[Gluten: Is the information available on the Internet valid?] / Gluten : l'information disponible sur Internet est-elle en accord avec les recommandations des sociétés savantes ?

BACKGROUND: Internet provides easy access to health information, but the quality and validity of this information vary. OBJECTIVES: Evaluate the quality of website structures and the information provided on celiac disease (CD), gluten sensitivity (GS), and wheat allergy (WA). MATERIALS AND METHODS: The websites addressing CD, GS, and WA appearing on the first two pages of Google, Yahoo, and Bing from seven selected queries were investigated. We initially assessed the website structures with one instrument (Netscoring) and the presence of certification (quality label Health On the Net (HON code)). Then we evaluated the content of each website concerning the information about CD, GS, and WA. Our repository was based on the most recent guidelines of the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) and the World Gastroenterology Organization (WGO) published in 2012. The websites were classified into eight categories. RESULTS: One hundred and five websites were included. Twenty-one websites obtained a sufficient score with the Netscoring instrument (average 113.6/312). There was a significant correlation between the referenced websites analyzed and the grades obtained with the Netscoring instrument (Pearson=0.39, P=0.2×10-5): websites of scientific societies (11.8/18), community websites (9.44/18), and website associations (9.4/18). There was a significant correlation between the results obtained for the websites on CD, GS, and WA and the results obtained for the websites with the Netscoring instruments (Pearson=0.41, P=2.6×10-6). Only three websites were consistent with the guidelines on CD, GS, and WA. CONCLUSION: The websites were partially in agreement with the guidelines. To date, the pediatrician remains the main actor in parental guidance concerning gluten information.

[Infant food diversification. Assessment of practices in relation to French recommendations in pediatricians and pediatric residents in southern France]. / Diversification alimentaire du nourrisson. Évaluation des pratiques en regard des recommandations françaises actuelles chez les pédiatres varois et les internes affectés à la faculté d'Aix-Marseille.

Infant food diversification has undergone a rapid succession of good practice recommendations in France, but there has been no assessment of pediatrician practices on food diversification. OBJECTIVE: To assess the practices of pediatricians in relation to current recommendations of the French Society of Pediatrics on infant food diversification. METHODS: This was an observational study conducted from 1 November 2014 to 31 March 2015. The study population consisted of 97 pediatricians in the Var department and 84 pediatric residents assigned to the University of Aix-Marseille in France. A questionnaire was sent by email or post to determine physician characteristics, food diversification methods in healthy children and those at atopic risk, and how the pediatric consultation was conducted. The expected answers were based on the most recent recommendations of the French Society of Pediatrics published in 2008, updated from 2003. In summary, breastfeeding is recommended up to 6 months. Food diversification can be started between 4 and 6 months in children with no allergy risk. Gluten, honey, legumes and cow's milk are introduced between 4 and 7 months, after 12 months and after 36 months, respectively. In atopic children, food diversification is delayed until after 6 months and the most allergenic foods (nuts, exotic fruits, peanuts, and shellfish) are introduced after the age of 12 months. RESULTS: Eighty-four responses were obtained (51%): 50 pediatricians and 34 pediatric residents. Sixteen items were classified depending on whether or not an update after 2003 existed. Over 80% of the physicians responded as recommended for the recently updated items for the age of introduction of "solid food in healthy children", "gluten", "cow's milk protein hydrolysates", and "the time until introduction of cow's milk in the atopic child". At best, 65% of physicians responded in accordance with recommendations for items without a recent update, age of introduction of "cow's milk", "milk desserts", "animal proteins", "fats", "vegetables", "use of a hypoallergenic infant formula", and "breastfeeding extension with atopic child". Pediatric residents had the same responses as pediatricians. Seventy-two physicians did not consider the allergenic status of the children to delay the introduction of the most allergenic foods. The lack of complete updating the introduction of solid foods schedule could explain the differences between pediatrician practices and recommendations. Moreover, old recommendations on allergenic food eviction are still available. CONCLUSION: Pediatricians and pediatric residents partially applied the current recommendations on the introduction of solid food.

[Infant food diversification: Is the information available on the Internet valid?]. / Diversification alimentaire : l'information disponible sur Internet est-elle en accord avec les recommandations des sociétés savantes ?

INTRODUCTION: The Internet provides easy access to information on health, but the quality and validity of this information are variable. OBJECTIVES: To evaluate the quality of websites and the information provided on the timing and consequences of food diversification for infants. MATERIALS AND METHODS: We analyzed the websites addressing infant food diversification that appeared on the first two pages of the search engines Google, Yahoo, and Bing. The websites were selected from four different queries. We initially assessed (a) the structure of the websites with two instruments (the Criteria for Assessing the Quality of Health Information on the Internet (HITI) and NetScoring) and (b) the presence of certification (quality label Health on the Net [HON] Code). Secondly, we evaluated the content of the websites concerning the time of introducing five classes of foods (gluten, fat, allergenic foods, solid foods, and animal protein), the duration of breastfeeding, and four potential consequences of food diversification (allergy, nutritional, autoimmune, and cardiovascular). Our repository was based on the most recent recommendations of the French Society of Pediatrics published in 2008. RESULTS: In all, 19 websites were included. Six of 19 websites scored above average on the two instruments (average: 131.26/312 with NetScoring and 46.73/104 with HITI). No correlation was observed between the referencing of websites analyzed and the notes obtained with both instruments. A majority of the websites analyzed were consistent with the recommendation favoring breast milk (100%), the age of introducing meat proteins (74%), and the age of introducing gluten (63%). A majority of the websites disagreed on the age of introducing solid foods (16%). As four consequences, only the risk of allergy (63%) was cited by a majority of the sites. There was a small nonsignificant correlation between the results obtained for the website about introducing solid foods and the results obtained for the websites analyzed with the NetScoring and HITI instruments (Pearson coefficient 41%, p=0.07). CONCLUSION: The websites were in partial agreement with the French recommendations. To date, the pediatrician remains the main actor in guiding parents on food diversification.