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Monge-Montero C, van der Merwe LF, Tagliamonte S, Agostoni C, Vitaglione P. Why do mothers mix milk feed their infants? Results from a systematic review. Nutr Rev 2023:nuad134. [PMID: 38041551 DOI: 10.1093/nutrit/nuad134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023] Open
Abstract
CONTEXT Combining or supplementing breastfeeding with formula feeding, also called mixed milk feeding (MMF), is a common infant feeding practice. However, there is no well-established MMF evidence-base for informing and guiding parents. A better understanding of the reasons why mothers practice MMF may facilitate identification of efficient strategies for supporting exclusive breastfeeding, and/or opportunities to prolong breastfeeding, at least partially. OBJECTIVE An updated systematic literature review was undertaken with the primary aim of gaining a deeper understanding of the reasons why mothers choose MMF. DATA SOURCES Six databases were searched for relevant articles published in English from January 2012 to January 2022. DATA EXTRACTION Two reviewers independently performed the screenings and data extraction, and any differences were resolved by a third reviewer. Data from 138 articles were included, 90 of which contained data on MMF reasons/drivers, and 60 contained data on infant age and/or maternal demographic factors associated with MMF. DATA ANALYSIS A total of 13 different unique MMF drivers/reasons were identified and categorized according to whether the drivers/reasons related to perceived choice, necessity, or pressure. Risk of bias was evaluated using the Quality Assessment Tool of Diverse Studies and the JBI Systematic Reviews tool. Several different terms were used to describe and classify MMF across the studies. The most commonly reported reasons for MMF were related to a perception of necessity (39% of drivers, eg, concerns about infant's hunger/perceived breast milk insufficiency or breastfeeding difficulties), followed by drivers associated with perceived choice (34%; eg, having more flexibility) and perceived pressure (25%; eg, returning to work or healthcare professionals' advice). This was particularly true for infants aged 3 months or younger. CONCLUSION The key global drivers for MMF and their distribution across infant age and regions were identified and described, providing opportunities for the provision of optimal breastfeeding support. A unified definition of MMF is needed in order to enable more comparable and standardized research. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022304253.
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Affiliation(s)
- Carmen Monge-Montero
- Department of Research, Monge Consultancy Food and Nutrition Research, Leiden, The Netherlands
| | | | - Silvia Tagliamonte
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
| | - Carlo Agostoni
- Fondazione IRCCS Ospedale Maggiore Policlinico, Pediatric Clinic, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paola Vitaglione
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
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Padhani ZA, Das JK, Siddiqui FA, Salam RA, Lassi ZS, Khan DSA, Abbasi AMA, Keats EC, Soofi S, Black RE, Bhutta ZA. Optimal timing of introduction of complementary feeding: a systematic review and meta-analysis. Nutr Rev 2023; 81:1501-1524. [PMID: 37016953 DOI: 10.1093/nutrit/nuad019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
CONTEXT The timing of introducing complementary feeding (CF) is crucial because premature or delayed CF can be associated with adverse health outcomes in childhood and adulthood. OBJECTIVE This systematic review aims to evaluate the impact of the timing of CF introduction on health, nutrition, and developmental outcomes among normal-term infants. DATA SOURCES Electronic databases and trial registries were searched, along with the reference lists of the included studies and relevant systematic reviews. DATA EXTRACTION Two investigators independently extracted data from the included studies on a standardized data-extraction form. DATA ANALYSIS Data were meta-analyzed separately for randomized controlled trials (RCTs) and observational studies on the basis of early introduction of CF (< 3 months, < 4 months, < 6 months of age) or late introduction of CF (> 6 months, > 8 months of age). Evidence was summarized according to GRADE criteria. In total, 268 documents were included in the review, of which 7 were RCTs (from 24 articles) and 217 were observational studies (from 244 articles). Evidence from RCTs did not suggest an impact of early introduction, while low-certainty evidence from observational studies suggested that early introduction of CF (< 6 months) might increase body mass index (BMI) z score and overweight/obesity. Early introduction at < 3 months might increase BMI and odds of lower respiratory tract infection (LRTI), and early introduction at < 4 months might increase height, LRTI, and systolic and diastolic blood pressure (BP). For late introduction of CF, there was a lack of evidence from RCTs, but low-certainty evidence from observational studies suggests that late introduction of CF (> 6 months) might decrease height, BMI, and systolic and diastolic BP and might increase odds of intestinal helminth infection, while late introduction of CF (> 8 months) might increase height-for-age z score. CONCLUSION Insufficient evidence does suggest increased adiposity with early introduction of CF. Hence, the current recommendation of introduction of CF should stand, though more robust studies, especially from low- and middle-income settings, are needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42020218517.
