Browsing by Subject "nutrition"
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Item Open Access Immediate Post-operative Enterocyte Injury, as Determined by Increased Circulating Intestinal Fatty Acid Binding Protein, Is Associated With Subsequent Development of Necrotizing Enterocolitis After Infant Cardiothoracic Surgery.(Frontiers in pediatrics, 2020-01) Watson, John D; Urban, Tracy T; Tong, Suhong S; Zenge, Jeanne; Khailova, Ludmilla; Wischmeyer, Paul E; Davidson, Jesse AObjectives: 1 Measure serial serum intestinal fatty acid binding protein levels in infants undergoing cardiac surgery with cardiopulmonary bypass to evaluate for evidence of early post-operative enterocyte injury. 2 Determine the association between immediate post-operative circulating intestinal fatty acid binding protein levels and subsequent development of necrotizing enterocolitis. Design: Observational cohort study. Intestinal fatty acid binding protein was measured pre-operatively, at rewarming, and at 6 and 24 h post-operatively. Percent of goal enteral kilocalories on post-operative day 5 and episodes of necrotizing enterocolitis were determined. Multivariable analysis assessed for factors independently associated with clinical feeding outcomes and suspected/definite necrotizing enterocolitis. Setting: Quaternary free-standing children's hospital pediatric cardiac intensive care unit. Patients: 103 infants <120 days of age undergoing cardiothoracic surgery with cardiopulmonary bypass. Interventions: None. Results: Median pre-operative intestinal fatty acid binding protein level was 3.93 ng/ml (range 0.24-51.32). Intestinal fatty acid binding protein levels rose significantly at rewarming (6.35 ng/ml; range 0.54-56.97; p = 0.008), continued to rise slightly by 6 h (6.57 ng/ml; range 0.75-112.04; p = 0.016), then decreased by 24 h (2.79 ng/ml; range 0.03-81.74; p < 0.0001). Sixteen subjects (15.7%) developed modified Bell criteria Stage 1 necrotizing enterocolitis and 9 subjects (8.8%) developed Stage 2 necrotizing enterocolitis. Infants who developed necrotizing enterocolitis demonstrated a significantly higher distribution of intestinal fatty acid binding protein levels at both 6 h (p = 0.005) and 24 h (p = 0.005) post-operatively. On multivariable analysis, intestinal fatty acid binding protein was not associated with percentage of goal enteral kilocalories delivered on post-operative day 5. Higher intestinal fatty acid binding protein was independently associated with subsequent development of suspected/definite necrotizing enterocolitis (4% increase in odds of developing necrotizing enterocolitis for each unit increase in intestinal fatty acid binding protein; p = 0.0015). Conclusions: Intestinal fatty acid binding protein levels rise following infant cardiopulmonary bypass, indicating early post-operative enterocyte injury. Intestinal fatty acid binding protein was not associated with percent of goal enteral nutrition achieved on post-operative day 5, likely due to protocolized feeding advancement based on clinically observable factors. Higher intestinal fatty acid binding protein at 6 h post-operatively was independently associated with subsequent development of necrotizing enterocolitis and may help identify patients at risk for this important complication.Item Open Access Molecular signatures of food intake in human stool(2024) Petrone, Brianna LeighDietary intake is one of the most complex and sustained environmental exposures of the human lifespan. At present, field standard methods for dietary assessment all depend on asking people to self-report what they eat. Self-reported dietary data have enabled the study of diet-health relationships and informed decades of nutritional policy, but they are also limited in their ability to collect data from individuals across the spectrum of age, cognitive ability, and culture. To address the need for alternative measures of diet, we leverage DNA sequencing technology to measure diet from degraded food DNA in human stool samples. This strategy, termed “DNA metabarcoding,” works by amplifying and sequencing regions of the genome to identify foods by their DNA sequence. Although metabarcoding strategies have been applied in other diet-related fields, they have never been used in nutritional epidemiology.
In Chapter 1, I describe the potential of DNA metabarcoding for human dietary assessment. In Chapter 2, we apply DNA metabarcoding with the chloroplast trnL-P6 marker region to >1,000 stool samples from >300 unique participants. Across multiple cohorts, we find that the number of plant taxa detected per sample by trnL metabarcoding correlates with dietary diversity and quality estimates from established self-report assessments. In a cohort where the administration of self-reports failed, we use trnL metabarcoding to retrospectively derive diet data, and detect relationships between trnL dietary diversity and age, socioeconomic indicators, and health that replicate prior epidemiologic findings.
In Chapter 3, we perform a pilot study of a second molecular technique— metaproteomics— to determine if it can address a key limitation of metabarcoding: the inability of DNA to distinguish food type for foods like chicken and egg, which are derived from the same source species. We identify tissue-specific protein signatures of food intake and confirm an overall correspondence between DNA- and protein- based dietary assessment in comparison to written records. We also expand our metabarcoding protocols to include the mitochondrial 12SV5 marker for combined detection of plant and animal intake. Taken together, these findings establish the value of molecular measurements from stool as a strategy to monitor and improve nutrition.
Item Open Access Women Veterans Experience with the VA MOVE! Weight Management Program.(Women's health reports (New Rochelle, N.Y.), 2020-01) Batch, Bryan C; Brown, Candace S; Goldstein, Karen M; Danus, Susanne; Sperber, Nina R; Bosworth, Hayden BBackground: Obesity prevalence is higher in women veterans overall than their civilian counterparts considering 44% of women veterans are obese. Thus, there is a critical need to understand the facilitators and barriers to women veterans' participation in weight management programs. The objective of this study is to explore facilitators and barriers to weight loss for women veterans enrolled in the Veterans Health Administration Motivating Overweight/Obese Veterans Everywhere (VA MOVE!) weight management program and gather feedback on the design and delivery of the MOVE!Program
Materials and Methods: Primary qualitative data were collected from women veterans who completed at least one MOVE! visit via semistructured telephone interviews. Two authors independently reviewed transcripts for data-derived codes. A content analysis approach was used within the software to code the transcripts. Results: The mean age of participants was 52 years. Sixty-eight percent (N = 17/25) were black, and 52% (N = 13/25) lived >64 kilometers from the location of the MOVE!Program
Facilitators to participation included both intrinsic (e.g., drive to become healthy) and extrinsic (e.g., drive to improve laboratories) motivating factors. Women expressed difficulty with learning in a group setting and applying lessons to their everyday lives. Others reported the setup of group classes triggered their post-traumatic stress disorder and prevented them from fully participating in the program. Additional barriers included distance traveled to group sessions and lack of access to exercise space. Conclusions: Our results illuminate barriers and facilitators to engagement in the MOVE!Program
Many of the barriers highlighted by these women veterans mirror barriers civilian women face, highlighting the possibility that our results could be applied to other programs designed to target weight loss in women.