Cow's Consumption Research Articles

Stochastic health risk assessment of aflatoxin M1 in cow's milk among Lebanese population

This study quantitatively assessed AFM1 exposure through consumption of cows' milk in Lebanese adolescents and adults. Lebanon-specific, non-aggregated data on (i) milk intake and body weight – from an existing survey for adults and from a new survey for adolescents, and (ii) AFM1 occurrence in milk, were fitted to distributions and incorporated into a probabilistic model. Risk of hepatocellular carcinoma (HCC) for milk consumers was estimated considering the incidence of hepatitis B virus in Lebanon and characterized using the margin of exposure (MOE). All subgroups’ mean risk estimates, expressed as additional HCC cases per 100 000 population per year, were significantly different (p < 0.05), and ranged from 2.2x10−4 for adult males to 4.9x10−4 for adolescent males. This variation is attributed to significant differences in body weight and milk intake. MOE identified adolescent males and females as at-risk populations (mean 9628 and 8108, respectively). For adults, levels of concern were only reached with extreme consumption and/or contamination events. Considering that exposure from other sources (e.g., dairy) is cumulative, control of AFM1 in milk in Lebanon should be a risk management priority to ensure protection of younger populations.

Cow's Milk Bioactive Molecules in the Regulation of Glucose Homeostasis in Human and Animal Studies.

Obesity disrupts glucose metabolism, leading to insulin resistance (IR) and cardiometabolic diseases. Consumption of cow's milk and other dairy products may influence glucose metabolism. Within the complex matrix of cow's milk, various carbohydrates, lipids, and peptides act as bioactive molecules to alter human metabolism. Here, we summarize data from human studies and rodent experiments illustrating how these bioactive molecules regulate insulin and glucose homeostasis, supplemented with in vitro studies of the mechanisms behind their effects. Bioactive carbohydrates, including lactose, galactose, and oligosaccharides, generally reduce hyperglycemia, possibly by preventing gut microbiota dysbiosis. Milk-derived lipids of the milk fat globular membrane improve activation of insulin signaling pathways in animal trials but seem to have little impact on glycemia in human studies. However, other lipids produced by ruminants, including polar lipids, odd-chain, trans-, and branched-chain fatty acids, produce neutral or contradictory effects on glucose metabolism. Bioactive peptides derived from whey and casein may exert their effects both directly through their insulinotropic effects or renin-angiotensin-aldosterone system inhibition and indirectly by the regulation of incretin hormones. Overall, the results bolster many observational studies in humans and suggest that cow's milk intake reduces the risk of, and can perhaps be used in treating, metabolic disorders. However, the mechanisms of action for most bioactive compounds in milk are still largely undiscovered.

Consumption of cow's milk formula in the nursery and the development of milk allergy.

The effect of the amount of transient cow's milk formula (CMF) consumed during the first days of life on IgE-cow's milk allergy (IgE-CMA) is unknown. A cohort of 58 patients with IgE-CMA was identified from a large scale population-based study of 13,019 infants followed from birth. A group of 116 infants matched for sex and breastfeeding only duration (beyond the nursery period), and another random group of 259 healthy infants were used as controls. Parents were interviewed and the infants' medical records were searched to assess CMF consumption in the nursery. While 96% of the mothers of the 174 infants (58 with Cow's milk allergy and 116 controls) reported on exclusive breastfeeding during the stay in the nursery, CMF consumption was documented in 96 (55%) of the infants. Of those, most (57; 59%) received one to three feedings, 20 (21%) received four to nine feedings, and 19 (20%) received ≥10 feedings. Fewer formula feeds (1-3) were significantly more common in the allergic group than ≥4 feeds (p=0.0003) and no feeds at all (p=0.02) compared to controls (n=116). Of those exclusively breastfed in the nursery, 13/23 allergic infants (57%) introduced CMF at age 105-194days (the period with highest-risk for IgE-CMA) compared to 33/98 (34%) from the random control group (n=259) (p=0.04). Most infants end up receiving few CMF feeds in the nursery. Transient CMF in the nursery is associated with increased risk of IgE-CMA.

Risk of exposure to aflatoxin M1 through consumption of cow's milk among children in Magadu, Morogoro.

