Child care attendance or having siblings increases the risk of developing doctor-diagnosed LRTI in the first year of life to a greater extent in allergy-prone children than in children who are not allergy prone.

To investigate whether resistant starch (RS) affects putative risk factors for colon cancer, 24 healthy men consumed a daily RS supplement for 4 wk in addition to their habitual diet in a single-blind, randomized, balanced multiple crossover trial. During the first week, all subjects consumed the control supplement containing glucose. Subsequently, each subject consumed, in random order, a supplement with RS2 (uncooked high-amylose cornstarch), RS3 (extruded and retrograded high-amylose cornstarch), and glucose, each for 1 wk. The RS2 and RS3 supplements provided 32 g RS/d. Lithium was added to the supplements to measure compliance. Feces, 24-h urine, and breath samples, as well as a 24-h food-consumption recall were obtained weekly from each subject. Compliance as measured by urinary lithium recovery was satisfactory. The mean composition of the background diet did not differ between the various supplementation periods. Breath-hydrogen excretion, stool weight, and fecal starch excretion were significantly higher during RS than during glucose supplementation, but did not differ during RS2 and RS3 supplementation. There were no significant differences in fecal dry weight, pH, or short-chain fatty acid concentrations, nor in the pH, bile acid concentrations, cytotoxicity, or osmolality of fecal water. It is concluded that in healthy men, supplementing the habitual diet for 1 wk with 32 g RS2 or RS3/d compared with glucose had no effect on putative risk factors for colon cancer, except for increasing stool weight and colonic fermentative activity. There were no significant differences between the effects of RS2 and RS3 on the indexes studied.

The question addressed was whether dietary resistant starch would lower serum cholesterol and triacylglycerol concentrations in healthy normolipidemic subjects. In a randomized single-blind 3 x 3 Latin-square study with corrections for any carryover effects, 27 males and 30 females consumed supplements containing glucose or resistant starch (RS) from raw high-amylose cornstarch (RS2) or from retrograded high-amylose cornstarch (RS3). The RS2 and RS3 supplements provided 30 g RS/d. Each type of supplement was consumed in addition to the habitual diet for 3 wk. At the end of each 3-wk period, fasting blood samples and a 24-h food-consumption recall were obtained from each subject. The subjects collected 24-h urine samples for lithium determination, which was added to the supplements to check compliance. Mean lithium recovery was 97% and did not differ between supplements. The mean composition of the background diet was similar when the three supplements were taken. Body weight remained constant throughout the study. There were no significant differences in the fasting concentrations of serum total, high-density-lipoprotein (HDL), and low-density-lipoprotein (LDL) cholesterol; triacylglycerols, or 3 alpha-hydroxy bile acids after consumption of glucose, RS2, or RS3. Evidence is presented that the lack of effect of RS2 and RS3 on serum lipid concentrations cannot be explained by insufficient statistical power, a low dose, or a short duration of treatment. The subjects reported softer stools and more gastrointestinal symptoms after supplementation with RS than after glucose. Neither the RS2 nor the RS3 supplements lowered serum lipid concentrations in healthy, normolipidemic men and women.

Because resistant starch (RS) is not absorbed as glucose in the small intestine of healthy humans, postprandial thermogenesis should be lower after the intake of RS as compared with digestible starch. To evaluate this hypothesis, we measured 5-h postprandial thermogenesis and substrate oxidation by indirect calorimetry after ingestion of 50 g pregelatinized (0% RS) and 50 g raw potato starch (54% type II RS) in 15 healthy, normal-weight young males. The subjects consumed each starch (mixed in diluted fruit syrup) twice on separate days and in random order. RS intake was followed by lower thermogenesis (46.5 +/- 13.1 compared with 115.4 +/- 10.4 kJ/5 h; P = 0.008), lower glucose oxidation (P < 0.0005), and greater fat oxidation (P = 0.013) than was pregelatinized starch consumption. Our results suggest that RS has no thermogenic effect and that its presence does not influence the size of the thermic response to digestible starch.

Objective: Congenital hypothyroidism (CH) is defined as thyroid hormone deficiency at birth due to disorders of the thyroid gland (thyroidal CH, CH-T), or the hypothalamus or pituitary (central CH, CH-C). The Dutch Newborn Screening (NBS) strategy is primarily based on determination of thyroxine (T4) concentrations in dried blood spots followed, if necessary, by thyroid-stimulating hormone (TSH) and thyroxine-binding globulin (TBG) measurement enabling detection of both CH-T and CH-C. A calculated T4/TBG ratio serves as an indirect measure for free T4. A T4/TBG ratio ≤17 in a second heel puncture is suggestive of CH-C. Design and methods: In the present study, we evaluated eleven years of Dutch CH NBS using a database of referred cases by assessing the contribution of each criterion in the unique stepwise T4-TSH-TBG NBS algorithm. Results: Between 2007 and the end of 2017, 1,963,465 newborns were screened in the Netherlands. Use of the stepwise algorithm led to 3,044 referrals and the identification of 612 CH cases, consisting of 496 CH-T, 86 CH-C, and 30 CH of unknown origin diagnoses. 62.8% of CH-C cases were detected by the T4/TBG ratio in the second heel puncture. The positive predictive value (PPV) of the stepwise T4-TSH-TBG NBS algorithm was 21.0%. Conclusion: This evaluation shows that the Dutch stepwise T4-TSH-TBG NBS algorithm with a calculated T4/TBG ratio is of great value for the detection of both CH-T and CH-C in the Netherlands, at the cost of a lower PPV compared to TSH-based NBS strategies.