Author Interviews, Coffee, Ophthalmology / 04.12.2021

MedicalResearch.com Interview with: [caption id="attachment_58458" align="alignleft" width="150"]Kristine Dalton PhD FAAO, FBCLA School of Optometry & Vision Science University of Waterloo Waterloo, Canada Dr. Dalton[/caption] Kristine Dalton PhD FAAO, FBCLA School of Optometry & Vision Science University of Waterloo Waterloo, Canada MedicalResearch.com: What is the background for this study? Response: Dynamic visual acuity refers to the ability to detect and perceive small details in objects that are moving relative to an observer.  Dynamic visual acuity is a complex visual function, that involves a number of different aspects of vision, including detecting the target, moving the eyes appropriately to observe the target, and processing the visual information from the target in the brain to interpret what we are seeing.   What makes dynamic visual acuity so interesting to study, is that as a visual function, it appears to play an important role in a number of real-world situations, including playing sports, driving, and piloting, and it may provide us more information about how the visual system is functioning compared to the more traditional, static vision tests alone. Previous research has demonstrated that consumption of caffeine has been shown to benefit physiological, psychomotor, and cognitive performance.  More recently there has been an increased interest in studying the impacts of caffeine on the vision system, however the impact of caffeine on dynamic visual acuity has not been studied.  This study was designed to address this limitation in the literature, particularly because dynamic visual acuity appears to be such an important visual function for real-world activities.  
Author Interviews, Coffee, OBGYNE / 25.08.2020

MedicalResearch.com Interview with: [caption id="attachment_55208" align="alignleft" width="128"]Professor Jack E. James, PhD Reykjavík University Reykjavík Iceland Prof. James[/caption] Professor Jack E. James, PhD Reykjavík University Reykjavík Iceland  MedicalResearch.com: What prompted this study?  Response: Chronic exposure to any chemical during pregnancy is cause for concern. There should be no exception simply because that chemical, caffeine, happens to be widely consumed. Caffeine is a habit-forming substance of no nutritional value. If anything, its widespread consumption suggests that it should be given special attention. Concern is heightened by what is known about the effects of caffeine on the human body, where it affects neural processes in the brain, including networks that control respiration and heart function. When consumed during pregnancy, caffeine readily crosses the placenta, exposing the fetus to the drug. Notably, the fetus is largely physically incapable of metabolising caffeine – that ability develops during the first year of life. Pregnancy studies have shown that caffeine can interfere with fetal heart function and oxygenation. 
Author Interviews, Coffee, Hepatitis - Liver Disease, JAMA, OBGYNE, Pediatrics / 30.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50491" align="alignleft" width="128"]Dr-Hui Wang Dr. Hui Wang[/caption] Prof Hui Wang PhD Wuhan University China MedicalResearch.com: What is the background for this study? What are the main findings? Response: We started our work in the adverse outcome of maternal caffeine intake during pregnancy about 15 years ago. Then, we found that prenatal caffeine intake could result in nonalcoholic fatty liver disease in the offspring. However, the underlying mechanism was unclear. So, we start the current work, and found that hat maternal caffeine intake disrupts liver development before and after birth, which might be the trigger of the adult non-alcoholic fatty liver disease in the offspring rats. Moreover, we further found that the fetal programming of liver glucocorticoid – insulin like growth factor 1 axis, a new endocrine axis first reported by our team, might participate in such process. 
Addiction, Author Interviews, Coffee / 16.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49187" align="alignleft" width="128"]Dr Lorenzo Stafford, PhD, CPsycholSenior Lecturer, Department of PsychologyUniversity of PortsmouthPortsmouth Stafford[/caption] Dr Lorenzo Stafford, PhD, CPsychol Senior Lecturer, Department of Psychology University of Portsmouth Portsmouth  MedicalResearch.com: What is the background for this study?   Response: The background to this work was that I had been thinking for sometime on the role of our sense of smell in drug consumption and addiction.  Most of the research in this area is dominated by visual processes, in particular showing how cues associated to drugs (e.g. packet of cigarettes, bottle of beer) become conditioned in such drug users. That work has been useful in explaining how in recovering addicts, long after the withdrawal symptoms have subsided, when exposed to such cues, they can nevertheless relapse to craving and consuming the drug; hence though a powerful driver, addiction is not just about reversing withdrawal symptoms. However, most of our richer experiences are multisensory, so it seems likely that other senses must also play a role in the addictive process. Years ago, I completed a PhD on the topic of caffeine and with the general importance placed on the sensory (especially smell) aspects of coffee, all planted the seed for a possible study. We completed two experiments that examined the lowest concentration at which participants (high, moderate and non-coffee consumers) could detect (Threshold test) a coffee associated chemical (exp 1) and in a separate task, how fast they were at identifying (Recognition test) the odour of real coffee. In experiment 2, participants (coffee consumers and non-consumers) completed the same Threshold test for the coffee odour but also completed a Threshold test for a control odour.
Author Interviews, Coffee, Heart Disease, Nutrition / 13.05.2019