Aflatoxin M1 (AFM1) contamination of milk affects the general population with particular attention to children who frequently consume milk as part of complementary food. This study determined AFM1 contamination of cow's milk and estimated the health risk of dietary AFM1 through consumption of cow's milk among children (6 to 36months) in the Magadu ward of Morogoro region in Tanzania. A total of 165 mother-baby pairs were recruited and interviewed on child feeding practices with a focus on feeding of cow's milk in the past 24h. Alongside the interview, 100 raw cows' milk samples were collected from subsampled respondent households and were analyzed for AFM1 using enzyme-linked immunosorbent assay (ELISA). The results showed that about 35% of the surveyed children consumed cow's milk in the form of plain milk, incorporated in porridge and/or tea. The amount consumed varied from 62.5 to 500 mls with a median of 125 (125, 250) mls at a frequency of 1 to 2 times a day. All raw cows' milk (100%) samples (n = 100) were found contaminated with AFM1 at concentrations ranging from 0.052 to 9.310µg/L and median of 2.076µg/L (1.27, 2.48). All samples were contaminated by AFM1 at levels above the limits of 0.05µg/L of raw milk set by the Tanzania Bureau of Standard and the European Union, while 97% exceeded 0.5µg/L set by the US Food and Drug Administration. Exposure to AFM1 due to consumption of cow's milk ranged from 0.0024 to 0.077 µg/kg bw per day with a median of 0.019 (0.0016, 0.026) µg/kg bw per day, while the margin of exposure (MOE) ranged from 5.19 to 166.76 and median 20.68 (15.33, 25.40) implying high risk of public health concern. This study recommends that advocacy on consumption of cows' milk to combat undernutrition in children should consider a holistic approach that considers the milk's safety aspect.

Associated factors in pediatric patients admitted with severe iron-deficiency anemia in the last seven years - the experience of a single pediatric unit.

To study the causes of iron deficiency, laboratory findings and clinical manifestation of infants aged 6-12 months and children aged 1-3 years diagnosed with severe iron-deficiency anemia. We conducted an observational, retrospective single tertiary center study between January 2015 and April 2022, which included 142 children. The control group (patients with no diagnosis of severe iron-deficiency anemia) included 71 patients and the study group (patients diagnosed with severe iron-deficiency anemia) included also 71 patients. Clinical data were retrospectively collected from hospital medical records. Statistical analysis was conducted using Statistical Package for the Social Sciences (SPSS) 25.0 software. Seventy-one children had hemoglobin <7 g∕dL and low values of ferritin/serum iron (22 infants aged 6-12 months and 49 children aged 1-3 years). In both the study and control groups, the male gender was slightly more prevalent. Mother's age at birth and living standard is significantly lower in the study group. We note a higher frequency of premature births (14.08%) in children identified with anemia compared to control group (8.45%). We found a statistically significant distribution of cow's milk consumption among the two groups (p<0.001). Pearson's correlation test revealed a significant positive correlation, indicating that anemia is directly proportional to cow's milk consumption. The most frequent cause of iron-deficiency anemia in infants and children 1-3 years old was the consumption of cow's milk following incorrect diversification and incomplete prophylaxis of iron-deficiency anemia.

Factors Affecting Toxic and Essential Trace Element Concentrations in Cow's Milk Produced in the State of Pernambuco, Brazil.

The aim of this study was to provide information on the levels of toxic (Cd and Pb) and essential (Cu, Fe, and Zn) elements in cow's milk produced in the State of Pernambuco (Brazil). A total of 142 samples of raw milk were collected, and the concentrations of essential and toxic elements were determined using inductively coupled plasma-optical emission spectrometry. In almost 30% of the samples analyzed, the Pb content exceeded the maximum level established in the Brazilian legislation (0.05 mg/L). By contrast, in all the samples, the Cd content was below the maximum allowable level (0.02 mg/L). The essential trace elements Cu, Fe, and Zn were generally present at lower concentrations than reported in other studies and can be considered within the deficient range for cow's milk. Statistical and chemometric procedures were used to evaluate the main factors influencing the metal concentrations (proximity to major roads, presence of effluents, and milking method). The study findings demonstrate that the proximity of the farms to major roads influences the concentrations of Cd, Pb, and Cu and that this is the main factor explaining the Pb content of milk. In addition, the presence of effluents influenced the concentrations of Cu, while no relationship between the metal content and the milking method was observed. Thus, in accordance with the study findings, the consumption of cow's milk produced in the region can be considered a risk to public health due to the high concentrations of Pb and the low concentrations of other essential minerals such as Cu, Zn, and Fe in some of the milk samples.

