Search Results (321)

Background: Thallium is a metal that is ubiquitous in our natural environment. Despite its potential for high toxicity, thallium is understudied and not regulated in food. The California Department of Public Health was alerted to a household cluster of elevated urine thallium levels noted among a mother (peak 5.6 µg/g creatinine; adult reference: ≤0.4 µg/g creatinine) and her three young children (peak 10.5 µg/g creatinine; child reference: ≤0.8 µg/g creatinine). Objectives: This case report identifies questions raised after a public health investigation linked a household’s thallium exposure to a commercially available food product. We provide an overview of the public health investigation. We then explore concerns, such as gaps in toxicological data and limited surveillance of thallium in the food supply, which make management of individual and population exposure risks challenging. Methods: We highlight findings from a cross-agency investigation, including a household exposure survey, sampling of possible environmental and dietary exposures (ICP-MS analysis measured thallium in kale chips at 1.98 mg/kg and 2.15 mg/kg), and monitoring of symptoms and urine thallium levels after the source was removed. We use regulatory and research findings to describe the challenges and opportunities in characterizing the scale of thallium in our food supply and effects of dietary exposures on health. Discussion: Thallium can bioaccumulate in our food system, particularly in brassica vegetables like kale. Thallium concentration in foods can also be affected by manufacturing processes, such as dehydration. We have limited surveillance data nationally regarding this metal in our food supply. Dietary reviews internationally show increased thallium intake in toddlers. Limited information is available about low-dose or chronic exposures, particularly among children, although emerging evidence shows that there might be risks associated at lower levels than previously thought. Improved toxicological studies are needed to guide reference doses and food safety standards. Promising action towards enhanced monitoring of thallium is being pursued by food safety agencies internationally, and research is underway to deepen our understanding of thallium toxicity. Full article

As veganism becomes more popular, the number of vegan pregnant women and children is steadily increasing. During vegan pregnancy and early childhood, there is a high risk for nutrient deficiencies that may impair child development. External factors, such as healthcare advice, social networks, and social environments, that affect the diet of vegan pregnant women, parents, and their children, as well as their approach towards dietary supplementation, have not yet been investigated. Various sources of information, combined with a lack of expertise, sparse food and nutritional health literacy, and qualitatively heterogeneous information provision by medical experts, unsettle vegan pregnant women and parents and affect their dietary choices and potentially the health of their children. The VedieS study aims to investigate potential connections between external influences and associated impacts on a vegan diet and the intake of dietary supplements (DS) of pregnant women and children. Two surveys are being conducted within the study: one targeting 1000 vegan pregnant women and parents, and another targeting 60 experts in each of five healthcare groups: gynecologists, pediatricians, general practitioners, pharmacists, and dietitians. This study is the first to examine how socio-economic, social, and further informational factors influence dietary practices during vegan pregnancy and childhood. It highlights the need for reliable, expert-led guidance, as current information sources are often inconsistent and may put these vulnerable groups at risk. Full article

While gestational Bisphenol A (BPA) exposure has been associated with autism, limited work has focused on dietary sources. Here, we sought to develop a summary metric to capture dietary exposure specifically and test its associations with measured levels, as well as child traits related to autism. Participants (n = 116) were from the Early Autism Risk Longitudinal Investigation (EARLI) Study, which recruited pregnant women who previously had a child diagnosed with autism. Maternal concentrations of BPA were quantified in urine, and dietary sources of BPA were ascertained via food frequency questionnaires during gestation. A novel BPA “dietary burden score” was developed based on reported intake of foods known to contribute to BPA exposure (i.e., canned foods) from a Dietary History Questionnaire modified for pregnancy. Child autism-related traits were assessed via the Social Responsiveness Scale (SRS-2). We examined associations between BPA biomarkers, dietary burden scores, and child SRS scores. Dietary burden scores were weakly correlated with urinary BPA concentrations (R = 0.19, p = 0.05) but were not associated with child SRS scores. Our work suggests that more detailed dietary assessments may be needed to fully capture diet-based BPA exposures and address diet as a modifiable source of chemical exposure to reduce associated health impacts of BPA. Full article

