Assuntos
Grão Comestível , Alimentos Infantis , Valor Nutritivo , Grão Comestível/química , Grão Comestível/normas , Alimentos Fortificados/efeitos adversos , Alimentos Fortificados/análise , Alimentos Fortificados/normas , Humanos , Lactente , Alimentos Infantis/efeitos adversos , Alimentos Infantis/análise , Alimentos Infantis/normas , Recomendações Nutricionais/legislação & jurisprudência , Estados Unidos , United States Food and Drug Administration/legislação & jurisprudência , United States Food and Drug Administration/normasRESUMO
OBJECTIVE: To characterize complementary feeding and to analyze the influence of individual and contextual factors on dietary practices of low birth weight infants. METHODS: This cross-sectional study included 2,370 low birth weight infants aged 6 to 12 months included in the Breastfeeding Prevalence Survey in Brazilian Municipalities (2008), which covered the 26 state capitals, the Federal District and 37 municipalities. Dietary practices were assessed using two indicators: I) dietary diversity, characterized by the consumption of five food groups: meat, beans, vegetables, fruit and milk; II) consumption of ultra-processed foods, characterized by the ingestion of at least one of the following foods on the day prior to the survey: soda, or processed juice, or cookie, cracker and crisps. The covariates of interest were the socioeconomic characteristics of infants, mothers and health services. The contextual factor was the "municipal prevalence of child undernutrition." The individualized effect of the study factors on outcomes was assessed by multilevel Poisson regression. RESULTS: Approximately 59% of infants consumed ultra-processed foods, while 29% had diverse feeding. Mothers living in municipalities with child undernutrition prevalence below 10%, with higher education and working outside the home were more likely to offer dietary diversity. Consumption of ultra-processed foods was higher among infants living in municipalities with child undernutrition prevalence below 10%, whose mothers were younger and multiparous. CONCLUSIONS: The low prevalence of diverse feeding combined with the high prevalence of ultra-processed food consumption characterizes the low quality of feeding of low birth weight Brazilian infants. Individual and contextual factors impact the feeding quality of this population, suggesting the need for effective strategies to increase the consumption of fresh and minimally processed foods and decrease the consumption of ultra-processed foods by this vulnerable population.
Assuntos
Aleitamento Materno/estatística & dados numéricos , Comportamento Alimentar , Alimentos Infantis/estatística & dados numéricos , Recém-Nascido de Baixo Peso , Brasil , Estudos Transversais , Laticínios , Inquéritos sobre Dietas , Feminino , Humanos , Lactente , Alimentos Infantis/efeitos adversos , Alimentos Infantis/classificação , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Masculino , Fatores SocioeconômicosRESUMO
ABSTRACT OBJECTIVE To characterize complementary feeding and to analyze the influence of individual and contextual factors on dietary practices of low birth weight infants. METHODS This cross-sectional study included 2,370 low birth weight infants aged 6 to 12 months included in the Breastfeeding Prevalence Survey in Brazilian Municipalities (2008), which covered the 26 state capitals, the Federal District and 37 municipalities. Dietary practices were assessed using two indicators: I) dietary diversity, characterized by the consumption of five food groups: meat, beans, vegetables, fruit and milk; II) consumption of ultra-processed foods, characterized by the ingestion of at least one of the following foods on the day prior to the survey: soda, or processed juice, or cookie, cracker and crisps. The covariates of interest were the socioeconomic characteristics of infants, mothers and health services. The contextual factor was the "municipal prevalence of child undernutrition." The individualized effect of the study factors on outcomes was assessed by multilevel Poisson regression. RESULTS Approximately 59% of infants consumed ultra-processed foods, while 29% had diverse feeding. Mothers living in municipalities with child undernutrition prevalence below 10%, with higher education and working outside the home were more likely to offer dietary diversity. Consumption of ultra-processed foods was higher among infants living in municipalities with child undernutrition prevalence below 10%, whose mothers were younger and multiparous. CONCLUSIONS The low prevalence of diverse feeding combined with the high prevalence of ultra-processed food consumption characterizes the low quality of feeding of low birth weight Brazilian infants. Individual and contextual factors impact the feeding quality of this population, suggesting the need for effective strategies to increase the consumption of fresh and minimally processed foods and decrease the consumption of ultra-processed foods by this vulnerable population.
