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Primer malnutrisyonlu çocukların prevalansının, demografik özelliklerinin, ilişkili risk faktörlerinin ve kullanılan enteral beslenme ürünlerinin etkilerinin değerlendirilmesi

Year 2021, Volume: 46 Issue: 1, 332 - 342, 31.03.2021
https://doi.org/10.17826/cumj.837986

Abstract

Amaç: Bu çalışmada malnütrisyonlu çocukların prevalansının, demografik özelliklerinin, ilişkili risk faktörlerinin ve kullanılan enteral beslenme ürünlerinin etkilerinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Primer malnütrisyona bağlı büyüme yetersizliği olan ve hiperkalorik enteral beslenme rejimi başlanmış 1-18 yaşları arasında toplam 229 pediatrik hasta çalışmaya dahil edildi. Büyümesi normal 73 sağlıklı çocuk kontrol grubunu oluşturdu. Antropometrik ölçümlere; boy (cm), ağırlık (kg), vücut kitle indeksi (kg/m2), yaşa göre boy Z skoru ve yaşa göre ağırlık Z skoru dahil edildi.
Bulgular: Malnutrisyonlu hastalar kontrol grubu ile kıyaslandığında; daha küçük yaşta ve doğum ağırlığı >3001 g olanlarda malnütrisyonun görülme olasılığının daha fazla olduğu, bu hastaların emzirme sürelerinin daha kısa, kardeş sayısının daha az, ailelerinin düşük aylık gelirli ve annelerinin okuma yazma bilmiyor oldukları gözlendi. Malnütrisyonlu grupta boy, ağırlık (, vücut kitle indeksi, yaşa göre boy ve yaşa göre ağırlık Z skorları; cinsiyet, kardeş sayısı, anne eğitimi ve aylık gelir düzeyinden bağımsız olarak, başlangıç değerlerine kıyasla, 3. ve 6. ay kontrollerinde önemli ölçüde iyileşmiştir.
Sonuç: Bulgularımız başlangıç semptomları ve sosyo-ekonomik risk faktörlerinden bağımsız olarak, primer malnutrisyonlu çocuklarda verilen 6 aylık yüksek kalorili enteral beslenme desteğinin etkililiğini ve tolere edilebilirliğini göstermektedir.

