Feeding Intervention Research Articles

Role of Chitin and Chitosan in Ruminant Diets and Their Impact on Digestibility, Microbiota and Performance of Ruminants

The slow progress in the development of the subsector, particularly of alternative feed sources such as agro-industrial byproducts and unconventional feed resources, has deepened the gap in the availability of and accessibility to animal feed. Production of animal feed is highly resource demanding. Recently, it has been shown that increasing climate change, land degradation, and the recurrence of droughts have worsened the feed gap. In the backdrop of these challenges, there has been attention to food-not-feed components, which have great potential to substitute human-edible components in livestock feeding. Chitosan, a non-toxic polyglucosamine, is widely distributed in nature and used as a feed additive. Chitosan is obtained from the de-acetylation process of the chitin and is mostly present in shrimp, crabs, and insect exoskeletons, and has antimicrobial and anti-inflammatory, anti-oxidative, antitumor, and immune-stimulatory hypo-cholesterolemic properties. This review article discusses the results of recent studies focusing on the effects of chitosan and chitin on the performance of dairy cows, beef steers, sheep, and goats. In addition, the effects of chitosan and chitin on feed intake, feed digestibility, rumen fermentation, and microbiota are also discussed. Available evidence suggests that chitosan and chitin used as a feed additive for ruminants including dairy cows, beef steers, sheep, goats, and yaks have useful biological effects, including immune-modulatory, antimicrobial, and other important properties. These properties of chitosan and chitin are different from the other feed additives and have a positive impact on production performance, feed digestibility, rumen fermentation, and bacterial population in dairy cows, beef steers, sheep, goats, and yaks. There is promising evidence that chitosan and chitin can be used as additives in livestock feed and that well-designed feeding interventions focusing on these compounds in ruminants are highly encouraged.

INTERVENTION OF STUNTING AGED 0-59 MONTHS REVIEWING FROM NUTRITION

Nutritional intervention is an effort to overcome nutritional problems with programs such as giving Fe and calcium tablets to pregnant women, giving zinc to children. To find out the factors that cause stunting and the effectiveness of Nutrition Interventions in Stunting Toddlers. This type of research is survey research with a cross-sectional design. The research sample was children aged 0-59 months with short or very short criteria, totaling 60 respondents. Sampling technique is purposive. Data analysis through Univariate and Multivariate. Univariate analysis to provide an overview of the prevalence of stunting in children aged 0-59 months and Multivariate Analysis to see the initial relationship of risk factors for stunting in children 0-59 months and the effectiveness of Nutrition Interventions for Stunting Toddlers. The analysis was performed by binary logistic regression. Of the risk factors for stunting found 5 factors that correlated with stunting, namely history of exclusive breastfeeding, p-value 0.007 <0.05 (OR 0.111, 95% CI 0.023 – 0.541), history of complementary feeding p-value 0.044 < 0, 05 (OR 0.297, 95% CI 0.091 – 0.970), the diversity of food content p-value 0.095 <0.10 and the odds ratio value of 2.743. Means that the diversity of food content consumed affects stunting by 2.743 times greater, nutritional adequacy p-value 0.042 <0.05 and odds ratio value of 3.429, meaning that nutritional adequacy affects stunting by 3,429 times greater and Immunity of toddlers with stunting p-value 0.029 <0.05 and OR 0.268, 95% CI 0.82 - 0.876. For the Nutrition Interventions studied in this study in the form of an intervention approach to pregnant women through supplementation of Fe tablets with a p-value of 0.02 <0.05 and an odds ratio of 0.194 and supplementary feeding obtained a p-value of 0.011 <0.05 and an odds ratio of 4.464. There is a significant relationship between the Nutritional Intervention of Fe tablet supplementation and feeding with stunting. History of complementary feeding, exclusive breastfeeding, nutritional adequacy, diversity of food content and immunity have an impact on stunting in toddlers. The main interventions that can be done to reduce stunting are by increasing good nutrition for pregnant and lactating women and conducting early intervention in cases of malnutrition by fulfilling a diet high in protein.

