Street food snacking habits, physical activity, and electronicmedia exposure in relation to obesity in elementary schoolstudents / Hábitos de merienda callejera, actividad física y exposición a medios electrónicos en relación con la obesidad en estudiantes de primaria

Introduction: Obesity is caused by an imbalance betweenincoming energy due to the consumption of more caloriesthan energy expended. Excessive fat accumulation has seri-ous and long-term health effects. This can be supported bylifestyles such as consumption of roadside snacks that arehigh in sugar, salt, and fat, but low in micronutrients and fiber.This study aims to determine the characteristics of respon-dents and analyze the relationship of street food snackinghabits, physical activity, and exposure to electronic mediawith the incidence of obesity in elementary school students atSD Adabiah Kota Padang in 2023.Methods: Research with cross sectional design. The pop-ulation in this study were students of SD Adabiah Padanggrades 1-5 with a total sample of 141 students, selected byproportional random sampling technique. Data on street foodsnacking habits and exposure to electronic media were ob-tained using a questionnaire, physical activity measured byPAQ-C (Physical Activity Questionnaire for Children), and obe-sity measured by IMT/U. Data were analyzed using the Chi-Square test.Results: The number of respondents with obese nutritionalstatus (19.9%), frequent street food snacking habits (62.4%),less physical activity (65.2%), and high exposure to electronicmedia (53.9%). Statistical test results showed that there wasno significant relationship between street food snacking habits(p-value=0.281), physical activity (p-value=0.443), and expo-sure to electronic media (p-value=0.701) with the incidence ofobesity in elementary school students.Conclusion: The results showed no association betweenstreet food snacking habits, physical activity, and exposure toelectronic media with the incidence of obesity in elementaryschool students.(AU)

A systematic review of educational nutrition interventions based on behavioral theories in school adolescents.

The purpose of this study was to summarize the evidence from studies conducted on adolescents, evaluating educational nutrition interventions for the modification of food consumption through controlled trials based on behavior change theories or models and implemented in school settings. A systematic search was carried out through PubMed and ERIC databases between November and December 2020, and updated in February 2023; English-language keywords were used, and no publication date limits were applied. Two authors independently performed the search, data extraction, data synthesis and risk of bias assessment. Twelve studies meeting the inclusion criteria were included. The interventions were based on different theories; the most used was the Social Cognitive Theory. Eleven of the twelve studies showed favorable modifications in the consumption of at least two of the food groups. Most studies were at low risk of bias, and only one was classified as high risk. It is concluded that educational nutrition interventions based on behavior change theories/models and implemented in the school setting influence positive changes in adolescents eating behavior.

Intervenções não farmacológicas no manejo da obesidade infantil: uma overview / Non-pharmacological interventions in the management of childhood obesity: an overview / Intervenciones no farmacológicas en el tratamiento de la obesidad infantil: una visión general

Objetivo: Analisar na literatura científica a efetividade das intervenções não farmacológicas para o manejo da obesidade infantil. Método: Trata-se de uma revisão sistemática do tipo overview. As bases científicas para coleta de dados foram: Cinahl, Cochrane, Lilacs, Medline, Scopus, Scielo e Science direct, e todo o processo de seleção foi feito por pares e avaliado pelo teste Kappa. A análise dos estudos utilizou os instrumentos: AMSTAR para avaliação da qualidade metodológica, Robis 2.0 para avaliação do risco de viés, e o Sistema Grade para classificar nível de evidência. Resultado: 17 estudos foram considerados elegíveis, e avaliação das evidências demonstrou que as intervenções não farmacológicas são efetivas para o manejo da obesidade infantil, sendo classificadas pelo Sistema Grade com alto e moderado nível de evidência. Essas intervenções são caracterizadas como: comportamentais, educacional, familiar, nutricional e tecnológica e são capazes de promover mudanças no Índice de Massa Corporal e estilo de vida. Conclusão: As intervenções não farmacológicas são capazes de promover mudanças positivas quanto ao comportamento alimentar e manejo da obesidade, entretanto os resultados não são imediatos.

Objective: To analyze the effectiveness of non-pharmacological interventions for the management of childhood obesity in the scientific literature. Method: This is a systematic review of the overview type. The scientific databases for data collection were: Cinahl, Cochrane, Lilacs, Medline, Scopus, Scielo and Science direct, and the entire selection process was done by pairs and evaluated by Kappa test. The analysis of the studies used the instruments: AMSTAR to assess methodological quality, Robis 2.0 to assess risk of bias, and the Grade System to rank level of evidence. Results: 17 studies were considered eligible, and evaluation of the evidence showed that non- pharmacological interventions are effective for the management of childhood obesity, being classified by the Grade System with high and moderate level of evidence. These interventions are characterized as: behavioral, educational, family, nutritional, and technological, and are able to promote changes in Body Mass Index and lifestyle. Conclusion: Non-pharmacological interventions are able to promote positive changes in eating behavior and obesity management, but the results are not immediate.

Objetivo: Analizar la efectividad de las intervenciones no farmacológicas para el manejo de la obesidad infantil en la literatura científica. Método: Se trata de una revisión sistemática de tipo panorámica. Las bases de datos científicas para la recogida de datos fueron: Cinahl, Cochrane, Lilacs, Medline, Scopus, Scielo y Science direct, y todo el proceso de selección se realizó por parejas y se evaluó mediante el test de Kappa. En el análisis de los estudios se utilizaron los instrumentos AMSTAR para evaluar la calidad metodológica, Robis 2.0 para evaluar el riesgo de sesgo y el Grade System para clasificar el nivel de evidencia. Resultados: Se consideraron elegibles 17 estudios, y la evaluación de la evidencia mostró que las intervenciones no farmacológicas son efectivas para el manejo de la obesidad infantil, siendo clasificadas por el Sistema Grade con nivel de evidencia alto y moderado. Estas intervenciones se caracterizan por ser: conductuales, educativas, familiares, nutricionales y tecnológicas, y son capaces de promover cambios en el Índice de Masa Corporal y en el estilo de vida. Conclusiones: Las intervenciones no farmacológicas son capaces de promover cambios positivos en la conducta alimentaria y en el manejo de la obesidad, pero los resultados no son inmediatos.

