Comprehensive assessment of nutrient intakes and food sources of nutrients in Filipino children under 5 years old are lacking. We studied energy and nutrient intakes and food sources in 4218 children aged 6–59.9 months using two 24-h dietary recalls. Usual energy and nutrient intakes were estimated using the PC-SIDE program. Reported foods and beverages were assigned to one of 85 food groups. Percentage contribution of each food group to nutrient intake was calculated. The results showed that the intake of total fat as a percentage of energy and of most micronutrients were highly inadequate. The prevalence of inadequate nutrient intakes, defined as the percent of children with intakes less than the estimated average requirements (EAR) ranged from 60–90% for iron, calcium, vitamin C, and zinc and ranged from 30–50% for others such as vitamin A, thiamine, riboflavin, niacin, vitamin B6, and phosphorus. The diets of these children were composed of limited foods, namely a large amount of refined rice and other low-nutrient-dense foods (cookies and sugar), while vegetables, fruits, meats, and eggs made little contribution to daily energy or nutrients. These findings provide direction to health professionals developing food-based recommendations and strategies to tackle the shortfalls in the diet of this population.

Introduction Multinutrient approaches may produce more robust effects on brain health through interactive qualities. We hypothesized that a blood‐based nutritional risk index (NRI) including three biomarkers of diet quality can explain cognitive trajectories in the multidomain Alzheimer prevention trial (MAPT) over 3‐years. Methods The NRI included erythrocyte n‐3 polyunsaturated fatty acids (n‐3 PUFA 22:6n‐3 and 20:5n‐3), serum 25‐hydroxyvitamin D, and plasma homocysteine. The NRI scores reflect the number of nutritional risk factors (0–3). The primary outcome in MAPT was a cognitive composite Z score within each participant that was fit with linear mixed‐effects models. Results Eighty percent had at lease one nutritional risk factor for cognitive decline (NRI ≥1: 573 of 712). Participants presenting without nutritional risk factors (NRI=0) exhibited cognitive enhancement (β = 0.03 standard units [SU]/y), whereas each NRI point increase corresponded to an incremental acceleration in rates of cognitive decline (NRI‐1: β = −0.04 SU/y, P = .03; NRI‐2: β = −0.08 SU/y, P < .0001; and NRI‐3: β = −0.11 SU/y, P = .0008). Discussion Identifying and addressing these well‐established nutritional risk factors may reduce age‐related cognitive decline in older adults; an observation that warrants further study.

Reported values for concentrations of micronutrients in human milk form the basis of the majority of micronutrient intake recommendations for infants and the additional maternal requirements for lactation. The infant recommendations may also be extrapolated to provide estimates for young children. The purpose of this review is to evaluate the adequacy of the milk micronutrient concentration data used by the Institute of Medicine to set recommendations for the United States and Canada, by FAO/WHO, the United Kingdom, and the European Food Safety Authority. The concentrations accepted by each agency are presented for each micronutrient accompanied by the source of information and comments on the number, location, status, and stage of lactation of the sample population, where known. These summaries show the small number of participants from which samples were collected in most studies, the wide range of concentrations within studies, the lack of longitudinal data, and the variability in collection methods. These factors contribute to the variability in nutrient intake recommendations among committees, although this variability is reduced by some committees that accept milk-composition values proposed by others. Values are also summarized from milk collected in studies in which mothers or infants were known to be deficient on the basis of clinical symptoms, biomarkers of inadequacy, or both, to show the extent to which milk micronutrients can be reduced by poor maternal nutritional status. We conclude that a new, multicenter study is needed to establish reference values for milk constituents across lactation.

Background Recognized as the gold-standard ideal fare, human milk has a unique composition that meets infants’ needs throughout development. Endocannabinoids and endocannabinoid-like compounds [endocannabinoid metabolome (ECM)] are endogenous lipid mediators derived from long-chain polyunsaturated fatty acids. Based on animal models, it has been proposed that endocannabinoid arachidonoyl glycerol (AG) plays a role in establishing the suckling response during lactation. In addition, endocannabinoid ethanolamides have been shown to stimulate food intake. The mechanisms of action and the role of the ECM in human milk are not fully understood. Objectives The present study aimed to characterize and quantify the ECM in human milk samples from an underserved population in Guatemala. Methods Human milk samples were collected from lactating women ( n = 26) for ECM characterization and quantification. Samples were taken at 3 different time points between 4 and 6 mo of lactation during maternal fasting. Human milk samples were analyzed by liquid chromatography-mass spectrometry. Identified members of the ECM were: arachidonoyl ethanolamide, palmitoyl ethanolamide (PEA), oleoyl ethanolamide, docosahexaenoyl ethanolamide, eicoapentaenoyl ethanolamide, eicosenoyl ethanolamide, AG, palmitoyl glycerol, oleoyl glycerol, docosahexaenoyl glycerol, eicosapentaenoyl glycerol, eicosenoyl glycerol, arachidonic acid (ARA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA). Results Overall, concentrations in the ethanolamide group were lower than the glycerols. A time effect was observed for ARA, DHA, EPA, and PEA across the 3 time points ( P ≤ 0.05). Conclusions Our study identified the ECM in mature human milk and provides the first report for a population with health disparities within a developing country. The few studies available have been conducted in developed countries. Hypotheses for future studies can be developed based on this study's data to help elucidate specific roles for members of the ECM and how this biological system modulates infant health and development.

