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Evaluation of the Validity of a Food Frequency Questionnaire and 24-Hour Dietary Recall to Assess Dietary Iron Intake in Children and Adolescents from the South American Youth/Child Cardiovascular and Environmental Study. J Acad Nutr Diet 2021; 122:384-393. [PMID: 34463258 DOI: 10.1016/j.jand.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/07/2021] [Accepted: 07/17/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND A food frequency questionnaire (FFQ) for South American children and adolescents was developed, but its validity for assessing dietary iron intake has not been evaluated. OBJECTIVE To evaluate the validity of the FFQ and 24-hour dietary recalls (24h-DR) for assessing dietary iron intake in children and adolescents. DESIGN The South American Youth/Child Cardiovascular and Environmental study is a multicenter observational study, conducted in five South American cities: Buenos Aires (Argentina), Lima (Peru), Medellin (Colombia), Sao Paulo, and Teresina (Brazil). The FFQ assessed dietary intake over the previous 3 months, and the 24h-DR was completed three times (2 weekdays and 1 weekend day) with a minimum 5-day interval between recalls. Blood samples were collected to assess serum iron, ferritin, and hemoglobin levels. PARTICIPANTS AND SETTING Data of 99 children (aged 3 to 10 years) and 50 adolescents (aged 11 to 17 years) from public and private schools were collected during 2015 to 2017. MAIN OUTCOME MEASURES Dietary iron intake calculated from the FFQ (using the sum of daily iron intake in all food/food groups) and 24h-DR (mean of 3 days using the multiple source method). STATISTICAL ANALYSES PERFORMED Dietary iron intake in relation to blood biomarkers were assessed using Spearman rank correlations adjusted for sex, age, and total energy intake, and the quadratic weighted κ coefficients for agreement. RESULTS Spearman correlations showed very good coefficients (range = 0.78 to 0.85) for the FFQ in both age groups; for the 24h-DR, the coefficients were weak in children and adolescents (range = 0.23 to 0.28). The agreement ranged from 59.9% to 72.9% for the FFQ and from 63.9% to 81.9% for the 24h-DR. CONCLUSION The South American Youth/Child Cardiovascular and Environmental study FFQ exhibited good validity to rank total dietary iron intake in children and adolescents, and as well as the 24h-DR, presented good strength of agreements when compared with serum iron and ferritin levels.
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Mendes FDC, Paciência I, Cavaleiro Rufo J, Farraia M, Silva D, Padrão P, Delgado L, Garcia-Larsen V, Moreira A, Moreira P. Higher diversity of vegetable consumption is associated with less airway inflammation and prevalence of asthma in school-aged children. Pediatr Allergy Immunol 2021; 32:925-936. [PMID: 33394508 DOI: 10.1111/pai.13446] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND A diet rich in fruits and vegetables has been suggested to counteract the oxidative stress and inflammation that characterize asthma. We aimed to assess the association between vegetable and fruit diversity consumption and asthma and its related outcomes in school-aged children. METHODS Participants included 647 children (49% females, aged 7-12 years) recruited from 20 public schools across the city of Porto, in Portugal. Vegetable intake and fruit intake were ascertained using a single self-reported 24-hour recall questionnaire. A diversity score was built taking into account the different number of individual vegetables and fruits consumed and categorized into two groups based on the total reported median consumption, which was rounded to the nearest whole number (≤3 and >3, for vegetables; and ≤1 and >1, for fruits). A questionnaire was used to enquire about self-reported medical diagnosis of asthma and respiratory symptoms. Airway inflammation was assessed measuring exhaled fractional nitric oxide concentration (eNO) and was categorized into two groups (<35 and ≥35 ppb). The association between fruit and vegetable diversity and respiratory outcomes was examined using logistic regression models, adjusting for confounders. RESULTS A higher vegetable diversity consumption per day was negatively associated with having self-reported asthma (OR = 0.67; 95% CI 0.47, 0.95), while having a vegetable diversity consumption superior to 3 items per day was negatively associated with levels of eNO ≥ 35 ppb (OR = 0.38; 95% CI 0.16, 0.88) and breathing difficulties (OR = 0.39; 95% CI 0.16, 0.97). CONCLUSION Eating a greater variety of vegetables was associated with a lower chance of airway inflammation and prevalence of self-reported asthma in school children.
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Affiliation(s)
- Francisca de Castro Mendes
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Inês Paciência
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - João Cavaleiro Rufo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Mariana Farraia
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Diana Silva
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,Serviço de Imunoalergologia, Centro Hospitalar São João, Porto, Portugal
| | - Patrícia Padrão
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - Luís Delgado
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,Serviço de Imunoalergologia, Centro Hospitalar São João, Porto, Portugal
| | - Vanessa Garcia-Larsen
- Program in Human Nutrition, Department of International Health, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - André Moreira
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Serviço de Imunoalergologia, Centro Hospitalar São João, Porto, Portugal.,Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - Pedro Moreira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
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Lee J, Kubik MY, Fulkerson JA. Fruit and Vegetable Snack Consumption Among Children With a Body Mass Index at or Above the 75th Percentile. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:619-624. [PMID: 33674237 PMCID: PMC8277684 DOI: 10.1016/j.jneb.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To describe fruit and vegetable (FV) consumption as snacks and the association with diet quality and compare the snacking environment and child and parent characteristics between children who consumed FV as snacks and those who did not. METHODS This secondary analysis study used baseline data from a healthy weight management study with 8- to 12-year-old children with a body mass index ≥75th percentile. Data collection included 24-hour dietary recalls, measured height/weight, and child and parent surveys. RESULTS Children (n = 119) consumed 0.1 cup equivalent per 1,000 kcal of FV as snacks, the equivalent of 16.9% of their daily FV consumption. More FV consumption as snacks occurred at home when a parent was present and was associated with higher parent support for FV consumption as snacks (P = 0.03). CONCLUSIONS AND IMPLICATIONS Renewed attention to strategies to promote FV consumption as snacks, especially at away-from-home locations, is merited.
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Affiliation(s)
- Jiwoo Lee
- School of Nursing, University of Minnesota, Minneapolis, MN.
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54
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Maltoni G, Zioutas M, Deiana G, Biserni GB, Pession A, Zucchini S. Gender differences in weight gain during lockdown due to COVID-19 pandemic in adolescents with obesity. Nutr Metab Cardiovasc Dis 2021; 31:2181-2185. [PMID: 33994065 DOI: 10.1016/j.numecd.2021.03.018] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/14/2021] [Accepted: 03/18/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIM Lockdown due to COVID-19 pandemic has forced a decrease in physical activity (PA), an increase in sedentary behavior (SB) and a possibly worsening of fat accumulation in already obese subjects. The aim of this study was to investigate how social restriction may have contributed to weight changes in adolescents with obesity. Secondary aim was to evaluate possible parameters influencing weight changes. METHODS AND RESULTS Parameters of 51 obese adolescents were compared between two visits: within 2 months before 8 March, start of lockdown, and within 40 days after the end of it. RESULTS Mean weight gain during lockdown was 2.8 ± 3.7 kg (p < 0.001). Weight increase was higher in males than in females (3.8 ± 3.4 kg vs 1.2 ± 3.7 kg, p = 0.02). The hours dedicated to SB increased (+2.9 ± 2.8 h/day; p < 0.001) while the hours of PA decreased (-1.0 ± 1.6 h/week; p < 0.001). Males spent more hours in SB than females (+3.8 ± 2.7 h/day vs +1.5 ± 2.5 h/day; p = 0.003). There were minor changes in diet during lockdown. The most significant variables influencing both delta BMI and waist/height ratio increase were hours devoted to SB during lockdown and differences in mild and moderate PA before and after lockdown. CONCLUSIONS Obese adolescents showed a worsening of obesity during lockdown, with males mainly affected, mainly due to a reduced mild PA and increased hours spent in SB.
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Affiliation(s)
- Giulio Maltoni
- Pediatric Unit, Department of Woman, Child and Urologic Diseases, University of Bologna, IRCCS S.Orsola-Malpighi Hospital, Italy
| | - Maximiliano Zioutas
- Pediatric Unit, Department of Woman, Child and Urologic Diseases, University of Bologna, IRCCS S.Orsola-Malpighi Hospital, Italy
| | - Giuseppina Deiana
- Pediatric Unit, Department of Woman, Child and Urologic Diseases, University of Bologna, IRCCS S.Orsola-Malpighi Hospital, Italy
| | - Giovanni Battista Biserni
- Pediatric Unit, Department of Woman, Child and Urologic Diseases, University of Bologna, IRCCS S.Orsola-Malpighi Hospital, Italy
| | - Andrea Pession
- Pediatric Unit, Department of Woman, Child and Urologic Diseases, University of Bologna, IRCCS S.Orsola-Malpighi Hospital, Italy
| | - Stefano Zucchini
- Pediatric Unit, Department of Woman, Child and Urologic Diseases, University of Bologna, IRCCS S.Orsola-Malpighi Hospital, Italy.
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55
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A comparison of the remote food photography method and the automated self-administered 24-h dietary assessment tool for measuring full-day dietary intake among school-age children. Br J Nutr 2021; 127:1269-1278. [PMID: 34085613 DOI: 10.1017/s0007114521001951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The limitations of self-report measures of dietary intake are well-known. Novel, technology-based measures of dietary intake may provide a more accurate, less burdensome alternative to existing tools. The first objective of this study was to compare participant burden for two technology-based measures of dietary intake among school-age children: the Automated-Self-Administered 24-hour Dietary Assessment Tool-2018 (ASA24-2018) and the Remote Food Photography Method (RFPM). The second objective was to compare reported energy intake for each method to the Estimated Energy Requirement for each child, as a benchmark for actual intake. Forty parent-child dyads participated in two, 3-d dietary assessments: a parent proxy-reported version of the ASA24 and the RFPM. A parent survey was subsequently administered to compare satisfaction, ease of use and burden with each method. A linear mixed model examined differences in total daily energy intake between assessments, and between each assessment method and the Estimated Energy Requirement (EER). Reported energy intake was 379 kcal higher with the ASA24 than the RFPM (P = 0·0002). Reported energy intake with the ASA24 was 231 kcal higher than the EER (P = 0·008). Reported energy intake with the RFPM did not differ significantly from the EER (difference in predicted means = -148 kcal, P = 0·09). Median satisfaction and ease of use scores were five out of six for both methods. A higher proportion of parents reported that the ASA24 was more time-consuming than the RFPM (74·4 % v. 25·6 %, P = 0·002). Utilisation of both methods is warranted given their high satisfaction among parents.
