Solid Food Research Articles

Gluten migration from biodegradable food contact materials poses a risk to celiac disease patients

AbstractDue to the ban of certain single-use plastics in the European Union, food contact materials (FCM) from biobased and/or biodegradable polymers are increasingly being used. Some FCM are made from wheat or rye and therefore contain gluten, which is a food allergen and known to cause celiac disease. Legislation currently does not require allergen labelling on FCM and there is only some first information that gluten from FCM can migrate into gluten-free foods. Our aim was to analyze the extent of gluten migration from six different FCM into a variety of liquid and solid foods to assess the risk of exposure for wheat allergy and celiac disease patients. We show that the extent of gluten migration depended on the properties of the material, the liquid or solid food it comes into contact with and contact time. There was no clear effect of temperature or pH value. Of the six FCM studied, wheat bran-based plates had the highest potential to release gluten with concentrations of up to 203.0 mg/L of gluten in deionized water after 30 min. To protect patients, it is important to raise awareness of the risk of gluten migration from such FCM and help patients identify and avoid gluten-containing FCM. Further, legislation needs to be adapted urgently to include mandatory labelling of allergens on these biodegradable FCM.

Free sugar intake is associated with reduced proportion of circulating invariant natural killer T cells among women experiencing overweight and obesity.

Higher prevalence of obesity has been observed among women compared to men, which can be explained partly by the higher consumption of sweets and physical inactivity. Obesity can alter immune cell infiltration, and therefore increase the susceptibility to develop chronic inflammation and metabolic disorders. In this study, we aimed to explore the association between free sugar intake and other unhealthy lifestyle habits in relation to the proportion of circulating iNKT cells among women with healthy weight and women experiencing overweight and obesity. A cross-sectional study was conducted on 51 Saudi women > 18 years, wherein their daily free sugar intake was assessed using the validated Food Frequency Questionnaire. Data on smoking status, physical activity, and supplement use were also collected. Anthropometric data including height, weight, waist circumference were objectively measured from each participants. The proportion of circulating iNKT cells was determined using flow cytometry. Smoking, physical activity, supplement use, and weight status were not associated with proportion of circulating iNKT cells. Significant association was found between proportion of circulating iNKT cells and total free sugar intake and free sugar intake coming from solid food sources only among women experiencing overweight and obesity (Beta: -0.10: Standard Error: 0.04 [95% Confidence Interval: -0.18 to -0.01], p= 0.034) and (Beta: -0.15: Standard Error: 0.05 [95% Confidence Interval: -0.25 to -0.05], p= 0.005), respectively. Excessive free sugar consumption may alter iNKT cells and consequently increase the risk for chronic inflammation and metabolic disorders.

Millet based Nutritious Powder for the Geriatric Population

Objective: This study aimed to utilize finger millet as a primary ingredient for creating nutritious millet powder suitable for hot beverages. Desiccated coconut was incorporated for color enhancement. The optimization process involved sensory evaluation and trials on a laboratory scale. Three variations of millet products and two recipes were developed: one for a beverage made by mixing millet (Ragi/ Finger millet) nutritious powder with hot water, and another for millet nutritious halua powder fortified with nutrients. Additionally, a millet nutritious powder based on Pearl millet was formulated for easy consumption by the ageing population.  Methods: The study involved the preparation and experimentation of three types of millet nutritious powder, derived from finger and pearl millet, targeting the nutritional needs of ageing individuals. Age-related challenges such as esophagus stenosis were taken into account during formulation. The viscosity graphs were utilized to refine the texture of the food, ensuring ease of swallowing. Laboratory-scale trials and benchtop sensory evaluations were conducted to optimize the formulations. The acceptability of the beverages was assessed using a 9-point hedonic scale.  Results: The formulated millet nutritious powders demonstrated excellent nutrient composition, with calcium content exceeding three times that of a cup of milk. The halua powder exhibited low viscosity, high solubility, and excellent swallowing properties. The optimized beverages achieved a total acceptability score exceeding 7 on the hedonic scale, indicating favourable consumer reception. The study successfully developed three variants of millet nutritious powder tailored for aging individuals, addressing concerns related to swallowing difficulties and offering a comfortable dietary option.  Conclusion: In conclusion, this study demonstrates the feasibility of utilizing finger and pearl millet to create nutritious powders suitable for hot beverages, particularly catering to the dietary needs of the aging population. The formulations offer a convenient and easily consumable option for individuals facing challenges with chewing solid food. Moreover, the affordability and widespread accessibility of the developed food products make them suitable for diverse populations, highlighting their potential for addressing nutritional needs on a broader scale.