Turkish version of the 'food and nutrition literacy questionnaire for Chinese school-age children' for school-age adolescents: a validity and reliability study.

BACKGROUND: In this study, it was aimed to examine the psychometric characteristics of the scale named 'Food and Nutrition Literacy Questionnaire for Chinese School-age Children (FNLQ-SC)' in Turkish school age adolescents. METHODS: The research was carried out with 341 school-age adolescents aged 10 to 17 years. The Cronbach's α coefficient was used to evaluate internal consistency reliability and the test-retest method was applied. The construct validity was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and the content validity was assessed by the Pearson correlation coefficient. RESULTS: EFA indicated that the Turkish version of FNLQ-SC had three factorial structures that accounted for 42.0% of the total variance. The overall Turkish version of FNLQ-SC questionnaire had acceptable internal consistency (Cronbach's α = 0.679). The dimensional structure obtained in the EFA was controlled by CFA and the three-factor model showed acceptable goodness-of-fit indices (χ2/df = 1.924, RMSEA = 0.052, CFI = 0.864, GFI = 0.949). The Pearson correlation coefficients between each dimension and the overall questionnaire ranged from 0.300 to 0.842. Multiple linear regression analysis indicated that age, gender, grade of class, being an only child and discussing nutrition information with families had an effect on food and nutrition literacy (R2 = 0.312; p < 0.001). CONCLUSION: The Turkish version of FNLQ-SC has good reliability and construct validity to assess the food and nutrition literacy of Turkish school age adolescents.

In vitro prebiotic activity of rhLf and galactooligosaccharideson infant intestinal microbiota / Actividad prebiótica in vitro de lactoferrina y galactooligosácridossobre la microbiota intestinal infantil

Objective: human lactoferrin (Lf) and human milk oligosaccharides possess a wide range of functions. So, the present study focusses on the role of Lf and/or galactooligosaccharides (GOS) in the modulation of gut microbiota composition.Methods: recombinant human lactoferrin (rhLf) was added to the first infant formula (0.10, 0.15, 0.20 %) alone or in combination with GOS (1 %) in vessels of a small-scale batch culture fermentation model. Short-chain fatty acids (SCFAs), microbial population groups, and pH were monitored through fermentation for 24 hours. Results: insignificant changes were observed in pH values and acetic acid accumulated during fermentation. Propionic acid content has been insignificantly increased while butyric acid has been insignificantly decreased. Moreover, increments in all bacterial groups except for Bacteroides were observed through the fermentation process. Lactobacillus and Bifidobacterium showed an increase in relation to initial time over thefermentation process, demonstrating the prebiotic effect of lactoferrin and GOS. After 24 hours of fermentation, all tested ingredients showed significant similarities in Enterococcus for controls except for 0.20 % rhLf + 1 % GOS, which provoked a diminution of Enterococci growth. Conclusion: despite the importance of the batch culture fermentation technique in uncovering the prebiotic activity of food ingredients, it is not useful for detecting the prebiotic nature of Lf due to its nature as a protein. Thus, Lf maybe shows its prebiotic activity on the gut microbiota through other mechanisms.(AU)

Objetivo: la lactoferrina humana (Lf) y los oligosacáridos de leche materna presentan un amplio rango de funciones. El presente estudio se centra en el papel de la Lf y/o galactooligosácridos (GOS) en la modulación de la composición de la microbiota intestinal. Métodos: se añadió lactoferrina humana recombinante (rhLf) a fórmula infantil (0,10, 0,15, 0,20 %), sola o en combinación con GOS (1 %) en botes de fermentación colónica. A lo largo de 24 horas de fermentación, se monitorizaron ácidos grasos de cadena corta, grupos de poblaciones microbianas y pH. Resultados: se observaron pequeños cambios en valores de pH y cantidad de ácido acético durante la fermentación. El contenido de ácido propiónico aumentó ligeramente, mientras que el butírico sufrió un ligero descenso. Todos los grupos bacterianos estudiados incrementaron, excepto los Bacteroides, durante la fermentación. Lactobacillus and Bifidobacterium mostraron un incremento respecto al valor inicial, demostrando el efecto prebiótico de la lactoferrina y los GOS. A las 24 horas de fermentación, todos los ingredientes estudiados mostraron similitud al control en cuanto a Enterococcus, excepto para 0,20 % rhLf + 1 % GOS, donde disminuyó el crecimiento de los enterococos. Conclusión: a pesar de la importancia de los estudios de fermentación in vitro para descubrir potenciales ingredientes prebióticos, no fue útil en el caso de lactoferrina debido a su naturaleza proteica. Por tanto, la lactoferrina podría mostrar su actividad prebiótica en la microbiota intestinal a través de otros mecanismos.(AU)

Evaluation of food intake through residual analysis in 90 Basque school canteens / Evaluación de la ingesta de alimentos a través del análisis residual en 90 comedores escolares vascos

