Vitamins are readily available in the modern diet due to liberalized fortification and supplementation policies. This research tested the hypothesis that high multi-vitamin intake by Wistar rats during pregnancy leads to the development of obesity and characteristics of the metabolic syndrome in the offspring. Pregnant Wistar rats were fed the AIN-93G diet containing either the recommended (RV) or 10-fold increase (HV) in vitamin content. Pups were weaned to the RV diet (Study 1), an obesogenic liquid diet (Ob, Study 2), low vitamin diets (1/3RV or 1/6RV, Study 3), or a nutrient selection paradigm (NSP) with 10% and 60% casein diets (Study 4). Body weight (BW), food intake (FI), glucose and insulin responses, appetite hormones, abdominal fat pad mass (FPM) and systolic blood pressure (SBP) was measured. Expressions of mRNA for hypothalamic serotonin (5-HT) receptors and proopiomelanocortin (POMC) were measured in Study 4. Males, but not females, born to HV dams had higher post-weaning BW and FI when weaned to the RV or 1/3RV diet, and exhibited components of metabolic syndrome, including higher FPM, hyperglycemia, insulin resistance and elevated SBP compared with those born to RV dams. The Ob diet led to exaggerated weight gain and expressions of components of metabolic syndrome in both sexes born to dams fed the HV diet. Female pups on the 1/6RV diet from HV dams had two-fold higher glucose response and lower insulin response, but no difference in post-weaning BW and daily FI compared to those from RV dams. In contrast to the pups born to HV dams and fed a single diet, those from the HV dams and on the NSP gained less weight and ate less, and had lower hypothalamic mRNA expressions of 5-HT receptors and POMC. In conclusion, high multi-vitamin intake during pregnancy may lead to obesity, and result in a higher risk of developing characteristics of metabolic syndrome in the offspring. However, sex, weaning diet composition, and the presence of diet choice alter the outcomes.

Vitamins are readily available in the modern diet due to liberalized fortification and supplementation policies. This research tested the hypothesis that high multi-vitamin intake by Wistar rats during pregnancy leads to the development of obesity and characteristics of the metabolic syndrome in the offspring. Pregnant Wistar rats were fed the AIN-93G diet containing either the recommended (RV) or 10-fold increase (HV) in vitamin content. Pups were weaned to the RV diet (Study 1), an obesogenic liquid diet (Ob, Study 2), low vitamin diets (1/3RV or 1/6RV, Study 3), or a nutrient selection paradigm (NSP) with 10% and 60% casein diets (Study 4). Body weight (BW), food intake (FI), glucose and insulin responses, appetite hormones, abdominal fat pad mass (FPM) and systolic blood pressure (SBP) was measured. Expressions of mRNA for hypothalamic serotonin (5-HT) receptors and proopiomelanocortin (POMC) were measured in Study 4. Males, but not females, born to HV dams had higher post-weaning BW and FI when weaned to the RV or 1/3RV diet, and exhibited components of metabolic syndrome, including higher FPM, hyperglycemia, insulin resistance and elevated SBP compared with those born to RV dams. The Ob diet led to exaggerated weight gain and expressions of components of metabolic syndrome in both sexes born to dams fed the HV diet. Female pups on the 1/6RV diet from HV dams had two-fold higher glucose response and lower insulin response, but no difference in post-weaning BW and daily FI compared to those from RV dams. In contrast to the pups born to HV dams and fed a single diet, those from the HV dams and on the NSP gained less weight and ate less, and had lower hypothalamic mRNA expressions of 5-HT receptors and POMC. In conclusion, high multi-vitamin intake during pregnancy may lead to obesity, and result in a higher risk of developing characteristics of metabolic syndrome in the offspring. However, sex, weaning diet composition, and the presence of diet choice alter the outcomes.

