Nestle Nutrition Institute workshop series最新文献

Necrotizing enterocolitis (NEC) is a devastating inflammatory condition of the intestine, which affects premature infants and causes untold damage. Its pathogenesis has to do with how colonizing bacteria interact with the immature newborn intestine. An immature innate immune response with increased TLR-4 on the cell surface and increased signaling molecules, such as NF-κB, can cause excessive inflammation. This is in conjunction with a decrease in the appearance of regulatory molecules which effect the control of innate responses. This condition is so devastating that it must be prevented and not treated. Fortunately, breast milk and probiotics can affect the condition leading to reduced inflammation. How does this effect work? We have shown that breast milk tryptophan and Bifidobacterium infantis result in a metabolite (indole-3-lactic acid) response, which is anti-inflammatory via inhibition of the aryl hydrocarbon receptor transcription factor which stimulates an IL-8 response. We have also shown that breast milk complex carbohydrates interacting with Bacteroides fragilis can cause short-chain fatty acids which exert anti-inflammatory effects on the newborn intestine. These breast milk metabolites could help prevent NEC if shown to be effective clinically.

Food composition tables and databases (FCT/FCDB) centralize data on the energy and nutrient content of foods of a certain country or region. They are essential for many activities related to nutrition. The main factors that can affect the quality of FCT/FCDB are the sources of the data, coverage of foods and components, food description, and component identification. Around 100 countries have published at least one FCT/FCDB, although many of them are outdated and vary considerably in terms of data quality, documentation, and accessibility. A great number of those FCT/FCDB contain very few up-to-date analytical data obtained for food composition purposes, resulting in many data being estimated or copied from publicly available FCT/FCDB from other countries. In addition, many other natural factors that can affect the composition of foods are often not reflected in FCT/FCDB, including biodiversity, maturation degree, soil, and harvest season. Therefore, the use of low-quality FCT/FCDB to convert food consumption data into energy and nutrient intakes may introduce errors resulting in under- or overestimated intake for a certain component. These wrong conclusions may lead to inappropriate or inefficient nutrition and health-related policies, especially to improve micronutrient status in populations and individuals.

Tackling the global burden of acute malnutrition in children remains a major public health challenge and is essential for achieving sustainable development. Despite having effective treatment options, most wasted children go untreated; treatment coverage for severe acute malnutrition (SAM) children is only about 20%. Milk is currently an essential component of effective SAM treatment, incorporated into ready-to-use therapeutic food (RUTF). Reaching the untreated children, as well as preventing SAM, requires investment in innovative and cost-efficient approaches. To date, attempts to replace or remove milk from RUTF have been either unsuccessful or unpersuasive. This is likely because milk provides the highest protein quality and density of all typical RUTF ingredients. However, alternative protein sources could provide cost savings. Alternative protein sources, especially plant-based protein alternatives, have had shown more promising progress for the treatment of children with moderate acute malnutrition. Acknowledging that cost is a major barrier to the scale-up of treatment of acute malnutrition and that alternative protein sources are a practical means to reduce cost, continued research focusing on alternative proteins is necessary.

Physical activity (PA) can improve physical, mental, cognitive, and brain health throughout the lifespan. During preadolescent childhood, the benefits of PA for cognitive health have been widely studied, with evidence indicating enhanced executive control, improved academic performance, and adaptation in underlying brain structure and function. Across school age children, the predominant literature has focused on preadolescent children, with a comparatively smaller body of evidence in adolescent children. Yet, preliminary findings suggest improvements in verbal, numeric, and reasoning abilities as well as academic achievements. Further, benefits of PA are also rarely examined in preschool children. Consequently, lack of standardization across studies has led to various approaches in the measurement of PA and fitness. However, since implementing tools that objectively quantify active play, PA has been related to better executive function, language acquisition, and academic achievement. Despite evidence that PA promotes cognitive and brain health during development, a growing number of schools have minimized PA opportunities across the school day. The minimization of PA along with several other factors, including lack of active commuting to school, nutrition transition, and availability of electronic devices, for example, has reduced children's physical and mental health. Accordingly, today's children have become increasingly inactive, which affects public health and contributes to educational concerns. By dedicating time to active play, sports, physical education, and other forms of PA, children are best positioned to thrive in both the physical and cognitive domains.

