The performance of parents of children receiving cow's milk free diets at identification of commercial food products with and without cows's milk

OBJECTIVE: To investigate how well the parents of children on cow's milk free diets perform at recognizing whether or not expressions describe and foods contain cow's milk proteins. METHODS: Interviews were conducted with 24 parents of children on cow's milk and by-products exclusion diets and 23 parents of children with no need for any type of exclusion diet. They were asked if they recognized 12 expressions relating to cow's milk. They were then asked to classify 10 commercial food products in terms of whether or not they contained cow's milk proteins. RESULTS: Terms that included the word milk were more often recognized by both groups of parents. The parents of children on exclusion diets recognized the terms cow's milk protein, traces of milk and milk formulation or preparation most frequently (p < 0.05). Less than 25.0% of those interviewed recognized casein, caseinate, lactalbumin and lactoglobulin. Both groups correctly identified more of the commercial products containing cow's milk than those free from milk. The median number of products containing cow's milk (total = 5) correctly identified by the parents of children on exclusion diets (4.0) was greater than for the control group (3.0; p = 0.005). Reading at least one label was associated with a greater chance of correctly identifying more than five of the 10 products (odds ratio = 8.0). CONCLUSIONS: Despite having received guidance, the parents of children on exclusion diets were not fully prepared to manage these diets, indicating a need for improvements to the instruction provided when indicating exclusion diets.OBJETIVO: Investigar o desempenho de pais de crianças em dieta isenta da proteína do leite de vaca no reconhecimento de expressões e alimentos que contenham ou não proteínas do leite de vaca. MÉTODOS: Foram entrevistados 24 pais de crianças em dieta de exclusão do leite de vaca e derivados e 23 sem necessidade de nenhum tipo de dieta de exclusão. Foi questionado se reconheciam 12 expressões relacionadas ao leite de vaca. A seguir, foi solicitado que classificassem 10 produtos industrializados quanto ao conteúdo ou não de proteínas do leite de vaca. RESULTADOS:Termos iniciados com a palavra leite foram os mais reconhecidos pelos dois grupos. Os responsáveis por crianças em dieta de exclusão reconheceram mais freqüentemente as palavras proteína do leite de vaca, traços do leite e formulação ou preparação láctea (p < 0,05). Caseína, caseinato, lactoalbumina e lactoglobulina foram reconhecidas por menos de 25,0% dos entrevistados. O número de identificação correta dos 10 produtos industrializados foi maior para os produtos com leite de vaca nos dois grupos. A mediana de acertos dos produtos com leite de vaca (n = 5) pelos pais em dieta de exclusão (4,0) foi maior que a do grupo controle (3,0; p = 0,005). Leitura de pelo menos um rótulo associou-se com maior chance de identificação correta de mais de cinco dos 10 produtos (razão de chance = 8,0). CONCLUSÃO:Apesar de orientados, os pais de crianças em dieta de exclusão não estão plenamente preparados para sua correta realização, indicando a necessidade de aprimoramento das orientações para essa dieta de exclusão.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Programa de Pós-graduaçãoUNIFESP-EPMUNIFESP, EPM, Programa de Pós-graduaçãoUNIFESP, EPMSciEL

Efecto de una suplementación láctea con ácido linoleico conjugado sobre el control de peso y la composición corporal de personas sanas con sobrepeso

