[Health consequences of obesity in children and adolescents]. / Conseguenze dell'obesità sulla salute del bambino e dell' adolescente.

Obesity in childhood is associated with the presence of complications that can undermine health immediately or in the long term. Several conditions, such as pulmonary or orthopedic complications are strictly associated with the severity of overweight, since they are directly associated to the mechanic stress of fat tissue on the airways or on the bones. Other conditions, such as metabolic or liver complications, although increasing with the extent of overweight, are associated with insulin resistance, which can be modulated by different other factors (ethnicity, genetics, fat distribution) and can occur in overweight children as well. No less important are psychological correlates, such as depression and stigma, which can seriously affect the health related quality of life. Pediatric services for the care of childhood obesity need to be able to screen overweight and obese children for the presence of physical and psychological complications, which can be still reversed by weight loss. This article provides pediatricians a comprehensive update on the main complications in obese children and adolescents and their treatment.

Amendment to 2010 Italian guidelines for the establishment and operation of a donor human milk bank.

The present paper is an amendment to the recent Italian Guidelines of human milk banking published in 2010. Working Group on Guidelines (Panel) of the Italian Association of Human Milk Banks (AIBLUD) states, in accordance with the European Union Comission's Amending Directive of January 2011, that the hard plastic feeding bottles used in the collection, storage and pasteurization of the human milk should be Bisphenol A (BPA) free. Until new evidence are available polycarbonate feeding bottles should not be used for collection, storage and pasteurization of human milk. The paper summarizes the former and current European Commission Directives and shows the related amending changes to the 2010 Italian Human Milk Banking Guidelines.

[Management of children and adolescents with severe obesity]. / Il percorsi terapeutico del bambino e dell' adolescente con obesità grave.

Obesity is a complex public health issue. Recent data indicate the increasing prevalence and severity of obesity in children. Severe obesity is a real chronic condition for the difficulties of long-term clinical treatment, the high drop-out rate, the large burden of health and psychological problems and the high probability of persistence in adulthood. A staged approach for weight management is recommended. The establishment of permanent healthy lifestyle habits aimed at healthy eating, increasing physical activity and reducing sedentary behavior is the first outcome, because of the long-term health benefits of these behaviors. Improvement in medical conditions is also an important sign of long-term health benefits. Rapid weight loss is not pursued, for the implications on growth ad pubertal development and the risk of inducing eating disorders. Children and adolescents with severe obesity should be referred to a pediatric weight management center that has access to a multidisciplinary team with expertise in childhood obesity. This article provides pediatricians a comprehensive and evidence based update on treatment recommendations of severe obesity in children and adolescents.

Monitoring of the benzene and toluene contents in human milk.

Twenty-three samples of human milk collected from the milk bank of a children's hospital were analysed with a view to monitoring the possible presence of some of the most common aromatic hydrocarbons (benzene and toluene) and to quantify their concentrations. The analysis was carried out by the "purge and trap" technique combined with gas chromatography and with the use of the mass spectrometer as detector. The hydrocarbons themselves were used in a deuterated form as internal standards. The analysis of the data showed the presence of both hydrocarbons, even though their quantity was much lower than that detected in other foods.

Feeding disorders in infancy: an empirical study on mother-infant interactions.

AIM: The objective of this paper is an empirical analysis of mother-infant feeding interactions through an observational instrument (Feeding Scale), which is applied to the videotape of a feeding session. METHODS: Three samples of mothers and their children have been examined (104 couples with children ranging in age from 2 to 36 months: a first group in which children presented a feeding disorder on organic and functional base (food intolerances and/or gastroesophageal reflux), a second group in which the disorder was not due to a medical condition and a third group of control. The Authors meant to test three hypotheses: 1) the presence of developmental changes in mother-infant interactional patterns during the course of the first three years of life; 2) higher degree of dysfunction of mother-infant interaction in those dyads in which the feeding disorder had not organic causes; 3) dysfunctional interactions in the couples of mothers and children in which the feeding disorder was on an organic base. RESULTS: The results of the statistic analyses have confirmed the hypotheses, providing different elements of reflection. CONCLUSIONS: The Authors underline the importance of a multidimensional, global and integrated approach in the clinical assessment and treatment, which evaluates the possible interconnections among organic, psychogenetic and relational factors in the origin and course of feeding disorders in infancy and early childhood.

Childhood obesity: results of a multicenter study of obesity treatment in Italy.

The prevalence of pediatric obesity is increasing and many patients are followed by specialized centers or private doctors. The aim of this study was to verify short- and medium term results of a therapeutic approach based on nutritional intervention in a large pediatric population: 1383 subjects (695 females, 688 males) aged 10.1 +/- 2.7 yr, followed in 11 pediatric departments in Italy. No difference was found between centers in age, height, weight, BMI and IBW. The drop-out rate after the first visit was 30.2% (58.1% IBW > 140%) in females and 34.2% (70.7% IBW > 140%) in males. After two years of follow-up only 9.7% of females and 6.4% of males remained on treatment. Of these patients only 7.3% of females and 6.4% of males had IBW < 120%. These data show that an approach based on nutritional intervention alone is not sufficient for long-term treatment of pediatric obesity. Only an approach started early and involving the family can produce permanent results.

Evaluation of ochratoxin A level in human milk in Italy.

In order to estimate the incidence of ochratoxin A (OA) in biological fluids, a study was carried out to determine the concentration of OA in breast milk of donor mothers in Italy. Out of 111 samples, 22 were contaminated in the range 0.1-12 micrograms/kg.

[The nutritional aspects and incidence of obesity and hypertension in a groups of Roman adolescents]. / Aspetti nutrizionali ed incidenza di obesità ed ipertensione in un gruppo di adolescenti romani.

Two-hundred-thirty teenagers of a Roman liceo (specializing in classical studies) have been checked with particular regard to growth, pressure and feeding. The diet of teenagers proved to be particularly unbalanced from the qualitative point of view. There is an excessive intake of fats especially to the detriment of carbohydrates and starches. The incidence of obesity (6.9%) and of hypertension (6%) is not particularly high, probably due to the fact that youngsters at this age "look at themselves in the mirror a lot" for the first case and the second one can be considered as a direct consequence of the first.

[Comparison between 2 types of feeding in acute diarrhea in childhood]. / Confronto tra due tipi di rialimentazione nelle diarree acute dell'infanzia.

134 infants under three years of age suffering from severe diarrhoea are related. 57 of these had quite serious dehydration and 77 presented protracted diarrhoea (less than or equal to 15 days). 50% were treated with a milk with reduced content of lactose. Other 50% with a diet lactose-free for a day followed by the same milk used before diarrheal disease. Results obtained, few relapses and quick normalization of stool are supporting the use of a milk with reduced contents of lactose.