1
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Yu HNZ, Chia SY. Scurvy presenting as difficulty in walking in a child. BMJ Case Rep 2023; 16:e258819. [PMID: 38160038 PMCID: PMC10759024 DOI: 10.1136/bcr-2023-258819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Scurvy, a disease caused by ascorbic acid (vitamin C) deficiency, is a rare disease in the modern world. We report a case of a boy in middle childhood, with a background of autism, presenting bed-bound due to progressive bilateral lower limb pain, with concomitant rashes, bleeding gums and worsening lethargy. Detailed dietary history revealed a severely restricted diet. Physical examination showed bilateral lower limb ecchymoses, perifollicular hemorrhages, perifollicular hyperkeratosis and cockscrew hairs which are pathognomonic features of scurvy. A low serum ascorbic acid level confirmed the diagnosis. Therapy with oral vitamin C supplement and rehabilitation with multidisciplinary care was successful, with complete resolution of symptoms. This case emphasises the importance of thorough dietary evaluation in children with autism and food selectivity presenting with non-specific symptoms. Physician awareness of nutritional deficiencies avoids unnecessary extensive investigations and sub-specialty referrals and translates to savings in medical expenses.
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Affiliation(s)
| | - Shi Yun Chia
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
- Department of Dermatology, KK Women's and Children's Hospital, Singapore
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2
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Bulut FD, Kor D, Kilavuz S, Cicek E, Koseci B, Kara E, Burgac E, Kaplan İ, Onenli Mungan N. Actions speak louder than words: Home visits and its effect on dietary adherence in patients with phenylketonuria. J Paediatr Child Health 2023; 59:1238-1243. [PMID: 37700622 DOI: 10.1111/jpc.16488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/22/2023] [Accepted: 08/30/2023] [Indexed: 09/14/2023]
Abstract
AIM Phenylketonuria (PKU) is an inherited metabolic disorder in which accumulation of phenylalanine (Phe) leads to poor neurological outcomes without treatment. Dietary therapy is the main treatment and nonadherence is associated with elevated blood Phe levels and correspondingly poor neuropsychiatric outcomes. This study aimed to examine the effect of home visits on blood Phe levels in PKU patients. METHODS Sixty-five paediatric PKU patients who were on low-phenylalanine diet were visited monthly at home for 6 months. At each visit, dietary education was provided, patients' height and weight were measured and blood samples were collected. RESULTS Twenty-eight (43.1%) patients had classic PKU and 37 (56.9%) had moderate PKU. Blood Phe levels decreased statistically significant at first, second, fifth, and sixth months compared with screening visit. Blood Phe levels in moderate PKU patients decreased significantly at the last visit unlike classic PKU patients. A significant decrease in blood Phe levels was observed in patients older than 10 years. Anthropometric parameters improved. CONCLUSIONS Dietary nonadherence is the main treatment failure in PKU. Home visits for education are a promising way to improve treatment outcomes by providing quality education, better assessment, and correction of mistakes but they should be ongoing and supported by different interventions that address patients' special needs.
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Affiliation(s)
- Fatma Derya Bulut
- Pediatric Metabolism and Nutrition Department, Çukurova University, Adana, Turkey
| | - Deniz Kor
- Pediatric Metabolism and Nutrition Department, Çukurova University, Adana, Turkey
| | - Sebile Kilavuz
- Pediatric Metabolism Department, Başakşehir Çam ve Sakura City Research and Education Hospital, İstanbul, Turkey
| | - Ebru Cicek
- Pediatric Metabolism and Nutrition Department, Çukurova University, Adana, Turkey
| | - Burcu Koseci
- Pediatric Metabolism and Nutrition Department, Çukurova University, Adana, Turkey
| | - Esra Kara
- Pediatric Metabolism and Nutrition Department, Çukurova University, Adana, Turkey
| | - Ezgi Burgac
- Pediatric Metabolism and Nutrition Department, Çukurova University, Adana, Turkey
| | - İrem Kaplan
- Pediatric Metabolism and Nutrition Department, Çukurova University, Adana, Turkey
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3
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Pillay D, Piddington M, Ali A, Wham C. Food menus within New Zealand primary school canteens: Do they meet the guidance? Health Promot J Austr 2023. [PMID: 37599010 DOI: 10.1002/hpja.793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/28/2023] [Accepted: 08/09/2023] [Indexed: 08/22/2023] Open
Abstract
ISSUE ADDRESSED Unhealthy food and drinks are widely available in New Zealand school canteens. The aim of this study was to assess primary school canteen food menus against the newly implemented Ministry of Health 'Food and Drink Guidance for Schools'. METHODS A convenience sample of 133 primary school canteen menus was collected in 2020 as part of the baseline evaluation of the Healthy Active Learning initiative across New Zealand. A menu analysis toolkit was developed to assess menus in accordance with the Ministry of Health's 'Food and Drink Guidance for Schools' which classifies food items into three food categories: 'green', 'amber' and 'red'. RESULTS Most menu items belonged to the less healthy amber (41.0%) and red (40%) food categories. Low decile schools had a lower percentage of green food items (8.6%) and a higher percentage of red food items (48.3%) compared to high decile schools. Sandwiches, filled rolls and wraps were the most commonly available items, followed by baked foods and foods with pastry. Over half of the in-house canteen menu items were classified as 'red' foods (55.3%). CONCLUSIONS Most school canteens were not meeting the guidelines for healthy food and drink provision outlined by the Ministry of Health. Improving the food environment for children in socio-economically deprived areas needs to be prioritised to reduce inequities. SO WHAT?: This study highlights the unhealthy food environments in New Zealand schools and emphasises the need for more robust national policies and mandated school guidance.