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56
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Cohen J, Goddard E, Brierley ME, Bramley L, Beck E. Poor Diet Quality in Children with Cancer During Treatment. J Pediatr Oncol Nurs 2021; 38:313-321. [PMID: 33960867 DOI: 10.1177/10434542211011050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: With improved long-term health outcomes and survivorship, the long-term nutritional management of childhood cancer survivors, from diagnosis to long-term follow-up, has become a priority. The aim of this study was to examine the diet quality of children receiving treatment for cancer. Methods: Participants were parents of children with cancer who were receiving active treatment and not receiving supplementary nutrition. A 24-h dietary recall assessed food and nutrient intake. Serves of food group intakes and classification of core and discretionary items were made according to the Australian Dietary Guidelines and compared with age and sex recommendations. Results: Sixty-four parents participated (75% female). Most children were not consuming adequate intake of vegetables (94% of patients), fruit (77%), and milk/alternatives (75%). Of the vegetables that were consumed, half were classified as discretionary foods (e.g., chips/fries). Nearly half (49%) of children exceeded recommendations for total sugar intake and 65% of patients had an excessive sodium intake. Discussion: Children receiving cancer treatment are consuming diets of reasonable quantity, but poor quality. Information provided during treatment should focus on educating parents on a healthy diet for their child, the importance of establishing healthy eating habits for life, and strategies to overcome barriers to intake during treatment.
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Affiliation(s)
- Jennifer Cohen
- School of Women's and Children's Health, 7800UNSW Sydney, Sydney, NSW, Australia.,Kids Cancer Centre, 63623Sydney Children's Hospital, Sydney, Australia
| | - Emma Goddard
- School of Medicine, 8691University of Wollongong & Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Mary-Ellen Brierley
- School of Women's and Children's Health, 7800UNSW Sydney, Sydney, NSW, Australia
| | - Lynsey Bramley
- Kids Cancer Centre, 63623Sydney Children's Hospital, Sydney, Australia
| | - Eleanor Beck
- School of Medicine, 8691University of Wollongong & Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
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57
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Korczak DJ, Perruzza S, Chandrapalan M, Cost K, Cleverley K, Birken CS, McCrindle BM. The association of diet and depression: an analysis of dietary measures in depressed, non-depressed, and healthy youth. Nutr Neurosci 2021; 25:1948-1955. [PMID: 33939946 DOI: 10.1080/1028415x.2021.1918981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The association of diet quality with depression among the pediatric age group has been inconsistent. This may be due, in part, to varying dietary assessment methods. The current study sought to examine this association, and its reliability, using four dietary measures previously studied in children and adolescents. METHODS Dietary habits among 139 children and adolescents (10-18 years, 66% female) with major depressive disorder [MDD (n = 77)], non-MDD psychiatric conditions (PSYCH; n = 31), or without psychiatric illness (healthy controls [HC]; n = 31) were examined. Using self-reported dietary intake, diet quality was characterized using the Youth Healthy Eating Index (YHEI), Dietary Questionnaire (DQ), Health Behaviour of Teenagers (HBT), and the Healthy Eating Habits Scale (HEHS). Multivariate Analysis of Covariances examined the association between depression status and dietary habits across measures controlling for participant age. RESULTS The multivariate effect was significant by diet measures, F (16, 256) = 1.9, p = .02, partial η2 = 0.12, with significant differences across groups on consumption of healthy dietary practices and minimal variability across measures. In subgroup analyses, MDD children had decreased consumption of healthy foods compared with PSYCH and HC children on three out of four measures. There was no difference in consumption of unhealthy foods across diagnostic groups. LIMITATIONS Cross-sectional design. CONCLUSIONS Children with MDD consume fewer healthy foods than non-MDD children, with little variation by dietary measure. Research examining the directionality of this association and specific dietary deficits among MDD youth is needed to elucidate potential preventative targets for intervention.
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Affiliation(s)
- Daphne J Korczak
- Neuroscience and Mental Health, SickKids' Research Institute, Toronto, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Stephanie Perruzza
- Neuroscience and Mental Health, SickKids' Research Institute, Toronto, Canada
| | | | - Katherine Cost
- Neuroscience and Mental Health, SickKids' Research Institute, Toronto, Canada
| | - Kristin Cleverley
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.,Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.,Margaret and Wallace McCain Centre for Child, Youth, and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Canada
| | - Catherine S Birken
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Brian M McCrindle
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada.,Division of Cardiology, Department of Pediatrics, Hospital for Sick Children, Toronto, Canada
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58
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Increasing Vegetable Diversity Consumption Impacts the Sympathetic Nervous System Activity in School-Aged Children. Nutrients 2021; 13:nu13051456. [PMID: 33922948 PMCID: PMC8146093 DOI: 10.3390/nu13051456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 11/17/2022] Open
Abstract
Evidence about the impact of vegetable and fruit diversity consumption on the autonomic nervous system (ANS) functioning is scarce. In this cross-sectional study (513 participants, 49.9% girls aged 7 to 12 years), we evaluated the association between vegetable and fruit diversity consumption and the ANS in school-aged children. Dietary intake was collected using a single 24-h recall questionnaire. Fruit and vegetable diversity consumption was estimated by summing up all the different individual vegetables and fruits consumed in one day. Pupillometry was used to assess pupillary light response, which evaluated the ANS activity. Adjusted linear regressions estimated the association between vegetable and fruit diversity consumption with pupillary light response measures. There was a positive and significant association between vegetable diversity consumption and the average dilation velocity, a measure related to the sympathetic nervous system activity (β-coefficient = 0.03, 95%CI: 0.002; 0.07). Our findings show that vegetable diversity consumption is associated with the ANS response, a possible early link between diet and health in school-aged children.
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59
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Sawh MC, Wallace M, Shapiro E, Goyal NP, Newton KP, Yu EL, Bross C, Durelle J, Knott C, Gangoiti JA, Barshop BA, Gengatharan JM, Meurs N, Schlein A, Middleton MS, Sirlin CB, Metallo CM, Schwimmer JB. Dairy Fat Intake, Plasma Pentadecanoic Acid, and Plasma Iso-heptadecanoic Acid Are Inversely Associated With Liver Fat in Children. J Pediatr Gastroenterol Nutr 2021; 72:e90-e96. [PMID: 33399331 PMCID: PMC8842839 DOI: 10.1097/mpg.0000000000003040] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES We sought to evaluate the relevance of pediatric dairy fat recommendations for children at risk for nonalcoholic fatty liver disease (NAFLD) by studying the association between dairy fat intake and the amount of liver fat. The effects of dairy fat may be mediated by odd chain fatty acids (OCFA), such as pentadecanoic acid (C15:0), and monomethyl branched chain fatty acids (BCFA), such as iso-heptadecanoic acid (iso-C17:0). Therefore, we also evaluated the association between plasma levels of OCFA and BCFA with the amount of liver fat. METHODS Observational, cross-sectional, community-based sample of 237 children ages 8 to 17. Dairy fat intake was assessed by 3 24-hour dietary recalls. Plasma fatty acids were measured by gas chromatography-mass spectrometry. Main outcome was hepatic steatosis measured by whole liver magnetic resonance imaging proton density fat fraction (MRI-PDFF). RESULTS Median dairy fat intake was 10.6 grams/day (range 0.0--44.5 g/day). Median liver MRI-PDFF was 4.5% (range 0.9%-45.1%). Dairy fat intake was inversely correlated with liver MRI-PDFF (r = -0.162; P = .012). In multivariable log linear regression, plasma C15:0 and iso-C17:0 were inverse predictors of liver MRI-PDFF (B = -0.247, P = 0.048; and B = -0.234, P = 0.009). CONCLUSIONS Dairy fat intake, plasma C15:0, and plasma iso-C17:0 were inversely correlated with hepatic steatosis in children. These hypothesis-generating findings should be tested through clinical trials to better inform dietary guidelines.
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Affiliation(s)
- Mary Catherine Sawh
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
| | - Martina Wallace
- Department of Bioengineering, University of California, San Diego, La Jolla, California
| | - Emma Shapiro
- Boston University College of Health & Rehabilitation Sciences: Sargent College, Boston, Massachusetts
| | - Nidhi P. Goyal
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
- Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California
| | - Kimberly P. Newton
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
- Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California
| | - Elizabeth L. Yu
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
- Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California
| | - Craig Bross
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
| | - Janis Durelle
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
| | - Cynthia Knott
- Altman Clinical and Translational Research Institute, School of Medicine, University of California, San Diego, La Jolla
| | - Jon A. Gangoiti
- Division of Genetics, Biochemical Genetics and Metabolomics Laboratory, Department of Pediatrics; University of California San Diego; La Jolla, California
| | - Bruce A. Barshop
- Division of Genetics, Biochemical Genetics and Metabolomics Laboratory, Department of Pediatrics; University of California San Diego; La Jolla, California
| | - Jivani M. Gengatharan
- Department of Bioengineering, University of California, San Diego, La Jolla, California
| | - Noah Meurs
- Department of Bioengineering, University of California, San Diego, La Jolla, California
| | - Alexandra Schlein
- Liver Imaging Group, Department of Radiology, University of California San Diego, La Jolla, California
| | - Michael S. Middleton
- Liver Imaging Group, Department of Radiology, University of California San Diego, La Jolla, California
| | - Claude B. Sirlin
- Liver Imaging Group, Department of Radiology, University of California San Diego, La Jolla, California
| | - Christian M. Metallo
- Department of Bioengineering, University of California, San Diego, La Jolla, California
| | - Jeffrey B. Schwimmer
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
- Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California
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Edwards S, Hyman PE, Mousa H, Bruce A, Cocjin J, Dean K, Fleming K, Romine RS, Davis AM. iKanEat: protocol for a randomized controlled trial of megestrol as a component of a pediatric tube weaning protocol. Trials 2021; 22:169. [PMID: 33640012 PMCID: PMC7913389 DOI: 10.1186/s13063-021-05131-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/13/2021] [Indexed: 11/10/2022] Open
Abstract
Background Although tube feeding routinely saves the lives of children who do not eat by mouth, chronic tube feeding can be a burden to patients, caregivers, and families. Very few randomized trials exist regarding the best methods for weaning children from their feeding tubes. Methods The current paper describes a randomized controlled trial of an empirically supported outpatient treatment protocol for moving children from tube to oral eating called iKanEat. Specifically, we describe the methods of randomized double-blind, placebo-controlled trial which includes a 4-week course of megestrol, the only medication used in the iKanEat protocol, to determine whether the addition of megestrol results in improved child outcomes. The primary and secondary aims are to assess the safety and efficacy of megestrol as part of the iKanEat protocol. The third aim is to provide critical information about the impact of the transition from tube to oral feeding on parent stress and parent and child quality of life. Discussion This trial will provide data regarding whether megestrol is a safe and effective component of the iKanEat tube weaning protocol, as well as important data on how the tube weaning process impacts parent stress and parent and child quality of life. Trial registration ClinicalTrials.gov NCT#03815019. Registered on January 17, 2019
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Affiliation(s)
- Sarah Edwards
- Pediatric Gastroenterology, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Paul E Hyman
- Pediatric Gastroenterology, New Orleans Children's Hospital, New Orleans, LA, USA
| | - Hayat Mousa
- Pediatric Gastroenterology, Hepatology and Nutrition, University of California San Diego/Rady Children's Hospital, San Diego, CA, USA
| | - Amanda Bruce
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 4004, Kansas City, KS, 66160, USA.,Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, USA
| | - Jose Cocjin
- Pediatric Gastroenterology, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Kelsey Dean
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 4004, Kansas City, KS, 66160, USA.,Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, USA
| | - Kandace Fleming
- Life Span Institute, University of Kansas, Lawrence, KS, USA
| | | | - Ann M Davis
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 4004, Kansas City, KS, 66160, USA. .,Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, USA.
