In the post-epidemic era, people's health awareness is constantly improving, and more attention is paid to nutritional supplements in life. On April 16th, the 8th Nestlé Health Science Nutrition Forum kicked off, with the theme of "Scientific Nutrition for Healthy Life", which was held online, and more than 20 pediatric experts gathered to share cutting-edge clinical experience and talk about children's nutrition and health. The forum set up three sections: "Food Allergy Prevention and Management", "International Advanced Exchange" and "Multi-disease Nutrition Management", inviting experts from different fields to discuss the most cutting-edge pediatric nutrition treatment solutions from different perspectives.
The forum had a strong lineup of guests and a strong international color, including Professor Cai Wei, chairman of the third session of the Parenteral Enteral Nutrition Branch (CSPEN) of the Chinese Medical Association, Professor Sanja Kola Ek, Chairman of the European Society of Pediatric Gastrointestinal Liver Diseases and Nutrition (ESPGHAN), Professor Yvan Vandenplas, Former Chairman of espghan Gastroenterology Committee, Professor Luo Xiaoping of Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, Professor Gong Sitang of Guangzhou Women and Children's Medical Center, Professor Qian Suyun of Beijing Children's Hospital affiliated to Capital Medical University and other well-known experts and scholars at home and abroad, and Ms. Gu Xinxin, President of Nestlé Health Sciences Greater China.
8th Nestlé Health Sciences Nutrition Forum
Cross-border new product listing: renewed nutrition to protect allergic babies
At this forum, Nestlé Health Sciences launched three new cross-border products - Enminshu HMO, Peptide Minshu HMO, and Caiershu HMO, as a cross-border e-commerce channel, took the lead in introducing a food allergy management product line with HMO ingredients[3], further improving the nutrition management methods of infants and young children under special circumstances, and helping allergic babies build their own strong "self-protection". Its innovative research and development, process and formula will lead the development of industry categories and provide better choices for babies with milk protein allergies.
Gu Xinxin, President of Nestlé Health Sciences Greater China, said: "For infants and young children, breast milk is the most golden nutrition, and the HMO in breast milk, full name breast milk oligosaccharides, is the third largest nutritional essence in breast milk after lactose and fat. It is very helpful for the early development of the baby, it can participate in the development of the baby's immune system, but also can help the development of the child's brain."
President Gu Xinxin was interviewed by reporters
In addition, Nestlé Health Sciences' 5 special medical products - Philharmonic, Peptide Minshu, Enminshu, Xiaobai Taineng and Xiaojiashan will be listed in new packaging, bringing a better visual experience to the majority of medical care and consumers with a trustworthy formula and unchanged quality. Nestlé Health Sciences' rare disease nutrition brand Vitaflo also appeared in the forum, focusing on congenital metabolic diseases, childhood epilepsy, pediatric kidney disease and nutritional support and other disease areas, focusing on phenylketonuria, maple glycolituria, glycogen accumulation and other disease research.
Favorable policies to promote the development of clinical nutrition: the development of registered dietitians can be expected in the future
Recently, a series of policies favorable to the development of clinical nutrition have landed, and the "Guidelines for the Construction and Management of Clinical Nutrition Departments (Trial)" issued by the General Office of the National Health Commission in March this year clarifies the diagnosis and treatment responsibilities and diagnosis and treatment scope of physicians and clinical nutritionists, which has a great role in promoting the diagnosis and treatment and standardized development of clinical nutrition. Professor Cai Wei said: "In the future, clinical nutritionists will become a shortage of talents, and registered dietitians will have great potential". As a good helper for dietitians, special medical foods that have been registered are believed to be more widely used.
Professor Cai Wei, President of the Conference, interacted with international experts
Talk about the new development of food allergy research, prevention and management of both hands
Allergic diseases are the sixth largest diseases in the world, and the World Health Organization has listed allergic diseases as one of the key public health diseases for protection in the 21st century. Among them, the incidence of food allergies in children is 0.02% to 8%, and has shown an upward trend in recent years. Food allergies can cause multiple systemic lesions throughout the body, and infants and young children whose food allergies are not managed in a timely and effective manner may have varying degrees of effect on their physical growth and long-term behavior [1].