References

  • 1. Becker PJ, Nieman Carney L, Corkins MR, Smith SE, Spear BA, White JW. Consensus statement of the academy of nutrition and dietetics/american society for parenteral and enteral nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition). J Acad Nutr Diet 2014:114; 1988-2000.
  • 2. Mehta NM, Corkins MR, Lyman B, Malone A, Goday PS, Carney LN et al.; American Society for Parenteral and Enteral Nutrition Board of Directors. Defining pediatric malnutrition: a paradigm shift toward etiology-related definitions. JPEN J Parenter Enteral Nutr. 2013 Jul;37(4):460-81.
  • 3. Alderman H, Behrman JR, Glewwe P, Fernald L, Walker S. Evidence of Impact of Interventions on Growth and Development during Early and Middle Childhood. In: Bundy DAP, Silva ND, Horton S, Jamison DT, Patton GC, editors. Child and Adolescent Health and Development. 3rd ed. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2017 Nov 20. Chapter 7.
  • 4. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M et al.; Maternal and Child Nutrition Study Group. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013 Aug 3;382(9890):427-451.
  • 5. World Bank (2006) Repositioning Nutrition as Central to Development. A Strategy for Large-Scale Action. Directions in Development Series. Washington, DC: World Bank. 2015. “Population Estimates and Projections.” World Bank, Washington, DC. http://data.worldbank.org/ data-catalog/population-projection-tables.
  • 6. Modjadji P & Madiba S. Childhood Undernutrition and Its Predictors in a Rural Health and Demographic Surveillance System Site in South Africa. Int J Environ Res Public Health 2019:16; pii: E3021.
  • 7. Turkey Demographic and Health Survey 2008 (TDHS-2008) (2009) Hacettepe University Institute of Population Studies, Ministry of Health General Directorate of Mother and Child Health and Family Planning, TR Prime Ministry Undersecretary of State Planning Organization and TÜBITAK. http://www.hips.hacettepe.edu.tr/eng/tdhs08/TDHS-2008_Main_Report.pdf
  • 8. Gür E, Can G, Akkus S, Ercan G, Arvas A, Güzelöz S et al. Is undernutrition a problem among Turkish school children?: Which factors have an influence on it? J Trop Pediatr. 2006 Dec;52(6):421-6.
  • 9. Beser OF, Cokugras FC, Erkan T, Kutlu T, Yagci RV, TUHAMAR Study Group. Evaluation of malnutrition development risk in hospitalized children. Nutrition 2018:48; 40-47.
  • 10. Durakbasa CU, Fettahoglu S, Bayar A, Mutus M, Okur H. The Prevalence of Malnutrition and Effectiveness of STRONGkids Tool in the Identification of Malnutrition Risks among Pediatric Surgical Patients. Balkan Med J 2014:31; 313-321.
  • 11. Shahrin L, Chisti MJ, Ahmed T. Primary and secondary malnutrition. In: Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet 2015:113; 139-46.
  • 12. Kizilyildiz BS, Sönmez B, Karaman K, Beger B, Mercen A, Alioglu S et al. Prevalence, Demographic Characteristics and Associated Risk Factors of Malnutrition Among 0-5 Aged Children: A Cross-Sectional Study From Van, Eastern Turkey. Pediatr Rep. 2016 Dec 9;8(4):6112.
  • 13. Ergin F, Okyay P, Atasoylu G, Beser E. Nutritional status and risk factors of chronic malnutrition in children under five years of age in Aydin, a western city of Turkey. Turk J Pediatr 2007:49; 283-9.
  • 14. Ulukanligil M & Seyrek A. Anthropometric status, anaemia and intestinal helminthic infections in shantytown and apartment schoolchildren in the Sanliurfa province of Turkey. Eur J Clin Nutr 2004:58; 1056-61.
  • 15. Stippler D, Bode V, Fischer M, Kollex K, Rohde E, Tisowsky B et al. Proposal for a new practicable categorization system for food for special medical purposes- Enteral nutritional products. Clin Nutr ESPEN 2015;10(6):e219-23.
  • 16. Alpers DH. Enteral feeding and gut atrophy. Curr Opin Clin Nutr Metab Care 2002:5; 679-83
  • 17. Kansu A, Durmaz Ugurcan O, Arslan D, Unalp A, Celtik C, Sarıoglu AA; ANTK Study Group. High-fibre enteral feeding results in improved anthropometrics and favourable gastrointestinal tolerance in malnourished children with growth failure. Acta Paediatr. 2018 Jun;107(6):1036-42.
  • 18. Comba A, Demir E, Barış Eren N. Nutritional status and related factors of schoolchildren in Çorum, Turkey. Public Health Nutr 2019:22; 122-31.
  • 19. Bhutia DT. Protein energy malnutrition in India: the plight of our under five children. J Family Med Prim Care 2014:3; 63-7.
  • 20. Müller O & Krawinkel M. Malnutrition and health in developing countries. CMAJ 2005:173; 279-86.
  • 21. Bundy D, Burbano C, Grosh M, Gelli A, Jukes M, Drake L. 2009. Rethinking School Feeding Social Safety Nets, Child Development, and the Education Sector. Directions in Development; human development. World Bank.© World Bank. https://openknowledge.worldbank.org/handle/10986/2634
  • 22. Kang A, Zamora SA, Scott RB, Parsons HG. Catch-up growth in children treated with home enteral nutrition. Pediatrics 1998:102, 951-55.
  • 23. Lampl M. Human growth from the cell to the organism: Saltations and integrative physiology. Ann Hum Biol 2009:36; 478-95.
  • 24. Papadopoulou A, Holden CE, Paul L, Sexton E, Booth IW. The nutritional response to home enteral nutrition in childhood. Acta Paediat 1995:84; 528-31.
  • 25. Halterman JS, Kaczorowski JM, Aligne CA, Auinger P, Szilagyi PG. Iron deficiency and cognitive achievement among school-aged children and adolescents in the United States. Pediatrics 2001:107;1381-86.
  • 26. Zhang H, Gu Y, Mi Y, Jin Y, Fu W, Latour JM. High-energy nutrition in paediatric cardiac critical care patients: a randomized controlled trial. Nurs Crit Care 2019:24; 97-102.
  • 27. Elia M, Engfer MB, Green CJ, Silk DBA. Systematic review and meta-analysis: the clinical and physiological effects of fibre-containing enteral formulae. Aliment Pharmacol Ther 2008:27; 120-45.
  • 28. Khoshoo V, Sun SS, Storm H. Tolerance of an enteral formula with insoluble and prebiotic fiber in children with compromised gastrointestinal function. J Am Diet Assoc; 2010:110; 1728-33.
  • 29. Pernitez-Agan S, Wickramage K, Yen C, Dawson-Hahn E, Mitchell T, Zenner D. Nutritional profile of Syrian refugee children before resettlement. Confl Health 2019:13; 22.

