Rates and time trends in the consumption of breastmilk, formula, and animal milk by children younger than 2 years from 2000 to 2019: analysis of 113 countries.

BACKGROUND: Previous analyses of trends in feeding indicators of children younger than 2 years have been limited to low-income and middle-income countries. We aimed to assess time trends in the consumption of different types of milk (breastmilk, formula, and animal milk) by children younger than 2 years from 2000 to 2019 at a global level. METHODS: In this time-series analysis, we combined cross-sectional data from 487 nationally representative surveys from low-income and middle-income countries and information from high-income countries to estimate seven infant and young child feeding indicators in up to 113 countries. Multilevel linear models were used in pooled analyses to estimate annual changes in feeding practices from 2000 to 2019 for country income groups and world regions. FINDINGS: For the absolute average annual changes, we found significant gains in any breastfeeding at age 6 months in high-income countries (1·29 percentage points [PPs] per year [95% CI 1·12 to 1·45]; p<0·0001) and at age 1 year in high-income countries (1·14 PPs per year [0·99 to 1·28]; p<0·0001) and upper-middle-income countries (0·53 PPs per year [0·23 to 0·82]; p<0·0001). We also found a small reduction in low-income countries for any breastfeeding at age 6 months (-0·07 PPs per year [-0·11 to -0·03]; p<0·0001) and age 1 year (-0·13 PPs per year [-0·18 to -0·09]; p<0·0001). Data on exclusive breastfeeding and consumption of formula and animal milk were only available for low-income and middle-income countries, where exclusive breastfeeding in the first 6 months of life increased by 0·70 PPs per year (0·51-0·88; p<0·0001) to reach 48·6% (41·9-55·2) in 2019. Exclusive breastfeeding increased in all world regions except for the Middle East and north Africa. Formula consumption in the first 6 months of life increased in upper-middle-income countries and in east Asia and the Pacific, Latin America and the Caribbean, the Middle East and north Africa, and eastern Europe and central Asia, whereas the rates remained below 8% in sub-Saharan Africa and south Asia. Animal milk consumption by children younger than 6 months decreased significantly (-0·41 PPs per year [-0·51 to -0·31]; p<0·0001) in low-income and middle-income countries. INTERPRETATION: We found some increases in exclusive and any breastfeeding at age 6 months in various regions and income groups, while formula consumption increased in upper-middle-income countries. To achieve the global target of 70% exclusive breastfeeding by 2030, however, rates of improvement will need to be accelerated. FUNDING: Bill & Melinda Gates Foundation, through WHO.

Practice Changes in Postoperative Feeding after Elective Colorectal Surgery: From Prospective Randomized Study to Everyday Practice.

Early postoperative feeding is the standard of care after colorectal surgery and is associated with improved outcomes. A controlled study performed at our center demonstrated faster bowel function recovery and shorter hospital stay without an increase in postoperative morbidity for a solid versus clear-liquid diet on postoperative day (POD) 1 after colorectal surgery. The present study aims to evaluate the impact of these findings on the practice of diet advancement by board-certified general surgeons (GS) and colorectal surgeons (CRS) at an urban teaching hospital. Patients undergoing elective colorectal surgery were prospectively evaluated. Data were compared with that of a study cohort that underwent elective colorectal surgery reported in 2012. Early postoperative feeding in the more recent cohort statistically increased for all cases on POD 0 and POD 1. Diet advancement over time revealed significant changes in early feeding on POD 0 for patients operated on by CRS (0% vs 83%; P < 0.0001) but not GS (13% vs 13%; P = 1). Patients operated on by either CRS or GS and offered early feeding on POD 1 did not significantly differ between time periods. Despite well-documented evidence of the advantages of early feeding, GS, but not CRS, remain reluctant to administer early diets to patients after colorectal surgery.