Leiomyosarcoma of the esophagus, arising from lamina muscularis mucosae, in a combination with microinvasive squamous cell carcinoma-A case report.

Leiomyosarcoma of the esophagus is a very rare disease, accounting for less than 0.5% of malignant esophageal tumors. Esophageal leiomyosarcoma combined with squamous cell carcinoma is even rarer than solitary leiomyosarcoma. To our knowledge, there are less than ten cases of simultaneously diagnosed leiomyosarcoma and squamous cell carcinoma of the esophagus. A 66-year-old male was admitted to our hospital suffering from epigastric pain, asthenia, weight loss, and difficulties when feeding with solid food which had been present for 2 weeks. A computed tomography scan showed a large tumor tissue mass in the mid-to-distal part of the esophagus. The patient underwent robot-assisted surgery-an esophagectomy with esophagogastrostomy. Histologically, the tumor consisted of highly pleomorphic spindle cells with multiple atypical mitosis and necrotic areas. An immunohistochemical examination was performed to distinguish leiomyosarcoma from spindle cell squamous carcinoma or malignant GIST. Tumor cells stained diffusely positive for smooth muscle actin, but negative for p63, CD117, and CKAE1/AE3. Tumor invasion involved mucosa and submucosa, without tunica muscularis propria. Microinvasive well-differentiated squamous cell carcinoma was also noted in the mucosa at the borders between the tumor and the healthy part of the esophagus. The aim of the manuscript is to present an extremely rare case of combined polypoid leiomyosarcoma and microinvasive squamous cell carcinoma of the esophagus, cured by robot-assisted surgical intervention and to emphasize that such cases should be examined carefully, including additional diagnostic tests such as Immunohistochemistry (IHC) in order to define the correct diagnosis.

Use of dishwashers fails to inactivate foodborne pathogens in home-canned model foods

Risky home canning techniques are still performed for food preservation due to limited science-based recommendations. This study aimed to evaluate the inactivation of Shiga toxin-producing Escherichia coli O157:H7, Salmonella enterica (ser. Typhimurium, Enteritidis, and Infantis) and Listeria monocytogenes during home canning with a household dishwasher. The 450 mL of blended tomato (acidic liquid food) and potato puree (non-acidic solid food) were prepared with 1.5 % salt and 25 mL vinegar as model foods in glass jars (660 mL). The two model foods were sterilized, then inoculated with separate cocktails of each pathogen at 106–107 CFU/g. The prepared jars were placed in the bottom rack of a dishwasher and subjected to the following cycles: economic (50 °C, 122 min), express (60 °C, 54 min), and intensive (70 °C, 96 min). Temperature changes in jars were monitored by using thermocouples during heat treatment. Within the center of the jars, temperatures were measured as 45 to 53 °C in blended tomato and 44 to 52 °C in potato puree during all tested dishwasher cycles, respectively. The economic cycle treatment reduced S. enterica, E. coli O157:H7, and L. monocytogenes populations by 3.1, 4.6, and 4.2 log CFU/g in blended tomato (P ≤ 0.05), where a <1.0 log reduction was observed in potato puree (P > 0.05). All pathogens showed similar heat resistance during the express cycle treatment with a log reduction ranging from 4.2 to 5.0 log CFU/g in blended tomato and 0.6 to 0.7 log CFU/g in potato puree. Reduction in L. monocytogenes population was limited (0.6 log CFU/g) compared to E. coli O157:H7 (2.0 log CFU/g) and S. enterica (2.7 log CFU/g) in blended tomato during the intensive cycle treatment (P ≤ 0.05). Dishwasher cycles at manufacturer defined settings failed to adequately inactivate foodborne pathogens in model foods. This study indicates that home-canned vegetables may cause foodborne illnesses when dishwashers in home kitchens are used for heat processing.

