Development, Validity, and Reliability of a Food Frequency Questionnaire Eliciting the Dietary Advanced Glycation End Product Consumption among Obese Adolescents Aged 10-19 Years.

BACKGROUND: Obesity has reached an alarming rate affecting all categories of the population. A tremendous rise in obesity has been observed in children and adolescents. In India, the prevalence of adolescent obesity is more than 30% of the population. Advanced glycation end products (AGEs) are a diverse group of compounds formed by the amalgamation of glucose and a protein moiety. These glycated compounds are found in processed foods subjected to high-temperature cooking techniques contributing to the formation of dietary AGEs (dAGEs). The enormous consumption of dAGE attributes to the development of metabolic diseases. OBJECTIVES: The objective of this study was to develop and validate a food frequency questionnaire (FFQ) among obese adolescents aged 10-19 years to gauge their dAGE consumption. MATERIALS AND METHODS: This questionnaire was developed from previous literature (15 articles), validated using the content validity ratio (CVR) by Lawshe, and estimated for reliability using the test-retest method. A pilot study was done among 50 obese adolescents aged 10-19 years, who completed the questionnaire twice, with a gap of 15 days. RESULTS: A total of 54 items were validated (CVR ≥0.99) from the 60 food items. A reliability score >0.7 was observed, and a significant correlation (P ≥ 0.01) between the test and retest results was determined. CONCLUSION: Hence, this FFQ is reliable and can be used for future research studies to elicit dAGE consumption among obese adolescents.

Anthropometric measurements and body composition of preterm infants born ≤34 weeks at 12-13 months corrected age as compared to term infants.

BACKGROUND: Growth in the first year of life depends primarily on nutrition. Currently, the infant feeding practices of term babies are being extrapolated for preterms. While extrapolating, it is not clear if corrected age (CA) or chronological age should be used. In preterm infants, born ≤34 week gestation age, this difference may be more than 6 weeks. We studied the growth parameters and body composition of preterm infants born ≤34 week gestation age as compared to that of term infants at 12-13 months CA. METHODS: The growth of 99 term infants and 170 preterm infants born ≤34 weeks was evaluated at 12-13 months CA. The anthropometric measurements, body mass index (BMI) and skin fold thickness (SFT) at four sites (biceps, triceps, subscapular and suprailiac) were compared in the two groups. The sum of the SFT was taken as a marker of fat mass. RESULT: At 12-13 months CA, preterm infants had significantly less weight, length and BMI as compared to term babies. The weight and BMI for age Z-scores, weight for length Z-scores and fat mass were also significantly less in preterm babies. CONCLUSION: The anthropometry measures in preterms (<34 weeks) at 12-13 months CA were significantly lower than that of term infants. In our study population, preterms did not catch up in growth in the first year even when the CA is used for comparison. The causes could be multifactorial and need to be studied further.

Food cue images and subjective appetitive responses in obese children.

BACKGROUND: Food decision-making is based on various intrinsic and extrinsic factors of an individual. Food preferences and food cue sensitivity influence energy intake, which in turn affects body weight. AIM: The present study assessed the subjective appetite of obese children in response to food cue images. METHODS: A total of 70 obese children (37 boys and 33 girls) of the age group 7-10 years were recruited for the study; 34 images of food items grouped under ten food blocks were used as cues to study the self-reported hunger, appetite and satiety sensations among the participants. A visual analogue scale (VAS) was used to measure participant responses for each food block. RESULTS: The mean (standard deviation (SD)) body mass index-for-age 'Z' scores (BAZ) of the participants was found to be 2.15 (0.36). The subjective appetitive responses assessed using VAS showed that the hunger ratings of participants were found to be higher in response to images of cereals and cereal products (92.86%), and sweets (97.14%); satiety ratings of the participants were observed to be higher for milk and milk products (87.14%); cereals and savoury foods (78.57%); and higher appetite ratings of participants were recorded for sweets (97.14%) and cereals (92.86%). CONCLUSION: Sophisticated neuroimaging techniques are well established in measuring appetite, but our study focused on the subjective analysis of appetite using cost-effective tools such as food cue images and visual analogue scales to further expand the research platform in appetite regulation and obesity.

Inflammation and nutritional status assessment by malnutrition inflammation score and its outcome in pre-dialysis chronic kidney disease patients.

