Purpose: Impaired intestinal mucosal integrity may affect the gastrointestinal function, especially in relation to nutrition, absorption, and barrier function. The purpose of this study was to measure the prevalence of impaired intestinal mucosal integrity in presumed healthy children aged 1-3 years and assess the effects of zinc, glutamine, fiber, and prebiotic supplementation in them. Methods: A cross-sectional study was conducted in 200 children aged 1-3 years in Pasar Minggu, South Jakarta, Indonesia. A randomized double-blind parallel group method clinical trial was then performed to assess the effects of zinc, glutamine, fiber, and prebiotic supplementation. Results: Elevated calprotectin was found in 91/200 subjects (45.5%) at the onset of the study. After 10 months, 144 subjects completed the study: 72 subjects received the trial formula, whereas the other 72 received the standard formula. A transitory decrease in fecal calprotectin (FC) was observed after 6 months in the subgroup with normal FC levels, who were fed the test formula (p=0.012). Conclusion: The prevalence of impaired intestinal mucosal integrity in this group of Indonesian children aged 1-3 years was high. Supplementation with zinc, glutamine, fiber, and prebiotics during 6 months reduced FC only in those who had low levels at baseline but not in those with impaired integrity.
This study was conducted to investigate the status of food allergy knowledge and management of the teachers and operators of child care facilities in the Daejeon Area. Surveys of 262 teachers and 50 operators of child care facilities in Dong-gu and Jung-gu in Daejeon were conducted. The prevalence of food allergies was found to be 3.6% (102 children). The average score of teachers in the anaphylaxis knowledge survey was $0.18{\pm}0.22$. Additionally, the needs for food allergy education among teachers and operators was 88.2% and 98%, respectively. The survey revealed that all child care facilities in this study provide food service menus to parents, but only 14 facilities (28%) provided alternative food to children with food allergies, and some of these 14 facilities did not provide adequate alternatives. To ensure the safety and healthy growth of children with food allergies, it is necessary to provide food allergy education to teachers and operators, as well as to establish safe food service and allergy management systems in all child care facilities.
This study examined the factors related to stages of dietary behavioral changes among 1449 child bearing aged women (mean age $\pm$ SD = 25.6 $\pm$ 5.3 years) residing in large cities. A self administered questionnaire was used to assess stages of dietary behavioral change, meal balance and regularity, food availability, nutrition knowledge, body mass index, nutrient intake, and psycho-social factors including self efficacy, perceived benefits and barriers, social modeling. Undesirable dietary behaviors (precontemplation and contemplation) were shown among 45.1-57.4% of the participants, among those, 33.4-43.0% were precontemplators. Participants' self efficacy scores associated with dietary changes were higher in specific situations (3.42) as compared to general situations (2.86). Similarly, they appeared to perceive more benefits (3.86) rather than barriers (2.76) by changing their inappropriate eating habits. Perception and accuracy scores of nutrition knowledge were relatively high, indicating 90.9 and 80.1, respectively. In terms of food availability at home, fresh fruits received the highest score, followed by milk and milk products, vegetables, meat, alcoholic beverages and soft drinks. In social modeling assessment, family members, as compared to friends, appeared to have better dietary habits. Stages of dietary behavioral change assessed in terms of meal regularity were associated with nutrient intake, showing higher energy and carbohydrate intakes but lower fat intake among those who belonged to the action and maintenance stage. They also presented higher self efficacy and perceived more benefits and less barriers regarding the change of undesirable eating habits. Fresh meat and vegetables were more available among those maintaining desirable dietary habits. Results of this study presented the significant relations of motivational and reinforcing social factors with stages of dietary behavioral changes and a need for the development of tailored nutrition education program considering these factors for child-bearing aged Korean women.
