Effect of Zinc Intake on Growth in Infants: A Meta-analysis.

A systematic review and meta-analysis of available randomized controlled trials (RCTs) was conducted to evaluate the effect of zinc (Zn) intake on growth in infants. Out of 5500 studies identified through electronic searches and reference lists, 19 RCTs were selected after applying the exclusion/inclusion criteria. The influence of Zn intake on growth was considered in the overall meta-analysis. Other variables were also taken into account as possible effect modifiers: doses of Zn intake, intervention duration, nutritional status, and risk of bias. From each select growth study, final measures of weight, length, mid upper arm circumference (MUAC), head circumference, weight for age z-score (WAZ), length for age z-score (LAZ), and weight for length z-score (WLZ) were assessed. Pooled ß and 95% confidence interval (CI) were calculated. Additionally, we carried out a sensitivity analysis. Zn intake was not associated with weight, length, MUAC, head circumference, and LAZ in the pooled analyses. However, Zn intake had a positive and statistically effect on WAZ (ß = 0.06; 95%CI 0.02 to 0.10) and WLZ (ß = 0.05; 95%CI 0.01 to 0.08). The dose-response relationship between Zn intake and these parameters indicated that a doubling of Zn intake increased WAZ and WLZ by approximately 4%. Substantial heterogeneity was present only in length analyses (I(2) = 45%; p = 0.03). Zn intake was positively associated with length values at short time (four to 20 weeks) (ß = 0.01; CI 95% 0 to 0.02) and at medium doses of Zn (4.1 to 8 mg/day) (ß = 0.003; CI 95% 0 to 0.01). Nevertheless, the effect magnitude was small. Our results indicate that Zn intake increases growth parameters of infants. Nonetheless, interpretation of these results should be carefully considered.

KIDMED TEST; PREVALENCE OF LOW ADHERENCE TO THE MEDITERRANEAN DIET IN CHILDREN AND YOUNG; A SYSTEMATIC REVIEW.

INTRODUCTION: during the last decades, a quick and important modification of the dietary habits has been observed in the Mediterranean countries, especially among young people. Several authors have evaluated the pattern of adherence to the Mediterranean Diet in this group of population, by using the KIDMED test. OBJECTIVES: the purpose of this study was to evaluate the adherence to the Mediterranean Diet among children and adolescents by using the KIDMED test through a systematic review and meta-analysis. METHODS: PubMed database was accessed until January 2014. Only cross-sectional studies evaluating children and young people were included. A random effects model was considered. RESULTS: eighteen cross-sectional studies were included. The population age ranged from 2 to 25 years. The total sample included 24 067 people. The overall percentage of high adherence to the Mediterranean Diet was 10% (95% CI 0.07-0.13), while the low adhesion was 21% (IC 95% 0.14 to 0.27). In the low adherence group, further analyses were performed by defined subgroups, finding differences for the age of the population and the geographical area. CONCLUSION: the results obtained showed important differences between high and low adherence to the Mediterranean Diet levels, although successive subgroup analyzes were performed. There is a clear trend towards the abandonment of the Mediterranean lifestyle.

Introducción: en las últimas décadas se ha observado una modificación rápida e importante de los hábitos dietéticos en los países mediterráneos, especialmente entre los jóvenes. Varios autores han evaluado el patrón de adhesión a la Dieta Mediterránea en este grupo de población, mediante el uso de la prueba KIDMED. Objetivos: el objetivo de este estudio fue evaluar la adhesión a la Dieta Mediterránea entre los niños y adolescentes mediante el uso de la prueba KIDMED a través de una revisión sistemática y un metaanálisis. Métodos: la base de datos PubMed fue revisada hasta enero de 2014. Los estudios incluidos solo fueron los transversales que evaluaron a niños y a jóvenes. Se consideró un modelo de efectos aleatorios. Resultados: se incluyeron dieciocho estudios transversales. La edad de la población varió de 2 a 25 años. La muestra total incluyó 24.067 personas. El porcentaje global de alta adhesión a la Dieta Mediterránea fue del 10% (IC del 95%: 0,07 a 0,13), mientras que la baja adhesión fue del 21% (IC 95%: 0,14 a 0,27). Nuevos análisis por subgrupos definidos fueron realizados en el grupo de baja adhesión, encontrando diferencias para la edad de la población y para la zona geográfica. Conclusión: los resultados obtenidos mostraron diferencias importantes entre alta y baja adhesión a la Dieta Mediterránea, a pesar de los sucesivos análisis de subgrupos que se realizaron. Existe una clara tendencia hacia el abandono del estilo de vida mediterráneo.