MedicalResearch.com Interview with: Professor Elina Hypponen Professor in Nutritional and Genetic Epidemiology Director: Australian Centre for Precision Health  Australian Centre for Precision Health| University of South Australia Cancer Research Institute | South Australian Health & Medical Research Institute  MedicalResearch.com: What is the background for this study? Response: In Randomised controlled trials caffeine, which is a key constituent of coffee, has been shown to increase blood pressure. There is also some past evidence to suggest that higher coffee consumption may increase the risk of cardiovascular disease, but only in individuals who are slow caffeine metabolisers. We used information from about 350,000 individuals from the UK, to look at the association between patterns of  habitual of coffee consumption and the subsequent risk of cardiovascular disease. As we also know that people are genetically different with respect to their ability to metabolise caffeine, a further aim for our study was to look at whether those people who are able to metabolise caffeine effectively, may also be more resistant to possible cardiovascular effects of coffee, compared to those who metabolise caffeine more slowly. 
Author Interviews, Coffee, Weight Research / 23.07.2018

MedicalResearch.com Interview with: Coffee being poured Coffee pot pouring cup of coffee. copyright American Heart Association Leah Panek-Shirley, PhD Assistant Professor Buffalo State College Health, Nutrition, and Dietetics Houston Texas MedicalResearch.com: What is the background for this study? What are the main findings? Response: The findings of existing previous research evaluating the effects of caffeine on appetite and eating are equivocal. This study evaluated the effects of no (0 mg/kg body weight, e.g. placebo), low (1 mg/kg body weight), and moderate (3 mg/kg body weight) doses of caffeine in juice on appetite and eating in the laboratory and under free-living conditions. While this study identified a small decrease (about 70 calories) in caloric intake after consuming the low (1 mg/kg) dose of caffeine in the laboratory at breakfast, this difference did not persist throughout the entire day.  In addition, there were no differences in hunger, fullness, thirst, or desire to eat as a result of caffeine.
Author Interviews, Coffee, Sleep Disorders / 01.03.2018

MedicalResearch.com Interview with: Coffee being poured Coffee pot pouring cup of coffee. copyright American Heart AssociationJulia F. van den Berg, PhD Leiden University, Department of Clinical Psychology Leiden, The Netherlands  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Caffeine is the most used psychoactive substance worldwide, mostly consumed via coffee, energy drinks, tea and chocolate. Experimental studies have shown that caffeine can negatively affect sleep quality. The timing of caffeine consumption may play a role; the closer to bedtime, the more caffeine consumption is  likely to have a negative effect on sleep. We also wondered if chronotype, being a morning or evening person, would make a difference in the effect of caffeine on sleep. We sent out questionnaires on sleep quality, chronotype, and a detailed questionnaire on type and timing of caffeine use to 880 secondary education students (mean age 21.3 years). We found that for the entire group, the amount of caffeine per week was not associated with sleep quality, regardless of chronotype. However, when we divided the group into subgroups of students who did, and students who did not usually consume caffeine in the evening (after 6PM), we found something interesting. Only for students who did not consume caffeine in the evening (20% of the total sample), a higher total caffeine consumption per week was associated with poorer sleep, in spite of the fact that these students consumed a lot less  caffeine per week than the group who did consume caffeine in the evening. This suggests a self-regulatory mechanism: students who know they are sensitive to caffeine do not drink it in the evening, nevertheless, the caffeinated beverages they drink during the day do affect their sleep.
Author Interviews, Coffee, Kidney Disease / 04.11.2017

