As Cow’s Milk Wanes in Popularity, Vitamin D Deficiency Rises

Up until recently, cow’s milk has been an integral part of the average child’s diet. It is often the drink of choice offered with meals and snacks. Packed with protein and vitamins, it’s no wonder it has been considered an essential part of a growing child’s diet.

According to research from the US Department of Agriculture, most Americans aren’t consuming enough dairy products. The Dietary Guidelines for Americans from 2010 recommends 2 cup-equivalents per day for children aged 2 to 3 years, 2.5 for those aged 4 to 8 years, and 3 for Americans older than age 8. However, per capita dairy consumption has long held steady at about 1.5 cup-equivalents, despite rising cheese consumption.

In terms of long term trends, interestingly, the USDA has found that per capita consumption of fluid milk is declining in high-income countries while growing in developing countries.

Fortified milk is an important source of vitamin D for children. However, parents in developed countries have been choosing in increasing numbers to feed their children unfortified non-cow’s milk such as soy, rice, almond or oat milks since the turn of the millennium. Fears of milk allergy, lactose intolerance, growth hormones and antibiotics often used to treat dairy cows have been cited as reasons for turning away from feeding their children cow’s milk after weaning.

What does this cultural shift mean for vitamin D levels in young children? A recent study published in the Canadian Medical Association Journal sought to find the answer.

Researchers tested the serum vitamin D levels of a group of 2831 children. The group included both cow’s milk and non-cow’s milk drinkers. Researchers looked at differences in blood levels of vitamin D associated with drinking cow's milk and non-cow's milk.

According to Dr. Jonathon Maguire, a pediatrician and researcher with St. Michael's Hospital who took part in the study:

 "Children drinking only non-cow's milk were more than twice as likely to be vitamin D deficient as children drinking only cow's milk. Among children who drank non-cow's milk, every additional cup of non-cow's milk was associated with a five per cent drop in vitamin D levels per month."

As western society moves away from the habit of drinking milk, these results are a cause for concern for the parents and the medical community. The key factors underlying proper vitamin D levels are either adequate milk intake or supplementation. We hope that this study will encourage parents and doctors to make sure to monitor vitamin D levels in children who avoid cow’s milk for various reasons.

Research Update on Omega 3 EPA and ADHD in Children

ADHD (Attention Deficit Hyperactivity Disorder) is a disorder with far reaching implications for children beyond its compromising effect on school achievements. ADHD has been linked to symptoms of anxiety, depression (1, 2) and impaired interpersonal relationships (2,3). One of the symptoms that characterize ADHD is the failure to recognize facial expressions which in turn causes difficulties in responding appropriately to social situations (3).

The ability to read correctly facial expressions and respond to them is important for successful interactions and healthy relationships with peers and family. One way scientists measure the ability to recognize social situations and react accordingly is through testing facial expression recognition.

An ongoing, double blind, placebo controlled, intervention study conducted by Granot et al. found that high EPA supplementation (500 mg EPA, 100 mg DHA daily) resulted in improvement of facial expression recognition and especially in recognition of happy faces, in 9-16 year old children diagnosed with ADHD and treated with Methylphenidate (MPH – commonly known as Ritalin). Interim results of this study were presented at the 2014 International Neuropsychological Society Mid-Year meeting. These results are shown in the figure below.

A significant difference over time was found in the treatment group for Happy facial expression recognition (t (25)= 2.57, p=0.016) 

T1 = before treatment / T2 = after treatment

These promising findings indicate improved social skills and raised optimism levels as a result of omega 3 high EPA supplementation. This is good news for children and parents coping with the challenges of ADHD, especially given the limitations of traditional Ritalin therapy.

While Ritalin is very effective in addressing impulsivity and improving focus and attention, it offers only slight improvement in emotional stability. Furthermore, Ritalin does not address other ADHD symptoms such as depression, anxiety, psychosomatic complaints and difficulty in successfully engaging in social situations. Omega 3 high EPA supplementation may complement traditional ADHD therapies and help these children deal with the emotional challenges concomitant with the disorder.

EPA is a central ingredient in Anlit's new Omega 3 Focus supplement that will be presented at the upcoming CPhI conference in Paris, October 7-9. For more information about this and other children focused supplement products, please visit us at booth 4G80, hall 4, at the conference. Click here to schedule a meeting with us at the conference. We look forward to seeing you there.

