Because microbes use carotenoids as an antioxidant for protection, dietary carotenoids could be associated with gut microbiota composition. We aimed to determine associations among reported carotenoid intake, plasma carotenoid concentrations, and fecal bacterial communities in pregnant women. Pregnant women ( n = 27) were enrolled in a two‐arm study designed to assess feasibility of biospecimen collection and delivery of a practical nutrition intervention. Plasma and fecal samples were collected and women were surveyed with a 24‐hr dietary checklist and recalls. Plasma carotenoids were analyzed by HPLC using photodiode array detection. Fecal bacteria were analyzed by 16S rRNA DNA sequencing. Results presented are cross‐sectional from the 36‐week gestational study visit combined across both study arms due to lack of significant differences between intervention and usual care groups ( n = 23 women with complete data). Recent intake of carotenoid‐containing foods included carrots, sweet potatoes, mangos, apricots, and/or bell peppers for 48% of women; oranges/orange juice (17%); egg (39%); tomato/tomato‐based sauces (52%); fruits (83%); and vegetables (65%). Average plasma carotenoid concentrations were 6.4 µg/dL α‐carotene (AC), 17.7 µg/dL β‐carotene (BC), 11.4 µg/dL cryptoxanthin, 39.0 µg/dL trans‐lycopene, and 29.8 µg/dL zeaxanthin and lutein. AC and BC concentrations were higher in women who recently consumed foods high in carotenoids. CR concentrations were higher in women who consumed oranges/orange juice. Microbiota α‐diversity positively correlated with AC and BC. Microbiota β‐diversity differed significantly across reported intake of carotenoid containing foods and plasma concentrations of AC. This may reflect an effect of high fiber or improved overall dietary quality, rather than a specific effect of carotenoids. Practical Application: Little is known about the association between the gut microbiome and specific dietary microconstituents, such as carotenoids, especially during pregnancy. This research demonstrates that a carotenoid‐rich diet during pregnancy supports a diverse microbiota, which could be one mechanism by which carotenoids promote health.

As obesity rates continue to rise, it is increasingly important to understand factors that can influence body weight and growth, especially from an early age. The infant gut microbiota has broad effects on a variety of bodily processes, but its relation to infant growth is not yet fully characterized. Since the infant gut microbiota is closely related to breastfeeding practices and maternal health, understanding the relationship between these factors and infant growth may provide insight into the origins of childhood obesity. Identify the relationship between human milk exposure, maternal pre-pregnancy body mass index (BMI), the infant gut microbiota, and 12-month-old BMI-for-age z-scores (12M BAZ) to identify key factors that shape infant growth. Two Michigan cohorts (ARCHGUT and BABYGUT) comprised of a total of 33 mother-infant dyads provided infant fecal samples at 12M. After DNA extraction, amplification, and sequencing of the V4 16S rRNA region using Illumina MiSeq v2 Chemistry, gut bacterial diversity metrics were analyzed in relation to human milk exposure, maternal pre-pregnancy BMI, and infant growth parameters. Recent human milk exposure was inversely related to maternal pre-pregnancy BMI and most strongly associated with infant gut bacterial community membership and individual gut microbiota richness differences. Maternal pre-pregnancy BMI was not associated with the infant gut microbiota after adjusting for human milk exposure. However, maternal pre-pregnancy BMI was the only factor significantly associated with 12M BAZ. Human milk exposure is one of the central influences on the infant gut microbiota at 12M of age. However, the lack of association between the infant gut microbiota and 12M-old infant BAZ suggests that genetic, physiological, dietary, and other environmental factors may play a more direct role than the gut microbiota in determining infant BAZ at 12M.

The infant gut microbiome is shaped by numerous factors such as diet and the maternal microbiota and is also associated with later atopy and obesity. The Archive for Research in Child Health and Baby Gut (ARCHBG) cohort was established in 2015 to (1) understand how the development of the infant gut microbiota is associated with atopy, obesity, and gastrointestinal disease and (2) characterize the associations of maternal pre-pregnancy BMI and infant diet with the development of the gut microbiota. Study participants for ARCHBG are convenience samples recruited through two pipelines in Lansing and Traverse City, Michigan: (1) Archive for Research in Child Health (ARCH_GUT) and (2) BABY_GUT. A total of (n = 51) mother–infant dyads have been enrolled to date. This prospective cohort study collects maternal pre-pregnancy fecal samples, maternal data, child fecal samples at four timepoints (one week, six months, 12 months, and 24 months), and child data up to five years of age. All samples and data are collected remotely by mail, phone, or drop-off at select locations. Of all participants enrolled, 76.5% (n = 39) of infants have a complete record of stool samples. At least 88.2% (n = 45) of fecal samples were submitted at each timepoint. ARCHBG will allow for a nuanced understanding of the temporal development of the infant gut microbiome and numerous child health outcomes.

