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Barcelona, Spain

Varea Calderon V.,Servicio de Gastroenterologia | Varea Calderon V.,Institute Dexeus | Lama More R.,Hospital Universitario La Paz | Leis Trabazo R.,University of Santiago de Compostela
Acta Pediatrica Espanola

In the first year, the breastfeeding is the gold standard for at least the first 6 months, but there is some dispersion of trends when it reaches the age of introducing complementary feeding. Traditionally, cereals are and have been the first foods that have been recommended as the start of complementary feeding. In recent times there has been a decline that is possibly related to some negative stereotypes so we thought it timely to update its role. The physiological characteristics of the first years of life are circumstances that are very important to get a good fit in the progression of food in response to the new capabilities will be acquired, in these early years, preferably in their digestive, renal and neuromuscular functions. Cereals are an excellent source of nutrition, but not everyone has the same properties, so it reviews the composition thereof, to assess the benefits that they have to the health of children, as well as the energy input is needed to cover their needs, and to avoid protected of deficits in vitamins and trace elements. Not only the quantity is important, it is undoubtedly the quality of them and place them in a context of varied and balanced diet that helps compensate the rest of the contributions. Being important cereals in the diet of our children, we should remember some updated recommendations in different periods of life will have on their use, either in the form of porridge in the early days, as more complex grain more advanced age and highlight the effect that conserve importance in the early years if used correctly. ©2013 Ediciones Mayo, S.A. All rights reserved. Source

Pena-Quintana L.,University of Las Palmas de Gran Canaria | Morais A.,Hospital Universitario La Paz | Varea V.,Institute Dexeus | Martinez M.J.,Seccion de Gastroenterologia | Soler B.,L.E.S.S.
Anales de Pediatria

Objective: The objeetive of the study was to analyze the nutritional patterns of ehildren under three years of age and to eompare the results against the reeommendations for energy and nutrient intake. Patients and methods: In this eross-seetional epidemiologieal study, parents eompleted a dietary diary on their food intake of their ehildren on 4 non-eonseeutive days. The pereentage of ehildren with mean intakes below the reeommendations for eaeh age and nutrient was analyzed using the "Estimated Average Requirement (EAR) eut-point method." Results: A total of 186 pediatrieians ineluded 1701 ehildren in the study. A total of 95.9% (n = 1320) of the ehildren between 7 and 36 months had a protein eonsumption more than twiee that of the Reeommended Daily Allowanees. The defieieneies observed (% < EAR) in the age groups 13-24 months and 25-36 months, respeetively, were: vitamin D in 81.7% and 92.1%; vitamin E in 39.3% and 53.4%; folie aeid in 12.5% and 14.8%; ealeium in 10.1% and 5.5%; iodine in 27.1% and 31%. It was observed that a higher pereentage in the daily intake of proteins (P=.013) and of earbohydrates (P<.0001), and a lower pereentage of total lipids (P<.0001), were related to a greater body mass index, regardless of energy intake. Conclusions: The study presents a very detailed view of the eating patterns of Spanish ehildren less than three years of age. The eneouragement of healthy feeding should be direeted towards the eorreetion of the dietary imbalanees deteeted, in order to promote the future health of ehildren. © 2014 Asoeiaeion Espanola de Pediatria. Published by Elsevier Espana, S.L.U. All rights reserved. Source

Morais A.,Hospital Universitario La Paz | Pena-Quintana L.,University of Las Palmas de Gran Canaria | Varea V.,Institute Dexeus | Martinez M.J.,Seccion de Gastroenterologia | Soler B.,L.E.S.S.
Anales de Pediatria