MedicalResearch.com Interview with: Coffee Wikipedia imageMedicalResearch.com Interview with: Miguel Bigotte Vieira, MD Centro Hospitalar Lisboa Norte Lisboa, Portugal Response: An inverse relationship between coffee consumption and mortality has been reported in the general population. However, the association between caffeine consumption and mortality in patients with chronic kidney disease (CKD) remains unclear. We examined the association between varying levels of caffeine consumption and mortality among 2328 patients with CKD in a prospective nationwide cohort, using the continuous National Health and Nutrition Examination Survey (NHANES) 1999-2010. A dose-dependent inverse association between caffeine and all-cause mortality was observed in patients with CKD. This association was independent of influential factors including age, gender, race, annual family income, education level, estimated GFR, albumin/creatinine ratio, hypertension, smoking status, dyslipidemia, body mass index, previous cardiovascular events and diet: consumption of alcohol, carbohydrates, polyunsaturated fatty acids and fibers. Comparing with 1st quartile of caffeine consumption, adjusted HR for death was 0.88 (95% CI, 0.68-1.44) for 2nd quartile, 0.78 (95% CI, 0.60-1.01) for 3rd quartile and 0.76 (95% CI, 0.59-0.97) for 4th quartile (p=0.027 for trend across quartiles)
Author Interviews, Coffee, Kidney Disease / 01.11.2017

MedicalResearch.com Interview with: [caption id="attachment_37801" align="alignleft" width="150"]Miguel Bigotte Vieira MD Centro Hospitalar Lisboa Norte Lisbon, Portugal Dr. Bigotte Vieira[/caption] Miguel Bigotte Vieira MD Centro Hospitalar Lisboa Norte Lisbon, Portugal  MedicalResearch.com: What is the background for this study? What are the main findings? Response:  An inverse relationship between coffee consumption and mortality has been reported in the general population. However, the association between caffeine consumption and mortality in patients with chronic kidney disease (CKD) remains unclear. We examined the association between varying levels of caffeine consumption and mortality among 2328 patients with CKD in a prospective nationwide cohort, using the continuous National Health and Nutrition Examination Survey (NHANES) 1999-2010. A dose-dependent inverse association between caffeine and all-cause mortality was observed in patients with CKD. This association was independent of influential factors including age, gender, race, annual family income, education level, estimated GFR, albumin/creatinine ratio, hypertension, smoking status, dyslipidemia, body mass index, previous cardiovascular events and diet: consumption of alcohol, carbohydrates, polyunsaturated fatty acids and fibers. Comparing with 1st quartile of caffeine consumption, adjusted HR for death was 0.88 (95% CI, 0.68-1.44) for 2nd quartile, 0.78 (95% CI, 0.60-1.01) for 3rd quartile and 0.76 (95% CI, 0.59-0.97) for 4th quartile (p=0.027 for trend across quartiles)
Author Interviews, Coffee, Weight Research / 28.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36667" align="alignleft" width="112"]MedicalResearch.com Interview with: Robin Dando, PhD Assistant Professor Director, Cornell Sensory Evaluation Facility Department of Food Science Cornell University Ithaca, NY 14853 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study arose from a previous paper I authored in the Journal of Neuroscience, where we found Adenosine receptors in taste. We managed to prove that they were there to amplify sweet signals. This led us to wonder, what about the foods we consume, that would come into contact with these receptors in taste buds. It just happens that a lot of us habitually consume a powerful blocker of adenosine receptors every morning. Caffeine. So is our coffee impairing sweet signals? It turns out when we gave people sweetened coffee containing caffeine, they judged it as less sweet than the same coffee without the caffeine, sampled on a different day. Interestingly, this persisted, and sweet solutions they tested afterwards were still a little less sweet. Finally, just for kicks, we asked them to rate how much caffeine they thought was in either coffee, and how much more alert it made them feel. Turns out, there was no difference. They couldn’t tell which was deacf, and either coffee gave them just as much of an alertness boost. MedicalResearch.com: What should clinicians and patients take away from your report? Response: Readers should consider that they may be altering how their food tastes when consuming coffee. And perhaps also, they could be drinking decaf, and getting just as good a jolt from it (as long as someone else was preparing it for them, so they didn’t know). MedicalResearch.com: What recommendations do you have for future research as a result of this study? Response: We’re interested in how many factors we encounter in our every day lives change our perception, from the foods we’re consuming themselves, to our own bodies. We’re currently looking into how obesity, pregnancy and sleep can change our sense of taste, and the foods we crave. If you’d like to hear more about what we do, you can follow our work on twitter @DandoLab. MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community. 1.Citation: Ezen Choo, Benjamin Picket, Robin Dando. Caffeine May Reduce Perceived Sweet Taste in Humans, Supporting Evidence That Adenosine Receptors Modulate Taste. Journal of Food Science, 2017; DOI: 10.1111/1750-3841.13836 Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions. [wysija_form id="5"] Dr. Dando[/caption]Robin Dando, PhD Assistant Professor Director, Cornell Sensory Evaluation Facility Department of Food Science Cornell University Ithaca, NY 14853  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study arose from a previous paper I authored in the Journal of Neuroscience, where we found Adenosine receptors in taste.  We managed to prove that they were there to amplify sweet signals.  This led us to wonder, what about the foods we consume, that would come into contact with these receptors in taste buds. It just happens that a lot of us habitually consume a powerful blocker of adenosine receptors every morning.  Caffeine.  So is our coffee impairing sweet signals?  It turns out when we gave people sweetened coffee containing caffeine, they judged it as less sweet than the same coffee without the caffeine, sampled on a different day.  Interestingly, this persisted, and sweet solutions they tested afterwards were still a little less sweet. Finally, just for kicks, we asked them to rate how much caffeine they thought was in either coffee, and how much more alert it made them feel.  Turns out, there was no difference.  They couldn’t tell which was deacf, and either coffee gave them just as much of an alertness boost.
Author Interviews, Coffee, Heart Disease, JAMA / 17.10.2016

