Growth trajectories in children with cleft lip and/or palate / Trayectorias de crecimiento en niños con fisura labial y/o palatina

Introduction: the nutritional status and growth of children with cleft lip and/or palate (CL/P) can be affected due to feeding difficulties caused by their anatomy and the surgical interventions. Objective: this retrospective longitudinal study aims to analyse the growth trajectories of a cohort of children with CL/P and compare them with a healthy representative cohort of children from Aragon (Spain). Methods: type of cleft, surgical technique and sequelae, and weight, length/height and body mass index (BMI) (weight/height2) at different ages (0-6 years) were recorded. Normalized age- and sex-specific anthropometric Z-scores values were calculated by World Health Organization (WHO) charts. Results: forty-one patients (21 male, 20 female) were finally included: 9.75 % cleft lip (n = 4/41), 41.46 % cleft palate (n = 17/41) and 48.78 % cleft lip and palate (n = 20/41). The worst nutritional status Z-scores were achieved at the age of three months (44.44 % and 50 % had a weight and a BMI lower than -1 Z-score, respectively). Mean weight and BMI Z-scores were both significantly lower than controls at one, three and six months of age, recovering from that moment until the age of one year. Conclusions: the highest nutritional risk in CL/P patients takes place at 3-6 months of age, but nutritional status and growth trajectories get recovered from one year of age compared to their counterparts. Nevertheless, the rate of thin subjects among CL/P patients is higher during childhood.(AU)

Introducción: el estado nutricional y el crecimiento de los niños con labio y/o paladar fisurado (CL/P) pueden verse afectados debido a lasdificultades de alimentación provocadas por su anatomía y las intervenciones quirúrgicas.Objetivo: este estudio longitudinal retrospectivo tiene como objetivo analizar las trayectorias de crecimiento de una cohorte de niños con CL/Py compararlos con una cohorte representativa de niños sanos de Aragón (España).Métodos: se registraron el tipo de fisura, la técnica quirúrgica y las secuelas, el peso, la longitud/talla y el índice de masa corporal (IMC) (peso/talla2) a diferentes edades (0-6 años). Se calcularon las Z-score de los valores antropométricos según edad y sexo, mediante las tablas de laOrganización Mundial de la Salud (OMS).Resultados: se incluyeron 41 pacientes (21 hombres, 20 mujeres): 9,75 % con fisura labial (n = 4/41), 41,46 % con fisura palatina (n = 17/41)y 48,78 % con fisura labiopalatina (n = 20/41). Los valores Z-scores de la antropometría más bajos se alcanzaron a los tres meses de edad (el44,44 % y el 50 % tenían un peso y un IMC inferiores a -1 Z-score, respectivamente). Los valores de peso medio y de las puntuaciones Z delIMC fueron significativamente más bajos en los pacientes con fisura que en los controles a los uno, tres y seis meses de edad, recuperándosea partir de ese momento hasta equipararse al año de edad.Conclusiones: el mayor riesgo nutricional en pacientes con CL/P se presenta entre los tres y seis meses de edad, pero su estado nutricionaly las trayectorias de crecimiento se normalizan a partir del año de edad. Sin embargo, la proporción de individuos delgados entre los pacientescon CL/P es mayor durante la infancia.(AU)

Growth trajectories in children with cleft lip and/or palate.

Introduction: Introduction: the nutritional status and growth of children with cleft lip and/or palate (CL/P) can be affected due to feeding difficulties caused by their anatomy and the surgical interventions. Objective: this retrospective longitudinal study aims to analyse the growth trajectories of a cohort of children with CL/P and compare them with a healthy representative cohort of children from Aragon (Spain). Methods: type of cleft, surgical technique and sequelae, and weight, length/height and body mass index (BMI) (weight/height2) at different ages (0-6 years) were recorded. Normalized age- and sex-specific anthropometric Z-scores values were calculated by World Health Organization (WHO) charts. Results: forty-one patients (21 male, 20 female) were finally included: 9.75 % cleft lip (n = 4/41), 41.46 % cleft palate (n = 17/41) and 48.78 % cleft lip and palate (n = 20/41). The worst nutritional status Z-scores were achieved at the age of three months (44.44 % and 50 % had a weight and a BMI lower than -1 Z-score, respectively). Mean weight and BMI Z-scores were both significantly lower than controls at one, three and six months of age, recovering from that moment until the age of one year. Conclusions: the highest nutritional risk in CL/P patients takes place at 3-6 months of age, but nutritional status and growth trajectories get recovered from one year of age compared to their counterparts. Nevertheless, the rate of thin subjects among CL/P patients is higher during childhood.

