Malnutrition in Institutionalized and Non-Institutionalized Neurologically Impaired Children in Bulgaria.

INTRODUCTION: The nutritional status of children with neurological impairment affects their health and quality of life. Bulgaria has many abandoned disabled children in residential homes. Lack of parental care puts them at risk for poor growth, suboptimal nutrition, and physical and mental development. Our study aims to identify factors associated with poor nutrition in Bulgarian children with neurological impairment living in different environments. METHODS: From January to December 2017, a cross-sectional study was conducted in northeastern Bulgaria. We recruited 109 residential and nonresidential children. The study included demographics, medical history, anthropometric measurements, biochemical tests, nutritional assessment, and gastrointestinal signs and symptoms. Data were analyzed with Jamovi 2.2.5 at a 0.05 significance level. Logistic regression was used to predict wasting in both environmental settings. RESULTS: About 70% of the neurologically impaired children living in residential settings have malnutrition based on weight-for-age Z-score, compared to 25% of the non-residential children. Prematurity, low gross motor function (as measured by the gross motor function classification system), pureed food consumption, birth before 37 weeks, and living in residential care homes are linked to poor nutrition. CONCLUSION: Neurologically impaired children have a poor nutritional state, especially those living in residential homes. The study underscores the pressing need for the allocation of additional nutrition resources to effectively address the nutritional and developmental needs of children with neurological disabilities in Bulgaria.

Dietary Behavior and Compliance to Bulgarian National Nutrition Guidelines in Patients With Type 1 Diabetes With Longstanding Disease.

Introduction: Nutrition education attempts to maintain and enhance good eating habits to achieve optimal metabolic control in people with type 1 diabetes (T1D). Recommendations for patients with T1D are comparable to those of the general population. This Study Aimed: To investigate dietary habits and adherence to nutritional recommendations of patients with T1D as compared with age, gender, and BMI matched people in Bulgaria. Methods: A case-control study included 124 patients with T1D with long disease duration (mean duration 25.3 ± 8.2 years) followed up at a diabetes clinic in Varna, Bulgaria for 2 years (2017-2019) and 59 controls matched for gender, age and BMI. A 24-h dietary recall method was used to assess the nutrition of both groups. A standardized questionnaire was applied to assess the frequency of food consumption (Feel4Diabtes). Height and weight were standardly measured, and BMI was calculated. Findings were compared with Bulgarian recommendations and reference values for energy and nutrient intake for healthy adults. The data were analyzed with the statistical package SPSSv21.0 and Jamovi v.22.5. Results: The nutritional characteristics of T1D men and women differ. Men with T1D had a higher intake of total carbohydrates (CHO) (p = 0.009), a lower intake of total fats (p = 0.007), and monounsaturated fatty acids (p = 0.029) as a percentage of total daily energy compared with the controls. Women with T1D had a different distribution of energy intake per meal compared to controls: they consumed more energy (p = 0.001) and a corresponding share of CHO for lunch, less for dinner (p = 0.015) and had a higher overall healthy diet score when compared to controls (p = 0.02). Adherence to dietary recommendations (e.g., CHO, total fats, saturated fat, fibers) was low in both genders, but lower in the general population compared to people with T1D. Conclusion: Our data demonstrate that people with T1D consume a healthier diet than the general population, which could be attributed to healthier diet awareness, still far from the recommendations. Introduction of annual consultations with a dietitian may improve long-term outcomes.

Benthic habitat mapping of Plazh Gradina - Zlatna ribka (Black Sea) and Karpathos and Saria Islands (Mediterranean Sea).

BACKGROUND: Habitat mapping is nеcessary for the efficient conservation and protection of marine ecosystems. In addition, it is a requirement for EU Member States as stated in the European Union (EU) Habitats Directive (92/43/EEC), as well as necessary for the achievement and maintenance of 'good environmental status (GES)' of benthic marine habitats in the framework of the EU Marine Strategy Framework Directive (2008/56/EC). NEW INFORMATION: This study provides baseline information on the marine benthic habitats of Sozopol Bay (Black Sea) and Karpathos and Saria Islands (Mediterranean Sea). These two Natura 2000 sites were selected as study sites of the RECONNECT project, which aimed at creating a transnational cooperative network to confront the environmental threats of ecosystems with a high natural and cultural interest, by the establishment of common practices and a joint regional strategy. The specific objective was to map the marine habitats using a defined a priori classification (EUNIS), with the ultimate purpose of supporting government marine spatial planning, management and decision-making processes through the development of a Decision Support System.