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Vandenplas Y, Broekaert I, Domellöf M, Indrio F, Lapillonne A, Pienar C, Ribes-Koninckx C, Shamir R, Szajewska H, Thapar N, Thomassen RA, Verduci E, West C. An ESPGHAN Position Paper on the Diagnosis, Management, and Prevention of Cow's Milk Allergy. J Pediatr Gastroenterol Nutr 2024; 78:386-413. [PMID: 38374567 DOI: 10.1097/mpg.0000000000003897] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 06/25/2023] [Indexed: 07/27/2023]
Abstract
A previous guideline on cow's milk allergy (CMA) developed by the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) was published in 2012. This position paper provides an update on the diagnosis, treatment, and prevention of CMA with focus on gastrointestinal manifestations. All systematic reviews and meta-analyses regarding prevalence, pathophysiology, symptoms, and diagnosis of CMA published after the previous ESPGHAN document were considered. Medline was searched from inception until May 2022 for topics that were not covered in the previous document. After reaching consensus on the manuscript, statements were formulated and voted on each of them with a score between 0 and 9. A score of ≥6 was arbitrarily considered as agreement. Available evidence on the role of dietary practice in the prevention, diagnosis, and management of CMA was updated and recommendations formulated. CMA in exclusively breastfed infants exists, but is uncommon and suffers from over-diagnosis. CMA is also over-diagnosed in formula and mixed fed infants. Changes in stool characteristics, feeding aversion, or occasional spots of blood in stool are common and in general should not be considered as diagnostic of CMA, irrespective of preceding consumption of cow's milk. Over-diagnosis of CMA occurs much more frequently than under-diagnosis; both have potentially harmful consequences. Therefore, the necessity of a challenge test after a short diagnostic elimination diet of 2-4 weeks is recommended as the cornerstone of the diagnosis. This position paper contains sections on nutrition, growth, cost, and quality of life.
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Affiliation(s)
- Yvan Vandenplas
- Vrije Universiteit Brussel (VUB), UZ Brussel, KidZ Health Castle, Brussels, Belgium
| | - Ilse Broekaert
- Department of Paediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Magnus Domellöf
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Flavia Indrio
- Department of Medical and Surgical Science, University of Foggia, Foggia, Italy
| | - Alexandre Lapillonne
- Neonatal Intensive Care Unit, Necker-Enfants Malades Hospital, Paris University, Paris, France
- CNRC, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Corina Pienar
- Department of Pediatrics, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Carmen Ribes-Koninckx
- Gastroenterology and Hepatology & Instituto de Investigacion Sanitaria, La Fe University Hospital, Valencia, Spain
| | - Raanan Shamir
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Lea and Arieh Pickel Chair for Pediatric Research, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Hania Szajewska
- Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland
| | - Nikhil Thapar
- Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
- Woolworths Centre for Child Nutrition Research, Queensland University of Technology, Brisbane, Australia
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Rut Anne Thomassen
- Department of Paediatric Medicine, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Elvira Verduci
- Department of Paediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Christina West
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
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Vandenplas Y, Meyer RM, Huysentruyt K. Food allergy: Prevention and treatment of Cow's milk allergy. Clin Nutr ESPEN 2024; 59:9-20. [PMID: 38220412 DOI: 10.1016/j.clnesp.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 11/08/2023] [Indexed: 01/16/2024]
Affiliation(s)
- Yvan Vandenplas
- Paediatric Gastroenterology, KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
| | - Rosan M Meyer
- Imperial College, London, United Kingdom; Winchester University, Winchester, United Kingdom
| | - Koen Huysentruyt
- Paediatric Gastroenterology, KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Yanni AE, Iakovidi S, Vasilikopoulou E, Karathanos VT. Legumes: A Vehicle for Transition to Sustainability. Nutrients 2023; 16:98. [PMID: 38201928 PMCID: PMC10780344 DOI: 10.3390/nu16010098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/23/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
Legumes are an excellent source of protein and have been used in the human diet for centuries. Consumption of legumes has been linked to several health benefits, including a lower risk of cardiovascular diseases, type 2 diabetes mellitus, and certain types of cancer, while legumes' high fiber content promotes digestive health. Aside from the positive health benefits, one of the most significant advantages of legumes is the low environmental footprint of their cultivation. They can be grown in a variety of climates and soil types, and they require less water and fertilizer than other crops, making them a sustainable option for farmers. Thanks to their nutritional and physicochemical properties, they are widely used by the food industry since the growing popularity of plant-based diets and the increasing demand for alternatives to meat offers the opportunity to develop legume-based meat substitutes. As the use of legumes as a source of protein becomes widespread, new market opportunities could be created for farmers and food industries, while the reduction in healthcare costs could have a potential economic impact. Achieving widespread adoption of legumes as a sustainable source of protein requires coordinated efforts by individuals, governments, and the private sector. The objective of this narrative review is to present the benefits coming from legume consumption in terms of health and environmental sustainability, and underline the importance of promoting their inclusion in the daily dietary pattern as well as their use as functional ingredients and plant-based alternatives to animal products.