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Affiliation(s)
- Zahra A Padhani
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Jai K Das
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
| | - Faareha A Siddiqui
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
| | - Rehana A Salam
- Centre of Research Excellence, Melanoma Institute Australia, University of Sydney, Sydney, New South Wales, Australia
| | - Zohra S Lassi
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | | | - Ammaar M A Abbasi
- Division of Women and Child Health, Aga Khan University, Karachi, Sindh, Pakistan
| | - Emily C Keats
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sajid Soofi
- Division of Women and Child Health, Aga Khan University, Karachi, Sindh, Pakistan
| | - Robert E Black
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Zulfiqar A Bhutta
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
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Li X, Xiao Z, Li C, Chen Q, Jia L. Maternal dietary patterns during pregnancy and the risk of infantile eczema during the first year of life: a cohort study in northeast China. BMC Public Health 2023; 23:1641. [PMID: 37641073 PMCID: PMC10463679 DOI: 10.1186/s12889-023-16577-9] [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: 02/24/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND There are few studies on the relationship between diet during pregnancy and infantile eczema and the conclusions are inconsistent. The aim of the present study was to explore the impact of dietary patterns during pregnancy on infantile eczema. METHODS A total of 495 mother-child pairs from a prospective cohort in Shenyang, China was recruited. Information on maternal dietary intake during pregnancy was assessed with a validated self-administered food frequency questionnaire. The data of infantile eczema was assessed using a structured questionnaire. Factor analysis to derive dietary patterns. The relationship between the dietary pattern and infantile eczema was examined by the logistic regression analysis. RESULTS The cumulative incidence of eczema in 6 months and 12 months in northeast China was 45.7% and 57.8%, respectively. Three dietary patterns were identified. There was a tendency for an expose-response relationship between the maternal high-protein dietary pattern during pregnancy and the risk of infantile eczema within 12 months (P for trend = 0.023): the adjusted odds ratio (95% confidence interval) in the Q1, Q2, Q3, Q4 were 1.00 (reference), 1.63 (0.96-2.76), 1.81 (1.06-3.06), and 1.87 (1.09-3.20), respectively. No association between Western and plant-based patterns during pregnancy and infantile eczema within 12 months was found. Infantile eczema within 6 months was not associated with any of the three dietary patterns. CONCLUSION The maternal high-protein pattern during pregnancy may be a risk factor for infantile eczema during the first year of life.
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Affiliation(s)
- Xuening Li
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, Liaoning, China
- Department of Pediatrics, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, Liaoning, China
| | - Zhe Xiao
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, Liaoning, China
| | - Chenyang Li
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, Liaoning, China
| | - Qi Chen
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, Liaoning, China
| | - Lihong Jia
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, Liaoning, China.
- Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang 110122, Liaoning, China.
