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Brito AM, Souto DO, Silva LC, Leite HR, Morais RLS. Social vulnerability among Brazilian children in early childhood: a scoping review. J Pediatr (Rio J) 2024:S0021-7557(24)00099-8. [PMID: 39159916 DOI: 10.1016/j.jped.2024.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 06/08/2024] [Accepted: 06/11/2024] [Indexed: 08/21/2024] Open
Abstract
OBJECTIVE To identify, map, and describe studies involving Brazilian children in early childhood in situations of social vulnerability. SOURCE OF DATA A scoping review including full articles published in Portuguese and English up to March 2023, with no temporal restrictions. Searches were conducted in the MEDLINE/PubMed, Scielo, EMBASE, Cochrane, Scopus, CINAHL, Web of Science, PEDro, and LILACS databases. Journal metrics, sample characteristics, study area, characterization of the situation of social vulnerability, and study outcomes were extracted. SUMMARY OF THE FINDINGS Seventy-six articles involving a total of 107.740 children in early childhood were included in this study. These studies presented relevant findings, including the temporal publication trend, the variability of social vulnerability indicators, the scarcity of intervention studies, and the fact that 100% of eligible studies were from the health area. Negative outcomes were associated with the condition of social vulnerability in almost the entire sample, reinforcing the need for government policies capable of protecting early childhood from the effects of social vulnerability. CONCLUSION This scoping review mapped important findings involving Brazilian children in social vulnerability. It also identified literature gaps such as the need for intervention and multisectoral studies among health, education, and social protection.
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Affiliation(s)
- Alcina M Brito
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Saúde, Sociedade e Meio Ambiente, Diamantina, MG, Brazil
| | - Deisiane O Souto
- Universidade Federal de Minas Gerais (UFMG), Escola de Educação Física, Fisioterapia e Terapia Ocupacional (EEFFTO), Departamento de Fisioterapia, Programa de Pós-Graduação em Ciências da Reabilitação (PPGCR), Belo Horizonte, MG, Brazil.
| | - Luana C Silva
- Universidade Federal de Minas Gerais (UFMG), Escola de Educação Física, Fisioterapia e Terapia Ocupacional (EEFFTO), Departamento de Fisioterapia, Programa de Pós-Graduação em Ciências da Reabilitação (PPGCR), Belo Horizonte, MG, Brazil
| | - Hércules R Leite
- Universidade Federal de Minas Gerais (UFMG), Escola de Educação Física, Fisioterapia e Terapia Ocupacional (EEFFTO), Departamento de Fisioterapia, Programa de Pós-Graduação em Ciências da Reabilitação (PPGCR), Belo Horizonte, MG, Brazil
| | - Rosane L S Morais
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Saúde, Sociedade e Meio Ambiente, Diamantina, MG, Brazil
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Venter C, Meyer R, Bauer M, Bird JA, Fleischer DM, Nowak-Wegrzyn A, Anagnostou A, Vickery BP, Wang J, Groetch M. Identifying Children at Risk of Growth and Nutrient Deficiencies in the Food Allergy Clinic. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:579-589. [PMID: 38280452 DOI: 10.1016/j.jaip.2024.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Food allergies affect growth in children by decreasing the availability of nutrients through decreased dietary intake, increased dietary needs, food-medication interactions, and psychosocial burden. Guidelines on food allergy management frequently recommend nutrition counseling and growth monitoring of children with food allergies. OBJECTIVE To provide clear guidance for clinicians to identify children with food allergies who are at nutritional risk and ensure prompt intervention. METHODS We provide a narrative review summarizing information from national and international guidelines, retrospective studies, population studies, review articles, case reports, and case series to identify those with food allergy at greatest nutritional risk, determine the impact of nutritional interventions on growth, and develop guidance for risk reduction in children with food allergies. RESULTS Children with food allergies are at increased risk of nutritional deficiencies and poor growth. Nutritional assessment and intervention can improve outcomes. Identifying poor growth is an important step in the nutrition assessment. Therefore, growth should be assessed at each allergy evaluation. Interventions to ensure adequate dietary intake for growth include appropriately prescribed elimination diets, breast-feeding support and assessment, supplemental formula, vitamin and/or mineral supplementation, appropriate milk substitutes, and timely introduction of nutrient-dense complementary foods. Access to foods of appropriate nutritional value is an ongoing concern. CONCLUSION Nutrition intervention or referral to registered dietitian nutritionists with additional training and/or experience in food allergy may result in improved growth and nutrition outcomes.
