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Bognanni A, Firmino RT, Arasi S, Chu DK, Chu AW, Waffenschmidt S, Agarwal A, Dziechciarz P, Horvath A, Mihara H, Roldan Y, Terracciano L, Martelli A, Starok A, Said M, Shamir R, Ansotegui IJ, Dahdah L, Ebisawa M, Galli E, Kamenwa R, Lack G, Li H, Pawankar R, Warner A, Wong GWK, Bozzola M, Assa'Ad A, Dupont C, Bahna S, Spergel J, Venter C, Szajewska H, Nowak-Wegrzyn AH, Vandenplas Y, Papadopoulos NG, Waserman S, Fiocchi A, Schünemann HJ, Brożek JL. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guideline update - XI - Milk supplement/replacement formulas for infants and toddlers with CMA - Systematic review. World Allergy Organ J 2024; 17:100947. [PMID: 39310372 PMCID: PMC11415968 DOI: 10.1016/j.waojou.2024.100947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 09/25/2024] Open
Abstract
Background Cow's milk allergy (CMA) is the most complex and common food allergy in infants. Elimination of cow's milk from the diet and replacement with a specialized formula for infants with cow's milk allergy who cannot be breastfed is an established approach to minimize the risk of severe allergic reactions while avoiding nutritional deficiencies. Given the availability of multiple options, such as extensively hydrolyzed cow's milk-based formula (eHF-CM), aminoacid formula (AAF), hydrolyzed rice formula (HRF), and soy formula (SF), there is some uncertainty regarding which formula might represent the most suitable choice with respect to health outcomes. The addition of probiotics to a specialized formula has also been proposed as a potential approach to possibly increase the benefit. We systematically reviewed specialized formulas for infants with CMA to inform the updated World Allergy Organization (WAO) DRACMA guidelines. Objective To systematically review and synthesize the available evidence about the use of specialized formulas for the management of individuals with CMA. Methods We searched from inception PubMed, Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and the websites of selected allergy organizations, for randomized and non-randomized trials of any language investigating specialized formulas with or without probiotics. We included all studies irrespective of the language of the original publication. The last search was conducted in January 2024. We synthesized the identified evidence quantitatively or narratively as appropriate and summarized it in the evidence profiles. We conducted this review following the PRISMA, Cochrane methods, and the GRADE approach. Results We identified 3558 records including 14 randomized trials and 7 observational studies. Very low certainty evidence suggested that in infants with IgE-mediated CMA, eHF-CM, compared with AAF, might have higher probability of outgrowing CMA (risk ratio (RR) 2.32; risk difference (RD) 25 more per 100), while showing potentially lower probability of severe vomiting (RR 0.12, 95% CI 0.02 to 0.88; RD 23 fewer per 100, 95% CI 3 to 26) and developing food protein-induced enterocolitis syndrome (FPIES) (RR 0.15, 95% CI 0.03 to 0.82; RD 34 fewer per 100, 95% CI 7 to 39). We also found, however, that eHF-CM might be inferior to AAF in supporting a physiological growth, with respect to both weight (-5.5% from baseline, 95%CI -9.5% to -1.5%) and length (-0.7 z-score change, 95%CI -1.15 to -0.25) (very low certainty). We found similar effects for eHF-CM, compared with AAF, also in non-IgE CMA. When compared with SF, eHF-CM might favor weight gain for IgE CMA infants (0.23 z-score change, 95%CI 0.01 to 0.45), and tolerance acquisition (RR 1.86, 95%CI 1.03 to 3.37; RD 27%, 95%CI 1%-74%) for non-IgE CMA (both at very low certainty of the evidence (CoE)). The comparison of eHF-CM vs. HRF, and HRF vs. SF, showed no difference in effect (very low certainty). For IgE CMA patients, low certainty evidence suggested that adding probiotics (L. rhamnosus GG, L. casei CRL431 and B. lactis Bb-12) might increase the probability of developing CMA tolerance (RR 2.47, 95%CI 1.03 to 5.93; RD 27%, 95%CI 1%-91%), and reduce the risk of severe wheezing (RR 0.12, 95%CI 0.02 to 0.95; RD -23%, 95%CI -8% to -0.4%). However, in non-IgE CMA infants, the addition of probiotics (L. rhamnosus GG) showed no significant effect, as supported by low to very low CoE. Conclusions Currently available studies comparing eHF-CM, AAF, HRF, and SF provide very low certainty evidence about their effects in infants with IgE-mediated and non-IgE-mediated CMA. Our review revealed several limitations in the current body of evidence, primarily arising from concerns related to the quality of studies, the limited size of the participant populations and most importantly the lack of diversity and standardization in the compared interventions. It is therefore imperative for future studies to be methodologically rigorous and investigate a broader spectrum of available interventions. We encourage clinicians and researchers to review current World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines for suggestions on how to use milk replacement formulas in clinical practice and what additional research would be the most beneficial.