Professor Gong Sitang called for attention to milk protein allergies in infants and young children
At the meeting, Prof Gong SiTang pointed out, "In the past, food allergies were often prevented by avoiding sensitive foods, but long-term epidemiological investigations showed that this did not help. Recent research and feeding guidelines suggest that the early, sustained and regular introduction of multiple allergenic food proteins may help reduce the risk of food allergies."
Professor Wu Jie from Beijing Children's Hospital and Professor Wang Hua from Chongqing Children's Hospital pointed out: "Cow's milk protein allergy (CMPA) is one of the most common food allergies in infants and young children, and when clinically diagnosed, it should be managed in a timely manner, and suitable alternative formulas should be selected for artificial feeding. The formula of infants and young children with milk protein allergy should follow the principle of hierarchical management, for most infants and young children with mild to moderate milk protein allergy, the deep hydrolyzed formula is preferred, and a small number of infants with severe milk protein allergy are preferred amino acid formulas. Moreover, for infants and young children with milk protein allergies who do not have severe gastrointestinal symptoms, it is not necessary to completely avoid the lactose in their diet. In addition, partial hydrolyzed formulas are not suitable for infants and young children with confirmed milk protein allergy, which is also a common cognitive misunderstanding."
Professor Anna Nowak-Wegrzyn from Icahn School of Medicine in Mount Sinai, New York, sharing the latest international advances in the management of milk protein allergy, said: "As the number one immunoactive nutrient in breast milk, human milk oligosaccharides (HMOs) play an important role in building the microbiome of the baby's intestinal tract, which helps the good bacteria in the baby's intestine to proliferate and promote the immune maturation of infants and young children. The latest research shows that infants and young children with cow's milk protein allergy are fed a deep hydrolyzed formula/amino acid formula with HMO, which is effective in relieving allergy symptoms, well tolerated and achieve catch-up growth, and can also help reduce infection and related drug doses."
Expert in food allergy prevention and management
Cutting-edge experience discussion: domestic and foreign celebrities gathered to discuss classic cases
It is generally believed that 70% of the body's immunity, 80% of the toxin elimination and 95% of the digestion and absorption of nutrients are related to the regulation of the intestinal flora. [2] Nutrition for common childhood diseases that scholars at home and abroad are most concerned about, such as short bowel syndrome, cow's milk protein allergy, inflammatory bowel disease, cerebral palsy and rare diseases. Children's experts from China, Professor Cai Wei, Professor Luo Xiaoping, Professor Gong Sitang, Professor Xiao Nong and Professor Geng Lanlan had a wonderful academic exchange with Professor Sanja Kola Ek, Professor Yvan Vandenplas, Professor Claudio Romano, Professor Rotem Sigall Boneh and the Caroline Charlesworth team from Vitaflo UK.
Professor Sanja Kola ek, specialist in gastrointestinal diseases and nutrition in children from Croatia, systematically introduced the application of enteral nutrition in pediatric inpatients, including the definition of enteral nutrition, indications, contraindications, formula selection and route selection, as well as monitoring and management of complications. At the same time, she also shared a case of tube feeding in an hospitalized child with short bowel syndrome, she said: "Enteral nutrition is a safe and effective nutritional treatment, and for some specifically identified children, such as dysphagia, nutritional support through gavage is a safe and effective method."
Professor Yvan Vandenplas from Belgium, in addition to further sharing the international latest international milk protein allergy grading management diagnosis and treatment path, also conducted an in-depth analysis of alternative formula selection: "Deep hydrolysis formula is the first-line formula choice for infants and young children with cow's milk protein allergy, suitable for more than 90% of infants and young children with milk protein allergy. However, not all deep hydrolysis formulas are the same! A real-world study covering 12 countries surveyed the hydrolysis levels of 76 commercially available deep hydrolysis formulations. The results are astounding, with different deep hydrolyzed formulations varying greatly in terms of peptide chain molecular weight spectra and residual immunoactive milk protein/peptide chain content, all of which are related to the effectiveness of the formulations." It is reported that the two deep hydrolysis formulas that have been registered and licensed by the mainland special medical food have performed prominently in this global survey, and the degree of hydrolysis is deep, which further verifies its effectiveness.
