NUTRITION
(Infants, Children, Adolescents, Pregnant & Breastfeeding Women and Elderly)
Some selected abstracts: |
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1 |
Agren J, Sjors G, Sedin G. Ambient humidity influences the rate of skin barrier maturation in extremely preterm infants. J Pediatr. 2006 May;148(5):613-7.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. johan.agren@kbh.uu.se
OBJECTIVES: To test the
hypothesis that
the level of relative humidity (RH) in which preterm infants are nursed
might influence their postnatal skin maturation. STUDY DESIGN: In 22 preterm
infants (GA 23-27 weeks), transepidermal water loss (TEWL) was determined at
postnatal ages (PNA) of 0, 3, 7, 14, and 28 days. At a PNA of 7 days, the
infants were randomized to care at either 50% or 75% RH. RESULTS: TEWL
decreased at a slower rate in infants nursed at the higher RH. At a PNA of
28 days, TEWL was about twice as high in infants nursed at 75% RH (22 +/- 2
g/m2 h) than in those nursed at 50% RH (13 +/- 1 g/m2 h; P < .001).
CONCLUSIONS: The results indicate that the level of RH influences skin
barrier development, with more rapid barrier formation in infants nursed at
a lower RH. The findings have an impact on strategies for promoting skin
barrier integrity in extremely preterm infants. |
2 |
Becquet R, Leroy V, Ekouevi DK, Viho I, Castetbon K, Fassinou P, Dabis F, Timite-Konan M; ANRS 1201/1202 Ditrame Plus Study Group. Complementary feeding adequacy in relation to nutritional status among early weaned breastfed children who are born to HIV-infected mothers: ANRS 1201/1202 Ditrame Plus, Abidjan, Cote d'Ivoire. Pediatrics. 2006 Apr;117(4):e701-10.
Unite INSERM 593, Institut de Sante Publique Epidemiologie et Developpement, Universite Victor Segalen, Bordeaux, France. Renaud.Becquet@isped.u-bordeaux2.fr
OBJECTIVE: In high HIV
prevalence resource-constrained settings, exclusive breastfeeding with early
cessation is one of the conceivable interventions aimed at the prevention of
HIV through breast milk. Nevertheless, this intervention has potential
adverse effects, such as the inappropriateness of complementary feeding to
take over breast milk. The purpose of our study first was to describe the
nature and the ages of introduction of complementary feeding among early
weaned breastfed infants up to their first birthday and second was to assess
the nutritional adequacy of these complementary foods by creating a child
feeding index and to investigate its association with child nutritional
status. METHODS: A prospective cohort study in Abidjan, Cote d'Ivoire,
was conducted in HIV-infected pregnant women who were willing to breastfeed
and had received a perinatal antiretroviral prophylaxis. They were requested
to practice exclusive breastfeeding and initiate early cessation of
breastfeeding from the fourth month to reduce breast milk HIV transmission.