RESUMO OBJETIVO Caracterizar a alimentação complementar e analisar a influência de fatores individuais e contextuais sobre práticas alimentares de lactentes que nasceram com baixo peso. MÉTODOS Este estudo transversal incluiu 2.370 lactentes nascidos com baixo peso e com idade entre 6 e 12 meses incluídos na Pesquisa de Prevalência de Aleitamento Materno em Municípios Brasileiros (2008), que abrangeu as 26 capitais, o Distrito Federal e mais 37 municípios. As práticas alimentares foram avaliadas usando dois indicadores: i) diversidade alimentar, caracterizada pelo consumo dos cinco grupos alimentares: carnes, feijão, legumes e verduras, frutas e leite; ii) consumo de alimentos ultraprocessados, caracterizado pela ingestão de pelo menos um dos seguintes alimentos no dia anterior à pesquisa: refrigerante, ou suco industrializado, ou bolacha, biscoito e salgadinho. As covariáveis de interesse corresponderam às características socioeconômicas, dos lactentes, das mães e dos serviços de saúde. O fator contextual foi a "prevalência municipal de desnutrição infantil". O efeito individualizado dos fatores de estudo sobre os desfechos foi avaliado mediante regressão de Poisson com estrutura multinível. RESULTADOS Aproximadamente 59% dos lactentes consumiram alimentos ultraprocessados, enquanto 29% apresentaram diversidade alimentar. Mães que residiam em municípios com prevalência de desnutrição infantil inferior a 10%, com maior nível de escolaridade e que trabalhavam fora de casa foram mais propensas a oferecer diversidade alimentar. O consumo de alimentos ultraprocessados foi maior entre lactentes residentes em municípios com prevalência de desnutrição infantil inferior a 10%, cujas mães eram mais jovens e multíparas. CONCLUSÕES A baixa prevalência de alimentação diversa aliada à alta prevalência do consumo de alimentos ultraprocessados caracteriza a baixa qualidade da alimentação dos lactentes brasileiros com baixo peso ao nascer. Fatores individuais e contextuais impactam a qualidade da alimentação dessa população, sugerindo a necessidade de adoção de estratégias eficazes para aumentar o consumo de alimentos in natura e minimamente processados e diminuir o consumo de alimentos ultraprocessados por esta população vulnerável.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Aleitamento Materno/estatística & dados numéricos , Recém-Nascido de Baixo Peso , Comportamento Alimentar , Alimentos Infantis/estatística & dados numéricos , Fatores Socioeconômicos , Brasil , Inquéritos sobre Dietas , Estudos Transversais , Laticínios , Alimentos Infantis/classificação , Alimentos Infantis/efeitos adversos , Fenômenos Fisiológicos da Nutrição do LactenteRESUMO
The Cuban population exhibits high prevalence of overweight and associated chronic non-communicable diseases, trends that begin in childhood. In addition to factors related to the mother's health, factors contributing to excess weight gain in Cuban children are: reduced prevalence of exclusive breastfeeding of infants up to six months of age, full-term low birth weight infants and nutritional mismanagement of this group, incorrect complementary feeding, obesogenic diet, family history and sedentary lifestyles. Thus, it is important to adopt comprehensive, multisectoral strategies that promote adequate nutrition and weight control. This is particularly important for full-term low birth weight infants, predisposed to body fat storage.
Assuntos
Aleitamento Materno/tendências , Doença Crônica/epidemiologia , Alimentos Infantis/efeitos adversos , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido de Baixo Peso , Efeitos Adversos de Longa Duração , Obesidade/etiologia , Adolescente , Criança , Cuba/epidemiologia , Comportamento Alimentar , Feminino , Humanos , Alimentos Infantis/normas , Recém-Nascido , Estilo de Vida , Masculino , Obesidade/epidemiologia , Obesidade/prevenção & controle , Gravidez , Gestantes , Fenômenos Fisiológicos da Nutrição Pré-Natal , Aumento de Peso/fisiologiaRESUMO
Chilean consumer preferences include foods that may contain considerable amounts of furan, a potential human carcinogen. However, there is no information regarding dietary exposure to furan in Chile. Thus, the objective of this work was to determine the Chilean exposure to dietary furan. To accomplish this objective, the furan concentration of 14 types of commercial foods processed at high temperature were analysed based on a modified headspace-GC/MS (HS-GC/MS) method in which the limits of detection for different food matrices ranged from 0.01 to 0.6 ng g(-1). In addition, a risk assessment was made with exposure estimates based on dietary data from national studies on different age groups (9-month-old babies, school children, adults and elderly people). Of the food items surveyed "American"-type coffee (espresso coffee plus hot water) obtained from automatic coffee machine (936 ng g(-1)) and low moisture starchy products like crisps and "soda"-type crackers showed the highest furan concentrations (259 and 91 ng g(-1), respectively). Furthermore, furan was also found in samples of breakfast cereals (approximately 20 ng g(-1)), jarred fruit baby foods (8.5 ng g(-1)) and orange juice (7.0 ng g(-1)). School children (aged 9-13 years) represented the highest intake of furan (about 500 ng kg(-1)(bw) day(-1)), with margins of exposure of 2479 and 2411, respectively, which points to a possible public health risk.