Objective: To measure the consumption of 25 food items (Comstock scale), to test whether school management type (public schools vs. private with subsidy schools) and food origin (on-site preparation vs. catering) affected food consumption and to quantify variability associated with territory, school and individual. Method: This cross-sectional study involved 14,717 schoolchildren of ages 2-16, recruited in 90 schools of the Basque Autonomous Community (Spain). Waste (non-consumed food) of 25 analysed food items was visually estimated by trained school monitors, via the Comstock categorical scale thus adapted: 1 = 0%; 2 = 25%; 3 = 50%, 4 = 75% and 5 = 100%. To analyse the data, mixed modelling was applied. Results: Vegetables, fish and fruits were the less-accepted food types. While school management did not affect food intake, on-site food preparation had better acceptance for legumes with vegetables, oily and lean fish, meat and pre-cooked meals. The largest source of variability in food intake not accounted for by school management and food preparation was the individual subject, while school and territory had moderate and almost no effects, respectively. Conclusions: Acceptance of the 25 evaluated foods is adequate, albeit can be improved. We believe that promoting on-site food preparation should improve the acceptance of legumes with vegetables, oily/lean fish, meat and pre-cooked meals. We recommend that future interventions oriented to improve intake should focus on individual subjects. (AU)

Objetivo: Medir el consumo de 25 alimentos (escala Comstock), comprobar si el tipo de gestión escolar (pública o concertada) y el origen de los alimentos (in situ o transportados) afecta al consumo, y cuantificar la variabilidad asociada con el territorio, la escuela y los individuos. Método: Estudio transversal con 14.717 escolares de 2-16 años reclutados en 90 escuelas del País Vasco. La estimación de residuos (alimento no consumido) de 25 grupos de alimentos la realizó visualmente personal escolar entrenado, mediante la escala categórica de Comstock así adaptada: 1 = 0%, 2 = 25%, 3 = 50%, 4 = 75% y 5 = 100%. Para analizar los datos se aplicó un modelo estadístico de efectos mixtos. Resultados: Verduras, pescado y frutas fueron los alimentos menos consumidos. Aunque el tipo de gestión escolar no afectó a la ingesta alimentaria, se determinó que la cocina in situ logró una mejor aceptación de legumbres con verduras, pescado azul y blanco, carne y precocinados. La mayor fuente adicional de variabilidad en la ingesta alimentaria fue el sujeto individual, mientras que la escuela y el territorio tuvieron efectos moderados y casi nulos, respectivamente. Conclusiones: La aceptación de los 25 alimentos evaluados es adecuada, aunque mejorable. Creemos que la promoción de cocinas in situ mejoraría la aceptación de legumbres con verduras, pescado azul y blanco, carne y platos precocinados. Recomendamos que las futuras intervenciones para mejorar la ingesta se dirijan al sujeto individual. (AU)

Habitos de sueño, alimentacion y uso de dispositivos tecnológicos durante la pandemia por covid-19 en población infantil Argentina / Eating, sleeping and screen exposure habits during the covid-19 pandemic in Argentinean children

Introducción: El estilo de vida de niños/as se afectó por la pandemia por Covid-19. Objetivos: Identificar conductas de sueño-vigilia, uso de la tecnología, comensalidad, participación en la compra y elaboración de las comidas y su valor nutricional. Materiales y métodos: Se realizó una encuesta a niñas/os de 6 a 12 años de La Pampa, Argentina. El estudio fue descriptivo, observacional y transversal. Resultados: de las 348 encuestas recabadas, 80% hacían las principales comidas en su casa y el 17% participó de la elaboración de las comidas, cocinando pizzas, purés, pastas, guisos, empanadas; preparaciones con hidratos de carbono complejos y grasas. Durante la noche, 43% optó por comer frutas y 24,7% galletitas y golosinas. 73,3% manifestó mirar televisión mientras come. 38,8% pasaba entre 3-4 horas con dispositivos tecnológicos. 33,5% comía galletitas, snacks, cereales, papas fritas, golosinas, sándwiches y jugos mientras usaba la tecnología. 82,5% dormía 8-10 horas diarias y 37,4% reportó dormir más horas que en pre- pandemia. 52% utilizaba pantallas antes de dormirse, del 31% que les costaba dormirse, 52% seguía usando dispositivos y del 11% ingería alimentos. Conclusiones: Se observaron hábitos de picoteos, ingestas de bajo valor nutricional, modificaciones en las horas de sueño y el uso de la tecnología. La infancia podría beneficiarse de la educación sobre rutinas de higiene tecnológica que permitan la distribución más eficaz del sueño, los horarios de comidas, el comer asociado a pantallas y el tiempo de juego y de actividad física

Introduction: The lifestyle of children was affected by the Covid-19 pandemic. Objectives: Identify sleep-wake behaviours, use of technology, participation in the purchase, preparation and sharing of meals and understand their nutritional value. Materials and Methods: A descriptive, observational and cross-sectional study was performed in children from 6 to 12 years old from La Pampa, Argentina Results: 348 were recruited, 80% ate the main meals at home and 17% participated in the preparation of meals, cooking pizzas, mash potatoes, pastas, stews, empanadas, which include food with complex carbohydrates and fats. Post dinner, 43 % chose to eat fruit and 24.7 % biscuits and sweets. 73.3% watched television while eating. 38.8 % spent between 3-4 hours with technological devices. 33.5 % ate cookies, snacks, cereals, chips, sweets, sandwiches, and drank juices while using technology. 82.5 % slept 8-10 hours a day and 37.4% reported sleeping more hours than pre-pandemic. 52% used screens before falling asleep, of the 31% who found it difficult to fall asleep, 52% continued to use devices and 11% ate food. Conclusions: snacking, food intake with low nutritional value, changes in sleeping and waking-up times, and excessive screen exposure were observed. Children could benefit from more education with regards to technological hygiene routines and the subsequent benefits of efficient sleep, meal times, food selection, playtime, and physical activity

Cyclic vomiting syndrome in children: a nationwide survey of current practice on behalf of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP) and Italian Society of Pediatric Neurology (SINP).