Nature and ages of introductory complementary feeding were described in
infants up to their first birthday by longitudinal compilation of 24-hour
and 7-day recall histories. These recalls were done weekly until 6 weeks of
age, monthly until 9 months of age, and then quarterly. We created an index
to synthesize the nutritional adequacy of infant feeding practices (in terms
of quality of the source of milk, dietary diversity, food, and meal
frequencies) ranging from 0 to 12. The association of this feeding index
with growth outcomes in children was investigated. RESULTS: Among the 262
breastfed children included, complete cessation of breastfeeding occurred in
77% by their first birthday, with a median duration of 4 months. Most of the
complementary foods were introduced within the seventh month of life, except
for infant food and infant formula that were introduced at age 4 months. The
feeding index was relatively low (5 of 12) at age 6 months, mainly as a
result of insufficient dietary diversity, but was improved in the next 6
months (8.5 of 12 at 12 months of age). Inadequate complementary feeding at
age 6 months was associated with impaired growth during the next 12 months,
with a 37% increased probability of stunting. CONCLUSION: Adequate feeding
practices around the weaning period are crucial to achieving optimal child
growth. HIV-infected women should turn to early cessation of breastfeeding
only when they are counseled properly to provide adequate complementary
feeding to take over breast milk. Our child feeding index could contribute
to the assessment of the nutritional adequacy of complementary feeding
around the weaning period and therefore help to detect children who are at
risk for malnutrition. |
3 |
Gibson A, Carney S, Wales JK. Growth and the premature baby. Horm Res. 2006;65 Suppl 3:75-81. Jessop Wing, Sheffield, UK. Alan.Gibson@sth.nhs.uk
There is considerable
evidence to show that babies born prematurely have poor postnatal growth,
and the more premature the baby, the greater the impairment is likely to be
and the longer it will persist. Nutrition has been shown to play an
important part in this, but adequate nutrition is difficult, if not
impossible, to achieve in these infants. In the most immature infants,
growth retardation may continue for many months and catch-up may be delayed
and incomplete. Evidence from long-term studies suggests that preterm
infants will be shorter and lighter than term controls and that reduced
stature and head size may be linked with lower intelligence. Although there
is evidence linking better growth to better neurodevelopmental outcome, with
reports suggesting that this can be achieved with dietary manipulation,
there are also data that suggest that there could be a link between
increased postnatal growth and increased morbidity and mortality in later
childhood and adult life. Here, we provide an overview of current
understanding of growth impairment in infants born prematurely and the
effects in later life. Copyright 2006 S. Karger AG, Basel. |
4 |
Hazel R. The
psychosocial impact on parents of tube feeding their child. Paediatr Nurs.
2006 May;18(4):19-22. Review. Luton and Dunstable Hospital.
A
review of 13 papers investigating parents' experience of long-term tube
feeding in disabled children and young people identified
a significant impact on parents and families related to oral feeding,
decision making and tube feeding itself. Mixed messages and pressure from
health professionals and relatives made decision making about tube feeding
more difficult for parents. Making the decision to tube feed or proceed to
gastrostomy was described in terms of 'giving in'. Parents expressed a need
for consistent, accurate information. Once tube feeding was established
there is a positive impact on the lives of the child and family - although
some parents reported reduced support and continued feelings of inadequacy.
The significance parents attach to oral feeding and their information and
respite care needs when tube feeding must be recognised and further
explored. |
5 |
James P. Marabou 2005: nutrition and human development. Nutr Rev. 2006 May;64(5 Pt 2):S1-11; discussion S72-91.
London School of Hygiene and Tropical Medicine, United Kingdom. jeanhjames@aol.com
Nutrition is now becoming once more of
intense interest to biological and medical scientists working on the control
of development and human health. It is also now of ever greater public
health interest. Few scientists, however, recognize that the same interest for those involved in fundamental
science and public health developed a century ago focusing on the way in
which nutrition and specific micronutrients, as well as general energy and
protein intakes, were crucial to infant growth and appropriate development.
The discovery of vitamins was matched by the proposition that stunted
children in poor communities in the Western world were suffering from
poverty-related poor diets. The critical role of nutrition was established
by feeding studies, which then led to major food and agricultural policy
changes during the Second World War, when food supplies were scarce
throughout Europe.
