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Nutritional status and nutritional therapy in inflammatory bowel diseases

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World Journal of Gastroenterology 2009年第21期15卷 2570-2578页

作者： Corina Hartman Rami Eliakim raanan shamir Institute of Gastroenterology Nutritionand Liver DiseaseSchneider Children's Medical Center of Israel Institute of Gastroenterology Rambam Health Care CampusRappaport School of MedicineTechnion Institute

Underweight and specific nutrient deficiencies are frequent in adult patients with inflammatory bowel disease(IBD).In addition,a significant number of children with IBD,especially Crohn's disease(CD) have impaired linear *** has an important role in the management of *** adults with CD,enteral nutrition(EN) is effective in inducing clinical remission of IBD,although it is less efficient than *** EN is an established primary therapy for pediatric *** data suggests that EN is as efficient as corticosteroids for induction of *** advantages of nutritional therapy are control of inflammation,mucosal healing,positive benefits to growth and overall nutritional status with minimal adverse *** available evidence suggests that supplementary EN may be effective also for maintenance of remission in *** studies are needed to confirm these ***,EN supplementation could be considered as an alternative or as an adjunct to maintenance drug therapy in *** does not have a primary therapeutic role in ulcerative *** compositions of enteral dietselemental diets or diets containing specific components-were not shown to have any advantage over standard polymeric diets and their place in the treatment of CD or UC need further *** theories suggest that diet may be implicated in the etiology of IBD,however there are no proven dietary approaches to reduce the risk of developing IBD.

关键词： Inflammatory bowel disease Crohn'sdisease Ulcerative colitis Adults Children Malnutrition Growth disorders Nutrition therapy

欧洲儿童急性胃肠炎处理循证指南（2014年版）

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中华儿科杂志 2015年第7期53卷 499-509页

作者： Alfredo Guarino Shai Ashkenazi Dominique Gendrel Andrea Lo Vecchio raanan shamir Hania Szajewska 方铁夫耿岚岚龚四堂 Department of Translational Medical Science Section ofPediatrics University of Naples Federico II Naples Italy Schneider Children's Medical Center Tel-Aviv UniversityTel-Aviv Israel University Paris 5 and Necker-Enfants-Malades Paris France Department ofTranslational Medical Science Section of Pediatrics University of NaplesFederico II Naples Italy Schneider Children'sMedical Center Tel-Aviv University Tel-Aviv Israel Medical University of Warsaw Department of Pediatrics Warsaw Poland 不详

1991年世界卫生组织（WHO）制订了第一版儿童急性腹泻病指南，2005年WHO和联合国儿童基金会（UNICEF）制订了第二版，我国专家在参照WHO指南的基础上，结合我国国情分别于1993年、2009年制订了中国儿童急性腹泻病的专家共识；WH0指南和... 详细信息

1991年世界卫生组织（WHO）制订了第一版儿童急性腹泻病指南，2005年WHO和联合国儿童基金会（UNICEF）制订了第二版，我国专家在参照WHO指南的基础上，结合我国国情分别于1993年、2009年制订了中国儿童急性腹泻病的专家共识；WH0指南和我国共识对中国儿童急性腹泻病的规范诊治发挥了重要的作用，收到了良好的效果。时至今日，欧洲儿科胃肠病学、肝病学和营养协会及欧洲儿科感染病协会对2008年儿童急性胃肠炎循证指南进行更新，即“2014年版”。指南中腹泻病原、低渗口服补液盐溶液使用、营养管理和常规对症治疗与我国现行共识基本一致。另首次对儿童脱水评估和疾病严重程度评分进行量化并提出通过鼻胃管补液，这是我们可以借鉴的。重度脱水休克的治疗强调了可重复3次20ml／kg0．9％氯化钠溶液，与我国危重专业观点相一致。静脉补充液体成分与我国现行共识存在差异，与指南执笔者之一意大利学者AndreaLoVecehio进行交流，其认同我国现用液体组成。细菌感染所致腹泻使用抗生素的指征与我国现行共识相同，但在抗生素选择上存在差异，建议根据我国药典和药敏结果选择合适抗生素。由于我国社会经济、文化和医学发展等与欧洲存在差异，因此指南中的观点、方法等应结合中国特点进行应用。

关键词：急性胃肠炎循证指南欧洲儿童初级保健医生儿科医生胃肠病学医护人员

Cardiovascular disease risk factor profiles in children with celiac disease on gluten-free diets