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Affiliation(s)
- Carina Venter
- Section of Pediatric Allergy and Immunology, Children's Hospital Colorado, University of Colorado, Aurora, Colo.
| | - Rosan Meyer
- Department of Medicine, Imperial College London, London, United Kingdom; Department of Nutrition and Dietetics, University of Winchester, Winchester, United Kingdom; Department of Medicine, KU Leuven, Leuven, Belgium
| | - Maureen Bauer
- Section of Pediatric Allergy and Immunology, Children's Hospital Colorado, University of Colorado, Aurora, Colo
| | - J Andrew Bird
- Department of Pediatrics, Division of Allergy and Immunology, UT Southwestern Medical Center, Dallas, Texas
| | - David M Fleischer
- Section of Pediatric Allergy and Immunology, Children's Hospital Colorado, University of Colorado, Aurora, Colo
| | - Anna Nowak-Wegrzyn
- Hassenfeld Children's Hospital, Department of Pediatrics, NYU Grossman School of Medicine, New York, NY; Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Aikaterini Anagnostou
- Section of Allergy and Immunology, Baylor College of Medicine, Houston, Texas; Section of Allergy and Immunology, Department of Pediatrics, Texas Children's Hospital, Houston, Texas
| | - Brian P Vickery
- Children's Healthcare of Atlanta, Atlanta, Ga; Department of Pediatrics, Emory University, Atlanta, Ga
| | - Julie Wang
- Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Marion Groetch
- Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY
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Nankumbi J, Grant F, Sibeko L, Mercado E, O'Neil K, Cordeiro LS. Effects of Food-Based Approaches on Vitamin A Status of Women and Children: A Systematic Review. Adv Nutr 2023; 14:1436-1452. [PMID: 37634852 PMCID: PMC10721510 DOI: 10.1016/j.advnut.2023.08.009] [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] [Received: 09/20/2022] [Revised: 08/02/2023] [Accepted: 08/15/2023] [Indexed: 08/29/2023] Open
Abstract
Vitamin A deficiency (VAD) increases risk for morbidity and mortality. Food-based approaches offer one strategy to improve vitamin A status. This systematic review assessed evidence of the effects of food-based approaches on the vitamin A status of women and children under 5 y. VAD was defined as clinical ocular symptoms, such as loss of vision, and/or retinol plasma or serum concentration <0.70 μmol/L. Searches on food-based approaches to improve vitamin A status were conducted for the period 2011-2022 on PubMed, CINHAL, Web of Science, and Google Scholar using PRISMA guidelines. English-language publications were included. Case studies, unpublished dissertations, and non-peer-reviewed studies were excluded. This review comprises 24 of 27,322 identified studies; 23 included studies focused on provitamin A carotenoids. There were 17,214 participants across the 24 studies with sample sizes ranging from 8 to 3571 individuals. Intervention studies spanned from 3 wk to 2 y. Fifteen (63%) studies were randomized control trials, 7 were cross-sectional, and 2 were longitudinal studies. Most studies (N = 21) used biochemical measurements, for example, serum retinol, to assess vitamin A status; other studies used clinical symptoms (for example, xerophtalmia) or dietary intake. Thirteen (54%) studies reported a statistically significant effect of food-based interventions (N = 8) or an association of diet (N = 5) on vitamin A status. This systematic review indicated that some food-based interventions improved vitamin A status, thus offering a safe and effective delivery mechanism for vitamin A. There appeared to be significant association between vitamin A status and consumption of foods with high concentrations of preformed vitamin A and provitamin A carotenoids. Differences across studies in regard to the period of evaluation, food approaches used, and statistical power may explain the lack of effectiveness of food-based approaches on vitamin A status in some studies.
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Affiliation(s)
- Joyce Nankumbi
- Department of Nutrition, University of Massachusetts, Amherst, MA, United States
| | | | - Lindiwe Sibeko
- Department of Nutrition, University of Massachusetts, Amherst, MA, United States
| | - Evelyn Mercado
- Department of Psychology and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, United States
| | - Kristina O'Neil
- Department of Nutrition, University of Massachusetts, Amherst, MA, United States
| | - Lorraine S Cordeiro
- Department of Nutrition, University of Massachusetts, Amherst, MA, United States.
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Soares MM, Juvanhol LL, Ribeiro SAV, Franceschini SDCC, Araújo RMA. Prevalence of processed and ultra-processed food intake in Brazilian children (6-24 months) is associated with maternal consumption and breastfeeding practices. Int J Food Sci Nutr 2021; 72:978-988. [PMID: 33645412 DOI: 10.1080/09637486.2021.1885016] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The aim of this study is to identify maternal consumption of processed and ultra-processed foods and to verify the factors associated with the supply of these foods to Brazilian children. This is a cross-sectional study with 231 mothers and children aged from 6 to 24 months. The mother's and children's food consumption was measured using three 24-hour recalls. The foods consumed were categorised according to the NOVA classification. The data were analysed by multinomial logistic regression. The supply of processed and ultra-processed foods to children was associated with the child's age (T2: OR = 1.17, p<.001; T3: OR = 1.23, p<.001), the absence of breast milk consumption (T3: OR = 3.82, p=.006) and the greater consumption of these foods by mothers (T2: OR = 3.15, p=.018; T3: OR = 4.59, p=.004). We conclude that mothers who consume processed and ultra-processed foods also include them in complementary feeding, and the consumption of these foods by the child increases with age, absence of breastfeeding, and with increased maternal consumption.