Background/Objectives: Growing pains are a common cause of recurrent limb pain in children, but their etiology remains unclear. Physical activity and nutrition are important factors for musculoskeletal health, but their specific relationship with growing pains has not been well established in young athletes. This study aimed to assess the prevalence of growing pains in child and adolescent athletes and evaluate their adherence to the Mediterranean Diet. Methods: A cross-sectional study was conducted with 916 athletes aged 8–17 years from sports academies in Alicante, Spain. Data were collected via an online survey assessing demographics, pain types, and adherence to the Mediterranean diet. Results: Self-reported pain was highly prevalent, affecting 78.5% of children and 93.5% of adolescents. Musculoskeletal and nocturnal pain increased with age, with nocturnal pain significantly more frequent in girls among children (p < 0.001). Additionally, 32.6% of children and 51.9% of adolescents had received a formal diagnosis of growing pains. Despite this, only 13.7% reported using analgesics, with no significant gender differences. Adherence to the Mediterranean diet was mostly moderate, with children reporting higher fruit and vegetable intake than adolescents, while adolescents consumed more healthy fats and carbohydrates, and participants without pain showed overall healthier dietary patterns. Conclusions: Idiopathic musculoskeletal pain is highly prevalent among young athletes, and their adherence to a healthy diet is suboptimal, challenging the assumption that physically active children maintain well-balanced diets. This underscores the importance of early nutritional education as a strategy to support musculoskeletal health and reduce pain in physically active youth. Full article

Anemia due to acquired copper deficiency is most commonly the result of malabsorption or dietary deficiency. However, it can occasionally be due to excess zinc intake, which impairs the absorption of copper. Copper deficiency may result in vacuolated erythroid and myeloid precursors in the bone marrow, and sometimes features resembling myelodysplasia that, although not specific, may be an important clue to the diagnosis. Background and Clinical Significance: We report bone marrow findings in a child with anemia due to zinc-induced copper deficiency. Case Presentation: An 18-year-old female with cerebral palsy admitted for respiratory failure was found to have anemia and leukopenia with absolute neutropenia. A bone marrow smear showed occasional ring sideroblasts. Additional testing revealed reduced serum copper and elevated serum zinc. Further inquiry uncovered a several-year history of high-dose zinc supplementation. Conclusions: It is important to consider copper deficiency as a potential etiology in patients with anemia and neutropenia, as it may otherwise be mistaken for vitamin B12 deficiency or myelodysplasia. The presence of small vacuoles in hematopoietic precursors is an important clue to the diagnosis and may help avoid ineffective interventions. Full article

Background/Objectives: The role of maternal diet in atopic dermatitis (AD) requires better understanding, as AD often manifests early in life and precedes other allergic diseases. We evaluated the association between maternal diet and AD up to 2 years of age. Methods: A total of 116 mother–child dyads from the CARE birth cohort study were included. Maternal diet during pregnancy was assessed with a validated self-administered 97-item food frequency questionnaire, and dietary scores were calculated. AD was evaluated at ages 4 months, 1 year, and 2 years. The associations between maternal dietary patterns and AD were examined by logistic regression analysis adjusting for total energy intake, gender of the child, maternal antibiotic therapy during pregnancy, and history of atopic disease among both parents. Results: Of the 116 children, 27 (23.3%) developed AD by 2 years, 11 of whom (40.7%) had persistent AD within the first 2 years. AD risk was reduced with a higher Mediterranean diet score during pregnancy (upper median > 3 points versus lower median: adjusted OR 0.24, 95% CI 0.08–0.69, p = 0.009) and with greater dietary diversity, as measured by the number of items consumed (upper median > 53 items versus lower median: OR 0.19, 95% CI 0.06–0.58, p = 0.005). No association was found with macronutrients and micronutrients. Red meat consumption showed a positive association with the persistent AD phenotype (adjusted OR 5.04, 95% CI 1.47 to 31.36, p = 0.034). Conclusions: Adherence to a Mediterranean diet and a diverse diet during pregnancy may decrease the risk of developing early childhood AD. This highlights the synergistic role of nutrients in dietary patterns as they modulate immune development and disease susceptibility. Full article