Purpose: To investigate the impact of omega-3-enriched lipid emulsion (LE) on liver enzyme (aspartate transaminase [AST] and alanine aminotransferase [ALT]) and triglyceride (TG) levels of children undergoing gastrointestinal surgery. Methods: This experimental randomized controlled group pretest-posttest design study included 14 children who underwent gastrointestinal surgery due to duodenal atresia, jejunal atresia, esophageal atresia, and need for parenteral nutrition for a minimum of 3 days at RSUD Dr. Soetomo Surabaya between August 2018 and January 2019. These children were divided into two groups, those who received standard intravenous LE (medium-chain triglyceride [MCT]/long-chain triglyceride [LCT]) and those who received intravenous omega-3-enriched LE. Differences in AST, ALT, and TG levels were measured before surgery and 3 days after the administration of parenteral nutrition. Results: Liver enzyme and TG levels in each group did not differ significantly before versus 3 days after surgery. However, TG levels were significantly lower in the omega-3-enriched intravenous LE group (p=0.041) at 3 days after surgery, and statistically significant difference in changes in TG levels was noted at 3 days after surgery between MCT/LCT intravenous LE group and the omega-3-enriched intravenous LE group (p=0.008). Conclusion: The intravenous omega-3-enriched LE had a better TG-lowering effect than the MCT/LCT intravenous LE in children undergoing gastrointestinal surgery.
Eating behaviour disorder during early childhood is a common pediatric problem. Many terminologies have been used interchangeably to describe this condition, hindering implementation of therapy and confusing a common problem. The definition suggests an eating behaviour which has consequences for family harmony and growth. The recent Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition does not cover the entire spectrum seen by pediatricians. Publications are substantive but level of evidence is most of the time low. This purpose of this review is to clarify terminology of eating behaviour problems during early childhood; including benign picky eating, limited diets, sensory food aversion, selective eating, food avoidance emotional disorder, pervasive refusal syndrome, tactile defensiveness, functional dysphagia, neophobia and toddler anorexia. This tool is proposed only to ease the clinical management for child care providers. Diagnostic criteria are set and management tools are suggested. The role of dietary counselling and, where necessary, behavioural therapy is clarified. It is hoped that the condition will make its way into mainstream pediatrics to allow these children, and their families, to receive the help they deserve.
BACKGROUND/OBJECTIVES: The 6-23 months for infants is the longest period in the "first 1,000 days" of life. This period is very important for child development, so complementary feeding (CF) practices should be optimized to maximize children's potential for growth and development. The aim of this study was to analyze the CF practices and nutritional status of children aged 6-23 months. SUBJECTS/METHODS: For this cross-sectional study, 392 children aged 6-23 months were selected using stratified random sampling. Socio-demographic data were collected through interviews. CF practices, collected by interviews and repeated 24-hour food recall method, were the timely introduction of CF, minimum meal frequency, dietary diversity and minimum acceptable diet, consumption food rich in proteins and vitamin A. Nutritional status was assessed using the indicators of underweight, wasting and stunting. To analyze the association between socio-demographic indicators and CF with nutritional status, the chi-square test with a confidence interval of 95% was used. RESULTS: Results showed that 39% were exclusively breastfed, only 61% received prolonged breastfeeding and 50% received timely introduction of CF. Minimum meal frequency was met by 74% of subjects, but dietary diversity and minimum acceptable diet were only realized in 50% and 40% of the children, respectively. The prevalence of underweight, wasting, and stunting were 26%, 23%, and 28%, respectively. Age of the child, birth order, birth weight, parents' education level, family size and incidence of fever and diarrhea during the previous two weeks were associated with underweight, while child's birth order, fathers' education level, mother's age, family size, completion of the age-appropriate vaccination and fish consumption frequency were associated with wasting. Age of the child, incidence of fever and acute respiratory infection, and fortified food consumption were associated with stunting. CONCLUSIONS: Suboptimal CF practices and high prevalence of underweight, wasting and stunting were found among children aged 6-23 months old in Aceh. These results highlight the need to improve CF and nutritional status.
