Browsing by Subject "nutrition"

Background and aim: Formula fed (FF) infants show consistently higher rates of infections, and accelerated growth rate during the first year of life compared to breastfed (BF) infants. Lipid components of bovine origin, such as the lipid membrane structure, and phospholipids have been suggested as promising in narrowing the gap in health and development between FF and BF infants. The aim of this master’s thesis was to identify differences in the development and health of infants primarily fed with either milk-fat (MF) or vegetable-oil (VO) based formula, during the first year of life, and to elucidate the relativeness of lipid source and structure in currently commercially available formulas for infant growth and infectious morbidity. Methods: This study was a secondary analysis of the observational, longitudinal Health and Early Life Microbiota (HELMi) cohort data, collected among healthy, term infants and their families during 2016 and 2019 in the capital region of Finland. FF infants were divided into two groups (MF, VO), and observational BF group was included as a reference. Infant growth was analysed with general linear model for repeated measures of WHO z-scores: weight-for age (WFA), weight-for-length (WFL), BMI-for-age (BMIFA), and length-for-age (LFA). Infectious morbidity was assessed as the odds ratio (OR) with 95% confidence interval (CI) for doctor visit and antibiotics use during the first year of life based on parental reports and using binary logistic regression model. Results: Type of feeding (FF vs BF) was significantly (p<0.001) associated with the pattern of growth during the first year of life. FF groups showed slower weight gain for age during the first 3 months of life, but MF were then characterized with rapid catch-up growth (≥0.67 mean change in z-score) from 3 to 12 months of life, compared to BF infants. After inclusion of formula, the adjusted OR of doctor visit for respiratory infections was 2.58 (CI 1.14-5.86, p=0.024) from 3 to 6, and 3.25 (CI 1.46-7.25, p=0.004) from 6 to 9, among MF, compared to BF infants. For the antibiotics use the adjusted OR was 2.98 (CI 1.03-8.64, p=0.043) among MF infants from 6 to 9 months, compared to BF. No significant differences were detected between the two formula groups in any of the outcome parameters. Conclusions: Type of feeding is significantly associated with infant growth pattern and infectious morbidity during the first year of life, but no significant association could be determined with the lipid source of formula. Infant feeding is certainly an area of high importance and based on the current findings commercially available formulas are lacking in terms of health outcomes and growth compared to BF infants.

Introduction Kenya has recently acquired lower-middle income country status and is facing the triple burden of malnutrition. There is a shortage of data on food intake habits of children and adolescents especially in the rapidly changing urban environments. To be able to reliably measure food intake, one must be able to accurately estimate food portion sizes. Children’s ability to recall portion sizes consumed can vary widely. When a photographic food atlas designed for children with applicable portions is used, it can improve children’s estimation of food portions. Objectives The aim of this study was to develop a photographic food atlas to be used in assessing portion sizes among Kenyan adolescents aged 9-14 years living in urban areas, to support a quantitative 7-day food frequency questionnaire. The second aim was to assess the usability of the atlas amongst 9-14-year-olds and professionals working in the field of nutrition. Methodology A steering group of Finnish and Kenyan nutritionists was formed to oversee the development of the atlas. Literature and other official documents were reviewed to identify the most commonly consumed foods among 9-14-year-old Kenyans. To obtain weighed portion size data, participants were recruited in Nairobi sub-counties Embakasi Central and Langata to represent low- and middle-socioeconomic status respectively. Twenty-one participants aged 9-14 years participated in the weighing of portion sizes, food portions from street markets were also weighed. Three portion sizes (A, B, C) were calculated for most of the 88 food items in the photographic food atlas. Portion B was the average of all weighed portion sizes, portion A was half of B, and portion C was one and half times B. Cooking demonstrations were arranged with the families of participants and the food portions were weighed out and photographed. A photographic food atlas was compiled, and its usability was tested amongst eight adolescents and four nutrition professionals. The usability survey consisted of Likert scale and open-end questions to ascertain acceptability of the atlas. Verbal feedback and observations were also recorded. Results Based on the usability survey, the photographic food atlas received the Usability Score of “OK” and “Good” from adolescents and nutrition professionals respectively. All eight adolescents agreed that the atlas helped them recall portion sizes, but half disagreed and one was unsure whether they could use the atlas on their own. All four professionals agreed they would use the atlas in their work, but all found the quality of photographs poor. Two adolescents disagreed when asked if the portion sizes were small enough and one disagreed when asked if the portion sizes were large enough. However, all professionals agreed that portion sizes were reasonable for the age group. Professionals gave verbal suggestions on improvements, for example, which foods were missing, how to adjust layout as well as the shapes of portion sizes. Conclusion An atlas consisting of 88 most commonly consumed Kenyan foods was developed based on weighed portion sizes of 9-14-year-old Kenyans. The shapes of portion sizes as well as range of portion sizes were crucial for its usability. Poor picture quality hampered recognition of pictures. Clear instructions and explanation of the purpose of the atlas were crucial. A second version of the atlas was developed based on the feedback. The updated atlas, including 173 food items, was used in a cross-sectional study in Nairobi. Further research is recommended to validate the photographic food atlas in order to identify the possible bias it may introduce to portion size estimation.

