Mary S Fewtrell

Mary S Fewtrell
University College London | UCL · Childhood Nutrition Research Centre (CNRC)

About

195
Publications
46,285
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15,914
Citations
Citations since 2017
28 Research Items
5383 Citations
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20172018201920202021202220230200400600800
20172018201920202021202220230200400600800
20172018201920202021202220230200400600800
Additional affiliations
June 1996 - present
University College London Institute of Child Health
Position
  • University College London

Publications

Publications (195)
Article
Full-text available
Introduction: Older adults with chronic kidney disease (CKD) can have low bone mineral density (BMD) with concurrent vascular calcification. Mineral accrual by the growing skeleton may protect young people with CKD from extraosseous calcification. Our hypothesis was that children and young adults with increasing BMD do not develop vascular calcific...
Article
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Parenteral nutrition is used to treat children that cannot be fully fed by the enteral route. While the revised ESPGHAN/ESPEN/ESPR/CSPEN pediatric parenteral nutrition guidelines provide clear guidance on the use of parenteral nutrition in neonates, infants, and children based on current available evidence, they have helped to crystallize areas whe...
Article
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In humans, high levels of investment are required to raise offspring, because of the prolonged developmental period and short interbirth intervals. The costs borne by individual mothers may be mitigated by obtaining social support from others. This strategy could be particularly valuable for first-time mothers, who lack first-hand experience and wh...
Article
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Introduction Clinical assessment of bone health by Dual‐Energy X-ray Absorptiometry (DXA) in the paediatric population requires robust reference values. The International Society for Clinical Densitometry (ISCD) recommends that country/regional reference values ideally should be used to improve precision in bone health assessment. Objective The ai...
Article
Background: Many chronic illnesses affect bone health, and commonly lead to mineralization abnormalities in young people. As cortical and trabecular bone may be differentially affected in certain diseases, an imaging technique that allows for detailed study of the bone structure is required. Peripheral quantitative computed tomography (pQCT) overco...
Article
Background: Biomarkers and dual-energy X-ray absorptiometry (DXA) are thought to be poor predictors of bone mineral density (BMD). The Kidney Disease: Improving Global Outcomes guidelines suggest using DXA if the results will affect patient management, but this has not been studied in children or young adults in whom bone mineral accretion continue...
Article
Background The COVID-19 New Mum Study is recording maternal experiences and infant feeding during the UK lockdown. This report from week 1 of the survey describes and compares the delivery and post-natal experiences of women who delivered before (BL) versus during (DL) the lockdown. Methods Women living in the UK aged ≥18 years with an infant ≤12...
Conference Paper
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Introduction Currently available biomarkers and Dual-energy X-ray Absorptiometry (DXA) are thought to be poor predictors of bone mineral density (BMD). The 2017 KDIGO guidelines on CKD-MBD propose using DXA if it will affect patient management. We set out to determine the clinical utility of DXA and routine clinical biomarkers by comparing them wit...
Article
More than 10,000 preterm infants have participated in randomised controlled trials on probiotics worldwide, suggesting that probiotics in general could reduce rates of necrotising enterocolitis (NEC), sepsis, and mortality. However, answers to relevant clinical questions as to which strain to use, at what dosage, and how long to supplement, are not...
Article
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Background: Clinical use of bioelectric impedance is limited by variability in hydration. Analysis of raw bioelectric impedance vectors (BIVA), resistance (R), reactance (Xc) and phase angle (PA) may be an alternative for monitoring disease progression/treatment. Clinical experience of BIVA in children is limited. We investigated predictors of BIV...
Article
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Mineral and bone disorder in chronic kidney disease (CKD-MBD) is a triad of biochemical imbalances of calcium, phosphate, parathyroid hormone and vitamin D, bone abnormalities and soft tissue calcification. Maintaining optimal bone health in children with CKD is important to prevent long-term complications, such as fractures, to optimise growth and...
Article
Background: Palm oil (PO) is used in infant formulas in order to achieve palmitic acid (PA) levels similar to those in human milk. PA in PO is esterified predominantly at the SN-1,3 position of triacylglycerol (TAG), and infant formulas are now available in which a greater proportion of PA is in the SN-2 position (typical configuration in human mil...
Article
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The provision of breast pumps is a potential strategy to increase breastfeeding duration. This trial compared the effectiveness and acceptability of two breast pumps in mothers exclusively breastfeeding (EBF) their healthy term infant. It also tested whether provision of pumps versus vouchers of equivalent value influenced breastfeeding or attainme...
