The American journal of clinical nutrition
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Randomized Controlled Trial Multicenter Study
Effects of prolonged and exclusive breastfeeding on child height, weight, adiposity, and blood pressure at age 6.5 y: evidence from a large randomized trial.
The evidence that breastfeeding protects against obesity and a variety of chronic diseases comes almost entirely from observational studies, which have a potential for bias due to confounding, selection bias, and selective publication. ⋯ The breastfeeding promotion intervention resulted in substantial increases in the duration and exclusivity of breastfeeding, yet it did not reduce the measures of adiposity, increase stature, or reduce blood pressure at age 6.5 y in the experimental group. Previously reported beneficial effects on these outcomes may be the result of uncontrolled confounding and selection bias.
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Randomized Controlled Trial Multicenter Study
Antenatal supplementation with micronutrients and biochemical indicators of status and subclinical infection in rural Nepal.
Previously we showed that women in rural Nepal experience multiple micronutrient deficiencies in early pregnancy. ⋯ In rural Nepal, antenatal supplementation with multiple micronutrients can ameliorate, to some extent, the burden of deficiency. The implications of such biochemical improvements in the absence of functional and health benefits remain unclear.
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Multicenter Study Comparative Study Clinical Trial
Predicting energy needs in ventilator-dependent critically ill patients: effect of adjusting weight for edema or adiposity.
Predicting energy needs in critical illness can be difficult because of uncertainties about the influence of multiple factors on energy expenditure. Understanding these components is important to avoid limiting optimal outcome by underfeeding and to avoid complications of overfeeding. Prediction strategies often use a patient's weight to estimate needs. ⋯ Adjusted-weight strategies could explain > 45% of the variability of resting energy expenditure in subjects 130-159% of ideal body weight. Results of this study suggest that using adjusted weights with the KPK prediction strategy may be preferable for this population, particularly for patients > or = 130% of ideal body weight. This study also indicated that multiple diagnoses may not lead to increased energy requirements.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Effects of weekly iron supplementation on pregnant Indonesian women are similar to those of daily supplementation.
The effect of daily rather than weekly iron supplementation was compared in women who were 8-24 wk pregnant. One group (n = 68) received 60 mg Fe/d, the second group (n = 71) received 120 mg Fe/wk, given at once. Supplementation lasted 11.3 wk on average, depending on gestational date at entry, and was not supervised. ⋯ In a subgroup of women with a hemoglobin concentration < 110 g/L at baseline (n = 45 daily; n = 54 weekly) no significant within-group changes occurred in serum ferritin, but the change in the daily group was 4.1 micrograms/L higher than in the weekly group (P = 0.049). Compliance, as indicated by two positive stool tests, was approximately equal to 54.3% in the daily group and 62.2% in the weekly group. We conclude that for the complete sample of subjects, the treatment effect of daily compared with weekly supplementation was similar under conditions resembling a normal antenatal care program.