Dietary elimination of children with food protein induced gastrointestinal allergy – micronutrient adequacy with and without a hypoallergenic formula?

Background: The cornerstone for management of Food protein-induced gastrointestinal allergy (FPGIA) is dietary exclusion; however the micronutrient intake of this population has been poorly studied. We set out to determine the dietary intake of children on an elimination diet for this food allergy and hypothesised that the type of elimination diet and the presence of a hypoallergenic formula (HF) significantly impacts on micronutrient intake. Method: A prospective observational study was conducted on children diagnosed with FPIGA on an exclusion diet who completed a 3 day semi-quantitative food diary 4 weeks after commencing the diet. Nutritional intake where HF was used was compared to those without HF, with or without a vitamin and mineral supplement (VMS). Results: One-hundred-and-five food diaries were included in the data analysis: 70 boys (66.7%) with median age of 21.8 months [IQR: 10 - 67.7]. Fifty-three children (50.5%) consumed a HF and the volume of consumption was correlated to micronutrient intake. Significantly (p <0.05) more children reached their micronutrient requirements if a HF was consumed. In those without a HF, some continued not to achieve requirements in particular for vitamin D and zinc, in spite of VMS. Conclusion: This study points towards the important micronutrient contribution of a HF in children with FPIGA. Children, who are not on a HF and without a VMS, are at increased risk of low intakes in particular vitamin D and zinc. Further studies need to be performed, to assess whether dietary intake translates into actual biological deficiencies

Family history of chronic renal failure is associated with malnutrition in Korean hemodialysis patients

The present study was to investigate the nutritional status and factors related to malnutrition in end-stage renal disease (ESRD) patients requiring hemodialysis (HD) in South Korea. Subjects were ESRD outpatients from general hospitals or HD centers in Seoul referred to the dialysis clinic for maintenance HD care. A total of 110 patients (46 men and 64 women; mean ages 58.6 ± 1.0 y) were eligible for this study. The family history of chronic renal failure (CRF) was considered positive if a patient reported having either a first-degree or second-degree relative with CRF. Malnutrition was defined as a triceps skinfold thickness or mid-arm muscle circumference below the fifth percentile for age and sex and forty-seven of the 110 patients were malnourished. Almost all (94%) patients had anemia (hemoglobin: <13 g/dL for men and <12 g/dL for women). Energy intake was below the recommended intake levels of energy [30-35 kcal/kg ideal body weight (IBW)] and protein (1.2 g/kg IBW) in 60% of patients. The duration of HD was longer in malnourished HD patients (P=0.0095). Malnutrition was more prevalent in women (P=0.0014), those who never smoked (P=0.0007), nondiabetic patients (P=0.0113), and patients with bone diseases (P=0.0427), adequate HD (spKt/V≥1.2) (P=0.0178), and those with a family history of CRF (P=0.0255). Multiple logistic regression was used to examine the relationship between malnutrition and potential risk factors. After adjusting for age, sex, and other putative risk factors for malnutrition, the OR for malnutrition was greater in HD patients with a family history of CRF (OR, 3.290; 95% CI, 1.003-10.793). Active nutrition monitoring is needed to improve the nutritional status of HD patients. A family history of CRF may be an independent risk factor for malnutrition in Korean HD patients. A follow-up study is needed to investigate whether there is a causal relationship between a family history of CRF and malnutrition in Korean ESRD patients

Analysis of dietary fibre of boiled and canned legumes commonly consumed in the United Kingdom

The use of different analytical methods to measure the dietary fibre content of foods complicates the interpretation of epidemiological studies. The aim of this study was to determine the total (TDF) and insoluble (IDF) fibre content of 14 boiled and canned legumes commonly consumed in the UK using the Association of Official Analytical Chemists (AOAC) enzymatic gravimetric method. The fibre values obtained were compared to non-starch polysaccharide (NSP) values. The results showed that mean values for TDF (2.7–11.2 g/100 g) were higher than NSP (2.6–6.7 g/100 g), with a mean NSP:TDF ratio of 1:1.43. TDF was correlated with NSP (r = 0.6; p = 0.02). Canning significantly reduced TDF and IDF by an average of 30% and 26% compared to boiling respectively. However, IDF represented at least 60% of the TDF in both boiled and canned samples. In conclusion, fibre values are affected by the processing and analytical method used

A qualitative study of a food intervention in a primary school: Pupils as agents of change.

