Nutrients

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3 pages, 173 KiB

Open AccessEditorial

Nutrition in Pediatric Gastroenterology

by Claudio Romano and Valeria Dipasquale

Nutrients 2021, 13(6), 1965; https://doi.org/10.3390/nu13061965 - 8 Jun 2021

Cited by 1 | Viewed by 2553

Abstract

Nutrition and intestinal function are strictly interrelated [...] Full article

(This article belongs to the Special Issue Nutrition and Pediatric Gastroenterology)

Research

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12 pages, 1044 KiB

Open AccessArticle

Lactobacillus reuteri DSM 17938 and Agave Inulin in Children with Cerebral Palsy and Chronic Constipation: A Double-Blind Randomized Placebo Controlled Clinical Trial

by Andrea A. García Contreras, Edgar M. Vásquez Garibay, Carmen A. Sánchez Ramírez, Mary Fafutis Morris and Vidal Delgado Rizo

Nutrients 2020, 12(10), 2971; https://doi.org/10.3390/nu12102971 - 28 Sep 2020

Cited by 22 | Viewed by 5701

Abstract

The main objective was to assess the efficacy of a probiotic (Lactobacillus reuteri DSM 17938), a prebiotic (agave inulin), and a synbiotic on the stool characteristics in children with cerebral palsy and chronic constipation. Thirty-seven children with cerebral palsy and chronic constipation [...] Read more.

The main objective was to assess the efficacy of a probiotic (Lactobacillus reuteri DSM 17938), a prebiotic (agave inulin), and a synbiotic on the stool characteristics in children with cerebral palsy and chronic constipation. Thirty-seven children with cerebral palsy and chronic constipation were included. The probiotic group received 1 × 10⁸ colony forming unit (cfu) of L. reuteri DSM 17938 plus placebo, the prebiotic group received 4 g of agave inulin plus placebo, the synbiotic group received L. reuteri DSM 17938 plus agave inulin, and the placebo group received two placebos for 28 days. The probiotic group showed a significant decrease in stool pH (p = 0.014). Stool consistency improved in the prebiotic group (p = 0.008). The probiotic, prebiotic, and synbiotic groups showed a significant improvement in the history of excessive stool retention, the presence of fecal mass in the rectum, and the history of painful defecation. L. reuteri concentration in feces was higher in the probiotic group than in the placebo group (p = 0.001) and showed an inverse correlation with stool pH in the probiotic group (r = −0.762, p = 0.028). This study showed that the use of L. reuteri DSM 17938 and/or agave inulin improved the stool characteristics such as the history of painful defecation and the presence of fecal mass in the rectum against placebo in children with cerebral palsy and chronic constipation. Full article

(This article belongs to the Special Issue Nutrition and Pediatric Gastroenterology)

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10 pages, 1496 KiB

Open AccessArticle

The Gluten Free Diet’s Impact on Growth in Children with Celiac Disease in Two Different Countries

by Naire Sansotta, Stefano Guandalini, Simone Romano, Karine Amirikian, Marco Cipolli, Gloria Tridello, Silvia Barzaghi and Hilary Jericho

Nutrients 2020, 12(6), 1547; https://doi.org/10.3390/nu12061547 - 26 May 2020

Cited by 12 | Viewed by 3730

Abstract

The effects of gluten free diet (GFD) on body mass index (BMI) and growth parameters in pediatric patients with celiac disease (CD) and their dependence on different socio-cultural environments are poorly known. We conducted an international retrospective study on celiac patients diagnosed at [...] Read more.

