Vitamin deficiencies in pediatric eosinophilic esophagitis: A systematic review.

BACKGROUND: Nutritional deficiencies are seen in patients with food allergy. Low vitamin D levels have been found in patients with atopic conditions. Eosinophilic esophagitis (EoE) is a chronic immune antigen-mediated disease found to be highly associated in patients with atopic disease and treated with dietary elimination with recommendations to utilize a dietician to prevent nutritional deficiencies. Nonetheless, the relationship between EoE and vitamin deficiency remains unclear. We aimed to systematically review the evidence to support a possible association between vitamin deficiency and eosinophilic esophagitis. METHODS: Electronic searches were performed with keywords relating to EoE and vitamins among pediatric patients in MEDLINE, EMBASE, and The Cochrane Library. Summary estimates were calculated. Citations were reviewed against pre-defined criteria. (Inclusion: human subjects, aged 0-18, with eosinophilic esophagitis. Exclusion: adults over 18 years, non-English papers). RESULTS: The search yielded 1707 studies. Five of these studies with a total of 137 pediatric patients were included in the systematic review. Outcome measures were assessed at different points in EoE treatment across studies. The single common outcome measure across all included studies was vitamin D. Reported prevalence of low vitamin D varied in these studies (0%-52%). Vitamin D levels of children with EoE both pre- and post-intervention were low. CONCLUSIONS: There is limited published literature on vitamin deficiencies associated with EoE both pre- and post-intervention. The limited data on vitamin D suggest that insufficiency or deficiency may be present in these patients, but it remains unclear whether deficiency is caused by diet. More prospective, well-defined studies, in addition to routine reporting on dietary intake and nutritional status, are needed to make any conclusions or recommendations for screening.

Culinary efficacy: an exploratory study of skills, confidence, and healthy cooking competencies among university students.

AIMS: This study was conducted to determine whether a group of college-age students in New Jersey, USA, had the requisite culinary skills, knowledge, and confidence to take personal control of their meal planning and production. The long-term threat to the public health systems posed by high rates of obesity among young adults in higher education institutions has garnered widespread attention across the world. Studies have shown that assuming personal responsibility over preparing and consuming food can play a key role in addressing the problem of poor nutrient intakes. METHODS: Focus groups were conducted with students (N = 24) who fit the eligibility criteria of not having a university meal plan, and living independently at the time of the study (not with family members). The sessions were recorded, transcribed, and then coded into themes. Two trained research assistants tested the results and inter-rater reliability was confirmed. RESULTS: Content analysis revealed three major themes: Health Perceptions, Life influences, and Barriers to Cooking and Eating Healthy. The students' comments indicated that while they had a basic knowledge of the key principles of eating a balanced diet, it may not have necessarily translated into actual food choices and cooking practices. Several students reported an overreliance on processed and prepared foods, and they consumed few fruits and vegetables. CONCLUSIONS: Factors such as lack of culinary knowledge and skill, financial instability, inadequate access to healthy food options, and other time/lifestyle constraints may have played a significant role in limiting their ability to prepare and consume healthy meals. The findings of this study highlight the importance of designing programmes with effective strategies to motivate and encourage college students to improve their food behaviours and practices.