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Affiliation(s)
- Amalia E. Yanni
- Laboratory of Chemistry-Biochemistry-Physical Chemistry of Foods, Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou Ave, 176-71 Athens, Greece; (S.I.); (E.V.); (V.T.K.)
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Zhou Y, Xu Y. Nutrition and Metabolism in the First 1000 Days of Life. Nutrients 2023; 15:nu15112554. [PMID: 37299517 DOI: 10.3390/nu15112554] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
The first 1000 days of life are a critical window period for rapid growth and development during which individuals are more sensitive to the stimulation of environmental factors [...].
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Affiliation(s)
- Yalin Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, No. 38 Xueyuan Road, Beijing 100083, China
| | - Yajun Xu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, No. 38 Xueyuan Road, Beijing 100083, China
- PKUHSC-China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, No. 38 Xueyuan Road, Beijing 100083, China
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Shi T, Cao J, Cao J, Zhu F, Cao F, Su E. Almond (Amygdalus communis L.) kernel protein: A review on the extraction, functional properties and nutritional value. Food Res Int 2023; 167:112721. [PMID: 37087278 DOI: 10.1016/j.foodres.2023.112721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/27/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023]
Abstract
Almond (Amygdalus communis L.) kernel, a source of nutrients in many traditional diets, is being used more frequently as a nutritious snack and component. It is well known that almond kernels are a protein-rich food. Compared to the amino acid profile recommended by FAO, almond kernel protein is an ideal protein with perfect balance of amino acids. It also has a variety of better functional properties such as solubility, emulsifying ability, oil absorption capacity and foaming ability. pH and ion strength have significant influences on these functional properties. Furthermore, almond kernel protein is easily digested and absorbed by the human body. So almond kernel protein can be used as a high-quality protein resource. This review describes the techniques for extracting almond kernel protein, as well as its functional properties, nutritional worth, and applications. The purpose of this review is to provide ideas for the effective use of almond kernel protein and the creation of related products.
