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Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances

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A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Global and Public Health".

Deadline for manuscript submissions: closed (25 April 2022) | Viewed by 33663

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Special Issue Editors

Prof. Dr. Tonia Vassilakou

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Guest Editor

Department of Public Health Policy, School of Public Health, University of West Attica, 11521 Athens, Greece
Interests: nutritional knowledge and behavior of children and adolescents; childhood obesity; lifestyle medicine; diet; exercise; sleep; dietary supplements; smoking cessation; medical nutrition therapy; diabetes; epilepsy
Special Issues, Collections and Topics in MDPI journals

Dr. Maria G. Grammatikopoulou

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Guest Editor

Unit of Immunonutrition & Clinical Nutrition, Department of Rheumatology & Clinical Immunology, Larissa University Hospital, Faculty of Medicine, University of Thessaly, Larissa, Greece
Interests: vulnerable populations; pediatric patients; nutrition recommendations; dietary interventions; nutritional status; evidence-based nutrition
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Undeniably, our children are an important segment of the population, and protecting their health means protecting the health of future adults. Indeed, childhood is a pivotal period epigenetically, setting the basis for health and disease, future healthcare use, and health-related expenses. In this matrix, nutritional status and dietary interventions are important environmental health effectors, interplaying with genetic and other environmental traits. Recent advances in healthcare, evidence-based nutrition recommendations, and the focus on children’s health have all resulted in significant improvements in the health of children, improving prognosis and life expectancy among vulnerable and patient populations.

In this Special Issue, we aim to synthesize existing evidence on the advances and updates regarding the nutritional care and status of pediatric patients and vulnerable populations, turning the spotlight on all nutrition-related problems in infants, children, and adolescents today. We thus welcome your submissions focusing on nutrition-related issues among the aforementioned populations and look forward to showcasing your research.

Prof. Dr. Tonia Vassilakou
Dr. Maria G. Grammatikopoulou
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

nutritional status
nutritional care
quality of life
cystic fibrosis
food insecurity
diabetes mellitus
cardiovascular risk
cancer
short stature
obesity
eating disorders
mental disorders

Published Papers (14 papers)

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Research

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26 pages, 610 KiB

Open AccessArticle

Correlates of Sub-Optimal Feeding Practices among under-5 Children amid Escalating Crises in Lebanon: A National Representative Cross-Sectional Study

by Maha Hoteit, Carla Ibrahim, Danielle Saadeh, Marwa Al-Jaafari, Marwa Atwi, Sabine Alasmar, Jessica Najm, Yonna Sacre, Lara Hanna-Wakim and Ayoub Al-Jawaldeh

Children 2022, 9(6), 817; https://0-doi-org.brum.beds.ac.uk/10.3390/children9060817 - 01 Jun 2022

Cited by 7 | Viewed by 2838

Abstract

Sub-optimal feeding practices among under-5 children are the major drivers of malnutrition. This study aims to assess the prevalence of malnutrition and the factors affecting exclusive breastfeeding, bottle feeding, and complementary feeding practices among under 5 children amid the COVID-19 pandemic as well as the economic and the political crises in Lebanon. A nationally representative stratified random sample of mother–child dyads (n = 511) was collected from households using a stratified cluster sampling design. The survey inquired about infant’s feeding and complementary feeding practices using a valid questionnaire. Anthropometric measurements of the mother and child were collected. Multivariate logistic regression was conducted to explore the determinants associated with under-5 children’s practices. The prevalence of underweight, stunting, wasting, overweight and obese children was 0.5%, 8.4%, 6.7%, 16.8% and 8.9%, respectively. In total, among under-5 children, the prevalence of ever breastfeeding, exclusive breastfeeding, and bottle feeding at birth was 95.1%, 59.1% and 25.8%, respectively. Half the children in this study started solid foods between 4 and 6 months. Regression analysis showed that supporting breastfeeding at hospital (aOR = 8.20, 95% CI (3.03–22.17)) and husband’s support (aOR = 3.07, 95% CI (1.9–4.92)) were associated with increased breastfeeding odds. However, mother’s occupation (aOR = 0.18, 95% CI (0.55–0.58)) was inversely associated with breastfeeding practices. Male children (aOR = 2.119, 95% CI (1.37–3.27), mothers diagnosed with COVID-19 (aOR = 0.58, 95% CI (0.35–0.95)), and bottle feeding at hospital (aOR = 0.5, 95% CI (0.32–0.77)) were more likely to induce early initiation of solid foods at 4 months of age. This study demonstrated non-negligible rates of malnutrition, low prevalence of exclusive breastfeeding, and high rates of early introduction of formula feeding and solid foods among Lebanese under-5-children amid escalating crises. Full article