Article
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Methods Literature search timeframe: Publications published after the previous guidelines [1] (i.e., from 2004–December 2014), were considered. Some studies published in 2015 or 2016 during the revision process have also been considered. References cited in the previous guidelines are not repeated here, except for some relevant publications; the pr...
Article
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Background/objectives: BMI (weight/height(2)) is the most widely used marker of childhood obesity and total body fatness (BF). However, its validity is limited, especially in children of South Asian and black African origins. We aimed to quantify BMI adjustments needed for UK children of black African and South Asian origins so that adjusted BMI r...
Article
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Background: An understanding of predictors of breast milk production may enable the provision of better advice and support to mothers with preterm infants who may need to express milk for long periods. Objective: To investigate factors predicting the amount of milk expressed by mothers for their preterm infant (1) during the first 10 days and (2...
Article
Background: The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) recommended in 2008, based on observational data, to avoid both early (less than 4 months) and late (7 or more months) introduction of gluten and to introduce gluten while the infant is still being breastfed. New evidence prompted ESPGHAN to revise...
Article
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Whether fat-free mass (FFM) and its components are depleted in eating-disorder (ED) patients is uncertain. Dual energy X-ray absorptiometry (DXA) is widely used to assess body composition in pediatric ED patients; however, its accuracy in underweight populations remains unknown. We aimed (1) to assess body composition of young females with ED invol...
Article
This paper presents an updated and revised summary of the 'core data set' that has been proposed to be recorded and reported in all clinical trials on infant nutrition by the recently formed Consensus Group on Outcome Measures Made in Paediatric Enteral Nutrition Clinical Trials (COMMENT). This core data set was developed based on a previous propos...
Article
Inorganic arsenic intake is likely to affect long-term health. High concentrations are found in some rice-based foods and drinks widely used in infants and young children. In order to reduce exposure we recommend avoidance of rice drinks for infants and young children. For all rice products, strict regulation should be enforced regarding arsenic co...
Article
The International Society for Clinical Densitometry Official Revised Positions on reporting of densitometry results in children represent current expert recommendations to assist health care providers determine which skeletal sites should be measured, which, if any, adjustments should be made, reference databases to be used, and the elements to inc...
Article
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Introduction: Breastfeeding has several advantages for both mother and child. Lactation consultants may promote prolonged breastfeeding, but little is known about their impact on the initiation of complementary feeding. Subjects and methods: Dietary intake during the initial complementary feeding period from 5 to 6 months was collected on mother...
Article
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Iron deficiency (ID) is the most common micronutrient deficiency worldwide and young children are a special risk group because their rapid growth leads to high iron requirements. Risk factors associated with a higher prevalence of ID anemia (IDA) include low birth weight, high cow's-milk intake, low intake of iron-rich complementary foods, low soci...
Article
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Breastfeeding during infancy may have beneficial effects on various developmental outcomes in childhood. In this study, exclusively breastfed infants were randomly assigned to receive complementary foods from the age of 4 months in addition to breast milk (CF, n = 60), or to exclusively breastfeed to 6 months (EBF, n = 59). At 18 months and again a...
Article
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Outcome of children with intestinal failure (IF) has improved on treatment with parenteral nutrition (PN). The effects of PN and IF on body composition (BC) are unknown. The aim was to review BC in PN-treated children and those weaned off and to compare with reference data. Children on long-term/home PN underwent measurement of regional fat mass (F...
Article
Iron deficiency (ID) is the most common micronutrient deficiency worldwide and young children are a special risk group since their rapid growth leads to high iron requirements. Risk factors associated with a higher prevalence of iron deficiency anemia (IDA) include low birth weight, high cow's milk intake, low intake of iron-rich complementary food...
Article
Watching television and playing video game being seated represent sedentary behaviours and increase the risk of weight gain and hypertension. We investigated the acute effects of violent and non-violent video-game playing on blood pressure (BP), appetite perception and food preferences. Forty-eight young, normal-weight men (age: 23.1±1.9 years; bod...
Article
The Committee on Nutrition of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition aims to document the existing evidence of the benefits and common concerns deriving from the use of donor human milk (DHM) in preterm infants. The comment also outlines gaps in knowledge and gives recommendations for practice and suggestions...
