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Zhao ZF, Li BY, He Q, Hao JY, Zhang KS, Zhang B, Hu W, Feng HT, Szeto IMY, Chen YM, Zhang GX, Tang XY. Impact of dairy supplementation on bone acquisition in children's limbs: a 12-month cluster-randomized controlled trial and meta-analysis. Arch Osteoporos 2024; 19:65. [PMID: 39043915 DOI: 10.1007/s11657-024-01422-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/13/2024] [Indexed: 07/25/2024]
Abstract
The impact of milk on bone health in rural preschoolers is under-researched. This study, through a clinical trial and a meta-analysis, finds that milk supplementation enhances forearm and calcaneus bone acquisition in children, supporting the benefits of daily milk consumption. PURPOSE This study evaluated the impact of dairy supplementation on bone acquisition in children's limbs through a cluster-randomized controlled trial and a meta-analysis. METHODS The trial involved 315 children (4-6 year) from Northwest China, randomized to receive either 390 ml of milk daily (n = 215) or 20-30 g of bread (n = 100) over 12 months. We primarily assessed bone mineral density (BMD) and content (BMC) changes at the limbs, alongside bone-related biomarkers, measured at baseline, the 6th and 12th months. The meta-analysis aggregated BMD or BMC changes in the forearm/legs/calcaneus from published randomized trials involving children aged 3-18 years supplemented with dairy foods (vs. control group). RESULTS Of 278 completed the trial, intention-to-treat analysis revealed significant increases in BMD (4.05% and 7.31%) and BMC (4.69% and 7.34%) in the left forearm at the 6th and 12th months in the milk group compared to controls (P < 0.001). The calcaneus showed notable improvements in BMD (2.01%) and BMC (1.87%) at 6 months but not at 12 months. Additionally, milk supplementation was associated with beneficial changes in bone resorption markers, parathyroid hormone (- 12.70%), insulin-like growth factor 1 (6.69%), and the calcium-to-phosphorus ratio (2.22%) (all P < 0.05). The meta-analysis, encompassing 894 children, indicated that dairy supplementation significantly increased BMD (SMD, 0.629; 95%CI: 0.275, 0.983) and BMC (SMD, 0.616; 95%CI: 0.380, 0.851) (P < 0.05) in the arms, but not in the legs (P > 0.05). CONCLUSION Milk supplementation significantly improves bone health in children's forearms, underscoring its potential as a strategic dietary intervention for bone development. Trial registration NCT05074836.
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Affiliation(s)
- Zi-Fu Zhao
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China
- Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot, China
| | - Bang-Yan Li
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Qin He
- Institute of Nutrition and Food Hygiene, School of Public Health, Lanzhou University, Lanzhou, Gansu Province, China
| | - Jing-Yu Hao
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China
- Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot, China
| | - Kai-Shuai Zhang
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China
| | - Bo Zhang
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China
| | - Wei Hu
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Hao-Tian Feng
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China
- Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot, China
| | - Ignatius Man-Yau Szeto
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China
- Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot, China
| | - Yu-Ming Chen
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, China.
| | - Ge-Xiang Zhang
- Institute of Nutrition and Food Hygiene, School of Public Health, Lanzhou University, Lanzhou, Gansu Province, China.
| | - Xin-Yi Tang
- Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
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Li L, Qiu L, Xia J, Xiao Y, Zhao L, Wang H. Changes of GH-IGFs and its relationship with growth retardation in children with bronchial asthma. Clinics (Sao Paulo) 2024; 79:100385. [PMID: 38754227 PMCID: PMC11126777 DOI: 10.1016/j.clinsp.2024.100385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/26/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVE To explore the relationship between Growth Hormone Insulin-like Growth Factors (GH-IGFs) and growth retardation in children with bronchial asthma. METHODS 112 children with bronchial asthma and 50 healthy children were studied. Serum GH, IGF-1, and Insulin-like Growth Factor Binding Protein 3 (IGFBP3) were assessed by ELISA. GH-IGFs-related parameters were compared, and the correlation between the parameters and bronchial asthma severity was analyzed. The bronchial asthma group was divided into the growth retardation group and non-growth retardation group to analyze the diagnostic value of GH-IGFs in growth retardation and the relationship between GH-IGFs and growth retardation. RESULTS GH, IGF-1, and IGFBP3 in the bronchial asthma group were lower. GH, IGF-1, and IGFBP3 levels were decreased with the severity of bronchial asthma. GH, IGF-1, and IGFBP3 in the growth retardation group were lower than those in the non-growth retardation group. The AUC of GH-IGFs combined detection was higher than that of GH and IGFBP3 alone detection. GH < 9.27 μg/L and IGF-1 < 179.53 mmoL/L were risk factors for growth retardation in patients with bronchial asthma. CONCLUSION GH-IGFs-related parameters have diagnostic value for growth retardation in children, and decreased levels of GH and IGF-1 are risk factors for growth retardation in children.
