Oral protein calorie supplementation for children with chronic disease
Editorial Group: Cochrane Cystic Fibrosis and Genetic Disorders Group
Published Online: 26 JUL 1999
Assessed as up-to-date: 9 NOV 2008
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
How to Cite
Poustie VJ, Smyth RL, Watling RM. Oral protein calorie supplementation for children with chronic disease. Cochrane Database of Systematic Reviews 1999, Issue 3. Art. No.: CD001914. DOI: 10.1002/14651858.CD001914.
- Publication Status: Edited (no change to conclusions)
- Published Online: 26 JUL 1999
Poor growth and nutritional status are common in children with chronic diseases. Oral protein calorie supplements are used to improve nutritional status in these children. These expensive products may be associated with some adverse effects, e.g. development of inappropriate eating behaviour patterns.
To examine evidence that in children with chronic disease, oral protein calorie supplements alter daily nutrient intake, nutritional indices, survival and quality of life and are associated with adverse effects, e.g. diarrhoea, vomiting, reduced appetite, glucose intolerance, bloating and eating behaviour problems.
Trials of oral protein calorie supplements in children with chronic diseases were identified through comprehensive electronic database searches, handsearching relevant journals and abstract books of conference proceedings. Companies marketing these products were also contacted.
Most recent search of the Group's Trials Register: April 2008.
Randomised or quasi-randomised controlled trials comparing oral protein calorie supplements for at least one month to increase calorie intake with existing conventional therapy (including advice on improving nutritional intake from food or no specific intervention) in children with chronic disease.
Data collection and analysis
We assessed: indices of nutrition and growth; anthropometric measures of body composition; calorie and nutrient intake (total from oral protein calorie supplements and food); eating behaviour; compliance; quality of life; specific adverse effects; disease severity scores; and mortality.
Three studies (135 children) met the inclusion criteria . All three studies were carried out in children with cystic fibrosis. Few statistical differences were found between treatment and control groups, except change in total energy intake at six and twelve months, mean difference 304.86 kcal/day (95% confidence interval 5.62 to 604.10) and mean difference 265.70 kcal/day (95% confidence interval 42.94 to 485.46) respectively. However, these were based on the analysis of 58 children in one study. No studies were identified assessing the effectiveness of oral protein calorie supplements in children with other chronic diseases.
Oral protein calorie supplements are widely used to improve the nutritional status of children with a number of chronic diseases. We identified a small number of studies assessing these products in children with cystic fibrosis, but were unable to draw any conclusions based on the limited data extracted. We recommend a series of large, randomised controlled trials be undertaken investigating the use of these products in children with different chronic diseases. Until further data are available, we suggest these products are used with caution.
Plain language summary
The use of oral protein calorie supplements in children with chronic disease
A lack of growth and poor nutrition are common in children with chronic diseases like cystic fibrosis and kidney disease. This may be due to reduced appetite, food not being absorbed properly and the need for extra calories caused by their disease. Oral protein calorie supplements are widely used to improve nutritional status and weight gain. These can take the form of whole protein milk or juice drinks. Adverse effects include the risk that the protein and calories in the supplement may replace those from normal food intake. This may have a negative effect on eating behaviours. It can also cause bloating, vomiting and diarrhoea due to potential for rapid ingestion of high calorie liquid. The review includes three studies with 135 children, all of whom had cystic fibrosis. We found insufficient evidence to support the use of these supplements. Until further data are available, we suggest these products are used with caution.
經由比較電子資料庫、handsearching相關期刊和會議論文摘要，RCTs出版物提到對罹患慢性疾病的孩童使用口服高蛋白質營養補充品的資料。並聯繫銷售產品的公司。最近一次進入Group's Trials Register檢索的日期為2004年11月。
此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。