The effects of gluten free diet (GFD) on body mass index (BMI) and growth parameters in pediatric patients with celiac disease (CD) and their dependence on different socio-cultural environments are poorly known. We conducted an international retrospective study on celiac patients diagnosed at the University of Verona, Italy, and at the University of Chicago, Chicago, IL, USA, as underweight. A total of 140 celiac children and 140 controls (mean age 8.4 years) were enrolled in Chicago; 125 celiac children and 125 controls (mean age 7.3 years, NS) in Verona. At time of diagnosis, Italian celiac children had a weight slightly lower (p = 0.060) and a BMI z-score significantly (p < 0.001) lower than their American counterparts. On GFD, Italian celiac children showed an increased prevalence of both underweight (19%) as well as overweight (9%), while American children showed a decrease prevalence of overweight/obese. We concluded that while the GFD had a similar impact on growth of celiac children in both countries, the BMI z-score rose more in American than in Italian celiac children. Additionally, in Italy, there was an alarming increase in the proportion of celiac children becoming underweight. We speculate that lifestyle and cultural differences may explain the observed variations. Full article

(This article belongs to the Special Issue Nutrition and Pediatric Gastroenterology)

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6 pages, 554 KiB

Open AccessArticle

The Cow’s Milk-Related Symptom Score (CoMiSS^TM): Health Care Professional and Parent and Day-to-Day Variability

by Yvan Vandenplas, Eva Carvajal, Stefaan Peeters, Nadine Balduck, Yesra Jaddioui, Carmen Ribes-Koninckx and Koen Huysentruyt

Nutrients 2020, 12(2), 438; https://doi.org/10.3390/nu12020438 - 9 Feb 2020

Cited by 16 | Viewed by 2947

Abstract

The Cow’s Milk-related Symptom Score (CoMiSS^TM) was created as an awareness tool for cow’s milk allergy. The aim of the present study was to analyze the inter-rater variability between a pediatrician, parents, and day to day variability. A Health Care Professional [...] Read more.

The Cow’s Milk-related Symptom Score (CoMiSS^TM) was created as an awareness tool for cow’s milk allergy. The aim of the present study was to analyze the inter-rater variability between a pediatrician, parents, and day to day variability. A Health Care Professional (HCP) and parent filled in the CoMiSS independently and blinded for each other to evaluate inter-rater variability. In order to validate day-to-day variability, a parent filled in the CoMiSS during 3 consecutive days and was compared to the CoMiSS scored by the HCP. The absolute agreement between parent and HCP was 75%, and 92.6% and 100% with a tolerance of 0, 1, and 2 points, respectively, resulting in excellent agreement with an intraclass correlation coefficient (ICC) 0.981 (95% Confidence Interval 0.974–0.986, p < 0.001). Day-to-day variability during 3 consecutive days resulted in an absolute agreement of 30%, increasing to 80% and 88.6% when 2 and 3 points, respectively, were accepted. The ICC was excellent for the parental prospective scores (0.93, 95% CI 0.90–0.96; p < 0.001). Day-to-day variability indicates that CoMiSS has a moderate inter-rater reliability. A very low variability was observed when scored prospectively over three days. Data suggest that the CoMiSS can reliably be scored by parents without additional training. Full article

(This article belongs to the Special Issue Nutrition and Pediatric Gastroenterology)

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Review

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19 pages, 1324 KiB

Open AccessReview

Diet and Nutrients in Gastrointestinal Chronic Diseases

by Antonio Corsello, Daniela Pugliese, Antonio Gasbarrini and Alessandro Armuzzi

Nutrients 2020, 12(9), 2693; https://doi.org/10.3390/nu12092693 - 3 Sep 2020

Cited by 38 | Viewed by 11905

Abstract

Diet and nutrition are known to play key roles in many chronic gastrointestinal diseases, regarding both pathogenesis and therapeutic possibilities. A strong correlation between symptomatology, disease activity and eating habits has been observed in many common diseases, both organic and functional, such as [...] Read more.

