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Monday, 12 June 2017 12:47

Short Duration of Breastfeeding and Maternal Obesity Linked to Fatty Liver in Adolescents Featured

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Novel study finds evidence for association between breastfeeding duration and maternal obesity and development of nonalcoholic fatty liver disease in adolescents, reports the Journal of Hepatology

breastfeedingInfants who were breastfed for less than six months before starting infant formula milk and infants who had mothers who were obese at the start of pregnancy, were much more likely to develop nonalcoholic fatty liver disease (NAFLD) as adolescents, according to a novel study in the Journal of Hepatology.
Non-alcoholic fatty liver disease (NAFLD) is the most common liver disorder in developed countries, affecting up to one in four adults. It occurs when fat accumulates within the liver cells in people who do not consume excessive alcohol and is commonly associated with obesity and insulin resistance. According to the U.S. National Health and Nutrition Examination Survey, NAFLD in adolescents has doubled in the last 20 years.
“There have been studies into the benefits of breastfeeding on other diseases, but there is little information about benefits of breastfeeding linked to liver disease,” explained lead investigator Oyekoya T. Ayonrinde, MBBS, of the School of Medicine and Pharmacology, The University of Western Australia, Perth, the Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch, and Faculty of Health Sciences, Curtin University, Bentley, Western Australia. “We therefore examined records of Australian adolescents to establish if infant nutrition and maternal factors could be associated with the subsequent diagnosis of NAFLD.”
Investigators performed liver ultrasound on more than 1,100 adolescents aged 17 years, who have been followed since before birth as part of the Western Australian Pregnancy (Raine) Cohort study. Records detailing maternal pregnancy and infant feeding were correlated with the presence of NAFLD during late adolescence.
NAFLD was diagnosed in about 15% of the adolescents examined. Ninety-four percent had been breastfed as infants. The duration of breastfeeding before starting supplementary milk was four months in 55% and six months in 40%. Adolescent children of women who were obese at the start of pregnancy were twice as likely to have NAFLD, while those fed infant formula milk before completing six months of breastfeeding had a 40% increased likelihood of NAFLD. Interestingly, offspring of mothers who smoked at the start of pregnancy had a significantly increased risk of NAFLD.
“A healthy weight of the mother and support with initiation and persistence with breastfeeding may have later benefits for the liver in their children,” added Dr. Ayonrinde. “This provides additional reasons to support opportunities for women to breastfeed their infants for at least six months while delaying the start of infant formula milk. The important nurturing role of mothers in child health should not be underestimated.”
In an accompanying editorial, Anna Alisi, PhD, of the Liver Research Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy, and Pietro Vajro, MD, of the Department of Medicine, Surgery and Dentistry, ‘‘Scuola Medica Salernitana,” Unit of Pediatrics, University of Salerno, Baronissi (Sa), Italy, commented, “This elegant observational study by Ayonrinde and colleagues is the first epidemiological evidence for the connection between maternal obesity, breastfeeding, and NAFLD.”
“Human breast milk is indeed complex and it may contain various biologically-active constituents with a protective effect upon obesity and obesity-related conditions that remain largely unexplored. The mechanisms for this merit further study.”
Dr. Alisi and Dr. Vajro also emphasized the study’s findings that there is a significantly increased risk of NAFLD in offspring of mothers who smoked at the start of pregnancy. This substantiates the results of a number of previous studies dealing with the epidemiology of childhood overweight and obesity.
“This study further supports the need to encourage comprehensive healthy lifestyles before and during pregnancy and prolonged exclusive breastfeeding for the long-term health benefits of future generations,” they concluded.

Source: Elsevier
Bibliographic information:
Infant nutrition and maternal obesity influence the risk of non-alcoholic fatty liver disease in adolescents,

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  • Postgrad course on exercise as medicine is being proposed

    Dear prospective applicant,

    A proposal for a postgrad course on physical activity (PA) as a therapy for non-communicable diseases is currently being evaluated. Hereunder, a two-question survey is being forwarded for your attention in order to assess whether the idea sounds appealable or not.

    Proposed award

    M.Sc in Therapeutic Physical Activity (TPA), with postgrad certificate (PgC) and postgrad diploma (PgD) exit routes

    Proposed specialisation titles[1]

    Holders of PgC, TPA can claim the title of: ‘Clinical exercise prescriber’.