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Hong J, Chang JY, Oh S. The Current Status of Prolonged Breastfeeding and Its Related Factors in Korean Infants and Their Mothers: A Nationwide Cross-Sectional Study. J Korean Med Sci 2023; 38:e261. [PMID: 37605500 PMCID: PMC10442503 DOI: 10.3346/jkms.2023.38.e261] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/10/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND International authorities recommend prolonged breastfeeding (PBF) for 12-24 months or more with 6 months of exclusive breastfeeding (EBF). Based on the Korean National Health and Nutrition Examination Survey (KNHANES) data, this study attempted to help encourage and educate breastfeeding (BF) over 1 year by investigating long-term BF trends and related factors in Korean infants and their mothers. METHODS This cross-sectional study was based on data on children aged 12-23 months and their mothers from 2010 to 2020. BF rates were compared between KNHANES V (2010-2012), KNHANES VI (2013-2015), KNHANES VII (2016-2018), and part of KNHANES VIII (2019-2020). In addition, data related to mothers and infants, including demographics, socioeconomic, educational, and health status, were collected, and their association with BF status was analyzed. RESULTS Of the 933 infants included in the study, the proportions achieving full BF at 6 months of age and PBF at 12 and 18 months were 34.8%, 33.7%, and 7.1%, respectively. Over the past 10 years, the trends of all three BF practices have significantly decreased since 2016 (P < 0.001). Of the 849 infants whose maternal data were available, multiple logistic regression analysis showed that EBF for 6 months (defined as full BF at 1, 3, and 6 months of age) positively correlated with maternal and infants' factors such as unemployed status, past BF experience, no history of drinking, and infants' birth weight of ≥ 2.5 kg. The mother's education level, particularly the nutrition label impact, current employment status, and smoking and drinking status, were significantly associated with PBF for ≥ 12 months but were not related to PBF for ≥ 18 months, except for drinking status. CONCLUSIONS In Korea, the long-term BF rate of ≥ 12 months has declined in the past 10 years, and BF becomes rare after 18 months. Higher maternal interest in nutrition information appears to be driving access to PBF over 12 months than EBF for 6 months or PBF over 18 months. To promote PBF over 12 months in Korea, it may be helpful to strengthen nutrition education that specifically emphasizes the benefits of PBF along with EBF, especially during infant health examinations.
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Affiliation(s)
- Jeana Hong
- Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Ju Young Chang
- Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
| | - Sohee Oh
- Medical Research Collaborating Center, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
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Giovannini M, Bolis M, Barni S, Liccioli G, Sarti L, Morelli S, Pontone M, Pessina B, Tomei L, Valleriani C, Novembre E, Mori F. Pearls and Pitfalls of Weaning an Infant with Severe Atopic Dermatitis and Sensitization/Allergy to Food. J Clin Med 2023; 12:3889. [PMID: 37373584 DOI: 10.3390/jcm12123889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/21/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Atopic dermatitis (AD) is a common chronic inflammatory skin disorder in childhood. Skin barrier impairment exposes infants to food allergens, potentially causing sensitization followed by IgE-mediated food allergy. We describe the case of an infant with severe AD in whom several sensitizations to foods are detected, with consequently difficult weaning, and a history of anaphylaxis to cashew nut. Foods for which skin tests were negative were introduced into the infant's diet. Then, when AD control was managed, oral food challenges (OFCs) for foods to which the patient was sensitized, with the exception of cashew nut, were performed. The simultaneous presence of sensitization toward multiple foods made it difficult to introduce them using classic OFC. Therefore, it was decided to perform the low-dose, gradual controlled OFC. This led to an introduction of sensitized foods into the infant's diet, with the exception of cashew nut, avoiding allergic reactions. Absolute recommendations on how, when, and where to perform OFCs with allergenic food to which the child with AD is sensitized are lacking so far. In our opinion, OFCs and the subsequent ntroduction of allergenic foods should be individualized, evaluating some factors such as their social and nutritional importance, the patient's age and clinical phenotype (including the history of anaphylaxis), and the sensitization profile. There is agreement on the fact that the dietary approach in children with moderate-severe AD should no longer include a strict elimination diet. We believe that an early, gradual controlled introduction of all allergenics to identify the amount of food tolerated in the absence of reactions, even if low dose, may improve patients' and families' quality of life. However, even if discussing a vast relevant literature, the limitation of our work is that we describe the management of a single patient. Extensive and high-quality research is needed in this field to improve the available evidence in the area.
