Safe and unsafe duration of fasting for children with MCAD deficiency
To study the safe and unsafe duration of fasting in children with medium chain acyl-Coenzyme A dehydrogenase (MCAD) deficiency, the literature and the database on Dutch MCAD-deficient patients were searched for data on fasting studies in patients with MCAD deficiency. These data were extended with i...
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Published in | European journal of pediatrics Vol. 166; no. 1; pp. 5 - 11 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Heidelberg
Springer
2007
Berlin Springer Nature B.V |
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Abstract | To study the safe and unsafe duration of fasting in children with medium chain acyl-Coenzyme A dehydrogenase (MCAD) deficiency, the literature and the database on Dutch MCAD-deficient patients were searched for data on fasting studies in patients with MCAD deficiency.
These data were extended with information on fasting studies performed on our patients with MCAD deficiency known in the Beatrix Children's Hospital, UMC Groningen, The Netherlands. The data reflect considerable inter-individual variation and overlap between safe and unsafe duration of fasting.
In six out of 35 fasting tests, symptoms were reported before hypoglycaemia was observed. Until 1 year of age, the median safe and unsafe duration of fasting was 12 hours (n=7, range 8-19 hours) and 18 hours (n=5, range 15-20 hours), respectively. After the first year of life, the median safe and unsafe duration of fasting was 18 hours (n=17, range 10-24 hours) and 20 hours (n=9, range 13-32 hours), respectively.
Therefore, to conclude, we recommend a maximum duration of fasting in children with MCAD deficiency of 8 hours between 6 months and 1 year of age, 10 hours in the second year of life and 12 hours thereafter. From this study, no conclusions can be drawn on the duration of fasting during situations of intercurrent illness, especially with fever. |
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AbstractList | To study the safe and unsafe duration of fasting in children with medium chain acyl-Coenzyme A dehydrogenase (MCAD) deficiency, the literature and the database on Dutch MCAD-deficient patients were searched for data on fasting studies in patients with MCAD deficiency.
These data were extended with information on fasting studies performed on our patients with MCAD deficiency known in the Beatrix Children's Hospital, UMC Groningen, The Netherlands. The data reflect considerable inter-individual variation and overlap between safe and unsafe duration of fasting.
In six out of 35 fasting tests, symptoms were reported before hypoglycaemia was observed. Until 1 year of age, the median safe and unsafe duration of fasting was 12 hours (n=7, range 8-19 hours) and 18 hours (n=5, range 15-20 hours), respectively. After the first year of life, the median safe and unsafe duration of fasting was 18 hours (n=17, range 10-24 hours) and 20 hours (n=9, range 13-32 hours), respectively.
Therefore, to conclude, we recommend a maximum duration of fasting in children with MCAD deficiency of 8 hours between 6 months and 1 year of age, 10 hours in the second year of life and 12 hours thereafter. From this study, no conclusions can be drawn on the duration of fasting during situations of intercurrent illness, especially with fever. OBJECTIVETo study the safe and unsafe duration of fasting in children with medium chain acyl-Coenzyme A dehydrogenase (MCAD) deficiency, the literature and the database on Dutch MCAD-deficient patients were searched for data on fasting studies in patients with MCAD deficiency.MATERIALS AND METHODSThese data were extended with information on fasting studies performed on our patients with MCAD deficiency known in the Beatrix Children's Hospital, UMC Groningen, The Netherlands. The data reflect considerable inter-individual variation and overlap between safe and unsafe duration of fasting.RESULTSIn six out of 35 fasting tests, symptoms were reported before hypoglycaemia was observed. Until 1 year of age, the