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Affiliation(s)
- Danika Pillay
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Marsha Piddington
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Ajmol Ali
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Carol Wham
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
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4
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Hendrixson DT, Naskidashvili N, Stephenson KB, Laury ML, Koroma AS, Manary MJ. An Alternative Oat-Containing, Ready-To-Use, Therapeutic Food Does Not Alter Intestinal Permeability or the 16S Ribosomal RNA Fecal Microbiome Configuration Among Children With Severe Malnutrition in Sierra Leone: A Randomized Controlled Trial. J Nutr 2023; 152:2744-2753. [PMID: 36055798 DOI: 10.1093/jn/nxac207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/20/2022] [Accepted: 08/29/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Previously, a novel oat ready-to-use therapeutic food (o-RUTF) resulted in improved recovery from severe acute malnutrition (SAM) when compared to a standard RUTF (s-RUTF). The o-RUTF contained 18% oat, while the s-RUTF has no cereal ingredients. OBJECTIVES We determined the effects of o-RUTF on intestinal permeability, as measured by lactulose permeability, and the 16S ribosomal RNA (rRNA) fecal microbiome configuration of children with SAM. METHODS This was a prospective, randomized, double-blinded, controlled clinical trial. Sierra Leonean children aged 6-59 mo with SAM, defined by a midupper arm circumference < 11.5 cm, were randomized to receive o-RUTF or s-RUTF. All children received 7 d of amoxicillin per guidelines. Lactulose permeability testing and fecal 16S rRNA sequencing were performed at baseline and after 4 wk of therapy. The change in lactulose permeability was the primary outcome, while the fecal 16S rRNA configuration at 4 wk was a secondary outcome. RESULTS Of the 129 children enrolled, lactulose permeability testing was completed by 100 at baseline and 82 at week 4. After 4 wk of therapeutic feeding, there were no differences in lactulose permeability between the o-RUTF and s-RUTF groups (P = 0.84), and over half of children had increased lactulose permeability (50% s-RUTF compared with 58% o-RUTF, mean difference = -7.5%; 95% CI: -29.2, 15.2; P = 0.50). After 4 wk of feeding, there were no differences in the 16S rRNA configurations between the o-RUTF and s-RUTF groups (Permanova, 999 permutations; P = 0.648; pseudo-F = 0.581), nor were there differences in α or β diversity. CONCLUSIONS Despite remarkably different compositions of o-RUTF and s-RUTF, no differences were identified in lactulose permeability or the fecal 16S rRNA configuration among children with SAM receiving these foods. These results suggest that the o-RUTF exerts its beneficial effects through mechanisms other than reducing intestinal permeability or altering the fecal 16S configuration. This trial was registered at clinicaltrials.gov as NCT04334538.
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Affiliation(s)
| | | | - Kevin B Stephenson
- Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Marie L Laury
- Genome Technology Access Center, Washington University in St Louis, St. Louis, MO, USA
| | - Aminata Shamit Koroma
- Ministry of Health and Sanitation, The Republic of Sierra Leone, Freetown, Sierra Leone
| | - Mark J Manary
- Project Peanut Butter, Freetown, Sierra Leone.,Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA.,USDA Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
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5
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Zuvadelli J, Paci S, Salvatici E, Giorgetti F, Cefalo G, Re Dionigi A, Rovelli V, Banderali G. Breastfeeding in Phenylketonuria: Changing Modalities, Changing Perspectives. Nutrients 2022; 14:4138. [PMID: 36235790 DOI: 10.3390/nu14194138] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/27/2022] [Accepted: 10/02/2022] [Indexed: 11/06/2022] Open
Abstract
Phenylketonuria (PKU) management aims to control phenylalanine (Phe) intakes. In newborns and infants this implies possible titration of Human milk (HM) with supplementation of Phe-free formula. HM benefits, better if prolonged, are well known in healthy populations, suggesting it may be used in PKU patients. Despite that, the current literature does not define recommendations on how best perform it in such a population. The main purpose of this study was to evaluate nutrition approaches in newborns and infants affected by PKU and to define if differences can influence the duration of breastfeeding. Data from 42 PKU infants were reviewed. Of these, 67% were breastfed with the use of three different approaches. The type of approach used impacted the duration of breastfeeding, which was longer when using a pre-measured amount of Phe-free formula administered prior to HM. This is the first study to suggest a specific method for breastfeeding in PKU. Considering widely known breastfeeding benefits, both for patients and their mothers, our data should encourage adequate awareness on how to choose correct breastfeeding modalities.
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6
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Jariwala P, Jadhav K, Jaishetwar G, Vallavoju P. Rare association of severe iron-deficiency anaemia and moderate pericardial effusion. BMJ Case Rep 2021; 14:e245591. [PMID: 34607817 PMCID: PMC8491283 DOI: 10.1136/bcr-2021-245591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 11/03/2022] Open
Abstract
Pericardial effusion secondary to isolated severe iron-deficiency anaemia is an extremely rare condition. We present a case with severe anaemia presented with moderate pericardial effusion. Pericardial effusion completely resolved with correction of anaemia.
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Affiliation(s)
- Pankaj Jariwala
- Cardiology, Yashoda Super Specialty Hospitals Somajiguda, Hyderabad, Telangana, India
| | - Kartik Jadhav
- Cardiology, Yashoda Super Specialty Hospitals Somajiguda, Hyderabad, Telangana, India
| | - Ganesh Jaishetwar
- Hematologist, Yashoda Super Specialty Hospitals Somajiguda Hyderabad, Hyderabad, Telangana, India
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7
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Crisóstomo M, Santos MC, Tavares E, Cunha F. Transient symptomatic zinc deficiency in an exclusively breastfed infant. BMJ Case Rep 2021; 14:14/6/e241754. [PMID: 34193450 DOI: 10.1136/bcr-2021-241754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 3-month-old, full term female infant, adequate for gestational age, and exclusively breastfed, was admitted with a 10 day history of generalised scaling erythematous dermatitis, affecting the face (perinasal, nasolabial folds and periauricular), acral and intertriginous areas, with irritability and failure to thrive. Her mother had been treated with isoniazid since the third trimester because of family contact with tuberculosis. Based on a diagnosis of suspected impetiginised eczema, the infant was treated with flucloxacillin and prednisolone, and maternal isoniazid was suspended, with no improvement. Investigations found low serum zinc levels in the infant (33 μg/dL; normal range (NR) >60 μg/dL), normal plasma zinc levels in the mother (111.3 μg/dL; NR 68-120 μg/dL) and lower than the normal range of zinc levels in breast milk (270μg/L; NR 1000-2500 μg/L), suggesting acrodermatitis caused by zinc deficiency. Oral zinc supplementation (3 mg/kg/day) was started with a marked improvement in skin lesions, as well as good weight gain. At the age of 6 months, after food diversification, supplementation was suspended, without any recurrence of symptoms.