References:

1. J Am Acad Child Adolesc Psychiatry. 2001;40:704-10

2. Child Adolesc Psychiatr Clin North Am. 1992;1:539-52

3. Pediatric Neurology. 2006;35:93-97

Micronutrient Levels and Childhood Obesity: What’s the Connection?

Childhood obesity is a topic of concern for parents spanning the globe as the number of children dealing with this problem has grown from year to year. Doctors and scientists are working tirelessly to understand how to curb this problem and provide a healthier future for all of our children.

According to the World Health Organization, in 2010 the number of overweight children under the age of five, was estimated to be over 42 million worldwide. In the US, the Centers for Disease Control and Prevention (CDC) estimates that over the past 30 years, childhood obesity has doubled in children and quadrupled in adolescents. Excess weight during childhood can lead to obesity during adulthood, as well as health problems such as diabetes and cardiovascular disease.

There is a medical consensus that childhood obesity can be prevented. How this can be done efficiently on a global scale remains a mystery. A few studies done in the last decade have explored the link between vitamin deficiency and childhood obesity. Doctors are keen to understand specifically how micronutrient levels in the body affect metabolism, insulin uptake and chronic inflammation.

According to a study published in Metabolic Syndrome and Related Disorders, Iranian researchers found that zinc supplementation had a marked effect on insulin resistance, oxidative stress, and inflammation among prepubescent children with metabolic syndrome, a common disease caused by obesity. Two groups of children participated in the study. One group was given a placebo and the second group was given daily zinc supplements. The groups were switched after a month-long break. In both groups, children who received zinc exhibited a decrease in their mean weight and BMI, in addition to decreased LDL cholesterol.

Another study published in the journal Nutrients in December 2013 examined how Vitamins A, C, E, iron and zinc affect children suffering from obesity and metabolic syndrome. The objective of this study was to evaluate the relationship between micronutrient status and obesity, lipid profile, insulin resistance and low-grade systemic inflammation in school-aged children.

The researchers examined a group of 197 school-aged children using the following parameters: body composition, blood analysis, dietary intake and socioeconomic status. After analyzing the data, the scientists came to the following conclusions:

In conclusion, low vitamin C concentration and the vitamin E:lipids ratio were associated with obesity. In addition, low concentrations of vitamins A, E and zinc in children who were overweight and obese were associated with lipids, inflammation and insulin resistance.

More research is required in order to fully understand how vitamin levels in the body affect obesity and vice versa. But this is a promising start that we hope will aid doctors and scientists in their search for a solution to the childhood obesity problem.

Zinc Is Vital For Infant Growth

Zinc is an essential trace element for children’s health. It plays an important role in supporting a wide range of biological functions, including:
immune system health

• skin, hair and nail strength
• brain processing for taste, smell and appetite
• activating growth and cell division in infants, children and teenagers

Worldwide, zinc deficiency is usually found among lower income populations and in many developing countries, where a normal diet is generally plant-based (lower zinc content). Global estimates of zinc deficiency by the World Health Organization are around 17% of the population, but figures can reach up to 25% and 29% for Sub-Saharan Africa and South Asia respectively. Zinc deficiency symptoms include slowed growth, low insulin levels, loss of appetite, irritability, generalized hair loss, rough and dry skin, slow wound healing, poor sense of taste and smell, diarrhea, and nausea. Zinc supplementation is one of strategies used by public health officials to combat zinc deficiency and its consequences in children.

A recent study published in the International Journal of Preventive Medicine takes a closer look at the relationship between zinc deficiency and infant growth. The goal of the study was to examine how zinc supplementation affects the linear growth of children 6-24 months of age and the feasibility of its implementation in the context of primary health care system.

According to the study:

Rural community health centers providing maternal and child care in two areas with moderate rates of malnutrition were randomly assigned to intervention and control groups, including 393 and 445 children 6-24 months of age, respectively. Children in both groups received routine iron and multivitamin or vitamin A and D supplements through PHC services. Mothers of children in the intervention group were asked to give a single dose of 5 ml/day zinc sulfate syrup (containing 5 mg elemental zinc) to their children for 3 months while children in the control group did not receive the supplement.

The study’s authors found a 0.5 cm difference in height in the group that received the supplement as compared with the control group. Zinc supplementation had no effect on either group’s weight.

The study concluded that oral zinc supplementation provided by primary health care workers was effective in increasing the linear growth rate of children less than 2 years of age.

The European Food Safety Authority has also concluded that there is scientific evidence to support health claims regarding the dietary intake of zinc, normal immune function, and normal DNA synthesis and cell division. Accordingly, zinc supplements have become an important part of immune system protection during the winter months in addition to supporting children’s growth.

