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Biomedical subjects

C Agostoni

Publications and source records attributed to C Agostoni.

At least 55 records · Page 3Linked to original sources

Polyunsaturated fatty acid concentrations in human hindmilk are stable throughout 12-months of lactation and provide a sustained intake to the infant during exclusive breastfeeding: an Italian study.

While a wealth of data on the fatty acid composition of mature human milk has been published, limited information is available on the quantities of individual fatty acids supplied to the suckling infant with maternal milk, through the whole first year of life. Our aim was to qualitatively and quantitatively evaluate the fatty acid composition of human milk from Italian mothers, throughout extended lactation with particular emphasis on the long-chain polyunsaturated fatty acids. We have thus measured the total fat content and the concentrations of major fatty acids by quantitative GLC in pooled breast hindmilk collected from all feedings over 24 h at colostrum, 1, 3, 6, 9 and 12 months in ten mothers recruited after delivery of full-term infants. Total saturated fatty acids progressively increase and total monounsaturated progressively decrease as percentage levels, while among long-chain polyunsaturated fatty acids, percentages of arachidonic acid and docosahexaenoic acid decrease from colostrum up to the third month. Hindmilk total lipids (mg/dl) rise more than twofold up to 3 months, and then remain stable. The amounts (mg/dl) of linoleic acid and alpha-linolenic acid progressively increase, following the trend of total fat, while arachidonic and docosahexaenoic concentrations (mg/dl) remain stable throughout the whole nursing period. Assessment of the intakes per kg body weight shows different trends for the individual major long-chain polyunsaturated fatty acids supplied to the infant from hindmilk during exclusive breast-feeding (3 months). This information may be useful for the evaluation of infant intakes during extended lactation.

Breast Feeding↗

Factors associated with initiation and duration of breastfeeding in Italy.

To evaluate factors associated with initiation and duration of breastfeeding in Italy, 1601 (73%) respondents among 2192 randomly selected mothers were interviewed within 1 mo of delivery. Mothers who started breastfeeding (85%) were followed-up for 12 mo. A compliance rate of 100% was obtained. At multiple logistic regression analysis, mother having been breastfed herself (p < 0.01), nursing guidance in the maternity ward (p = 0.01) and higher social class (p = 0.03) were positively associated with initiation of breastfeeding. We found that 42%, 19%, 10% and 4% mothers were still breastfeeding at 3, 6, 9 and 12 mo after delivery, respectively. Cox multiple regression analysis showed a negative association between duration of breastfeeding and pacifier use (p < 0.01), and a positive association with a higher level of maternal education (p = 0.04). Formula supplementation in the maternity ward (given to 30% of infants) was associated with a shorter duration of exclusive breastfeeding (p = 0.03). Mothers need support with breastfeeding, particularly those from lower social backgrounds and with lower levels of education. Early use of the pacifier should be discouraged.

Adult↗

Epidemiology of breastfeeding in Italy.

To evaluate the rates of initiation and duration of breastfeeding in the major geographical areas of Italy, 1601 mothers randomly selected as representative of the November 1995 deliveries in all 20 regional districts underwent interviews within 1 mo after delivery. A cross-sectional telephone scanner-ready questionnaire was administered by trained personnel. Mothers who started breastfeeding were interviewed again at 3, 6, 9 and 12 mo after delivery. The results indicate that 85.3% mothers initiated breastfeeding, with significant geographical differences (rate ranging from 75.8% in the islands to 90.8% in the north-east; p < 0.0001). The overall breastfeeding prevalence considering all 1601 mothers decreased steadily to 41.8% at 3 mo and 19.4% at 6 mo, and was even lower when considering only exclusive/predominant breastfeeding (37.3% and 8.1%, respectively). The duration of breastfeeding was shorter in the islands than in other areas, particularly the north-east (p = 0.001). Although the rate of breastfeeding initiation is fairly high in Italy, the rapid decrease in breastfeeding practice throughout the first 6 mo requires strategies for improvement. The differences between the continental areas and the islands should be considered in programming intervention plans.

Breast Feeding↗

Long-chain polyunsaturated fatty acids in human milk.

