Thursday, November 11, 2021

Study finds no benefit of enriched formula milks on later academic performance


School exam results were the same for children regardless of having had standard or modified formula as a baby, study shows

Peer-Reviewed Publication

BMJ


Study finds no benefit of enriched formula milks on later academic performance

School exam results were the same for children regardless of having had standard or modified formula as a baby, study shows

Children who are given nutrient or supplement enriched formula milk as babies do not appear to have higher exam scores as adolescents than those fed with standard formula, suggests a study published by The BMJ today.

Researchers linked data from seven randomised controlled trials to children’s performance in school exams at ages 11 and 16 and found no clear differences in their results.

Breastfeeding is best for infant nutrition, but breastfeeding rates beyond six weeks are low in many countries. Instead, infant formulas (breast milk substitutes) are widely used to supplement or replace breastfeeding and are consumed globally by more than 60% of infants aged less than six months. 

It has been suggested that modifying formula milk promotes cognitive development, but trial evidence that modified formulas result in long term cognitive advantages is inconclusive.

To address this, researchers from UCL Great Ormond Street Institute of Child Health and Institute of Education set out to compare differences in academic performance between adolescents who were randomly given modified or standard infant formula as babies.

They analysed results from seven randomised trials of nutritionally modified infant formula carried out at five English hospitals between August 1993 and October 2001 involving 1,763 adolescents.

Two of the trials tested formula milks enriched with a long chain polyunsaturated fatty acid (LCPUFA), one of the many breast milk constituents with a role in brain development; one tested added iron; two tested formula milks with higher macronutrient concentrations; and two tested formulations with added sn-2 palmitate or nucleotides, not thought to relate to cognition.

In 2018, these trial data were linked to school records, focusing on what effect (if any) the formula had had on scores for national mandatory exams (GCSEs) in maths and English at ages 11 and 16 years, as well as eligibility for special educational needs support and achieving five or more GCSE grades of C or higher.

Results were gathered for 1,607 (91.2%) participants linked to school records.

No benefit was found for performance in maths exams at age 16 years for children given any modified formula.

There was no difference in scores for English at age 16, and for maths and English at age 11, between children who had standard formula as infants and those who had nutrient enriched, added iron, sn-2 palmitate or nucleotide formulas.

However, at age 11, children who had been given the LCPUFA supplemented formula scored lower in both English and maths.

The researchers point out that the trials were carried out several decades ago and, since then, the composition of formulas and neonatal care have changed.

This is relevant, they say, because nowadays, a larger number of sick and small preterm infants survive, and these infants could have different sensitivities to the nutritional modifications investigated in this study.

Nevertheless, the study’s strengths include the high rate of follow-up and the use of  GCSE scores that the authors say have real world relevance to young people and their future. 

“In summary, differences in academic performance between modified and standard formulas were consistent with differences measured in the original trials and in the external literature; that is, no benefit of the infant formula modifications on cognitive outcomes,” they write.

“This study sets a precedent for other trials and cohorts to use linkage to administrative data to answer important questions about long term outcomes in children and young people,” they add.

In a linked editorial, researchers at the University of Glasgow argue that added nutrients could also do harm and that baby milk trials were often not well conducted. 

They conclude: “Recently published evidence suggests a need to better regulate research into infant formulas and to ensure that this evidence is used to remove unnecessary and potentially harmful nutrients from formula milk, and to prevent misleading promotional claims.”

[Ends]
 

European cities could avoid an extra 114,000 premature deaths every year by meeting the new WHO air quality guidelines


An update of the ISGlobal Ranking of Cities shows that the new air pollution recommendations could save up to 58,000 additional deaths for PM2.5 and 56,000 for NO2 compared to the previous recommendations


Peer-Reviewed Publication

BARCELONA INSTITUTE FOR GLOBAL HEALTH (ISGLOBAL)

04 Ranking pollution levels EN 

IMAGE: AIR POLLUTION MAXIMUM LEVELS view more 

CREDIT: BARCELONA INSTITUTE FOR GLOBAL HEALTH (ISGLOBAL)

Barcelona, November 10, 2021-. A health impact assessment from the Barcelona Institute for Global Health (ISGlobal), a centre supported by the ”la Caixa” Foundation, has concluded that European cities could avoid an extra 114,000 premature deaths every year if they met the new air quality guidelines presented by the World Health Organization (WHO) in September 2021 compared to the previous guidelines.

These estimates are an update of a study originally published in January 2021 in The Lancet Planetary Health, in which ISGlobal researchers showed that European cities could avoid up to 51,000 premature deaths per year by meeting WHO’s previous air quality guidelines, which had been in place since 2005. After the publication of the new guidelines, the research team performed a new assessment of the mortality burden attributable to fine particulate matter (PM2.5) and nitrogen dioxide (NO2in the same 1,000 European cities included in the original study. The overall results have been published in a letter in The Lancet Planetary Health, while the specific results for each city have been published on the ISGlobal Ranking of Cities website.