Maternity and child health clinics have a central role in preventing childhood obesity and providing the entire family with lifestyle counselling. The Pilot Intervention Study on Diet of Toddlers in Finland aims at evaluating the feasibility of a nutrition intervention in child health clinics. The Resourceful Family counselling method developed by the Finnish Heart Association is a family-centred and empowerment-based method employed in child health clinics that are part of the nutrition intervention group in the Pilot Intervention Study on Diet of Toddlers in Finland. The aim of this thesis was to describe the discussions about lifestyle issues in child health clinic. Another aim was to evaluate the translation of the principles and objectives of the Resourceful Family method into practice. Ten child’s one-year visits to child health clinic recorded in the Pilot Intervention Study on Diet of Toddlers in Finland were analyzed in this study. The check-up visits had been recorded in three child health clinics where the nutrition intervention was carried out. The research method was content analysis. The most frequent themes in discussions about lifestyle during the child’s one-year visit to child health clinic were: adjusting of the child to the family diet, milk or milk products in the child’s diet and vitamin D supplementation of the child (discussed during 8/10 child health clinic appointments). Salt in food preparation was also a common theme (6/10). In nearly all of the appointments (9/10) one or more theme related to the lifestyle of parents and/or the entire family was discussed. The nurse mostly controlled the counselling situation by bringing up new topics. The nurses invited families to participate in the discussions in more than half of the appointments in accordance with a specific guidance practice part of the Resourceful Family counselling method. The nurses linked the invitation to the Resourceful Family card. They provided families with information in a neutral manner. Some of the information provided was client-centred. Discussions related to changing habits were evident in more than half of the appointments. These discussions did not lead to setting specific goals or creating plans due to the lack of guidance practices aimed at helping the family proceed in the change process. Family-centred and resource-based lifestyle counselling should be developed especially regarding motivating the family and supporting the family members in the change process. Thus the importance of these two areas of counselling should be emphasized in the education of nurses.

The aim of this master’s thesis was to quantify the net benefits when 7 % of Finnish adults shift from their average diet to a low carbohydrate diet (VHH), a very low carbohydrate diet (EVHH) or a diet based on Finnish nutrition recommendations (SUOSITUS). The low carbohydrate diets were based on 84 food diaries that were collected by an online survey. The diet shifts were conducted by social cost-benefit-analysis (CBA) including environmental and health impacts in monetary values. The environmental impacts included changes in greenhouse gas emissions and nutrient emissions into Baltic sea while the health impacts included changes in myocardial infarction and stroke incidence related on consumption of fruits and vegetables, and in colorectal cancer incidence related on red and processed meat. The net benefits were quantified also in a scenario when the energy intake in VHH, EVHH and SUOSITUS were lower and the diets lead to 15 kilograms weight reduction and to normal weight. In the weight loss scenario the changes in colorectal cancer and type 2 diabetes incidence related on overweight were included in addition to other impacts. In the non-weight loss scenario when 7 % of Finnish adults shift to VHH, EVHH or SUOSITUS diet, the total net benefits were respectively -3,7 million, -10,8 million and 7,3 million euros per year. The net benefits of environmental impacts dominated: in VHH, EVHH and SUOSITUS cases they were -6,5 million, -12,9 million and 3,3 million euros. The largest difference between diets resulted from consumption of meat and milk products. In weight loss scenario, the net benefits from VHH, EVHH and SUOSITUS cases were 11,2 million, 5,8 million and 20,6 million euros per year and the benefits of reduced incidence of type 2 diabetes dominated: in all cases they were 10,0 million euros. In conclusion, the sift to the diet based on Finnish nutrient recommendations resulted in the highest positive net benefit. The net benefits of sifting to the VHH and EVHH diets were positive only if when these lead to significant weight loss. However, many potential impacts and factors (e.g. saturated fat, dietary fiber) were not included in this study. Further research is needed.