Caffeine intake enhances bowel recovery after colorectal surgery: a meta-analysis of randomized and non-randomized studies.

Postoperative ileus (POI) after colorectal surgery is a major problem thataffects both patient recovery and hospital costs highlighting the importance of preventive strategies. Therefore, we aimed to perform a systematic analysis of the effects of postoperative caffeine consumption on bowel recovery and surgical morbidity after colorectal surgery. A comprehensive literature search was conducted through September 2023 for randomized and non-randomized trials comparing the effect of caffeinated versus non-caffeinated drinks on POI by evaluating bowel movement resumption, time to first flatus and solid food intake, and length of hospital stay (LOS). Secondary outcome analysis included postoperative morbidity in both groups. After data extraction and inclusion in a meta-analysis, odds ratios (ORs) for dichotomous variables and standardized mean differences (SMDs) for continuous outcomes with 95% confidence intervals (CIs) were calculated. Subgroup analyses were performed in cases of substantial heterogeneity. Six randomized and two non-randomized trials with a total of 610 patients were included in the meta-analysis. Caffeine intake significantly reduced time to first bowel movement [SMD -0.39, (95% CI -0.66 to -0.12), p = 0.005] and time to first solid food intake [SMD -0.41, (95% CI -0.79 to -0.04), p = 0.03] in elective laparoscopic colorectal surgery, while time to first flatus, LOS, and the secondary outcomes did not differ significantly. Postoperative caffeine consumption may be a reasonable strategy to prevent POI after elective colorectal surgery. However, larger randomized controlled trials (RCTs) with homogeneous study protocols, especially regarding the dosage form of caffeine and coffee, are needed.

Influence of fasting on the efficacy of anthelminthics in naturally infected sheep

The aim of this study was to verify the effect of fasting on the anti-helminthic efficiency of ivermectin-albendazole-levamisole (IAL) combination (first stage) and the closantel and albendazole (second stage) in sheep naturally infected with gastrointestinal nematodes. To this end, fecal samples from young (4 to 6 months), male and female sheep were evaluated seven and 14 days after the treatments, using the Egg count Per Gram of feces (EPG) and the Fecal Egg Count Reduction Test (FECRT). In the first stage of the experiment, the mean EPG of the animals treated and fasted beforehand was lower than the mean EPG of the animals treated, but not fasted 14 days after treatment. Moreover, the group of fasted animals exhibited a better reduction in fecal egg count rate. In the second stage, there was no significant decrease in the mean EPG of the animals in any group (closantel and albendazole) and the efficiency calculated by FECRT was low for the closantel group and zero for the albendazole group. However, the decrease in EPG in animals treated with closantel after fasting was 326.8% greater than the decrease in EPG in animals treated without prior fasting. It was evident that fasting had a positive influence on the reduction of the genera Haemonchus, Cooperia, Trichostrongylus and Oesophagostomum in the animals treated with closantel. The anthelminthic effect of closantel, albendazole and ivermectin-albendazole-levamisole (IAL) combination in sheep was significantly enhanced by previous fasting. Therefore, it is strongly recommended to withhold solid food for a minimum of 12 hours before administering these treatments.

Large-Caliber Empiric Esophageal Dilation Results in Sustained Improvement for Selected Patients With Nonobstructive Dysphagia.