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Affiliation(s)
- Mafalda Crisóstomo
- Serviço de Pediatria, Hospital of Vila Franca de Xira, Vila Franca de Xira, Lisboa, Portugal
- Área da Pediatria, Hospital Dona Estefânia, CHULC, Lisboa, Portugal
| | - Mafalda Casinhas Santos
- Serviço de Pediatria, Hospital of Vila Franca de Xira, Vila Franca de Xira, Lisboa, Portugal
| | - Ermelindo Tavares
- Serviço de Dermatologia, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Florbela Cunha
- Serviço de Pediatria, Hospital of Vila Franca de Xira, Vila Franca de Xira, Lisboa, Portugal
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8
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Abstract
Atopic dermatitis (AD) is a common presenting complaint by children and their caretakers to their primary care providers. On testing, children with AD frequently exhibit positive food-specific IgE levels in the absence of immediate allergic reactions. Misinterpretation of these false positive tests can lead to unnecessary food avoidance, which can have tremendous psychosocial, economic and nutritional consequences and, in some cases, facilitate the development of an immediate hypersensitivity to the food. We present a child with persistent AD who underwent broad testing that led to unnecessary food avoidance resulting in Vitamin D deficiency, growth failure and the development of an IgE-mediated food allergy. This case underscores the need for caution by primary care clinicians in using food avoidance diets as a treatment for AD and the importance of limiting allergy testing to foods only when the clinical history indicates an immediate hypersensitivity reaction.
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Affiliation(s)
- Stephanie Ann Kubala
- Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Paula Mariam Mohyi
- Internal Medicine, George Washington University School of Public Health and Health Services, Washington, District of Columbia, USA
| | - Kristin Sokol
- Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
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9
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Zarraga CM, Borowitz SM. Growth failure and metabolic acidosis due to total body sodium depletion in an infant with an ileostomy. BMJ Case Rep 2021; 14:e241570. [PMID: 33766972 PMCID: PMC8006820 DOI: 10.1136/bcr-2021-241570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 11/04/2022] Open
Abstract
Sodium is an essential nutrient and inadequate sodium intake and/or excessive sodium losses can result in suboptimal growth. Infants with ileostomies are at significant risk of developing growth failure as a result of excessive sodium loss in their ileostomy effluent. Chronic sodium depletion can also limit the kidney's ability to excrete hydrogen and potassium ions, mimicking electrolyte abnormalities found in type 4 renal tubular acidosis. This report describes an infant with an ileostomy with severe growth failure, hyperkalaemia and metabolic acidosis-all of which promptly resolved with sodium supplementation.
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10
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Xie L, Atem F, Gelfand A, Delclos G, Messiah SE. Association between asthma and sugar-sweetened beverage consumption in the United States pediatric population. J Asthma 2021; 59:926-933. [PMID: 33625285 DOI: 10.1080/02770903.2021.1895210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES United States (US) youth consume an average of 10 teaspoons of added sugar from sugar-sweetened beverages (SSB) on any given day. Few population-based studies have examined the association between SSB consumption and asthma in children and adolescents. This study aimed to examine the association between SSB consumption and asthma in the US pediatric population. DESIGN Analytical cross-sectional study. SETTING AND PARTICIPANTS A total of 9,938 children aged 2-to-17 years old who participated in the 2011-2016 National Health and Nutrition Examination Surveys. SSB consumption was categorized into 3 groups based on the caloric intake from 24-hour food recall data as follows: 1) no consumption (0 kcal/day); 2) moderate consumption (1-499 kcal/day); and 3) heavy consumption (≥ 500 kcal/day). The primary outcome of interest was self-reported current asthma condition. RESULTS Asthma prevalence estimates were significantly higher in heavy (16.4%) and moderate (11.0%) SSB consumers versus non-consumers (7.5%) (p < 0.05 for both comparisons). The adjusted odds of asthma were twice that among children with heavy SSB consumption (aOR 2.01, 95% confidence interval [CI] 1.31-3.08) versus non-SSB consumers. The odds of asthma were higher among those who consumed fruit drinks (aOR 2.51, 95% CI 1.55-4.08), non-diet soft drinks (aOR 1.89, 95% CI 1.23-2.89) and sweet tea (aOR 1.87, 95% CI 1.13-3.09) compared to nondrinkers. The effect was independent of obesity status (p-interaction = 0.439). CONCLUSIONS Findings here suggest a dose-response relationship between SSB intake and asthma diagnosis, therefore controlling SSB consumption may potentially improve pulmonary health risk in the US pediatric population.
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Affiliation(s)
- Luyu Xie
- University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, TX, USA.,Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center, Dallas, TX, USA
| | - Folefac Atem
- University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, TX, USA.,Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center, Dallas, TX, USA
| | - Andrew Gelfand
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - George Delclos
- University of Texas Health Science Center, School of Public Health, Houston Campus, Houston, TX, USA
| | - Sarah E Messiah
- University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, TX, USA.,Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center, Dallas, TX, USA
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11
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Kazmi S, Akparibo R, Ahmed D, Faizi N. Prevalence and predictors of exclusive breastfeeding in urban slums, Bihar. J Family Med Prim Care 2021; 10:1301-1307. [PMID: 34041169 PMCID: PMC8140268 DOI: 10.4103/jfmpc.jfmpc_2000_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 12/02/2020] [Accepted: 01/01/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Various socio-cultural factors influence infant feeding practices and thus early childhood nutrition and child survival in India. This study aimed to examine the prevalence of exclusive breastfeeding, its promoters and barriers in urban slums of Bihar, India. METHODS We conducted a community based cross-sectional survey involving 297 mothers living in slum settlements in Bihar. Data were collected using structured questionnaire on exclusive breastfeeding practices, and the factors that could influence this. Descriptive analysis was done to estimate the prevalence of exclusive breastfeeding and regression model was performed to identify the predictors of exclusive breastfeeding. RESULTS Only 23% of mothers initiate breastfeeding within 1 hour of delivery and 27.6% mothers practise exclusive breastfeeding up to six months. Mother's education was found to be associated with duration of exclusive breastfeeding (OR 11, 95% CI 2-59). Term babies were more likely to be breastfed exclusively for six months than pre-term babies (OR 8.6, 95% CI 1.6-47.6). Antenatal care visits and completing immunization were significantly associated with duration of exclusive breastfeeding (P < 0.001). The majority of mothers acquire exclusive breastfeeding knowledge through television/radio (OR 68, 95% CI 5.5-832.5) and newspaper advertisements (OR 14, 95% CI 2.6-76). CONCLUSION Prevalence of exclusive breastfeeding up to six months of age and early initiation of breastfeeding remains low in slums of Bihar. Exclusive breastfeeding and early initiation of breastfeeding rates could be improved by educating and counselling mothers during health facility contacts by primary care providers.
