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2024, Number 5

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Acta Pediatr Mex 2024; 45 (5)

Use of nutritional modules in current pediatrics

López ML, Núñez BI, Bautista SM, Silva MI, Vela AMB, Guillén LS

Language: Spanish
References: 71
Page: 488-502
PDF size: 260.85 Kb.


ABSTRACT

The modular nutrients are mixtures or isolated macronutrients that can be enriched with micronutrients. Modules are generally added in pediatrics, to the formula or to enteral preparations, to increase the energy intake or some specific nutrient. The existing carbohydrate modules are: maltodextrins, cereals, corn starch. The protein modules comprise; the formula concentration as well as the addition of fortifiers and finally, the lipid modules are made up of vegetable oil, medium chain triglycerides and mixed mixtures. The osmolarity must be considered depending on the type of formula and module to be used, carbohydrate modules are generally the ones that increase osmolarity the most. The usefulness of adding nutritional modules in current pediatrics persists and is a beneficial tool in various pathologies and nutritional status.


REFERENCES

  1. Pedrón-Giner C, Moreno-Villares JM, Dalmau-Serra J, etal. Fómulas de nutrición enteral en pediatría. An PediatrContin. 2011; 9(4):209-23.

  2. Secretaría de Salud (SSA). Norma Oficial Mexicana NOM-086-SSA1-1994, Bienes y servicios. Alimentos y bebidasno alcohólicas con modificaciones en su composición.Especificaciones nutrimentales. Ciudad de México: SSA.

  3. Davis A, Baker S. The use of modular nutrients in pediatrics.JPEN J Parenter Enteral Nutr. 1996; 20(3):228-36.Doi: 10.1177/0148607196020003228. Erratum in: JPEN JParenter Enteral Nutr .1996;20(4):305.

  4. Pereira-da-Silva L, Pitta-Grós M, Virella D, et al. Osmolalityof elemental and semi-elemental formulas supplementedwith nonprotein energy supplements. J HumNutr Diet. 2008; 21(6): 584–90. Doi: 10.1111/j.1365-277X.2008.00897.x.

  5. Moreno-Villares JM, Oliveros- Leal L, Galiano-SegoviaMJ. Cómo enriquecer la alimentación del lactante: usode los módulos nutricionales. Acta Pediatr Esp. 2003;

  6. 61(8): 406-12.6. Simone L. Enteral Nutrition. Chapter 19. En: Queen-SamourP, King K, editores. Pediatric Nutrition. 4a edición. Sudbury:Jones & Barlett Learning; 2012. p. 401.

  7. Steele JR, Meskell RJ, Foy J, et al. Determining the osmolalityof over-concentrated and supplemented infant formulas.J Hum Nutr Diet. 2013;26(1):32-7. Doi: 10.1111/j.1365-277X.2012.01286.x.

  8. Sociedad Española de Gastroenterología, Hepatología yNutrición Pediátrica. Tratamiento en Gastroenterología,Hepatología y Nutrición Pediátrica. 5ª edición. Madrid,España: Ergon; 2021.

  9. Bello-Pérez LA, Sánchez-Hernández L, Moreno-DamíanE, et al. Laboratory scale production of maltodextrinsand glucose syrup from banana starch. Acta Cient Venez.2002; 53 (1):44-8.

  10. Hofman DL, van Buul VJ, Brouns FJ. Nutrition, Health,and Regulatory Aspects of Digestible Maltodextrins.Crit Rev Food Sci Nutr. 2016; 56(12):2091-100. Doi:10.1080/10408398.2014.940415.

  11. Livesey G, Tagami H. Interventions to lower the glycemicresponse to carbohydrate foods with a low-viscosity fiber(resistant maltodextrin): meta-analysis of randomizedcontrolled trials. Am J Clin Nutr. 2009; 89: 114–25. Doi:10.3945/ajcn.2008.26842.

  12. Greer F, Sicherer S, Burks A, et al. Effects of Early NutritionalInterventions on the Development of Atopic Disease inInfants and Children: The Role of Maternal Dietary Restriction,Breastfeeding, Timing of Introduction of ComplementaryFoods, and Hydrolyzed Formulas. Pediatrics. 2008; 121(1):183-91. Doi: 10.1542/peds.2007-3022.

  13. Agostoni C, Brunser O. Issues in Complementary Feeding.Basel: S. Karger AG;2007.

  14. Chao HC, Vandenplas Y. Effect of cereal-thickened formulaand upright positioning on regurgitation, gastric emptying,and weight gain in infants with regurgitation. Nutrition.2007;23(1):23-8. Doi: 10.1016/j.nut.2006.10.003.

