Epidemiologic and clinical research has provided a large body of evidence supporting the developmental origins of health and disease (DOHaD), but there has been a relative dearth of mechanistic ...studies in humans due to the complexity of working with large, longitudinal cohorts. Nonetheless, animal models of undernutrition have provided substantial evidence for the potential epigenetic, metabolic, and endocrine mechanisms behind DOHaD. Furthermore, recent research has explored the interaction between the environment and the gastrointestinal system by investigating how the gut microbial ecology may impact the capacity for nutrient processing and absorption in a manner that may limit growth. This review presents a summary of current research that supports the concept of DOHaD, as well as potential mechanisms and interactions that explain how nutrition in utero and during early childhood influences lifelong health.
Developmental origins of metabolic diseases Hoffman, Daniel J.; Powell, Theresa L.; Barrett, Emily S. ...
Physiological reviews,
07/2021, Letnik:
101, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Almost 2 billion adults in the world are overweight, and more than half of them are classified as obese, while nearly one-third of children globally experience poor growth and development. Given the ...vast amount of knowledge that has been gleaned from decades of research on growth and development, a number of questions remain as to why the world is now in the midst of a global epidemic of obesity accompanied by the “double burden of malnutrition,” where overweight coexists with underweight and micronutrient deficiencies. This challenge to the human condition can be attributed to nutritional and environmental exposures during pregnancy that may program a fetus to have a higher risk of chronic diseases in adulthood. To explore this concept, frequently called the developmental origins of health and disease (DOHaD), this review considers a host of factors and physiological mechanisms that drive a fetus or child toward a higher risk of obesity, fatty liver disease, hypertension, and/or type 2 diabetes (T2D). To that end, this review explores the epidemiology of DOHaD with discussions focused on adaptations to human energetics, placental development, dysmetabolism, and key environmental exposures that act to promote chronic diseases in adulthood. These areas are complementary and additive in understanding how providing the best conditions for optimal growth can create the best possible conditions for lifelong health. Moreover, understanding both physiological as well as epigenetic and molecular mechanisms for DOHaD is vital to most fully address the global issues of obesity and other chronic diseases.
Hoffman dfocuses on modifying the methods used to study growth. The prevalence of stunting and wasting in low- and middle-income countries (LMICs) decreased from 40% and 11% in 1990 to 26% and 7%, ...respectively, in 2020. However, the economic and social impact of the COVID-19 pandemic has led to a global increase in food insecurity, creating the potential for a reversal of this trend. Despite decades of efforts to reduce the burden of undernutrition in LMICs, it is projected that 22 million children will become stunted and 40 million will become wasted over the next 10 years. At the same time, there is an abundance of literature supporting the developmental origins, which posits that poor growth in utero or during early in life is associated with an increased risk for chronic metabolic diseases in adulthood.
Hoffman discusses the report by Siervo and colleagues (13) on the results of a feasibility trial of the effect of nitrate-rich beetroot juice extract (BrtEx; 400 mg/d), with and without added ...high-dose folic acid (5 mg/d), on BP in hypertensive adults in Tanzania. The trial was conducted in this LMIC where 35% of the population is hypertensive, but the diagnosis and successful treatment of hypertension are challenged by economic instability, especially in the health sector. Siervo et al found that providing BrtEx significantly reduced systolic and diastolic BP in Tanzanian adults after 30 and 60 d of treatment.
Hoffman discusses a study by Maciel and colleagues from the MAL-ED (Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and ...Development) Network which presents the impact of specific dietary components of complementary feeding (CF) on nutritional status in children from 7 countries in Africa, Asia, and South America. With regard to wasting and underweight, Maciel et al found that although there was a 20-25% difference in the energy intakes of children with and those without either underweight or wasting at any time point, the difference in zinc intake was 5-8%. Yet both nutrients were reported to be protective against each condition by approximately 10%, suggesting that when CF is energy sufficient but zinc is deficient, CF may not be as effective as possible.