BACKGROUND: Malnutrition-inflammation complex syndrome (MICS), hyperhomocysteinemia, calcium and phosphate levels derangement have been predicted as important contributing factors for the progression of cardiovascular burden. Among patients with earlier stage of CKD, hypoalbuminaemia and inflammation deliberated as non-traditional cardiovascular risk factors, which add more burden to circulatory disease, mortality and rapid advancement to CKD stage 5. AIM: The aim of the study is to evaluate inflammation and nutritional status of CKD patients not on dialysis using Malnutrition inflammation score (MIS) and to verify the association with mortality in the follow-up period. METHODS AND MATERIAL: In this prospective cohort study 129 (66 males, 63 females) pre-dialysis CKD patients enrolled between June 2013 to August 2014 and censored until March 2017. Malnutrition and Inflammation assessed using Malnutrition inflammation score. Blood urea nitrogen, serum creatinine, albumin, Interleukin - 6, highly sensitive C reactive protein (hsCRP), total cholesterol and anthropometric data were analyzed. RESULTS: The Malnutrition inflammation score in pre-dialysis CKD patients ranged from 0 to 18 with the median score of two. During 36 or more months of follow-up, there were 30 (23.2%) deaths, 35 (27%) patients initiated on hemodialysis, one (0.7%) patient was initiated on peritoneal dialysis, two (1.4%) patients underwent renal transplantation and two (1.4%) patients were lost for follow-up. In this study, 33% had varying degree of malnutrition and inflammation. Patients who had MIS ≥7 had significant increase in IL-6 (p = 0.003) and HsCRP levels (p < 0.001) when compared with other tertiles of MIS. ROC curve analysis of MIS showed 56.5% sensitivity and 81% specificity in predicting death rate (AUC 0.709; 95% CI 0.604-0.815, p < 0.001). Kaplan-Meier survival analysis showed MIS ≥7 had a strong association (log rank test, p < 0.001) with mortality during 36 and more months of follow-up time. In unadjusted analyses, MIS (HR 1.140; 95% CI 1.054-1.233; p < 0.05) and HsCRP (HR 2.369; 95% CI 1.779-3.154; p < 0.001) found to be predictors of mortality. MIS and HsCRP remained predictors of mortality even after adjustments. CONCLUSIONS: This study shows MIS is an important factor that determines mortality in pre-dialysis CKD patients during 36 and more months of follow-up time. Patients with MIS ≥7 have high risk for mortality and needs close monitoring. In clinical setting application of MIS has a greater utilization in pre-dialysis CKD patients. Further research with longitudinal assessment of MIS and its association with outcomes are warranted. Pre-dialysis CKD patients should be assessed for their nutritional status and inflammation using MIS regularly to prevent malnutrition and its associated complications through appropriate medical and nutritional intervention.

Assessment of abdominal aortic calcification in predialysis chronic kidney disease and maintenance hemodialysis patients.

Vascular calcification is associated with increased morbidity and mortality among chronic kidney disease (CKD) patients. The aim of the study was to assess the abdominal aortic calcification (AAC) in predialysis CKD patients and patients on hemodialysis (HD) and to study the risk factors associated with it. In this prospective study, 205 patients were including 104 patients with predialysis CKD and 101 patients were on maintenance hemodialysis. AAC was assessed using lateral lumbar radiography. Blood urea nitrogen, serum creatinine, albumin, calcium, phosphorus, highly sensitive C-reactive protein (hsCRP) and total cholesterol were analyzed. AAC was observed in 26 % of predialysis CKD patients and 34% in HD patients. Using multivariate analysis, the age (P = 0.001) was identified as independent predictor for the presence of AAC in predialysis patients, and for HD, the predictors were age (P = 0.025), time on dialysis (P = 0.001), hsCRP (P = 0.002), and corrected calcium (P = 0.030). In conclusion, the prevalence of AAC varies mainly with age and glomerular filtration rate levels in predialysis CKD patients. Advanced age, time on dialysis, and inflammation may be associated with presence and extent of AAC in HD patients. Further research into the risk factors and outcome for AAC is warranted.

Weight Gain Pattern of Infants with Orofacial Cleft on Three Types of Feeding Techniques.

OBJECTIVE: To compare the efficacy of the three feeding techniques commonly used in authors' setup in improving the weight gain pattern of children with orofacial cleft. METHODS: A cohort prospective study was employed. A total sample of 150 infants at the age of 2 mo with cleft of both lip and palate were recruited and followed bimonthly until their first birthday to assess the pattern of weight gain. The subjects were categorized into three groups based on their habitual feeding techniques such as Group I: Paladai fed; Group II: Bottle fed and Group III: Spoon fed with 50 subjects in each group. The three groups were counseled on nutritional aspects, correct infant positioning and hygienic practices. RESULTS: The mean weight of the Group I subjects was observed to be higher than the other two groups at every visit and was also found to be statistically significant at p < 0.001. Over all comparison proved that the weight gain of 1.364 ± 0.191, 1.348 ± 0.284 and 1.450 ± 0.205 and the velocity of weight gain, kg per week of 0.17 ± 0.023, 0.168 ± 0.035 and 0.181 ± 0.025 of Group I at 4, 6 and 8th mo respectively were significantly higher than the other two groups (p < 0.001). CONCLUSIONS: Of the three feeding techniques adopted by the mothers of infants with orofacial cleft, it was noted that paladai feeding was better than the bottle or spoon-feeding.