Drugs via enteral feeding tubes in inpatients: dispersion analysis and safe use of dispensers / Medicamentos a través de las sondas de nutrición enteral en pacientes: análisis de dispersión y uso seguro de los dispensadores

Objective: This study aimed to improve knowledge about drug administration through enteral feeding tubes (EFTs) in order to minimize efficacy and safety problems. Material and methods: The study was performed in a public secondary care hospital with level II accreditation by the National Accreditation Organization (Organização Nacional de Acreditação ONA), in Fortaleza, Ceará, north-eastern Brazil. Results: One hundred and eight oral solid medications that could be administered through EFTs and were not available in liquid forms were evaluated via transformation of their solid dosage forms into liquid forms. Dispersion times and conditions were assessed to determine which medications should be crushed. We compared the use of dispensers and syringes and their connections to enteral feeding tubes and intravenous devices. Medications whose dispersion occurred within 20 minutes and could be visually perceived and whose content could be expelled without occluding the oral syringe were considered «satisfactory». Conclusions: The dispersion was «satisfactory» in 82 (75.9%) of the medications; they were classified as capable of being dispersed in water in the oral syringe for further administration via EFTs without the need for crushing. Use the dispenser instead of the syringe for drug administration was safer because the dispenser apparatus did not fit into equipment for intravenous drug administration (AU)

Objetivo: este estudio tuvo como objetivo aumentar el conocimiento de la administración de medicamentos a través de las sondas de nutrición enteral (SNE), con el fin de reducir al mínimo los problemas de eficacia y seguridad inherentes al uso de esta vía. Material y métodos: el estudio se realizó en un hospital público en la atención secundaria, con el nivel II de acreditación por la Organización Nacional de Acreditación (ONA) en Fortaleza, Ceará, noreste de Brasil. Resultados: se evaluaron 108 preparaciones galénicas en forma sólida que podrían administrarse por SNE, no disponibles en forma líquida, mediante su preparación en una dilución. Se evaluaron los tiempos y las condiciones de dispersión para determinar qué medicamentos deberían triturarse. Se comparó el uso de dispositivos de distribución y de jeringas y sus conexiones con las SNE. Los fármacos cuya dispersión se produjo a los 20 minutos, que pudieran percibirse visualmente y cuyo contenido podría ser administrado sin ocluir la jeringa se consideraron de dispersión «satisfactoria». Conclusiones: la dispersión fue «satisfactoria» en 82 (75,9%) de los fármacos y se calificaron como capaces de dispersarse en agua en una jeringa, para la administración posterior a través de SNE, sin necesidad de ser triturados. El uso del dispensador en lugar de la jeringa para la administración enteral de medicamentos se considera más seguro debido a que el dispensador no se ajusta a los conectores utilizados para la administración de fármacos por vía intravenosa (AU)

Perioperative Feeding Approaches in Single Ventricle Infants: A Survey of 46 Centers.

Background Feeding dysfunction occurs commonly in infants with single ventricle heart disease and impacts growth and long-term outcomes. Little evidence exists to guide safe feeding in this population. This study surveyed centers participating in the National Pediatric Cardiology Quality Improvement Collaborative to assess prevailing feeding practices amongthose caring for single ventricle neonates. Methods Web-based survey of 56 pediatric cardiac surgical centers was conducted. Questions addressed peri-operative feeding approaches and responses were presented and analyzed descriptively. Results Of 56 centers, 46 (82%) completed a survey. Preoperative feeding was common in single ventricle infants (30/46; 65%), routes varied. Centers who did not feed infants preoperatively cited the risk of necrotizing enterocolitis (16/16; 100%), presence of umbilical artery catheter (12/16; 75%), and prostaglandin infusion (9/16; 56%) as main concerns. 67% of centers reported no specific vital sign thresholds for withholding enteral feedings. In the postoperative period, most centers used an "internal guideline" (21/46; 46%) or an "informal practice" (15/46; 33%) to determine feeding readiness. Approaches to findings were significantly different among centers. About 40% of centers did not send patients home with feeding tubes, and there was no clear consensus between preferred feeding tube modality at discharge. Conclusion Considerable variation exists in feeding practices for infants with single ventricle congenital heart disease among 46 centers participating in a quality improvement collaborative. Although most centers generally feed infants preoperatively, feeding practices remain center-specific. Variability continues in the immediate post-operative and interstage periods. Further opportunities exist for investigation, standardization and development of best-practice feeding guidelines.

Development of infant oral feeding skills: what do we know?

