Effects of vitamin D supplementation in obese and overweight children and adolescents: A systematic review and meta-analysis.

Due to the lipophilic nature of vitamin D, overweight and obese patients have an increased risk of inadequate circulating 25-hydroxy-vitamin D (25(OH)D) concentrations. Vitamin D deficiency has in turn several consequences especially among children and adolescents. Therefore, a few supplementation strategies of vitamin D for pediatric subjects with an excessive body weight have been proposed, but their efficacy remains controversial. The aim of this systematic review and meta-analysis was to evaluate the effect of vitamin D supplementation in overweight and obese children and adolescents. Three databases (PubMed, Embase and Web of Science) were searched to collect trials on the effect of vitamin D supplementation in the pediatric overweight or obese population. Twenty-three studies were included in the systematic review. Results on modification of metabolic or cardiovascular outcomes were controversial. On the other hand, the meta-analysis showed a mean difference by 1.6 ng/ml in subjects supplemented with vitamin D as compared to placebo. In conclusion, vitamin D supplementation slightly increases 25(OH)D levels in pediatric subjects with overweight and obesity. However, the effects on metabolic and cardiovascular outcomes remain controversial. New efforts should be devoted to promoting effective interventions to improve the health of children and adolescents with overweight and obesity.

Omega-3 fatty acids dietary intake for oocyte quality in women undergoing assisted reproductive techniques: A systematic review.

Dietary intake of omega-3 polyunsaturated fats (PUFAs) may be associated with successful assisted reproductive techniques (ART). However, heterogeneous studies were conducted and opposing results were obtained. This systematic review aims to summarize the evidence on the effect of omega-3 dietary intake on oocyte and embryo quality for a positive ART outcome. The PRISMA 2020 statement was followed and the review protocol was registered with PROSPERO (CRD42021283881). Inclusion and exclusion criteria were: eligible studies examined women undergoing ART cycles whose diet was evaluated for omega-3 intake or experienced an increase in omega-3 compared with women who followed in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) but did not increase the omega-3 intake before the cycle. 5,412 records were identified and five studies were included in the analysis. Two studies focused on sub-fertile or infertile women specifically, yet all women in all studies went through IVF/ICSI procedures. All five studies demonstrated how omega-3 FAs may be beneficial by increasing the positive rate of ART outcomes and embryo quality evaluated according to morphology and morphokinetic parameters. More research focusing on comparable and/or equal outcomes is required to strengthen supporting evidence with the aim to provide valid recommendations for women seeking a pregnancy.

Effect of Vitamin D and Docosahexaenoic Acid Co-Supplementation on Vitamin D Status, Body Composition, and Metabolic Markers in Obese Children: A Randomized, Double Blind, Controlled Study.

Obese children are at high risk of developing vitamin D deficiency. Omega-3 polyunsaturated fatty acids and their derivatives might have a beneficial effect on vitamin D status of obese children, due to their anti-inflammatory action, and increasing its absorption. This multicenter, randomized, double-blind controlled study aims to investigate the effect of vitamin D and docosahexaenoic acid (DHA) co-supplementation for six months on vitamin D status, body composition, and metabolic markers of obese children with vitamin D deficiency. A total of 108 children were enrolled and 73 children completed the study: 33 were supplemented with an oral dose of 500 mg of DHA and 1200 IU/day of vitamin D3 and 41 were supplemented with 1200 IU/day of vitamin D3 + wheat germ oil. At the end of the study, more than 50% of the subjects improved their vitamin D status. However, co-supplementation was not more effective than vitamin D plus wheat germ oil. Fat mass percentage was significantly reduced, and body mass index improved in both groups, even if all the subjects were still obese at the end of the study. Children receiving both vitamin D and DHA presented a higher increase of DHA levels that could be relevant to prevent inflammatory-associated complications of obesity, but they had no effect on vitamin D levels.

Long-Chain Polyunsaturated Fatty Acids Supplementation and Respiratory Infections.

BACKGROUND: Long-chain polyunsaturated fatty acids (LCPUFAs) can actively affect the maintenance and optimal functioning of immune cells. The metabolites of both omega-3 and omega-6 play an important role in the synthesis of different mediators, such as prostaglandins, leukotrienes, thromboxanes, protectins, and resolvins, that can interfere with the virus and modulate inflammation. SUMMARY: In this narrative review, we aim to identify whether LCPUFA supplementation may be effective in protecting the population against respiratory tract infections. We included only randomized controlled trials performed in both pediatric and adult subjects. Eight papers were selected: five trials were conducted in a pediatric population and three in adults. Different concentrations of fatty acids supplementation were associated with a lower incidence of common respiratory symptoms, except for two studies that did not provide significant results. Most of the studies are of low quality, and respiratory infections were assessed as secondary or even safety outcomes. KEY MESSAGES: No data were available on the role of LCPUFAs in coronavirus disease 2019 (COVID-19). Although these data showed that LCPUFAs may be effective in preventing respiratory tract infections, future studies are still needed to clarify their possible co-adjuvant role in the prevention and treatment of respiratory infections.

Nutrient supplementation for prevention of viral respiratory tract infections in healthy subjects: A systematic review and meta-analysis.

