Papers by John Wallingford
Maternal & Child Nutrition, 2010
We assessed eight World Health Organization (WHO) core child feeding indicators for their associa... more We assessed eight World Health Organization (WHO) core child feeding indicators for their association with stunting and underweight in Cambodia in 2000 and 2005. We compared the feeding data from the Cambodian Demographic and Health Surveys for 2000 with 2005 for 0-24 months children using the WHO feeding indicators, with stunting and underweight as outcomes. Prevalence of stunting and underweight was significantly less in 2005 than in 2000 among children aged 0-5 and 6-11 months, but stunting among children 18-23 months remained >50%. Prevalence of compliance with seven of the eight core healthy feeding indicators was higher in 2005. Exclusive breastfeeding among 0-5 months infants increased more than fivefold; among 6-11 and 12-17 months children, prevalence of feeding diversity and meeting a minimally acceptable diet, while improved, remained ª25%. Modelling showed compliance with breastfeeding indicators was associated with reduced risk of underweight in 0-5 months infants, no association between compliance with feeding indicators and growth outcomes in other ages, and a significant association of higher relative wealth with growth outcomes overall. Between 2000 and 2005, Cambodia stabilized and focused resources on infant feeding. Prevalence of meeting the WHO feeding indicators improved, but modelling indicated that, in general, relative wealth, not feeding practices, was associated with improved growth outcomes. Yet, over 50% of children 18-23 months were stunted in 2005. Similar to the success with breastfeeding, focus on complementary feeding of 6-23 months children may reduce the risk of stunting in Cambodia.
Frontiers in Nutrition
Oligosaccharides in human milk support healthviaintestinal microbiome. We studied effects of addi... more Oligosaccharides in human milk support healthviaintestinal microbiome. We studied effects of addition of 2-fucosyllactose (2′FL) to the infant formula on infant growth, occurrence of adverse events (AE), and infant microbiome, including expression of microbial genes that metabolize 2′FL. Our hypothesis was that while 2′FL would not affect growth, it would cause changes in microbiome metabolism. In a double-blinded randomized controlled study fashion, the infant formula ± 2′FL or human milk was fed to healthy term infants for 16 weeks. Fecal samples obtained at baseline and week 16 were analyzed for microbial populations, metagenomic species concept (MGS), and genetics of gut metabolic modules (GMMs). There were no effects of addition of 2′FL on growth or AEs. There were no significant differences by feeding group in MGS richness or Shannon diversity at baseline, but formula groups each had significantly greater richness (p< 0.05) and diversity (p< 0.05) after 16 weeks of feedi...
Journal of Nutrition & Food Sciences, 2018
Background: Extensively hydrolyzed formulas are used for the dietary management of cow's milk all... more Background: Extensively hydrolyzed formulas are used for the dietary management of cow's milk allergy. There is a limited repertoire of commercially available formulas for infants with cow's milk allergy. Methods: This was a multi-center, double-blind, randomized, crossover clinical study of 75 children younger than 12 years, 11 months with documented cow's milk allergy. The primary outcome was the incidence of reactivity of a new extensively hydrolyzed casein formula and Nutramigen ® during a Double-Blind Oral Food Challenge. A subset of subjects under the age of three years, 11 months at the time of enrollment received either the new formula or Nutramigen ® for 16 weeks to investigate tolerance, taste preferences, growth and nutritional variables. Results: Sixty-one subjects completed both challenges in the per-protocol groups. The new formula was noninferior to Nutramigen regarding allergic symptoms of reactivity in both per protocol and intent to treat analyses, the latter addressing risk of bias from attrition during DBOFC. Both formulas met the American Academy of Pediatrics criteria for hypoallergenicity and had similar adverse event profiles. The new formula was comparable to Nutramigen ® in supporting growth and tolerance. Conclusion: The new hypoallergenic formula broadens access to formulations for dietary management of children with cow's milk allergy. Intent to treat analyses should be included in DBOFC studies of hypoallergenicity to reduce risk of bias from early discontinuation.