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61
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Validation and reproducibility of a FFQ focused on pregnant women living in Northeastern Brazil. Public Health Nutr 2021; 24:5769-5776. [PMID: 33563352 DOI: 10.1017/s1368980021000549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of the current study is to assess the validity and reproducibility of a FFQ focused on pregnant women living in Northeastern Brazil. DESIGN Three 24-hour-dietary recalls (24 hR) and two FFQ were applied at 15-d intervals between research stages in order to confirm the validity and reproducibility of the FFQ. Validity assessment was based on Pearson's correlation coefficient (PCC) or Spearman's correlation coefficient (SCC) between FFQ and the mean of three 24 hR (the 24 hR was used as reference standard), whereas reproducibility assessment was based on the intraclass correlation coefficient (ICC) among FFQ, and P < 0·05 was set as significance level. SETTING Public health network of a capital city in Northeastern Brazil. PARTICIPANTS Overall, 100 pregnant women were included in the study. RESULTS The PCC or SCC adopted in the validity analysis recorded the recommended values (from 0·4 and 0·7) for energy (0·44; P < 0·001), carbohydrate (0·40; P < 0·001), vitamins B2 (0·40; P < 0·001), B5 (0·40; P < 0·001), E (0·47; P < 0·001), B12 (0·48; P < 0·001), phosphorus (0·92; P < 0·001), Mg (0·81; P < 0·001), Se (0·70; P < 0·001), cholesterol (0·64; P < 0·001), saturated (0·76; P < 0·001), polyunsaturated (0·73; P < 0·001) and monounsaturated fats (0·87; P < 0·001) and fibres (0·77; P < 0·001). Mg (0·72; P < 0·001), Fe (0·65; P < 0·001), lipid (0·56; P < 0·001) and energy (0·55; P < 0·001) presented ICC within the recommended reproducibility values. CONCLUSIONS The FFQ developed in the current study is a useful tool to assess the usual food intake of pregnant women.
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Weinfield NS, Borger C, Gola AA. Breastfeeding Duration in a Low-Income Sample Is Associated With Child Diet Quality at Age Three. J Hum Lact 2021; 37:183-193. [PMID: 32091965 DOI: 10.1177/0890334420903029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Little research has focused on breastfeeding and diet quality, particularly in low-income populations at risk for shorter breastfeeding duration and poorer diet quality. RESEARCH AIM The aim of this study was to examine the association between breastfeeding duration and later diet quality in a low-income population. METHODS For this longitudinal prospective cohort study we conducted a secondary analysis of data from the Infant and Toddler Feeding Practices Study-2, a national study of infant feeding practices and child outcomes. Study infants were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children by 2.5 months of age and followed until 36 months (N = 1,223). We examined the association between breastfeeding duration until 13 months of age, and child diet quality derived from a 24-hour dietary recall with a usual intake adjustment at child age 36 months. Multiple regression analyses were used to examine the association of breastfeeding duration with overall diet quality, as measured by the Heathy Eating Index 2015, and with consumption of specific food groups. RESULTS Longer breastfeeding duration during infancy was associated with better diet quality at child age 36 months after controlling for key socio-demographic variables. In follow-up analyses, the origin of the association was narrowed to greater consumption of mature/dried beans and peas. CONCLUSIONS Longer breastfeeding duration in infancy was associated with better diet quality at 36 months, in a population at risk for shorter breastfeeding duration and poorer diet quality. Breastfeeding was particularly associated with children's consumption of mature/dried beans and peas. CLINICAL TRIAL REGISTRATION This study is registered at clinicaltrials.gov as Feeding My Baby-A National WIC Study, NCT02031978.
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Affiliation(s)
- Nancy S Weinfield
- 6956 Westat, Rockville, MD, USA.,51636 Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD, USA
| | | | - Alice Ann Gola
- 393022 Office of Policy Support, Food and Nutrition Service, U.S. Department of Agriculture, Alexandria, VA, USA
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Butler ÉM, Fangupo LJ, Cutfield WS, Taylor RW. Systematic review of randomised controlled trials to improve dietary intake for the prevention of obesity in infants aged 0-24 months. Obes Rev 2021; 22:e13110. [PMID: 32776705 DOI: 10.1111/obr.13110] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 07/14/2020] [Accepted: 07/14/2020] [Indexed: 02/06/2023]
Abstract
Improving dietary intake early in life is a common behavioural target in obesity prevention trials. We undertook a systematic review of randomised controlled trials aiming to improve dietary intake of complementary foods during infancy (0-24 months). PubMed, Cochrane Library, EMBASE, Medline, and PsycInfo were searched for trials focussed on obesity prevention conducted between January 2000 and August 2019 where dietary intake was an outcome. Two reviewers screened studies and extracted data from selected articles. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias 2 tools. The protocol was registered on Open Science Framework (https://osf.io/6srg7/). Seventeen articles from 12 trials were selected for data extraction. Statistically significant group differences in outcomes were observed in 36 of 165 (21.8%) of dietary variables examined. Measurement and analysis of outcomes varied between studies. Overall risk of bias was rated as high, primarily due to missing outcome data. Improving dietary intake at this age appears challenging based on a relatively limited number of studies. Future research could consider dietary pattern analyses, which may provide more meaningful outcomes for this age group. Opportunities exist for further exploration of maternal-focussed interventions, responsive feeding interventions, and interventions delivered outside of homes.
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Affiliation(s)
- Éadaoin M Butler
- A Better Start - National Science Challenge, New Zealand.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Louise J Fangupo
- A Better Start - National Science Challenge, New Zealand.,Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Wayne S Cutfield
- A Better Start - National Science Challenge, New Zealand.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Rachael W Taylor
- A Better Start - National Science Challenge, New Zealand.,Department of Medicine, University of Otago, Dunedin, New Zealand
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64
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Valizadeh P, Ng SW. The New school food standards and nutrition of school children: Direct and Indirect Effect Analysis. ECONOMICS AND HUMAN BIOLOGY 2020; 39:100918. [PMID: 32992091 PMCID: PMC7718326 DOI: 10.1016/j.ehb.2020.100918] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 06/11/2023]
Abstract
The Healthy, Hunger-Free Kids Act (HHFKA) of 2010 made sweeping changes to school nutritional standards. We estimate the impacts of shifts in school nutritional standards on dietary quality as well as dietary quantity of children's food intakes from school and away-from-school food sources. We find the average effect of consuming school food, rather than away-from-school food, on children's overall dietary quality significantly increased from the pre- to post-HHFKA implementation period. This effect was solely driven by substantial improvements in the dietary quality of foods acquired at school, mainly among older and higher-income children. Our indirect effect analysis indicated that children shifted towards consuming lower-quality diets at home in the post-HHFKA period, thereby partially offsetting the positive effects of the HHFKA on their overall dietary quality. Indirect impacts were primarily driven by a subset of children consuming more than a third of their daily calories from school food. Additionally, we find suggestive evidence of a modest decrease in daily calorie intake, particularly among older and higher-income children. Together, our findings imply that the HHFKA, despite its unintended negative indirect effects, led children to consume more-nutritious, less-energy-dense diets.
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Affiliation(s)
- Pourya Valizadeh
- Carolina Population Center, University of North Carolina at Chapel Hill, Carolina Population Center, CB #8120 University Square. 123 West Franklin Street, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27516-3997, United States.
| | - Shu Wen Ng
- Carolina Population Center, University of North Carolina at Chapel Hill, Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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65
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Bekelman TA, Sauder KA, Rockette-Wagner B, Glueck DH, Dabelea D. Sociodemographic Predictors of Adherence to National Diet and Physical Activity Guidelines at Age 5 Years: The Healthy Start Study. Am J Health Promot 2020; 35:514-524. [PMID: 33118362 DOI: 10.1177/0890117120968654] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess adherence to the 2015-2020 Dietary Guidelines for Americans and 2018 Physical Activity Guidelines, and identify sociodemographic predictors of adherence among children. DESIGN Cross sectional. SETTING Colorado, United States. PARTICIPANTS Children aged 5 (n = 482). MEASURES Sex, race/ethnicity, maternal education, maternal employment, maternal subjective social status and household income were assessed via questionnaires. Diet was assessed via 2 interviewer-administered 24-hour dietary recalls. Physical activity was objectively-measured with accelerometry for 7 days. Adherence was defined as a Healthy Eating Index-2015 score of ≥70 and/or ≥6 hours/day of light, moderate and vigorous activity. ANALYSIS For each predictor, logistic regression was used to estimate odds ratios for adherence to the diet guidelines only, the activity guidelines only or both guidelines. RESULTS In the full sample, 29% of children were non-adherent to both guidelines, 6% adhered to the dietary guidelines only, 50% adhered to the activity guidelines only and 14% adhered to both. Girls had a 41% lower odds of adhering to the physical activity guidelines than boys (p = 0.01), after adjustment for race/ethnicity, household income and maternal education level, perceived social status and employment status. CONCLUSION Efforts to improve the health of young children should promote adherence to the Dietary Guidelines for Americans among all children. Targeted interventions that increase physical activity among girls may help to mitigate health disparities.
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Affiliation(s)
- Traci A Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, CO, USA.,Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | - Katherine A Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, CO, USA.,Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA.,Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Deborah H Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, CO, USA.,Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, CO, USA.,Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA.,Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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66
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Poulimeneas D, Grammatikopoulou MG, Devetzi P, Petrocheilou A, Kaditis AG, Papamitsou T, Doudounakis SE, Vassilakou T. Adherence to Dietary Recommendations, Nutrient Intake Adequacy and Diet Quality among Pediatric Cystic Fibrosis Patients: Results from the GreeCF Study. Nutrients 2020; 12:nu12103126. [PMID: 33066268 PMCID: PMC7602117 DOI: 10.3390/nu12103126] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/04/2020] [Accepted: 10/09/2020] [Indexed: 01/19/2023] Open
Abstract
Nutrition is an important component of cystic fibrosis (CF) therapy, with a high-fat diet being the cornerstone of treatment. However, adherence to the dietary recommendations for CF appears suboptimal and burdensome for most children and adolescents with CF, leading to malnutrition, inadequate growth, compromised lung function and increased risk for respiratory infections. A cross-sectional approach was deployed to examine the degree of adherence to the nutrition recommendations and diet quality among children with CF. A total of 76 children were recruited from Aghia Sophia’s Children Hospital, in Athens, Greece. In their majority, participants attained their ideal body weight, met the recommendations for energy and fat intake, exceeding the goal for saturated fatty acids consumption. Carbohydrate and fiber intake were suboptimal and most participants exhibited low or mediocre adherence to the Mediterranean diet prototype. It appears that despite the optimal adherence to the energy and fat recommendations, there is still room for improvement concerning diet quality and fiber intake.
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Affiliation(s)
- Dimitrios Poulimeneas
- Department of Public Health Policy, School of Public Health, University of West Attica, 196, Alexandras Avenue, GR-11521 Athens, Greece;
- Department of Nutrition and Dietetics, Harokopio University, E. Venizelou 70, GR-17671 Athens, Greece
| | - Maria G. Grammatikopoulou
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, GR-57001 Thessaloniki, Greece; (M.G.G.); (P.D.)
| | - Panagiota Devetzi
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, GR-57001 Thessaloniki, Greece; (M.G.G.); (P.D.)
