Metabolic syndrome (MetS) is characterized by the clustering of obesity, impaired glucose metabolism, hypertension, and dyslipidemia, and is predictive for development of cardiovascular disease and type 2 diabetes. The high prevalence of MetS is a serious health problem, especially among obese adolescents. Because insulin resistance and obesity play a central role in MetS, treatment of MetS should be primarily focused on improving insulin sensitivity and weight reduction. Nutritional therapy of MetS aims to reduce the intakes of saturated fat and free fructose, and increasing the intakes of dietary fiber, unsaturated fat, and antioxidant nutrients may also be beneficial.
Adolescent ; Cardiovascular Diseases ; Dietary Fiber ; Dyslipidemias ; Fructose ; Glucose ; Humans ; Hypertension ; Insulin Resistance ; Nutrition Therapy ; Obesity ; Prevalence ; Weight Loss

Infancy and childhood are marked by rapid physical growth and development, and infant's and child's health and development depends on good nutrition. Any disruption in appropriate nutrient intake may have lasting effects on growth potential and development achievement. Nutrition needs and feeding patterns vary significantly in each stage of growth and development. This article summarized the key nutritional issues in the Korea national health screening program for infants and children as followings: encouraging breastfeeding, healthier complementary feeding, healthy foods selection, healthy eating habits, coping with feeding problem (picky eating), and overweight prevention with an emphasis on physical activity.
Achievement ; Breast Feeding ; Child ; Eating ; Feeding Behavior ; Growth and Development ; Humans ; Infant ; Infant Nutritional Physiological Phenomena ; Korea ; Mass Screening ; Motor Activity ; Overweight

Worldwide, diarrhea remains one of the most common illnesses among children. Oral rehydration therapy (ORT) is the cornerstone of diarrhea treatment. Yet, the rates at which ORT is used are still disappointingly low. Additional treatment interventions include antimotility drugs, antisecretary drugs, adsorbents, probiotics, antibiotics, oral immunoglobulin, micronutrient supplementation. Drugs are generally not necessary. However, selected probiotics may reduce the duration and intensity of diarrhea. Zinc is beneficial especially to malnourished children with diarrhea. Antibiotic treatment is effective mainly in shigella and cholera infection. Other drugs may be effective but require further investigations.
Anti-Bacterial Agents ; Child ; Cholera ; Diarrhea ; Fluid Therapy ; Humans ; Immunoglobulins ; Micronutrients ; Probiotics ; Shigella ; Zinc

Worldwide, diarrhea remains one of the most common illnesses among children. Oral rehydration therapy (ORT) is the cornerstone of diarrhea treatment. Yet, the rates at which ORT is used are still disappointingly low. Additional treatment interventions include antimotility drugs, antisecretary drugs, adsorbents, probiotics, antibiotics, oral immunoglobulin, micronutrient supplementation. Drugs are generally not necessary. However, selected probiotics may reduce the duration and intensity of diarrhea. Zinc is beneficial especially to malnourished children with diarrhea. Antibiotic treatment is effective mainly in shigella and cholera infection. Other drugs may be effective but require further investigations.
Anti-Bacterial Agents ; Child ; Cholera ; Diarrhea ; Fluid Therapy ; Humans ; Immunoglobulins ; Micronutrients ; Probiotics ; Shigella ; Zinc

PURPOSE: Helicobacter pylori infection is probably acquired in childhood and persists as an asymptomatic infection for decades in most individuals. It is unclear why only a minority of those infected develop a clinical manifestation, even in childhood, such as peptic ulcer disease. H. pylori infection activates local immune responses and causes lymphocyte infiltration in the gastric mucosa. We have previously reported that both T and B cells in the lamina propria play important roles in the local immune response of H. pylori-infected children. The aim of this study was to investigate the association between H. pylori genotypes and gastric mucosal lymphocytes. METHODS: Twenty-five H. pylori-infected children (10 with peptic ulcer disease and 15 with gastritis) were enrolled in this study. We investigated the genotypes (cagA, cagE, vacA, and babA2) and evaluated the association with clinical manifestations, histopathology, and gastric mucosal lymphocytes. RESULTS: The prevalence of cagA, cagE, vacA s1m1, and babA2 was 80%, 60%, 84%, and 88%, respectively. The most prevalent (68%) combination of cagA, vacA, and babA2 genotypes was cagA+/ vacA s1m1+/babA2+. H. pylori genotypes were not associated with clinical manifestations, histopathology, or gastric mucosal lymphocytes. CONCLUSION: There was no association between the cagA, cagE, vacA, or babA2 status and gastric mucosal lymphocytes. The role of the host immune response in relation to H. pylori genotypes and disease potential in children needs further studies.
Asymptomatic Infections ; B-Lymphocytes ; Child ; Gastric Mucosa ; Genotype ; Helicobacter ; Helicobacter pylori ; Humans ; Lymphocytes ; Mucous Membrane ; Peptic Ulcer ; Prevalence

