Volume 148 (3) | March 2018
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The Journal of Nutrition Media Alerts
The following articles have been published in the March 2018 issue of  The Journal of Nutrition, a publication of the American Society for Nutrition. Summaries of the selected articles appear below; the full text of each article is available by clicking on the links listed. Manuscripts published in  The Journal of Nutrition are embargoed until the article appears online either as in press ( Articles in Press) or as a final version. The embargoes for the following articles have expired ( Editor's Choice in bold):

  • Researchers characterize “reference” microbiomes of very-low-birth-weight infants exclusively fed their own mothers’ milk
  • Omega 3 supplementation during pregnancy or early life may be beneficial
  • Estimates of energy expenditure using an activity monitor approximate those obtained with doubly labeled water
  • Amino acid balance reduces seizure risk in epilepsy-prone animals fed ketogenic diets
  • Serious consideration needs to be given to the use of stunting as a criterion for individual level assessment of growth and health
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Researchers characterize “reference” microbiomes of very-low-birth-weight infants exclusively fed their own mothers’ milk
For almost all babies, exclusive breastfeeding is the nutritional gold standard during the first 4 to 6 months of life. This is particularly true for premature and very-low-birth-weight infants who, compared to full-term and healthy-weight infants, are at increased risk for illness. However, many of these at-risk infants are unable to feed at the breast and must be fed either via tube feeding their own mother’s milk or that provided by donor mothers. Although scientists are still trying to understand why feeding human milk (rather than commercial formula) is so beneficial to these infants, they believe that its effects on the bacteria living in the infant’s gastrointestinal (GI) tract is likely important. As such, there is growing interest in developing probiotic (live bacteria-containing) products that could be given to very-low-birth weight infants to help similarly colonize their GI tracts when human milk is not available. O’Connor, Stintzi, et al. answer an even more basic question that they believed needed to be answered first. That is: what are the bacterial communities in stool samples of very-low-birthweight infants exclusively fed their own mothers’ milk? Indeed, this question should be answered prior to manipulating fecal microbiota in this at-risk population of infants via probiotics.

Reference: Butcher J, Unger S, Li J, Bando N, Romain G, Francis J, Mottawea W, Mack D, Stintzi A, O’Connor DL. Independent of birth mode or gestational age, very-low-birth-weight infants fed their mothers’ milk rapidly develop personalized microbiotas low in Bifidobacterium. Journal of Nutrition 2018 148:326-35.
For More Information To contact the corresponding authors, Drs. Deborah O’Connor or Alain Stintzi, send an e-mail to deborah.oconnor@utoronto.ca or astintzi@uottowa.ca.

Omega 3 supplementation during pregnancy or early life may be beneficial
Maintaining brain health and function is a life-long priority. However, making sure that brain development is optimal may be most critical during fetal and early postnatal life. Made primarily of fat-derived substances, the brain has a very high requirement for omega-3 fatty acids, particularly docosahexaenoic acid (DHA). Although infants can make some DHA, growing fetuses and newborns rely mainly on their mothers during pregnancy or breastmilk or DHA-fortified formulas after birth to obtain the DHA they need. Some research also suggests that, in addition to obtaining DHA from dietary sources, there might be benefits of supplementing mothers, infants, and/or toddlers with extra DHA. Results, however, are not consistent in this regard, likely because of substantial differences in how the trials have been conducted. To help fill this knowledge gap, Mozaffarian et al. mathematically combined results from 38 previously conducted trials designed to explore the effects of maternal and/or infant omega-3 supplementation on neural development – particularly cognition, muscle (motor) development, and eyesight.

Reference: Shulkin M, Pimpin L, Bellinger D, Kranz S, Fawzi W, Duggan C, Mozaffarian D. n–3 Fatty Acid Supplementation in Mothers, Preterm Infants, and Term Infants and Childhood Psychomotor and Visual Development: A Systematic Review and Meta-Analysis. Journal of Nutrition 2018 148:409-18.
For More Information: To contact the corresponding author, Dr. Dariush Mozaffarian, please send an e-mail to dariush.mozaffarian@tufts.edu.

