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Micronutrients Are Not Deficient in Children with Nonorganic Failure to Thrive

  • Hong, Junho (Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine) ;
  • Park, Sowon (Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Severance Pediatric IBD Research Group, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Kang, Yunkoo (Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Severance Pediatric IBD Research Group, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Koh, Hong (Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Severance Pediatric IBD Research Group, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Kim, Seung (Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Severance Pediatric IBD Research Group, Severance Children's Hospital, Yonsei University College of Medicine)
  • Received : 2018.08.07
  • Accepted : 2018.09.01
  • Published : 2019.03.15

Abstract

Purpose: Inadequate calorie intake is one of the most important causes of nonorganic failure to thrive (NOFTT) and is thought to lead to multiple micronutrient deficiencies. However, there have been few studies on NOFTT and micronutrients. The aim of this study was to evaluate the micronutrient status of children with NOFTT. Methods: We conducted a retrospective cohort study in 161 children (106 with NOFTT and 55 health controls) at a single institution. Data on weight for age, height for age, body mass index, and biochemical parameters, indicating the children's nutritional and micronutrient status were reviewed via electronic medical records, and the two groups were compared. Results: Except inorganic phosphate levels, no statistically significant differences were seen in the laboratory findings indicating the children's nutritional and micronutrient status; notably, the inorganic phosphate levels were within the normal range in both groups. We then compared the severe NOFTT (weight for age below the first percentile) and control groups; however, no statistically significant differences were seen for any of the measured parameters. Conclusion: Most children with NOFTT in this study had normal micronutrient levels and other laboratory findings. Therefore, element deficiencies should not be considered a natural consequence of NOFTT or in healthy children. Close monitoring and additional evaluations are needed.

Keywords

References

  1. Zenel JA Jr. Failure to thrive: a general pediatrician's perspective. Pediatr Rev 1997;18:371-8. https://doi.org/10.1542/pir.18-11-371
  2. Olsen EM. Failure to thrive: still a problem of definition. Clin Pediatr (Phila) 2006;45:1-6. https://doi.org/10.1177/000992280604500101
  3. Rudolf MC, Logan S. What is the long term outcome for children who fail to thrive? A systematic review. Arch Dis Child 2005;90:925-31. https://doi.org/10.1136/adc.2004.050179
  4. Reif S, Beler B, Villa Y, Spirer Z. Long-term follow-up and outcome of infants with non-organic failure to thrive. Isr J Med Sci 1995;31:483-9.
  5. Jaffe AC. Failure to thrive: current clinical concepts. Pediatr Rev 2011;32:100-7. https://doi.org/10.1542/pir.32-3-100
  6. Moon JH, Beck NS, Kim JY. Clinical manifestation of children with failure to thrive. Korean J Pediatr Gastroenterol Nutr 2000;3:68-74. https://doi.org/10.5223/kjpgn.2000.3.1.68
  7. Jeong SJ. Nutritional approach to failure to thrive. Korean J Pediatr 2011;54:277-81. https://doi.org/10.3345/kjp.2011.54.7.277
  8. Gernand AD, Schulze KJ, Stewart CP, West KP Jr, Christian P. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention. Nat Rev Endocrinol 2016;12:274-89. https://doi.org/10.1038/nrendo.2016.37
  9. Shenkin A. Micronutrients in health and disease. Postgrad Med J 2006;82:559-67. https://doi.org/10.1136/pgmj.2006.047670
  10. Black MM. Micronutrient deficiencies and cognitive functioning. J Nutr 2003;133:3927S-31S. https://doi.org/10.1093/jn/133.11.3927S
  11. Bhan MK, Sommerfelt H, Strand T. Micronutrient deficiency in children. Br J Nutr 2001;85 Suppl 2:S199-203. https://doi.org/10.1079/BJN2001315
  12. Tulchinsky TH. Micronutrient deficiency conditions: global health issues. Public Health Rev 2010;32:BF03391600.
  13. Cole SZ, Lanham JS. Failure to thrive: an update. Am Fam Physician 2011;83:829-34.
  14. Saper RB, Rash R. Zinc: an essential micronutrient. Am Fam Physician 2009;79:768-72.
  15. Salgueiro MJ, Zubillaga M, Lysionek A, Sarabia MI, Caro R, De Paoli T, et al. Zinc as an essential micronutrient: a review. Nutr Res 2000;20:737-55. https://doi.org/10.1016/S0271-5317(00)00163-9
  16. World Health Organization. The world health report 2002: reducing risks, promoting healthy life. Geneva: World Health Organization, 2002.
  17. Aburto NJ, Ramirez-Zea M, Neufeld LM, Flores-Ayala R. Some indicators of nutritional status are associated with activity and exploration in infants at risk for vitamin and mineral deficiencies. J Nutr 2009;139:1751-7. https://doi.org/10.3945/jn.108.100487
  18. Berkovitch M, Heyman E, Afriat R, Matz-Khromchenko I, Avgil M, Greenberg R, et al. Copper and zinc blood levels among children with nonorganic failure to thrive. Clin Nutr 2003;22:183-6. https://doi.org/10.1054/clnu.2002.0619
  19. Kanis JA. Primer on the metabolic bone diseases and disorders of mineral metabolism. Clin Endocrinol (Oxf) 2000;52:526. https://doi.org/10.1046/j.1365-2265.2000.0977c.x
  20. Holick MF. Vitamin D deficiency. N Engl J Med 2007;357:266-81. https://doi.org/10.1056/NEJMra070553
  21. Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 2006;84:18-28. https://doi.org/10.1093/ajcn/84.1.18
  22. Lee JH. Micronutrient deficiency syndrome: zinc, copper and selenium. Pediatr Gastroenterol Hepatol Nutr 2012;15:145-50. https://doi.org/10.5223/pghn.2012.15.3.145
  23. Kang DS, Lee KS. The status of dietary supplements intake in Korean preschool children: data from the Korea national health and nutrition examination survey 2010-2012. Pediatr Gastroenterol Hepatol Nutr 2014;17:178-85. https://doi.org/10.5223/pghn.2014.17.3.178
  24. Kim YH, Lee SG, Kim SH, Song YJ, Chung JY, Park MJ. Nutritional status of Korean toddlers: from the Korean national health and nutrition examination survey 2007-2009. Korean J Pediatr Gastroenterol Nutr 2011;14:161-70. https://doi.org/10.5223/kjpgn.2011.14.2.161

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  1. Failure to Thrive or Growth Faltering: Medical, Developmental/Behavioral, Nutritional, and Social Dimensions vol.42, pp.11, 2019, https://doi.org/10.1542/pir.2020-001883