Nutritional Management of Cow's Milk Allergy in Infants: A Comparison of DRACMA, ESPGHAN, and AAP Guidelines

Cow’s Milk Allergy (CMA) is one of the most common food allergies presented during infancy and childhood. The diagnosis and management of CMA is a complex task. First and foremost, CMA is manifested by a variety of symptoms classified by their type of mediation (either IgE and/or non-IgE responses), organ systems involved, and the onset of the reaction. Second, although several guidelines for the management of CMA have been published worldwide, they differ in their recommendations. To our knowledge, no global consensus exists for the management of the different symptoms associated with CMA. This review provides a table to compare three widely accepted published guidelines to enable the reader to easily navigate and compare the nutritional recommendations to be followed depending on the symptomatology. This review is intended to represent a practical tool to assess the nutritional recommendations for the management of CMA.

Cereal-based Complementary Foods Marketed in the City of Yaounde: Assessment of the Compliance to Labeling and Nutritional Composition Standards

Background: Complementary foods are foods intended for consumption by infants and young children to supplement then replace their milk diet. Compliance with labeling and nutritional composition standards conditions their nutritional quality. Objective: The aim of this study was to assess the compliance level of Cereal-based Complementary Foods (CCFs) marketed in the city of Yaounde to related standards. Methods: A descriptive cross-sectional study was conducted among 125 mothers in 2 hospitals of Yaounde using probabilistic cluster sampling. The labelings and nutritional compositions of the most consumed CCFs coded as “ASC O”, “ASC I”, “ASC E” and “ASC A”, were compared to Codex Alimentarius standards at an acceptability threshold of 80%. Results: The labeling standards were 95.24%, 93.48%, 89.68% and 59.34% compliant for “ASC O”, “ASC I”, “ASC E” and “ASC A” respectively, 52.5%, 73.75%, 83. 75% and 35% for nutritional composition standards. 90% of these CCFs complied with labeling standards, while only 26% with nutritional composition standards. Conclusion: CCFs in Yaounde have as main defects: incomplete labels, labels with errors and falsities, protein and mineral deficiencies. Their producers, controllers, and buyers should respectively improve, control and seek their good quality for the well-being and good health of infants and young children.

Effect of Oral Nutritional Supplementation on Growth in Vietnamese Children with Stunting

Background: The impact of oral nutritional supplementations (ONS) is not well-elucidated in children with stunting. Objective: The aim is to evaluate the effect of ONS on growth in Vietnamese children with stunting. Methods: This 6-month, prospective, single-arm trial evaluated 121 children aged 24–48 months with stunting (height-for-age z-score [HAZ] < -2) and low weight-for-height z-score (WHZ < -1) in Vietnam. Children consumed ONS twice daily. The outcomes included the change in HAZ, WHZ, and weight-for-age z-score (WAZ) from baseline to 3- and 6 months; change in height and weight from baseline to 3- and 6 months; and the prevalence of stunting, wasting (WHZ < -2 SD), and underweight (WAZ < -2 SD) at 6 months. We also examined factors associated with a change in HAZ over the intervention period. Results: The mean age was 34.7 months and 49% were male. Height and weight increased from baseline to 3- and 6-months (p<0.0001). There was a significant increase in median HAZ (0.25 units), WHZ (0.72 units), and WAZ (0.65 units) from baseline to 6 months (p<0.0001). Notably, approximately 40% of children recovered from stunting at 6 months (p<0.0001). The prevalence of wasting and underweight status were also significantly lower at 6 months (p=0.0310 and p<0.0001, respectively) relative to the baseline. Lower HAZ and younger age at baseline were significantly associated with higher linear growth at 6 months. Conclusion: ONS helped improve linear and ponderal growth and reduce the prevalence of stunting, wasting, and underweight status in stunted children at risk of wasting.