Study of Clinical, Hematological, and Biochemical Profile of Under Five Hospitalized Children with Diarrhea from a Tertiary Care Institute in Himachal Pradesh

Background: Diarrhea is still the second leading cause of death in children under 5. These deaths can be easily prevented by early recognition and appropriate intervention. Understanding of symptoms, signs, and complications of acute diarrhea is necessary in preventing these deaths. The main focus of this study was to study clinico-epidemiological and laboratory profile of under 5 hospitalized children with diarrhea. Materials and Methods: This prospective study was conducted in the Department of Pediatrics, of a tertiary care teaching hospital in North-west India from June 2016 to November 2018. Children presenting with acute watery diarrhea, between age of 1 month and 5 years, were enrolled in study. Clinical symptoms/signs along with demographic details and lab investigations of each case were studied. Results: Out of 179 admitted children, majority were males and maximum were in age group of 1–24 months. 136 (75.97%) children were exclusively breastfed till 6 months of age. Fever (88.82%), vomiting (74.30%), and oliguria (82.68%) were most common symptoms observed at admission. Depressed anterior fontanelle (63.12%), dry sunken eyes (80.45%), and/or delayed skin turgor (78.21%) were most common clinical signs observed. 140 (78.21%) children had some dehydration and 11 (6.15%) had severe dehydration. Severe features of bradycardia (2.23%), tachypnea (2.79%), and hypothermia (1.67%) were also noted. Deranged blood urea nitrogen and creatinine levels were observed in 48 (26.82%) and 15 (8.4%) children. Conclusion: Complications of diarrhea can be prevented by improving prevalent poor knowledge, attitude, and practices among parents regarding feeding and home-based interventions in diarrhea.

The effectiveness of short-duration in-feed organic acid use in finisher pigs for Salmonella control at slaughter

Reducing the risk of Salmonella contaminated pork products entering the food chain is important for improving food safety. This study aimed to evaluate the effectiveness of the short-duration use of three acidified feed interventions in finisher pigs for reducing the faecal shedding, caecal carriage and carcase contamination of Salmonella at slaughter. We also investigated the presence of Salmonella in transportation vehicles and abattoir lairages used prior to slaughter. In a series of seven farm trials, two groups of pigs received either their normal ration (control), or a ration containing one of three organic acid products (intervention) for a four-week period before slaughter. Product A was trialled on five farms, and Products B and C were trialled on one farm each, included in the ration of intervention pigs at the manufacturers recommended rate. Faecal samples were collected and examined before and after the four-week intervention; caecal content samples and carcase swab samples were collected at slaughter. The lorry used to transport pigs to slaughter and abattoir lairage pens used to hold pigs were also sampled. During one trial (farm ID: AT03), no Salmonella was detected during either farm visit, and therefore this farm was excluded from further analysis of the effectiveness of organic acid interventions. Overall regression analysis indicated there was no significant difference in faecal shedding between the control groups at the baseline visit and the follow-up visit in pigs which received Product A (P = 0.262) or Product B (P = 0.094) in comparison to the control groups. On the other hand, there was evidence to suggest that the use of Product C was associated with an increase in faecal shedding compared to the control groups (P < 0.001). Similarly, Product A was not significantly associated (P > 0.05) with the caecal carriage of Salmonella. However, Product B (P = 0.029) and Product C (P = 0.050) were associated with an increase in caecal carriage in comparison to the control groups. These latter products were only trialled on one farm each, and these results may be attributable to natural random variation.

Responsive Feeding Environments in Childcare Settings: A Scoping Review of the Factors Influencing Implementation and Sustainability.