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Affiliation(s)
- Shahwar Kazmi
- School of Health and Related Research, University of Sheffield, United Kingdom
| | - Robert Akparibo
- School of Health and Related Research, University of Sheffield, United Kingdom
| | - Danish Ahmed
- National Polio Surveillance Project, WHO Country Office for India, New Delhi, India
| | - Nafis Faizi
- Department of Community Medicine, J.N. Medical College, A.M.U., Aligarh, India
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12
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Kendall E, Millard A, Beaumont J. The "weanling's dilemma" revisited: Evolving bodies of evidence and the problem of infant paleodietary interpretation. Am J Phys Anthropol 2021; 175 Suppl 72:57-78. [PMID: 33460467 DOI: 10.1002/ajpa.24207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/23/2020] [Accepted: 12/06/2020] [Indexed: 01/02/2023]
Abstract
Breastfeeding is known to be a powerful mediator of maternal and childhood health, with impacts throughout the life course. Paleodietary studies of the past 30 years have accordingly taken an enduring interest in the health and diet of young children as a potential indicator of population fertility, subsistence, and mortality patterns. While progress has been made in recent decades toward acknowledging the agency of children, many paleodietary reconstructions have failed to incorporate developments in cognate disciplines revealing synergistic dynamics between maternal and offspring biology. Paleodietary interpretation has relied heavily on the "weanling's dilemma," in which infants are thought to face a bleak choice between loss of immunity or malnutrition. Using a review of immunological and epidemiological evidence for the dynamic and supportive role that breastfeeding plays throughout the complementary feeding period, this article offers context and nuance for understanding past feeding transitions. We suggest that future interpretative frameworks for infant paleodietary and bioarchaeological research should include a broad knowledge base that keeps pace with relevant developments outside of those disciplines.
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Affiliation(s)
- Ellen Kendall
- Department of Archaeology, Durham University, Durham, UK
| | - Andrew Millard
- Department of Archaeology, Durham University, Durham, UK
| | - Julia Beaumont
- School of Archaeological and Forensic Sciences, University of Bradford, Bradford, UK
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13
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Pizzuto M, Ellul S, Shoukry M. Gastric antral vascular ectasia in children, rare presentation. BMJ Case Rep 2020; 13:13/11/e236896. [PMID: 33257371 DOI: 10.1136/bcr-2020-236896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 14-year-old boy, a known case of perinatal hypoxic cerebral palsy, presented to paediatric emergency with acute melaena and blood staining around feeding gastrostomy site. Physical examination revealed pallor, but no signs of distress with an unremarkable abdominal examination. Routine blood tests revealed normochromic. Abdominal ultrasound scan and Meckel's scan were unremarkable. The patient underwent examination under anaesthesia of the perianal area and joint upper and lower gastrointestinal endoscopy. Streak-like gastritis with no signs of active bleeding lesions were noted and patchy areas of colitis involving the descending and sigmoid colon and the rectum. All clinical findings and evidence-based diagnosis matched gastric antral vascular ectasia. He was successfully managed conservatively with elemental hydrolysed feeding formula.
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14
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Higuchi Y, Hosojima M, Kabasawa H, Kuwahara S, Goto S, Toba K, Kaseda R, Tanaka T, Kitamura N, Takihara H, Okuda S, Taniguchi M, Arao H, Narita I, Saito A. Rice Endosperm Protein Administration to Juvenile Mice Regulates Gut Microbiota and Suppresses the Development of High-Fat Diet-Induced Obesity and Related Disorders in Adulthood. Nutrients 2019; 11:E2919. [PMID: 31810329 DOI: 10.3390/nu11122919] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 11/27/2019] [Accepted: 11/29/2019] [Indexed: 12/12/2022] Open
Abstract
Obesity and related disorders, which are increasing in adults worldwide, are closely linked to childhood diet and are associated with chronic inflammation. Rice endosperm protein (REP) intake during adulthood has been reported to improve lipid metabolism and suppress the progression of diabetic kidney disease in animal models. However, the effects of REP intake during childhood on adulthood health are unclear. Therefore, we used a mouse model to experimentally investigate the preconditioning effects of REP intake during childhood on the development of obesity and related disorders in adulthood. Male C57BL/6J mice were pair-fed a normal-fat diet containing casein or REP during the juvenile period and then a high-fat diet (HFD) containing casein or REP during adulthood. Mice fed REP during the juvenile period showed better body weight, blood pressure, serum lipid profiles, lipopolysaccharide (LPS)-binding protein levels, and glucose tolerance in adulthood than those fed casein during the juvenile period. HFD-induced renal tubulo-glomerular alterations and hepatic microvesicular steatosis were less evident in REP-fed mice than in casein-fed ones. REP intake during the juvenile period improved HFD-induced dysbiosis (i.e., Escherichia genus proliferation and reduced gut microbiota diversity), thereby suppressing endotoxin-related chronic inflammation. Indeed, REP-derived peptides showed antibacterial activity against Escherichia coli, a major producer of LPS. In conclusion, REP supplementation during the juvenile period may regulate the gut microbiota and thus suppress the development of obesity and related disorders in adulthood in mice.