- Faculty of Biotechnology, Universidade Católica Portuguesa, Rua de Diogo Botelho, 1327, 4169-005 Porto, Portugal
| | - Argyri Petrocheilou
- Cystic Fibrosis Department, Agia Sophia Children’s Hospital, Thivon 1, GR-11527 Athens, Greece; (A.P.); (A.G.K.); (S.E.D.)
| | - Athanasios G. Kaditis
- Cystic Fibrosis Department, Agia Sophia Children’s Hospital, Thivon 1, GR-11527 Athens, Greece; (A.P.); (A.G.K.); (S.E.D.)
- Division of Pediatric Pulmonology and Sleep Disorders Laboratory, First Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine and Aghia Sophia Children’s Hospital, Thivon 1, GR-11527 Athens, Greece
| | - Theodora Papamitsou
- Laboratory of Histology and Embryology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, GR-54124 Thessaloniki, Greece
- Correspondence: (T.P.); (T.V.)
| | - Stavros E. Doudounakis
- Cystic Fibrosis Department, Agia Sophia Children’s Hospital, Thivon 1, GR-11527 Athens, Greece; (A.P.); (A.G.K.); (S.E.D.)
| | - Tonia Vassilakou
- Department of Public Health Policy, School of Public Health, University of West Attica, 196, Alexandras Avenue, GR-11521 Athens, Greece;
- Correspondence: (T.P.); (T.V.)
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67
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Validation of a life-logging wearable camera method and the 24-h diet recall method for assessing maternal and child dietary diversity. Br J Nutr 2020; 125:1299-1309. [PMID: 32912365 DOI: 10.1017/s0007114520003530] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Accurate and timely data are essential for identifying populations at risk for undernutrition due to poor-quality diets, for implementing appropriate interventions and for evaluating change. Life-logging wearable cameras (LLWC) have been used to prospectively capture food/beverage consumed by adults in high-income countries. This study aimed to evaluate the concurrent criterion validity, for assessing maternal and child dietary diversity scores (DDS), of a LLWC-based image-assisted recall (IAR) and 24-h recall (24HR). Direct observation was the criterion method. Food/beverage consumption of rural Eastern Ugandan mothers and their 12-23-month-old child (n 211) was assessed, for the same day for each method, and the IAR and 24HR DDS were compared with the weighed food record DDS using the Bland-Altman limits of agreement (LOA) method of analysis and Cohen's κ. The relative bias was low for the 24HR (-0·1801 for mothers; -0·1358 for children) and the IAR (0·1227 for mothers; 0·1104 for children), but the LOA were wide (-1·6615 to 1·3012 and -1·6883 to 1·4167 for mothers and children via 24HR, respectively; -2·1322 to 1·8868 and -1·7130 to 1·4921 for mothers and children via IAR, respectively). Cohen's κ, for DDS via 24HR and IAR, was 0·68 and 0·59, respectively, for mothers, and 0·60 and 0·59, respectively, for children. Both the 24HR and IAR provide an accurate estimate of median dietary diversity, for mothers and their young child, but non-differential measurement error would attenuate associations between DDS and outcomes, thereby under-estimating the true associations between DDS - where estimated via 24HR or IAR - and outcomes measured.
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Jústiz AM, Landry MJ, Asigbee FM, Ghaddar R, Jeans MR, Davis JN. Associations between Child and Parent Knowledge of Added Sugar Recommendations and Added Sugar Intake in Multiethnic Elementary-Aged Children. Curr Dev Nutr 2020; 4:nzaa140. [PMID: 32923924 PMCID: PMC7475003 DOI: 10.1093/cdn/nzaa140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 08/05/2020] [Accepted: 08/12/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND A key goal of the Dietary Guidelines for Americans 2015-2020 is to reduce added sugar intake by increasing public knowledge about added sugars. However, research has not shown if knowledge of added sugar recommendations is associated with intake. OBJECTIVES To determine the relation between parent and child knowledge of added sugar recommendations with added sugar intake in primarily low-income and Hispanic third- to fifth-grade students. METHODS Analysis examined baseline, cross-sectional data from TX Sprouts, a 1-y cooking, gardening, and nutrition clustered randomized controlled trial. Participants were 685 parent-child dyads from 16 elementary schools in the greater Austin area. Parents and children completed a survey to assess knowledge of added sugar recommendations. Children completed two 24-h dietary recalls to assess average intake of added sugars. Mixed effects linear regression models were used to estimate associations between child and parent knowledge of added sugar recommendations and average total added sugar intake. RESULTS Children who correctly identified the added sugar recommendation consumed lower amounts of added sugar compared with children who did not correctly identify the recommendation (34.8 ± 2.7 compared with 41.0 ± 2.5 g; P = 0.003), after adjusting for sociodemographic characteristics. Parent knowledge of added sugar recommendations was not associated with child intake. CONCLUSIONS Child knowledge of added sugar recommendations was associated with lower intake of added sugars. Findings suggest that child nutrition education should focus on increasing knowledge of national recommendations. Future research should investigate a causal relation between added sugar knowledge and intake in elementary-aged children.
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Affiliation(s)
- Amanda M Jústiz
- Department of Nutritional Sciences, Dell Pediatric Research Institute, The University of Texas at Austin, Austin, TX, USA
| | - Matthew J Landry
- Department of Nutritional Sciences, Dell Pediatric Research Institute, The University of Texas at Austin, Austin, TX, USA
| | - Fiona M Asigbee
- Department of Nutritional Sciences, Dell Pediatric Research Institute, The University of Texas at Austin, Austin, TX, USA
| | - Reem Ghaddar
- Department of Nutritional Sciences, Dell Pediatric Research Institute, The University of Texas at Austin, Austin, TX, USA
| | - Matthew R Jeans
- Department of Nutritional Sciences, Dell Pediatric Research Institute, The University of Texas at Austin, Austin, TX, USA
| | - Jaimie N Davis
- Department of Nutritional Sciences, Dell Pediatric Research Institute, The University of Texas at Austin, Austin, TX, USA
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Abstract
Sugar-sweetened beverage (SSB) consumption has been associated with visceral fat partitioning in adults; however, the underlying mechanisms in childhood remain unclear and warrant exploration. This cross-sectional study aimed to investigate the association between SSB consumption and body fat in children aged 9-13 years and the potential modifying effect of children's sex and serum cortisol levels. A sample of 2665 Greek schoolchildren participated in the 'Healthy Growth Study', and anthropometric, body composition, dietary intake and serum cortisol data were assessed. SSB consumption was defined as low (<1 serving/d), medium (1-2 servings/d) or high (>2 servings/d). We used linear regression models to assess the association between SSB consumption and measures of adiposity and to assess effect modification; models were stratified by sex and tertiles of morning serum cortisol. A significant positive association was observed between high SSB consumption and visceral adipose tissue (VAT) (β = 1·4, 95 % CI 0·4, 2·3, P = 0·01) but not BMI or BMI z-score. When stratified by sex, the association was observed in boys (β = 1·8, 95 % CI 0·3, 3·4, P = 0·02) but not in girls. When stratified by cortisol levels, SSB consumption was associated with VAT in children with cortisol levels in the lowest tertile (β = 2·8, 95 % CI 1·0, 4·6, P < 0·01). These results indicate that increased SSB consumption is associated with visceral adiposity in schoolchildren and this association may be modified by sex and morning serum cortisol. To prevent VAT accumulation and concomitant disease risk, dietary interventions should target SSB consumption during childhood.
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70
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Berger AT, Widome R, Erickson DJ, Laska MN, Harnack LJ. Changes in association between school foods and child and adolescent dietary quality during implementation of the Healthy, Hunger-Free Kids Act of 2010. Ann Epidemiol 2020; 47:30-36. [PMID: 32713505 DOI: 10.1016/j.annepidem.2020.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 05/02/2020] [Accepted: 05/26/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The purposes of the study were to estimate the effect of Healthy, Hunger-Free Kids Act of 2010 (HHFKA) implementation on dietary quality of all U.S. school-aged children and adolescents and examine whether those effects differed by the demographic group. METHODS We used survey regression on 2007-2016 National Health and Nutrition Examination Survey data to estimate the proportion of energy intake from school foods and the association between school food intake and dietary quality, before and after HHFKA passage/implementation. To account for demographic changes in the U.S. population over time, inverse probability weighting was used. The product of the proportion of energy from school foods and the association between school food intake and dietary quality estimated the effect of HHFKA implementation on dietary quality. RESULTS School food intake quantity remained stable during the study period. HHFKA implementation improved students' dietary quality by 4.3 Healthy Eating Index-2010 points (95% confidence interval: 2.5, 6.1) on days when school foods were eaten and by 1.3 Healthy Eating Index-2010 points (95% confidence interval: 0.73, 1.8) averaged over all days annually. CONCLUSIONS HHFKA implementation improved the total dietary quality of U.S. school students. U.S. students would benefit from eating school meals in the post-HHFKA era, and HHFKA regulations should not be relaxed.
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Affiliation(s)
- Aaron T Berger
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis.
| | - Rachel Widome
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
| | - Darin J Erickson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
| | - Melissa N Laska
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
| | - Lisa J Harnack
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
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71
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Alves JM, Zink J, Chow T, Luo S, Belcher BR, Xiang AH, Page KA. Contributions of Prenatal Exposures and Child Lifestyle to Insulin Sensitivity. J Clin Endocrinol Metab 2020; 105:dgaa201. [PMID: 32301999 PMCID: PMC7271763 DOI: 10.1210/clinem/dgaa201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 04/14/2020] [Indexed: 02/03/2023]
Abstract
CONTEXT Prenatal exposures and lifestyle factors are important for metabolic health. OBJECTIVE Determine how prenatal exposures to maternal obesity and/or gestational diabetes mellitus (GDM) and childhood lifestyle factors independently contribute to child insulin sensitivity. DESIGN AND PARTICIPANTS Ninety children aged 7 to 11 years (56% girls, 60% exposed to GDM), born at Kaiser-Permanente Southern California, completed an oral glucose tolerance test (OGTT) as part of the BrainChild Study. Matsuda insulin sensitivity index (ISI) was used to estimate insulin sensitivity. Participants completed two 24-hour dietary recalls, and daily energy intake (EI), dietary added sugar, and total sugar were calculated. The 3-day physical activity recall determined the average minutes per day of moderate to vigorous physical activity (MVPA) and the average minutes per day spent sedentary. Maternal prepregnancy body mass index (BMI) and GDM status were extracted from electronic medical records. MAIN OUTCOME MEASURE Matsuda-ISI. RESULTS Linear regression showed that children who spent more time in MVPA had better ISI (β = 0.33; P = 0.001), and results remained after adjustment for maternal prepregnancy BMI, GDM exposure, child age, sex, daily EI, dietary added sugar (β = 0.34; P = 0.001), and further adjustment for child adiposity (β = 0.29; P = 0.001). Time spent sedentary, maternal prepregnancy BMI, GDM exposure, dietary added sugar, total sugar, and EI were not associated with ISI. CONCLUSIONS Physical activity was the only predictor of ISI at this age, suggesting that engaging in physical activity during childhood is beneficial for insulin sensitivity and may ameliorate future risk for metabolic disease.