Previous research examined effects of human milk on the infant gut microbiota, but little attention has been given to the microbiota of lactating women. To determine associations between exclusive human milk feeding and gut microbiota characteristics in mothers and infants at 6-weeks postpartum. A sample of mother–infant dyads (N = 24) provided fecal samples and questionnaire responses at 6-weeks postpartum as part of the Pregnancy, EAting & POstpartum Diapers study. Deoxyribonucleic acid was extracted from stool samples, followed by (V4) 16S ribosomal ribonucleic acid gene amplicon sequencing. Alpha and beta diversity, in addition to taxa differences, were compared by human milk exposure status, exclusive versus non-exclusive. A subset of dyads (those exclusively fed human milk; n = 14) was analyzed for shared bifidobacterial species using polymerase chain reaction. Alpha diversity was significantly lower in exclusively human milk-fed infants. Maternal lactation status (exclusive vs. partial) and Shannon diversity were associated in univariate analysis but were no longer associated in multivariable regression including body mass index category in the model. Beta diversity (Sorensen dissimilarity) of fecal samples from women and infants was significantly associated with human milk feeding. Of six infants with Bifidobacterium longum subspecies longum in their fecal samples, all their mothers shared the same species. Maternal gut microbiotas differ by lactation status, a relationship potentially confounded by body mass index category. Further research is needed to identify whether lactation directly influences the maternal gut microbiota, which may be another mechanism by which lactation influences health.

Background: Medically tailored meals (MTMs) are personalized meals designed to meet the therapeutic needs of patients with chronic diseases. Most MTM programs rely on philanthropic support, and the optimal parameters for these programs are not well-defined. Aim: To assess the feasibility of an MTM program developed by a major healthcare institution using internal investments and an online platform for meal ordering. Methods: Single-arm prospective cohort feasibility MTM project implemented between August 2021 and June 2022. Each participant received 14 frozen meals per week over 3 months via a courier system. Participants answered several questionnaires and healthcare utilization was abstracted from electronic medical records up to 6 months post-intervention. Results: Sixty participants were enrolled. Emergency department (ED) visits and inpatient days significantly decreased in the 180 days post-intervention compared to the 180 days pre-intervention (ED visits: 1.2 vs 1.7, P = 0.005; inpatient days: 3.2 vs 5.1, P = 0.02). Participants saved an average of $12,046 in healthcare costs. Despite challenges with implementation, including upfront costs and sustainability, client and service outcomes were highly favorable. Patients were overwhelmingly satisfied with the program, although there was no quantitative improvement in global mental health (GMH) or global physical health (GPH) scores. Conclusion: MTM programs run by healthcare institutions can enhance patient satisfaction, reduce hospital visits, and lower healthcare costs, particularly for vulnerable populations. Providing healthy, frozen meals over an extended period is feasible, though it requires significant initial investment. Large healthcare institutions should consider implementing such programs to prioritize primary prevention in the US healthcare system.

This study examined the pre- and post-operative variables that are associated with one-year and long-term insulin independence following total pancreatectomy and islet auto-transplantation (TPIAT). Charts of 46 TPIAT patients seen from 2010 to 2022 in a single hospital system were retrospectively analyzed. Pre- and post-operative variables were compared between short- (one year) and long-term (last follow up outside of year one) insulin-independent versus dependent patients. Nine (20%) and seven (15%) patients achieved short- and long-term insulin independence, respectively. The patients were followed for a median of 2.8 years (IQR 1.0, 4.7). Short term insulin-independence was associated with higher median transplanted islet equivalents IEQ/kg (6,981 vs 4,493, p=0.02), lower units of basal insulin on discharge (7 vs 12, p=0.009), and lower rates of discharge from the hospital with an insulin regimen (67% vs 100%, p=0.006). The odds of having short term insulin independence increased by 80% for every 1,000 increase in IEQ/kg (OR 1.80, CI 1.18 to 3.12, p=0.005) and decreased by 32% for every additional basal unit of insulin on discharge (OR 0.68, CI 0.42 to 0.91, p=0.003) on average. Long-term insulin independence was also associated with transplanted IEQ/kg in univariable analysis. No patient on antihyperglycemic medication prior to surgery achieved insulin independence. Short- and long-term insulin independence after TPIAT is associated with higher transplanted IEQ/kg and immediate post-operative variables that can be used to inform the discussions clinicians have with their patients regarding glycemic prognosis following TPIAT. Complete insulin independence remains low following TPIAT.