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Biomedical subjects

K F Michaelsen

Publications and source records attributed to K F Michaelsen.

At least 109 records · Page 6Linked to original sources

Zinc intake, zinc status and growth in a longitudinal study of healthy Danish infants.

Mild, growth-limiting zinc deficiency might be prevalent in otherwise healthy infants according to recent studies. We examined zinc intake and status in 91 healthy term infants from birth to 12 months, as part of the Copenhagen Cohort Study on Infant Nutrition and Growth. Zinc intake was recorded monthly and the amount of zinc absorbed was estimated. These estimates were below recently published FAO/WHO/IAEA values for basal requirements in 68%, 62% and 14% of the infants at 2, 4 and 9 months of age, respectively. Serum zinc decreased significantly (p < 0.01) from 10.6 mumol/l at 6 months to 8.4 mumol/l at 9 months of age (normal range 10-18 mumol/l). Erythrocyte metallothionein values, a tentative indicator of long-term zinc status, decreased significantly from 2 to 6 months (p < 0.001) and from 6 to 9 months (p < 0.01). Serum zinc at 9 months was positively associated with growth velocity during the period from 6 to 9 months (weight: p = 0.05; knee-heel length: p = 0.002). The results provide descriptive data on zinc intake and zinc status in healthy Danish infants. Although some of our data suggest suboptimal zinc status during late infancy, evidence for this can only be obtained through a randomized intervention study.

Deficiency Diseases↗

Weight, length, head circumference, and growth velocity in a longitudinal study of Danish infants.

Two longitudinal studies of infant growth, performed from 1985 to 1988 in the Copenhagen area, have been combined to develop an up-to-date growth reference. Percentile curves were constructed and median growth velocities were calculated for monthly intervals, based on individually estimated growth curves. Compared with references based on data from periods when the prevalence of breast-feeding was low, these data support previous suggestions of a new growth pattern, with higher velocities during the first months and slower velocities during the remaining infancy. The growth of breast-fed infants differs from that of infants not being breast-fed, and special growth references for breast-fed infants have been suggested. We therefore examined growth patterns in the present study according to duration of breast-feeding. At 12 months, infants breast-fed > or = 9 months weighed less (400 g (95% CI: 70 g, 740 g) and were 1.0 cm shorter (0.3 cm, 1.8 cm) than infants breast-fed < 9 months. Part of this difference was already present at six months. Despite this we recommend a single growth reference for Danish infants regardless of mode of feeding. The slower growth in infants breast-fed > or = 9 months, which could be due to differences in composition of weaning foods, should be investigated further.

Body Height↗

Cholesterol-lowering diets may increase the food costs for Danish children. A cross-sectional study of food costs for Danish children with and without familial hypercholesterolaemia.

Food costs for 30 children under dietary treatment for familial hypercholesterolaemia were compared with those of 105 other Danish children. The daily intake of macronutrients and the daily cost of the diet for each child were calculated from dietary intakes and average prices of 365 different food items. The mean +/- SE percentages of energy (E%) from fat in the diet of children with and without known familial hypercholesterolaemia were 23.6 +/- 0.8 E+ and 34.5 +/- 0.5 E%, respectively (P < 0.001). The dietary costs per MJ in these two groups were 3.79 +/- 0.12 Danish crowns (DKr) and 3.34 +/- 0.05 DKr (P < 0.001), taking into account food wastage due to preparation and cooking. The cost per unit of energy increased with decreasing fat energy percentage of the diet for all children as one group (r = -0.37, P < 0.001), as well as for the group of children without familial hypercholesterolaemia (r = -0.35, P < 0.001). Stepwise multiple regression analysis showed that the differences in cost per MJ between the groups could be explained primarily by differences in percentage of energy from fat. We conclude that a reduction of dietary fat from 35 E% to 25 E% may increase food costs by 10-20% for Danish children.

Adolescent↗

Growth during treatment of familial hypercholesterolemia.

