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Cheung KY, Petrou L, Helfer B, Porubayeva E, Dolgikh E, Ali S, Ali I, Archibald-Durham L, Brockway MM, Bugaeva P, Chooniedass R, Comberiati P, Cortés-Macías E, D'Elios S, Feketea G, Hsu P, Kana MA, Kriulina T, Kunii Y, Madaki C, Omer R, Peroni D, Prokofiev J, Simpson MR, Shimojo N, Siziba LP, Genuneit J, Thakor S, Waris M, Yuan Q, Zaman S, Young BE, Bugos B, Greenhawt M, Levin ME, Zheng J, Boyle RJ, Munblit D. Health and nutrition claims for infant formula: international cross sectional survey. BMJ 2023; 380:e071075. [PMID: 36792145 PMCID: PMC9930154 DOI: 10.1136/bmj-2022-071075] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
OBJECTIVES To review available health and nutrition claims for infant formula products in multiple countries and to evaluate the validity of the evidence used for substantiation of claims. DESIGN International cross sectional survey. SETTING Public facing and healthcare professional facing company owned or company managed formula industry websites providing information about products marketed for healthy infants delivered at full term in 15 countries: Australia, Canada, Germany, India, Italy, Japan, Nigeria, Norway, Pakistan, Russia, Saudi Arabia, South Africa, Spain, the United Kingdom, and the United States in 2020-22. MAIN OUTCOME MEASURES Number and type of claims made for each product and ingredient. References cited were reviewed and risk of bias was assessed for registered clinical trials using the Cochrane risk of bias tool, and for systematic reviews using the Risk Of Bias in Systematic reviews tool. RESULTS 757 infant formula products were identified, each with a median of two claims (range from 1 (Australia) to 4 (US)), and 31 types of claims across all products. Of 608 products with ≥1 claims, the most common claim types were "helps/supports development of brain and/or eyes and/or nervous system" (323 (53%) products, 13 ingredients), "strengthens/supports a healthy immune system" (239 (39%) products, 12 ingredients), and "helps/supports growth and development" (224 (37%) products, 20 ingredients). 41 groups of ingredients were associated with ≥1claims, but many claims were made without reference to a specific ingredient (307 (50%) products). The most common groups of ingredients cited in claims were long chain polyunsaturated fatty acids (278 (46%) products, 9 different claims); prebiotics, probiotics, or synbiotics (225 (37%) products, 19 claims); and hydrolysed protein (120 (20%) products, 9 claims). 161/608 (26%) products with ≥1 claims provided a scientific reference to support the claim-266 unique references were cited for 24 different claim types for 161 products. The reference types most frequently cited were clinical trials (50%, 134/266) and reviews (20%, 52/266). 28% (38/134) of referenced clinical trials were registered, 14% (19/134) prospectively. 58 claims referred to 32 registered clinical trials, of which 51 claims (27 trials) related to a randomised comparison. 46 of 51 claims (90%) referenced registered clinical trial outcomes at high risk of bias, and all cited systematic reviews and pooled analyses, carried a high risk of bias. CONCLUSIONS Most infant formula products had at least one health and nutrition claim. Multiple ingredients were claimed to achieve similar health or nutrition effects, multiple claims were made for the same ingredient type, most products did not provide scientific references to support claims, and referenced claims were not supported by robust clinical trial evidence.
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Affiliation(s)
- Ka Yan Cheung
- Faculty of Medicine, Imperial College London, London, UK
| | - Loukia Petrou
- Faculty of Medicine, Imperial College London, London, UK
| | - Bartosz Helfer
- National Heart and Lung Institute, Imperial College London, London W2 1PG, UK
- Institute of Psychology, University of Wroclaw, Wroclaw, Poland
- Meta Research Centre, University of Wroclaw, Wroclaw, Poland
| | - Erika Porubayeva
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, I.M. Sechenov First Moscow State Medical University, Sechenov University, Moscow, Russia
| | - Elena Dolgikh
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, I.M. Sechenov First Moscow State Medical University, Sechenov University, Moscow, Russia
| | - Sana Ali
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Insaf Ali
- College of Medicine, King Faisal University, Kingdom Saudi Arabia
| | - Lindsay Archibald-Durham
- Wits Donald Gordon Medical Centre, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | | | - Polina Bugaeva
- Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Rishma Chooniedass
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, Winnipeg, BC, Canada
| | - Pasquale Comberiati
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | - Erika Cortés-Macías
- Institute of Agrochemistry and Food Technology (IATA-CSIC), National Research Council, 46980 Valencia, Spain
| | - Sofia D'Elios
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | - Gavriela Feketea
- Department of Pediatrics, Pediatric Allergy Outpatient Clinic, "Karamandaneio," Children Hospital, Patras, Greece
- Department of Pharmacology, "luliu Hatieganu" University of Medicine and Pharmacy, 400337, Cluj-Napoca, Romania
| | - Peter Hsu
- Department of Allergy and Immunology, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Musa Abubakar Kana