Assuntos
Contaminação de Alimentos/análise , Furanos/efeitos adversos , Furanos/análise , Adolescente , Adulto , Idoso , Carcinógenos/análise , Criança , Chile , Café/efeitos adversos , Café/química , Feminino , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Lactente , Alimentos Infantis/efeitos adversos , Alimentos Infantis/análise , Masculino , Medição de RiscoRESUMO
RATIONALE: Infant formulae are being supplemented with probiotics, prebiotics, or symbiotic despite uncertainties regarding their efficacy. Mexican agave is an interesting source of fructans with particular features and with potential prebiotic effects. MATERIAL AND METHODS: RCT in 600 healthy term babies (20 ± 7 days), allocated to receive standard infant formula (control) or infant formula added with a dual prebiotic system "Metlin® and Metlos®", from Mexican agave. Primary outcomes include stools frequency, stools consistency, gastrointestinal intolerance (frequency of abdominal distension, flatulency, regurgitations, vomiting). Secondary outcomes include changes on weight and height along the study and frequency of dermatologic problems (eczema). RESULTS: In 66,120 days of total follow-up, there were no differences on the frequency of stools passage (Human Milk: 3.8 ± 2.4 evacuations per day; Pro + Metlin + Metlos 3.6 ± 2.0; Pro + Metlin 3.6 ± 2; only Pro 3.4 ± 2.3¸ only formula 3.4 ± 2.0; p NS). Consistency of stools was similar between human milk and prebiotics supplemented groups. Also the frequency of gastrointestinal symptoms was significantly low between these groups. CONCLUSIONS: Fructans derivate from agave and added to infant formula are safe and well tolerated by Mexican healthy term babies.
Assuntos
Agave , Frutanos/efeitos adversos , Gastroenteropatias/induzido quimicamente , Transtornos do Crescimento/induzido quimicamente , Alimentos Infantis/efeitos adversos , Extratos Vegetais/efeitos adversos , Prebióticos/efeitos adversos , Estatura/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Defecação/efeitos dos fármacos , Diarreia Infantil/induzido quimicamente , Feminino , Flatulência/induzido quimicamente , Seguimentos , Frutanos/administração & dosagem , Frutanos/isolamento & purificação , Humanos , Recém-Nascido , Masculino , Leite Humano , Extratos Vegetais/administração & dosagem , Extratos Vegetais/farmacologia , Vômito/induzido quimicamente , Aumento de Peso/efeitos dos fármacosRESUMO
Los alimentos cariogénicos son aquellos que contienen un alto porcentaje de azúcares fermentables como la sacarosa y carbohidratos, son alimentos de consistencia blanda, que se depositan con facilidad en las superficies retentivas de los dientes. La dieta cariogénica constituye un promotor primordial para la caries dental. La vida escolar juega vital importancia en la formación de hábitos alimenticios porque niños y adolescentes pasan muchas horas de su tiempo diario en este entorno. En el ambiente escolar, la cantina es considerada como un espacio donde es posible observar los hábitos alimenticios de los alumnos. En muchos países, latinoamericanos y europeos los servicios de alimentación disponibles en las cantinas escolares, están reglamentados desde el punto de vista nutricional y sanitario. En Paraguay, el Ministerio de Educación y Cultura, a través de su resolución Nº 12774/03 establece que estas cantinas deben estar manejadas por personal capacitado en cuanto a venta de alimentos saludables, manipulación y almacenamiento de los mismos, basándose en el Código Sanitario. Con el objetivo de determinar alimentos cariogénicos consumidos y ofertados en 40 cantinas escolares de escuelas públicas y privadas de Asunción y Gran Asunción, en el año 2012, se realizó un estudio observacional descriptivo de corte transversal con componente analítico. Los datos fueron obtenidos a través de un cuestionario y observación de los hábitos alimenticios de 1566 niños en los recreos, para luego ser asentados en las fichas elaboradas para el efecto. Se obtuvo como resultado que del 94% de los alimentos cariogénicos ofertados en las cantinas privadas, 48% era de alto grado de cariogenicidad y 56% de los mismos eran ofertados por las cantinas de escuelas públicas. El 99,49% de los niños consumió alimentos cariogénicos. Al aplicar la prueba exacta de Fischer se observó que existe diferencia significativa en el consumo de alimentos cariogénicos....
