Publications by authors named "Evgen Benedik"

12 Publications

  • Page 1 of 1

The Influence of Maternal Levels of Vitamin D and Adiponectin on Anthropometrical Measures and Bone Health in Offspring.

Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2019 Dec;40(3):91-98

Department of Neonatology, University Children's Hospital, University Medical Centre Ljubljana, 1000Ljubljana, Slovenia.

Background: From the conception onward, certain parameters associated with maternal health may affect foetal body composition, growth and bone mineral content. The objective of the study was to determine the association between maternal vitamin D and adiponectin status with the anthropometrical measures of newborns, and bone health status measured by Quantitative Ultrasound (QUS) at birth.

Methods: Circulating 25OHD and adiponectin concentration were measured in 73 pregnant women. Correlations with the anthropometrical measures and bone health status in their infants were studied. Bone health was evaluated using QUS with the measurements of speed of sound (SOS, in m/s) and Z score on the right tibia.

Results: There was no significant association between maternal 25OHD and newborn's anthropometrical measures at birth (weight p=0.35, length p=0.59 and head circumference p=0.47). There was a significant negative correlation between a maternal serum adiponectin and a) weight of infants at birth (R= -0.37, p=0.002); b) birth length (R= -0.31, p=0.008) and c) head circumference (R= -0.29, p=0.014). There was no significant correlation between maternal 25OHD blood levels during pregnancy and SOS in newborns (p=0.48). Additionally, a correlation between maternal adiponectin concentration during pregnancy and SOS in newborns was not significant (p=0.82).

Conclusion: Although a high prevalence of low 25OHD level among pregnant women was found, maternal vitamin D status did not influence growth and bone health of their offspring at birth. Maternal adiponectin levels in plasma showed an inverse relationship with anthropometrical measures of infants at birth, while no correlation with the newborn's bone health was found.
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December 2019

Partial enteral nutrition induces clinical and endoscopic remission in active pediatric Crohn's disease: results of a prospective cohort study.

Eur J Pediatr 2020 Mar 28;179(3):431-438. Epub 2019 Nov 28.

Department of Gastroenterology, Hepatology and Nutrition, University Children's Hospital Ljubljana, Bohoričeva 20, 1000, Ljubljana, Slovenia.

The aim of this study was to evaluate rates of clinical remission, endoscopic remission, and mucosal healing after a 6-week treatment period with partial enteral nutrition (PEN) and to compare them to those obtained by standard exclusive enteral nutrition (EEN) treatment in children with active Crohn's disease (CD). Twenty-five patients with active CD (median age 13.6 years, range 3.6-18.0) were recruited to either PEN (n = 12) or EEN (n = 13) treatment groups. The PEN group received 75% of their dietary needs from a polymeric formula plus one meal per day from an anti-inflammatory diet (AID). Patients were assessed at weeks 0, 1, 3, and 6 using clinical and laboratory parameters. Endoscopic assessment was performed at induction and week 6. On intention to treat analysis, clinical remission (Pediatric CD Activity Index < 10) was achieved in 69.2% and 75.0% of EEN and PEN patients, respectively (p = 0.999). The endoscopic remission (Simple Endoscopic Score for CD (SES-CD) ≤ 2) rates were 45.5% in both groups, while mucosal healing rates (SES-CD = 0) were 45.5% with EEN and 27.3% with PEN (p = 0.659).Conclusion: The results of our prospective pilot study suggest that PEN, allowing one meal from AID, could be as effective as EEN in inducing clinical and endoscopic remission in children with active CD. However, larger randomized controlled studies are warranted to confirm our findings.Trial registration: This clinical trial was registered under the number ClinicalTrials.govidentifier: NCT03176875.What is Known:• Exclusive enteral nutrition is a first-line treatment in active pediatric Crohn's disease; however, patients often find it difficult to adhere to.• Exclusive enteral nutrition is more effective than corticosteroids in achieving mucosal healing.What is New:• This is the first prospective study on partial enteral nutrition in active pediatric Crohn's disease, evaluating not only clinical, but also endoscopic remission.• A novel approach of partial enteral nutrition that allows one meal per day from an anti-inflammatory diet was as effective as exclusive enteral nutrition in inducing clinical and endoscopic remission in active Crohn's disease.
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March 2020

Nutrition of Patients with Severe Neurologic Impairment.

Radiol Oncol 2018 Mar 7;52(1):83-89. Epub 2017 Dec 7.

University Medical Centre Ljubljana, Children's Hospital, Ljubljana, Slovenia.

Background: Commercial enteral formulas are generally recommended for gastrostomy feeding in patients with severe neurologic impairment. However, pureed food diets are still widely used and even gaining popularity among certain groups. We tried to compare the effectiveness of gastrostomy feeding for treatment of severe malnutrition with either enteral formulas or pureed feeds.