MedicalResearch.com Interview with: [caption id="attachment_28941" align="alignleft" width="200"]Luis E. Rohde, MD, ScD Postgraduate Program in Health Science: Cardiology and Cardiovascular Sciences, Medical School, Federal University of Rio Grande do Sul, Cardiovascular Division, Hospital de Clínicas de Porto Alegre Dr. Luis E. Rohde[/caption] Luis E. Rohde, MD, ScD Postgraduate Program in Health Science: Cardiology and Cardiovascular Sciences, Medical School, Federal University of Rio Grande do Sul, Cardiovascular Division, Hospital de Clínicas de Porto Alegre MedicalResearch.com: What is the background for this study? Response: Caffeine-rich beverages have been implicated as a common cause of several cardiac-related symptoms, such as palpitations, tachycardia, or irregular heartbeats. Because of this “intuitive” assumption, counseling to reduce or avoid caffeine consumption is still widely recommended in clinical practice by most physicians for patients with any heart disease.
Author Interviews, Coffee, Hepatitis - Liver Disease / 24.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24648" align="alignleft" width="200"]Sikarin Upala MD, MS, LLB Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, New York Preventive and Social Medicine Mahidol University, Bangkok, Thailand Dr. Sikarin Upala[/caption] Sikarin Upala MD, MS, LLB Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, New York Preventive and Social Medicine Mahidol University, Bangkok, Thailand MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Upala: Chronic hepatitis C virus infection is the most common cause of chronic liver disease and cirrhosis as well as the most common cause of liver transplantation in the United States. As caffeine has been found to be related to decreased liver enzymes, chronic liver disease,cirrhosis, and risk of hepatocellular carcinoma in several liver disease pathologies. There is inconclusive findings on the effect of caffeine on hepatitis C infected patients. Thus, we conducted a systematic review and meta-analysis to summarize the effect of caffeine consumption in patients with chronic hepatitis C. We found that caffeine consumers have a 61% reduced risk of developing advanced hepatic fibrosis, which is one of the consequence of chronic hepatitis C. Our meta-analysis result is in the same way with other studies who found that coffee consumption could prevent the development of hepatic fibrosis in patients with liver disease. However, we cannot conclude about the effect of caffeine on HCV viral load as there is not enough information.
Author Interviews, Coffee, Fertility, Lifestyle & Health, NIH, OBGYNE / 24.03.2016