Advances in Nutrition, 2018
In the context of a food product label, the term "claim"refers to information that attributes val... more In the context of a food product label, the term "claim"refers to information that attributes value to the product. The term extends to many different types of information, from product identity, descriptors of intended use, and identification of characteristic properties to the physiologic effects in the body of substances in the food, including the reduction of risk of disease. Food labeling, which includes claims, provides information that consumers want and use to improve their diets. Consumers prefer short statements on the front label claims to longer, more detailed information, including ingredients statements and a nutrition panel. Three types of claims are permitted in the United States. Nutrient content claims describe the level of the nutrient in the food relative to an established daily value, e.g., "Excellent source of choline," and are subject to composition limits for other nutrients, such as total fat, saturated fat, and cholesterol. Health claims describe the relation between a food substance and the risk of disease, e.g., "Adequate calcium and vitamin D throughout life, as part of a well-balanced diet, may reduce the risk of osteoporosis." They must undergo a premarket evaluation by the FDA to ensure that there is significant scientific agreement about the relation in question. The third type of claim, structure-function (SF) claims, has recently come under scrutiny, particularly regarding their use on infant formula. Such claims represent a food's effect on the structure or function of the body for maintenance of good health and nutrition. These claims must be truthful and not misleading, but are not subject to premarket approval before use. The purpose of this perspective is to describe the origins and unique niche of SF claims, and to comment on recent proposals to further regulate such claims on infant formula.
Current Developments in Nutrition, 2019
Growth of infants fed isocaloric infant formulas differing in nutritional content was studied. Tw... more Growth of infants fed isocaloric infant formulas differing in nutritional content was studied. Twenty-three of 109 randomized clinical trials reported some difference in weight, length or head circumference between formula groups. Logistic regression demonstrated no relationship between finding a significant difference in a growth outcome with enrollment prior to 15 d or observation of 15 wk, parameters specified in regulation. Sample size and year of publication also were not correlated with report of a significant growth difference, though reporting separate data by sex was (p = 0.012). The difference in mean weight gain between control and test formula groups was comparable to that between formula-fed and breast-fed infants (1 g/d) and smaller than that between male and female infants (4 g/d). Encouraging alternate study designs with flexible enrollment ages and infants who transition from breastfeeding to formula would gain information on physiologic outcomes and common feeding ...
Journal of Dairy Science, 2004
Adding human milk fortifiers (HMF) to human milk (HM) is one way of overcoming the nutrient defic... more Adding human milk fortifiers (HMF) to human milk (HM) is one way of overcoming the nutrient deficits found in the latter. In this study, the bioavailabilities of calcium, zinc, and iron in S-26/SMA HMF added to HM were compared with those in HM fortified with various bovine milk proteins: α-lactalbumin, colostrum, caseinate, casein phosphopeptides, and whey protein concentrate. The bioavailability of each mineral was assessed using an in vitro digestion/Caco-2 cell culture model. Calcium and zinc uptake by the cells was traced with radioisotopes; iron uptake was assessed via cell ferritin levels. Samples were prepared on an equal protein content basis and with added calcium, but no zinc or iron was added. Results revealed that calcium uptake from HM + S-26/SMA was not different from any of the HM fortified with the bovine milk proteins, except for unfortified HM and HM + colostrum in which calcium uptake was significantly lower (−89 and −38%, respectively). Uptake of zinc and iron were significantly higher for HM + S-26/SMA than for the other HM + fortifiers.
Maternal & Child Nutrition, 2011
Eight World Health Organization (WHO) feeding indicators (FIs) and Demographic and Health Survey ... more Eight World Health Organization (WHO) feeding indicators (FIs) and Demographic and Health Survey data for children <24 months were used to assess the relationship of child feeding with stunting and underweight in 14 poor countries. Also assessed were the correlations of FI with country gross national income (GNI). Prevalence of underweight and stunting increased with age and Ն50% of 12-23-month children were stunted. About 66% of babies received solids by sixth to eighth months; 91% were still breastfeeding through months 12-15. Approximately half of the children were fed with complementary foods at the recommended daily frequency, but <25% met food diversity recommendations. GNI was negatively correlated with a breastfeeding index (P < 0.01) but not with other age-appropriate FI. Regression modelling indicated a significant association between early initiation of breastfeeding and a reduction in risk of underweight (P < 0.05), but a higher risk of underweight for continued breastfeeding at 12-15 months (P < 0.001). For infants 6-8 months, consumption of solid foods was associated with significantly lower risk of both stunting and underweight (P < 0.001), as was meeting WHO guidance for minimum acceptable diet, iron-rich foods (IRF) and dietary diversity (P < 0.001); desired feeding frequency was only associated with lower risk of underweight (P < 0.05). Timely solid food introduction, dietary diversity and IRF were associated with reduced probability of underweight and stunting that was further associated with maternal education (P < 0.001). These results identify FI associated with growth and reinforce maternal education as a variable to reduce risk of underweight and stunting in poor countries.
The Journal of Nutrition, 1980
Pregnant Sprague-Dawley rats were fed, ad libitum, diets containing either 24% (control) or 4% ca... more Pregnant Sprague-Dawley rats were fed, ad libitum, diets containing either 24% (control) or 4% casein (deprived) from conception through gestation. On the 13th, 14th, 15th, 16th, 17th or the 18th day of gestation the dams of both dietary groups were injected with 2.5 mCi [3H]thymidine per gram of body weight. Pups born to these dams were reared by stock diet-fed foster mothers to insure normal postnatal nutrition and were killed on postnatal day 28. Retention of isotope in the nuclei of four types of macroneurons, as visualized in autoradiographs prepared from cerebellar tissues, was used to determine the time of final DNA synthesis in these cells. In the brains of animals malnourished in utero, the time of administration of the label which resulted in maximal retention and peak cerebellar neurogenesis had occurred as early as the 13th day of gestation.
The Lancet, 2016
breastfeeding at 6 months and 23% were breastfeeding at 9 months; the trend is unlikely to decrea... more breastfeeding at 6 months and 23% were breastfeeding at 9 months; the trend is unlikely to decrease to 0•5% at 12 months (figure). Moreover, in Cesar Victora and colleagues' appendix p 22, 1 a country with a breastfeeding prevalence of 34% at 6 months is predicted to have a 10% prevalence at 12 months. We corroborate this with independent, unpublished data from the Millennium Cohort Study of UK babies born in 2000-01. The mothers reported their breastfeeding duration at 9 months 5 and 5 years postnatally. The prevalence of breastfeeding up to 9 months was very similar in those interviewed at 9 months (n=18 756) compared with those who responded at 5 years (n=14 848). Among the latter group, 9•6% (95% CI 8•7-10•4) reported breastfeeding at 12 months (fi gure). This potential inaccuracy will not aff ect the main fi ndings of the papers. 1,2 However, while UK mothers have one of the lowest rates of breastfeeding at 12 months, it is probably around 10% rather than 0•5%, hence displaying similar prevalences at 6 months and 12 months to Canada, France, and the Netherlands. 1 We declare no competing interests.
Food and nutrition bulletin, 2004
Edible oil is an important element in the diet of most transitional countries; nevertheless, litt... more Edible oil is an important element in the diet of most transitional countries; nevertheless, little is known about the fatty acid composition of these oils. We examined the consumption of edible oils and the fatty acid composition of these oils obtained from a market survey conducted in seven Chinese provinces and in Beijing. Three days of measured household food intake from the 1997 China Health and Nutrition Survey households provided data on the consumption of edible oils. Edible oils sold in the capital cities of eight provinces were purchased. One hundred twenty-six samples, representing 14 different oils according to their labels, were assayed for their fatty acid content in 2001. Fatty acids were analyzed by standard gas chromatographic methods. More than 76% of households in China consume edible oil, providing an average of 29.6 g of edible oil per day to persons aged two years or older. Rapeseed was consumed by one-quarter of individuals. Rapeseed is rich in C22:1n9 cis (er...
