An allergen-reduced dietary recommendation that includes a moderate whey hydrolysate infant formula (pHF) has no negative effects on growth parameters up to 6 months of life in an infant population unselected for atopic risk. The dietary intervention produced improvements in general health status when compared with a control cohort that received infant formula with unhydrolysed proteins (IF), and high allergenic weaning foods at an earlier age. The difference between cohorts was principally due to fewer adverse skin findings. (ABSTRACT TRUNCATED)
ExtractCeliac disease provides a model for investigation of one form of infantile malnutrition occurring under fully controlled circumstances. Thirteen patients aged 9-15 months were followed for a period of at least 3 years while they were on a strict gluten-free diet.Observed values for height, weight, bone age, metacarpal diameter, and cortical thickness are compared with the normal range based on local standards, and the results are expressed as standard scores. The mean curves of these data are presented in Figures 1 and 2. At the time of diagnosis and the beginning of diet (zero time), all variables were retarded, and standard scores were significantly below normal in height (P < 0.01), weight (P < 0.001), bone age (P < 0.01), metacarpal cortex (P < 0.05), and diameter (P < 0.001). Weight was significantly more depressed than height (P < 0.01), bone age (P < 0.001), metacarpal cortex (P < 0.001), and diameter (P < 0.001). Height was significantly more depressed than bone age (P < 0.05). As the patients recovered, weight caught up faster than the other measurements; weight was not significantly below normal after the patients had been on a gluten-free diet for 6 months and it reached normal values between 6 months and 1 year after initiation of diet. Height and bone age did not reach normal levels until after 2 years of treatment, although the values were no longer significantly depressed after 1 year on the diet. Cortical thickness was no longer significantly depressed after 6 months on the diet; it reached normal values by 6 months to 1 year after initiation of diet, and then showed an overshooting type of catch-up with values remaining significantly elevated at 2 years (P < 0.05) and 3 years (P < 0.05) after the onset of diet. Metacarpal diameter showed a slow steady catch-up growth which remained below normal throughout the follow-up period although the values were no longer significantly below normal 3 years after patients had begun diet.The study provides evidence that children aged 1 year (±3 months) who suffer from malnutrition caused by celiac disease catch up completely in weight, height, bone age, and metacarpal cortical thickness during a dietary treatment period of 3 years.
SpeculationPoor physical growth resulting from this type and this degree of malnutrition in the second half of the 1st year of life is completely remediable. Permanent somatic sequelae from a similar severity of late infantile malnutrition in underdeveloped countries, therefore, might not be inevitable, provided that the therapeutic program is optimal and adverse factors do not continue to operate.
In a cross-sectional survey, plasma concentrations of α- and γ-tocopherol, α- and β-carotene (cis and trans isomers), lycopene, and retinol were determined by reversed-phase HPLC, and ratios of plasma α-tocopherol to cholesterol were calculated in 208 Swiss individuals ages 0.4–38.7 years. The influence of age, sex, and season of sampling was studied. Age was a significant predictor of all plasma concentrations except α-carotene. No sex-related differences were observed. Season of sampling affected α-tocopherol and retinol (higher in winter) and γ-tocopherol and cholesterol concentrations (higher in winter and spring than in the other seasons). After correction for seasonal influences, age differences were 0.24 μmol/L per year for α-tocopherol, 0.04 μmol/L per year for retinol, and 0.04 μmol/L per year for cholesterol concentrations; ratios of plasma α-tocopherol to cholesterol were not affected by age. We constructed age-specific reference intervals from the regression line and a multiple of the standard deviation. Separate regression equations are presented for seasons with low and high values.
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