Caustic Ingestion in Children

Caustic ingestion (CI) is an unfortunate event that occurs in families with a poor prevention culture. Its prevalence is unknown in developing countries; it occurs mainly in children < 5 years and is more common in boys. The chemical caustic agents are alkaline (85%) or acid products stored in food or beverage containers without warning labels and safety caps. The immediate symptoms include salivation, oropharyngeal burns, vomiting and oropharyngeal/retrosternal pain. Upper endoscopy is the first‐line tool to identify the type and extension of oesophageal and gastric damage. A barium swallow performed 2–3 weeks after the CI may identify oesophageal stricture. Dysphagia occurs in about one‐third of cases. Regarding the nutritional status, children with dysphagia and/or oesophageal strictures may have lower fat reserves or muscle mass than the cases without these complications, meaning impaired nutritional status. All patients should be hospitalized for evaluation and treatment. Hemodynamic stabilization and adequacy of the patient’s airway are priorities; vomiting induction and gastric lavage are contraindicated. Methylprednisolone in II-b oesophageal burns for 3 days diminishes the risk of stricture. Selected cases will require oesophageal dilatations, gastrostomy or oesophageal replacement by colon or stomach. There are other promising agents in the management of caustic oesophageal strictures

Relationship between Sucralose Consumption and Seru m Concentration of Glycosylated Hemoglobin in People with Type 2 Di abetes Mellitus without Complications

People who live with diabetes consume sucralose to control their blood glucose, but there is a controversy about this topic. To evaluate the relationship between sucralose consumption and serum concentration of glycosylated hemoglobin in people with Type 2 Diabetes Mellitus without complications. Cross-sectional study. Universe of 27 214 people with Type 2 Diabetes Mellitus without complications, users of a primary care unit from the Instituto Mexicano del Seguro Social in the state of Jalisco, Mexico. Simple probabilistic sample, n = 194 (p = 0,05). Propositive sampling. Selection criteria: adults of any gender and education level who agreed to participate. Variables: sociodemographic, anthropometric, clinical and dietary. Data collection instruments: Sociodemographic questionnaire, Tanita Fitscan© 585 scale, Tanita Fitscan© HR-200 stadiometer, Body Flex© tape-measure, Slim Guide© plicometer, Afinion© AS100 analyzer, and Frequency of Food Consumption Questionnaire. Information sources: clinical files and Mexican System of Equivalent Foods. Analysis: descriptive and inferential statistics (p ≤ 0,05). 194 people. Mean age 60,23 ± 11,16, interval 28-93 years. 56,2% females and 43,8% males. Difference between glycosilated hemoglobin means: sucralose consumers 7,5% ± 1,7%, no sucralose consumers 8,1% ± 2,1% (p < 0,01). Association force “sucralose consumption/high glycosilated hemoglobin concentration” OR = 1,42 (CI95% 0,63, 3,21). Lineal correlation “quarterly sucralose consumption/serum concentration of glycosylated hemoglobin” ρ = -0,754 (R2 = 0,0057, p = 0,333). This results were partially consistent to the pre-existing literature. Studies with representative stratified samples and control of dietary variables are required for better results

Influence of breastfeeding factors on polyamine content in human milk

The polyamine content of human breast milk, which is the first exogenous source of polyamines for the newborn, can be affected by several factors associated with the mother, the infant, or breastfeeding itself. The aim of this study was to evaluate the influence of different breastfeeding factors on the polyamines found in human milk. For this study, a cohort of 83 mothers was considered for up to 4 months, and a subgroup of 33 mothers were followed during the first six months of breastfeeding. Two breast milk samples were collected at each sampling point (foremilk and hindmilk) and the polyamine content was determined by UHPLC-FL. Polyamine levels varied considerably between the mothers and tended to decrease over time. Putrescine was the minor polyamine, whereas spermidine and spermine contents were very similar. The concentrations of the three polyamines were significantly higher in hindmilk than foremilk (p < 0.001). Spermidine and spermine levels decreased significantly through the lactation progress (p < 0.05). Finally, slightly higher levels of polyamines were observed in the milk of mothers providing partial, rather than full, breastfeeding, although the differences were not significant. The polyamine content in human milk was found to change during a single feed (foremilk versus hindmilk) and as lactation progressed, mainly in response to the specific circumstances of the newborn

Influence of the Type of Breastfeeding and Human Milk Polyamines on Infant Anthropometric Parameters

Feeding choices in the early months of life are key determinants of growth during infancy. Polyamines participate in cell proliferation and differentiation, and it has also been suggested that polyamine metabolism plays a role in adipogenesis. As the main exogenous source of polyamines in the infant is human milk, the aim of this work was to study if the type of breastfeeding received and the polyamine intake from human milk has an influence on infant anthropometric parameters. A cohort of 78 full-term healthy newborns was followed up until 4 months of age; 55 were fully and 23 partially breastfed. Anthropometric measurements were taken at 2 and 4 months, when human milk samples were also collected for analysis of polyamine content by UHPLC-FL. Fully breastfed infants had a better anthropometric profile than those partially breastfed (p < 0.05). Furthermore, polyamine intake in partially breastfed infants was significantly lower compared to those fully breastfed. However, only two of the 15 anthropometric indicators evaluated (triceps skinfold and mean upper arm circumference) showed a significant inverse association with polyamine content in human milk and intake (p < 0.05). Infant growth and body composition differ according to the type of breastfeeding received. Based on the weak associations between polyamines and anthropometric indicators, it is not possible to conclude the influence of polyamines in infant growth and body composition