The hospital discharge of premature infants in neonatal intensive care units is often delayed due to their inability to feed by mouth safely and competently. With immature physiologic functions, infants born prematurely cannot be expected to readily feed by mouth at the equivalent age of a third trimester of gestation as the majority of their term counterparts do. Consequently, it is crucial that health care professionals gain an adequate knowledge of the development of preterm infants' oral feeding skills so as to optimize their safety and competency as they transition to oral feeding. With a greater sensitivity toward their immature skills, we can offer these infants a safer and smoother transition to independent oral feeding than is currently observed. This review article is an overview of the evidence-based research undertaken over the past 2 decades on the development of very-low-birth-weight infants' oral feeding skills. The description of the different functional levels where these infants can encounter hurdles may assist caregivers in identifying a potential cause or causes for their individual patients' oral feeding difficulties.

Alimentación de las pacientes durante la etapa de puerperio atendidas en el hospital básico Shushufindi / Food intake patients during puerperium tretaed at the basic hospital Shushufindi

Fundamentos: Algunas creencias y costumbres relacionadas con la alimentación en mujeres indígenas pueden ocasionar problemas en el embarazo y post-parto. Objetivo: El objetivo de esta investigación es conocer la relación entre alimentación, creencias y costumbres asociadas al puerperio en mujeres indígenas atendidas en el Hospital Básico Shushufindi. Métodos: Se realizó una encuesta para determinar las características culturales y costumbres alimentarias que mantenían durante su puerperio, así como los alimentos más consumidos. Resultados/Conclusión: Entre los principales resultados se observó que las pacientes mantenían malos hábitos alimenticios durante esta etapa, debido a las costumbres y creencias que han venido adquiriendo en sus hogares, y que traen consigo altos índices de anemia acompañados de problemas digestivos, que las obliga a consumir suplementos nutricionales (AU)

Background: Some believes and used in native women, related to food practices may lead to health problems during pregnancy and post-partum. Objective: The objective of this investigation is to know the relationship between food, beliefs, and custom associated with the puerperium in indigenous women who attended in the Hospital Basico Shushufindi. Methods: We realized a survey to determine the cultural characteristics and food customs that they maintain during the puerperium, just like the food most consumed. Results/Conclusions: Between the principal results we observed that the patients maintained bad food habits during this stage, due to the customs and beliefs that they had acquired in their houses, and they bring high rates of anemia accompanied by digestive problems, forcing them to consume nutritional supplements (AU)

Alimentación y hábitos alimentarios de la población en la Zona 1 del Ecuador: aportaciones a la identidad cultural andina y de América Latina / Nutrition and nuritional in zone 1 in Ecuador: contributions to the Andean and Latin American cultural indentity

Fundamento: Presentación del Proyecto: «Alimentación y hábitos alimentarios de la población en la Zona 1 de Ecuador: aportaciones a la identidad cultural andina y de América Latina», con cobertura en las provincias de Esmeraldas, Imbabura, Sucumbíos y Carchi. Objetivo: Caracterizar la alimentación y los hábitos alimentarios de la población de la Zona 1 de Ecuador, resaltando aquellas comidas, platos y preparaciones que constituyen aportes a la identidad cultural andina y de América Latina. Métodos: Se ha catalogado, desde el punto de vista teórico-metodológico, como un estudio de larga duración por la extensión del tiempo histórico, los marcos geográficos inherentes y las realidades biológicas actuantes. Por tanto, es diacrónico y sincrónico: lo primero, porque analiza un fenómeno social a lo largo de diversas fases históricas, atendiendo a su desarrollo y la sucesión cronológica de los hechos relevantes a lo largo del tiempo; lo segundo, porque a su vez permite la observación de este mismo fenómeno en un momento dado de su evolución, en el presente. Complementándose con aspectos tanto cualitativos como cuantitativos (AU)

Background: Presentation of the project: «Nutrition and nutritional habits of the population in Zone 1 in Ecuador: Contributions to the Andean and Latin American cultural identity», with coverage in the provinces of Esmeraldas, Imbabura, Sucumbíos and Carchi. Objective: The main goal of this research is to characterize the nutrition and nutritional habits of the population of Zone 1 in Ecuador, highlighting those meals, plates and preparations that contribute to the Latin American and Andean cultural identity. Methods: The research catalogues, from a theoretical and methodological point of view, and as a long duration study because of the length of the historical time, the inherent geographical frames and the acting biological realities. Therefore, the study is diachronic and synchronous. Diachronic because it analyses a social phenomenon through several historical phases, attending to its development and the chronological succession of relevant facts through time; synchronous because at the same time it permits the observation of the same phenomenon in a certain moment of its evolution, the present time. Both quantitative and qualitative aspects complement the research (AU)

