13 research outputs found
The stereospecific triacylglycerol structures and fatty acid profiles of human milk and infant formulas
No full textBackground: The stereospecific structures of the triacylglycerol molecules in human milk differ from that of cow's milk and vegetable oils, which are the fat sources used in infant formula. In human milk, palmitic acid (16:0) is predominantly esterified in the sn2 position, whereas vegetable oils or cow's milk fat contain most of their 16:0 in the outer positions of the triacylglycerol molecules. Furthermore, human milk contains long-chain polyunsaturated fatty acids, which are not present in either cow's milk or vegetable oils. Methods: By standard lipid analysis procedures, we examined the triacylglycerol structures and fatty acid profiles of fats from 28 infant formulas or formulas for special indications available in the Danish market from 1999 to 2003. Results: The total fatty acid compositions of the formulas showed a 16:0 content almost similar to human milk, whereas the content in the sn2 position was considerably lower. The content of oleic acid was found to be equal to or higher than in human milk in 21 of 28 formulas, whereas the content in the sn2 position was higher in all but one formula. Most formulas had linoleic acid levels considerably above that of human milk. Long-chain polyunsaturated fatty acids (arachidonic acid and docosahexaenoic acid) were present in all preterm formulas, but only in 3 of the term formulas. Conclusion: We found that most of the examined infant formulas, both preterm and term as well as special formulas, had stereospecific structures and fatty acid profiles that differed considerably from that of human milk
Allergic diseases among very preterm infants according to nutrition after hospital discharge
No full textTo determine whether a cow's milk-based human milk fortifier (HMF) added to mother's milk while breastfeeding or a cow's milk-based preterm formula compared to exclusively mother's milk after hospital discharge, increases the incidence of developing allergic diseases among very preterm infants (VPI) during the first year of life. Of a cohort of 324 VPI (gestational age 24-32 wk), the exclusively breastfed VPI were shortly before discharge randomized to breastfeeding without fortification or supplementing with a fortifier. Those not breastfed were fed a preterm formula. The intervention period was from discharge until 4 months corrected age (CA). Follow-up was performed at 4 and 12 months CA including specific IgE to a panel of allergens at 4 months CA. The incidence during and prevalence at 12 months CA of recurrent wheezing (RW) was 39.2% and 32.7%, while atopic dermatitis (AD) was 18.0% and 12.1%, respectively. Predisposition to allergic disease increased the risk of developing AD (p=0.04) [OR 2.6 (95% CI 1.0-6.4)] and the risk of developing RW (p=0.02) [OR 2.7 (95% CI 1.2-6.3)]. Boys had an increased risk of developing RW (p=0.003) [OR 3.1 (95% CI 1.5-6.5)]. No difference was found between nutrition groups. None developed food allergy. Compared to exclusively breastfed, VPI supplemented with HMF or fed exclusively a preterm formula for 4 months did not have an increased risk of developing allergic diseases during the first year of life
Pediatric inflammatory bowel disease: increasing incidence, decreasing surgery rate, and compromised nutritional status: A prospective population-based cohort study 2007-2009
No full textBackground: The aim was to evaluate the incidence, treatment, surgery rate, and anthropometry at diagnosis of children with inflammatory bowel disease (IBD). Methods: Patients diagnosed between January 1, 2007 to December 31, 2009 in Eastern Denmark, Funen, and Aarhus were included from a background population of 668,056 children <15 years of age. For evaluation of incidence, treatment, and surgery rate, a subcohort from Eastern Denmark was extracted for comparison with a previously published population-based cohort from the same geographical area (1998–2006). Results: In all, 130 children with IBD: 65 with Crohn's disease (CD), 62 with ulcerative colitis (UC), and three with IBD unclassified (IBDU) were included. The mean incidence rates per 106 in 2007–2009 were: IBD: 6.4 (95% confidence interval [CI]: 5.4–7.7), CD: 3.2 (2.5–4.1), UC: 3.1 (2.4–4.0) and IBDU: 0.2 (0.05–0.5). Comparing the two cohorts from Eastern Denmark we found higher incidence rates for IBD (5.0 and 7.2 in 1998–2000 and 2007–2009, respectively, P = 0.02) and CD (2.3 versus 3.3, P = 0.04). Furthermore, we found a significant decrease in surgery rates (15.8/100 person-years versus 4.2, P = 0.02) and an increase in the rate of initiating immunomodulators (IM) within the first year (29.0/100 person-years versus 69.2, P < 0.001). IM use was associated with a trend towards a decreased surgery risk (relative risk [RR] 0.38; 0.15–1.0). Children with CD had poor nutritional status at diagnosis compared with the general pediatric population. Conclusions: Over the past 12 years we found an increase in the incidence of IBD in children, an increasing use of IM, and decreasing 1-year surgery rates. CD patients had poor nutritional status. <br/
Chronic care treatment of obese children and adolescents
No full textObjectives. Clinically-relevant protocols for the treatment of childhood obesity are lacking. This study report results for a clinic-based structured treatment program for chronic childhood obesity. Methods. Patients were measured at baseline and for up to 24 months; there were no prior eligibility criteria. At baseline, height, weight, Tanner stages, testicular size, time of menarche, and social class of the parents were registered. A structured, tailored treatment plan including best-practice-based interventions was initiated. Height, weight, and pubertal development were measured at subsequent visits. Results. A total of 617 children or youths were included; 325 were girls and 292 were boys. At entry, the mean age was 11.6 years and the mean body mass index (BMI) standard deviation score (SDS) was 3.0. Seventy stopped treatment, 547 were in treatment, 125 had 1 examination, and 492 had two or more examinations, with a mean visit interval of six weeks. After 12 months, the mean BMI SDS decreased by 0.23 (P < 0.0001) in girls and by 0.32 (P < 0.0001) in boys. After one year, the retention rate was 90.2%, and 68.7% had reduced BMI SDS. After two years, the retention rate was 75.0%, of which 62.5% had reduced BMI SDS. The reductions in BMI SDS were independent of baseline adiposity, age (in boys), puberty stage, and social class, but were dependent on sex, age (girls), and place of referral. Conclusions. This clinical obesity treatment was safe and effective in reducing BMI SDS independent of baseline adiposity, age (boys), or social class in these young people
