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Copyright of Ümraniye Pediatri Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. Obesity is a significant factor in the development of numerous chronic kidney diseases. Chronic kidney disease reduces exercise capacity and muscle strength, which is suggested to improve through exercise. The study investigated the effect of a diet program and aerobic exercises in obese children with chronic kidney disease. Methods. Thirty children of both sexes aged 12-16 years with class II or class III obesity in accordance with body mass index (BMI) and first 2 stages of chronic kidney disease were selected from Paediatric Nephrology Unit, Cairo University. They were randomly assigned into 2 equal groups. The control group received routine medical treatment (blood pressure control, treatment of hyperlipidaemia, non-steroidal anti-inflammatory drugs). The experimental group received routine medical treatment in addition to a diet program and aerobic exercises 3 times per week for 3 months. Blood urea nitrogen, serum creatinine, C-reactive protein, urine albumin, sodium, potassium, cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides were evaluated before and after treatment in both groups. Results. There were significant differences between the mean pre- and post-treatment parameters of kidney function, lipid profile, and BMI within each group (p < 0.05). Significant differences were observed in the mean parameters of kidney function, lipid profile, and BMI between the 2 groups after treatment in favour of the experimental group (p < 0.05). Conclusions. As the experimental group showed more positive results, the diet control program and aerobic exercise had a positive effect in class II and class III obese children with chronic kidney disease. [ABSTRACT FROM AUTHOR]

Background: In clinical settings, there is a challenge in providing nutritional care for critically burned children and infants to improve survival. Steps must be taken to address changes in oral support. Materials and Methods: Nutritional interventions were admitted for over 88% of patients in burn units and ICUs by the resident nutritionist of the unit. Their healing process and nutritional outcome were checked every 3-7 days. Results: Energy intake and protein requirement are better to be considered using Curreri junior formula and 2-4 gr/kg body weight. Providing energy may require mixed forms of oral nutrition support or enteral nutrition with partial parenteral. At least 3.5 gr L-arginine and 3.5 gr LGlutamin are recommended. To increase appetite, syrup form of Multivitamins and zinc is suggested from the first day of admission. In children under 13, the suggested daily intake includes 2500-5000 IU of vitamin E, 250-1000 mg of Vitamin C, 60-140 mg of selenium, and 3-15 cc Multivitamins (B group) along with 12-25 mg of zinc. For children over 13, daily intake includes 10000 IU vitamin E, 0.5-3 g Vitamin C, 300-500 mg selenium, and 10-30 cc Multivitamins along with 25-40 mg zinc. One dose vitamin D intake of 50000 IU is recommended for children over 4 years, and weekly for children with over 60% burn with the risk of sepsis. Iron therapy is not recommended due to the risk of infection. Conclusion: Proper nutrition and supplement therapy play a critical role in the survivability of burn children and infants, demanding careful attention. [ABSTRACT FROM AUTHOR]

Background: Caries risk assessment in preschool children has been limited validated. Aim: To validate caries predictive ability of Cariogram using different combinations of factors and settings in preschool children from areas with high caries risk. Design: Two to five years old children (N = 175) were examined for caries (cavitated and non‐cavitated lesions), at baseline and after 1 and 2 years. Mutans streptococci counts (MS) and saliva buffer capacity (SBC) were measured with chair side tests. Diet and oral health attitude were assessed through a parental questionnaire. Baseline caries risk was calculated using standard and high‐risk group variables in Cariogram either with nine factors or excluding MS and SBC. Poisson regression models, ROC analysis and information criteria (AIC and BIC), P < 0.05, were used to investigate the predictive ability of Cariograms and to quantify the associations. Results: Accuracy of Cariogram was found limited. Cariograms with MS showed higher sensitivity but lower specificity than those without bacterial counts. Standard set Cariograms with MS counts performed slightly better than the other models, but the difference was not statistically significant. Caries prediction with standard and high set Cariograms was also found limited. Conclusions: Cariogram with various factors and settings displayed suboptimal ability to predict caries in this population. [ABSTRACT FROM AUTHOR]

