA varied from 1.3% (10:1 group) to 26.8% (0.5:1 group). Incorporation of the n-3 long chain PUFA EPA and 22:5n-3 into erythrocytes, plasma, liver, and brain tissues was linearly related to dietary ALA. Conversely, incorporation of DHA into all tissues was related to dietary ALA in a curvilinear manner, with the maximum incorporation of DHA appearing to be between the LA-ALA ratios of 4:1 and 2:1. Feeding LA-ALA ratios of 10:1 and 0.5:1 resulted in lower and similar proportions of DHA in tissues despite the very different levels of dietary ALA (1.3 vs. 26.8% of total fats, respectively). These results are relevant to term infant studies in that they confirm our earlier findings of the positive effect on DHA status by lowering the LA-ALA ratio from 10:1 to 3:1 or 4:1, and they predict that ratios of LA-ALA below 4:1 would have little further beneficial effect on DHA status.

Animals↗