KIDMED test; prevalence of low adherence to the Mediterranean Diet in children and young; a systematic review / Test KIDMED; prevalencia de la baja adhesión a la dieta mediterránea en niños y adolescentes; revisión sistemática

Introduction: during the last decades, a quick and important modification of the dietary habits has been observed in the Mediterranean countries, especially among young people. Several authors have evaluated the pattern of adherence to the Mediterranean Diet in this group of population, by using the KIDMED test. Objectives: the purpose of this study was to evaluate the adherence to the Mediterranean Diet among children and adolescents by using the KIDMED test through a systematic review and meta-analysis. Methods: PubMed database was accessed until January 2014. Only cross-sectional studies evaluating children and young people were included. A random effects model was considered. Results: eighteen cross-sectional studies were included. The population age ranged from 2 to 25 years. The total sample included 24 067 people. The overall percentage of high adherence to the Mediterranean Diet was 10% (95% CI 0.07-0.13), while the low adhesion was 21% (IC 95% 0.14 to 0.27). In the low adherence group, further analyses were performed by defined subgroups, finding differences for the age of the population and the geographical area. Conclusion: the results obtained showed important differences between high and low adherence to the Mediterranean Diet levels, although successive subgroup analyzes were performed. There is a clear trend towards the abandonment of the Mediterranean lifestyle (AU)

Introducción: en las últimas décadas se ha observado una modificación rápida e importante de los hábitos dietéticos en los países mediterráneos, especialmente entre los jóvenes. Varios autores han evaluado el patrón de adhesión a la Dieta Mediterránea en este grupo de población, mediante el uso de la prueba KIDMED. Objetivos: el objetivo de este estudio fue evaluar la adhesión a la Dieta Mediterránea entre los niños y adolescentes mediante el uso de la prueba KIDMED a través de una revisión sistemática y un metaanálisis. Métodos: la base de datos PubMed fue revisada hasta enero de 2014. Los estudios incluidos solo fueron los transversales que evaluaron a niños y a jóvenes. Se consideró un modelo de efectos aleatorios. Resultados: se incluyeron dieciocho estudios transversales. La edad de la población varió de 2 a 25 años. La muestra total incluyó 24.067 personas. El porcentaje global de alta adhesión a la Dieta Mediterránea fue del 10% (IC del 95%: 0,07 a 0,13), mientras que la baja adhesión fue del 21% (IC 95%: 0,14 a 0,27). Nuevos análisis por subgrupos definidos fueron realizados en el grupo de baja adhesión, encontrando diferencias para la edad de la población y para la zona geográfica. Conclusión: los resultados obtenidos mostraron diferencias importantes entre alta y baja adhesión a la Dieta Mediterránea, a pesar de los sucesivos análisis de subgrupos que se realizaron. Existe una clara tendencia hacia el abandono del estilo de vida mediterráneo (AU)

Zinc intake, status and indices of cognitive function in adults and children: a systematic review and meta-analysis.

