Ukrepe, povezane s prehransko podporo pediatričnih bolnikov, ki so imeli presajen organ, kostni mozeg oz. krvotvorne matične celice, izvajamo zaradi preprečevanja okužb ob imunosupresivni terapiji ...ter za hitrejše okrevanje po posegu. Pri otrocih na imunosupresivni terapiji predstavljajo visoko tveganje za okužbo tudi nekatera živila. Tipični primeri živil z visokim tveganjem za okužbo so surova in toplotno neobdelana živila. Zaradi teh prehranskih omejitev je potrebno nameniti posebno pozornost vzdrževanju ustreznega prehranskega stanja. Pomembno je, da zagotovimo vsa potrebna hranila in energijo za rast in razvoj otroka, kar prispeva tudi k hitrejšemu okrevanju po presaditvi. Zato je ključnega pomena, da ustrezno izobražujemo zdravstveno osebje, kuhinjsko osebje in starše o ustrezni higieni, varnem ravnanju z živili z visokim tveganjem in ustrezni pripravi hrane na podlagi obstoječih smernic za mikrobiološko varnost živil.
Sindrom Prader-Willi (PWS) je kompleksna genetska motnja, ki je posledica pomanjkljivega izražanja genov na kromosomski regiji 15q, za katero so značilne hipotonija, težave s hranjenjem in ...čustveno-vedenjske težave. Celostna obravnava vključuje somatsko zdravljenje z nadomeščanjem rastnega hormona kot tudi z drugim medikamentnim zdravljenjem npr. zdravljenje depresije, motnje pozornosti, psihoze. Poleg tega pa so ključnega pomena nemedikamentni ukrepi: dietetična in fiziatrična obravnava ter opremljenost z medicinskimi pripomočki in vedenjske strategije. V prispevku prikazujemo celostno obravnavo otrok s sindromom Prader-Willi, kot se izvaja v Centru za izobraževanje, rehabilitacijo in usposabljanje CIRIUS Kamnik od vstopa v šolo do končanega šolanja oziroma do dopolnjenega 26. leta starosti. Predstavimo kohorto otrok z genetsko potrjenim PWS (starost 11.4 ± 3.1 let, od tega 4 fantje in 1 dekle) in način zdravstvene obravnave v naši ustanovi s spremljanjem pri dietetiku, merjenjem telesne sestave (z elektronskim analizatorjem BIVA) in z individualnimi prehranskimi ukrepi, s fiziatrično obravnavo s predpisovanjemm medicinskih pripomočkov in psihološko obravnavo, kar vse prispeva k njihovi boljši funkcionalnosti in obvladovanju stanja. Na prikazu primerov so predstavljeni tudi praktični napotki, kako ravnati v specifičnih vedenjskih situacijah.
V prispevku predstavljamo priporočila za prehransko obrav-navo kronično bolnih otrok in mladostnikov. Kronične bolezni so bolezni, ki trajajo dlje časa in pogosto omejujejo vsakodnevno življenje. ...Povečajo lahko tveganje za zao-stanek v rasti in razvoju ter vplivajo na telesno, duševno in družbeno življenje otrok in mladostnikov oziroma celotne družine. Zato sta odločilna njihova celostna obravnava in multidisciplinarni tim, v katerem ima pomembno vlogo kli-nični dietetik. Z zgodnjim odkrivanjem prehransko ogroženih pediatričnih bolnikov in ustrezno prehransko oskrbo ter rednim spremljanjem lahko pomembno vplivamo na njihovo zdravje in na kakovost življenja celotne družine. V prispevku predstavljamo najpogostejše kronične bolezni in stanja v pediatrični populaciji, pri katerih je prehranska obravnava izjemno pomembna. To so kronične vnetne črevesne bolezni, alergije na hrano, prirojene presnovne bolezni, motnje avtističnega spektra, cistična fibroza, rak in cerebralna paraliza.