Assuntos
Humanos , Alimentos Infantis/efeitos adversos , Doces , Odontologia , Odontologia PreventivaRESUMO
OBJETIVOS: Descrever a metodologia de preparo de dois aditivos, líquido e em pó, derivados do leite humano e comparar a constituição com aditivo comercial FM85®. MÉTODOS: Foram utilizadas 40 amostras de leite humano para o preparo dos suplementos líquido e em pó. Ambos passaram por três fases de preparo: desnate, evaporação e retirada da lactose. Após essas fases, o suplemento líquido está pronto, e o em pó necessita da quarta fase - a liofilização. Em cada amostra dos suplementos líquido e em pó, foram adicionados, respectivamente, 80 mL (grupo I) e 100 mL (grupo II) de pool de leite humano de banco. Para comparação, 20 amostras de 100 mL do pool foram acrescidas de 5 g do suplemento FM85® (Nestlé) (grupo III). Realizaram-se análises de hidratos de carbono, proteína, lipídios, cálcio, fósforo, sódio, osmolalidade e conteúdo calórico, considerando diferença significativa p < 0,05. RESULTADOS: Os grupos I, II e III mostraram, respectivamente, os seguintes resultados: proteínas = 1,81, 2,38 e 1,96 g/dL (p < 0,001); hidratos de carbono = 6,70, 7,25 e 10,06 g/dL (p = 0,006); gordura = 3,75, 3,75 e 3,73 g/dL (p = 0,96); cálcio = 36,92, 44,75 e 79,37 mg/dL (p = 0,001); fósforo = 20,02, 23,28 e 56,30 mg/dL (p = 0,02); sódio = 14,32, 14,40 e 20,33 mEq/L (p = 0,143); osmolalidade = 391,45, 412,47 e 431, 00 mOsmol/kgH2O (p = 0,074); e conteúdo calórico = 67,78, 72,27 e 81,65 kcal (p = 0,001). CONCLUSÃO: Os aditivos estudados diferem significativamente do aditivo comercial FM85® em alguns de seus constituintes, e a sua constituição pode ou não atender às quantidades de nutrientes propostas pelas recomendações mais recentes.
OBJECTIVES: To describe the methodology for the preparation of two additives derived from human milk, liquid and powdered, and to compare this composition with the commercial additive FM85®. METHODS: For the preparation of the liquid and powdered supplements, 40 samples of human milk were used. Both supplements have been through three preparation phases: skimming, evaporation and lactose removal. After these phases, the liquid supplement is ready, and the powdered requires a fourth phase - lyophilization. To each sample of the liquid and powdered supplements were added, respectively, 80 mL (group I) and 100 mL (group II) of pooled banked human milk. For comparison, 20 samples of 100 mL of the pool were added to 5 g of the FM85® supplement (Nestlé) (group III). Analyses of carbohydrates, protein, lipids, calcium, phosphorus, sodium, osmolality and caloric content were performed, considering a significant difference p < 0.05. RESULTS: Groups I, II, and III showed, respectively, the following results: protein = 1.81, 2.38 and 1.96 g/dL (p < 0.001); carbohydrates = 6.70, 7.25 and 10.06 g/dL (p = 0.006); fat = 3.75, 3.75 and 3.73 g/dL (p = 0.96); calcium = 36.92, 44.75 and 79.37 mg/dL (p = 0.001); phosphorus = 20.02, 23.28 and 56.30 mg/dL (p = 0.02); sodium = 14.32, 14.40 and 20.33 mEq/L (p = 0.143); osmolality = 391.45, 412.47 and 431.00 mOsmol/kgH2O (p = 0.074); and caloric content = 67.78, 72.27 and 81.65 kcal (p = 0.001). CONCLUSION: The studied additives differ significantly from the commercial additive FM85® in some of its components, and its composition may or may not meet the quantity of nutrients suggested by the most recent recommendations.
Assuntos
Humanos , Recém-Nascido , Aditivos Alimentares/administração & dosagem , Alimentos Fortificados/análise , Recém-Nascido de muito Baixo Peso , Alimentos Infantis/análise , Bancos de Leite Humano , Leite Humano/química , Necessidades Nutricionais , Análise de Variância , Gorduras na Dieta/análise , Proteínas Alimentares/análise , Aditivos Alimentares/classificação , Alimentos Fortificados/normas , Alimentos Infantis/efeitos adversos , Minerais/análise , Concentração Osmolar , Preservação Biológica/métodosRESUMO
BACKGROUND: The WHO recommends the introduction of nutritionally adequate, safe, and appropriate complementary foods at 6 mo of age, with continued breastfeeding up to 2 y and beyond. Suggested strategies to support continued breastfeeding often postulate optimal use of customary "family foods" and adequate amounts of indigenous foodstuffs and local foods. OBJECTIVE: The objective was to determine the nutrient adequacy of the diet of Guatemalan children aged 6-24 mo receiving continued breastfeeding and "family foods" rather than specially formulated "baby foods" as complementary foods. DESIGN: "Critical nutrient densities" for complementary foods were determined by using specific energy and protein requirements, assuming children to be in the 50th or 15th weight percentile of the 2006 WHO standards. Nutrient requirements for the total diet were determined by using the recommended nutrient intakes. Breast milk was assumed to provide 75% of total energy between 7 and 9 mo, 50% between 10 and 12 mo, and 40% between 13 and 24 mo. Gaps between computed critical nutrient densities and the best-scenario Guatemalan adult's diet, as a proxy for family foods, were examined. RESULTS: Energy complementation with these diets provided adequate nutrient density for protein, thiamine, riboflavin, and vitamins B-6, B-12, and C but not vitamin A, niacin, and folate in some groups. Major gaps for calcium, iron, and zinc were ubiquitous. CONCLUSIONS: The critical nutrient density concept is useful to evaluate the nutrient adequacy of the young child's diet. Multiple micronutrients are likely to be limited in the diets of Guatemalan young children with continued breastfeeding and family foods.