Background/Objectives: Child undernutrition remains a critical public health issue in Nepal, especially in the rural district of Solukhumbu. This study aimed to assess the prevalence and clinical characteristics of undernutrition, dietary patterns, and related health indicators in school-aged children from the Shree Saraswoti Basic School in Phuleli. Methods: A descriptive, cross-sectional study was conducted between July and August 2022. Fifty-four children (51.8% boys; mean age 9.4 ± 2.1 years) were evaluated using anthropometry, clinical examination, hemoglobin measurement, and three-day 24 h dietary recall. Data were analyzed using descriptive and inferential statistics. Results: BMI z-scores indicated that 39% of children were at risk of acute undernutrition, and 2% were at risk of moderate acute undernutrition. After adjusting for altitude, 87% were classified as anemic. Diets were dominated by cereals and vegetables, with a very low intake of fruits and proteins and no dairy consumption. Dental caries affected 59% of participants. Girls presented slightly higher subcutaneous fat percentages; however, 14.8% of the children exceeded the recommended thresholds. A dietary assessment revealed poor eating habits, including excessive intake of simple carbohydrates and insufficient nutrient diversity. Although socioeconomic data were not directly collected, the findings reflect the typical context of the vulnerability of isolated mountain communities. Undernutrition indicators (BMI, clinical signs, anemia) were associated with poorer health outcomes. An unexpected moderate inverse correlation was found between BMI and both systolic (r = −0.601) and diastolic (r = −0.550) blood pressure. Conclusions: The findings reveal a high burden of undernutrition and anemia among children in Solukhumbu, linked to poor diet and structural vulnerability. Urgent, community-based interventions—including nutrition education, agricultural diversification, and improved healthcare access—are needed. Longitudinal monitoring is essential to track progress and design sustainable, multisectoral solutions. Full article

Background: The majority of Australian children exceed the World Health Organization’s recommended dietary intake of free sugar, particularly through the consumption of sugar-sweetened beverages. Front-of-pack nutrition labels increase perceived risk and deter the consumption of sugar-sweetened beverages. However, past studies of young children have focused almost exclusively on a parent’s choice of beverage for children. This study investigated the influence of four label designs (text-based warning, tooth decay pictorial, teaspoons of sugar, and Health Star Rating) on the beverage choices of N = 1229 Australian children (aged 4–11 years) and their parents. Methods: In an online vending machine scenario, parent–child dyads were separately asked to select which beverage they would choose for themselves before and after being randomised to one label condition. The beverages displayed included 100% fruit juice, soft drink, soft drink with a non-nutritive sweetener, flavoured milk, plain milk and bottled water. Beverage healthiness was determined by a 1–10 rating based on a review by a panel of experts (10 dietitians and nutritionists). Results: Mixed-model ANOVAs showed that for parents, each label design performed comparably; however, for children, small but significant differences were seen in the effectiveness of different label designs, with the teaspoons of sugar label, text-based warning, and tooth decay pictorial found to be more impactful in promoting healthier drink choices than the Health Star Rating. Conclusions: These findings can inform public health advocacy efforts to improve food labelling and could be incorporated into educational resources to help children understand the nutritional profiles of different sugary drinks. Full article

Background: The growth patterns of children and adolescents are influenced by multiple factors. This study employed structural equation modeling (SEM) to determine the primary factors influencing the growth of Palestinian children and adolescents in the West Bank (WB). Methods: A cross-sectional survey conducted in 2022 in the WB collected data from 1400 households, of which 500 with children aged 5–17 years and were selected for analysis. The survey assessed household food insecurity, socioeconomic status (SES), parental health history, nutritional awareness, food consumption patterns, and nutrient intake. The latent construct “Child Growth” was measured using Body Mass Index-for-age Z-score (BAZ), height-for-age Z-score (HAZ), and Mean Adequacy Ratio (MAR). SEM was employed to examine the interrelations among latent variables and their observed indicators. Results: Mineral intake showed the strongest direct effect on child growth (β = 0.812, p < 0.001), followed by food availability (β = 0.492), vitamin intake (β = 0.481), SES (β = 0.439), and macronutrient intake (β = 0.383). MAR exhibited the highest factor loading as a growth indicator, while HAZ had limited significance, suggesting its chronic nature. SES influenced growth both directly and indirectly through its effects on food availability and dietary intake pathways. Strong correlations between nutritional knowledge and nutrient classes reflect the interrelationship between behavioral and biological determinants. Conclusions: Both structural and immediate nutritional factors influence child growth. In Palestinian youth, mineral intake, food security, and SES have the greatest influence. These findings offer a framework for understanding the growth determinants of Palestinian youth in the WB and support the development of targeted interventions to improve dietary quality and overall nutritional status. Full article

