Fatty Acids In Children Research Articles

1956-LB: Altered Gut Microbiota and Short-Chain Fatty Acids in Children with Diabetic Ketoacidosis at Onset of Type 1 Diabetes

1956-LB: Altered Gut Microbiota and Short-Chain Fatty Acids in Children with Diabetic Ketoacidosis at Onset of Type 1 Diabetes

No Impact of Enteral Nutrition on Fecal Short-Chain Fatty Acids in Children with Cerebral Palsy.

Bacteria can impact the host organism through their metabolites, with short-chain fatty acids (SCFAs) being the most important, including acetate (C2), propionate (C3), butyrate (C4), valerate (C5n), and isovalerate (C5i). This study aimed to identify the impact of enteral nutrition on SCFAs in children with cerebral palsy and to test the hypothesis that the type of nutrition in cerebral palsy affects gut SCFA levels. Cerebral palsy is a heterogeneous syndrome resulting from non-progressive damage to the central nervous system. The study group included 30 children diagnosed with cerebral palsy, receiving enteral nutrition (Cerebral Palsy Enteral Nutrition (CPEN)) via gastrostomy. The first reference group (Cerebral Palsy Controls (CPCs)) consisted of 24 children diagnosed with cerebral palsy and fed orally on a regular diet. The second reference group (Healthy Controls (HCs)) consisted of 24 healthy children with no chronic disease and fed on a regular diet. Isolation and measurement of SCFAs were conducted using gas chromatography. Differences were observed in the median contents of isobutyric acid, valeric acid, and isovaleric acid between the CPC group, which had significantly higher levels of those acids than the HC group. No differences were found between the CPEN and CPC groups nor between the CPEN and HC groups. We conclude that enteral nutrition in cerebral palsy has no influence on the levels of SCFAs.

Administration of Human Milk Oligosaccharide (2′-fucosyllactose) Reduces Dysbiosis and Increases Short Chain Fatty Acids in Children and Young Adults Following HSCT: A Prospective, Single-Center Study

Administration of Human Milk Oligosaccharide (2′-fucosyllactose) Reduces Dysbiosis and Increases Short Chain Fatty Acids in Children and Young Adults Following HSCT: A Prospective, Single-Center Study

Omega-3 Fatty Acid Supplementation Improves Attention Deficit-Hyperactivity Disorder Symptoms in Children

Background: Attention Deficit-Hyperactivity Disorder (ADHD) is one of the most common neuropsychiatric disorders in children. Increasing evidence suggests an association between omega-3 fatty acid and ADHD. We aimed to investigate the effects of 6-month omega- 3 fatty acid supplementation on the fatty-acid profile of erythrocytes and on the clinical severity of ADHD symptoms in children. Methods: Recruitment included 32 children aged 6-14 years diagnosed with ADHD at the Child and Adolescent Psychiatry Department at Ziv Medical Center, Israel. Intervention included refrigerated omega-3 fatty acid supplementation normalized to body weight. Blood samples were taken at baseline, 3 and 6 months after intervention for quantification of fatty acids from erythrocyte membranes. ADHD symptoms were assessed by parents and teachers according to the ADHD Rating-Scale and the Strengths and Difficulties Questionnaire. ADHD severity was additionally assessed by a psychiatrist according to the Clinical Global Impressions Scale. Results: Supplementation of omega-3 fatty acid in children with ADHD raised their omega-3 index statistically significantly from an average of 4.4% omega-3 index at baseline to 11.6% after 6 months and had beneficial effects on ADHD symptoms, as measured by validated questionnaires and in accordance with a pediatric psychiatrist examination. Conclusion: Our pilot study showed that dietary supplementation of omega-3 fatty acid increased the blood omega-3 index levels and improved ADHD symptoms even at the midpoint of 3 months.

The Role of Omega-3 Fatty Acids in the Treatment of Depression in Children and Adolescents: A Literature Review.

Depression is one of the most common mental disorders diagnosed in children and adolescents. Many individuals benefit from pharmacotherapy including antidepressants, however, there is a fair likelihood of remission and recurrence.Of the several pathophysiologies, depression has been linked to inflammation. Complementary and alternative medications such as the use of omega-3 fatty acids are gaining popularity given their anti-inflammatory properties. The goal of this literature review is to assess the efficacy and the clinical use of omega-3 fatty acids in children and adolescents with depression. We conducted an extensive literature search on PubMed, Ovid MEDLINE, and PsycINFO from January 1, 2005, to September 2021, for published articles (case reports, systematic review, RCT) in any language. A total of seven published studies were included in our literature review.Results indicated a huge heterogenicity in the studies and hence the clinical use of omega-3 fatty acids as monotherapyin depression was not determined. However, it was well tolerated with an extremely low side effect profile. Further research on the use of omega-3 fatty acids as an adjunct to antidepressants would be valuable.

