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This Month in Archives of Pediatrics & Adolescent Medicine
Arch Pediatr Adolesc Med. 2008;162(6):503.
Hypovitaminosis D: A Systematic Review of the Current Evidence
There is increasing recognition of the importance of vitamin D for various aspects of health. In this systematic review of studies on the prevalence of vitamin D deficiency, Rovner and O’Brien found that there were no consistent definitions of vitamin D deficiency or of tests used to measure serum levels in these studies. Their review does indicate that vitamin D deficiency is prevalent, affecting healthy children of all ages and races. Breastfed infants in the winter who did not receive vitamin D supplementation were the group most commonly affected. Other risk factors for vitamin D deficiency were winter season, black race, and a higher body mass index. Efforts to address vitamin D deficiency are indicated and may include further vitamin D fortification of foods and other methods of vitamin supplementation.
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Prolonged Heart Rate–Corrected QT Interval During Diabetic Ketoacidosis in Children
Prior studies have suggested an association between prolonged QT interval corrected for heart rate (QTc) and various ketotic conditions, such as diabetic ketoacidosis (DKA), ketogenic diets, and very-low-carbohydrate, calorie-restricted diets. This study assessed the QTc in 30 children during acute and after recovery from DKA. Nearly half (47%) of the children had a prolonged QTc during DKA, and 4 had persistently prolonged QTc during recovery. The QTc correlated with the anion gap during DKA, but not with the serum potassium, calcium, or magnesium levels. Cardiac monitoring during ketosis is warranted to avoid fatal arrhythmia.
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Association Between 100% Juice Consumption and Weight in Children Aged 2 to 11 Years
Food consumption patterns may play an important role in the increasing prevalence of overweight in children. One potential source of calories for children is 100% fruit juice. Using data from the National Health and Nutrition Examination Survey, Nicklas and colleagues found that children 2 to 11 years of age who consumed 100% fruit juice had higher daily intakes of energy and carbohydrates, fruit consumption, and intake of many vitamins and minerals compared with children who did not drink 100% fruit juice. However, consumers of fruit juice also had lower intakes of fat and added sugar, but there was no difference in milk consumption. There was no relationship between weight and the consumption of fruit juice. The evidence supports the nutritional benefits of 100% fruit consumption.
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Figure. Discretionary fat and added sugar intakes by 100% juice consumption in children aged 2 to 11 years. * Indicates significantly different than no juice consumption (P < .001).
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The Impact of Kinship Care for Children in Out-of-Home Care
The last 2 decades have brought significant growth in the number of children being raised by relatives in kinship care in the United States. The most common reason for kinship care is placement after reports of child abuse or neglect. The evidence is conflicting on whether children fare better in kinship or foster care. This study examined the prevalence of behavior problems in 1309 children 18 and 36 months after placement in out-of-home care following a maltreatment report. The authors found that 32% of children initially placed into kinship had behavior problems at follow-up compared with 46% of those who were in foster care. Children who moved from one home to another had substantially more behavior problems than children who had a stable placement. This study suggests that timely entry into kinship care for maltreated children is beneficial for them and should be facilitated.
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Figure. Standardized estimates of behavior problems at 36 months in out-of-home care stratified by a child's placement setting and placement stability. These data are marginally standardized using survey-weighted logistic regression, adjusting for the risk for instability and reunification status of the child. Probabilities presented with 95% confidence intervals.
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