Consequences of Incomplete Carbohydrate Absorption From Fruit Juice Consumption in Infants

Cole, Conrad R.; Rising, Russell; Lifshitz, Fima

doi:10.1001/archpedi.153.10.1098

Cited by 25 publications

(33 citation statements)

References 18 publications

(23 reference statements)

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“…The breath hydrogen test, which measures bacterial fermentation products of D-glucose, is relatively sensitive and has been used in children to assess bacterial overgrowth and carbohydrate malabsorption (24, 26). The choice of D-glucose rather than lactulose in children with SBS reduces the false-positive rate, because, glucose is rapidly absorbed by the small intestines (27).…”

Section: Discussionmentioning

confidence: 99%

The Rate of Bloodstream Infection Is High in Infants with Short Bowel Syndrome: Relationship with Small Bowel Bacterial Overgrowth, Enteral Feeding, and Inflammatory and Immune Responses

Cole

Frem

Schmotzer

et al. 2010

The Journal of Pediatrics

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154

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Objective-This pilot study in parenteral nutrition (PN) dependent infants with short bowel syndrome (SBS) evaluated the impact of feeding route and intestinal permeability on bloodstream infection (BSI), small bowel bacterial overgrowth (SBBO) and systemic immune responses, and fecal calprotectin as a biomarker for SBBO.Study design-10 infants (ages 4.2-15.4 months) with SBS due to necrotizing enterocolitis were evaluated. Nutritional assessment, breath hydrogen testing, intestinal permeability, fecal calprotectin, serum flagellin-and LPS-specific antibody titers, and proinflammatory cytokine concentrations (TNF-α, IL-1 β, IL-6, IL-8) were performed at baseline, 60 and 120 days. Healthy, age-matched controls (n=5) were recruited.Results-BSI incidence was high (80%) and SBBO was common (50%). SBBO increased the odds for BSI (> 7-fold; p=0.009). Calprotectin levels were higher in children with SBS and SBBO versus those without SBBO and healthy controls (p<0.05). Serum TNF-α, was elevated at baseline versus controls. Serum TNF-α, IL-1 β, IL-6 and IL-8 levels diminished with increased enteral nutrition. Anti-flagellin and anti-LPS IgG levels in children with SBSwere lower versus controls and rose over time.Contact Information: Conrad R. Cole. M.D., M.P.H., M.Sc., Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta GA 30225, crcole@emory.edu, Phone: (404) Fax: (404) 727-4069. Edited by SL and WFB Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusion-In children with SBS, SBBO increases the risk for BSI and systemic proinflammatory response decreases with increasing enteral feeding and weaning PN. NIH Public AccessShort bowel syndrome (SBS) is a rare but devastating clinical entity that is defined as a spectrum of diarrhea and malabsorption with associated complications (e.g. growth stunting, malnutrition) due to insufficient bowel length (1). In children, SBS is often the result of massive small bowel resection due to necrotizing enterocolitis (NEC) or major congenital gastrointestinal malformations (e.g. gastroschisis, intestinal atresia) (2). Recurrent bloodstream infections (BSI) and small bowel bacterial overgrowth (SBBO) are believed to be common complications associated with pediatric SBS, though only limited data are available (2,3). We recently reported that BSI and malnutrition were the most frequent indication for readmission of very low birth weight infants with SBS (2). Inpatient admissions account for majority of the cost of care in pediatric...

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Section: Discussionmentioning

confidence: 99%

The Rate of Bloodstream Infection Is High in Infants with Short Bowel Syndrome: Relationship with Small Bowel Bacterial Overgrowth, Enteral Feeding, and Inflammatory and Immune Responses

Cole

Frem

Schmotzer

et al. 2010

The Journal of Pediatrics

Self Cite

154

140

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“…Moreover, sweetened beverages, including fruit juices, are associated with negative health outcomes due to increase adiposity gain in low-income children [33]. Carbohydrate malabsorption is also high in infants consuming sorbitol-containing juices with high fructose-to-glucose ratio which has a negative impact on metabolism and activity [34]. The American Academy of Pediatrics [35] recommends reducing overall fruit juice intake among children and replacing it with whole fruits due to these documented negative effects associated with intake of large volumes of fruit juices.…”

