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Growth of healthy term infants fed an extensively hydrolyzed casein-based or free amino acid-based infant formula: a randomized, double-blind, controlled trial.
Borschel, MW, Ziegler, EE, Wedig, RT, Oliver, JS
Clinical pediatrics. 2013;(10):910-7
Abstract
A masked, randomized, parallel growth study was conducted in infants fed an amino acid-based formula (AF) or an extensively hydrolyzed casein-based formula (HF). Infants were enrolled between 0 and 9 days and studied to 112 days of age. Growth, formula intake, stool patterns, and serum albumin concentrations were assessed. There were no significant differences between groups in weight, length, or head circumference, gains in weight or length, or study formula intake. The number of stools parents rated as being formed, and the mean daily number of stools were greater in the HF than in the AF group at 14 and 28 days of age. Mean serum albumin concentrations were not significantly different between groups and were within the normal range. This study demonstrates that AF supports normal growth of infants comparable to that of infants fed HF during the critical first 4 months of life.
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Prevalence of advanced bone age in a cohort of patients who received cis-retinoic acid for high-risk neuroblastoma.
Hobbie, WL, Mostoufi, SM, Carlson, CA, Gruccio, D, Ginsberg, JP
Pediatric blood & cancer. 2011;(3):474-6
Abstract
In the last decade, 13-cis-retinoic acid (13-cis-RA) has been added to the treatment of patients with high-risk neuroblastoma. In survivors of neuroblastoma, short stature is consistently observed. Causes include growth hormone deficiency and poor growth of irradiated long bones. Within the survivorship program at CHOP, we have observed that a number of these patients also have advanced bone ages. Children treated with 13-cis-RA are at risk for advanced bone age that may dramatically impact their linear growth. Ongoing evaluation is necessary to examine the effect of 13-cis-RA on final adult height and to inform clinical practice in this cohort.
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3.
Puberty and observed energy intake: boy, can they eat!
Shomaker, LB, Tanofsky-Kraff, M, Savastano, DM, Kozlosky, M, Columbo, KM, Wolkoff, LE, Zocca, JM, Brady, SM, Yanovski, SZ, Crocker, MK, et al
The American journal of clinical nutrition. 2010;(1):123-9
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Abstract
BACKGROUND Anecdotal reports suggest that adolescent males consume large quantities of food to meet the growth demands of pubertal development. However, limited experimental data exist to support this impression. OBJECTIVE The objective was to measure energy intakes of youth at different pubertal stages. DESIGN Participants were 204 volunteers (50.5% male) aged 8-17 y. Pubertal development was categorized by physical examination into prepuberty (males: testes < 4 mL; females: Tanner breast stage 1), early-mid puberty (males: testes = 4-12 mL; females: Tanner breast stages 2-3), or late puberty (males: testes >12 mL; females: Tanner breast stages 4-5). Energy intake was measured as consumption from a 9835-kcal food array during 2 lunch time meals. RESULTS Males consumed more energy than did females across all pubertal stages (P < 0.001). Intake increased with pubertal development (P < 0.001), but the timing and magnitude of change varied by sex (P = 0.02). Males' unadjusted energy intake was greater in late puberty (mean +/- SE: 1955 +/- 70 kcal) than in prepuberty (1287 +/- 90 kcal) or early-mid puberty (1413 +/- 92 kcal) (P < 0.001). Females' unadjusted energy intake tended to be lower among prepubertal girls (905 +/- 140 kcal) than among females in early-mid puberty (1278 +/- 82 kcal, P = 0.07) or late puberty (1388 +/- 68 kcal, P = 0.01). After adjustment for fat-free mass, fat mass, height, overweight status, race, and meal instruction, the main effect of sex (P < 0.001) remained significant, but the effect of puberty was not significant (P = 0.66). CONCLUSIONS The observed intake patterns are congruent with known sexual dimorphisms for body composition, peak growth velocity, and pubertal development. Consistent with their higher energy requirements, males can consume significantly larger amounts of food than females, especially during later puberty. This trial was registered at clinicaltrials.gov as NCT00320177.
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[The effect of one year therapy with recombinant human growth hormone (rhGH) on growth velocity, calcium-phosphorus metabolism, bone mineral density and changes in body composition in children with growth hormone deficiency (GHD)].