Nutritional status assessment and intervention with a red palm oil biscuit among pre-school children attending informal crèches, in the Eastern Cape, South Africa

Little information is available on the nutritional and health status of pre-school children attending informal crèches. The study aimed to determine the status of blood carotenoid, vitamin E, inflammatory markers and omega-3 fatty acids in children attending crèches in the Eastern Cape, South Africa. Baseline measurements were followed by an intervention to determine the effect of a biscuit baked with red palm oil (RPO) shortening on these parameters. Forty-seven (n=47) children were randomly assigned to a RPO (Group A) (n=25) and non-RPO (Group B) (n=22) group. Group A received biscuits providing carotenoids, tocotrienols and α-tocopherol while Group B biscuits provided only tocotrienols and α-tocopherol. Biscuits were distributed daily during the school week. Blood samples were obtained at baseline, 3 months and 6 months during intervention as well as 6 months post intervention. At baseline, children showed a mild (10%) vitamin A deficiency, severe vitamin E deficiency (69%) while 98% presented with omega-3 fatty acid indexes below 8%. For vitamin E data was pooled as both groups received similar amounts of vitamin E while no significant differences were observed between the groups during the intervention. Significant increases (p ≤ 0.05) in α-tocopherol levels were observed in both groups at 3-, 6- and 6- months post intervention. Deficiency levels declined to 10% and 0% at 6- and 6-months post, respectively. In group A, plasma α-carotene levels (p ≤ 0.05) increased significantly from baseline (0.04 μmol/L; 95% CI: 0.03 – 0.06) at 3 (0.36 μmol/L; 95% CI: 0.29 – 0.45) and 6 months (0.48 μmol/L; 95% CI: 0.39 – 0.60). Similar significant (p ≤ 0.05) results were observed for plasma β-carotene levels (3 months (0.31 μmol/L; 95% CI: 0.27 – 0.40) and 6 months (0.33 μmol/L; 95% CI: 0.28 – 0.40). Consumption of a biscuit baked with RPO can play a significant role in alleviating vitamin E deficiency and can significantly increase plasma α- and β-carotene levels in pre-school children. Key words: Vitamin A, carotenoids, vitamin E, CRP, IL-6, fortification, omega-3 fatty acids

Lipid modulatory effects of omega-3 fatty acids in children with sickle cell disease

BackgroundSickle cell disease (SCD) is one of the commonest prevalent blood inherited disorders, accompanied by inflammation, oxidative stress, pain and alterations in the membrane lipid composition. These have harmful impacts on the cardiovascular system, making it important to address the hypolipidemia observed in these patients at an early age, for effective treatment strategies. Omega-3 fatty acids are known to positively modulate the integrity of the erythrocyte membrane. Being a dietary supplement, having multi benefits, they seem to be ideal nutrients which could be tried out for lipid modulation in these patients. Objective- In this study, we explore the potential of omega-3 fatty acids in rectifying the lipid profile changes in pediatric SCD patients, in a small prospective interventional trial. Methods- Omega-3 fatty acids were orally given to forty-three pediatric patients with SCD for a period of six months, and their lipid profile markers studied, before and after the supplementation period. Results and Conclusion- Improvement in the lipid profile was observed after omega-3 supplementation, resulting in overall favorable changes. Omega3 fatty acids may therefore possibly be used as effective and safe add on supplements during therapy, to reduce the complications accompanying SCD.

