ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

During the complementary feeding period, children require a nutrient-dense diet to meet their high nutritional requirements. International interest exists in the promotion of affordable, nutritionally adequate complementary feeding diets based on locally available foods. In this context, two questions are often asked: 1) is it possible to design a diet suitable for the complementary feeding period using locally available food? and 2) if this is possible, what is the lowest-cost, nutritionally adequate diet available? These questions are usually answered using a “trial and error” approach. However, a more efficient and rigorous technique, based on linear programming, is also available. It has become more readily accessible with the advent of powerful personal computers. The purpose of this review, therefore, is to inform pediatricians and public health professionals about this tool. In this review, the basic principles of linear programming are briefly examined and some practical applications for formulating sound food-based nutritional recommendations in different contexts are explained. This review should facilitate the adoption of this technique by international health professionals.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundIn order to achieve normal intellectual development, the plasma phe-nylalanine (PHE) levels of patients with hyperphenylalaninemia should not exceed toxic levels. This goal is usually accomplished by employing special diets in which the patient's protein intake is in the form of PHE-free mixtures of amino acids. There is evidence from our own observations in animals and a preliminary observation in patients with hyperphenylalaninemia that supplemental dietary threonine (THR) might decrease plasma PHE concentrations.MethodsIn this placebo-controlled crossover study, the effect of supplemental oral THR on the plasma amino acid concentrations of 12 patients with hyperphenylalaninemia was investigated. Before starting the first treatment period of this cross-over study, the patients were randomly assigned to one of two groups supplemented either with approximately 50 mg THR/kg per day or with a similar amount of maltodextrin as placebo. After a feeding period of 8 weeks and a wash-out period of 8 weeks, the supplements were crossed over and the study continued for an additional 8 weeks. Blood was obtained at the start and the end of each supplementation period.ResultsDietary THR supplementation of approximately 50 mg/kg per day resulted in a significant decrease of plasma PHE levels (P= 0.0234). There was a close positive correlation between plasma and urinary PHE concentrations (P< 0.001) indicating that the lower plasma PHE levels in the THR supplemented patients were not caused by higher urinary excretion of PHE.ConclusionsThe data of the present study show that oral THR supplementation has a clear plasma-PHE-reducing effect but they do not allow any conclusion about the mechanisms responsible for the observed effect. Although it seems attractive on the basis of the present data to use THR supplementation in patients with hyperphenylalaninemia, the mechanism of the observed effect should be clarified before introduction of such a treatment in these patients.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectivesThe authors investigated whether low vitamin B12intake, impaired gastric function,Helicobacter pyloriinfection, and bacterial overgrowth were risk factors for the high prevalence of cobalamin deficiency observed in Guatemalan children.MethodsThe plasma cobalamin concentration of 556 school children was measured and classified as low, marginal, or adequate. In 60 children from each of these three groups, concentrations of serum methylmalonic acid (MMA), plasma homocysteine, and plasma holotranscobalamin II were measured, and usual dietary B12intake was estimated. Serum gastrin and pepsinogen I concentrations were measured, andH. pyloriand bacterial overgrowth were diagnosed using13C-urea and13C-xylose breath tests, respectively.ResultsH. pyloriinfection was present in 83% (144 of 174) of children, and bacterial overgrowth was found in 25% (28 of 113). Children withH. pyloriinfection had higher serum gastrin and pepsinogen I. There were no significant differences among the plasma cobalamin groups in the prevalence ofH. pyloriinfection, bacterial overgrowth, serum gastrin, or pepsinogen I concentrations. However, there was a significant positive correlation between serum MMA and gastrin concentrations. The average daily consumption of dietary B12was 5.5 ± 5.2 &mgr;g/day, but intakes for 23% of children were <1.8 &mgr;g/day. B12intake from fortified snacks added an additional 0.3 ± 0.2 &mgr;g/day. B12intake was not significantly different among the plasma cobalamin groups, but it was significantly correlated with plasma cobalamin.ConclusionsThe specific cause of cobalamin deficiency in this population remains unclear, but these results suggest that low dietary B12intake is a risk factor and alterations in gastric secretions may also play a role.