International Journal for Vitamin and Nutrition Research, 2005
The calcium, zinc, and iron bioavailabilities of human milk with commercial and noncommercial hum... more The calcium, zinc, and iron bioavailabilities of human milk with commercial and noncommercial human milk fortifiers (HMFs) were evaluated under a variety of conditions: peptic digestion at pH 2 and pH 4, supplementation of ascorbic acid, and addition of three calcium salts. The noncommercial HMFs consisted of casein phosphopeptides (CPPs), alpha-lactalbumin, colostrum, and hydrolyzed whey protein concentrate (WPC). They were mixed with human milk (HM) and calcium, zinc, and iron were added. Ascorbic acid (AA) was added in certain studies. The commercial HMFs were Nestlé FM-85, Similac HMF (SHMF), and Enfamil HMF (EHMF). All HMFs were compared to S-26/SMA HMF. Results showed that the peptic pH (2 vs. 4) had no effect on mineral bioavailability. Addition of different calcium salts had no effect on calcium cell uptake and cell ferritin levels (an indicator of iron uptake), however, the addition of calcium glycerophosphate/gluconate increased zinc uptake by Caco-2 cells. Addition of AA ...
Experimental Eye Research, 1988
The photopigment of avian pineal which mediates light sensitivity was sought via its chromophore.... more The photopigment of avian pineal which mediates light sensitivity was sought via its chromophore. Chick pineal cells in primary cultures were incubated overnight in the dark with [3H]retinol. Reduction of Schifffs bases with cyanoborohydride prior to SDS-PAGE revealed radioactivity bound to a 30 kDa component in pinealocyte membranes. All-trans-retinal, but not retinol or retinoic acid, incubated with pinealocyte homogenates prior to reduction, resulted in a loss of radioactivity from the 30 kDa region of the gel. The radioactivity was also displaced by NH20H in the dark. Incubation of cultured cells or homogenates with retinoyl fluoride, an acylating agent specific for the retinal binding site of opsins, also displaces radioactivity from the protein. Furthermore, retinoyl fluoride, added to chick pineal cells in culture, blocked the suppressive effect of light on melatonin output by these cells. Taken together these results raise the possibility that the 30 kDa protein mediates photosensitivity in the chick pineal.
ELECTROPHORESIS, 2002
We identified several low-abundance proteins of bovine colostrum and mature milk using the immuno... more We identified several low-abundance proteins of bovine colostrum and mature milk using the immunoabsorption technique and two-dimensional electrophoresis (2-DE) followed by microsequencing and mass spectrometry. Two major milk proteins, beta-casein and immunoglobulin G (IgG), were effectively removed from the milk using immunoabsorbents. Milk samples before and after immunoabsorption were separated by 2-DE. Protein identification of the spots on 2-DE was performed by either gel comparison, microsequencing, matrix-assisted laser desorption/ionization-time of flight mass-spectrometry (MALDI-TOF-MS), peptide mass fingerprinting or peptide sequencing using tandem MS by hybrid quadrupole/orthogonal acceleration time of flight-MS (Q-TOF). Significant differences in protein patterns were observed between the low-abundance proteins of colostrum and mature milk. In addition, several low-abundance proteins including fibrinogen beta-chain, chitinase 3-like 1, alpha-antitrypsin, complement C3 alpha-chain, gelsolin and apolipoprotein H were observed only in colostrum. However, the level of beta-casein fragments increased significantly during this lactation period. alpha-Lactalbumin and beta-lactoglobulin as well as some low-abundance proteins including bovine serum albumin, serotransferrin and lactoferrin were identified in both colostral and mature milk. Low-abundance proteins in bovine colostrum may have special physiologic relevance to the health and development of calves early in lactation.
The FASEB Journal, 2015
Information on complementary foods, especially commercially prepared complementary foods (CCF) in... more Information on complementary foods, especially commercially prepared complementary foods (CCF) in diets of older infants and young children is limited in most countries. Nine target countries of di...
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Papers by John Wallingford