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Keywords = child-nutrition disorders

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19 pages, 323 KB  
Article
Diet Quality and Nutritional Value in Children and Adolescents with Excess Body Weight and Dyslipidemia Undergoing Low-Glycemic Index or Standard Diet
by Beata Bondyra-Wiśniewska and Anna Harton
Nutrients 2026, 18(3), 448; https://doi.org/10.3390/nu18030448 - 29 Jan 2026
Viewed by 3
Abstract
Background/Objectives: The increasing problem of excess body weight and the resulting dyslipidemia among children and adolescents is a serious health challenge that may have long-term consequences. In this context, the search continues for an optimal diet that will support both body weight [...] Read more.
Background/Objectives: The increasing problem of excess body weight and the resulting dyslipidemia among children and adolescents is a serious health challenge that may have long-term consequences. In this context, the search continues for an optimal diet that will support both body weight normalization and improvement in lipid parameters. In the prevention and treatment of cardiovascular diseases and lipid disorders, limiting highly processed foods and replacing them with natural, minimally processed options lower in fat, saturated fatty acids (SFA), cholesterol, sugar, and salt is recommended. This study aimed to assess the quality and nutritional value of the low-glycemic index (LGI) diet and standard (ST) diet. Methods: Both diets were based on the principal recommendation of the Cardiovascular Health Integrated Lifestyle Diet-2 (CHILD-2). The Diet Quality Index (DQI) was used to assess the diet quality. Moreover, the nutritional value of the diet was assessed before and after 8 weeks of intervention. The study included 40 patients aged 8–16 years with excess body weight and dyslipidemia who completed the entire nutritional intervention. Results: This study demonstrated that both LGI and ST diets were effective in improving diet quality. The nutritional intervention led to an almost 2-fold reduction in the mean DQI score in the LGI diet group and almost 1.5-fold reduction in the ST diet group (significant differences between groups). No participants were classified into a lower diet quality category than at baseline. The percentage of participants with minimum moderate diet quality reached 100% in the LGI diet group and 44% in the ST diet group. Changes in nutritional value were similar in the LGI and ST diet groups. Both interventions resulted in a significant increase in protein and fiber consumption, as well as a decrease in cholesterol, SFA, and sodium. A greater improvement in diet quality was significantly associated with lower fat and SFA, as well as higher vitamin C intake, in both groups; specifically, it was also associated with reduced cholesterol and sugar intake in the LGI diet group, and reduced sodium intake in the ST diet group. Conclusions: These results suggest that in the dietary therapy of children and adolescents with excess body weight and dyslipidemia, the quality of the diet is crucial, as it is associated with beneficial changes in nutritional value, which may have a positive impact on patient health. To achieve this, however, constant and consistent cooperation with a dietitian is necessary to help implement appropriate dietary recommendations in practice. Further long-term, larger-scale studies are needed. Full article
(This article belongs to the Special Issue Endocrine Disturbances and Nutritional Therapies)
15 pages, 651 KB  
Article
Cultural Adaptation and Reliability Testing of the Coeliac Disease Food Attitudes and Behaviours Scale in Brazil
by Camila dos Santos Ribeiro, Eduardo Yoshio Nakano and Renata Puppin Zandonadi
Nutrients 2026, 18(1), 162; https://doi.org/10.3390/nu18010162 - 3 Jan 2026
Viewed by 366
Abstract
Background: Coeliac disease (CD) is an autoimmune chronic condition that requires a strict diet without gluten as a single effective treatment. However, adherence to a life-long gluten-free diet (GFD) may promote psychological suffering and disordered eating. The Coeliac Disease Food Attitudes and [...] Read more.
Background: Coeliac disease (CD) is an autoimmune chronic condition that requires a strict diet without gluten as a single effective treatment. However, adherence to a life-long gluten-free diet (GFD) may promote psychological suffering and disordered eating. The Coeliac Disease Food Attitudes and Behaviours Scale (CD-FAB) is the only instrument specifically designed to evaluate these aspects in individuals with CD. Objective: This study aimed to translate the CD-FAB and test its reliability in the Brazilian population. Methods: The research was conducted in three stages: (i) translation and cultural adaptation of CD-FAB into Brazilian Portuguese; (ii) pretesting with Brazilian individuals diagnosed with CD to assess item understanding; and (iii) psychometric evaluation through reproducibility (test–retest reliability) via intraclass correlation coefficient (ICC) and internal consistency via Cronbach’s alpha. Results: The CD-FAB was successfully adapted to the Brazilian CD population (Child CD-FAB-BR) and demonstrated strong internal consistency (α = 0.807) and an intraclass correlation coefficient (ICC = 0.928). Conclusions: The Brazilian version of CD-FAB proved to be reliable for assessing food attitudes and behaviours in people with CD, potentially allowing for the identification of factors to guide research and clinical practice by driving behaviour-based strategies to improve nutritional education and strategic policies for coeliac patients. Studies with larger and more diverse samples are recommended to provide external validation of the instrument. Full article
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12 pages, 237 KB  
Review
Challenges in Dietary Therapy in Pediatric Eosinophilic Esophagitis (EoE)—A Narrative Review
by A. Stochel-Gaudyn, A. Kozioł-Kozakowska and K. Kowalska-Duplaga
Nutrients 2026, 18(1), 82; https://doi.org/10.3390/nu18010082 - 26 Dec 2025
Viewed by 356
Abstract
Eosinophilic esophagitis (EoE) is a chronic, allergic, immune-mediated inflammation of the esophagus caused by food antigens. The prevalence in pediatric population is approximately 34 to 57 cases per 100,000 children, with a male to female ration 3:1. This number may be underestimated due [...] Read more.