Особливості обміну омега-3/омега-6 жирних кислот у дітей з епілептичними енцефалопатіями та розладами аутистичного спектра

Purpose - to study the level of the serum fatty acids in children with autism spectrum disorders (ASD); to compare omega-6/omega-3 ratio depending of the clinical manifestation epileptic encephalopathy (EE) and ASD and electroencephalography data (EEG). Materials and methods. The study examined 101 children aged 2-6 years (mean age 4.02±0.95 years) with clinical manifestations ASD, who had been treated in a neuropsychiatric unit of the SI «Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova of the NAMS of Ukraine». According to the clinical features of epileptic encephalopathies and ASD, EEG monitoring data formed three groups: the group 1 - 35 children with clinical manifestations of ASD but without epileptic seizures and epileptiform changes in the EEG; the group 2 - 32 children with cognitive disintegration, clinical manifestations of ASD in which parents and health professionals did not note or noted a single history of epileptic seizures, but with epileptiform changes in the EEG; the group 3 - 34 children with clinical manifestations of ASD in which parents or health professionals have noted epileptic seizures and epileptiform changes in the EEG. In all children the level of blood fatty acids was determined by gas-liquid chromatography. Results. Indicators of fatty acid concentration indicate that the serum of children showed a significantly low level of omega-3 polyunsaturated fatty acids (PUFA) and saturation of omega-6 po PUFA in all groups of children. The level of concentration of the main metabolites of essential fatty acids reflects the imbalance due to deficiency of essential linolenic acid and its metabolite - docosapentaenoic acid, especially in children with ASD and epileptiform changes in the EEG (group 2), (p<0.01). Among the omega-6 PUFA found a high content of essential linoleic acid and its metabolite - arachidonic acid, which causes the total excess of this group of PUFA, more pronounced in the groups 1 and 2. The level of index of unsaturated fatty acids in children from the group 1 was 10.1, in children from the group 2 - 9.8, and in the group 3 - 9.3. The obtained results of the assessment of the unsaturation index reflect the lower level of index of unsaturated fatty acids in children of the group 3 who have manifestations of ASD and epileptic seizures compared to other groups (p<0.05, r=0.99). Conclusions. The data is a reliable evidence that children with ASD, epileptic seizures and epileptiform changes in the EEG have higher levels of omega-6 PUFA and arachidonic acid and omega-3 and docosahexaenoic acid deficiency. The most pronounced imbalance in both the ratio of omega-6 / omega-3 and arachidonic acid / docosahexaenoic acid in the group of children with ASD and epileptiform changes in the EEG. These results may support the theory of changes in the properties of the phospholipid membrane and ion channels of nerve cells and require further study using electron microscopy. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Keywords: autism spectrum disorders, epileptic seizures, essential fatty acids, monounsaturated fatty acids, unsaturated fatty acids, fatty acid unsaturation index.

Serum concentration of fatty acids in children with obesity and nonalcoholic fatty liver disease

ObjectivesIt has been suggested that circulating fatty acids (FAs) take part in the pathogenesis of nonalcoholic fatty liver disease (NAFLD) in children with obesity. The aims of this study were to evaluate the serum FA concentration in this pediatric population. MethodsThe prospective study included 80 children with obesity and suspected liver disease. Patients with viral hepatitis, autoimmune, toxic, and selected metabolic liver diseases were excluded. Criteria for NAFLD diagnosis included liver steatosis in ultrasound as well as elevated alanine transaminase (ALT) serum activity. The total intrahepatic lipid content (TILC) was assessed by magnetic resonance proton spectroscopy (1H-MRS). Fasting serum FA concentrations were measured in all children using gas-liquid chromatography. ResultsNAFLD was diagnosed in 31 children. Total FA concentration was significantly higher (P < 0.01) in all obese children as well as in obese children with NAFLD compared with controls. In children with NAFLD, a significant, positive correlation was found between total FA concentration and cholesterol (R = 0.47, P < 0.01), triacylglycerols (R = 0.78, P < 0.001), and insulin (R = 0.45, P < 0.011). In a group of children with obesity, TILC correlated positively with saturated FA concentration (R = 0.23, P < 0.05). ConclusionData from the present study do support the hypothesis that FAs are potentially involved in the pathogenesis of NAFLD in children with obesity.

