The aim of this study was to evaluate rates of clinical remission, endoscopic remission, and mucosal healing after a 6-week treatment period with partial enteral nutrition (PEN) and to compare them ...to those obtained by standard exclusive enteral nutrition (EEN) treatment in children with active Crohn’s disease (CD). Twenty-five patients with active CD (median age 13.6 years, range 3.6–18.0) were recruited to either PEN (
n
= 12) or EEN (
n
= 13) treatment groups. The PEN group received 75% of their dietary needs from a polymeric formula plus one meal per day from an anti-inflammatory diet (AID). Patients were assessed at weeks 0, 1, 3, and 6 using clinical and laboratory parameters. Endoscopic assessment was performed at induction and week 6. On intention to treat analysis, clinical remission (Pediatric CD Activity Index < 10) was achieved in 69.2% and 75.0% of EEN and PEN patients, respectively (
p =
0.999). The endoscopic remission (Simple Endoscopic Score for CD (SES-CD) ≤ 2) rates were 45.5% in both groups, while mucosal healing rates (SES-CD = 0) were 45.5% with EEN and 27.3% with PEN (
p =
0.659).
Conclusion
: The results of our prospective pilot study suggest that PEN, allowing one meal from AID, could be as effective as EEN in inducing clinical and endoscopic remission in children with active CD. However, larger randomized controlled studies are warranted to confirm our findings.
Trial registration
: This clinical trial was registered under the number
ClinicalTrials.gov
identifier: NCT03176875
.
What is Known
:
•
Exclusive enteral nutrition is a first-line treatment in active pediatric Crohn’s disease; however, patients often find it difficult to adhere to
.
•
Exclusive enteral nutrition is more effective than corticosteroids in achieving mucosal healing.
What is New
:
•
This is the first prospective study on partial enteral nutrition in active pediatric Crohn’s disease, evaluating not only clinical, but also endoscopic remission
.
•
A novel approach of partial enteral nutrition that allows one meal per day from an anti-inflammatory diet was as effective as exclusive enteral nutrition in inducing clinical and endoscopic remission in active Crohn’s disease
.
Background: Partial enteral nutrition (PEN) coupled with the Crohn’s disease (CD) exclusion diet (CDED) was shown to be effective in inducing clinical remission in paediatric CD. There are currently ...no robust data on the endoscopic outcomes of PEN. The aim of this study was to evaluate the clinical and endoscopic rates of remission after PEN combined with a modified CDED (mCDED) adjusted to the local cuisine in comparison with exclusive enteral nutrition (EEN) for the induction of remission. Methods: Between June 2017 and February 2021, a prospective cohort study on children with active CD, treated with PEN + mCDED or EEN, was performed at a single tertiary centre. Results: During the study period, 54 patients were screened and 15 were excluded according to the exclusion criteria, with six patients excluded in the first two days due to intolerance of the enteral formula. Fourteen patients were included in the PEN and 19 in the EEN group. They were assessed at Weeks 0, 1, 3 and 6, using clinical and laboratory parameters. Endoscopy was performed at Weeks 0 and 6. Clinical remission rates per protocol analysis were 84.6% in the PEN group and 81.3% in the EEN group (p = 0.99). At Week 6, an endoscopic response (a decline in the Simple Endoscopic Score for CD (SES-CD) > 50%) was observed in 84.6% of patients on PEN and in 68.8% on EEN treatment (p = 0.41). Endoscopic remission (SES-CD ≤ 2) was achieved in 53.8% of patients in the PEN group and in 50.0% in the EEN group (p = 0.99), while the mucosal healing rates (SES-CD = 0) were 38.5% with PEN and 43.8% with EEN (p = 0.99). A significant decline in the clinical and endoscopic activity scores was observed in both groups. Conclusion: Our study suggests that PEN + mCDED could be effective in inducing endoscopic remission and mucosal healing in active paediatric CD patients. Here, we present an analysis of the data from our cohort of patients and our real-world experience with PEN + mCDED.