(This article belongs to the Special Issue Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances)

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11 pages, 265 KiB

Open AccessArticle

Body Composition and Cardiovascular Risk Factors in a Paediatric Population

by Sonja Golob Jančič, Mirjam Močnik, Marjetka Švigelj and Nataša Marčun Varda

Children 2022, 9(5), 603; https://0-doi-org.brum.beds.ac.uk/10.3390/children9050603 - 24 Apr 2022

Cited by 2 | Viewed by 1704

Abstract

The aim of our study was to evaluate associations between body composition parameters and several clinical parameters. A total of 206 children and adolescents (120 male, 86 female) were prospectively included. Body impedance measurement was performed in all participants. During the hospital work-up, several clinical parameters such as anthropometric measurements and laboratory and ultrasound findings were obtained and correlated to body composition parameters. There was a significant association between body composition parameters and anthropometric measurements, systolic blood pressure, insulin levels, serum creatinine, urate, liver function tests, triglycerides, cholesterols and apolipoproteins, homocysteine, vitamin D and proteins in 24-h urine. Body composition differed by gender, between participants with and without hepatic steatosis and between patients with and without left ventricular hypertrophy. Interestingly, body composition did not correlate with diastolic blood pressure, pulse wave velocity and intima media thickness. This study showed that several clinical parameters are associated with body composition in children. Obesity and body composition play an important role in the development of other cardiovascular risk factors and are not dependent on fat mass alone, and the latter might be used for cardiovascular risk determination. Full article

(This article belongs to the Special Issue Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances)

11 pages, 291 KiB

Open AccessArticle

Moderators of Food Insecurity and Diet Quality in Pairs of Mothers and Their Children

by Christine Aggeli, Maria Patelida, Maria G. Grammatikopoulou, Ekaterini-Avrakomi Matzaridou, Marina Berdalli, Xenophon Theodoridis, Konstantinos Gkiouras, Angeliki Persynaki, Kyriaki Tsiroukidou, Theodore Dardavessis, Christos Tzimos, Dimitrios G. Goulis and Tonia Vassilakou

Children 2022, 9(4), 472; https://0-doi-org.brum.beds.ac.uk/10.3390/children9040472 - 29 Mar 2022

Cited by 1 | Viewed by 1740

Abstract

Research has suggested that maternal diet and characteristics may influence the diet of offspring during childhood. The present cross-sectional study aimed to assess the influence of distinct maternal characteristics and the diet quality of mothers on the prevalence of household food insecurity (FI) and the diet quality of children. A total of 179 mother–child pairs were recruited from two primary schools in the metropolitan area of Thessaloniki. The children were aged between 10 and 12 years old. Diet quality was assessed as the level of adherence to the Mediterranean diet (MD), with the use of the KIDMED for the children and the MedDietScore for the mothers. The household FI and the social and demographic characteristics of the mothers were also recorded, and anthropometric measures of both the mothers and their children were collected. Approximately ¼ (26.3%) of the pairs reported some degree of FI, with a greater prevalence (64.7%) within single-mother families. Moreover, FI affected the level of maternal MD adherence (p = 0.011). On the other hand, FI was decreased in households with a greater maternal educational level (OR: 0.25; 95% CI: 0.10–0.63) and conjugal family status (OR: 0.15; 95% CI: 0.87–0.52). Maternal adherence to the MD was inversely related to the respective adherence of their offspring (OR: 0.93; 95% CI: 0.86–0.997), suggesting that during periods of financial constraints, maternal diet quality is compromised at the expense of affording a better diet for the minors in the family. Full article