Hoffman and Baratto discuss the study by Diongue et al on the association between exclusive breastfeeding (EBF) and motor development in Senegalese children. EBF was assessed with stable isotopes ...using the dose-to-mother (DTM) method, and motor development was evaluated on the basis of time taken to achieve the 6 stages of gross motor development, according to the WHO. The authors reported 2 distinct but related results. First, EBF infants reached 2 of the 6 milestones (that is, sitting without support and crawling on hands and knees) 0.67 and 0.43 mo earlier than non-EBF infants, respectively, after adjusting for confounding factors such as socioeconomic status and maternal and child characteristics. Second, EBF infants also had a lower incidence of diarrhea and fever at 4-5 mo, although no difference was observed at 18 mo, most likely due to the introduction of complementary foods for all children.
This paper is in response to the article entitled, “Identifying Potential Types of Guidance for Supporting Student Inquiry When Using Virtual and Remote Labs in Science: A Literature Review” ...(Zacharia et al. in Educ Technol Res Dev 63(2):257–302, 2015). After a brief recap of the original study, this paper examines the impact of Zacharia et al.’s (2015) two-dimensional system for categorizing guidance tools in inquiry learning contexts. It suggests a number of ways researchers can apply the existing categorization system to advance the field’s understanding of how to support student inquiry within digital environments. The paper addresses some limitations of the original study—such as the need to include learner perspectives when evaluating guidance tools—and ends with suggestions for future research on when and how to study guidance mechanisms in computer-supported environments.
Preventing harmful algal blooms (HABs) is needed to protect lakes and downstream ecosystems. Traditionally, reducing phosphorus (P) inputs was the prescribed solution for lakes, based on the ...assumption that P universally limits HAB formation. Reduction of P inputs has decreased HABs in many lakes, but was not successful in others. Thus, the “P-only” paradigm is overgeneralized. Whole-lake experiments indicate that HABs are often stimulated more by combined P and nitrogen (N) enrichment rather than N or P alone, indicating that the dynamics of both nutrients are important for HAB control. The changing paradigm from P-only to consideration of dual nutrient control is supported by studies indicating that (1) biological N fixation cannot always meet lake ecosystem N needs, and (2) that anthropogenic N and P loading has increased dramatically in recent decades. Sediment P accumulation supports long-term internal loading, while N may escape via denitrification, leading to perpetual N deficits. Hence, controlling both N and P inputs will help control HABs in some lakes and also reduce N export to downstream N-sensitive ecosystems. Managers should consider whether balanced control of N and P will most effectively reduce HABs along the freshwater-marine continuum.
Breast adenomyoepithelioma (AME) is rare. We sought to evaluate clinical characteristics, treatment, and outcomes of a contemporary patient cohort stratified by histology.
We queried health records ...containing “adenomyoepithelioma” between 2000 and 2018. Histology was confirmed with centralized review and classified into benign, atypical, and malignant. Clinical characteristics, demographics, treatment, and oncologic outcomes were compared.
Our query yielded 24 patients with adenomyoethelioma. Histologic diagnosis was confirmed in 12 (benign n = 6, atypical n = 3, malignant n = 3). Excision (n = 11) was the usual initial treatment, with margin status available in 10 patients. Mean follow up was 44 months (range 1–138 months) with no local recurrence observed. Two patients with benign AME presented with concurrent contralateral breast cancer, and one with malignant AME died of metastatic AME.
Wide excision of atypical and malignant AME is recommended as local recurrence when excised completely was not observed. Given metastatic potential of malignant AME, multimodal therapy may be warranted.
•Unique organization of benign, atypical, malignant AME epidemiology/outcomes.•No local recurrences observed with negative margins in atypical, malignant AME.•Malignant AME carries metastatic potential and may require multimodal therapy.•AME rarity: within 18 years only 12 cases were found after centralized review.•Compares published AME manuscripts in a concise, easy to read table with discussion.
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