• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권3호
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• pp.194-210
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• 2022

Human milk contains a number of nutritional and bioactive molecules including microorganisms that constitute the so-called "Human Milk Microbiota (HMM)". Recent studies have shown that not only bacterial but also viral, fungal, and archaeal components are present in the HMM. Previous research has established, a "core" microbiome, consisting of Firmicutes (i.e., Streptococcus, Staphylococcus), Proteobacteria (i.e., Serratia, Pseudomonas, Ralstonia, Sphingomonas, Bradyrhizobium), and Actinobacteria (i.e., Propionibacterium, Corynebacterium). This review aims to summarize the main characteristics of HMM and the role it plays in shaping a child's health. We reviewed the most recent literature on the topic (2019-2021), using the PubMed database. The main sources of HMM origin were identified as the retrograde flow and the entero-mammary pathway. Several factors can influence its composition, such as maternal body mass index and diet, use of antibiotics, time and type of delivery, and mode of breastfeeding. The COVID-19 pandemic, by altering the mother-infant dyad and modifying many of our previous habits, has emerged as a new risk factor for the modification of HMM. HMM is an important contributor to gastrointestinal colonization in children and therefore, it is fundamental to avoid any form of perturbation in the HMM that can alter the microbial equilibrium, especially in the first 100 days of life. Microbial dysbiosis can be a trigger point for the development of necrotizing enterocolitis, especially in preterm infants, and for onset of chronic diseases, such as asthma and obesity, later in life.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권3호
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• pp.135-145
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• 2023

Antibiotics are frequently administered during pregnancy. Although necessary to address acute infections, their use facilitates antibiotic resistance. Other associations have also been found with the use of antibiotics, such as perturbations of gut bacteria, delays in microbial maturation, and increased risks of allergic and inflammatory diseases. Little is known about how the prenatal and perinatal administration of antibiotics to mothers affects the clinical outcomes of their offspring. A literature search was conducted of the Cochrane, Embase, and PubMed engines. The retrieved articles were reviewed by two authors and verified for relevance. The primary outcome was the effect of pre- and perinatal maternal antibiotic use on clinical outcomes. Thirty-one relevant studies were included in the meta-analysis. Various aspects are discussed, including infections, allergies, obesity, and psychosocial factors. In animal studies, antibiotic intake during pregnancy has been suggested to cause long-term alterations in immune regulation. In humans, associations have been found between antibiotic intake during pregnancy and different types of infections and an increased risk of pediatric infection-related hospitalization. A dose-dependent positive association between pre- and perinatal antibiotic use and asthma severity has been reported in animal and human studies, while positive associations with atopic dermatitis and eczema were reported by human studies. Multiple associations were identified between antibiotic intake and psychological problems in animal studies; however, relevant data from human studies are limited. However, one study reported a positive association with autism spectrum disorders. Multiple animal and human studies reported a positive association between pre- and perinatal antibiotic use by mothers and diseases in their offspring. Our findings have potentially significant clinical relevance, particularly considering the implications for health during infancy and later in life as well as the related economic burden.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제27권3호
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• pp.186-195
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• 2024

Purpose: Infantile colic diagnostic criteria were established by Rome IV. A universally accepted management remains to be established. We aimed to evaluate diagnostic criteria, management strategies, and perceived regional prevalence of infantile colic in Pakistan, as well as its effect on physicians and parents. Methods: A questionnaire was distributed amongst 1,256 physicians. Results: We received 800 replies. Wessel and Rome IV criteria were used by most physicians for diagnosis; however, the response "any infant who cries a lot" was selected by older physicians (48% of those over 60 years), physicians in rural areas (32%), physicians practicing in private clinics (27%), and general physicians (30%). Estimated prevalence of infantile colic ranges from 21-40%. Reassurance was the most widely recommended management strategy followed by herbal teas (51%), switching to a different formula (49%), probiotics (28%) and antibiotics (26%), discontinuation of breastfeeding (14%), elimination of dairy products from the breastfeeding mothers' diet (6%), and the administration of colic drops (1%). Most physicians considered the negative impact of colic on their personal lives and the parents as mild-to-moderate. Notably, 38% of percent of physicians routinely screened for maternal depression, and 45% of physicians were aware of the association between infantile colic and shaken baby syndrome. Conclusion: Most physicians in Pakistan diagnose and manage infantile colic according to the established guidelines. However, the guidelines pertaining to treatment planning are not followed. Educational efforts directed toward general physicians and doctors practicing in rural areas and clinics must be implemented to avoid unnecessary testing and treatment burden.