This research demonstrates how vital trace elements like zinc are to proper growth and development for all children. Most kids who eat a balanced diet usually get enough of this mineral but parents of picky eaters should pay particular attention to zinc intake. Zinc deficiency can have serious consequences and all parents and doctors should be aware of them.

Treating Children’s Asthma with Magnesium

Chronic childhood asthma is a global public health challenge. According to World Health Organization estimates, it is the most commonly diagnosed chronic disease among children, with 235 million people currently suffering from the disease.

Asthma is often under-diagnosed and under-treated, which can create a substantial burden for children and families in terms of both cost and the need to limit sports and other physically demanding activities.

Standard asthma treatment usually takes a two-pronged approach: The “rescue” treatment which includes inhaled short-acting bronchodilators to relieve immediate symptoms such as shortness of breath, and the “maintenance” treatment, which includes the use of inhaled corticosteroids and leukotriene antagonist medications to help keep symptoms under long term control.

A new study published in the July issue of the Paediatric Respiratory Review suggests that magnesium should be added to the roster of conventional therapies for acute asthma in children. Acute asthma occurs when symptoms cannot be controlled with the treatments mentioned above and the patient must seek emergency treatment.

Until now, doctors have been uncertain as to whether magnesium is really an effective agent in relieving acute asthma symptoms. However, the authors of the study, Stephen Jacobe and Mon Ohn, now believe that there is accumulating evidence that either inhaled or intravenous magnesium is both safe and beneficial to children presenting with acute severe asthma. Further study is needed to determine the optimum dose and mode of administration.

These results are not all that surprising. A previous study from 2010 had concluded that adults who received oral magnesium supplements over a six month period showed marked improvement in asthma control and quality of life. This is in addition to a double-blind study from 2007 which demonstrated that children who received oral magnesium supplementation experienced improved bronchial health, fewer skin allergies and better symptom control when paired with inhaled fluticasone, a standard asthma medication.

Every child deserves to live a healthy and active life. We are pleased to hear that magnesium supplements are being integrated into standard asthma treatment for children and we look forward to further scientific research in this area. 

Micronutrient Deficiencies May Slow Down Wound Healing

Wound care is the process by which the skin repairs itself following any kind of injury, whether it’s the smallest paper cut or a major traumatic injury. Many common childhood injuries require either basic or advanced wound care - including scrapes and skin punctures due to common playground accidents, or surgical incisions for common surgeries such as appendectomies.

Basic topical wound care, such as regularly changing bandages and keeping the cut clean and dry, is common knowledge. But the role nutrition plays in aiding wound care in children is less well known.

Proper nutrition during wound care is vital for effective healing. If the body is suffering from vitamin or mineral deficiencies, it could lack the correct building blocks that enable effective wound healing. Diet can affect how fast a wound heals, how strong the wound tissue becomes and how well the body fights off infection. A poor diet can turn a normal wound into a chronic one that never heals.

There is a lack of consensus regarding nutritional guidelines for wound healing because there have been no generally accepted guidelines governing optimal nutrition to aid the wound healing process for children or adults.

Against this background, a recent study published the journal Nutrition in Clinical Practice sought to create evidence and consensus-based recommendations on optimal nutrition guidelines that would support wound healing in children. The study’s researchers were also trying to understand whether micronutrient deficiencies affect wound healing in children.

As a result of an initial meta-analysis of the current research, 6 articles were found that addressed the researchers’ clinical questions, and based on this information, they formulated 5 clinical recommendations. The researchers applied these recommendations to the care of 49 patients from December 5, 2011, to December 5, 2012.

According to the study:

Evidence supported evaluating patients for vitamin C, zinc, and protein deficiency. Of the patients where laboratory values were checked, 9 patients were zinc deficient (33%) and 12 patients were vitamin C deficient (48%).

The implementation of the researchers’ recommendations has led to increased awareness and testing for micronutrient deficiencies in children undergoing wound care treatment. In addition, there is closer monitoring of nutrition status and intake during the wound healing process.

This is an interesting study that will hopefully further the case for an international consensus on proper nutritional guidelines for wound care and other medical issues. We look forward to continued research into the impact of nutrition on disease and wound care.

Can Iron Play a Role in ADHD Diagnosis and Treatment?

