Do early intake of fish and fish oil protect against eczema and doctor-diagnosed asthma at 2 years of age?

Penelitian ini mencari hubungan antara konsumsi ikan dan n-3 PUFA terhadap pencegahan penyakit alergi (asma dan eczema) pada anak. Apakah sebaiknya cod liver oil dan ikan dikonsumsi selama kehamilan atau diberikan kepada bayi?

 

Hasil penelitian terhadap >3000 anak menunjukkan bahwa umur rerata konsumsi ikan adalah 9,1 bulan. Bayi yang makan ikan sekali seminggu atau lebih mempunyai risiko alergi yang lebih rendah yaitu adjusted OR (aOR) segala jenis ikan 0.62 (95% CI 0.42 to 0.91 p=0.02), untuk ikan berlemak aOR 0.21 (95% CI 0.05 to 0.86 p=0.03) dan untuk ikan tak berlemak aOR 0.67 (95% CI 0.41 to 1.08 p=0.10). Hubungan antara maternal diet dan penyakit alergi pada usia 2 tahun tidak signifikan.

 

Kesimpulan untuk mencegah penyakit alergi konsumsi ikan pada bayi lebih unggul dibanding konsumsi ibu selama kehamilan. Konsumsi ikan lebih unggul dibanding konsumsi n-3 PUFA.

 

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Research report

Do early intake of fish and fish oil protect against eczema and doctor-diagnosed asthma at 2 years of age? A cohort study

2. Torbjørn Øien, 
3. Ola Storrø, 
4. Roar Johnsen

1. J Epidemiol Community Health 2010;64:124-129 doi:10.1136/jech.2008.084921

Abstract

Background There are ambiguous results regarding the role n-3 polyunsaturated fatty acids and fish might play in primary prevention of allergic diseases. The aim was to investigate the association between cod liver oil and fish consumption during pregnancy and in the first year of life and asthma and eczema at 2 years of age.

Methods From the Prevention of Allergy among Children in Trondheim study, a prospective birth cohort study in primary healthcare in Trondheim, Norway, 3086 children were followed prospectively from 1 year to approximately 2 years of age. The primary outcome variable was parental reported asthma and eczema at 2 years.

Results The mean age for introducing fish in the diet was 9.1 months. Excluding children with incident eczema before 1 year, a reduced risk of developing eczema was found if the child was eating fish once a week or more, adjusted OR (aOR) for any kind of fish 0.62 (95% CI 0.42 to 0.91 p=0.02), for oily fish aOR 0.21 (95% CI 0.05 to 0.86 p=0.03) and for lean fish aOR 0.67 (95% CI 0.41 to 1.08 p=0.10). The associations between maternal diet and eczema at 2 years and between the dietary factors and doctor-diagnosed asthma were all insignificant.

Conclusions Fish consumption in infancy was more important than maternal fish intake during pregnancy in preventing eczema in childhood. The intake of fish per se, not specifically n-3 polyunsaturated fatty acids, was most important in preventing eczema.

Metformin Extended Release Treatment of Adolescent Obesity

Metformin XR dapat digunakan untuk terapi obesitas pada remaja

 

Metformin Extended Release Treatment of Adolescent Obesity

A 48-Week Randomized, Double-Blind, Placebo-Controlled Trial With 48-Week Follow-up

Glaser Pediatric Research Network Obesity Study Group 

Arch Pediatr Adolesc Med. 2010;164(2):116-123.

Background  Metformin has been proffered as a therapy for adolescent obesity, although long-term controlled studies have not been reported.

Objective  To test the hypothesis that 48 weeks of daily metformin hydrochloride extended release (XR) therapy will reduce body mass index (BMI) in obese adolescents, as compared with placebo.

Design  Multicenter, randomized, double-blind, placebo-controlled clinical trial.

Setting  The 6 centers of the Glaser Pediatric Research Network from October 2003 to August 2007.

Participants  Obese (BMI >95th percentile) adolescents (aged 13-18 years) were randomly assigned to the intervention (n = 39) or placebo groups.

Intervention  Following a 1-month run-in period, subjects following a lifestyle intervention program were randomized 1:1to 48 weeks' treatment with metformin hydrochloride XR, 2000 mg once daily, or an identical placebo. Subjects were monitored for an additional 48 weeks.

Main Outcome Measure  Change in BMI, adjusted for site, sex, race, ethnicity, and age and metformin vs placebo.