Aim: This study compared follow-up protocols for paediatric celiac disease (CD) led by either paediatricians or dietitians at Swedish university hospitals.Methods: We followed 363 CD patients under 18 years at the university hospitals in Malmö (n = 140) and Lund (n = 79) between 2011 and 2013 and after they merged to become Skåne (n = 144) between 2014 and 2016. Both Lund and Malmö provided regular paediatrician follow-up visits, whereas Skåne provided mainly dietitian-led visits.Results: Children at Lund were followed for a mean of 1.0 ± 0.5 visits per year, compared to 0.7 ± 0.6 at Malmö (p < 0.0001) and 0.9 ± 0.6 at Skåne (p = 0.11). The ratio of annual paediatrician to dietitian annual visits was 1.4:1.0 at Lund, which was higher than Malmö (0.9:1.0; p = 0.0017) and Skåne (0.6:1.0; p < 0.0001). There was no difference in the prevalence of non-compliant patients between the clinics (p = 0.26, Malmö 13.6%, Lund 10.1%, Skåne 7.6%). Tissue transglutaminase autoantibody levels reversed equally over time at all three clinics after the subjects started a gluten-free diet (r = -0.55, p < 0.0001). The total mean annual cost per patient was lowest at Malmö and highest at Lund (p < 0.0001).Conclusion: Dietary compliance was similar regardless of whether care was provided by a dietitian or paediatrician. Dietitian-led follow-up visits may provide lower long-term costs. [ABSTRACT FROM AUTHOR]

Introduction: Introduction: the dietary intake patterns of children should be monitored because of their influence on health in adulthood. It is now widely accepted that childhood nutrition is linked to specific diseases such as obesity and to risk factors for cardiovascular disease in adulthood. Therefore, knowledge of dietary intake during childhood may be useful to identify possible risk factors for disease in adulthood. The main focus of research into children's diets has been the contribution of macronutrients and micronutrients. Objective: several indices have been developed for assessing the diet quality of previously defined population groups. The aim of the present study was to compare the nutritional status of Andalusian children and adolescents and examine the relationship between their diet quality and socio-demographic or lifestyle factors. Results and conclusions: the food intake of the younger children in this study was closer to RDIs compared with the adolescents, who generally reported a lower energy supply in their diet than the recommended. The mean (SD) diet quality score was 12.1 (1.9) for the younger children (6-9 years) and 9.4 (3.2) for the older group (10-17 years), a statistically significant difference. A good correlation was found between energy intake (MJ/kg body weight) and estimated energy (MET MJ/kg body weight). [ABSTRACT FROM AUTHOR]

Aim: This study described outcomes following treatment for lactose intolerance, which is common in children.Methods: The medical records of children aged 6-18 years who underwent lactose hydrogen breath testing at Dana-Dwek Children's Hospital, Tel Aviv, Israel, from August 2012 to August 2014 were analysed. We compared 154 children with gastrointestinal symptoms and positive lactose hydrogen breath tests to 49 children with negative test results.Results: Of the 154 children in the study group, 89 (57.8%) were advised to follow a lactose-restricted diet, 32 (20.8%) were advised to avoid lactose completely, 18 (11.7%) were instructed to use substitute enzymes, and 15 (9.7%) did not receive specific recommendations. Only 11 patients (7.1%) received recommendations to add calcium-rich foods or calcium supplements to their diet. Lactose reintroduction was attempted in 119 of 154 patients (77.3%), and 65 of 154 (42.2%) experienced clinical relapses. At the final follow-up of 3.3 years, 62.3% of the study children were still observing a restricted diet. Older children and those who were symptomatic during lactose hydrogen breath testing were more likely to be on a prolonged restricted diet.Conclusion: Our long-term follow-up of lactose-intolerant children showed that only a third were able to achieve a regular diet. [ABSTRACT FROM AUTHOR]