(This article belongs to the Special Issue Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances)

8 pages, 227 KiB

Open AccessArticle

Determinants of Gender Disparity in Nutritional Intake among Children in Pakistan: Evidence from PDHS

by Awaisra Shafiq, Abid Hussain, Muhammad Asif, Arif Jameel, Saiqa Sadiq and Shahida Kanwel

Children 2022, 9(1), 7; https://0-doi-org.brum.beds.ac.uk/10.3390/children9010007 - 24 Dec 2021

Cited by 10 | Viewed by 3360

Abstract

The purpose of this study is to analyze early age malnutrition on a gender basis in Pakistan. Pakistan Demographic and Health Survey (PDHS) 2012–2013 data related to households’ characteristics that affect the nutrition of children less than 5 years of age are used for the estimation of results. Gender disparity (measured by girl malnourished in household/boy malnourished in a household) is constructed for the measurement of gender disparity in early age child nutrition. After synthesizing the PDHS data set, 2119 observations are used for regression results of gender disparity. Regression results are analyzed at the level of 5% confidence interval otherwise insignificant. egression results for gender disparity show that households in good socioeconomic status, a greater number of household members, a mother’s higher level of education, mother employment, and the male head of the household, causes a decrease in gender disparity in nutrition intake of children. Full article

(This article belongs to the Special Issue Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances)

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15 pages, 2674 KiB

Open AccessArticle

Standards of Nutritional Care for Patients with Cystic Fibrosis: A Methodological Primer and AGREE II Analysis of Guidelines

by Maria G. Grammatikopoulou, Tonia Vassilakou, Dimitrios G. Goulis, Xenophon Theodoridis, Meletios P. Nigdelis, Arianna Petalidou, Konstantinos Gkiouras, Dimitrios Poulimeneas, Olga Alexatou, Kyriaki Tsiroukidou, Georgios Marakis, Zoe Daniil and Dimitrios P. Bogdanos

Children 2021, 8(12), 1180; https://0-doi-org.brum.beds.ac.uk/10.3390/children8121180 - 14 Dec 2021

Cited by 3 | Viewed by 2948

Abstract

Although many Clinical Practice Guidelines (CPGs) have been published for the care of patients with Cystic Fibrosis (CF), including a variety of nutrition recommendations, the quality of these CPGs has never been evaluated. The aim of this study was to compare, review, and critically appraise CPGs for the nutritional management of CF, throughout the lifespan. We searched PubMed, Guidelines International Network (GIN), ECRI Institute, and Guidelines Central for CPGs, with information on the nutritional management of CF. Retrieved CPGs were appraised by three independent reviewers, using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument and checklist. A total of 22 CPGs (seven solely nutrition oriented), by 14 different publishers, were retrieved. The Thoracic Society of Australia and New Zealand CPGs scored the highest overall quality (94.4%), while the Paediatric Gastroenterology Society/Dietitians Association of Australia CPGs had the lowest score (27.8%). Great variation in AGREE II domain-specific scores was observed in all CPGs, suggesting the existence of different strengths and weaknesses. Despite the availability of several CPGs, many appear outdated, lacking rigor, transparency, applicability, and efficiency, while incorporating bias. Considering that CPGs adherence is associated with better outcomes and the need for improving life expectancy in patients with CF, the development of CPGs of better quality is deemed necessary. Full article

(This article belongs to the Special Issue Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances)

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17 pages, 1136 KiB

Open AccessArticle

Level of Adherence to the Mediterranean Diet and Weight Status among Adolescent Female Gymnasts: A Cross-Sectional Study

by Ioanna Kontele, Maria G. Grammatikopoulou and Tonia Vassilakou

Children 2021, 8(12), 1135; https://0-doi-org.brum.beds.ac.uk/10.3390/children8121135 - 04 Dec 2021