BACKGROUND: Cyclic Vomiting Syndrome (CVS) is a rare functional gastrointestinal disorder, which has a considerable burden on quality of life of both children and their family. Aim of the study was to evaluate the diagnostic modalities and therapeutic approach to CVS among Italian tertiary care centers and the differences according to subspecialties, as well as to explore whether potential predictive factors associated with either a poor outcome or a response to a specific treatment. METHODS: Cross-sectional multicenter web-based survey involving members of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP) and Italian Society of Pediatric Neurology (SINP). RESULTS: A total of 67 responses were received and analyzed. Most of the respondent units cared for less than 20 patients. More than half of the patients were referred after 3 to 5 episodes, and a quarter after 5 attacks. We report different diagnostic approaches among Italian clinicians, which was particularly evident when comparing gastroenterologists and neurologists. Moreover, our survey demonstrated a predilection of certain drugs during emetic phase according to specific clinic, which reflects the cultural background of physicians. CONCLUSION: In conclusion, our survey highlights poor consensus amongst clinicians in our country in the diagnosis and the management of children with CVS, raising the need for a national consensus guideline in order to standardize the practice.

Concordância entre medidas antropométricas e perfil lipídico aplicados na avaliação nutricional de crianças e adolescentes com excesso de peso / Agreement between anthropometric measures and lipid profile applied in the nutritional assessment of overweight children and adolescents

Introdução: Existem diferentes métodos para avaliaçãodo estado nutricional, porém, são escassos estudos que realizaram a concordância entre medidas antropométricas aplicadas à faixa etária pediátrica para avaliar o excesso de peso. Objetivo: Verificar a concordância entre as medidas antropométricas e o perfil lipídico aplicados na avaliação nutricional de crianças e adolescentes com excesso de peso. Métodos: Estudo transversal realizado com 84 pacientesportadores de excesso de peso com idade entre 5 a 19 anos,ambos sexos, atendidos no centro de referência do nordeste,entre janeiro de 2018 a abril de 2019. O estado nutricional foiavaliado por meio do índice de massa corporal por idade(IMC/I) da Organização Mundial de Saúde 2006/2007, circun-ferência do braço, circunferência da cintura e razão cinturaestatura. A concordância foi medida a partir do índice ponderado kappa. Resultados: Observouse presença de perfil lipídico alterado em todas as categorias de IMC/I. O teste de kappa evidenciou discordância significativa entre os indicadores índicede massa corporal por idade e as demais aferições antropométricas (circunferência do braço, circunferência da cintura,razão cintura estatura) com os seguintes valores: r=0,102(p=0,021), r=0,001 (p=0,007) e r=0,021 (p=0,000) respectivamente, no grupo de adolescentes, sendo semelhante nogrupo de crianças que apresentaram a mesma discordânciapara as variáveis avaliadas. Discussão: Foi observado que os métodos utilizados paraavaliação nutricional de crianças e adolescente com excessode peso apresentam discordância entre si, reforçando a necessidade de se utilizar mais de uma medida de aferição antropométrica para esta população. Conclusão: O estudo sugere que diferentes medidas utilizadas para avaliar o estado nutricional de crianças e adolescentes divergem do indicador índice de massa corporal poridade, o mais utilizado nesta população, subestimando ou superestimando o excesso de peso.(AU)

Introduction: There are different methods for assessingnutritional status, however, there are few studies that performed the agreement between anthropometric measures applied to the pediatric age group to assess overweight. Objective: To verify the agreement between anthropometric measurements and the lipid profile applied in the nutritional evaluation of overweight children and adolescents. Methods: Cross-sectional study conducted with 84 over-weight patients aged 5 to 19 years, both sexes, attended atthe reference center in the northeast, between January 2018and April 2019. Nutritional status was assessed using thebody mass index by age (BMI/I) of the World HealthOrganization 2006/2007, arm circumference, waist circumference and waist height ratio. Agreement was measured fromthe weighted kappa index. Results: The presence of altered lipid profile was observedin all BMI/I categories. The kappa test showed significant disagreement between the body mass index indicators by ageand the other anthropometric measurements (arm circumfer-ence, waist circumference, waist height ratio) with the following values: r=0.102 (p=0.021), r=0.001 (p=0.007) andr=0.021 (p=0.000) respectively, in the adolescent group, being similar in the group of children who presented the samedisagreement for the variables evaluated. Discussion: It was observed that the methods used forthe nutritional evaluation of overweight children and adolescents show disagreement with each other, reinforcing theneed to use more than one anthropometric measurement forthis population. Conclusion: The study suggests that different measuresused to assess the nutritional status of children and adolescents diverge from the body mass index indicator by age, themost used in this population, underestimating or overestimating excess weight.(AU)

Determinants of exclusive breastfeeding among Haitian children under 6 months of age

[ABSTRACT]. Objective. To identify the determinants of exclusive breastfeeding (EBF) among children under 6 months of age from three regions in the South and Grand’Anse Departments of Haiti. Methods. Data were pooled from three cross-sectional surveys conducted yearly from 2017 to 2019 with the guardians of 638 children under 6 months of age. A non-quantitative 24-hour dietary recall was used to assess EBF the day before the survey. Using unadjusted and adjusted prevalence ratios, associations were assessed between EBF and several explanatory factors: infant’s age and sex; maternal age, educational attainment, mid-upper arm circumference (MUAC), dietary diversity, number of children under 5 years of age, responsibility for the main or secondary source of income of the household, initiation of breastfeeding within one hour, knowledge of EBF duration; household severe food insecurity, socioeconomic status, dependency ratio, region, and residential zone (urban/rural). Results. Prevalence of EBF was 68% in the study sample. From the fully adjusted model, prevalence of EBF was statistically significantly higher among younger infants, mothers with larger MUAC, who met or exceeded Minimum Dietary Diversity for Women (MDD-W), who initiated breastfeeding within one hour, who were knowledgeable of the recommendations for EBF duration, and living in the Jérémie region. Conclusions. The main determinants of EBF identified in this study attest to the importance of breastfeeding mothers’ access to nutritious food for the practice and maintenance of EBF and the need for geographically equitable access to health services and education that support breastfeeding.