ABSTRACT Background Maternal supplementation during lactation could increase milk B-vitamin concentrations, but little is known about the kinetics of milk vitamin responses. Objectives We compared acute effects of maternal lipid-based nutrient supplement (LNS) consumption (n = 22 nutrients, 175%–212% of the RDA intake for the nutrients examined), as a single dose or at spaced intervals during 8 h, on milk concentrations and infant intake from milk of B-vitamins. Methods This randomized crossover trial in Quetzaltenango, Guatemala included 26 mother–infant dyads 4–6 mo postpartum who were randomly assigned to receive 3 treatments in a random order: bolus 30-g dose of LNS (Bolus); 3 × 10-g doses of LNS (Divided); and no LNS (Control), with control meals. Mothers attended three 8-h visits during which infant milk consumption was measured and milk samples were collected at every feed. Infant intake was assessed as $\mathop \sum \nolimits_{i\ = \ 1}^n ( {{\rm{milk\ volum}}{{\rm{e}}_{{\rm{feed\ }}n}} \times \ {\rm{nutrient\ concentratio}}{{\rm{n}}_{{\rm{feed}}\ n}}} )\ $over 8 h. Results Maternal supplementation with the Bolus or Divided dose increased least-squares mean (95% CI) milk and infant intakes of riboflavin [milk: Bolus: 154.4 (138.2, 172.5) μg · min−1 · mL−1; Control: 84.5 (75.8, 94.3) μg · min−1 · mL−1; infant: Bolus: 64.5 (56.1, 74.3) μg; Control: 34.5 (30.0, 39.6) μg], thiamin [milk: Bolus: 10.9 (10.1, 11.7) μg · min−1 · mL−1; Control: 7.7 (7.2, 8.3) μg · min−1 · mL−1; infant: Bolus: 5.1 (4.4, 6.0) μg; Control: 3.4 (2.9, 4.0) μg], and pyridoxal [milk: Bolus: 90.5 (82.8, 98.9) μg · min−1 · mL−1; Control: 60.8 (55.8, 66.3) μg · min−1 · mL−1; infant: Bolus: 39.4 (33.5, 46.4) μg; Control: 25.0 (21.4, 29.2) μg] (all P &lt; 0.001). Only the Bolus dose increased cobalamin in milk [Bolus: 0.054 (0.047, 0.061) μg · min−1 · mL−1; Control: 0.041 (0.035, 0.048) μg · min−1 · mL−1, P = 0.039] and infant cobalamin intake [Bolus: 0.023 (0.020, 0.027) μg; Control: 0.015 (0.013, 0.018) μg, P = 0.001] compared with Control. Niacin was unaffected. Conclusions Maternal supplementation with LNS as a Bolus or Divided dose was similarly effective at increasing milk riboflavin, thiamin, and pyridoxal and infant intakes, whereas only the Bolus dose increased cobalamin. Niacin was unaffected in 8 h. This trial was registered at clinicaltrials.gov as NCT02464111.