The wild forest reindeer (Rangifer tarandus fennicus) is one of the two native reindeer subspecies in Finland. The other one is semi-domesticated reindeer (Rangifer tarandus tarandus), which is a common livestock species in Lapland. A total of 22 zoos hold wild forest reindeer in Europe. These individuals along with individuals from the wild population are the base of a reintroduction program implemented in central Finland. The objective of this thesis is to shed light on the diet of wild forest reindeer in the wild and in captivity. From individuals in the wild and in reintroduction enclosures, a total of 17 fecal samples were collected. The samples were analyzed with DNA metabarcoding technique to determine the diet. The samples were analyzed at the Institute of Biotechnology and the obtained sequences were identified as plant genera with NCBI BLAST. The data was grouped according to sampling date and snow coverage to two groups and according to sampling site to two groups. The genera were assigned under types. 17 zoos submitted their feeding guideline of wild forest reindeer for the study. These were analyzed to obtain data about the different food item types corresponding to the types of plant genera found from the fecal samples. Fecal sample results were compared as frequencies of sequence reads assigned to genera and types. The most frequent types in the whole data was forbs and shrubs (42,1 %) and deciduous trees (38,9 %). The biggest differences were in the two groups when the data was grouped according to season. Differences were less prominent in the locationally grouped data. In the feeding guidelines from zoos, most of them (94 %) stated feeding deciduous trees and almost as many (88 %) stated feeding graminoids. In the fecal sample data, graminoids accounted for only 0,5 % of the sequence reads. The wild forest reindeer diets in the wild seem to have seasonal variation and not so much locational variation. The captive forest reindeer diets could be advanced with increasing the amount of forbs and shrubs offered and decreasing the amount of graminoids. The small sample size of 17 makes the results of this study indicative at best and further research is needed.

In Finnish beef production, high quality silage is the main ingredient in bull nutrition. The aim is to maximize the growth potential of the bulls with ad libitum feeding, which increases the daily energy supply. The effect of the quality of the feed is emphasized, especially in ad libitum feeding. High quality and well-preserved silage increases palatability, which increases the daily feed rate. In addition, high quality silage reduces the need for concentrated feed, which means lower production costs than low-quality feed. The role of preservatives is to improve nutrient stability by preventing unfavorable fermentation and the growth of molds and yeasts during preservation. The failure of storage increases the costs of production, and the effects on farm economy are considerable. This study looked at the effect of two different types of silage additives on the feeding and production results of dairy bulls. 45 Ayrshires and 45 Holstein bulls were chosen to the study. The bulls were randomly divided into three groups. The groups consisted of three treatments: 1. timothy silage, without preservative + barley (CONTROL), 2. timothy silage, preserved with acid additive + barley (ACID), 3. timothy silage with salt additive + barley (SALT). The bulls were fed ad libitum with total mixed rations. The statistical analysis of the results was performed in the SAS software GLM procedure. The average intake of dry matter during the experiment (259 days) was 10.1 kg/day, and there were no significant difference between the treatments. The average live weight gain was 1363 g and the carcass gain was 741 g/day. The control group's daily growth was 5% higher than the preservatives (P <0.05), but the carcass quality score was on average 6% higher in the preservative groups than in the control group (P<0.01). It can be concluded that the results of the experiment are indicative and it is possible that the silage without additives can be successful when the dry matter content of the feed is 350-400 g / kg and the feed is ensiled in round bales. In that case the effect of the additives is not necessarily significant.