[RESUMEN]. Objetivo. Determinar cuáles son los determinantes de la lactancia materna exclusiva en menores de 6 meses de edad de tres regiones de los departamentos Sur y Grand'Anse de Haití. Métodos. Se agruparon los datos de tres encuestas transversales realizadas anualmente entre 2017 y 2019 a representantes de 638 bebés menores de 6 meses de edad. Se empleó una descripción no cuantitativa de los alimentos consumidos en las últimas 24 horas para evaluar la lactancia materna exclusiva el día anterior a la encuesta. Mediante cocientes de prevalencia ajustados y no ajustados, se evaluó la relación entre la lactancia materna exclusiva y varios factores explicativos: sobre el lactante: edad y sexo; sobre la madre: edad, nivel educativo, circunferencia del brazo media, diversidad alimentaria, número de hijos menores de 5 años y responsabilidad como fuente principal o secundaria de ingresos del hogar; inicio de la lactancia materna en un plazo de una hora después del nacimiento y conocimiento sobre la duración de la lactancia materna exclusiva; inseguridad alimentaria grave en el hogar, situación socioeconómica y tasa de dependencia; y región y zona residencial (urbana/rural). Resultados. La prevalencia de la lactancia materna exclusiva fue de 68% en la muestra del estudio. A partir del modelo totalmente ajustado, la prevalencia de la lactancia materna exclusiva fue significativamente mayor desde un punto de vista estadístico en los bebés más pequeños, las madres con una mayor circunferencia del brazo media, la que cumplieron o excedieron la Diversidad Alimentaria Mínima para las Mujeres, las que iniciaron la lactancia materna dentro de una hora después del parto, las que conocían bien las recomendaciones sobre la duración de la lactancia materna exclusiva y las que vivían en la región de Jérémie. Conclusiones. Los principales determinantes de la lactancia materna exclusiva identificados en este estudio confirman la importancia de que las madres lactantes tengan acceso a alimentos nutritivos para la práctica y el mantenimiento de la lactancia materna exclusiva, así como la necesidad de disponer de un acceso geográfico equitativo a los servicios de salud y la educación que respaldan la lactancia materna.

[RESUMO]. Objetivo. Identificar os determinantes do aleitamento materno exclusivo (AME) entre crianças com menos de 6 meses de idade de três regiões dos departamentos Sul e Grand’Anse do Haiti. Métodos. Agruparam-se dados de três pesquisas transversais realizadas anualmente, de 2017 a 2019, com pais e responsáveis de 638 crianças com menos de 6 meses de idade. Um recordatório alimentar não quantitativo de 24 horas foi utilizado para avaliar o AME no dia anterior à pesquisa. Usando taxas não ajustadas e ajustadas de prevalência, avaliou-se a associação entre AME e diversos fatores explicativos: idade e sexo do bebê; idade da mãe, seu nível de escolaridade, circunferência do braço (CB), diversidade da dieta, número de filhos com menos de 5 anos, responsabilidade pela fonte primária ou secundária de renda da família, início do aleitamento materno na primeira hora, conhecimento sobre a duração do AME; insegurança alimentar domiciliar grave, status socioeconômico, índice de dependência, região e zona residencial (urbana/rural). Resultados. A prevalência de AME na amostra do estudo foi de 68%. Com base no modelo totalmente ajustado, a prevalência do AME foi maior, de forma estatisticamente significante, entre bebês mais jovens, mães com maior CB, que atendiam ou excediam a Diversidade Alimentar Mínima para Mulheres (MDD-W), que começaram a amamentar na primeira hora, que estavam familiarizadas com as recomendações sobre a duração do AME e que moravam na região de Jérémie. Conclusões. Os principais determinantes de AME identificados neste estudo atestam a importância do acesso das lactantes a alimentos nutritivos para a prática e a continuidade do AME, e a necessidade de acesso geograficamente equitativo a educação e serviços de saúde que apoiem o aleitamento materno.

Evaluation de la qualité physico-chimique et microbiologique de quelques farines infantiles locales vendues à Ouagadougou, Burkina Faso / Evaluation of the physicochemical and microbiological quality of some local infant flours sold in Ouagadougou, Burkina Faso

