MATERNAL UNDERNUTRITION, INFANT REFEEDING, ADIPOSITY AND DIABETES
Funder
National Health and Medical Research Council
Funding Amount
$297,323.00
Summary
Malnutrition is a major health problem throughout the world and one of the priority areas for the WHO. Refeeding program guidelines have been established and implemented when children are assessed as being malnourished. Recent studies on the effect of these important programs throughout the world have suggested they may not have been as successful as wished. Indeed, even though many of the subjects are the urban poor, it has been found that many are developing diabetes in their twenties. This is ....Malnutrition is a major health problem throughout the world and one of the priority areas for the WHO. Refeeding program guidelines have been established and implemented when children are assessed as being malnourished. Recent studies on the effect of these important programs throughout the world have suggested they may not have been as successful as wished. Indeed, even though many of the subjects are the urban poor, it has been found that many are developing diabetes in their twenties. This is associated with an increase in abdominal fatness, out of proportion to the rest of the body's size and shape. The increase in diabetes in this group is most worrying and a major public health problem. It is not known whether the diabetes and abdominal fatness are caused by the refeeding programs or whether they are due to the fact that the body's metabolism was programmed during pregnancy. Perhaps the infants were malnourished whilst they were developing during pregnancy and metabolism was changed so they could store fat easily and not use glucose as readily in the rest of the body. This study is designed to show whether there are metabolic changes which predispose to diabetes and fatness present at birth in those who are malnourished or whether the refeeeding program designed to help them grow is the cause of these later problems.Read moreRead less
Human ageing is characterised by reduced appetite and food intake, so that average body weight decreases after 70-75 years. This physiological anorexia predisposes to pathological weight loss and malnutrition, worsening of other illnesses, and increased mortality. This project aims to identify causes of this anorexia of ageing, with a view to developing prevention and treatment strategies. We hypothesise that (1) Satiety signals are overactive in the elderly. We will determine whether older peop ....Human ageing is characterised by reduced appetite and food intake, so that average body weight decreases after 70-75 years. This physiological anorexia predisposes to pathological weight loss and malnutrition, worsening of other illnesses, and increased mortality. This project aims to identify causes of this anorexia of ageing, with a view to developing prevention and treatment strategies. We hypothesise that (1) Satiety signals are overactive in the elderly. We will determine whether older people are more sensitive to gastric distension, which reduces appetite and food intake, by measuring perceptions (fullness, hunger, etc), gastric compliance and food intake during intragastric balloon inflation. This will also be done during nutrient infusion into the small intestine, to assess the interaction between gastric and intestinal satiety factors. The contribution of age-related slowing of gastric emptying to the anorexia of ageing will be assessed and the possibility that reduced energy intake worsens the anorexia of ageing will be examined in a nutrient supplementation study. We will have shown that the release of the satiety hormone cholecystokinin (CCK) is greater in older than young adults and that CCK administration causes a greater suppression of food intake in older people, suggesting that increased CCK activity may be a cause of the anorexia of ageing. We will pursue these findings by attempting to increase appetite and food intake in the lderly by administration of a CCK antagonist (blocker). We will also measure the satiating effects of two other probable satiety hormones, amylin and glucagon like peptide 1 in older and young people. (2) The feeding drive is reduced in the elderly Opioids stimulate feeding. In animals this effect is reduced by ageing. To determine whetther this is also so in humans, the suppressive effect of the opioid antagonist naloxone on feeding will be assessed in young and older subjects.Read moreRead less