Background To date, the vast majority of studies on infant feeding behavior of Chinese population have been conducted in Asian and some western countries but not the U.S. As the fastest growing Asian subgroup and with the largest Chinese community outside of Asia, studies that focus on their health choices in the U.S. are long overdue. Where studies are available, the overseas Chinese population is often regarded as high formula feeding and low breastfeeding. Chinese mothers often cite family, cultural, and social expectations as the determining factors for their choice of infant feeding. Given the cultural beliefs and traditions of Chinese immigrant population in the U.S., this study argues for the importance of including the input of the overall community, as opposed to only mothers, as a more data-based explanation of the prevalence of formula feeding among the Chinese community in New York City, and in addition, why this community continues to accept formula feeding as the norm. Methods Guided by Theory of Planned Behavior, this study incorporated both quantitative and qualitative components. A total of 434 surveys and 20 in-person interviews were collected in Chinese populated areas in New York City. Results In examining the prevalence of formula feeding in the Chinese community, both quantitative and qualitative findings consistently identified the central role friends and family played in motivating certain groups to use formula. These less acculturated, educated, and China-born subgroups are likely to conform to the idea that breast milk supplemented by infant formula is necessary in order to meet the nutritional demand of a growing infant. For the first-generation immigrants who breastfeed for health benefits and tradition, their attitudes towards infant feeding shifted after seeing other formula-fed children in populated Chinese communities as evident by shorter breastfeeding durations for the child born in the U.S. as compared to previous child born in China. As for the second-generation, who are more acculturated and educated, although they are aware of the benefits of breastfeeding and intend to breastfeed, they are expected by the older generation to continue the formula feeding tradition in the family. Conclusion When investigating why infant formula remained as the popular choice of feeding and is often perceived as the norm by this community, the current study identified the psychosocial variables that motivated individual subgroups and the context underlay. The findings provided new insights to the current literature and are intended to help guide future studies and to develop educational policy interventions to improve the overall infant feeding experiences for the Chinese community in New York City.

Background Vitamin D deficiency is prevalent in many places across the world. Breastfeeding has been suggested to be a significant predictor of vitamin D deficiency during infancy, which is preventable through proper supplementation. However, whether Hong Kong should adopt the international recommendation for supplementation of exclusive breastfed infants is still not yet answered. Objective: To review the available evidence regarding the association between breastfeeding and vitamin D deficiency during infancy, as well as the effectiveness of vitamin D supplementation of breastfed infants as an intervention measure. Methods A total of 5112 potentially relevant articles were searched and identified from MEDLINE (OVID, Pubmed), Science Citation Index Expanded (ISI Web of Science), Cochrane Central Register of Controlled Trials, EMBASE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Chinese database (CNKI) without restriction from inception to July-06-2012. 5065 articles were excluded after the initial scanning of title and abstracts. 36 were subsequently excluded due to methodological issues. A total of 11 studies were included and reviewed by two independent reviewers. Results This review pooled together a total of 1126 exclusively breast-fed infants for less than one year old from 11 studies. The pooled average prevalence of vitamin D deficiency was 54.2%. The association between breastfeeding and vitamin D deficiency during infancy has been reported consistently, and it was found to be one of the strongest predictors of vitamin D deficiency for infants less than one year old. Sunlight exposure, season, and skin pigmentation were also found to be important affecting factors. Supplementation to breastfed infants with the dosages as recommended by American Academy of Pediatrics (AAP) seem to be effective in lifting up the vitamin D levels. Conclusions The Hong Kong Government and relevant health sectors should conduct local epidemiological study to investigate the problem of concern among our breast-fed infants, and seriously consider or evaluate the AAP recommendation of supplementation. / published_or_final_version / Public Health / Master / Master of Public Health

Our objective was to study the effect of GLN supplementation on whole body protein turnover, somatic growth and gastrointestinal tolerance to enteral feeding in neonates following surgical stress. We hypothesized that GLN in total parenteral nutrition (TPN) would (1) favor retention of lean body mass by reducing protein breakdown (PB) during the acute phase after surgery, (2) promote somatic growth, (3) decrease length of time to achieve full feeds. Protein turnover was measured in a double-blind randomized trial involving neonates admitted to the Neonatal Intensive Care Unit after major surgery. L-GLN (n = 6) was added to TPN at a dose of 200 mg/g of protein intake. Controls (n = 7) were isonitrogenous. Isotope studies were performed on Day 4 of TPN. Subjects were given a 4-hour primed constant intravenous infusion of L-[1-13C]-leucine and [15N2]-urea. In the GLN group, a 15% reduction in PB was measured (unpaired t-test, p < 0.05). There was a trend towards improved net protein balance which was statistically different from zero in the GLN group. There were no differences in somatic growth during TPN course and in the length of time to achieve full enteral feeds. Results suggest that early TPN supplemented with GLN has a beneficial sparing effect on protein metabolism in critically ill neonates after major surgical stress.

