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Special Issue "Nutrition in Pediatric Gastroenterology: Selected Papers from SIGENP"

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (31 March 2018)

Special Issue Editors

Guest Editor
Prof. Dr. Carlo Catassi

Head, Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Past President, Italian Society for Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP)
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Phone: +39 071 596 23 64 / +39 349 22 35 447
Fax: +39 071 36281
Interests: celiac disease; gluten-related disorders; gluten sensitivity; pediatric gastroenterology; pediatric nutrition
Guest Editor
Prof. Dr. Carlo Agostoni

Clinica Pediatrica, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Dipartimento di Scienze Cliniche e di Comunità, Università di Milano, Via della Commenda 9, 20122 Milan, Italy
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Phone: +39 02 55032497
Interests: fatty acids; nutrition and metabolism in disease; energy expenditure; later effects of early nutrition; systematic reviews in infant and pediatric nutrition

Special Issue Information

Dear Colleagues,

Pediatric Gastroenterology (GE) is one of the most important subspecialty areas in the field of childhood diseases, due to the large number of conditions affecting the intestinal tract, the high prevalence of these disorders in the pediatric population, and the possible impact on childhood mortality, morbidity and quality of life. The pediatric GE scenario ranges from severe conditions such as congenital microvillus atrophy or chronic intestinal pseudo obstruction requiring total parenteral nutrition or intestinal transplant, to chronic disorders affecting the quality of life, such as inflammatory bowel diseases (IBD) and celiac disease (CD) to highly prevalent conditions such as irritable bowel syndrome (IBS) or functional constipation.

Due to the unique interaction between ingested nutrients, the intestinal microbiota and the digestive tract, such as the colonocyte trophic effect of short chain fatty acids (SCFA) produced by intestinal bacteria from dietary fiber, nutrition has a special role in intestinal diseases, that goes well beyond the mere support of energy, macro- and micro-nutrients. For example, an “anti-inflammatory” diet to treat IBDs is currently under scrutiny. Food itself may be the elective cause and treatment of the disease, such as food allergy, a disorder that is particularly common in infants and children due to the immaturity of the intestinal immune system and barrier function. 

This Special Issue originates from the collaboration between Nutrients and the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP), one of the most active organization in the Italian pediatric setting, which is well known for many important scientific contributions and collaborative studies. This Special Issue will accept original articles and reviews from authors with interest on the physiological, pathogenic and therapeutic role of nutrition in pediatric gastroenterology, including nutrition of the healthy infant and child, eating disorders, and artificial (enteral and parenteral) nutrition.

Prof. Dr. Carlo Catassi
Prof. Dr. Carlo Agostoni
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pediatric gastroenterology
  • pediatric nutrition
  • nutritional therapy
  • artificial nutrition
  • eating disorders

Published Papers (7 papers)