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15
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Łuszczki E, Sobek G, Bartosiewicz A, Baran J, Weres A, Dereń K, Mazur A. Analysis of Fruit and Vegetable Consumption by Children in School Canteens Depending on Selected Sociodemographic Factors. ACTA ACUST UNITED AC 2019; 55:medicina55070397. [PMID: 31336674 PMCID: PMC6681238 DOI: 10.3390/medicina55070397] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/10/2019] [Accepted: 07/19/2019] [Indexed: 12/20/2022]
Abstract
Background and Objectives: Eating habits acquired or changed during childhood are likely to track into adulthood. Due to the fact that nutritional behaviours are not so strongly formed among children, it is easier to change and develop them in children than in adults. The aim of this study was to assess the impact of selected sociodemographic factors affecting fruit and vegetable consumption (i.e., age, parents' body mass index, parents' level education, duration of breastfeeding, child's time spent in front of computer/television) among children in school canteens. Materials and Methods: The sample consisted of 106 participants (52 girls, 54 boys) aged 6-12. The frequency of consuming fruits and vegetables at a school canteen was assessed using bar code cards for two weeks. Body composition estimates were obtained using a foot-to-foot bioelectrical impedance analysis, body height was measured using a stadiometer Seca 213. The questionnaire contained questions about selected factors which can have an influence on fruit and vegetable consumption. In the study group, 13.2% of participants were overweight and 17.9% were obese. Results: Our results showed a statistically significant relationship between age and fruit and vegetable consumption, and it increased with age in both sexes. Conclusions: Bearing in mind the various conditions discussed when shaping the eating habits of pre-school- and early-school-aged children, the importance of proper nutritional education should be stressed both among children and parents.
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Affiliation(s)
- Edyta Łuszczki
- Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Grzegorz Sobek
- Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Anna Bartosiewicz
- Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszow, 35-959 Rzeszow, Poland.
| | - Joanna Baran
- Institute of Physiotherapy, Faculty of Medicine, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Aneta Weres
- Institute of Physiotherapy, Faculty of Medicine, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Katarzyna Dereń
- Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Artur Mazur
- Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszow, 35-959 Rzeszow, Poland
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Manzione LC, Kriser H, Gamboa EG, Hanson CM, Mulokozi G, Mwaipape O, Hoj TH, Linehan M, Torres S, Hall PC, West JH, Crookston BT. Maternal Employment Status and Minimum Meal Frequency in Children 6-23 Months in Tanzania. Int J Environ Res Public Health 2019; 16:E1137. [PMID: 30934891 DOI: 10.3390/ijerph16071137] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 03/19/2019] [Accepted: 03/26/2019] [Indexed: 11/17/2022]
Abstract
As women in developing world settings gain access to formal work sectors, it is important to understand how such changes might influence child nutrition. The purpose of this paper is to examine the relationship between maternal employment status and minimum meal frequency (MMF) among children in Tanzania. Interviews were conducted with 5000 mothers of children ages 0⁻23 months. The questionnaire used in these interviews was developed by adopting questions from Tanzania's latest Demographic and Health Survey (2015⁻2016) where possible and creating additional questions needed for programmatic baseline measurements. MMF was used as proxy for child nutrition. Logistic regression analyses were used to identify associations between employment status and parenting practices of Tanzanian mothers and MMF of their children. After adjusting for confounders, informal maternal employment [OR = 0.58], lack of financial autonomy [OR = 0.57] and bringing the child with them when working away from home [OR = 0.59] were negatively associated with meeting MMF. Payment in cash [OR = 1.89], carrying food for the child [OR = 1.34] and leaving food at home for the child [OR = 2.52] were positively associated with meeting MMF. Informal maternal employment was found to be negatively associated with meeting MMF among Tanzanian children. However, behaviors such as bringing or leaving prepared food, fiscal autonomy and payment in cash showed significant positive associations. These findings could help direct future programs to reduce child stunting.
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Avelar Rodriguez D, Toro Monjaraz EM, Ignorosa Arellano KR, Ramirez Mayans J. Childhood obesity in Mexico: social determinants of health and other risk factors. BMJ Case Rep 2018; 2018:bcr-2017-223862. [PMID: 29602890 DOI: 10.1136/bcr-2017-223862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Approximately 50 million children and adolescents in Latin America are affected by the childhood obesity pandemic. We present the case of a 5-year-old Mexican girl with obesity and gastro-oesophageal reflux disease (GORD), in whom prenatal, lifestyle and environmental risk factors were identified. Here, we demonstrate how childhood obesity is rooted since pregnancy and the perinatal stage, and how the social determinants of health like unsafe outdoor conditions, lack of infrastructure to exercise and a suboptimal physical activity curriculum in government schools strongly influence the development and maintenance of childhood obesity and complicate management.
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Affiliation(s)
- David Avelar Rodriguez
- Pediatric Gastroenterology and Nutrition Unit, Instituto Nacional de Pediatria, Coyoacan, Mexico
| | | | | | - Jaime Ramirez Mayans
- Pediatric Gastroenterology and Nutrition Unit, Instituto Nacional de Pediatria, Coyoacan, Mexico
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Abstract
Chyluria, a chronic manifestation of lymphatic filariasis, is rare in children. Clinicians must have a high index of suspicion to diagnose this condition in children as it mimics nephrotic syndrome. We present an unusual case in which a 7-year-old boy hailing from a filarial endemic region presented with a passage of milky urine, which on evaluation was diagnosed as parasitic chyluria. The child showed remission after medical management that persisted until 1 year of follow-up.
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Affiliation(s)
- Gaurav Garg
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Apul Goel
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sunny Goel
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Manmeet Singh
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
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19
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Affiliation(s)
- Lesa Dawman
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Indar Kumar Sharawat
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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20
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Bush R, Capra S, Box S, McCallum D, Khalil S, Ostini R. An Integrated Theatre Production for School Nutrition Promotion Program. Children (Basel) 2018; 5:E35. [PMID: 29498690 DOI: 10.3390/children5030035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/08/2018] [Accepted: 02/26/2018] [Indexed: 12/22/2022]
Abstract
In the context of stubbornly high childhood obesity rates, health promotion activities in schools provide a potential avenue to improve children’s nutritional behaviours. Theatre production has a rich history as a health behaviour promotion strategy but lacks sound, outcome-based evaluation. This study evaluated the effect of an integrated, two-part, place-based theatre performance program with 212 students in five schools in a regional urban and semi-rural area. The program included a theatre performance and a healthy eating competition. A brief survey assessed student healthy eating knowledge and attitudes at three time points. Nutrition behaviour was measured by scoring the contents of children’s lunch boxes before, during and up to six weeks after the intervention. Statistical analysis tested change over time on five variables (Knowledge, Attitude, Sometimes foods, Everyday foods, Overall lunch box score). Results showed that both components of the integrated program improved nutrition knowledge and that the theatre performance improved children’s healthy eating attitudes. All three lunch box scores peaked after the integrated program and remained significantly higher than baseline at 4–6 weeks follow-up. Interaction effects were identified for school catchment area on four of the five dependent variables. Evaluation of this integrated theatre production program indicates the potential benefit of taking a “super-setting” approach. It demonstrates an effect from students taking home information they had learned and incorporating it into lunch box preparation. It also showed consistent effects for school geographical catchment. This study suggests that, with careful, theory-based design, theatre productions in schools can improve student nutritional activities.