Objective The present study evaluates energy and nutrient intake in Spanish children under three years of age, and compares the results with the current recommendations in order to identify possible inadequate nutrient intake. Patients and methods A cross-sectional pilot study. The mothers completed a diet diary for four non-consecutive days, recording the products and amounts consumed by their children. Nutrient intake was calculated, and the results were compared with the dietary reference intakes (DRI) for each age group. Results A total of 188 children (93 boys and 95 girls) aged 0-6 (n = 41), 7-12 (n = 24), 13-24 (n = 57), and 25-36 months (n = 66) were included. Statistically significant differences in DRI were observed for most of the nutrients analyzed. Protein intake, in particular was 376% of DRI in children between 1-3 years of age. By age groups, 96% of the children aged 7-12 months, 88% of the children aged 13-24 months, and 97% of the children aged 25-36 months showed protein intakes more than two-fold DRI. Conclusions Nutrient intake differed from the DRI, particularly as regards proteins. A new study is required to determine whether the observed study deviations could be representative of the national population of this age group, as well as the possible effects on child health. © 2013 Asociación Española de Pediatría. Publicado por Elsevier España, S.L. Todos los derechos reservados. Source

Morais Lopez A.,Hospital Universitario La Paz | Martinez Gomez M.J.,Hospital Universitario Nino Jesus | Pena-Quintana L.,University of Las Palmas de Gran Canaria | Varea Calderon V.,Institute Dexeus
Nutricion Hospitalaria

Introduction: Parents are most responsible for nutritional education of children, and pediatritians must advise and help them with their doubts. The purpose of this study was to know the relevance of nutritional topics in daily practice and the main nutritional problems perceived by pediatritians in children under 3 years of age. Methods: Descriptive, cross-sectional study performed in 2 stages. First stage consisted on discussion meetings with 30 random-selected pediatritians from Madrid and Barcelona. Results were used to design the on-line questionnaire of the second stage (76 questions related to nutrition in children under 3 years). A random and representative sample of Spanish pediatritians was selected for this stage. Results: One hundred and fifty one pediatritians, among 258 sampled, completed the questionnaire. They referred to see a mean of 588 patients/month. The main perceived nutritional problems in the first year of life were iron and vitamin deficiencies and poor weight gain. In the next months, excess in carbohydrates and lipid intake and overweight were the main problems perceived. Parents were considered the main actors regarding their children's nutritional health, but their concern in these questions significantly reduced with children's age (p < 0,0001). Factors considered to have the greatest relevance in the acquisition of good nutritional habits were to provide a diet adjusted for children's requirements and to observe the appropriate sleeping hours. The proportion of children who receive nutritional counseling varied from 88% (0-6 months) to 61% (24-36 months). Conclusions: Despite of the relevance given by pediatritians, educational intervention regarding nutritional health is not ideal. Nutritional problems perceived by pediatritians varied with children's age. Source

Eddy Ives L.S.,Center Medic Sant Ramon | de Frutos Gallego E.,ABS Raval Nord | Calvo Terrades M.,ABS Albera Salut | Curell Aguila N.,Institute Dexeus
Pediatria de Atencion Primaria

Objective: to assess lifestyle habits and efficacy of a lifestyle intervention to reduce body mass index (BMI) in adolescents. Methods: one-year randomized control trial, carried out in 48 pediatrc primary care units of Catalonia. A random sample of 174 overweight and obese adolescents 10-14 years old was taken, 87 allocated to intervention group (IG) and 87 to control (CG). IG received baseline lifestyle counseling (food and exercise habits) plus 5 interventions at months 1, 3, 6, 9 and 12. CG received baseline intervention plus final control. Main outcome measures were: change in lifestyle habits, and of BMI and waist circumference (WC). Results: mean (SD) age was 11.81 (1.21) and 50% were female. A total of 125 participants (71.8%) completed follow-up at 12 months. Body mass index Z-scores showed a significant reduction in both study groups (p < 0.001), reducing from a mean (SD) initial value of 2.35 (0.46) to final value of 2.06 (0.60), which represents approximately 12% reduction of baseline Z-score, without showing differences between study groups. The waist circumference Z-score also was statistically reduced in both study groups: IG from mean 2.06 to 1.77; and CG from mean 2.06 to 1.82 (p < 0.001). Counseling improved many food habits (highlighting increase of fruit, decrease of candy and habit to pick-on food when bored) but physical activities decreased instead of increasing (p = 0.002). Conclusions: lifestyle counseling was effective to reduce body mass index and waist circumference in adolescents, regardless of intensity. Counseling improved food habits, but not exercise. Source

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