- Department of Community Medicine, College of Medicine, Kaduna State University, Kaduna, Nigeria
| | - Tatiana Kriulina
- Department of Paediatrics and Paediatric Rheumatology, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Yuzuka Kunii
- Centre for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Comfort Madaki
- Kaduna Infant Development (KID) Birth Cohort Study Project, Kaduna, Nigeria
| | - Rihab Omer
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | | | - Melanie Rae Simpson
- Department of Public Health and General Practice, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Laboratory Medicine, St Olavs Hospital, Trondheim, Norway
| | - Naoki Shimojo
- Centre for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Linda P Siziba
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Jon Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Sohini Thakor
- Faculty of Medicine, Imperial College London, London, UK
| | - Marium Waris
- National Heart and Lung Institute, Imperial College London, London W2 1PG, UK
| | - Quan Yuan
- Department of Allergy and Immunology, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Sadia Zaman
- Faculty of Medicine, Imperial College London, London, UK
| | - Bridget E Young
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Brighid Bugos
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Matthew Greenhawt
- Department of Pediatrics, Section of Allergy/Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA
| | - Michael E Levin
- Division of Paediatric Allergy, Department of Paediatrics, University of Cape Town, Cape Town, South Africa
| | - Jonathan Zheng
- Department of Electrical and Electronic Engineering, Imperial College London, London, UK
| | - Robert J Boyle
- National Heart and Lung Institute, Imperial College London, London W2 1PG, UK
| | - Daniel Munblit
- National Heart and Lung Institute, Imperial College London, London W2 1PG, UK
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, I.M. Sechenov First Moscow State Medical University, Sechenov University, Moscow, Russia
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Pazukhina E, Andreeva M, Spiridonova E, Bobkova P, Shikhaleva A, El-Taravi Y, Rumyantsev M, Gamirova A, Bairashevskaia A, Petrova P, Baimukhambetova D, Pikuza M, Abdeeva E, Filippova Y, Deunezhewa S, Nekliudov N, Bugaeva P, Bulanov N, Avdeev S, Kapustina V, Guekht A, DunnGalvin A, Comberiati P, Peroni DG, Apfelbacher C, Genuneit J, Reyes LF, Brackel CLH, Fomin V, Svistunov AA, Timashev P, Mazankova L, Miroshina A, Samitova E, Borzakova S, Bondarenko E, Korsunskiy AA, Carson G, Sigfrid L, Scott JT, Greenhawt M, Buonsenso D, Semple MG, Warner JO, Olliaro P, Needham DM, Glybochko P, Butnaru D, Osmanov IM, Munblit D, Artigas E, Avagyan A, Baziyants L, Belkina A, Berbenyuk A, Bezbabicheva T, Bezrukov V, Bordyugov S, Borisenko A, Bratukhina M, Bugaiskaya E, Chayka J, Cherdantseva Y, Degtyareva N, Druzhkova O, Dubinin A, Elifkhanova K, Eliseev D, Ezhova A, Frolova A, Ganieva J, Gorina A, Gorlenko C, Gribaleva E, Gudratova E, Ibragimova S, Kabieva K, Kalan Y, Kalinina M, Khitrina N, Kirillov B, Kiseljow H, Kislova M, Kogut N, Konova I, Korgunova M, Kotelnikova A, Kovygina K, Krupina A, Kuznetsova A, Kuznetsova A, Lavginova B, Lidjieva E, Listovskaya E, Lobova M, Loshkareva M, Lyubimova E, Mamchich D, Markina N, Maystrenko A, Mursalova A, Nagornov E, Nartova A, Nikolaeva D, Novoselov G, Ogandzhanova M, Pavlenko A, Perekosova O, Porubayeva E, Presnyakova K, Pushkareva A, Romanova O, Roshchin P, Salakhova D, Sarukhanyan I, Savina V, Shatrova J, Shishkina N, Shvedova A, Smirnov D, Solovieva V, Spasskaya O, Sukhodolskaya O, Suleimanov S, Urmantaeva N, Usalka O, Ustyan V, Valieva Y, Varaksina K, Varaksina M, Varlamova E, Vodianova M, Yegiyan M, Zaikina M, Zorina A, Zuykova E. Prevalence and risk factors of post-COVID-19 condition in adults and children at 6 and 12 months after hospital discharge: a prospective, cohort study in Moscow (StopCOVID). BMC Med 2022; 20:244. [PMID: 35794549 PMCID: PMC9257572 DOI: 10.1186/s12916-022-02448-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 06/21/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous studies assessing the prevalence of COVID-19 sequelae in adults and children were performed in the absence of an agreed definition. We investigated prevalence of post-COVID-19 condition (PCC) (WHO definition), at 6- and 12-months follow-up, amongst previously hospitalised adults and children and assessed risk factors. METHODS Prospective cohort study of children and adults with confirmed COVID-19 in Moscow, hospitalised between April and August, 2020. Two follow-up telephone interviews, using the International Severe Acute Respiratory and Emerging Infection Consortium survey, were performed at 6 and 12 months after discharge. RESULTS One thousand thirteen of 2509 (40%) of adults and 360 of 849 (42%) of children discharged participated in both the 6- and 12-month follow-ups. PCC prevalence was 50% (95% CI 47-53) in adults and 20% (95% CI 16-24) in children at 6 months, with decline to 34% (95% CI 31-37) and 11% (95% CI 8-14), respectively, at 12 months. In adults, female sex was associated with PCC at 6- and 12-month follow-up (OR 2.04, 95% CI 1.57 to 2.65) and (OR 2.04, 1.54 to 2.69), respectively. Pre-existing hypertension (OR 1.42, 1.04 to 1.94) was associated with post-COVID-19 condition at 12 months. In children, neurological comorbidities were associated with PCC both at 6 months (OR 4.38, 1.36 to 15.67) and 12 months (OR 8.96, 2.55 to 34.82) while allergic respiratory diseases were associated at 12 months (OR 2.66, 1.04 to 6.47). CONCLUSIONS Although prevalence of PCC declined one year after discharge, one in three adults and one in ten children experienced ongoing sequelae. In adults, females and persons with pre-existing hypertension, and in children, persons with neurological comorbidities or allergic respiratory diseases are at higher risk of PCC.