Efectos de los programas escolares de promoción de actividad física y alimentación en adolescentes españoles: revisión sistemática / Effects of school-based physical activity and nutrition programs in spanish adolescents: systematic review

Introducción: la inactividad física y las conductas de alimentación poco saludable desde edades tempranas son dos de los grandes problemas de salud pública en los países desarrollados. Objetivo: realizar una revisión sistemática de los programas de promoción de actividad física y/o de alimentación desarrollados en España con adolescentes, desde el ámbito educativo y publicados en las principales bases de datos nacionales e internacionales en los últimos quince años. Método: se han revisado los artículos originales en inglés y español publicados en las bases de datos electrónicas: Web of Science, Scopus, ERIC, PsycINFO, Dialnet e ISOC, teniendo en cuenta los principios establecidos por la declaración PRISMA para revisiones sistemáticas. Resultados y discusión: de los 522 artículos identificados, 13 cumplían los criterios de inclusión establecidos. El aspecto de mayor coincidencia en los trabajos analizados es el de involucrar a las familias en la intervención. Al mismo tiempo, destaca el protagonismo del profesorado de Educación Física en la implementación de los programas, junto a la figura de los sanitarios, que también adquieren un elevado protagonismo. En todos ellos se logró incidir positivamente, como mínimo, en una de las variables objeto de estudio. Conclusión: en los últimos 15 años solamente se han identificado 13 programas con adolescentes de promoción de actividad física y/o de alimentación en España. Pero en todos ellos se obtuvieron mejoras, lo que confirma el relevante papel de la institución educativa sobre la adquisición y/o mejora de dichos hábitos desde una perspectiva saludable (AU)

Background: physical inactivity and unhealthy nutrition behaviours in early ages are two of the biggest problems related with public health in developed countries. Aims: to carry out a systematic review of school-based programs related with physical activity promotion and/or nutrition in adolescents implemented in Spain and published in the principal national and international data bases in the last 15 years. Method: the literature was searched in spanish and english data bases Web of Science, ERIC, PsycINFO, Dialnet and ISOC, following PRISMA declaration principles for systematic reviews. Results and discussion: from a total of 522 references, were retained 13 studies due to inclusion criteria. The most prevalent programs included families participation in the intervention. At the same time, the Physical Education teachers and the health personnel were the principal actor in programs development. Both of them were the principal protagonist in interventions. All the programs were able to improve at least one of the variables. Conclusion: were identified only 13 school-based intervention programs related with physical activity and/or nutrition in adolescents in the last 15 years in Spain. All the programs reached improvements, so school shows a relevant role in acquisition or improvement of this health behavior (AU)

Optimizing Eating Performance for Older Adults With Dementia Living in Long-term Care: A Systematic Review.

BACKGROUND: Review of research to date has been focusing on maintaining weight and nutrition with little attention on optimizing eating performance. OBJECTIVE: To evaluate the effectiveness of interventions on eating performance for older adults with dementia in long-term care (LTC). METHODS: A systematic review was performed. Five databases including Pubmed, Medline (OVID), EBM Reviews (OVID), PsychINFO (OVID), and CINAHL (EBSCOHost) were searched between January 1980 and June 2014. Keywords included dementia, Alzheimer, feed(ing), eat(ing), mealtime(s), oral intake, autonomy, and intervention. Intervention studies that optimize eating performance and evaluate change of self-feeding or eating performance among older adults (≥65 years) with dementia in LTC were eligible. Studies were screened by title and abstract, and full texts were reviewed for eligibility. Eligible studies were classified by intervention type. Study quality was accessed using the Quality Assessment Tool for Quantitative Studies, and level of evidence using the 2011 Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence. RESULTS: Eleven intervention studies (five randomized controlled trials [RCTs]) were identified, and classified into four types: training program, mealtime assistance, environmental modification, and multicomponent intervention. The quality of the 11 studies was generally moderate (four studies were rated as strong, four moderate, and three weak in quality), with the main threats as weak designs, lack of blinding and control for confounders, and inadequate psychometric evidence for measures. Training programs targeting older adults (Montessori methods and spaced retrieval) demonstrated good evidence in decreasing feeding difficulty. Mealtime assistance offered by nursing staff (e.g., verbal prompts and cues, positive reinforcement, appropriate praise and encouragement) also showed effectiveness in improving eating performance. LINKING EVIDENCE TO ACTION: This review provided preliminary support for using training and mealtime assistance to optimize eating performance for older adults with dementia in LTC. Future effectiveness studies may focus on training nursing caregivers as interventionists, lengthening intervention duration, and including residents with varying levels of cognitive impairment in diverse cultures. The effectiveness of training combined with mealtime assistance may also be tested to achieve better resident outcomes in eating performance.