• Asian-Australasian Journal of Animal Sciences
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• 제20권2호
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• pp.295-306
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• 2007

The growth and health of the fetus and neonate are directly influenced by the nutritional and physiological status of sows. Sows are often under catabolic conditions due to restrict feeding program during pregnancy and low voluntary feed intake during lactation. The current restrict feeding program, which aims at controlling energy intake during gestation, results in an inadequate supply of dietary protein for fetal and mammary gland growth. Low voluntary feed intake during lactation also causes massive maternal tissue mobilization. Provision of amino acids and fatty acids with specific functions may enhance the performance of pregnant and lactating sows by modulating key metabolic pathways. These nutrients include arginine, branched-chain amino acids, glutamine, tryptophan, proline, conjugated linoleic acids, docosahexaenoic acid, and eicosapentaenoic acid, which can enhance conception rates, embryogenesis, blood flow, antioxidant activity, appetite, translation initiation for protein synthesis, immune cell proliferation, and intestinal development. The outcome is to improve sow reproductive performance as well as fetal and neonatal growth and health. Dietary supplementation with functional amino acids and fatty acids holds great promise in optimizing nutrition, health, and production performance of sows and piglets. (Supported by funds from Texas Tech, USDA, NLRI-RDA-Korea, and China NSF).

• 가정과삶의질연구
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• 제11권2호
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• pp.134-146
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• 1993

The purpose of this study was to collect the datas about the child care arrangement and the needs of day care programs of teaching mothers with preschool children and to develop the more desirable day care programs for them. The objects were 255 teaching mothers with preschool children. The results were as follows: 1) Teaching mothers who didn't use the day care center tended to put their children in the care of the paternal or maternal grandmothers, Major contributions of those baby-sitters were to protect the children and make everyday life training (44.0%) 2) The first reason for the mothers who used the day care center was that they had no other hands for their children(43.7%) and next reason was that the concerns for their children's socialization(35.4%) 3) Teaching mothers did not want the day care service during the vacation except 20% of them. 4) Teaching mothers absolutely wanted the day care service center especially inside their jobsite(61.0%) than any other type of day care programs and also wanted supporting by the government(66.5%) About the choice criterions of the day care center nutrition health and safety were suggested as the most important factor. They also prefered the experience with other peers and the programs focusing on the emotional development of the children.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제8권1호
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• pp.21-30
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• 2005