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectivesThe aim of this study was to compare the effects of an infant formula fortified with nucleotides (NF) with those of a control formula (CF) on the incidence of diarrhea, respiratory tract infections (RTIs), and immune responses in healthy term infants.MethodsThis 12-month, double-blind study was conducted on 1- to 7-day-old infants randomized to receive NF or CF exclusively until 12 weeks of age, and fed the assigned formula with solid food until 12 months. NF was supplemented with 72 mg/L of nucleotides, based on the total potentially available nucleotide content of human milk. Subjects were evaluated within 1 week of birth, at 4 weeks, and every 4 weeks thereafter until 48 weeks of age. The primary outcome variable was the incidence of diarrhea. Secondary variables included RTIs, serum immunoglobulin concentrations, and response to hepatitis B vaccine.ResultsCompared with subjects fed CF (n = 170), those fed NF (n = 166) had a trend toward reduced risk of diarrhea from 8 to 48 weeks of age and a significantly lower risk of 25.4% (P= 0.05) between 8 and 28 weeks. NF subjects had significantly higher serum immunoglobulin A concentrations (P< 0.05) throughout the 48-week study. The NF group had an increased risk of upper RTIs, the same incidence of lower RTIs, and the same antibody response to hepatitis B vaccination as the CF group, based on one-sided tests. Growth was normal in both groups, and no adverse events were considered to be formula-related.ConclusionsHealthy term infants from 8 to 28 weeks of life are less likely to experience diarrhea and have higher serum immunoglobulin A concentrations with NF compared with formula without added nucleotides.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundPatients with cow milk allergy (CMA) are potentially at risk for osteopenia because their milk-free diet usually contains a low calcium content. In our study, different parameters of bone mineralization in children with CMA were investigated.Patients and MethodsTwenty-seven CMA patients (mean age, 4.3 years; range, 3–8 years) were enrolled in the study. During a mean milk-free diet period of 11.8 months, children were fed extensively hydrolyzed or soy-based formulas. After a milk challenge test, 7 patients showed allergic symptoms, and the other 20 children had transient CMA. From the sera of all patients, the levels of sodium, potassium, chloride, calcium, phosphate, and magnesium ions, as well as alkaline phosphatase (AP), parathyroid hormone (PTH), osteocalcin, and beta-crosslaps, were determined. These values were compared with those of 20 healthy age-matched controls. Bone mineral density was measured as well.ResultsThe AP and PTH concentrations were higher in CMA patients than in the control group (AP: 610.2 U/L vs. 499.7 U/L,P< 0.01; PTH: 1.56 pmol/L vs. 0.83 pmol/L,P< 0.03), but all values were in the normal range. The osteocalcin concentration was similar in both groups, and the beta-crosslaps concentration was lower in CMA patients than in controls (0.92 vs. 1.47 ng/mL,P< 0.001). The mean Z score of bone mineral density in patients with CMA was −0.6. In 10 cases, the Z score was less than the −1 SD value. On the basis of the Z score, CMA patients were divided into two groups. The PTH concentration was significantly elevated in the group with lower Z score (2.24 pmol/L vs. 1.16 pmol/L;P< 0.03).ConclusionThe results suggest that, in children with CMA who are on a cow milk–free diet, slight disturbances of bone mineralization can be observed by osteodensitometry.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundThere is controversy about the potential risk of sustained high concentrations of cholesterol and triglyceride in patients with cholestatic chronic liver disease. However, it is currently accepted that cholesterol-lowering therapy may reduce morbidity and mortality rates in hypercholesterolemic patients without preexisting coronary heart disease, as well as in those with coronary heart disease. The objective of this study was to evaluate the effect of cholestyramine on the serum lipid profile of a group of children with Alagille syndrome and hypercholesterolemia.MethodsFive children with Alagille syndrome and basal serum cholesterol concentrations greater than 230 mg/dL were included. Total serum cholesterol, triglyceride, low-density, and high-density lipoprotein cholesterol concentrations were measured on days 0, 10, 20, and 30 after the administration of oral cholestyramine 100, 250, and 500 mg(kg·d), respectively. Lipid fractions were reported as mean ± 1 SD. Statistical analysis was performed with Friedman analysis of variance.ResultsThe basal values and those of the three 10-day subsequent 100-, 250-, and 500-mg(kg·d) cholestyramine periods were as follows: total cholesterol: 327.6 ± 77.1, 305.4 ± 52.1, 290.6 ± 24.1, and 320.6 ± 32.3, respectively (P= 0.668); triglyceride: 136.4 ± 14.6, 144.8 ± 41.3, 161 ± 30.9, and 165.4 ± 40.7, respectively (P= 0.356); low-density lipoprotein cholesterol: 245.4 ± 57.8, 239.8 ± 48.6, 242.2 ± 68.6, and 246.4 ± 49.5, respectively (P= 0.782); and high-density lipoprotein cholesterol: 44.4 ± 11.2, 41.8 ± 12.8, 44.6.2 ± 13.2, and 47 ± 8.5, respectively (P= 0.431).ConclusionUnder the conditions of the current study, no significant effect of variable doses of cholestyramine could be demonstrated on the serum lipid profile of a series of children with Alagille syndrome. While the controversy on the potential atherogenic risk of low-density lipoprotein hypercholesterolemia in patients with chronic liver disease persists, new, prospective pharmacologic or nutritional trials are required.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID