The source of dietary protein has been linked to cognitive outcomes; however, evidence on the association between isocaloric substitution of protein sources and academic performance in adolescents is limited. This study examined whether replacing animal-based protein with plant-based protein was associated with academic performance in adolescents. This secondary analysis used data from the Eating Healthy and Daily Life Activities (EHDLA) study (n = 769; 55.5% girls; 12–17 years). Dietary intake was assessed using the 45-item food-frequency questionnaire. Academic performance was evaluated using grade point average and specific subjects (i.e., language, maths, and foreign language). Isocaloric substitution models were applied to estimate the association of replacing animal-based with plant-based protein, adjusting for relevant sociodemographic, lifestyle, and anthropometric factors. Robust linear regression was used. Replacing animal- with plant-based protein was consistently associated with higher academic performance across all outcomes (all p < 0.001). Substituting 5% of total energy intake was associated with higher grade point average and subject-specific scores. These associations were primarily driven by replacing protein from red/processed meat and certain fish with plant-based sources. Isocaloric substitution of animal-based protein with plant-based protein was associated with better academic performance in adolescents, highlighting the potential importance of protein source in dietary patterns related to educational outcomes.
Heme-oxygenase-1 (HO-1) is a key regulatory factor in organ development, organ function, cellular metabolism, heme processing, and bilirubin production. HO-1 homeostasis is crucial for healthy pregnancy and fetus. Dysregulation of HO-1 adversely affects placentation, yolk sac development, cardiovascular development, immune function, angiogenesis, microcirculation, alters the oxidoreductive balance, and is associated with adverse respiratory outcomes and necrotizing enterocolitis. The impact of HO-1 on neonatal neurodevelopment is unknown and is currently being investigated by our laboratory. In this review, we will discuss the morbidities associated with HO-1 dysregulation and importantly, we will navigate the unknown. We will highlight how infection or inflammation affect HO-1 homeostasis, its implications on neonatal morbidities at the limits of viability, summarize the relevant basic, translational, clinical and epidemiologic studies. We will conclude with proposing new approaches for the future, filling the gap between what is currently known and unknown.
Despite causing severe neurological morbidity, neonatal encephalopathy (NE) lacks reliable biochemical markers for early diagnosis and intervention. This study investigated if alterations in microRNA (miRNA) expression, previously identified in umbilical cord blood in NE, remain altered in postnatal whole blood samples. Term infants with NE (and matched controls) born in Cork University Maternity Hospital (CUMH) between 2017 and 2020 were recruited. Whole blood was collected within the first 6 (T0), 24 (T24) and 48 (T48) hours after delivery via dried blood spot microsampling. Encephalopathy grade (mild, moderate, or severe) was determined based on modified Sarnat at 1 h. 19 candidate and three housekeeping miRNAs were analyzed in all infants via the 2−ΔΔCt method. 66 neonates were included in the study; 53 with encephalopathy; (25 mild, 22 moderate and 6 severe), and 13 controls. 105 whole blood samples were taken across the three timepoints. Comparing NE (n = 28) with controls (n = 13) at T0 confirmed alteration of eight miRNAs, including newly identified miR-205-5p. Comparison of NE infants across the three timepoints found the persistent alteration of four miRNAs. Persistent miRNA alterations are seen in NE 0–48 h postnatally and are detectable through minimally invasive microsampling.
Patients with repaired tetralogy of Fallot (TOF) can develop right ventricular (RV) dilation and failure. We sought to utilize an untargeted serum proteomics approach to characterize the proteome signature associated with RV dilation in repaired TOF to improve the understanding of mechanistic drivers of RV remodeling. Patients with repaired TOF undergoing cardiac magnetic resonance imaging were recruited. Groups were based on indexed RV end-diastolic volume (RVEDVi). Serum proteomics identified differentially abundant proteins (p value < 0.05), and pathway enrichment identified functional pathways. Fourteen TOF adolescents (median age 16 years; IQR 15, 18) were divided into Group 1 (n = 9; median RVEDVi 146 ml/m2; IQR 139, 164) and Group 2 (n = 5; median RVEDVi 114 ml/m2; IQR 104, 130). Group 1 had a higher indexed RV stroke volume (85 ml/m2 vs. 59 ml/m2, p = 0.023) with a similar RV ejection fraction. Group 1 had altered regulation of genes in multiple pathways, including glucose and fatty acid metabolism and antioxidant response. Patients with repaired TOF and moderate-severe RV dilation have a distinct serum proteomic profile despite preserved ejection fraction, which may reflect alterations in fuel sources and oxidative stress. These hypothesis-generating findings are a first step in the integration of proteomics into clinical management.
Nutritional well-being in childhood chronic kidney disease (CKD) represents a multidisciplinary problem. Nevertheless, reliable nutritional status assessment considering underlying pathogenesis remains challenging. So, we aimed to assess the collaborative role of quadriceps muscle ultrasonography and subjective global nutritional assessment (SGNA) in evaluating childhood end-stage renal disease on hemodialysis (ESRD-HD). Sixty-eight children with ESRD-HD were enrolled in addition to 68 age- and sex-matched healthy controls. All participants underwent nutritional screening through SGNA, 24-h dietary recall estimation, anthropometric measurements, evaluation of protein energy wasting (PEW), and quadriceps muscle ultrasonography. SGNA identified malnourishment in 85.3% of ESRD-HD children, while reduced/low muscle mass (LMM) by ultrasound was estimated in 73.6%, compared to PEW documentation in 70.6% of them. Total caloric intake discriminates LMM at a cutoff level of ≤34.022 kcal/kg/day with 93.75% sensitivity and 85.0% specificity and revealed a significant association with both PEW and LMM on regression analysis. Concerning concordance with muscle ultrasonography, SGNA had statistically good agreement, unlike anthropometric parameters. Inadequate dietary intake, though highly prevalent, is still underestimated in CKD children with a negative impact on muscle mass. Also, SGNA, through combining objective anthropometry with nutrition-focused assessment, could represent a potential role for nutritional status evaluation.
