Riboflavin deficiency in infants and children with heart disease

Steier, Moshe; Lopez, Rafael; Cooperman, Jack M.

doi:10.1016/s0002-8703(76)80247-5

Cited by 14 publications

(3 citation statements)

References 9 publications

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“…Finally, there is evidence that micronutrient deficiencies may be relatively common in children with CHD 40 . This has never been explored in low- and middle-income countries where it is even more likely to be an issue.…”

Section: Failure To Thrive In Children With Chdmentioning

confidence: 99%

Management of undernutrition and failure to thrive in children with congenital heart disease in low- and middle-income countries

et al. 2017

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Poor growth with underweight for age, decreased length/height for age, and underweight-for-height are all relatively common in children with CHD. The underlying causes of this failure to thrive may be multifactorial, including innate growth potential, severity of cardiac disease, increased energy requirements, decreased nutritional intake, malabsorption, and poor utilisation of absorbed nutrition. These factors are particularly common and severe in low-and middle-income countries.Although nutrition should be carefully assessed in all patients, failure of growth is not a contraindication to surgical repair, and patients should receive surgical repair where indicated as soon as possible.Close attention should be paid to nutritional support -primarily enteral feeding, with particular use of breast milk in infancy -in the perioperative period and in the paediatric ICU. This nutritional support requires specific attention and allocation of resources, including appropriately skilled personnel.Thereafter, it is essential to monitor growth and development and to identify causes for failure to catch-up or grow appropriately.

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Section: Failure To Thrive In Children With Chdmentioning

confidence: 99%

Management of undernutrition and failure to thrive in children with congenital heart disease in low- and middle-income countries

et al. 2017

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“…The investigators concluded that 400 -500 g (58 g/kg or 48 g/100 kcal) of riboflavin daily resulted in freedom from deficiency symptoms, normal urinary secretion, and maintenance of normal levels of riboflavin in the serum, RBCs, and white cells. Chronic respiratory infections, measles, and other conditions associated with negative nitrogen balance have been reported to reduce riboflavin status in physiologically stressed infants and children (Bamji et al, 1987;Greene & Smidt, 1993;Steier et al, 1976). Rönnholm et al (1986) studied 39 LBW infants in Finland who were randomized to be fed human milk with or without a daily supplement of 300 g (0.8 mol) of riboflavin for the first 12 weeks after birth.…”

Section: Review Of the Literaturementioning

confidence: 99%

Nutrient Requirements For Preterm Infant Formulas

Klein

2002

The Journal of Nutrition

328

231

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Achieving appropriate growth and nutrient accretion of preterm and low birth weight (LBW) infants is often difficult during hospitalization because of metabolic and gastrointestinal immaturity and other complicating medical conditions. Advances in the care of preterm-LBW infants, including improved nutrition, have reduced mortality rates for these infants from 9.6 to 6.2% from 1983 to 1997. The Food and Drug Administration (FDA) has responsibility for ensuring the safety and nutritional quality of infant formulas based on current scientific knowledge. Consequently, under FDA contract, an ad hoc Expert Panel was convened by the Life Sciences Research Office of the American Society for Nutritional Sciences to make recommendations for the nutrient content of formulas for preterm-LBW infants based on current scientific knowledge and expert opinion. Recommendations were developed from different criteria than that used for recommendations for term infant formula. To ensure nutrient adequacy, the Panel considered intrauterine accretion rate, organ development, factorial estimates of requirements, nutrient interactions and supplemental feeding studies. Consideration was also given to long-term developmental outcome. Some recommendations were based on current use in domestic preterm formula. Included were recommendations for nutrients not required in formula for term infants such as lactose and arginine. Recommendations, examples, and sample calculations were based on a 1000 g preterm infant consuming 120 kcal/kg and 150 mL/d of an 810 kcal/L formula. A summary of recommendations for energy and 45 nutrient components of enteral formulas for preterm-LBW infants are presented. Recommendations for five nutrient:nutrient ratios are also presented. In addition, critical areas for future research on the nutritional requirements specific for preterm-LBW infants are identified.

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“…In human plasma, riboflavin is bound to proteins, predominantly albumin, but also to immunoglobulins, and mainly found as flavin adenine dinucleotide (FAD). The significance of this protein binding is not fully understood (Steier et al, 1976;Natraj et al, 1988).…”

Section: Distribution and Metabolismmentioning

confidence: 99%

Scientific Opinion on the re‐evaluation of riboflavin (E 101(i)) and riboflavin‐5′‐phosphate sodium (E 101(ii)) as food additives

2013

EFS2

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The EFSA ANS Panel provides a scientific opinion re‐evaluating the safety of riboflavin (E 101(i)) and riboflavin‐5′‐phosphate sodium (E 101(ii)) which are authorised as food additives in the EU and have been previously evaluated by JECFA and by the SCF. JECFA allocated a group ADI for riboflavin and riboflavin‐5′‐phosphate sodium of 0‐0.5 mg/kg bw/day. The SCF considered that the use of riboflavin‐5′‐phosphate sodium as a food colour should not alter significantly the average daily intake of riboflavin for which no ADI was established. The Panel was not provided with a newly submitted dossier and based its evaluation on previous evaluations, additional literature that became available since then and the data available following a public call for data. The Panel considered that riboflavin‐5′‐phosphate sodium is rapidly dephosphorylated to free riboflavin in the intestinal mucosa and then metabolised using normal metabolic pathways. The Panel noted that no adverse effects were observed in two 90‐day studies in rat and that riboflavin and riboflavin‐5′‐phosphate do not raise concern with respect to genotoxicity. The Panel also noted that there are limited data from clinical studies, in which no significant adverse effects were reported. The Panel considered that the use of riboflavins as food additives will result in an exposure above that from the regular diet and that the available database is insufficient to assess whether potential high intakes from all combined sources cause adverse effects or not. Due to the absence of carcinogenicity/chronic toxicity studies and lack of relevant reproductive and developmental toxicity studies, the Panel considered that it is not appropriate to allocate an ADI. The Panel concluded, despite the uncertainties in the database, that riboflavin (E 101(i)) and riboflavin‐5′‐phosphate sodium (E 101(ii)) are unlikely to be of safety concern at the currently authorised uses and use levels as food additives.

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Riboflavin deficiency in infants and children with heart disease

Cited by 14 publications

References 9 publications

Management of undernutrition and failure to thrive in children with congenital heart disease in low- and middle-income countries

Management of undernutrition and failure to thrive in children with congenital heart disease in low- and middle-income countries

Nutrient Requirements For Preterm Infant Formulas

Scientific Opinion on the re‐evaluation of riboflavin (E 101(i)) and riboflavin‐5′‐phosphate sodium (E 101(ii)) as food additives

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