목 적: 식품 단백질 유발성 직결장염(dietary protein induced proctocolitis, DPIPC)의 임상적 특성과 장기 추적 관찰에 따른 자연 경과 과정을 알아보고, 모유 수유아에서의 어머니 식이 조절에 관한 새로운 방안을 모색하여 보고자 본 연구를 시행하였다. 방 법: 2003년 3월에서 2004년 7월까지 계명의대소아과 외래와 병동을 방문하여 DPIPC로 진단되고 6개월 이상 추적 관찰된 30명을 대상으로 후향적으로 조사되었다. 모유 수유아는 진단 직후 우유를 포함한 유제품, 계란, 견과류 및 콩류, 어패류, 밀가루 및 메밀의 5가지 음식을 어머니의 식단에서 7일간 제거 한 후 혈변의 소실을 관찰하였으며, 분유 수유아, 모유 부족의 경우는 단백가수분해물을 이용하였다. 결 과: 1) DPIPC의 발병 당시 모유 수유아는 28례(93.3%)이었으며, 2례(6.7%)는 분유 수유아였다. 2) 발병 연령은 생후 $11.5{\pm}5.1$ (5~24)주, 진단 연령은 $17.8{\pm}9.5$ (8~56)주이었다. 발병에서 진단까지 $6.3{\pm}6.7$ (0~36)주가 소요되었다. 3) 진단 당시의 말초 혈액 검사상 호산구수가 $250/mm^3$ 이상 증가된 경우가 27례(90.0%)로 $478{\pm}320$ (40~1,790)/$mm^3$으로 관찰되었고, 혈중 IgE가 증가된 경우는 없었다. 알레르기 MAST 검사를 시행한 26례 중 13례(50.0%)에서 양성 반응을 보였다. 4) S상 결장경을 시행한 15례 중 14례(93.3%)가 결절성 비후(nodular hyperplasia)와 미란에 의한 점막 출혈이 함께 관찰되었으며, 1례(6.7%)에서 국소적 발적만 관찰되었다. 5) 어머니 식단에서 5가지 음식을 배제한 27례 중 20례(74.1%)가 혈변이 소실되었으며, 7례(25.9%)에서 지속되었다. 혈변이 사라진 20례에서 5가지 음식을 선호도에 따라 하나씩 식단에 추가하였을 때 18례(90.0%)에서 혈변을 보였으며, 혈변을 보인 식품은 40건으로 중복 관찰되어, 우유 37.5%, 밀가루 27.5%, 어패류 20.0%, 견과류와 계란이 각각 7.5%로 관찰되었다. 6) 어머니 식단이 혈변없이 완전히 자유로워진 때는 관찰된 27례에서 환자 생후 $29.4{\pm}8.7$ (9~44)주이었다. 7) 환자의 식단이 혈변없이 완전히 자유로워진 시기는 관찰된 25례에서 생후 $37.5{\pm}9.7$ (12~56)주였다. 결 론: DPIPC는 일반적으로 알려진 바와 달리 모유 수유아에 집중되고, 호산구의 증가가 높게 관찰되었다. 어머니의 식단 중 5가지 식품을 제거하여 높은 혈변 소실률을 보였으므로 식이 조절의 방안으로 활용될 수 있을 것으로 판단된다. DPIPC는 생후 12개월까지 96.0%에서 완전한 소실이 관찰되었다.

• The Korean Journal of Physiology and Pharmacology
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• 제22권4호
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• pp.409-417
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• 2018

Pre-eclampsia (PE) is a pregnancy disorder that is characterised by severe hypertension and increased risks of foetal and maternal mortality. The aetiology of PE not completely understood; however, maternal nutrition and oxidative stress play important roles in the development of hypertension. The treatment options for PE are currently limited to anti-hypertensive drugs. Punicalagin, a polyphenol present in pomegranate juice, has a range of bioactive properties. The effects of supplementation with punicalagin on angiogenesis and oxidative stress in pregnant rats with induced hypertension were investigated. The pregnant rats were randomly divided into five experimental groups (n=12 per group). Hypertension was induced using an oral dose of NG-nitro-L-arginine methyl ester (L-NAME, 50 mg/kg/day) on days 14-19 of pregnancy. Punicalagin (25, 50 or 100 mg/kg) was given orally on days 14-21 of pregnancy. Punicalagin treatment at the tested doses significantly reduced diastolic, systolic, and mean arterial blood pressure in L-NAME treated rats from day 14. Punicalagin also restored angiogenic balance by increasing the expression of vascular endothelial growth factor and downregulating vascular endothelial growth factor receptor-1/fms-like tyrosine kinase-1. Punicalagin, significantly increased the placental nitric oxide levels as compared to PE group. The increased levels of oxidative stress in rats with PE were markedly decreased by treatment with punicalagin. Punicalagin at the tested doses markedly (p<0.05) enhanced the placental antioxidant capacity in L-NAME-treated rats. The raised catalase activity observed following L-NAME induction was significantly (p<0.05) and restored to normal activity levels in punicalagin treatment. Further, 100 mg dose of punicalagin exhibited higher protective effects as compared to lower doses of 25 and 50 mg. This study shows that supplementation with punicalagin decreased blood pressure and oxidative stress and restored angiogenic balance in pregnant rats with induced PE.