Introducción: Introducción: el estado nutricional y el crecimiento de los niños con labio y/o paladar fisurado (CL/P) pueden verse afectados debido a las dificultades de alimentación provocadas por su anatomía y las intervenciones quirúrgicas. Objetivo: este estudio longitudinal retrospectivo tiene como objetivo analizar las trayectorias de crecimiento de una cohorte de niños con CL/P y compararlos con una cohorte representativa de niños sanos de Aragón (España). Métodos: se registraron el tipo de fisura, la técnica quirúrgica y las secuelas, el peso, la longitud/talla y el índice de masa corporal (IMC) (peso/talla2) a diferentes edades (0-6 años). Se calcularon las Z-score de los valores antropométricos según edad y sexo, mediante las tablas de la Organización Mundial de la Salud (OMS). Resultados: se incluyeron 41 pacientes (21 hombres, 20 mujeres): 9,75 % con fisura labial (n = 4/41), 41,46 % con fisura palatina (n = 17/41) y 48,78 % con fisura labiopalatina (n = 20/41). Los valores Z-scores de la antropometría más bajos se alcanzaron a los tres meses de edad (el 44,44 % y el 50 % tenían un peso y un IMC inferiores a -1 Z-score, respectivamente). Los valores de peso medio y de las puntuaciones Z del IMC fueron significativamente más bajos en los pacientes con fisura que en los controles a los uno, tres y seis meses de edad, recuperándose a partir de ese momento hasta equipararse al año de edad. Conclusiones: el mayor riesgo nutricional en pacientes con CL/P se presenta entre los tres y seis meses de edad, pero su estado nutricional y las trayectorias de crecimiento se normalizan a partir del año de edad. Sin embargo, la proporción de individuos delgados entre los pacientes con CL/P es mayor durante la infancia.

Early Nutrition and Later Excess Adiposity during Childhood: A Narrative Review.

BACKGROUND: Studies on childhood obesity mainly focus on the genetic component and on the lifestyle that may be associated with the development of obesity. However, the study of perinatal factors in their programming effect toward future obesity in children or adults is somewhat more recent, and there are still mechanisms to be disentangled. SUMMARY: In this narrative review, a comprehensive route based on the influence of some early factors in life in the contribution to later obesity development is presented. Maternal pre-pregnancy BMI and gestational weight gain have been pointed out as independent determinants of infant later adiposity. Lifestyle interventions could have an impact on pregnant mothers through epigenetic mechanisms capable of redirecting the genetic expression of their children toward a future healthy weight and body composition and dietary-related microbiome modifications in mothers and newborns might also be related. After birth, infant feeding during the first months of life is directly associated with its body composition and nutritional status. From this point of view, all the expert committees in the world are committed to promote exclusive breastfeeding up to 6 months of age and to continue at least until the first year of life together with complementary feeding based on healthy dietary patterns such as Mediterranean Diet. KEY MESSAGES: To develop future effective programs to tackle early obesity, it is necessary not only by controlling lifestyle behaviors like infant feeding but also understanding the role of other mechanisms like the effect of perinatal factors such as maternal diet during pregnancy, epigenetics, or microbiome.

Are Spanish children drinking enough and healthily? An update of the Liq.in7 cross-sectional survey in children and adolescents / ¿Beben los niños y adolescentes españoles lo suficiente y de forma saludable? Actualización del estudio transversal Liq. in7 en niños y adolescentes