Evaluation of prevalence, demographic characteristics, associated risk factors and effects of enteral nutrition products in children with primary malnutrition

Year 2021, Volume: 46 Issue: 1, 332 - 342, 31.03.2021
https://doi.org/10.17826/cumj.837986

Abstract

Purpose: The present study aims to evaluate the prevalence, demographic characteristics, associated risk factors and effects of enteral nutrition products in malnourished children.
Materials and Methods: A total of 229 pediatric outpatients aged 1-18 years with primary malnutrition related growth failure and prescribed with hypercaloric enteral feeding regimen were included. A total of 73 healthy children with normal growth served as the control group. Anthropometric measurements included height (cm), weight (kg), body mass index (kg/m2), height for age Z score and weight for age Z score.
Results: When the malnourished patients were compared with the control group; patients were aged younger and associated with higher likelihood of having a birth weight >3001 , shorter duration of breastfeeding, lower number of siblings, family with lower monthly income and illiterate mothers. In the malnourished group, height, weight, body mass index and height for age and weight for age Z scores improved significantly during 3rd month and 6th month as compared with baseline scores, regardless of gender, sibling number, maternal education and monthly income level.
Conclusion: Our findings show the efficacy and tolerability of 6-month high-calorie enteral nutritional support given to children with primary malnutrition, regardless of initial symptoms and socio-economic risk factors.