Cited by 7 | Viewed by 3249

Abstract

Adolescent female gymnasts are a vulnerable population in terms of their diet, as their nutritional needs are higher due to their growth and high daily training demands. The Mediterranean diet (MD) is a well-known dietary pattern that is associated with a greater nutritional adequacy and a lower prevalence of overweight. The aim of this cross-sectional study was to evaluate the degree of adherence to the MD among adolescent female athletes who participated in all disciplines of gymnastics in Greece, as well as to explore the potential correlations between MD adherence, body weight, and body mass index (BMI). A total of 269 female gymnasts (between 11–18 years old) completed the Mediterranean Diet Quality Index (KIDMED) and reported their weight and height. Approximately 10% of the participants were underweight and a mere 5.6% were classified as overweight. A high adherence to the MD was reported by 34.9% of the sample and this was correlated with a healthier BMI. Moreover, specific eating habits, such as eating nuts 2–3 times per week and eating fast-food less than once-weekly, were also associated with BMI. Athletes, parents, and coaches of gymnastics should be informed and educated regarding balanced nutrition habits. Future studies could evaluate adherence to MD, as well as the factors that influence the eating behaviors of adolescent female and male athletes in various sports. Full article

(This article belongs to the Special Issue Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances)

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11 pages, 507 KiB

Open AccessArticle

Effectiveness and Coverage of Treatment for Severe Acute Malnutrition Delivered by Community Health Workers in the Guidimakha Region, Mauritania

by Pilar Charle-Cuéllar, Noemí Lopez-Ejeda, Hassane Toukou Souleymane, Diagana Yacouba, Moussa Diagana, Abdias Ogobara Dougnon, Antonio Vargas and André Briend

Children 2021, 8(12), 1132; https://0-doi-org.brum.beds.ac.uk/10.3390/children8121132 - 04 Dec 2021

Cited by 7 | Viewed by 2703

Abstract

Geographical and economic access barriers to health facilities (HF) have been identified as some of the most important causes of the low coverage of severe acute malnutrition (SAM) treatment. The objective of this study is to assess the effectiveness and coverage of SAM treatment delivered by community health workers (CHWs) in the Guidimakha region in Mauritania, compared to the HF based approach. This study was a nonrandomized controlled trial, including two rural areas. The control group received outpatient treatment for uncomplicated SAM from HF, whilst the intervention group received outpatient treatment for uncomplicated SAM from HF or CHWs. A total of 869 children aged 6–59 months with SAM without medical complications were included in the study. The proportion of cured children was 82.3% in the control group, and 76.4% in the intervention group, we found no significant difference between the groups. Coverage in the intervention zone increased from 53.6% to 71.7%. In contrast, coverage remained at approximately 44% in the control zone from baseline to end-line. This study is the first to demonstrate in Mauritania that the decentralization model of CHWs treating SAM improves acute malnutrition treatment coverage and complies with the international quality standards for community treatment of acute malnutrition. The non-randomized study design may limit the quality of the evidence, but these results could be used by political decision-makers as a first step in revising the protocol for acute malnutrition management. Full article

(This article belongs to the Special Issue Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances)

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18 pages, 578 KiB

Open AccessArticle

The Effect of a Fat-Restricted Diet in Four Patients with Familial Chylomicronemia Syndrome: A Long-Term Follow-Up Study

by Alexandra Thajer, Gabriele Skacel, Charlotte de Gier and Susanne Greber-Platzer

Children 2021, 8(11), 1078; https://0-doi-org.brum.beds.ac.uk/10.3390/children8111078 - 22 Nov 2021