Empiric esophageal dilation (EED) remains a controversial practice for managing nonobstructive dysphagia (NOD) secondary to concerns about safety and efficacy. We examine symptom response, presence of tissue disruption, and adverse events (AEs) after EED. We examined large-caliber bougie EED for NOD at 2 tertiary referral centers: retrospectively evaluating for AEs. Esophageal manometry diagnoses were also reviewed. We then prospectively assessed EED's efficacy using the NIH Patient-Reported Outcomes Measurement Information System disrupted swallowing questionnaire to assess dysphagia at baseline, 1, 3, and 6 months after EED. Treatment success was defined by improvement in patient-reported outcome scores. AE rate for large-caliber dilation in the retrospective cohort of 180 patients undergoing EED for NOD was low (0.5% perforations, managed conservatively). Visible tissue disruption occurred in 18% of patients, with 47% occurring in the proximal esophagus. Obstructive motility disorders were found more frequently in patients with tissue disruption compared with those without (44% vs 14%, P = 0.05). The primary outcome, the mean disrupted swallowing T -score was 60.1 ± 9.1 at baseline, 56.1 ± 9.5 at 1 month ( P = 0.03), 57 ± 9.6 at 3 months ( P = 0.10), and 56 ± 10 at 6 months ( P = 0.02) (higher scores note more symptoms). EED resulted in a significant and durable improvement in dysphagia and specifically solid food dysphagia among patients with tissue disruption. EED is safe in solid food NOD and particularly effective when tissue disruption occurs. EED tissue disruption in NOD does not preclude esophageal dysmotility.

Assessment of Some of the Feeding Practices and Local Infant Flours' Consumption by 6 to 23 Months Children in the City of Ouagadougou, Burkina Faso

Background: From birth to 6 months, children must be exclusively breastfed, and from 6 months, food diversification starts to supplement breast milk. This cross-sectional study aims to evaluate some of the feeding practices regarding children aged 6 to 23 months in the city of Ouagadougou. Methods: First, data were food consumption data as well as recalling meals over the past 24 hours were collected. Then, technological and labeling data regarding infant flours produced locally and sold in Ouagadougou were obtained. For analysis, data were entered into Sphinx V5 and IBM SPSS Statistics 20 software, and means were compared using XLSTAT 2016 software. Results: In total, 33 local infant flours were evaluated, and all the formulations contained cereals. Fruits and legumes (30.30%), milk (30.30%), and eggs (0,00%) were the least used materials. Instant type flours were rarely encountered (9.09%), and packaging in plastic bags was consumed the most (57.57%). Regarding labeling information, batch number (28%) and the method of preservation (32%) were the least identified. With respect to food consumption, 94.84% of the children were breastfed and 98.33% aged 6 to 8 months consumed solid foods. At least 85.28% of women considered the age of 6 months for introduction of solid foods. Concerning consumption of infant porridges, imported infant porridges were preferred the most (37.44%). Conclusion: Concerning local infant flour, some of them did not meet WHO guidelines. With regard to food practice indicators in Ouagadougou, some of them are relatively satisfactory; however, there is still a need to raise awareness regarding feeding practices.

Motor function is not impaired in all components of the oral phase of feeding in a rat rotenone model of Parkinson’s disease

Parkinson’s disease results in pathological swallowing, or dysphagia, in up to 90% of cases. Severity and extent of functional impairment of feeding is highly variable in this disease. Feeding is a multi step neuromuscular process of tightly coordinated orofacial behaviors -transport, food reduction, pharyngeal swallowing- involving multiple musculoskeletal systems — tongue, jaw muscles, hyolaryngeal muscles — innervated by multiple cranial and cervical spinal nerves. The type of food being ingested further affects this sequence. The pesticide rotenone, a type II mitochondrial inhibitor, has been epidemiologically linked to Parkinson’s disease. The goal of this project is to identify how parkinsonian neurodegeneration affects this sequence in an animal model. We hypothesize that not all elements of the sequence will be equally affected. Twelve young adult male Lewis rats received daily intraperitoneal injections of either 2.75 mg/kg of rotenone or vehicle control for 8 days. The rats were trained to eat breakfast cereal and drink water mixed with barium in front of a high speed (200 fps) videofluoroscope. From the high speed video recording duration of intraoral transport and chewing of solid food as well as lick duration for liquid drinking were measured for multiple swallows per individual on day 0 (before injection), day 1, day 4, and day 7. On day 8 animals were perfused and brains harvested, sliced, stained with immunofluorescent markers for striatal tyrosine hydroxylase to confirm effectiveness of the model. Mixed model ANOVA was used to test the hypothesis that duration of the phases varied over the course of treatment. Duration of intra oral transport changed in neither control nor rotenone treated animals (p=0.1136), but duration of chewing increased in rotenone treated rats only by day 4 (p&lt;0.001). Duration of licks increased in liquid drinking rats from day 0. Different components of the oral feeding process vary in degree and timing of impairment in the rat rotenone model of Parkinson’s disease, with coordinated rhythmic tongue and jaw movements (licking and chewing) being most sensitive. The neurological basis for this differential sensitivity remains unclear. Internal Rowan funds to Dr. Gould supported this work. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Socioeconomic Characteristics and the Home Food Environment Are Associated With Feeding Healthful and Discretionary Foods During the First Year of Life in the Pregnancy Eating Attributes Study

