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Vandenplas Y.,Universitair Ziekenbuis Brussel Kinderen | Plaskie K.,Universitair Ziekenhuis Brussel Kinderen
Minerva Pediatrica

Aim. Infants and children with cow's milk-sensitive enteropathy are treated with extensively hydroryzed formulas. A formula (New Alfaré) was developed by a protein hydrolysis method that yields an amino acid profile that more closely resembles human milk compared to previous formulas, and contains nucleotides. Methods. The current study was a prospective, open trial aimed at evaluating the safety and nutritional adequacy of this formula for pediatric patients with clinical indications for the enteral use of semi-elemental diet Safety was measured as normal growth based on Eurogrowth standards for body mass index (BMI)for-age z-scores, and nutritional adequacy was evaluated based on measurements of blood parameters. Forty-seven patients <32 months old, having a gestational age of ≥26 weeks, and weighing ≥1 500 g were enrolled, and fed with New Alfaré for four weeks. Weight, length and blood parameters were measured at the beginning and end of the study. Signs of tolerance to the formula (amount of formula intake, gastrointestinal symptoms and stool characteristics) were recorded daily by the parents. Twenty-five patients completed the study with all measurements. Results. There was a significant increase in the mean BMI-for-age z-score (P<0.05) and albumin concentration (P<0.01) after four weeks. Mean plasma threonine concentration decreased significantly (P=0.01) and the mean tryptophan concentration tended to increase by the end of the study (P=0.06). No adverse events related to the study formula were reported. Conclusions. These results show that New Alfaré is safe and nutritionally adequate for pediatric patients with cow's milk-sensitive enteropathy. Source

Salvatore S.,University of Insubria | Wagner P.,University of Insubria | Nespoli L.,University of Insubria | Vandenplas Y.,Universitair Ziekenhuis Brussel Kinderen
CAB Reviews: Perspectives in Agriculture, Veterinary Science, Nutrition and Natural Resources

Zinc is an essential micronutrient involved in many metabolic processes, cell growth, neurological, intestinal and immune functions. Zinc deficiency is common in developing countries because of inadequate intake or reduced absorption, and may also be a result of excessive intestinal losses of zinc caused by diarrhoea. Several hospital-and community-based randomized trials, all performed in developing countries, consistently showed that zinc is an effective treatment for acute or persistent diarrhoea in children younger than 5 years. The mechanism of action of zinc in acute diarrhoea is not completely known. Plausible mechanisms include improved absorption of water and electrolytes by the intestine, faster regeneration of gut epithelium, increased levels of enterocyte brush-border enzymes and an enhanced immune response. In developing countries, zinc also showed a significant effect in the prevention of diarrhoea. Dispersible tablet formulation (20 mg/day) has demonstrated to be a cheap, stable, easy-to-prepare and acceptable alternative. Populations that would benefit from zinc treatment, other than those with zinc-deficient diets, are still to be defined. © CAB International 2010 (Online ISSN 1749-8848). Source

Vandenplas Y.,Universitair Ziekenhuis Brussel Kinderen | Plaskie K.,Universitair Ziekenhuis Brussel Kinderen | Hauser B.,Universitair Ziekenhuis Brussel Kinderen
Amino Acids

A prospective, open trial was conducted to evaluate the nutritional adequacy of a semi-elemental diet in 47 children with functional gastro-intestinal disorders. Nutritional adequacy was assessed based on growth relative to Euro-growth standards for body mass index (BMI)-for-age z-scores and evaluations of blood parameters. Twenty-five patients completed the study. In total, 533 l of "New-Alfare" was consumed during 775 trial-days. The mean intake per infant was 85.8 ± 26.8 kcal/kg/day or 122.5 ± 38.3 ml/kg/day. Weight and length evolution during the 4 weeks trial were within normal range. The mean BMI-for-age z-score (P < 0.05) and albumin concentration (P < 0.01) increased significantly after 4 weeks. Plasma threonine concentration decreased significantly (P = 0.01) and the tryptophan concentration increased (P = 0.06). No adverse events related to the study formula were reported. These results show that "New Alfaré" is safe and nutritionally adequate for pediatric patients with gastro-intestinal disease. © 2009 The Author(s). Source

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