Results  After 48 weeks, mean (SE) adjusted BMI increased 0.2 (0.5) in the placebo group and decreased 0.9 (0.5) in the metformin XR group (P = .03). This difference persisted for 12 to 24 weeks after cessation of treatment. No significant effects of metformin on body composition, abdominal fat, or insulin indices were observed.

Conclusion  Metformin XR caused a small but statistically significant decrease in BMI when added to a lifestyle intervention program.

Vitamin D dan kalsium untuk pencegahan fraktur

Untuk mencegah fraktur, pemberian vitamin D harus disertai kalsium.

Patient level pooled analysis of 68 500 patients from seven major vitamin D fracture trials in US and Europe

The DIPART (vitamin D Individual Patient Analysis of Randomized Trials) Group

BMJ 2010;340:b5463

Objectives To identify participants' characteristics that influence the anti-fracture efficacy of vitamin D or vitamin D plus calcium with respect to any fracture, hip fracture, and clinical vertebral fracture and to assess the influence of dosing regimens and co-administration of calcium.

Design Individual patient data analysis using pooled data from randomised trials.

Data sources Seven major randomised trials of vitamin D with calcium or vitamin D alone, yielding a total of 68 517 participants (mean age 69.9 years, range 47-107 years, 14.7% men).

Study selection Studies included were randomised studies with at least one intervention arm in which vitamin D was given, fracture as an outcome, and at least 1000 participants.

Data synthesis Logistic regression analysis was used to identify significant interaction terms, followed by Cox's proportional hazards models incorporating age, sex, fracture history, and hormone therapy and bisphosphonate use.

Results Trials using vitamin D with calcium showed a reduced overall risk of fracture (hazard ratio 0.92, 95% confidence interval 0.86 to 0.99, P=0.025) and hip fracture (all studies: 0.84, 0.70 to 1.01, P=0.07; studies using 10 µg of vitamin D given with calcium: 0.74, 0.60 to 0.91, P=0.005). For vitamin D alone in daily doses of 10 µg or 20 µg, no significant effects were found. No interaction was found between fracture history and treatment response, nor any interaction with age, sex, or hormone replacement therapy.

Conclusion This individual patient data analysis indicates that vitamin D given alone in doses of 10-20 µg is not effective in preventing fractures. By contrast, calcium and vitamin D given together reduce hip fractures and total fractures, and probably vertebral fractures, irrespective of age, sex, or previous fractures.

Paparan bisphenol A dalam food packaging menyebabkan penyakit jantung

Bisphenol A (BPA) adalah suatu bahan kimia yang banyak dipakai untuk pembungkus makanan dan minuman. Paparan terhadap BPA dapat diketahui dari konsentrasi BPA dalam urin. 

Terdapat hubungan antara konsentrasi BPA urin dengan penyakit jantung, diabetes dan kelainan enzim hati sebagaimana telah dilaporkan pada survei NHANES 2003/04.

Kesimpulan paparan BPA konsisten berhubungan dengan penyakit jantung pada orang dewasa. 

Konsumen perlu lebih berhati-hati mengkonsumsi makanan dan minuman dalam packaging

PLoS ONE 5(1): e8673, published online 13 January 2010 (doi:10.1371/journal.pone.0008673) © 2010 Melzer et al
Association of Urinary Bisphenol A Concentration with Heart Disease: Evidence from NHANES 2003/06. David Melzer, Neil E. Rice, Ceri Lewis, William E. Henley, and Tamara S. Galloway. 

Exposure to food, drinks packaging chemical associated with heart disease

Bisphenol A (BPA) is a high production volume chemical widely used in food and drinks packaging. Associations have previously been reported between urinary BPA concentrations and heart disease, diabetes and liver enzymes in adult participants of the National Health and Nutrition Examination Survey (NHANES) 2003/04. The researchers from the UK aimed to estimate associations between urinary BPA concentrations and health measures in NHANES 2005/06 and in data pooled across collection years. Subjects were n = 1455 (2003/04) and n = 1493 (2005/06) adults aged 18-74 years from the USA.

Higher urinary BPA concentrations were significantly associated with coronary heart disease in 2005/06 and in pooled data. Associations with diabetes did not reach significance in 2005/06, but pooled estimates remained significant. There was no overall association with gamma glutamyl transferase concentrations, but pooled associations with alkaline phosphatase and lactate dehydrogenase remained significant.

The researchers concluded: "Higher BPA exposure, reflected in higher urinary concentrations of BPA, is consistently associated with reported heart disease in the general adult population of the USA. Studies to clarify the mechanisms of these associations are urgently needed." 

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Salam sehat,
Dr. David Fadjar Putra, MS
Spesialis Gizi Klinik
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