Frequency of gastroesophageal reflux disease in adolescent girls with anorexia nervosa. / Czestosc choroby refluksowej u pacjentek z jadlowstretem psychicznym.

OBJECTIVES: The aim of the study was to assess the incidence of gastroesophageal reflux disease (GERD) in young females with anorexia nervosa (AN). METHODS: Participation in the study was proposed to young females with AN aged 12-18 who were hospitalized in the Department of Child Psychiatry, Medical University of Warsaw. Exclusion criteria were psychiatric disorders other than AN and treatment with prokinetic drugs and/or antacids (such as proton pump inhibitors or histamine receptor antagonists) in the last 2 weeks prior to the study. Patients were interviewed for gastrointestinal symptoms that can be related to GERD. Anthropometric measurements were obtained to assess the nutritional condition of the patients, and all of them were subjected to 24-hour pH-impedance monitoring. The pH-impedance recording was considered abnormal when the total number of reflux episodes exceeded 70 and/or the overall esophageal acid exposure time exceeded 6%. RESULTS: 23 female patients with AN were included in the study. They reported numerous symptoms, e.g., epigastric pain, nausea, vomiting, heartburn, chest pain, or excessive belching. However, only 2 of them (8.7%) were diagnosed with GERD on the basis of 24-hour pH-impedance monitoring. Both were suffering from a restrictive subtype of anorexia. CONCLUSIONS: Even if numerous gastrointestinal symptoms indicative of GERD are reported by patients with AN, diagnosis of the disease in this group should not be based on symptoms, but it should be confirmed in an objective examination, preferably pH-impedance test.

Liver involvement in children with collagen vascular diseases.

Liver injury such as hepatomegaly, splenomegaly and various degrees of biochemical abnormalities are quite common in children with collagen vascular diseases. They may be primary or secondary, particularly due to drug therapy (drug toxicity, fatty infiltration), superadded infections, diabetes or overlap with autoimmune hepatitis.

Effect of oligofructose supplementation on body weight in overweight and obese children: a randomised, double-blind, placebo-controlled trial.

Limited evidence suggests that the dietary inclusion of oligofructose, an inulin-type fructan with prebiotic properties, may increase satiety and, thus, reduce energy intake and body weight in overweight and obese adults. The aim of the present study was to assess the effect of oligofructose supplementation for 12 weeks on the BMI of overweight and obese children. A total of ninety-seven children aged 7-18 years who were overweight and obese (BMI >85th percentile) were randomly assigned to receive placebo (maltodextrin) or oligofructose (both at an age-dependent dose: 8 g/d for children aged 7-11 years and 15 g/d for children aged 12-18 years) for 12 weeks. Before the intervention, all children received dietetic advice and they were encouraged to engage in physical activity. The primary outcome measure was the BMI-for-age z-score difference between the groups at the end of the intervention. Data from seventy-nine (81%) children were available for analysis. At 12 weeks, the BMI-for-age z-score difference did not differ between the experimental (n 40) and control (n 39) groups (mean difference 0.002, 95% CI - 0.11, 0.1). There were also no significant differences between the groups with regard to any of the secondary outcomes, such as the mean BMI-for-age z-score, percentage of body weight reduction and the difference in total body fat. Adverse effects were similar in both groups. In conclusion, oligofructose supplementation for 12 weeks has no effect on body weight in overweight and obese children.

Maternal and paternal body mass index and offspring obesity: a systematic review.

BACKGROUND/AIMS: It has been hypothesized that the intrauterine environment is an independent factor in obesity development. If so, the maternal effect is likely to be a stronger influencing factor ('fetal overnutrition hypothesis'). We aimed to systematically evaluate the associations of offspring body mass index (BMI, or adiposity) with pre-pregnancy BMI (or adiposity) of the mother and the father. METHODS: The Medline, Embase and Cochrane Library databases were searched in March 2012. RESULTS: Seven cohort studies were eligible for the analysis. Among these, 2 groups of trials presented different data from the same parent-offspring cohorts (the Avon Longitudinal Study of Parents and Children, ALSPAC, and the Mater-University Study of Pregnancy, MUSP). In total, 3 large birth cohorts and 1 additional small study were identified. Three studies provided a direct comparison of parent-offspring associations, with a statistically stronger maternal influence found only in the MUSP cohort. Equivocal results were obtained from all studies describing the ALSPAC cohort. The parental effect (indirectly estimated based on the presented odds ratio) was similar in the Finnish cohort. In 1 additional small study, maternal BMI was found to be a strong predictor of childhood obesity. CONCLUSIONS: There is only limited evidence to support the 'fetal overnutrition hypothesis'.

Effects of inulin-type fructans on appetite, energy intake, and body weight in children and adults: systematic review of randomized controlled trials.

AIM: To systematically evaluate the effects of inulin-type fructan (ITF) supplementation on appetite, energy intake, and body weight (BW) in children and adults. METHODS: The MEDLINE, EMBASE, and Cochrane Library databases were searched up to December 2012 for randomized controlled trials (RCTs) that compared the effects of supplementation with well-defined ITF with placebo or no intervention. RESULTS: For the pediatric population, 4 RCTs (n = 232) met the inclusion criteria. In infants, very limited evidence (1 RCT, n = 62) showed no effect of ITF supplementation on energy intake and BW. One RCT involving 97 nonobese adolescents aged 9 to 13 years found a reduced increase in BW in the oligofructose + inulin (8 g/day) group compared with the control group after 1 year. For the adult population, 15 RCTs (n = 545) met the inclusion criteria. Five RCTs found no effect of ITF supplementation on appetite sensations. Eleven RCTs found no effect of ITF supplementation on daily energy intake or energy intake during a meal tolerance test. Among 3 RCTs that assessed the effect of ITF supplementation on BW, 2 RCTs showed a (significant) reduction in BW. Of 3 RCTs that evaluated body mass index (BMI), 1 RCT showed a significant reduction in BMI in subjects supplemented with ITF. CONCLUSION: Limited data suggest that long-term administration of ITF may contribute to weight reduction.