PURPOSE: To evaluate current feeding practices and maternal nutritional knowledge on complementary feeding. METHODS: Mothers of babies aged 9-15 months who visited pediatric clinics of 14 general hospitals between September and December 2008 were asked to fill questionnaires. Data from 1,078 questionnaires were analyzed. RESULTS: Complementary food was introduced at 4-7 months in 89% of babies. Home-made rice gruel was the first complementary food in 93% cases. Spoons were used for initial feeding in 97% cases. At 6-7 months, <50% of babies were fed meat (beef, 43%). Less than 12-month-old babies were fed salty foods such as salted laver (35%) or bean-paste soup (51%) and cow's milk (11%). The following were the maternal sources of information on complementary feeding: books/magazines (58%), friends (30%), internet web sites (29%), relatives (14%), and hospitals (4%). Compared to the 1993 survey, the incidence of complementary food introduction before 4 months (0.4% vs. 21%) and initial use of commercial food (7% vs. 39%) had decreased. Moreover, spoons were increasingly used for initial feeding (97% vs. 57%). The average maternal nutritional knowledge score was 7.5/10. Less percentage of mothers agreed with the following suggestions: bottle formula weaning before 15-18 months (68%), no commercial baby drinks as complementary food (67%), considering formula (or cow's milk) better than soy milk (65%), and feeding minced meat from 6-7 months (57%). CONCLUSION: Complementary feeding practices have considerably improved since the last decade. Pediatricians should advise timely introduction of appropriate complementary foods and monitor diverse information sources on complementary feeding.
Aged ; Friends ; Hospitals, General ; Humans ; Incidence ; Infant ; Infant Nutritional Physiological Phenomena ; Internet ; Korea ; Meat ; Milk ; Mothers ; Organothiophosphorus Compounds ; Surveys and Questionnaires ; Soy Milk ; Weaning

Vitamin D is an important fat-soluble vitamin that functions as a prohormone and affects bone mineralization and calcium homeostasis. Vitamin D deficiency causesboth musculoskeletal manifestations, including rickets, and extra-musculoskeletal symptoms. Because vitamin D is naturally present in only some foods, intake of daily foods cannot meet the dietary reference intake for vitamin D. Sunlight is the main source of vitamin D in humans therefore, the lack of sunlight can easily cause vitamin D deficiency in children and adolescents. Vitamin D deficiency can be diagnosed on the basis ofits typical clinical manifestation, laboratory tests, and radiologic findings. Detection of vitamin D deficiency in children or adolescents necessitates the simultaneous administration of vitamin D and calcium supplements. To prevent vitamin D deficiency, 200 IU of daily vitamin D intake is recommended in infants, and 400 IU of daily vitamin D intake is recommended in Korean children and adolescents.
Adolescent ; Calcification, Physiologic ; Calcium ; Child ; Homeostasis ; Humans ; Infant ; Rickets ; Sunlight ; Vitamin D ; Vitamin D Deficiency ; Vitamins

Purpose: Helicobacter pylori infection is one of the most common gastrointestinal infections worldwide; it almost invariably causes chronic gastritis. Pediatric studies may provide important insights into the mucosal immune response of H. pylori-infection, as children are not submitted to environmental factors such as alcohol, tobacco and anti-inflammatory medication. The aim of the present study was to investigate the mucosal immune response against H. pylori in clinically well-defined groups: H. pylori-positive (divided into peptic ulcer disease and gastritis) and H. pylori-negative control. Methods: Antral biopsies were obtained from 45 children undergoing an upper GI endoscopy for dyspeptic symptoms. T cells (CD3+, CD4+, CD8+) and B cells (CD20+) were analyzed by quantitative immunohistochemistry. The correlation of lymphocyte subsets of gastric mucosa with histology was evaluated. Results: T cells (CD3+, CD4+, CD8+) and B cells (CD20+) were significantly increased in the lamina propria of H. pylori-positive group (p<0.01). CD8+ T cells were significantly increased in the lamina propria of the H. pylori-positive peptic ulcer disease (p<0.01). Within the epithelium, only CD4+ T cells were significantly increased in the H. pylori-positive group (p<0.01). Gastric histological parameters had a closer correlation with lymphocytes in the lamina propria than intraepithelial lymphocytes. Conclusion: This study suggests that both T cells and B cells in the lamina propria play important roles in the local immune response of H. pylori-infected children. Furthermore, it remains to be elucidated whether CD8+ T cells in the lamina propria may contribute to peptic ulcer formation in H. pylori-infected children.
B-Lymphocytes ; Biopsy ; Carbamates ; Child ; Endoscopy ; Epithelium ; Gastric Mucosa ; Gastritis ; Helicobacter ; Helicobacter pylori ; Humans ; Immunity, Mucosal ; Immunohistochemistry ; Lymphocyte Subsets ; Lymphocytes ; Mucous Membrane ; Organometallic Compounds ; Peptic Ulcer ; T-Lymphocytes ; Tobacco

