Dietary treatments for childhood constipation: Efficacy of dietary fiber and whole grains

Department of Human Nutrition, Food, and Animal Science, University of Hawaii at Manoa, Honolulu, Hawaii, USA.
Nutrition Reviews (Impact Factor: 6.08). 02/2013; 71(2):98-109. DOI: 10.1111/nure.12010
Source: PubMed


Constipation in children is defined on the basis of several clusters of symptoms, and these symptoms are likely to persist into adulthood. The aim of this review article is to summarize the current literature on the use of dietary fiber and whole grains as treatments for childhood constipation. Current recommendations for fiber intake in children vary substantially among organizations, suggesting that the function of fiber in children is not fully understood. Additionally, no formal definition of "whole grain" exists, which further complicates the interpretation of the literature. Few randomized controlled trials have examined the effect of dietary fiber supplementation in children with constipation. Currently, no randomized controlled trials have investigated the efficacy of whole grains in treating childhood constipation. This is an area that warrants further attention. Increasing the intake of dietary fiber and/or whole grain has the potential to relieve childhood constipation; however, additional randomized controlled trials are necessary to make a formal recommendation.

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    ABSTRACT: Chronic childhood functional constipation is highly prevalent and a public health problem. Prevention should begin early, since its onset after weaning is frequent. This chapter discusses breastfeeding, other preventive measures, and dietary fiber (DF) recommendations. Population surveys show that DF intake is mostly below what is recommended. An adequate DF intake from weaning onwards seems fundamental, but recommendations concerning complementary foods/DF for premature weaning, and DF for 6- to 12-month-olds, are lacking.The relationship between DF intake and constipation is presented, along with a detailed account of the factors possibly involved in the conflicting data. A vicious circle maintains and aggravates constipation; thus, treatment should not be postponed. A DF-dense diet is recommended, but little emphasis is placed on this in the guidelines. The chapter provides a dietary treatment schedule, proposals to implement its acceptance, and a summary of studies in adults and children evaluating dietary treatment of constipation with emphasis on supplements with DF/wheat bran. More studies are necessary to recommend DF supplements. Nevertheless, DF treatment of constipation should not be neglected, since, in general, studies show its beneficial effects.
    No preview · Article · Mar 2014
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    ABSTRACT: The aim of this chapter is to present an overview of the significance of traditional food items and their components as targets of research for functional foods and dietary supplements. Sugar is one of the most successfully marketed nutritional chemicals, which addicts consumers from a time when they are very young. Understanding the role of foods in the maintenance of health and cure of diseases has its roots in ancient culture. Nutraceuticals are food or food ingredients that have defined physiological effects. Functional foods must remain foods and they must achieve their effects in amounts normally consumed in a diet. Evidence from human studies, based on markers relating to biological response or on intermediate endpoint markers of disease, could provide a sound scientific basis for messages and claims about the functional food products. There are different theories about how the health behavior of people can be modified. The better functionality of the foods can be promoted in different ways. There are many natural varieties of plants grown as part of agriculture. Better understanding of their nutritionally valuable components may revitalize their cultivation, as has taken place in the case of ancient wheat varieties. The International Alliance of Dietary Food Supplement Associations (IADSA) works closely with these international bodies to ensure that the views of the dietary supplement industry are taken into account in the development of policy.
    No preview · Chapter · Apr 2014
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    ABSTRACT: Objectives: The aim of the study was to analyze the knowledge, approaches, and practices of pediatricians participating in a regional pediatric conference regarding functional constipation (FC) to identify knowledge gaps. Methods: Cross-sectional regional study based on a semistructured questionnaire related to the Rome III criteria and the participant profiles. Results: Of 400 questionnaires distributed, 264 (66.0%) were completed. Most pediatricians (76.7%) did not recognize the Rome III criteria, but the majority did recognize the following risk factors for FC: low-fiber diet (97.8%), family history (86.6%), onset of toilet training (76.4%), and weaning (62.4%). Foods considered high in fiber were oats (95.7%), leafy vegetables (95.3%), and wheat bran (93.2%). Digital rectal examination was not performed by 57.7% of nongastroenterologists. Complementary examinations were ordered in 27.5% and 72.5% of patients by general pediatricians and pediatric gastroenterologists, respectively, although the sample of gastroenterologists was not representative. The most prescribed drugs by nongastroenterologists were mineral oil (72.6%), magnesium hydroxide (52.1%), lactulose (41.0%), and polyethylene glycol (25.2%). Pediatric gastroenterologists prescribed magnesium hydroxide (91.7%), polyethylene glycol (91.7%), and mineral oil (58.3%). Most pediatricians (70.0%) considered the average treatment duration to be less than 1 year, although gastroenterologists considered it to be more than 1 year (54.6%). Conclusions: The knowledge of pediatricians regarding FC is inadequate. Constipation may not receive the public health attention it deserves within pediatric residency programs. The authors suggest that better education regarding FC should be included in medical school and residency program curricula to improve patient care.
    No preview · Article · Feb 2015 · Journal of Pediatric Gastroenterology and Nutrition
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