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Jiménez-Ortega AI, Martínez-García RM, Salas-González MD, Cervera-Muñoz A, Lozano-Estevan MDC. [Nutritional problems of vegetarian and vegan children]. NUTR HOSP 2023; 40:20-23. [PMID: 37929910 DOI: 10.20960/nh.04949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Introduction The number of people following plant-based diets to a greater or lesser degree is increasing, but the more restrictive a diet, the greater the risk of nutritional deficiencies. The childhood stage is a stage of great physical and maturational growth, therefore, nutritional deficiencies at this stage can have serious and sometimes permanent consequences. People who follow restrictive diets of any kind, such as plant-based diets, should receive support from specialized staff to ensure that their diets are varied and balanced, as is desirable in any case.
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Affiliation(s)
| | - Rosa M Martínez-García
- Departamento de Enfermería, Fisioterapia y Terapia Ocupacional. Facultad de Enfermería. Universidad de Castilla-La Mancha
| | - María Dolores Salas-González
- Departamento de Nutrición y Ciencia de los Alimentos. Facultad de Farmacia. Universidad Complutense de Madrid. Grupo de Investigación VALORNUT-UCM (920030)
| | - Adrián Cervera-Muñoz
- Departamento de Nutrición y Ciencia de los Alimentos. Facultad de Farmacia. Universidad Complutense de Madrid
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2
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Aygun E, Sayman OA, Erturk EY, Yılmaz Semerci S, Kanburoglu MK. An Implicit Cause of Prolonged Neonatal Jaundice: Vitamin B12 Deficiency. JOURNAL OF CHILD SCIENCE 2023. [DOI: 10.1055/s-0043-1761422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Abstract
Objective Prolonged jaundice is defined as a serum bilirubin level of more than 5 mg/dL, which persists at postnatal 14 days in term infants and 21 days following birth in preterm infants. Although the underlying causes cannot be found in the majority of prolonged jaundice cases, this may be the first sign of a serious issue. Therefore, this study aimed to evaluate the association between vitamin B12 deficiency and prolonged jaundice in newborns.
Material and Methods This descriptive cross-sectional study was performed in a university hospital between January 1, 2015 and October 1, 2020. All participants consisted of infants who were admitted to the pediatric outpatient clinics. Infants > 35 weeks of gestation and with prolonged jaundice of unknown etiology were included in the study group. The control group consisted of infants > 35 weeks of gestation without prolonged jaundice. Demographic and clinical characteristics and serum vitamin B12 levels were evaluated comparatively.
Results A total of 126 infants, 66 of whom had prolonged jaundice, were included. The mean gestational week of the study group was 38.4 ± 1.8, and the control group was 38.6 ± 1.9 weeks. There was no difference between the groups in terms of demographics and laboratory data. The vitamin B12 level of the study group was significantly lower (median = 170 pg/mL) than the control (median = 268 pg/mL).
Conclusion Based on the findings of this study, vitamin B12 deficiency was thought to be an important cause of prolonged jaundice, and further studies are needed to explain the role of vitamin B12 deficiency in the etiology of prolonged jaundice.
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Affiliation(s)
- Erhan Aygun
- Division of Neonatology, Health Sciences University, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Ozden Aksu Sayman
- Department of Pediatrics, Ordu University Training and Research Hospital, Ordu, Turkey
| | - Emine Yurdakul Erturk
- Department of Pediatrics, Ordu University Training and Research Hospital, Ordu, Turkey
| | - Seda Yılmaz Semerci
- Division of Neonatology, Health Sciences University, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Kenan Kanburoglu
- Division of Neonatology, Department of Pediatrics, Recep Tayyip Erdogan University, Rize, Turkey
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Villette C, Vasseur P, Lapidus N, Debin M, Hanslik T, Blanchon T, Steichen O, Rossignol L. Vegetarian and Vegan Diets: Beliefs and Attitudes of General Practitioners and Pediatricians in France. Nutrients 2022; 14:nu14153101. [PMID: 35956277 PMCID: PMC9370229 DOI: 10.3390/nu14153101] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 02/01/2023] Open
Abstract
Studies suggest a decreasing trend in the consumption of meat products and a growing interest in vegetarian diets. Medical support may be relevant, especially when switching to a vegan diet. Our objective was to describe the beliefs and attitudes of primary care physicians toward vegetarian diets. A cross-sectional survey was conducted among general practitioners and pediatricians thorough a questionnaire including socio-demographic characteristics, specific care to vegetarians, and the risks and benefits of vegetarian diets according to physicians. Out of the 177 participating physicians, 104 (59%) have seen at least one vegetarian patient in consultation in the last three months. Half of the physicians declared that they would dissuade their patients from switching to a vegan diet (n = 88, 51%) and 14% (n = 24) from switching to an ovo-lacto-vegetarian (OLV) diet. Most physicians (n = 141, 88%) did not feel informed enough about these diets. Physicians thought that the most frequent deficiencies for OLV and vegan diets were iron (76% and 84%, respectively) and protein (45% and 79%, respectively). These results highlight the fact that French primary care physicians feel concerned by this subject and need more information on these diets. Specific recommendations would be useful to support their practice and relationship with vegetarians.