Patients And Methods: A 6-month nutritional intervention was made with 37 malnourished children, adolescents and young adults (2-26 years old) with severe neurologic impairment (Gross Motor Function Classification system [GMFCS] grade V). The individual needs were calculated. Participants were fed by gastrostomy with either enteral formulas (n = 17) or pureed food (n = 20). Measurements to assess nutritional status were made at the beginning and at the end of intervention.

Results: The Z scores for weight-for-age and for the body-mass index increased more in enteral formula than in pureed food group (2.07 . 0.70, p = 0.0012; and 3.75 . 0.63, p = 0.0014, respectively). Fat mass index increased more in enteral formula than in pureed food group (1.12 kg/m. 0.38 kg/m; p = 0.0012). Patients in the enteral formula group showed increase in lean body mass expressed as fat-free mass index (0.70 kg/m), while those in pureed food group did not (-0.06 kg/m) (p = 0.0487).

Conclusions: The results suggest that even professionally planned pureed food diet is less effective than commercial enteral formula for nutritional rehabilitation of malnourished patients with severe neurologic impairment. However, larger and if possible randomised clinical studies should be made to confirm our findings.
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March 2018

Microbes in Infant Gut Development: Placing Abundance Within Environmental, Clinical and Growth Parameters.

Sci Rep 2017 09 11;7(1):11230. Epub 2017 Sep 11.

Institute of Dairy Science and Probiotics, Biotechnical Faculty, University of Ljubljana, Domžale, Slovenia.

Sound and timely microbial gut colonization completes newborn's healthy metabolic programming and manifests in infant appropriate growth and weight development. Feces, collected at 3, 30, and 90 days after birth from 60 breastfed Slovenian newborns, was submitted to microbial DNA extraction and qPCR quantification of selected gut associated taxa. Multivariate regression analysis was applied to evaluate microbial dynamics with respect to infant demographic, environmental, clinical characteristics and first year growth data. Early microbial variability was marked by the proportion of Bacilli, but diminished and converged in later samples, as bifidobacteria started to prevail. The first month proportions of enterococci were associated with maternity hospital locality and supplementation of breastfeeding with formulae, while Enterococcus faecalis proportion reflected the mode of delivery. Group Bacteroides-Prevotella proportion was associated with infant weight and ponderal index at first month. Infant mixed feeding pattern and health issues within the first month revealed the most profound and extended microbial perturbations. Our findings raise concerns over the ability of the early feeding supplementation to emulate and support the gut microbiota in a way similar to the exclusively breastfed infants. Additionally, practicing supplementation beyond the first month also manifested in higher first year weight and weight gain Z-score.
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September 2017

Vitamin D Status and Its Determinants in Healthy Slovenian Pregnant Women.

Ann Nutr Metab 2015 5;67(2):96-103. Epub 2015 Sep 5.

Department of Neonatology, Hepatology and Nutrition, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.

Background/aims: Vitamin D deficiency is a common underdiagnosed condition. The aim of this was to analyze the status of vitamin D and its determinants in healthy Slovenian pregnant women.

Methods: A total of 132 volunteer pregnant women completed a questionnaire including baseline demographics, food frequency, physical activities; anthropometrical measurements, body mass index and levels of 25-(OH)D in serum were performed during the third trimester, and dietary intakes were assessed during the 27-28th week of gestation.

Results: Vitamin D deficiency was present in 14% while insufficiency was present in 41% of women. The risk for inadequacy was higher in women older than 30 years (p = 0.01), in those with less frequent outdoor physical activity (p = 0.01) and in pregnancies during the low sun exposure season (p = 0.04). Insufficiency was not significantly more frequent in less educated women, unemployed and in those living in urban area. The median value of vitamin D from habitual dietary intake was 1.5 µg/day (range 0.1-13.4) and did not influence 25-hydroxyvitamin D level (p = 0.91).

Conclusions: The prevalence of vitamin D inadequacy was 55% and was dependent on age, season and outdoor physical activities. The results suggest a discrepancy between vitamin D intake through habitual diet and the reference needs.
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August 2016

Comparison of a Web-Based Dietary Assessment Tool with Software for the Evaluation of Dietary Records.

Zdr Varst 2015 Jun 13;54(2):91-7. Epub 2015 Mar 13.

University Medical Centre Ljubljana, University Children's Hospital, Department of Gastroenterology, Hepatology and Nutrition, Bohoriceva 20, 1000 Ljubljana, Slovenia.

Background: Dietary assessment in clinical practice is performed by means of computer support, either in the form of a web-based tool or software. The aim of the paper is to present the results of the comparison of a Slovenian web-based tool with German software for the evaluation of four-day weighted paper-and-pencil-based dietary records (paper-DRs) in pregnant women.