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Affiliation(s)
- Li Li
- Department of Pediatrics, Ganzhou People's Hospital, Ganzhou City, Jiangxi Province, China
| | - Lihua Qiu
- Department of Pediatrics, Huaian Hospital of Huaian City, Huaian City, Jiangsu Province, China
| | - Junchao Xia
- Department of Pediatrics, Ganzhou People's Hospital, Ganzhou City, Jiangxi Province, China
| | - Yichun Xiao
- Department of Pediatrics, Ganzhou People's Hospital, Ganzhou City, Jiangxi Province, China
| | - Li Zhao
- Department of Pediatrics, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang City, Hebei Province, China
| | - Haiyan Wang
- Department of Pediatrics, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang City, Hebei Province, China.
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Stephenson KB, Wegner DR, Hershey TG, Doty T, Davis E, Steiner-Asiedu M, Saalia FK, Shani I, Manary MJ. Effect of Peanut Paste-based Ready-to-use School Meals With and Without Milk on Fluid Cognition in Northern Ghana: A Randomized Controlled Trial. Am J Clin Nutr 2023; 118:782-791. [PMID: 37567391 PMCID: PMC10579044 DOI: 10.1016/j.ajcnut.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/24/2023] [Accepted: 08/07/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Few studies have investigated the role of school feeding in low- and middle-income countries as a means of improving childhood cognition. Peanut/milk ready-to-use food (PM-RUF) or cowpea offers an affordable, scalable option that might improve cognition. OBJECTIVES To determine whether micronutrient-fortified PM-RUF or peanut/cowpea ready-to-use food (PC-RUF) would improve fluid cognition as assessed by 4 tests from the National Institutes of Health Toolbox Cognitive Battery when compared with a micronutrient-fortified millet porridge (FP) after a year of school feeding. METHODS An individually randomly assigned, investigator-blinded, controlled clinical trial was conducted at 6 schools in Mion District in rural northern Ghana. Eight hundred seventy-one school children aged 5-12 y were randomly assigned and allocated to receive PM-RUF (n = 282), PC-RUF (n = 292), or FP (n = 297), each providing ∼400 kcal/d. The primary outcomes were 4 fluid cognition test scores: Dimensional Change Card Sort test, Flanker Inhibitory Control and Attention test, Pattern Comparison Processing Speed test, and a modified List Sorting Working Memory test. Secondary outcomes included a composite median ranking of the 4 primary outcomes and anthropometry changes. RESULTS Among the 871 participants (median age, 8.8 y; 47% female), 795 (91%) completed endline cognitive testing. Median attendance rates exceeded 87% in all groups. PM-RUF group demonstrated better fluid cognition on the Dimensional Change Card Sort test [odds ratio (OR): 1.5; 95% CI: 1.1, 2.0; P = 0.016] and Pattern Comparison Processing Speed test (OR: 1.4; 95% CI: 1.0, 1.9; P = 0.026) than FP, whereas there were no significant differences on Flanker Inhibitory Control and Attention or List Sorting Working Memory tests. PC-RUF group demonstrated no improvement over FP on any cognitive tests. PM-RUF group had superior fluid cognition composite median rankings (OR: 1.5; 95% CI: 1.1, 2.0; P = 0.007). CONCLUSIONS Among rural Ghanaian children aged 5-12 y, PM-RUF compared with FP resulted in superior fluid cognition. This trial was registered at clinicaltrials.gov as NCT04349007.