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Affiliation(s)
- Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Marta Bolis
- Pediatrics Clinic, ASST-Spedali Civili of Brescia, 25123 Brescia, Italy
| | - Simona Barni
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Giulia Liccioli
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Lucrezia Sarti
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Susanna Morelli
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Matteo Pontone
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Benedetta Pessina
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Leonardo Tomei
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Claudia Valleriani
- Immunology Laboratory, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Elio Novembre
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Francesca Mori
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
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Rahman T, Sarwar PF, Potter C, Comstock SS, Klepac-Ceraj V. Role of human milk oligosaccharide metabolizing bacteria in the development of atopic dermatitis/eczema. Front Pediatr 2023; 11:1090048. [PMID: 37020647 PMCID: PMC10069630 DOI: 10.3389/fped.2023.1090048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/23/2023] [Indexed: 04/07/2023] Open
Abstract
Despite affecting up to 20% of infants in the United States, there is no cure for atopic dermatitis (AD), also known as eczema. Atopy usually manifests during the first six months of an infant's life and is one predictor of later allergic health problems. A diet of human milk may offer protection against developing atopic dermatitis. One milk component, human milk oligosaccharides (HMOs), plays an important role as a prebiotic in establishing the infant gut microbiome and has immunomodulatory effects on the infant immune system. The purpose of this review is to summarize the available information about bacterial members of the intestinal microbiota capable of metabolizing HMOs, the bacterial genes or metabolic products present in the intestinal tract during early life, and the relationship of these genes and metabolic products to the development of AD/eczema in infants. We find that specific HMO metabolism gene sets and the metabolites produced by HMO metabolizing bacteria may enable the protective role of human milk against the development of atopy because of interactions with the immune system. We also identify areas for additional research to further elucidate the relationship between the human milk metabolizing bacteria and atopy. Detailed metagenomic studies of the infant gut microbiota and its associated metabolomes are essential for characterizing the potential impact of human milk-feeding on the development of atopic dermatitis.
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Affiliation(s)
- Trisha Rahman
- Department of Biological Sciences, Wellesley College, Wellesley, MA, United States
| | - Prioty F. Sarwar
- Department of Biological Sciences, Wellesley College, Wellesley, MA, United States
| | - Cassie Potter
- Department of Biological Sciences, Wellesley College, Wellesley, MA, United States
| | - Sarah S. Comstock
- Department of Food Science & Human Nutrition, Michigan State University, East Lansing, MI, United States
| | - Vanja Klepac-Ceraj
- Department of Biological Sciences, Wellesley College, Wellesley, MA, United States
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7
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Kum DJ, Bang KS. Health Behavior and Social-Emotional Health Status of School-Aged Children According to their Experience with Atopic Dermatitis Diagnosis: Based on the 12th (2019) Panel Study on Korean Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020288. [PMID: 36832417 PMCID: PMC9955207 DOI: 10.3390/children10020288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease that is common in children and is increasing worldwide. This study aimed to identify differences in children's health behavior and social-emotional health status based on AD diagnosis at late school age. For this purpose, we conducted a descriptive survey using the 12th Panel Study on Korean Children data obtained in 2019. The data were analyzed using descriptive statistics, the Rao-Scott χ2 test, and a t-test using a complex sample analysis. A total of 1412 11-year-old Korean children participated in the study, of whom an estimated 8.2% were diagnosed with AD. In the children diagnosed with AD, the transition from exclusive breastfeeding to mixed feeding was later than that in children without AD (F = 5.71, p = 0.024), and the prevalence of AD in their parents was higher (F = 6.97, p = 0.014). Regarding health behaviors, the children diagnosed with AD had a higher intake frequency of protein (F = 5.41, p = 0.028) and vegetables (F = 6.09, p = 0.020). Regarding social-emotional health, subjective health status (F = 3.94, p = 0.026) and friend relationships (F = 2.95, p = 0.007) were lower in the children diagnosed with AD. These results, as preliminary data for interventions for school-aged children with AD, suggest that the difficulties of children's peer relationships should be considered and dealt with in further interventions.