Diet and nutrition are known to play key roles in many chronic gastrointestinal diseases, regarding both pathogenesis and therapeutic possibilities. A strong correlation between symptomatology, disease activity and eating habits has been observed in many common diseases, both organic and functional, such as inflammatory bowel disease and irritable bowel syndrome. New different dietary approaches have been evaluated in order improve patients’ symptoms, modulating the type of sugars ingested, the daily amount of fats or the kind of metabolites produced in gut. Even if many clinical studies have been conducted to fully understand the impact of nutrition on the progression of disease, more studies are needed to test the most promising approaches for different diseases, in order to define useful guidelines for patients. Full article

(This article belongs to the Special Issue Nutrition and Pediatric Gastroenterology)

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9 pages, 235 KiB

Open AccessReview

Acute Malnutrition in Children: Pathophysiology, Clinical Effects and Treatment

by Valeria Dipasquale, Ugo Cucinotta and Claudio Romano

Nutrients 2020, 12(8), 2413; https://doi.org/10.3390/nu12082413 - 12 Aug 2020

Cited by 77 | Viewed by 34230

Abstract

Acute malnutrition is a nutritional deficiency resulting from either inadequate energy or protein intake. Children with primary acute malnutrition are common in developing countries as a result of inadequate food supply caused by social, economic, and environmental factors. Secondary acute malnutrition is usually [...] Read more.

Acute malnutrition is a nutritional deficiency resulting from either inadequate energy or protein intake. Children with primary acute malnutrition are common in developing countries as a result of inadequate food supply caused by social, economic, and environmental factors. Secondary acute malnutrition is usually due to an underlying disease causing abnormal nutrient loss, increased energy expenditure, or decreased food intake. Acute malnutrition leads to biochemical changes based on metabolic, hormonal, and glucoregulatory mechanisms. Most children with primary acute malnutrition can be managed at home with nutrition-specific interventions (i.e., counseling of parents, ensuring household food security, etc.). In case of severe acute malnutrition and complications, inpatient treatment is recommended. Secondary acute malnutrition should be managed by treating the underlying cause. Full article

(This article belongs to the Special Issue Nutrition and Pediatric Gastroenterology)

16 pages, 537 KiB

Open AccessFeature PaperReview

Failure to Thrive in the Outpatient Clinic: A New Insight

by Antonella Lezo, Letizia Baldini and Monica Asteggiano

Nutrients 2020, 12(8), 2202; https://doi.org/10.3390/nu12082202 - 24 Jul 2020

Cited by 14 | Viewed by 9949

Abstract

Failure to thrive (FTT) is an abnormal growth pattern determined by inadequate nutrition. It is a common problem in children, representing 5% to 10% of patients seen in an outpatient setting. Many definitions have been proposed based on anthropometric deterioration; however, they show [...] Read more.

Failure to thrive (FTT) is an abnormal growth pattern determined by inadequate nutrition. It is a common problem in children, representing 5% to 10% of patients seen in an outpatient setting. Many definitions have been proposed based on anthropometric deterioration; however, they show poor concordance. No single definition is sufficiently sensitive in identifying faltering growth whilst a combination of multiple criteria seems more accurate. In light of the recent redefinition of pediatric malnutrition as a disequilibrium between requirements and intakes of energy, and macro- and micronutrients, a wider conception of FTT as an unsatisfactory nutritional status related to poor growth and health is useful. Although the most severe problems of micronutrient malnutrition are found in developing countries, people of all regions of the world can be affected by micronutrient deficiencies (MNDs), a form of undernutrition with relevant effects on growth and health. Changes in diets and lifestyle, elimination diets, food insecurity, and food intake disorders create the conditions at risk of faltering growth and MNDs. This new insight integrates the “classical” anthropometric criteria for definition and treatment, in the aim of warranting both a regular increase in size and an overall adequate development and health status. Full article

(This article belongs to the Special Issue Nutrition and Pediatric Gastroenterology)

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19 pages, 1420 KiB

Open AccessReview

Persistent Iron Deficiency Anemia in Patients with Celiac Disease Despite a Gluten-Free Diet

by Gianpiero Stefanelli, Angelo Viscido, Salvatore Longo, Marco Magistroni and Giovanni Latella

Nutrients 2020, 12(8), 2176; https://doi.org/10.3390/nu12082176 - 22 Jul 2020

Cited by 34 | Viewed by 12693

Abstract

Celiac disease (CD) is an autoimmune disorder characterized by intolerance to dietary gluten in genetically predisposed subjects. Iron deficiency anemia (IDA) is a common sign in CD, being the only abnormality in approximately 40% of celiac patients. A multifactorial etiology leads to IDA [...] Read more.