Arachidonic acid and docosahexaenoic acid are the most representative long-chain polyunsaturated fatty acids (LCPUFA) since they may affect infants' growth and development. LCPUFA are present in the milk of all lactating women throughout lactation. The mothers' dietary habits may affect the levels of these fatty acids in maternal blood lipids and then in milk. LCPUFA show marked differences in levels as wt%, particularly from colostrum to mature human milk, but only mild differences in absolute content. Both the major presence of LCPUFA in human milk phospholipids and some regulatory mechanisms in the mammary gland cells could contribute to the LCPUFA levels in milk beyond those in maternal plasma.

Arachidonic Acid↗

Growth patterns of breast fed and formula fed infants in the first 12 months of life: an Italian study.

AIM: To compare the growth patterns of breast fed and formula fed Italian infants in the first 12 months of life using World Health Organisation (WHO) reference data. METHODS: The growth patterns of 73 breast fed infants (36 male, 37 female) and 65 formula fed infants (35 male, 30 female) were compared. Solid foods were introduced with the same weaning schedules from the 5th month in both groups. The weight for age (WA), length for age (LA), and weight for length (WL) z scores (National Center for Health Statistics-WHO data) were calculated at birth, 1, 2, 3, 4, 6, 9, and 12 months. RESULTS: Breast fed infants had the highest z scores (WA, WL) at birth. Breast fed groups had significantly higher growth indices at 1 month (WA, LA), 2 months (WA) and 3 months (WA, LA) of age. Compared to breast fed groups, formula fed infants showed significantly higher WA z score changes in the 1-2, 2-3, 3-4, and 4-6 month intervals. LA z score changes were higher for breast fed infants at 0-1 month and for the formula fed infants at 4-6 months. In the 6-12 month interval growth indices progressively increased for the formula fed infants and declined for infants breast fed for longer (12 months). The 0-12 month changes in WA, LA, and WL z scores were positive for formula fed infants and negative for the 12 month breast fed group. Nevertheless, the 12 month breast fed group showed an absolute WA z score just below 0 (mean (SEM) -0.04 (0.26)) at 12 months. CONCLUSION: The growth pattern of breast fed and formula fed Italian infants differs in the first 12 months of life. This questions the validity of current reference values for monitoring the growth of breast fed infants. Growth indices in breast fed groups, high at birth and closer than expected to the reference at 12 months, may reflect differences in genetic factors, intrauterine conditions, or both.

Body Height↗

Anthropometric indicators of human immunodeficiency virus infection in infants with early and late symptoms in the first months of life.

UNLABELLED: Standardised growth indices (Z-scores of weight-for-age, WA, length-for-age, LA, weight-for-length, WL, according to the reference data of the World Health Organization) have been compared for the first 4 months of life among 119 infants born to mothers affected by the type-1 human immunodeficiency virus (HIV). Infants were subdivided according to their HIV serostatus and the clinical expression of the disease. Uninfected status (n = 92), late (>6 months, n = 18) and early (<3 months, n = 9) onset of symptoms among the HIV infected defined three groups. Infants with early symptoms showed the lowest median WA and LA Z-scores at all times and the LA difference with their uninfected counterparts was already significant at birth. Infants with late symptoms showed early differences in WL and then in WA also compared with the uninfected ones. A < -0.40 LA Z-score at birth gave a 5.9 relative risk (RR) to be an infant with early symptoms (95% CI = 1.2-27.4) while a negative WL Z-score at 2 months of age gave a 4.2 RR for the HIV seropositivity (95% CI = 2.1-8.3). CONCLUSION: Linear growth is the first parameter to be negatively affected among human immunodeficiency virus seropositive infants with early symptoms. In infants with late symptoms the lack of rapid WA and WL increase found among uninfected patients may be viewed as an early anthropometric indicator of HIV status.

Age Factors↗

The role of dietary polyunsaturated fatty acids during the first 2 years of life.

The early dietary supply of long-chain polyunsaturated fatty acids (LCPUFA) might contribute to the higher developmental scores of children breast-fed as infants. Preterm infants' improved visual acuity and neurodevelopmental performance correlate with dietary supplementation of LCPUFA in amounts similar to those that breast-fed infants receive and studies of term infants report similar effects with LCPUFA supplementation. Whether term infants may benefit from LCPUFA-unsupplemented formulas with higher amounts of alpha-linolenic acid (n - 3 LCPUFA precursor) is controversial. With the onset of weaning, the question of the exact quantity and quality of which dietary lipids to give for prevention purposes is still open. Early dietary intervention studies of weaned children under 2 years are in progress in populations at high risk for early cardiovascular disorders. Preliminary results indicate that these interventions, while preventing an age-dependent increase in blood lipid levels, are safe for growth, but the balance of all the macronutrients should be carefully considered before general recommendations can be made.