Article
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To investigate the growth and the prevalence of overweight in early childhood among infants exclusively breastfed for 6 months (EBF) compared with those receiving complementary foods from 4 months of age in addition to breast milk (CF). A total of 119 mother-infant pairs were randomized either in the CF or EBF group. Each infant's weight, length an...
Article
Growth charts are essential for evaluating children's health including their nutrition; however, the evaluation of child growth trajectories and consequently the decision to intervene are highly dependent on the growth charts used. The aim of this discussion paper of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Co...
Article
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Background: Mothers with preterm infants may need to express milk for considerable periods. Research to improve breast pump design has focused on compression stimuli, frequencies, and vacuums. Objective: This study aimed to compare the effectiveness of 2 electric pumps: Medela Symphony (pump S) and a novel pump (Philips AVENT Twin electronic pum...
Article
Background: Whether infants use suction or peristaltic tongue movements or a combination to extract milk during breast-feeding is controversial. The aims of this pilot study were 1] to evaluate the feasibility of using 3D ultrasound scanning to visualise infant tongue movements; and 2] to ascertain whether peristaltic tongue movements could be dem...
Article
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Clinical application of body composition (BC) measurements for individual children has been limited by lack of appropriate reference data. (1) To compare fat mass (FM) and fat free mass (FFM) standard deviation scores (SDS) generated using new body composition reference data and obtained using simple measurement methods in healthy children and pati...
Article
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Background: Children with chronic intestinal failure (IF) treated with long-term parenteral nutrition (PN) may present with low bone mineral density (BMD). The cause may reflect small body size or suboptimal bone mineralization. Objective: We assessed growth and bone health in children with severe IF. Design: Height, weight, and fracture histo...
Article
In recent years, reports suggesting a resurgence of vitamin D deficiency in the Western world, combined with various proposed health benefits for vitamin D supplementation have resulted in increased interest from healthcare professionals, the media and the public. The aim of this position paper is to summarize the published data on vitamin D intake...
Article
We have used an expansive definition of a micropreterm infant as <30 weeks' gestation to provide a global perspective to a "high risk" group of preterm infants for which there are little published data to guide nutritional management. Consensus nutritional guidelines for preterm infants have been developed for infants >1000 g birth weight and >28 w...
Article
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Few studies have investigated the effects of infant nutrition on later bone health in term infants, although low sn-2 palmitate in infant formulas has been shown to result in the formation of stool fatty acid soaps, reduced Ca absorption and lower bone mass in the short term. To investigate the effect of (1) breast-feeding (BF) and (2) the type of...
Article
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Objective: To examine relationships among daily activity levels, body composition and bone outcomes in children aged 6.7 years who were born at term with birth weights <20th centile. Methods: Activity data collected using accelerometers were correlated with body composition and bone outcome z-scores from dual-energy X-ray absorptiometry in 36 ch...
Article
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In paediatric practice, mean reference energy requirements for groups are often used to predict individual infant energy requirements. References from the FAO/WHO/United Nations University are based on infants not fed according to the current infant feeding recommendations. The objective of the present study was to measure total energy expenditure...
Article
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Objective: To increase knowledge on iron status and growth during the first 6 months of life. We hypothesized that iron status would be better in infants who received complementary foods in addition to breast milk compared with those exclusively breastfed. Methods: One hundred nineteen healthy term (≥37 weeks) singleton infants were randomly ass...
Article
Background: A routine pediatric clinical assessment of body composition is increasingly recommended but has long been hampered by the following 2 factors: a lack of appropriate techniques and a lack of reference data with which to interpret individual measurements. Several techniques have become available, but reference data are needed. Objective...
Article
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South Asian children and adults have a more adipose body composition compared with those of European ancestry. This is thought to be related to their increased risk of metabolic disorders. However, little is known about how early in life such differences are manifest. To determine whether there are differences in fat mass (FM) and fat-free mass (FF...
Article
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The Early Nutrition Academy and the Child Health Foundation, in collaboration with the Committee on Nutrition, European Society for Paediatric Gastroenterology, Hepatology and Nutrition, held a workshop in March 2011 to explore guidance on acquiring evidence on the effects of nutritional interventions in infants and young children. The four objecti...
Article
Data on clinical safety and efficacy are ideally collected in a randomized clinical trial or, failing this, an observational study. Suitable outcomes vary depending on the intervention and population group, and certain outcomes such as growth may test both efficacy and safety. The use of growth as an important safety outcome has some limitations si...
