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LE Magazine January 2001
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Child Health

Vitamin A status in children with pneumonia.

OBJECTIVE: To assess vitamin A status in children with pneumonia. INTERVENTIONS: Thirty-four hospitalised patients with pneumonia were randomly allocated into two groups: the study group, besides the routine treatment, received a high dose of aqueous retinyl palmitate oral solution; the control group received only the routine treatment. METHODS: The concentrations of plasma vitamin A and carotenoids were determined by colorimetric method. Retinol binding protein (RBP) was determined by the radial immunodiffusion technique. RESULTS: After 1 week of treatment there was a statistically significant (P < 0.05) increase in the levels (mean +/- s.e.) of vitamin A (study group: 14.1 +/- 1.6 to 26.5 +/- 5.8 micrograms/dl; control group: 16.1 +/- 3.3 to 24.1 +/- 2.3 micrograms/dl) and RBP (study group: 0.8 +/- 0.2 to 2.2 +/- 0.6 mg/dl; control group: 0.6 +/- 0.2 to 3.0 +/- 0.5 mg/dl) in both groups as compared to the baseline. On day 7 of treatment when the average levels of vitamin A (26.5 +/- 5.8 and 24.1 +/- 2.3 micrograms/dl) were compared, there was no statistically significant difference between the groups. CONCLUSION: This study suggests that low levels of circulating plasma vitamin A in child with pneumonia may be a consequence of acute phase of infectious disease.

Eur J Clin Nutr 1995 May;49(5):379-84

Signs of impaired cognitive function in adolescents with marginal cobalamin status.

BACKGROUND: Lack of cobalamin may lead to neurologic disorders, which have been reported in strict vegetarians. OBJECTIVE: The objective of this study was to investigate whether cognitive functioning is affected in adolescents (aged 10-16 y) with marginal cobalamin status as a result of being fed a macrobiotic diet up to an average age of 6 y. DESIGN: Data on dietary intake, psychological test performance, and biochemical variables of cobalamin status were collected from 48 adolescents who consumed macrobiotic (vegan type) diets up to the age of 6 y, subsequently followed by lactovegetarian or omnivorous diets, and from 24 subjects (aged 10-18 y) who were fed omnivorous diets from birth onward. Thirty-one subjects from the previously macrobiotic group were cobalamin deficient according to their plasma methylmalonic acid concentrations. Seventeen previously macrobiotic subjects and all control subjects had normal cobalamin status. RESULTS: The control subjects performed better on most psychological tests than did macrobiotic subjects with low or normal cobalamin status. A significant relation between test score and cobalamin deficiency (P: = 0.01) was observed for a test measuring fluid intelligence (correlation coefficient: -0.28; 95% CI: -0.48, -0.08). This effect became more pronounced (P: = 0.003) within the subgroup of macrobiotic subjects (correlation coefficient: -0.38; 95% CI: -0.62, - 0.14). CONCLUSION: Our data suggest that cobalamin deficiency, in the absence of hematologic signs, may lead to impaired cognitive performance in adolescents.

Am J Clin Nutr 2000 Sep;72(3):762-9

The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study.

BACKGROUND: Although overweight and obesity in childhood are related to dyslipidemia, hyperinsulinemia, and hypertension, most studies have examined levels of these risk factors individually or have used internal cutpoints (eg, quintiles) to classify overweight and risk factors. OBJECTIVE: We used cutpoints derived from several national studies to examine the relation of overweight (Quetelet index, >95th percentile) to adverse risk factor levels and risk factor clustering. DESIGN: The sample consisted of 9167 5- to 17-year-olds examined in seven cross-sectional studies conducted by the Bogalusa Heart Study between 1973 and 1994. RESULTS: About 11% of examined schoolchildren were considered overweight. Although adverse lipid, insulin, and blood pressure levels did not vary substantially with the Quetelet index at levels <85th percentile, risk factor prevalences increased greatly at higher levels of the Quetelet index. Overweight schoolchildren were 2.4 times as likely as children with a Quetelet index <85th percentile to have an elevated level of total cholesterol. Odds ratios for other associations were 2.4 (diastolic blood pressure), 3.0 (low-density lipoprotein cholesterol), 3.4 (high-density lipoprotein cholesterol), 4.5 (systolic blood pressure), 7.1 (triglycerides), and 12.6 (fasting insulin). Several of these associations differed between whites and blacks, and by age. Of the 813 overweight schoolchildren, 475 (58%) were found to have at least one risk factor. Furthermore, the use of overweight as a screening tool could identify 50% of schoolchildren who had two or more risk factors. CONCLUSIONS: Because overweight is associated with various risk factors even among young children, it is possible that the successful prevention and treatment of obesity in childhood could reduce the adult incidence of cardiovascular disease.

Pediatrics 1999 Jun;103(6 Pt 1):1175-82

Attention Deficit/Hyperactivity disorder (ADHD) in children: rationale for its integrative management.

Attention Deficit/Hyperactivity Disorder (ADHD) is the most common behavioral disorder in children. ADHD is characterized by attention deficit, impulsivity, and sometimes overactivity ("hyperactivity"). The diagnosis is empirical, with no objective confirmation available to date from laboratory measures. ADHD begins in childhood and often persists into adulthood. The exact etiology is unknown; genetics plays a role, but major etiologic contributors also include adverse responses to food additives, intolerances to foods, sensitivities to environmental chemicals, molds, and fungi, and exposures to neurodevelopmental toxins such as heavy metals and organohalide pollutants. Thyroid hypofunction may be a common denominator linking toxic insults with ADHD symptomatologies. Abnormalities in the frontostriatal brain circuitry and possible hypofunctioning of dopaminergic pathways are apparent in ADHD, and are consistent with the benefits obtained in some instances by the use of methylphenidate (Ritalin) and other potent psychostimulants. Mounting controversy over the widespread use of methylphenidate and possible life-threatening effects from its long-term use make it imperative that alternative modalities be implemented for ADHD management. Nutrient deficiencies are common in ADHD; supplementation with minerals, the B vitamins (added in singly), omega-3 and omega-6 essential fatty acids, flavonoids, and the essential phospholipid phosphatidylserine (PS) can ameliorate ADHD symptoms. When individually managed with supplementation, dietary modification, detoxification, correction of intestinal dysbiosis, and other features of a wholistic/integrative program of management, the ADHD subject can lead a normal and productive life.

Altern Med Rev. 2000 Oct;5(5):402-428.

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