Children benefit from responsive feeding environments, where their internal signals of hunger and satiety are recognized and met with prompt, emotionally supportive and developmentally appropriate responses. Although there is existing research on responsive feeding environments in childcare, there is little synthesized literature on the implementation practices using a behavior change framework. This scoping review sought to explore the factors influencing the implementation and sustainability of responsive feeding interventions in the childcare environment, using the behavior change wheel (BCW). A total of 3197 articles were independently reviewed and 39 met the inclusion criteria. A thematic analysis identified the factors influencing the implementation and sustainability of responsive feeding, including the following: (1) pre-existing nutrition policies, (2) education and training, (3) provider beliefs and confidence, (4) partnership development and stakeholder engagement and (5) resource availability. The most common BCW intervention functions were education (n = 39), training (n = 38), environmental restructuring (n = 38) and enablement (n = 36). The most common policy categories included guidelines (n = 39), service provision (n = 38) and environmental/social planning (n = 38). The current literature suggests that broader policies are important for responsive feeding, along with local partnerships, training and resources, to increase confidence and efficacy among educators. Future research should consider how the use of a BCW framework may help to address the barriers to implementation and sustainability.

Clinical validation of the infant-driven feeding scales© in Turkey

BackgroundSupporting the development of feeding skills among preterm infants is an important component of neonatal care. The selection of appropriate and supportive feeding interventions begins with a comprehensive assessment of the infant's skills. PurposeThis study aimed to adapt the Infant-Driven Feeding Scales© (IDFS) to the Turkish language. MethodsThis was a methodological, observational, single-center cross-sectional study. The study included 80 infants born at a gestational age ≥ 32 weeks, consecutively admitted to a tertiary Neonatal Intensive Care Unit (NICU). Research data were collected using a premature infant descriptive information form (IDIF), IDFS, and LATCH Score for Breastfeeding Assessment. For the Turkish validity-reliability of the IDF, the translate-back translate method was used with the content validity index (CVI) assessed. ResultsThe scale had CVI values between 0.90 and 1.00 with a mean CVI = 0.96. For measures 1 and 2, there were significant positive and high-level correlations between IFDS-R and IFDS-Q correlation values (r = 0.553–0.958; p = 0.001) and significant negative, low-level correlations between IFDS-R and IFDS-Q with the LATCH scale (r = 0.439–0.532; p = 0.001). According to inter-observer compatibility analyses, the kappa value was 0.94–1.00 for the first measure and 0.96–1.00 for the second measure (p = 0.001). There were negative significant correlations between IDFS-R points with gestational age and postmenstrual age (PMA) (p = 0.001), and gestational age and PMA were explanatory factors for 13.8% of IDFS-R points (F = 7.30, p = 0.001). ConclusionsThe IDFS is recommended for use as a valid and reliable tool to ease the safe and successful development of oral feeding skills in preterm infants and to plan evidence-based interventions. Implications for practiceThe IDFS appears to be a beneficial measurement device for use in assessing the state of readiness of preterm infants for oral feeding and for early determination of risks that may occur due to delayed feeding independence of infants.

Effect of Feeding Obturator on Growth Parameter in a Patient with Pierre-Robin Sequence

Pierre-Robin Sequence is a developmental anomaly characterized by the triad of mandibular micrognathia, cleft palate, and glossoptosis. Neonates born with a cleft palate have difficulty in feeding that is further complicated by nasal regurgitation of food, excessive air intake, choking and recurrent aspiration pneumonitis. Due to difficulty in feeding, child’s growth can be affected. To combat these problems, different feeding interventions such as maternal advice and support, modified bottles, Orogastric/nasogastric tubes and feeding obturators, etc have been advocated. However, there is evidence of delay in the growth of children with a cleft as compared to those without clefting. The article describes the importance of measuring growth parameters to evaluate the growth of cleft palate patients.

