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Early exposure to solid foods and the development of eczema in children up to 4 years of age Early exposure to solid foods in infancy has been positively associated with the development of allergic diseases (1-4). For that reason, prophylactic nutritional guidelines for the prevention of asthma and allergy have been established for the general population as well as for children at increased risk for asthma and allergy (usually children with a positive family history of asthma and allergy). These guidelines recommend exclusive breastfeeding during the first 4-6 months of life with complementary foods (ÔbeikostÕ) after the 5th month (Joint Statement of the Nutritional

ABSTRACT:We investigated whether obese children and adolescents have early echocardiographic signs of subclinical cardiac dysfunction and evaluated the respective influence of obesity per se versus parameters of carbohydrate and lipid metabolism that are frequently abnormal in obese subjects. The role of tissue Doppler imaging as a screening tool for these abnormalities was explored. Blood pressure and echocardiographic parameters, including tissue Doppler measurements of the septal mitral annulus were evaluated in 49 obese children and adolescents and 45 age and sex matched controls. The respective influence of obesity versus parameters of carbohydrate and lipid metabolism was examined with linear regression analysis. Obese subjects showed significantly larger left ventricular wall dimensions (posterior wall, septum, and left ventricular mass index) and signs of early diastolic filling abnormalities on conventional and tissue Doppler echocardiography compared with nonobese subjects. Multiple regression analysis showed that mainly BMI-SD scores and/or body surface area explained significant proportions of the variance of the early cardiac abnormalities. In conclusion, young, obese children and adolescents have significant changes in left ventricular wall dimensions and early diastolic filling compared with nonobese subjects. Obesity per se and not the parameters of carbohydrate and lipid metabolism predicted the early cardiac abnormalities. T he prevalence of overweight and obesity in children is increasing worldwide at an alarming rate in both developing and developed countries (1). In the United States, approximately 31.2% of children (aged 6 -11) are overweight of which 15.8% are obese. For adolescents (aged 12-19), 30.9% are overweight of which 16.1% are obese (2). It is well established that obesity is a strong risk factor for cardiovascular morbidity and mortality. Studies in adults using echocardiography, catheterization, and necropsy examinations have shown relations between morbid obesity, structural alterations of the heart and systolic function, which may lead to a clinical syndrome known as "obese cardiomyopathy" (3). However, the relation between obesity and cardiac structure and function in children is less well documented and conflicting results have been reported (4 -7). In addition, obesity is associated with a heterogeneity of metabolic abnormalities (e.g., dyslipidemia (8), insulin resistance (9), hyperglycaemia) and hypertension (10) that may provide a plausible biologic link between obesity and the increased risk of cardiovascular morbidity and mortality. The clustering of these risk factors for cardiovascular disease is referred to as the "metabolic syndrome." Although the concept and definition of the metabolic syndrome are controversial at the moment, there is no doubt that a cluster of cardiovascular risk factors is present in obese children and adolescents and that their presence increases with worsening obesity (11-13). Little is however known about the relative influence of obesity pe...

In this study, we have demonstrated the presence of rare SIM1 variants in both an obese pediatric population and a population of lean adult controls. Further, we have shown that functional in vitro analysis of SIM1 variants may help in distinguishing benign variants of no pathogenic significance from variants which contribute to the obesity phenotype.

The forced oscillation technique according to Làndsér et al. (J. Appl. Physiol. 41:101-106, 1976) was modified for use in infants. Adaptations, including a flexible tube to connect the infant to the measuring system and a bias flow to avoid rebreathing, did not influence impedance values. The linearity of the respiratory system was assessed and confirmed by 1) applying pseudo-random noise oscillations at three different amplitudes to 7 infants and 2) comparing in 12 infants impedance values obtained with pseudo-random noise and with sinusoidal oscillations at 12 and 32 Hz. Intersubject variability, averaged for all frequencies, was 6%. In 17 infants the relative error (+/- SD) between two series of five measurements within a time interval of 15 min was 0.5 +/- 5.7%. No statistically significant difference was found between impedance values before and after repositioning of the infant's head, whereas rotation resulted in a decrease in resistance and no effect on reactance. Our results indicate that the infant-adapted forced pseudo-random noise oscillation technique has the potential to give valuable information about ventilatory lung function in infants.