Introduction: Conjugated linoleic acids (CLAs) have shown beneficial effects in weight control therapy however this relation is not clear. Objetive: The aim of the study was to examine the effects and safety of 3 g of a 1:1 mix of c9-t11 and t10-c12 on weight control and body composition in healthy overweight individuals. Methods: A prospective, placebo-controlled, randomised double-blind, parallel clinical trial lasting 24 weeks was carried out in 38 volunteers (29w, 9m) aged 30-55 years and BMI ≥27-<30 kg/m2 who consumed 200 ml/day of skimmed milk with 3g of CLAs or 3g olive oil (placebo). Anthropometric, biochemical and dual x-ray absorptiometry (DXA) tests were measured. Diet and physical activity were assessed. Results: Subjects maintained their habitual dietary and exercise patterns over the study. Only CLA group showed a significant decrease in weight (74.43 ± 10.45 vs 73.54 ± 11.66 kg, p = 0.029) and waist circumference (91.45 ± 10.33 vs 90.65 ± 9.84 cm, p = 0.012) between baseline and end of the study. BMI and waist height ratio decreased (28.44 ± 1.08 vs 27.81 ± 1.43 kg/m2, p = 0.030 and 0.57 ± 0.05 vs 0.56 ± 0.04 p = 0.013 respectively) in CLA group at the end. CLA group experienced a reduction in total fat mass after 24 weeks (38.62 ± 5.02 vs 36.65 ± 5.64%, p = 0.035). No decrease was observed in Control group. HOMA index had no changes. Conclusions: The consumption of skimmed milk enriched with 3g of a 1:1 mixture of c9-t11 and t10-c12 for 24 weeks led to a decrease in body weight and total fat mass in healthy, overweight subjects who maintained habitual diets and exercise patterns. No adverse effects were observed. Registered under ClinicalTrials.gov Identifier No. NCT01503047Introducción: Los ácidos linoleicos conjugados (ALC) han mostrado unos efectos beneficiosos en el tratamiento del control de peso; sin embargo, esta relación no está clara. Objetivo: El propósito de este estudio fue examinar los efectos y la seguridad de 3 g de una mezcla 1:1 de c9-t11 y t10-c12 sobre el control de peso y la composición corporal en individuos sanos con sobrepeso. Métodos: Se realizó un estudio clínico prospectivo, de grupos paralelos, de distribución aleatoria, a doble ciego y con control placebo, de 24 semanas de duración, en 38 voluntarios (29 mujeres, 9 hombres) con edades de 30-55 años y un IMC ≥27- < 30 kg/m2 que consumieron 200 ml/día de leche desnatada con 3 g de ALC o 3 g de aceite de oliva (placebo). Se midieron datos de antropometría, bioquímica y absorciometría dual de rayos X (DXA). Se evaluaron la dieta y la actividad física. Resultados: Los sujetos mantuvieron sus patrones habituales de dieta y ejercicio a lo largo del estudio. Sólo el grupo de ALC mostró una reducción significativa del peso (74,43 ± 10,45 vs 73,54 ± 11,66 kg, p = 0,029) y de la circunferencia de la cintura (91,45 ± 10,33 vs 90,65 ± 9,84 cm, p = 0,012) entre el periodo basal y el final del estudio. El IMC y el cociente cintura/talla disminuyeron (28,44 ± 1,08 vs 27,81 ± 1,43 kg/m2, p = 0,030 y 0,57 ± 0,05 vs 0,56 ± 0,04 p = 0,013, respectivamente) en el grupo ALC al final del estudio. El grupo ALC experimentó una reducción de la masa grasa total tras 24 semanas (38,62 ± 5,02 vs 36,65 ± 5,64 %, p = 0,035). No se observó reducción en el grupo control. El índice HOMA no experimentó cambios. Conclusiones: El consumo de leche desnatada enriquecida con 3 g de una mezcla 1:1 de c9-t11 y t10-c12 durante 24 semanas produjo un descenso del peso corporal y la masa grasa total en sujetos sanos con sobrepeso que mantuvieron sus patrones habituales de dieta y ejercicio físico. No se observaron efectos adversos. Registrado con el identificador núm. NCT01503047 en ClinicalTrials. govThis study was funded by CAPSA (Corporación Alimentaria Peñasanta

Predictor variables for low adherence to a lifestyle modification program of overweight treatment in primary health care