BackgroundFeeding of nutrient-poor foods begins in infancy and may adversely influence long-term food preferences. ObjectiveTo examine associations of socioeconomic characteristics, childbearing parent eating behaviors, and home food environment with infant feeding characteristics. DesignSecondary analysis of a prospective cohort study from first trimester of pregnancy through 12 months postpartum. Participants/settingParticipants with uncomplicated singleton pregnancies and no major chronic illness were enrolled from November 2014 through October 2016 from 2 university-based obstetrics clinics in Chapel Hill, NC. Of 458 enrolled, 321 were retained through 12 months postpartum. Main outcome measuresParticipants completed infant food frequency questionnaires indicating age at introduction and frequency of consuming multiple food groups. Exposures included childbearing parent socioeconomic characteristics, hedonic hunger, addictive-like eating, Healthy Eating Index 2015 calculated from three 24-hour diet recalls, and home food environment fruit/vegetable and obesogenic scores. Statistical analyses performedMultiple imputation using Heckman selection model; linear and logistic regressions examining associations with infant feeding characteristics. ResultsLower education and income were associated with later infant age at introduction to, and lower frequency of consuming fruits and vegetables at age 12 months. Socioeconomic characteristics were not associated with age at introduction to discretionary solid foods; however, lower education and income were associated with greater infant frequency of intake of discretionary foods and greater odds of introducing fruit juice and sweetened beverages by age 12 months. Childbearing parent Healthy Eating Index 2015, hedonic hunger, and addictive-like eating were not consistently associated with infant feeding characteristics. A more obesogenic food environment was associated with greater frequency of intake of discretionary foods, lower frequency of intake of fruit, and greater odds of fruit juice introduction by age 12 months. ConclusionsInfant feeding characteristics may be important intervention targets for addressing socioeconomic disparities in child diet quality. Efforts to reduce routine feeding of discretionary foods across socioeconomic groups are needed; modifying the home food environment may promote healthful infant feeding.

Hubungan antara Akses Informasi dengan Pemberian ASI Eksklusif

Exclusive breastfeeding for 6 months is stated to be able to reduce under-5 mortality by 13%. After that the child must be given solid food as a supplementary food besides breast milk until the child is 2 years old. Therefore, good nutrition is needed during the growth and development of the brain so that it can develop optimally. In general, women in Indonesia, especially young mothers, are currently aggressively promoting exclusive breastfeeding. However, the exclusive breastfeeding program is still not running optimally as expected. The aim of this studied is to analyzed the correlation between accessibility of information and the success of exclusive breastfeeding. The type of research used is quantitative research with a case control approach. This research was conducted in the Work Area of ​​the Lameuru Health Center. The sample size for each case and control group was 41 mothers of infants aged 6-12 months. Data analysis used the Chi-Square test. The results showed that there was a relationship between access to information and the success of exclusive breastfeeding with a value of p=0.005 (p˂0.05) and odds ratio values ​​of 0.778 and 4.200. This shows that the better/more information about breastfeeding is given to pregnant/breastfeeding women, the higher the success of exclusive breastfeeding. The suggestion from this research is to make innovations to convey information about exclusive breastfeeding, such as making media that is more varied about exclusive breastfeeding, it is hoped that the achievement of exclusive breastfeeding can reach the national target.

