ABSTRACT. Objectives. To examine the genotype: phenotype association in children compared with their parents.Methods. Variations at 4 key gene loci, namely lipoprotein lipase (LPL S447X), hepatic lipase (HL ؊480C>T), cholesteryl ester transfer protein (CETP TaqIB), and apolipoprotein CIII (APOC3 ؊455T>C and ؊482C>T), were examined in children (n ‫؍‬ 495) and their parents (n ‫؍‬ 353) in the Columbia University BioMarkers Study, 1994 to 1998.Results. The frequencies of the rare alleles of the HL ؊480C>T and APOC3 ؊455T>C and ؊482C>T (but not LPL S447X or CETP TaqIB) were significantly lower in non-Hispanic white participants compared with Hispanics. Overall, genotype effects seen in the adults were weaker in the children, although similar trends were seen. In an examination of the effect of body fat on the genotypic effects in the children, there was significant HL ؊480C>T:sum of skinfold interaction.Conclusions. All genotypes were associated with clear relationships to plasma lipid levels in adults, but the effects were weaker in their children, unless stressed by body fat. Pediatrics 2001;108(3). URL: http://www. pediatrics.org/cgi/content/full/108/3/e50; atherosclerosis, cardiovascular disease, child, lipids, genetics.

Plasma fibrinogen has emerged as a risk factor for cardiovascular disease in adults, but relatively little is known about the correlates of plasma fibrinogen level in childhood. In the Columbia University BioMarkers Study (1994-1998), the authors evaluated the association between physical fitness and plasma fibrinogen level in 193 children 4-25 years old; 68% were Hispanic and 46% male. Fitness level assessed by treadmill testing was inversely associated with plasma fibrinogen (r = -0.24, p<0.001). Plasma fibrinogen levels showed a graded inverse relation with tertiles of fitness assessed by treadmill (p<0.001). In multivariate analyses, after adjustment for age, sex, race/ethnicity, body mass index, and presence of the A allele in the -455 position of the beta-fibrinogen promoter gene, the fitness level remained inversely associated with plasma fibrinogen level (beta = -1.3, 95% confidence interval (CI): -2.3, -0.34). Resting heart rate was also correlated with plasma fibrinogen level (r = 0.18, p<0.05). Fibrinogen levels (mg/dl) increased over tertiles of resting heart rate (p = 0.002) and were significantly associated with resting heart rate in multivariate analysis (beta = 0.82, 95% CI: 0.17, 1.5). These findings indicate that plasma fibrinogen is inversely associated with physical fitness in children independent of body mass index.

The unravelling of the human genome has the potential to radically extend many of the strategies used in public health nutrition to improve health and to increase food availability, accessibility and utilization. The present paper divides nutrigenomics into two broad but differing areas in asking about possible public health applications: (1) the increasing mismatch between population growth and global food security, on top of the already approximately 800 million of the world population who are food insecure; (2) possible responses to the rising prevalence of non-communicable diseases as the Western diet becomes increasingly inappropriate to the needs of those consuming it. It is clear that complex interactions of multiple polymorphisms play a role in how individuals and sub-populations respond to dietary interventions. All these applications present public health and ethical challenges, particularly in ensuring that any benefits that do come from nutrigenomics are not restricted to the wealthy minority of only the affluent nations. The present paper concludes that the public health applications of nutrigenomics are probably at least a decade away, especially for developing countries. Clinical applications are likely to be more immediate, probably resulting in ‘designer diets’ for individuals with particular polymorphisms, but unless governments take on the role of ensuring some extent of equity in access, any benefits are most likely to go to those who can afford the screening, tests and treatment. At the same time, greatly increased international efforts are needed towards the continuing, and in some cases worsening, global malnutrition, as genetic manipulation of crops is unlikely to provide more than part of the solution.

Malnutrition coexists with HIV in sub-Saharan Africa. Food supplementation is recommended for food-insecure, HIV-positive individuals. This study was part of a larger six-month food supplementation program for adults initiating antiretroviral therapy (ART) in central Kenya. We conducted 10 focus group interviews with program participants to examine the perceptions of participants regarding the food supplementation program. Focus group transcripts were analyzed for themes and six were identified. These were perception of food insecurity and the health of the participants, the benefits of participating, use of the food, coping strategies after the program ended, suggestions for improving the program, and sustainability of the benefits. Participants perceived that the food improved their health and ART adherence, and reduced stigma. The improvements were not always sustained. Sharing with people beyond the immediate family was very common, depleting the food available to the participants. Interventions with sustainable effects for food-insecure, HIV-positive individuals and their families are needed.

No abstract