The success of these wartime policies led to a revolution in governmental
thinking and a cheap food policy, together with a major boost in national
agricultural production as an issue of national security. Nutritionists
transferred their scientific interest to the study of childhood malnutrition
in the developing world. The promotion of intensive agriculture and the food
industry led to a revolution in food supplies, with the intense promotion of
meat, milk, butter, and sugar production and consumption. The resulting
escalation in cardiovascular disease related to the dietary change slowly
altered public health policies, but as cardiovascular deaths decreased in
the developed world, obesity and diabetes progressively increased. Now the
lower- and middle-income countries (i.e., the developing world) have far
more cardiovascular disease as Western diets and cultural habits are
imported. The remarkable escalation of diabetes and cardiovascular disease,
particularly in populations currently and previously subjected to
malnutrition, now reveals unusual susceptibility to these diseases. This
susceptibility is increasingly related to the conjunction of fetal
malnutrition and later inappropriate diets. The alarming escalation in the
health burden suggests that two-thirds of the world's population is
super-sensitive to weight gain, diabetes, cardiovascular disease, and
perhaps many cancers. New evidence on epigenetics and the structural changes
in the fetus in response to inappropriate maternal diets provides mechanisms
to explain this. Unfortunately, a vicious intergenerational cycle of
maternal and fetal epigenetic change seems to herald markedly increased
future burdens of disease. The nutrition field is therefore challenged not
only in terms of science, but also in new dimensions of public health of
immense economic significance. |
6 |
Moss RL, Dimmitt RA, Barnhart DC, Sylvester KG, Brown RL, Powell DM, Islam S, Langer JC, Sato TT, Brandt ML, Lee H, Blakely ML, Lazar EL, Hirschl RB, Kenney BD, Hackam DJ, Zelterman D, Silverman BL. Laparotomy versus peritoneal drainage for necrotizing enterocolitis and perforation. N Engl J Med. 2006 May 25;354(21):2225-34.
Section of Pediatric Surgery, Yale University School of Medicine, New Haven, Conn 06520-8062, USA. larry.moss@yale.edu
BACKGROUND: Perforated necrotizing
enterocolitis is a
major cause of morbidity and mortality in premature infants, and the optimal
treatment is uncertain. We designed this multicenter randomized trial to
compare outcomes of primary peritoneal drainage with laparotomy and bowel
resection in preterm infants with perforated necrotizing enterocolitis.
METHODS: We randomly assigned 117 preterm infants (delivered before 34 weeks
of gestation) with birth weights less than 1500 g and perforated necrotizing
enterocolitis at 15 pediatric centers to undergo primary peritoneal drainage
or laparotomy with bowel resection. Postoperative care was standardized. The
primary outcome was survival at 90 days postoperatively. Secondary outcomes
included dependence on parenteral nutrition 90 days postoperatively and
length of hospital stay. RESULTS: At 90 days postoperatively, 19 of 55
infants assigned to primary peritoneal drainage had died (34.5 percent), as
compared with 22 of 62 infants assigned to laparotomy (35.5 percent,
P=0.92). The percentages of infants who depended on total parenteral
nutrition were 17 of 36 (47.2 percent) in the peritoneal-drainage group and
16 of 40 (40.0 percent) in the laparotomy group (P=0.53). The mean (+/-SD)
length of hospitalization for the 76 infants who were alive 90 days after
operation was similar in the primary peritoneal-drainage and laparotomy
groups (126+/-58 days and 116+/-56 days, respectively; P=0.43). Subgroup
analyses stratified according to the presence or absence of radiographic
evidence of extensive necrotizing enterocolitis (pneumatosis intestinalis),
gestational age of less than 25 weeks, and serum pH less than 7.30 at
presentation showed no significant advantage of either treatment in any
group. CONCLUSIONS: The type of operation performed for perforated
necrotizing enterocolitis does not influence survival or other clinically
important early outcomes in preterm infants. (ClinicalTrials.gov number,
NCT00252681.). Copyright 2006 Massachusetts Medical Society. |
7 |
Ong KK. Size at birth, postnatal growth and risk of obesity. Horm Res. 2006;65 Suppl 3:65-9. MRC Epidemiology Unit, Strangeways Research Laboratory, Cambridge, UK. ken.ong@mrc-epid.cam.ac.uk
Epidemiological studies over the last 15 years have shown
that size at birth, early postnatal catch-up growth and excess childhood
weight gain are associated with an increased risk of adult cardiovascular
disease and type 2 diabetes. At the same time, rising rates of obesity and
overweight in children, even at pre-school ages, have shifted efforts
towards the identification of very early factors that predict risk of
subsequent obesity, which may allow early targeted interventions. Overall,
higher birth weight is positively associated with subsequent greater body
mass index in childhood and later life; however, the relationship is
complex. Higher birth weight is associated with greater subsequent lean