Introduction: insufficient and/or unhealthy total fluid intake (TFI), especially in the early stages of life, may have a negative impact on health. Objective: to assess the current patterns of fluid consumption in children and adolescents in Spain, including drinking occasions and locations (e.g., at home or at school), and to compare TFI with adequate intake (AI) of water from fluids as recommended by the European Food Safety Agency (EFSA). Methodology: a Spanish cross-sectional study was performed assessing TFI from all sources of fluid consumption according to drinking occasions during the day and location, using a validated liquid intake 7-day record (Liq.in7). Data collection occurred between April and May, 2018. A sample of 146 (63 % boys) children (4-9 years old) and adolescents (10-17 years old) was included. Parents reported such information when children were under 16 years. Results: a high proportion of children and adolescents did not meet EFSA-derived reference values for fluid intake (73 % and 72 %, respectively). Forty percent of children and about 50 % of adolescents consumed at least one serving of sugar-sweetened beverage (SSB) per day, while about 20 % consumed only one or less servings of water per day. Consumption during the main meals was most important for both children and adolescents (representing 50 % and 54 % of TFI, respectively), and was mainly driven by water (62 %). Consumption at home in children (70 % of TFI) was made of water (47 %). In the same way, at school, water contributed to half intake. However, adolescent girls at school drink more SSBs (41 %) than water (34 %), the former being the most consumed fluid. At other locations, adolescent boys also drink more SSBs (51 %) than either water (29 %) or milk and derivatives (10 %). (AU)

Introducción: la ingesta total de líquidos insuficiente o poco saludable, especialmente en las primeras etapas de la vida, puede tener un impacto negativo sobre la salud. Objetivo: evaluar el patrón actual de consumo de líquidos en niños y adolescentes en España, incluyendo el número de veces y los lugares para beber, y comparar la ingesta total de líquidos con la ingesta adecuada establecida por la Agencia Europea de Seguridad Alimentaria (EFSA). Metodología: estudio transversal que evaluó la ingesta total de líquidos utilizando un registro validado de ingesta de líquidos de 7 días (Liq.in7). Se realizó entre abril y mayo de 2018, incluyendo una muestra de 146 niños de 4 a 9 años y adolescentes de 10 a 17 años españoles (63 % varones). Los padres detallaron dicha información en caso de que los niños fueran menores de 16 años. Resultados: una alta proporción de niños y adolescentes no cumplían con los valores de referencia de la EFSA para la ingesta de líquidos (73 % y 72 %, respectivamente). El 40 % de los niños y aproximadamente el 50 % de los adolescentes consumían al menos una porción (250 ml) de bebidas azucaradas por día, y el 20 % consumían una porción o menos de agua al día. Durante las comidas principales se consumía la mayor cantidad de líquidos tanto en los niños como en los adolescentes (representando el 50 % y el 54 % de la ingesta total de líquidos, respectivamente), principalmente agua (62 %). El consumo de los niños en el hogar (70 % de la ingesta total de líquidos) también consistía principalmente en agua (47 %). Del mismo modo, en la escuela, el agua contribuía a la mitad de la ingesta. Sin embargo, los adolescentes en el instituto bebían más bebidas azucaradas (41 %) que agua (34 %). En otros lugares, los adolescentes varones también bebían más bebidas azucaradas (51 %) que agua (29 %) o leche y derivados (10 %). (AU)

Are Spanish children drinking enough and healthily? An update of the Liq.in7 cross-sectional survey in children and adolescents.

INTRODUCTION: Introduction: insufficient and/or unhealthy total fluid intake (TFI), especially in the early stages of life, may have a negative impact on health. Objective: to assess the current patterns of fluid consumption in children and adolescents in Spain, including drinking occasions and locations (e.g., at home or at school), and to compare TFI with adequate intake (AI) of water from fluids as recommended by the European Food Safety Agency (EFSA). Methodology: a Spanish cross-sectional study was performed assessing TFI from all sources of fluid consumption according to drinking occasions during the day and location, using a validated liquid intake 7-day record (Liq.in7). Data collection occurred between April and May, 2018. A sample of 146 (63 % boys) children (4-9 years old) and adolescents (10-17 years old) was included. Parents reported such information when children were under 16 years. Results: a high proportion of children and adolescents did not meet EFSA-derived reference values for fluid intake (73 % and 72 %, respectively). Forty percent of children and about 50 % of adolescents consumed at least one serving of sugar-sweetened beverage (SSB) per day, while about 20 % consumed only one or less servings of water per day. Consumption during the main meals was most important for both children and adolescents (representing 50 % and 54 % of TFI, respectively), and was mainly driven by water (62 %). Consumption at home in children (70 % of TFI) was made of water (47 %). In the same way, at school, water contributed to half intake. However, adolescent girls at school drink more SSBs (41 %) than water (34 %), the former being the most consumed fluid. At other locations, adolescent boys also drink more SSBs (51 %) than either water (29 %) or milk and derivatives (10 %). Conclusion: the drinking habits of Spanish young populations are far removed from current recommendations because of a low fluid intake, specifically water, and a high proportion of SSB consumption in children and adolescents. Interventions to ensure that EFSA TFI recommendations are met are of special importance for children and adolescents, with - according to our results - a special focus on male adolescents.