Trends of early infant feedings practices after counseling in infant born to HIV positive women in Yaoundé, Cameroon.

UNLABELLED: The objective is to describe the trends of infant feedings choices in HIV context after infant feeding counseling. Descriptive retrospective study: Infant feeding counseling (IFC) sessions were offered to HIV pregnant women by the same team of counselors from April 2008 to December 2012. Counseling content was promoting either exclusive breastfeeding (EBF) or exclusive formula feeding (EFF) prior to 2010. Later on, versus EBF+ antiretroviral (ARV) drug given either to the mother or the infant or EFF was the gold standard. Mixed feeding was prohibited. Infants feeding were practices recorded at the first post natal visit. MAIN MEASUREMENT: rate of EBF/ EFF per year and period. We included a total of 1114 live-born babies. During the five year the overall rate of EBF and EFF stood at 41% and 59% respectively. The rate of EBF/EFF was recorded as follow: varies from 25/75% in year one to 52/48% in year five(p ≤ 0.001). The rate of mixed was virtually cancelled during the same period, 3/237 (1.2%) in year one to period 1/165 (0.6%) in the latest period. In conclusion, in Yaoundé, there is a slight increase in breastfeeding rate among HIV exposed infants during the first two months of life. Further investigations are required to confirm this tendency and analyze the new features of breastfeeding practices.

Data needs for B-24 and beyond: NHANES data relevant for nutrition surveillance of infants and young children.

The period from birth to 24 mo (B-24) is a critical phase in which nutrient requirements for growth and development are high and several transitions in food consumption practices occur. A few large-scale national studies (eg, the Feeding Infants and Toddlers Study and Infant Feeding Practices Study) offer important insights into infant feeding practices and food consumption patterns in young children in the United States. The NHANES collects comprehensive cross-sectional data on the nutrition and health of Americans including infants and toddlers. This article describes the NHANES program and data from NHANES 1999-2010 on young children that are relevant for the B-24 Project. NHANES is a nationally representative survey of the noninstitutionalized US population that combines personal interviews with standardized physical examination and measurements via mobile examination centers. Data on infant feeding practices (breastfeeding and timing of introduction and nature of complementary foods), dietary intake (two 24-h recalls), and nutrient supplements are collected. Data on demographic characteristics, anthropometric measurements, biomarkers of nutrient status, food security, and participation in federal nutrition programs are also available. Data can be accessed online, downloaded, and pooled over several survey cycles, allowing examination of infant feeding practices, food and nutrient intakes, and nutritional status of Americans <2 y old. Subgroup analyses by race-ethnicity and income status are also possible. NHANES responds to evolving data needs, as feasible, in the context of the survey design, research priorities, and funding. It offers a vehicle for potentially gathering additional data on children <2 y to address the objectives of the B-24 Project in the future.

Dependencia al ejercicio físico y trastornos de la conducta alimentaria / No disponible

El objetivo de estudio fue conocer el riesgo de dependencia al ejercicio físico a través de la Escala Revisada de Dependencia del Ejercicio (EDS-R, de Sicilia & González, 2011) de 49 pacientes con Trastornos de la Conducta Alimentaria (TCA), además de los motivos y las creencias que presentan respecto al ejercicio físico. Los resultados obtenidos indican como principal motivación la mejora de su aspecto físico bajo la creencia fundamental de que puede mejorar su salud física y psicológica, y en una notable mayoría el control de su peso. Los pacientes que realizan más de cuatro horas semanales de ejercicio físico presentan una media global más elevada de los síntomas consistentes con una dependencia al ejercicio físico frente aquellos que realizan menos de cuatro horas semanales. Este trabajo facilita la elaboración de estrategias de tratamiento ajustadas en pacientes con un TCA y el cuestionamiento de la recomendación de la práctica deportiva, pudiendo convertir un hábito sano en una posible adicción y agravamiento de su trastorno

