Enteric infections, enteropathy and undernutrition in early childhood are preventable risk factors for child deaths, impaired neurodevelopment, and later life metabolic diseases. However, the mechanisms linking these exposures and outcomes remain to be elucidated, as do biomarkers for identifying children at risk. By examining the urinary metabolic phenotypes of nourished and undernourished children participating in a case-control study in Semi-Arid Brazil, we identified key differences with potential relevance to mechanisms, biomarkers and outcomes. Undernutrition was found to perturb several biochemical pathways, including choline and tryptophan metabolism, while also increasing the proteolytic activity of the gut microbiome. Furthermore, a metabolic adaptation was observed in the undernourished children to reduce energy expenditure, reflected by increased N-methylnicotinamide and reduced β-aminoisobutyric acid excretion. Interestingly, accelerated catch-up growth was observed in those undernourished children displaying a more robust metabolic adaptation several months earlier. Hence, urinary N-methylnicotinamide and β-aminoisobutyric acid represent promising biomarkers for predicting short-term growth outcomes in undernourished children and for identifying children destined for further growth shortfalls. These findings have important implications for understanding contributors to long-term sequelae of early undernutrition, including cognitive, growth, and metabolic functions.
Currently, authorities and specialists in child development and public health have been concerned with the growth and nutritional status of children, especially due to the uncontrollable increase in overweight / obesity that has occurred in recent years. Obesity causes organic-functional complications, such as chronic-degenerative diseases (diabetes, high blood pressure, coronary heart disease), and psychosocial complications, such as withdrawal from social relationships, shame, exclusion and disturbances in body awareness. The objective was to identify in the literature the parents' knowledge about complementary feeding for infants. Integrative literature review based on the guidelines recommended by PRISMA. The search was carried out between the months of May and June 2017 by two researchers independently in the Scopus, PubMed, Scielo, LILACS and CINAHL databases. The following descriptors were used: “infant”, “complementary feeding”, “parents” and “knowledge” and “infant”, “complementary feeding”, “relatives” and “knowledge” in the DECs and MESH respectively. 1,012 studies were identified and a sample of 06 articles was obtained after applying the eligibility criteria. The knowledge evidenced was: use of appropriate utensils for feeding the child, not using cow's milk, caution with processed foods, issues related to breastfeeding and age of introduction of food and other liquids. Even so, there were still mistakes by parents regarding the recommendations of the main bodies dealing with food, such as the use of processed foods from the fourth month of life of the child and the relationship of the “fat” baby being the health model. It was concluded that the knowledge of parents / caregivers about complementary feeding is still permeated by mistakes. Thus, the nursing consultation should focus on health education and search for strategies that facilitate the process of introducing complementary feeding and help parents in this period. Key messages Targeting health strategies on complementary feeding in a timely manner. Guidance for the prevention of obesity in early childhood and the development of non-infectious diseases.
The Universal Agenda 2030 was developed by representatives of all countries as an action plan covering the three dimensions of sustainable development: economic, social and environmental. 17 objectives were agreed upon, highlighting objective 03, which aims to ensure a healthy life and promote well-being for all at all ages, having as one of the established goals to end preventable deaths of newborns by 2030. Infections neonatal care reflects deficits in health care, covering the entire perinatal period, and it is necessary to understand its causes in order to promote quality preventive and health promotion actions. The question is: what are the causes that make up the indicator of early neonatal mortality, due to preventable causes in Brazil between 2007 to 2017? Retrospective study carried out between September and October 2019 using secondary data collection from Department of Informatics of the Unified Health System - SUS (DATASUS). The outcome variable was early neonatal mortality from preventable causes and the independent variable was the infections component of the newborn). Twelve preventable causes of death have been identified in this category: congenital rubella syndrome; congenital syphilis; neonatal tetanus; diphtheria; haemophilus and non-haemophilus meningitis; human immunodeficiency virus diseases; neonatal infections; pneumonia; acute infections of lower airways; bacterial diseases and intestinal infectious diseases. The main cause of preventable death was infections from the neonatal period, which include congenital viral diseases (cytomegalovirus and herpes simplex); newborn bacterial septicemia; congenital parasitic diseases; omphalitis of newborn with or without mild hemorrhage; intra-amniotic infection of the fetus, neonatal infection of the urinary tract and/or skin. There is a need for more effective public health actions to modify the neonatal mortality situation, as well as health surveillance actions. Key messages Warn about causes of perinatal mortality that can be avoided. Strengthen the fulfillment of objective 3 of the 2030 Agenda to ensure and promote health in the perinatal period.
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