Children's Composition Research Articles

Instrument Validity Tests With Causal Forests

Assumptions that are sufficient to identify local average treatment effects (LATEs) generate necessary conditions that allow instrument validity to be refuted. The degree to which instrument validity is violated, however, probably varies across subpopulations. In this article, we use causal forests to search and test for such local violations of the LATE assumptions in a data-driven way. Unlike previous instrument validity tests, our procedure is able to detect local violations. We evaluate the performance of our procedure in simulations and apply it in two different settings: parental preferences for mixed-sex composition of children and the Vietnam draft lottery.

Assessment of the content of toxic and essential elements in the urine of children residing in rural and industrial regions in Western Urals

Introduction. The element composition of urine is relevant and demanded index in biomedical, biomonitoring studies to assess the level of contamination of biological media and public health risks. Material and methods. The content of 12 elements (V, Cr, Mn, Ni, Cu, Zn, As, Se, Sr, Cd, Tl, Pb) in urine of unexposed children (n = 100 and n = 57, respectively, average age < 6 years) residing in the rural and industrial region of the Western Urals was determined by ICP-MS using Agilent 7500cx inductively coupled plasma quadrupole mass spectrometer (Agilent Technologies, USA) with an octopole reaction / collision cell (ORS). The measurement was carried out according to Methodical Guidelines 4.1. 3230-14 (FR.1.31.2014.17064) developed by the authors. Urine samples were directly analyzed after 1/10 dilution (V / V) with 1% nitric acid solution. The validity of the results was confirmed by analysis of standard urine samples SERONORMTM urine (Norway). The results were presented as basic statistical indices: minimum and maximum values, arithmetic mean (AM), geometric mean (GM), 5th, 50th, 95th percentiles, and were interpreted in accordance with current international requirements. Results. In the unexposed group of children the arithmetic mean (AM) for vanadium is 0.68 μ/l; chromium - 1.91 μg/l; manganese 0.96 - μg/l; nickel - 1.84 μg/l; copper - 13.28 μg/l; zinc - 270.56 μg/l; arsenic - 18.- 99 μg/l; selenium - 22.55 μg/l; strontium - 239.09 μg/l; cadmium - 0.12 μg/l; thallium - 0.16 μg/l; lead - 0.83 μg/l. The arithmetic mean in the group of children of the industrial territory for vanadium is - 0.72 μg/l; chromium - 2.13 μg/l; manganese - 1.11 μg/l; nickel - 2.76 μg/l; copper - 26.67 μg/l; zinc - 482.1 μg/l; arsenic - 10.09 μg/l; selenium - 32.84 μg/l; strontium - 1275.35 μg/l; cadmium - 0.122 μg/l; thallium - 0.16 μg/l; lead - 2.16 μg/l. Evaluation of the results of the study showed AM excess of nickel, copper, zinc, strontium and lead. Conclusion. The paper presents regional features of the urine elemental composition in children who permanently reside in Western Urals’ rural and industrial areas. The study results based on the 95 percentile (P95) can be used as approximate reference data as a basis for assessing the risk associated with exposure to metals. The comparative evaluation of the obtained results with the reference concentrations used in Europe, the USA and Canada for national human biomonitoring programs was carried out.

Determination of Body Fat Ratio Standards in Children at Early School Age Using Bioelectric Impedance.

Background and objectives: Body mass index (BMI) is commonly used to assess the proportionality of body mass; however, there are currently no standards for assessing the weight status of the child population for the needs of epidemiological studies. This study aims to establish bioelectric impedance analysis (BIA) standards for assessing the body weight of children (body fat, visceral fat) using BMI percentile growth charts. Materials and Methods: The study was implemented in a group of 1674 children (816 boys and 858 girls), ages 6 to 11. To classify the subjects at a percentile level, the percentile growth charts from the 6th national anthropological study in the Czech Republic were used. Body composition parameters were ascertained by BIA. Results: Body fat (%) and visceral fat standard values were determined for all age categories. The standards were in three-stages, enabling the determination of underweight, normal weight and overweight children aged 6–11 years. For boys with proportionate body mass, standard body fat values ranging from 14.3–16.0% to 15.5–18.0% were determined, while for girls’ values ranging from 16.7–19.4% to 18.3–20.5% were determined, depending on age. As far as visceral fat is concerned, standard values in boys ranging from 30.3–36.9 cm2 to 36.1–44.9 cm2 and in girls 30.3–36.9 cm2 to 36.1–44.9 cm2 were determined, depending on age. Conclusions: Standards for assessing weight status are applicable to children aged 6–11 years, while it can be confirmed that BMI can be considered as an objective tool in assessing body mass and body composition in children.