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Affiliation(s)
- Jasmin M Alves
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Jennifer Zink
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Ting Chow
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Shan Luo
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Britni R Belcher
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Anny H Xiang
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Kathleen A Page
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, California
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72
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Rešetar J, Pfeifer D, Mišigoj-Duraković M, Sorić M, Gajdoš Kljusurić J, Šatalić Z. Eveningness in Energy Intake among Adolescents with Implication on Anthropometric Indicators of Nutritional Status: The CRO-PALS Longitudinal Study. Nutrients 2020; 12:nu12061710. [PMID: 32517370 PMCID: PMC7352272 DOI: 10.3390/nu12061710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 12/19/2022] Open
Abstract
Shifting of energy intake towards a later time in the day is associated with an increased risk of obesity in adults. However, there is a lack of data for adolescents. The aim of this study was to investigate adolescents eveningness in energy intake (EV) and its association with anthropometric indicators of nutritional status. This investigation was based on results from the Croatian physical activity in adolescence longitudinal study (CRO-PALS). The cohort included 607 adolescents (50.25% females and 49.75% males) who were assessed at the age of 15/16 and 18/19. A single multi-pass 24-h recall was used as a dietary assessment method, while anthropometric indicators of nutritional status included body mass index (BMI), waist to hip ratio (WHR) and the sum of four skinfolds. The School Health Action, Planning and Evaluation System (SHAPES) questionnaire was used to assess active daily energy expenditure and sedentary behaviors. EV was significantly higher at 18/19 years compared to 15/16 years in whole population (p < 0.01), among male adolescents (p < 0.01), but not among female adolescents (p > 0.05). Although a significant correlation between EV and WHR was found in females at the age of 15/16 (p < 0.01), the results of this study suggest that EV has no or a minor effect on anthropometric indicators of nutritional status in adolescence.
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Affiliation(s)
- Josip Rešetar
- Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia; (J.R.); (D.P.); (Z.Š.)
| | - Danijela Pfeifer
- Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia; (J.R.); (D.P.); (Z.Š.)
| | - Marjeta Mišigoj-Duraković
- Faculty of Kinesiology, University of Zagreb, Horvaćanski zavoj 15, 10000 Zagreb, Croatia; (M.M.-D.); (M.S.)
| | - Maroje Sorić
- Faculty of Kinesiology, University of Zagreb, Horvaćanski zavoj 15, 10000 Zagreb, Croatia; (M.M.-D.); (M.S.)
- Faculty of Sport, University of Ljubljana, Gortanova ulica 22, 1000 Ljubljana, Slovenia
| | - Jasenka Gajdoš Kljusurić
- Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia; (J.R.); (D.P.); (Z.Š.)
- Correspondence: ; Tel.: +385-14-605-025
| | - Zvonimir Šatalić
- Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia; (J.R.); (D.P.); (Z.Š.)
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Marcos-Pasero H, Aguilar-Aguilar E, Colmenarejo G, Ramírez de Molina A, Reglero G, Loria-Kohen V. The Q223R Polymorphism of the Leptin Receptor Gene as a Predictor of Weight Gain in Childhood Obesity and the Identification of Possible Factors Involved. Genes (Basel) 2020; 11:genes11050560. [PMID: 32429577 PMCID: PMC7288327 DOI: 10.3390/genes11050560] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/11/2020] [Accepted: 05/15/2020] [Indexed: 12/13/2022] Open
Abstract
(1) Background: Childhood rapid weight gain during development has been postulated as a predictor of obesity. The objective of this study was to investigate the effect of single nucleotide polymorphisms (SNPs) on the annual weight gain and height growth, as well as identifying possible lifestyle factors involved. (2) Methods: As part of the GENYAL study, 221 children (6–8 years old) of Madrid (Spain) were enrolled. A total of 11 SNPs associated with high childhood body mass indexes (BMIs) were assessed. Anthropometric measurements, dietary and physical activity data, were collected in 2017 and 2018. Bonferroni-corrected linear models were used to fit the data. (3) Results: A significant association between the Q223R LEPR and the weight growth was found, showing a different behavior between GA and GG genotypes (p = 0.001). Regarding lifestyle factors, an interaction between Q223R genotypes and total active weekly hours/week to predict the weight growth (kg/year) was observed (p = 0.023). In all the genotypes, a beneficial effect against rapid weight growth was observed, but the effect size of the interaction was much more significant in homozygous (GG) minor homozygous (β = −0.61 (−0.95, −0.26) versus heterozygous (AG) and wild-type homozygous (AA) genotypes (β = −0.07 (−0.24, 0.09) and β = −0.12 (−0.32, 0.08), respectively). (4) Conclusions: These results may contribute to more personalized recommendations to prevent childhood obesity.
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Affiliation(s)
- Helena Marcos-Pasero
- Nutrition and Clinical Trials Unit, GENYAL Platform IMDEA-Food Institute, CEI UAM+CSIC, 28049 Madrid, Spain; (H.M.-P.); (E.A.-A.)
| | - Elena Aguilar-Aguilar
- Nutrition and Clinical Trials Unit, GENYAL Platform IMDEA-Food Institute, CEI UAM+CSIC, 28049 Madrid, Spain; (H.M.-P.); (E.A.-A.)
| | - Gonzalo Colmenarejo
- Biostatistics and Bioinformatics Unit, IMDEA Food Institute, CEI UAM+CSIC, Ctra. De Canto Blanco 8, 28049 Madrid, Spain;
| | - Ana Ramírez de Molina
- Molecular Oncology and Nutritional Genomics of Cancer, IMDEA-Food Institute, CEI UAM+CSIC, 28049 Madrid, Spain;
| | - Guillermo Reglero
- Production and Development of Foods for Health, IMDEA-Food Institute, CEI UAM+CSIC, 28049 Madrid, Spain;
- Production and Characterization of Novel Foods, CIAL, CEI UAM+CSIC, 28049 Madrid, Spain
| | - Viviana Loria-Kohen
- Nutrition and Clinical Trials Unit, GENYAL Platform IMDEA-Food Institute, CEI UAM+CSIC, 28049 Madrid, Spain; (H.M.-P.); (E.A.-A.)
- Correspondence: ; Tel.: +34-912-796-957
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74
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Zhang T, Au Yeung SL, Kwok MK, Hui LL, Leung GM, Schooling CM. Association of Sugar-Sweetened Beverage Frequency with Adiposity: Evidence from the "Children of 1997" Birth Cohort. Nutrients 2020; 12:nu12041015. [PMID: 32272690 PMCID: PMC7231010 DOI: 10.3390/nu12041015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/03/2020] [Accepted: 04/03/2020] [Indexed: 01/04/2023] Open
Abstract
Background: Observationally, sugar-sweetened beverage (SSB) consumption is associated with adiposity in Western children but could be confounded. We examined the association of SSB frequency with adiposity in the non-Western setting of Hong Kong. Methods: We examined the associations of SSB consumption frequency at 11 and 13 years assessed by using a food frequency questionnaire with subsequent body mass index (BMI) z-score and overweight/obesity up to 18 years using generalized estimating equations, and with waist circumference, waist-to-hip ratio, and body fat percentage at 16–19 years using linear regression in a population-representative Chinese birth cohort “Children of 1997” (n = 3628). Results: At 11 and 13 years, 6.8% and 8.2% of children respectively consumed SSB daily. Neither SSB frequency at 11 nor at 13 years was associated with subsequent BMI z-score or overweight/obesity up to 18 years, or with waist circumference, waist-to-hip ratio, or body fat percentage at 16–19 years adjusted for age, sex, socioeconomic position, health status, physical activity and other food consumption, although bias to the null from under-reporting cannot be eliminated. Conclusion: Although we cannot definitively exclude a small association of SSB frequency with adiposity, lack of association of SSB frequency with adiposity in a non-Western setting with low SSB consumption suggests that the role of SSB in adiposity appears to be minor.
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Affiliation(s)
- Ting Zhang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; (T.Z.); (S.L.A.Y.); (M.K.K.); (L.L.H.); (G.M.L.)
| | - Shiu Lun Au Yeung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; (T.Z.); (S.L.A.Y.); (M.K.K.); (L.L.H.); (G.M.L.)
| | - Man Ki Kwok
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; (T.Z.); (S.L.A.Y.); (M.K.K.); (L.L.H.); (G.M.L.)
| | - Lai Ling Hui
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; (T.Z.); (S.L.A.Y.); (M.K.K.); (L.L.H.); (G.M.L.)
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Gabriel Matthew Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; (T.Z.); (S.L.A.Y.); (M.K.K.); (L.L.H.); (G.M.L.)
| | - C. Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; (T.Z.); (S.L.A.Y.); (M.K.K.); (L.L.H.); (G.M.L.)
- CUNY School of Public Health and Health Policy, New York, NY 10027, USA
- Correspondence: ; Tel.: (852) 3917 6732; Fax: (852) 3520 1945
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Herman DR, Rhoades N, Mercado J, Argueta P, Lopez U, Flores GE. Dietary Habits of 2- to 9-Year-Old American Children Are Associated with Gut Microbiome Composition. J Acad Nutr Diet 2020; 120:517-534. [PMID: 31668602 PMCID: PMC7089824 DOI: 10.1016/j.jand.2019.07.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 07/29/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND The human gut microbiome is recognized as an important determinant of human health, yet little is known about how dietary habits are related to the microbiome in post-weaned, pre-pubescent children. OBJECTIVE The goal of this work was to link quantitative dietary intake with microbiome features in a diverse population of children consuming a predominantly Western diet. DESIGN This was a cross-sectional study. PARTICIPANTS/SETTINGS English- or Spanish-speaking families with healthy children between the ages of 2 and 9 years were recruited from a community-based, early childhood learning center in suburban Los Angeles, California between June and September 2014. MAIN OUTCOME MEASURES Children included in the analyses (n=75) contributed three fecal samples and three quantitative 24-hour dietary recalls using the multiple-pass method with an average of 5.7 days between samples. Microbial communities of each fecal sample were characterized using Illumina sequencing of the 16S ribosomal RNA gene. Dietary recalls were analyzed using the Automated Self-Administered 24-Hour Recall Dietary Assessment Tool. STATISTICAL ANALYSIS PERFORMED Associations between dietary factors and microbiome features were assessed using the Kruskal-Wallis test, Spearman rank correlations, or permutational multivariate analysis of variance. For demographic and health-related variables, χ2 analyses were used to test for differences between age groups for categorical variables. RESULTS Our results show that age is correlated with three metrics of microbiome diversity (P<0.05) and is associated with both community structure (P=0.0488) and membership (P=0.0002). Several dietary food groups and nutrients were likewise associated with microbiome features. For example, consumption of non-whole-grain foods was associated with community structure (P=0.0089) and membership (P=0.0057), but not diversity (P>0.05). Likewise, the relative abundance of several bacterial taxa were linked to consumption of particular food groups and/or nutrients, as illustrated by the positive associations between total fruit (Pfalsediscovery rate<0.05) and fiber (Pfalsediscovery rate<0.05) consumption with the relative abundance of the Lachnospira genera. CONCLUSIONS This hypothesis-generating study demonstrates that the composition of the child gut microbiome remains dynamic beyond the age of 3 years and responds to dietary differences across individuals. In particular, non-whole-grain foods fortified with vitamins and minerals appear to be associated with the composition of the microbiome. Future interventional or model organism-based studies will be needed to test these associations between diet and microbiome composition.