References

  • 1. Becker PJ, Nieman Carney L, Corkins MR, Smith SE, Spear BA, White JW. Consensus statement of the academy of nutrition and dietetics/american society for parenteral and enteral nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition). J Acad Nutr Diet 2014:114; 1988-2000.
  • 2. Mehta NM, Corkins MR, Lyman B, Malone A, Goday PS, Carney LN et al.; American Society for Parenteral and Enteral Nutrition Board of Directors. Defining pediatric malnutrition: a paradigm shift toward etiology-related definitions. JPEN J Parenter Enteral Nutr. 2013 Jul;37(4):460-81.
  • 3. Alderman H, Behrman JR, Glewwe P, Fernald L, Walker S. Evidence of Impact of Interventions on Growth and Development during Early and Middle Childhood. In: Bundy DAP, Silva ND, Horton S, Jamison DT, Patton GC, editors. Child and Adolescent Health and Development. 3rd ed. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2017 Nov 20. Chapter 7.
  • 4. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M et al.; Maternal and Child Nutrition Study Group. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013 Aug 3;382(9890):427-451.
  • 5. World Bank (2006) Repositioning Nutrition as Central to Development. A Strategy for Large-Scale Action. Directions in Development Series. Washington, DC: World Bank. 2015. “Population Estimates and Projections.” World Bank, Washington, DC. http://data.worldbank.org/ data-catalog/population-projection-tables.
  • 6. Modjadji P & Madiba S. Childhood Undernutrition and Its Predictors in a Rural Health and Demographic Surveillance System Site in South Africa. Int J Environ Res Public Health 2019:16; pii: E3021.
  • 7. Turkey Demographic and Health Survey 2008 (TDHS-2008) (2009) Hacettepe University Institute of Population Studies, Ministry of Health General Directorate of Mother and Child Health and Family Planning, TR Prime Ministry Undersecretary of State Planning Organization and TÜBITAK. http://www.hips.hacettepe.edu.tr/eng/tdhs08/TDHS-2008_Main_Report.pdf
  • 8. Gür E, Can G, Akkus S, Ercan G, Arvas A, Güzelöz S et al. Is undernutrition a problem among Turkish school children?: Which factors have an influence on it? J Trop Pediatr. 2006 Dec;52(6):421-6.
  • 9. Beser OF, Cokugras FC, Erkan T, Kutlu T, Yagci RV, TUHAMAR Study Group. Evaluation of malnutrition development risk in hospitalized children. Nutrition 2018:48; 40-47.
  • 10. Durakbasa CU, Fettahoglu S, Bayar A, Mutus M, Okur H. The Prevalence of Malnutrition and Effectiveness of STRONGkids Tool in the Identification of Malnutrition Risks among Pediatric Surgical Patients. Balkan Med J 2014:31; 313-321.
  • 11. Shahrin L, Chisti MJ, Ahmed T. Primary and secondary malnutrition. In: Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet 2015:113; 139-46.
  • 12. Kizilyildiz BS, Sönmez B, Karaman K, Beger B, Mercen A, Alioglu S et al. Prevalence, Demographic Characteristics and Associated Risk Factors of Malnutrition Among 0-5 Aged Children: A Cross-Sectional Study From Van, Eastern Turkey. Pediatr Rep. 2016 Dec 9;8(4):6112.
  • 13. Ergin F, Okyay P, Atasoylu G, Beser E. Nutritional status and risk factors of chronic malnutrition in children under five years of age in Aydin, a western city of Turkey. Turk J Pediatr 2007:49; 283-9.
  • 14. Ulukanligil M & Seyrek A. Anthropometric status, anaemia and intestinal helminthic infections in shantytown and apartment schoolchildren in the Sanliurfa province of Turkey. Eur J Clin Nutr 2004:58; 1056-61.
  • 15. Stippler D, Bode V, Fischer M, Kollex K, Rohde E, Tisowsky B et al. Proposal for a new practicable categorization system for food for special medical purposes- Enteral nutritional products. Clin Nutr ESPEN 2015;10(6):e219-23.
  • 16. Alpers DH. Enteral feeding and gut atrophy. Curr Opin Clin Nutr Metab Care 2002:5; 679-83
  • 17. Kansu A, Durmaz Ugurcan O, Arslan D, Unalp A, Celtik C, Sarıoglu AA; ANTK Study Group. High-fibre enteral feeding results in improved anthropometrics and favourable gastrointestinal tolerance in malnourished children with growth failure. Acta Paediatr. 2018 Jun;107(6):1036-42.
  • 18. Comba A, Demir E, Barış Eren N. Nutritional status and related factors of schoolchildren in Çorum, Turkey. Public Health Nutr 2019:22; 122-31.
  • 19. Bhutia DT. Protein energy malnutrition in India: the plight of our under five children. J Family Med Prim Care 2014:3; 63-7.
  • 20. Müller O & Krawinkel M. Malnutrition and health in developing countries. CMAJ 2005:173; 279-86.
  • 21. Bundy D, Burbano C, Grosh M, Gelli A, Jukes M, Drake L. 2009. Rethinking School Feeding Social Safety Nets, Child Development, and the Education Sector. Directions in Development; human development. World Bank.© World Bank. https://openknowledge.worldbank.org/handle/10986/2634
  • 22. Kang A, Zamora SA, Scott RB, Parsons HG. Catch-up growth in children treated with home enteral nutrition. Pediatrics 1998:102, 951-55.
  • 23. Lampl M. Human growth from the cell to the organism: Saltations and integrative physiology. Ann Hum Biol 2009:36; 478-95.
  • 24. Papadopoulou A, Holden CE, Paul L, Sexton E, Booth IW. The nutritional response to home enteral nutrition in childhood. Acta Paediat 1995:84; 528-31.
  • 25. Halterman JS, Kaczorowski JM, Aligne CA, Auinger P, Szilagyi PG. Iron deficiency and cognitive achievement among school-aged children and adolescents in the United States. Pediatrics 2001:107;1381-86.
  • 26. Zhang H, Gu Y, Mi Y, Jin Y, Fu W, Latour JM. High-energy nutrition in paediatric cardiac critical care patients: a randomized controlled trial. Nurs Crit Care 2019:24; 97-102.
  • 27. Elia M, Engfer MB, Green CJ, Silk DBA. Systematic review and meta-analysis: the clinical and physiological effects of fibre-containing enteral formulae. Aliment Pharmacol Ther 2008:27; 120-45.
  • 28. Khoshoo V, Sun SS, Storm H. Tolerance of an enteral formula with insoluble and prebiotic fiber in children with compromised gastrointestinal function. J Am Diet Assoc; 2010:110; 1728-33.
  • 29. Pernitez-Agan S, Wickramage K, Yen C, Dawson-Hahn E, Mitchell T, Zenner D. Nutritional profile of Syrian refugee children before resettlement. Confl Health 2019:13; 22.
There are 29 citations in total.

Details

Primary Language English
Subjects Paediatrics
Journal Section Research
Authors

Adnan Barutçu 0000-0001-8930-1122

Saliha Barutçu 0000-0002-6951-5999

Publication Date March 31, 2021
Acceptance Date January 2, 2021
Published in Issue Year 2021 Volume: 46 Issue: 1

Cite

MLA Barutçu, Adnan and Saliha Barutçu. “Evaluation of Prevalence, Demographic Characteristics, Associated Risk Factors and Effects of Enteral Nutrition Products in Children With Primary Malnutrition”. Cukurova Medical Journal, vol. 46, no. 1, 2021, pp. 332-4, doi:10.17826/cumj.837986.