Introduction: la qualité des farines infantiles utilisées pendant la période de diversification alimentaire est d´une grande importance. Malheureusement, les processus de transformation occasionnent des pratiques d'hygiène insuffisantes. L´objectif de cette étude était d´évaluer la qualité physico-chimique et microbiologique des farines infantiles locales vendues à Ouagadougou. Méthodes: les paramètres physico-chimiques et microbiologiques ont été déterminés selon les méthodes standards. Les données ont été traitées sur Excel 2016 et les moyennes comparées sur XLSTAT 2016. Résultats: sur 102 unités de 20 marques de farines infantiles locales analysées, les matières premières de base étaient constituées par les céréales locales, les légumineuses, les enzymes, les minéraux et les vitamines. La teneur en eau variait de 1,92±0,01% à 5,51±0,03% tandis que le pH variait de 5,55±0,01 à 6,36±0,00. La flore totale variait de 2,4.102 UFC/g à 1,1.104 UFC/g, les coliformes totaux de 0 à 2,8.103 UFC/g, les coliformes fécaux de 0 à 5,3.102UFC/g et les levures et moisissures de 4 UFC/g à 1,1.103UFC/g. Aucune colonie confirmée de salmonelles et d´Escherichia coli n´a été détectée. Concernant l´évaluation microbiologique, toutes les farines à cuire ont présenté une flore aérobie totale, des Escherichia coli et des salmonella satisfaisantes, 64,71% ont présenté des coliformes fécaux satisfaisantes et 94,12% ont présenté des levures et moisissures satisfaisantes. Toutes les farines instantanées ont présenté des charges microbiologiques satisfaisantes. Conclusion: globalement, les farines infantiles locales vendues à Ouagadougou sont de qualité physico-chimiques et microbiologiques satisfaisantes à l´exception de quelques farines à cuire.

Introduction: the quality of infant flours used to support dietary diversification is of great importance. Unfortunately, transformation processes result in poor hygiene practices. The purpose of this study was to evaluate the physicochemical and microbiological quality of local infant flours sold in Ouagadougou. Methods: physicochemical and microbiological parameters were determined according to standard methods. Data were processed on Excel 2016 and the averages were compared using XLSTAT 2016. Results: out of the 102 units of 20 local infant flour brands analyzed, the basic raw materials consisted of local cereals, legumes, enzymes, minerals and vitamins. Water content ranged from 1.92±0.01% to 5.51±0.03%, while pH ranged from 5.55±0.01 to 6.36±0.00. Total flora ranged from 2,4.102 CFU/g to 1,1.104 CFU/g, total coliforms from 0 to 2,8.103 CFU/g, fecal coliforms from 0 to 5,3.102 CFU/g, and yeasts and moulds from 4 CFU/g to 1,1.103 CFU/g. No confirmed Salmonella and Escherichia coli colonies were detected. With respect to the microbiological evaluation, all the cooking flours showed satisfactory total aerobic flora, Escherichia ncoli and Salmonella, 64.71% showed satisfactory faecal coliforms and 94.12% showed satisfactory yeasts and moulds. All instant flours had satisfactory microbiological loads. Conclusion: overall, local infant flours sold in Ouagadougou are of satisfactory physicochemical and microbiological quality, with the exception of some cooking flours.

Developments in pediatrics in 2020: choices in allergy, autoinflammatory disorders, critical care, endocrinology, genetics, infectious diseases, microbiota, neonatology, neurology, nutrition, ortopedics, respiratory tract illnesses and rheumatology.

In this article, we describe the advances in the field of pediatrics that have been published in the Italian Journal of Pediatrics in 2020. We report progresses in understanding allergy, autoinflammatory disorders, critical care, endocrinology, genetics, infectious diseases, microbiota, neonatology, neurology, nutrition, orthopedics, respiratory tract illnesses, rheumatology in childhood.

Etiquetado nutricional de alimentos procesados (semáforo nutri-cional) y su relación con factores socioeconómicos, culturales, demográficos y publicitarios, según padres de niños entre 5-11 años de dos colegios de Quito / Nutritional labeling of processed foods (nutritional stoplight) and its relationship with socioeconomic, cultural, demographic and advertising factors, according to parents of children between 5-11 years of age from two schools in Quito

Introducción: El etiquetado nutricional es una herramienta gráfica para notificar al consumidor sobre las propiedades nutricionales de un alimento lo que facilita su selección. El objetivo del presente estudio fue determinar la influencia del etiquetado nutricional y los factores socioeconómicos, culturales, demográficos, publicitarios en la selección de alimentos en un grupo de padres de niños entre 5-11 años en dos unidades educativas públicas y privadas de Quito. Métodos: Con diseño mixto, cuantitativo- transversal y cualitativa interpretativa se analizó una muestra de opiniones de 240 padres en las Unidades Educativas (UE) Nueva Aurora (Privada) y 235 padres en la UE Julio María Matovelle (Pública) de Quito. Se realizaron tres grupos focales, grabados y transcriptos de forma textual y se aplicó un cuestionario. El paquete esta-dístico usado fue SPSS v24.0. Resultados: Hubo mayor consumo de alimentos procesados en la UE Privada n=79/240 (32.9%). Selección por fácil preparación (39.2% UE Privada y 46.4% UE Pública). El 54.2 % y 57 % de los padres ven publicidad en la televisión. El conocimiento del etiquetado fue superior en la UE privada (94.9%; n=223). Asociación entre edad [OR: 2.3; IC 95%: 1.08-5.04] instrucción [OR: 3.95; IC 95%: 2.12-7.37], exposición a la publicidad [OR: 0.62; IC 95%: 0.36-1.05] y conocimientos (P<0.05). La actitud se asoció con el nivel de instrucción [OR: 2.57; IC 95%: 1.62-4.09] e ingresos (P<0.05). Análisis cualitativo: grado de conocimiento y publicidad elevados, con un impacto importante en la selección de los alimentos. Conclusiones: El conocimiento sobre el etiquetado nutricional fue elevado; pero no fue el principal factor para seleccionar alimentos. El tiempo de preparación y el sabor fueron más importantes que las especificaciones nutricionales