Objective: To characterize associations of snacking frequency with weight status among US children aged 1 to 5 years.Methods: Participants were children (n = 4,669) aged 1 to 5 years in the 2005 to 2014 National Health and Nutrition Examination Survey (NHANES). Snacking was assessed by two 24-hour dietary recalls using definitions that considered "snack" occasions as well as other foods/beverages consumed between meals. Overweight/obesity (OW/OB) was defined using percentile cutoffs: ≥ 97.7th weight-for-length (< 2 years) cutoff and the ≥ 85th BMI-for-age (≥ 2 years) cutoff. Linear/logistic regressions evaluated snacking based on daily occasions and relative to current recommendations (two to three snacks per day).Results: During 2005 to 2014, US children aged 1 to 5 years consumed, on average, two to three snacks daily. Children with normal weight in both age groups tended to snack less frequently than children with OW/OB when considering all foods/beverages eaten between meals (P < 0.01-0.12). Across most snacking definitions, children < 2 years who snacked more frequently than recommended had greater odds of having OW/OB (P < 0.01-0.12) and consumed greater daily snack energy than those who snacked within recommendations (all P < 0.01). Recommendations did not clearly delineate weight status among children aged 2 to 5 years.Conclusions: Snacking frequency and weight are positively associated among US children 1 to 5 years old, with most consistent associations seen among children < 2 years old and when considering all foods/beverages consumed between meals. [ABSTRACT FROM AUTHOR]

Introduction: The present study aimed to assess the nutritional status, the dietary patterns and its associated factors in the HIV-infected population of children and adolescents on antiretroviral treatment at the El Salvador reference center for pediatric HIV care (CENID). Methods: A cross-sectional survey was carried out between December 2010 and December 2011. Socio-demographic and clinical characteristics were collected from 307 children and adolescents aged 2–18 years and receiving antiretroviral therapy. Nutritional status was assessed by height-for-age, weight-for-height and body mass index-for-age. Dietary data was collected through a 24 hour recall, and through a weekly food frequency questionnaire. Dietary patterns were identified by principal component analysis. Bivariate and multivariable statistical methods were used to assess the factors associated with “high adherence” to the “healthy diet” pattern. Results: More than a third of the study group (33.2%) were stunted, 3.3% were identified as being wasted, and 10% were overweight or obese. Their diets were predominantly based on a high consumption of cereals, beans, eggs and processed foods and a low consumption of fruits, vegetables and dairy products. Three dietary patterns were identified: “healthy diet”, “high fat/sugar diet” and “low diversity diet”. Being female (OR: 1.63; 95%CI: 0.97–2.75), younger (OR: 2.37; 95%CI: 1.28–4.36) and institutionalized (OR: 14.5; 95%CI: 5.35–39.50) increased the odds to adhere to the “healthy diet” pattern. Conclusion: Our findings reveal a high prevalence of stunting and overweight in HIV-infected children in El Salvador. Institutionalized children were more likely to adhere to a healthy dietary pattern whereas children in poverty were more likely to have less varied and healthy diets. These results highlight the need to assess the dietary patterns of HIV-infected children and adolescents in order to guide public policies to design healthy life style interventions for this population at risk. [ABSTRACT FROM AUTHOR]

Obesity is an increasing problem in young people. Childhood obesity and overweight have increased rapidly on a global scale, and have tripled in the past 30 years, to affect approximately one in five children. Diets high in refined fats and sugar are a major contributor to the development of obesity, and the effects of such obesity-inducing hypercaloric diets on brain function may contribute to the high prevalence of anxiety disorders in people with obesity. Anxiety disorders typically emerge in childhood and adolescence, and symptoms often continue into adulthood. Based on this symptomology, we consider anxiety-related behavioral consequences of hypercaloric diets across development. We review research on the effects of hypercaloric dietary manipulations across the lifespan on emotion regulation and the neurobiological mechanisms that underpin these processes. Cumulatively, the findings reveal that gestation and the juvenile/adolescent developmental periods may be early-life windows of vulnerability for developing anxiety in later life due to the augmented effects of these diets on neuroendocrine stress systems and the maturation of neural circuitry supporting emotion regulation. [ABSTRACT FROM AUTHOR]