Impact of cow, buffalo, goat or camel milk consumption on oxidative stress, inflammation and immune response post weaning time

Milk is a whitish liquid that is secreted from mammary glands; and considered as the primary source of nutrition for newborns since they are not able to digest solid food. However, it contains primary nutrients, as well as growth and immune factors. Early weaning is a critical issue that face women and their babies in developing countries. To avoid infant malnutrition, they tend to use other milk types instead of baby formula. Therefore, the present study aimed to evaluate the impact of cow, buffalo, goat or camel milk consumption on oxidative stress, inflammation and immune response in male and female Sprague Dawley rats post weaning time. The amino acids, fatty acids, minerals and vitamins in the tested milk types were evaluated. Animals were divided into 5 groups (control, cow, buffalo, goat and camel milk administrated groups) (10 rats/group); each animal was administrated by 3.4 ml/day. Rats were administered with milk for 6 weeks; at the end of the 5th week, five animals of each group were isolated and the remaining five animals were immunized with sheep red blood cells (SRBCs) and kept for another week to mount immune response. The effect of different milk types on rats’ immune response towards SRBCs was evaluated through pro-inflammatory cytokines, antioxidants, ESR and CRP measurement; together, with the histopathological examination of spleen samples and hemagglutination assay. Camel milk consumption reduced oxidative stress and inflammation in spleen that resulted from SRBCs immunization; in addition to, B cell stimulation that was apparent from the high level of anti-SRBCs antibodies. Camel milk is recommended for newborn consumption, due to its high-water content, unsaturated fatty acids, and vitamin C, as well as low lactose and fat content.

Examination of Microbial Contamination of Fresh Cow Milk in the Limau Manis Area, Tanjung Morawa, Deli Serdang

Background: Milk serves as a crucial source of human nutrition, particularly for infants who rely on it before they can digest solid foods. The mammary glands of female mammals produce it and is typically characterized by its pure white appearance. Objective: This study aimed to assess the levels of mesophilic aerobic bacteria and yeast mould present in fresh cow's milk obtained from farms in Limau Manis Tanjung Morawa. Methods: The investigation into contamination levels employed the Total Plate Count (TPC) method for aerobic bacteria and the Yeast Mold Count (YMC) method, both of which are based on the guidelines outlined in the Indonesian National Standard (SNI) No. 3141.1 of 2011. Results: Findings revealed that the levels of aerobic mesophilic bacteria, as determined by the TPC method, met the stipulated requirements of SNI No. 3141.1 of 2011 across all five farms surveyed. However, the research utilizing the YMC method indicated that the yeast mould counts in the milk from all five farms did not meet the established criteria. Conclusion: The analysis of microbial contamination using the TPC and YMC methods demonstrated compliance and non-compliance, respectively, with the standards outlined in SNI No. 3141.1 of 2011.

Longitudinal changes in bifidobacterial population during the first two years of life.

Early life microbiota encompasses of a large percentage of Bifidobacterium, while it is not sufficiently understood how the Bifidobacterium population develops after infant's birth. Current study investigated the longitudinal changes in Bifidobacterium population during the first two years of life in 196 term born infants (1,654 samples) using 16S rRNA-23S rRNA internal transcribed spacer (ITS) sequence analysis. Throughout the first two years of life, Bifidobacterium breve, Bifidobacterium longum subsp. longum and Bifidobacterium adolescentis were most dominant and prevalent in the Bifidobacterium population, while B. breve had the highest relative abundance and prevalence during the first week of life and it was taken over by B. longum subsp. longum around two years after birth. Sampling time points, early antibiotic(s) exposure (effect only measurable within a month after birth), delivery mode (effect still detectable two-months after birth) and feeding mode (effect lasted until six months after birth), significantly contributed to the overall variation in the bifidobacterial population. From six months onwards, introducing of solid food and cessation of breastfeeding were accompanied with drastic changes in the composition in bifidobacterial population. Altogether, current study confirmed the effect of potential contributors to the longitudinal changes within the bifidobacterial population during the first two years of life. Registered at https://clinicaltrials.gov: NCT02536560.