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Bradley J, Gardner G, Rowland MK, Fay M, Mann K, Holmes R, Foster E, Exley C, Don Bosco A, Hugueniot O, Moynihan P. Impact of a health marketing campaign on sugars intake by children aged 5-11 years and parental views on reducing children's consumption. BMC Public Health 2020; 20:331. [PMID: 32223751 PMCID: PMC7104521 DOI: 10.1186/s12889-020-8422-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 02/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The association between Free Sugars intake and non-communicable diseases such as obesity and dental caries is well documented and several countries are taking measures to reduce sugars intakes. Public Health England (PHE) instigated a range of approaches to reduce sugars, including a national health marketing campaign (Sugar Smart). The campaign aimed to raise awareness of the amount of sugars in foods and drinks and to encourage parents to reduce their children's intake. The aim of this study was to determine whether the campaign was effective in altering dietary behaviour, by assessing any impact of the campaign on sugars intake among children aged 5-11 years. Parental perceptions of the campaign and barriers to reducing sugars intake were also explored. METHODS Parents of 873 children aged 5-11 years, identified from an existing PHE database, were invited to take part. Dietary information was collected online using Intake24 before, during, and at 1, 10 and 12 months following the campaign. Change in sugars intake was assessed using mixed effects linear regression models. One-to-one telephone interviews were conducted with a purposive sample of parents to explore perceptions of the campaign and identify barriers and facilitators to reducing children's sugars intake. RESULTS Completion rates for dietary assessment ranged from 61 to 72% across the follow up time points. Qualitative telephone interviews were conducted with 20 parents. Total sugars intake decreased on average by ~ 6.2 g/day (SD 43.8) at peak campaign and the percentage of energy from total sugars significantly decreased immediately and 1 year post campaign. The percentage of energy from Free Sugars significantly decreased across all time points with the exception of the long term follow up at 12-months post campaign. The percentage of energy intake from total fat increased. Parents expressed a willingness to reduce sugars intakes, however, identified barriers including time constraints, the normalisation of sugary treats, and confusing information. CONCLUSIONS A health marketing campaign had a positive impact in reducing sugars intake but reductions in sugars were not sustained. Parents want to reduce their child's sugars intake but societal barriers and confusion over which sources of sugars to avoid hamper efforts to change.
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Affiliation(s)
- Jennifer Bradley
- Human Nutrition Research Centre, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK.
| | - Grace Gardner
- Human Nutrition Research Centre, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK.,School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK
| | - Maisie K Rowland
- Human Nutrition Research Centre, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Michaela Fay
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Kay Mann
- The Australian e-Health Research Centre, CSIRO, Brisbane, QLD, 4029, Australia
| | - Richard Holmes
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK
| | - Emma Foster
- Human Nutrition Research Centre, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Catherine Exley
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Ann Don Bosco
- Public Health England, 133 - 155 Waterloo Road, London, SE1 8UG, UK
| | - Orla Hugueniot
- Public Health England, 133 - 155 Waterloo Road, London, SE1 8UG, UK
| | - Paula Moynihan
- Adelaide Dental School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia
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Zanella PB. Letter to the editor regarding the article "Total protein or leucine intakes are not associated with handgrip strength in hemodialysis patients: A pilot study". Clin Nutr ESPEN 2020; 36:171. [PMID: 32220364 DOI: 10.1016/j.clnesp.2019.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 10/29/2019] [Indexed: 11/24/2022]
Affiliation(s)
- Priscila B Zanella
- Department of Nutrition, Medical School - Universidade Federal do Rio Grande do Sul (UFRGS), Brazil.
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78
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Comparison of the eating behaviour and dietary consumption in older adults with and without visual impairment. Br J Nutr 2020; 123:712-720. [PMID: 31791430 DOI: 10.1017/s000711451900312x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Globally, a high prevalence of obesity and undernutrition has been reported in people with visual impairment (VI) who have reported multi-factorial obstacles that prevent them from achieving a healthy diet, such as having restricted shopping and cooking abilities. The present study is the first to investigate the relationship between VI and dietary consumption using a representative sample size, standardised methods to categorise VI and a detailed analysis of dietary consumption. Ninety-six participants with VI and an age-matched control group of fifty participants were recruited from across the UK. All participants were aged 50 years or over. The participants completed a 24-h food recall for a period of 3 d. The participants also answered questions about their abilities to shop for and cook food as well as their knowledge of healthy eating. The participants with VI in this sample consumed significantly fewer energy content and other nutrients than is recommended for their age group and when compared with an age-matched control group. The participants with VI mainly made food choices irrespective of nutritional value. The results of the present study highlight for the first time that a large proportion of older adults with VI in the UK are undernourished. These results suggest local and government-led initiatives should be implemented to support the diets of older adults in the UK, and these initiatives could include healthy eating workshops, café clubs or skills training and rehabilitation.
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Dietary Fructose Intake and Hippocampal Structure and Connectivity during Childhood. Nutrients 2020; 12:nu12040909. [PMID: 32224933 PMCID: PMC7230400 DOI: 10.3390/nu12040909] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/21/2020] [Accepted: 03/24/2020] [Indexed: 01/06/2023] Open
Abstract
In rodent literature, there is evidence that excessive fructose consumption during development has a detrimental impact on hippocampal structure and function. In this study of 103 children ages 7–11 years old, we investigated whether dietary fructose intake was related to alterations in hippocampal volume and connectivity in humans. To examine if these associations were specific to fructose or were related to dietary sugars intake in general, we explored relationships between dietary intake of added sugars and the monosaccharide, glucose, on the same brain measures. We found that increased dietary intake of fructose, measured as a percentage of total calories, was associated with both an increase in the volume of the CA2/3 subfield of the right hippocampus and increased axial, radial, and mean diffusivity in the prefrontal connections of the right cingulum. These findings are consistent with the idea that increased fructose consumption during childhood may be associated with an inflammatory process, and/or decreases or delays in myelination and/or pruning. Increased habitual consumption of glucose or added sugar in general were associated with an increased volume of right CA2/3, but not with any changes in the connectivity of the hippocampus. These findings support animal data suggesting that higher dietary intake of added sugars, particularly fructose, are associated with alterations in hippocampal structure and connectivity during childhood.
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Madrigal C, Soto-Méndez MJ, Hernández-Ruiz Á, Valero T, Ávila JM, Ruiz E, Lara Villoslada F, Leis R, Martínez de Victoria E, Moreno JM, M. Ortega R, Ruiz-López MD, Varela-Moreiras G, Gil Á. Energy Intake, Macronutrient Profile and Food Sources of Spanish Children Aged One to <10 Years-Results from the EsNuPI Study. Nutrients 2020; 12:E893. [PMID: 32218330 PMCID: PMC7231217 DOI: 10.3390/nu12040893] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/17/2020] [Accepted: 03/22/2020] [Indexed: 12/13/2022] Open
Abstract
The present study aimed to assess energy intake, nutrient profile and food sources in Spanish children participating in the EsNuPI ("Estudio Nutricional en Población Infantil Española") study. Plausibility of energy intake and adequacy of nutrient intakes to international recommendations were analyzed in a final sample of 1448 subjects (728 boys and 720 girls) and one group representative of the 1 to <10 years old urban Spanish children (reference sample (n = 707)) who consumed milk and one of the same age who consumed adapted milk over the last year (adapted milk consumers sample (n = 741)) were compared. Both groups completed data of a face-to-face and a telephone 24-h dietary recalls. Both the reference and the adapted milk consumers samples reported an adequate daily energy intake (1503 kcal/day and 1404 kcal/day); and a high contribution to total energy from protein (16.5% and 15.6%) and fat (36.5% and 35.9%). Also, a high percentage of children from both samples were below the lower limit of the recommendations for carbohydrates (47.8% and 39.3%). As the percentage of plausible energy reporters was high for both groups (84.7% and 83.5%, respectively), data for the whole sample were analyzed. Milk and dairy, cereals, meat and derived products, fats and oils, bakery and pastry, fruits and vegetables contributed to about 80% of the total energy intake in both groups. However, the reference sample reported significantly more contribution to energy from cereals, meat and meat products, bakery and pastry and ready to cook/eat foods; meanwhile, the adapted milk consumers sample reported significantly more energy from milk and dairy products, fruits and eggs. Those results suggest that adapted milk consumers have better adherence to the food-based dietary guidelines. Further analyses are warranted to characterize food patterns and the quality of the diet in the EsNuPI study population.
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Affiliation(s)
- Casandra Madrigal
- Department of Nutrition and Bromatology, Faculty of Pharmacy, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain;
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3 ª pta, Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
| | - María José Soto-Méndez
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3 ª pta, Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
| | - Ángela Hernández-Ruiz
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3 ª pta, Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
| | - Teresa Valero
- Spanish Nutrition Foundation (FEN), c/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain; (T.V.); (J.M.Á.); (E.R.); (G.V.-M.)
| | - José Manuel Ávila
- Spanish Nutrition Foundation (FEN), c/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain; (T.V.); (J.M.Á.); (E.R.); (G.V.-M.)
| | - Emma Ruiz
- Spanish Nutrition Foundation (FEN), c/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain; (T.V.); (J.M.Á.); (E.R.); (G.V.-M.)
- CIBERESP, Consortium for Biomedical Research in Epidemiology and Public Health, Carlos III Health Institute, 28029 Madrid, Spain
- National Center for Epidemiology, Carlos III Health Institute, 28029 Madrid, Spain
| | | | - Rosaura Leis
- Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University Clinical Hospital of Santiago, IDIS, ISCIII, University of Santiago de Compostela, 15700 Santiago de Compostela, Spain;
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Emilio Martínez de Victoria
- Department of Physiology, Faculty of Pharmacy, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain;
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100 Granada, Spain
| | - José Manuel Moreno
- Pediatric Department, University of Navarra Clinic, Calle Marquesado de Sta. Marta, 1, 28027 Madrid, Spain;
| | - Rosa M. Ortega
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain;
| | - María Dolores Ruiz-López
- Department of Nutrition and Bromatology, Faculty of Pharmacy, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain;
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3 ª pta, Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100 Granada, Spain
| | - Gregorio Varela-Moreiras
- Spanish Nutrition Foundation (FEN), c/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain; (T.V.); (J.M.Á.); (E.R.); (G.V.-M.)