  15. Rosen R, Vandenplas Y, Singendonk M, et al. PediatricGastroesophageal Reflux Clinical Practice Guidelines:Joint Recommendations of the North American Societyfor Pediatric Gastroenterology, Hepatology, and Nutritionand the European Society for Pediatric Gastroenterology,Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr.2018;66(3):516-554.

  16. Fewtrell M, Bronsky J, Campoy C, et al. ComplementaryFeeding: A Position Paper by the European Society forPaediatric Gastroenterology, Hepatology, and Nutrition(ESPGHAN) Committee on Nutrition. J PediatrGastroenterol Nutr. 2017;64(1):119-32. Doi: 10.1097/MPG.0000000000001454.

  17. Klerks M, Bernal MJ, Roman S. Infant Cereals: CurrentStatus, Challenges, and Future Opportunities forWhole Grains. Nutrients. 2019;11(2):473. Doi: 10.3390/nu11020473.

  18. Yu JK, Moon YS. Corn Starch: Quality and Quantity Improvementfor Industrial Uses. Plants (Basel). 2021;11(1):92.Doi:10.3390/plants11010092.

  19. Derks TGJ, Rodriguez-Buritica DF, Ahmad A, et al. GlycogenStorage Disease Type Ia: Current Management Options,Burden and Unmet Needs. Nutrients. 2021;13(11):3828.Doi: 10.3390/nu13113828.

  20. Kishnani PS, Austin SL, Abdenur JE, et al. Diagnosis andmanagement of glycogen storage disease type I: a practiceguideline of the American College of Medical Genetics andGenomics. Genet Med. 2014;16(11):e1. Doi: 10.1038/gim.2014.128

  21. Della Pepa G, Vetrani C, Lupoli R, Massimino E, et al.Uncooked cornstarch for the prevention of hypoglycemicevents. Crit Rev Food Sci Nutr. 2022;62(12):3250-63. Doi:10.1080/10408398.2020.1864617.

  22. Murray, R.D. Savoring Sweet: Sugars in Infant and ToddlerFeeding. Ann Nutr Metab. 2017; 70: 38–46.

  23. Fidler Mis N, Braegger C, Bronsky J, et al. Sugar in Infants,Children and Adolescents: A Position Paper of the EuropeanSociety for Paediatric Gastroenterology, Hepatology andNutrition Committee on Nutrition. J Pediatr GastroenterolNutr. 2017;65(6):681-96.

  24. Gugliucci A, Rodríguez-Mortera R. Fructosa, un factor clavemodificable en la patogenia del síndrome metabólico, laesteatosis hepática y la obesidad. Rev Méd Urug. 2020;36(4): 418-30. Doi: 10.29193/RMU.36.4.10.

  25. Saraiva A, Carrascosa C, Ramos F, et al. Agave Syrup:Chemical Analysis and Nutritional Profile, Applications inthe Food Industry and Health Impacts. Int J Environ ResPublic Health. 2022;19(12):7022.

  26. Yamamura R, Inoue KY, Nishino K, et al. Intestinal and fecalpH in human health. Front. Microbiomes. 2023; 2:1192316.Doi: 10.3389/frmbi.2023.1192316

  27. Codex Alimentarius Commission. Standards for infant formulasand formulas for special medical purposes intendedfor infants: Codex Stan 72-1981 [Internet]. FAO/OMS; 1981[Revisado 2007, citado el 26 de mayo de 2023]. Disponibleen: https://www.fao.org/fao-who-codexalimentarius/shproxy/en/?lnk=1&url=https%253A%252F%252Fworkspace.fao.org%252Fsites%252Fcodex%252FStandards%252FCXS%2B72-1981%252FCXS_072e.pdf.

  28. Fomon AJ, Ziegler EE. Carga renal de Solutos. En: FomonSJ. Nutrición del lactante. Madrid: Mosby/Doyma libros;1995. p. 90-101.

  29. Organización mundial de la salud. Estrategia mundial dellactante y del niño pequeño. Ginebra, Suiza: Organizaciónmundial de la salud; 2003.

  30. Joint WHO/FAO/UNU Expert Consultation. Protein andamino acid requirements in human nutrition. World HealthOrgan Tech Rep Ser. 2007;(935):1-265.

  31. Paxson CL Jr, Adcock EW 3rd, Morriss FH Jr. Osmolalitiesof infant formulas. Am J Dis Child. 1977;131(2):139-41.DOI:10.1001/archpedi.1977.02120150021002.

  32. EFSA NDA Panel. Scientific Opinion on the essential compositionof infant and follow-on formulae. EFSA Journal2014;12(7):3760. Doi:10.2903/j.efsa.2014.3760

  33. Francis DK, Smith J, Saljuqi T, et al. Oral protein caloriesupplementation for children with chronic disease. CochraneDatabase Syst Rev. 2015; 2015(5):CD001914. Doi:10.1002/14651858.CD001914.pub2.