Eosinophilic esophagitis (EoE) is a chronic, allergic, immune-mediated inflammation of the esophagus caused by food antigens. The prevalence in pediatric population is approximately 34 to 57 cases per 100,000 children, with a male to female ration 3:1. This number may be underestimated due to diagnostic challenges and variety of clinical presentations in different age groups. Diagnosis of EoE requires histopathological assessment of esophageal biopsies retrieved during gastroscopy, with at least 15 eosinophils per high-power field (HPF) in the esophageal tissue being the cut off value. According to recommendations, treatment options of EoE include dietary interventions (elimination diets), medical treatment (inhibitors of proton pump, steroids, biologics), and in some cases surgical intervention (dilation). Dietary intervention, such as elimination diets, target the triggering factors of the disease and, if supervised by professional nutritionist, have the least systemic side effects. On the other hand, depending on the number of allergens eliminated from the pediatric patients’ diet, the quality of life both of the child and their caretakers may be compromised. Additional challenges such as nutritional risks, feeding disorders, financial burden, and social life impairment also have to be taken into consideration. On top of this, an effectiveness assessment of chosen therapy requires repeated endoscopic examination with several biopsies of the esophagus, further increasing diseases burden in EoE patients. Taking all of this factors into consideration, the main objective of this narrative review was to address challenges that pediatric patients with EoE on dietary treatment face with reference to current research and daily practice. Full article
(This article belongs to the Special Issue Dietary Strategies and Mechanistic Insights in Pediatric Allergies)
14 pages, 244 KB  
Article
Correlates of Presence of Feeding Difficulties in Children with Autism Spectrum Disorder and Other Developmental Conditions
by Tammy S. H. Lim, Pravin Anand, Ying Qi Kang, Jennifer S. H. Kiing, Mae Yue Tan, Shang Chee Chong, Liang Shen, Kalyani V. Mulay and Ramkumar Aishworiya
Nutrients 2026, 18(1), 10; https://doi.org/10.3390/nu18010010 - 19 Dec 2025
Viewed by 414
Abstract
Background/Objectives: Feeding difficulties are more common in children with autism spectrum disorder (ASD) or other developmental conditions and are associated with nutritional risk and caregiver stress. However, they may be overlooked as growth tends to be preserved. We aimed to identify clinical [...] Read more.
Background/Objectives: Feeding difficulties are more common in children with autism spectrum disorder (ASD) or other developmental conditions and are associated with nutritional risk and caregiver stress. However, they may be overlooked as growth tends to be preserved. We aimed to identify clinical and behavioral features associated with feeding difficulties among children with developmental conditions. Methods: This cross-sectional study included caregiver–child dyads, with children aged 1–7 years with ASD and other developmental conditions. Caregivers completed the Repetitive Behavior Questionnaire, Second Edition (RBQ-2) to assess child restricted and repetitive behaviors (RRBs) and the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) to assess feeding difficulties. Demographics, anthropometric measures and cognitive and adaptive scores were retrieved from medical records. Results: Of the 132 participants (mean age 41.8 months, range 15–67; 74.2% male) included, majority had normal weight (87.7%) and height (89.2%) z scores. Among participants, 54.5% had autism, 26.5% language delay and 18.9% other developmental diagnoses. Over half (53.0%) had elevated BPFAS scores. Children not enrolled in school showed significantly more feeding difficulties compared to those who were enrolled (32.6% vs. 16.7%, p < 0.05). The RBQ-2 total score positively correlated with the BPFAS total frequency score (r = 0.33, p = 0.01) after adjusting for gender, age and developmental diagnosis. Conclusions: Feeding difficulties were common in this sample. Higher RRBs and absence of formal schooling were associated with higher rates of feeding difficulties. Longitudinal studies are needed to ascertain the role of RRBs and school enrollment as clinical indicators associated with feeding difficulties. Full article
26 pages, 617 KB  
Review
Decoding Picky Eating in Children: A Temporary Phase or a Hidden Health Concern?