Section: Discussionmentioning

confidence: 99%

Food group intake patterns and nutrient intake vary across low-income Hispanic and African American preschool children in Atlanta: a cross sectional study

Salvo

Frediani

Ziegler

et al. 2012

Nutr J

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BackgroundThe food group intake patterns of low income Hispanic and African American preschool children are not well documented. The aim of this study was to perform a food group intake analysis of low income minority preschool children and evaluate how macronutrient and micronutrient intake compares to Dietary Reference Intakes (DRI).MethodsA cross sectional study design using three-day food diaries analyzed by dietary analysis software (Nutrient Database System for Research) was used. Children were recruited from well-child clinics at Children’s Healthcare of Atlanta at Hughes Spalding and North Dekalb Grady Satellite Clinic, Atlanta, GA. Low-income, African American and Hispanic preschool age children (n = 291) were enrolled. A total of 105 completed and returned the 3-day food diaries. Chi-squared tests were used to assess demographic variables. The mean percentage of intake per day of specific food groups and sub-groups were obtained (servings of given food group/total daily servings). Food intake data and proportion of children meeting DRIs for macro- and micronutrients were stratified by race/ethnicity, nutritional status, and caloric intake, and were compared using t-tests. Regression models controlling for age, BMI and sex were obtained to assess the effect of total caloric intake upon the proportional intake of each studied food group.ResultsThe mean age of African American children was 2.24 ± 1.07 years and Hispanic children 2.84 ± 1.12 years. African Americans consumed more kcal/kg/day than Hispanics (124.7 ± 51 vs. 96.9 ± 33, p < 0.05). Hispanics consumed more fruits (22.0 ± 10.7% vs. 14.7 ± 13.7%, p < 0.05), while African Americans consumed more grains (25.7 ± 7.8% vs. 18.1 ± 6.4%, p < 0.05), meats (20.7 ± 9.0% vs. 15.4 ± 6.1%, p < 0.05), fats (9.8 ± 5.4% vs. 7.0 ± 5.8%, p < 0.05), sweet drinks (58.7 ± 17.1% vs. 41.3 ± 14.8%, p < 0.05) and low-fat dairy products (39.5 ± 19.3% vs. 28.9 ± 12.6%, p < 0.05). Among Hispanics, the proportional intake of fruits, fats and grains varied by total caloric intake, while no difference by total caloric intake was found for the dietary patterns of African Americans. Micronutrient intake also differed significantly between African American and Hispanic children.ConclusionsFood group intake patterns among low-income children differ by ethnic group. There is a need for more research to guide program design and target nutritional interventions for this population.

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“…Upon completion of the 24-hour metabolic measurement, macronutrient intake was determined from the amount of formula or complementary food fed utilizing the manufacturer's proximate analysis. This methodology of determining nutrient intake is valid and has been utilized in several previous studies in infants [21,22] and adults [20,23]. Investigators also recorded the interaction time and type of interaction and the observed periods of infant sleep.…”

Section: Methodsmentioning

confidence: 99%

Relationship between maternal obesity and infant feeding-interactions

Rising¹,

Lifshitz

2005

Nutr J

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Background: There are no data regarding the relationship between maternal adiposity and interaction and feeding of infants and possible contribution to childhood obesity. In this study we determined the relationship between maternal body weight and composition and infant feeding patterns and maternal-infant interaction during 24-hour metabolic rate measurements in the Enhanced Metabolic Testing Activity Chamber (EMTAC).

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Consequences of Incomplete Carbohydrate Absorption From Fruit Juice Consumption in Infants

Cited by 25 publications

References 18 publications

The Rate of Bloodstream Infection Is High in Infants with Short Bowel Syndrome: Relationship with Small Bowel Bacterial Overgrowth, Enteral Feeding, and Inflammatory and Immune Responses

The Rate of Bloodstream Infection Is High in Infants with Short Bowel Syndrome: Relationship with Small Bowel Bacterial Overgrowth, Enteral Feeding, and Inflammatory and Immune Responses

Food group intake patterns and nutrient intake vary across low-income Hispanic and African American preschool children in Atlanta: a cross sectional study

Relationship between maternal obesity and infant feeding-interactions

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