To understand the development of children's flavor preferences, it is important to consider the context of the feeding environment. Although children are predisposed to prefer sweet-tasting foods and beverages and to avoid bitter-tasting foods such as dark-green vegetables, parents can play a central role in shifting these innate food acceptance patterns throughout development. Beginning before birth, the fetus detects the continually changing flavor profile of amniotic fluid, which reflects the mother's diet. After birth, if mothers choose to breastfeed, these sensory experiences continue. Through this process of familiarization, women who maintain a healthy diet throughout pregnancy and lactation prepare their infants to like healthful foods. Upon the introduction of solid foods, repeated exposure to a variety of healthful foods promotes acceptance for these foods and for novel foods. In addition to providing sensory exposures to a range of healthful foods, parents can shape children's flavor preferences by modeling healthy eating behaviors and by creating supportive feeding environments. The degree to which parents engage in these practices is influenced by demographic and societal characteristics. Considering the context in which children and families live will encourage the development of evidence-based strategies that more effectively support children's healthy eating habits.

Toddlers and young children need an adequate and diverse diet to provide all of the nutrients required for optimal growth and development. Unfortunately, inadequate intake of vitamins and minerals is still identified by the World Health Organization (WHO) as a major public health threat for young children. Organizations like the WHO and the World Bank focus primarily on iron, zinc, vitamin A, and iodine for children ≤5 years of age in low-income countries. In addition to the data from these organizations, individual-level food consumption surveys are needed to provide a fuller picture of food and nutrient intakes. Where studies are available, intakes of dietary fiber and vitamin D are generally below recommendations for toddlers and young children. Other nutrient gaps differ by country and are related to food availability and local dietary habits. For example, young children in the US regularly consume dairy products, and <10% fall below recommendations for calcium intake compared to 2- to 4-year-old toddlers in the Philippines where dairy food consumption is low, and 66-84% fall below calcium recommendations. Dietary intake studies can help to identify the foods and beverages most relevant to alleviate nutrient gaps and improve dietary intakes of toddlers and young children around the world.

The neonatal immune system has its own reactivity, constraints, and challenges, which profoundly differ from the adult. Breast milk is most probably a key requirement both for optimal immune function in early life and for imprinting of the immune system for long-term immune health. Here, we will highlight how breast milk fills the needs and the gaps of the developing immune system and thereby represents the unbeatable way to prevent infectious disease. We will further focus on some factors in breast milk that we extensively studied and found to actively influence the immune trajectory and long-term immune health. More specifically, we will review how the presence of allergens in breast milk together with maternal milk cofactors such as TGF-β, vitamin A, and immunoglobulins influence mucosal immunity in early life with long-term effects on allergic disease susceptibility. We will see that, depending on the content and the nature of allergens in breast milk as well as the presence of immune modulators, very different outcomes are observed, ranging from protection to an increased allergy risk. We are starting to decipher the specific requirements for the neonatal immune system to function optimally. We are discovering how breast milk fulfills these requirements and guides immune trajectories from early life. Answering these questions will provide the infant with preventive and curative approaches that are tailored to this very specific period of life and will ensure long-term immune health.

Over the past decades, Brazil has faced important challenges regarding the nutrition of toddlers. Changes in dietary intake and feeding habits switched the scenario from undernutrition to increased rates of overweight and obesity. Determinants related to that issue involve the disparity in income distribution, the structure of food production and access, and the role of programs and policies, mostly related to its historical context. The feeding of Brazilian toddlers is characterized by low consumption of fruits, vegetables, and fiber, and high and early intake of fried foods, salty snacks, and sugar. Skipping important meals, e.g., breakfast, and poor snacking habits are also important practices related to excess weight. Integrated actions aiming to establish healthy eating habits in children must involve families, schools, governments, and food industry. Exploring the variety of fruits and vegetables available in the country helps to provide a healthy nutrition environment. Increasing the availability of nutrient-dense foods in the home environment improves the quality of food directed to children. Improving children's diet quality goes beyond promoting nutrition education. A favorable environment enabling to translate intentions into practice is essential, and it involves a multisectoral and an integrated framework with individual modifications and political interventions.

Greater abilities for executive control in childhood have long-term benefits for academic and vocational success. Therefore, lifestyle approaches with the potential to support executive control in childhood stand to have long-term implications not only for physical but also for cognitive health. Nutrition plays a fundamental role in brain structure and function. While a considerable amount of literature demonstrates the detrimental effects of deficiencies in essential nutrients, comparatively little is known is about the role of overall diet quality in promoting executive control among children without diagnosed nutrient deficiencies. Emerging evidence provides preliminary support for the importance of key nutrients (e.g., water, dietary fiber, carotenoids, and choline) that contribute to diet quality. This article represents a brief narrative review that aims to highlight the importance of habitual diet quality for executive control in childhood. Additional research is needed to continue developing the evidence base for diet patterns and nutrients that preferentially support executive control during childhood. This is an important goal given that nutritional recommendations for children's cognitive function are absent from the US dietary guidelines, making the endeavor to develop the evidence base for diet patterns and nutrients that preferentially support executive control during childhood all the more important.