Objetivos: Identificar variables predictoras de baja adherencia a un programa piloto de Modificación de Estilos de Vida (MEV) para el tratamiento del exceso de peso en Atención Primaria (AP). Material y métodos: Se reclutaron 60 sujetos con IMC > 27 kg/m². Profesionales sanitarios dirigieron el programa, en formato grupal y con una periodicidad quincenal, basado en educación nutricional, pautas dietéticas individualizadas, promoción de actividad física y apoyo motivacional. Para identificar las variables relacionadas con la adherencia al programa se utilizó un cuestionario validado sobre Hábitos de Vida de personas con Sobrepeso y Obesidad y se midieron variables antropométricas al inicio y a los seis meses del tratamiento. Una baja adherencia al programa fue considerada cuando los sujetos del estudio acudían a menos del 80% de las visitas quincenales. Resultados: Se adhirieron al programa 27 sujetos (45%). Las variables asociadas a baja adherencia estuvieron relacionadas al inicio del estudio con IMC ≥ 35 kg/m2 (p < 0,05); período de exfumador ≤ 4 meses (p < 0,01); mayor contenido calórico de la dieta (p < 0,01) y menor práctica de ejercicio físico (p < 0,05). A los 6 meses los sujetos que finalizaron el programa presentaron una disminución significativa de: peso (86,0 ± 15,6 vs 79,2 ± 13,4 kg; p < 0,001);% de masa grasa (41,6 ± 4,6 vs 38,8 ± 5,4%; p < 0,001) y glucemia (108 ± 45,48 vs 94,38 ± 11,97 mg/dl; p < 0,01). Además mejoró el perfil calórico de su dieta, disminuyendo sobretodo el porcentaje de grasa sobre el valor calórico total (39,6 ± 4,8 vs. 35,5 ± 5,6%; p < 0,01). Conclusión: Haber dejado de fumar recientemente, padecer obesidad de grado dos o superior, el alto contenido calórico de la dieta y la menor práctica de ejercicio físico fueron las variables basales identificadas como predictoras de una baja adherencia a un programa de MEV para el tratamiento de sobrepeso y obesidad en AP. Esta experiencia piloto una vez evaluada no la consideramos satisfactoria y otras nuevas estrategias están en fase de desarrolloObjectives: To identify predictive variables of low adherence to a pilot Lifestyle Modification Program (LMP) for overweight and obesity treatment in primary health care (PC ). Material and methods: Sixty subjects with BMI > 27 kg/m² were recruited. Health professionals directed the program in a group structure and biweekly, based on nutrition education with individualized dietary guidelines, promotion of physical activity and motivational support. A validated questionnaire on lifestyle habits for overweight and obesity subjects was used to identify variables related with program adherence and anthropometric variables were measured before and 6 months after intervention. Low adherence was considered when patients attended to less than 80% of visits. Results: Twenty-seven subjects (45%) presented high adherence to the program. The variables associated to low adherence were related to baseline with IMC ≥ 35 kg/m2 (p < 0.05); ex smoker period ≤ 4 months (p < 0.01); high caloric diet (p < 0.01) and scarce physical activity (p < 0.05). At 6 months the subjects who finalized the program presented a significant decrease of weight (86.0 ± 15.6 vs 79.2 ± 13.4 kg; p < 0,001); fat mass percentage (41,6 ± 4,6 vs 38.8 ± 5,4%; p < 0.001), blood glucose (108 ± 45.48 vs 94.38 ± 11.97 mg/dl; p < 0.01). It also improved caloric diet profile, above all decreasing the percentage of fat (39.6 ± 4.8 vs 35.5 ± 5.6%; p < 0.01). Conclusion: Have recently left smoking, obesity degree two or higher, a high caloric diet and scarce physical activity were basal variables identified as predictive of a low adhesion to a LMP for the treatment of overweight and obesity in primary health care. We do not consider this pilot experience as satisfactory and other new strategies are under developmentEste proyecto ha sido subvencionado a través del “Subprograma de Proyectos de Investigación de Evaluación de Tecnologías Sanitarias e Investigación en servicios de salud” de la convocatoria 2008 de ayudas de la Acción Estratégica en Salud, en el marco del Plan Nacional de I+D+I 2008-201

Valores de referencia para leptina, cortisol, insulina y glucosa entre los adolescentes europeos y su asociación con adiposidad: Estudio Helena