Methods: A volunteer group of pregnant women (n=63) completed paper-DRs. These records were entered by an experienced research dietitian into a web-based application (Open Platform for Clinical Nutrition, OPEN,, Ljubljana, Slovenia) and software application (Prodi 5.7 Expert plus, Nutri-Science, Stuttgart, Germany, 2011). The results for calculated energy intake, as well as 45 macro- and micronutrient intakes, were statistically compared by using the non-parametric Spearman's rank correlation coefficient. The cut-off for Spearman's rho was set at >0.600.

Results: 12 nutritional parameters (energy, carbohydrates, fat, protein, water, potassium, calcium, phosphorus, dietary fiber, vitamin C, folic acid, and stearic acid) were in high correlation (>0.800), 18 in moderate (0.600-0.799), 11 in weak correlation (0.400-0.599), while 5 (arachidonic acid, niacin, alpha-linolenic acid, fluoride, total sugars) did not show any statistical correlation.

Conclusion: Comparison of the results of the evaluation of dietary records using a web-based dietary assessment tool with those using software shows that there is a high correlation for energy and macronutrient content.
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June 2015

Binding of flavonoids to staphylococcal enterotoxin B.

Food Chem Toxicol 2014 Dec 2;74:1-8. Epub 2014 Sep 2.

Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, 1000 Ljubljana, Slovenia; Centre of Excellence for Integrated Approaches in Chemistry and Biology of Proteins (CipKeBiP), Jamova 39, Ljubljana, Slovenia. Electronic address:

Staphylococcal enterotoxins are metabolic products of Staphylococcus aureus that are responsible for the second-most-commonly reported type of food poisoning. Polyphenols are known to interact with proteins to form complexes, the properties of which depend on the structures of both the polyphenols and the protein. In the present study, we investigated the binding of four flavonoid polyphenols to Staphylococcal enterotoxin B (SEB) at pH 7.5 and 25 °C: (-)-epigallocatechin-3-gallate (EGCG), (-)-epigallocatechin (EGC), kaempferol-3-glucoside (KAM-G) and kaempferol (KAM). Fluorescence emission spectrometry and molecular docking were applied to compare experimentally determined binding parameters with molecular modeling. EGCG showed an order of magnitude higher binding constant (1.4 × 10(5) M(-1)) than the other studied polyphenols. Our blind-docking results showed that EGCG and similar polyphenolic ligands is likely to bind to the channel at the surface of SEB that is responsible for the recognition of the T-cell beta chain fragment and influence the adhesion of SEB to T cells.
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December 2014

Comparison of paper- and web-based dietary records: a pilot study.

Ann Nutr Metab 2014 9;64(2):156-66. Epub 2014 Aug 9.

Department of Gastroenterology, Hepatology and Nutrition, University Children's Hospital, University Medical Center Ljubljana, Slovenia.

Background/aims: Paper-based dietary records (Paper-DR) can be replaced by web-based dietary records (Web-DR) in both epidemiological studies and clinical practice to reduce the time and logistic burden. We aimed to compare Paper-DR and Web-DR.

Methods: We compared the matching of different food items (n = 1,103) from Paper-DR and Web-DR for energy and 48 nutrients among 16 pregnant volunteers, with DR for the same individuals matched for the same 4 days. Paper-DR were coded into the web-based version (referred to as Paper-Web-DR) independently by the same research dietitian. The Wilcoxon signed-rank test comparing mean rank differences, Spearman's ρ to measure associations and Bland-Altman limits of agreement to evaluate the level of agreement between the two dietary methods across the range of parameters were used. Volunteers also completed an evaluation questionnaire regarding the user acceptability of Paper-DR and Web-DR.

Results: A high correlation between Paper-DR and Web-DR was noted. There were statistically insignificant differences among 45 nutrients, except for free sugars (p < 0.001), α-linolenic acid (p = 0.041), folate (p = 0.036) and pantothenic acid (p = 0.023). Volunteers found the Paper-DR equally time-consuming as the Web-DR. The majority of the volunteers (75%) preferred the Web-DR.

Conclusions: Paper-DR and Web-DR were comparable across a range of nutritional parameters, with a few exceptions. The Web-DR was more convenient for the majority and has substantial logistic and cost advantages.
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May 2015

Challenges in determining body fat in pregnant women.

Ann Nutr Metab 2013 6;63(4):341-9. Epub 2014 Mar 6.

Department of Biology, Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia.

Background/aims: Determining body composition in pregnant women is challenging as not all of the existing applicable methodologies can be used during pregnancy and not all of the methods have been properly standardized. The aim of this study was to compare the existing anthropometric methods for the evaluation of body composition, especially in pregnant women.