Objectives Nutrients and their metabolites have interactive qualities that may be harnessed for prevention of cognitive decline. Simultaneous modulation of one-carbon, fatty acid and vitamin D metabolism (25-OH-D) may offer neuroprotection. We examined whether n-3 polyunsaturated fatty acids (n-3 PUFA), 25-OH-D, and homocysteine (HCy) formed into a Nutritional Risk Index (NRI) can explain cognitive performance of older non-demented adults. Methods The NBAS enrolled older participants from the NIA-Layton Oregon Alzheimer's Disease Center aging studies with serum samples available yielding 306 cognitively characterized older adults. Plasma fatty acids were quantified by GC-FID and 25-hydroxyvitamin D and homocysteine by LC-MS/MS. Nutritional risk defined as population nutrient biomarker tertiles with NRI calculated as the number of nutrient biomarkers meeting a sub-optimum criterion with scores ranging from 0 to 3. Global and domain specific cognitive z-scores were fit with multivariate linear regression models and NRI as the primary exposure of interest. Results Mean age was 85.8 (7.6) years, MMSE was 27.8 (2.8) and 70% were female. Sixty-five % met criteria for ‘nutritional risk’ (NRI ³ 1: 193/293). Participants with optimum nutritional status exhibited superior global cognitive performance (NRI-0: mean global z-score ± SE = 0.10 ± 0.097) while each addition NRI point score associated with an incremental decrease in cognitive performance (NRI-1: 0.02 ± 0.09; NRI-2: −0.23 ± 0.13; NRI-3: −0.53 ± 0.19, P for trend = 0.002). Significant and similar trends were seen in specific cognitive domains, including attention (NRI-0: mean z-score ± SE = 0.20 ± 0.11; NRI-1: 0.02 ± 0.10; NRI-2: −0.32 ± 0.13; NRI-3: −0.38 ± 0.19, P for trend < 0.001) and executive function (NRI-0: mean z-score ± SE = 0.15 ± 0.10; NRI-1: −0.09 ± 0.10; NRI-2: −0.15 ± 0.13; NRI-3: −0.55 ± 0.20, P for trend = 0.002). Conclusions The Nutritional Risk Index representing plasma n-3 PUFA, 25-OH-D and HCy explains significant variance in the cognitive performance of older adults, particularly attention and executive skills. These results in exceptionally healthy older adults suggest that cognitive performance is superior in those with plasma EPA + DHA wt% ≥ 2.53, 25-OH-D ≥ 25 ng/ml, and HCy < 11.57 umol/L. Funding Sources Nestle Institute of Health Sciences, Hinda and Arthur Marcus Institute for Aging Research, NIA-Layton Aging & Alzheimer Disease Center, Department of Veterans Affairs.

Background:Nutritional status and nutrient interaction are underappreciated in the design and interpretation of clinical nutrition trials. Nutritional biomarkers are objective measures of diet and metabolism readily available to the brain. We created a nutritional risk index (NRI) to test the hypothesis that nutritional status and nutrient interaction explain the heterogeneity in rates of cognitive decline in the MAPT. Methods: Erythrocyte omega 3 fatty acids measured by GC-FID, plasma homocysteine by enzymatic assay and serum

Objectives Nutritional metabolomics to objectively assess dietary intake in aging permit the opportunity to circumvent measurement errors that accompany subjective means of dietary assessment. At the same time, they may offer insights into mechanisms of action and metabolic disturbances that are actionable targets for modulation through diet in hopes of disease prevention and treatment. However, prior to more broad deployment the pre-analytical and temporal variation over time should be documented in order to design and interpret epidemiological studies properly. We quantified and examined 155 nutrient biomarkers and metabolites selected for their potential relevance to dementia. Methods Blood samples from three time points, spanning a 2-year period, were obtained from older adults participating in the NIA-Layton Oregon Alzheimer's Disease Center's Nutrition and Brain Aging Study (NBAS). Blood samples were batched randomly across three time points for quantification of blood amino acids, minerals, water and fat-soluble micronutrients, lipids, one carbon, and kynurenine pathway metabolites using a variety of methods including, tandem mass spectrometry. Pre-analytical coefficients of variation (CV) were calculated for all the biomarkers and intraclass correlation coefficients (ICC) were calculated to evaluate the within-person reproducibility in a subset of 137 participants. Results The mean baseline age of the analytic sample (n = 137) was 85.6 (± 8.3, 57 - 101 years), 70% are female, 21% carry the ApoEe4 allele and MMSE was 28.3 (± 1.78). The pre-analytical CVs ranged from 0.9% to 55.0% and the ICC ranged from 0 to 0.87 (25%-tile/median/75%-tile 0.41/0.54/0.66). Twenty four % had ICC < 0.40, 66% had ICC 0.40 −0.75 and 10% had ICC > 0.75. Conclusions The pre-analytical and within-person reproducibility of nutritional metabolomics in aging ranges widely. The majority can reliably estimate average concentrations over a 2 year period from a single time point and the biomarkers with ICC's above 0.40 can be used for correction of measurement error and those below 0.40 should consider multiple samples per subject and exploring the methodological and biological explanation for the variation over time. Funding Sources Nestle Institute of Health Sciences, Hinda and Arthur Marcus Institute for Aging Research, NIA-Layton Aging & Alzheimer's Disease Center (P30AGO8017).