Introduction: Nutrition labeling is a graphic tool to notify consumers about the nutritional properties of a food, which facilitates their selection. The objective of this study was to determine the influence of nutri-tional labeling and socioeconomic, cultural, demographic, and advertising factors on food selection in a group of parents of children between 5-11 years old in two public and private educational units in Quito. Methods: With a mixed, quantitative-transversal and qualitative interpretative design, a sample of opin-ions of 240 parents in the Educational Units (EU) Nueva Aurora (Fiscal) and 235 parents in the EU Julio María Matovelle (Private) of Quito was analyzed. Three focus groups were carried out, recorded and transcribed textually, and a questionnaire was administered. The statistical package used was SPSS v24.0. Results: There was a higher consumption of processed foods in the private EU n = 79/240 (32.9%). Selection for easy preparation (39.2% Private EU and 46.4% Public EU). 54.2% and 57% of parents see advertising on television. Knowledge of labeling was higher in the private EU (94.9%; n = 223). Association between age [OR: 2.3; 95% CI: 1.08-5.04] instruction [OR: 3.95; 95% CI: 2.12-7.37], exposure to advertising [OR: 0.62; 95% CI: 0.36-1.05] and knowledge (P <0.05). Attitude was associated with educational level [OR: 2.57; 95% CI: 1.62-4.09] and admissions (P <0.05). Qualitative analysis: high degree of knowledge and publicity, with a significant impact on food selection. Conclusions: Knowledge about nutritional labeling was high, but it was not the main factor in selecting food. Prep time and flavor were more important than nutritional specifications.

Diverse Immune Effects of Bovine Colostrum and Benefits in Human Health and Disease.

The health benefits of bovine colostrum have extensively been studied, including immune effects mediated by immunoglobulins, lactoferrin, and casein, as well as by certain growth factors. Some of these effects are not directly related to the absorption of proteins from the intestinal tract. The ingestion of BC can modulate the function of subsets of lymphocytes, macrophages, and dendritic cells and increase regulatory cytokines such as interleukin 10. In this review, we predominantly focused on evidence from human studies on benefits in health and disease. This review highlights that clear evidence of the prevention of infectious diseases in pre-term infants such as necrotizing enterocolitis, neonatal sepsis or prevention of cancer metastasis is lacking. This is clearly an area where translational science has to be strengthened, taking the considerable evidence from numerous ex vivo studies on cells and tissues and from animal interventions. The review focuses predominantly on human data.

Early-Life Development of the Bifidobacterial Community in the Infant Gut.

The establishment of the gut microbiota poses implications for short and long-term health. Bifidobacterium is an important taxon in early life, being one of the most abundant genera in the infant intestinal microbiota and carrying out key functions for maintaining host-homeostasis. Recent metagenomic studies have shown that different factors, such as gestational age, delivery mode, or feeding habits, affect the gut microbiota establishment at high phylogenetic levels. However, their impact on the specific bifidobacterial populations is not yet well understood. Here we studied the impact of these factors on the different Bifidobacterium species and subspecies at both the quantitative and qualitative levels. Fecal samples were taken from 85 neonates at 2, 10, 30, 90 days of life, and the relative proportions of the different bifidobacterial populations were assessed by 16S rRNA-23S rRNA internal transcribed spacer (ITS) region sequencing. Absolute levels of the main species were determined by q-PCR. Our results showed that the bifidobacterial population establishment is affected by gestational age, delivery mode, and infant feeding, as it is evidenced by qualitative and quantitative changes. These data underline the need for understanding the impact of perinatal factors on the gut microbiota also at low taxonomic levels, especially in the case of relevant microbial populations such as Bifidobacterium. The data obtained provide indications for the selection of the species best suited for the development of bifidobacteria-based products for different groups of neonates and will help to develop rational strategies for favoring a healthy early microbiota development when this process is challenged.

New Methodologies for Conducting Maternal, Infant, and Child Nutrition Research in the Era of COVID-19.

The severe acute respiratory syndrome coronavirus disease 2019 (COVID-19) outbreak rapidly became a worldwide pandemic in early 2020. In Australia, government-mandated restrictions on non-essential face-to-face contact in the healthcare setting have been crucial for limiting opportunities for COVID-19 transmission, but they have severely limited, and even halted, many research activities. Our institute's research practices in the vulnerable populations of pregnant women and young infants needed to adapt in order to continue without exposing participants, or staff, to an increased risk of exposure to COVID-19. Here, we discuss our pre-and-post COVID-19 methods for conducting research regarding nutrition during pregnancy, infancy, and early childhood. We discuss modifications to study methods implemented to avoid face-to-face contact when identifying and recruiting potential participants, gaining informed consent, conducting appointments, and collecting outcome data, and the implications of these changes. The COVID-19 pandemic has required numerous changes to the conduct of research activities, but many of those modifications will be useful in post-COVID-19 research settings.

Global e-Learning in Early Nutrition and Lifestyle for International Healthcare Professionals: Design and Evaluation of the Early Nutrition Specialist Programme (ENS).

BACKGROUND: Every encounter a healthcare professional has with new or expecting parents offers an opportunity for addressing improved early nutrition and lifestyle. Evidence-based qualification programmes via e-learning offer valuable tools for attenuating the world's huge double burden of both under- and overnutrition in early childhood. We evaluated use and learner satisfaction of a global e-learning programme on early nutrition and lifestyle addressing international healthcare professionals. METHODS: We implemented the Early Nutrition Specialist Programme (ENS) with six interactive e-learning courses on early nutrition building on more than ten years of experience with global e-learning platforms, expert knowledge and an international network in the subject field. We collected descriptive and explorative evaluation data on usage and learner satisfaction with a questionnaire and log data over three years among 4003 learners from 48 countries. RESULTS: Results show high completion of the ENS programme, with 85.5% of learners finalizing the programme after enrollment into the first of six courses. Very good results were provided for learner satisfaction with the courses (96.7% of users), for increasing understanding of the topic (97.4%) and matching the indicated time investment (94.4%). Most predominant themes in the open text fields of user feedback questionnaires were "Increase interactivity or number of audio-visuals", "Content suggestions or more examples" and "Technical (quality) issues or navigation problems". CONCLUSIONS: The ENS programme evaluation shows high completion rates and level of satisfaction by learners from numerous countries. The different needs for Continuing Medical Education (CME) of healthcare professionals in diverse healthcare system settings can be met by a joint e-learning qualification programme. Further optimizations will be implemented based on user feedback. More research with a learning analytics approach may help to further identify the most effective and efficient didactic and pedagogic elements of e-learning.