Serum Vitamin D, Folate and Fatty Acid Levels in Children with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis

Vitamin and fatty acid deficiency in children diagnosed with autism has been linked to the etiology and course of the disease but the results have been inconsistent. In our work, we present a narrative review, which includes 20 observational studies that provide data on the blood levels of vitamin D, folate, or fatty acids of children diagnosed with ASD (Autism Spectrum Disorder—AG group), and of a control group (children without this disorder—CG group). The main characteristics and results are presented in a summary table. Of the 20 above-mentioned studies, a meta-analysis of vitamin D and folate levels was carried out in 14 of them, with a total of 2269 children (AG = 1159, CG = 1110). Vitamin D levels were lower in AG compared to CG: SMD, 95% CI = − 0.83 [− 1.15, − 0.50]. In terms of folate levels, a total of 299 children (AG = 148, CG = 151) were analyzed, finding no significant differences with the control group: SMD, 95% CI = − 0.16 [− 0.63, 0.32]. Only one study that provided data on fatty acids in children with ASD was included in the review although it was not possible to include it in the meta-analysis. We conclude that the nutritional status (vitamin and fatty acid levels) of patients diagnosed with ASD should be taken into account, as correct adjustment of these levels—may produce an improvement in the course of the disease and could also reduce the risk of its development.

Analysis of the content of I-FABP in urine and blood serum in children with gastrointestinal food allergy

Abstract Introduction. Protein-induced enteropathy is one of the common manifestations of gastrointestinal food allergy in young children. The search of non-invasive methods for intestine estimation is especially relevant for early diagnosis and timely prevention of exacerbation.The aimof the study was to determine the serum and urinal levels of the intestinal fraction of the protein binding fatty acids in children with protein-induced enteropathy and to evaluate their clinical and diagnostic significance.Materials and methods. It was examined 36 children with protein-induced enteropathy aged 1.5 months to 1 year and 20 healthy children (control group). All patients underwent esophagogastroenteroscopy with morphological examination of biopsy specimens for differential diagnosis with congenital gastrointestinal diseases. The Cow’s Milk-related Symptom Score (CoMMiS) was used to evaluate clinical symptoms. The intestinal fraction of a fatty acid binding protein was determined for all children in blood serum, urine by enzyme- linked immunosorbent analysis.Results.It was found the increase its serum level (125.20 ± 23.79 pg / ml), and urinal level (0.164 ± 0.031 pkg / ml) compared with the control group (19.21 ± 4.94 pg / ml, 00.039 ± 4.62 pkg / ml, respectively, p &lt; 0.05). There were found direct strong correlations between the severity of gastrointestinal manifestations and its serum and urine level (p &lt; 0.05).Discussion.Epithelial barrier damage provides an increased penetration of intact food allergens. It plays a key role in allergic sensitization, and it is the first pathogenetic link of allergic inflammation in most cases. A statistically significant I-FABP increased level in all studied biological fluids correlates with morphological changes in the children with protein-induced enteropathy, as well as with clinical symptoms of gastrointestinal tract lesions. That confirms its high informational value for an indirect assessment of the state of the intestinal barrier.Conclusions.Thus, an increase in serum and urinal I-FABP levels in children with protein-induced enteropathy confirms the clinical and diagnostic significance of determining this biomarker in all biological fluids. Its high sensitivity and specificity of determination in urine are promising for use in pediatric practice.

The level of intestinal protein binding fatty acids in children with autism spectrum disorders, depending on the style of nutrition

Introduction. Autism spectrum disorders are a widespread pathology, but the etiological factors of their occurrence have not yet been established. The aim of the study was to compare the levels of I-FABP in children with autism spectrum disorders, depending on the adherence to a gluten-free diet. Materials and methods. The study included 36 patients with autism committed to a gluten-free diet for more than six months and 49 patients with autism spectrum disorders who did not have dietary restrictions. There are no statistically significant age differences between the groups. The patients were evaluated and compared with the level of intestinal protein binding fatty acids. Results. Children using diet therapy were found to have significantly lower intestinal permeability. In particular, the average level of I-FABP in children with autism spectrum disorders followed a gluten-free diet is 156.20 ± 102.16 pg/ml, with non-compliance with diet therapy. The average value of the index is diagnosed at the level of 528.26 ± 255.95 pg/ml because the protein binding fatty acids are a marker of small intestine permeability. Children with autism spectrum disorders without adherence to a gluten-free diet show intestinal permeability higher than that of their peers with autism, who long exclude gluten from the diet. Conclusions. Further research is needed to assess the significance of the intestinal fatty acid-binding protein in the etiology and clinical presentation of various diseases, particularly in autism spectrum disorders. Before using diet therapy, all patients with autism need to consult a gastroenterologist to objectively assess the need for its compliance and dynamic monitoring of its effectiveness in case of use.

Abnormalities of Serum Fatty Acids in Children With Henoch-Schönlein Purpura by GC-MS Analysis.