Blood Lipid Responses to Diets Enriched with Cottonseed Oil Compared with Olive Oil in Adults with High Cholesterol in a Randomized Trial

BackgroundIncreasing unsaturated fat intake is beneficial for cardiovascular health, but the type of unsaturated fat to recommend remains equivocal. ObjectivesWe investigated the effects of an 8-week diet intervention that was rich in either cottonseed oil (CSO; PUFA rich) or olive oil (OO; MUFA rich) on blood lipids in hypercholesterolemic adults. MethodsForty-three men and women with hypercholesterolemia (53 ± 10 years; BMI, 27.6 ± 4.8 kg/m2) completed this randomized parallel clinical trial consisting of an 8-week partial outpatient feeding intervention. Participants were given meals and snacks accounting for ∼60% of their daily energy needs, with 30% of energy needs from either CSO (n = 21) or OO (n = 22). At pre- and postdiet intervention visits, participants consumed a high-SFA meal (35% of total energy needs; 70% of energy from fat). The primary outcomes of fasting cholesterol profiles and secondary outcomes of postprandial blood lipids and glycemic markers were assessed over a 5-hour period. ResultsThere were greater reductions from baseline to week 8 in fasting serum total cholesterol (TC; −17.0 ± 3.94 mg/dL compared with −2.18 ± 3.72 mg/dL, respectively; P = 0.008), LDL cholesterol (−19.7 ± 3.94 mg/dL compared with −5.72 ± 4.23 mg/dL, respectively; P = 0.018), non–HDL cholesterol (−20.8 mg/dL ± 4.00 compared with −6.61 ± 4.01 mg/dL, respectively; P = 0.014), and apoB (−11.8 mg/dL ± 2.37 compared with −3.10 ± 2.99 mg/dL, respectively; P = 0.05), in CSO compared with OO. There were also visit effects from baseline to week 8 for increases in HDL cholesterol (CSO, 56.5 ± 2.79 mg/dL to 60.2 ± 3.35 mg/dL, respectively; OO: 59.7 ± 2.63 mg/dL to 64.1 ± 2.24 mg/dL, respectively; P < 0.001), and decreases in the TC:HDL-cholesterol ratio (CSO, 4.30 ± 0.27 mg/dL to 3.78 ± 0.27 mg/dL, respectively; OO, 3.94 ± 0.16 mg/dL to 3.57 ± 0.11 mg/dL, respectively; P < 0.001), regardless of group assignment. In response to the high-SFA meal, there were differences in postprandial plasma glucose (P = 0.003) and triglyceride (P = 0.004) responses and a trend in nonesterified fatty acids (P = 0.11) between groups, showing protection in the postprandial state from an occasional high-SFA fat meal with CSO, but not OO, diet enrichment. ConclusionsCSO, but not OO, diet enrichment caused substantial improvements in fasting and postprandial blood lipids and postprandial glycemia in hypercholesterolemic adults. This trial was registered at clinicaltrials.gov as NCT04397055.

Impact of a nurse education programme on oral feeding in a neonatal unit.

Premature neonates often experience feeding difficulties during their hospital stay, and evidence-based interventions have been shown to improve feeding outcomes. This study investigated whether an infant-cue based nurse educational feeding bundle accelerates the achievement of independent oral feeding in neonates in a neonatal intensive care unit. A quality improvement study with a pre, during and post intervention test design. All premature neonates admitted to the unit were eligible. The feeding programme included a four-month nurse training module and nurse coaching. A hundred and twenty-five nurses or nurse assistants attended the programme and 706 neonates were included. The median time to independent oral feeding (IOF) was 40, 36 and 37 days, respectively, for pre, during and post intervention. The reduction in time to IOF observed during the post-intervention period compared with the baseline period was significant (HR=1.32, CI 95%: 1.01-1.74). No difference was noted in the length of hospital stay between the three study periods. An infant-cue based nurse educational feeding bundle can promote earlier achievement of IOF in preterm neonates. This quality improvement study demonstrates the impact that a nurse-driven intervention in neonatal care can have on improving practice. Feeding interventions involve the early introduction of oral feeding, non-nutritive sucking (NNS), and oral motor stimulation, and should be individualized for each neonate. These individualized feeding interventions applied by all nurses and assistant nurses, can facilitate the achievement of earlier independent oral feeding in preterm infants and should be included in neonatal critical care nurse education programs.