mass, rather than fat mass. In contrast, lower birth weight is associated
with a subsequent higher ratio of fat mass to lean mass, and greater central
fat and insulin resistance. This paradoxical effect of lower birth weight is
at least partly explained by the observation that infants who have been
growth restrained in utero tend to gain weight more rapidly, or 'catch up',
during the early postnatal period, which leads to increased central fat
deposition. There is still debate as to whether there are critical early
periods for obesity: does excess weight gain during infancy, childhood or
even very early neonatal life have a greater impact on long-term fat
deposition and insulin resistance? Early identification of childhood obesity
risk will be aided by identification of maternal and fetal genes that
regulate fetal nutrition and growth, and postnatal genes that regulate
appetite, energy expenditure and the partitioning of energy intake into fat
or lean tissue growth. Copyright 2006 S. Karger AG,
Basel. |
8 |
Valverde E, Pellicer A, Madero R, Elorza D, Quero J, Cabanas F. Dopamine versus epinephrine for cardiovascular support in low birth weight infants: analysis of systemic effects and neonatal clinical outcomes. Pediatrics. 2006 Jun;117(6):e1213-22.
Department of Neonatology, La Paz University Hospital, Madrid, Spain.
BACKGROUND: Early postnatal adaptation to transitional
circulation in low birth weight infants frequently is associated with low
blood pressure and decreased blood flow to organs. Catecholamines have been
used widely as treatment, despite remarkably little empirical evidence on
the effects of vasopressor/inotropic support on circulation and on
clinically important outcomes in sick newborn infants. AIMS: To explore the
effectiveness of low/moderate-dose dopamine and epinephrine in the treatment
of early systemic hypotension in low birth weight infants, evaluate the
frequency of adverse drug effects, and examine neonatal clinical outcomes of
patients in relation to treatment. DESIGN/METHODS: Newborns of <1501-g birth
weight or <32 weeks of gestational age, with a mean blood pressure lower
than gestational age in the first 24 hours of life, were assigned randomly
to receive dopamine (2.5, 5, 7.5, and 10 microg/kg per minute; n = 28) or
epinephrine (0.125, 0.250, 0.375, and 0.5 microg/kg per minute; n = 32) at
doses that were increased stepwise every 20 minutes until optimal mean blood
pressure was attained and maintained (responders). If this treatment was
unsuccessful (nonresponders), sequential rescue therapy was started,
consisting first of the addition of the second study drug and then
hydrocortisone. OUTCOME MEASURES: These included: (1) short-term changes
(first 96 hours, only responders) in heart rate, mean blood pressure,
acid-base status, lactate, glycemia, urine output, and fluid-carbohydrate
debit; and (2) medium-term morbidity, enteral nutrition tolerance,
gastrointestinal complications, severity of lung disease, patent ductus
arteriosus, cerebral ultrasound diagnoses, retinopathy of prematurity, and
mortality. RESULTS: Patients enrolled in this trial did not differ in birth
weight or gestational age (1008 +/- 286 g and 28.3 +/- 2.3 weeks in the
dopamine group; 944 +/- 281 g and 27.7 +/- 2.4 weeks in the epinephrine
group). Other main antenatal variables were also comparable. However,
responders and nonresponders differed significantly with respect to the need
for cardiorespiratory resuscitation at birth (3% vs 23%), Critical Risk
Index for Babies score (3.8 +/- 3 vs 7 +/- 5), and premature rupture of
membranes >24 hours (39.5% vs 13.6%), respectively. No differences were
found in the rate of treatment failure (dopamine: 36%; epinephrine: 37%) or
need for rescue therapy according to treatment allocation. Groups did not
differ in age at initiation of therapy (dopamine: 5.3 +/- 3.9 hours;
epinephrine: 5.2 +/- 3.3 hours), but withdrawal was significantly later in
the dopamine group. For short-term changes, mean blood pressure showed a
significant increase from baseline throughout the first 96 hours with no
differences between groups. However, epinephrine produced a greater increase
in heart rate than dopamine. After treatment began, epinephrine patients
showed higher plasma lactate (first 36 hours) and lower bicarbonate and base
excess (first 6 hours) and received more bicarbonate. Patients in the
epinephrine group also had higher glycemia (first 24 hours) and needed
insulin therapy more often. Groups did not differ in urine output or
fluid-carbohydrate supply during the first 96 hours. For medium-term
morbidity, there were no differences in neonatal clinical outcomes in
responders. However, significant differences were found in the incidence of
patent ductus arteriosus, bronchopulmonary dysplasia, need for
high-frequency ventilation, occurrence of necrotizing enterocolitis, and
death between responders and nonresponders. CONCLUSIONS: Low/moderate-dose
epinephrine is as effective as low/moderate-dose dopamine for the treatment
of hypotension in low birth weight infants, although it is associated with
more transitory adverse effects. |
9 |
Zhang J, Wu TX, Liu GJ. Chinese herbal medicine for the treatment of pre-eclampsia. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD005126. Review.