INTRODUCCIÓN: Introducción: la ingesta total de líquidos insuficiente o poco saludable, especialmente en las primeras etapas de la vida, puede tener un impacto negativo sobre la salud. Objetivo: evaluar el patrón actual de consumo de líquidos en niños y adolescentes en España, incluyendo el número de veces y los lugares para beber, y comparar la ingesta total de líquidos con la ingesta adecuada establecida por la Agencia Europea de Seguridad Alimentaria (EFSA). Metodología: estudio transversal que evaluó la ingesta total de líquidos utilizando un registro validado de ingesta de líquidos de 7 días (Liq.in7). Se realizó entre abril y mayo de 2018, incluyendo una muestra de 146 niños de 4 a 9 años y adolescentes de 10 a 17 años españoles (63 % varones). Los padres detallaron dicha información en caso de que los niños fueran menores de 16 años. Resultados: una alta proporción de niños y adolescentes no cumplían con los valores de referencia de la EFSA para la ingesta de líquidos (73 % y 72 %, respectivamente). El 40 % de los niños y aproximadamente el 50 % de los adolescentes consumían al menos una porción (250 ml) de bebidas azucaradas por día, y el 20 % consumían una porción o menos de agua al día. Durante las comidas principales se consumía la mayor cantidad de líquidos tanto en los niños como en los adolescentes (representando el 50 % y el 54 % de la ingesta total de líquidos, respectivamente), principalmente agua (62 %). El consumo de los niños en el hogar (70 % de la ingesta total de líquidos) también consistía principalmente en agua (47 %). Del mismo modo, en la escuela, el agua contribuía a la mitad de la ingesta. Sin embargo, los adolescentes en el instituto bebían más bebidas azucaradas (41 %) que agua (34 %). En otros lugares, los adolescentes varones también bebían más bebidas azucaradas (51 %) que agua (29 %) o leche y derivados (10 %). Conclusión: de acuerdo con nuetros resultados, la población joven española no cumple las recomendaciones actuales tanto por presentar una baja ingesta total de líquidos como por realizar un alto consumo de bebidas azucaradas. Es importante que las intervenciones que intenten mejorar la ingesta de líquidos en los niños y adolescentes basen sus objetivos en alcanzar los valores de referencia de la EFSA con un enfoque especial, según nuestros resultados, consistente en mejorar los comportamientos de ingesta de líquidos en los adolescentes varones.

Long-term growth patterns in children born with cleft lip and/or palate. A systematic review / Patrones de crecimiento a largo plazo en niños nacidos con fisura labial y/o palatina. Una revisión sistemática

INTRODUCTION: in children with cleft lip and/or palate nutritional status and growth may be impaired due to early life feeding difficulties. OBJECTIVE: to review the existing literature on the nutritional prognosis during childhood of patients undergoing surgery for cleft lip and/or palate (CLP), their body composition and growth patterns from 2 to 10 years of age, and the possible effects of their early nutritional status on the long-term onset of overweight. METHODS: a systematic search of growth and body composition parameters in 2-10 year-old CLP children, including cross-sectional and longitudinal studies, and using the Pubmed and Scopus databases. From the 2,983 retrieved articles, 6 were finally included. RESULTS: two studies out of 6 were longitudinal and the other 4 were cross-sectional, including very heterogeneous samples. Weight and height were used as growth parameters in 2 studies; 2 studies used body mass index (BMI); and the remaining 2 used indexes of nutritional status derived from anthropometric measures. The studies showed discrepancies among results: 3 of them found growth differences between children with CLP and their counterparts, whereas the other 3 did not. The two longitudinal studies did not show any significant differences between the mean BMI z-scores or growth curves of cleft patients and their counterparts. When differences existed, the most affected group was that under 5 years, syndromic children, and adopted children with CL/P. CONCLUSIONS: the literature is scarce comparing growth patterns between children with CLP and controls, and results cannot confirm that children with CLP aged 2-10 years, excluding those with syndromes or belonging to vulnerable populations, have different growth patterns or a worse nutritional status than their counterparts