The Importance of Lactose in the Human Diet:Outcomes of a Mexican Consensus Meeting

Lactose is a unique component of breast milk, many infant formulas and dairy products, and is widely used in pharmaceutical products. In spite of that, its role in human nutrition or lactose intolerance is generally not well-understood. For that reason, a 2-day-long lactose consensus meeting with health care professionals was organized in Mexico to come to a set of statements for which consensus could be gathered. Topics ranging from lactase expression to potential health benefits of lactose were introduced by experts, and that was followed by a discussion on concept statements. Interestingly, lactose does not seem to induce a neurological reward response when consumed. Although lactose digestion is optimal, it supplies galactose for liver glycogen synthesis. In infants, it cannot be ignored that lactose-derived galactose is needed for the synthesis of glycosylated macromolecules. At least beyond infancy, the low glycemic index of lactose might be metabolically beneficial. When lactase expression decreases, lactose maldigestion may lead to lactose intolerance symptoms. In infancy, the temporary replacing of lactose by other carbohydrates is only justified in case of severe intolerance symptoms. In those who show an (epi)genetic decrease or absence of lactase expression, a certain amount (for adults mostly up to 12 g per portion) of lactose can still be consumed. In these cases, lactose shows beneficial intestinal-microbiota-shaping effects. Avoiding lactose-containing products may imply a lower intake of other important nutrients, such as calcium and vitamin B-12 from dairy products, as well as an increased intake of less beneficial carbohydrates

Crecimiento acelerado en escolares obesos frente a escolares con peso saludable

La asociación entre crecimiento y obesidad ha sido poco estudiada en la población de escolares obesos mexicanos. El objetivo de este estudio fue comparar la talla para la edad entre escolares obesos y con peso saludable. Métodos: Estudio transversal realizado en 369 escolares con peso saludable y 162 obesos en una escuela primaria; 49.4 era de sexo femenino. Se utilizó la clasificación percentilar del índice de masa corporal: peso saludable: del percentil 5 al 84, obesidad: valor > percentil 95; se agruparon por sexo e intervalos de clase de un año. El análisis estadístico se hizo con U de Mann-Whitney. Resultados: En las niñas obesas la talla fue mayor a la del grupo con peso saludable en todos los intervalos de clase sin que se identificara una tendencia de incremento o decremento en relación con la edad. En los niños no se observaron diferencias de talla en los 6 y 7 años; sin embargo, de los 8 a los 11 años la talla se incrementó en forma progresiva en los obesos, con diferencia máxima de 8.8 cm a los 10 años. Conclusión: La asociación de obesidad con periodos de crecimiento acelerado sugiere la existencia de variantes fenotípicas relacionadas con factores metabólicos y hormonales. Se identificaron valores de talla que fueron significativamente mayores en los niños con obesidad al ser comparados con sus pares con peso saludable

Modelo de predicción de obesidad en niños a partir de variables dietéticas y actividad física

Si la obesidad es el resultado de variables que involucran al sujeto y a su entorno, las alternativas para abordar el problema pueden ser diversas. El objetivo fue mostrar el mejor modelo de predicción de obesidad en escolares a partir de la ingesta de energía, hábitos de alimentación y actividad física. Métodos: Estudio de casos y controles en 99 escolares obesos y 100 con peso saludable (criterio del Centro de Control de Enfermedades). La ingestión de energía se estimó por medio de dos recordatorios de 24 horas; los hábitos de alimentación y de actividad física, con instrumentos validados. El análisis se hizo con regresión logística. Resultados: Las variables asociadas a obesidad en forma independiente fueron mayor ingestión de energía; menor frecuencia en los tiempos de comida; colación vespertina fuera del hogar; mayor frecuencia de consumo de grasas, productos chatarra y bebidas endulzadas; menor tiempo de actividad física moderada en la escuela y en su casa, mayor tiempo en la realización de la tarea escolar y frente al televisor. Las variables incluidas en el modelo de regresión logística fueron: ingestión de energía, frecuencia de consumo de productos chatarra y bebidas endulzadas, y tiempo de actividad física moderada en la escuela y en casa. Conclusión: La diversidad de variables asociadas identificadas muestra la complejidad y el carácter multifactorial de la obesida

Modelo de predicción de obesidad en niños a partir de variables dietéticas y actividad física

Si la obesidad es el resultado de variables que involucran al sujeto y a su entorno, las alternativas para abordar el problema pueden ser diversas. El objetivo fue mostrar el mejor modelo de predicción de obesidad en escolares a partir de la ingesta de energía, hábitos de alimentación y actividad física. Métodos: Estudio de casos y controles en 99 escolares obesos y 100 con peso saludable (criterio del Centro de Control de Enfermedades). La ingestión de energía se estimó por medio de dos recordatorios de 24 horas; los hábitos de alimentación y de actividad física, con instrumentos validados. El análisis se hizo con regresión logística. Resultados: Las variables asociadas a obesidad en forma independiente fueron mayor ingestión de energía; menor frecuencia en los tiempos de comida; colación vespertina fuera del hogar; mayor frecuencia de consumo de grasas, productos chatarra y bebidas endulzadas; menor tiempo de actividad física moderada en la escuela y en su casa, mayor tiempo en la realización de la tarea escolar y frente al televisor. Las variables incluidas en el modelo de regresión logística fueron: ingestión de energía, frecuencia de consumo de productos chatarra y bebidas endulzadas, y tiempo de actividad física moderada en la escuela y en casa. Conclusión: La diversidad de variables asociadas identificadas muestra la complejidad y el carácter multifactorial de la obesida