Diet quality and nutritional status of HIV-exposed children aged between 6 and 18 months in the Greater Accra Region of Ghana

IntroductionHIV-exposed children, even when uninfected, have a greater risk of malnutrition than unexposed counterparts. WHO guidelines recommend children aged 6–23 months be fed a variety of foods to meet nutrient requirements. This study aimed to determine infant and young child feeding (IYCF) practices among HIV-exposed children under 2 years old enrolled in a dietary intervention and to explore correlates of the IYCF indicators and associations between IYCF and nutritional status.MethodologySix hundred and eighty mother–child pairs were recruited from 19 health facilities from the Greater Accra Region. The sociodemographic data, anthropometry, hemoglobin, and dietary intake were recorded.ResultsNinety-five percent of HIV-positive mothers breastfed their babies, and 53% initiated breastfeeding in a timely manner. Around one in five mothers (21%) introduced liquids other than breastmilk to their children within the first 2 days of birth, and only around one in four children (26%) aged 12–23 months had received breast milk on the day before assessment. Ninety-three percent of babies between 6 and 8 months had been introduced to solid, semi-solid, or soft foods. Eighteen percent of children reached the threshold for Minimum Dietary Diversity (MDD) by eating from over five of eight food groups. Fifty-four percent received Minimum Meal Frequency (MMF), eating between 2 and 4 meals in a day. Eleven percent received the Minimum Acceptable Diet (MAD). Thirty-two percent were anemic. Underweight and stunting were 12 and 11%, respectively. Children of mothers aged 31–40 years were more likely to meet the MDD and MAD [OR = 2.8, 95%CI (1.185, 6.519), p &amp;lt; 0.05 and OR = 2.8, 95%CI (1.256, 6.279), p &amp;lt; 0.05] compared to children of mothers aged 30 years or less or aged above 40 years. Children from households earning more than GHS 500 were more likely to meet MMF than those from households earning less. No associations were found between IYCF and nutritional status.ConclusionFindings highlight the need for nutrition programs to educate HIV-exposed children’s caregivers on optimal feeding practices. The importance of continued breastfeeding and dietary diversity needs to be highlighted. Affordable, iron-rich foods should be promoted. Special attention should be paid to younger, less educated, and lower socioeconomic status mothers.

Plummer–Vinson syndrome: a rare occurrence in paediatrics

BackgroundPlummer–Vinson syndrome (PVS) is characterized by a triad of symptoms consisting of microcytic hypochromic anaemia, oesophageal webs, and dysphagia. PVS is commonly found in women in the fourth and fifth decades of life and is rarely reported in the paediatric population.Case presentationWe report the case of a 1-year-old male South Asian child who presented with dysphagia and anaemia for 4 months and frequent episodes of vomiting after ingesting semisolid and solid food. A complete blood analysis revealed microcytic hypochromic anaemia. An oesophagogram revealed circumferential narrowing of the upper thoracic oesophagus. Based on these findings, our suspicion was that the patient had an oesophageal web and vascular ring. Oesophageal dilation was performed with a Savary-Gilliard dilator; initially, 5 mm and 7 mm probes were used, and final dilation with a 9 mm probe was performed.ConclusionAlthough rare in paediatric patients, a high suspicion of this syndrome is necessary in these patients to provide relief to the patient for better growth and development. Iron supplements increase the haemoglobin level but do not subside dysphagia, and oesophageal dilation is needed to open the blocked enteral pathway.