INTRODUCCIÓN: en niños con fisura labial y/o palatina, el estado nutricional y el crecimiento pueden verse afectados debido a dificultades en la alimentación. OBJETIVOS: revisar el pronóstico nutricional de pacientes sometidos a cirugía de fisura labiopalatina (FLP), su composición corporal y sus patrones de crecimiento de los 2 a los 10 años, así como los posibles efectos del estado nutricional durante la primera infancia sobre la aparición posterior de sobrepeso. MÉTODOS: búsqueda sistemática de parámetros de crecimiento y composición corporal en niños con CLP de 2 a 10 años, incluyendo estudios transversales y longitudinales en las bases de datos Pubmed y Scopus. De los 2983 artículos potencialmente relevantes, 6 fueron finalmente incluidos. RESULTADOS: dos estudios de 6 fueron longitudinales y los otros 4, transversales, con muestras muy heterogéneas. El peso y la altura se utilizaron como parámetros de crecimiento en 2 estudios; 2 estudios utilizaron el índice de masa corporal (IMC), y los otros 2, índices del estado nutricional a partir de medidas antropométricas. Los estudios mostraron discrepancias entre los resultados: 3 de ellos encontraron diferencias de crecimiento entre los niños con CLP y sus coetáneos, mientras que los otros 3, no las encontraron. Los dos estudios longitudinales no mostraron diferencias significativas entre el IMC (z-score) ni entre las curvas de crecimiento de los pacientes con FLP y sus coetáneos. Cuando existían diferencias, el grupo más afectado fue el de los menores de 5 años, niños sindrómicos y niños adoptados con CL/P. CONCLUSIONES: la literatura sobre los patrones de crecimiento de los niños con CLP es escasa y los resultados no pueden confirmar que los niños con CLP de 2 a 10 años, excluyendo aquellos con síndromes o pertenecientes a poblaciones vulnerables, tengan patrones de crecimiento diferentes o un peor estado nutricional que sus coetáneos

Long-term growth patterns in children born with cleft lip and/or palate. A systematic review.

INTRODUCTION: Introduction: in children with cleft lip and/or palate nutritional status and growth may be impaired due to early life feeding difficulties. Objective: to review the existing literature on the nutritional prognosis during childhood of patients undergoing surgery for cleft lip and/or palate (CLP), their body composition and growth patterns from 2 to 10 years of age, and the possible effects of their early nutritional status on the long-term onset of overweight. Methods: a systematic search of growth and body composition parameters in 2-10 year-old CLP children, including cross-sectional and longitudinal studies, and using the Pubmed and Scopus databases. From the 2,983 retrieved articles, 6 were finally included. Results: two studies out of 6 were longitudinal and the other 4 were cross-sectional, including very heterogeneous samples. Weight and height were used as growth parameters in 2 studies; 2 studies used body mass index (BMI); and the remaining 2 used indexes of nutritional status derived from anthropometric measures. The studies showed discrepancies among results: 3 of them found growth differences between children with CLP and their counterparts, whereas the other 3 did not. The two longitudinal studies did not show any significant differences between the mean BMI z-scores or growth curves of cleft patients and their counterparts. When differences existed, the most affected group was that under 5 years, syndromic children, and adopted children with CL/P. Conclusions: the literature is scarce comparing growth patterns between children with CLP and controls, and results cannot confirm that children with CLP aged 2-10 years, excluding those with syndromes or belonging to vulnerable populations, have different growth patterns or a worse nutritional status than their counterparts.

