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Now the content of linoleic acid is different in different milks. Human milks contain 3-7% of the calories from linoleic acid. Common formulas contain 10%. Cows milk … see, this is human milk, this is one of the reasons why the cows milk formulas are supplemented. So if you just look at cows milk and fed that to a baby from the very beginning, you would get a baby that would be linoleic acid deficient. They would also be linolenic deficient. That’s why the formulas, which are based on cows milk, have taken and added linoleic acid but they outdo what even the humans, what the mothers produce. They’ve tried to make it a little bit better in this way and give 10% of the calories coming from linoleic acid. But human milk is 3-7%. Again, it’s the kind of thing you might be asked about.
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Recommendation of expert panel on blood cholesterol in children and adults. Greater than two-year-olds, no more than 30% of the total calories should come from fat. Saturated fat, less than 10% of the total calories should come from this. Intake of dietary cholesterol is not to exceed 300 mg per day. I mean, this is what the American Academy of Pediatrics, their panel of experts, says. So they are trying to … I don’t know how many children are following this but this is considered to be a relatively low fat diet. But really it’s quite a decent diet but it doesn’t allow for a lot of junk foods that contain fat.
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Let’s talk about the vitamins. Water soluble vitamins. These are the ones that are considered to be water soluble. So again it’s important to at least recognize them. The deficiency states with the water soluble vitamins; again, one of the typical things to recognize is that thiamin is associated with beriberi. And this is congestive heart failure, tachycardia, and peripheral edema. And the peripheral edema is believed to be associated with the congestive heart failure. So the main manifestation is by heart failure and its consequences. There is a so-called dry beriberi which also can be seen as a manifestation of B1 deficiency, which mainly has neurological manifestations associated with it and is more likely to be a complaint that one would see some of these things in the older children or adults. Again, it’s so uncommon. There are very few youngsters, at least in this country, who have ever experienced this state. But anything is possible. Riboflavin deficiency, clinical presentation; seborrheic dermatitis, hyalosis, photophobia. Be aware that some of these features can overlap with other nutritional deficiencies and you need to be able to separate them out or to show which conditions overlap, as you will see. Pyridoxine deficiency, again vitamin B6 deficiency. In newborns it can present as convulsions. In older children, skin manifestations as well as neurological manifestations, so there is overlap of some of these conditions and you need to be able to separate them out.