Nutrition Publications

Thise Editorial highlights middle childhood and adolescence, between 5 and 19 years of age, as a transformative period in the lifecycle. These “school-age years” bridge early life and adulthood through significant and specific physiologic, somatic, cognitive, and psychosocial bursts of change.

The maximum rate of bone mass accumulation occurs during the school-age years and plateaus in late adolescence, after which little incremental accrual will occur.

School age is also a critical period of brain growth and development. By 12 years of age, brain and grey matter growth reach final adult size, and the brain tissue undergoes a great increase in pruning of “less utilized” neuronal synapses, which significantly increases brain efficiency.

While a significant number of reports document poor diets in significant segments of young children and adults, such data is scant for children in middle childhood (5-11years of age) and adolescence (12-19 years of age).

Standardized methodological approaches have greatly focused on infants and adults, and only recently have they been assessed and applied to adolescent populations. This is particularly true in reference to predictors of weight and adiposity and their relationship to nutrient intake and diet composition.

The persistence of undernutrition and the explosion of overnutrition and its consequences in later life have led to a concurrent burden of under- and overnutrition, aggravated by micronutrient deficiencies, all of which are more prevalent in low- and middle-income countries (LMIC).

The pandemic has made good nutrition more important, and also harder to achieve. Breastfeeding supports the infant immune system and has benefits for maternal mental health, but the pandemic has restricted support for new mothers and increased early termination of breastfeeding. Vaccination against COVID-19 has minimal impact on lactation or adverse impacts on infants, although an initial lack of clinical data has made many mothers hesitate to accept vaccination.

Cow milk protein allergy (CMPA) is the most common cause of food allergies in infants and young children less than 3 years old. It presents multiple ways and is the result of an immunologic response to cow milk proteins, which may be IgE or non-IgE-mediated.

Atopic dermatitis is a chronic, relapsing, inflammatory skin condition commonly seen in infants & children. Characterized by redness, scaling, oozing or crusting lesions, it usually presents in a typical morphological manner. It generally begins in early childhood and could be the initial step in the “atopic march”.

Throughout the last two decades, there has been a steady upsurge in allergic disease, notably food allergies, that it has “emerged over the last 10-15 years as a ‘second wave’ of the allergy epidemic.

Peanut allergy is one of the most common food allergies among children in Western countries. In majority, the allergy persists until adulthood. A US database study found an increase in peanut allergy prevalence from 1.7% in 2001 to 5.2% in 2017. In Asia, the incidence of peanut allergy seems to be lower, with an estimated prevalence of 0.47%-0.64% in Singaporean school children. However, peanuts are fast becoming triggers in anaphylactic reactions in the region due to changes in dietary habits.

Feeding a child with food allergies can be quite challenging. A major concern for parents is trying to feed their infants who may already have eczema or other allergic manifestations, including urticaria, anaphylaxis or wheezing.

Over the past decades, we have been seeing the role of nutritional interventions in the primary prevention of allergic diseases. As the AAP 2019 Clinical Report discusses, one of the earliest possible influences on the development of atopic disease in infants is the prenatal diet.

Allergies now affect more people than we think. About 1 in 3 children suffer from at least one allergy in developed countries alone. With the steady hike in cases of allergies and its different manifestations, we veer focus now to preventing allergies and lowering long term risks. In this edition of The Nest, we investigate the role nutrition plays in achieving better outcomes for allergy prevention.

Cognitive function declines with ageing. When this decline begins to be more pronounced, mild cognitive impairment occurs.

The highest growth rates in weight and length occur during fetal life and in the first two years of life after birth and during adolescence. Nutrition is childhood is crucial for adequate growth and development, including adequate immune system functioning and brain development.

Throughout human history it has been known that adequate nutrition is crucial for normal child growth, and this has become a common concern to all child health care givers since at least the 19th century. Yet, the precise mechanisms underpinning the interaction between nutrition and growth have not been fully clarified. It is important, yet challenging, to define the best nutrition for healthy and active children as well as for those who suffer from acute or chronic disease, considering varying needs of different age groups.

The first 1000 days of a child is considered to be a vital stage and a point of development in nourishing infants from birth to lifelong health. Balanced growth in this period is needed as it can lower the risk of developing obesity later on.

Bifidobacterium longum subsp. infantis (B. infantis) is a unique probiotic as it is able to metabolize the full range of human milk oligosaccharide in breastfed infants. A recent trial evaluated healthy breastfed and formula-fed infants randomized to receive a placebo-control or a low or high dose B. infantis supplement for 8 weeks.

Human milk composition changes dynamically during lactation, whereas infant formula composition is relatively static. This may contribute to growth/metabolic differences between breastfed and formula-fed infants. The aim of this study was to evaluate growth and metabolic outcomes in healthy term infants fed sequential formulas with age-adapted protein concentrations from birth to 12 months, in comparison to breastfed infants.