Objective: To estimate the percentage of children with low, moderate and high caries risk; and to determine the predictors of caries risk amongst 11-12 year old Pakistani school children. Methods: Subjects' caries risk was assessed using the Cariogram programme. The survey was done among school children in Bhakkar district of Punjab, Pakistan. Caries and plaque level were assessed using the DMFT and Sillnes and Loe indices respectively, while diet content and frequency were assessed using a three-day diet diary. Results: A total of 226 children participated in this study, giving a response rate of 75%. Most subjects (39.8%) were in the low risk category with DMFT score of 0. The overall mean DMFT score was 1.49 (±0.63). Linear and multiple regressions were performed to evaluate the predictability of caries risk. Previous experience of dental caries was found to be the most relevant predictor of caries risk (40%). Conclusion: The levels of caries risk amongst Pakistani 11-12 year old school children were generally low. Past caries experience was the most significant factor in predicting future caries lesion in this sample population. [ABSTRACT FROM AUTHOR]

Background Mitochondrial Trifunctional Protein deficiency (TFPD) is a severe genetic disease characterized by altered energy metabolism and accumulation of long-chain (LC) acylcarnitines in blood and tissues. This accumulation could impair the mitochondrial oxidative phosphorylation (OxPhos), contributing to the non-optimal outcome despite conventional diet therapy with medium-chain triglycerides (MCT). Method Acylcarnitine and OxPhos parameters were measured in TFPD-fibroblasts obtained from 8 children and cultured in medium mimicking fasting (LCFA) or conventional treatment (MCT), with or without Etomoxir (ETX) an inhibitor of carnitine palmitoyltransferase 1 (CPT1) activity, and were compared to results obtained with fibroblasts from 5 healthy-control children. The effects of various acylcarnitines were also tested on control fibroblasts. Results In the LCFA-condition, TFPD-fibroblasts demonstrated a large accumulation of LC-acylcarnitines associated with decreased O 2 -consumption (63 ± 3% of control, P < 0.001) and ATP production (67 ± 5%, P < 0.001) without modification of coupling efficiency. A dose-dependent decrease in O 2 -consumption was reproduced in control fibroblasts by addition of increasing dose of LC-acylcarnitines, while it was almost preserved with MC-acylcarnitines. The MCT-condition reduced LC-acylcarnitine accumulation and partially improved O 2 -consumption (80 ± 3%, P < 0.01) in TFPD-fibroblasts. The addition of ETX in both LCFA- and MCT-conditions normalized acylcarnitine profiles and restored O 2 -consumption and ATP production at the same levels than control. Conclusion Accumulation of LC-acylcarnitines plays a major role in the pathophysiology of TFPD, reducing OxPhos capacities. These deleterious effects could be partially prevented by MCT-therapy and totally corrected by ETX. Inhibition of CPT1 may be view as a new therapeutic target for patients with a severe form of TFPD. [ABSTRACT FROM AUTHOR]

The outcome for patients attempting dietary therapy for epilepsy a second time is unknown. Twenty-six subjects treated with the ketogenic diet as children who then began either the ketogenic diet or a Modified Atkins Diet (MAD) at least 6 months later were evaluated. The mean age at the first diet trial was 5.6 years and at the second diet trial was 11.5 years. Most restarted dietary therapy because of persistent seizures (65%) or recurrence after seizure freedom (19%). Overall, 77% had a ≥50% seizure reduction with the first diet, and 50% with the second diet, P = .04. Individual subject responses were largely similar, with 14 (54%) having identical seizure reduction both times, 9 worse (35%) with the second attempt, and 3 (16%) improved. The second diet trial was more likely to lead to >50% seizure reduction if the first trial was started at a later age (7.4 vs 3.9 years, P = .04). [ABSTRACT FROM AUTHOR]