Circulating insulin-like growth factor-1 is positively associated with growth and cognition in 6- to 9-year-old schoolchildren from Ghana

There is increasing evidence that dairy milk positively affects linear growth, weight and body composition in children, particularly in low- and middle-income countries (1)(2). This effect of milk on growth has been proposed to be mediated by IGF-I (2), (3). The aim of this double-blinded, controlled trial was to evaluate the effect of milk supplements on circulating IGF-I and to assess IGF-I as a correlate of growth and cognition in children. The study enrolled 261 healthy children (median age 6–9 years) from 13 schools in Ghana. They were divided into 3 groups on the basis of milk intake (Milk8 = 8.8 g milk protein; Milk/Rice = 4.4 g milk + 4.4 g rice protein; Milk4 = 4.4 g milk protein) and control children who received a powder containing multiple micronutrients. Auxology, body composition (assessed by bioelectric impedance analysis), IGF-I and free amino acids (analyzed by dried blood spots at 3.5 and 8.5 months) and cognitive function (Cambridge Neuropsychological Test Automated Battery-CANTAB) were measured. Only Milk8 group showed a statistically significant increase in IGF-I compared to control subjects (+15.3; 95% CI: 9.4, 31.2). During the intervention, IGF-I increased more in girls than in boys. The change in IGF-I levels was positively associated with changes in amino acids (valine, leucine, Amino-butyric acid, Threonine, Trytophan), height, weight, fat free mass and 4 of 5 CANTAB domains.

Gut microbiota composition in children with obstructive sleep apnoea syndrome: a pilot study

BackgroundObstructive Sleep Apnoea syndrome (OSAS) is considered a systemic inflammatory disease and is characterized by intermittent hypoxia that can damage the integrity of intestinal barrier and alter gut microbiota composition in adults and animal models. To date there is only one study on snoring children and microbiota but no studies are present on paediatric OSAS related dysbiosis. Study objectivesTo evaluate gut microbiota composition in OSAS children in respect to healthy subjects and investigate the role of sleep parameters in changing gut microbiome. MethodsSixteen children divided in OSAS and healthy groups. Stool samples were collected from both the two groups to assess gut microbiota composition using 16S rRNA sequencing and a nocturnal pulsossimetry and polysomnography were performed in OSAS children. ResultsOSAS children showed a decreased microbial diversity in respect to healthy subjects in terms of number of observed species and Chao1 index (p = 0,01). Firmicutes/Bacteroidetes ratio was directly correlated to Sleep Clinical Record (p = 0,03). The abundance of several inflammation-related strains (Proteobacteria, Clostridiaceae, Oscillospiraceae, Klebsiella) were found significantly modified in relation to sleep parameters. Bacteria implied in the gut barrier integrity (Desulfovibrionaceae, Bacteroides fragilis and Faecalibacterium prausnitzii) were found significantly different in the two study groups and correlated with sleep parameters. ConclusionsOSAS children showed a lower microbiota diversity in respect to heathy subjects and an increase of inflammation and gut barrier disruptors-related strains probably induced by intermittent hypoxia. Further studies should be conducted to understand the role of gut microbiota in OSAS physiopathology and comorbidities in children.

Evaluation of the body adiposity index against dual-energy X-ray absorptiometry for assessing body composition in children and adolescents.

