No Effect of Glucomannan on Body Weight Reduction in Children and Adolescents with Overweight and Obesity: A Randomized Controlled Trial.

OBJECTIVE: To assess the efficacy of water-soluble dietary fiber, glucomannan supplementation, on the body mass index (BMI) in children with overweight or obesity. STUDY DESIGN: In this randomized, double-blind, placebo-controlled trial, we enrolled 96 children aged 6-17 years with overweight or obesity based on the World Health Organization growth criteria (>+1 SD or >+2 SD, respectively). Participants were assigned to receive glucomannan or placebo (maltodextrin), both at a dose of 3 g/d for 12 weeks and were followed up for the next 12 weeks. Concomitant care included dietary and lifestyle advice. The primary outcome was the difference in the BMI-for-age z score change between the groups at 12 weeks. RESULTS: Compared with the placebo, glucomannan had no effect on the BMI-for-age z score at 12 weeks (mean difference: 0.0, 95% CI -0.1 to 0.1). Compared with the placebo, the glucomannan group had lower total and low-density lipoprotein cholesterol concentrations at 12 weeks. In addition, the blood pressure was greater at 12 weeks (systolic) and at 24 weeks (diastolic) in the glucomannan group. No differences between the groups in adverse events and other secondary outcomes were observed. CONCLUSIONS: Glucomannan supplementation compared with placebo had no effect on weight reduction in children with overweight and obesity. TRIAL REGISTRATION: ClinicalTrials.govNCT02280772.

Nutrition of infants and young children (one to three years) and its effect on later health: A systematic review of current recommendations (EarlyNutrition project).

BACKGROUND: EarlyNutrition ( www.project-earlynutrition.eu ) is an international research project investigating the effects of early nutrition on metabolic programming. OBJECTIVE: To summarize, by performing a systematic review, current standards, recommendations, guidelines, and regulations (hereafter, referred to as documents) on the nutrition of children up to three years of age. Special emphasis was placed on long-term effects of early nutrition, such as the risk of cardiovascular disease, hypertension, overweight, obesity, metabolic syndrome, diabetes, or glucose intolerance. METHODS: MEDLINE, selected databases, and websites were searched for documents published between 2008 and January 2013. RESULTS: Forty two documents met the inclusion criteria. The strongest and most consistent evidence for a protective, long-term effect was documented for breastfeeding. Also, limiting the intake of sodium and rapidly absorbed carbohydrates, use of a specific meal pattern, reducing the consumption of saturated fatty acids by replacing them with polyunsaturated fatty acids, and lowering the intake of trans fatty acids, seems beneficial. Many documents did not evaluate long-term outcomes of interest to us, or reported insufficient or imprecise data. Inconsistency in recommendations for some outcomes and research gaps were identified. CONCLUSIONS: Our findings may serve as a helpful tool in planning further research, preventive actions against important diet-related diseases, and guidelines improvement.

Non-specific immune stimulation in respiratory tract infections. Separating the wheat from the chaff.

Parents of children suffering from recurrent respiratory infections can be persuaded by advertisements to pressure their family physicians and pediatricians for "immune-stimulating enhancements". However, the evidence base behind these immune stimulants is usually lacking. Often there is no peer-reviewed studies available that support claims made by "immune-booster" supplements. In this review, we critically analyze most of the marketed immuno-active drugs (including vitamin preparations, dietary supplements, homeopathic remedies, Ecchinacea, bacterial lysates, and probiotics) and identify the necessity to exclude an immunodeficiency in every child suffering from recurrent respiratory tract infections.

Effect of glucomannan supplementation on body weight in overweight and obese children: protocol of a randomised controlled trial.

INTRODUCTION: Glucomannan (GNN), a water-soluble dietary fibre derived from the plant Amorphophallus konjac, is marketed for weight reduction. The exact mechanisms by which GNN might exert its actions are unclear. However, it has been shown that GNN slows gastric emptying by forming a viscous gel of large volume, which increases the feeling of satiety. Current evidence on the effectiveness of GNN for weight reduction is sparse, and well-designed trials performed in children are needed to assess the efficacy of this modality. We aim to systematically evaluate the efficacy of GNN consumption for the management of children who are overweight or obese. METHODS AND ANALYSIS: Children aged 6-17 years who are overweight or obese (based on the WHO growth criteria) will be randomly assigned to receive GNN or placebo (maltodextrin) (both at a dose of 3 g/day) for 3 months and will be followed-up for 3 months. Before the intervention, all children will receive dietetic advice, and they will be encouraged to engage in physical activity. The primary outcome measure will be the body mass index-for-age z-score difference between the groups at the end of the intervention. ETHICS AND DISSEMINATION: The study was approved by the Bioethics Committee of the Medical University of Warsaw. The findings of this trial will be submitted to a peer-reviewed journal (paediatric, nutrition or gastroenterology). Abstracts will be submitted to relevant national and international conferences. TRIAL REGISTRATION NUMBER: NCT02280772.

Environmental tobacco smoke exposure and risk of allergic sensitisation in children: a systematic review and meta-analysis.

BACKGROUND: Environmental tobacco smoke (ETS) exposure in children is linked with the development of allergic asthma. However, its influence on allergic sensitisation in children has not been conclusively determined. OBJECTIVE: To systematically review existing evidence of ETS exposure's impact on markers of allergic sensitisation in children. METHODS: CENTRAL, MEDLINE and EMBASE databases were searched. Included studies assessed following markers of atopic sensitisation: total immunoglobulin E (tIgE) concentrations, at least one specific IgE (sIgE+), and positive skin-prick tests (SPTs+) in ETS-exposed and non-exposed children. RESULTS: 8 studies on the influence of ETS on tIgE concentration (2603 patients), 6 studies on ETS and sIgE+ (9230 participants) and 14 papers on ETS and SPT (14 150 patients) met our inclusion criteria. ETS was shown to raise tIgE concentrations by 27.7 IU/mL (95% CI 7.8 to 47.7; I(2)=58%; results based on 3 studies) and to increase the risk of atopic sensitisation, as assessed by sIgE+ (OR=1.12, 95%CI 1.00 to 1.25; I(2)=54%; results based on 4 studies) and SPT+ (OR=1.15; 95% CI 1.04 to 1.28; I(2)=0%; results based on 10 studies). In a subgroup analysis, this effect was most pronounced in children <7 years (preschoolers) by OR=1.20; (95% CI 1.05 to 1.38) and OR=1.30 (95% CI 1.05 to 1.61), (for sIgE+ and SPT+, respectively). CONCLUSIONS: Current analysis supports an association between ETS exposure in early childhood and the increased risk of allergic sensitisation. Subgroup meta-analyses demonstrate that younger children suffer the most from detrimental immunomodulating effects of ETS exposure. This study underscores ETS as an important but avoidable risk factor for the development of allergic disease in children.