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Affiliation(s)
- Antonio Bognanni
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Clinical Epidemiology and Research Center (CERC), Humanitas University & Humanitas Research Hospital, Pieve Emanuele, Milano, Italy
- Department of Medicine, Evidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada
| | - Ramon T. Firmino
- Academic Unit of Biological Sciences, Federal University of Campina Grande, Patos, Paraíba, Brazil
| | - Stefania Arasi
- Translational Research in Pediatric Specialties Area, Division of Allergy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Derek K. Chu
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, Evidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, Division of Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada
| | - Alexandro W.L. Chu
- Department of Medicine, Evidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Siw Waffenschmidt
- Institute for Quality and Efficiency in Health Care, Cologne, Germany
| | - Arnav Agarwal
- Department of Medicine, Division of Internal Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Hanako Mihara
- Clinical Development Infectious Disease, Moderna Japan Co., Ltd., Japan
| | | | - Luigi Terracciano
- Pediatric Primary Care, National Pediatric Health Care System, Milan, Italy
- Italian Society of Preventive and Social Pediatrics (SIPPS), Italy
| | - Alberto Martelli
- Italian Society of Allergy and Pediatric Immunology (SIAIP), Italy
| | | | - Maria Said
- Allergy & Anaphylaxis Australia, Sydney, Australia
| | - Raanan Shamir
- Institute for Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Faculty of Medical and Health Sciences, Tel Aviv University, Israel
| | - Ignacio J. Ansotegui
- Department of Allergy & Immunology, Hospital Quironsalud Bizkaia, Erandio, Bilbao, Spain
| | - Lamia Dahdah
- Translational Research in Pediatric Specialties Area, Division of Allergy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Kanagawa, Japan
| | - Elena Galli
- Pediatric Allergy Unit, Research Center, San Pietro Hospital - Fatebenefratelli, Rome, Italy
| | - Rose Kamenwa
- Department of Pediatrics and Child Health, Aga Khan University Hospital, Nairobi, Kenya
| | - Gideon Lack
- Department of Women and Children's Health/Peter Gorer Department of Immunobiology, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, United Kingdom
- Evelina London Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust, United Kingdom
| | - Haiqi Li
- Department of Primary Child Care, Children's Hospital, Chongqing Medical University, China
| | - Ruby Pawankar
- Department of Pediatrics. Nippon Medical School, Tokyo, Japan
| | | | - Gary Wing Kin Wong
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Martin Bozzola
- Pediatric Allergy and Immunology Section, Dept of Pediatrics, Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | - Amal Assa'Ad
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, and the University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Sami Bahna
- Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, USA
| | - Jonathan Spergel
- Division of Allergy and Immunology, Children's Hospital of Philadelphia, USA
- Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA, USA
| | - Carina Venter
- Section of Allergy and Clinical Immunology, University of Colorado, USA
- Children's Hospital Colorado. Denver, Colorado, USA
| | - Hania Szajewska
- Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland
| | - Anna H. Nowak-Wegrzyn
- Department of Pediatrics, Hassenfeld Children's Hospital, New York University, Grossman School of Medicine, New York, NY, USA
- Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Yvan Vandenplas
- Vrije Universiteit Brussel (VUB), UZ Brussel, Belgium
- KidZ Health Castle, Brussels, Belgium
| | - Nikolaos G. Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
- Lydia Becker Institute, University of Manchester, Manchester, United Kingdom
| | - Susan Waserman
- Department of Medicine, Division of Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada
| | - Alessandro Fiocchi
- Translational Research in Pediatric Specialties Area, Division of Allergy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Holger J. Schünemann
- Clinical Epidemiology and Research Center (CERC), Humanitas University & Humanitas Research Hospital, Pieve Emanuele, Milano, Italy
| | - Jan L. Brożek
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, Division of Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada
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Kumar R, Guleria A, Padwad YS, Srivatsan V, Yadav SK. Smart proteins as a new paradigm for meeting dietary protein sufficiency of India: a critical review on the safety and sustainability of different protein sources. Crit Rev Food Sci Nutr 2024:1-50. [PMID: 39011754 DOI: 10.1080/10408398.2024.2367564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
India, a global leader in agriculture, faces sustainability challenges in feeding its population. Although primarily a vegetarian population, the consumption of animal derived proteins has tremendously increased in recent years. Excessive dependency on animal proteins is not environmentally sustainable, necessitating the identification of alternative smart proteins. Smart proteins are environmentally benign and mimic the properties of animal proteins (dairy, egg and meat) and are derived from plant proteins, microbial fermentation, insects and cell culture meat (CCM) processes. This review critically evaluates the technological, safety, and sustainability challenges involved in production of smart proteins and their consumer acceptance from Indian context. Under current circumstances, plant-based proteins are most favorable; however, limited land availability and impending climate change makes them unsustainable in the long run. CCM is unaffordable with high input costs limiting its commercialization in near future. Microbial-derived proteins could be the most sustainable option for future owing to higher productivity and ability to grow on low-cost substrates. A circular economy approach integrating agri-horti waste valorization and C1 substrate synthesis with microbial biomass production offer economic viability. Considering the use of novel additives and processing techniques, evaluation of safety, allergenicity, and bioavailability of smart protein products is necessary before large-scale adoption.
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Affiliation(s)
- Raman Kumar
- Applied Phycology and Food Technology Laboratory, Biotechnology Division, CSIR - Institute of Himalayan Bioresource Technology, Palampur, Himachal Pradesh, India
- Academy of Scientific and Innovative Research (AcSIR), CSIR-Human Resource Development Centre (CSIR-HRDC) Campus, Ghaziabad, Uttar Pradesh, India
| | - Aditi Guleria
- Applied Phycology and Food Technology Laboratory, Biotechnology Division, CSIR - Institute of Himalayan Bioresource Technology, Palampur, Himachal Pradesh, India
| | - Yogendra S Padwad
- Academy of Scientific and Innovative Research (AcSIR), CSIR-Human Resource Development Centre (CSIR-HRDC) Campus, Ghaziabad, Uttar Pradesh, India
- Protein Processing Centre, Dietetics, and Nutrition Technology Division, CSIR-Institute of Himalayan Bioresource Technology, Palampur, Himachal Pradesh, India