Purpose: The objectives of this work were to test the levels of serum medium- and long- chain fatty acids (MLCFAs) in children and to discover their possible relationship with Henoch-Schönlein Purpura (HSP), also known as Immunoglobulin A vasculitis.Methods: A total of 57 children with HSP (HSP group) and 28 healthy children (CON group) were recruited for this study. Serum specimens were collected to detect the compositions and contents of MLCFAs by gas chromatography with mass spectrometry (GC-MS) analysis.Results: The contents of all detected 37 MLCFAs in the HSP group were higher than the healthy group. Thirty-one species of MLCFAs were discovered to have a significant difference (p < 0.05) in two groups. Comparing to healthy controls, there were 31, 31, 18 fatty acids showed a statistical difference in the untreated group, regular treated group, and withdrawal group of HSP, respectively. The trend of fatty acids in the three HSP groups was similar to the healthy controls, as well as the untreated group and regular treated group changed more obviously than the withdrawal group. Almitate (C16:0) and 18 carbon atoms (C18) of fatty acids were abundant in all three HSP groups, divided according to the treatment of glucocorticoid. Some fatty acids were found having considerable differences (p < 0.05) in three groups. Monounsaturated fatty acids (MUFAs), including elaidate (C18:1T), cis-11,14,17-eicosatrienoic acid ester (C20:1), and cis-15-tetracosenoate (C24:1), were distinctly higher in HSP children with renal damage.Conclusion: Our study revealed that the abnormalities in MLCFA may be associated with the development of HSP. Another interesting finding was that fatty acids contents were changing during the glucocorticoid treatment. Meanwhile, long-chain MUFAs may have an impact on renal damage in HSP patients. Further studies need to be carried out in order to explore the specific mechanism of fatty acids in the course of HSP.

Fecal short chain fatty acids in children living on farms and a link between valeric acid and protection from eczema

Children growing up on farms have low rates of allergy, but the mechanism for this protective effect has not been fully elucidated. Short chain fatty acids (SCFAs) produced by the gut microbiota may play a role in protection from allergy. We measured fecal SCFA levels in samples collected from 28 farming and 37 control children over the first 3 years of life using gas chromatography. Data on diet and other host factors were recorded and allergy was diagnosed at 8 years of age. Among all children, median propionic and butyric acid concentration increased over the first 3 years, and longer SCFAs typically appeared by 1 year of age. Farm children had higher levels of iso-butyric, iso-valeric and valeric acid at 3 years of age than rural controls. In addition, children with elder siblings had higher levels of valeric acid at 3 years of age, and dietary factors also affected SCFA pattern. High levels of valeric acid at 3 years of age were associated with low rate of eczema at 8 years of age. The fecal SCFA pattern in farm children suggests a more rapid maturation of the gut microbiota. Valeric acid or associated microbes may have protective potential against eczema.

Dietary Intake, Nutritional Adequacy and Food Sources of Total Fat and Fatty Acids, and Relationships with Personal and Family Factors in Spanish Children Aged One to

We aimed to determine the usual intake of total fat, fatty acids (FAs), and their main food sources in a representative cohort of the Spanish pediatric population aged 1 to <10 years (n = 707) who consumed all types of milk and an age-matched cohort who consumed adapted milk over the last year (including follow-on formula, toddler’s milk, growing-up milk, and fortified and enriched milks) (n = 741) who were participants in the EsNuPI study (in English, Nutritional Study in the Spanish Pediatric Population). Dietary intake, measured through two 24 h dietary recalls, was compared to the European Food Safety Authority (EFSA) and the Food and Agriculture Organization of the United Nations (UN-FAO) recommendations. Both cohorts showed a high intake of saturated fatty acids (SFAs), according to FAO recommendations, as there are no numerical recommendations for SFAs at EFSA. Also, low intake of essential fatty acids (EFAs; linoleic acid (LA) and α-linolenic acid (ALA)) and long-chain polyunsaturated fatty acids (LC-PUFA) of the n-3 series, mainly docosahexaenoic acid (DHA) were observed according to EFSA and FAO recommendations. The three main sources of total fat and different FAs were milk and dairy products, oils and fats, and meat and meat products. The consumption of adapted milk was one of the main factors associated with better adherence to the nutritional recommendations of total fat, SFAs, EFAs, PUFAs; and resulted as the main factor associated with better adherence to n-3 fatty acids intake recommendations. Knowledge of the dietary intake and food sources of total fat and FAs in children could help in designing and promoting effective and practical age-targeted guidelines to promote the consumption of EFA- and n-3 PUFA-rich foods in this stage of life.