Sources of vitamin D for humans Benedik, Evgen
International journal for vitamin and nutrition research,
03/2022, Letnik:
92, Številka:
2
Journal Article
Recenzirano
Both vitamin D insufficiency and deficiency are now well-documented worldwide in relation to human health, and this has raised interest in vitamin D research. The aim of this article is therefore to ...review the literature on sources of vitamin D. It can be endogenously synthesised under ultraviolet B radiation in the skin, or ingested through dietary supplements and dietary sources, which include food of animal and plant origin, as well as fortified foods. Vitamin D is mainly found in two forms, D
(cholecalciferol) and D
(ergocalciferol). In addition to the D
and D
forms of vitamin D, 25-hydroxy vitamin D also contributes significantly to dietary vitamin D intake. It is found in many animal-derived products. Fortified food can contain D
or D
forms or vitamin D metabolite 25-hydroxy vitamin D. Not many foods are a rich source (> 4 μg/100 g) of vitamin D (D represents D
and/or D
), e.g., many but not all fish (5-25 μg/100 g), mushrooms (21.1-58.7 μg/100 g), Reindeer lichen (87 μg/100 g) and fish liver oils (250 μg/100 g). Other dietary sources are cheese, beef liver and eggs (1.3-2.9 μg/100 g), dark chocolate (4 μg/100 g), as well as fortified foods (milk, yoghurt, fat spreads, orange juice, breakfast grains, plant-based beverages). Since an adequate intake of vitamin D (15 μg/day set by the European Food Safety Authority) is hard to achieve through diet alone, dietary supplements of vitamin D are usually recommended. This review summarizes current knowledge about different sources of vitamin D for humans.
BackgroundRapid weight loss (RWL) followed by rapid weight gain (RWG) is a regular pre-competition routine in combat sports and weightlifting. With the prevalence of these sports exceeding 20% at the ...2020 Tokyo Olympics, there are limited data on RWL and RWG practices and their impact on well-being and competitive success in elite-level athletes. MethodsA total of 138 elite-level female and male judokas, 7.7% of the athletes ranked as top 150 on the International Judo Federation Senior World Ranking List (WRL), completed a survey on RWL, RWG, and the consequences of these practices. ResultsOur findings showed that 96% of the respondents practice RWL. The average reduced body mass percentage was 5.8 ± 2.3%. Respondents who used either of the dehydration methods - fluid restriction, sauna suit, and/or sauna/hot bath - to reduce weight were 88%, 85%, and 76%, respectively. Furthermore, 91% of the respondents reported reduced energy as a negative consequence of RWL and 21% experienced a collapse episode during the RWL period. Respondents ranked 1-20 on the WRL experienced fewer negative consequences of RWL and RWG (p = 0.002) and had more dietitian and/or medical doctor support (p = 0.040) than lower-ranked respondents. Those who started with RWL practices before the age of 16 (38%) were ranked lower on the WRL (p = 0.004) and reported more negative consequences of RWL and RWG (p = 0.014). ConclusionsThis study is the first to provide insight into the RWL practices of worldwide elite-level judokas and provides valuable information for the combat sports society, especially coaches. Proper weight management and optimal timed initiation of RWL practices in a judoka's career may contribute to success at the elite level.
UŽIVANJE ALKOHOLA MED NOSEČNOSTJO Kranjc, Kaja; Lipovec, Neža; Benedik, Evgen
Slovenska pediatrija,
04/2023, Letnik:
30, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Slovenija se glede količine popitega alkohola uvršča v vrh evropskih držav. Pitje alkoholnih pijač je del slovenske kulture, družbeno vezivo, neobhodni sestavni del družabnih dogodkov in praznovanj. ...Uživanje alkohola pogosto preseže mejo manj tveganega pitja in tako predstavlja pomembno tveganje zdravstvenih težav in blagostanja posameznika, njegove družine ter ožje in širše okolice. Etanol deluje opojno, škodljivo in povzroča zasvojenost, vse več pa ga uživajo tudi mladi odrasli (25–34 let), pri katerih je najvišja tudi rodnost. Uživanje etanola med nosečnostjo škodljivo vpliva na otroka ter lahko povzroči resne in nepopravljive posledice, ki jih poznamo kot spekter fetalnih alkoholnih motenj. Varne količine alkoholnih pijač in obdobja v nosečnosti, ko uživanje alkohola ne bi pomenilo tveganja za otroka, ne poznamo, zato v Sloveniji velja priporočilo, da se nosečnice uživanja alkoholnih pijač povsem vzdržijo.
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.