The updated results show that achieving the new air quality guidelines for PM2.5 would result in a 113% increase in the number of deaths that could be avoided in European cities compared to the previous air quality guidelines from 2005, avoiding 109,188 premature deaths each year. For NO2, achieving the new recommended levels could prevent up to 57,030 premature deaths, 56,130 more than the 900 avoidable deaths estimated for the former NO2, recommended levels.

Going further, meeting the lowest levels of PM2.5 and NO2 observed in any city, could prevent 125,000 and 79,000 annual premature deaths, respectively.

Avoidable deaths in European cities

 

PM2.5

NO2

2005 WHO guidelines

51,213

900

2021 WHO guidelines

109,188

57,030

 

“Even though there is no safe exposure threshold below which air pollution becomes innocuous, these new results show how the new WHO global air quality guidelines offer a much better framework for protecting human health and prevent a large number of deaths”, says ISGlobal researcher Sasha Khomenko, first author of the study.

The new data show that the number of avoidable deaths is much higher if the new WHO reference levels are adopted as targets. This effect is much more noticeable in the case of NO2. Among the cities with the highest mortality attributable to this pollutant, Madrid would go from avoiding 206 annual deaths if the old WHO recommendations were met to avoiding 1,966 using the new targets. Antwerp would go from 22 avoidable annual deaths to 254; Turin from 34 to 562; Paris from 185 to 2,135; Milan from 103 to 1,864 and Barcelona from 82 to 1,554.

Nearly 100% of the population above recommended levels

One statistic that shows how far European cities have to go to achieve clean air is the percentage of the population living in areas with concentrations of air pollutants higher than those recommended by the WHO. While under the previous WHO recommendations this percentage was 84% for PM2.5 and 9% for NO2, under the new recommendations these figures rise to 99.8% and 99.7% of the urban population, respectively. It should be noted, however, that the study was based on air pollution data for 2015.

“Since the current levels of air pollution in European cities are putting more than 100,000 lives at stake every year, the EU should align its legislation to match the WHO recommendations”, says Mark Nieuwenhuijsen, senior author of the study and Director of the Urban Planning, Environment and Health Initiative at ISGlobal. “In turn, local, regional and national governments should set the reduction of air pollution as a priority. We urgently need to reduce fossil fuel use, remove private cars and add more green spaces in our cities. This will not only reduce air pollution, but also contribute to climate action, which is one of our highest priorities for humankind”, he adds.

Current European directives stipulate an upper limit of 25 µg/m3 for annual mean PM2.5 and 40 µg/m3 for annual mean NO2. 

Air Pollution Maximum Levels (annual mean)

 

New 2021 WHO Guidelines

2005 WHO Guidelines

EU directives

PM2.5

5 µg/m3 

10 µg/m3 

25 µg/m3 

NO2

10 µg/m3 

40 µg/m3 

40 µg/m3 

Full data on www.isglobalranking.org

From November 11, 2021, updated avoidable mortality data using the new WHO recommendations for the 1,000 cities included in the study will be available at www.isglobalranking.org, where the recently published ranking of mortality associated with lack of access to green space is also available.

The update of the WHO's air quality recommendations has not changed the position of the cities within the rankings of mortality associated with excess air pollution.

CAPTION

European Cities with the Highest Mortality Due to Air Pollution

CREDIT

Barcelona Institute for Global Health (ISGlobal)

Top 10 cities with the highest mortality burden

The ten cities with the highest mortality burden due to PM2.5:

  1. Brescia (Italy)
  2. Bergamo (Italy)
  3. Karviná (Czech Republic)
  4. Vicenza (Italy)
  5. Silesian Metropolis (Poland)
  6. Ostrava (Czech Republic)
  7. Jastrzębie-Zdrój (Poland)
  8. Saronno (Italy)
  9. Rybnik (Poland)
  10. Havířov (Czech Republic)

The ten cities with the highest mortality burden due to NO2:

  1. Madrid (metropolitan area) (Spain)
  2. Antwerp (Belgium)
  3. Turin (Italy)
  4. Paris (metropolitan area) (France)
  5. Milan (metropolitan area) (Italy)
  6. Barcelona (metropolitan area) (Spain)
  7. Mollet del Vallès (Spain)
  8. Brussels (Belgium)
  9. Herne (Germany)
  10. Argenteuil-Bezons (France)

CAPTION

European Cities with the Lowest Mortality Due to Air Pollution

CREDIT

Barcelona Institute for Global Health (ISGlobal)


Top 10 cities with the lowest mortality burden

The ten cities with the lowest mortality burden attributable to PM2.5:

  1. Reykjavík (Iceland)
  2. Tromsø (Norway)
  3. Umeå (Sweden)
  4. Oulu (Finland)
  5. Jyväskylä (Finland)
  6. Uppsala (Sweden)
  7. Trondheim (Norway)
  8. Lahti (Finland)
  9. Örebro (Sweden)
  10. Tampere (Finland)

The ten cities with the lowest mortality burden attributable to NO2:

  1. Tromso (Norway)
  2. Umeå (Sweden)
  3. Oulu (Finland)
  4. Kristiansand (Norway)
  5. Pula (Croatia)
  6. Linköping (Sweden)
  7. Galway (Ireland)
  8. Jönköping (Sweden)
  9. Alytus (Lithuania)
  10. Trondheim (Norway)

CAPTION

Avoidable Deaths in European Cities

CREDIT

Barcelona Institute for Global Health (ISGlobal)

Back-to-back hurricanes expected to increase in the Gulf Coast

Parts of Gulf Coast are twice as likely to get two hurricanes in a fortnight by end of century, leaving infrastructure and people with less recovery time.