Treatment of hypercholesterolemic children with restriction of dietary saturated fat may result in an inadequate supply of energy for normal somatic growth. We examined the growth of 30 children with familial hypercholesterolemia, some of whom were also treated with colestipol, a bile acid-binding resin. The median duration of treatment was 8.5 years in 13 patients on diet only, and 5.5 years + 3.5 years in 17 patients treated with diet followed by diet and colestipol. Statistically significant reductions in serum total cholesterol were obtained in both groups. The SD scores for both height/age and weight/age decreased by approximately 0.4 during dietary treatment (p < 0.05), but were not affected by treatment with colestipol. These results document the risk of growth retardation during dietary treatment of children with familial hypercholesterolemia.

Child↗

Serum bone gamma-carboxyglutamic acid protein in a longitudinal study of infants: lower values in formula-fed infants.

Bone gamma-carboxyglutamic acid protein [BGP (osteocalcin)] is a protein synthesized by osteoblasts and incorporated in the bone matrix. Serum BGP is a sensitive marker of bone formation, and it parallels the growth velocity curve during childhood and adolescence. Serum BGP was measured at the age of 2, 6, and 9 mo in a cohort study of nutrition and growth in 91 healthy infants. At 2 mo, the mean BGP value (+/- SD) was 275 +/- 87 ng/mL in infants exclusively breast-fed, and 80 +/- 44 ng/mL in formula-fed infants. At 6 mo, the values were 142 +/- 58 ng/mL and 55 +/- 30 ng/mL, and at 9 mo 75 +/- 39 ng/mL and 45 +/- 19 ng/mL in partially breast-fed and formula-fed infants, respectively. The differences were significant (p less than 0.001) at all three ages. At 2 and 9 mo, breast-milk intake was measured by test-weighing. Serum BGP was positively correlated to breast milk intake (mL/kg body wt) at 2 mo (r = 0.59, p less than 0.001) and 9 mo (r = 0.41, p = 0.06). When breast-feeding was stopped, the high BGP concentrations were not sustained. There were no significant differences in linear growth velocity between breast-fed and formula-fed infants and no correlation between BGP values and linear growth velocity. We speculate that either a factor in human milk or the level of minerals in human milk causes the high BGP values. Moreover, if the higher values are associated with increased osteoblast activity, then the remodeling or the mineralization of bone might be different in infants not being breast-fed.

Age Factors↗

Predicting and monitoring of growth in children with short stature during the first year of growth hormone treatment.

Fifteen prepubertal short stature children (10 girls, 5 boys), mean age 9.6 years (range 5.2-12.7 years), with normal response to growth hormone stimulation tests (group A) or partial growth hormone deficiency (GHD) of idiopathic nature (group B) were included in a controlled longitudinal study for evaluation of predictive parameters for the long-term growth response after administration of biosynthetic human growth hormone (B-hGH). The average knee-heel length velocity for the first 3 months was significantly correlated to total body height velocity during the following 9 months (p less than 0.0008). By contrast, this association could not be found for height velocity during the same period. The increase in serum values of alkaline phosphatase and insulin-like growth factor I (IGF-1) during the first month of treatment was not significantly correlated to height velocity during the first year. During one year of treatment with B-hGH the mean height velocity for groups A and B increased from 4.4 cm/year (range 2.5-6.5) to 7.6 cm/year (range 4.7-10.6). Bone age advanced by 1.08 +/- 0.60 per chronological year. The ratio between total height and knee-heel length prior to treatment was 3.34 +/- 0.10 and after one year 3.33 +/- 0.10, suggesting a proportional linear growth. An inverse relationship was observed between the ratio and chronological age. In conclusion, early knee-heel measurement may be a useful non-invasive predictor of long-term linear growth in children during treatment with growth hormone, and the ratio of total height to lower leg length may be of importance in detecting dysproportional growth.

Age Determination by Skeleton↗

Short-term measurement of linear growth in preterm infants: validation of a hand-held knemometer.

A hand-held electronic knemometer, resembling a pair of callipers, for measuring knee-heel length in preterm infants was developed to improve the accuracy of measuring linear growth velocity in infants. The measuring system is based on a magnetic encoder and has a resolution of 0.01 mm. The knee-heel length is recorded automatically when the pressure applied on the heel reaches a preset value. The result of a measurement sequence is expressed as the average of five sequential readings. The error of one measurement sequence was 0.82 mm, corresponding to a coefficient of variation of 0.8% or 2 d of growth in knee-heel length. It includes the technical error and an error component due to the correlation of the readings within a series. The estimated error on the measurement of the knee-heel growth velocity (expressed as mm/d), measured over a 3-wk period, was 0.04 mm, corresponding to a coefficient of variation of 8%. Longitudinal growth data from 11 healthy preterm infants (birth weight 918-1482 g) are presented. Knee-heel length velocity from birth until day of regained birth weight was similar to the velocity during the following weeks, showing that there was no deceleration of growth immediately after birth. In conclusion, the method is accurate and gentle in measuring linear growth velocity over short periods and can be useful in monitoring the progress of ill infants and in growth studies of preterm and mature infants, in which linear growth is a more relevant short-term outcome than weight gain.