Background/Objectives: Glycogen storage disease type IX (GSD IX) is a group of inherited metabolic disorders caused by phosphorylase kinase deficiency affecting the liver or muscle. Despite being relatively common among GSDs, GSD IX remains underexplored. Methods: A systematic review of GSD IX was conducted per PRISMA guidelines using SCOPUS and PubMed, registered with PROSPERO. Inclusion focused on human clinical studies published up to 31 December 2024. Results: A total of 400 patients with GSD IX were analyzed: 274 IXa (mean age at diagnosis 5.1 years), 72 IXc (mean age at diagnosis 4.9 years), 39 IXb (mean age at diagnosis 4.2 years), and 15 IXd (mean age at diagnosis 44.9 years). Hepatomegaly was commonly reported in types IXa, IXb, and especially IXc (91.7%), but was rare in IXd. Elevated transaminases were frequently observed in types IXa, IXb, and particularly IXc, while uncommon in IXd. Fasting hypoglycemia was occasionally observed in types IXa and IXb, more frequently in IXc (52.7%), and was not reported in IXd. Growth delay or short stature was observed in a substantial proportion of patients with types IXa (43.8%), IXb, and IXc, but was rare in IXd. Muscle involvement was prominent in IXd, with all patients showing elevated CPK (mean 1011 U/L). Neurological involvement was infrequently reported in types IXa and IXc. Conclusions: This systematic review includes the most extensive clinical case history of GSD IX described in the literature. The clinical spectrum of GSD IX varies widely among subtypes, with IXc being the most aggressive. While liver forms are generally present in early childhood, muscle-type IXd shows delayed onset and milder symptoms, often leading to diagnostic delays. For diagnosis, it is essential not to underestimate key clinical features such as hepatic involvement and hypoglycemia in a child under 5 years of age. Other manifestations, including the as-yet unexplored systemic involvement of bone and kidney, remain insufficiently understood and require further investigation. Next-generation sequencing has improved diagnostic precision over traditional biopsy. Dietary management, including uncooked cornstarch, Glycosade^®, and high-protein intake, remains the cornerstone of treatment. However, there is a paucity of well-designed, evidence-based studies to determine the most effective therapeutic approach. Despite its historically perceived benign course, the broad phenotypic variability of GSD IX, including progressive liver involvement and potential neurological complications, highlights its substantial clinical relevance and underscores the need for accurate diagnostic classification and long-term multidisciplinary follow-up. Full article

Background: Dietary intake during the first year of life is a key determinant of a child’s growth and development. ORIGINS is a longitudinal birth cohort study investigating factors that contribute to a ‘healthy start to life’ and the prevention of non-communicable diseases. Methods: This descriptive cross-sectional study aims to describe the dietary intakes of one-year-old children participating in ORIGINS and compare these to the Australian Dietary Guidelines and Nutrient Reference Values (NRVs). Between 2020 and 2023, dietary intake data were collected on 779 one-year-old children using a Food Frequency Questionnaire (FFQ). The analysis explored milk intake (breastmilk, infant formula, and cow’s milk), the introduction to solids, macronutrient, micronutrient, and food group intakes. Results: The results indicated that 41.5% were still being breastfed at one year of age, while 58.0% continued to receive formula milk. While the cohort met NRV cut-offs for most micronutrients, iodine intake fell below requirements, and sodium intake exceeded recommendations. Diet quality, based on the food group intake, did not meet recommendations, with children over-consuming fruit and discretionary foods, while under-consuming vegetables and cereals and grains foods. Conclusions: These findings highlight areas for improvement in the dietary intake of one-year-old children. Full article

Background/Objectives: Dietary patterns rich in plant-based foods during pregnancy have been associated with neurodevelopmental outcomes in offspring. However, not all components of these diets are healthy, and the impact of their quality on behavioral outcomes remains unexplored. Therefore, this study aimed to examine the association between healthy and unhealthy plant-based diets and offspring behavioral problems at the age of four. Methods: This research involved 201 mother–child pairs from the ECLIPSES study. Maternal diet during pregnancy was assessed using a validated food frequency questionnaire, from which the healthy plant-based diet index (hPDI) was calculated, emphasizing the consumption of fruits, vegetables, legumes and nuts, along with the unhealthy plant-based diet index (uPDI), highlighting the intake of sugary drinks and refined grains. Children’s behavior was evaluated using the Child Behavior Checklist 1.5-5. Multivariable logistic regression analyses were conducted to estimated odds ratios (ORs) and their 95% confidence intervals (CIs). Results: Greater adherence to the uPDI during pregnancy was associated with higher odds for externalizing problems, including attention-deficit/hyperactivity problems (OR = 1.08; 95%CI from 1.01 to 1.16) and oppositional defiant behavior (OR = 1.09; 95%CI from 1.00 to 1.19) in offspring, particularly girls. Higher adherence to the hPDI was not associated with children’s behavior. Conclusions: The consumption of unhealthy components of a plant-based dietary pattern during gestation has been associated with adverse behavioral outcomes in children at age four. These findings underscore the importance of discerning between the healthy and unhealthy components of plant-based diets when assessing their impact on child development. Full article

