Skipping breakfast is common among children and adolescents. However, there is uncertainty regarding whether breakfast consumption contributes to or protects against overweight or obesity. We aimed to review the evidence on the effects of breakfast consumption on body weight outcomes in children and adolescents in Europe. The Cochrane Library, MEDLINE, and EMBASE were searched in January 2009. We identified 16 studies. All were cross-sectional or cohort trials involving more than 59,000 children/adolescents from Europe. Thirteen studies (n = 57,481) consistently showed that breakfast has a protective effect against becoming overweight or obese. One trial (n = 886) showed that this effect was significant only for boys. The effect of eating breakfast on the body mass index (BMI) was analyzed in 4 studies (n = 2897). All of these studies showed an increase in BMI in breakfast skippers. In one study (n = 1245), this effect was significant only for boys. The results of this analysis suggest that eating breakfast is associated with a reduced risk of becoming overweight or obese and a reduction in the BMI in children and adolescents in Europe. However, almost all of the data in this review were gathered from observational studies, thus, causality should not be assumed based on these findings.

As an imbalance in the intestinal microbiota can lead to the development of several diseases (e.g., type 1 diabetes, cancer, among others), the use of prebiotics, probiotics, and postbiotics to alter the gut microbiome has attracted recent interest. Postbiotics include any substance released by or produced through the metabolic activity of the microorganism, which exerts a beneficial effect on the host, directly or indirectly. As postbiotics do not contain live microorganisms, the risks associated with their intake are minimized. Here, we provided a critical review of postbiotics described in the literature, including their mechanisms of action, clinical characteristics, and potential therapeutic applications. We detailed the pleiotropic effects of postbiotics, including their immunomodulatory, anti-inflammatory, antioxidant, and anti-cancer properties. Although the use of postbiotics is an attractive strategy for altering the microbiome, further study into its efficacy and safety is warranted.

Current data indicate that the “bronchiolitis” diagnosis comprises more than one condition. Clinically, pathophysiologically, and even genetically three main clusters of patients can be identified among children suffering from severe bronchiolitis (or first wheezing episode): (a) respiratory syncytial virus (RSV)‐induced bronchiolitis, characterized by young age of the patient, mechanical obstruction of the airways due to mucus and cell debris, and increased risk of recurrent wheezing. For this illness, an effective prophylactic RSV‐specific monoclonal antibody is available; (b) rhinovirus‐induced wheezing, associated with atopic predisposition of the patient and high risk of subsequent asthma development, which may, however, be reversed with systemic corticosteroids in those with severe illness; and (c) wheeze due to other viruses, characteristically likely to be less frequent and severe. Clinically, it is important to distinguish between these partially overlapping patient groups as they are likely to respond to different treatments. It appears that the first episode of severe bronchiolitis in under 2‐year‐old children is a critical event and an important opportunity for designing secondary prevention strategies for asthma. As data have shown bronchiolitis cannot simply be diagnosed using a certain cutoff age, but instead, as we suggest, using the viral etiology as the differentiating factor.

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SUMMARY AimTo review evidence for the effectiveness of Lactobacillus GG (LGG) in treating acute infectious diarrhoea in children. MethodsThe following electronic databases were searched through August 2006 for studies relevant to acute infectious diarrhoea and LGG: MEDLINE, EMBASE, CINAHL and The Cochrane Library; additional references were obtained from reviewed articles. Only randomized-controlled trials (RCTs) were included. ResultsEight RCTs (988 participants) met the inclusion criteria. Compared with controls, LGG had no effect on the total stool volume (two RCTs, n = 303). However, LGG was associated with a significant reduction in diarrhoea duration (seven RCTs, 876 infants, weighted mean difference, WMD )1.1 days (95% confidence interval, CI )1.9 to )0.3), particularly of rotavirus etiology (WMD )2.1 days, 95% CI )3.6 to )0.6), risk of diarrhoea >7 days (one RCT, n = 287, relative risk 0.25, 95% CI 0.09-0.75) and duration of hospitalization (three RCTs, n = 535, WMD )0.58, 95% CI )0.8 to )0.4; significance was lost in the random effect model). There was no reduction in the number of stools at any time interval. ConclusionsThe use of LGG is associated with moderate clinical benefits in the treatment of acute diarrhoea in children. These findings should be interpreted with caution due to the important methodological limitations and heterogeneity of most of the studies.

SUMMARY BackgroundThe efficacy of each probiotic should be evaluated separately. Previously, we have shown that Lactobacillus GG (LGG) is effective in treating acute gastroenteritis (AGE) in children.

Limited available evidence suggests that iron supplementation in infants may positively influence children's psychomotor development, whereas it does not seem to alter their mental development or behavior.

Background:Recently, evidence from a large randomised controlled trial (RCT) negated efficacy of Lactobacillus rhamnosus GG for treating acute gastroenteritis in children.Aim: To review RCTs in which L rhamnosus GG was used to treat acute gastroenteritis in children. Methods:The Cochrane Library, MEDLINE, and EMBASE databases were searched from May 2013 (end of last search) to January 2019. The primary outcomes were stool volume and duration of diarrhoea.Results: Eighteen RCTs (n = 4208) were included. Compared with placebo or no treatment, L rhamnosus GG use had no effect on stool volume but was associated with a reduced duration of diarrhoea (15 RCTs, n = 3820, mean difference, MD −0.85 day, 95% CI −1.15 to −0.56). L rhamnosus GG was effective when used at a daily dose of ≥10 10 CFU or <10 10 CFU; however, the latter produced results of borderline significance. L rhamnosus GG was more effective when used in European countries compared with non-European countries, particularly when considered by region.L rhamnosus GG use was associated with a reduced duration of hospitalisation. One RCT found that L rhamnosus GG had no effect on the total clinical severity score at 14 days after enrolment. Conclusions:Despite a recent large RCT demonstrating no effect of L rhamnosus GG, current evidence shows that, overall, L rhamnosus GG reduced both the duration of diarrhoea (with a higher impact in European countries) and hospitalisation in inpatients. These findings should be viewed in the context of the high heterogeneity and methodological limitations of the included trials. | 1377SZAJEWSKA Et Al.