The influence of the texture and color of goat’s salad cheese on the emotional reactions of consumers compared to cow’s milk cheese and Feta cheese

In this study, the sensory and mechanical aspects of the texture of goat’s milk salad cheese were correlated with the emotional profiles of consumers. Using descriptive sensory analysis and instrumental assessment, the texture profile of goat’s milk salad cheese was compared to cow’s milk salad cheese and Feta cheese. Texture measurements confirmed that goat’s cheese compared to cow’s cheese had more softness and less hardness, and Feta cheese had the highest whiteness index compared to the other cheeses. Goat’s milk salad cheese was much less acceptable to consumers compared to cow’s milk cheese and Feta cheese. Consumers also indicated that the hardness of goat’s cheese was lower than that of cow’s cheese and Feta cheese. A reduction in “stickiness” in comparison with cow’s cheese was also reported; however, it was much higher than that for Feta cheese. The “fracturability” and “graininess” of goat’s cheese was similar to cow’s cheese. Emotional profile analysis showed that goat’s cheese evokes mainly negative emotions. Consumers indicated only one positive emotion in the case of this cheese, which was “healthy”. The most frequently mentioned emotions after the consumption of goat’s cheese were “upset”, “disgusted” and “worried”. Many consumers also indicated “disappointed” and “angry”, which did not occur after the consumption of cow’s cheese. This research shows how important it is to combine several analyses and techniques when evaluating dairy products, including salad cheeses. It is also important that consumer research is enriched by emotional profiling.Graphical abstract

Effect of Adulterants on Quality and Safety of Cow Milk: A Review

Cow milk adulteration is the act of intentionally decreasing the quality of milk offered for sale either the admixture or substitution of substance or removing of some valuable ingredient. Milk has a high food value, since it comprised of a variety of nutrients. Scientific evidence supports, the consumption of cow’s milk and dairy products as part of a balanced diet and it is perfect and complete food. Therefore, milk and its derivatives contribute essential micro and macronutrients to the diet, when consumed according to appropriate national guidelines. However, different adulterants are added, to increase its quantity and done for financial gain. The common adulterants used in cow milk adulteration are water, starch, flour, urea, formalin, sodium hydro oxide and cane sugar. Water is the most common adulterant. These adulterants have effect on the nutritional quality of cow milk by decreasing the concentration of ingredients found and wholesomeness of the milk. To dilute milk, cheaper materials will be added. Almost all commercially available milk comes from cow and major milk adulteration occurs with cow’s milk and its products. These, adulteration of milk can pose serious risk to human health. The composition of milk varies with the breed of cow, stage of lactation; feed, season of the year. Therefore, both intentional and incidental milk adulterations affect nutritional quality and safety of milk. This review aims to review the effect of adulterants on safety and quality of cow milk. Even while financial gain is one of the main drivers of cow milk adulteration.

Cow's Milk in Human Nutrition and the Emergence of Plant-Based Milk Alternatives.

Cow's milk is considered a complete food, providing high-quality protein and essential micronutrients, including vitamins and minerals. For medical reasons or as a lifestyle choice, consumers are replacing cow's milk with plant-based milk alternatives (PBMA); some perceive them as healthier alternatives to cow's milk due to their low saturated fatty acid content and no cholesterol content. However, the nutritional composition of PBMA is quite variable between different types and even within, which makes a comparison with cow's milk a complex issue. Furthermore, the consumption of PBMA has been associated with the development of some diseases in infants and children. Meanwhile, the consumption of cow's milk in human health is a controversial issue since it has been associated with a favorable effect in some diseases (such as obesity, type 2 diabetes, and Alzheimer's) and a negative effect in others (such as prostate cancer risk and Parkinson's disease); while in some diseases, there is no consensus in the cow's milk consumption effect. The aim of this review is to make a nutritional comparison of cow's milk with PBMA and to clarify the potential health issues related to their consumption.