The number of children being diagnosed with ADHD has grown tremendously over the last 15 years. According to the US Centers for Disease Control and Prevention, the percentage of children with an ADHD diagnosis continues to rise, from 7.8% in 2003 to 9.5% in 2007 and to 11.0% in 2011. There is vigorous debate as to what is causing the rise in diagnoses. The etiology of attention deficit hyperactivity disorder (ADHD) is attributed to different factors: genetic, environmental, and biological (specifically dopamine neurotransmitters). Iron plays a vital role, as it is essential for the correct functioning of dopamine hormones and neurotransmitters.

The U.S. National Institutes of Mental Health reports that thanks to brain imaging studies, scientists now understand that children with ADHD have brains that mature in a normal pattern but on a schedule that’s delayed by about 3 years. It is this delay that causes symptoms including hyperactivity, difficulty in paying attention and controlling behavior. These symptoms are usually controlled with some form of psychostimulant medication like Ritalin.

A recent study, published in the July 2014 edition of the Society’s journal Radiology and sponsored by the Radiological Society of North America, may help doctors more accurately diagnose children with ADHD and thus enable them to more effectively treat children with the disorder in a timely manner.

Currently, doctors rely on subjective clinical interviews and questionnaires in order to detect ADHD. The purpose of the study was to look at whether brain iron levels could offer a potential biomarker for more accurate diagnosis of ADHD, especially in borderline cases.

The research team measured brain iron levels in 22 children and adolescents with ADHD, 12 of whom had never been on medication for their condition, and 27 healthy control children and adolescents. The team used a magnetic resonance imaging (MRI) technique called magnetic field correlation imaging. This is a new technique introduced by the study’s co-authors in 2006. Iron levels in the body for all of the participants were measured by blood draws.

The study showed that the 12 ADHD patients who had never received medication had significantly lower brain iron levels than the 10 ADHD patients who had been on psychostimulant medication. Their brain iron levels were also lower than the iron levels of the 27 children and adolescents in the control group. In contrast, ADHD patients who had previous psychostimulant medication treatment had brain iron levels comparable to the controls. This suggests that brain iron may increase to normal levels with psychostimulant treatment.

"Our research suggests that iron absorption into the brain may be abnormal in ADHD given that atypical brain iron levels are found even when blood iron levels in the body are normal," said Vitria Adisetiyo, Ph.D., postdoctoral research fellow at the Medical University of South Carolina in Charleston, S.C. "We found no differences in blood iron measures between controls, medication-naïve ADHD patients or psychostimulant-medicated ADHD patients."

Scientists are continuing to study the relationship between iron and ADHD. Another recent study  suggests that blood iron levels can affect the severity of ADHD symptoms, since iron deficiency is common in patients with ADHD, and its correction may be useful in the treatment of the disorder.

Scientists Discover Key Probiotic for Allergy Relief

Spring is generally known as “allergy season”, but July and August can be as challenging for allergy sufferers as April and May. Weeds and grasses are the main allergy triggers. The worst of these is ragweed, which usually arrives in August. Ragweed can travel many kilometers on wind currents, and therefore can trigger a reaction even in allergy sufferers who don’t have any of the plant growing in their immediate vicinity.

According to the CDC, 6.6 million people have reported hay fever symptoms in the US in the last 12 months and 7.8 million have reported respiratory allergy symptoms. Reported skin and food allergy sufferers were 8.8 million and 4.1 million respectively.

Traditional allergy treatments include over the counter antihistamines, analgesics for pain relief and nasal sprays. Doctors can prescribe stronger remedies if OTC medicines fail to relieve symptoms.

For decades, doctors and allergy sufferers have relied on these treatments to help allergy sufferers. But recently, scientists investigated the possibility of using probiotics to treat allergy symptoms. According to the World Journal of Gastroenterology, researchers started to study the relationship between probiotic supplements and allergies a few years ago and found that certain combinations of probiotics could reduce the nasal symptoms of allergic reactions.

Another study recently published in the Journal of Functional Foods looked at the anti-allergic behavior of ten lactic acid bacteria strains prepared from Mongolian dairy products and orally administered to mice injected with three type I allergy models. Type I allergy models include allergic rhinitis, food allergies, atopic dermatitis, and allergic asthma. Doctors have expressed concern that the incidence of these allergic diseases is increasing.

Japanese and Mongolian researchers involved in the study observed that of the 10 strains, the oral administration of the Lactobacillus plantarum (strain 06CC2 probiotic strain) “significantly alleviated” type I allergy symptoms across all three allergy models in the mice. The strain was isolated from the traditional Mongolian cheese, Aaruul – a curdled cow’s milk cheese which is dehydrated and dried in the sun.