It is important to clarify the association of lean and fat mass between children and adolescents considering the rising prevalence of overweight and obesity in this age group. The aim of this study was to verify the association between the body adiposity index (BAI) and dual-energy X-ray absorptiometry (DXA) methods for analyzing body composition, as well as analyzing the validity of BAI to verify the percentage of fat in children and adolescents. The sample was composed of 106 children and adolescents, 44 females (age: 11.5± 1.8 years) and 62 evils (13.6± 2.6 years). The body fat (%F) was measured using DXA and the doubly indirect BAI body fat estimation technique. The BAI and DXA estimates of %F were strongly correlated (boys: r=.71, P<.0001; girls: r=.72, P<.0001). The linear regression analyses showed that BAI is significant to estimate the %F in total sample (P<.0001). For boys, the %F analyzes performed by BAI and DXA did not show any differences when compared (P=.2). In addition, BAI pointed out a significant proportion bias for both sexes (P<.0001), which suggests its inefficiency in the analysis of %F. BAI and DXA correlate; however, there is low reliability and a high proportion bias for the analysis of %F by BAI.

Nutritional intake and body composition in children with inflammatory bowel disease

AbstractPurposeIn this study we assessed nutritional intake, body composition, and their relationship in patients with paediatric inflammatory bowel disease (IBD).MethodsWe conducted a longitudinal, prospective study of 38 patients' nutritional intake using 3-day food records (FR) and bioimpedance analysis of body composition. FR were evaluated by Nutricomp DietCAD software. Results were analysed with Microsoft Excel 2013 and IBM SPSS Statistics 22 software.ResultsPatients treated with biological and conventional therapy (CT) had a higher intake of vegetable protein and carbohydrate from starch than those treated earlier with exclusive enteral nutrition (EEN) in the remission phase (F = 5.926, F = 5.130, P &lt; 0.05). The former EEN group had a higher intake of iron compared to the other two groups (F = 3.967, P = 0.036). Protein intake and fat-free mass (FFM) had a significant positive correlation, while added sugar correlated with body fat mass (BFM) in the same way (R2 = 0.122, R2 = 0.169, P &lt; 0.05). Body-fat mass in patients of the biological therapy (BT) group overstepped the healthy median, and the FFM in the EEN group stayed under it.ConclusionsOur results confirm that it is essential to monitor body composition and not only measure body weight. Patients should be advised based on their body composition, therapy, and phase of the disease.

Validity of quantitative ultrasound and bioelectrical impedance analysis for measuring bone density and body composition in children.

Using dual X-ray absorptiometry (DXA) to assess body composition in children has limitations including expense, lack of portability, and exposure to radiation. The aims of this study were to examine: (1) validity of quantitative ultrasound (QUS) against DXA for measuring bone density and (2) the validity of in-built algorithm of bioelectrical impedance analysis (BIA) for measuring body composition in children (8-13 years) living in New Zealand. Total body less head (TBLH), bone mineral content (BMC), bone mineral density (BMD), and body composition were measured with DXA (QDR Discovery A, Hologic, USA); calcaneal BMD and stiffness index (SI) with QUS (Sahara QUS, Hologic, USA), and BIA on the InBody 230 (Biospace Ltd., Seoul, Korea). Relative validity was assessed using Pearson's and Lin's concordance correlation coefficients (CCC), and Bland-Altman plots. In 124 healthy children, positive correlations between QUS SI and DXA (BMC and BMD) were observed (range = 0.30-0.45, P < 0.01). Results from Lin's CCC test showed almost perfect correlations between BIA and DXA fat free mass (0.96), fat mass (0.92), and substantial correlation for percentage of fat mass (0.75) (P < 0.05). Although BIA results were not as accurate as DXA and DXA remains the gold standard method for clinical assessment, BIA can be an alternative method for investigating body composition among children in large cohort field studies. Calcaneal QUS and DXA are not interchangeable methods for measuring bone density in children similar to our study population.

Imaging of body composition in children.