Early childhood malnutrition is a global public health problem with serious short- and long-term consequences. The aim of this thesis is to evaluate the effects of psychosocial stimulation (PS) with or without food supplementation (FS) on growth and development of severely malnourished children, quality of home environment, mother’s child-rearing practices and depressive symptoms. The study setting was Dhaka, Bangladesh, and the participants were severely malnourished children, aged 6-24 months, admitted at Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B). A hospital-based study was conducted in Nutrition Rehabilitation Unit of ICDDR,B hospital, where a control group (n=43) was studied initially, followed by an intervention group (n=54). All received standard nutrition rehabilitation care. The intervention group received daily group meetings and play sessions in the hospital, and was thereafter visited at home for 6 months. A community-based randomised trial was conducted including children (n=507) admitted at hospital for initial treatment of an acute infection, and thereafter assigned to PS, FS, PS+FS, clinic control or hospital control groups. PS was delivered at follow-up visits, fortnightly for 6 months at community clinics. FS included distribution of cereal-based food packets (150–300 kcal/day depending on age) for 3 months. All groups received standard medical care and micronutrient supplementation. In the hospital-based study, the intervention group had significantly higher scores in mental (p<0.001, effect size 0.52 SD) and motor development (p=0.047, effect size 0.37 SD), and weight (p=0.03, effect size 0.39 SD), after 6- months intervention. In the community-based trial, there was a significant effect of stimulation after six months of intervention on children’s mental development (group*session interaction p=0.037, effect size=0.37 SD) and weight (group*session interaction p=0.02, effect size=0.26 SD) but no effect on motor development or linear growth. The PS+FS and PS groups differed in total HOME score, two HOME subscales (maternal involvement and play materials), and in mother’s child- rearing practices scores but not in depressive symptoms. PS with or without FS had small improvement on children’s growth and development, quality of home environment and mother’s rearing-practices of severely malnourished children. More intensive interventions with longer duration are therefore recommended.

Oxidative stress has been associated with many disease conditions in adults and neonates based on clinical and post mortem studies. Trauma is the commonest cause of oxidative stress. However a gap in knowledge of the natural history of oxidative stress in humans was identified as most studies have been post mortem or in animals. <p>The aim of this research is to understand treat and oxidative stress in trauma and surgical patients. The study involved three components including: the development and evaluation of the novel oxistress assay; study of clinical trauma and oxidative stress; and clinical trial of alanyl-glutamine supplementation following major surgery. The novel oxistress assay was used on urine samples in the normal population to determine reference values and subsequently on hospital patients to determine sensitivity and specificity. The study of clinical trauma and oxidative stress evaluated plasma antioxidants (FRAP assay), red cell glutathione (Asensis method), plasma and urine protein carbonyl (Levines method) and total oxidants in plasma and urine (oxistress assay) over 7 day period following trauma. The clinical trial was a double blind study of 69 major surgery patients evaluating biochemical and clinical parameters over 7 day period in comparison with pre-operative status. <p>The novel oxistress assay proves to be a sensitive and accurate bedside diagnostic tool for oxidative stress. It can also be used in the laboratory setting. Oxidative stress is associated with increased trauma severity resulting in antioxidant depletion, strong oxidant production and protein degradation. The presence of pre-morbid medical factors also increased oxidative stress in trauma patients. Oral alanyl-glutamine supplementation (0.3 g/kg) increased plasma glutamine and antioxidant levels while decreasing urine oxidant levels. It significantly reduced hospital stay in non-cancer and higher disease complexity patients. The intervention also reduced the resource intensity weighting (RIW) score. <p>Oxidative stress is a clinical problem in surgery and trauma patients that can now be easily diagnosed at the bedside using the novel oxistress assay. Treatment with alanyl-glutamine is effective in reducing oxidative stress and improving clinical outcome. It is highly recommended probably at a higher dose in order to achieve optimal results.

Fescue toxicosis can produce negative effects on animal weight gain and physiology. Sixty-four steers were grazed on endophyte-infected (E+) KY-31 tall fescue for 77 days in 2007 and sixty steers grazed for 86 days in 2008 to evaluate interactions with implantation of steroidal implants and concentrate feeding on performance and physiology of yearling steers. Steers were stratified by body weight for assignment to six, 3.0-ha toxic tall fescue pastures. The main plot treatment of with or without pelleted soybean hulls (SBH) were randomly assigned to pastures. Pelleted SBH were group-fed to provide daily consumptions of 2.3 kg/steer/d (as fed). Sub-plot treatments of with or without ear implantation with steroid hormone (200 mg progesterone--20 mg estradiol were assigned to groups of five or six steers within each pasture. Average daily gain in the experiment showed an additive effect of feeding SBH and implanting (P