Dietary Fatty Acids and Cancer

In this review, the influence of dietary fat on the development of cancer is discussed. In epidemiological studies, a relationship between dietary fat and breast cancer has been found in correlational studies, but prospective studies do not support a role for dietary fat. Prospective epidemiological studies examining the role of dietary fat in the development of colon, pancreatic, and prostate cancers have produced conflicting results. The Women’s Health Initiative intervention studies did not show any statistically significant effects of dietary fat on the development of either colon or breast cancer in women. In experimental studies, dietary fat generally enhances chemically-induced skin, liver, pancreatic, and mammary carcinogenesis, whereas conflicting results have been observed in colon carcinogenesis. Dietary fat appears to act primarily during the promotional stage of carcinogenesis in all of these models except the liver, where the effect of dietary fat is primarily on initiation.

The Short- and Long-term Effectiveness of the WhyDairy? School-based Nutrition Education Intervention: A Randomized Controlled Trial

Background:Despite the known health benefits of dairy products, their daily consumption continues to decline in many populations, particularly in pre-adolescents and adolescents.Objective:The primary objective of the cluster randomized controlled trial was to assess whether a school-based intervention enhanced with a web-based component, known as WhyDairy? was more effective than a standardized dairy education program at changing: (i) knowledge of dairy products, (ii) intentions to consume dairy products, and (iii) dietary intake of dairy products.Methods:Grade 7 students (n=175) in 10 Southwestern Ontario schools were randomized by the school, into intervention or control. Intervention schools received the WhyDairy? intervention with a website component while control schools received a DFO education program. Intervention schools were further randomized to receive follow-up contact, through monthly emails, or no follow-up contact. A questionnaire, consisting of three surveys (knowledge, FFQ, and intention), was delivered at baseline, post-intervention, and follow-up.Results:All groups significantly increased their knowledge post-intervention but only intervention schools with follow-up email contact maintained this positive change in knowledge. No groups saw significant changes in dietary behaviour. The email campaign was successful in reaching parents but did not result in high engagement or changes in student outcomes.Conclusion:The results of this study demonstrate the effectiveness of a school-based intervention enhanced with a web-based component in changing student knowledge regarding dairy products and the engagement of the website during the intervention period. Future work should consider longer durations to see changes in dietary behaviour and more targeted approaches during follow-up periods.

A Questionnaire-based Assessment of Dietary Adherence and Identification of Barriers to Healthy Eating

Background: Adherence to a Mediterranean-style diet is associated with an extensive list of health benefits for people both with and without a disease. Objective: The objective of this study was to develop/modify a questionnaire to investigate the current adherence to a Mediterranean-style dietary eating pattern amongst the New Zealand male population, and to assess the association between perceived barriers to change and behaviours. Methods: The development of this questionnaire was based upon a modified 14-point validated Mediterranean diet adherence screener (PREDiMED) and included an additional section wherein we explored the reasons behind men’s food choices and barriers to healthy eating. Questionnaires were analysed from 295 men. Descriptive analyses were used to determine major barriers to change. Results: The modification of the PREDiMED questionnaire resulted in a 23 question questionnaire encompassing adherence, demographics and barriers to change. We found that 90.8% of respondents had either low or intermediate adherence to a Mediterranean style diet. Significant associations also existed between adherence and smoking (p=0.003), age (p< 0.01) and opinion of the importance of healthy eating (p< 0.01). We found participants felt the ‘major’ barrier to consume a healthy diet, to be a busy lifestyle, and the most common influencer of food choices was people. Conclusion: Through identifying how New Zealand men consume food and how they consider their barriers to change, we can better direct policy to aid changes in behaviour and integrate the Mediterranean style diet to complement the New Zealand food culture.