Background and Objective: Adequate concentrations of leptin, cortisol, and insulin are important for a suitable metabolism and development during adolescence. These hormones jointly with glucose play a major role in fat metabolism and development of childhood obesity. Our main objective was to quantify biomarkers as leptin, cortisol, insulin and glucose status in European adolescents to contribute to establish reference ranges. Methods: A representative sample of 927 adolescents (45% males, 14.9±1.2 years for the overall population) from ten European cities of the HELENA study was used to obtain fasting blood samples for these biomarkers. The percentile distributions were computed by sex and age and percentiles were associated with BMI classification. Results: Serum leptin concentration in adolescents varied significantly according to BMI, sex and age (all p<0.001). Cortisol presented a tendency to increase with age, both for females and males, while insulin and glucose were stable with age. Leptin and insulin were highest in obese adolescents (p<0.001), whilst cortisol and glucose did not vary with BMI. Percentiles 5, 25, 50, 75 and 95, 26.70 and 65.33 ng/ml for leptin; 5.00, 8.11, 11.14, 15.00 and 24.51 μg/dl for cortisol and 3.65, 6.15, 8.52, 11.90 and 20.53 μlU/ml for insulin. Conclusions: In adolescents, leptin, cortisol, insulin and glucose concentrations are differently affected by age, sex and BMI. Establishment of reference ranges (percentiles) of these biomarkers would be of great interest when pediatricians have to assess the trend of an adolescent to develop obesity years after.Objetivo: Concentraciones adecuadas de leptina, cortisol e insulina son importantes para un metabolismo normal durante la adolescencia, puesto que valores alterados de estas hormonas, junto con la glucosa, se asocian con el desarrollo de la obesidad infantil. Nuestro principal objetivo fue cuantificar estos marcadores en adolescentes europeos con el fin de establecer rangos de referencia. Métodos: Muestras de sangre procedentes de 927 adolescentes en ayunas (14,9 ± 1,2 años, 45% varones, estudio HELENA), fueron analizadas para cuantificar la leptina, cortisol, insulina y glucosa. Las distribuciones de percentiles se determinaron teniendo en cuenta el sexo y la edad. También se estudió la asociación entre percentiles y la clasificación del IMC. Resultados: La concentración de leptina en suero variaba significativamente con el IMC, el sexo y la edad (todos p<0,001). El cortisol presentó una tendencia a aumentar con la edad, tanto para varones como mujeres, mientras que la insulina y la glucosa eran estables con la edad. La leptina y la insulina fueron más altas en los adolescentes obesos (p <0,001), mientras que el cortisol y glucosa no variaron con el IMC. Los percentiles 5, 25, 50, 75 y 95, para los valores de hormonas fueron, respectivamente: 1.27, 4.06, 11.54, 26.70 y 65.33 ng/ml para la leptina; 5.00, 8.11, 11.14, 15.00 y 24.51 μg/dl para el cortisol y 3.65, 6.15, 8.52, 11.90 y 20.53 μlU/ml de insulina.The HELENA study has taken place with the financial support of the European Community Sixth RTD Framework Programme (Contract FOODCT- 2005-007034). This study was also supported by a grant from the Spanish Ministry of Science and Innovation AGL2007-29784-E

Gastrointestinal Microbiota and Some Children Diseases: A Review

The bacterial colonization is defined immediately after birth, through direct contact with maternal microbiota and may be influenced during lactation. There is emerging evidence indicating that quantitative and qualitative changes on gut microbiota contribute to alterations in the mucosal activation of immune system leading to intra- or extra-intestinal diseases. A balance between pathogenic and beneficial microbiota throughout childhood and adolescence is important to gastrointestinal health, including protection against pathogens, inhibition of pathogens, nutrient processing (synthesis of vitamin K), stimulation of angiogenesis, and regulation of host fat storage. Probiotics can promote an intentional modulation of intestinal microbiota favoring the health of the host. This paper is a review about modulation of intestinal microbiota on prevention and adjuvant treatment of pediatric gastrointestinal diseases

Evolução da dieta no pós-operatório de cirurgias bariátricas: revisão integrativa da literatura