by Dorina Pjetraj, Amarildo Pjetraj, Dalia Sayed, Michele Severini, Ludovica Falcioni, Lucia Emanuela Svarca, Simona Gatti and Maria Elena Lionetti
Nutrients 2025, 17(24), 3884; https://doi.org/10.3390/nu17243884 - 12 Dec 2025
Viewed by 2095
Abstract
Background: Picky eating (PE), also termed food selectivity, is one of the most common feeding concerns in childhood. Although often a transient developmental stage, persistent or severe selectivity may lead to nutritional deficiencies, growth impairment, and psychosocial consequences. Methods: This narrative [...] Read more.
Background: Picky eating (PE), also termed food selectivity, is one of the most common feeding concerns in childhood. Although often a transient developmental stage, persistent or severe selectivity may lead to nutritional deficiencies, growth impairment, and psychosocial consequences. Methods: This narrative review is based on literature searches conducted in April 2025 across PubMed, Web of Science, Embase, Medline, and Google Scholar. Articles published between 2015 and 2025 were included if they addressed the epidemiology, etiology, assessment, or management of PE in children aged 0–18 years. Additional seminal references predating this period were also considered. Results: Prevalence estimates of PE vary widely (13–50%), with peak incidence between ages two and six. Contributing factors include genetic predisposition, sensory sensitivities, temperament, family feeding practices, environmental influences, and adverse feeding experiences. Distinction from avoidant/restrictive food intake disorder (ARFID) and pediatric feeding disorder (PFD) is essential, as these conditions carry greater risk of nutritional and psychosocial impairment. Assessment relies on caregiver-report instruments, clinical observation, growth monitoring, and targeted nutritional evaluation. Effective management integrates parental education, responsive feeding strategies, repeated exposure to novel foods, and, when indicated, nutritional supplementation or referral to multidisciplinary teams. Sensory-based therapies, behavioral interventions, and psychoeducational programs show particular benefit in persistent cases. Conclusions: While most children outgrow PE without adverse outcomes, a subset remains at risk of long-term nutritional compromise and psychosocial difficulties. Early recognition, family-centered guidance, and evidence-based interventions are essential. Future research should refine diagnostic criteria, develop culturally sensitive assessment tools, and evaluate innovative therapies to improve outcomes. Full article
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13 pages, 2125 KB  
Article
Association of Diet Quality with Depression, Anxiety, and Comorbidity Symptoms in Chinese School-Aged Children
by Yuankai Zhao, Manman Chen, Jiahui Wang, Zichen Ye, Yimin Qu, Zhenghe Wang, Xijie Wang and Yu Jiang
Nutrients 2025, 17(24), 3842; https://doi.org/10.3390/nu17243842 - 9 Dec 2025
Viewed by 708
Abstract
Background: Depression and anxiety are prevalent mental health disorders among children and adolescents, with diet quality emerging as a modifiable risk factor. However, evidence regarding the association between comprehensive diet quality and mental health in school-aged children remains limited. Methods: This cross-sectional study [...] Read more.
Background: Depression and anxiety are prevalent mental health disorders among children and adolescents, with diet quality emerging as a modifiable risk factor. However, evidence regarding the association between comprehensive diet quality and mental health in school-aged children remains limited. Methods: This cross-sectional study included 400 Chinese children aged 8–12 years. Diet quality was assessed using the low-burden Diet Quality Questionnaire (DQQ), from which three Global Diet Recommendations (GDRs) scores were derived: GDR-Healthy, GDR-Limit, and total GDR. Depression and anxiety symptoms were evaluated using the Children’s Depression Inventory (CDI) and the Social Anxiety Scale for Children (SASC), respectively. Log-binomial regression models were used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for the associations between GDR scores and mental health symptoms (depression, anxiety, comorbidity). Subgroup analyses stratified by age and sex were conducted to explore heterogeneity. Results: Higher total GDR scores were associated with lower risks of depressive symptoms (RR = 0.90, 95% CI: 0.84–0.96), anxiety symptoms (RR = 0.93, 95% CI: 0.88–0.99), and their comorbidity (RR = 0.88, 95% CI: 0.79–0.97) after adjustment for age, sex, zBMI, physical activity, region of residence, only-child status and parental education. The GDR-Healthy score was independently associated with lower risks of depression symptoms (RR = 0.89, 95% CI: 0.83–0.96) and comorbidity (RR = 0.87, 95% CI: 0.79–0.95), while no significant associations between GDR-Limit score and mental health disorders were observed. Subgroup analyses indicated that the association was consistent across sex and age subgroups. Conclusions: Better diet quality and particularly higher intake of health-protective foods is associated with lower risks of depression, anxiety, and their comorbidity symptoms in Chinese school-aged children in this cross-sectional study. These findings support the integration of diet quality monitoring and nutritional interventions into public health strategies to promote mental health in children. Full article
(This article belongs to the Section Nutrition and Public Health)
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21 pages, 413 KB  
Review
Obesity and Mental Health in Childhood and Adolescence: A Scoping Review of Recent Scientific Evidence
by María Morales-Suárez-Varela, Esther López-García, Isabel Peraita-Costa, José Manuel Pérez Puente, Agustín Llopis-Morales, Agustín Llopis-Gonzalez and Pilar Guallar-Castillón
Children 2025, 12(11), 1512; https://doi.org/10.3390/children12111512 - 7 Nov 2025
Cited by 1 | Viewed by 2123
Abstract
Background: Child and adolescent obesity represent an increasing public health concern due to their physical consequences and impact on mental health. Recent studies have shown a significant association between obesity and depressive disorders during childhood and adolescence. The primary aim of this review [...] Read more.