The aim of study was to determine the risk exercise dependence through Exercise Dependence Scale-Revised (Sicilia & González, 2011) in 49 patients with eating disorders, in addition to motives and beliefs having regard to physical exercise. The results indicate like main motivation the improve of their physical appearance under the fundamental belief that it can improve their physical and psychological health, and in a remarkable majority the control of his weight. The patients that realised more than four weekly hours of physical exercise present a global average more elevated of the consistent symptoms with a dependence to the physical exercise front those that realised less than four weekly hours. This work facilitates the preparation of strategies of treatment become adjusted in patients with eating disorders. We ask about if an increasing number of hours of his physical exercise may be harmful to health with risk from exercise addiction aggravating their disorder

Alimentación y envejecimiento / Feeding and aging

El envejecimiento se caracteriza por un aumento relativo de la población de 65 años y mayores, pudiendo afirmar que, en nuestro país, constituye un fenómeno demográfico, político, social y sanitario.Diversos estudios han demostrado que el estado nutricional de la población general y de los ancianos, en particular, es un indicador válido para predecir la longevidad y la calidad de vida de este grupo de personas. La Organización Mundial de la Salud (OMS) señaló que la población anciana es un grupo nutricionalmente muy vulnerable como consecuencia de los cambios anatómicos y fisiológicos asociados al envejecimiento. Entre el 35-40% de los ancianos presenta algún tipo de alteración nutricional o malnutrición: desnutrición proteica o proteico-energética, déficit selectivo de vitaminas y minerales, inadecuado aporte hídrico, obesidad, etc.La mejor forma de favorecer la calidad de vida y de prevenir la enfermedad es una adecuada alimentación, denominada también alimentación saludable, adaptada a las circunstancias especiales que pueden presentar las personas mayores, sin olvidar que la gastronomía no está reñida con la salud. En el presente artículo, además, se ofrecen algunos consejos para preparar y cocer los alimentos, así como estrategias culinarias para introducirlos en el menú diario(AU)

Aging is characterized by an increase in relative population of 65 years and older, and can say that, in our country, it is a phenomenon demographic, political, social, and health. Several studies have shown that the nutritional status of the general population and the elderly, in particular, is a valid indicator to predict longevity and quality of life of this group of people. The World Health Organization (who) pointed out that the elderly population is a group nutritionally very vulnerable as a result of anatomical and physiological changes associated with aging. Between 35-40 of the elderly has some kind of altered nutrition or malnutrition: protein or protein-energy malnutrition, selective deficiency of vitamins and minerals, inadequate water intake, obesity, etc. The best way to promote the quality of life and prevent disease is a proper diet, also called healthy eating, adapted to the special circumstances which older persons may present without forgetting gastronomy is not incompatible with health. In this article, some tips are also available for preparing and cooking food, as well as culinary strategies to introduce them in the daily menu(AU)

La organización diaria del comer familiar en contextos de pobreza urbana en Córdoba, Argentina / Organization of daily family meals in urban poverty contexts in Cordoba, Argentina

Fundamento: Este trabajo tiene por objetivo analizar cómo se organiza diariamente el comer familiar en contextos de pobreza y bajo qué razones. Particularmente, en Villa La Tela, Córdoba, Argentina. Material y métodos: Enfoque cualitativo a partir del paradigma interpretativista. Se seleccionó una muestra intencional conformada por seis técnicos estatales y nueve referentes comunitarios a través del método de redes de contacto. Se realizaron entrevistas abiertas estandarizadas y observaciones participantes durante 2009-2010. La información fue cargada en AtlasTi para su análisis a través de la teoría fundamentada. Resultados: La organización diaria del comer familiar involucra un engranaje de prácticas alimentarionutricionales que estructuran el qué y cómo se come: lo que aquí llamamos comida a secas. Para su materialización, los sectores en situación de pobreza ponen gran empeño y creatividad en la coordinación entre: actores (principalmente mujeres), acciones (gestión), insumos (experiencias, información, contactos, bienes materiales), tiempos (en el sostenimiento de redes) y escenarios (privados y públicos). Conclusión: La organización diaria del comer familiar basada en una estrategia que brinda un papel protagónico a los comedores y a la comida rápida, no es objeto de cuestionamientos familiares; al fin de cuentas, la alimentación fue resuelta y por ende la gestión femenina resultó exitosa (AU)