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Affiliation(s)
- Da-Jeong Kum
- College of Nursing, Seoul National University, Seoul 03080, Republic of Korea
| | - Kyung-Sook Bang
- College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul 03080, Republic of Korea
- Correspondence: ; Tel.: +82-2-740-8819
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Li XN, Wu D, Liu Y, Zhang SS, Tian FL, Sun Q, Wei W, Cao X, Jia LH. Prenatal exposure to bisphenols, immune responses in cord blood and infantile eczema: A nested prospective cohort study in China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 228:112987. [PMID: 34781129 DOI: 10.1016/j.ecoenv.2021.112987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 06/13/2023]
Abstract
Increasing evidence shows that human exposure to bisphenols can increase the risk of allergic disease, such as child asthma. However, the mechanism by which exposure to bisphenols causes allergic disease is unclear. In addition, the effects of exposure to bisphenols during pregnancy on infantile eczema have been poorly studied. The aim of our study was to investigate the effect of bisphenols (BPA, BPF and BPS) exposure during pregnancy on immune cells in cord blood, and on the occurrence of infantile eczema. 111 mother-child pairs with urine samples from pregnant women and cord blood were recruited from a birth cohort established in February 2019 in Shenyang, China. The levels of urinary bisphenols and Th1-, Th2-, Treg- and Th17-related genes, and cytokines in cord blood, as well as the incidence of infantile eczema at 6 and 12 months follow up were determined. Our results show that BPA, BPF and BPS were detected in 100%, 63.1% and 46.8% of the urine samples, respectively. The median concentration of urine specific gravity adjusted BPA (SG-BPA) was 7.46 ng/mL. High SG-BPA levels during pregnancy was independently associated with increased risk of infantile eczema (adjusted OR = 2.731, 95%CI: 1.064-7.012, P = 0.037). Higher levels of FOXP3 gene in cord blood had a significantly lower risk of developing eczema in infants (adjusted OR=0.430, 95%CI: 0.190-0.972, P = 0.042). However, BPS and BPF levels were not associated with infantile eczema. FOXP3 gene levels in cord blood mediated the relationship between SG-BPA levels during pregnancy and infantile eczema (indirect effect: β = 0.350 [CI:0.011,1.077]). Our findings indicate that high levels of BPA exposure during pregnancy increase the risk of infantile eczema, which may be associated with down-regulation of FOXP3 gene expression in cord blood.
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Affiliation(s)
- Xue-Ning Li
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China; Department of Pediatrics, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China
| | - Dan Wu
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Ying Liu
- Department of Pediatrics, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China
| | - Shuang-Shuang Zhang
- Department of Pediatrics, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China
| | - Fu-Lin Tian
- Center for Public Health Safety Risk Assessment, School of Public Health, China Medical University, Shenyang 110122, China
| | - Qi Sun
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Wei Wei
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Xia Cao
- Department of obstetrics, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China
| | - Li-Hong Jia
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China; Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang 110122, China.
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Kang M, Choi SY, Jung M. Dietary intake and nutritional status of Korean children and adolescents: a review of national survey data. Clin Exp Pediatr 2021; 64:443-458. [PMID: 33445834 PMCID: PMC8426097 DOI: 10.3345/cep.2020.01655] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/07/2020] [Indexed: 12/11/2022] Open
Abstract
In Korea, several national cross-sectional surveys monitor the diet, nutritional status, and health status of children. This continual dedicated national surveillance system contributes to the identification of nutritional and health issues, establishment of public health policies, and development of nutrition recommendations. This paper provides recent information about the Korea National Health and Nutrition Examination Survey and the Korean Youth Risk Behavior Web-based Survey and describes key nationwide survey findings published in the last 5 years on infant feeding practices and the dietary intake and nutritional status of Korean infants, children, and adolescents. There have been increasing trends in children, and teenagers who skip breakfast, eat fast food, consume sugary drinks, have vitamin D deficiency, and are obese. This review will inform pediatricians, nutritionists, and other health care practitioners who track children's growth and development. It may also help researchers and policymakers identify diet-related policies and strategies for chronic disease prevention in Korean infants, children, and adolescents.