Assuntos
Aleitamento Materno , Dieta/efeitos adversos , Promoção da Saúde , Alimentos Infantis/análise , Transtornos da Nutrição do Lactente/prevenção & controle , Fenômenos Fisiológicos da Nutrição do Lactente , Aleitamento Materno/etnologia , Transtornos da Nutrição Infantil/etnologia , Transtornos da Nutrição Infantil/prevenção & controle , Pré-Escolar , Países em Desenvolvimento , Dieta/etnologia , Feminino , Guatemala , Humanos , Lactente , Alimentos Infantis/efeitos adversos , Transtornos da Nutrição do Lactente/etnologia , Fenômenos Fisiológicos da Nutrição do Lactente/etnologia , Masculino , Modelos Biológicos , Política Nutricional , Necessidades Nutricionais/etnologia , Valor Nutritivo , Fatores Socioeconômicos , Organização Mundial da SaúdeRESUMO
OBJECTIVES: To describe the methodology for the preparation of two additives derived from human milk, liquid and powdered, and to compare this composition with the commercial additive FM85®. METHODS: For the preparation of the liquid and powdered supplements, 40 samples of human milk were used. Both supplements have been through three preparation phases: skimming, evaporation and lactose removal. After these phases, the liquid supplement is ready, and the powdered requires a fourth phase - lyophilization. To each sample of the liquid and powdered supplements were added, respectively, 80 mL (group I) and 100 mL (group II) of pooled banked human milk. For comparison, 20 samples of 100 mL of the pool were added to 5 g of the FM85® supplement (Nestlé) (group III). Analyses of carbohydrates, protein, lipids, calcium, phosphorus, sodium, osmolality and caloric content were performed, considering a significant difference p < 0.05. RESULTS: Groups I, II, and III showed, respectively, the following results: protein = 1.81, 2.38 and 1.96 g/dL (p < 0.001); carbohydrates = 6.70, 7.25 and 10.06 g/dL (p = 0.006); fat = 3.75, 3.75 and 3.73 g/dL (p = 0.96); calcium = 36.92, 44.75 and 79.37 mg/dL (p = 0.001); phosphorus = 20.02, 23.28 and 56.30 mg/dL (p = 0.02); sodium = 14.32, 14.40 and 20.33 mEq/L (p = 0.143); osmolality = 391.45, 412.47 and 431.00 mOsmol/kgH(2)O (p = 0.074); and caloric content = 67.78, 72.27 and 81.65 kcal (p = 0.001). CONCLUSION: The studied additives differ significantly from the commercial additive FM85® in some of its components, and its composition may or may not meet the quantity of nutrients suggested by the most recent recommendations.
Assuntos
Aditivos Alimentares/administração & dosagem , Alimentos Fortificados/análise , Alimentos Infantis/análise , Recém-Nascido de muito Baixo Peso , Bancos de Leite Humano , Leite Humano/química , Necessidades Nutricionais , Análise de Variância , Gorduras na Dieta/análise , Proteínas Alimentares/análise , Aditivos Alimentares/classificação , Alimentos Fortificados/normas , Humanos , Alimentos Infantis/efeitos adversos , Recém-Nascido , Minerais/análise , Concentração Osmolar , Preservação Biológica/métodosRESUMO
OBJECTIVE: To analyze the weight gain and to describe the metabolic complications in preterm newborns with nutritional support (NS) and to describe nutritional practices in the first month of hospitalization for 52 preterm newborns. MATERIAL AND METHODS: Descriptive and prospective study of preterm infants (30-36 gestational weeks), with birth weight > 1 kg, hospital stay > 12 days, without respiratory support or complications, conducted at a public hospital in Leon, Guanajuato, Mexico from January to November 2006. Weight, serum glucose, insulin, cholesterol, triglycerides, gamma-glutamyltransferase, creatinine, urea nitrogen, type of NS (parenteral PN, enteral EN, mixed MN), energy content, and macronutrient intake were measured weekly. To obtain representative data, nutritional practices were not altered by the study protocol. One way ANOVA and Wilcoxon tests were used in data analyses. RESULTS: Overall, 52 newborns were included, averaging 33 gestational weeks and 1,590 g of weight. The NS was started by the fourth day on average. Parenteral nutrition was the most frequent NS during the first 2 weeks (75%). Energy and macronutrient supply was 50% less than the recommended. Weight gain ranged from -100 to 130 g/week. Parenteral nutrition showed better weekly weight gain, followed by EN. The metabolic complication rate per person-day was greater for MN (0.56), than for EN (0.16) or PN (0.09). Routine surveillance of weight and metabolic complications was deficient. CONCLUSIONS: Late onset of NS, insufficient energy supply, and deficient surveillance were obstacles to weight gain and to prevent the metabolic complications in these newborns.