Copyright of Acta Pediátrica Española is the property of Ediciones Mayo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent psychiatric conditions in childhood. Dietary changes have been suggested as a way of reducing ADHD symptoms. Aims: To provide an overview of the evidence available on dietary interventions in children with ADHD, a systematic review was carried out of all dietary intervention studies in children with ADHD. Methods: Relevant databases were searched in October 2011, with an update search in March 2013. The studies included describe diet interventions in children with ADHD or equivalent diagnoses measuring possible changes in core ADHD symptoms: inattention, hyperactivity and impulsivity. Results: A total of 52 studies were identified, some investigating whether ADHD symptoms can improve by avoiding certain food elements (20 studies), and some whether certain food elements may reduce ADHD symptoms (32 studies). Conclusion: Elimination diets and fish oil supplementation seem to be the most promising dietary interventions for a reduction in ADHD symptoms in children. However, the studies on both treatments have shortcomings, and more thorough investigations will be necessary to decide whether they are recommendable as part of ADHD treatment. [ABSTRACT FROM AUTHOR]

Objective: Analyzing the characteristics of the diet in Argentinian children aged 2 to 5, who received alimentary interventions at home during 2005. Methods: We analyzed the National Survey of Nutrition and Health (ENNyS). The ENNys had a probabilistic sampling, stratified by conglomerates. n = 7046. The Propensity Score Matching (PMS) methodology was used to constitute comparable groups of children who received and did not receive alimentary interventions at home. We analyzed the consumption of macro and micronutrients, energy, energy ratio assigned to each meal time and food groups. Results and Conclusions: We observed a lower consumption of energy and calcium and a higher proportion of energy from cereals in children that received alimentary intervention at home. This would show that children that receive alimentary programs do not present a better quality of their diets. [ABSTRACT FROM AUTHOR]

BACKGROUND/OBJECTIVES: Glycogen storage disease type I (GSD I) is an autosomal recessive metabolic disorder caused by defects in the glucose-6-phosphatase complex. Deficient activity in the glucose-6-phosphatase-α catalytic unit characterizes GSD Ia and defects in the glucose-6-phosphate transporter protein characterize GSD Ib. Type Ia involves the liver, kidney and intestine (and Ib also leukocytes), and the clinical manifestations are hepatomegaly, failure to thrive, severe fasting hypoglycemia within 3-4 h after a meal, hyperlactatemia, hyperuricemia and hyperlipidemia. The aim of the present study was to examine the safety and efficacy of a continuous subcutaneous glucose monitoring system to determine the magnitude and significance of hypoglycemia in GSD I and to evaluate the efficacy of the revised dietary treatment. SUBJECTS/METHODS: Sixteen children with GSD I were studied over a 72-h period. Continuous glucose monitoring (CGM) was repeated in all patients 3–6 months after the first monitoring to examine the effects of revised dietary instructions on glycemic control. RESULTS: All the patients completed the study without any major adverse events. Significant periods of asymptomatic hypoglycemia (below 4 mmol/l, 70 mg/dl) were noted. There was a close correlation between CGM sensor and capillary blood glucose values measured by a glucometer. CGM indicated a considerable reduction in duration of hypoglycemia, liver size and improvements in secondary metabolic derangements such as hyperlacticacidemia and hyperlipidemia. CONCLUSIONS: CGM could be applied in the clinical setting to help the physician to identify hypoglycemic events, and repeated CGM may serve as a safe and useful tool for the assessment of the long-term management of patients with GSD I. [ABSTRACT FROM AUTHOR]