Importance of breastfeeding and complementary feeding for management and prevention of childhood diarrhoea in low- and middle-income countries.

BackgroundEarly and exclusive breastfeeding have been shown to protect young infants from all-cause and diarrhoea-related mortality. Ideally breastfeeding should be initiated within the first hour of birth. Despite efforts to increase rates of early and exclusive breastfeeding in low- and middle-income countries (LMICs), challenges with uptake remain. This analysis reviews trends in early and exclusive breastfeeding, and the impact of infant feeding interventions in reducing childhood diarrhoea.MethodsWe conducted a detailed review of articles written in English between 1990 and 2020 on the impact and efficacy of breastfeeding and complementary feeding on diarrhoea in children aged 0-2 years in LMICs. Using data from 86 countries and all WHO global regions collected from the mid-1980s through 2018 obtained from publicly available Demographic Health Surveys, we assessed trends in five-year intervals of timing of breastfeeding initiation, exclusive breastfeeding, median and mean duration of exclusive breastfeeding, and complementary feeding.ResultsThe literature search identified ten articles that described variable rates of early initiation of breastfeeding from 20% in Pakistan to 76% in Egypt. An analysis of 288 DHS studies found that the proportion of women who reported initiating breastfeeding within an hour of birth increased from 32% in the early 1990s to 55% between 2016 and 2020. Exclusive breastfeeding increased from 20% in the late 1980s to 48% between 2016 and 2020 and the mean duration of exclusive breastfeeding of 2-to-4-month-old infants doubled. Early initiation of breastfeeding and exclusive breastfeeding was associated with reductions in diarrhoea prevalence in the South East Asian, Western Pacific, Eastern Mediterranean, and African regions. Eight studies evaluating the effectiveness of different maternal education interventions, health care worker training, and media campaigns demonstrated improvements in exclusive breastfeeding, and most resulted in reductions in the incidence or duration of diarrhoea.ConclusionsDuring the last two decades, early and exclusive breastfeeding have increased. Nevertheless, the uptake of this basic, low-cost intervention remains suboptimal across all global regions. Given the potential benefits the in reduction of diarrhoea and diarrhoea-associated mortality, interventions for improving the uptake of early and exclusive breastfeeding in different sociological contexts need to be designed, implemented, and evaluated.

Evidence for Global Health Care Interventions for Preterm or Low Birth Weight Infants: An Overview of Systematic Reviews.

Twenty-four research questions (framed as population, intervention, comparator, and outcomes) for global health care interventions for preterm and low birth weight (LBW) infants were identified at a World Health Organization guideline development group expert meeting in December 2020. To describe which systematic reviews had addressed these research questions in the last 3 years. Medline (Ovid); the Cochrane Database of Systematic Reviews; the Cochrane Database of Systematic Review Protocols; and the PROSPERO International prospective register of systematic reviews databases from January 1, 2019 to December 31, 2021 were used.Randomized controlled trials or observational studies. Two reviewers independently extracted data. We found 9 systematic reviews. Eight reviews of 121 studies and 25 465 preterm or LBW infants published in the last 36 months "fully" addressed 8 of our 24 research questions (donor human milk, multicomponent fortifier, formula milk, probiotics, emollients, continuous positive airways pressure [CPAP] any, CPAP early, CPAP prophylactic); and 1 systematic review found no trials (mother's own milk). All received a "high" AMSTAR quality rating. Fifteen research questions (kangaroo mother care, early initiation, responsive feeding, advancement, exclusive breastfeeding duration, iron, zinc, vitamin D, vitamin A, calcium and phosphorous, multiple micronutrients, CPAP pressure source, methyl xanthines, family involvement, and family support) had no systematic review. Limitations include that we restricted our search to those interventions identified as a priority at a World Health Organization scoping meeting. Other interventions that may be of importance to preterm or LBW infants were not able to be considered. Almost a third of our research questions were addressed by high quality systematic reviews. We found gaps in thermal care, feeding, and familysupport interventions, which need to be addressed.