Peer-Reviewed Publication

AMERICAN GEOPHYSICAL UNION

Power lines at sunrise 

IMAGE: LOUISIANA AND FLORIDA ARE THE STATES WITH THE HIGHEST RISK FOR BACK-TO-BACK HURRICANES, WHICH CAN EXACERBATE INFRASTRUCTURE DAMAGE AND SLOW RECOVERY TIMES, ACCORDING TO NEW RESEARCH IN GEOPHYSICAL RESEARCH LETTERS. view more 

CREDIT: ANDREY METELEV

WASHINGTON—Over the past four decades, the time between tropical storms making landfall in the Gulf Coast has been getting shorter. By the end of the century, Louisiana and Florida could be twice as likely to experience two tropical storms that make landfall within nine days of each other, according to new model estimates.

As global climate changes, more tropical storms have been packed into a single hurricane season, which in the Gulf region typically runs from June through November. The time between storms in the region is shrinking, according to new findings published in the AGU journal Geophysical Research Letters, which publishes high-impact, short-format reports with immediate implications spanning all Earth and space sciences.

Florida and Louisiana are most likely to experience “sequential landfall,” where one hurricane moves over land faster than infrastructure damaged in a previous storm can be repaired. The researchers estimate this timescale between hurricanes to be 10 days for those states. Being hit by two storms in quick succession gives communities and infrastructure less time to recover between disasters — a significant problem for a region with a swelling population that has struggled to recover following previous natural disasters.

“In previous research, people have mostly focused on the resilience of infrastructure, [rather than] the time to restore it after a storm,” said Dazhi Xi, a climate scientist at Princeton University who led the study.

With both a longer storm season and shorter breaks between disasters, stresses on infrastructure, ecosystems and people are intensified.

“If you need 15 days to restore infrastructure — for example, a power system — after a storm hits, and the second storm makes landfall before the system can recover, residents will face dangerous conditions,” said Xi. In a community without power, transportation or communications, problems around health risks, rescue and clean-up operations, and restoring systems are all exacerbated by sequential tropical storms.

More cyclones, more problems

The study examined hurricane seasons from 1979 to 2020, focusing on years in which at least two tropical storms made landfall in the same region within two weeks of each other. Xi looked at how that number changed over time and paired that trend with a climate model to estimate how the number of back-to-back hurricanes would change over time. Xi also broke down the Gulf Coast into different regions to identify which areas are most at risk of these sequential storms, historically and in the future. He found that Louisiana and Florida are the most likely places for multiple tropical storms to strike, but the entire coast will see more storms.

The number of tropical storms is projected to grow rapidly even relative to the lengthening hurricane season, Xi said.

The need to focus on quicker restoration times after disasters was highlighted earlier this year by the extreme cold snap in Texas in February, when much of the state’s power grid went offline. That disaster was followed later by Tropical Storm Henri, which swamped New York’s subway system in August, and Hurricane Ida, which in September hit Louisiana — a state still “reeling” from last year’s hurricane season with three sequential landfalling storms, according to hurricane climatologist and geographer Jill Trepanier at Louisiana State University, who was not involved in the study.

“Even the best-case scenario of this worst-case scenario still spells devastation for the coast,” said Trepanier. “That's why climate refugees exist. They’re people who are displaced because they can no longer live in an area due to changing climate conditions. If we're unable to put power grid structures back in place, adequately house people, or provide water and other resources, we can't have people living there.”

###

AGU (www.agu.org) supports 130,000 enthusiasts to experts worldwide in Earth and space sciences. Through broad and inclusive partnerships, we advance discovery and solution science that accelerate knowledge and create solutions that are ethical, unbiased and respectful of communities and their values. Our programs include serving as a scholarly publisher, convening virtual and in-person events and providing career support. We live our values in everything we do, such as our net zero energy renovated building in Washington, D.C. and our Ethics and Equity Center, which fosters a diverse and inclusive geoscience community to ensure responsible conduct.


Notes for Journalists:
This research study is published with open access and is freely available. Download a PDF copy of the paper here. Neither the paper nor this press release is under embargo.

Paper title:
“Sequential Landfall of Tropical Cyclones in the United States: From Historical Records to Climate Projections.”

Authors:

  • Dazhi Xi (corresponding author), Ning Lin, Department of Civil and Environmental Engineering, Princeton University, Princeton, NJ, USA