The effect of long-chain polyunsaturated fatty acids intake during pregnancy on adiposity of healthy full-term offspring at birth.

OBJECTIVE: The adjusted effect of long-chain polyunsaturated fatty acid (LCPUFA) intake during pregnancy on adiposity at birth of healthy full-term appropriate-for-gestational age neonates was evaluated. STUDY DESIGN: In a cross-sectional convenience sample of 100 mother and infant dyads, LCPUFA intake during pregnancy was assessed by food frequency questionnaire with nutrient intake calculated using Food Processor Plus. Linear regression models for neonatal body composition measurements, assessed by air displacement plethysmography and anthropometry, were adjusted for maternal LCPUFA intakes, energy and macronutrient intakes, prepregnancy body mass index and gestational weight gain. RESULT: Positive associations between maternal docosahexaenoic acid intake and ponderal index in male offspring (ß=0.165; 95% confidence interval (CI): 0.031-0.299; P=0.017), and between n-6:n-3 LCPUFA ratio intake and fat mass (ß=0.021; 95% CI: 0.002-0.041; P=0.034) and percentage of fat mass (ß=0.636; 95% CI: 0.125-1.147; P=0.016) in female offspring were found. CONCLUSION: Using a reliable validated method to assess body composition, adjusted positive associations between maternal docosahexaenoic acid intake and birth size in male offspring and between n-6:n-3 LCPUFA ratio intake and adiposity in female offspring were found, suggesting that maternal LCPUFA intake strongly influences fetal body composition.

Resting energy expenditure, macronutrient utilization, and body composition in term infants after corrective surgery of major congenital anomalies: A case-study.

INTRODUCTION: Knowledge on the metabolic changes and nutritional needs during the postsurgical anabolic phase in infants is scarce. This analysis explores the associations of resting energy expenditure (REE) and macronutrient utilization with body composition of full-term infants, during catch-up growth after corrective surgery of major congenital anomalies. METHODS: A cohort of full-term appropriate for-gestational-age neonates subjected to corrective surgery of major congenital anomalies were recruited after gaining weight for at least one week. REE and macronutrient utilization, measured by respiratory quotient (RQ), were assessed by indirect calorimetry using the Deltatrac II Metabolic Monitor ®. Body composition, expressed as fat-free mass (FFM), fat mass (FM) and adiposity defined as percentage of FM (% FM), was measured by air displacement plethysmography using the Pea Pod ®. RESULTS: Four infants were included at 3 to 5 postnatal weeks. Recommended energy and macronutrient intakes for healthy term infants were provided. Through the study, the median (min-max) REE (Kcal/Kg FFM/d) was 70.8 (60.6-96.1) and RQ was 0.99 (0.72-1.20). Steady increases in both body weight and FFM were associated with initial decrease in FM and adiposity followed by their increase. Low RQ preceded decrease in adiposity. CONCLUSION: The marked adiposity depletion, not expected during steady weight gain in the postsurgical period, prompts us to report this finding. The subsequent adiposity catch-up was associated with relatively high REE and RQ, suggesting preferential oxidation of carbohydrates and preservation of lipids for fat storage.

Factores de riesgo para la enfermedad meningocócica en la infancia. Estudio controlado en una población de un hospital de área en Portugal / Risk factors for meningococcus disease in the child. Controlled study in a population of an area hospital in Portugal

La Neisseria meningitidis es una causa importante de morbilidad y mortalidad en nuestro medio. Con el objetivo de evaluar la existencia de factores de riesgo para la enfermedad meningocócica en las Áreas de Salud de Amadora y Sintra se realizó un estudio retrospectivo, casos-control, en niños menores de 15 años de edad, internados desde el 1 de enero de 1997 hasta el 31 de diciembre de 2001. Se investigaron: edad, sexo, mes de ingreso, lactancia materna, asistencia a guarderías/escuelas, número de personas convivientes en el domicilio, número de habitaciones en el domicilio, hábitos tabáquicos de los padres, frecuencia por parte de los padres de bares/discotecas y grandes superficies comerciales. De un total de 56 casos, se verificó un predominio de la enfermedad en los menores de 6 años (85,7 por ciento), en el Sexo masculino (57 por ciento) y en los meses de enero a abril (53,6 por ciento). En el análisis multivariado (regresión logística) la enfermedad meningocócica estaba asociada de forma independiente al tabaquismo de la madre (o.r. 6,2 IC: 2,12 -18,35) y a la frecuentación de los padres a los centros comerciales (o.r. 4,6 IC: 1,45 - 14,37), bares y discotecas (o.r. 4,4IC: 1,57 - 12,54). El estudio confirma por tanto factores de riesgo ya anteriormente conocidos y otros todavía no descritos (AU)

Fibra en la alimentación infantil / Fiber in children's nutrition

La dieta habitual en las sociedades industrializadas, rica en grasas y pobre en fibra, parece contribuir a la aparición de patología cardiovascular y algunos tipos de cáncer. La modificación de los hábitos dietéticos se torna por lo tanto un imperativo de salud pública.Para una mayor eficacia esas alteraciones deben ser iniciadas en la edad pediátrica. Las fibras alimenticias son químicamente heterogéneas y su acciones fisiológicas son también diversas. Las fibras solubles atrasan el tránsito intestinal y al ser fermentadas por las bacterias del colon producen ácidos grasos de cadena corta que desempeñan un papel metabólico importante. Las fibras insolubles aceleran el tiempo de tránsito y aumentan el bolo fecal. El aporte diario recomendado, entre los 3 y 20 años de edad, por American Health Fundation como la edad + 5 en gramos parece lo más apropiado. Estudios en los EE.UU.y Europa occidental demuestran que la mayoría de los niños consumen menos fibras que esas recomendaciones. Además de la prevención de enfermedades en el adulto el incremento de las fibras en la dieta tiene un papel en el tratamiento de algunas patologías pediátricas: obesidad, estreñimiento, dolor abdominal recurrente, diabetes. Ese incremento debe ser realizado en forma de alimentos ricos en fibra (frutas, cereales, verduras) que contienen proporciones diversas de fibra soluble e insoluble, bien como minerales o vitaminas necesarias para un crecimiento armonioso (AU)

Manometrical evaluation in visceral neuropathies in children.

Manometrical recordings were made at three levels of the digestive tract in 20 children with chronic intestinal pseudoobstruction (CIPO) defined clinically and histopathologically by deep biopsies showing a neuropathic process. Duodenal manometry showed severe abnormalities with hypomotility in all cases and absence of migrating motor complex in 13 of 20 cases. There was no relation between the histopathologic type and the motility pattern, but the most severe abnormalities were seen in the patients with extensive involvement of the digestive tract and the most severe clinical course. Esophageal manometry was abnormal in 18 of 19 patients, with altered peristalsis consisting of simultaneous, short-lasting, or low-amplitude waves. Rectoanal manometry showed the presence of the rectosphincteric inhibitory reflex in all patients. In conclusion, there is a high frequency of small bowel manometrical abnormalities in CIPO which seem to correlate with the extent of the pathological process and the prognosis of the disease. Esophageal manometry is useful for defining the extent of dysmotility and confirming the diagnosis of CIPO in some cases.