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21
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Ozturk OD, McInnes MM, Blake CE, Frongillo EA, Jones SJ. Development of a structured observational method for the systematic assessment of school food-choice architecture. Ecol Food Nutr 2015; 55:119-40. [PMID: 26654767 DOI: 10.1080/03670244.2015.1094062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The objective of this study is to develop a structured observational method for the systematic assessment of the food-choice architecture that can be used to identify key points for behavioral economic intervention intended to improve the health quality of children's diets. We use an ethnographic approach with observations at twelve elementary schools to construct our survey instrument. Elements of the structured observational method include decision environment, salience, accessibility/convenience, defaults/verbal prompts, number of choices, serving ware/method/packaging, and social/physical eating environment. Our survey reveals important "nudgeable" components of the elementary school food-choice architecture, including precommitment and default options on the lunch line.
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Affiliation(s)
- Orgul D Ozturk
- a Economics Department, Darla Moore School of Business , University of South Carolina , Columbia , South Carolina , USA
| | - Melayne M McInnes
- a Economics Department, Darla Moore School of Business , University of South Carolina , Columbia , South Carolina , USA
| | - Christine E Blake
- b Department of Health Promotion, Education, and Behavior , Arnold School of Public Health, University of South Carolina , Columbia , South Carolina , USA
| | - Edward A Frongillo
- b Department of Health Promotion, Education, and Behavior , Arnold School of Public Health, University of South Carolina , Columbia , South Carolina , USA
| | - Sonya J Jones
- c Center for Research in Nutrition and Health Disparities , University of South Carolina , Columbia , South Carolina , USA
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Abstract
Childhood obesity in the USA has more than tripled in the last three decades, and the prevalence is higher in the Mississippi Delta. Insight into the social, cultural and environmental factors that influence inequity can inform efforts to mediate health disparities. Focus groups (n = 12) among parents/guardians of elementary school children (n = 44) and teachers (n = 59) in the Mississippi Delta were used to investigate barriers and facilitators of healthy eating. Transcriptions were analyzed for themes. A strong preference for junk food among children and the pervasiveness of junk foods in schools and communities were cited as barriers to healthy eating. Potential facilitators of healthy eating included desire to avoid chronic disease, effort to limit junk food consumption and school support. Despite support for efforts to improve nutrition in the Delta, participants voiced a sense of inevitability related to children's consumption of unhealthy foods. This study suggests that parents and teachers express concern related to eating habits of children, yet they experience barriers to healthy eating which contribute to a sense of disempowerment. Improving health in the Mississippi Delta requires comprehensive strategies that offer its citizens a sense of agency.
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Affiliation(s)
- Virginia B Gray
- Department of Family and Consumer Sciences, California State University Long Beach, Long Beach, CA, USA
| | - Sylvia H Byrd
- Department of Food Science, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, MS, USA
| | - Brent J Fountain
- Department of Food Science, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, MS, USA
| | - Nicole E Rader
- Department of Sociology, Mississippi State University, Mississippi State, MS, USA
| | - Andrew D Frugé
- Department of Food Science, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, MS, USA
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23
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Scherr RE, Linnell JD, Smith MH, Briggs M, Bergman J, Brian KM, Dharmar M, Feenstra G, Hillhouse C, Keen CL, Nguyen LM, Nicholson Y, Ontai L, Schaefer SE, Spezzano T, Steinberg FM, Sutter C, Wright JE, Young HM, Zidenberg-Cherr S. The Shaping Healthy Choices Program: design and implementation methodologies for a multicomponent, school-based nutrition education intervention. J Nutr Educ Behav 2014; 46:e13-e21. [PMID: 25457732 DOI: 10.1016/j.jneb.2014.08.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 08/06/2014] [Accepted: 08/11/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To provide a framework for implementation of multicomponent, school-based nutrition interventions. This article describes the research methods for the Shaping Healthy Choices Program, a model to improve nutrition and health-related knowledge and behaviors among school-aged children. DESIGN Longitudinal, pretest/posttest, randomized, controlled intervention. SETTING Four elementary schools in California. PARTICIPANTS Fourth-grade students at intervention (n = 252) and control (n = 238) schools and their parents and teachers. Power analyses demonstrate that a minimum of 159 students per group will be needed to achieve sufficient power. The sample size was determined using the variables of nutrition knowledge, vegetable preference score, and body mass index percentile. INTERVENTION A multicomponent school-based nutrition education intervention over 1 academic year, followed by activities to support sustainability of the program. MAIN OUTCOME MEASURES Dietary and nutrition knowledge and behavior, critical thinking skills, healthy food preferences and consumption, and physical activity will be measured using a nutrition knowledge questionnaire, a food frequency questionnaire, a vegetable preferences assessment tool, the Test of Basic Science Process Skills, digital photography of plate waste, PolarActive accelerometers, anthropometrics, a parent questionnaire, and the School and Community Actions for Nutrition survey. ANALYSIS Evaluation will include quantitative and qualitative measures. Quantitative data will use paired t, chi-square, and Mann-Whitney U tests and regression modeling using P = .05 to determine statistical significance.