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Affiliation(s)
- Tingting Shi
- Co-innovation Center for the Sustainable Forestry in Southern China, Nanjing Forestry University, Nanjing 210037, China; Department of Food Science and Technology, College of Light Industry and Food Engineering, Nanjing Forestry University, Nanjing 210037, China
| | - Jiarui Cao
- Co-innovation Center for the Sustainable Forestry in Southern China, Nanjing Forestry University, Nanjing 210037, China; Department of Food Science and Technology, College of Light Industry and Food Engineering, Nanjing Forestry University, Nanjing 210037, China
| | - Jun Cao
- Co-innovation Center for the Sustainable Forestry in Southern China, Nanjing Forestry University, Nanjing 210037, China; Department of Food Science and Technology, College of Light Industry and Food Engineering, Nanjing Forestry University, Nanjing 210037, China
| | - Feng Zhu
- Co-innovation Center for the Sustainable Forestry in Southern China, Nanjing Forestry University, Nanjing 210037, China; Department of Food Science and Technology, College of Light Industry and Food Engineering, Nanjing Forestry University, Nanjing 210037, China
| | - Fuliang Cao
- Co-innovation Center for the Sustainable Forestry in Southern China, Nanjing Forestry University, Nanjing 210037, China
| | - Erzheng Su
- Co-innovation Center for the Sustainable Forestry in Southern China, Nanjing Forestry University, Nanjing 210037, China; Department of Food Science and Technology, College of Light Industry and Food Engineering, Nanjing Forestry University, Nanjing 210037, China; Co-Innovation Center for Efficient Processing and Utilization of Forest Products, Nanjing Forestry University, Nanjing 210037, China; Bai Ma Future Food Research Institute, Nanjing 211225, China.
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Brusati M, Baroni L, Rizzo G, Giampieri F, Battino M. Plant-Based Milk Alternatives in Child Nutrition. Foods 2023; 12:foods12071544. [PMID: 37048365 PMCID: PMC10094203 DOI: 10.3390/foods12071544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/01/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
Abstract
Plant-based milk alternatives can be distinguished in two main categories, differing in production processes and regulation: plant-based formulas and plant-based drinks. They are now a widely accepted class of products on the international market. The various plant-based milk alternatives differ in nutritional characteristics due to their origin and manufacturing; more importantly, whereas formulas from plant and cow origin can be used interchangeably, plant-based drinks are nutritionally different from cow's milk and can be consumed by children subsequently to the use of formula. Several scientific organizations have expressed differing opinions on the use of these products in the diets of children. In the face of unanimous conclusions regarding the use of these products during the first year of life, in subsequent ages there were conflicting opinions regarding the timing, quantities, and type of product to be used. From the viewpoint of the child's overall diet and health, it could be suggested that these foods be considered not as simple substitutes for cow's milk, but as part of a varied diet, within individual advice of use. We suggest accepting the presence of these products in a baby's diet (omnivores included), planning their use correctly in the context of a balanced diet, according to the specific product and the needs of the individual.
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Affiliation(s)
- Marco Brusati
- Pediatric and Educational Center "La Volpe e il Canguro", 25062 Concesio, Italy
| | - Luciana Baroni
- Scientific Society for Vegetarian Nutrition, 30171 Venice, Italy
| | - Gianluca Rizzo
- Independent Researcher, Via Venezuela 66, 98121 Messina, Italy
| | - Francesca Giampieri
- Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain
| | - Maurizio Battino
- International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang 212013, China
- Department of Clinical Specialistic and Odontostomatological Sciences, University Polytechnic of Marche, 60131 Ancona, Italy
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Rahim MA, Naeem M, Khalid K, Imran M, Khan MK, Khan MI, Nisa MU, Sarwar M, Awuchi CG. Effects of different levels of egg protein replacement in weaned diets on hematology, kidney functions, and immunity biomarkers. Food Sci Nutr 2023; 11:1747-1754. [PMID: 37051337 PMCID: PMC10084960 DOI: 10.1002/fsn3.3204] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 01/09/2023] Open
Abstract
Eggs are good sources of nutrients essential for the growth and development of infants. Introducing eggs as a weaning food can improve dietary adequacy in infants at risk for protein energy malnutrition (PEM). To evaluate the current objective, 72 pups (36 males and 36 females) were used to calculate the impact of various egg protein levels on blood parameters. Nonisonitrogenous and isocaloric pellet diets were offered to pups for 28 days using nine pups with three replicates according to a completely randomized design (CRD). The water intake and ad libitum diet were offered to weaned pups. The pups were randomly assigned to different concentrations of diet, which contained WF0, control diet, 14% of soybean protein; WF1, 14% of egg protein; WF2, 16% of egg protein; and WF3, 18% of egg protein, respectively. After weaning, the intraperitoneal injection with the drug (xylazine with ketamine) was used to anesthetize before killing on the 28th day. Blood samples were used to measure the blood metabolites. The results indicated that the concentration of red blood cells, white blood cells, serum triglycerides, and serum protein was significantly (p ≤ .05) increased in pups fed with high egg protein levels compared to the control. The highest platelet count was observed in the pups fed WF3 diet. In contrast, the amount of alanine aminotransferase and aspartate aminotransferase was significantly (p ≤ .05) reduced with increasing the level of egg protein in the diets of weaned pups. Immunity biomarkers (immunoglobulin A, immunoglobulin G, and immunoglobulin M) and kidney functions (creatinine and blood urine nitrogen) were nonsignificantly (p ≤ .05) increased in the pups fed a high level of protein due to a high biological value of soybean protein. Moreover, the concentration of immunoglobulin E in all pups remained unchanged. Egg protein in infant formula feed can be used for the growth and development of infants.