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Affiliation(s)
- Cécile Villette
- Département de Médecine Générale, Université de Paris Cité, 16 rue Henri Huchard, F75018 Paris, France
| | - Pauline Vasseur
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, IPLESP, 27 rue de Chaligny, F75012 Paris, France
| | - Nathanael Lapidus
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, IPLESP, 27 rue de Chaligny, F75012 Paris, France
- Public Health Department, Saint-Antoine Hospital, AP-HP, Sorbonne Université, F75012 Paris, France
| | - Marion Debin
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, IPLESP, 27 rue de Chaligny, F75012 Paris, France
| | - Thomas Hanslik
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, IPLESP, 27 rue de Chaligny, F75012 Paris, France
- UFR Simone Veil-Santé, Université Versailles Saint Quentin en Yvelines, 55 Avenue de Paris, F78000 Versailles, France
- AP-HP, Hôpital Ambroise Paré, Service de Médecine Interne, 9 Avenue Charles de Gaulle, F92100 Boulogne Billancourt, France
| | - Thierry Blanchon
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, IPLESP, 27 rue de Chaligny, F75012 Paris, France
| | - Olivier Steichen
- AP-HP, Hôpital Tenon, Service de Médecine Interne, Sorbonne Université, 4 rue de la Chine, F75020 Paris, France
| | - Louise Rossignol
- Département de Médecine Générale, Université de Paris Cité, 16 rue Henri Huchard, F75018 Paris, France
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, IPLESP, 27 rue de Chaligny, F75012 Paris, France
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Světnička M, Sigal A, Selinger E, Heniková M, El-Lababidi E, Gojda J. Cross-Sectional Study of the Prevalence of Cobalamin Deficiency and Vitamin B12 Supplementation Habits among Vegetarian and Vegan Children in the Czech Republic. Nutrients 2022; 14:nu14030535. [PMID: 35276893 PMCID: PMC8838497 DOI: 10.3390/nu14030535] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/22/2022] [Accepted: 01/24/2022] [Indexed: 12/04/2022] Open
Abstract
Vegetarian (VG) and vegan (VN) diets in childhood are of growing interest due to their perceived health and environmental benefits. Concerns remain due to the possible disruption of healthy growth and development of children because of the scarcity of evidence-based studies. Among the nutrients of special concern is vitamin B12. Therefore, the Czech Vegan Children Study (CAROTS) decided to examine the relationship between B12 metabolism parameters and B12 intake through diet and supplementation. We analyzed laboratory parameters within n = 79 VG, n = 69 VN, and n = 52 omnivores (OM) children (0−18 years old). There were no significant differences in levels of holotranscobalamin (aB12), folate, homocysteine (hcys), or mean corpuscular volume. However, there was a significant difference in levels of cyanocobalamin (B12) (p = 0.018), even though we identified only n = 1 VG and n = 2 VN children as B12 deficient. On the other hand, we identified n = 35 VG, n = 28 VN, and n = 9 OM children with vitamin B12 hypervitaminosis (p = 0.004). This finding was related to a high prevalence of over-supplementation in the group (mean dose for VG 178.19 ± 238.5 µg per day; VN 278.35 ± 394.63 µg per day). Additionally, we found a significant (p < 0.05) difference between B12, aB12, and hcys levels of supplemented vs. non-supplemented VG/VN children. This can show that the intake of vitamin B12 via diet in the VG group might not be sufficient. Secondly, we analyzed a relation between supplement use in pregnancy and breastfeeding and its impact on vitamin B12 levels of children aged 0−3 years. Out of n = 46 mothers, only n = 3 (e.g., 6.5%) were not supplemented at all. We have not identified any clinical manifestation of B12 deficiency and only n = 1 child with low serum cobalamin, a child who did not receive vitamin B12 supplementation and whose mother took only low doses of vitamin B12 (25/µg/day).To conclude, we did not observe any life-threatening or severe consequences of laboratory-stated vitamin B12 deficiency; thus, our group was well supplemented. On the other hand, we have identified many subjects with vitamin B12 hypervitaminosis of unknown impact on their health. Further research and new guidelines for B12 supplementation among VG and VN children are needed.