Background/Objectives: To analyze the macular pigment optical density (MPOD) values in a child population and to evaluate the relation between MPOD and adherence to the Mediterranean diet using a validated questionnaire specially created for children. Eighty-eight children were included in this cross-sectional study from two primary education schools of Seville (Spain). Methods: MPOD values were measured using Macular Pigment Screener II ^®. Lutein and Zeaxanthin intake was evaluated by KIDMED questionnaire, which classifies children according to adherence to the Mediterranean diet. A whole ocular exam with slit-lamp biomicroscopy was conducted by a specialized optometrist. Results: The mean age ranged between 6 and 8 years. The mean MPOD value was 0.46 ± 0.18. The mean score of the KIDMED questionnaire was 7.19 ± 1.85. No statistically significant differences were found as a function of gender or among Mediterranean diet adherence groups. No significant differences in MPOD values between answers were found in any KIDMED questions. No correlations were found for MPOD with several variables, such as Mediterranean diet adherence and KIDMED score. Conclusions: MPOD levels in children could not be correlated with Mediterranean Diet adherence and, thus, good dietary habits. Genetic characteristics, mother’s diet habits, oxidative stress, and body fat composition in children could be the main factors influencing MPOD levels. Full article

Although the adverse health effects of consuming ultra-processed foods (UPFs) are well-documented, limited evidence exists on their impact during lactation. This study examined the association between maternal UPF consumption, feeding practices, and malnutrition in breastfed infants. A cross-sectional analysis was conducted with 111 mother–child pairs up to 150 days postpartum. Infant feeding practices were assessed using WHO indicators, and malnutrition was evaluated by length-for-age and BMI-for-age. Maternal dietary intake was estimated using two 24 h recalls, and UPF consumption was classified by the Nova classification. Dyads were grouped based on the highest UPF consumption quartile, and adjusted binary logistic regression was applied. UPFs accounted for 26% of the maternal diet on average. While 71.2% of infants were exclusively breastfed, one-third were overweight, and 11.7% were stunted. High maternal UPF consumption (>32% of energy) was associated with increased odds of malnutrition by BMI-for-age (wasting or overweight) (OR 3.38; 95% CI: 1.29–8.83) and stunting (OR 3.89; 95% CI: 1.04–14.58). Feeding practices showed no association. These findings highlight that maternal UPF consumption is associated with malnutrition odds in breastfed infants in the population assessed, emphasizing the need for dietary guidance during lactation to improve infant health outcomes. Full article

Background/Objectives: Research suggests that diet influences oxidative stress status in pregnant women and is related to their stress and depressive symptoms. This study aimed to investigate how maternal diet during late pregnancy affects oxidative stress status, maternal stress, depression, and fetal physical development. Methods: This study included 58 mother–child pairs. Dietary intake, depressive symptoms, and clinical information were obtained through questionnaires and clinical records. Maternal and cord blood concentrations of malondialdehyde (MDA), paraoxonase-1, platelet activating factor-acetylhydrolase, and cortisol were measured using spectrophotometric and enzyme-linked immunosorbent assays. Results: Maternal serum MDA levels were inversely associated with nut consumption (β = −0.40, p = 0.01) and positively associated with vitamin B2 (β = 2.43, p = 0.04) and manganese intake (β = 0.44, p = 0.02). Fruit consumption was positively associated with Center for Epidemiologic Studies Depression Scale score (β = 0.35, p = 0.03). Intakes of beans (β = −3.37, p = 0.04), vitamin B1 (β = −738.92, p = 0.04), vitamin B6 (β = −562.21, p = 0.04), vitamin C (β = −4.75, p = 0.009), iron (β = −106.63, p = 0.03), and copper (β = −863.31, p = 0.01) were inversely associated with maternal serum cortisol level, whereas dairy intake (β = 1.45, p = 0.003) showed a positive association. Cord plasma cortisol levels were inversely associated with the consumption of other vegetables (β = −2.89, p = 0.02). Conclusions: The findings encourage further research towards the refinement of dietary guidelines for pregnant women and recommendations for expecting mothers. Full article