Overweight and obesity in children and adolescents have become a worldwide public health concern with an ever-increasing prevalence. An excessive accumulation of intraabdominal fat tissue increases the risk of developing insulin resistance, diabetes, and cardiovascular diseases in adulthood. Body composition has a role in metabolism regulation in children and adolescents with differences between genders and age groups. Until recently, Air Displacement Plethysmography and Dual-energy X-ray Absorptiometry (DXA) have been the most common techniques used to assess body composition in children. Ultrasound (US) is an accurate, readily available, and radiation-free technique to quantify intra-abdominal fat in adults, but its use in children has not yet been validated. Computed tomography (CT) is a reliable tool to assess body composition, but its use in children should be avoided due to the significant radiation burden. Quantitative Magnetic Resonance Imaging (qMRI) provides an accurate measurement of body composition, through the quantification of the visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and brown adipose tissue (BAT), as well as lean mass. Furthermore, qMRI provides other significant estimates such as the Proton Density Fat-Fraction of the fat tissue. This review article aims to briefly describe the state of art of the advanced imaging techniques to provide a quantitative assessment of body composition in children and adolescents.

Utility of specific bioelectrical impedance vector analysis for the assessment of body composition in children

SummaryBackground & aimsBioelectrical impedance analysis (BIA) is widely considered a body composition technique suitable for routine application. However, its utility in sick or malnourished children is complicated by variability in hydration. A BIA variant termed vector analysis (BIVA) aims to resolve this, by differentiating hydration from cell mass. However, the model was only partially supported by children's data. To improve accuracy, further adjustment for body shape variability has been proposed, known as specific BIVA (BIVAspecific).MethodsWe re-analysed body composition data from 281 children and adolescents (46% male) aged 4–20 years of European ancestry. Measurements included anthropometry, conventional BIA, BIVA outcomes adjusted either for height (BIVAconventional), or for height and body cross-sectional area (BIVAspecific), and fat-free mass (FFM) and fat mass (FM) by the criterion 4-component model. Graphic analysis and regression analysis were used to evaluate different BIA models for predicting FFM and FM.ResultsAge was strongly correlated with BIVAconventional parameters, but weakly with BIVAspecific parameters. FFM correlated more strongly with BIVAconventional than with BIVAspecific parameters, whereas the opposite pattern was found for FM. In multiple regression analyses, the best prediction models combined conventional BIA with BIVAspecific parameters, explaining 97.0% and 89.8% of the variance in FFM and FM respectively. These models could be further improved by incorporating body weight.ConclusionsThe prediction of body composition can be improved by combining two different theoretical models, each of which appears to provide different information about the two components FFM and FM. Further work should test the utility of this approach in pediatric patients.

A novel approach to assess body composition in children with obesity from density of the fat-free mass

Assessment of Fat Mass (FM) and fat-free mass (FFM) using Air-displacement plethysmography (ADP) technique assumes constant density of FFM (DFFM) by age and sex. It has been recently shown that DFFM further varies according to body mass index (BMI), meaning that ADP body composition assessments of children with obesity could be biased if DFFM is assumed to be constant. The aim of this study was to validate the use of the calculations of DFFM (rather than constant density of the FFM) to improve accuracy of body composition assessment in children with obesity. cross-sectional validation study in 66 children with obesity (aged 8-14 years) where ADP assessments of body composition assuming constant density (FFMBODPOD and FMBODPOD) were compared to those where DFFM was adjusted in relation to BMI (FFMadjusted and FMadjusted), and both compared to the gold standard reference, the 4-component model (FFM4C and FM4C). FFMBODPOD was overestimated by 1.50kg (95%CI -0.68kg, 3.63kg) while FFMadjusted was 0.71kg (-1.08kg, 2.51kg) (percentage differences compared to FFM4C were 4.9% (±2.9%) and 2.8% (±2.1%), respectively (p<0.001)). Consistently, FM was underestimated by both methods, representing a mean difference between methods of 4.0% (±2.9%) and 6.8% (±3.8%), respectively, when compared to the reference method. The agreement and reliability of body composition assessments were improved when adjusted using calculations (adjusted models) rather than assuming constant DFFM. The use of constant values for fat-free mass properties may increase bias when assessing body composition (FM and FFM) in children with obesity by two-component techniques such as ADP. Using adjusted corrections as proposed in the present work may reduce the bias by half.