Metabolomics-Guided Comparison of Pollen and Microalgae-Based Artificial Diets in Honey Bees.

Managed honey bee colonies used for crop pollination are fed artificial diets to offset nutritional deficiencies related to land-use intensification and climate change. In this study, we formulated novel microalgae diets using Chlorella vulgaris and Arthrospira platensis (spirulina) biomass and fed them to young adult honey bee workers. Diet-induced changes in bee metabolite profiles were studied relative to a natural pollen diet using liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-mass spectrometry (GC-MS) metabolomics. Untargeted analyses of pollen- and microalgae-fed bees revealed significant overlap, with 248 shared features determined by LC-MS and 87 shared features determined by GC-MS. Further metabolomic commonalities were evident upon subtraction of unique diet features. Twenty-five identified metabolites were influenced by diet, which included complex lipids, essential fatty acids, vitamins, and phytochemicals. The metabolomics results are useful to understand mechanisms underlying favorable growth performance as well as increased antioxidant and heat shock protein gene expression in bees fed the microalgae diets. We conclude that the tested microalgae have potential as sustainable feed additives and as a source of bee health-modulating natural products. Metabolomics-guided diet development could eventually help tailor feed interventions to achieve precision nutrition in honey bees and other livestock animals.

The Effect of Supplementary Feeding Interventions on Nutritional Status of Pregnant Women with Chronic Energy Deficiency

Background: The high number of pregnant women with Chronic Energy Deficiency at Puskesmas Kuwarasan, Kebumen District can increase the Maternal Mortality Rate and Infant Mortality Rate. One of the efforts made to reduce the number of pregnant women with chronic energy deficiency is the provision of supplementary foods in the form of biscuits and milk per day for 90 days. This study aims to determine the effect of the intervention of supplementary feeding on the nutritional status of pregnant women with chronic energy deficiency. Method: This research used descriptive-analytical method with a case study design. It involved 5 cases of pregnant women with Chronic Energy Deficiency. The nutritional status of pregnant women was measured using the mid-upper arm circumference indicator. Differences in nutritional status before and after the intervention were measured based on the mid-upper arm circumference. After the intervention with the provision of supplementary foods in the form of biscuits and milk for 90 days, the chronic energy deficiency issue was resolved as indicated by a change in nutritional status in pregnant women with chronic energy deficiency whose status changed to normal nutritional status. Result: The average value of mid-upper arm circumference increased from 21.8 to 23.82 cm. The Wilcoxon test obtained a p-value of 0.038 (there is a significant relationship before and after the intervention of supplementary foods for 90 days). Conclusion: Supplementary foods of biscuits and milk can improve nutritional status to normal..

Experience and Perceptions of Mothers Participating in an In-Home, Parent-Mediated Feeding Intervention for Their Child With Autism

Abstract Date Presented 04/02/2022 Children with autism spectrum disorder (ASD) have significant feeding challenges that create barriers to successful mealtimes. A qualitative study consisted of thematic analysis of 12 semistructured interviews of mothers who participated in 24 home-based feeding sessions and parent education to examine the perceived impact of parent-mediated feeding therapy. Data validated the complexity of maternal roles and supported positive child-specific goals as well as parenting efficacy and family participation. Primary Author and Speaker: Libby Hladik Additional Authors and Speakers: Karla Ausderau, Brittany St John

Effectiveness of Outpatient Pediatric Feeding Interventions on Increasing Variety of Foods Consumed and Adaptive Mealtime Behaviors