Cited by 3 | Viewed by 2103

Abstract

(1) Background: Familial chylomicronemia syndrome (FCS) is a very rare autosomal recessive disorder characterized by severely elevated triglycerides and clinical symptoms in early childhood mainly presenting with abdominal pain, acute pancreatitis and hepatosplenomegaly. Primary treatment is a lifelong very strict low-fat diet, which might be challenging in pediatric patients. So far, data about children with FCS are rare. The aim of this study was to show the familial chylomicronemia syndrome traffic light table for pediatric patients and to assess the dietary fat intake and impact on triglycerides in children with FCS. (2) Methods: We performed a retrospective analysis in four children (50% male) affected by FCS from the Department of Pediatrics and Adolescent Medicine, Medical University of Vienna between January 2002 and September 2020. (3) Results: The four patients presented with classical FCS symptoms and showed baseline triglycerides (TG) exceeding 30,000 mg/dL in two patients, 10,000 mg/dL and 2400 mg/dL in one patient each. After diagnosis, fat percentage of total daily caloric intake was decreased and resulted immediately in triglyceride reduction. In all patients, FCS was genetically confirmed by mutations in genes encoding lipoprotein lipase. Acute pancreatitis and hepatosplenomegaly disappeared under the fat-restricted diet. A FCS traffic light table was developed as a dietary tool for affected families. (4) Conclusions: A restriction of dietary fat between 10% to 26% of the total daily caloric intake was feasible and effective in the long-term treatment of genetically confirmed FCS in children and could reduce the risk for acute pancreatitis. The dietary tool, the pediatric FCS traffic light table and the age-appropriate portion sizes for patients between 1 to 18 years, supports children and their parents to achieve and adhere to the lifelong strict low-fat diet. Full article

(This article belongs to the Special Issue Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances)

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12 pages, 1005 KiB

Open AccessArticle

Dietary Patterns, Weight Perception and Obesity Status, among 10–12-Year-Old Children; an Epidemiological Study in Greece

by Aikaterini Kanellopoulou, Rena I. Kosti, Venetia Notara, George Antonogeorgos, Andrea Paola Rojas-Gil, Ekaterina N. Kornilaki, Areti Lagiou, Mary Yannakoulia and Demosthenes B. Panagiotakos

Children 2021, 8(8), 626; https://0-doi-org.brum.beds.ac.uk/10.3390/children8080626 - 23 Jul 2021

Cited by 7 | Viewed by 1881

Abstract

Adherence to certain dietary patterns influences obesity status in both children and adults. Weight perception influences dietary habits. The aim of this study was to examine children’s dietary habits and obesity status, in relation to weight perception. One thousand seven hundred Greek students enrolled in this study during 2014–2016. Children’s characteristics were assessed through validated questionnaires, and weight status was classified according to the criteria of the International Obesity Task Force. Dietary patterns were assessed through exploratory factor analysis. Overall, 52.2% of children characterized themselves as normal weight, 34.5% as low weight, and 13.3% as overweight/obese; 52.5% of children were in accordance with their actual weight status, with girls being more likely to overestimate their weight. Children followed three dietary patterns, i.e., starchy and protein foods, unhealthy/high-fat foods, and healthy foods. Children who followed the healthy dietary pattern and had accurate weight perception (in accordance with their actual weight), had lower odds of being overweight/obese (p < 0.001). Accurate weight perception in conjunction with healthy dietary habits may play a determinant role in the prevention of obesity. From a public health perspective, early identification of children’s weight misperception along with healthy dietary habit promotion shape a crucial role in childhood obesity confrontation. Full article

(This article belongs to the Special Issue Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances)

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Review

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25 pages, 492 KiB

Open AccessReview

Food Allergies and Quality of Life among School-Aged Children and Adolescents: A Systematic Review

by Artemis-Eirini Drakouli, Ioanna Kontele, Dimitrios Poulimeneas, Stella Saripanagiotou, Maria G. Grammatikopoulou, Theodoros N. Sergentanis and Tonia Vassilakou

Children 2023, 10(3), 433; https://0-doi-org.brum.beds.ac.uk/10.3390/children10030433 - 23 Feb 2023