Background and aim Complementary feeding is defined as the period during which there is a progressive reduction of breastfeeding or formula while the infant is gradually introduced to solid foods at 4-6 months of age. Improper complementary feeding practices, such as introducing solid foods beyond 6 months of age or having a low dietary diversity could lead to negative infant health outcomes. Therefore, it is important to identify factors that might detrimentally affect complementary feeding, such as maternal stress. This thesis aimed to study the associations between maternal stress indicators, the age of solid food introduction, and dietary diversity during complementary feeding within a Finnish birth cohort. Methods The Health and Early Life Microbiota (HELMi) is a longitudinal birth cohort study. Participants of the HELMi cohort included 1055 healthy infants and their parents, mainly residing in the capital region of Finland. Pre-collected data from the HELMi study were used. The data collection occurred between 2016-2018. The main variables used in this thesis were collected via extensive online questionnaires. Binomial logistic regression analyses were used to study whether prenatal and postpartum stress indicators were associated with the age of solid food introduction and/or the infant’s dietary diversity during complementary feeding. Results Late introduction of solid foods (> 6 months) was less likely among infants whose mothers reported moderate or high prenatal stress (moderate prenatal stress OR=0.66, 95%CI 0.45-0.97, high prenatal stress OR 0.62, 95%CI 0.39-0.98), when compared to infants whose mothers reported low prenatal stress. Maternal stress indicators were not associated with low dietary diversity (0-3 food groups introduced) at 6 months of life. Among infants with a low dietary diversity at 9 months of age, mothers were more likely to report high levels of prenatal stress (OR=4.88, 95%CI 1.27-18.79), when compared to mothers with low levels of prenatal stress. Further, infants with a low dietary diversity at 9 months were less likely to have mothers report low to moderate levels of life satisfaction (OR=0.25, 95%CI 0.06-1.02) when compared to mothers with very high life satisfaction. They were also less likely to report moderate levels of infant health worry (OR=0.18, 95%CI 0.05-0.67) when compared to mothers with no infant health worry. Conclusions This is the first study to look at the associations between maternal stress indicators and dietary outcomes during complementary feeding. Maternal stress indicators were associated with the age of solid food introduction and the infant’s dietary diversity at 9 months, but not at 6 months. In future studies on this topic, a more socio-demographically representative sample should be recruited, and validated tools should be used to collect dietary and psychological data. Health practitioners and family clinic workers should be made aware of the possibly long-lasting effects of prenatal stress and consider its possible effects on dietary outcomes during complementary feeding.

Aikaisemmin porsaille valmistettuihin teollisiin rehuihin lisättiin rutiininomaisesti antibioottisia lisäaineita, joilla pyrittiin ehkäisemään patogeenisten bakteerien lisääntyminen porsaan ruuansulatuskanavassa. Euroopan Unionin alueella antibioottisten lisäaineiden käyttö kotieläinten rehuissa kiellettiin 1.9.1999. Antibiootteja käytetään kuitenkin edelleen runsaasti vieroitusripulin hoidossa, mutta niiden käyttö lisää resistenssin kehittymistä bakteeripopulaatiossa ja resistenssitekijät saattavat siirtyä myös humaanipatogeeneihin kantoihin. Vieroitusripulin aiheuttamat suuret taloudelliset tappiot lisääntyneen porsaskuolleisuuden ja heikentyneen kasvun kautta sekä porsaan hyvinvoinnin turvaaminen puoltavat antibioottisia lisäaineita korvaavien menetelmien kartoittamista. Useat aikaisemmat tutkimukset ovat osoittaneet emon maidon proteiinien antibakteerisen tehon mm. Escherichia coli bakteerin aiheuttamassa ripulissa. Tutkimuksessa selvitettiin porsasrehuun lisättävän laktoferriinin mahdollista käyttöä vieroitusripulin ennaltaehkäisyssä ja hoidossa. Tutkimus suoritettiin Eläinlääketieteellisen tiedekunnan kotieläinhygienian opetusnavetassa neljän emakon pahnueista muodostetuilla kuudella (A, B, C, D, E, F) kuuden porsaan ryhmällä. Kolme ryhmää (A, B, C) saivat laktoferriiniä eri annostasoilla (0.25, 0.5, 1.0 g / pvä) ruiskulla suuhun annosteltuna kahteen antokertaan jaettuna seitsemän päivää ennen ja seitsemän päivää jälkeen vieroituksen. Ryhmät A, B ja C infektoitiin vieroitusripulin yhteydessä eristetyllä enterotoksiinia tuottavalla Escherichia coli (1.14x10^10 CFU bakteerilla päivä vieroituksen jälkeen. Ryhmä D infektoitiin E. coli bakteerilla (infektoitu kontrolli) ja ryhmä E oli kokeen terve kontrolli. Kokeen aikana seurattiin myös laktoferriinin raudansitomisominaisuuden vaikutusta porsaiden hemoglobiini ja hematokriitti arvoihin yhdellä ryhmällä (F), joka sai laktoferriiniä 0.5 g päivässä. Tilastollisen analyysin (kaksisuuntainen varianssianalyysi, alfa 0.05) mukaan laktoferriiniä saaneiden ryhmien (A, B, C) välillä oli tilastollisesti erittäin merkitsevä ero (Phav=0.007) päiväkasvuissa yksittäisten päivien välillä. Erot tasottuivat jo viikossa, joten biologista merkitystä eroilla ei ollut. Tilastollinen käsittely ei osoittanut laktoferriinillä käsiteltyjen ryhmien A, B ja C välillä tai verrattaessa ryhmää D laktoferriiniä saaneisiin ryhmiin (A, B ja C) tilastollisesti merkitsevää eroa (Phav=0.26 ja Phav 0.42) ripuliin sairastumisessa. Verinäytteiden perusteella laktoferriinillä ei havaittu kokeen aikana merkittävää vaikutusta porsaiden hemoglobiiniin tai hematokriittiin. In vitro koe osoitti laktoferriinin antobakteerisen tehon riippuvan laktoferriinin pitoisuudesta ja E.coli bakteerien lukumäärästä.