MedicalResearch.com Interview with: [caption id="attachment_22845" align="alignleft" width="133"]Germaine M. Buck Louis, Ph.D., M.S. Office of the Director, Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development Rockville, Maryland 20852. Dr-Germaine M. Buck-Louis[/caption] Germaine M. Buck Louis, Ph.D., M.S. Office of the Director Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development Rockville, Maryland 20852. MedicalResearch.com: What is the background for this study? What are the main findings? Response: To understand the association between couples’ lifestyles and risk of pregnancy loss.  Couples were recruited upon discontinuing contraception to try for pregnancy and followed daily for up to one year of trying or until pregnancy.  Pregnant women were followed daily for 7 weeks following conception then monthly.
Author Interviews, JAMA, Pediatrics / 19.11.2014

Dr. Abhay Lodha, MBBS, MD, DM, MSC Assistant Professor, Department of Pediatrics and Community Health Sciences, University of Calgary, Staff Neonatologist and Clinical Epidemiologist, Section of Neonatology, Alberta Health Services, Chairman, CME Foothills Medical Centre, Calgary, Alberta, CanadaMedicalResearch.com Interview with: Dr. Abhay Lodha, MBBS, MD, DM, MSC Assistant Professor, Department of Pediatrics and Community Health Sciences, University of Calgary, Staff Neonatologist and Clinical Epidemiologist, Section of Neonatology, Alberta Health Services, Chairman, CME Foothills Medical Centre, Calgary, Alberta, Canada Medical Research: What is the background for this study? What are the main findings? Dr. Lodha: Apneic episodes (cessation of breathing) occur in the premature infants. Caffeine is the most commonly used medication for apnea of prematurity. Normally caffeine started on day 3 of life for apnea. However, there is no strong evidence that starting caffeine on day 1 or 2 life has some extra advantages in premature infants. Our study has a large number of premature infants. Our study determined the association of early initiation of caffeine therapy in very preterm neonates and neonatal outcomes. The main finding of our study was that early use of caffeine was associated with a reduction in the rate of death or bronchopulmonary dysplasia and patent ductus arteriosus. We did not find any adverse impact on any other outcomes.
Author Interviews, Coffee, Kidney Stones / 06.10.2014

Pietro Manuel Ferraro, MD PhD Candidate Division of Nephrology Catholic University of the Sacred Heart Rome ItalyMedicalResearch.com Interview with: Pietro Manuel Ferraro, MD PhD Candidate Division of Nephrology Catholic University of the Sacred Heart Rome Italy Medical Research: What are the main findings of the study? Dr. Ferraro: We analyzed the association between caffeine intake and the risk of developing kidney stones in three large cohorts of U.S. health professionals. The 217,883 participants included did not have any history of kidney stones when follow-up began. During 20 years of follow-up, 4,982 of them developed a kidney stone. In all three cohorts, participants with higher intakes of caffeine had a reduced risk of developing kidney stones. Intake of caffeine from sources other than coffee was also associated with reduced risk of kidney stones. Among 6,033 participants with 24-hour urine data, intake of caffeine was associated with higher excretion of calcium but also higher urine volume and lower likelihood of calcium and uric acid stone formation.
Author Interviews / 06.09.2014