The aim of this research was to examine differences in general nutrition knowledge and prenatal sources of infant feeding information among women planning to feed breast milk, breast-milk substitutes, or a combination of breast milk and breast-milk substitutes. Subjects completed a demographic survey, a test of nutrition knowledge, and a questionnaire on sources of infant feeding information. There were no statistical differences in age, education, and nutrition knowledge scores among women in the three groups. A significant relationship was observed between education and nutrition knowledge; women who had attended college courses scored higher.003) on the nutrition knowledge test than those who had not attended. Health care providers (82%) and reading materials (82%) were the most frequently cited sources of infant feeding information. While general nutrition knowledge appears to be positively related to education, it does not appear to influence the infant feeding decision. / Department of Family and Consumer Sciences

Demographic Characteristics And Breastfeeding Confidence Of Mothers Who Choose To Exclusively Breastfeed And Combination Feed Their Infants Subjects were recruited from physicians' offices and public clinics in a metropolitan area (n=71). Fifteen (21%) of the subjects were planning to combination feed while 56 (79%) were planning to exclusively breastfeed. Subjects completed the Maternal Confidence Survey (O'Campo et al, 1992) and provided demographic information. A higher proportion of women planning to exclusively breastfeed were married (p=0.003), Caucasian (p=0.005), and educated beyond the high school level (p=0.04). Subjects in the exclusively breastfeeding group were significantly older (mean age = 26.7) than those in the combination feeding group (mean age = 22.8) (p=0.009). Confidence scores were significantly higher (mean score = 4.7) among women planning to exclusively breastfeed compared to women planning to combination feed (mean score = 4.3) (p=0.04). Results of this study suggest women who intend to combination feed are distinctly different from those who intend to exclusively breastfeed. Women planning to combination feed may benefit from prenatal intervention to enhance breastfeeding confidence. / Department of Family and Consumer Sciences

Human milk fortification is recommended to meet the nutritional requirements of preterm infants. Most human milk fortifiers (HMFs) contain non-protein energy (NPE) predominantly as carbohydrate which may lead to high fat deposition relative to lean mass accretion. We hypothesized that fortifying human milk with a HMF containing NPE predominantly as fat (fatHMF) would result in a higher (1) lean mass accretion (percent lean mass) and (2) growth (anthropometry), compared to fortifying with an isocaloric, isonitrogenous HMF containing NPE predominantly as carbohydrate (carbHMF). In a double-blind randomized trial, 29 infants (≤32 weeks and appropriate for gestational age) admitted to the Neonatal Intensive Care Unit received either mother's milk fortified with the fatHMF (n = 14) or the carbHMF (n = 15). Body composition and growth measurements were performed at Baseline (at ≤10% of goal intake 150 ml/kg), Phase 1, and Phase 2 (3 weeks and 6 weeks, respectively, from starting HMF). Although neither percent lean (fat) mass nor growth were statistically different, by Phase 2 infants receiving fatHMF showed a 63% increase in percent fat mass, gained 1194 g in weight and 8.8 cm in length, whereas the carbHMF showed a 96% increase in percent fat mass, gained 1005 g in weight and 6.9 cm in length (p = 0.3586, 0.3815, and 0.1851 respectively). By Phase 2, the fatHMF infants gained 128 g in absolute dry lean tissue, whereas the carbHMF infants gained 99 g (p = 0.0362, Post hoc analysis). Differences of this magnitude are clinically important, but a larger study is required to demonstrate statistical significance.

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No description available.