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Affiliation(s)
- Muhammad Abdul Rahim
- Department of Food Science, Faculty of Life Sciences Government College University Faisalabad Pakistan
| | - Muhammad Naeem
- National Institute of Food Science & Technology University of Agriculture Faisalabad Pakistan
| | - Khunsha Khalid
- University Medical and Dental College Faisalabad Pakistan
| | - Muhammad Imran
- Department of Food Science, Faculty of Life Sciences Government College University Faisalabad Pakistan
| | - Muhammad Kamran Khan
- Department of Food Science, Faculty of Life Sciences Government College University Faisalabad Pakistan
| | - Muhammad Imran Khan
- Department of Mathematics & Statistics, Faculty of Sciences University of Agriculture Faisalabad Pakistan
| | - Mahr Un Nisa
- Department of Nutritional Sciences, Faculty of Medical Sciences Government College University Faisalabad Pakistan
| | - Muhammad Sarwar
- Postgraduate Studies and Research The University of Lahore Lahore Pakistan
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Reverri EJ, Arensberg MB, Murray RD, Kerr KW, Wulf KL. Young Child Nutrition: Knowledge and Surveillance Gaps across the Spectrum of Feeding. Nutrients 2022; 14:nu14153093. [PMID: 35956275 PMCID: PMC9370290 DOI: 10.3390/nu14153093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/18/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
The first 1000 days is a critical window to optimize nutrition. Young children, particularly 12–24 month-olds, are an understudied population. Young children have unique nutrient needs and reach important developmental milestones when those needs are met. Intriguingly, there are differences in the dietary patterns and recommendations for young children in the US vs. globally, notably for breastfeeding practices, nutrient and food guidelines, and young child formulas (YCFs)/toddler drinks. This perspective paper compares these differences in young child nutrition and identifies both knowledge gaps and surveillance gaps to be filled. Parental perceptions, feeding challenges, and nutrition challenges are also discussed. Ultimately, collaboration among academia and clinicians, the private sector, and the government will help close young child nutrition gaps in both the US and globally.
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Affiliation(s)
- Elizabeth J. Reverri
- Abbott Nutrition, Abbott Laboratories, Columbus, OH 43219, USA; (M.B.A.); (K.W.K.); (K.L.W.)
- Correspondence:
| | - Mary Beth Arensberg
- Abbott Nutrition, Abbott Laboratories, Columbus, OH 43219, USA; (M.B.A.); (K.W.K.); (K.L.W.)
| | - Robert D. Murray
- Department of Pediatrics, The Ohio State University, Columbus, OH 43219, USA;
| | - Kirk W. Kerr
- Abbott Nutrition, Abbott Laboratories, Columbus, OH 43219, USA; (M.B.A.); (K.W.K.); (K.L.W.)
| | - Karyn L. Wulf
- Abbott Nutrition, Abbott Laboratories, Columbus, OH 43219, USA; (M.B.A.); (K.W.K.); (K.L.W.)
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