Almonds and Walnuts Consumption Modifies PUFAs Profiles and Improves Metabolic Inflammation Beyond the Impact on Anthropometric Measure

Purpose:To evaluate changes in serum fatty acids, metabolic profile and inflammation markers after a dietary intervention of 15g of walnuts and 15g of almonds for 8 weeks in obese subjects,Patients and Methods:We studied a total of 48 sedentary obese grade I subjects (13 men and 35 women). Anthropometric measures, body composition, serum glucose, lipid profile, insulin, lipocalina-2, high sensitivity C-reactive protein (hsCRP), adiponectin, and fatty acids profile were analyzed at the baseline and after dietary intervention.Results:The adiponectin (30.4%, p = 0.007), and lipocalin-2 concentrations (17.9%, p = 0.014), and total Polyunsaturated Fatty Acids (PUFAs) percentage (1.6% p = 0.040) significantly increased after the intervention; particularly the eicosapentaenoic acid and docosahexaenoic acid percentages were increased marginally. A significant decrease in saturated fatty acids levels (3%, p = 0.001), in particular the C:14, C:16, in total cholesterol (6.7%, p = 0.01), LDL (11.4%, p = 0.002) levels, and in all adiposity measures (weight, waist circumference, hip circumference, BMI and fat mass, p < 0.0001) was found. The effect size was large for all adiposity measures, except for BMI as well as for adiponectin which was moderate.Conclusion:The intake of almonds and walnuts to short-time may improve significantly the metabolic profile and decrease adiposity.

Cardiomyopathy Secondary to Selenium Deficiency: A Review of Clinical Cases

Background:Selenium is an essential micronutrient for the human body because it is needed for the synthesis of selenoproteins, which have various biological functions. As a result, selenium deficiency associated with diets and/or environments manifests in different disease states such as epilepsy, multiminicore disease and cardiovascular injury which in some cases is a presage of cardiomyopathy.Objective:This objective was to review published cases and identify selenium-responsive cardiomyopathy due to selenium deficiency by various factors.Methods:Published case reports in English were identified and extracted from PubMed, Scopus, Embase, and Science Direct Library.Results:28 case reports met inclusion criteria out of an initial 189 articles.Conclusion:Acquired selenium deficiency is a causative factor for the development of cardiomyopathy in patients under different conditions, and treatment of these patients with selenium is effective in normalizing cardiac function or reducing cardiac dysfunction. Thus, it is important to include selenium deficiency as a possible cause of cardiomyopathy for diagnosis and treatment purposes.

Sarcopenic Obesity: Definition, Health Consequences and Clinical Management

Over the last decade, a new condition, which occurs in the presence of both sarcopenia and obesity, has been termed “sarcopenic obesity”. The term describes the coexistence of obesity, defined as the increase in body fat mass deposition, and sarcopenia, defined as the reduction in lean mass and muscle strength. However, many uncertainties still surround the condition of sarcopenic obesity in terms of its definition, the adverse short- and long-term health effects (i.e., medical disease, psychosocial functioning, quality of life and mortality) and its clinical management. The aim of this short communication is to emphasize some crucial aspects that future research should take into account in order to avoid bias and misinterpretations and to underline that the study of sarcopenic obesity should be considered a scientific and clinical priority, as reported by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO).

Probiotics: A Promising Tool for Calcium Absorption

As we know nutrients are necessary for the development and proper functioning of the human organism. Bioavailabilities of nutrients are the major concern rather than the supply of an adequate amount of nutrients in the diet. Many of the researches have been shown that the consumption of probiotics along with dairy foods buffers the acidity of the stomach and increases the bacterial survival rate into the intestine. A dairy product with probiotics also provides many of essential nutrients, including protein and calcium. From all the necessary nutrients the calcium having a major role in the human body including the development of bone and teeth are also regulating enzymes and many more. Calcium is the most essential nutrient, about 99% of calcium found in teeth and bone in the body and only 1% is found in serum. A numbers of researches have shown that adequate amount of calcium intake leads to reduce risk of fracture, Osteoporosis and Hypoglycaemia and diabetes in some population. Many of the researches suggested that the Probiotics having a significant role in improvement of calcium uptake and absorption, hence the present review gives information about the relationship of probiotics and calcium, ensuring higher bioavailability of calcium and promising a better bone health. Here, the review study showed a significant role of probiotics in calcium absorption and thus the bioavailabilities. Moreover, it is focused on glimpse of various studies and in-vitro models associated with the phenomena of calcium absorption and uptake.