Background: A few Finnish municipalities have chosen to offer the option of a vegan diet at day-care if the parents request it. The food offered at day-care plays an important part in a child’s nutrition and should be guided by official recommendations. As little evidence exists for the adequacy of a vegan diet for children in day-care more studies on the subject is needed. The food provided by the day-care should cover 2/3 of the daily energy requirements and the quantity of saturated fat, salt and sucrose should be limited. Aim: The aim of this thesis is to compare and analyse the nutritional adequacy of vegan and omnivore meals offered by the municipality of Helsinki. Additionally, to describe the dietary sources of intakes from both meals. Data and methods: This thesis is part of the MIRA Helsinki study, conducted by the University of Helsinki. The objective of the project is to study the impact of a vegan diet on the nutritional status of children in day-care in Helsinki. The data for this thesis was collected through food diaries. The children range in age from one to six years and are divided into two groups based on meals eaten at day-care, vegan meals (n=9) and omnivore meals (n=16). All statistical analyses were done with the SPSS program (version 25). Results: In most cases the dietary intake followed official recommendations. Of concern is that salt intake was high in both groups. The two diets provided similar amounts of energy, carbohydrates and sucrose at day-care. However, protein (p<0,001), fat (p=0,008) and fibre (p<0,001) intakes were significantly more favourable when eating vegan meals. The group eating vegan meals also had a higher intake of monounsaturated and polyunsaturated fat (p=0,007; p<0,001) as well as linolenic acid (p<0,001) and α-linolenic acid (p<0,001) in comparison to the omnivore group. Further, the omnivore group had higher intakes of cholesterol (p<0,001) and saturated fat (p=0,007). There was no dietary intake of EPA and DHA in the vegan meals. Intakes of saturated fat and cholesterol outside the day-care were higher than at day-care. The vegan meal group had significantly higher intakes of folate (p<0,001), iron (p<0,001) and zinc (p=0,001) while lower intakes of iodine (p=0,006) and calcium (p=0,01), were noted in comparison to the omnivore group. Although the intake of vitamin C does not significantly differ between the groups, the intake at day-care is low in both groups (vegan meals 38 %, and omnivore 21 % of total intake). In the diet of the children eating vegan meals at day-care, fortified plant-based milk played a central role as a source of many nutrients. Conclusions: Because of the small sample size no general conclusions can be drawn from these results, but it seems the vegan meals have many positive characteristics compared to the omnivore meals. The results may give an insight to nutritional differences between a vegan and an omnivore diet of under school age children in Helsinki. A more plant-based diet would be a sustainable choice for the future, but supplementation is recommended to guarantee sufficient intakes of critical nutrients. More studies are needed on the long-term effects of a vegan diet on young children and the characteristics of a vegan diet in Finland.