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Affiliation(s)
- Kevin B Stephenson
- Department of Medicine, Washington University, St. Louis, MO, United States.
| | - Donna R Wegner
- Department of Pediatrics, Washington University, St. Louis, MO, United States
| | - Tamara G Hershey
- Departments of Psychiatry and Radiology, Washington University, St. Louis, MO, United States
| | - Tasha Doty
- Program in Occupational Therapy, Washington University, St. Louis, MO, United States
| | - Ephious Davis
- Department of Pediatrics, Washington University, St. Louis, MO, United States
| | | | - Firibu K Saalia
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana
| | - Issah Shani
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana
| | - Mark J Manary
- Department of Pediatrics, Washington University, St. Louis, MO, United States.
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Grenov B, Larnkjær A, Ritz C, Michaelsen KF, Damsgaard CT, Mølgaard C. The effect of milk and rapeseed protein on growth factors in 7-8 year-old healthy children - A randomized controlled trial. Growth Horm IGF Res 2021; 60-61:101418. [PMID: 34333391 DOI: 10.1016/j.ghir.2021.101418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Milk protein may stimulate linear growth through insulin-like growth factor-1 (IGF-1). However, the effect of plant proteins on growth factors is largely unknown. This study assesses the effect of combinations of milk and rapeseed protein versus milk protein alone on growth factors in children. DESIGN An exploratory 3-armed randomized, double-blind, controlled trial was conducted in 129 healthy 7-8 year-old Danish children. Children received 35 g milk and rapeseed protein (ratio 54:46 or 30:70) or 35 g milk protein per day for 4 weeks. The primary outcome was difference in IGF-1 changes between intervention groups after 4 weeks. Secondary outcomes included changes in IGF-1 after 1 week and changes in insulin-like growth factor binding protein-3 (IGFBP-3), IGF-1/IGFBP-3, insulin, height, weight and body composition after 1 and 4 weeks. Results were analysed by multiple linear mixed-effect models. RESULTS There were no differences in changes of plasma IGF-1, insulin-like growth factor binding protein-3 (IGFBP-3), IGF-1/IGFBP-3 ratio or insulin between groups after 1 or 4 weeks based on 89 complete cases (P > 0.10). IGF-1 increased by 13.7 (95% CI 9.7;17.7) ng/mL and 18.0 (14.0;22.0) ng/mL from baseline to week 1 and 4, respectively, a 16% increase during the intervention. Similarly, insulin increased by 31% (14; 50) and 33% (16; 53) from baseline to week 1 and 4. Fat-free mass index (FFMI) increments were higher with milk alone than rapeseed blends (P < 0.05), coinciding with a trend towards a lower height increment. Body mass index increased within all groups (P < 0.05), mainly due to an increase in FFMI (P < 0.01). CONCLUSION There were no differences in changes of growth factors between the combinations of milk and rapeseed protein and milk protein alone in healthy, well-nourished children with a habitual intake of milk. Within groups, growth factors increased considerably. Future studies are needed to investigate how intakes of plant and animal proteins affect childhood growth.
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Affiliation(s)
- Benedikte Grenov
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark.
| | - Anni Larnkjær
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark.
| | - Christian Ritz
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark.
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark.
| | - Camilla T Damsgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark.
| | - Christian Mølgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark.