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Research

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Open AccessArticle The Role of Lipids in Human Milk and Infant Formulae
Nutrients 2018, 10(5), 567; https://doi.org/10.3390/nu10050567
Received: 4 April 2018 / Revised: 26 April 2018 / Accepted: 1 May 2018 / Published: 4 May 2018
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Abstract
The quantity and quality of dietary lipids in infant formulae have a significant impact on health outcomes, especially when fat storing and/or absorption are limited (e.g., preterm birth and short bowel disease) or when fat byproducts may help to prevent some pathologies (e.g.,
[...] Read more.
The quantity and quality of dietary lipids in infant formulae have a significant impact on health outcomes, especially when fat storing and/or absorption are limited (e.g., preterm birth and short bowel disease) or when fat byproducts may help to prevent some pathologies (e.g., atopy). The lipid composition of infant formulae varies according to the different fat sources used, and the potential biological effects are related to the variety of saturated and unsaturated fatty acids. For example, since lipids are the main source of energy when the normal absorptive capacity of the digestive tract is compromised, medium-chain saturated fatty acids might cover this requirement. Instead, ruminant-derived trans fatty acids and metabolites of n-3 long-chain polyunsaturated fatty acids with their anti-inflammatory properties can modulate immune function. Furthermore, dietary fats may influence the nutrient profile of formulae, improving the acceptance of these products and the compliance with dietary schedules. Full article
(This article belongs to the Special Issue Nutrition in Pediatric Gastroenterology: Selected Papers from SIGENP)
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Open AccessArticle Assessment of Lactose-Free Diet on the Phalangeal Bone Mineral Status in Italian Adolescents Affected by Adult-Type Hypolactasia
Nutrients 2018, 10(5), 558; https://doi.org/10.3390/nu10050558
Received: 27 March 2018 / Revised: 25 April 2018 / Accepted: 26 April 2018 / Published: 1 May 2018
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Abstract
Adult-type hypolactasia (ATH) is a clinical syndrome of primary lactase deficiency. A lactose-free diet is advisable to avoid the symptoms linked to the condition, but this potentially creates problems for optimal bone mineralization due to reduced calcium intake. To evaluate the effect of
[...] Read more.
Adult-type hypolactasia (ATH) is a clinical syndrome of primary lactase deficiency. A lactose-free diet is advisable to avoid the symptoms linked to the condition, but this potentially creates problems for optimal bone mineralization due to reduced calcium intake. To evaluate the effect of the lactose-free diet on the bone mineral status (BMS), we compared the phalangeal BMS of adolescents with ATH to that of peers on a normal diet. Also, we analyzed the correlations between BMS and dietary behavior, physical exercise, and calcium and vitamin D intake. A total of 102 cases and 102 healthy controls filled out a diet record and underwent phalangeal Quantitative Ultrasound (QUS). No difference in BMS was observed. The time spent on lactose-free diet (4.8 ± 3.1 years) was inversely correlated to the BMS. More than 98% of cases consumed lactose-free milk, but calcium and vitamin D intake were significantly lower. Calcium intake was correlated to physical exercise but not to BMS. Our results suggest that a lactose-free diet does not affect the phalangeal BMS of adolescents with primary lactase deficiency when their diet includes lactose-free cow’s milk. However, there is still a significantly lower calcium intake than in the population reference. The inverse correlation observed between the BMS and the time spent on a lactose-free diet suggests that a long-term follow-up is advisable. Full article
(This article belongs to the Special Issue Nutrition in Pediatric Gastroenterology: Selected Papers from SIGENP)
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Open AccessArticle Assessment of Mycotoxin Exposure in Breastfeeding Mothers with Celiac Disease
Nutrients 2018, 10(3), 336; https://doi.org/10.3390/nu10030336
Received: 12 January 2018 / Revised: 6 March 2018 / Accepted: 7 March 2018 / Published: 10 March 2018
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Abstract
Objective: To assess the risk of mycotoxin exposure (aflatoxin M1, ochratoxin A, and zearalenone) in celiac disease (CD) breastfeeding mothers and healthy control mothers, as well as in their offspring, by quantifying these contaminants in breast milk. Study design: Thirty-five breastfeeding women with
[...] Read more.
Objective: To assess the risk of mycotoxin exposure (aflatoxin M1, ochratoxin A, and zearalenone) in celiac disease (CD) breastfeeding mothers and healthy control mothers, as well as in their offspring, by quantifying these contaminants in breast milk. Study design: Thirty-five breastfeeding women with CD on a gluten-free diet and 30 healthy breastfeeding controls were recruited. Milk sampling was performed three times per day for three consecutive days. Mycotoxin content was investigated by an analytical method using immunoaffinity column clean-up and high-performance liquid chromatography (HPLC) with fluorometric detection. Results: Aflatoxin M1 (AFM1) was detected in 37% of CD group samples (mean ± SD = 0.012 ± 0.011 ng/mL; range = 0.003–0.340 ng/mL). The control group showed lower mean AFM1 concentration levels in 24% of the analyzed samples (0.009 ± 0.007 ng/mL; range = 0.003–0.067 ng/mL, ANOVA on ranks, p-value < 0.01). Ochratoxin A and zearalenone did not differ in both groups. Conclusion: Breast milk AFM1 contamination for both groups is lower than the European safety threshold. However, the estimated exposures of infants from CD mothers and control mothers was much higher (≃15 times and ≃11 times, respectively) than the threshold set by the joint FAO/WHO Expert Committee on Food Additives (JECFA). Since incongruities exist between JECFA and the European Union standard, a novel regulatory review of the available data on this topic is desirable. Protecting babies from a neglected risk of high AFM1 exposure requires prompt regulatory and food-control policies. Full article
(This article belongs to the Special Issue Nutrition in Pediatric Gastroenterology: Selected Papers from SIGENP)
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Open AccessArticle Effectiveness and Safety of a Probiotic-Mixture for the Treatment of Infantile Colic: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial with Fecal Real-Time PCR and NMR-Based Metabolomics Analysis
Nutrients 2018, 10(2), 195; https://doi.org/10.3390/nu10020195
Received: 14 January 2018 / Revised: 5 February 2018 / Accepted: 7 February 2018 / Published: 10 February 2018
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Abstract
Introduction: To investigate the effectiveness and the safety of a probiotic-mixture (Vivomixx®, Visbiome®, DeSimone Formulation®; Danisco-DuPont, Madison, WI, USA) for the treatment of infantile colic in breastfed infants, compared with a placebo. Methods: A randomized, double-blind, placebo-controlled
[...] Read more.
Introduction: To investigate the effectiveness and the safety of a probiotic-mixture (Vivomixx®, Visbiome®, DeSimone Formulation®; Danisco-DuPont, Madison, WI, USA) for the treatment of infantile colic in breastfed infants, compared with a placebo. Methods: A randomized, double-blind, placebo-controlled trial was conducted in exclusively breastfed infants with colic, randomly assigned to receive a probiotic-mixture or a placebo for 21 days. A structured diary of gastrointestinal events of the infants was given to the parents to complete. Samples of feces were also collected to evaluate microbial content and metabolome using fecal real-time polymerase chain reaction (qPCR) and Nuclear magnetic resonance (NMR)-based analysis. Study registered at ClinicalTrials.gov (NCT01869426). Results: Fifty-three exclusively-breastfed infants completed three weeks of treatment with a probiotic-mixture (n = 27) or a placebo (n = 26). Infants receiving the probiotic-mixture had less minutes of crying per day throughout the study by the end of treatment period (68.4 min/day vs. 98.7 min/day; p = 0.001). A higher rate of infants from the probiotic-mixture group responded to treatment (defined by reduction of crying times of ≥50% from baseline), on day 14, 12 vs. 5 (p = 0.04) and on day 21, 26 vs. 17 (p = 0.001). A higher quality of life, assessed by a 10-cm visual analogue scale, was reported by parents of the probiotic-mixture group on day 14, 7.1 ± 1.2 vs. 7.7 ± 0.9 (p = 0.02); and on day 21, 6.7 ± 1.6 vs. 5.9 ± 1.0 (p = 0.001). No differences between groups were found regarding anthropometric data, bowel movements, stool consistency or microbiota composition. Probiotics were found to affect the fecal molecular profile. No adverse events were reported. Conclusions: Administration of a probiotic-mixture appears safe and reduces inconsolable crying in exclusively breastfed infants. Full article
(This article belongs to the Special Issue Nutrition in Pediatric Gastroenterology: Selected Papers from SIGENP)
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Open AccessArticle Pediatric Chronic Intestinal Failure in Italy: Report from the 2016 Survey on Behalf of Italian Society for Gastroenterology, Hepatology and Nutrition (SIGENP)
Nutrients 2017, 9(11), 1217; https://doi.org/10.3390/nu9111217
Received: 9 October 2017 / Revised: 25 October 2017 / Accepted: 27 October 2017 / Published: 5 November 2017
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Abstract
Background: Intestinal failure (IF) is the reduction in functioning gut mass below the minimal level necessary for adequate digestion and absorption of nutrients and fluids for weight maintenance in adults or for growth in children. There is a paucity of epidemiologic data on
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Background: Intestinal failure (IF) is the reduction in functioning gut mass below the minimal level necessary for adequate digestion and absorption of nutrients and fluids for weight maintenance in adults or for growth in children. There is a paucity of epidemiologic data on pediatric IF. The purpose of this study was to determine the prevalence, incidence, regional distribution and underlying diagnosis of pediatric chronic IF (CIF) requiring home parenteral nutrition (HPN) in Italy. Methods: Local investigators were selected in 19 Italian centers either of reference for pediatric HPN or having pediatric gastroenterologists or surgeons on staff and already collaborating with the Italian Society for Pediatric Gastroenterology, Hepatology and Nutrition with regard to IF. Data requested in this survey for children at home on Parenteral Nutrition (PN) on 1 December 2016 included patient initials, year of birth, gender, family’s place of residence and underlying diagnosis determining IF. Results: We recorded 145 CIF patients on HPN aged ≤19 years. The overall prevalence was 14.12/million inhabitants (95% CI: 9.20–18.93); the overall incidence was 1.41/million inhabitant years (95% CI: 0.53–2.20). Conclusion: Our survey provides new epidemiological data on pediatric CIF in Italy; these data may be quantitatively useful in developing IF care strategy plans in all developed countries. Full article
(This article belongs to the Special Issue Nutrition in Pediatric Gastroenterology: Selected Papers from SIGENP)
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Review