More and more people are using bariatric surgery for weight loss and improvement of comorbidities associated with overweight, the most common Roux-en-Y gastric bypass technique (Fobi-Capella), this surgical technique is currently considered standard gold. The weight loss of these patients is guaranteed by low food intake due to decreased gastric capacity and also by malabsorption of nutrients. Objective: This study aims to verify the different types of dietary conducts in the OP applied in different places and their aspects more relevant to the behavior of the nutritionist. Methods: Survey of literary articles, search in the Latin American and Caribbean databases on Health Sciences (LILACS), Medline, Ibecs, Sec. Est. Saúde P, Scielo and Google Scholar. Being used for the search of the articles the descriptors bariatric surgery and postoperative diet and their combinations in the Portuguese and English languages. Results: The authors emphasize the need to start the postoperative diet through the liquid diet, in small amounts and progress until reaching the general diet, however, they differ as to the time in days for the evolution of the consistency of the diets. Conclusion: Despite the similarity of the conduct, further studies are needed to establish a standardized protocol on diet after bariatric surgery in order to guide health professionals and to avoid that nutrient and micronutrient deficits continue to occur in these patients.Cada vez mais as pessoas estão recorrendo à cirurgia bariátrica para a perda ponderal e melhora das comorbidades associadas ao excesso de peso, sendo a técnica mais comum bypass gástrico em Y de Roux (Fobi-Capella), esta técnica cirúrgica atualmente é considerada padrão ouro. A perda de peso desses pacientes é garantida pela baixa ingestão alimentar devido à diminuição da capacidade gástrica e também pela má absorção dos nutrientes. Objetivo: Esse trabalho tem como objetivo verificar os diferentes tipos de condutas dietéticas no PO aplicadas em diferentes locais e seus aspectos mais relevantes para a conduta do nutricionista. Métodos: Levantamento dos artigos literários, busca nas bases de dados Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Medline, Ibecs, Sec. Est. Saúde P, Scielo e Google Acadêmico.  Sendo utilizados para a busca dos artigos os descritores cirurgia bariátrica e dieta pós-operatória e suas combinações nas línguas portuguesa e inglesa. Resultados: Os autores ressaltam a necessidade de começar a dieta pós-operatória pela dieta líquida, em pequenas quantidades e progredir até chegar à dieta geral, no entanto, divergem quanto ao tempo em dias para evolução da consistência das dietas. Conclusão: Apesar das condutas apresentarem semelhanças ainda são necessários mais estudos para a realização de um protocolo padronizado sobre alimentação pós-cirurgia bariátrica com o objetivo de nortear os profissionais de saúde e evitar que continuem ocorrendo déficits de nutrientes e micronutrientes nesses pacientes. ABSTRACTEvolution of the diet in the pos-operatory of bariatric surgeries: integrating review of the literature More and more people are using bariatric surgery for weight loss and improvement of comorbidities associated with overweight, the most common Roux-en-Y gastric bypass technique (Fobi-Capella), this surgical technique is currently considered standard gold. The weight loss of these patients is guaranteed by low food intake due to decreased gastric capacity and also by malabsorption of nutrients. Objective: This study aims to verify the different types of dietary conducts in the OP applied in different places and their aspects more relevant to the behavior of the nutritionist. Methods: Survey of literary articles, search in the Latin American and Caribbean databases on Health Sciences (LILACS), Medline, Ibecs, Sec. Est. Saúde P, Scielo and Google Scholar. Being used for the search of the articles the descriptors bariatric surgery and postoperative diet and their combinations in the Portuguese and English languages. Results: The authors emphasize the need to start the postoperative diet through the liquid diet, in small amounts and progress until reaching the general diet, however, they differ as to the time in days for the evolution of the consistency of the diets. Conclusion: Despite the similarity of the conduct, further studies are needed to establish a standardized protocol on diet after bariatric surgery in order to guide health professionals and to avoid that nutrient and micronutrient deficits continue to occur in these patients

Evolution of the diet in the pos-operatory of bariatric surgeries: integrating review of the literature