Celiac disease (CD) is an autoimmune disorder characterized by intolerance to dietary gluten in genetically predisposed subjects. Iron deficiency anemia (IDA) is a common sign in CD, being the only abnormality in approximately 40% of celiac patients. A multifactorial etiology leads to IDA in CD. The two main causes are the villous atrophy of the mucosa at the site of iron absorption (the duodenum) and the resulting inflammation, which triggers the mechanism that leads to the anemia of chronic disease. Until now, it has been unclear why some patients with CD continue to have IDA despite a careful gluten-free diet (GFD) and the normalization of villous atrophy. Furthermore, some celiac patients are refractory to oral iron supplementation despite the healing of the mucosa, and they thus require periodic intravenous iron administration. The Marsh classification evaluates the degree of inflammation and villous atrophy, but it does not assess the possible persistence of ultrastructural and molecular alterations in enterocytes. The latter was found in CD in remission after adopting a GFD and could be responsible for the persistently reduced absorption of iron and IDA. Even in non-celiac gluten sensitivity, anemia is present in 18.5–22% of patients and appears to be related to ultrastructural and molecular alterations in intestinal microvilli. It is possible that a genetic component may also play a role in IDA. In this review, we evaluate and discuss the main mechanisms of IDA in CD and the possible causes of its persistence after adopting a GFD, as well as their therapeutic implications. Full article

(This article belongs to the Special Issue Nutrition and Pediatric Gastroenterology)

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29 pages, 1962 KiB

Open AccessReview

Non-IgE-Mediated Gastrointestinal Food Allergies in Children: An Update

by Roxane Labrosse, François Graham and Jean-Christoph Caubet

Nutrients 2020, 12(7), 2086; https://doi.org/10.3390/nu12072086 - 14 Jul 2020

Cited by 86 | Viewed by 18241

Abstract

Non-immunoglobulin E-mediated gastrointestinal food allergic disorders (non-IgE-GI-FA) include food protein-induced enterocolitis syndrome (FPIES), food protein-induced enteropathy (FPE) and food protein-induced allergic proctocolitis (FPIAP), which present with symptoms of variable severity, affecting the gastrointestinal tract in response to specific dietary antigens. The diagnosis of [...] Read more.

Non-immunoglobulin E-mediated gastrointestinal food allergic disorders (non-IgE-GI-FA) include food protein-induced enterocolitis syndrome (FPIES), food protein-induced enteropathy (FPE) and food protein-induced allergic proctocolitis (FPIAP), which present with symptoms of variable severity, affecting the gastrointestinal tract in response to specific dietary antigens. The diagnosis of non-IgE-GI-FA is made clinically, and relies on a constellation of typical symptoms that improve upon removal of the culprit food. When possible, food reintroduction should be attempted, with the documentation of symptoms relapse to establish a conclusive diagnosis. Management includes dietary avoidance, nutritional counselling, and supportive measures in the case of accidental exposure. The prognosis is generally favorable, with the majority of cases resolved before school age. Serial follow-up to establish whether the acquisition of tolerance has occurred is therefore essential in order to avoid unnecessary food restriction and potential consequent nutritional deficiencies. The purpose of this review is to delineate the distinctive clinical features of non-IgE-mediated food allergies presenting with gastrointestinal symptomatology, to summarize our current understanding of the pathogenesis driving these diseases, to discuss recent findings, and to address currents gaps in the knowledge, to guide future management opportunities. Full article

(This article belongs to the Special Issue Nutrition and Pediatric Gastroenterology)

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