Nutritional insults and conditions in fetal life and infancy may influence later growth and body composition as well as the development of chronic diseases in adult life. We studied the effects of maternal food and micronutrient supplementation and exclusive breast-feeding counseling on offspring growth 0-54 months and body composition at 54 months of age. We also validated and developed equations for a leg-to-leg bioimpedance analyzer in order to assess body composition of Bangladeshi children aged 4-10 years. In the MINIMat trial in Matlab, Bangladesh, pregnant women were randomized to Early (around 9 weeks) or a Usual invitation (around 20 weeks) to food supplementation and to one of three daily micronutrient supplementations with capsules of either 30 mg Fe and 400 µg folic acid, or 60 mg Fe and 400 µg folic acid, or multiple micronutrient supplements (MMS) (15 micronutrients including 30 mg Fe and 400 µg folic acid). They were also randomized to exclusive breastfeeding counseling (EBC) or to usual health messages (UHM). Growth of their children was measured from birth to 54 months, when body composition also was assessed. There were no differences in background characteristics across the different intervention groups. There was no differential effect by prenatal interventions on birth weight or length. Early invitation to food supplementation reduced stunting from early infancy up to 54 months for boys (average difference 6.5 percent units, 95% CI=1.7 to 11.3, p=0.01), but not for girls (average difference 2.4 percent units, 95% CI=-2.2 to 7.0, p=0.31). MMS resulted in more stunting than standard Fe60F (average difference 4.8 percent units, 95% CI=0.8 to 8.9, p=0.02). Breast-feeding counseling prolonged the duration of exclusive breastfeeding (difference 35.0 days, 95% CI 30.6-39.5, p&lt;0.001). Neither the pregnancy interventions nor the breast-feeding counseling influenced body composition at 54 months. Early food supplementation in pregnancy reduced the occurrence of stunting in boys 0-54 months, while prenatal MMS increased the proportion of stunting. Early food and multiple micronutrient supplementation or exclusive breastfeeding intervention provided to rural Bangladeshi women during pregnancy did not affect offspring body composition at 54 months of age. The effects on postnatal growth suggest programming effects in early fetal life.

Background - The first 1000 days of life (from conception to two years of age) is a critical period of nutritional vulnerability, affecting lifelong health. Iron deficiency (ID) and iron deficiency anaemia (IDA) are considered major public health problems that adversely affect development and growth, impair immunity, and increase morbidity and mortality in infants. ID and IDA in sub-Saharan Africa can be attributed to poor dietary, socioeconomic and disease conditions. One of the major obstacles in determining the prevalence of ID, using serum ferritin (SF) as marker of iron status, is that it not only reflects the amount of iron that is stored in the body, but also functions as an acute phase reactant that is raised in the presence of infection or inflammation. Aim - We conducted a re-analysis of the International Research on Infant Supplementation (IRIS) study’s baseline data to determine a more accurate estimation of the ID prevalence in apparently healthy four to thirteen-month-old infants from rural KwaZulu-Natal while accounting for the effect of chronic and acute inflammation on SF. Study design and methods - A cross-sectional analysis was performed on the baseline data (192 infants) of the IRIS study that was conducted in 2000. Infants’ haemoglobin (Hb), SF, C-reactive protein (CRP) and alpha-1 glycoprotein (AGP) concentrations were interpreted to determine the prevalence of ID. Literature of the past four years served as a guide to compare the ID prevalence obtained from four methods that account for the influence of inflammation on SF concentrations, to a reference method that does not take inflammation into consideration, and to what was reported in the original IRIS study. Weight and recumbent length measurements were converted to z-scores to interpret subjects’ anthropometric nutritional status. Results - A high prevalence of inflammation (52.6%) was present, with 11.5% of the subjects being in the incubation, 17.2% in the early convalescent, and 24% in the late convalescent phase of inflammation. SF was significantly associated with both CRP (ß = 0.200; P = 0.005) and AGP (ß = 0.223; P = 0.002) when adjusting for gender and age. The IRIS study reported an ID prevalence of 18.3%, whereas the results of this study ranged from 17.2 to 52.1%. We derived an IDA prevalence that ranged from 12 to 24.5% according to the different methods. The prevalence of stunting [length-for-age Z-score <-2SD] was 12.5%; while 25.1% of infants were overweight/obese [weight-for-length z-score >2SD]. Conclusion - A double burden of malnutrition was evident from the high prevalence of both overweight and ID, together with inflammation. The disconcertingly large variance in ID prevalence observed between the different methods that were employed highlights that iron supplementation interventions to treat anaemia must be based upon accurate estimates of IDA prevalence, otherwise they pose an increased risk of adverse effects to susceptible, iron-replete, but anaemic infants. Given the detrimental consequences of ID, it is imperative that governments, health care providers and parents must act to prevent or treat ID and IDA among vulnerable infants. / MSc (Dietetics), North-West University, Potchefstroom Campus, 2014