• Journal of Nutrition and Health
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• 제44권5호
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• pp.416-427
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• 2011

본 연구는 부모의 사회경제적 수준과 초등학교 6학년 자녀의 과체중 위험도, 식습관, 식사 질과의 관계에 대하여 알아보고자 하였으며 그 결과는 다음과 같다. 1) 어머니 교육수준이 낮은 여학생 집단이 비교 집단에 비해 과체중의 위험도가 1.91배 높았다. 하지만 남학생의 경우에는 과체중 위험도와 사회경제수준 간에 유의성이 없었다. 2) 남녀 모두 수입 및 부모의 교육수준이 낮은 집단에서 과일류 섭취량이 유의적으로 낮은 것으로 나타났으며, 여학생의 경우 이와 함께 가구 월수입 및 부모의 교육수준이 낮은 집단에서 어패류의 섭취량도 유의적으로 낮았다. 3) 1일 평균 영양소 섭취량을 비교한 결과 여학생의 경우 가구 월수입 및 부모의 교육수준이 낮은 집단에서 총 섭취량과 식물성 식품의 섭취가 유의적으로 낮았으며, 이와 함께 탄수화물, 비타민 C, 칼륨, 식이 섬유의 섭취도 유의적으로 낮게 나타났다. 4) 여학생의 경우 아버지의 교육수준이 낮은 집단에서 높은 집단 보다 탄수화물을 통하여 섭취하는 에너지의 비율은 낮았던 반면, 지방의 비율은 유의적으로 높았다. 하지만 남학생의 경우 가구 월수입 및 부모의 교육수준에 따른 열량 및 영양소 섭취량에서 유의적인 차이가 없었다. 5) 가구 월수입 및 부모의 교육수준이 낮은 집단에서 EAR 미만으로 영양소를 섭취하는 대상자 비율이 높았다. 남학생은 월수입이 낮은 집단에서 나이아신, 철분 섭취가 EAR 보다 부족한 학생비율이 높았으며, 부모의 교육수준에 따라서는 유의적인 차이가 없었다. 여학생은 사회경제적 수준이 낮은 집단에서 인의 섭취가 EAR 미만인 대상자가 비율이 유의적으로 높았고, 이와 함께 부모 교육수준이 낮은 집단에서 나이아신과 비타민 B6의 섭취량이 EAR 보다 부족한 비율이 높았다. 6) 여학생의 경우 가구 월수입에 따른 비교에서 가구 월수입이 낮은 집단에서 라면의 섭취 빈도가 높은 것으로 나타났으며, 부모의 교육수준에 따른 비교에서는 교육수준이 낮은 집단에서 남녀 모두 아침 식사 결식 횟수가 높고, 라면의 섭취 빈도가 높은 것으로 나타났다. 7) 여학생의 경우 가구 월수입 및 부모의 교육수준이 낮은 집단에서 식품섭취 다양성과 균형성이 모두 비교 집단에 비하여 낮게 나타났다. 하지만 남학생의 경우 가구 월수입 및 부모의 교육수준에 따른 유의적인 차이가 관찰되지 않았다. 본 연구를 통하여 부모의 사회경제적 수준은 여학생의 식습관과 식사의 질에 영향을 미치는 것으로 나타났다. 부모의 낮은 사회경제적 수준은 자녀의 바람직하지 않은 식습관과 낮은 식사의 질과 관련되어 있었으며, 이는 영양소 섭취량에도 영향을 미치고 있었다. 또한 어머니 교육수준은 여학생의 과체중 위험도에 영향을 미치는 것으로 나타났다. 따라서 사회경제적 수준이 낮은 집단에 대한 건강한 식습관과 체중 관리를 위한 교육 및 영양 정책이 필요하다.