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, Urb. Montepríncipe, crta. Boadilla km. 5.3, Boadilla del Monte, 28668 Madrid, Spain
| | - Ángel Gil
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3 ª pta, Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100 Granada, Spain
- Department of Biochemistry and Molecular Biology II University of Granada, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain
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Watkins BA. Nutrition Research: new direction and scope are refining the Journal. Nutr Res 2020; 71:1-7. [PMID: 31896395 DOI: 10.1016/j.nutres.2019.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 12/11/2018] [Accepted: 12/20/2018] [Indexed: 11/17/2022]
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PEREIRA LJ, HINNIG PDF, DI PIETRO PF, ASSIS MAAD, VIEIRA FGK. Trends in food consumption of schoolchildren from 2nd to 5th grade: a panel data analysis. REV NUTR 2020. [DOI: 10.1590/1678-9865202033e190164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
ABSTRACT Objective To identify trends in food consumption among schoolchildren (2nd-5th grades) from public schools in the city of Florianópolis, Brazil, in a period of three years. Methods Three cross-sectional surveys were carried out in 2013 (n=1,942), 2014 (n=1,989) and 2015 (n=2,418). Dietary intake data were obtained using the Web-Based Food Intake and Physical Activity of Schoolchildren questionnaire. Food items were aggregated to eight food groups. Kruskal-Wallis heterogeneity and trend tests were used to analyze the differences and trends among the mean intake frequency of food groups. Results There were trends to decrease the mean intake frequency of sweets in the total sample (2013: 0.72±0.91; 2014: 0.68±0.87; 2015: 0.67±0.89, p=0.03) which was determined by children between 7-9 years old (2013: 0.69±0.88; 2014: 0.64±0.85; 2015: 0.62±0.87, p=0.02), and boys (2013: 0.75±0.90; 2014: 0.70±0.86; 2015: 0.68±0.88, p=0.03). Younger children also tended to increase the mean intake frequency of fruits and vegetables (2013: 1.03±1.35; 2014: 1.16±1.45; 2015: 1.17±1.41, p=0.03) and those aged ten-12 years decreased their intake of dairy products (2013: 1.32±1.25; 2014: 1.23±1.18; 2015: 1.20±1.20, p=0.05). Conclusion The results suggest positive trends for younger children, with an increased consumption of fruits and vegetables in both sexes and decreased consumption of sweets for boys. Older children reduced their consumption of dairy products over the three-year period of this study.
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Gunther C, Rogers C, Holloman C, Hopkins LC, Anderson SE, Miller CK, Copeland KA, Dollahite JS, Pratt KJ, Webster A, Labyk AN, Penicka C. Child diet and health outcomes of the simple suppers program: a 10-week, 2-group quasi-experimental family meals trial. BMC Public Health 2019; 19:1657. [PMID: 31823753 PMCID: PMC6902334 DOI: 10.1186/s12889-019-7930-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 11/08/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Racial minority children, particularly from low-income households, are at risk for obesity. Family meals have a protective effect on child nutritional health. However, the current evidence is limited in racial and socioeconomic diversity. The objective of this study was to evaluate the impact of a family meals intervention, Simple Suppers, on improvements in diet and health outcomes from baseline (T0) to post-intervention (T1) in intervention compared to waitlist control participants, and determine retention of change in outcomes among intervention participants at 10-week follow-up (T2). METHODS Simple Suppers was a 10-week family meals intervention implemented as a 2-group quasi-experimental trial. Ten 90-min lessons were delivered weekly. Data were collected at T0 and T1, and from intervention participants at T2. Participants were racially diverse 4-10 year-old children from low-income households. Setting was a faith-based community center. Main outcomes were daily servings of fruit, vegetables, and sugar-sweetened beverages and diet quality; z-scores for body mass index (BMI), waist circumference, systolic and diastolic blood pressure (BP); weight status categories; food preparation skills; and family meals (frequency of dinner, breakfast, TV viewing during meals, meals in dining area). Generalized linear mixed models (GLMMs) and mixed-effects ordinal regression models were used to assess intervention impact (T0:T1). Paired t-tests examined retention of change among intervention participants (T1:T2). RESULTS One hundred forty children enrolled and 126 completed T1 (90% retention); 71 of 87 intervention participants completed T2(79% retention). Mean (SD) age was 6.9(1.9) yr, 62% female, 60% Black, and 42% low-income. Intervention vs waitlist controls had higher food preparation skills (p < 0.001) and lower TV viewing during meals (p = 0.04) at T1.There were no group differences in dietary intake or quality or z-scores for BMI, waist circumference, or BP, however intervention versus waitlist controls experienced a greater change toward healthy weight (p = 0.04) At T2, intervention participants demonstrated a retention of improved food preparation skills. CONCLUSIONS Simple Suppers led to improvements in children's weight status, food preparation skills, and TV viewing during meals, but not diet or z-scores for BMI, waist circumference, or BP. Future research should examine the preventive effects of healthy family mealtime routines in children at greatest risk for obesity. TRIAL REGISTRATION NCT02923050; Simple Suppers Scale-up (S3); Retrospectively registered on Oct 2016; First participant enrolled on Jan 2015.
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Affiliation(s)
- Carolyn Gunther
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
| | - Catherine Rogers
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
- Present Address: Department of Nutrition, Case Western Reserve University, 10900 Euclid Ave, Wood Building, Cleveland, OH 44106 USA
| | - Christopher Holloman
- Department of Statistics, The Ohio State University, Columbus, USA
- Present Address: Information Control Company (ICC), 2500 Corporate Exchange Dr, Columbus, OH 43231 USA
| | - Laura C. Hopkins
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
| | - Sarah E. Anderson
- Division of Epidemiology, The Ohio State University, 1841 Neil Avenue, Cunz Hall, Columbus, OH 43210 USA
| | - Carla K. Miller
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
| | - Kristen A. Copeland
- Division of General and Community Pediatrics, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH 45229 USA
| | - Jamie S. Dollahite
- Division of Nutritional Sciences, Cornell University, 408 Savage Hall, Ithaca, NY 14853 USA
| | - Keeley J. Pratt
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
| | - Alison Webster
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
- Present Address: Food Directions, 1101 K St NW #650, Washington, DC 20005 USA
| | - Allison N. Labyk
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
| | - Christine Penicka
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
- Present Address: Albany Medical Center, 43 New Scotland Ave, Albany, NY 12208 USA
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The Use of Tablet-Based Multiple-Pass 24-Hour Dietary Recall Application (MP24Diet) to Collect Dietary Intake of Children under Two Years Old in the Prospective Cohort Study in Indonesia. Nutrients 2019; 11:nu11122889. [PMID: 31783608 PMCID: PMC6950229 DOI: 10.3390/nu11122889] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 11/20/2019] [Indexed: 11/16/2022] Open
Abstract
Dietary intake data are crucial for developing or evaluating nutrition interventions to improve the nutritional status of populations. The collection of accurate and reliable dietary data in developing countries, however, remains challenging. The emergence of new technologies, which facilitate electronic data capture, might address some of these challenges. This paper aims to describe an application developed to collect a multiple-pass 24-h dietary recall, using electronic data capture, and compare the results to those estimated using a paper-based method. In this study, a tablet-based application was developed, in the CommCare platform, to evaluate the effectiveness, for improving dietary adequacy, of a package of behavior change interventions to reduce stunting and anemia among 6-23-month-old children in East Java, Indonesia (Baduta project). Dietary intakes of energy and nutrients were estimated using electronic data capture in the cohort study of the Baduta project (n = 680). We compared these results with those estimated using paper-based data capture in the project's end-line cross-sectional study (n = 2740). We found a higher percentage of children classified as acceptable energy reporters (reported energy intake within the 95% CI of Total Energy Expenditure) with the electronic data capture compared with paper-based data capture (i.e., 60.8%, 72.4% and 80.7% for 6-8-, 9-11- and 12-23-month-old children, respectively, vs. 40.9%, 56.9%, and 54.3%, respectively). The estimated mean energy and nutrient intakes were not significantly different between these dietary data capture methods. These results suggest dietary data collection, using a tablet-based application, is feasible and can improve the quality of dietary data collected in developing countries.
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85
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Loth KA, Tate A, Trofholz A, Orlet Fisher J, Neumark-Sztainer D, Berge JM. The Contribution of Snacking to Overall Diet Intake among an Ethnically and Racially Diverse Population of Boys and Girls. J Acad Nutr Diet 2019; 120:270-279. [PMID: 31780383 DOI: 10.1016/j.jand.2019.08.173] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 08/20/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Children in low-income and minority populations are at risk for poor dietary quality. At least one-third of the calories consumed by children are eaten between meals (ie, snacks). The contribution of snacking to diet quality among children is poorly understood. OBJECTIVE The current study examined associations between snacking and children's diet quality along with differences across ethnicity or race, sex, and weight status. DESIGN Cross-sectional data came from Phase I of the Family Matters Study, an observational study. PARTICIPANTS/SETTING This study included 150 families with children aged 5 to 7 years old from six ethnic or racial groups (n=25 from each: African American, Hispanic, Hmong, Native American, Somali, non-Hispanic white); data were collected in Minneapolis-Saint Paul, MN in 2017-2018. MAIN OUTCOME MEASURES Total daily energy (kilocalories), overall diet quality using the Healthy Eating Index (HEI-2010), and food group intakes (eg, fruit, vegetables, refined grains, sugar-sweetened beverages [SSB]) were assessed using three 24-hour dietary recalls. STATISTICAL ANALYSES PERFORMED Conditional fixed effects estimators (within-child variation) were used in regression analyses to characterize the relationship between daily snacking and dietary intake relative to dietary intake at all other daily meal occasions. Mean (±standard deviation) overall dietary intake including all meals and snacks was compared with mean (±standard deviation) intake of meals only. RESULTS Among boys, snacking was found to contribute positively to HEI-2010 scores (HEI-2010=57.6, HEI-2010 without snacks=55.0; effect size [ES]=0.28, P=0.03). Snacking was an important source of fruit (ES=0.71) and dairy (ES=0.53), but also contributed to children's consumption of refined grains (ES=0.68) and SSB (ES=0.31). Very few vegetables were consumed as snacks. Furthermore, snacks contributed more to the overall diet quality (HEI-2010) of Native American (ES=0.30) and Somali (ES=0.35) youth as compared with youth from other ethnic or racial backgrounds. CONCLUSIONS Findings suggest that snacks have the potential to improve diet quality in children. Future research should examine influences on children's food choices at snack times and barriers to serving more healthful foods as snacks that are faced by ethnically or racially diverse families.
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86
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Bekelman TA, Bellows LL, McCloskey ML, Martin CK, Johnson SL. Assessing dinner meals offered at home among preschoolers from low-income families with the Remote Food Photography Method. Pediatr Obes 2019; 14:e12558. [PMID: 31347302 PMCID: PMC6991120 DOI: 10.1111/ijpo.12558] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/18/2019] [Accepted: 05/29/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND The high prevalence of obesity among preschoolers may be partially explained by the type and quantity of foods offered by parents and left unconsumed by preschoolers. OBJECTIVES (a) To compare foods offered and consumed at dinner to the Dietary Guidelines for Americans (DGAs) and the Child and Adult Care Food Program (CACFP) standards and (b) to examine the types, quantities, and nutrient composition of foods offered to and consumed by preschoolers and their plate waste. METHODS Participants were recruited from six Head Start/preschool centres. The Remote Food Photography Method was used to document dinner meals over 1 week (n = 153 meals). Energy and nutrients for foods offered, consumed, and plate waste were calculated. Foods offered and consumed were compared with the DGAs and CACFP standards. RESULTS Foods and beverages offered at dinner equaled 506 kcal, which is 36% of the DGA-recommended total daily energy intake. Meals offered and consumed were high in fat and sodium and low in fibre. Adherence to CACFP standards was low for fruits (25%) and milk (2%) and moderate for vegetables (63%). Mean plate waste (29%) was similar across food types. CONCLUSIONS Opportunities exist to improve preschoolers' adherence to the DGAs and CACFP standards by enhancing the quality of dinner meals offered to them.
