When should we use partially hydrolysed formulae for frequent gastrointestinal symptoms and allergy prevention?

UNLABELLED: Experts reviewed the literature to determine whether partially whey hydrolysed formulas (HF) offer benefits in the dietary management of frequent gastrointestinal symptoms and allergy prevention. Compared with standard cow's milk-based formulas, partially whey HF confer a limited protective effect against allergic disease in high-risk infants, particularly atopic dermatitis, but not respiratory allergies. No randomised clinical trials have been published on partially whey HF in infants with colicky symptoms. The group did not find sufficient evidence to support the use of partially whey HF in regurgitation, although recent data suggest that a thickened partially whey HF may be more effective. Partially whey HF, fortified with prebiotics and/or probiotics, with high levels of sn-2 palmitate in the fat blend or without palm oil, provide some benefit in functional constipation. CONCLUSION: Overall, partially whey HF may offer a useful alternative to intact protein in the dietary management of common functional gastrointestinal symptoms.

Epidemiological evaluation of acute gastroenteritis and therapeutic approaches in Middle East Countries.

OBJECTIVE: Gastroenteritis represents with respiratory tract infection the most common infectious disease syndrome of humans in developing countries. Gut microbiota regional variation and dysbiosis play a crucial role in triggering and worsening this devastating GI disease. MATERIALS AND METHODS: With this manuscript, we want to explore and emphasize the critical aspect of acute gastroenteritis in Middle-East Countries and its correlation with the clinical aspect of gut microbiota modification and intestinal homeostasis. RESULTS: Approximately 1 of 50 children born each year in developed nations is hospitalized for acute gastroenteritis sometime during childhood. The highest rate of illness occurs in children between 3 and 24 months of age. The common causes of diarrhea are infections with viruses and bacteria, diarrhea due to a systemic infection other than gastrointestinal, diarrhea associated with antibiotic administration, and feeding related diarrhea. The single most common diarrheal disorder observed in the Emergency Department and general practice is viral gastroenteritis. In particular, Rotavirus is the cause of more than 2 million hospitalizations and over half a million deaths from acute GE in infants and young children. This burden produces also direct and indirect economic costs. The use of probiotics to counterbalance commensal dysbiosis is emerging as a standard medical practice in these countries. CONCLUSIONS: In this scenario, one of the most interesting aspects is that probiotics and gut microbiota modulation could deeply improve the prevention and treatment of this devastating GI pathology. At the same time, vaccination might represent a cost-effective strategy to reduce the health and economic burden of some pathogens, such as rotavirus.

Vitamin D deficiency and insufficiency in Africa and the Middle East, despite year-round sunny days.

Exposure to sunlight, specifically ultraviolet B (UVB), is essential for cutaneous vitamin D synthesis. Despite significant daily sunlight availability in Africa and the Middle East, persons living in these regions are frequently vitamin D insufficient or deficient. Vitamin D insufficiency (25-hydroxyvitamin D (25(OH)D) between 15 and 20 ng/mL (37.5-50 nmol/L)) has been described in various population groups, ranging from 5% to 80%. Risk factors include traditional dress and avoidance of sunlight exposure, and multiple dietary factors as a result of specific cultural beliefs. Vitamin D resistance due to calcium deficiency mechanisms has been described in similar population groups, which may lead to hypovitaminosis D. Should the new diseases related to hypovitaminosis D prove to be truly associated, Africa and the Middle East will become an epicentre for many of these conditions. Urgent attention will need to be paid to cultural dress and dietary behaviours if hypovitaminosis D is to be taken seriously. Should such factors not be correctable, new strategies for supplementation or food fortification will have to be devised.