Background: Current WHO guidelines on the management and treatment of diarrhea in children strongly recommend continued feeding alongside the administration of oral rehydration solution and zinc therapy, but there remains some debate regarding the optimal diet or dietary ingredients for feeding children with diarrhea. Methods: We conducted a systematic search for all published randomized controlled trials evaluating food-based interventions among children under five years old with diarrhea in low- and middle-income countries. We classified 29 eligible studies into one or more comparisons: reduced versus regular lactose liquid feeds, lactose-free versus lactose-containing liquid feeds, lactose-free liquid feeds versus lactose-containing mixed diets, and commercial/ specialized ingredients versus home-available ingredients. We used all available outcome data to conduct randomeffects meta-analyses to estimate the average effect of each intervention on diarrhea duration, stool output, weight gain and treatment failure risk for studies on acute and persistent diarrhea separately. Results: Evidence of low-to-moderate quality suggests that among children with acute diarrhea, diluting or fermenting lactose-containing liquid feeds does not affect any outcome when compared with an ordinary lactosecontaining liquid feeds. In contrast, moderate quality evidence suggests that lactose-free liquid feeds reduce duration and the risk of treatment failure compared to lactose-containing liquid feeds in acute diarrhea. Only limited evidence of low quality was available to assess either of these two approaches in persistent diarrhea, or to assess lactose-free liquid feeds compared to lactose-containing mixed diets in either acute or persistent diarrhea. For commercially prepared or specialized ingredients compared to home-available ingredients, we found low-tomoderate quality evidence of no effect on any outcome in either acute or persistent diarrhea, though when we restricted these analyses to studies where both intervention and control diets were lactose-free, weight gain in children with acute diarrhea was shown to be greater among those fed with a home-available diet. Conclusions: Among children in low- and middle-income countries, where the dual burden of diarrhea and malnutrition is greatest and where access to proprietary formulas and specialized ingredients is limited, the use of locally available age-appropriate foods should be promoted for the majority of acute diarrhea cases. Lactose intolerance is an important complication in some cases, but even among those children for whom lactose avoidance may be necessary, nutritionally complete diets comprised of locally available ingredients can be used at least as effectively as commercial preparations or specialized ingredients. These same conclusions may also apply to the dietary management of children with persistent diarrhea, but the evidence remains limited. [ABSTRACT FROM AUTHOR]

In Chile childhood obesity is a growing public health problem. Intervention programs within schools have shown variable results, with better impacts when multiple aspects are involved and included the entire educational community. The objective of the study was to evaluate the effect on the nutritional status of children in intervention schools within 2 years of duration (Healthy Living Program). The sample included 2,527 students first through fourth grade of 3 counties of Santiago. The students were intervened and followed for a period of two years in their food and nutrition habits, physical activity and self-care practices, by a team of nutritionists and physical education teachers. Weight and height were measured at start of program, end of the first and second years of intervention, under standardized conditions and calculated the Z score of BMI and nutritional status according to the WHO reference 2007. At the end of the second year 1,453 children were reassessed. There was a significant decrease in BMI Z score in obese children (-0.3 SD) and obesity decreased from 21.8% to 18.4% at the end of the intervention. 75% of schoolchildren obese and 60.5% overweight decreased their BMI Z score, reduction that was greater in men and students in the upper grades. 51.9% of normal weight children increased their BMI Z-score age, although most less than 0.5 SD. The intervention in education, nutrition and physical activity among schoolchildren in three communes of Greater Santiago was effective in reducing the prevalence of obesity (-3.4 percentage points). The big challenge is to find mechanisms to give continuity to the program and evaluate long-term effects. [ABSTRACT FROM AUTHOR]

Abstract: Objective: This article clarifies the choices made by the HUS concerning the ways of preparing food reserved to neutropenic children hospitalized in pediatric oncology service. We will describe the results of microbiological analysis of food realized from 2002 to 2007. Methods: A specific team prepares this food which is canned and treated by “appertisation” (autoclaving). Each dish portion produced is provided to the service only if the microbiological results are conform, that is to say free of organisms. Results: Three thousand and seventy-eight dishes were analysed: 82.9% of the analysed packs were conform. The contamination ratio decreased significantly (P <0.001) from 2002 to 2007. The organisms which cause the majority of dishes contamination are Bacillus (44.7%) and environmental mould exhibiting sterile mycelium (8.7%). The food which is the most frequently “nonconform” is the dry food with a contamination rate of 37.9%. The identified concentrations remain mainly lower than 50 colony-forming units per millilitre (CFU/mL): 66.2% for the bacteria and 97.2% for the fungi. Conclusion: Considering the lack of consensus on the acceptable microbiological thresholds and on the food protection level, the HUS make it a rule to have a maximal precautionary principle. Currently, this principle appears to us to be a safety option required for the patients hospitalized in pediatric oncology service. [Copyright &y& Elsevier]