| | - Vidyashankar Srivatsan
- Applied Phycology and Food Technology Laboratory, Biotechnology Division, CSIR - Institute of Himalayan Bioresource Technology, Palampur, Himachal Pradesh, India
- Academy of Scientific and Innovative Research (AcSIR), CSIR-Human Resource Development Centre (CSIR-HRDC) Campus, Ghaziabad, Uttar Pradesh, India
| | - Sudesh Kumar Yadav
- Academy of Scientific and Innovative Research (AcSIR), CSIR-Human Resource Development Centre (CSIR-HRDC) Campus, Ghaziabad, Uttar Pradesh, India
- CSIR-Institute of Himalayan Bioresource Technology, Palampur, Himachal Pradesh, India
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Alfonso RMJ, Rubí IAK, Manuel TME, Roberto CB, Alejandra RCM, de Jesús MVI, Gabriela AGA, Vladimir BND, Lucía CG, Antonio CBJ, Sergio DM, Esther FFL, Manuel Enrique GPM, Ileana GCJ, Elena HHR, Elena LRA, Héctor MA, Carlos MN, José Antonio OM, Iván OGC, Rubén PV, Nicolás RMJ, Del Mar SDOGM, Gerardo SM, Eugenia URM, Liliana WD, Hideo WKG, Yvan V. Mexican consensus on cow's milk protein allergy. Allergol Immunopathol (Madr) 2024; 52:24-37. [PMID: 38186191 DOI: 10.15586/aei.v52i1.958] [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: 07/17/2023] [Accepted: 10/04/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND The aim of this study is to present the current views of a diverse group of experts on the diagnosis and treatment of Cow's Milk Protein Allergy (CMPA) in children under 2 years of age in Mexico. MATERIAL AND METHODS The study, led by a scientific committee of five experts in CMPA, was divided into six phases, including a modified Delphi process. A total of 20 panelists, all of whom were pediatric specialists, participated in administering a comprehensive 38-item questionnaire. The questionnaire was divided into two blocks: Diagnosis and Treatment (20 items each). RESULTS Consensus was reached on all the proposed items, with an agreement rate of over 70% for each of them. As a result, a diagnostic and treatment algorithm was developed that emphasized the reduction of unnecessary diagnostic studies and encouraged breastfeeding whenever possible. In cases where breast milk is not available, appropriate use of hypoallergenic formulas was recommended. In addition, recommendations on treatment duration and gradual reintroduction of cow's milk protein were provided. CONCLUSIONS The recommendations endorsed by 20 Mexican pediatricians through this study are applicable to everyday clinical practice, thereby enhancing the diagnosis and treatment of children under 2 years of age with CMPA. This, in turn, will foster improved health outcomes and optimize the utilization of healthcare resources.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Casas Guzik Lucía
- Pediatric Gastroenterology, Hospital Infantil de Morelia Eva Sámano de López Mateos, Morelia, México
| | | | | | | | | | | | | | | | | | - Méndez Nieto Carlos
- Pediatric Gastroenterology, Hospital Infantil de Especialidades, Ciudad Juárez, Mexico
| | | | | | - Peña Vélez Rubén
- Pediatric Gastroenterology, Hospital General de Puebla Dr. Eduardo Vázquez N., Puebla, Mexico
| | | | | | | | | | | | | | - Vandenplas Yvan
- Pediatric Gastroenterology, KidZ Health Castle, UZ Brussel; Vrije Universiteit Brussel, Brussels, Belgium
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Yanni AE, Iakovidi S, Vasilikopoulou E, Karathanos VT. Legumes: A Vehicle for Transition to Sustainability. Nutrients 2023; 16:98. [PMID: 38201928 PMCID: PMC10780344 DOI: 10.3390/nu16010098] [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: 11/24/2023] [Revised: 12/23/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
Legumes are an excellent source of protein and have been used in the human diet for centuries. Consumption of legumes has been linked to several health benefits, including a lower risk of cardiovascular diseases, type 2 diabetes mellitus, and certain types of cancer, while legumes' high fiber content promotes digestive health. Aside from the positive health benefits, one of the most significant advantages of legumes is the low environmental footprint of their cultivation. They can be grown in a variety of climates and soil types, and they require less water and fertilizer than other crops, making them a sustainable option for farmers. Thanks to their nutritional and physicochemical properties, they are widely used by the food industry since the growing popularity of plant-based diets and the increasing demand for alternatives to meat offers the opportunity to develop legume-based meat substitutes. As the use of legumes as a source of protein becomes widespread, new market opportunities could be created for farmers and food industries, while the reduction in healthcare costs could have a potential economic impact. Achieving widespread adoption of legumes as a sustainable source of protein requires coordinated efforts by individuals, governments, and the private sector. The objective of this narrative review is to present the benefits coming from legume consumption in terms of health and environmental sustainability, and underline the importance of promoting their inclusion in the daily dietary pattern as well as their use as functional ingredients and plant-based alternatives to animal products.
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Affiliation(s)
- Amalia E. Yanni
- Laboratory of Chemistry-Biochemistry-Physical Chemistry of Foods, Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou Ave, 176-71 Athens, Greece; (S.I.); (E.V.); (V.T.K.)
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Andrade VL, Ribeiro I, dos Santos APM, Aschner M, Mateus ML. Metals in Cow Milk and Soy Beverages: Is There a Concern? TOXICS 2023; 11:1013. [PMID: 38133414 PMCID: PMC10747271 DOI: 10.3390/toxics11121013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/05/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
Nowadays, there is an increased consumption of plant-based protein beverages like soy beverages (SBs) as substitutes for cow milk (CM). Both accumulate toxic metals like lead (Pb), cadmium (Cd), and manganese (Mn), which, although essential, are neurotoxic at high levels. Metals can also perturb the normal development of children. This work aimed to evaluate these metal concentrations in CM and SB purchased on the Portuguese market. After validation of the method, linearity of calibration curves, work range, detection and quantification limits, and selectivity, metals were determined in 14 CM and 14 SB brands using atomic absorption spectrometry. The values were compared between CM and SB and with permissible limit values. Soy beverages had significantly (p < 0.05) higher concentrations of Cd (5.6 ± 4.2 µg/L) and Mn (117.4 ± 30.3) µg/L) than CM (2.15 ± 1.84 µg/L and 5.93 ± 1.21 µg/L, respectively); the Pb concentrations in CM (19.3 ± 12.1 µg/L) were not significantly (p > 0.05) higher than in SB (13.4 ± 9.6 µg/L). These values were similar to other studies and close to but under permissible limit values. Nevertheless, due to the toxicity and bioaccumulation of metals, the fact that these foods are routinely ingested by all ages, mainly children, and represent key ingredients in many processed foods, including baby foods, we suggest strict surveying of metal levels in CM and SBs.