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Affiliation(s)
- Minji Kang
- BK21 FOUR Education and Research Team for Sustainable Food & Nutrition, Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
| | - So Yoon Choi
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University School of Medicine, Busan, Korea
| | - Minyoung Jung
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University School of Medicine, Busan, Korea
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Lee J, Shin M, Lee B. Influence of age at complementary food introduction on the development of asthma and atopic dermatitis in Korean children aged 1-3 years. Clin Exp Pediatr 2021; 64:408-414. [PMID: 33147910 PMCID: PMC8342876 DOI: 10.3345/cep.2020.01382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/12/2020] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Complementary food in infancy is necessary for human growth, neurodevelopment, and health. However, the role of allergen consumption in early infancy and its effects on the development of food allergy or tolerance remain unclear. PURPOSE To investigate the influence of age at the time of complementary food introduction on the development of asthma and atopic dermatitis in Korean children aged 1-3 years. METHODS We combined data from the Korea National Health and Nutrition Examination Survey collected from 2010 to 2014 and analyzed 1619 children aged 1-3 years who were included in the survey. Multivariate regression analysis was used to identify associations among type of feeding, age at the time of complementary food introduction, and doctor-diagnosed atopic dermatitis and asthma. RESULTS Age at the time of complementary food introduction was not significantly associated with doctor-diagnosed atopic dermatitis and asthma in children aged 1-3 years. In the univariate analysis, children with asthma showed higher water and sodium intake levels than nonasthmatic children. However, this relationship was not significant in the multivariate regression analysis. CONCLUSION The present study revealed no statistically significant relationship between age at the time of complementary food introduction and the risk of atopic dermatitis and asthma in young Korean children. A national prospective study is needed to clarify the influence of age at the time of complementary food introduction on the development of allergic diseases.
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Affiliation(s)
- Jihyun Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon, Korea
| | - Meeyong Shin
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon, Korea
| | - Bora Lee
- Institute of Health & Environment, Graduate School of Public Health, Seoul National University, Seoul, Korea
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Mukherjee N, Sutter TR, Arshad SH, Holloway JW, Zhang H, Karmaus W. Breastfeeding duration modifies the effect of smoking during pregnancy on eczema from early childhood to adolescence. Clin Exp Allergy 2019; 48:1688-1697. [PMID: 30311981 DOI: 10.1111/cea.13294] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 09/26/2018] [Accepted: 10/05/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cigarette smoke contains compounds similar to coal tar, an ancient remedy of eczema. Some studies have reported protective effects of maternal gestational smoking on offspring eczema; however, others have shown no or increased risks. Similarly, studies linking breastfeeding duration and eczema have demonstrated contradictory findings. No study has yet investigated combined effects of these two factors on eczema. OBJECTIVE Since tobacco compounds can pass to offspring via breast milk, we investigated their combined effects on eczema development from childhood to adolescence. METHODS We obtained information regarding gestational smoking, exclusive breastfeeding duration, and eczema at ages 1-or-2, 4, 10, and 18 years from the Isle of Wight (IOW) birth cohort, UK. Using generalized estimating equations, we assessed the interaction of gestational smoking and residual exclusive breastfeeding duration (Resid-BF-duration, obtained by regressing the latter on maternal smoking) on eczema over time adjusting for confounders. For the three transition periods of 1-or-2 to 4 years, 4-10, and 10-18 years, we estimated risks of persistent, incident, and remitting eczema associated with the interaction using repeated measurements. RESULTS If the mother smoked during gestation, longer Resid-BF-duration was associated with a lower risk of eczema, compared to if she did not smoke. The risk ratios (95% CI) if the mother smoked during gestation and exclusively breastfed for at least 3, 9, 15, 21 weeks are 0.7 (0.6, 1.7), 0.6 (0. 4, 0.9), 0.5 (0.3, 0.8), and 0.4 (0.2, 0. 8), respectively. Additionally, in all three transition periods, the risk of persistent eczema was lower with longer Resid-BF-duration if the mother smoked during gestation. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest a protective effect of gestational smoking combined with longer duration of exclusive breastfeeding on early-onset persistent eczema. Future studies should examine underlying biological mechanisms. Prolonged breastfeeding should be encouraged even if the mother smoked during gestation.