Assuntos
Alimentos Infantis , Transtornos da Nutrição do Lactente/etiologia , Doenças do Prematuro/etiologia , Recém-Nascido Prematuro/crescimento & desenvolvimento , Doenças Metabólicas/etiologia , Apoio Nutricional , Peso ao Nascer , Cefalometria , Carboidratos da Dieta/administração & dosagem , Gorduras na Dieta/administração & dosagem , Proteínas Alimentares/administração & dosagem , Ingestão de Energia , Nutrição Enteral , Feminino , Idade Gestacional , Hospitais Públicos/estatística & dados numéricos , Humanos , Alimentos Infantis/efeitos adversos , Alimentos Infantis/análise , Transtornos da Nutrição do Lactente/epidemiologia , Transtornos da Nutrição do Lactente/metabolismo , Transtornos da Nutrição do Lactente/prevenção & controle , Recém-Nascido , Recém-Nascido Prematuro/metabolismo , Doenças do Prematuro/epidemiologia , Doenças do Prematuro/metabolismo , Doenças do Prematuro/prevenção & controle , Tempo de Internação/estatística & dados numéricos , Masculino , Doenças Metabólicas/epidemiologia , Doenças Metabólicas/metabolismo , Doenças Metabólicas/prevenção & controle , México/epidemiologia , Apoio Nutricional/efeitos adversos , Apoio Nutricional/métodos , Nutrição Parenteral , Aumento de PesoRESUMO
Introducción: El reflujo gastroesofágico es una patología frecuente en la consulta ambulatoria pediátrica. Esta revisión trata de realizar un abordaje completo del tema considerando las controversias que aún existen sobre la indicación de las leches AR. Objetivos: Evaluar la evidencia existente sobre la eficacia de las leches antirreflujo para el tratamiento de los síntomas del RGE fisiológico (vómitos, regurgitaciones) para poder recomendar o desaconsejar su uso en la práctica diaria. Material y métodos: Se realizó una revisión sistemática, utilizando las bases de datos Medline, LILACS, y Cochrane. Se utilizaron las Guías JAMA para el análisis. Se limitó la búsqueda en inglés/español, en niños/lactantes. Desde 1994 hasta 2010. Quedando ésta búsqueda actualizada hasta enero 2010. Criterios de inclusión de los estudios: ECA, niños sanos de 1 mes a 2 años. Resultados: Se analizaron 6 artículos de un total de 12, debido a que los elegidos cumplían con los criterios de inclusión;. Se excluyeron seis estudios: dos debido a que no fueron ECA ( Borrelli 1997; Chevallier 1998;), uno debido a que trató a recién nacidos ( Heacock 1992), uno debido a que comparó dos alimentos espesados diferentes (Ramirez-Mayas 2000), uno debido a que el resultado del estudio no fue un resultado de revisión primario o secundario (Fabiani 2000) y uno debido a que trató a adultos (Waterhouse 2000). Conclusiones: Las leches antirreflujo son eficaces para disminuir los síntomas de RGE como vómitos y regurgitaciones, pero no mejoran los valores de la Phmetria (Indice de Reflujo). Por otro lado, se contraindican en la ERGE o esofagitis ya que al espesar su contenido, disminuye el aclaramiento esofágico perpetuando el tiempo de permanencia del alimento y aumentando el daño a la mucosa. Las calorías aportadas por las leches AR son las necesarias para el crecimiento de los lactantes, mientras que el espesamiento de la leche con cereal de arroz genera mayor aporte de energía (AU)
Introduction: Gastroesophageal reflux (GER) is a common finding in pediatric outpatients. The present review tries to offer a comprehensive approach of GER considering the controversies that still exists on the indication of AR formulas. Objectives: To assess the existing evidence on the efficacy of anti-reflux formulas for the treatment of the symptoms of physiologic GER (vomiting, regurgitations) in order to recommend or advise against its use in the daily practice. Material and Methods: A systematic search was performed in Medline, LILACS, and Cochrane databases. JAMA Guides were used for analysis. The search was limited to English/Spanish, in children/infants between 1994 and 2010. The search was updated until January 2010. Inclusion criteria for the studies were: RCT and healthy children between 1 month and 2 years of age. Results: Six studies of a total of 12 met the inclusion criteria. Six studies were excluded for the following reasons: two were not RCTs ( Borrelli 1997; Chevallier 1998;), one was a study in newborns ( Heacock 1992), one compared two different thickened formulas (Ramirez-Mayans 2000), one because the study was not the result of a primary or secondary review (Fabiani 2000), and one because the study was performed in adult subjects (Waterhouse 2000). Conclusions: Antireflux formulas are efficient in reducing symptoms of GER, such as vomiting and regurgitations, but do not improve Ph-metry values (Reflux Index). On the other hand, AR formulas are contraindicated in GERD and esophagitis as the thickened formula diminishes esophageal clearance prolonging the permanence of the food and increasing the damage to the mucosa. Calories provided by AR formulas are necessary for the growth of the infants while rice-cereal thickening increases energy intake (AU)