Background: Child and adolescent obesity represent an increasing public health concern due to their physical consequences and impact on mental health. Recent studies have shown a significant association between obesity and depressive disorders during childhood and adolescence. The primary aim of this review was to analyze scientific evidence on the relationship between obesity and mental health in children and adolescents, with a particular focus on depressive symptoms and the use of anthropometric indicators. Secondary objectives included identifying the most common assessment tools, describing treatment approaches, and exploring mediating factors. Methods: A scoping literature review was conducted. The PubMed, Cochrane, and SciELO databases were searched for records published between 2015 and 2025 that met the inclusion criteria. Results: The 24 studies identified revealed a significant association between obesity and depressive symptoms, although considerable methodological heterogeneity was noted. Some studies reported a direct relationship with BMI, whereas others emphasized mediating factors such as body image perception and self-esteem. Cognitive–behavioral interventions and integrated programs showed both physical and psychological benefits. Conclusions: The relationship between child and adolescent obesity and mental health is complex and multifactorial. Findings support the development of multidisciplinary interventions that simultaneously address nutritional and psychological aspects. Full article
(This article belongs to the Special Issue Depression in Adolescents: Risk, Outcomes, and Intervention)
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21 pages, 346 KB  
Review
Chrononutrition in Gestational Diabetes: Toward Precision Timing in Maternal Care
by Viktoria Xega and Jun-Li Liu
J. Pers. Med. 2025, 15(11), 534; https://doi.org/10.3390/jpm15110534 - 3 Nov 2025
Cited by 1 | Viewed by 1770
Abstract
Gestational diabetes mellitus (GDM) is a heterogeneous disorder that compromises maternal and offspring health. Conventional medical nutrition therapy focuses on nutrient composition and caloric targets but largely omits timing and individualized biology. This narrative review synthesizes mechanistic, epidemiologic and interventional evidence linking circadian [...] Read more.
Gestational diabetes mellitus (GDM) is a heterogeneous disorder that compromises maternal and offspring health. Conventional medical nutrition therapy focuses on nutrient composition and caloric targets but largely omits timing and individualized biology. This narrative review synthesizes mechanistic, epidemiologic and interventional evidence linking circadian biology and meal timing (chrononutrition) to maternal glycemic control. Observational cohorts associate late eating and breakfast skipping with worse glycemia, while pilot interventions and CGM-based studies indicate that front-loading carbohydrates, restricting evening carbohydrate, extending overnight fasting (≈10–12 h), and simple within-meal sequencing can reduce postprandial excursions and increase time-in-range. We propose a pragmatic, tiered clinical pathway in which routine second-trimester triage (50 g glucose challenge test and ultrasound abdominal subcutaneous fat thickness) identifies higher-risk women for short-term CGM phenotyping and prioritized chrononutrition counseling. Integrating phenotype-matched timing interventions with dietetic support and digital decision tools allows rapid, individualized adjustments informed by real-time glucose patterns and patient chronotype. In principle, this tiered strategy could improve daily glycemic profiles, reduce the need for pharmacotherapy, and translate into better neonatal outcomes if supported by larger randomized trials. Chrononutrition therefore offers a promising extension of standard care: simple, low-cost adjustments to “when” food is eaten, supported by digital tools, could allow nutrition therapy for GDM to become more precise, more responsive, and ultimately more effective for both mother and child. Key priorities include validating bedside and chrono-omic stratifiers, testing scalable delivery platforms, and ensuring equitable access to personalized chrononutrition in pregnancy. Full article
(This article belongs to the Special Issue Personalized Medicine of Obesity and Metabolic Disorders)
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23 pages, 904 KB  
Article
Association of Maternal Sociodemographic, Anthropometric, and Lifestyle Factors with Childhood Anthropometric Measures and Anxiety Symptoms: A Nationally Representative Cross-Sectional Study of Preschool-Aged Children in Greece
by Exakousti-Petroula Angelakou, Athina Spyrilioti, Maria Tsiakara, Maria Vasilakaki and Constantinos Giaginis
Diseases 2025, 13(10), 327; https://doi.org/10.3390/diseases13100327 - 2 Oct 2025
Viewed by 1627
Abstract
Background/Objective: Childhood obesity and mental health disorders in preschool-aged children represent critical public health challenges with a rising global prevalence, closely linked to lifestyle behaviors and the family environment. This cross-sectional study aims to investigate the combined influence of maternal sociodemographic, socioeconomic, anthropometric [...] Read more.