median safe and unsafe duration of fasting was 12 hours (n=7, range 8-19 hours) and 18 hours (n=5, range 15-20 hours), respectively. After the first year of life, the median safe and unsafe duration of fasting was 18 hours (n=17, range 10-24 hours) and 20 hours (n=9, range 13-32 hours), respectively.CONCLUSIONTherefore, to conclude, we recommend a maximum duration of fasting in children with MCAD deficiency of 8 hours between 6 months and 1 year of age, 10 hours in the second year of life and 12 hours thereafter. From this study, no conclusions can be drawn on the duration of fasting during situations of intercurrent illness, especially with fever. To study the safe and unsafe duration of fasting in children with medium chain acyl-Coenzyme A dehydrogenase (MCAD) deficiency, the literature and the database on Dutch MCAD-deficient patients were searched for data on fasting studies in patients with MCAD deficiency. These data were extended with information on fasting studies performed on our patients with MCAD deficiency known in the Beatrix Children's Hospital, UMC Groningen, The Netherlands. The data reflect considerable inter-individual variation and overlap between safe and unsafe duration of fasting. In six out of 35 fasting tests, symptoms were reported before hypoglycaemia was observed. Until 1 year of age, the median safe and unsafe duration of fasting was 12 hours (n=7, range 8-19 hours) and 18 hours (n=5, range 15-20 hours), respectively. After the first year of life, the median safe and unsafe duration of fasting was 18 hours (n=17, range 10-24 hours) and 20 hours (n=9, range 13-32 hours), respectively. Therefore, to conclude, we recommend a maximum duration of fasting in children with MCAD deficiency of 8 hours between 6 months and 1 year of age, 10 hours in the second year of life and 12 hours thereafter. From this study, no conclusions can be drawn on the duration of fasting during situations of intercurrent illness, especially with fever. |
Author | VAN SPRONSEN, Francjan J DERKS, Terry G. J SPAN, Mark M RAKE, Jan Peter SMIT, G. Peter A VAN DER HILST, Christian S |
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Cites_doi | 10.1016/0009-8981(85)90015-4 10.1016/S0022-3476(94)70363-9 10.1007/BF01800712 10.1001/jama.290.19.2564 10.1002/humu.1380010402 10.1016/0026-0495(82)90024-5 10.1016/S0002-8223(02)90386-X 10.1136/adc.70.5.410 10.1038/sj.ejhg.5201428 10.1053/meta.2001.20177 10.1007/BF01799733 10.1136/adc.67.1.142 10.3310/hta8120 10.1136/adc.80.5.459 10.1007/BF02072043 10.1016/S0022-3476(85)80514-X 10.1023/A:1022003726224 10.1136/adc.67.11.1387 10.1016/0009-8981(85)90186-X 10.1007/s00431-004-1558-y 10.1023/A:1024485117095 10.1136/adc.79.2.116 10.1016/0026-0495(83)90135-X 10.1136/adc.63.11.1353 |
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Keywords | Human Pediatrics Therapy Neonatal Fasting Inborn errors of metabolism Enzyme Deficiency Metabolic diseases Duration Medium chain acyl-Coenzyme A dehydrogenase Medium chain Medical screening Enzymopathy Congenital disease Acyl-CoA dehydrogenase Newborn Treatment Coenzyme A Oxidoreductases Fast Child Neonatal screening |
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Snippet | To study the safe and unsafe duration of fasting in children with medium chain acyl-Coenzyme A dehydrogenase (MCAD) deficiency, the literature and the database... OBJECTIVETo study the safe and unsafe duration of fasting in children with medium chain acyl-Coenzyme A dehydrogenase (MCAD) deficiency, the literature and the... |
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SubjectTerms | Acyl-CoA Dehydrogenase - deficiency Biological and medical sciences Child, Preschool Dehydrogenases Enzymes Fasting Fatty acids Fever General aspects Humans Hypoglycemia Infant Medical sciences Metabolism Metabolism, Inborn Errors - therapy Netherlands Oxidation Prevention and actions Public health. Hygiene Public health. Hygiene-occupational medicine Time Factors |
Title | Safe and unsafe duration of fasting for children with MCAD deficiency |
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