Zak, T, Basiak, A, Zubkiewicz-Kucharska, A, Noczyńska, A
Pediatric endocrinology, diabetes, and metabolism. 2010;(1):39-43
Abstract
INTRODUCTION The most significant effect of growth hormone treatment is growth promotion. For adults the metabolic effect is the most important. This treatment has an influence on the forming of correct composition of body mass, on metabolism of osseous tissue and bone mineral density. AIM OF THE STUDY Comparison between the rate of growth and estimation of calcium-phosphorus metabolism, bone mineral density and change of body composition in children with growth hormone deficiency during the first year of growth hormone treatment. MATERIAL AND METHODS The treatment included 120 children and adolescents (85 boys and 35 girls) in age from 6 to 21.5 years old (the average age: 14.2+/-3.0) who were treated in Dept. of Endocrinology and Diabetology for Children and Adolescents during the years 2002-2006 as a result of growth hormone deficiency. Children suffering from panhypopituitarism and other diseases were excluded from the research. The following parameters were included in the analysis: age and sex, age at the start of treatment, the degree of growth hormone deficiency, concentration of calcium, magnesium and phosphates in blood serum, mineral density of bones (BMD), the concentration of osseous minerals, concentration of adipose tissue and lean body mass. All the children were treated with recombined human growth hormone (rhGH) in dose of 0.7 j/kg per week. No interruption of the treatment was noticed. RESULTS Partial growth hormone deficiency (GHD) was diagnosed in the group of 71 children (52 boys and 19 girls), total GHD diagnosed in 49 cases (34 boys and 15 girls). Average age at the start of treatment was 11.7+/-2.9 years. During the first year of treatment the rate of growing increases from 3.9+/-1,1 cm per year before treatment to 8.72+/-2.27 cm per year (p<0.01) for the whole examined group, for girls from 3.8+/-1.2 cm per year to 8.77 cm per year (p<0.01), for boys from 3.2+/-1.3 per year to 8.58+/-2.20 cm per year (p<0.01). Average concentrations of calcium, magnesium and alkaline phosphatase (ALP) in blood serum remain in accordance with laboratory standards and were statistically not significant. In the majority of patients LBM increased significantly from 28 689+/-4423 g to 35 549.09+/-2968 g (p<0,05) and FM decreased from 21 070+/-4019,8 g (33,15+/-7,6%) to 19 075.37+/-4307,3 g (26.15+/-8.6%) (p<0.05). The alternations of the body composition in GH deficient children treated with rhGH occurred during the first year of therapy.
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Multiple micronutrient fortification of salt.
Vinodkumar, M, Rajagopalan, S
European journal of clinical nutrition. 2009;(3):437-45
Abstract
BACKGROUND/OBJECTIVE To develop a salt fortified with multiple micronutrients, to test its stability during storage and cooking, and to assess its efficacy in improving the micronutrient status and the health of schoolchildren. SUBJECT/METHODS A salt fortified with multiple micronutrients was developed containing chelated ferrous sulfate and microencapsulated vitamins A, B1, B2, B6, B12, folic acid, niacin, calcium pantothenate and iodine. Its stability during 20 min of cooking and 6 months of storage was determined. Thereafter, the efficacy of the salt was assessed in 5- to 15-year-old schoolchildren in Chennai, India. For the experimental group (N=119), the food in the school kitchen was cooked with fortified salt for a period of 1 year. The control group (N=126) consisted of day scholars who did not eat at the school. Hemoglobin, red blood cell count, hematocrit, serum vitamin A and urinary iodine were measured at baseline and at the end of the study after 1 year. RESULTS All micronutrients were stable during cooking and storage. Over the study period, there was a significant improvement (P<0.05) in hemoglobin, red cell count, urinary iodine and serum vitamin A in the experimental group, while there was a significant drop (P<0.05) in hemoglobin, hematocrit, red cell count and urinary iodine in the control group. In the experimental group, there was a mean increase of 0.55 g/dl in hemoglobin, 0.001 l/l in hematocrit, 0.470 million/mm(3) in red cell count, 212 microg/l in urinary iodine and 5.6 microg/dl in serum vitamin A. CONCLUSION The study shows that the salt fortified with multiple micronutrients is stable during cooking and storage and effective in combating multiple micronutrient deficiencies.
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The impact of constipation on growth in children.
Chao, HC, Chen, SY, Chen, CC, Chang, KW, Kong, MS, Lai, MW, Chiu, CH
Pediatric research. 2008;(3):308-11
Abstract
The observation on the impact of constipation on nutritional and growth status in healthy children was never reported. During a 4-y period, we evaluated the consequence of constipation on growth in children. The enrolled children were aged between 1 and 15 y with constipation. Medical response of constipation to treatment was evaluated by the scoring of constipation symptoms. The correlation of therapeutic effect of constipation with growth status at 12 wk and 24 wk was statistically evaluated. About 2426 children (1284 boys, 1142 girls) with a mean age of 7.31 +/- 3.65 (range 1.1-14.9) y were enrolled. After 12-wk treatment, significant increase of z-scores of height-for-age, weight-for-age, and body mass index-for-age were all found in patients with good medical responses (1377 cases) than in those with poor medical responses (1049 cases). The 1049 patients with poor medical response received advanced medications; significant increase of z-scores of height-for-age, weight-for-age, and body mass index were also found in these patients. A marked increase of appetite was significantly correlated with better gain on height and weight after treatment. We conclude that chronic constipation may retard growth status in children, and a long-term medication for constipation in children appears beneficial to their growth status.
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Effects of vitamin A, vitamin A plus iron and multiple micronutrient-fortified seasoning powder on preschool children in a suburb of Chongqing, China.
Chen, K, Li, TY, Chen, L, Qu, P, Liu, YX
Journal of nutritional science and vitaminology. 2008;(6):440-7
Abstract
Preschool children in developing countries are likely to have multiple, concurrent micronutrient deficiencies. This study was designed to evaluate the effectiveness of different combinations of nutritional fortified diet to improve the blood levels of iron, vitamin A and other essential micronutrients in the preschool population of Banan District of Chongqing, China. From December 2005 to June 2006, a total of 226 2-6 y old preschool children were recruited from three nurseries in the area, and they were randomly assigned to three different fortified diet groups for 6 mo. Group I was fortified with vitamin A; groups II and III were fortified with vitamin A plus iron and vitamin A plus iron, thiamine, riboflavin, folic acid, niacinamide, zinc and calcium, respectively. Subjects' weight and height were measured for assessing the children's growth and development. Blood samples were taken at the beginning and the end of the 6-mo study period for measuring serum levels of micronutrients. Group III with the multiple micronutrient fortified diet was the most effective to improve the serum level of retinol from [media (P25, P75): 1.06 (0.89, 1.32)] micromol/L to 1.29 (1.04, 1.39) micromol/L (p<0.05) and retinol binding protein from 17.0 (12.6, 25.6) mg/L to 31.6 (24.4, 44.0) mg/L (p<0.05) and to mobilize the stored iron in the liver (p<0.05). In addition, the three groups' hemoglobin levels were elevated from 117.0 (109.0, 124.1) g/L, 114.0 (109.2, 119.7) g/L and 115.0 (109.5, 122.7) g/L to 125.7 (119.2, 133.1) g/L, 126.5 (122.2, 135.9) g/L and 125.1 (119.8, 131.6) g/L over the 6 mo of intervention period, but there were no difference among the three groups (p>0.05). Nevertheless, unexpected results were obtained when comparing the effects on growth status among the different supplement groups. Our study has demonstrated that a multiple micronutrient fortified diet for 6 mo is more effective to improve the levels of hemoglobin, serum retinol, and RBP as well as to facilitate the mobilization of iron storage in preschool children.
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Effects of arginine treatment on nutrition, growth and urea cycle function in seven Japanese boys with late-onset ornithine transcarbamylase deficiency.
Nagasaka, H, Yorifuji, T, Murayama, K, Kubota, M, Kurokawa, K, Murakami, T, Kanazawa, M, Takatani, T, Ogawa, A, Ogawa, E, et al
European journal of pediatrics. 2006;(9):618-24
Abstract
BACKGROUND The aim of this study was to investigate the effects of arginine on nutrition, growth and urea cycle function in boys with late-onset ornithine transcarbamylase deficiency (OTCD). Seven Japanese boys with late-onset OTCD enrolled in this study resumed arginine treatment after the cessation of this therapy for a few years. Clinical presentations such as vomiting and unconsciousness, plasma amino acids and urinary orotate excretion were followed chronologically to evaluate urea cycle function and protein synthesis with and without this therapy. In addition to height and body weight, blood levels of proteins, lipids, growth hormone (GH), insulin-like growth factor-I (IGF-I) and IGF-binding protein -3 (IGFBP-3) were monitored. RESULTS The frequency of hyperammonemic attacks and urinary orotate excretion decreased significantly following the resumption of arginine treatment. Despite showing no marked change in body weight, height increased gradually. Extremely low plasma arginine increased to normal levels, while plasma glutamine and alanine levels decreased considerably. Except for a slight increase in high-density lipoprotein cholesterol level, blood levels of markers for nutrition did not change. In contrast, low serum IGF-I and IGFBP-3 levels increased to age-matched control levels, and normal urinary GH secretion became greater than the level observed in the controls. CONCLUSION Arginine treatment is able to reduces attacks of hyperammonemia in boys with late-onset OTCD and to increase their growth.
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Longitudinal investigation of the relationship between breast milk leptin levels and growth in breast-fed infants.
Dundar, NO, Anal, O, Dundar, B, Ozkan, H, Caliskan, S, Büyükgebiz, A
Journal of pediatric endocrinology & metabolism : JPEM. 2005;(2):181-7
Abstract
BACKGROUND It has been shown that leptin is present in breast milk and human mammary epithelial cells are able to synthesize leptin. It has been suggested that leptin in human milk might be involved in the regulation of postnatal nutrition and growth. AIMS To investigate whether there is a relationship between leptin levels in human milk and weight gain in the postnatal period and to compare variations of milk-borne maternal leptin concentrations for small for gestational age (SGA), large for gestational age (LGA) and appropriate for gestational age (AGA) infants. INFANTS AND METHODS Forty-seven healthy lactating women aged from 17-38 years and their infants were included in the study. The infants were separated into three groups according to birth weight as SGA (n = 11), LGA (n = 14) and AGA (n = 22). All infants were fed with breast milk during the study period. Anthropometric measurements were performed on the 15th day of life and at 1, 2, and 3 months of age, and the body mass index (BMI) of the infants' mothers was calculated. Breast milk leptin levels were analyzed by radioimmunoassay. RESULTS Breast milk leptin levels were found reduced in the SGA group and increased in the LGA group compared to the AGA group at 15 days of life (13.4 +/- 2.2, 28.5 +/- 4.4 and 18.4 +/- 2 ng/ml, respectively; p <0.05). At 1 month of age, leptin levels in breast milk were significantly lower in the LGA group than in the AGA group (15.5 +/- 4.9, 19.4 +/- 1.7 ng/ml, respectively; p<0.05). There was no difference among the three groups at 2 and 3 months of age (p>0.05). There was a positive correlation between birth Weight and breast milk leptin levels on the 15th day (r = 0.47, p = 0.001). A negative correlation was found between weight gain during the first 15 days and 1 month of life and breast milk leptin levels on the 15th day (r = -0.44, p = 0.002; r = -0.40, p = 0.005, respectively). No relationship could be determined between breast milk leptin levels and BMI of the mothers. CONCLUSION Maternal milk of SGA, LGA and AGA infants had different leptin levels, especially during the first month of life. More rapid growth was shown in the SGA infants during the first postnatal 15 days compared to AGA and LGA infants, and human milk leptin levels were significantly reduced in the SGA group. However, LGA infants gained more weight during the second 15 days of life and breast milk leptin levels were dramatically decreased in LGA and increased in SGA infants at the end of first month of life. These findings suggest that the presence of leptin in breast milk might have a significant role in growth, appetite and regulation of nutrition in infancy, especially during the early lactation period, and the production of leptin in breast tissue by human mammary epithelial cells might be regulated physiologically according to necessity and state of the infant.
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Serum leptin concentrations in children with mild protein-energy malnutrition and catch-up growth.
Büyükgebiz, B, Oztürk, Y, Yilmaz, S, Arslan, N
Pediatrics international : official journal of the Japan Pediatric Society. 2004;(5):534-8
Abstract
BACKGROUND The aim of the present study was to clarify the relationship between changing nutritional anthropometric data and serum leptin concentrations during the catch-up growth process in children. METHODS Thirty children with mild protein-energy malnutrition (PEM) were followed for 6 months and their anthropometric measurements and serum leptin concentrations were recorded during follow up. RESULTS Twenty-two (73.3%) of the 30 children showed catch-up growth. All parameters and serum leptin concentrations increased during the period of catch-up growth. In the remaining eight children, weight for height, percentage standard body mass index, percentage standard body height and mean serum leptin concentrations did not show any significant increase at the 6 month follow-up. Mean serum leptin concentration was higher in children with catch-up growth than in the controls. CONCLUSION During recovery from malnutrition, leptin concentrations increase in relation to fat mass if the fat mass reaches a critical point, and leptin might trigger catch-up growth with its regulator effects on growth. Although weight gain was noted in both groups, an increase in leptin concentration was observed only in children who showed catch-up growth. More interestingly, the mean leptin concentration was much higher in children with PEM who had catch-up growth compared to the control group and in children who failed to have catch-up growth. In children with catch-up growth, the higher serum leptin concentrations compared to healthy children and to children without catch-up growth despite significant weight gain suggests that leptin affects nutritional status in catch-up growth as a dynamic process, rather than merely being an index of body fat content.