Background/Objective: Childhood obesity and mental health disorders in preschool-aged children represent critical public health challenges with a rising global prevalence, closely linked to lifestyle behaviors and the family environment. This cross-sectional study aims to investigate the combined influence of maternal sociodemographic, socioeconomic, anthropometric characteristics, and lifestyle factors on the physical and mental health status of preschool-aged children. Methods: Validated questionnaires were administered to assess dietary habits, psychosocial parameters (depression, anxiety, stress), and sociodemographic, socioeconomic, and anthropometric variables among 200 preschool-aged children and their mothers, who served as the primary informants. Results: Maternal obesity was associated with a higher prevalence of childhood overweight/obesity (36.7% vs. 18.5% in children of non-obese mothers, p = 0.009). Maternal psychological factors, specifically depressive symptoms (B = 0.998, OR = 2.712, 95% CI: 1.222–6.020, p = 0.014) and anxiety (B = 1.676, OR = 5.346, 95% CI: 2.471–11.565, p < 0.001), were independently associated with an increased likelihood of child anxiety. Anthropometric measures, including waist circumference (p = 0.032) and hip circumference (p = 0.031), primarily influenced children’s physical health, whereas maternal psychological factors predominantly affected their emotional well-being. Conclusions: The findings underscore the necessity for targeted interventions focusing on enhancing maternal nutrition and mental health literacy, aiming to promote healthy dietary patterns, physical activity, and lifestyle behaviors. Such interventions are pivotal for preventing childhood obesity and fostering overall well-being at the population level. Full article
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14 pages, 552 KB  
Article
Oro-Dental Characteristics Associated with Pediatric Dental Neglect: A Retrospective Study
by Anamaria Violeta Țuțuianu, Abel Emanuel Moca, Teodora Ștefănescu, Dan Alexandru Slăvescu, Lucian Roman Șipoș, Horia Câlniceanu and Anca Ionel
Children 2025, 12(9), 1266; https://doi.org/10.3390/children12091266 - 21 Sep 2025
Viewed by 713
Abstract
Background/Objectives: Dental neglect represents a preventable form of child maltreatment that may lead to significant oral and systemic health complications. This study primarily aimed to investigate the main oral manifestations and determinants of dental neglect in a pediatric population from Bihor County, Romania. [...] Read more.
Background/Objectives: Dental neglect represents a preventable form of child maltreatment that may lead to significant oral and systemic health complications. This study primarily aimed to investigate the main oral manifestations and determinants of dental neglect in a pediatric population from Bihor County, Romania. Additionally, it assessed the association between systemic factors, such as nutritional status and psychological conditions, and the severity of oro-dental lesions, with the goal of informing future preventive strategies and public health interventions. Methods: A retrospective analysis was conducted on 333 pediatric patients diagnosed with dental neglect. Clinical data were collected from two centers between 2020 and 2024. Oral health status, socio-demographic characteristics, and psychological conditions were evaluated. Statistical analyses included Fisher’s Exact Test, Mann–Whitney U Test, and Bonferroni-adjusted Z-tests, with significance set at p ≤ 0.05. Results: Among the 333 participants, 52.9% were male, with a mean age of 8.75 ± 3.29 years. Most children (81.7%) resided in rural areas, and 55.6% were first-born. Carious lesions were identified in 100% of cases, with 54.7% showing complications such as endodontic pathology. Poor oral hygiene was reported in 99.1% of children, while 58.6% presented signs of periodontal disease and 37.2% reported spontaneous gingival bleeding. Acute pain was experienced by 40.2% of participants. Nutritional issues were prevalent, with 24.3% classified as obese and 21.6% as malnourished. Significant associations were found between lesion severity and both psychological disorders (p < 0.001) and malnutrition (p < 0.001). Conclusions: This study identifies untreated carious lesions, poor oral hygiene, acute dental pain, and oro-dental trauma as key clinical indicators of pediatric dental neglect, with rural residency and limited education as significant socio-demographic risk factors. The findings highlight the urgent need for integrated, community-based strategies, including school-based screenings, parental education, and referral pathways, to improve early detection and prevention in Romania. Full article
(This article belongs to the Special Issue Dental Status and Oral Health in Children and Adolescents)
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15 pages, 3866 KB  
Article
Prevalence and Factors Associated with Anaemia and Undernutrition Among Children Aged 6–24 Months in Rural Tanzania
by Naelijwa Mshanga, Sally Moore, Neema Kassim, Carolyn I. Auma, Yun Yun Gong and Haikael D. Martin
Int. J. Environ. Res. Public Health 2025, 22(6), 962; https://doi.org/10.3390/ijerph22060962 - 19 Jun 2025
Cited by 1 | Viewed by 1853
Abstract
Background: Anaemia and undernutrition remain a significant public health problem in low and middle-income countries (LMICs), particularly affecting under-five children. In Tanzania, the prevalence of anaemia and undernutrition in under-five children is still high; however, less is known about the prevalence and predictors [...] Read more.