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Affiliation(s)
- Martin Světnička
- Centre for Research on Diabetes Metabolism, Nutrition of Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic; (A.S.); (E.S.); (M.H.); (E.E.-L.); (J.G.)
- Department of Internal Medicine, Third Faculty of Medicine, University Hospital Královské Vinohrady, Charles University, 10000 Prague, Czech Republic
- Department of Pediatrics, Third Faculty of Medicine, University Hospital Královské Vinohrady, Charles University, 10000 Prague, Czech Republic
- Correspondence: ; Tel.: +420-725-569-697
| | - Anat Sigal
- Centre for Research on Diabetes Metabolism, Nutrition of Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic; (A.S.); (E.S.); (M.H.); (E.E.-L.); (J.G.)
- Department of Pediatrics, Third Faculty of Medicine, University Hospital Královské Vinohrady, Charles University, 10000 Prague, Czech Republic
| | - Eliška Selinger
- Centre for Research on Diabetes Metabolism, Nutrition of Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic; (A.S.); (E.S.); (M.H.); (E.E.-L.); (J.G.)
- Department of Internal Medicine, Third Faculty of Medicine, University Hospital Královské Vinohrady, Charles University, 10000 Prague, Czech Republic
- Centre for Public Health Promotion, The National Institute of Public Health, 10000 Prague, Czech Republic
| | - Marina Heniková
- Centre for Research on Diabetes Metabolism, Nutrition of Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic; (A.S.); (E.S.); (M.H.); (E.E.-L.); (J.G.)
- Department of Internal Medicine, Third Faculty of Medicine, University Hospital Královské Vinohrady, Charles University, 10000 Prague, Czech Republic
| | - Eva El-Lababidi
- Centre for Research on Diabetes Metabolism, Nutrition of Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic; (A.S.); (E.S.); (M.H.); (E.E.-L.); (J.G.)
- Department of Pediatrics, Third Faculty of Medicine, University Hospital Královské Vinohrady, Charles University, 10000 Prague, Czech Republic
| | - Jan Gojda
- Centre for Research on Diabetes Metabolism, Nutrition of Third Faculty of Medicine, Charles University, 10000 Prague, Czech Republic; (A.S.); (E.S.); (M.H.); (E.E.-L.); (J.G.)
- Department of Internal Medicine, Third Faculty of Medicine, University Hospital Královské Vinohrady, Charles University, 10000 Prague, Czech Republic
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Vaccaro JA, Naser SA. The Role of Methyl Donors of the Methionine Cycle in Gastrointestinal Infection and Inflammation. Healthcare (Basel) 2021; 10:healthcare10010061. [PMID: 35052225 PMCID: PMC8775811 DOI: 10.3390/healthcare10010061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/21/2021] [Accepted: 12/27/2021] [Indexed: 12/01/2022] Open
Abstract
Vitamin deficiency is well known to contribute to disease development in both humans and other animals. Nonetheless, truly understanding the role of vitamins in human biology requires more than identifying their deficiencies. Discerning the mechanisms by which vitamins participate in health is necessary to assess risk factors, diagnostics, and treatment options for deficiency in a clinical setting. For researchers, the absence of a vitamin may be used as a tool to understand the importance of the metabolic pathways in which it participates. This review aims to explore the current understanding of the complex relationship between the methyl donating vitamins folate and cobalamin (B12), the universal methyl donor S-adenosyl-L-methionine (SAM), and inflammatory processes in human disease. First, it outlines the process of single-carbon metabolism in the generation of first methionine and subsequently SAM. Following this, established relationships between folate, B12, and SAM in varying bodily tissues are discussed, with special attention given to their effects on gut inflammation.
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Zahodnik T. Evaluating Patients for Nutritional Deficiencies. PHYSICIAN ASSISTANT CLINICS 2021. [DOI: 10.1016/j.cpha.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gizard F, Fernandez A, De Vadder F. Interactions between gut microbiota and skeletal muscle. Nutr Metab Insights 2021; 13:1178638820980490. [PMID: 33402830 PMCID: PMC7745561 DOI: 10.1177/1178638820980490] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 11/23/2020] [Indexed: 12/11/2022] Open
Abstract
The gut microbiota is now recognized as a major contributor to the host’s nutrition, metabolism, immunity, and neurological functions. Imbalanced microbiota (ie, dysbiosis) is linked to undernutrition-induced stunting, inflammatory and metabolic diseases, and cancers. Skeletal muscle also takes part in the interorgan crosstalk regulating substrate metabolism, immunity, and health. Here, we review the reciprocal influence of gut microbiota and skeletal muscle in relation to juvenile growth, performance, aging, and chronic diseases. Several routes involving the vascular system and organs such as the liver and adipose tissue connect the gut microbiota and skeletal muscle, with effects on fitness and health. Therapeutic perspectives arise from the health benefits observed with changes in gut microbiota and muscle activity, further encouraging multimodal therapeutic strategies.