Background: This paper aims to analyze how is the daily family eating organization in poverty contexts and which are their reasons. Particularly, what happens in Villa La Tela, Cordoba, Argentina. Methods: Qualitative approach from the interpretive paradigm. The intentional sample was formed by six technicians of the state and nine community leaders, made through the networking method. Open standardized interviews and participant observations were done during 2009-2010. The information was charged in AtlasTi for analysis through grounded theory. Results: The daily family eating organization involves a gear of food and nutrition practices that structure what and how they eat: what we call dry food. For its realization, subordinate social sectors invest big effort and creativity in the coordination of: members (mostly women), actions (resource management), inputs (experiences, information, contacts, material resources), times (in sustaining networks) and settings(private and public). Conclusion: The daily family eating organization based on a strategy that gives a central role to the refectories and fast food, not open a family question, after all, food was resolved and therefore female management was successful (AU)

Fiberoptic Endoscopic Evaluation of Swallowing in children: feeding outcomes related to diagnostic groups and endoscopic findings.

OBJECTIVE: Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is used as an adjunct to assess swallowing function in children with complex feeding disorders. We report the feeding outcomes of patients who underwent FEES to determine whether associations exist between clinical diagnoses or FEES findings and feeding outcomes. METHODS: Retrospective review of children who underwent FEES for dysphagia or aspiration from 2003 to 2009. The clinical diagnoses and initial FEES findings were compared to follow up feeding status for associations. RESULTS: 79 patients were included (44 males and 35 females). The change from initial to final status: total oral feeding (42-67%), NPO ± minimal tastes (39-21%) and oral feeding with tube feeding (19-12%). Of the clinical diagnoses, tonsillar hypertrophy was associated with ultimately obtaining total oral feeding status (p = 0.046) while the inability to obtain total oral feeding status was associated with neurologic (p < 0.001). The initial FEES findings showed no significant associations with long-term feeding status. CONCLUSION: Many children overcome their dysphagia but those with neurologic disorders are less likely to achieve total oral feeding status. In children with dysphagia evaluated by FEES, the long-term feeding status is not significantly associated with the initial FEES findings.

Secular trends in the prevalence of stunting, overweight and obesity among South African children (1994-2004).

BACKGROUND/OBJECTIVES: Various nutrition programs and free health care for children less than 6 years old were introduced in South Africa in the mid-1990s. We aim to describe secular trends for nutritional status of South African (SA) children in the 10-year period following these reforms. SUBJECTS/METHODS: The SA National Primary Schools' Anthropometric Survey (n=105 000) is a cross-sectional survey of children from all SA Education Departments sampled during 1994. The Health of the Nation Study (n=10 295) is a cross-sectional study, including children from primary schools in five SA Provinces sampled from 2001 to 2004. Height and weight of SA children were measured during both surveys. In 8-11 year olds, the National Centre for Health Statistics reference was used to calculate the prevalence of mild and moderate stunting, and overweight and obesity were calculated according to the International Obesity Task Force reference. Coexistence of stunting, overweight and obesity among these two age- and sex-matched cohorts were also calculated. RESULTS: When compared with previous SA data, moderate stunting (24.6-4.9%, P<0.001) decreased over the 7-10 years considered, whereas overweight (1.2-13.0%, P<0.001) and obesity (0.2-3.3%, P<0.001) prevalence increased. There were lower levels of mild stunting and similar levels of moderate stunting among overweight/obese children when compared with non-overweight/non-obese children. CONCLUSIONS: Our findings suggest that feeding policies may have been effective in reducing the prevalence of under-nutrition. However, inter-sectoral policies should recognize the apparent secular trend for an increased prevalence in overweight/obesity among young South Africans.

Epidemiological research drives a paradigm shift in complementary feeding - the celiac disease story and lessons learnt.