Background: Anaemia and undernutrition remain a significant public health problem in low and middle-income countries (LMICs), particularly affecting under-five children. In Tanzania, the prevalence of anaemia and undernutrition in under-five children is still high; however, less is known about the prevalence and predictors of these conditions in rural areas. Therefore, the current cross-sectional study presents the prevalence and determinants of anaemia and undernutrition among 457 children aged 6–24 months in the Babati and Hanang districts of Tanzania. Method: Haemoglobin concentration was assessed through capillary blood samples. Anaemia was classified according to WHO 2011 guidelines using a cut-off of <11.0 g/dL for children under five, while the WHO 2006 growth indicators were used to classify the nutritional status (i.e., stunting, wasting and underweight). Results: The results from this study show that 32%, 32%, 20% and 4% of children aged 6–24 months were anaemic, stunted, underweight and wasted, respectively, while only 33% had an adequate minimum dietary diversity (MDD). In addition, the child’s age (13–24 months) was significantly associated with anaemia (AOR: 2.1 95% CI 1.4, 3.1), stunting (AOR:17.4 95% CI 10.3, 29.4) and underweight (AOR: 15.9 95% CI 7.9, 32.0). Moreover, male children were three times more likely to be wasted (AOR: 3.5 95% CI 1.1, 10.9) than their female counterparts. Anaemia and stunting were the most prevalent nutritional disorders among 6–24-month-old children in the Hanang and Babati districts. Moreover, age (13–24 months) was found to be the common predictor for anaemia, stunting and underweight. Conclusion: The observed association between age and anaemia, as well as undernutrition, suggest that age may be an essential factor when designing nutrition-related programs in similar rural settings. Full article
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17 pages, 290 KB  
Review
Effect of Iodine Nutrition During Pregnancy and Lactation on Child Cognitive Outcomes: A Review
by Zheng Feei Ma and Louise Brough
Nutrients 2025, 17(12), 2016; https://doi.org/10.3390/nu17122016 - 16 Jun 2025
Cited by 6 | Viewed by 11400
Abstract
Iodine deficiency remains one of the most serious global public health challenges, recognised as the leading cause of preventable brain damage worldwide. It is widely accepted as the primary aetiological factor underlying iodine deficiency disorders (IDD). Inadequate maternal iodine intake reduces thyroxine synthesis, [...] Read more.
Iodine deficiency remains one of the most serious global public health challenges, recognised as the leading cause of preventable brain damage worldwide. It is widely accepted as the primary aetiological factor underlying iodine deficiency disorders (IDD). Inadequate maternal iodine intake reduces thyroxine synthesis, impairing foetal brain development and leading to long-term deficits in cognitive function across childhood and adulthood. However, emerging evidence also suggests that excessive iodine intake may disrupt thyroid function, particularly in individuals with underlying thyroid autoimmunity, potentially leading to adverse neurodevelopmental outcomes. In this state-of-the-art review, we examine the effects of iodine nutrition during pregnancy and lactation on child cognitive outcomes. We provide an overview of the recent global iodine status, critically appraise the current evidence linking both iodine deficiency and excess to neurodevelopmental outcomes, and offer expert interpretation of the key findings. We further highlight areas of uncertainty, introduce emerging evidence from contemporary studies, and propose directions for future research to inform and optimise public health policies and clinical practice. Our findings highlight a U-shaped association, whereby both insufficient and excessive iodine exposure during pregnancy and lactation may impair optimal brain development in the offspring. Full article
(This article belongs to the Special Issue Iodine Nutrition During Pregnancy, Lactation and Early Life)
56 pages, 11868 KB  
Review
Modifiable Nutritional Biomarkers in Autism Spectrum Disorder: A Systematic Review and Meta-Analysis of Vitamin D, B12, and Homocysteine Exposure Spanning Prenatal Development Through Late Adolescence
by Oana-Elisabeta Avram, Elena-Alexandra Bratu, Cecilia Curis, Lavinia-Alexandra Moroianu and Eduard Drima
Int. J. Mol. Sci. 2025, 26(9), 4410; https://doi.org/10.3390/ijms26094410 - 6 May 2025
Cited by 1 | Viewed by 6091
Abstract
Autism Spectrum Disorder (ASD) has been associated with disruptions in one-carbon metabolism and vitamin D pathways. Nutritional exposures—particularly vitamin D, vitamin B12, and homocysteine—may influence neurodevelopmental outcomes. However, a comprehensive, lifespan-spanning synthesis of these modifiable nutritional biomarkers has not been conducted. [...] Read more.