Cited by 4 | Viewed by 2373

Abstract

Recently, besides the focus on the medical diagnosis and therapeutic interventions for food allergy (FA), the psychosocial aspects of this frequent condition have also been investigated. The current systematic review aimed to explore and synthesize the scientific evidence published from January 2015 to April 2022 on Health-Related Quality of Life (HRQoL) among children and adolescents with FAs. Twenty-eight research studies were included in the review, which was conducted on three databases (PubMed, Scopus and Cochrane Library). In most studies, the scores indicate an average level of HRQoL for children and adolescents with FAs, with girls and older children being more negatively affected than boys and younger ones, respectively. Few studies compared HRQoL between children with FA and healthy children, with 3 of them showing worse HRQoL for children with FAs. Immunotherapy has been found to improve the QoL of children with FAs. Anaphylaxis history, number of FAs, additional allergies, number and severity of symptoms were identified as the main factors with a negative impact on QoL. More comparative studies on the HRQoL of children and adolescents with FAs and healthy populations or children with other chronic diseases are required in order to improve QoL of children with FAs. Full article

(This article belongs to the Special Issue Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances)

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31 pages, 848 KiB

Open AccessReview

Nutritional Aspects of Juvenile Idiopathic Arthritis: An A to Z for Dietitians

by Maria G. Grammatikopoulou, Konstantinos Gkiouras, Vasiliki Syrmou, Tonia Vassilakou, Theodora Simopoulou, Chistina G. Katsiari, Dimitrios G. Goulis and Dimitrios P. Bogdanos

Children 2023, 10(2), 203; https://0-doi-org.brum.beds.ac.uk/10.3390/children10020203 - 23 Jan 2023

Viewed by 3738

Abstract

Juvenile idiopathic arthritis (JIA) represents a chronic, autoimmune, rheumatic musculoskeletal disease with a diagnosis before 16 years of age. Chronic arthritis is a common manifestation in all JIA subtypes. The nature of JIA, in combination to its therapy often results in the development of nutrition-, gastrointestinal (GI)- or metabolic-related issues. The most-common therapy-related nutritional issues involve methotrexate (MTX) and glucocorticosteroids (GCC) adverse events. MTX is a folic acid antagonist, thus supplementation with folic acid in required for improving GI side effects and correcting low serum levels. On the other hand, long-term GCC administration is often associated with hyperglycemia, insulin resistance and growth delay. This relationship is further aggravated when more joints are affected and greater doses of GCC are being administered. Apart from stature, body mass index z-scores are also suboptimal in JIA. Other signs of malnutrition include decreased phase angle and muscle mass, especially among patients with polyarthritis JIA. Evidence also points to the existence of an inverse relationship between disease activity and overweight/obesity. Specific dietary patterns, including the anti-inflammatory diet, might confer improvements in selected JIA outcomes, but the level of available research is yet insufficient to draw safe conclusions. The majority of patients exhibit suboptimal vitamin D status; hence, supplementation is recommended. Collectively, the evidence indicates that, due to the age of onset and the complexity of the disease, along with its pharmacotherapy, children with JIA are prone to the development of several nutritional problems, warranting expert monitoring. Vitamin deficiencies, oral and GI-problems limiting dietary intake, faltering growth, overweight and obesity, physical inactivity, or impaired bone health are among the many nutritional issues in JIA requiring dietitian support. Full article

(This article belongs to the Special Issue Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances)

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17 pages, 1885 KiB

Open AccessEditor’s ChoiceReview

Burden of Childhood Malnutrition: A Roadmap of Global and European Policies Promoting Healthy Nutrition for Infants and Young Children

by Marianthi Sotiraki, Aggeliki Malliou, Ntaniela Tachirai, Nikoletta Kellari, Maria G. Grammatikopoulou, Theodoros N. Sergentanis and Tonia Vassilakou

Children 2022, 9(8), 1179; https://0-doi-org.brum.beds.ac.uk/10.3390/children9081179 - 06 Aug 2022

Cited by 7 | Viewed by 5561

Abstract

Childhood malnutrition is a global epidemic with significant public health ramifications. The alarming increase in childhood obesity rates, in conjunction with the COVID-19 pandemic, pose major challenges. The present review aims to critically discuss policies and action plans promoting healthy nutrition among infants and children, globally. Since the Convention on the Rights of the Child in 1989 and the joint consortium held by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) that led to the “Ten Steps to Successful Breastfeeding”, several policymakers and scientific societies have produced relevant reports. Today, the WHO and UNICEF remain the key players on the field, elaborating the guidelines shaped by international expert teams over time, but we still have a long way to go before assuring the health of our children. Full article