Methods: One hundred forty-seven pregnant volunteers aged [average (SD)] 31 years (± 4) in gestational week 32 (± 3) provided information on their age and prepregnancy body mass. Their height, current mass, skinfold thicknesses, and limb circumferences were measured. The body density and fat percentage were calculated according to 17 different anthropometric equations obtained from the literature. Data were analyzed with ANOVA.

Results: For the same sample of pregnant women, the body fat percentages obtained using the existing anthropometric methods varied greatly (p < 0.0001) and ranged from 16% (± 5) to 38% (± 4); methods developed specifically for pregnant women yielded disturbingly large differences, with body fat values ranging from 16% (± 5) to 36% (± 6).

Conclusions: This study revealed large discrepancies among anthropometric methods for body composition assessment in pregnant women. As the results from the same sample obtained with different existing equations are wide ranging, the existing methodologies should be examined and improved before they can serve as sources of information regarding the health status of pregnant women.
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November 2014

Food composition databases for effective quality nutritional care.

Food Chem 2013 Oct 24;140(3):553-61. Epub 2013 Feb 24.

Computer Systems Department, Jožef Stefan Institute, Jamova cesta 39, SI-Ljubljana, Slovenia.

Background And Objectives: The main aim of this study was to validate a nutrient-estimation method applied using OPEN, a Slovenian platform for clinical nutrition. As the most desirable validation is a direct comparison of the calculated values with the values obtained from a chemical analysis of the same food, we performed a chemical analysis and a calculation for a representative set of daily meals (n=20) and compared the data. The secondary aim was to evaluate the usability of the OPEN for dietary assessment.

Methods: We used a Student's t test to observe any differences between the analysed and calculated nutrient-content data, considering the 0.01 significance level.

Results: No statistically significant differences were observed in the mean contents of energy, total dietary fibre, water, macro-nutrients, and selected essential minerals: Ca, Fe, Mg, Zn, Na, P, Cu and I. We notice statistically significant difference in the mean calculated and analytical values of selenium.

Conclusions: We noticed remarkable, but not statistically significant, difference in the mean values of iodine (-11%). The present study also indicates that the OPEN is a useful and cost-effective tool for both dieticians and patients.
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October 2013

Identification and expression of stressosomal proteins in Mycobacterium marinum under various growth and stress conditions.

FEMS Microbiol Lett 2013 May 2;342(2):98-105. Epub 2013 Apr 2.

Department of Cell and Molecular Biology, Biomedical Centre, Uppsala University, SE-751 24 Uppsala, Sweden.

Like other bacteria, Mycobacterium spp. have developed different strategies in response to environmental changes such as nutrient limitations and other different stress situations. We have identified candidate genes (rsb genes) from Mycobacterium marinum involved in the regulation of the activity of the alternative sigma factor, σ(F) . This is a homolog of the master regulator of general stress response, σ(B) , and the sporulation-specific sigma factor, σ(F) , in Bacillus subtilis. The organization of these genes in M. marinum and B. subtilis is similar. Transcriptome and qRT-PCR data show that these genes are indeed expressed in M. marinum and that the levels of expression vary with growth phase and exposure to stress. In particular, cold stress caused a significant rise in the expression of all identified rsb and sigF genes. We discuss these data in relation to what is currently known for other Mycobacterium spp.
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May 2013

Interactions of different polyphenols with bovine serum albumin using fluorescence quenching and molecular docking.

Food Chem 2012 Dec 14;135(4):2418-24. Epub 2012 Jul 14.

Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia.

Polyphenols are responsible for the major organoleptic characteristics of plant-derived foods and beverages. Here, we investigated the binding of several polyphenols to bovine serum albumin (BSA) at pH 7.5 and 25°C: catechins [(-)-epigallocatechin-3-gallate, (-)-epigallocatechin, (-)-epicatechin-3-gallate], flavones (kaempferol, kaempferol-3-glucoside, quercetin, naringenin) and hydroxycinnamic acids (rosmarinic acid, caffeic acid, p-coumaric acid). Fluorescence emission spectrometry and molecular docking were applied to compare experimentally determined binding parameters with molecular modelling. Among these polyphenols, (-)-epicatechin-3-gallate showed the highest Stern-Volmer modified quenching constant, followed by (-)-epigallocatechin-3-gallate. Similarly, (-)-epicatechin-3-gallate had the highest effect on the Circular Dichroic spectrum of BSA, while the changes induced by other polyphenols were negligible. Molecular docking predicted high binding energies for (-)-epicatechin-3-gallate and (-)-epigallocatechin-3-gallate for the binding site on BSA near Trp213. Our data reveal that the polyphenol structures significantly affect the binding process: the binding affinity generally decreases with glycosylation and reduced numbers of hydroxyl groups on the second aromatic ring.
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December 2012