    Holders of PgD, TPA can claim the titles of: ‘Advanced exercise prescriber’ or ‘Clinical and public health exercise prescriber’.

    Holders of M.Sc, TPA can claim the title of: ‘Physical activity - health specialist’.

    Are you sure you know why physical activity is so important?

    Everyone is aware that physical inactivity is a major health concern but, do you know that through the right type of exercise you can prevent or treat at least 35 chronic conditions? In 2007 the American College of Sports Medicine officially declared an important statement: ‘Exercise is medicine’. Moreover, health-enhancing physical activity (HEPA) is important in today’s world not only in view of improving health and wellbeing but also for its economic values. For example, a lifestyle intervention involving 150 minutes of weekly PA was scientifically shown to be significantly more effective than the administration of metformin.

    Possibilities of further career development in exercise prescription

    Exercise prescription, that is, being qualified to professionally recommend the right type of exercise for health does not stop on a one-to-one basis. Do you think you are qualified to: (a) conduct research on PA interventions, and (b) develop, implement and evaluate community or population programmes involving PA strategies? Unfortunately, many wide-scale programmes that are implemented undergo no evaluation to determine how they have worked or what their effects may be. Have you ever imagined the possibility of attending a tertiary course which would be designed to: (a) give you the ability to design a project for the generation of new knowledge and be able to publish it internationally, or (b) train you on how to evaluate wide-scale interventions and how to apply strategies to sustain their continuities?


    A glimpse of the proposed programme of studies

    Intended for:

    The programme of studies is aimed at a wide and diverse cohort of students wishing to pursue any careers in HEPA sectors mainly: exercise prescription; health promotion (policies and practice); general health and fitness industry; and to further their studies (e.g. PhD). It can also serve as an adjunct to enrich one’s knowledge of his / her established profession or career. Examples include: medical practitioners; pharmacists; nurses; physiotherapists; nutritionists; public health specialists; sport medicine specialists; sport psychologists; teachers of physical education (PE); coaches; gym instructors; and personal trainers. Fitness and sport enthusiasts are also encouraged to apply.

    Duration:

    Three years part-time leading to an M.Sc in PA as an effective therapy, with postgrad certificate and postgrad diploma exit routes after the first and second years respectively.

    Mode of delivery:

    Seventy per cent will be delivered online and the rest of the thought units will be offered on a once weekly two-hour evening basis starting at 18.00hrs.

    Admission criteria:

    You should provide evidence of higher educational qualification(s) - normally, a diploma or a degree related to health and / or PA / sport. An award in PE is also ideal. Mature students without these basic qualifications would be required to present evidence of experience related to PA and health.

    Mode of assessment:

    Units will be assessed through the submission of coursework. These will vary from short assessments to long essays. If you would like to progress at Masters’ level, a traditional dissertation or paper in the format for journal publication and a final presentation (in the form of slides or poster) of your research findings will have to be undertaken.

    Round-up

    Unlike other under- and postgrad courses which only cover a fraction from the whole science of HEPA, this comprehensive programme of studies would lead to a specialization specifically on TPA. For careers in promotion, prescription and research of PA, the proposed programme of studies is a must.

    Important notice

    All the above information is subject to change and would eventually have to be approved by the Programme Validation Committee of the University of Malta. Needless to say, your feedback in the next two questions is extremely important.

    Yours in health & exercise,

    Charles Micallef B.Pharm (Hons), M.Sc PAPH (Staff)                                                8th August 2017

    The two questions hereunder.

    1. In view of the above information, would you be interested in applying for this particular postgrad course leading to a specialisation in physical activity with respect to health, that is, a qualification that gives you the right to prescribe exercise for health, even at population levels?

    Yes or No: 

    1. What would you change from or suggest to what is being proposed?

    Please state your name & surname:

    Your current job / profession:

    Please save your changes and forward your reply to Charles Micallef on: This email address is being protected from spambots. You need JavaScript enabled to view it.

    Your cooperation is greatly appreciated.


    [1] In order to professionally recommend exercise for health, you may need to be registered in the appropriate regulatory board and be in possession of a warrant to operate with the respective titles.

    University of Malta

    Written on August 19, 2017
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