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Pedraza DF. Vitamin A deficiency in Brazilian Children younger than 5 years old: a systematic review. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2020. [DOI: 10.1590/1806-93042020000300002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to examine the nutritional status of vitamin A in Brazilian children under 5 years old, delimiting their deficiency and associated factors. Methods: this is a systematic review of articles published between 2008 and 2018, using the SciELO, Bireme, and PubMed electronic databases. A validated instrument critically evaluated the studies. The summary measures were obtained by the random effect model, and their results are presented using the Forest Plot graph. The qualitative synthesis was based on the description of the main factors associated with Vitamin A Deficiency. Results: we included 14 cross-sectional studies with observations in basic health units, daycare centers, and households. The summary measure indicated Vitamin A Deficiency of 20% (CI95%= 17% - 23%), with high homogeneity according to the source of the sample. Lower age of the child, low birth weight, poor iron nutritional status, diarrhea, subclinical infection, inadequate basic sanitation conditions, younger mothers and less maternal educa-tion represented the main exposures associated with the outcome. Conclusion: the results show Vitamin A Deficiency as a public health problem in Brazilian children under 5 years old, especially when related to the development of infectious processes and maternal and child characteristics that show greater susceptibility.
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de Miranda WD, Guimarães EAA, Campos DS, Antero LS, Beltão NRM, da Luz ZMP. [Vitamin A Supplementation Program in Brazil: evaluability assessmentPrograma Nacional de Suplementación de Vitamina A en Brasil: un estudio de evaluación]. Rev Panam Salud Publica 2019; 42:e182. [PMID: 31093210 PMCID: PMC6385853 DOI: 10.26633/rpsp.2018.182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 09/07/2018] [Indexed: 11/24/2022] Open
Abstract
Objetivo Descrever as etapas do estudo de avaliabilidade do Programa Nacional de Suplementação de Vitamina A (PNSVA) no Brasil. Métodos Estudo com abordagem qualitativa que adotou como referencial o sistema de sete elementos proposto por Thurston e Ramaliu. Foram realizados análise de documentos, revisão teórica sobre o PNSVA e encontros com referências técnicas para a elaboração da linha do tempo e modelos teórico e lógico do Programa. O modelo lógico subsidiou a elaboração de dois questionários a serem utilizados para avaliar a implantação do PNSVA. Foi realizada a validação de conteúdo das perguntas avaliativas dos questionários por meio da técnica Delphi. Resultados O estudo possibilitou compreender a evolução das estratégias para prevenção e controle da deficiência de vitamina A no país, além do funcionamento do PNSVA e seu contexto externo. O modelo lógico revelou-se uma ferramenta valiosa para identificar áreas específicas que devem ser priorizadas em avaliações futuras. A validação dos questionários indicou que esses instrumentos abordam questões necessárias para a avaliação da implantação do Programa em municípios. A etapa da técnica Delphi foi de grande importância para guiar ajustes pertinentes quanto ao conteúdo e à forma de apresentação de algumas questões, o que certamente aumentará o poder analítico da ferramenta. Conclusão O estudo de avaliabilidade apontou a possibilidade de avaliações posteriores do PNSVA. Espera-se que os resultados desta investigação auxiliem futuras avaliações em países que adotam ações semelhantes às do Brasil.
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Affiliation(s)
| | | | | | - Laís Santos Antero
- Secretaria de Estado de Saúde de Minas Gerais (SES - MG), Belo Horizonte (MG), Brasil
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Barbalho SM, Goulart RDA, Batista GLDSA. Vitamin A and inflammatory bowel diseases: from cellular studies and animal models to human disease. Expert Rev Gastroenterol Hepatol 2019; 13:25-35. [PMID: 30791845 DOI: 10.1080/17474124.2019.1543588] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Vitamin A (VA) and metabolites such as Retinoic Acid (RA) and all-trans-RA (at-RA) are crucial in the modulation of the immune system and may be determinative in the balance of the immune responses. Inflammatory bowel diseases (IBD) consist of chronic relapsing and heterogeneous disorders with not well-known etiology. Due to its role in inflammatory processes, VA may be helpful in the treatment of IBD. Area covered: As VA plays a significant role in the inflammatory processes, this review aims to show the potential role of this vitamin in IBD, searching for cellular studies, animal models, and studies with humans. Expert commentary: Many studies have described the importance of alternative therapeutic approaches for IBD. Due to its role in the immune system, VA may also exert an indispensable role in the IBD. Nevertheless, some authors have shown that these compounds could stimulate the release of pro-inflammatory cytokines. For these reasons, more studies should be performed to establish the precise mechanisms of VA and its metabolites in systemic and intestinal inflammation.
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Affiliation(s)
- Sandra Maria Barbalho
- a School of Medicine , University of Marília (UNIMAR) , São Paulo , Brazil.,b Department of Biochemistry and Nutrition , Faculty of Food Technology of Marília (FATEC) , São Paulo , Brazil
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