Autism Spectrum Disorder (ASD) has been associated with disruptions in one-carbon metabolism and vitamin D pathways. Nutritional exposures—particularly vitamin D, vitamin B12, and homocysteine—may influence neurodevelopmental outcomes. However, a comprehensive, lifespan-spanning synthesis of these modifiable nutritional biomarkers has not been conducted. This systematic review and stratified meta-analysis critically synthesized data on vitamin D, vitamin B12, and homocysteine to elucidate their relationships with ASD risk and symptomatology. Our central question was: How do levels of vitamin D, vitamin B12, and homocysteine—measured before and after birth—affect the risk, severity, and potential treatment outcomes for ASD? We conducted a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) compliant systematic review and stratified meta-analysis (2015–2025) of 35 studies (11 randomized controlled trials, 24 observational), examining prenatal, neonatal, and postnatal biomarker levels. Eligibility criteria were defined using the PICOS (Population, Intervention, Comparator, Outcome, and Study Design) framework to ensure scientific rigor and clinical relevance, including studies involving human participants aged 0–18 years with a formal Autism Spectrum Disorder (ASD) diagnosis or prenatal exposures potentially linked to later ASD onset, while excluding animal studies, adult-only ASD populations, and studies lacking ASD cohorts or biomarker data. The search strategy, developed according to PRISMA, and Cochrane best practices, encompassed five major databases (PubMed/MEDLINE, Cochrane Library, Google Scholar, ClinicalTrials.gov, and ProQuest) alongside manual searches of key references, grey literature, and clinical trial registries to ensure comprehensive retrieval of both published and unpublished studies. Study quality was assessed using version 2 of the Cochrane risk-of-bias tool for RCTs (RoB2) and the Newcastle–Ottawa Scale (NOS) for observational studies; certainty of evidence was graded via GRADE (Grading of Recommendations Assessment, Development and Evaluation). Random-effects meta-analyses were stratified by biomarker and study design. Heterogeneity, small-study effects, and publication bias were evaluated using Cochran’s Q, I2, Egger’s test, and trim-and-fill. Prenatal vitamin D deficiency was associated with approximately two-fold increased odds of Autism Spectrum Disorder (ASD) in offspring (pooled OR ≈ 2.0; p < 0.05), while excessively elevated maternal B12 concentrations, often co-occurring with folate excess, were similarly linked to increased ASD risk. Meta-analytic comparisons revealed significantly lower circulating vitamin D (SMD ≈ −1.0; p < 0.001) and B12 levels (SMD ≈ −0.7; p < 0.001), alongside elevated homocysteine (SMD ≈ 0.7; p < 0.001), in children with ASD versus neurotypical controls. Early-life vitamin D/B12 insufficiency and elevated homocysteine are important, modifiable correlates of ASD risk and severity. Adequate maternal and child nutritional status could have risk-reducing and symptom-mitigating effects, although causality remains to be confirmed. This evidence supports tailored nutritional interventions as a component of ASD risk reduction and management strategies, within the bounds of overall developmental healthcare. The article processing charges (APC) were supported by “Dunărea de Jos” University of Galati, Romania. No external funding was received for the execution of the research. The review was not prospectively registered in PROSPERO or any other systematic review registry. Full article
(This article belongs to the Special Issue The Role of Vitamin D in Human Health and Diseases 4.0)
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17 pages, 798 KB  
Article
Assuring Primary Healthcare Services to Vulnerable Children in a Disadvantaged Suburb of Rome Metropolitan City During the Pandemic: Responses to the Crisis
by Aurelia Rughetti, Anna Rita Buonomini, Leonardo Russo, Francesca Mazzoli, Suleika Urbano, Fotinì Iordanoglou, Cataldo Palagiano, Manuel Barletta, Samuele Casartelli, Aldo Morrone and Lucia Ercoli
Children 2025, 12(4), 443; https://doi.org/10.3390/children12040443 - 30 Mar 2025
Viewed by 968
Abstract
Background/Objective: This retrospective observational study describes the social, health, and psychological conditions of children living in a disadvantaged and degraded suburb of Rome Metropolitan City during the COVID-19 pandemic as registered by the primary healthcare service of the Solidarity Medicine Institute, with the [...] Read more.