Increased adiposity in children with obesity is associated with low red blood cell omega-3 fatty acid status and inadequate polyunsaturated fatty acid dietary intake.

The association between total dietary fat intake and measures of body fatness in children with obesity remains inconsistent. This study aimed to determine whether dietary long-chain polyunsaturated fatty acids (LCPUFA) and LCPUFA status relate to body composition in children with obesity. Children (n = 63, 9.0 ± 0.2 year, BMI Z-score 3.1 ± 0.2) were divided into tertiles of percentage body fat assessed by dual-energy X-ray absorptiometry. Diet was assessed 3-days food diaries. Fatty acid proportions in red blood cells (RBC) were measured by gas chromatography. Data stratified by sex and Tanner stages were compared with a MIXED model ANOVA. Associations between RBC fatty acid status and dietary intakes were examined with Spearman correlation. Moderate correlations were observed between RBC eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) proportions, dietary EPA and DHA (r = 0.39, P < .05) as well as fish servings (r = 0.33, P < .05). Dietary LCPUFA did not differ among tertiles. Children in tertile 3 had lower RBC α-linolenic acid (-40%) and EPA + DHA (-15%) proportions adjusted for age, Tanner stages and race compared with tertile 1. The lower omega-3 LCPUFA status in children with greater adiposity is consistent with suboptimal intakes of omega-3 LCPUFA and fish in the diet.

Development of population-specific prediction equations for bioelectrical impedance analyses in Vietnamese children.

There is a need for accurate, inexpensive and field-friendly methods to assess body composition in children. Bioelectrical impedance analysis (BIA) is a promising approach; however, there have been limited validation and use among young children in resource-poor settings. We aim to develop and validate population-specific prediction equations for estimating total fat mass (FM), fat free-mass (FFM) and percentage body fat (PBF) in Vietnamese children (4-7 years) using reactance and resistance from BIA, anthropometric variables and demographic information. We conducted a cross-sectional survey of 120 children. Body composition was measured using dual-energy X-ray absorptiometry (DXA), BIA and anthropometry. To develop prediction equations, we split all data into development (70 %) and validation datasets (30 %). The model performance was evaluated using predicted residual error sum of squares, root mean squared error (RMSE), mean absolute error (MAE) and R2. We identified a top performing model with the least number of parameters (age, sex, weight and resistance index or resistance and height), low RMSE (FM 0·70, FFM 0·74, PBF 3·10), low MAE (FM 0·55, FFM 0·62, PBF 2·49), high R2 (FM 0·95, FFM 0·92, PBF 0·82) and the least difference between predicted values and actual values from DXA (FM 0·03 kg or 0·01 sd, FFM 0·06 kg or 0·02 sd, PBF 0·27 % or 0·04 sd). In conclusion, we developed the first valid and highly predictive equations to estimate FM, FFM and PBF in Vietnamese children using BIA. These findings have important implications for future research on the double burden of disease and risks associated with overweight and obesity in young children.