  34. Ren Q, Li K, Sun H, Zheng C, et al. The Association ofFormula Protein Content and Growth in Early Infancy:A Systematic Review and Meta-Analysis. Nutrients.2022;14(11):2255. Doi: 10.3390/nu14112255.

  35. Germán-Díaz M, Moreno-Villares JM, Dalmau-Serra J. Yahora, si es preciso aumentar el contenido en energía ynutrientes en la alimentación de un lactante, ¿qué deboemplear? Acta Pediatr Esp. 2014; 72 (9): 195-201.

  36. Lin YH, Hsu YC, Lin MC, et al . The association of macronutrientsin human milk with the growth of preterm infants.PLoS One. 2020;15(3): e0230800. Doi: 10.1371/journal.pone.0230800.

  37. Adamkin DH. Use of human milk and fortification in theNICU. J Perinatol. 2023;43(5):551-59. Doi: 10.1038/s41372-022-01532-0.

  38. Arslanoglu S, Boquien CY, King C, et al. Fortification ofHuman Milk for Preterm Infants: Update and Recommendationsof the European Milk Bank Association (EMBA)Working Group on Human Milk Fortification. Front Pediatr.2019;7: 76. Doi: 10.3389/fped.2019.00076.

  39. Hair AB, Scottoline B, Good M. Dilemmas in human milkfortification. J Perinatol. 2023;43(1):103-107. Doi: 10.1038/s41372-022-01502-6.

  40. Picaud JC, Vincent M, Buffin R. Human Milk Fortificationfor Preterm Infants: A Review. World Rev Nutr Diet. 2021;122: 225-47. Doi: 10.1159/000514744.

  41. Brown JV, Lin L, Embleton ND,et al. Multi-nutrient fortificationof human milk for preterm infants. CochraneDatabase Syst Rev. 2020 Jun 3;6(6):CD000343. Doi:10.1002/14651858.CD000343.pub3.

  42. Gu X, Shi X, Zhang L, et al. Evidence summary of humanmilk fortifier in preterm infants. Transl Pediatr.2021;10(11):3058-67. Doi: 10.21037/tp-21-476.

  43. Villalpando-Hernández S, Villalpando-Carrión S. Utilidad delos sucedáneos de la leche humana, Capítulo 3. En: MillerK, editor. Prácticas modernas de la alimentación infantil 2ªedición. México: Productos Gerber;2001. p.82.

  44. Łoś-Rycharska E, Kieraszewicz Z, Czerwionka-SzaflarskaM. Medium chain triglycerides (MCT) formulas in paediatricand allergological practice. Prz Gastroenterol.2016;11(4):226-31. Doi: 10.5114/pg.2016.61374.

  45. Valenzuela A, Nieto MS. Docosahexaenoic acid (DHA) infetal development and in infant nutrition. Rev Med Chil.2001;129(10):1203-11.

  46. Bradbury J. Docosahexaenoic acid (DHA): an ancient nutrientfor the modern human brain. Nutrients. 2011;3(5):529-54. Doi: 10.3390/nu3050529.

  47. Yang Q, Welch CD, Ayers K, et al. Early enteral fat supplementationwith microlipid and fish oil in the treatmentof two premature infants with shortbowel. Neonatology.2010;98(4):348-53. Doi:10.1159/000316067.

  48. Yang Q, Ayers K, Chen Y, et al. Early enteral fat supplementand fish oil increases fat absorption in the premature infantwith an enterostomy. J Pediatr. 2013, 163(2): 429-34. Doi:10.1016/j.jpeds.2013.01.056.

  49. Nimbkar S, Leena MM, Moses JA, et al. Medium chaintriglycerides (MCT): State-of-the-art on chemistry, synthesis,health benefits and applications in food industry.Compr Rev Food Sci Food Saf. 2022;21(2):843-67. Doi:10.1111/1541-4337.12926.

  50. Lee YY, Tang TK, Chan ES, et al. Medium chain triglycerideand medium-and long chain triglyceride: metabolism,production, health impacts and its applications-a review.Crit Rev Food Sci Nutr. 2022;62(15):4169-85. Doi:10.1080/10408398.2021.1873729.

  51. Jadhav HB, Annapure US. Triglycerides of medium-chainfatty acids: a concise review. J Food Sci Technol. 2022:1-10.Doi: 10.1007/s13197-022-05499-w.

  52. Bellini C, Ergaz Z, Radicioni M, et al. Congenital fetal andneonatal visceral chylous effusions: neonatal chylothoraxand chylous ascites revisited. A multicenter retrospectivestudy. Lymphology. 2012;45(3):91-102.