Article
Full-text available
The Early Nutrition Academy and the Child Health Foundation, in collaboration with the Committee on Nutrition, European Society for Paediatric Gastroenterology, Hepatology and Nutrition, held a workshop in March 2011 to explore guidance on acquiring evidence on the effects of nutritional interventions in infants and young children. The four objecti...
Article
The WHO recommends exclusive breastfeeding (EBF) for 6 mo after birth. However, the time at which breast milk ceases to provide adequate energy and nutrition, requiring the introduction of complementary foods, remains unclear. Most studies that investigated this issue were observational and potentially confounded by variability in social circumstan...
Article
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To evaluate whether dual energy x-ray absorptiometry (DXA) and quantitative ultrasound (QUS) classify the same children as 'abnormal' (SD (z) score (SDS) ≤-2). Speed of sound (SOS) was measured at the radius and tibia using QUS and lumbar spine bone mineral density (BMD) using DXA in 621 subjects aged 5-20 years; healthy 412, cystic fibrosis 117 an...
Article
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Whether the design of an anti-vacuum infant feeding bottle influences infant milk intake, growth or behavior is unknown, and was the subject of this randomized trial. 63 (36 male) healthy, exclusively formula-fed term infants. Randomisation to use Bottle A (n = 31), one-way air valve: Philips Avent) versus Bottle B (n = 32), internal venting system...
Article
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Background/objectives: Bioelectrical impedance analysis (BIA) is widely used to predict body composition in paediatric research and clinical practice. Many equations have been published, but provide inconsistent predictions. Aims: To test whether a single equation for lean mass (LM) estimation from BIA is appropriate across wide ranges of age, p...
Article
Increasing evidence suggests that rapid postnatal weight gain is associated with increased risks of being overweight or obese later in life and of co-morbidities, such as diabetes, the metabolic syndrome and cardiovascular disease. In children as young as two years of age, as well as in adults, an appetitive system-linked impulsivity trait has been...
Article
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To test whether and how human lactation and breastfeeding practices can adapt to fulfill infant energy requirements during exclusive breastfeeding for 6 months. The First-Feed study was a longitudinal, observational field study to measure milk intake, energy intake (from the doubly labeled water method), anthropometry, and breastfeeding practices a...
Article
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To test the hypothesis that long-chain polyunsaturated fatty acid (LCPUFA) supplementation in infancy would improve cognition into later childhood (after 9 years) at both general and specific levels. A comprehensive cognitive battery was completed by 107 formerly preterm infants (mean age: 128 months). As infants, they had been assigned randomly to...
Article
Public health recommendations should be based on the best available scientific evidence, and this necessitates careful appraisal of the available data and management of scientific uncertainty. This paper discusses the difficulties in collecting and interpreting scientific data on infant feeding, in particular the fact that since it is not feasible...
Article
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Aluminium is the most common metallic element, but has no known biological role. It accumulates in the body when protective gastrointestinal mechanisms are bypassed, renal function is impaired, or exposure is high - all of which apply frequently to preterm infants. Recognised clinical manifestations of aluminium toxicity include dementia, anaemia a...
Article
The relationship between breast-feeding and later cardiovascular health has been investigated in randomised trials and observational studies. This review focuses on randomised control trials, regarded as the 'gold standard' in establishing causal relationships between interventions and outcomes. Since it is not ethical to randomise healthy term inf...
Article
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Body composition techniques are required for monitoring response to treatment in individual obese children, and assessing the efficacy of weight loss programmes. Densitometry is readily undertaken, using air displacement plethysmography (ADP), but requires appropriate information on the density of lean tissue (D(LT)). The aims of this study were to...
Article
Preterm infants are at risk of metabolic bone disease (MBD) because of an inadequate mineral intake. Although infants with MBD are frequently asymptomatic during the neonatal period, we previously reported that MBD predicted reduced linear growth in infancy and midchildhood. Nevertheless, some studies suggest that preterm infants undergo catch-up g...
Article
Early life nutrition may influence later osteoporosis risk. Preterm infants are at particular risk of suboptimal early nutrition, which is associated with poor neonatal bone mineralization and metabolic bone disease, but it is unclear whether this has long-term consequences for bone health. This review discusses the long-term effects of early diet...
Article
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Stable isotope techniques using deuterium or (18)O are reference methods for assessing total body water (TBW) for body composition. In combination, they provide total energy expenditure and human milk intake in exclusively breast-fed (EBF) infants. These techniques require an oral administration of an accurately quantified dose of labelled water to...