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Affiliation(s)
- Vanda Lopes Andrade
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal; (V.L.A.); (A.P.M.d.S.)
- Life Quality Research Centre (CIEQV), IPSantarem/IPLeiria, 2040-413 Rio Maior, Portugal
| | - Iolanda Ribeiro
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal; (V.L.A.); (A.P.M.d.S.)
- Faculty of Sciences, Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal
| | - A. P. Marreilha dos Santos
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal; (V.L.A.); (A.P.M.d.S.)
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Forchheimer Building, Room 209, Bronx, NY 10461, USA;
| | - Maria Luisa Mateus
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal; (V.L.A.); (A.P.M.d.S.)
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Venter C, Shamir R, Fleischer DM. Early Introduction of Novel and Less-Studied Food Allergens in the Plant-Based Era: Considerations for US and EU Infant Formula Regulations. Nutrients 2023; 15:4530. [PMID: 37960183 PMCID: PMC10649096 DOI: 10.3390/nu15214530] [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: 09/06/2023] [Revised: 09/23/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Early life feeding practices may affect the long-term health of individuals, particularly in terms of the development of non-communicable diseases, such as metabolic and allergic diseases. Accumulating evidence suggests that the interplay of breastfeeding and/or formula feeding followed by the introduction of solids plays a role in the occurrence of non-communicable diseases both in the short and long term. International food allergy guidelines recommend that breastfeeding women do not need to avoid food allergens and do not recommend any infant formula for allergy prevention. Guidelines regarding solid food introduction for food allergy prevention recommend the introduction of well-cooked eggs and peanuts around 4-6 months of age, and not to delay the introduction of other food allergens. There is also an increasing trend to feed infants a plant-based or plant-forward diet and have access to infant formulas based on plant-based ingredients. The use of novel plant-based infant formulas raises a few questions reviewed in this paper: (1) Do fortified, plant-based infant formulas, compliant with US Food and Drug Administration (FDA) regulations and European Food Safety Authority (EFSA) (European) guidelines, support adequate infant growth? (2) Are plant-based infant formulas suitable for the management of cow's milk allergy? (3) Does feeding with novel, plant-based infant formulas increase the risk of food allergies to the food allergens they contain? (4) Does feeding infants plant-based food allergens in early life increase the risk of allergic and severe allergic reactions? The review of the literature indicated that (1) plant-based formulas supplemented with amino acids and micronutrients to comply with FDA regulations and EFSA guidelines, evaluated in sufficiently powered growth studies, can support adequate growth in infants; (2) currently available plant-based infant formulas are suitable for the management of CMA; (3) an early introduction and continuous intake of food allergens are more likely to prevent food allergies than to increase their risk; and (4) an early introduction of food allergens in young infants is safe.
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Affiliation(s)
- Carina Venter
- University of Colorado/Children’s Hospital Colorado: Section of Pediatric Allergy and Clinical Immunology, Aurora, CO 80045, USA;
| | - Raanan Shamir
- Institute for Gastroenterology, Nutrition and Liver Disease, Schneider Children’s Medical Center of Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv 74071-12-20, Israel;
| | - David Mark Fleischer
- University of Colorado/Children’s Hospital Colorado: Section of Pediatric Allergy and Clinical Immunology, Aurora, CO 80045, USA;
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Park H, Park NY, Koh A. Scarring the early-life microbiome: its potential life-long effects on human health and diseases. BMB Rep 2023; 56:469-481. [PMID: 37605613 PMCID: PMC10547969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/30/2023] [Accepted: 08/14/2023] [Indexed: 08/23/2023] Open
Abstract
The gut microbiome is widely recognized as a dynamic organ with a profound influence on human physiology and pathology. Extensive epidemiological and longitudinal cohort studies have provided compelling evidence that disruptions in the early-life microbiome can have long-lasting health implications. Various factors before, during, and after birth contribute to shaping the composition and function of the neonatal and infant microbiome. While these alterations can be partially restored over time, metabolic phenotypes may persist, necessitating research to identify the critical period for early intervention to achieve phenotypic recovery beyond microbiome composition. In this review, we provide current understanding of changes in the gut microbiota throughout life and the various factors affecting these changes. Specifically, we highlight the profound impact of early-life gut microbiota disruption on the development of diseases later in life and discuss perspectives on efforts to recover from such disruptions. [BMB Reports 2023; 56(9): 469-481].
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Affiliation(s)
- Hyunji Park
- Department of Life Sciences, Pohang University of Science and Technology, Pohang 37673, Korea
| | - Na-Young Park
- Department of Life Sciences, Pohang University of Science and Technology, Pohang 37673, Korea
| | - Ara Koh
- Department of Life Sciences, Pohang University of Science and Technology, Pohang 37673, Korea
- Institute of Convergence Science, Yonsei University, Seoul 03722, Korea
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PARLAK Z, İLGÜN GÜREL D, SOYER Ö, ŞEKEREL BE, ŞAHİNER ÜM. Nutritional risks in children with food allergy. Turk J Med Sci 2023; 53:845-858. [PMID: 38031941 PMCID: PMC10765559 DOI: 10.55730/1300-0144.5648] [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: 02/15/2023] [Revised: 08/18/2023] [Accepted: 04/04/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Food allergies (FA) are a growing problem in the pediatric population and clinical features differ according to the underlying immunological mechanisms. While the primary management strategy is to eliminate the culprit food from the diet, assessment of the potential nutritional risks of elimination is also an integral part of management. In cases that do not improve over time; if you have basic food allergies and multiple food allergies, this can also lead to negative nutritional consequences. The contribution of basic nutrients, economical and easily accessible foods to the diet, is critical and has an important place in meeting the daily adequate intake of many nutrients. In the presence of food allergy, it is necessary to meet the vitamins and minerals that cannot be obtained from allergic foods, with alternative sources or supplements. For example, insufficient calcium intake in cow's milk allergy (CMA), the most common FA in early childhood, is very likely if an alternative supplement has not been introduced. In the management of CMA, choosing the appropriate formula and/or supplement for the clinical characteristics of children, when necessary, has an important place. In conclusion, nutritional risk assessment of children with FA requires a comprehensive, detailed, and multidisciplinary approach.