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Affiliation(s)
- Rachel E Scherr
- Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, University of California, Davis, Davis, CA
| | - Jessica D Linnell
- Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, University of California, Davis, Davis, CA
| | - Martin H Smith
- Department of Population Health and Reproduction, University of California, Davis, Davis, CA; Department of Human Ecology, University of California, Davis, Davis, CA; University of California Agriculture and Natural Resources, University of California Cooperative Extension, Davis, CA
| | - Marilyn Briggs
- Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, University of California, Davis, Davis, CA
| | - Jacqueline Bergman
- Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, University of California, Davis, Davis, CA
| | - Kelley M Brian
- Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, University of California, Davis, Davis, CA
| | - Madan Dharmar
- University of California Agriculture and Natural Resources, University of California Cooperative Extension, Merced and Stanislaus Counties, Modesto, CA
| | - Gail Feenstra
- UC Sustainable Agriculture Research and Education Program, Agricultural Sustainability Institute, University of California, Davis, Davis, CA
| | - Carol Hillhouse
- School Gardening Program, Agricultural Sustainability Institute, University of California, Davis, Davis, CA
| | - Carl L Keen
- Department of Nutrition, University of California, Davis, Davis, CA; Department of Internal Medicine, University of California, Davis, Davis, CA
| | - Lori M Nguyen
- Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, University of California, Davis, Davis, CA
| | - Yvonne Nicholson
- University of California Agriculture and Natural Resources, University of California Cooperative Extension, Sacramento County, Sacramento, CA
| | - Lenna Ontai
- Department of Human Ecology, University of California, Davis, Davis, CA; University of California Agriculture and Natural Resources, University of California Cooperative Extension, Davis, CA
| | - Sara E Schaefer
- Foods for Health Institute, University of California, Davis, Davis, CA
| | - Theresa Spezzano
- University of California Agriculture and Natural Resources, University of California Cooperative Extension, Merced and Stanislaus Counties, Modesto, CA
| | | | - Carolyn Sutter
- Department of Human Ecology, University of California, Davis, Davis, CA
| | - Janel E Wright
- University of California Agriculture and Natural Resources, University of California Cooperative Extension, Davis, CA
| | - Heather M Young
- Davis Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA
| | - Sheri Zidenberg-Cherr
- Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, University of California, Davis, Davis, CA; University of California Agriculture and Natural Resources, University of California Cooperative Extension, Davis, CA.
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24
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Furuta GT, Kagalwalla AF, Lee JJ, Alumkal P, Maybruck BT, Fillon S, Masterson JC, Ochkur S, Protheroe C, Moore W, Pan Z, Amsden K, Robinson Z, Capocelli K, Mukkada V, Atkins D, Fleischer D, Hosford L, Kwatia MA, Schroeder S, Kelly C, Lovell M, Melin-Aldana H, Ackerman SJ. The oesophageal string test: a novel, minimally invasive method measures mucosal inflammation in eosinophilic oesophagitis. Gut 2013; 62:1395-405. [PMID: 22895393 PMCID: PMC3786608 DOI: 10.1136/gutjnl-2012-303171] [Citation(s) in RCA: 188] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Eosinophil predominant inflammation characterises histological features of eosinophilic oesophagitis (EoE). Endoscopy with biopsy is currently the only method to assess oesophageal mucosal inflammation in EoE. We hypothesised that measurements of luminal eosinophil-derived proteins would correlate with oesophageal mucosal inflammation in children with EoE. DESIGN The Enterotest diagnostic device was used to develop an oesophageal string test (EST) as a minimally invasive clinical device. EST samples and oesophageal mucosal biopsies were obtained from children undergoing upper endoscopy for clinically defined indications. Eosinophil-derived proteins including eosinophil secondary granule proteins (major basic protein-1, eosinophil-derived neurotoxin, eosinophil cationic protein, eosinophil peroxidase) and Charcot-Leyden crystal protein/galectin-10 were measured by ELISA in luminal effluents eluted from ESTs and extracts of mucosal biopsies. RESULTS ESTs were performed in 41 children with active EoE (n=14), EoE in remission (n=8), gastro-oesophageal reflux disease (n=4) and controls with normal oesophagus (n=15). EST measurement of eosinophil-derived protein biomarkers significantly distinguished between children with active EoE, treated EoE in remission, gastro-oesophageal reflux disease and normal oesophagus. Levels of luminal eosinophil-derived proteins in EST samples significantly correlated with peak and mean oesophageal eosinophils/high power field (HPF), eosinophil peroxidase indices and levels of the same eosinophil-derived proteins in extracts of oesophageal biopsies. CONCLUSIONS The presence of eosinophil-derived proteins in luminal secretions is reflective of mucosal inflammation in children with EoE. The EST is a novel, minimally invasive device for measuring oesophageal eosinophilic inflammation in children with EoE.
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Affiliation(s)
- Glenn T Furuta
- Department of Pediatrics, Gastrointestinal Eosinophilic Diseases Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Mucosal Inflammation Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Digestive Health Institute, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Pediatrics, National Jewish Health, Denver, Colorado, USA
| | - Amir F Kagalwalla
- Department of Pediatrics, Ann and Robert H Lurie Children's Hospital of Chicago and Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Pediatrics, John H. Stroger Hospital of Cook County, Chicago, Illinois, USA
| | - James J Lee
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Scottsdale, Arizona, USA
| | - Preeth Alumkal
- Departments of Biochemistry and Molecular Genetics, and Medicine, College of Medicine, University of Illinois at Chicago, Illinois, USA
| | - Brian T Maybruck
- Departments of Biochemistry and Molecular Genetics, and Medicine, College of Medicine, University of Illinois at Chicago, Illinois, USA
| | - Sophie Fillon
- Department of Pediatrics, Gastrointestinal Eosinophilic Diseases Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Mucosal Inflammation Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Digestive Health Institute, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Joanne C Masterson
- Department of Pediatrics, Gastrointestinal Eosinophilic Diseases Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Mucosal Inflammation Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Digestive Health Institute, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Sergei Ochkur
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Scottsdale, Arizona, USA
| | - Cheryl Protheroe
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Scottsdale, Arizona, USA
| | - Wendy Moore
- Department of Pediatrics, Gastrointestinal Eosinophilic Diseases Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Mucosal Inflammation Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Digestive Health Institute, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Pediatrics, National Jewish Health, Denver, Colorado, USA
| | - Zhaoxing Pan
- Department of Pediatrics, Gastrointestinal Eosinophilic Diseases Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Digestive Health Institute, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Katie Amsden
- Department of Pediatrics, Ann and Robert H Lurie Children's Hospital of Chicago and Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Zachary Robinson
- Department of Pediatrics, Gastrointestinal Eosinophilic Diseases Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Mucosal Inflammation Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
| | - Kelley Capocelli
- Department of Pediatrics, Gastrointestinal Eosinophilic Diseases Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Department of Pathology, University of Colorado Denver School of Medicine, Colorado, USA
| | - Vince Mukkada