BACKGROUND/OBJECTIVES: In the United States, one in every 5 children is obese with greater likelihood in low-income households. The coronavirus disease 2019 (COVID-19) pandemic may have accelerated disparities in child obesity risk factors, such as poor dietary intake and increased sedentary behaviors, among low-income families because of financial difficulties, social isolation and other struggles. This study reveals insights into nutrition and health challenges among low-income families of young children in West Texas to better understand needs and develop interventions. SUBJECTS/METHODS: In-depth individual interviews were performed via Zoom among 11 families of children under the age of 3. A semi-structured interview guide was developed to explore 3 areas: changes in (1) dietary intake and (2) sedentary behaviors and (3) families' preferences regarding a parent nutrition education program. Each interview was audiorecorded, transcribed, and coded using MaxQDA software. RESULTS: Eating together as a family become challenging because of irregular work schedules during the COVID-19 pandemic. Most parents stated that their children's dietary habits shifted with an increased consumption of processed foods. Many parents are unable to afford healthful foods and have utilized food and nutrition assistance programs to help feed their families. All families reported that their children's screen time substantially increased compared to the pre-pandemic times. Moreover, the majority of parents did not associate child screen time with an obesity risk, so this area could be of particular interest for future interventions. Meal preparation ideas, remote modality, and early timing were identified as key intervention strategies. CONCLUSIONS: Online nutrition interventions that emphasize the guidelines for child screen time and regular meal routines will be effective and promising tools to reach low-income parents for early childhood health promotion and obesity prevention.
This study intends to analyse the concept on the child-rearing of parents. Through analysis, several concepts on the child-rearing would be cleared, and therefore the groundwork of the theoretical framework can be constructed. The concepts were analyzed by the method of Walker & Avant(1995). The attribute of child-rearing is as follows; nutrition supply, affectionate mind, caring, growth development supporting, protecting, instructing, pregnancy, delivery etc. The proper child-rearing helps reinforce child development, mother-infant attachment, social disposition, parental-role contentment and family relationship. This study would be helpful to the establishment of child-rearing paradigm. And therethrough this result although helps construct proper child-rearing as well as theoretical groundwork.
Recurrent acute pancreatic attacks is a rare clinical condition (2-5% of all acute pancreatis) in children and is mainly idiopathic in most cases. Sometimes it may be associated with congenital anomalies, metabolic diseases or hereditary conditions. Isovaleric acidemia (IVA) is a rare autosomal recessive amino acid metabolism disorder associated with isovaleryl coenzyme A dehydrogenase deficiency presenting the clinical findings such metabolic acidosis with increased anion gap, hyperammonemia, ketonemia, hypoglycemia, "the odor of sweaty feet," abdominal pain, vomiting, feeding intolerance, shock and coma. Recurrent acute pancreatitis associated with IVA have been rarely reported. Herein; we report a child who admitted with recurrent acute pancreatic attacks and had the final diagnosis of IVA. Mutation analysis revealed a novel homozygous mutation of (p.E117K [c.349G>A]) in the IVA gene. Organic acidemias must kept in mind in the differential diagnosis of recurrent acute pancreatic attacks in children.
This study was performed to develop dietary education programs for children, by researching the actual conditions of dietary education and its demand aimed at teachers in child centers in Masan. Most of the interviewed teachers were in their 20s(71%) with under 5 years teaching experiences(56.8%), and working in a kindergarten environment(34.9%). The rate of doing dietary education on mealtime was 96.4%. The main items taught pertained to 'not leaving food(20.6%)' and 'washing hands before meals(20.5%)'. The primary teaching method for students with unbalanced eating habits was 'eating after teaching them to understood(76.8%). The primary reward for good behavior was 'using food(76.8%)', usually as 'candy'(50.8%) or 'cookies'(25.8%). The desirable dietary education type was 'during spare moments(52.6%)' and 'at mealtime (23.5%)'. The concepts taught were 'balanced eating(23.2%)' and 'food hygiene(21.2%), and the students were interested in 'the roles of foods and nutrients'(34.5%), 'balanced eating(20.9%)', and 'food hygiene(19.1%)'. Educational activities encompassed 'pictures and drawing(25.7%)', 'fairy tales(23.4%)', 'songs(19.4%)', and 'play(14.1%)'. Also, the activities of most interest were 'fairy tales(29.4%)', 'play(24.4%)', and then 'songs(23.1%)'. The greatest difficulties during dietary education were 'attracting interest from the children(37.8%)' and 'making and purchasing materials(33.9%)'. Approximately, 44.2% of the teachers had experiences in dietary education, and 96.4% stated teachers had the intention to participate in dietary education. They want to address 'child meal direction(23.0%)', 'health problems(22.7%)', and then 'child nutrient requirements (17.3%)'. Also the majority wanted it two times per year(57.6%) or one time per year(30.9%). This study indicated that proper dietary education must be established in child centers by developing various practical dietary education programs and then implementing them.
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