INTRODUCCIÓN: Introducción: en niños con fisura labial y/o palatina, el estado nutricional y el crecimiento pueden verse afectados debido a dificultades en la alimentación. Objetivos: revisar el pronóstico nutricional de pacientes sometidos a cirugía de fisura labiopalatina (FLP), su composición corporal y sus patrones de crecimiento de los 2 a los 10 años, así como los posibles efectos del estado nutricional durante la primera infancia sobre la aparición posterior de sobrepeso. Métodos: búsqueda sistemática de parámetros de crecimiento y composición corporal en niños con CLP de 2 a 10 años, incluyendo estudios transversales y longitudinales en las bases de datos Pubmed y Scopus. De los 2983 artículos potencialmente relevantes, 6 fueron finalmente incluidos. Resultados: dos estudios de 6 fueron longitudinales y los otros 4, transversales, con muestras muy heterogéneas. El peso y la altura se utilizaron como parámetros de crecimiento en 2 estudios; 2 estudios utilizaron el índice de masa corporal (IMC), y los otros 2, índices del estado nutricional a partir de medidas antropométricas. Los estudios mostraron discrepancias entre los resultados: 3 de ellos encontraron diferencias de crecimiento entre los niños con CLP y sus coetáneos, mientras que los otros 3, no las encontraron. Los dos estudios longitudinales no mostraron diferencias significativas entre el IMC (z-score) ni entre las curvas de crecimiento de los pacientes con FLP y sus coetáneos. Cuando existían diferencias, el grupo más afectado fue el de los menores de 5 años, niños sindrómicos y niños adoptados con CL/P. Conclusiones: la literatura sobre los patrones de crecimiento de los niños con CLP es escasa y los resultados no pueden confirmar que los niños con CLP de 2 a 10 años, excluyendo aquellos con síndromes o pertenecientes a poblaciones vulnerables, tengan patrones de crecimiento diferentes o un peor estado nutricional que sus coetáneos.

Rapid Weight Gain, Infant Feeding Practices, and Subsequent Body Mass Index Trajectories: The CALINA Study.

We aimed to study growth patterns according to rapid weight gain (RWG) and infant feeding practices during the first 120 days and whether infant feeding practices mediated the association between RWG in the first semester of life and subsequent body mass index (BMI) z-score in children from age 1 to 6. (1) Methods: 862 children from the Growth and Feeding during Lactation and Early Childhood in Children of Aragon study (CALINA in Spanish) were examined. Repeated-measures ANOVA analyses were conducted to assess growth trajectories according to RWG and type of feeding practice. The product of coefficients mediation method was used to assess the potential contribution of infant feeding practices to the association between RWG and BMI z-score. Mediation models were conducted using IBM SPSS-PROCESS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp. (2) Results: BMI and weight z-score trajectories were significantly higher in the RWG group and the formula-fed group. No significant differences were found regarding height. Infant feeding practices did not mediate the association between RWG and BMI z-score but were associated with BMI at 6 years. (3) Conclusions: Infant feeding practices and RWG determine different growth trajectories of BMI and weight during childhood. Although infant feeding practices did not mediate the association between early RWG and BMI later in life, formula feeding is independently related to higher BMI growth patterns later in childhood.

Factors that affect zinc bioavailability and losses in adult and elderly populations.

The most widely used method for estimating dietary zinc requirements is the factorial approach, in which it is assumed, in adults, that the physiological zinc requirement is the lowest intake that replaces endogenous zinc losses. Presented here are the results of two reviews: a narrative review of zinc losses from the human body and a systematic review of factors affecting zinc bioavailability in adult and elderly populations. The narrative review presents data on losses from integumental and excretory routes, obtained from 29 papers published up to April 2013. The systematic review includes a total of 87 publications describing dietary factors that impact zinc bioavailability, 30 of which examined phytate. A meta-analysis revealed an overall lowering of fractional zinc absorption by 0.14 (45% of control values) when the phytate : zinc molar ratio of the test meal or diet was greater than 15. These reviews provide a comprehensive resource for use in the setting of human dietary zinc requirements and emphasize the need for more high-quality data to improve estimates of zinc losses and gains.

Evidencia científica sobre el papel del yogur y otras leches fermentadas en la alimentación saludable de la población española / Scientific evidence ab out the role of yogurt and other fermented milks in the healthy diet for the spanish population