This study explored the impact of a school-based kitchen project at a large inner London school. Timetabled kitchen classroom sessions (90 min every fortnight) were held with all 7-9 year old pupils. Semi-structured focus group discussions (with 76 pupils, 16 parents) and interviews (with headteachers, catering managers and specialist staff) were conducted at the intervention school and a matched control school. Categories and concepts were derived using a grounded theory approach. Data analysis provided three main categories each with their related concepts: Pupil factors (enthusiasm and enjoyment of cooking, trying new foods, food knowledge and awareness, producing something tangible); School factors (learning and curriculum links, resource implications and external pressures) and Home factors (take home effects, confidence in cooking and self-esteem, parents' difficulties cooking at home with children). Children's engagement and the opportunity to cook supported increased food awareness, skills and food confidence. In the grounded theory that emerged, take home effects beyond the school gate dominate, as children act as agents of change and influence cooking and food choice at home. These short term outcomes have the potential to lead to longer term outcomes including changing eating behaviour and diet

Modelling the impact of compliance with dietary recommendations on cancer and cardiovascular disease mortality in Canada

Abstract: Objectives: Despite strong evidence indicating that unbalanced diets relate to chronic diseases and mortality, most adults do not comply with dietary recommendations. To help determine which recommendations could yield the most benefits, we estimated the number of deaths attributable to cardiovascular diseases and cancer that could be delayed or averted in Canada if adults changed their diet to adhere to recommendations. Study Design: Macrosimulation based on national population-based survey and vital statistics data. Methods: We used a macrosimulation model to draw age- and sex-specific changes in relative risks based on the results of meta-analyses of relationship between food components and risk of cardiovascular disease and diet-related cancers. Inputs in the model included Canadian recommendations (fruit and vegetable, fiber, salt, and total-, monounsaturated-, polyunsaturated-, saturated-, and trans-fats), average dietary intake (from 35 107 participants with 24-h recall), and mortality from specific causes (from Canadian Vital Statistics). Monte Carlo analyses were used to compute 95% credible intervals (CI). Results: Our estimates suggest that 30 540 deaths (95% CI: 24 953, 34 989) per year could be averted or delayed if Canadians adhered to their dietary recommendations. By itself, the recommendation for fruit and vegetable intake could save as many as 72% (55-87%) of these deaths. It is followed by recommendations for fibers (29%, 13-43%) and salt (10%, 9-12%). Conclusions: A considerable number of lives could be saved if Canadians adhered to the national dietary intake recommendations. Given the scarce resources available to promote guideline adhesion, priority should be given to recommendations for fruit and vegetable intake

Beverage patterns and trends among school-aged children in the US, 1989-2008

<p>Abstract</p> <p>Background</p> <p>High intake of sugar-sweetened beverages in childhood is linked to increased risk of obesity and type II diabetes later in life. Using three nationally representative surveys of dietary intake, we investigated beverage patterns and trends among US school-aged children from 1989/91 to 2007/08.</p> <p>Methods</p> <p>3, 583 participants ages 6-11 y old were included. We reported per capita trends in beverage consumption, percent consuming, and amount per consumer for the following categories of beverages: sugar-sweetened beverages (SSB), caloric nutritional beverages (CNB) and low calorie beverages (LCB). Statistically significant differences were tested using the Student's t test in Stata 11.</p> <p>Results</p> <p>While per capita kcal contribution from total beverages remained constant over the study period, per capita consumption of SSBs increased and CNBs decreased in similar magnitude. The substantial increase in consumption of certain SSBs, such as fruit drinks and soda, high fat high sugar milk, and sports drinks, coupled with the decrease in consumption of high fat low sugar milk was responsible for this shift. The percent consuming SSBs as well as the amount per consumer increased significantly over time. Per capita intake of total milk declined, but the caloric contribution from high fat high sugar milk increased substantially. Among ethnicities, important differences in consumption trends of certain SSBs and 100% juice indicate the complexity in determining strategies for children's beverage calorie reduction.</p> <p>Conclusions</p> <p>As upward trends of SSB consumption parallel increases in childhood obesity, educational and policy interventions should be considered.</p