Assuntos
Humanos , Lactente , Refluxo Gastroesofágico/dietoterapia , Refluxo Gastroesofágico/prevenção & controle , Eficácia , Leite , Alimentos Infantis/efeitos adversosRESUMO
OBJECTIVE: In study 1, to compare the effect on growth in healthy infants of a new amino acid-based formula (AAF) and a control extensively hydrolyzed formula (EHF), with both docosahexaenoic acid (DHA) and arachidonic acid (ARA) at levels similar to those in human milk worldwide. In study 2, to evaluate the hypoallergenicity of this new AAF in infants and children with confirmed cow's milk allergy (CMA). STUDY DESIGN: In study 1, a total of 165 healthy, full-term, formula-fed infants randomly received the new AAF or control formula. Anthropometric measurements, tolerance, and adverse events were recorded throughout the study. Plasma amino acid profiles were evaluated in a subset of the infants. In study 2, the hypoallergenicity of the new AAF was evaluated in 32 infants and children using a double-blind, placebo-controlled food challenge; an open challenge; and a 7-day feeding. RESULTS: In study 1, overall growth, tolerance, and safety outcomes were similar in both groups. In study 2, 29 of the 32 subjects completed both challenges; no allergic reaction was seen in any of the 32 subjects. CONCLUSIONS: The new AAF with DHA and ARA at levels similar to those in human milk worldwide is hypoallergenic. It also is safe and supports growth in healthy, term infants.
Assuntos
Aminoácidos/administração & dosagem , Ácido Araquidônico/administração & dosagem , Ácidos Docosa-Hexaenoicos/administração & dosagem , Fórmulas Infantis/administração & dosagem , Hipersensibilidade a Leite/dietoterapia , Animais , Criança , Pré-Escolar , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Crescimento/efeitos dos fármacos , Humanos , Lactente , Alimentos Infantis/efeitos adversos , Recém-Nascido , Masculino , Leite/efeitos adversos , Hipersensibilidade a Leite/etiologia , Estudos Prospectivos , Resultado do TratamentoRESUMO
Tyrosinemia resulting from administration of protein-dense infant diets was detected by newborn screening in two infants. Change of formula resulted in rapid resolution of the hypertyrosinemia. These cases identify nonstandard infant diets as a benign and reversible cause of tyrosinemia and a potential cause of positive newborn phenylketonuria screening.
Assuntos
Proteínas Alimentares/administração & dosagem , Tirosinemias/etiologia , Diagnóstico Diferencial , Dietoterapia , Feminino , Humanos , Alimentos Infantis/efeitos adversos , Recém-Nascido , Masculino , Fenilalanina/sangue , Fenilcetonúrias/diagnóstico , Fenilcetonúrias/etiologia , Fenilcetonúrias/terapia , Resultado do Tratamento , Tirosina/sangue , Tirosinemias/terapiaRESUMO
Soy-based formulas are the most employed cow's milk substitutes in the treatment of cow's milk allergy in our country. Since adverse reactions have been reported in allergic patients as a consequence of exposure to soy proteins, we have investigated the possible cross-reactivity between components from soybean and cow's milk. A cow's milk specific polyclonal antiserum and casein specific monoclonal antibodies were used in immunoblotting and competitive ELISA studies to identify a 30-kD component from soybean that cross-reacts with cow's milk caseins. Its IgE binding capacity was tested by EAST, employing sera from cow's milk allergic patients, not previously exposed to soy proteins. The 30 kD protein was isolated and partially sequenced. It is constituted by two polypeptides (A5 and B3) linked by a disulphide bond. The protein's capacity to bind to the different antibodies relies on the B3 poly-peptide. These results indicate that soy-based formula, which contains the A5-B3 glycinin molecule, could be involved in allergic reactions observed in cow's milk allergic patients exposed to soy-containing foods.