Professor Claudio Romano shared with us at the meeting the nutritional management of children with cerebral palsy, he brought 3 cases of children with cerebral palsy who were under-fed, unable to eat safely or could not eat using ostomy tube feeding to provide enteral nutrition support, and told us through vivid case sharing that tube feeding is a safe and effective nutritional treatment for long-term enteral feeding in children with cerebral palsy. Nutritionally balanced special medicine formulas can be selected according to the age, energy needs and tolerance of the child, which can reduce the risk of infection compared with the use of artificial enteral nutrient solution special medicine formulas.
Professor Rotem Sigall Boneh, a clinical and research dietitian from Holon Wolfson Medical Center in Israel, shared the role of diet in the treatment of inflammatory bowel disease (IBD) at the meeting, noting that nutrition is very important in the treatment of IBD, whole enteral nutrition is the first-line therapy for moderate to severe Crohn's disease in European children, and restrictive diet for Crohn's disease combined with partial enteral nutrition is an effective treatment with efficacy comparable to whole enteral nutrition. At the same time, she also pointed out that dietitians play a very important role in the treatment of IBD.
Caroline Charlesworth, CEO of Vitaflo, a subsidiary of Nestlé Health Sciences, and his team shared Vitaflo's innovative specialty line of rare/congenital metabolic diseases. Vitaflo's R&D team is constantly working to use advanced process technology, raw materials and packaging to ensure that new products with high nutritional value and consumer-friendly products are available to patients with congenital metabolic diseases. At the same time, the new progress of glycogen accumulation and its treatment was introduced in depth at this meeting. Glycosade is an innovative and improved corn starch developed by Vitaflo that significantly prolongs normal blood glucose maintenance.
International Advanced Exchange expert
Domestic case sharing: Targeted special medical food can meet the nutritional needs of children
Children's clinical nutrition supplementation has always been a key issue in the field of pediatrics, before the age of two is the baby's brain and intestinal development of the critical period, and for babies with food allergies, blood tumors, diarrhea, liver disease and growth dysplasia and other common diseases in children, it is more necessary to ingest targeted special medical food to strengthen nutrient absorption to fully meet the nutritional needs of children in the process of growth and development and disease recovery. At this conference, a number of domestic experts from the fields of pediatric critical care medicine, surgery, hematology and oncology, immunology, digestion and liver disease, and health care shared with us online the nutrition management programs for a variety of childhood diseases.
Professor Qian Suyun from Beijing Children's Hospital and Professor Liu Chunfeng from Shengjing Hospital affiliated to China Medical University said: "Nutrition management is a very important part of the treatment of critically ill children's diseases, and reasonable nutritional support treatment is conducive to improving the prognosis and growth and development of children, and scientific nutritional assessment and intervention should be carried out. Enteral nutrition has the advantages of being economical, effective and convenient, so it has become the first choice for clinical nutritional support. Depending on the nutritional status and tolerance of the child, oral or tube feeding can be given a nutritionally comprehensive formula that is easy to absorb, tolerate, and calorie-adequate."
Malnutrition is a common disease in children with surgical perioperative diseases, and surgical trauma can also easily lead to gastrointestinal damage, exacerbate malnutrition, affect wound healing and disease prognosis. Therefore, nutritional support is an important part of the perioperative period. Professor Tang Weibing from the Children's Hospital affiliated to Nanjing Medical University systematically introduced the strategy of enteral nutrition support, especially the application of tube feeding in enteral nutrition support in perioperative children and the formula selection of enteral nutrition. He noted, "Enteral nutrition is the first choice for nutritional support in perioperative children, and children who cannot eat orally and who cannot meet their nutritional needs should choose tube-fed enteral nutrition. It is recommended that children with impaired gastrointestinal function or malabsorption should choose a half-element formula, such as a deep hydrolyzed formula or a peptide formulation."
Professor Wang Jianjian from the Children's Hospital of Fudan University and Professor Wang Ying from Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine shared the importance of enteral nutrition therapy in the two areas of digestion and liver disease. Professor Wang Jianshe pointed out, "In infantile cholestasis, enteral nutrition is the preferred method of nutritional therapy. This method is simple, convenient and safe to operate, with diverse nutrients and economy, which can maintain the normal physiological function of the digestive tract, prevent the digestive tract from shrinking, and reduce the displacement of bacteria in the digestive tract. In addition, in terms of formula selection, it is recommended that children with liver disease choose formulas with sufficient calories and nutrients such as medium-chain fats to help improve their nutritional status."