Aim: Given the importance of food presentation and childhood nutrition, we aimed to test the degree to which adults and children might demonstrate different preferences for various ways in which food can be presented on plates. Methods: Twenty-three pre-teen children and 46 adults were individually presented full-size photos of 48 different combinations of food on plates. The photos varied according to seven dimensions (e.g. number of items, placement of entrée and organization of the food). Results: Contrary to the default assumption that parents and children share preferences for the ways in which food is presented on plates, we find that children have notably different preferences than adults. Most remarkably, we show that children tended to prefer seven different items and six different colours on their ideal plates, while adults tended to prefer three different colours and three different items. Conclusion: The assumption that children prefer food presentations that match adult preferences appears to be unjustified. Future research and interventions that are designed to improve childhood nutrition should test for the impact of diverse presentations on actual food consumption among a variety of populations across institutional settings. [ABSTRACT FROM AUTHOR]

Summary Background Orofacial granulomatosis is a rare chronic granulomatous inflammatory disease of the lips, face and mouth. The aetiology remains unclear but may involve an allergic component. Improvements have been reported with cinnamon- and benzoate-free diets. Aims To explore the prevalence of compound and food sensitivity and examine the dietary treatments used in orofacial granulomatosis. Methods A comprehensive literature search was carried out and relevant studies from January 1933 to January 2010 were identified using the electronic database search engines; AGRIS 1991-2008, AMED 1985-2008, British Nursing and Index archive 1985-2008, EMBASE 1980-2008, evidence based medicine review databases (e.g. Cochrane DSR), International Pharmaceutical and Medline 1950-2008. Results Common sensitivities identified, predominantly through patch testing, were to benzoic acid (36%) food additives (33%), perfumes and flavourings (28%), cinnamaldehyde (27%), cinnamon (17%), benzoates (17%) and chocolate (11%). The cinnamon- and benzoate-free diet has been shown to provide benefit in 54-78% of patients with 23% requiring no adjunctive therapies. A negative or positive patch test result to cinnamaldehyde, and benzoates did not predict dietary outcome. The most concentrated source of benzoate exposure is from food preservatives. Use of liquid enteral formulas can offer a further dietary therapy, particularly in children with orofacial granulomatosis. Conclusion Management of orofacial granulomatosis is challenging but cinnamon- and benzoate-free diets appear to have a definite role to play. [ABSTRACT FROM AUTHOR]

Background/Objectives:Undernutrition and chronic suppurative otitis media (CSOM) in children are common in low resource settings, but there are few studies of their interactions. The aim is to evaluate nutritional factors associated with CSOM in Yemeni children.Subjects/Methods:A case-control study of 75 children with CSOM and 74 healthy controls. Assessment included dietary history, anthropometry, haemoglobin (Hb) and serum analytes zinc (Zn), copper (Cu), selenium (Se), iron, calcium, phosphate (PO4) and total 25-hydroxy vitamin D (25(OH)D).Results:Cases had lower mean Z-scores for weight-for-age, weight-for-height, body mass index and mid-upper arm circumference (MUAC) (all P<0.05), and lower mean concentrations of serum Zn (P=0.032), Se (P<0.001) and calcium adjusted for albumin (P=0.026). Age-adjusted Hb and iron biomarkers did not differ between cases and controls. There was high prevalence of low serum Zn concentration (90%) and vitamin D deficiency in both cases (80%) and controls (96%). Duration of ear discharge was negatively correlated with total 25(OH)D (P=0.028), calcium adjusted for albumin (P<0.001), PO4 (P=0.002), transferrin receptor/log ferritin ratio (P<0.001) and Cu (P<0.001), and positively correlated with child age and MUAC (both P<0.001).Conclusions:Children with CSOM were more undernourished than controls with lower mean serum Zn, Se and calcium concentrations. Vitamin D-deficient and iron-replete children had longer duration of infection, although this association was lost with age adjustment. Trials evaluating specific micronutrients are required in order to investigate specific nutrient-infection interactions in CSOM. [ABSTRACT FROM AUTHOR]