It remains uncertain as to whether nutrient supplementation for the general population considered healthy could be useful in the prevention of RTIs, such as COVID-19. In this systematic review and meta-analysis, the evidence was evaluated for primary prevention of any viral respiratory tract infection (RTI) such as SARS-CoV-2, through supplementation of nutrients with a recognized role in immune function: multiple micronutrients, vitamin A, folic acid, vitamin B12, C, D, E, beta-carotene, zinc, iron and long-chain polyunsaturated fatty acids. The search produced 15,163 records of which 93 papers (based on 115 studies) met the inclusion criteria, resulting in 199,055 subjects (191,636 children and 7,419 adults) from 37 countries. Sixty-three studies were included in the meta-analyses, which was performed for children and adults separately. By stratifying the meta-analysis by world regions, only studies performed in Asia showed a significant but heterogeneous protective effect of zinc supplementation on RTIs (RR 0.86, 95% CI 0.7-0.96, I2  = 79.1%, p = .000). Vitamin D supplementation in adults significantly decreased the incidence of RTI (RR 0.89, 95% CI 0.79-0.99, p = .272), particularly in North America (RR 0.82 95% CI 0.68-0.97), but not in Europe or Oceania. Supplementation of nutrients in the general population has either no or at most a very limited effect on prevention of RTIs. Zinc supplementation appears protective for children in Asia, whilst vitamin D may protect adults in the USA and Canada. In 10/115 (8.7%) studies post-hoc analyses based on stratification for nutritional status was performed. In only one study zinc supplementation was found to be more effective in children with low zinc serum as compared to children with normal zinc serum levels.

Fructooligosaccharides: From Breast Milk Components to Potential Supplements. A Systematic Review.

Breast milk is the optimal food choice for infant growth and development. Among breast milk components, fructooligosaccharides (FOSs) are being actively studied because of their role in microbiota development. In particular, 2'-fucosyllactose is being proposed as a potential supplement/nutraceutical or component of infant formula. In this systematic review, we critically summarize the available information on FOSs and we discuss their future use in infant nutrition. We searched the main electronic databases (PubMed, Embase, and Scopus), with a final check in May 2021. Search terms were inserted individually and using the Boolean tools AND and OR. Relevant articles were identified using the following words: ("fructooligosaccharides" OR "FOS") AND ("human milk" OR "breast milk" OR "donor milk" OR "bank milk"). The search retrieved 1814 articles. After removal of duplicates, we screened 1591 articles based on title, abstract, and exclusive use of the English language. We included articles describing the concentration of FOSs in human milk and assessed the relevant ones. We excluded reviews, studies on animals, and studies exclusively carried out on adults. Also, we excluded studies that have not reported evidence either on FOSs or on galactooligosaccharides from human milk. The resulting publications were reviewed, and 10 studies were included in the systematic review. We conclude that human milk FOSs are, indeed, crucial to infant gut development and their addition to infant formula is safe, well-tolerated, and might provide immune benefits to newborns. However, we would like to underscore the scantiness of human data and the need to avoid the immediate translation of infant research to the commercialization of supplements marketed to adults.

Nutritional management of food allergies: Prevention and treatment.

An individualized allergen avoidance plan is the cornerstone of the nutritional management of food allergy (FA). In pediatric age, the main objective is preventing the occurrence of acute and chronic symptoms by avoiding the offending food(s) and providing an adequate, nutritionally balanced and personalized diet at the same time. For this reason, the presence of a trained dietitian is recommended in order to meet nutritional needs of patients with FA and to provide a tailored nutritional plan, minimizing the impact of FA on quality of life and maintaining optimal growth.

Personalized nutrition approach in pediatrics: a narrative review.

Dietary habits represent the main determinant of health. Although extensive research has been conducted to modify unhealthy dietary behaviors across the lifespan, obesity and obesity-associated comorbidities are increasingly observed worldwide. Individually tailored interventions are nowadays considered a promising frontier for nutritional research. In this narrative review, the technologies of importance in a pediatric clinical setting are discussed. The first determinant of the dietary balance is represented by energy intakes matching individual needs. Most emerging studies highlight the opportunity to reconsider the widely used prediction equations of resting energy expenditure. Artificial Neural Network approaches may help to disentangle the role of single contributors to energy expenditure. Artificial intelligence is also useful in the prediction of the glycemic response, based on the individual microbiome. Other factors further concurring to define individually tailored nutritional needs are metabolomics and nutrigenomic. Since most available data come from studies in adult groups, new efforts should now be addressed to integrate all these aspects to develop comprehensive and-above all-effective interventions for children. IMPACT: Personalized dietary advice, specific to individuals, should be more effective in the prevention of chronic diseases than general recommendations about diet. Artificial Neural Networks algorithms are technologies of importance in a pediatric setting that may help practitioners to provide personalized nutrition. Other approaches to personalized nutrition, while promising in adults and for basic research, are still far from practical application in pediatrics.

The Role of Lipids in Human Milk and Infant Formulae.

The quantity and quality of dietary lipids in infant formulae have a significant impact on health outcomes, especially when fat storing and/or absorption are limited (e.g., preterm birth and short bowel disease) or when fat byproducts may help to prevent some pathologies (e.g., atopy). The lipid composition of infant formulae varies according to the different fat sources used, and the potential biological effects are related to the variety of saturated and unsaturated fatty acids. For example, since lipids are the main source of energy when the normal absorptive capacity of the digestive tract is compromised, medium-chain saturated fatty acids might cover this requirement. Instead, ruminant-derived trans fatty acids and metabolites of n-3 long-chain polyunsaturated fatty acids with their anti-inflammatory properties can modulate immune function. Furthermore, dietary fats may influence the nutrient profile of formulae, improving the acceptance of these products and the compliance with dietary schedules.

May biscuits contribute to iron balance? An observation in children with juvenile idiopatic arthritis.

Within an observational open study on the effects of a scheduled dosage of biscuits with iron, children with juvenile idiopathic arthritis were either supplemented with biscuits supplying iron fumarate (median 3.6 mg per day) or left to their customary dietary habits. After 4 months, supplemented children showed a more favourable percentage change of blood haemoglobin, while ferritin levels (markers of inflammation) remained stable. We conclude that the supply of iron with available dietary products may contribute to an adequate iron status in children with chronic inflammatory disorders in a stable situation.