In developing countries, deficiencies of micronutrients are thought to have a major impact on child development; however, a consensus on the specific relationship between dietary zinc intake and cognitive function remains elusive. The aim of this systematic review was to examine the relationship between zinc intake, status and indices of cognitive function in children and adults. A systematic literature search was conducted using EMBASE, MEDLINE and Cochrane Library databases from inception to March 2014. Included studies were those that supplied zinc as supplements or measured dietary zinc intake. A meta-analysis of the extracted data was performed where sufficient data were available. Of all of the potentially relevant papers, 18 studies met the inclusion criteria, 12 of which were randomised controlled trials (RCTs; 11 in children and 1 in adults) and 6 were observational studies (2 in children and 4 in adults). Nine of the 18 studies reported a positive association between zinc intake or status with one or more measure of cognitive function. Meta-analysis of data from the adult's studies was not possible because of limited number of studies. A meta-analysis of data from the six RCTs conducted in children revealed that there was no significant overall effect of zinc intake on any indices of cognitive function: intelligence, standard mean difference of <0.001 (95% confidence interval (CI) -0.12, 0.13) P=0.95; executive function, standard mean difference of 0.08 (95% CI, -0.06, 022) P=0.26; and motor skills standard mean difference of 0.11 (95% CI -0.17, 0.39) P=0.43. Heterogeneity in the study designs was a major limitation, hence only a small number (n=6) of studies could be included in the meta-analyses. Meta-analysis failed to show a significant effect of zinc supplementation on cognitive functioning in children though, taken as a whole, there were some small indicators of improvement on aspects of executive function and motor development following supplementation but high-quality RCTs are necessary to investigate this further.

The relationship between zinc intake and growth in children aged 1-8 years: a systematic review and meta-analysis.

BACKGROUND/OBJECTIVES: It is estimated that zinc deficiency affects 17% of the world's population, and because of periods of rapid growth children are at an increased risk of deficiency, which may lead to stunting. This paper presents a systematic review and meta-analysis of the randomised controlled trials (RCTs) that assess zinc intake and growth in children aged 1-8 years. This review is part of a larger systematic review by the European Micronutrient Recommendations Aligned Network of Excellence that aims to harmonise the approach to setting micronutrient requirements for optimal health in European populations (www.eurreca.org). SUBJECT/METHODS: Searches were performed of literature published up to and including December 2013 using MEDLINE, Embase and the Cochrane Library databases. Included studies were RCTs in apparently healthy child populations aged from 1 to 8 years that supplied zinc supplements either as capsules or as part of a fortified meal. Pooled meta-analyses were performed when appropriate. RESULTS: Nine studies met the inclusion criteria. We found no significant effect of zinc supplementation of between 2 weeks and 12 months duration on weight gain, height for age, weight for age, length for age, weight for height (WHZ) or WHZ scores in children aged 1-8 years. CONCLUSIONS: Many of the children in the included studies were already stunted and may have been suffering from multiple micronutrient deficiencies, and therefore zinc supplementation alone may have only a limited effect on growth.

Acute experimental esophagitis impairs signal transduction in cat lower esophageal sphincter circular muscle.

It has been previously shown that induction of experimental esophagitis in the cat by esophageal perfusion for 30 minutes with 0.1N HCl for 4 consecutive days results in a significant reduction of in vivo lower esophageal sphincter (LES) resting pressure and in vitro spontaneous tone without affecting esophageal response to KCl. It has also been shown that basal LES tone and LES contraction in response to acetylcholine depend on the release of calcium from intercellular stores, whereas esophageal contraction is mediated by extracellular calcium. The present report shows that esophageal acid perfusion impairs the transduction pathway mediating lower esophageal sphincter contraction in response to acetylcholine through release of intracellular calcium because LES strips and single cells no longer contract in response to acetylcholine if calcium is removed from the physiologic salt solution. This suggests that either the intracellular calcium stores or the release mechanisms that mediate maintenance of tone and contraction in response to acetylcholine may be damaged. However, the acid perfusion has no effect on the acetylcholine response in the esophagus, which is mediated by the influx of extracellular calcium. In the LES circular muscle, the injury results in reduced levels of inositol phosphates without affecting resting levels of 5'-cyclic adenosine monophosphate or 5'-cyclic guanosine monophosphate. The reduced levels of 1,4,5-inositol trisphosphate are consistent with impairment in the mechanisms responsible for release of intracellular calcium, although concurrent damage to calcium stores may also occur.