The study’s authors noted that the impact of Lactobacillus plantarum was linked to T helper type 1 (Th1)/T helper type 2 (Th2) balance cells that play an important role in the immune system. Each type of cell has a different trigger and area of immunity specialization.

According to the study:

The 06CC2 strain was suggested to alter the Th1/Th2 balance toward Th1 dominance through intestinal immunity in these allergy models in mice, resulting in the suppression of mast cell activation, followed by histamine release and vascular permeability.

The researchers concluded that functional foods which include probiotic supplements could be an important part of allergic disease treatment both prophylactically and therapeutically. We welcome this research and look forward to further study.

Research Update on Vitamin D and Immune Response

Relying on the sun for vitamin D
can present challenges

As summer approaches, now is a good time to consider the importance of proper vitamin D levels for children. Although the human body can obtain vitamin D from exposure to the sun and, to a lesser extent, from food, deficiencies still abound. 

There are many factors that can prevent children from getting sufficient doses of vitamin D from the sun, including decreased time outdoors, more clothing while outside and high factor sunscreen. The growing prevalence of obesity is also another cause of vitamin D deficiency. 

The body must have vitamin D in order to absorb calcium and promote bone growth throughout childhood. Too little vitamin D results in soft bones in children (rickets) and fragile, misshapen bones in adults (osteomalacia).

While vitamin D’s crucial role in bone health is well-known, recent research has shown that vitamin D is also necessary for healthy immune response.

A study published in the Journal of Investigative Medicine suggests that vitamin D can play a vital role in proper immune system function. Scientists have found that vitamin D can actually regulate the innate and adaptive immune responses. According to the article:

Deficiency in vitamin D is associated with increased autoimmunity and an increased susceptibility to infection. As immune cells in autoimmune diseases are responsive to the ameliorative effects of vitamin D, the beneficial effects of supplementing vitamin D-deficient individuals with autoimmune disease may extend beyond the effects on bone and calcium homeostasis.

There have also been a number of randomized studies which associate lower levels of vitamin D with increased infection. The Archives of Internal Medicine reported in 2012 on a secondary analysis of the Third National Health and Nutrition Examination Survey which studied almost 19,000 subjects between 1988 and 1994. Individuals with lower vitamin D levels (<30 ng/ml) were more likely to self-report a recent upper respiratory tract infection than those with sufficient levels, even after adjusting for variables including season, age, gender, body mass and race

It is this type of research that drives the need for high quality vitamin D supplements. The far reaching importance of healthy vitamin D levels, and the lack of a consistent supply of vitamin D through nutrition or sun exposure, supports the use of a tasty, appealing vitamin D supplement as an important part of a child’s daily nutritional intake.

FPE/Vitafoods Wrap-Up: Enthusiastic Response to Anlit Product Launches

Meeting new prospects at FPE/Vitafoods

Anlit’s participation in the Finished Products Europe/Vitafoods conference was, as always, engaging and productive. We met many colleagues and learned a great deal about current and future industry trends. The conference was a great meeting place for vendors and global players in the pharmaceutical and food supplement industries and afforded us many excellent networking opportunities.

Anlit launched two new products at the conference: our new Fiber Gummy format and High EPA Omega 3 Focus product were featured at the event’s New Products Zone and Tasting Bar. The New Products Zone showcased new products launched by FPE participants. The Tasting Bar gave participants a chance to experience the taste and texture of the new products first hand. The response to both products was very positive with many visitors coming directly from the New Product Zone and Tasting Bar directly to Anlit's booth with inquiries and requests for follow-up discussions.

The new Omega 3 Focus product also drew the attention of the conference professional team that included Anlit's booth in FPE’s ‘Stay Smart’ Innovation Tour. The goal of the tour was to “improve communication and information surrounding the nutritional markets” and we were delighted to have a chance to share our products and knowledge of the latest research in a semi-formal framework.

Mrs. Sigal Tepper, Anlit’s Scientific Director, gave a seminar entitled “Putting it into Practice – Omega 3 in Kids Nutrition” on the last day of the conference. Ms. Tepper spoke of the importance of omega-3s for proper brain growth and development, in particular for children diagnosed with ADHD. The seminar had an intimate atmosphere and the audience was engaged, showing a keen interest in this important topic.

Indeed, the conference was very eventful and productive, however our work has just begun. We look forward to a fruitful year following FPE/Vitafoods conference with many new partners and projects.