ASSOCIATION BETWEEN BREASTFEEDING AND OVERWEIGHT/OBESITY IN SCHOOLCHILDREN AGED 7-14 YEARS.

OBJECTIVE: To evaluate the prevalence of breastfeeding (BF) and the association between occurrence/duration of BF and overweight/obesity in schoolchildren aged 7-14 years. METHODS: This is a cross-sectional study, conducted in 2012-2013, on schoolchildren aged 7-14 years from Florianópolis, Santa Catarina, Southern Brazil. Weight and height were measured according to procedures of the World Health Organization. Breastfeeding and sociodemographic data were obtained from a questionnaire responded by parents/guardians. BF was categorized as a dichotomous variable (yes/no) and according to duration (months). Nutritional status was evaluated according to the Z score of the body mass index per age for sex and it was categorized into two groups: normal weight (

Alimentação e obesidade de crianças na fase pré-escolar: significados atribuídos pelos pais / Children's food and obesity in the pre-school phase: meanings assigned by parents / Alimentos y obesidad de los niños en la fase preescolar: significados por los padres

Objetivos: Avaliar a percepção dos pais de crianças com sobrepeso ou obesidade, em relação à qualidade da alimentação dos seus filhos, na fase pré-escolar. Método: Estudo descritivo e qualitativo, realizado por meio de entrevistas semi-estruturadas, com pais de crianças com sobrepeso ou obesas matriculadas em um Centro Municipal de Educação Infantil (CEMEI) e cadastrado nas Estratégias de Saúde da Família (ESF's) do município de Divinópolis-MG. Resultados: Em relação à caracterização dos pais, todos eram do sexo feminino. A faixa etária alternou entre 22 a 45 anos. A partir da análise dos dados, as categorias elencadas foram: Alimentação inadequada; Tecnologia e sedentarismo; A subestimação do sobre peso; Prevenção e tratamento da obesidade infantil nas ESF. Conclusão: Identificou-se a necessidade de um melhor preparo por parte dos profissionais de saúde em relação a correta nutrição das crianças e também um envolvimento entre esses profissionais, os pais e a escola.(AU)

Objectives: To evaluate the perception of parents of overweight or obese children, in relation to the quality of their children's food, in the preschool phase. Method: Descriptive and qualitative study, carried out through semi-structured interviews, with parents of overweight or obese children enrolled in a Municipal Center for Early Childhood Education (CEMEI) and registered in the Family Health Strategies (ESF's) in the municipality of Divinópolis -MG. Results: Regarding the characterization of the parents, all were female. The age group alternated between 22 to 45 years. From the data analysis, the categories listed were: Inadequate food; Technology and sedentary lifestyle; The underestimation of overweight; Prevention and treatment of childhood obesity in the FHS. Conclusion: There was a need for better preparation by health professionals in relation to the correct nutrition of children and also an involvement between these professionals, parents and the school.(AU)

Objetivos: Evaluar la percepción de los padres de niños con sobrepeso u obesidad, en relación a la calidad de la alimentación de sus hijos, en la etapa preescolar. Método: Estudio descriptivo y cualitativo, realizado a través de entrevistas semiestructuradas, con padres de niños con sobrepeso u obesidad inscritos en un Centro Municipal de Educación Infantil (CEMEI) y registrados en las Estrategias de Salud de la Familia (ESF's) del municipio de Divinópolis. -MG. Resultados: En cuanto a la caracterización de los padres, todos fueron del sexo femenino. El grupo de edad alternaba entre 22 y 45 años. Del análisis de datos, las categorías enumeradas fueron: Alimentos inadecuados; Tecnología y estilo de vida sedentario; La subestimación del sobrepeso; Prevención y tratamiento de la obesidad infantil en la ESF. Conclusión: Se identificó la necesidad de una mejor preparación por parte de los profesionales de la salud en relación a la correcta nutrición de los niños y también una participación entre estos profesionales, los padres y la escuela.(AU)

Compositional and functional characteristics of goat milk and relevance as a base for infant formula.

Goat milk has a long history of use for human nutrition. There are a number of studies investigating the technofunctional properties and nutritional value of goat milk for production of consumer products such as cheese, yoghurts, and Ultra-high temperature (UHT) milks. Although fresh goat milk was traditionally used for feeding young children, use of goat milk for commercial production of formula for infants or young children has only been considered in the scientific literature since 2000s. In this review, the nutritional science relating to goat milk is discussed from the perspective of infant nutrition. A critical analysis of the scientific data concerning the composition and functional characteristics of goat milk that pertain to infant nutrition is included. From this overview, three key conclusions are possible: (1) there is a range of compositional data to support the application of goat milk for infants, provided it is fortified; (2) goat milk has the potential to influence the gastrointestinal environment differently to cow milk; and (3) the nutritional adequacy of fortified goat milk formula for newborn infants has been confirmed in clinical trials.