Antibody cross-reactivity between casein and myelin-associated glycoprotein results in central nervous system demyelination

Multiple sclerosis (MS) is a neuroinflammatory demyelinating disease of the central nervous system (CNS) with a high socioeconomic relevance. The pathophysiology of MS, which is both complex and incompletely understood, is believed to be influenced by various environmental determinants, including diet. Since the 1990s, a correlation between the consumption of bovine milk products and MS prevalence has been debated. Here, we show that C57BL/6 mice immunized with bovine casein developed severe spinal cord pathology, in particular, demyelination, which was associated with the deposition of immunoglobulin G. Furthermore, we observed binding of serum from casein-immunized mice to mouse oligodendrocytes in CNS tissue sections and in culture where casein-specific antibodies induced complement-dependent pathology. We subsequently identified myelin-associated glycoprotein (MAG) as a cross-reactive antigenic target. The results obtained from the mouse model were complemented by clinical data showing that serum samples from patients with MS contained significantly higher B cell and antibody reactivity to bovine casein than those from patients with other neurologic diseases. This reactivity correlated with the B cell response to a mixture of CNS antigens and could again be attributed to MAG reactivity. While we acknowledge disease heterogeneity among individuals with MS, we believe that consumption of cow’s milk in a subset of patients with MS who have experienced a previous loss of tolerance to bovine casein may aggravate the disease. Our data suggest that patients with antibodies to bovine casein might benefit from restricting dairy products from their diet.

STUDY OF BETA-CASEIN GENE POLYMORPHISM AND ITS RELATIONSHIP WITH MILK COMPOSITION IN SIMMENTAL COWS

STUDY OF BETA-CASEIN GENE POLYMORPHISM AND ITS RELATIONSHIP WITH MILK COMPOSITION IN SIMMENTAL COWS

Beneficial Effects of Vitamins, Minerals, and Bioactive Peptides on Strengthening the Immune System Against COVID-19 and the Role of Cow's Milk in the Supply of These Nutrients.

The COVID-19 pandemic, which causes severe respiratory tract infections in humans, has become a global health concern and is spreading rapidly. At present, the most important issue associated with COVID-19 is the immune system and the factors that affect it. It is well known that cow’s milk is highly rich in micronutrients that increase and strengthen the immune system. Research shows that the administration of these nutrients is very effective in fighting COVID-19, and a deficiency in any of them can be a weakness in the fight against the virus. On the other hand, cow’s milk is accessible to the whole population, and drinking colostrum, raw, and micro-filtered milk from cows vaccinated against SARS-CoV-2 could provide individuals with short-term protection against the SARS-CoV-2 infection until vaccines become commercially available. This review aimed to discuss the effects of milk vitamins, minerals, and bioactive peptides on general health in humans to combat viral diseases, especially COVID-19, and to what extent cow’s milk consumption plays a role in providing these metabolites. Cow’s milk contains many bioactive compounds that include vitamins, minerals, biogenic amines, nucleotides, oligosaccharides, organic acids, and immunoglobulins. Humans can meet a significant portion of their requirements for vitamins and minerals through the consumption of cow’s milk. Recent studies have shown that micronutrients such as vitamins D, E, B, C, and A as well as minerals Zn, Cu, Mg, I, and Se and bioactive peptides, each can have positive and significant effects on strengthening the immune system and general health in humans.

Mare's Milk: Composition, Properties, and Application in Medicine.

Mare's milk is a highly valuable organic substance that has a great potential to replace cow's milk. Consumption of cow's milk causes digestive disorders in some individuals. Immunoglobulin E (IgE)-mediated cow's milk allergy (CMA) is one of the most common food allergies among infants. Therefore, finding a protein substitute with the same nutritional value is a priority. Mare's milk can be a good substitute for cow's milk, especially for those suffering from CMA. Prerequisites for this study were the recent interest in mare's milk, as an ancient relic of the Turkic peoples which contains lots of nutrients. The present study aimed to systematize relevant information on the composition of mare's milk and its application in medicine. Google Scholar, PubMed, Cochrane, Elsevier, CyberLeninka were employed for a comprehensive literature search. The searched keywords for this study were mare's milk, saumal, composition, properties, use in medicine. A total of 77 sources were selected for reviewing the literature. Most sources were in English, except for one of the bottom 40 sources published in the last 10 years. Among the milk of many mammalian species, mare's milk is chemically similar to human milk so it can be used as a substitute. It is also used to feed people with various health conditions, especially in patients at risk, or suffering from tuberculosis, hepatitis C, psoriasis, and various types of immunodeficiency. The present study describes the rich composition, antibacterial and antiviral properties of mare's milk. A review of the literature revealed that mare's milk is an excellent thirst quencher, and has valuable nutrients necessary for the human body which is by no means inferior to human milk.