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Open AccessFeature PaperReview Prevention and Treatment of Intestinal Failure-Associated Liver Disease in Children
Nutrients 2018, 10(6), 664; https://doi.org/10.3390/nu10060664
Received: 29 March 2018 / Revised: 21 May 2018 / Accepted: 22 May 2018 / Published: 24 May 2018
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Abstract
Intestinal failure-associated liver disease (IFALD) is a threatening complication for children on long-term parenteral nutrition because of intestinal failure. When progressive and intractable, it may jeopardize intestinal rehabilitation and lead to combined liver and intestinal transplantation. The institution of dedicated intestinal failure centers
[...] Read more.
Intestinal failure-associated liver disease (IFALD) is a threatening complication for children on long-term parenteral nutrition because of intestinal failure. When progressive and intractable, it may jeopardize intestinal rehabilitation and lead to combined liver and intestinal transplantation. The institution of dedicated intestinal failure centers has dramatically decreased the incidence of such complication. IFALD may rapidly fade away if very early management aimed at preventing progression to end-stage liver disease is provided. In this review, we address the etiology and risk factors of IFALD in order to introduce pillars of prevention (nutritional management and catheter-related infections control). The latest evidence of therapeutic strategies, such as medical and surgical treatments, is also discussed. Full article
(This article belongs to the Special Issue Nutrition in Pediatric Gastroenterology: Selected Papers from SIGENP)
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Other