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Kjaer TW, Grenov B, Yaméogo CW, Fabiansen C, Iuel-Brockdorff AS, Cichon B, Nielsen NS, Filteau S, Briend A, Wells JCK, Michaelsen KF, Friis H, Faurholt-Jepsen D, Christensen VB. Correlates of serum IGF-1 in young children with moderate acute malnutrition: a cross-sectional study in Burkina Faso. Am J Clin Nutr 2021; 114:965-972. [PMID: 33963730 DOI: 10.1093/ajcn/nqab120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/22/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Serum insulin-like growth factor 1 (sIGF-1) is an important growth factor in childhood. However, studies on sIGF-1 among children from low-income countries are few, and the role of body composition is unknown. OBJECTIVES To assess the associations of anthropometry, body composition, inflammation, and breastfeeding with sIGF-1 among children with moderate acute malnutrition (MAM). METHODS A cross-sectional study based on admission data from 6- to 23-mo-old children with MAM participating in a nutrition intervention trial (Treatfood) in Burkina Faso. Linear regression analysis was used to identify correlates of sIGF-1. RESULTS Among 1546 children, the median (IQR) sIGF-1 was 12 (8.2-18.3) ng/mL. sIGF-1 was highest at 6 mo, with a nadir ∼10-11 mo, and higher in girls than boys. Length-for-age z score (LAZ), weight-for-length z score (WLZ), and midupper arm circumference were positively associated with sIGF-1 (P ≤ 0.001). Fat-free mass (FFM) was also positively associated, as sIGF-1 increased 1.5 (95% CI: 0.5, 2.5) ng/mL for each 1-kg increase in FFM. However, the association disappeared after adjustment for height. Elevated serum C-reactive protein and α1-acid glycoprotein were negatively associated with sIGF-1 (P ≤ 0.001), as was fever (P < 0.001) but not a positive malaria test per se (P = 0.15). Children never breastfed had lower sIGF-1 (-5.1; 95% CI: -9.8, -0.3). CONCLUSIONS LAZ and WLZ were positively and inflammation negatively associated with sIGF-1. As all children were moderately malnourished and many had inflammation, this probably explains the very low median sIGF-1. The association of FFM with sIGF-1 was fully explained by height. There was a marked age pattern, with a nadir in late infancy, confirming findings from smaller studies from well-nourished populations. There is a need for prospective studies to disentangle the role of sIGF-1 in growth and health. This trial was registered at https://www.isrctn.com as ISRCTN42569496.
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Affiliation(s)
- Thora W Kjaer
- Department of Pediatrics and Adolescent Health, Rigshospitalet, Copenhagen, Denmark
| | - Benedikte Grenov
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Charles W Yaméogo
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,Département Biomédical et Santé Publique, Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Christian Fabiansen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,The Pediatric Department, Holbæk Sygehus, Holbæk, Denmark
| | | | - Bernardette Cichon
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Nick S Nielsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Suzanne Filteau
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - André Briend
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,Department for International Health, University of Tampere, School of Medicine, Tampere, Finland
| | - Jonathan C K Wells
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Daniel Faurholt-Jepsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke B Christensen
- Department of Pediatrics and Adolescent Health, Rigshospitalet, Copenhagen, Denmark.,Médecins Sans Frontières-Denmark, Copenhagen, Denmark
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Dor C, Stark AH, Dichtiar R, Keinan-Boker L, Shimony T, Sinai T. Milk and dairy consumption is positively associated with height in adolescents: results from the Israeli National Youth Health and Nutrition Survey. Eur J Nutr 2021; 61:429-438. [PMID: 34406484 DOI: 10.1007/s00394-021-02661-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 08/10/2021] [Indexed: 01/17/2023]
Abstract
PURPOSE Milk consumption is associated with increased height primarily in early childhood. However, in adolescents, data are scarce with inconsistent results. Since height is a proxy for overall health and well-being, this study evaluated the association of dairy intake with height in adolescents. METHODS Students in 7th-12th grades, participating in the 2015-2016 Israeli Health and Nutrition Youth Survey, a school-based cross-sectional study, completed self-administered questionnaires, including a semi-quantitative food frequency questionnaire (n = 3529, 48% males, 15.2 ± 1.6 years). Anthropometric measurements were also performed. Dairy servings were calculated as the calcium equivalent of 1 cup of milk, and consumption was divided into four categories from very low (< 1 serving/day) to high (3 + servings/day). BMI- and Height-for-age z scores (HAZs) were calculated according to WHO growth standard; relatively short stature (RSS) was defined as HAZ < - 0.7 SD (< 25th percentile). Multivariable linear and logistic regression analyses were performed to evaluate the association of dairy intake with HAZ and prevalence of RSS, respectively. RESULTS Median consumption of dairy products was 2 servings/day, 1.4 from unsweetened products (milk, cheese and yogurt). Controlling for age, sex, BMI-z-score and socioeconomic status, each increment of unsweetened dairy intake was associated with on average 0.04 higher HAZ (equivalent to 0.3-0.4 cm, p < 0.05), and with reduced risk for RSS: OR 0.90, 95%CI: 0.84, 0.97, p < 0.01. No such associations were found with sweetened dairy products. CONCLUSION Consumption of unsweetened dairy products (3-4 servings/day) appears to contribute to achieving growth potential in adolescents. Intervention studies are necessary to determine the causal relationship between dairy intake and linear growth.