Consumption of differently processed milk products and the risk of asthma in children.

Consumption of unprocessed cow's milk has been associated with a lower risk of childhood asthma and/or atopy. Not much is known about differently processed milk products. We aimed to study the association between the consumption of differently processed milk products and asthma risk in a Finnish birth cohort. We included 3053 children from the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Nutrition Study. Asthma and its subtypes were assessed at the age of 5years, and food consumption by food records, at the age of 3 and 6months and 1, 2, 3, 4, and 5years. We used conventional and processing (heat treatment and homogenization)-based classifications for milk products. The data were analyzed using a joint model for longitudinal and time-to-event data. At the age of 5years, 184 (6.0%) children had asthma, of whom 101 (54.9%) were atopic, 75 (40.8%) were nonatopic, and eight (4.3%) could not be categorized. Consumption of infant formulas [adjusted hazard ratio (95% confidence intervals) 1.15 (1.07, 1.23), p<.001] and strongly heat-treated milk products [1.06 (1.01, 1.10), p=.01] was associated with the risk of all asthma. Consumption of all cow's milk products [1.09 (1.03, 1.15), p=.003], nonfermented milk products [1.08 (1.02, 1.14), p=.008], infant formulas [1.23 (1.13, 1.34), p<.001], and strongly heat-treated milk products [1.08 (1.02, 1.15), p=.006] was associated with nonatopic asthma risk. All these associations remained statistically significant after multiple testing correction. High consumption of infant formula and other strongly heat-treated milk products may be associated with the development of asthma.

THE EFFECT OF COW AND SOY MILK CONSUMPTION ON CALCIUM LEVELS OF WISTAR RAT TEETH

Background: Complementary food (MPASI) is the main food after the child weans from exclusive breastfeeding. One of the main sources of complementary food is milk. Most children are fed with cow’s milk, but since some children are lactose intolerant, they will be recommended to consume soy milk. However, soy milk and cow’s milk are known to have different amount of calcium as one of the key nutrients for tooth growth and development. The purpose of this study was to compare the effect of cow’s milk and soy milk consumption on the calcium concentration of Wistar rat teeth. Method: Subjects were 27 male Wistar rats aged 1 month old divided into 3 groups, equally with 9 rats in each: groups that consumed cow’s milk, soy milk, and control group. The group consuming Cow and soy milk was fed 2 times a day, in the morning and evening for 28 days. Each subject was then euthanized and their mandibular right incisor was taken at the end of the treatment to measure calcium concentration by atomic absorption spectrophotometry. Result: The results of the one way ANOVA test showed that there were significant differences (p &lt;0.05) in the calcium concentration of incisors in the teeth of rat consuming cow’s milk, soy milk, and control group. Hence, it can be concluded that the consumption of cow’s milk and soy milk has an effect on the calcium concentration of Wistar rat teeth. Conclusion: Calcium concentration of Wistar rat teeth that consume cow’s milk is higher than those that consume soy milk.

Functional Constipation in Children: Demography and risk factors analysis from a Tertiary Care Hospital of Bangladesh

Background: Constipation is not uncommon in childhood. This study was aimed to evaluate demography and probable/potential risk factors for functional constipation in Bangladeshi children.&#x0D; Materials &amp; Method: This cross-sectional study was carried out among 179 children from May 2018 to June 2019 in the department of Pediatric Gastroenterology and Nutrition, BSMMU, Dhaka both indoor and outdoor basis. Collected data from children with constipation who fulfilled the Rome III criteria were analyzed by SPSS 20.&#x0D; Results: Among 179 children, 54.75% were boys, and 45.25% girls. It was found more in age group above 5 years (56.42%), then in 2 to 5 years (33.52%) and lower in below 2 years (10.6%). Constipation was more in urban areas (55.3%) than in rural (44.69%). Among potential risk factors, low fiber in diet (72.63%) was most common, other factors were ingestion of cow’s milk (32.96%), not having regular meals with parents (19.55%), consumption of junk foods (28.49%), Staying with grandparents (16.76%), living in hostel or madrasa / residential, religious institute (5.03%), long period of academic activity (7.26%), unhygienic toilet in school (6.14%) were also found to be probable risk factors in this study.&#x0D; Conclusion: Functional constipation was found more in boys &amp; above five-year age groups. Low dietary fiber, consumption of cow’s milk &amp; junk food, unwillingness to use toilets in school were found as potential underlying risk factors of constipation.&#x0D; Bangladesh J Child Health 2020; VOL 44 (3) :148-152