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Open AccessBrief Report Weaning Time in Preterm Infants: An Audit of Italian Primary Care Paediatricians
Nutrients 2018, 10(5), 616; https://doi.org/10.3390/nu10050616
Received: 17 April 2018 / Revised: 7 May 2018 / Accepted: 9 May 2018 / Published: 15 May 2018
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Abstract
Introduction: According to the 2016 Italian National Institute of Statistics (Istat) data in Italy, about 6.7% of all newborns are born prematurely. Due to the lack of data on current complementary feeding in preterm infants in Italy, the aim of the survey was
[...] Read more.
Introduction: According to the 2016 Italian National Institute of Statistics (Istat) data in Italy, about 6.7% of all newborns are born prematurely. Due to the lack of data on current complementary feeding in preterm infants in Italy, the aim of the survey was to evaluate individual attitudes of primary care paediatricians, concerning the introduction of complementary foods in preterm infants. Methods: An internet-based survey was conducted among primary care paediatricians, working in Italy, regarding (1) timing of the introduction of complementary foods to preterm newborns; (2) type of complementary foods introduced; (3) vitamin D and iron supplementations. Results: A total of 347 primary care Italian paediatricians answered the questionnaire; 44% of responders based the timing of the introduction of solid food exclusively on an infant’s age, 18% on an infant’s neurodevelopmental status and 4% on the body weight; the remaining 34% based the timing on two or more of these aspects. The type of complementary foods did not comply with an evidence-based sequence; 98% of participants promoted vitamin D supplementation and 89% promoted iron supplementation with great diversity in timing and doses. Conclusions: Due to limited evidence, there is a great heterogeneity in the attitudes of primary care paediatricians concerning the introduction of complementary foods to preterm newborns. Further research is needed to provide evidence-based guidelines regarding weaning preterm newborns. Full article
(This article belongs to the Special Issue Nutrition in Pediatric Gastroenterology: Selected Papers from SIGENP)
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