Alterations In Musculoskeletal Function And Body Composition In Children With Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a neurological disorder characterized by impaired social interaction and atypical behaviors. Children with ASD appear to have weaker muscular function and low bone mineral density. Recent studies have indicated that adolescents with ASD develop obesity and bone fracture incidence at a higher rate compared to typically developing peers (TDC). Limited information is available to identify levels of obesity and its relation to muscular function and body composition in children with ASD before they start puberty. PURPOSE: To determine whether differential body composition may affect muscular strength and function in children with ASD METHODS: Total of 40 adults, TDC and children with ASD participated in the study. Muscular strength (i.e., torque, work, and power) during knee extension and flexion was measured at 90, 150, and 210 °/sec in the lower extremity using Humac Norm Isokinetic Dynamometer. Maximal isometric forearm muscular strength was measured using a handgrip dynamometer. Body mass index (BMI), waist-to-hip ratio, and whole-body scan from Dual Energy X-Ray Absorptiometry were used to identify the body composition. RESULTS: Compared to control adults, TDC and ASD had lower BMI (20.1±0.7 TDC, 22.3±4.4 ASD vs. 27.2±2.3 Adults, kg/m2). All groups had similar percent body fat (26.4± 2.3 Adults, 29.8±1.83 TDC, 32.9±3.84 ASD, %) and percent lean body mass (69.5±2.2 Adults, 66.8±1.7 TDC, 64.4±3.6 ASD, %). However, compared to TDC, ASD children had significantly lower bone mass percentage (2.7±0.3 ASD vs. 3.2±0.2 TDC, %). Waist-to-hip ratio was significantly higher for ASD (0.91±0.04 ASD vs. 0.85±0.01 TDC). The maximal forearm and leg strength were significantly lower in ASD compared to TDC normalized for their body weight (30.2 ±5.2 ASD vs. 42.8 ± 2.5 TDC, kg). There is a significant inverse relationship with muscular strength and regional percent fat in the forearm. CONCLUSION: These findings suggest that body composition appeared to influence muscular strength in children with ASD. Less regional fat and higher bone mass rather than the total body fat may contribute for higher leg or forearm muscular strength in children with ASD. Supported by CASA RSCA Infusion, Central RSCA, and Undergraduate Research Grant, SJSU

The effect of subclinical hypothyroidism on body composition parameters in children.

It's known that overt hypothyroidism increases body fat content and weight. There's limited research about the effect of subclinical hypothyroidism (SH) on body composition in children and the effect of LT4 treatment. We aimed to evaluate body composition parameters in healthy subjects and in children with mild SH (MSH) and determine the effect of LT4 treatment. Sixty-four healthy children and 32 children with MSH were included. Anthropometric measurements and hormonal parameters were evaluated. Body composition was evaluated using bioelectric impedance analysis (BIA). Patients were put on LT4 treatment. BIA was performed again after 12months of therapy. There was no significant difference between the anthropometric parameters and basal metabolic rate of the healthy children and the MSH group. The percentage of trunk muscle mass (TMM) in the MSH group was lower than in the control group (P<.05). After 12months of LT4 treatment, the percentage of total fat-free mass (FFM), TMM and trunk fat-free mass (TFFM) were increased and percentage of total body fat mass and trunk fat mass were decreased (P<.05). The difference between the percentage of TMM in the MSH group and control group was insignificant after LT4 treatment (P>.05). The percentage of TMM in children with MSH was found lower than healthy control group. After LT4 treatment, the percentage of the FFM, TMM and TFFM were increased and the difference between percentage of TMM in children with MSH and healthy controls was insignificant. Our data indicated that MSH might be associated with early changes in body composition parameters.

P305 Evaluation of maximum exercise capacity and its relationship to lung volumes and capacities and body composition of children with cystic fibrosis

P305 Evaluation of maximum exercise capacity and its relationship to lung volumes and capacities and body composition of children with cystic fibrosis

Anthropometric measurements, nutritional status and body composition in children with cystic fibrosis – the prospective study

Background Cystic fibrosis(CF),despite much progress in therapy, remains the disease which affects nutrition. Nutrition is an important prognostic factor of the outcome of the disease. We want to evaluate physical development, nutrition and body composition in CF children.