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Affiliation(s)
- Zeynep PARLAK
- Department of Pediatric Allergy and Asthma, Faculty of Medicine, Hacettepe University, Ankara,
Turkiye
- Department of Nutrition and Dietetics, Hacettepe İhsan Doğramacı Children’s Hospital, Hacettepe University, Ankara,
Turkiye
| | - Deniz İLGÜN GÜREL
- Department of Pediatric Allergy and Asthma, Faculty of Medicine, Hacettepe University, Ankara,
Turkiye
| | - Özge SOYER
- Department of Pediatric Allergy and Asthma, Faculty of Medicine, Hacettepe University, Ankara,
Turkiye
| | - Bülent Enis ŞEKEREL
- Department of Pediatric Allergy and Asthma, Faculty of Medicine, Hacettepe University, Ankara,
Turkiye
| | - Ümit Murat ŞAHİNER
- Department of Pediatric Allergy and Asthma, Faculty of Medicine, Hacettepe University, Ankara,
Turkiye
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Baker MG, Sampson HA. Recent trends in food protein-induced enterocolitis syndrome (FPIES). J Allergy Clin Immunol 2023; 151:43-46. [PMID: 36608982 DOI: 10.1016/j.jaci.2022.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/27/2022] [Accepted: 11/08/2022] [Indexed: 01/05/2023]
Abstract
Food protein-induced enterocolitis syndrome (FPIES) was first described in detail in the late 20th century as a non-IgE-mediated food allergy characterized by delayed gastrointestinal symptoms after ingestion of a trigger food. Although the initial case series reported infants reacting to cow's milk- and soy-based formulas, we now recognize that FPIES affects patients across the age spectrum. This brief review highlights our evolving understanding of FPIES with a discussion of triggers, epidemiology, food challenges, and pathophysiology.
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Affiliation(s)
- Mary Grace Baker
- Elliot and Roslyn Jaffe Food Allergy Institute, Division of Pediatric Allergy & Immunology, Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Hugh A Sampson
- Elliot and Roslyn Jaffe Food Allergy Institute, Division of Pediatric Allergy & Immunology, Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
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10
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Langton CR, Harmon QE, Upson K, Baird DD. Soy-Based Infant Formula Feeding and Uterine Fibroid Development in a Prospective Ultrasound Study of Black/African-American Women. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:17006. [PMID: 36696103 PMCID: PMC9875846 DOI: 10.1289/ehp11089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 11/14/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Uterine fibroids are highly prevalent, benign tumors. They are the leading indication for hysterectomy, and Black women are disproportionally burdened. Soy-based infant formula contains phytoestrogens, and exposure during sensitive developmental windows may adversely affect the developing uterus; early phytoestrogen treatment in rodent studies led to detrimental uterine effects, including increased fibroid risk in Eker rats. Limited epidemiological studies also have suggested increased fibroid development with soy formula infant feeding. OBJECTIVE The goal of this study was to examine the association between soy formula feeding in infancy and fibroid development in adulthood. METHODS We evaluated this association among 1,610 Black/African-American women age 23-35 y in the Study of Environment, Lifestyle & Fibroids (SELF). Soy formula feeding data was gathered directly from the participants' mothers (89%). A standardized ultrasound examination was conducted during 4 clinic visits over 5 y to detect fibroids ≥0.5cm in diameter. We used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between soy formula feeding and incident fibroids adjusted for early-life and adult factors. Fibroid growth was calculated as change in log-volume for fibroids matched at successive visits. RESULTS Of 1,121 fibroid-free participants at baseline, 150 (13%) were ever fed soy formula as infants, and 269 (24%) developed incident fibroids. We did not observe an association between ever being fed soy formula and incident fibroid risk (HR=1.08; 95% CI: 0.75, 1.54). However, participants fed soy formula within 2 months of birth and for >6 months (n=53) had an elevated risk of fibroid incidence in comparison with those never fed soy formula (HR=1.56; 95% CI: 0.92, 2.65). Fibroid growth rates did not differ. DISCUSSION Adding support to limited human data, this prospective fibroid study found that soy-based formula feeding during infancy was associated with a suggestive increase in risk of ultrasound-identified incident fibroids in adulthood. https://doi.org/10.1289/EHP11089.
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Affiliation(s)
- Christine R. Langton
- Women’s Health Group, Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Quaker E. Harmon
- Women’s Health Group, Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Kristen Upson
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Donna D. Baird
- Women’s Health Group, Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
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11
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Wright K, Feeney M, Yerlett N, Meyer R. Nutritional Management of Children with Food Allergies. CURRENT TREATMENT OPTIONS IN ALLERGY 2022. [DOI: 10.1007/s40521-022-00320-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abstract
Purpose of the Review
The purpose of the review is to review the evidence for the nutritional management of paediatric food allergy and provide a practical approach for healthcare professionals working in this area.
Recent Findings
Dietary elimination remains the mainstay for management of food allergies in children. However, the elimination of food allergens increases the risk for growth faltering, micronutrient deficiencies and feeding difficulties. Breastmilk remains the ideal source of nutrition for infants, but when not available, the vast majority will tolerate an extensively hydrolysed formula, and rice hydrolysate has also been suggested as a suitable alternative. Only in severe cases, including anaphylaxis, eosinophilic oesophagitis and growth faltering, is an amino acid formula indicated. The early introduction of peanut and egg and avoiding the delay in the introduction of other allergens, when not already allergic, has been highlighted by recent studies.
Summary
Whilst the elimination of allergens increases the risk of developing poor growth, micronutrient deficiencies and feeding difficulties, optimal, early dietary input, including advice on active introduction of allergens and alternative feeds, ideally from a registered dietitian/nutritionist, may be prevent and improve outcomes.