Los lácteos contienen proteínas de alto valor biológico y alta digestibilidad, grasa, hidratos de carbono, y vitaminas y minerales, especialmente calcio y fósforo. La diversificación del consumo de lácteos permite un mayor consumo de los mismos, e ingestas más adecuadas de nutrientes. Entre el 20 y el 40% de niños y entre un 30 y un 45% de adultos ingieren un número de raciones de lácteos inferior a lo recomendado. En España, los lácteos aportan entre el 44 y el 70% del calcio. El consumo de lácteos se asocia positivamente con una mayor densidad mineral ósea. Más del 35% de los niños y adultos en España ingieren cantidades de calcio por debajo de las recomendaciones. El yogur contiene menos cantidad de lactosa que la leche y las bacterias que lo fermentan expresan lactasa funcionante. Se recomienda la ingesta de yogur para mejorar la digestión de la lactosa en individuos con maldigestión de la misma. Parece razonable recomendar la ingesta de yogur para mejorar la absorción de calcio, al menos en mujeres postmenopáusicas y para disminuir la incidencia y duración de las enfermedades infecciosas gastrointestinales en niños. El consumo de productos lácteos fermentados antes, durante y después del tratamiento médico de erradicación de Helicobacter Pylori, aumenta el efecto del medicamento entre un 5 y un 10%. El consumo de productos lácteos fermentados antes, durante y después del tratamiento con antibióticos, podría disminuir el riesgo de diarreas asociadas al uso de estos medicamentos. La FESNAD recomienda el siguiente consumo de leche y productos lácteos: Adultos, 2-3 raciones/día; escolares, 2-3 raciones/día; adolescentes, 3-4 raciones/día; mujeres en embarazo, lactancia o menopausia, 3-4 raciones/día; personas mayores, 2-4 raciones/día. Teniendo en cuenta que el consumo de yogur y otras leches fermentadas presenta algunas ventajas sobre el consumo de otros productos lácteos se recomienda incluir el yogur dentro del consumo diario y variado de lácteos (AU)

Milk products contain proteins of high biologic value and digestibility; they also contain fat, carbohydrates, vitamins and minerals, specially calcium and phosphorus. Diversification of milk products consumption allows a high consumptiom of the above mentioned products, optimizing nutrient intake. In Spain, food consumption of milk products lower than the recommended amounts was observed in 20 to 40 % of the children and 30 to 45 % of the adults. Milk products represent 44 to 70 % of calcium intake in the Spanish population. Milk products consumption is positively associated with a high bone mineral density. More than 35 % of children and adults in Spain had calcium intakes below the national recommendations. Yogur contains less lactose than regular milk and fermenting milk bacteries express functioning lactase. Yogur intake is recommended to improve lactose digestion in individuals having lactose maldigestion. It seems reasonable to recommend yogur to improve calcium absorption, at least in post-menopausal women, and also for decreasing incidence and duration of infectious gastrointestinal disorders in children. Fermented milk products consumption, before, during and after medical eradication of Helicobacter Pylori, increases 5 to 10 % the effect of the specific drug therapy. Its consumption before, during and after antibiotic treatment, could also reduce the risk of diarrhea associated with the use of the above mentioned drugs. The Spanish Federation of Nutrition, Feeding and Dietetic Societies (FESNAD) recommend the following consumption of milk and milk products: Adults, 2-3 portions/day; school-age children, 2-3 portions/day; adolescents, 3-4 portions/day; pregnant and lactating women and during menopause, 3-4 portions/day; elderly, 2-4 portions/day. Considering yogur and fermented milk consumption show some advantages when compared with other milk products, we can recommend yogur within a daily and varied consumption of milk products (AU)

[Scientific evidence about the role of yogurt and other fermented milks in the healthy diet for the Spanish population]. / Evidencia cientifica sobre el papel del yogur y otras leches fermentadas en la alimentacion saludable de la población española.

Milk products contain proteins of high biologic value and digestibility; they also contain fat, carbohydrates, vitamins and minerals, specially calcium and phosphorus. Diversification of milk products consumption allows a high consumptiom of the above mentioned products, optimizing nutrient intake. In Spain, food consumption of milk products lower than the recommended amounts was observed in 20 to 40 % of the children and 30 to 45 % of the adults. Milk products represent 44 to 70 % of calcium intake in the Spanish population. Milk products consumption is positively associated with a high bone mineral density. More than 35 % of children and adults in Spain had calcium intakes below the national recommendations. Yogur contains less lactose than regular milk and fermenting milk bacteries express functioning lactase. Yogur intake is recommended to improve lactose digestion in individuals having lactose maldigestion. It seems reasonable to recommend yogur to improve calcium absorption, at least in post-menopausal women, and also for decreasing incidence and duration of infectious gastrointestinal disorders in children. Fermented milk products consumption, before, during and after medical eradication of Helicobacter Pylori, increases 5 to 10 % the effect of the specific drug therapy. Its consumption before, during and after antibiotic treatment, could also reduce the risk of diarrhea associated with the use of the above mentioned drugs. The Spanish Federation of Nutrition, Feeding and Dietetic Societies (FESNAD) recommend the following consumption of milk and milk products: Adults, 2-3 portions/day; school-age children, 2-3 portions/day; adolescents, 3-4 portions/day; pregnant and lactating women and during menopause, 3-4 portions/day; elderly, 2-4 portions/day. Considering yogur and fermented milk consumption show some advantages when compared with other milk products, we can recommend yogur within a daily and varied consumption of milk products.

