all but one used regular vitamin D and iodine supplementation, indicating that Finnish vegan families are well familiar with the previously known nutritional requirements of vegan diets. However, current nutritional recommendations are based on studies conducted on adult vegans, and previous studies on metabolic effects of vegan diets in children do not exist. In their recently published article, Topi Hovinen, MD, and Liisa Korkalo, PhD, together with the multidisciplinary team led by academy professor Anu Suomalainen-Wartiovaara and docent Maijaliisa Erkkola studied comprehensively the nutrition and metabolism of 40 healthy children in day care centres of Helsinki. The children were following a vegan, vegetarian or omnivore diet according to the choice of their families. Their nutritional intake, metabolic biomarkers and micronutrient statuses were extensively studied. The children on a fully vegan diet were found to have significantly lower vitamin D levels compared to children without a special diet despite having regular vitamin D supplementation and blood samples being collected in late summer. Surprisingly, also their vitamin A status was lowered. Levels for LDL and HDL cholesterol, essential amino acids and docosahexaenoic acid, a fatty acid with a central role in development of visual function, were low while folate levels were remarkably high in vegan children. According to the researchers, the new findings motivate further and larger studies on the health consequences of a vegan diet in young children. c“The vegan families were active participants in our study. This is important, because without such voluntary contribution of the families it is not possible to undertake this kind of study,” remarked Korkalo. Reference Vegan diet in young children remodels metabolism and challenges the statuses of essential nutrients. EMBO Molecular Medicine (2021). doi: https://doi. org/10.15252/emmm.202013492
Corticosteroids may be an effective treatment for COVID-19 complications in children Corticosteroids may be an effective treatment for children who develop a rare but serious condition after COVID-19 infection. This is the finding of an international study of 614 children, published in the New England Journal of Medicine, led by Imperial College London. All children in the study developed a serious disorder following COVID-19 infection. This condition, called multi-system inflammatory syndrome in children (MISC), is thought to affect 1 in 50,000 children with SARS-CoV-2 infection. Paediatric inflammatory multi-system syndrome The new disorder, which is also called paediatric inflammatory multi-system syndrome temporally associated with SARSCoV-2 infection (PIMS-TS), affects children of all ages but is more common in older children and teenagers. The disorder generally occurs 2-6 weeks after infection with the SARS-CoV-2 virus. The illness is characterisedzzz by persistent high fever, often accompanied by abdominal pain, vomiting, red eyes and red rash. Severely affected children have developed heart inflammation, with shock and failure of multiple organs. Fortunately, with optimal treatment the majority of affected children have recovered well. However, worldwide most reports suggest a fatality rate of 2-4%. An important concern has been that some affected children have developed inflammation of their arteries that supply the heart with blood, resulting in widening of these arteries.
The finding that outcome is similar for patients treated with steroids alone as with those treated with steroids and immunoglobulin or immunoglobulin alone, suggests that steroids may be a cheaper and more available alternative to immunoglobulin. This is also known to happen in another condition called Kawasaki disease. The new study, supported by the EU’s Horizon 2020 programme, investigated two initial treatments for this condition: corticosteroids (such as methyl prednisolone) and antibody treatment (immunoglobulin). The antibodies come from human blood, and have been shown to reduce inflammation in the body. The study also compared initial treatment with steroids together with immunoglobulin. The study involved hundreds of doctors worldwide uploading information about patient outcomes onto an online database, and was not a randomised controlled trial. Three treatments All three treatments (immunoglobulin, immunoglobulin combined with corticoste-
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