• Journal of Nutrition and Health
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• 제36권5호
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• pp.459-469
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• 2003

We examined the effects of calcium intake levels on mineral metabolism during pregnancy using calcium-deficient young adult rats. Five week-old female Sprague-Dawley rats were fed normal Ca (NCa, 0.5%) and low Ca (LCa, 0.15%) diets for five weeks (pre-pregnancy). The low Ca intake group was then divided into three groups and fed low Ca (0.15%), normal Ca (0.5%) and high Ca (1.5%) diets for 3 weeks (pregnancy). All of the rats were mated with normal male rats. The control group was fed a consistently normal Ca (0.5%) diet during pre-pregnancy and pregnancy. On the day after delivery, dams and their pups were sacrificed. We measured total protein, albumin, alkaline phosphatase and mineral content in serum and weight, length, breaking force, ash and mineral content in the femur and lumbar (L2-L4) of the dams. Whole body mineral content was measured in the pups. There was no difference in weight gain and food intake among the groups. Serum total protein and albumin were in the normal range but a little lower during pregnancy. High Ca supplementation decreased serum Mg and Fe during pregnancy. Weight, ash and Ca of the femur and lumbar significantly decreased in rats fed a chronically low Ca diet during pre-pregnancy and pregnancy. Calcium supplementation levels were above normal during pregnancy and increased the bone weight and breaking force of rats fed the low Ca diet during pre-pregnancy. However, Ca supplementation did not increase the ash and Ca contents in the bones. High Ca supplementation during pregnancy significantly decreased Mg in the bones and increased Ca and P in the kidneys. Ash content of pups from dams fed the chronically low Ca diet decreased but there was no difference in whole body Ca among the groups. Mg and Fe in the whole body decreased in pups from dams fed the high Ca diet. Pregnancy performance was reduced in dams fed the low Ca diet. These results suggest that above normal Ca supplementation levels during pregnancy restored maternal bone status to some extent in rats fed the chronically low Ca diet. The same could not be said for mineral content. Also, high Ca supplementation during pregnancy may deteriorate mineral composition in bones and other tissues. Therefore, more detailed research is needed to facilitate sound recommendations on appropriate calcium intake during pregnancy. (Korean J Nutrition 36(5): 459∼469, 2003)

• Journal of Nutrition and Health
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• 제54권6호
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• pp.584-593
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• 2021

2020 한국인 영양소 섭취기준에서 탄수화물은 만성질환 예방을 위한 섭취기준으로 총 에너지 섭취량에 대한 탄수화물로부터의 에너지 섭취비율인 에너지적정비율을 1세 이후 모든 연령에서 55-65%로설정하였다. 그리고 2020년에 처음으로 탄수화물의 평균필요량과 권장섭취량을 설정하였다. 인체의 탄수화물 필요량은 뇌에서 하루에 소비되는 포도당량과 케톤체 생성이 나타나지 않는 양을 기준으로 1세 이후 모든 연령에서 1일 100 g을 설정하고, 권장섭취량은 15% 변이계수를 사용하여 두 배의 변이계수를 더한 130 g/일로 설정하였다. 탄수화물의 평균필요량은 최소필요량의 개념이지 에너지원으로서 적절한 섭취량에 대한 개념은 아니므로 탄수화물의 영양소섭취상태를 평가할 경우에는 평균필요량이나 권장섭취량에 비교하는 것은 적절하지 않고, 에너지적정비율을 활용하여 탄수화물로부터의 에너지 섭취비율의 적절성을 평가하는 것이 적절하다. 탄수화물은 에너지 적정비율범위에서 섭취할 때 만성질환의 위험을 낮출 수 있으며, 이를 탄수화물의 양뿐만 아니라 급원도 고려하는 식생활에 활용해야 할 것이다.