Gut Microbiota Dysbiosis Associated With Altered Production of Short Chain Fatty Acids in Children With Neurodevelopmental Disorders.

While gut microbiota dysbiosis has been linked with autism, its role in the etiology of other neurodevelopmental disorders (NDD) is largely underexplored. To our knowledge this is the first study to evaluate gut microbiota diversity and composition in 36 children from the Republic of Serbia diagnosed with NDD and 28 healthy children. The results revealed an increased incidence of potentially harmful bacteria, closely related to Clostridium species, in the NDD patient group compared to the Control group: Desulfotomaculum guttoideum (P < 0.01), Intestinibacter bartlettii (P < 0.05), and Romboutsia ilealis (P < 0.001). On the other hand, significantly lower diversity of common commensal bacteria in the NDD group of patients was noticed. Enterococcus faecalis (P < 0.05), Enterococcus gallinarum (P < 0.01), Streptococcus pasteurianus (P < 0.05), Lactobacillus rhamnosus (P < 0.01) and Bifidobacteria sp. were detected in lower numbers of patients or were even absent in some NDD patients. In addition, butyrate-producing bacteria Faecalibacterium prausnitzii (P < 0.01), Butyricicoccus pullicaecorum (P < 0.05), and Eubacterium rectale (P = 0.07) were less frequent in the NDD patient group. In line with that, the levels of fecal short chain fatty acids (SCFAs) were determined. Although significant differences in SCFA levels were not detected between NDD patients and the Control group, a positive correlation was noted between number of rDNA amplicons obtained with universal primers and level of propionic acid, as well as a trend for levels of total SCFAs and butyric acid in the Control group. This correlation is lost in the NDD patient group, indicating that NDD patients' microbiota differs from the microbiota of healthy children in the presence or number of strong SCFA-producing bacteria. According to a range-weighted richness index it was observed that microbial diversity was significantly lower in the NDD patient group. Our study reveals that the intestinal microbiota from NDD patients differs from the microbiota of healthy children. It is hypothesized that early life microbiome might have an impact on GI disturbances and accompanied behavioral problems frequently observed in patients with a broad spectrum of NDD.

Equity, acceptability and feasibility of using polyunsaturated fatty acids in children and adolescents with autism spectrum disorder: a rapid systematic review

IntroductionSome recent randomized controlled trials (RCTs) assessed the efficacy and safety of polyunsaturated fatty acids (PUFAs) for the treatment of autism spectrum disorder (ASD). To optimally inform the Italian guideline for the management of ASD in children and adolescents, we reviewed the impact on equity, acceptability and feasibility for developing a pilot recommendation for PUFAs.MethodsWe performed a rapid systematic review of observational and experimental studies on PUFAs for children and adolescents with ASD, extracting data on resources required, equity, acceptability, and feasibility of PUFAs. We followed the framework provided by the grading of recommendations assessment, development and evaluation (GRADE) methodology, and we assessed risk of bias and methodological quality of included studies. Results were synthesized both narratively and quantitatively to address clinically relevant questions on equity, acceptability, and feasibility.ResultsWe found 14 papers related to equity. PUFAs did not seem to impact equity importantly. We did not find variation in effectiveness across subgroups and in a base case scenario, the cost of a 12 weeks cycle of therapy with 1.155 g/day of PUFAs was €65.51 euro.The acceptability of PUFAs was evaluated in 17 studies, 9 of which were RCTs. PUFAs were widely used among children and adolescents with ASD (18 to 51%), and 50% of parents considered nutritional supplementation as useful. Difficulty in swallowing capsules and bad taste were identified as possible causes of poor compliance, but treatment adherence, when measured in included RCTs, was judged to be good to excellent. Discontinuation due to any cause for PUFAs could not differ from placebo (low certainty of evidence).The feasibility of using PUFAs was assessed in 12 studies. PUFAs were probably sustainable, and no particular critical issue emerged from the feasibility assessment. However, the evidence appeared scarce and indirect.ConclusionsWe found the administration of PUFAs in children and adolescents with ASD to be potentially equitable, acceptable and feasible. These results are limited by the limited number and quality of retrieved documents, and need to be viewed in light of efficacy and safety data to formulate clinical recommendations.