Abstract Date Presented 03/31/2022 Pediatric feeding difficulties can negatively affect a child’s ability to gain adequate nutrition and participate in mealtime occupations. This retrospective study examined the effectiveness of outpatient pediatric feeding therapy examining the variety of foods consumed on a regular basis and mealtime behaviors. Results indicate improvements in foods eaten and adaptive mealtime behaviors. Primary Author and Speaker: Aimee Piller Additional Authors and Speakers: Jenna Penning, Aaron Bonsall

Sensory processing and eating behaviours in autism: A systematic review.

ObjectivesThe aim of this study was to assess the relationship between sensory processing and a broad range of eating behaviours across the lifespan.MethodsFive electronic databases of published and unpublished quantitative studies were systematically searched, evaluated for risk of bias and synthesised according to identified eating outcomes.ResultsAcross 25 studies, there was consistent evidence of a relationship between sensory processing and a range of eating behaviours. There was early evidence for the particular role of taste/smell sensitivities, as well as hypersensitivities, although future research is needed looking at different sensory patterns and modalities. There was also tentative evidence to suggest this relationship extends across development.DiscussionStudy findings are discussed in relation to implications for sensory‐based eating and feeding interventions and the development of eating disorders. Methodological and conceptual limitations are discussed and suggestions for future research are made to address these limitations. A broader investigation of multi‐sensory issues and clearly defined eating behaviours, including disordered eating in clinically diagnosed samples, will allow for a more comprehensive and robust understanding of the relationship between sensory processing and eating behaviours in autism.

Feeding Skill and Behavior Changes in Children With Complex Feeding Disorders Following Therapy in an Intensive Multidisciplinary Feeding Program

Purpose: This study aims to measure and describe changes in oral feeding skills and mealtime behaviors observed in children with complex feeding disorders and/or feeding tube dependence after participation in an intensive multidisciplinary feeding program. This is the first study to use a standardized tool to report feeding outcomes after patients received intensive feeding therapy using a combination of therapeutic strategies. Method: This was a prospective observational study examining the treatment outcomes of 34 patients (range: 13 months to 6.5 years) admitted into the Intensive Multidisciplinary Feeding Program using the Pediatric Eating Assessment Tool (PediEAT). Eighteen patients were tube dependent; 16 patients were oral feeders. All patients received 19 days of intensive feeding intervention. The PediEAT was completed by patient's caregiver at admission and discharge from the feeding program. Caregiver and patient demographics were also collected. Results: Statistical analysis of scores at admission (prescore) and at discharge (postscore) revealed significant improvements in PediEAT total scores and across all subscales for all patients. The largest degree of change was noted in the Problematic Mealtime Behaviors subscale. Patients who were oral feeders also demonstrated significant improvements in the Oral Processing subscale in addition to Problematic Mealtime Behaviors subscale. Tube-dependent patients presented with a large degree of change in the Selective Restrictive Eating subscale and in the Problematic Mealtime Behaviors subscale. Conclusions: This study demonstrates that the use of an individualized approach using a combination of therapeutic strategies results in statistically significant improvements in multiple feeding domains as measured by a validated tool after participating in an intensive multidisciplinary feeding program. Improvement in a child's ability to manage advanced textures and consistencies can have a significant impact on their willingness to engage in mealtimes. It is important to measure and report on their skills, in addition to behavioral responses and intake.

Cultural influences on infant and toddler feeding among low-income Latinx mothers.