Professor Wang Ying also said: "Children with prolonged diarrhea and chronic diarrhea are prone to damage to the mucosa of the small intestine, resulting in malnutrition in children, and the occurrence of malnutrition will exacerbate the process of diarrheal disease, forming a vicious circle. Therefore, nutritional support is needed to help children improve their nutritional status, and domestic and foreign authoritative institutions and guidelines recommend the preferred enteral nutrition for nutritional support. For children with prolonged diarrhea and chronic diarrhea with small intestinal mucosa damage, deep hydrolysis formulas and peptide formulations can be used to help children better repair the gastrointestinal tract, improve diarrhea symptoms and nutritional status, and shorten the course of the disease."
Children with blood and tumors are often accompanied by nutritional problems, and treatment such as radiotherapy and chemotherapy and stem cell transplantation and the consequent psychological trauma can easily lead to the deterioration of the nutritional status of children, so nutritional management of children with blood tumors is very important. Professor Liu Yufeng from the First Affiliated Hospital of Zhengzhou University and Professor Zhang Ruidong from Beijing Children's Hospital pointed out: "Malnutrition in children's tumor patients, clinical manifestations of weight loss, anorexia, fatigue and hypoproteinemia, etc., have higher requirements for energy and protein, and choosing some high-energy and high-protein formulas can help children quickly improve their nutritional status." At the same time, the hydrolyzed peptide formula rich in medium chain triglycerides is suitable for children with hematological tumors with gastrointestinal function impairment due to radiotherapy and chemotherapy, meeting their low-fat dietary needs, promoting disease recovery, and reducing complications and hospitalization costs."
Professor Tongxin Chen from Shanghai Children's Medical Center brought us an interpretation of the "Guidelines for the Diagnosis and Nutritional Intervention of Mild to Moderate Non-IgE-Mediated Cow's Milk Protein Allergy in Chinese Infants" published in the Chinese Journal of Practical Pediatrics in February this year. "The guidelines, which are based on international guidelines and combined with mainland clinical practice, have a total of 42 recommendations in 7 categories involving non-IgE-mediated cow's milk protein allergy," he said.
Children's growth and development are affected by many factors, and timely growth and development monitoring and intervention management are very important. Professor Sheng Xiaoyang from Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, pointed out: "The monitoring and evaluation of children's growth and development should be carried out as soon as possible, the cause should be detected in time, and intervention should be carried out as soon as possible. For children with physical growth deviations, dietary guidance and nutritional management, such as fortification, supplementation with high-quality protein, energy and other nutrients, and moderate catch-up growth are required, along with regular follow-up and evaluation."
Lactobacillus rhamnosus HN001 is listed in the list of 13 strains approved by the National Health Commission for infant food. Dr. Haiti Xu from Nestlé Health Sciences brought a study on the clinical efficacy and mechanism of the infant allergy strain Lactobacillus rhamnosus HN001, pointing out: "For infants and young children at high risk of allergies, supplementing with sufficient amounts of HN001 early in life may have a positive impact on skin hypersensitivity reactions, and the study of HN001 is of great significance for the clinical treatment of anti-allergy in infants and young children."
Specialist in nutrition management of childhood diseases
The 8th Nestlé Health Science nutrition forum was successfully concluded, which not only continued the scientific and high standard of the previous seven forums, but also provided new inspiration and new ideas for the clinical development of pediatrics. Nestlé Health Sciences, as the organizer of the forum, will continue to carry forward the tradition of research and development of science professions, practice the work guidance of General Secretary Xi Jinping's "four aspects for people's life and health", actively promote the new development of scientific nutrition, escort the healthy growth of Chinese children, and let the concept of nutrition support be deeply rooted in the hearts of the people in the context of the new era.
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Content review: Wang Dongfang, Liang Si
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Title image source: Figureworm Creative
Reference sources:
Shen Mei. Food allergies in infants and young children need to be paid attention to[J]. Food Industry, 2020, (4):72-73.
Wang Shanshan, Han Yonghe, Li Min, Metabolic regulation and mechanism of diet and intestinal microbiome on obesity[J].Chemistry of Life. 2021,41(03)
[3]. Blanchard C,JHrvi ACristianil,ete. Nestle:Ajoumey ofrescarch and innovationin the fightagainst allergicshtts:/www.nature.com/articles/42473-020-(00491-4.