BACKGROUND: Pre-eclampsia is a common
disorder of pregnancy with uncertain etiology. In Chinese herbal
medicines, a number of herbs are used for treating pre-eclampsia.
Traditional Chinese medicine considers that, when a woman is pregnant, most
of the blood of the mother is directed to the placenta to provide the baby
with the required nutrition; other maternal organs may in consequence be
vulnerable to damage. These organs include the liver, the spleen, and the
kidneys. The general effects of Chinese herbal medicines that can protect
these organs may be valuable in pre-eclampsia by encouraging vasodilatation,
increasing blood flow, and decreasing platelet aggregation. The use of
Chinese herbal medicine is often based on the individual and presence of
traditional Chinese medicine symptoms. OBJECTIVES: To assess the effect of
Chinese herbal medicine for treating pre-eclampsia and compare it with that
of placebo, no treatment or Western medicine. SEARCH STRATEGY: We searched
the Cochrane Pregnancy and Childbirth Groups Trial Register (31 March 2024),
the Cochrane Central Register of Controlled Trials (The Cochrane Library,
Issue 1, 2005), MEDLINE (1969 to December 2004), EMBASE (1984 to March 2004)
and CBM (1978 to February 2005) and we handsearched several main journals
published in China. SELECTION CRITERIA: Randomized controlled trials in
which Chinese herbal medicine was used for treating pre-eclampsia. DATA
COLLECTION AND ANALYSIS: One review author assessed trials for inclusion.
The trials were also assessed by a second review author if there was any
doubt about whether or not to include the trial. Analysis was not performed
as there were no trials included in this review. MAIN RESULTS: No trials
were suitable for inclusion in this review. AUTHORS' CONCLUSIONS: The effect
of Chinese herbal medicine for treating pre-eclampsia remains unclear. There
are currently no randomized controlled trials to address the efficacy and
safety of Chinese herbal medicine for the treatment of pre-eclampsia. Well
conducted randomized controlled trials are required. |
14792. Anderson PM, Butcher KE. Childhood obesity: trends and potential causes. Future Child. 2006 Spring;16(1):19-45. Review. 14793. Berger J, Ninh NX, Khan NC, Nhien NV, Lien DK, Trung NQ, Khoi HH. Efficacy of combined iron and zinc supplementation on micronutrient status and growth in Vietnamese infants. Eur J Clin Nutr. 2006 Apr;60(4):443-54. 14794. Blakely ML, Tyson JE, Lally KP, McDonald S, Stoll BJ, Stevenson DK, Poole WK, Jobe AH, Wright LL, Higgins RD; NICHD Neonatal Research Network. Laparotomy versus peritoneal drainage for necrotizing enterocolitis or isolated intestinal perforation in extremely low birth weight infants: outcomes through 18 months adjusted age. Pediatrics. 2006 Apr;117(4):e680-7. 14795. Chapman DJ. Does maternal diet contribute to colic among breastfed infants? J Hum Lact. 2006 May;22(2):236-7. 14796. Garlick PJ. Toxicity of methionine in humans. J Nutr. 2006 Jun;136(6 Suppl):1722S-1725S. Review. 