Patients undergoing elective surgery typically fast for 8-12 hours before surgery. However, oral preoperative carbohydrate ingestion may increase postoperative insulin sensitivity and reduce complications. To determine the effects of carbohydrate supplementation prior to CABG or spinal surgery, 38 patients were randomized to receive a carbohydrate supplement or to fast for 12 hours preoperatively. Baseline and postoperative measurements of insulin sensitivity were completed using the short insulin tolerance test and homeostasis model assessment (HOMA). Patient discomfort was measured immediately before surgery. Insulin sensitivity was not significantly different between groups. However, the supplemented group experienced a significantly smaller rise in glucose levels following surgery (p=0.03) and had higher postoperative HOMA-β scores (p=0.02). Fasted patients were significantly more thirsty (p=0.01), hungry (p=0.04) and anxious (p=0.01) before surgery and experienced a significantly longer hospital stay (p=0.008). Carbohydrate supplementation improved outcomes, warranting re-evaluation of fasting practices prior to major surgery.

Patients undergoing elective surgery typically fast for 8-12 hours before surgery. However, oral preoperative carbohydrate ingestion may increase postoperative insulin sensitivity and reduce complications. To determine the effects of carbohydrate supplementation prior to CABG or spinal surgery, 38 patients were randomized to receive a carbohydrate supplement or to fast for 12 hours preoperatively. Baseline and postoperative measurements of insulin sensitivity were completed using the short insulin tolerance test and homeostasis model assessment (HOMA). Patient discomfort was measured immediately before surgery. Insulin sensitivity was not significantly different between groups. However, the supplemented group experienced a significantly smaller rise in glucose levels following surgery (p=0.03) and had higher postoperative HOMA-β scores (p=0.02). Fasted patients were significantly more thirsty (p=0.01), hungry (p=0.04) and anxious (p=0.01) before surgery and experienced a significantly longer hospital stay (p=0.008). Carbohydrate supplementation improved outcomes, warranting re-evaluation of fasting practices prior to major surgery.

Aktuell gibt es für Selen (Se) keine Bedarfsempfehlungen für das Damwild (Dama dama) in Gehegehaltung. Diese Studie soll die typische Se-Aufnahme bei Gehegehaltung von Damwild ermitteln und klären, welche Parameter sich eignen, um die Se-Versorgung des Damwildes zu reflektieren. Dazu wurden 19 Damhirsche in zwei Gruppen unter identischen Bedingungen gehalten. Die Tiere ernährten sich von dem natürlichen Grasaufwuchs und Mischfutter (0,15 mg/kg TS bzw. 1,07 - 1,91 mg/kg TS). In Blut, Plasma und die Organen wurden der Se-Gehalt, die Aktivität der Se-abhängigen Glutathionperoxidase (GPx) sowie teilweise die Gesamt-GPx-Aktivität (gesGPx), die Aktivität der Glutathion-S-Transferase (GST) und die Expression verschiedener GPx analysiert. Durch die Se-Supplementierung wurden ein signifikanter Anstieg des Plasma-Se in der Versuchsgruppe und ein moderater Unterschied der Vollblut-Se-Konzentration sowie der Vollblut-GPx-Aktivität zwischen der Kontroll- und der Versuchsgruppe beobachtet (p = 0,08). Außerdem wurde in allen Organen der Versuchsgruppe ein höherer Se-Gehalt als in der Kontrollgruppe festgestellt. In der Hierarchie der untersuchten Organe ist die Niere am höchsten angeordnet, absteigend folgen der Herz- und Skelettmuskel, die Milz und die Leber. Eine Se-Aufnahme von 0,05 - 0,08 mg/kg TS führt beim Damwild nicht zur Ausprägung von Se-Mangelsymptomen und stellt daher eine ausreichende Se-Versorgung dar. Die Empfehlungen zur Se-Versorgung für Damwild sind somit nicht von Hauswiederkäuern zu übernehmen. Im Plasma und im Vollblut scheinen Se-Konzentrationen von 28 - 64 µg/l und 81 - 200 µg/l für eine ausreichende Se-Versorgung zu sprechen, in der Leber Se-Konzentrationen von 270 - 663 µg/kg TS.