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Affiliation(s)
- Traci A. Bekelman
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Laura L. Bellows
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, Colorado
| | - Morgan L. McCloskey
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, Colorado
| | - Corby K. Martin
- Pennington Biomedical Research Center, Ingestive Behavior, Weight Management & Health Promotion Laboratory, Baton Rouge, Louisiana
| | - Susan L. Johnson
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Landry MJ, Ranjit N, Hoelscher DM, Asigbee FM, Vandyousefi S, Ghaddar R, Davis JN. Validity and Reliability of an Expanded Vegetable Questionnaire Among Elementary School Children. Curr Dev Nutr 2019; 3:nzz080. [PMID: 31414072 PMCID: PMC6686082 DOI: 10.1093/cdn/nzz080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/25/2019] [Accepted: 07/02/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The purpose of this study was to expand the School Physical Activity and Nutrition questionnaire to include a greater variety of vegetables and to evaluate the relative validity and reliability of these revised items. OBJECTIVES This study utilized 2 convenience samples of third to fifth graders for an analysis: validity (n = 70) and reliability (n = 76). Validity was assessed by comparing questionnaire items with vegetable intake reported from a 24-hour dietary recall covering the same reference period. Reliability estimates were assessed via same-day test-retest. RESULTS Agreement correlations ranged from 0.35 to 0.71. Kappa statistics varied from 0.16 to 0.66. Percentage agreements ranged from 57% to 87%. Test-retest Spearman coefficients were greater than 0.50 for 6 items, weighted Kappa values were greater than 0.40 for all 7 items, and percentage agreement exceeded 75% for 5 items. CONCLUSIONS Results suggest that the questionnaire is a valid and reliable measure of the previous day's vegetable intake in third- to fifth-grade students. This trial was registered at ClinicalTrials.gov as NCT02668744.
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Affiliation(s)
- M J Landry
- The University of Texas at Austin, Department of Nutritional Sciences, Austin, TX
| | - N Ranjit
- The University of Texas Health Science Center at Houston School of Public Health in Austin, Michael and Susan Dell Center for Healthy Living, Austin, TX
| | - D M Hoelscher
- The University of Texas Health Science Center at Houston School of Public Health in Austin, Michael and Susan Dell Center for Healthy Living, Austin, TX
| | - F M Asigbee
- The University of Texas at Austin, Department of Nutritional Sciences, Austin, TX
| | - S Vandyousefi
- The University of Texas at Austin, Department of Nutritional Sciences, Austin, TX
| | - R Ghaddar
- The University of Texas at Austin, Department of Nutritional Sciences, Austin, TX
| | - J N Davis
- The University of Texas at Austin, Department of Nutritional Sciences, Austin, TX
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88
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Child-Report of Food Insecurity Is Associated with Diet Quality in Children. Nutrients 2019; 11:nu11071574. [PMID: 31336880 PMCID: PMC6683069 DOI: 10.3390/nu11071574] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 01/07/2023] Open
Abstract
Food insecurity (FI) is adversely associated with physical and mental wellbeing in children. The mechanism underlying this association is assumed to be dietary intake; however, evidence has been mixed. This study examined the relationship between self-reported FI and dietary quality among low-income children. Cross-sectional data were used from TX Sprouts, a school-based cooking, gardening, and nutrition intervention. A sample of 598 children completed two 24-h dietary recalls and a questionnaire including an adapted version of the 5-item Child Food Security Assessment (CFSA). Food security was categorized as food secure or FI based on summed CFSA scores. Dietary quality was assessed using the Health Eating Index-2015 (HEI-2015). Mixed effects linear regression models examined associations between FI and dietary quality. Children were 64% Hispanic, 55% female, and were 9.2 years old on average. Adjusting for sociodemographic characteristics, BMI percentile, and energy intake, FI was associated with lower HEI-2015 total scores (β = −3.17; 95% CI = −5.28, −1.06; p = 0.003). Compared to food secure children, FI children had lower greens and beans (2.3 vs. 1.9, p = 0.016), seafood and plant protein (2.0 vs. 1.6, p = 0.006), and added sugar (7.4 vs. 8.0, p = 0.002) component scores. Interventions targeting low-income and FI children should investigate ways to improve dietary quality.
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89
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Consuming school meals improves Brazilian children’s diets according to their social vulnerability risk. Public Health Nutr 2019; 22:2714-2719. [DOI: 10.1017/s1368980019001459] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AbstractObjective:To estimate usual diets among Brazilian children regarding the consumption of school meals and social vulnerability risks.Design:A cross-sectional study. School meal consumers were considered those children who reported consuming school meals ≥3 times/week. Social vulnerability risk was classified by an index. Dietary intake was evaluated by one 24 h dietary recall for the whole sample; a second 24 h dietary recall was administered in a sub-sample (38·6 %). The National Cancer Institute’s method was used to estimate children’s usual intake of nutrients and food groups.Setting:Municipal public schools from Belo Horizonte, Brazil.Participants:Children (n 1357) aged 8–12 years.Results:Half of the sample lived in low/medium social vulnerability risk areas and 27·9 % were school meal non-consumers. School meal consumers more frequently lived in high/very high social vulnerability risk areas (76·2 v. 68·7 %). Children with low/medium social vulnerability risk had a higher mean intake of thiamin (1·13 v. 1·04 mg) and a lower mean intake of candy (1·35 v. 1·42 g). Consumption of school meals among children under high/very high social vulnerability risk was associated with higher mean consumption of vitamin C (31·9 v. 24·1 mg), unprocessed/minimally processed foods (956·3 v. 851·9 g), fruits (128·5 v. 90·9 g) and vegetables (58·2 v. 47·1 g). Ultra-processed food product consumption was lower among school meal consumers (136·2 v. 187·7 g), especially ultra-processed beverages (252·5 v. 305·7 g).Conclusions:Consuming school meals was associated with a better usual diet quality, particularly among those with higher social vulnerability risk.
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90
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Wilson JE, Blizzard L, Gall SL, Magnussen CG, Oddy WH, Dwyer T, Venn AJ, Smith KJ. An age- and sex-specific dietary guidelines index is a valid measure of diet quality in an Australian cohort during youth and adulthood. Nutr Res 2019; 65:43-53. [DOI: 10.1016/j.nutres.2019.01.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 10/27/2022]
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Home environment predictors of vegetable and fruit intakes among Australian children aged 18 months. Appetite 2019; 139:95-104. [PMID: 30991083 DOI: 10.1016/j.appet.2019.04.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 04/08/2019] [Accepted: 04/10/2019] [Indexed: 11/21/2022]
Abstract
Suboptimal vegetable and fruit consumption by young children is common. Identifying predictors of vegetable and fruit intakes is important for informing strategies to promote sufficient intakes of these foods from early life. The aim of the present study was to examine predictors of toddlers' vegetable and fruit intakes at age 18 months. This study involved secondary analysis of data from 361 child-mother dyads participating in the Melbourne Infant Feeding, Activity and Nutrition Trial in 2008-2010 at child ages four, nine and 18 months. Children's vegetable and fruit intakes were assessed at age 18 months using multiple 24-h dietary recalls. Data on potential predictor measures were collected via parent-completed questionnaires when children were four or nine months of age. Bivariate and multivariable linear regression models were used to test associations between children's average daily vegetable or fruit intake and potential predictors controlling for treatment arm and clustering by parent group. Multivariable models also controlled for covariates and potential confounders. Home availability of vegetables at age nine months was found to predict children's vegetable intake at age 18 months and remained significant (β = 20.19, 95% CI:7.23, 33.15, p = 0.003) in the multivariable model. Children's average daily fruit intake at age 18 months was predicted by maternal education at child age four months and the availability of fruits in their home at child age nine months. Maternal education remained significant (β = 30.83, 95% CI:12.17, 49.48, p = 0.002) in the multivariable model. Strategies to promote adequate vegetable and fruit intakes among young children should address known barriers to the availability of vegetables and fruits in the home from early in life. Additionally, messages encouraging fruit consumption may need to be tailored to mothers with lower levels of education.
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Nutritional Status, Nutrient Intake, and Food Diversity Among Children With Sickle Cell Anemia. J Pediatr Hematol Oncol 2019; 41:e141-e145. [PMID: 30897609 DOI: 10.1097/mph.0000000000001377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Children with sickle cell anemia (SCA) often exhibit nutritional deficiencies and are at high risk of dying before the age of 5 years. Ensuring adequate nutrition is a critical part of health care for such children. This study aimed to investigate the association between nutritional status, nutrient intake, and food diversity in children with SCA. A descriptive cross-sectional study was conducted on 74 children with SCA, between 24 and 71 months of age. Anthropometric measurements, food and nutrients consumption were determined. The prevalence of low weight, stunting, and overweight/obesity were 16.2%, 35.1%, and 16.2%, respectively. Mean folic acid intake was low (49.05%±51.22%), whereas the intakes of protein (426.71%±171.93%), retinol (292.97%±403.88%), phosphorus (204.55%±151.35%), magnesium (233.02%±151.14%), iron (250.76%±165.81%), and zinc (243.21%±148.40%) were high. The dietary phosphorus/protein ratio was high for 31.1% of the children, and 44.6% of the children had low dietary diversity score. No correlation was found between food diversity, nutrient adequacy, and nutritional status. Despite the adequacy of the intake of most micronutrients, diet quality was inadequate, constituting mainly ultraprocessed foods. Knowing the food consumption pattern of these children enables a more resolute nutritional intervention.
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93
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Horta PM, Verly Junior E, Santos LCD. Usual diet quality among 8- to 12-year-old Brazilian children. CAD SAUDE PUBLICA 2019; 35:e00044418. [DOI: 10.1590/0102-311x00044418] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 08/27/2018] [Indexed: 11/22/2022] Open
Abstract
Abstract: Nutritional surveys are important information sources for public policy in the food and nutrition field. They focus on assessing usual dietary patterns, because health outcomes result from the long-term intake. Here we aimed to evaluate diet quality adjusted for day-to-day variance among Brazilian children. Data were collected between March 2013 and August 2015. The sample included 8- to 12-year-old children (n = 1,357) from public schools from all administrative regions of a Brazilian city. One 24-h dietary recall (24HR) was collected for the whole sample and two 24HR for two non-consecutive days of the same week for a subsample. The Healthy Eating Index-2010 (HEI-2010) was adapted to Brazilian food habits and the Brazilian dietary guidelines were used to evaluate diet quality. Statistical analysis included a multipart, nonlinear mixed model with correlated random effects proposed by the U.S. National Cancer Institute to correct diet quality for day-to-day variance. The adapted HEI-2010 total score was 51.8. Children with poorer diet quality (< 10th percentile) scored less than 41.1, and children with higher diet quality (> 90th percentile) scored more than 62.4. The overall adequacy of adapted HEI-2010 components was low. Higher adequacy percentages were identified for total protein foods (94.9%), greens (62.3%), and seafood and plant proteins (52.2%). Seven components showed less than 10% of adequacy: refined grains, fatty acids, dairy, sodium, total vegetable, whole grains, and empty calories. This study identified the main inadequacies among children’s diet quality, which can guide promotion actions for healthy eating.
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