Background/Objective: This retrospective observational study describes the social, health, and psychological conditions of children living in a disadvantaged and degraded suburb of Rome Metropolitan City during the COVID-19 pandemic as registered by the primary healthcare service of the Solidarity Medicine Institute, with the aim of fighting social exclusion and health disparities during lockdown and offering free health care to vulnerable families. Methods: The access to pediatric interventions was assessed from April 2020 to December 2022. For each child, biometric parameters were recorded, and the physical and psychological states of health were assessed. Furthermore, data regarding family socio-economic variables were collected. Results: From April 2020 to December 2022, 638 children, aged 0 to 18 years, had access to the healthcare system, which was provided by the Solidarity Medicine Institute, with a total of 2300 pediatric visits. Moreover, food supplements, drugs, and hygiene kits that were necessary for the containment of the COVID-19 infection were freely distributed at the center. The highest proportion of children included in this study were from African and Eastern European families (46% and 35.8%, respectively), and 41% of these children did not have a pediatrician from the public health service. Children aged 0 to 5 years comprised 50.81% of the entire population of this study. Nutritional status assessment indicated that among the 117 infants aged 0–12 months, 5.7% were below the 3rd weight percentile, while 28.9% exceeded the 85th weight percentile. BMI assessment for children aged 2 years and older (i.e., 521 children) indicated that 21.7% of these children were overweight, and 9.5% were obese. Sixty-nine cases of psychiatric disorders were also detected among these children, with a high frequency of cases of Specific Language Disorder (31.8%), Attention Deficit Hyperactivity Disorder (21.7%), and Specific Learning Disorder (14.5%). Psychiatric and rehabilitative interventions were also offered. Conclusions: The Solidarity Medicine Institute responded to the request of the municipality of Rome to remain open and offer social and health assistance to the most vulnerable people during the pandemic. The Solidarity Medicine Institute has efficaciously served a fragile pediatric population, intercepting social, health, and psychological needs and overcoming social exclusion, health disparity, and the fragmentation of welfare services exacerbated by the COVID-19 pandemic. Full article
(This article belongs to the Section Global Pediatric Health)
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Article
A Preliminary Single-Centre Study on the Risk Factors Associated with Persistent Feeding Disorders in Children
by Marta Ewelina Lis, Martyna Chojnacka, Ewa Łoś-Kiszkowiak, Beata Ziółkowska and Aneta Krogulska
Nutrients 2025, 17(7), 1111; https://doi.org/10.3390/nu17071111 - 22 Mar 2025
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Abstract
Background/Objectives: The epidemiology of childhood feeding disorders (PFDs) reveals a significant prevalence. The aim of the study was to identify risk factors for the persistence of PFDs. The study considered psychosocial and biological factors. Methods: A retrospective cross-sectional study was performed [...] Read more.
Background/Objectives: The epidemiology of childhood feeding disorders (PFDs) reveals a significant prevalence. The aim of the study was to identify risk factors for the persistence of PFDs. The study considered psychosocial and biological factors. Methods: A retrospective cross-sectional study was performed at two time points (Stage I and II); the mean interval was three years. The study included 56 children hospitalised between 2013 and 2023. Participants were divided into Group A (n = 39) and Group B (n = 17). Group A included children whose feeding disorders persisted until Stage II, while Group B included children whose symptoms of feeding disorders were no longer noted at Stage II. The mean age of children in Stage I was 4.5 ± 4.3 years in Group A and 6.25 ± 6.1 years in Group B. In Stage II, the mean age was 7.76 ± 5.3 years in Group A and 9.4 ± 6.7 years in Group B. Results: In Stage I (Groups A + B), 22 (39.29%) children refused to eat all foods, 26 (46.43%) consumed fewer foods than in the previous period, 19 (33.93%) ate only at night, and 12 (21.43%) consumed only selected food. A significant difference in the prevalence of wasting was noted at Stage II (Group A n = 19, 48.7% vs. Group B n = 3, 17.6%, p = 0.029). Feeding difficulties were found to start during exclusive breastfeeding in 28.6% in Group B but only in 10.8% in Group A. Feeding disorders concerning foods other than milk were significantly more common in Group A (n = 31; 83.8%) than Group B (n = 6; 42.9%; p = 0.011). At the end of one year of age, foods of all consistencies were consumed more often by children in Group B (n = 9; 64.3% vs. n = 10; 27%; p = 0.036). Conclusions: Children with feeding disorders comprise a heterogeneous group of patients. Those who only present feeding disorders associated with the consumption of milk and who consume foods of different consistencies by the end of one year of age demonstrate a better prognosis. Full article
(This article belongs to the Section Pediatric Nutrition)
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