0881 Clinical Evaluation of Adeno-Tonsillar Hyperplasia in Non-Syndromic Children and Adolescents During Growth Hormone Treatment

Abstract Introduction Recombinant human Growth Hormone (rhGH) is an important pharmacological agent for linear growth stimulation and body composition in children with growth hormone deficiency (GHD). However, reports indicate that treatment with rhGH can be associated with adeno-tonsillar hyperplasia. This condition can lead to occurrence of obstructive sleep apnea (OSA) and worsening of sleep and life quality. Nonetheless, studies assessing this outcome in non-syndromic children are scarce. Methods We evaluated the difference in size of pharyngeal and palatine tonsils in patients aged between 5 and 17 being treated with recombinant human Growth Hormone (rhGH). We conducted a prospective longitudinal observational study. Twelve patients in treatment with rhGH were evaluated by otorhinolaryngological physical examination, nasofibrolaryngoscopy and obstructive sleep apnea (OSA)-18 questionnaire in two different time-points: when selected (T0) and after 6 months (T1). Results No significant associations were found regarding palatine and pharyngeal tonsil size with rhGH treatment. In relation to OSA 18 questionnaires, there was no statistically significant result in the absence of covariables for the general score as well as for the five domains that it comprises. When covariables were included in the analyses, controlled by the patients age, we observed statistically significant increases in the general score and in the domains relating to sleep disorders, emotional suffering, diurnal problems and the caretaker′s concerns. Conclusion In the present study, pharyngeal or palatine tonsils hyperplasia were infrequent during treatment with rhGH in the non-syndromic children and adolescents. However, the impact on sleep and quality of life that may arise warrant careful monitoring during therapy. Support Associação Fundo de Incentivo à Pesquisa (AFIP).

The Nasopharyngeal and Gut Microbiota in Children in a Pediatric Otolaryngology Practice.

The human microbiome evolves rapidly in early life with contributions from various factors such as diet, delivery mode, medical history, antibiotics exposure, genetics, immunomodulators and the environment. A high use of antibiotics in pediatric outpatient settings has been well documented, and improvement in antibiotic selection is required to reduce the risks of antibiotic resistance and disruption of the microbiome. We performed an exploratory study using 16S rRNA gene-based sequencing to characterize the gut and nasopharyngeal microbiome of children (n = 50) age 1-6 years of age in a pediatric otolaryngology practice. Relative abundance of Haemophilus and Moraxella were higher in nasopharyngeal swabs, while Prevotella, Bacteroides, Porphyromonas and Faecalibacterium were highly abundant in rectal swabs. The gut microbiome composition in children <2 years old was different compared with children ≥2 years age. Gut bacterial diversity increased with an increase in age of the children. Children taking probiotics had a notable increase in abundance of potentially beneficial gut bacteria such as Bacteroides and Akkermansia. The nasopharyngeal microbiome differed between children who received antibiotics in the 3 months before sample collection compared with those that did not. Haemophilus spp. was highly abundant in children who received antibiotics 3 months before sampling. The pediatric nasopharyngeal and rectal microbiomes differ in bacterial composition and diversity. The increased abundance of Haemophilus spp. in the nasopharyngeal microbiome of children who received antibiotics during the 3 months before sampling suggests a potential impact of antibiotics in colonization with the otopathogen and may be relevant to clinical practice.

The Implementation of Eating Healthy Program in Early Childhood

&#x0D; &#x0D; &#x0D; Eating habits develop during the first years of a child's life, children learn what, when, and how much to eat through direct experience with food and by observing the eating habits of others. The aim of this study is to get a clear picture of the Eating program Healthy, starting from the planning, implementation, supervision, and evaluation as a case study of nutrition education; to get information about the advantages, disadvantages and effects of implementing a healthy eating program for children. This research was conducted through a case study with qualitative data analysed using Miles and Huberman techniques. Sample of children in Ananda Islāmic School Kindergarten. The results showed the Healthy Eating program could be implemented well, the diet was quite varied and could be considered a healthy and nutritious food. The visible impact is the emotion of pleasure experienced by children, children become fond of eating vegetables, and make children disciplined and responsible. Inadequate results were found due to the limitations of an adequate kitchen for cooking healthy food, such as cooking activities still carried out by the cook himself at the Foundation's house which is located not far from the school place; use of melamine and plastic cutlery for food; the spoon and fork used already uses aluminium material but still does not match its size; does not involve nutritionists.&#x0D; Keywords: Early Childhood, Eating Healthy Program&#x0D;