Child Nutritional Physiological Phenomena↗

Dietary fatty acids and cholesterol in the first 2 years of life.

Both long-chain polyunsaturated (LCP) fatty acids and cholesterol are supplied by human milk. Dietary long-chain polyunsaturated fatty acids in the first 2 years of life have been associated with growth and developmental indices. Cholesterol supply does not seem relevant for structural purposes, but could have a role in the metabolism of LCP. Complex relationships between dietary fatty acids and cholesterol seem to be major determinants of blood lipid levels in the first months of life. Data from both suckling and weaned infants indicate that their blood lipid profile reacts to changes in their diet in a manner similar to adults. Early intervention trials on weaned infants (<2 years of age) have been addressed in populations at high risk for early cardiovascular disorders and seem safe for growth at short-term assessments, but the balance of all the macronutrients should be carefully considered. While the effects of plasma cholesterol concentrations in the suckling infant on the subsequent development of atheroslerosis are still unknown, both the diet composition and the way by which food is supplied to infants seem to be major determinants of their metabolic profile.

Arteriosclerosis↗

Plasmodium vivax congenital malaria in a newborn of a Zairian immigrant.

We report a case of congenital malaria in a newborn whose mother is a native of Zaire now living in Italy. The baby developed remittent fever in the 3rd week of life with anaemia and hepatosplenomegaly. Malaria parasites found in blood smears and erroneously diagnosed initially as Plasmodium falciparum were subsequently recognized as Plasmodium vivax. On the basis of the first diagnosis, treatment with quinine chlorhydrate was successfully undertaken without significant side-effects. P. vivax parasites were also recovered a posteriori in blood smears of the mother who was febrile during the week of her delivery. This report suggests that symptomatic congenital malaria may be more common than is generally thought and should be suspected in non-malarious countries in febrile newborns born to mothers who have travelled in or immigrated from malaria-endemic areas.

Animals↗

Low levels of linoleic acid in plasma total lipids of HIV-1 seropositive children.

OBJECTIVE: To assess the plasma fatty acid status of a group of well-nourished children with the human immunodeficiency virus type-1 (HIV-1) and how this relates to the blood total CD4+ lymphocyte count. SUBJECTS: Fourteen HIV-1 seropositive children at various stages of disease and with adequate growth indices were assessed and compared to a control group of 30 healthy children. RESULTS: The concentrations (mg/dL) of plasma total fatty acids were not different between the two groups. HIV-1 seropositive children presented lower levels of 18-C essential polyunsaturated fatty acids (PUFA: linoleic acid, LA, and alpha-linolenic acid) and higher levels of their 20-C long-chain derivatives (di-homo-gamma-linolenic acid, arachidonic acid, AA, and eicosapentaenoic acid) and docosahexaenoic acid in their plasma total lipids. The lowest plasma LA levels were observed in the subgroup of patients with more advanced stages of disease. In bivariate analyses the plasma LA levels related positively (Spearman r = 0.50, p = 0.06), while the LA/AA ratio related negatively (Spearman r = -0.51, p = 0.06), to the total CD4+ count. CONCLUSIONS: Childhood HIV-1 infection is associated with changes in plasma fatty acid profile suggestive of an increased PUFA turnover. Decreased levels of LA (together with higher plasma AA levels) appear to be associated with more advanced clinical and biochemical stages of disease.

8,11,14-Eicosatrienoic Acid↗

Body mass index development during the first 6 months of life in infants born to human immunodeficiency virus-seropositive mothers.

The development of body mass index (BMI) was measured during the first 6 months of life in three groups of infants [human immunodeficiency virus (HIV) -uninfected, n = 92; later symptomatic HIV-infected, n = 18; early symptomatic HIV-infected, n = 9] born to HIV-positive mothers and compared with a reference group (n = 65) born to healthy mothers. A trend towards lower values in the two groups of HIV-infected infants was already evident at birth. Among the four groups, HIV-uninfected infants showed the highest BMI values while the early-infected infants showed the lowest BMI values at all measurements. The later-infected group had a value close to the reference at 1 month, and then increased at slower rates than the uninfected and the reference groups. Infants born to HIV-positive mothers may have higher energy and nutrient requirements after birth, either to sustain an increased BMI development (when uninfected) or to meet catabolic mechanisms (when infected).

Body Mass Index↗