OnFoods at Parma Pediatria 2023

The increasing speed at which new information relevant to a more precise diagnosis, as well as more effective prevention and treatment of pediatric diseases, is acquired, demands periodic updates of easily accessible and high-quality information for those involved in monitoring children's health.

To meet these needs, Parma Pediatrics aims to inform pediatricians and all those involved in child health about the latest and most interesting discoveries made in recent times. Food and nutrition are clearly among the key topics.

Spoke 05 "Lifelong Nutrition" aims to promote food and nutrition security through a life-course approach according to the needs of different population groups based on age, gender, and predisposition to the disease. It is intended to facilitate models for healthy nutritional schemes by mapping the national population status, including specific population targets, and by disseminating the healthy and sustainable principles of the Mediterranean Diet.

Beyond the simple act of consuming various meals, eating food always concerns the human body's acquisition of certain nutrients, which, depending on their own properties, contribute differently to both physical and cognitive development.

Proper nutrition, essential for human survival and growth, is particularly important during childhood, representing for children a period of rapid body and brain development, progress, and activity. The early years of life, namely the first infants’ 1,000.

The first 1,000 days of life - from conception to 24 months - have been, in fact, recognised as a unique window of opportunities for healthier beginnings and long-term benefits. The Lancet series on “Maternal and Child Undernutrition” in 2008 recognised for the first time the importance of ‘early life nutrition’ for growth and development. Further studies in this regard have indicated that proper nutrition during the earliest period of life, including child-feeding practices like breastfeeding and supplemental feeding and the maternal diet during pregnancy and lactation, plays a critical role in the rapid growth of a child, ensuring optimal chances to develop their full potential. On the contrary, it has been demonstrated that malnutrition occurring during pregnancy and through children’s second birthday irreversibly affects the health and development of a child, with harmful short-term and long-term consequences, of which many associated with a high mortality risk, delayed cognitive development, higher vulnerability to infectious diseases.

According to the most recent publication jointly produced by UNICEF, WHO and the World Bank (2021), in 2020, an estimated 45 million children under the age of five were suffering from wasting, the deadliest form of malnutrition, which increases children’s risk of death by up to 12 times. 149 million children under the age of five had stunted growth and development due to a chronic lack of essential nutrients in their diets, while 39 million were overweight. During the same year, at least 32 million pregnant and breastfeeding women experienced different forms of micronutrient deficiency.

The “PERMED” project, namely “Early nutrition with PERsonalized MEDiterranean diet to decrease long-term chronic diseases burden: the PERMED study”, developed within OnFoods’ Spoke 05 and its Work Package 5.3, in addressing the impact of proper nutrition on long-term health and the lifespan, aims to develop personalised Mediterranean algorithm-based diets to help decrease postprandial blood glucose levels in pregnant women and children.

In order to achieve the project’s expected results, the research team involved will undertake a prospective clinical trial to investigate the effects of a standardised Mediterranean diet versus a standardised Western diet on the health of 100 pregnant women and 100 healthy children. The participants will be randomly assigned to one of the two diets. Throughout the trial, they will collect continuous glucose blood monitoring and serial blood tests, stool samples for microbiome analysis, and urine for metabolomics analysis. Additional data will be gathered using a specific app to track anthropometrics, blood pressure, dietary intake, physical activity, and sleep-wake rhythm. These data will be integrated to develop an algorithm, which will be validated in two independent prospective cohorts following the trials.

The project’s objective is to assess the effectiveness of an algorithm in predicting the post-meal glucose response for children and pregnant women on an individualised basis. By creating and validating these algorithms, it is hoped that personalised Mediterranean diet plans can be established to reduce the occurrence of hyperglycaemia and gestational diabetes during pregnancy. Additionally, the use of this model in paediatrics is expected to have an immediate impact on reducing overweight and obesity. In the long term, it is anticipated that there will be a decrease in the incidence of metabolic syndrome and diabetes overall.

"The PERMED study has been developed starting from the assumpt that Universal dietary recommendations may not suit everyone. Our project will allow us to develop a personalized Mediterranean Diet algorithms in pregnant mothers that will be hopefully able to decrease the incidence of gestational diabetes and to have an impact on the onset of overweight and obesity in their inborns at 24 months." Annamaria Staiano