Assuntos
Alérgenos/imunologia , Caseínas/imunologia , Glycine max/imunologia , Alimentos Infantis/efeitos adversos , Hipersensibilidade a Leite/imunologia , Proteínas de Plantas/isolamento & purificação , Proteínas de Soja/isolamento & purificação , Alérgenos/química , Animais , Especificidade de Anticorpos , Bovinos , Pré-Escolar , Reações Cruzadas , Ensaio de Imunoadsorção Enzimática , Humanos , Immunoblotting , Imunoglobulina E/sangue , Imunoglobulina E/imunologia , Lactente , Hipersensibilidade a Leite/sangue , Peso Molecular , Proteínas de Plantas/química , Proteínas de Plantas/imunologia , Estrutura Terciária de Proteína , Análise de Sequência de Proteína , Proteínas de Soja/química , Proteínas de Soja/imunologia , Glycine max/químicaRESUMO
This study evaluated the cariogenic potential of infant formulas and cow's milk, using a high cariogenic challenge in the animal model. Sixty female Wistar rats infected with Streptococcus sobrinus and desalivated were randomly divided into 6 groups, which received ad libitum: 1) sterilized deionized distilled water (SDW) with 5% sucrose; 2) cow's milk; 3) Nan 2; 4) Nestogeno 2; 5) Ninho growth supporting; 6) SDW. Groups 1 and 6 also received essential diet NCP#2 by gavage, twice a day. After 21 days, the animals were killed and evaluated according to recovered oral microbiota and caries score by using a modified Keyes method. The analysis of the carbohydrates in the milk samples was performed using HPLC. The results were analyzed by Shapiro-Wilk and Kruskal-Wallis tests. Cow's milk had the lowest cariogenic potential compared to the other test groups, but it was not statistically different from group 6. The percentage of S. sobrinus obtained from the oral cavity of the animals was not statistically different among the groups studied, except for the SDW group. It was concluded that cow's milk was not cariogenic and infant formulas showed some cariogenic potential.
Assuntos
Cariogênicos , Cárie Dentária/etiologia , Alimentos Infantis/efeitos adversos , Leite/efeitos adversos , Animais , Carboidratos da Dieta/efeitos adversos , Carboidratos da Dieta/metabolismo , Feminino , Humanos , Lactente , Modelos Animais , Ratos , Ratos Wistar , Saliva/fisiologia , Estatísticas não Paramétricas , Streptococcus sobrinus/isolamento & purificação , Streptococcus sobrinus/metabolismoRESUMO
BACKGROUND: Asthma is a multifactorial disease. Children with atopy history could be sensitized with indoor and food allergens from early stages of the life and this predispose to develop asthma. Controversy exists about the factors that increase or decrease the risk of disease, such as breast feeding, early weaning, smoking exposition, immunizations. OBJECTIVE: To determine if these risk factors and inhaled and food allergen sensitization predispose to asthma development. METHODS: A case-control study was performed. Cases (1 to 3 year-old 74 children) with asthma and control (74 healthy age-matched children) were included, r2 = 0.90. Skin-prick test (SPT) was performed by using indoor and food allergens. Test was considered positive if skin reaction was equal or higher than 3 mm. The results were compared by means of the x2 test. A logistic regression analysis was performed for obtaining odds ratio (OR) (95% confidence interval for each factor). RESULTS: Out of the SPT carried out with aero-allergens, 23 (31%) were positive in the two groups. Regarding the food, 27 cases (36.4%) and 15 controls (20.2%) were positive (x2 = 4.7); p < 0.05, OR = 2.2, IC 95% (1.6-3.1). Atopy was positive in 50 (67.5%) cases and 39 (52.7%) of the controls (x2 = 3.4); p < 0.05, OR 1.8 (1.3 to 2.5). The weaning before the first three months of life was positive in 44 (59.4%) of the cases against 15 (20.2%) of the controls (x2 = 23.7) p < 0.05 with a OR 5.7 (4.9 at 6.6). CONCLUSIONS: We found a probability 2.2 times higher for developing asthma when children were sensitive to at least one food. We also reported that 100% of our sensitized cases with food had received breast feeding during the first four months of life, which is similar to results of other authors where the breast feeding during an intermediate time (one to six months) does not protect against allergic disease. Early introduction of solid food (before the three months of age) was the main factor increasing probability for developing asthma. In our study, atopy almost duplicated this probability.
Assuntos
Alérgenos/efeitos adversos , Asma/etiologia , Animais , Animais Domésticos , Asma/epidemiologia , Roupas de Cama, Mesa e Banho , Aleitamento Materno , Estudos de Casos e Controles , Pré-Escolar , Eosinofilia/epidemiologia , Eosinofilia/etiologia , Feminino , Hipersensibilidade Alimentar/epidemiologia , Hipersensibilidade Alimentar/etiologia , Humanos , Umidade , Imunoglobulina E/sangue , Lactente , Alimentos Infantis/efeitos adversos , Masculino , México/epidemiologia , Fatores de Risco , Testes Cutâneos , Poluição por Fumaça de Tabaco/efeitos adversosRESUMO
The food-induced eosinophilic proctocolitis is a major cause of blood-tinged stools and appears in the first two months of life. The infant is generally described as well, but the clinical features and laboratory results are often nonspecific. We present an early infant with fresh blood stools at 50 days. The colonoscopy and biopsy of the rectum and lower sigmoid revealed lymphoid nodular hyperplasia of the submucose and eosinophil infiltration (40 to 50 per high power field) of the lamina propria and intraepithelial. Elimination of the offending protein from the diet, through the use of an extensively hydrolyzed casein-based formula and soy, lead to clinical resolution of bleeding at 48 hours. We made a review of the case.