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World Journal of Gastroenterology 2013年第34期19卷 5658-5664页

作者： Lorenzo Norsa raanan shamir Noam Zevit Elvira Verduci Corina Hartman Diana Ghisleni Enrica Riva Marcello Giovannini Department of Pediatrics San Paolo Hospital University of Milan Institute of Gastroenterology Nutrition and Liver DiseasesSchneider Children’s Medical Center of Israel Sackler Faculty of Medicine Tel-Aviv University Marcello Giovannini Università degli Studi di Milano

AIM:To describe the cardiovascular disease(CVD)risk factors in a population of children with celiac disease(CD)on a gluten-free diet(GFD).METHODS:This cross-sectional multicenter study was performed at Schneider Children’s Medical Center of Israel(Petach Tiqva,Israel),and San Paolo Hospital(Milan,Italy).We enrolled 114 CD children in serologic remission,who were on a GFD for at least one *** enrollment,anthropometric measurements,blood lipids and glucose were assessed,and compared to values at *** homeostasis model assessment-estimated insulin resistance was calculated as a measure of insulin ***:Three or more concomitant CVD risk factors[body mass index,waist circumference,low density lipoprotein(LDL)cholesterol,triglycerides,blood pressure and insulin resistance]were identified in 14%of CD subjects on a *** most common CVD risk factors were high fasting triglycerides(34.8%),elevated blood pressure(29.4%),and high concentrations of calculated LDL cholesterol(24.1%).On a GFD,four children(3.5%)had insulin *** insulin and HOMA-IR were significantly higher in the Italian cohort compared to the Israeli cohort(P<0.001).Children on a GFD had an increased prevalence of borderline LDL cholesterol(24%)when compared to values(10%)at diagnosis(P=0.090).Trends towards increases in overweight(from 8.8%to 11.5%)and obesity(from 5.3%to 8.8%)were seen on a ***:This report of insulin resistance and CVD risk factors in celiac children highlights the importance of CVD screening,and the need for dietary counseling targeting CVD prevention.

关键词： Celiac disease Cardiovascular disease risk factors Gluten-free diet Insulin resistance Children Hyperlipidemia Cholesterol

Burden of celiac disease in the Mediterranean area

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World Journal of Gastroenterology 2011年第45期17卷 4971-4978页

作者： Luigi Greco Laura Timpone Abdelhak Abkari Mona Abu-Zekry Thomas Attard Faouzi Bouguerrà Paskal Cullufi Aydan Kansu Dusanka Micetic-Turk Zrinjka Miak Eleftheria Roma raanan shamir Selma Terzic European Laboratory for Food Induced Diseases Federico Ⅱ University of Naples Hopital des Enfant Ibn Rochd de Casablanca Children's Hospital Gastrointestinal Unit Cairo University University of Malta Medical School Hopital des Enfants de Tunis Department of Gastroenterology and Hepatology University Hospital Center "Mother Teresa" Department of Pediatric Gastroenterology Ankara University Dikimevi/Mamak University Medical Centre Paediatric Department Children's Hospital Zagreb Athens University Aghia Sophia Children's Hospital Schneider Children's Medical Center of Israel Tel-Aviv University University Clinical Center Tuzla Children's Hospital

AIM: To estimate the burden of undiagnosed celiac disease (CD) in the Mediterranean area in terms of morbidity, mortality and health cost. METHODS: For statistics regarding the population of each country in the Mediterranean area, we accessed authoritative international sources (World Bank, World Health Organization and United Nations). The prevalence of CD was obtained for most countries from published reports. An overall prevalence rate of 1% cases/total population was finally estimated to represent the frequency of the disease in the area, since none of the available conf idence intervals of the reported rates significantly excluded this rate. The distribution of symptoms and complications was obtained from reliable reports in the same cohort. A standardized mortality rate of 1.8 was obtained from recent reports. Crude health cost was estimated for the years between symptoms and diagnosis for adults and children, and was standardized for purchasing power parity to account for the different economic prof iles amongst Mediterranean countries. RESULTS: In the next 10 years, the Mediterranean area will have about half a billion inhabitants, of which 120 million will be children. The projected number of CD diagnoses in 2020 is 5 million cases (1 million celiac children), with a relative increase of 11% compared to 2010. Based on the 2010 rate, there will be about 550 000 symptomatic adults and about 240 000 sick children: 85% of the symptomatic patients will suffer from gastrointestinal complaints, 40% are likely to have anemia, 30% will likely have osteopenia, 20% of children will have short stature, and 10% will have abnormal liver enzymes. The estimated standardized medical costs for symptomatic celiac patients during the delay between symptom onset and diagnosis (mean 6 years for adults, 2 years for children) will be about €4 billion (€387 million for children) over the next 10 years. A delay in diagnosis is expected to increase mortality: about 600 000 celiac pat