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12
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Zaeifi F, Sedaghati F, Samari F. A new electrochemical sensor based on green synthesized CuO nanostructures modified carbon ionic liquid electrode for electrocatalytic oxidation and monitoring of l-cysteine. Microchem J 2022. [DOI: 10.1016/j.microc.2022.107969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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13
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Anania C, Martinelli I, Brindisi G, De Canditiis D, De Castro G, Zicari AM, Olivero F. Hydrolyzed Rice Formula: An Appropriate Choice for the Treatment of Cow's Milk Allergy. J Clin Med 2022; 11:4823. [PMID: 36013062 PMCID: PMC9410499 DOI: 10.3390/jcm11164823] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/29/2022] Open
Abstract
Cow's milk allergy (CMA) is a common condition in the pediatric population. CMA can induce a diverse range of symptoms of variable intensity. It occurs mainly in the first year of life, and if the child is not breastfed, hypoallergenic formula is the dietary treatment. Extensively hydrolyzed cow's milk formulas (eHF) with documented hypo-allergenicity can be recommended as the first choice, while amino acid-based formulas (AAF) are recommended for patients with more severe symptoms. Hydrolyzed rice-based formulas (HRFs) are a suitable alternative for infants with CMA that cannot tolerate or do not like eHF and in infants with severe forms of CMA. In the present paper, we reviewed the nutritional composition of HRFs as well as studies regarding their efficacy and tolerance in children, and we provided an updated overview of the recent evidence on the use of HRFs in CMA. The available studies provide evidence that HRFs exhibit excellent efficacy and tolerance and seem to be adequate in providing normal growth in healthy children as well as in children with CMA.
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Affiliation(s)
- Caterina Anania
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Ivana Martinelli
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Giulia Brindisi
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | | | - Giovanna De Castro
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Anna Maria Zicari
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Francesca Olivero
- Pediatric Clinic, Department of Pediatrics, Fondazione IRCSS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
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14
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Verwendung von diätetischen Lebensmitteln für besondere medizinische Zwecke („bilanzierte Diäten“) für Säuglinge, Aktualisierung 2022. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01528-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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15
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Alternatives to Cow’s Milk-Based Infant Formulas in the Prevention and Management of Cow’s Milk Allergy. Foods 2022; 11:foods11070926. [PMID: 35407012 PMCID: PMC8997926 DOI: 10.3390/foods11070926] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 12/27/2022] Open
Abstract
Cow’s milk-based infant formulas are the most common substitute to mother’s milk in infancy when breastfeeding is impossible or insufficient, as cow’s milk is a globally available source of mammalian proteins with high nutritional value. However, cow’s milk allergy (CMA) is the most prevalent type of food allergy among infants, affecting up to 3.8% of small children. Hypoallergenic infant formulas based on hydrolysed cow’s milk proteins are commercially available for the management of CMA. Yet, there is a growing demand for more options for infant feeding, both in general but especially for the prevention and management of CMA. Milk from other mammalian sources than the cow, such as goat, sheep, camel, donkey, and horse, has received some attention in the last decade due to the different protein composition profile and protein amino acid sequences, resulting in a potentially low cross-reactivity with cow’s milk proteins. Recently, proteins from plant sources, such as potato, lentil, chickpeas, quinoa, in addition to soy and rice, have gained increased interest due to their climate friendly and vegan status as well as potential lower allergenicity. In this review, we provide an overview of current and potential future infant formulas and their relevance in CMA prevention and management.
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16
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Verduci E, Di Profio E, Corsello A, Scatigno L, Fiore G, Bosetti A, Zuccotti GV. Which Milk during the Second Year of Life: A Personalized Choice for a Healthy Future? Nutrients 2021; 13:nu13103412. [PMID: 34684413 PMCID: PMC8540900 DOI: 10.3390/nu13103412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 01/20/2023] Open
Abstract
Nutrition in early life is a crucial element to provide all essential substrates for growth. Although this statement may appear obvious, several studies have shown how the intake of micro and macronutrients in toddlers differs a lot from the recommendations of scientific societies. Protein intake often exceeds the recommended amount, while the intake of iron and zinc is frequently insufficient, as well as Vitamin D. Nutritional errors in the first years of life can negatively impact the health of the child in the long term. To date, no clear evidence on which milk is suggested during the second year of life is yet to be established. In this study, we compare the nutrient profiles of cow’s milk and specific formulas as well as nutritional risks in toddlers linked to growth and childhood obesity development. The purpose of this review is to resume the latest clinical studies on toddlers fed with cow’s milk or young children formula (YCF), and the potential risks or benefits in the short and long term.
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Affiliation(s)
- Elvira Verduci
- Department of Health Sciences, University of Milan, 20146 Milan, Italy
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.P.); (A.C.); (L.S.); (G.F.); (A.B.); (G.V.Z.)
- Correspondence:
| | - Elisabetta Di Profio
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.P.); (A.C.); (L.S.); (G.F.); (A.B.); (G.V.Z.)
- Department of Animal Sciences for Health, Animal Production and Food Safety, University of Milan, 20133 Milan, Italy
| | - Antonio Corsello
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.P.); (A.C.); (L.S.); (G.F.); (A.B.); (G.V.Z.)
| | - Lorenzo Scatigno
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.P.); (A.C.); (L.S.); (G.F.); (A.B.); (G.V.Z.)
| | - Giulia Fiore
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.P.); (A.C.); (L.S.); (G.F.); (A.B.); (G.V.Z.)
| | - Alessandra Bosetti
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.P.); (A.C.); (L.S.); (G.F.); (A.B.); (G.V.Z.)
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.P.); (A.C.); (L.S.); (G.F.); (A.B.); (G.V.Z.)