Gastric antral web presenting with esophageal stricture and severe malnutrition

Gastric antral web is a rare cause of gastric outlet obstruction in children. Common complaints include intermittent non-bilious vomiting, bloating, pain, loss of appetite, and weight loss. Herein, we report a case of gastric antral web presenting with esophageal stricture and malnutrition, which was followed for many years with a misdiagnosis. An 8-year-old African boy was referred to our pediatric gastroenterology clinic due to recurrent vomiting and severe malnutrition. According to his medical history, the patient began experiencing non-bilious vomiting at 40 days of age and a diagnosis of gastroesophageal reflux was made. He was hospitalized multiple times and received nasogastric tube feedings in the following 4 years. He was re-evaluated for growth retardation and malnutrition at 4 years of age. He had been diagnosed with gluten enteropathy and was fed a gluten-free diet. Recently, he developed difficulty swallowing solid food and was only able to consume liquid meals. Esophagography revealed segmental stenosis in the distal portion of the esophagus. After stricture excision with thoracotomy, upper gastrointestinal series with a radiopaque substance indicated normal esophageal passage; however, prolonged gastric emptying time was also noted. Upon examination during laparotomy, a congenital web was detected in the antral region and was excised. Esophageal and gastric pathologies were consistent with stricture caused by reflux esophagitis and gastric antral web. Today, gastric antral web is mostly diagnosed and treated in infancy. Near total obstruction is relatively easy to diagnose; however, many patients with partial obstruction are followed-up for years with an incorrect diagnosis. Therefore, it should be considered in such cases, persistent vomiting and gastroesophageal reflux may be associated with esophageal stricture.

Early Life Exposures and the Development of the Infant Gut Microbiome: A Review

The influence of the intestinal microbiota on metabolic, nutritional, and immunological processes is widely reported. With increasing literature associating altered microbial compositions with adverse health outcomes, it is important to understand how early life exposures may impact the development of gut microbial colonization and subsequent risk of altered metabolic and immune regulation. The purpose of this review is to describe factors in the maternal prenatal and perinatal period that may impact the intestinal microbiome over the first 2 years of life. A comprehensive search of MEDLINE, EMBASE, and the Cochrane Library using Medical Subject Headings (MeSH) and keywords for studies reporting on determinants of gut microbiota in infants (0 to 24 months) born at full term was conducted. Articles using culture techniques were included but not those that exclusively used molecular techniques that lacked sensitivity. Each citation title and abstract was independently assessed for inclusion for full text review. Findings related to the maternal prenatal period, mode of birthing, infant diet and antibiotics were included. Bifidobacteria and Bacteroides abundance were consistently greater in the first weeks of life in children born vaginally, and increased Bacteroides presence persisted throughout the first year. Bifidobacteria abundance was greater in breastfed children. Introduction of solid food was associated with greater presence of bacteria of the Firmicutes phylum. Although these studies advance our knowledge of how exposures in prenatal, intrapartum, and early life may impact colonization, larger studies with longitudinal follow-up are needed to improve our understanding of how perturbations may contribute to early origins of disease. This article has been peer reviewed.

Evaluation of Plummer-Vinson syndrome in pediatric patients with dysphagia

Aim: In our study, after excluding all other causes of dysphagia in the pediatric age, we tried to present the patients who were followed up and treated with the diagnosis of Plummer-Vinson syndrome(PWS) with iron deficiency anemia and dysphagia. Our aim is to emphasize that there may be dysphagia that can only be cured with anemia treatment and that it can be improved with treatment by a pediatrician. Material method: Pediatric patients who applied to our hospital with the complaint of dysphagia between May 2019-November 2020 were included in the study. After excluding all other causes of dysphagia, patients diagnosed with PWS were evaluated retrospectively. It was aimed to evaluate the age, gender, type, characteristics and duration of dysphagia of the patients retrospectively and to present them in the light of the literature. Results: PWS was detected in 24 of 200 pediatric patients who presented with dysphagia. The proportion of male patients was 37.5%, and their mean age was 97 months. The mean duration of dysphagia complaints was 11.2 months. Four patients had difficulty swallowing liquid food only, 12 patients had solid swallowing difficulties, and 8 patients had difficulty swallowing both solid and liquid food. Anemia was diagnosed by performing a complete blood count and having hemoglobin and hematocrit levels below 2 standard deviations appropriate for age; Those with vitamin B12 levels below 200 pg/ml were defined as cobalamin deficiency. Esophageal web was detected in 4 patients who underwent contrast esophagography. In esophagogastroduodensoscopy, stenosis was treated endoscopically in patients with web. In 20 patients, dysphagia did not persist after six months of iron deficiency anemia treatment. Conclusion: Although the diagnosis of PVS is rare in children, it should be considered and treated in all children with dysphagia associated with iron deficiency anemia. Patients whose complaints continue after treatment at the appropriate dose and duration should be referred for pediatric gastroenterology evaluation.