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Affiliation(s)
- Chen Dor
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, 7610001, Rehovot, Israel
| | - Aliza Hannah Stark
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, 7610001, Rehovot, Israel
| | - Rita Dichtiar
- Israel Center for Disease Control, Israel Ministry of Health, 5262100, Ramat Gan, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, 5262100, Ramat Gan, Israel
- School of Public Health, University of Haifa, 3498838, Haifa, Israel
| | - Tal Shimony
- Israel Center for Disease Control, Israel Ministry of Health, 5262100, Ramat Gan, Israel
| | - Tali Sinai
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, 7610001, Rehovot, Israel.
- Israel Center for Disease Control, Israel Ministry of Health, 5262100, Ramat Gan, Israel.
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Ferré N, Luque V, Closa-Monasterolo R, Zaragoza-Jordana M, Gispert-Llauradó M, Grote V, Koletzko B, Escribano J. Association of Protein Intake during the Second Year of Life with Weight Gain-Related Outcomes in Childhood: A Systematic Review. Nutrients 2021; 13:583. [PMID: 33578699 PMCID: PMC7916342 DOI: 10.3390/nu13020583] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 12/19/2022] Open
Abstract
There is accumulating evidence that early protein intake is related with weight gain in childhood. However, the evidence is mostly limited to the first year of life, whereas the high-weight-gain-velocity period extends up to about 2 years of age. We aimed to investigate whether protein intake during the second year of life is associated with higher weight gain and obesity risk later in childhood. We conducted a systematic review with searches in both PubMed®/MEDLINE® and the Cochrane Central Register of Controlled Trials. Ten studies that assessed a total of 46,170 children were identified. We found moderate-quality evidence of an association of protein intake during the second year of life with fat mass at 2 years and at 7 years. Effects on other outcomes such as body mass index (BMI), obesity risk, or adiposity rebound onset were inconclusive due to both heterogeneity and low evidence. We conclude that higher protein intakes during the second year of life are likely to increase fatness in childhood, but there is limited evidence regarding the association with other outcomes such as body mass index or change in adiposity rebound onset. Further well-designed and adequately powered clinical trials are needed since this issue has considerable public health relevance.
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Affiliation(s)
- Natalia Ferré
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, 43201 Reus, Spain; (N.F.); (V.L.); (R.C.-M.)
- Institut d’Investigació Sanitaria Pere Virgili, 43001 Tarragona, Spain; (M.Z.-J.); (M.G.-L.)
| | - Verónica Luque
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, 43201 Reus, Spain; (N.F.); (V.L.); (R.C.-M.)
- Institut d’Investigació Sanitaria Pere Virgili, 43001 Tarragona, Spain; (M.Z.-J.); (M.G.-L.)
| | - Ricardo Closa-Monasterolo
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, 43201 Reus, Spain; (N.F.); (V.L.); (R.C.-M.)
- Institut d’Investigació Sanitaria Pere Virgili, 43001 Tarragona, Spain; (M.Z.-J.); (M.G.-L.)
- Pediatrics Unit, Hospital Universitari de Tarragona Joan XXIII, 43005 Tarragona, Spain
| | - Marta Zaragoza-Jordana
- Institut d’Investigació Sanitaria Pere Virgili, 43001 Tarragona, Spain; (M.Z.-J.); (M.G.-L.)
| | | | - Veit Grote
- Department Paediatrics, Dr. von Hauner Children’s Hospital, LMU University Hospital, Ludwig-Maximilians Universität München, 43201 Munich, Germany; (V.G.); (B.K.)
| | - Berthold Koletzko
- Department Paediatrics, Dr. von Hauner Children’s Hospital, LMU University Hospital, Ludwig-Maximilians Universität München, 43201 Munich, Germany; (V.G.); (B.K.)
| | - Joaquín Escribano
- Pediatric Nutrition and Human Development Research Unit, Universitat Rovira i Virgili, 43201 Reus, Spain; (N.F.); (V.L.); (R.C.-M.)
- Institut d’Investigació Sanitaria Pere Virgili, 43001 Tarragona, Spain; (M.Z.-J.); (M.G.-L.)
- Pediatrics Unit, Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain
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