Evaluation of the effectiveness of treatment of rickets in childrenby gas-liquid chromatography

This article examined 87 patients with rickets aged 1 to 2 years. All patients were divided into 2 groups. Traditional therapy was used for group I (38 patients) of children with rickets. Group II of children with rickets (49 patients) received apricot oil and aevit on the background of traditional treatment. Significant abnormalities in fatty acid content were found in children with rickets. In order to correct the dysmetabolism of high fatty acids in children with rickets, it is recommended to prescribe apricot kernel oil and aevit in addition to traditional therapy, which ensures high effectiveness of therapy.

Blood Pressure Abnormalities Associated with Gut Microbiota-Derived Short Chain Fatty Acids in Children with Congenital Anomalies of the Kidney and Urinary Tract.

Both kidney disease and hypertension can originate from early life. Congenital anomalies of the kidney and urinary tract (CAKUT) are the leading cause of chronic kidney disease (CKD) in children. Since gut microbiota and their metabolite short chain fatty acids (SCFAs) have been linked to CKD and hypertension, we examined whether gut microbial composition and SCFAs are correlated with blood pressure (BP) load and renal outcome in CKD children with CAKUT. We enrolled 78 children with CKD stage G1–G4. Up to 65% of children with CAKUT had BP abnormalities on 24 h ambulatory blood pressure monitoring (ABPM). CKD children with CAKUT had lower risk of developing BP abnormalities and CKD progression than those with non-CAKUT. Reduced plasma level of propionate was found in children with CAKUT, which was related to increased abundance of phylum Verrucomicrobia, genus Akkermansia, and species Bifidobacterium bifidum. CKD children with abnormal ABPM profile had higher plasma levels of propionate and butyrate. Our findings highlight that gut microbiota-derived SCFAs like propionate and butyrate are related to BP abnormalities in children with an early stage of CKD. Early assessments of these microbial markers may aid in developing potential targets for early life intervention for lifelong hypertension prevention in childhood CKD.

The Positive Clinical Consequence of Early Intervention of Combined Therapy (Omega 3 Fatty Acids and B12 Vitamin) in Children Under 5 with Variable Forms of Cerebral Palsy

Background: Cerebral palsy is a common pediatric problem encountered in about 1:3 per 1000 born children and causing variable mental, motor and behavioral dilemmas. Newly introduced trials of neurogenesis with different agents are now extensively evaluated. Objective: Our study was conducted to evaluate the neurotrophic response to B12 vitamin and omega-3 fatty acids in children diagnosed early with variable forms of cerebral palsy. The response was monitored both clinically and with C.T Scan as being a highly predictive tool for assessing cerebral palsy. Design: The study was carried out on 40 cerebral palsy patients; 26 (65%) out of them were girls, and 14 of them were boys, aged from 0 to 5 years old; from outpatient clinic at Zakho/Duhok General Hospital in Kurdistan Region-Iraq. Patients were treated and followed up for 6 months to one year. They were represented and adjusted by full history taking and clinical examination. Brain C.T scans was done for every patient to assess the degree of brain atrophy before starting this combined therapy, and every month for six months to one year. There was an improvement in general health of children after interventional therapy. Results: The study revealed that early intervention of both omega 3 and B12 vitamin in children under 5 with cerebral palsy (cp) shows great response based on clinical examination and CT scan findings. Almost, after combined therapy, 80% of children with delayed speech delay have very good response and improvement, 77% of children with delayed milestone and hypertonia, and 87% with delayed walking have positive clinical outcomes. Both sexes have equal response to combined therapy. Such findings were obtained as a result of early treatment and diagnosis of children with (CP). In addition, among the treated children with CP, improvement in CT scan results was obtained. 84% of treated children have great improvement in their neuroimaging results from moderate/severe forms of brain atrophy to mild form of brain atrophy after being treated and followed up for 6 months to 1 year. Conclusion: The damaged brain sites based on CT scan results, showed progressive improvement in response to B12 and omega-3 fatty acids upon daily supplement throughout 6 months to one year. However, combining these 2 drugs showed preservative synergistic consequences. B12 vitamin and omega- 3 fatty acids are valuable therapy for children with various forms of cerebral palsy particularly when being linked. The greatest improvement in speech and motor development was significantly observed in about 32 patients (80%) of treated children with B12 vitamin and omega- 3 fatty acids. Others have less response to combine therapy as being presented and diagnosed beyond 1 year of age (16%).