MedicalResearch.com Interview with: Naman Ahluwalia, PhD, DSc, FACN Nutrition Monitoring Advisor Office of the Director Division of Health and Nutrition Examination Surveys, NCHS, CDC Hyattsville, MD 20782 Medical Research: What are the main findings of the study? Dr. Ahluwalia: Health Canada has put forth caffeine intake guidelines for children and adolescents in absolute amounts (mg) and in mg/kg body weight for teens. The maximal caffeine intakes of 45, 63, and 85 mg/day are suggested for children ages 4-6, 7-9, and 10-12 years and for teens (13 y and over) Health Canada suggests that caffeine intake be no more than 2.5 mg/kg body weight/day. Although no such recommendations have been set in the US, the American Academy of Pediatrics (AAP) underlines that “caffeine and other stimulant substances contained in energy drinks have no place in the diet of children.” This study provides national estimates of dietary caffeine intake in US children 2-19 y of age, both in absolute amounts (mg) and in relation to body weight (mg/kg), to update estimates that were published in another study in 2005 based on older data from the Continuing Survey of Food Intakes by individuals in 1994-96 and 1998. The key findings were: 1. Majority (71%) of children in the survey reported consuming caffeine on a given day; over one-half of US children aged 2-5 y and 3 in 4 children ages 6 y and over consumed caffeine on a given day. 2. Certain socio-demographic patterns in caffeine intake were observed. More non-Hispanic white and Mexican American children reported consuming caffeine than non-Hispanic black children; in addition, the amount of caffeine consumed by non-Hispanic white and Mexican American children was higher than that consumed by non-Hispanic black children. Caffeine intake increased with age. For instance, 2-5 year-old caffeine consumers reported 5 mg of caffeine intake on a given day, compared to 9 mg for 6-11 y olds and ~ 40 mg for teens (12-19 y). For reference, a 8 fl oz can of soda contains about 24-50 mg of caffeine. 3. Another finding was that on a given day one in ten children (6-19 y) had caffeine intakes that exceeded the Canadian maximal guidelines. 4. Caffeine intake (mg or mg/kg) stayed relatively constant among teens over the last decade, but trends towards decreased intake were noted in younger (2-11 y old) children.
Alzheimer's - Dementia, Author Interviews, Coffee / 08.04.2014

Prof. Dr. Christa E. Müller University of Bonn Pharmaceutical Institute Pharmaceutical Chemistry I An der Immenburg 4 D-53121 Bonn (Endenich) Germany MedicalResearch.com Interview with: Prof. Dr. Christa E. Müller University of Bonn Pharmaceutical Institute Pharmaceutical Chemistry I An der Immenburg 4  D-53121 Bonn (Endenich) Germany MedicalResearch.com: What are the main findings of the study? Prof. Dr. Christa E. Müller: Genetically altered mice which show an aggregation of Tau protein and many symptoms of Alzheimer's Disease which progressively worsen with time was used. Caffeine was given to one group of mice at an early stage, when the symptoms were still moderate. The caffeine-treated mice showed better memory and less inflammation and brain damages in comparison to the non-treated control mice. This means that caffeine protected the mice to some extent. The side effects were moderate.
Author Interviews, Nutrition / 18.03.2013

MedicalResearch.com Interview with: Yoshihiro Kokubo, MD, PhD, FACC, FAHA, FESC Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishiro-dai, Suita, Osaka, MedicalResearch.com: What are the main findings of the study? Dr. Kokubo:  In this study, higher green tea (2 or more cups/day) and coffee (3 to 6 times/week, 1 or more cups/day) consumption were found to be inversely associated with the incidences of cardiovascular disease and stroke. Higher green tea (2 or more cups/day) or coffee (1 or more cups/day) consumption reduced the risks of cardiovascular disease, strokes, and its subtypes, especially in intracerebral hemorrhage (P for interaction between green tea and coffee=0.04).
Author Interviews, Nutrition, OBGYNE, Pediatrics / 17.03.2013

MedicalResearch.com Interview with : Verena Sengpiel, researcher Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg MedicalResearch.com: What are the main findings of the study? Response: 1. Coffee, but not caffeine, consumption was associated with marginally increased gestational length but not with the risk of spontaneous preterm delivery. 2. Caffeine intake was consistently associated with decreased birth weight and increased odds of SGA (small for gestational age). This might have clinical implications as even caffeine consumption below the recommended maximum (200 mg/d in the Nordic countries and USA, 300 mg/d according to WHO) was associated with increased risk for SGA.