Abstract In Slovenia, table salt iodization has been applied to combat iodine deficiency. Recently, we found that Slovenian adolescents attained iodine sufficiency (median urinary iodine ...concentration was 140 μ g/L; prevalence of goiter was <1%). National data indicate that salt intake of Slovenian population is too high (150% above the recommended limit); therefore, we hypothesized that sufficient iodine intake in adolescents can be primarily attributed to excessive salt intake. In a cross-sectional study, we investigated iodine and salt intake in Slovenian adolescents as well as the contributions of different foods to their intake. We determined the iodine and salt intake of a national representative sample of 2581 adolescents, aged 14 to 17 years, using the Food Frequency Questionnaire (FFQ). The FFQ covered habitual diets over the past year, and 2485 (96%) adolescents completed a valid FFQ (1370 girls, 1115 boys). The iodine intake was 189.7 ± 2.6 μ g/d (mean ± standard error of mean), well above the recommended 150 μ g/d ( P < .001). Table salt was by far the biggest dietary source of iodine and sodium for both sexes. Total salt intake (mean ± standard error of mean, 10.4 ± 0.2 g/d) significantly exceeded the upper World Health Organization limit (<5 g/d, P < .001), especially in boys (11.5 ± 0.3 vs 9.4 ± 0.2 g/d in girls, P < .001). The main food sources of salt were table salt (33%), bread (24%), salty snack products (10%), meat products (8%), fish products (6%), and milk (4%). Salt intake from foods, excluding table salt, was 6.9 g/d (67% of total salt intake). We conclude that although Slovenian adolescents are iodine sufficient, their salt intake, especially among boys, is too high. Several nutritional interventions are proposed to reduce total salt intake while ensuring adequate iodine intake.
Iodine intake of Slovenian adolescents Stimec, M; Mis, N.F; Smole, K ...
Annals of nutrition and metabolism,
01/2007, Letnik:
51, Številka:
5
Journal Article
Recenzirano
Background: Slovenia is classified as being iodine-deficient. We recently found that Slovenian adolescents are iodine-sufficient (median urinary iodine concentration of the population 140 µg/l) and ...the prevalence of goiter is low (0.9%). The objective of this study was to evaluate iodine intake, the prevalence of marginal, low and excessive intake (<50, 50–100 and ≧300 µg/day), as well as the main sources of iodine in the diet of Slovenian adolescents. Methods: A cross-sectional study included 2,581 adolescents (1,415 girls, 1,166 boys, mean age ± SD 15.6 ± 0.5 years) representing 10% of 15-year-old Slovenian adolescents. Iodine intake was determined using a food frequency questionnaire (FFQ) in the whole population studied (n = 2,485) and weighted 3-day dietary protocols (3DPs) in a subgroup of participants (n = 191). Results: Median iodine intake determined from FFQ was 155.8 µg/day. There was no significant difference between genders. Marginal, low and excessive iodine intake was observed in 3.3, 20.3 and 11.3% of the adolescents, respectively. The major food sources of dietary iodine included table salt (39 % of the mean daily iodine intake), beverages (22%) and milk/milk products (19%). Conclusions: Dietary iodine intake in Slovenian adolescents is adequate, illustrating the effective salt iodization program.
This paper provides recommendations for the nutritional management of children with chronic illnesses. Chronic diseases last for a long time and often substantially decrease the quality of life. They ...can increase the risk of stunting and affect the physical, mental and social life of children and adolescents and the whole family. Multidisciplinary team should treat this group of children in which the clinical dietitian plays an important role. Early identification of paediatric patients at risk, appropriate nutritional care and regular follow-up can have a significant impact on their health and the quality of life. This article presents some of the most common chronic diseases in the paediatric population for which nutritional management is of utmost importance. These include inflammatory bowel disease, food allergies, inborn errors of metabolism, autism spectrum disorders, cystic fibrosis, cancer and cerebral palsy.