Breast milk is the initial natural food for infants, but already during the second half year complementary feeding is essential. Epidemiological research, first on celiac disease and later on atopic diseases, has driven a paradigm shift with respect to most favorable age to introduce complementary feeding. Simplified, this implies a shift from later to earlier introduction, which is now taken into account in recommendations on infant feeding. Complementary feeding, including all foods, should not be initiated for any infant before 4 months of age, and not later than around 6 months, including infants with elevated disease risk (e.g. for celiac disease or atopic diseases). Motivating reasons could be that ongoing breastfeeding provides an 'immunological umbrella' and/ or a different age interval gives a 'window of opportunity' for developing oral tolerance towards gluten and other food antigens. This will for some infants be in conflict with recent WHO recommendations on exclusive breastfeeding for 6 months. Epidemiology has evolved over time and could, if increasingly used, contribute even more to innovations in pediatric nutrition and other phenomena related to population health.

Technological progress as a driver of innovation in infant foods.

Advances in nutrition and food sciences are interrelated components of the innovative framework for infant formula and foods. While nutrition science continues to define the composition and functionality of human milk as a reference, food ingredient, formulation and processing technologies facilitate the design and delivery of nutritional and functional concepts to infant products. Expanding knowledge of both nutritive and non-nutritive components of human milk and their functionality guides selection and development of novel ingredient, formulation and processing methods to generate enhanced infant products targeting benefits including healthy growth, development as well as protection of health through the life cycle. In this chapter, identification and application of select novel ingredients/technologies will be discussed in the context of how these technological advancements have stimulated innovation in infant foods. Special focus will be given to advancements in protein technologies, as well as bioactive long-chain polyunsaturated fatty acids, prebiotics, probiotics that have allowed infant formula composition, and more critically functionality, to more closely align with that of human milk.

Ácidos grasos n-3 y n-6 en plasma al nacer y al año de edad y relación con el tipo de alimentación / n-3 and n-6 fatty acids in plasma at birth and one year of age and relationship with feeding

Objetivo: Comparar las variaciones de los ácidos grasos poliinsaturados de cadena larga (LCPUFA) al nacer y al año de edad en niños alimentados con lactancia materna prolongada, lactancia materna de duración media y fórmula artificial. Pacientes: Un total de 77 niños sanos a término con alimentación conocida fueron divididos en grupos: el grupo A (n = 25) había recibido lactancia prolongada (más de 6 meses); el B (n = 26), lactancia media (más de 3 meses y menos de 5), y el C (n = 26), cuyos sujetos fueron alimentados únicamente con fórmula artificial. Se midió la proporción de ácidos grasos plasmáticos al nacer y al primer año de vida. Resultados: No existen diferencias en el momento del nacimiento. Sin embargo, hay una disminución significativa de la proporción de los principales LCPUFA, ácido docosahexaenoico (DHA) y ácido araquidónico (AA), entre el nacimiento y el primer año de vida. Al año, el porcentaje de DHA varía significativamente entre el grupo A y los otros dos: 2,46 ± 0,84 frente a 1,80 ± 0,48 y 1,89 ± 0,75 (p < 0,01). Conclusiones: 1. Al nacer no existen diferencias en el contenido de LCPUFA. 2. Se observa una disminución significativa de los principales LCPUFA con la edad. 3. El grupo con lactancia materna prolongada posee mayores proporciones de DHA que los otros dos. Por consiguiente, la lactancia durante más de 6 meses es necesaria para obtener valores más elevados de DHA (AU)

Aim: Compare the variations of long-chain polyunsaturated fatty acids (LCPUFA) levels at birth and at the first year of age in children on extended breast-feeding, medium term breast-feeding and formula feeding. Patients: 77 healthy term infants divided in three groups: A (N = 25): extended breast-feeding (more than 6 months), B (N = 26): medium term breast-feeding (more than 3 and less than 5 months) and C (N = 26): exclusive formula feeding. Fatty acids in plasma were measured at birth and at the first year of age. Results: There were no differences in the levels at birth. However, there is a significant decrease in the proportion of the main LCPUFA, docosahexaenoic acid (DHA) and arachidonic acid (AA), between birth and the first year of age. At one year of age, the percentage of DHA in Group A differs significantly between the other two: 2.46 ± 0.84 vs. 1.80 ± 0.48 and 1.89 ± 0.75 (p < 0.01). Conclusions: 1. At birth, there are no differences in LCPUFA. 2. A significant decrease in the main LCPUFA is observed with age. 3. The extended breast-feeding group shows higher DHA levels than the other two. Therefore, breast-feeding for more than 6 months is required to achieve higher plasma DHA values (AU)