PURPOSE: To identify factors that influence serum zinc concentrations in children with acute gastroenteritis. METHODS: Thirty-two children under 5 years of age (15 boys and 17 girls) were selected randomly among those who visited to an pediatric emergency room of Ehwa Womans University Mokdong Hospital with acute gastroenteritis from May to August 2005. This study estimated the association between serum zinc concentrations and clinical, biochemical variables in patients with acute gastroenteritis. RESULTS: Serum zinc concentration was lower in febrile patients than afebrile patients with acute gastroenteritis (67.0+/-25.3 vs 85.5+/-14.2, p<0.05). It also was lower in patients with positive C-reactive protein (CRP) than those with negative CRP (63.9+/-25.4 vs 86.7+/-13.8, p<0.05). Serum zinc concentration was negatively correlated (r=-0.494, p<0.05) with CRP concentration, whereas positively correlated with hematocrit (r=0.370, p<0.05), total protein (r=0.474, p<0.05), and albumin (r=0.636, p<0.05). Twelve patients (37.5%) showed very low serum zinc concentration (<70 microgram/dL) without clinical symptoms of deficiency or growth retardation. Frequency of febrile illness or positive CRP is significantly greater in group with zinc <70 microgram/dL than the group with zinc > or =70 microgram/dL (91.7% vs 55%, p<0.05; 91.7% vs 40%, p<0.05, respectively). CONCLUSION: In patients with acute gastroenteritis, serum zinc concentration was influenced by various factors such as fever, CRP, and biochemical factors. For evaluating zinc status in the body. factors.
C-Reactive Protein ; Child* ; Emergency Service, Hospital ; Female ; Fever ; Gastroenteritis ; Hematocrit ; Humans ; Zinc*

PURPOSE: Obesity is rapidly increasing in Korean children. Obesity is a risk factor for cardiovascular morbidity and is frequently associated with hypertension, diabetes mellitus and coronary artery disease. This study was designed to evaluate risk factors of the metabolic syndrome in obese children. METHODS: From February 2000 to June 2004, eighty eight obese (body mass index > or =95th percentile) children aged 4 to 15 years were included. We measured serum lipid levels (total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol), fasting sugar levels and insulin levels. Insulin resistance was determined by homeostasis model assessment, fasting insulin/glucose ratio and quantitative insulin sensitivity check index. RESULTS: Clustering of risk factors for the metabolic syndrome in obese children demonstrated that 60.2% had more than one risk factors. Hypertension (14.8%), hypertriglyceridemia (14.8%), HDL-hypocholesterolemia (14.8%), LDL-hypercholesterolemia (12.5%) and hyperinsulinemia (12.5%) were observed. As BMI increased, there was statistically significant increase in systolic blood pressure, insulin and insulin resistance values. Insulin resistance was correlated to systolic blood pressure, serum lipid and insulin levels. The more risk factors for the metabolic syndrome obese children had, the higher was their insulin resistance. CONCLUSION: The increase in insulin resistance and clustering of risk factors for the metabolic syndrome are already apparent in obese children. Monitoring these risk factors for the metabolic syndrome should become a part of routine medical care for obese children.
Blood Pressure ; Child* ; Cholesterol ; Cholesterol, HDL ; Coronary Artery Disease ; Diabetes Mellitus ; Fasting ; Homeostasis ; Humans ; Hyperinsulinism ; Hypertension ; Hypertriglyceridemia ; Insulin ; Insulin Resistance ; Obesity ; Risk Factors ; Triglycerides