- Department of Pediatrics, Gastrointestinal Eosinophilic Diseases Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Mucosal Inflammation Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Digestive Health Institute, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Dan Atkins
- Department of Pediatrics, Gastrointestinal Eosinophilic Diseases Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Department of Pediatrics, National Jewish Health, Denver, Colorado, USA
| | - David Fleischer
- Department of Pediatrics, Gastrointestinal Eosinophilic Diseases Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Department of Pediatrics, National Jewish Health, Denver, Colorado, USA
| | - Lindsay Hosford
- Department of Pediatrics, Gastrointestinal Eosinophilic Diseases Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Mucosal Inflammation Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Digestive Health Institute, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Mark A Kwatia
- Departments of Biochemistry and Molecular Genetics, and Medicine, College of Medicine, University of Illinois at Chicago, Illinois, USA
| | - Shauna Schroeder
- Department of Pediatrics, Gastrointestinal Eosinophilic Diseases Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Mucosal Inflammation Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Digestive Health Institute, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Caleb Kelly
- Department of Pediatrics, Gastrointestinal Eosinophilic Diseases Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Mucosal Inflammation Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
| | - Mark Lovell
- Department of Pediatrics, Gastrointestinal Eosinophilic Diseases Program, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
- Department of Pathology, University of Colorado Denver School of Medicine, Colorado, USA
| | - Hector Melin-Aldana
- Department of Pediatrics, Ann and Robert H Lurie Children's Hospital of Chicago and Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Pathology, Ann and Robert H Lurie Children's Hospital of Chicago and Northwestern University, Chicago, Illinois, USA
| | - Steven J Ackerman
- Departments of Biochemistry and Molecular Genetics, and Medicine, College of Medicine, University of Illinois at Chicago, Illinois, USA
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Williamson DA, Han H, Johnson WD, Martin CK, Newton RL. Modification of the school cafeteria environment can impact childhood nutrition. Results from the Wise Mind and LA Health studies. Appetite 2013; 61:77-84. [PMID: 23154216 PMCID: PMC3953152 DOI: 10.1016/j.appet.2012.11.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 10/30/2012] [Accepted: 11/05/2012] [Indexed: 11/25/2022]
Abstract
Recent changes in nutrition standards for the National School Lunch and School Breakfast Programs assume that modification of the nutritional serving practices of school cafeterias will result in improved childhood nutrition in the school environment. The primary aim of this paper is to summarize the findings from two recent cluster randomized controlled trials (Wise Mind and LA Health) that tested the hypothesis that modification of school cafeteria environments, including changes in nutrition standards, would yield beneficial changes in childhood nutrition and healthy eating in the school lunch environment. A secondary aim was to investigate the association of participant characteristics and changes in nutrition and healthy eating. A third aim was to investigate the relationships between the food intake of children and: (1) foods selected by the children and (2) food that was uneaten during the lunch meal (plate waste). The studies used similar approaches for modifying the school cafeteria environment and both studies used the digital photography method to measure changes in food intake, food selection, and plate waste. Both studies reported significant improvements in childhood nutrition, and the LA Health study reported improved healthy eating, following introduction of the cafeteria modification program in comparison to baseline and/or control arms. These studies confirm the hypothesis that interventions that modify the school cafeteria environment can beneficially impact childhood nutrition.
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Abstract
OBJECTIVE Obesity is an enormous public health problem and children have been particularly highlighted for intervention. Of notable concern is the fast-food consumption of children . However, we know very little about how children or their parents make fast-food choices, including how they respond to mandatory calorie labeling. We examined children's and adolescents' fast-food choice and the influence of calorie labels in low-income communities in New York City (NYC) and in a comparison city (Newark, NJ). DESIGN Natural experiment: Survey and receipt data were collected from low-income areas in NYC, and Newark, NJ (as a comparison city), before and after mandatory labeling began in NYC. Study restaurants included four of the largest chains located in NYC and Newark: McDonald's, Burger King, Wendy's and Kentucky Fried Chicken. SUBJECTS A total of 349 children and adolescents aged 1-17 years, who visited the restaurants with their parents (69%) or alone (31%) before or after labeling was introduced. In total, 90% were from racial or ethnic minority groups. RESULTS We found no statistically significant differences in calories purchased before and after labeling; many adolescents reported noticing calorie labels after their introduction (57% in NYC) and a few considered the information when ordering (9%). Approximately 35% of adolescents ate fast food six or more times per week and 72% of adolescents reported that taste was the most important factor in their meal selection. Adolescents in our sample reported that parents have some influence on their meal selection. CONCLUSIONS Adolescents in low-income communities notice calorie information at similar rates as adults, although they report being slightly less responsive to it than adults. We did not find evidence that labeling influenced adolescent food choice or parental food choices for children in this population.
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Affiliation(s)
- B Elbel
- Division of General Internal Medicine, New York University School of Medicine, 423 East 23rd Street, New York, NY 10010, USA.
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Montenegro-Bethancourt G, Vossenaar M, Doak CM, Solomons NW. Contribution of beverages to energy, macronutrient and micronutrient intake of third- and fourth-grade schoolchildren in Quetzaltenango, Guatemala. Matern Child Nutr 2010; 6:174-89. [PMID: 20624213 PMCID: PMC6860656 DOI: 10.1111/j.1740-8709.2009.00193.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Beverages are selected based on availability, culture, taste preference, health, safety and social context. Beverages may be important to energy and to the macronutrient and micronutrient quality of overall intake. The aim of this study was to determine the contribution of beverages to the dietary energy and estimated macro- and micronutrient intake to the diet of young schoolchildren. We analyzed data from third- and fourth-grade urban Guatemalan school-children aged predominantly 8-10 years old. One-day pictorial registries of all beverages, foods and snacks consumed over a 24-h period were collected from children from private (n = 219) and public (n = 230) schools. Food composition nutrient values were assigned to the items consumed. Eleven main categories of beverages were identified. The contribution of each of the 11 beverage categories to energy, macro- and micronutrients was evaluated. The estimated intake of beverages was 475,300 mL, as reported by the 449 children. As a group, the beverage consumed in the greatest quantity was coffee (126,500 mL), followed by plain water (62,000 mL). Beverages represented a mean energy contribution of 418 +/- 26 kcal (21.5% of total dietary energy). The beverages varied in energy density from 0 (water) to 1.5 kcal mL(-1) (thin gruels). Beverages contributed one-third of the dietary carbohydrate. Through the contribution of fortified drinks, beverages were important sources of vitamin A (55%), vitamin C (38%), zinc (21%) and calcium (19%). Milk was an important source for vitamin D (10%). These results show the importance of drinks to nutrition and the balance of concerns of overweight/obesity with micronutrient quality.
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