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, 20157 Milan, Italy
- Pediatric Clinical Research Center Fondazione Romeo ed Enrica Invernizzi, University of Milan, 20157 Milan, Italy
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17
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D’Auria E, Salvatore S, Acunzo M, Peroni D, Pendezza E, Di Profio E, Fiore G, Zuccotti GV, Verduci E. Hydrolysed Formulas in the Management of Cow's Milk Allergy: New Insights, Pitfalls and Tips. Nutrients 2021; 13:2762. [PMID: 34444922 PMCID: PMC8401609 DOI: 10.3390/nu13082762] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/03/2021] [Accepted: 08/07/2021] [Indexed: 12/12/2022] Open
Abstract
An allergy to cow's milk requires the avoidance of cow's milk proteins and, in some infants, the use of a hypoallergenic formula. This review aims to summarize the current evidence concerning different types of hydrolysed formulas (HF), and recommendations for the treatment of IgE- and non-IgE-mediated cow's milk allergy and functional gastrointestinal disorders in infancy, for which some dietary intervention and HF may be of benefit to both immune and motor mechanisms. Current guidelines recommend cow's milk protein (i.e., whey or casein) extensively hydrolysed formula (eHF) as the first choice for cow's milk allergy treatment, and amino acid formulas for more severe cases or those with reactions to eHF. Rice hydrolysed formulas (rHF) have also become available in recent years. Both eHF and rHF are well tolerated by the majority of children allergic to cow's milk, with no concerns regarding body growth or adverse effects. Some hydrolysates may have a pro-active effect in modulating the immune system due to the presence of small peptides and additional components, like biotics. Despite encouraging results on tolerance acquisition, evidence is still not conclusive, thus hampering our ability to draw firm conclusions. In clinical practice, the choice of hypoallergenic formula should be based on the infant's age, the severity, frequency and persistence of symptoms, immune phenotype, growth pattern, formula cost, and in vivo proof of tolerance and efficacy.
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Affiliation(s)
- Enza D’Auria
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.A.); (E.P.); (E.D.P.); (G.F.); (G.V.Z.); (E.V.)
| | - Silvia Salvatore
- Department of Pediatrics, Ospedale “F. Del Ponte”, University of Insubria, 21100 Varese, Italy;
| | - Miriam Acunzo
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.A.); (E.P.); (E.D.P.); (G.F.); (G.V.Z.); (E.V.)
| | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, 56126 Pisa, Italy;
| | - Erica Pendezza
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.A.); (E.P.); (E.D.P.); (G.F.); (G.V.Z.); (E.V.)
| | - Elisabetta Di Profio
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.A.); (E.P.); (E.D.P.); (G.F.); (G.V.Z.); (E.V.)
| | - Giulia Fiore
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.A.); (E.P.); (E.D.P.); (G.F.); (G.V.Z.); (E.V.)
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.A.); (E.P.); (E.D.P.); (G.F.); (G.V.Z.); (E.V.)
| | - Elvira Verduci
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy; (M.A.); (E.P.); (E.D.P.); (G.F.); (G.V.Z.); (E.V.)
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18
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Laha A, Panja AS, Bandopadhyay R. Structural Phylogeny of Different Allergens May Reveal Common Epitopic Footprint. Protein Pept Lett 2021; 28:1099-1107. [PMID: 34161203 DOI: 10.2174/0929866528666210622145710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/01/2021] [Accepted: 04/17/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The incidence of allergy is increasing at an alarming rate for the last few decades. OBJECTIVE Our present study is focused on finding out the structurally homologous motifs present in different proteinaceous allergens Methods: Significant number of protein sequences and their corresponding structures of various pollen, fungal, bacterial, and food allergens were retrieved, and the sequence and structural identity were analyzed. RESULTS Intra- and inter-sequence and their structural analysis of the proteinaceous allergens, resulted in no significant relationships among them. A few, but not negligible number of high structural similarities were observed within different groups of allergens from fungus, angiosperms, and animals (Aves and Mammalia). CONCLUSION Our in silico study on thirty-six different allergens showed a significant level of structural similarities among themselves, regardless of their sequences.
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Affiliation(s)
- Anubhab Laha
- Department of Botany, Chandernagore College, Chandernagore-712136, Hooghly, West Bengal, India.,UGC Centre for Advanced Study, Department of Botany, The University of Burdwan, Golapbag, Burdwan - 713104, West Bengal, India
| | - Anindya Sundar Panja
- Department of Biotechnology and Biochemistry, Oriental Institute of Science and Technology, Burdwan, West Bengal, India
| | - Rajib Bandopadhyay
- UGC Centre for Advanced Study, Department of Botany, The University of Burdwan, Golapbag, Burdwan - 713104, West Bengal, India
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19
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Bivi D, Di Chio T, Geri F, Morganti R, Goggi S, Baroni L, Mumolo MG, de Bortoli N, Peroni DG, Marchi S, Bellini M. Raising Children on a Vegan Diet: Parents' Opinion on Problems in Everyday Life. Nutrients 2021; 13:nu13061796. [PMID: 34070399 PMCID: PMC8226937 DOI: 10.3390/nu13061796] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/14/2021] [Accepted: 05/23/2021] [Indexed: 01/29/2023] Open
Abstract
A growing number of Italian families are adopting a vegan diet (VD) for their offspring from infancy for various reasons, with health benefits and ethics being the most common reasons. Barriers to effective communication with primary care pediatricians (PCPs) are perceived by many parents and, depending on the actors involved and the environment, a VD may affect social interactions in everyday life. A national cross-sectional survey was conducted between July and September 2020. Parents of children following a VD completed an online questionnaire. Data from 176 Italian parents were collected. About 72% (71.8%) of the children included in this study had been on a VD since weaning. Parents did not inform their primary care pediatricians (PCP) about the VD in 36.2% of the cases. In 70.8% of the cases, PCPs were perceived as skeptical or against a VD. About 70% (71.2%) of the parents relied on medical dietitians, and 28.2% on nutritionists/dietitians for dietary counseling. Parents administered an individual B12 supplement in 87.2% of the cases. To the best of our knowledge, this survey is the first which explores the relationship between vegan parents and their PCPs, the parental management of their children's diet and problems regarding the implementation of a VD in everyday life.