Anthropometry↗

Variation in macronutrients in human bank milk: influencing factors and implications for human milk banking.

Protein (P), fat (F), and carbohydrate (C) concentration in expressed human bank milk was determined by infrared analysis of 2,554 samples from 224 mothers. The mean contents of P, F, C, and energy (E, calculated from P, F, and C) were 9.0 g/L, 39.0 g/L, 71.9 g/L, and 696 kcal/L, respectively. There was a large variation in the concentration of energy-yielding macronutrients. The contents of P, F, C, and E in the samples with the highest values (97.5 percentile) were 2.3-, 4.8-, 1.2-, and 2.3-fold, respectively, above the contents in the samples with the lowest values (2.5 percentile). The P content decreased exponentially during the 1st 8 months, followed by an increase during the following months. The F content decreased during the 1st 4 months, followed by an almost linear increase. The possible influence of different maternal characteristics on the macronutrient content of the milk was examined. The main results were as follows: the P and F contents increased slightly with increasing body mass index of the mother, the P content decreased with increasing amounts of milk delivered to the milk bank, and the F content was higher in mothers delivering large amounts of milk. By selecting incoming milk with a high P content, we have developed a "high-protein" milk with a P content of about 12 g/L (true protein) and an E content of about 725 kcal/L. Thus, by continuous monitoring of macronutrient content in human bank milk it is possible to develop a "high-protein" milk with sufficient P and E content to cover the needs of preterm infants with very low birth weights (less than 1,500 g).

Adult↗

[Perinatal growth. A practical perinatal growth curve].

A linear perinatal growth curve, covering the period from 28 weeks gestation to 18 weeks after term birth is presented. The curve was first presented 15 years ago, and is now supported by Danish data, both cross-sectional and longitudinal. It may be used for classification of birth weight in relation to gestational age and at the same time for monitoring of postnatal growth, regardless of gestational age at birth. Limitations of empirical curves are pointed out. The postnatal growth potential of preterm infants is stressed.

Denmark↗

Inadequate supplies of potassium and magnesium in relief food--implications and countermeasures.

Analyses of relief food used in Ethiopia showed that, because of food refinement, 6 out of 10 samples of cereals contained too little potassium and magnesium to cover daily needs. Malnutrition is often associated with gastrointestinal infections, which lead to further deficiency of these electrolytes. Potassium and magnesium are required for protein synthesis, growth, and tissue repair. Since protein supplies are often marginal, relief food should contain sufficient potassium and magnesium to allow optimum utilisation of dietary nitrogen sources. This may be achieved by using coarse qualities of cereals, by supplementing cereals with legumes, and by avoiding cooking procedures that extract these salts from the cereals.

Disasters↗

Hookworm infection in Kweneng District, Botswana, A prevalence survey and a controlled treatment trial.

Stool specimens from a sample of schoolchildren at six schools in Kweneng District were examined for hookworm infection, using the brine flotation method. Necator americanus was the only hookworm identified. The western part of the District forms part of the Kalahari Desert, and in four villages here 90%, 88%, 88% and 86% of the children were infected. In two villages in the eastern non-desert part, only 13% and 9% were infected. Most infections were light. There was no significant correlation between severity of infection and anaemia. In one school (228 pupils; 86% infected with hookworm), half the children were treated with tetrachloroethylene (0.1 ml/kg, maximum 5 ml) and the other half with placebo. Two weeks after treatment the prevalence of infection were 28% and 75% respectively (p less than 0.001), and five months after treatment 51% and 69% (p less than 0.05). Measured over the five-month period there were no significant changes in haemoglobin and nutritional status (weight/height). Based on the results of the survey, a hookworm mass treatment programme was not recommended.

Adolescent↗