Los lácteos contienen proteínas de alto valor biológico y alta digestibilidad, grasa, hidratos de carbono, y vitaminas y minerales, especialmente calcio y fósforo. La diversificación del consumo de lácteos permite un mayor consumo de los mismos, e ingestas más adecuadas de nutrientes. Entre el 20 y el 40% de niños y entre un 30 y un 45% de adultos ingieren un número de raciones de lácteos inferior a lo recomendado. En España, los lácteos aportan entre el 44 y el 70% del calcio. El consumo de lácteos se asocia positivamente con una mayor densidad mineral ósea. Más del 35% de los niños y adultos en España ingieren cantidades de calcio por debajo de las recomendaciones. El yogur contiene menos cantidad de lactosa que la leche y las bacterias que lo fermentan expresan lactasa funcionante. Se recomienda la ingesta de yogur para mejorar la digestión de la lactosa en individuos con maldigestión de la misma. Parece razonable recomendar la ingesta de yogur para mejorar la absorción de calcio, al menos en mujeres postmenopáusicas y para disminuir la incidencia y duración de las enfermedades infecciosas gastrointestinales en niños. El consumo de productos lácteos fermentados antes, durante y después del tratamiento médico de erradicación de Helicobacter Pylori, aumenta el efecto del medicamento entre un 5 y un 10%. El consumo de productos lácteos fermentados antes, durante y después del tratamiento con antibióticos, podría disminuir el riesgo de diarreas asociadas al uso de estos medicamentos. La FESNAD recomienda el siguiente consumo de leche y productos lácteos: Adultos, 2-3 raciones/día; escolares, 2-3 raciones/día; adolescentes, 3-4 raciones/día; mujeres en embarazo, lactancia o menopausia, 3-4 raciones/día; personas mayores, 2-4 raciones/día. Teniendo en cuenta que el consumo de yogur y otras leches fermentadas presenta algunas ventajas sobre el consumo de otros productos lácteos se recomienda incluir el yogur dentro del consumo diario y variado de lácteos.

The effect of iron on cognitive development and function in infants, children and adolescents: a systematic review.

A systematic review was conducted to summarize the evidence currently available from randomized controlled trials (RCTs) concerning the effect of iron intake of infants, children and adolescents on measures of cognitive development and function. The Cochrane Library, MEDLINE and Embase were searched up to and including February 2010. Studies were also identified by checking the bibliographies of the articles retrieved. All RCTs with an adequate control group in which iron supply was provided by natural food sources, fortified foods, formula or supplements to infants, children or adolescents until the age of 18 years were considered for inclusion. No language restrictions were applied. Fourteen studies met the selection criteria. Twelve out of these 14 studies had a high or moderate risk of bias. A large degree of heterogeneity of study populations, iron dosages and outcome measures precluded performing a quantitative meta-analysis. Overall, the studies suggest a modest positive effect of iron supplementation on cognition and psychomotor outcomes in anemic infants and children after supplementation periods of at least 2 months of duration.

The nutritional requirements of infants. Towards EU alignment of reference values: the EURRECA network.

This paper presents a review of the current knowledge regarding the macro- and micronutrient requirements of infants and discusses issues related to these requirements during the first year of life. The paper also reviews the current reference values used in European countries and the methodological approaches used to derive them by a sample of seven European and international authoritative committees from which background scientific reports are available. Throughout the paper, the main issues contributing to disparities in micronutrient reference values for infants are highlighted. The identification of these issues in relation to the specific physiological aspects of infants is important for informing future initiatives aimed at providing standardized approaches to overcome variability of micronutrient reference values across Europe for this age group.