  53. Lai Y, Yu T, Qiao XY, et al. Primary intestinal lymphagiectasiadiagnosed by double-balloon enteroscopy and treated bymedium-chain triglycerides: case report. J Med Case Rep.2013; 7:19. Doi: 10.1186/1752-1947-7-19.

  54. Tessitore M, Sorrentino E, Schiano Di Cola G, et al. Malnutritionin Pediatric Chronic Cholestatic Disease: AnUp-to-Date Overview. Nutrients. 2021;13(8):2785. Doi:10.3390/nu13082785.

  55. Desai AP, Guvenc BH, Carachi R. Evidence for mediumchain triglycerides in the treatment of primary intestinallymphangiectasia. Eur J Pediatr Surg. 2009;19(4):241-5.Doi: 10.1055/s-0029-1216389.

  56. Campos-Costa F, Mateus JE, Fonseca J. Effect of mediumchaintriglycerides in chylothorax composition. PostgradMed J. 2020;96(1131):57. Doi: 10.1136/postgradmedj-2019-136878.

  57. Watanabe S, Tsujino S. Applications of Medium-ChainTriglycerides in Foods. Front Nutr. 2022; 9:802805. Doi:10.3389/fnut.2022.802805.

  58. Liu YmC, Wang HS. Medium-chain Triglyceride KetogenicDiet, An Effective Treatment for Drug-resistant Epilepsy andA Comparison with Other Ketogenic Diets. Biomed J. 2013;36:9-15. Doi: 10.4103/2319-4170.107154.

  59. Liu YM. Medium-chain triglyceride (MCT) ketogenictherapy. Epilepsia. 2008;49 Suppl 8:33-6.

  60. Merritt JL 2nd, Norris M, Kanungo S. Fatty acid oxidationdisorders. Ann Transl Med. 2018;6(24):473. Doi:10.21037/atm.2018.10.57.

  61. Van Calcar SC, Sowa M, Rohr F, et al. Nutrition managementguideline for very-long chain acyl-CoA dehydrogenasedeficiency (VLCAD): An evidence- and consensus-basedapproach. Mol Genet Metab. 2020;131(1-2):23-37. Doi:10.1016/j.ymgme.2020.10.001.

  62. Erstad BL. Osmolality and osmolarity: narrowing theterminology gap. Pharmacotherapy. 2003;23(9):1085-6.

  63. Srinivasan L, Bokiniec R, King C, et al. Increased osmolalityof breast milk with therapeutic additives. Arch Dis ChildFetal Neonatal Ed. 2004;89(6):F514-7. Doi: 10.1136/adc.2003.037192.

  64. Johnston M, Landers S, Noble L, et al. Breastfeeding andthe use of human milk. Pediatrics. 2012; 129: 827-41. Doi:10.1542/peds.2011-3552.

  65. De Abreu J, López E, Dini E. Osmolality of products andformulas for nutritional therapy. Invest Clin. 2009; 50(4):433-45.

  66. Pearson F, Johnson MJ, Leaf AA. Milk osmolality: doesit matter? Arch Dis Child Fetal Neonatal Ed. 2013;98(2):F166-9. Doi: 10.1136/adc.2011.300492.

  67. Salvia G, De Vicia B, Manguso F, et al. Effect of intragastricvolume and osmolality on mechanisms of gastroesophagealreflux in children with gastroesophageal refluxdisease. Am J Gastroenterol. 2001; 96(6):1725-32. Doi:10.1111/j.1572-0241.2001.03865.x.

  68. Ellis ZM, Tan HSG, Embleton ND, Sangild PT, van ElburgRM. Milk feed osmolality and adverse events in newborninfants and animals: a systematic review. Arch Dis ChildFetal Neonatal Ed. 2019;104(3):F333-F340. Doi: 10.1136/archdischild-2018-315946.

  69. Shaw V, McCarthy H.Nutritional assessment, dietaryrequirements, feed supplementation. En: Shaw V, editor.Clinical Paediatic Dietetics 3a edición. Oxford: BlackwellPublishing; 2007. pp. 3–20.

  70. Goulet O, Ruemmele F, Lacaille F,et al. Irreversible intestinalfailure. J Pediatr Gastroenterol Nutr. 2004;38(3):250-69.Doi: 10.1097/00005176-200403000-00006.

  71. González-Islas D, Orea-Tejeda A, Castillo-Martínez L, et al.The effects of a low-carbohydrate diet on oxygen saturationin heart failure patients: a randomized controlled clinicaltrial. Nutr Hosp. 2017;34(4):792-98. Doi: 10.20960/nh.784.




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