(This article belongs to the Special Issue Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances)

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12 pages, 288 KiB

Open AccessReview

Eating Disorders and Disordered Eating Behaviors in Cystic Fibrosis: A Neglected Issue

by Anastasia Petropoulou, Georgia Bakounaki, Maria G. Grammatikopoulou, Dimitrios P. Bogdanos, Dimitrios G. Goulis and Tonia Vassilakou

Children 2022, 9(6), 915; https://0-doi-org.brum.beds.ac.uk/10.3390/children9060915 - 18 Jun 2022

Cited by 4 | Viewed by 3014

Abstract

As with the majority of chronic diseases having specific nutrition recommendations, in cystic fibrosis (CF), the emphasis placed on patients regarding their diet and ideal body weight status often increases the risk of developing disordered eating behaviors and by inference, eating disorders (EDs). Body weight appears to be an important concern for patients with CF, with many patients struggling to lose weight. Between sexes, women appear more preoccupied with dieting compared to men, but exhibit a better body image, mainly due to their preference for a lower weight. Several comorbidities appear to change these dynamics, and visibly apparent factors, including scars, ports, and tubes, and the need for supplementary oxygen supply, may also influence body image perception. Disordered eating is usually initiated during a bout of pulmonary infection, with the patient feeling unwell to eat. Regarding the prevalence of EDs, research appears conflicting on whether it is higher among individuals with a CF diagnosis or not. As for comorbidities, anxiety and depression consist of the most common psychiatric diagnoses in CF, also greatly prevalent in EDs. Despite the plethora of studies, non-specific CF tools, small samples, and lack of data regarding important outcomes, including lung health, indicate the need for more research. Full article

(This article belongs to the Special Issue Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances)

Other

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10 pages, 784 KiB

Open AccessCase Report

The Synergistic Effects of a Complementary Physiotherapeutic Scheme in the Psychological and Nutritional Treatment in a Teenage Girl with Type 1 Diabetes Mellitus, Anxiety Disorder and Anorexia Nervosa

by Pelagia Tsakona, Vaios Dafoulis, Anastasios Vamvakis, Konstantina Kosta, Styliani Mina, Ioannis Kitsatis, Alexandra Hristara-Papadopoulou, Emmanuel Roilides and Kyriaki Tsiroukidou

Children 2021, 8(6), 443; https://0-doi-org.brum.beds.ac.uk/10.3390/children8060443 - 25 May 2021

Cited by 1 | Viewed by 3284

Abstract

Type 1 diabetes mellitus (T1DM) is a chronic disease that can affect the physical and mental health of children and adolescents, often leading to anxiety disorders with chronic activation of the hypothalamic axis (HPA). Moreover, a great proportion of adolescents with T1DM also demonstrate anorexia nervosa (AN), due to the increased preoccupation with food and the need to have an acceptable body image. Herein is described the first case study of an adolescent patient diagnosed with T1DM, anxiety disorder (AD), and AN. A 14-year-old girl with T1DM since the age of 12 years presented weight loss at age 13 years and 3 months and low body mass index (BMI), which did not improve despite dietary recommendations and adequate disease control. Additionally, she presented menstrual disorders at the age of 12 years and 11 months (menstrual age 12 years and 1 month). A psychological evaluation of the teenager was conducted using a semi-structured interview that assessed perceived stress, health status, quality of life, and depression. AD and AN were diagnosed and the patient initiated an intervention focusing on psychological health and nutrition and which incorporated physiotherapeutic relaxation sessions and breathing exercises. After 3 months of treatment, the patient’s BMI was increased, and a normal menstrual cycle was apparent. These results have since remained consistent. Stress leads to the appearance of AN and menstrual disorders. Therefore, physiotherapeutic programs could reduce stress and effectively ameliorate AN and AD. Full article

(This article belongs to the Special Issue Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances)

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