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Affiliation(s)
- Ekaterina Pazukhina
- Laboratory of Health Economics, Institute of Applied Economic Studies, The Russian Presidential Academy of National Economy and Public Administration, Moscow, Russia.,Center for Advanced Financial Planning, Macroeconomic Analysis and Financial Statistics, Financial Research Institute of the Ministry of Finance of the Russian Federation, Moscow, Russia
| | - Margarita Andreeva
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Ekaterina Spiridonova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Polina Bobkova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anastasia Shikhaleva
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Yasmin El-Taravi
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Mikhail Rumyantsev
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Aysylu Gamirova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anastasiia Bairashevskaia
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Polina Petrova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Dina Baimukhambetova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Maria Pikuza
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Elina Abdeeva
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Yulia Filippova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Salima Deunezhewa
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Nikita Nekliudov
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Polina Bugaeva
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Nikolay Bulanov
- Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Sergey Avdeev
- Clinic of Pulmonology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Valentina Kapustina
- Department of Internal Medicine №1, Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Alla Guekht
- Research and Clinical Center for Neuropsychiatry, Moscow, Russia.,Pirogov Russian National Research Medical University, Moscow, Russia
| | - Audrey DunnGalvin
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,School of Applied Psychology, University College Cork, Cork City, Ireland
| | - Pasquale Comberiati
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Diego G Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Jon Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Luis Felipe Reyes
- Universidad de La Sabana, Chía, Colombia.,Clínica Universidad de La Sabana, Chía, Colombia
| | - Caroline L H Brackel
- Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, the Netherlands.,Department of Pediatrics, Tergooi MC, Hilversum, the Netherlands
| | - Victor Fomin
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Andrey A Svistunov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Peter Timashev
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Lyudmila Mazankova
- Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | | | - Elmira Samitova
- Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia.,ZA Bashlyaeva Children's Municipal Clinical Hospital, Moscow, Russia
| | - Svetlana Borzakova
- Pirogov Russian National Research Medical University, Moscow, Russia.,Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department, Moscow, Russia
| | - Elena Bondarenko
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anatoliy A Korsunskiy
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Gail Carson
- Nuffield Department of Medicine, ISARIC Global Support Centre, University of Oxford, Oxford, UK
| | - Louise Sigfrid
- Nuffield Department of Medicine, ISARIC Global Support Centre, University of Oxford, Oxford, UK
| | - Janet T Scott
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Matthew Greenhawt
- Department of Pediatrics, Section of Allergy/Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, USA
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Malcolm G Semple
- Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.,Department of Respiratory Medicine, Alder Hey Children's Hospital, Liverpool, UK
| | - John O Warner
- Inflammation, Repair and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | - Piero Olliaro
- Nuffield Department of Medicine, ISARIC Global Support Centre, University of Oxford, Oxford, UK
| | - Dale M Needham
- Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, USA.,Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Petr Glybochko
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Denis Butnaru
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Ismail M Osmanov
- Pirogov Russian National Research Medical University, Moscow, Russia.,ZA Bashlyaeva Children's Municipal Clinical Hospital, Moscow, Russia
| | - Daniel Munblit
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. .,Research and Clinical Center for Neuropsychiatry, Moscow, Russia. .,Inflammation, Repair and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK.
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