In the first part of this study, a non-ferric method for selective elimination of β-lactoglobulin from cheese whey was investigated. A new method was developed based on hexametaphosphate treatment of cheese whey. When Cheddar cheese whey was treated under the optimized conditions, i.e., 1.33 mg/mL sodium hexametaphosphate at 22°C and pH 4.07 for 1 hr, more than 80% of β-lactoglobulin was removed by precipitation. Almost all of the immunoglobulins and the major portion of α-lactalbumin were retained in the supernatant as indicated by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and immunochemical assays. By dialysis against distilled water 72.2% of the phosphorus was removed from the supernatant. In the second and the third part of the thesis, chromatographic methods were used for isolation of immunoglobulins and lactoferrin from whey proteins. By using gel filtration on Sephacryl S-300, 99, 83.3 and 92.1% biologically active immunoglobulin G were obtained for colostral whey, acid and Cheddar cheese whey, respectively. Lactoferrin, selectively adsorbed to the heparin-attached Sepharose, was eluted with 5 mM Veronal-HC1 containing 0.5M NaC1, at pH 7.2. 1,4-Butanediol diglycidyl ether-iminodiacetic acid on Sepharose 6B, or so-called metal chelate-interaction chromatography (MCIC), was loaded with copper ion and used for the same purpose. Of the two peaks obtained, the first yellowish peak was rich in lactoferrin, while the second peak was rich in immunoglobulins. Some of the physical and chemical properties of the proteins in these peaks, including immunochemical properties, isoelectric points, binding to bacterial lipopolysaccharides, and the mechanism of protein-metal interaction via histidine modification, and the capacity of the method were studied. The possibility of isolating immunoglobulins and lactoferrin from electrodialyzed whey was also investigated. In the fourth, fifth and sixth parts of the thesis, the method developed for isolation of immunoglobulins and lactoferrin from whey protein was applied to isolate these biologically important proteins directly from skimmilk, blood and egg white. The casein in skimmilk was found to compete with immunoglobulins for binding to copper ion in MCIC column when skimmilk was loaded in presence of 0.05 M Tris-acetate buffer containing 0.5 M NaC1, pH 8.2; however, this problem was solved by changing the equilibrating buffer to 0.02 M phosphate buffer containing 0.5 M NaC1, pH 7.0. When blood was directly applied to MCIC column, the yield of biologically active IgG was more than 95%. Ovotransferrin, strongly adsorbed to the MCIC column, was eluted with two-step elution protocols which suggests it exists in two forms. The histidine residues in immunoglobulins, caseins, transferrin and ovotransferrin were found to be involved in the mechanism of the interaction with the MCIC column. / Land and Food Systems, Faculty of / Graduate

Periods of rapid growth are periods of special vulnerability to nutritional injury. Growth during pregnancy and in the first two years of life is more rapid than at any other stage in the life cycle and hence, optimum nutrition is vital at this time. Physicians are frequently the primary professionals concerned with the dissemination of nutrition advice to pregnant women and mothers of new infants. However, there are no studies in the literature that assess the quality of nutrition information provided by physicians in this important area of maternal and infant nutrition. A study was designed to investigate the nutrition attitudes and practices of general practitioners, pediatricians and obstetricians in the province of British Columbia. The influence of selected variates upon the criterion variables, nutrition attitudes and practices, was assessed. Variates studied included demographic and professional data on country of medical training, sex of respondent, location and type of practice, years of practice, number of patients seen weekly, sources of nutrition information consulted, attendance at continuing education programs, additional training for specialization, and inclusion of nutrition in medical school education. The nature of the relationship between nutrition attitudes and practices was also assessed. In March 1975, questionnaires were mailed to all 1981 practising general practitioners, pediatricians and obstetricians in the province of British Columbia. Questionnaires were returned by 724 ( 41.3% ) general practitioners, 69 ( 62.7% ) pediatricians and 51 ( 43.2% ) obstetricians. Responses from completed questionnaires were analyzed by computer; all tests were conducted at the 5% level of significance. Results were reported at the highest level of significance. Mean scores for nutrition attitudes for general practitioners, pediatricians and obstetricians were 72%, 81% and 64% respectively. Nutrition practices' scores were 60%, 66% and 65% for general practitioners, pediatricians and obstetricians respectively. Regression analysis indicated that nutrition attitude and practice scores of general practitioners were significantly higher for physicians who: (a) were female (b) consulted with a nutritionist-dietitian (c) had additional training (d) attended continuing education programs and (e) had nutrition in their medical school education. General practitioners who were in practice more than 10 years scored significantly lower on the attitude and practice tests. Nutrition practice scores were significantly higher for pediatricians trained in Canada while nutrition attitude scores were higher for pediatricians who were in practice more than five but fewer than 10 years. Obstetricians' attitude scores were significantly lower for physicians who were in practice more than 10 years. Obstetricians who consulted with non-human sources of nutrition information other than professional journals and human sources of information other than nutritionist-dietitians scored significantly higher on the nutrition practice test. Correlation analysis showed that nutrition attitudes were significantly correlated to nutrition practices for general practitioners ( r = 0.370 ), pediatricians ( r = 0.259 ) and obstetricians ( r = 0.424 ). Student t-test analysis indicated that pediatricians' and obstetricians' practice test scores were significantly higher than those of general practitioners. There were no significant differences among the nutrition attitude scores for the three groups. Implications for nutrition educators included the need for nutrition in the medical school curriculum, the incorporation of nutrition into continuing education programs and the need for nutritionists to act as consultants to physicians. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate