Vitamin D insufficiency and deficiency in pediatric renal transplant recipients.

Vitamin D deficiency is prevalent in the pediatric CKD population. Recognizing that renal transplant recipients have CKD, we assessed the prevalence of vitamin D insufficiency and deficiency in pediatric renal transplant recipients, compared to a healthy pediatric population. We prospectively studied 25(OH)D levels in 29 pediatric renal transplant recipients and 45 control patients over one yr. The overall prevalence of vitamin D insufficiency and deficiency was common in both populations, at 76% (95% CI: 61, 87%) in the pediatric renal transplant recipients and 91% (95% CI: 80, 98%) in the control group. In the paired renal transplant samples, the mean 25(OH)D level was 52.3 ± 17.9 nmol/L in the winter and 65.6 ± 18.8 nmol/L in the summer (95% CI diff.: 3.9, 22.7), in keeping with a significant seasonal difference. The mean dietary intake of vitamin D in the renal transplant recipients, assessed by three-day dietary record, was 5.7 µg/day, with a vitamin D intake below the EAR in the majority. We did not find an association between vitamin D intake and 25(OH)D levels in this study, likely due to the low dietary intake of vitamin D within the transplant population, identifying a potential area for intervention and improvement.

Child and family adjustment following pediatric solid organ transplantation: factors to consider during the early years post-transplant.

Adjusting to life after transplant can be challenging to pediatric solid organ transplant recipients and their families. In this review, we discuss a number of important factors to consider during the first 2-3 yr after transplant (defined as the "early years"), including transitioning from hospital to home, returning to physical activity, feeding and nutrition, school reentry, potential cognitive effects of transplant, family functioning, and QOL. We highlight steps that providers can take to optimize child and family adjustment during this period.

Eating attitudes and behaviours in elite Canadian athletes with a spinal cord injury.

Athletes with a spinal cord injury (SCI) appear to have relatively modest energy requirements despite demanding training regimes. Virtually nothing is known about the factors which influence the energy intake of those with a SCI including food related attitudes and behaviours. Using a cross-sectional observational design, three aspects of eating attitudes were measured using the Three-Factor Eating Questionnaire (TFEQ) along with six days of self-reported dietary intake and anthropometrics. Between March 2007 and May 2009, a total of 32 Canadian athletes with a SCI (n=24 men, n=8 women) completed the study. The TFEQ scales showed a cognitive dietary restraint score of 10.8±4.7, disinhibition score of 2.8±1.8 and hunger score of 3.1±2.2. When the group was split into high and low restraint groups using a median of 11.5, no differences were detected in any of the absolute parameters of reported dietary intake although the higher restraint group had protein intakes account for a greater proportion of total energy. Those with higher restraint scores also had a relatively higher disinhibition score. While the cognitive dietary restraint scores for the women were similar to other able-bodied populations, the scores for men were higher than population norms from other studies. The scores for disinhibition and hunger were lower than reported ranges from able-bodied subjects. These athletes may be actively monitoring or limiting dietary intake to avoid the high prevalence of obesity associated with a SCI or perhaps to maintain an ideal body composition for their sport performance.

Risk of nutrient inadequacies in elite Canadian athletes with spinal cord injury.

Energy intakes of adults with spinal cord injury (SCI) have been reported to be relatively low, with many micronutrients below recommended amounts, but little is known about the diets of athletes with SCI. The purpose of this cross-sectional, observational study was to assess energy intakes and estimate the prevalence of dietary inadequacy in a sample of elite Canadian athletes with SCI (n = 32). Three-day self-reported food diaries completed at home and training camp were analyzed for energy (kcal), macronutrients, vitamins, and minerals and compared with the dietary reference intakes (DRIs). The prevalence of nutrient inadequacy was estimated by the proportion of athletes with mean intakes below the estimated average requirement (EAR). Energy intakes were 2,156 ± 431 kcal for men and 1,991 ± 510 kcal for women. Macronutrient intakes were within the acceptable macronutrient distribution ranges. While at training camp, >25% of men had intakes below the EAR for calcium, magnesium, zinc, riboflavin, folate, vitamin B12, and vitamin D. Thiamin, riboflavin, calcium, and vitamin D intakes were higher at home than training camp. Over 25% of women had intakes below the EAR for calcium, magnesium, folate, and vitamin D, with no significant differences in mean intakes between home and training camp. Vitamin/mineral supplement use significantly increased men's intakes of most nutrients but did not affect prevalence of inadequacy. Women's intakes did not change significantly with vitamin/mineral supplementation. These results demonstrate that athletes with SCI are at risk for several nutrient inadequacies relative to the DRIs.