Cada vez mais as pessoas estão recorrendo à cirurgia bariátrica para a perda ponderal e melhora das comorbidades associadas ao excesso de peso, sendo a técnica mais comum bypass gástrico em Y de Roux (Fobi-Capella), esta técnica cirúrgica atualmente é considerada padrão ouro. A perda de peso desses pacientes é garantida pela baixa ingestão alimentar devido à diminuição da capacidade gástrica e também pela má absorção dos nutrientes. Objetivo: Esse trabalho tem como objetivo verificar os diferentes tipos de condutas dietéticas no PO aplicadas em diferentes locais e seus aspectos mais relevantes para a conduta do nutricionista. Métodos: Levantamento dos artigos literários, busca nas bases de dados Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Medline, Ibecs, Sec. Est. Saúde P, Scielo e Google Acadêmico.  Sendo utilizados para a busca dos artigos os descritores cirurgia bariátrica e dieta pós-operatória e suas combinações nas línguas portuguesa e inglesa. Resultados: Os autores ressaltam a necessidade de começar a dieta pós-operatória pela dieta líquida, em pequenas quantidades e progredir até chegar à dieta geral, no entanto, divergem quanto ao tempo em dias para evolução da consistência das dietas. Conclusão: Apesar das condutas apresentarem semelhanças ainda são necessários mais estudos para a realização de um protocolo padronizado sobre alimentação pós-cirurgia bariátrica com o objetivo de nortear os profissionais de saúde e evitar que continuem ocorrendo déficits de nutrientes e micronutrientes nesses pacientes. ABSTRACTEvolution of the diet in the pos-operatory of bariatric surgeries: integrating review of the literature More and more people are using bariatric surgery for weight loss and improvement of comorbidities associated with overweight, the most common Roux-en-Y gastric bypass technique (Fobi-Capella), this surgical technique is currently considered standard gold. The weight loss of these patients is guaranteed by low food intake due to decreased gastric capacity and also by malabsorption of nutrients. Objective: This study aims to verify the different types of dietary conducts in the OP applied in different places and their aspects more relevant to the behavior of the nutritionist. Methods: Survey of literary articles, search in the Latin American and Caribbean databases on Health Sciences (LILACS), Medline, Ibecs, Sec. Est. Saúde P, Scielo and Google Scholar. Being used for the search of the articles the descriptors bariatric surgery and postoperative diet and their combinations in the Portuguese and English languages. Results: The authors emphasize the need to start the postoperative diet through the liquid diet, in small amounts and progress until reaching the general diet, however, they differ as to the time in days for the evolution of the consistency of the diets. Conclusion: Despite the similarity of the conduct, further studies are needed to establish a standardized protocol on diet after bariatric surgery in order to guide health professionals and to avoid that nutrient and micronutrient deficits continue to occur in these patients.More and more people are using bariatric surgery for weight loss and improvement of comorbidities associated with overweight, the most common Roux-en-Y gastric bypass technique (Fobi-Capella), this surgical technique is currently considered standard gold. The weight loss of these patients is guaranteed by low food intake due to decreased gastric capacity and also by malabsorption of nutrients. Objective: This study aims to verify the different types of dietary conducts in the OP applied in different places and their aspects more relevant to the behavior of the nutritionist. Methods: Survey of literary articles, search in the Latin American and Caribbean databases on Health Sciences (LILACS), Medline, Ibecs, Sec. Est. Saúde P, Scielo and Google Scholar. Being used for the search of the articles the descriptors bariatric surgery and postoperative diet and their combinations in the Portuguese and English languages. Results: The authors emphasize the need to start the postoperative diet through the liquid diet, in small amounts and progress until reaching the general diet, however, they differ as to the time in days for the evolution of the consistency of the diets. Conclusion: Despite the similarity of the conduct, further studies are needed to establish a standardized protocol on diet after bariatric surgery in order to guide health professionals and to avoid that nutrient and micronutrient deficits continue to occur in these patients

Efficacy of a point-of-care test based on deamidated gliadin peptides for the detection of celiac disease in pediatric patients

Objective: The objective of the study was to assess the effectiveness of a point-of-care test (POCT) based on deamidated gliadin peptides (DGP) compared to the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) criteria diagnosis in the early detection of celiac disease (CD) in pediatric patients. Methods: One hundred children (≤ 18 years) with suspected CD were selected, including siblings of celiac children that underwent gastroscopy for other gastrointestinal conditions. Patients with severe disease, following a gluten-free diet (GFD), with gastrointestinal bleeding, coagulopathy and infections in the last month were excluded. All children were evaluated with a POCT that detects immunoglobulin A (IgA) and immunoglobulin G (IgG) antibodies to DGP and total IgA. The POCT results were compared to CD diagnosis according to current ESPGHAN criteria. This involved the detection of IgA tissue transglutaminase (tTG) antibodies, the results of an intestinal biopsy and genetic testing. Results: The prevalence of CD found in the present study was 48% (95% confidence interval in parenthesis 37.9-58.2%). The results of the POCT were concordant with the CD diagnosis made according to ESPGHAN criteria: 95.8% (85.7-99.4%) sensitivity, 98.1% (89.7-99.7%) specificity, 97.9% (88.7-99.6%) positive predictive value and 96.2% (87.0-99.4%) negative predictive value. Positive and negative likelihood ratios were 49.8 (7.2-347.5) and 0.04 (0.01-0.17), respectively. The POCT showed a 100% diagnostic accuracy in children younger than ten years of age. In total, three discordant results were found. Conclusion: Due to the high diagnostic accuracy in the pediatric population, the POCT can be considered as an effective tool for the early diagnosis of CD, especially in patients younger than ten years of age