The impact of consumer personality on purchasing behavior in the dairy market in terms of psychological factors

Since the 1990s of the 20th century, the Slovak dairy industry has undergone many significant changes which have been related to the reduction of the herds of cattle and milk cows, the decrease of quantity of milked milk, low purchase prices of milk, the decline of a great number of milk producers and processors. The consumption of cow´s milk and dairy products in Slovakia is very low in comparison with the countries of the European Union (about 320 kg), Europe (293 kg), the Czech Republic (280 kg), and the rest of the world. It varies around 170 kg per capita per year, which is also considerably lower consumption than the dose of 220 – 240 kg per capita per year recommended by doctors. Since 1990 the production and consumption of dairy products and cheeses have decreased significantly. In Slovakia, the consumption is twice even three times less than in the developed countries of Europe. The reason for this situation is the behavior of a consumer and the factors having an impact on the consumption of cow`s milk and dairy products. The objective of the paper is to indicate the impact of the personal consumers` characteristics on the purchasing decisions on the market of the products of cow`s milk origin, based on the processed answers of the respondents participating in the questionnaire survey. The primary data were obtained via the questionnaire survey, which was conducted with 786 respondents. The questionnaire consisted of four parts – Eysenck`s personality test, the questions targeted at the detection of factors influencing the consumers` purchasing behavior and decision making, the questions related to expressing opinions about cow`s milk and dairy products, and the classification questions providing the information about the respondents. The data were processed by the methods of quantitative and qualitative statistics – Chi-square statistic χ2 test of square contingency, Chi-square χ2 goodness of fit test, two proportion test, Kolmogorov-Smirnov test, the test of hypotheses of relative proportion.

CASE-CONTROL STUDY ON VITAMIN D STATUS IN CHILDREN AND ADOLESCENTS WITH EOSINOPHILIC ESOPHAGITIS.

Vitamin D is an essential fat-soluble steroid hormone and vitamin D deficiency is a global public health problem especially among children and adolescents. Factors such as the low intake of vitamin D-rich food sources, poor absorption and less exposure to the sun influence this outcome. Vitamin D has an anti-inflammatory effect in the body by promoting regulatory T cell differentiation as well as recovering T helper 17 cell response and secretion of anti-inflammatory cytokines. Eosinophilic esophagitis (EoE) is a chronic disease, histologically characterized by predominantly eosinophilic inflammation. The most common therapeutic approaches are allergen-eliminating diets, such as excluding cow's milk, egg, soy, wheat, peanuts and seafood, or more specific dietary restrictions. To verify the serum levels of vitamin D in children and adolescents with eosinophilic esophagitis on a restricted food diet and to analyze their association with nutritional status, consumption of different food sources, exposure to the sun and skin color. Case-control study conducted in the city of Campinas-SP, Brazil, in which included patients were aged 2 to 18 years old, and those diagnosed with eosinophilic esophagitis was referred to as the case group (n=15), meanwhile a control group (n=17) was also formed. Epidemiological data, nutritional status, data on vitamin D intake (24-hour recall - performed only by EoE patients - and self-reported intake of vitamin D food sources: milk and dairy products, canned tuna and sardines, Bull's liver, chicken eggs - applied in both groups), and daily time of sun exposure (≥30 min or ≤30 min) were recorded. The samples were collected for serum levels of 25-hydroxy-vitamin D, where sufficiency levels >30 ng/mL were considered, insufficiency 21 to 30 ng/mL, deficiency <20 ng/mL. There was a higher frequency of vitamin D insufficiency/ deficiency in the Eosinophilic Esophagitis group (P=0.035), even with longer sun exposure (P= 0.035). Skin color was not associated with lower levels of vitamin D in both groups studied. No difference was found in nutritional status between the groups. The present study demonstrated a higher frequency of inadequate/ deficient levels of vitamin D in children and adolescents with EoE on a restricted diet. When necessary, serum levels should be investigated and correct exposure to the sun should be encouraged, with special attention to the recommended guidelines, time spent in the sun and the appropriate clothing for correct absorption. Since exposure for more than 30 minutes in the sun does not appear to have provided a protective effect in the EoE group, even in a region with high levels of solar radiation. There was a significant difference only in the consumption of cow's milk between the case and control groups, demonstrating the low adherence to the restriction diet by the case group. No association was found between serum 25 hydroxyvitamin D levels and nutritional status. Moreover, no association regarding the adequate or inadequate status of 25 hydroxyvitamin D and the consumption vitamin D-rich foods was identified. Multicentered studies with a larger number of cases should be performed to assess serum 25 hydroxyvitamin D levels and associated factors in pediatric patients with EoE.