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Affiliation(s)
- Florence Gizard
- Mammalian Cell Biology Group, Institute of Human Genetics UMR9002, CNRS-University of Montpellier, Montpellier, France
| | - Anne Fernandez
- Mammalian Cell Biology Group, Institute of Human Genetics UMR9002, CNRS-University of Montpellier, Montpellier, France
| | - Filipe De Vadder
- Institut de Génomique Fonctionnelle de Lyon, Université de Lyon, École Normale Supérieure de Lyon, Centre National de la Recherche Scientifique, Université Claude Bernard Lyon 1, UMR5242, Lyon, France
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Cyr A, Frehlick R, Stammers D, Crone M. Case Report: Propranolol Therapy for Infantile Tremor Syndrome in a Child With Vitamin B12 Deficiency. Front Pediatr 2021; 9:774747. [PMID: 34900874 PMCID: PMC8652196 DOI: 10.3389/fped.2021.774747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 10/25/2021] [Indexed: 11/18/2022] Open
Abstract
Vitamin B12 deficiency in childhood presents with a wide variety of symptoms including anemia, failure to thrive and developmental delays. It is a diagnostic consideration in children who are exclusively breastfed or have minimal solid intake, especially if their mother is vegetarian or has underlying vitamin B12 deficiency. Infantile tremor syndrome (ITS) has been associated with vitamin B12 deficiency. ITS presents with neurological symptoms such as developmental delays and tremors. The tremors seen in ITS can be profound and interfere with daily functioning. Different therapies have been tried for those tremors without much evidence or information regarding their efficacy and dosing regimens. We present the case of a 13-month-old girl with vitamin B12 deficiency who developed ITS with significant tremors after initiation of vitamin B12 therapy. She was treated with propranolol which resulted in significant improvement in her tremors. This case highlights the efficacy and safety of propranolol for the treatment of ITS in the context of vitamin B12 deficiency.
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Affiliation(s)
- Amélie Cyr
- Department of Pediatrics, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Ryan Frehlick
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - David Stammers
- Division of Pediatric Hematology and Oncology, Jim Pattison Children's Hospital, Saskatoon, SK, Canada
| | - Megan Crone
- Division of Pediatric Neurology, Jim Pattison Children's Hospital, Saskatoon, SK, Canada
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Sharma V, Sharma V, Khan A, Wassmer DJ, Schoenholtz MD, Hontecillas R, Bassaganya-Riera J, Zand R, Abedi V. Malnutrition, Health and the Role of Machine Learning in Clinical Setting. Front Nutr 2020; 7:44. [PMID: 32351968 PMCID: PMC7174626 DOI: 10.3389/fnut.2020.00044] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 03/23/2020] [Indexed: 12/16/2022] Open
Abstract
Nutrition plays a vital role in health and the recovery process. Deficiencies in macronutrients and micronutrients can impact the development and progression of various disorders. However, malnutrition screening tools and their utility in the clinical setting remain largely understudied. In this study, we summarize the importance of nutritional adequacy and its association with neurological, cardiovascular, and immune-related disorders. We also examine general and specific malnutrition assessment tools utilized in healthcare settings. Since the implementation of the screening process in 2016, malnutrition data from hospitalized patients in the Geisinger Health System is presented and discussed as a case study. Clinical data from five Geisinger hospitals shows that ~10% of all admitted patients are acknowledged for having some form of nutritional deficiency, from which about 60-80% of the patients are targeted for a more comprehensive assessment. Finally, we conclude that with a reflection on how technological advances, specifically machine learning-based algorithms, can be integrated into electronic health records to provide decision support system to care providers in the identification and management of patients at higher risk of malnutrition.
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Affiliation(s)
- Vaibhav Sharma
- Geisinger Commonwealth School of Medicine, Scranton, PA, United States
| | - Vishakha Sharma
- Geisinger Commonwealth School of Medicine, Scranton, PA, United States
| | - Ayesha Khan
- Neuroscience Institute, Geisinger Health System, Danville, PA, United States
| | - David J. Wassmer
- Neuroscience Institute, Geisinger Health System, Danville, PA, United States
| | | | | | | | - Ramin Zand
- Neuroscience Institute, Geisinger Health System, Danville, PA, United States
| | - Vida Abedi
- Department of Molecular and Functional Genomics, Geisinger Health System, Danville, PA, United States
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