关键词： Pediatric Celiac disease Short stature Anemia Osteopenia Purchasing power parity Standardized mortality rate Mediterranean area

Lean Healthy Children with Short Stature Have Distinct Eating Patterns

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Journal of Food Science and Engineering 2016年第6期6卷 299-307页

作者： Shir Hadani Yael Lebenthal Liora Lazar raanan shamir Moshe Phillip Michal Yackobovitch-Gavan The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes National Center for Childhood Diabetes Schneider Children's Medical Center of Israel Petah Tikva 49202 Israel Sackler Faculty of Medicine Tel Aviv University Tel Aviv 699 78 Israel Institute for Gastroenterology Nutrition and Liver Diseases Schneider Children's Medical Center of Israel Petah Tikva 49202 Israel

Nutrition plays an essential role in normal linear growth in children. Knowledge of the eating styles and dietary consumption of healthy short children from developed countries is scarce. The aim of this study was to investigate the dietary patterns in idiopathic short stature （ISS） and relatively low weight children compared to children with normal stature and weight. This research is a case-control study of 86 pre-pubertal healthy children, mean age 5.9 ± 1.5 years. The study group comprised 43 ISS children; 43 age-matched children with normal stature and weight served as controls. Outcome measures included： dietary patterns and physical activity. The absolute daily average energy, protein and carbohydrate intake was significantly lower in the ISS children （P 〈 0.05）; after correcting for body surface area, no significant differences were found between groups. Intake of micronutrients calcium, iron, zinc, vitamin A and vitamin C, expressed as percentage from Recommended Dietary Allowance, was significantly lower in the ISS children （P 〈 0.05）, who had lower food responsiveness, higher satiety responsiveness, lesser enjoyment of food and were slower eaters （P 〈 0.001）. Physical activity was sedentary in both the ISS cases and controls. Our findings in healthy, pre-pubertal, relatively lean ISS children point to a distinct eating pattern with no alteration in physical activity. Understanding the differences in dietary intake and eating behaviors may be beneficial in the development of targeted nutritional intervention for lean ISS children.

关键词： Dietary patterns eating behaviors lean children short stature.

婴儿配方粉成分的全球标准:欧洲儿科胃肠病、肝病和营养学会牵头的国际专家组建议

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中国循证儿科杂志 2006年第4期1卷 307-319页

作者： Berthold Koletzko Susan Baker Geoff Cleghorn Ulysses Fagundes Neto Sarath Gopalan Olle Hernell Quak Seng Hock Pipop Jirapinyo Bo Lonnerdal Paul Pencharz Hildegard Pzyrembel Jaime Ramirez-Mayans raanan shamir Dominique Turck Yuichiro Yamashiro 丁宗一(译) 无德国慕尼黑大学冯豪内儿童医院国际专家组美国纽约州布法罗大学儿科系澳大利亚布里斯班昆士兰大学儿科与儿童健康系巴西圣保罗联邦大学儿科系印度新德里营养支持系统研究中心瑞典Umea大学儿科系临床科学部新加坡国立大学儿科系泰国曼谷大学儿科系美国加州大学营养与内科系加拿大多伦多儿童医院胃肠病与营养系德国柏林联邦风险评估研究所墨西哥国家儿科研究所胃肠病与营养系以色列海法Meyer儿童医院儿科胃肠病与营养系法国里尔胃肠病肝病与营养系日本东京顺天堂大学儿科系中国北京市儿童医院欧洲儿科胃肠病肝病和营养学会牵头的国际专家组

联合国粮食及农业组织(FAO)和WHO的食品法典委员会提出的食品标准、指南和其他相关文件旨在保护消费者健康以及全球的公平贸易.

关键词：全球标准婴儿配方营养学会胃肠病专家组食品法典委员会儿科欧洲