14797. Henriksen T. Nutrition and pregnancy outcome. Nutr Rev. 2006 May;64(5 Pt 2):S19-23; discussion S72-91. Review. 14798. Islam MM, Peerson JM, Ahmed T, Dewey KG, Brown KH. Effects of varied energy density of complementary foods on breast-milk intakes and total energy consumption by healthy, breastfed Bangladeshi children. Am J Clin Nutr. 2006 Apr;83(4):851-8. 14799. Jyothi DV, Umamaheshwari K. Health status and prevalence of anaemia among the adolescent girls of integrated child development services projectarea. J Res ANGRAU 2005, 33(1), 74111-7. 14800. Lakshmi Devi N, Khader V, Vimala V. Nutritional Status of the Institutionalized Elderly in Andhra Pradesh. Indian J clin Pract 2005, 16(4), 14-19. 14801. Lawrence RA. Lower breastfeeding rates among supplemental nutrition program for women, infants, and children participants: a call for action. Pediatrics. 2006 Apr;117(4):1432-3. 14802. Lindsay AC, Sussner KM, Kim J, Gortmaker S. The role of parents in preventing childhood obesity. Future Child. 2006 Spring;16(1):169-86. 14803. Lovelady CA, Stephenson KG, Kuppler KM, Williams JP. The effects of dieting on food and nutrient intake of lactating women. J Am Diet Assoc. 2006 Jun;106(6):908-12. 14804. Miech RA, Kumanyika SK, Stettler N, Link BG, Phelan JC, Chang VW. Trends in the association of poverty with overweight among US adolescents, 1971-2004. JAMA. 2006 May 24;295(20):2385-93. 14805. Reilly JK, Lanou AJ, Barnard ND, Seidl K, Green AA. Acceptability of soymilk as a calcium-rich beverage in elementary school children. J Am Diet Assoc. 2006 Apr;106(4):590-3. 14806. Reiter PD, Novak K, Valuck RJ, Rosenberg AA, Fish D. Effect of a closed drug-delivery system on the incidence of nosocomial and catheter-related bloodstream infections in infants. Epidemiol Infect. 2006 Apr;134(2):285-91. 14807. Shaheen R, de Francisco A, El Arifeen S, Ekstrom EC, Persson LA. Effect of prenatal food supplementation on birth weight: an observational study from Bangladesh. Am J Clin Nutr. 2006 Jun;83(6):1355-61. 14808. Taylor C. Lactose intolerance in infants. Nurs Times. 2006 Apr 25-May 1;102(17):43-4. Review. 14809. Uauy R, Dangour AD. Nutrition in brain development and aging: role of essential fatty acids. Nutr Rev. 2006 May;64(5 Pt 2):S24-33; discussion S72-91. Review. 14810. Wright K, Coverston C, Tiedeman M, Abegglen JA. Formula supplemented with docosahexaenoic acid (DHA) and arachidonic acid (ARA): a critical review of the research. J Spec Pediatr Nurs. 2006 Apr;11(2):100-12; discussion 112-3. Review. 14811. Zhou SJ, Gibson RA, Crowther CA, Baghurst P, Makrides M. Effect of iron supplementation during pregnancy on the intelligence quotient and behavior of children at 4 y of age: long-term follow-up of a randomized controlled trial. Am J Clin Nutr. 2006 May;83(5):1112-7. 14812. Zlotkin SH, Schauer C, Owusu Agyei S, Wolfson J, Tondeur MC, Asante KP, Newton S, Serfass RE, Sharieff W. Demonstrating zinc and iron bioavailability from intrinsically labeled microencapsulated ferrous fumarate and zinc gluconate Sprinkles in young children. J Nutr. 2006 Apr;136(4):920-5. |