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Affiliation(s)
- Daisy Bivi
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
| | - Teresa Di Chio
- Pediatric Institute of Southern Switzerland, Ospedale Regionale di Bellinzona e Valli, Via Ospedale 12, 6500 Bellinzona, Switzerland
- Correspondence: ; Tel.: +41-77-953-70-77
| | - Francesca Geri
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
| | - Riccardo Morganti
- Section of Statistics, University Hospital of Pisa, 56100 Pisa, Italy;
| | - Silvia Goggi
- Scientific Society for Vegetarian Nutrition, Scientific Committee, Via Verdi 10/9, 30171 Mestre (VE), Italy; (S.G.); (L.B.)
| | - Luciana Baroni
- Scientific Society for Vegetarian Nutrition, Scientific Committee, Via Verdi 10/9, 30171 Mestre (VE), Italy; (S.G.); (L.B.)
| | - Maria Gloria Mumolo
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
| | - Nicola de Bortoli
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
| | - Diego Giampietro Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, 56126 Pisa, Italy;
| | - Santino Marchi
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
| | - Massimo Bellini
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
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20
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Fernandez-Garcia JM, Carrillo B, Tezanos P, Collado P, Pinos H. Genistein during Development Alters Differentially the Expression of POMC in Male and Female Rats. Metabolites 2021; 11:293. [PMID: 34063209 PMCID: PMC8147459 DOI: 10.3390/metabo11050293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/23/2021] [Accepted: 04/29/2021] [Indexed: 11/16/2022] Open
Abstract
Phytoestrogens are considered beneficial for health, but some studies have shown that they may cause adverse effects. This study investigated the effects of genistein administration during the second week of life on energy metabolism and on the circuits regulating food intake. Two different genistein doses, 10 or 50 µg/g, were administered to male and female rats from postnatal day (P) 6 to P13. Physiological parameters, such as body weight and caloric intake, were then analyzed at P90. Moreover, proopiomelanocortin (POMC) expression in the arcuate nucleus (Arc) and orexin expression in the dorsomedial hypothalamus (DMH), perifornical area (PF) and lateral hypothalamus (LH) were studied. Our results showed a delay in the emergence of sex differences in the body weight in the groups with higher genistein doses. Furthermore, a significant decrease in the number of POMC-immunoreactive (POMC-ir) cells in the Arc in the two groups of females treated with genistein was observed. In contrast, no alteration in orexin expression was detected in any of the structures analyzed in either males or females. In conclusion, genistein can modulate estradiol's programming actions on the hypothalamic feeding circuits differentially in male and female rats during development.
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Affiliation(s)
- Jose Manuel Fernandez-Garcia
- Departamento de Psicobiología, Facultad Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain; (J.M.F.-G.); (B.C.); (P.C.)
- Instituto Mixto de Investigación Escuela Nacional de Sanidad-UNED (IMIENS), 28040 Madrid, Spain
| | - Beatriz Carrillo
- Departamento de Psicobiología, Facultad Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain; (J.M.F.-G.); (B.C.); (P.C.)
- Instituto Mixto de Investigación Escuela Nacional de Sanidad-UNED (IMIENS), 28040 Madrid, Spain
| | - Patricia Tezanos
- Departamento de Neurociencia Traslacional, Instituto Cajal, Consejo Superior de Investigaciones Científicas (CSIC), 28002 Madrid, Spain;
| | - Paloma Collado
- Departamento de Psicobiología, Facultad Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain; (J.M.F.-G.); (B.C.); (P.C.)
- Instituto Mixto de Investigación Escuela Nacional de Sanidad-UNED (IMIENS), 28040 Madrid, Spain
| | - Helena Pinos
- Departamento de Psicobiología, Facultad Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain; (J.M.F.-G.); (B.C.); (P.C.)
- Instituto Mixto de Investigación Escuela Nacional de Sanidad-UNED (IMIENS), 28040 Madrid, Spain
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21
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Vandenplas Y, Hegar B, Munasir Z, Astawan M, Juffrie M, Bardosono S, Sekartini R, Basrowi RW, Wasito E. The role of soy plant-based formula supplemented with dietary fiber to support children's growth and development: An expert opinion. Nutrition 2021; 90:111278. [PMID: 34004412 DOI: 10.1016/j.nut.2021.111278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/05/2021] [Accepted: 04/01/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Soy-based formula has evolved in usage and processing technology since its introduction in 1909, and has been used as substitute formula for infants or children with cow milk allergy since 1929. At present, personal opinions, religious background, availability, palatability, and cost are part of the reasons soy-based formula is chosen. Technology in processing soy-based formula has evolved from using soy flour to soy protein isolate, which provides advantages. However, concerns remain regarding the impact of its use on the growth and development of children. METHODS An expert meeting, attended by 12 experts, was initiated in Jakarta, Indonesia, to obtain an evidence-based consensus on the role of soy protein isolate formula, as well as its nutritional value to support growth and development. RESULTS Ensuring that plant-based formula (i.e., soy protein isolate formula) is fortified with key nutrients, such as calcium, iron, and dietary fiber is important. CONCLUSIONS Consensus was achieved, concluding that soy protein isolate formula is safe, affordable, and an alternative option for cow's milk-based formula for term infants.
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Affiliation(s)
- Yvan Vandenplas
- KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, Belgium.
| | - Badriul Hegar
- Department of Pediatric, Faculty of Medicine, Universitas Indonesia; Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Zakiudin Munasir
- Department of Pediatric, Faculty of Medicine, Universitas Indonesia; Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Made Astawan
- Department of Food Science and Technology, IPB University, Bogor, Indonesia
| | - Mohammad Juffrie
- Department of Child Health, Faculty of Medicine, Universitas Gajah Mada, Yogyakarta, Indonesia
| | - Saptawati Bardosono
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia; Cipto Mangunkusumo General Hospital; Jakarta, Indonesia
| | - Rini Sekartini
- Department of Pediatric, Faculty of Medicine, Universitas Indonesia; Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | | | - Erika Wasito
- Danone Specialized Nutrition Indonesia, Jakarta, Indonesia
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