Latinx infants and toddlers experience higher obesity rates than their black or white counterparts, increasing chronic disease risk later in life. Infant and toddler feeding (ITF) interventions are shown to improve dietary behaviours, but few studies target Latinx populations. Culturally tailoring such interventions is imperative, but cultural influences on Latinx ITF practices remain unclear. The purpose of this study was to characterize how culture influences ITF practices among Latinx mothers of low income. A brief survey and semistructured interview informed by the theory of planned behaviour (TPB) were conducted on Zoom with New York City‐based Latinx mothers of children 4 to 24 months old. A directed content analysis approach was used to identify themes using TPB theoretical codes and inductive codes. Transcripts were coded independently by two researchers using NVivo 12. Survey data were analyzed using descriptive statistics in Excel. Participants (n = 19) were of Dominican, Mexican and Central and South American origin, had low acculturation scores and mean child age was 16.7 months (range: 5–24 months old). The central theme identified was that participants balanced cultural information with evidence‐based health information to determine which ITF practices were most beneficial to infant/toddler health. This resulted in the adoption of evidence‐based ITF recommendations, adoption of cultural practices that aligned with evidence‐based recommendations and dismissal or postponement of cultural ITF practices that contradicted evidence‐based recommendations. The present results can be applied to culturally relevant ITF education as follows: emphasizing the benefits of desirable ITF practices on children's health and promoting healthy cultural ITF practices.

Behavior Analytic Feeding Interventions: Current State of the Literature.

The purpose of this paper was to review the current state of the behavior analytic feeding intervention literature. We highlight studies that we found to be important contributions to the recent literature in the following areas: food selectivity, chewing, packing, and food refusal/tube weaning and provide suggestions for future research and clinical work in these areas. We also discuss several current topics relevant to the field in hopes to further advance research and clinical practice. These topics include considering the benefits of innovative models of service delivery such as telehealth and caregiver-implemented interventions, the importance of evaluating long-term outcomes of behavioral feeding interventions, and lastly, ethical issues to consider in the designing and implementation of behavioral feeding interventions and training of practitioners in our field.

Effects of Red Meat and Proton Pump Inhibitors on Rat Gut pH and Claudin-2

ObjectivesProlonged use of Proton Pump Inhibitors (PPIs) may alter the gut pH and integrity of the gut barrier which play significant roles in health and the aging process. High consumption of red meat may lead to inflammatory gastrointestinal (GI) conditions, including colorectal cancer; however, research results have been inconsistent. There is limited research evaluating the effects of red meat vs white meat and the interaction with PPI treatment, focusing on the integrity of the gut. Therefore, the purpose of this study was to examine the effects of white meat vs red meat on GI organ pH, and claudin-2 levels in rats treated with and without PPI. MethodsIn a 2 (diet) × 2 (treatment) factorial design, 28 nine-month-old Sprague Dawley male rats were arranged into four groups: white meat, white meat with PPI, red meat, red meat with PPI. Diets consisted of 70% rat chow and 30% meat powder with or without PPI administered at 0.05 g/kg in the feed. After an 8-week feeding intervention, blood samples were collected to examine claudin- 2 levels. Gut pH levels were taken in the stomach, duodenum, ileum, cecum, proximal colon, distal colon, and anus. ResultsPPI administration increased pH in the stomach (P = 0.026). Red meat diets exhibited a decreased pH in the cecum (P = 0.005) and the proximal colon (P = 0.013). Red meat with PPI increased pH in the proximal colon (P = 0.009). Red meat groups showed greater claudin-2 levels (P = 0.007), especially with PPI (P = 0.026). ConclusionsIncreased levels of claudin-2 are associated with leaky gut and inflammation in the digestive system. Our study demonstrated that red meat with PPI may disturb gut integrity as compared to non-PPI, or to white meat groups. Elevated pH by PPI may reduce symptoms in patients with acid reflux but also increase their chance of leaky guts, especially with red meat. Further studies are needed to investigate the association of lowering gut pH in red meat diets with the risk of inflammation. It is vital to investigate these relationships because PPIs are often used for gastric acid problems, and diet is a critical component of such treatment. Funding SourcesSan Diego State University College of Health and Human Services faculty Jump Start Grant (PI: Tianying Wu, Co-PI: Mee-Young Hong).