Read full summaries here .
JN  Editor's Choice Articles

Estimates of energy expenditure using an activity monitor approximate those obtained with doubly labeled water
This paper and commentary describe the benefit of using data generated from activity monitors to better estimate energy intake from the energy balance equation. Estimates of energy expenditure obtained from an activity monitor or from doubly labeled water were almost identical, with similar levels of measurement error. Importantly, the estimates of energy intake generated with these two methods from the energy balance equation were much more accurate than those obtained from dietitian-administered dietary recalls. An important point made in the paper and the commentary is that the estimates of energy intake were accurate at the population level but were not accurate at the individual level. Therefore, conclusions made by the authors of both articles is that more work is needed to improve individual level results to have better data as we attempt to better understand the relationships between energy intake and various health outcomes.

References: Shook RP, Hand GA, O’Connor DP, Thomas DM, Hurley TG, Hébert JR, Drenowatz C, Welk GJ, Carriquiry AL, and Blair SN. Energy Intake Derived from an Energy Balance Equation, Validated Activity Monitors, and Dual X-Ray Absorptiometry Can Provide Acceptable Caloric Intake Data among Young Adults. Journal of Nutrition 2018 148:490-96. Commentary: Gibbs BB and Davis KK. In Pursuit of the “Something” that is Better than Nothing for Measuring Energy Intake. Journal of Nutrition 2018 148:309-10
For More Information: To contact the corresponding author, Robin P. Shook, send an e-mail to rpshook@cmh.edu. To contact the author of the commentary, Bethany Barone Gibbs, send an e-mail to bbarone@pitt.edu.

Amino acid balance reduces seizure risk in epilepsy-prone animals fed ketogenic diets
Gietzen et al. report on the importance of indispensable (essential) amino acids (IAA) in the regulation of seizures in the March issue of The Journal of Nutrition. They used chemical, electroshock and genetic animal models to explore the responses to ketogenic diets, to diets devoid of threonine (an IAA), and their combinations on seizures. They validated the benefit of a ketogenic diet in reducing seizures, but report that diets (control or ketogenic) devoid of threonine contributed to shortened latency and increased severity of seizures. Biochemical analyses of a region of the brain prone to seizure activity was found to have altered gene transcript levels and glutamate transport, which would contribute to less inhibitory feedback and enhanced excitation of the tissue. The authors conclude that ketogenic diets must be carefully designed to ensure sufficient IAA are available to improve seizure control. Westmark writes in a commentary that seizure prone individuals need to be warned to monitor their ketogenic diets to avoid negative side effects of IAA deficiencies.

References: Gietzen DW, Lindström SH, Sharp JW, Teh PS, and Donovan MJ. Indispensable Amino Acid-Deficient Diets Induce Seizures in Ketogenic Diet-Fed Rodents Demonstrating a Role for Amino Acid Balance in Dietary Treatments for Epilepsy. Journal of Nutrition 2018 148:480-89. Commentary: Westmark CJ. A Role for Amino Acid Balance in Dietary Treatments for Epilepsy. Journal of Nutrition 2018 148:307-8.
For More Information: To contact the corresponding author, Dorothy W. Gietzen, please send an e-mail to dwgietzen@ucdavis.edu. To contact the author of the commentary, Cara J. Westmark, please send an e-mail to westmark@wisc.edu.

Serious consideration needs to be given to the use of stunting as a criterion for individual level assessment of growth and health
This opinion paper reviews and discusses the evolution and use of the current definition of stunting, which is defined as a height for age z score < -2 standard deviations from the values for a healthy population living under optimal growth conditions. This metric was originally developed to assess the growth and health of children in a population, but now is routinely used at the individual level. Perumal et al. suggest this statistical cut off may not reflect appropriate biological endpoints, and when used to evaluate short term public health or nutritional interventions, may not be sensitive enough to detect their benefits. The authors conclude that a better approach to application and to interpretation of stunting data is needed for both child growth research and for the assessment of public health programs.

References: Perumal N, Bassani DG, Roth DE.  Use and misuse of stunting as a measure of child healthJournal of Nutrition 2018 148:311-15.
For More Information: To contact the corresponding author, Daniel E. Roth, please send an email to daniel.roth@sickkids.ca.
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