Association between Consumption of Cow’s Milk and Iron Deficiency Anemia in Children: Are There Roles for Hepcidin-25/Ferroportin? A Case-Control Study

Systemic iron homeostasis is regulated by the interaction of the peptide hormone, hepcidin and the iron exporter, ferroportin. The objective was to investigate the relationship between the consumption of cow’s milk and iron deficiency anemia in children 2–10 years old and its association with the hepcidin-25 and ferroportin concentrations. The study population consisted of 187 prepubescent children of similar ideal body weight (IBW:90–120%); 82 children with iron deficiency anemia (37girls and 45boys; 4.27 ± 0.28 years) and 105 (47girls and 58boys; 4.25 ± 0.34 years) healthy age-sex-matched controls. Serum fasting hepcidin-25/ferroportin concentrations were measured by enzyme immunoassay in all subjects. Mean cow’s milk consumption in the anemic group (373 ± 248 mL/d) tended to be higher than that in the control group (320 ± 226 mL/d), but the result was not statistically significant (p = 0.063).The mean hepcidin-25 level was significantly higher in the anemic group (19.5 ± 18.4 ng/mL) than in the healthy controls (11.0 ± 10.7, p < 0.001). The mean ferroportin level was lower in the anemic group (21.04 ± 5.74 ng/mL) than in the healthy controls (22.68 ± 4.77 ng/ml, p = 0.037). Consuming cow’s milk was not associated with IDA in prepubertal children, provided that it was adequately supplemented with iron-enriched foods. We observed a significant increase in hepcidin-25 levels and a decrease in ferroportin levels in children with iron deficiency anemia compared with healthy controls. Children who consumed more cow’s milk had higher levels of hepcidin-25. Iron deficiency anemia is not a concern when cow’s milk is given to children if the complementary foods are rich in iron.

Functional constipation in Bangladeshi children: experience of demography and probable risk factors from a tertiary care hospital

Background: Constipation is a common problem throughout childhood. It is important to be fully aware of the factors involved in developing constipation in children. There are few published articles on childhood constipation in Bangladesh. In this study, our aim was to evaluate demography and probable/potential risk factors for functional constipation in Bangladeshi children.Methods: The study was carried out among 179 children from May 2018 to June 2019 in the department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU) both indoor and outdoor basis. Children with constipation who fulfilled the ROME III criteria were evaluated for demography and probable/potential risk factors of constipation.Results: A total of 179 subjects were included in the final analysis. Among them, 54.75% were boys and 45.25% were girls. Constipation was found more in the age group above 5 years (56.42%), then in 2 to 5 years age group (33.52%) and lower in below 2 years of age (10.6%). Constipation was more among children living in urban area (55.3%) than in rural area (44.69%). Constipation was the presenting complaint in 76.54% subjects, other complaints were abdominal pain (47.49%), anorexia (24.02%), vomiting (19.56%). Diet low in fiber (72.63%) was found as the most common potential risk factor, other factors were ingestion of cow’s milk (32.96%), not having regular meals with parents (19.55%), consumption of junk foods (28.49%). Staying with grandparents (16.76%), living in hostel or madrasa / residential religious institute (5.03%), long period of academic activity, [homework (10.61%) / tutor and coaching (7.26%)], unhygienic toilet in school (6.14%) were also found to be probable associated factors in this study.Conclusions: Functional constipation was found more in boy’s and above five year age group. Low dietary fiber, consumption of cow’s milk and junk food, unwillingness to use toilets in school, long time in academic activity, were found to be potential underlying risk factors of constipation.