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Affiliation(s)
- Nandini Mukherjee
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, Tennessee
| | - Thomas R Sutter
- Department of Biological Sciences, University of Memphis, Memphis, Tennessee
| | - Syed Hasan Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, Isle of Wight, UK.,NIHR Respiratory Biomedical Research Unit, University Hospital Southampton, Southampton, UK
| | - John W Holloway
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, Tennessee
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, Tennessee
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12
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Castenmiller J, de Henauw S, Hirsch-Ernst KI, Kearney J, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Naska A, Pelaez C, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Bresson JL, Fewtrell M, Kersting M, Przyrembel H, Dumas C, Titz A, Turck D. Appropriate age range for introduction of complementary feeding into an infant's diet. EFSA J 2019; 17:e05780. [PMID: 32626427 PMCID: PMC7009265 DOI: 10.2903/j.efsa.2019.5780] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Following a request from the European Commission, the Panel on Nutrition, Novel Foods and Food Allergens (NDA) revised its 2009 Opinion on the appropriate age for introduction of complementary feeding of infants. This age has been evaluated considering the effects on health outcomes, nutritional aspects and infant development, and depends on the individual's characteristics and development. As long as foods have an age-appropriate texture, are nutritionally appropriate and prepared following good hygiene practices, there is no convincing evidence that at any age investigated in the included studies (< 1 to < 6 months), the introduction of complementary foods (CFs) is associated with adverse health effects or benefits (except for infants at risk of iron depletion). For nutritional reasons, the majority of infants need CFs from around 6 months of age. Infants at risk of iron depletion (exclusively breastfed infants born to mothers with low iron status, or with early umbilical cord clamping (< 1 min after birth), or born preterm, or born small-for-gestational age or with high growth velocity) may benefit from earlier introduction of CFs that are a source of iron. The earliest developmental skills relevant for consuming pureed CFs can be observed between 3 and 4 months of age. Skills for consuming finger foods can be observed in some infants at 4 months, but more commonly at 5-7 months. The fact that an infant may be ready from a neurodevelopmental perspective to progress to a more diversified diet before 6 months of age does not imply that there is a need to introduce CFs. There is no reason to postpone the introduction of potentially allergenic foods (egg, cereals, fish and peanut) to a later age than that of other CFs as far as the risk of developing atopic diseases is concerned. Regarding the risk of coeliac disease, gluten can be introduced with other CFs.
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13
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Human Milk and Allergic Diseases: An Unsolved Puzzle. Nutrients 2017; 9:nu9080894. [PMID: 28817095 PMCID: PMC5579687 DOI: 10.3390/nu9080894] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/01/2017] [Accepted: 08/01/2017] [Indexed: 02/07/2023] Open
Abstract
There is conflicting evidence on the protective role of breastfeeding in relation to the development of allergic sensitisation and allergic disease. Studies vary in methodology and definition of outcomes, which lead to considerable heterogeneity. Human milk composition varies both within and between individuals, which may partially explain conflicting data. It is known that human milk composition is very complex and contains variable levels of immune active molecules, oligosaccharides, metabolites, vitamins and other nutrients and microbial content. Existing evidence suggests that modulation of human breast milk composition has potential for preventing allergic diseases in early life. In this review, we discuss associations between breastfeeding/human milk composition and allergy development.
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14
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Kim JH. Role of Breast-feeding in the Development of Atopic Dermatitis in Early Childhood. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2017; 9:285-287. [PMID: 28497914 PMCID: PMC5446942 DOI: 10.4168/aair.2017.9.4.285] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 04/13/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Jeong Hee Kim
- Department of Pediatrics, School of Medicine, Inha University Hospital, Incheon, Korea.,Environmental Health Center for Allergic Rhinitis, Inha University Hospital, Ministry of Environment, Incheon, Korea.
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