Dietary intake and nutritional status of children and adolescents in Europe

Traditional v. modified dietary patterns and their influence on adolescents' nutritional profile

Korea has experienced exceptionally rapid economic developments. Even though the country has managed to maintain aspects of its traditional diet, dietary habits are changing, especially among adolescents. This study was carried out to identify prevailing dietary patterns among Korean adolescents and to compare the nutrient intakes and dietary behaviours between the patterns. A 3 d diet record, collected from 671 Korean adolescents aged 12–14 years in Seoul, Korea, was assessed. By cluster analysis, subjects were classified into a modified (69·9 %) and a traditional (30·1 %) dietary pattern group. The modified group consumed more bread, noodles, cookies and pizza/hamburgers compared with the traditional group, which consumed mainly rice and kimchi (fermented cabbage). The modified group had significantly higher intakes of all nutrients. It had a higher total daily energy intake (7719 kJ), a higher daily energy intake from fat (29·8 %) and a higher cholesterol intake (326 mg/d), compared with the traditional group (6686 kJ, 24·8 % and 244 mg/d, respectively). The modified group was more likely to consume fast foods, fried foods and carbonated beverages even though they consumed more fresh fruits and milk, while the traditional group was more likely to have a rice-based diet and not to skip breakfast. These results suggest that monitoring dietary behaviours of adolescents, especially in a society experiencing a nutrition transition, is necessary in order to identify both negative and positive changes in respect of risk factors for nutrition-related chronic diseases as well as for undernutrition.

Nutrient adequacy in Spanish children and adolescents

The nutritional intakes of the Spanish child and adolescent population are presented, as well as the population at risk of inadequate nutrient status. A random sample of 3534 people aged 2–24 years were interviewed between 1998 and 2000. Interviews included two 24 h recalls and a general questionnaire and anthropometric evaluations for the entire sample. After excluding under-reporters (18·7 %), the final sample was 2855 individuals (1348 males and 1507 females). The average intake of energy was 9543 kJ in males and 7804 kJ in females, with important variations seen by age group. Energy intake increased with age in both sexes until 14–17 years, which also applied to almost all of the nutrients studied, with the exception of vitamin C. A decreasing trend in the percentage of energy from carbohydrates was seen in both sexes. At the low socioeconomic level, it was observed that all nutrient intakes were less favourable when compared with higher socioeconomic levels. Nutrients with associated intakes below one-third of the Spanish recommended nutrient intake (RNI) included vitamin D (42 % of the sample) and folate (10 % of females), and the percentages falling below two-thirds of the RNI corresponded to: vitamin D (97 %), vitamin A (60 %), vitamin E (54 %), folate (58 % of females), Fe (23 % of females), vitamin C (8 %), Mg (4·5 %), Ca (5 % of females) and vitamin B6 (5 % of females). Adolescents aged between 14 and 17 years was the group with the highest nutritional risk, especially among girls. Nutritional adequacy in Spanish children was, in general, adequate, although it is necessary to analyse the implications of high inadequate intakes of vitamins D, E and A, which means that the current recommended intakes should be reconsidered. It should be noted that folate levels should be doubled in the near future.

The contribution of psychosocial and home environmental factors in explaining eating behaviours in adolescents

OBJECTIVE

The present study aimed at investigating the influence of food availability, rules and television viewing habits on eating behaviours in adolescents.

DESIGN

Cross-sectional study.

SETTING

Four randomly selected middle schools.

SUBJECTS

A sample of 534 seventh and eighth graders.

INTERVENTIONS

Validated questionnaires were used to measure the family environment and fat, soft drink and fruit consumption. Hierarchical regression analyses on fat, soft drink and fruit consumption, with demographic and psychosocial variables entered as the first and environmental factors as the second block were conducted in boys and girls.

RESULTS

Boys with more unhealthy products available at home consumed more fat (P< or =0.001, 95% CI: 8.2-29.4) and more soft drinks (P< or =0.01, 95% CI: 0.2-1.4). Boys who reported better television viewing habits ate more fruit (P< or =0.001, 95% CI: -1.7 to -0.5). Girls who reported better television viewing habits consumed less fat (P< or =0.01, 95% CI: 1.4-9.0) and more fruit (P< or =0.05, 95% CI: -1.0 to -0.1). Girls who reported higher availability of healthy products at home (P< or =0.05, 95% CI: 0.3-3.1) and more food rules (P< or =0.001, 95% CI: -1.8 to -0.5), consumed more fruit. Environmental factors were poor predictors of soft drink consumption among girls.

CONCLUSION

Availability of (un)healthy food products, family food rules and TV viewing habits were related to one or more eating behaviours in boys or girls. Although home environmental factors can play an important role in influencing adolescents' eating behaviours, these factors were generally less predictive than demographic and psychosocial variables.

Nutrition and bone growth and development

The growth and development of the human skeleton requires an adequate supply of many different nutritional factors. Classical nutrient deficiencies are associated with stunting (e.g. energy, protein, Zn), rickets (e.g. vitamin D) and other bone abnormalities (e.g. Cu, Zn, vitamin C). In recent years there has been interest in the role nutrition may play in bone growth at intakes above those required to prevent classical deficiencies, particularly in relation to optimising peak bone mass and minimising osteoporosis risk. There is evidence to suggest that peak bone mass and later fracture risk are influenced by the pattern of growth in childhood and by nutritional exposures in utero, in infancy and during childhood and adolescence. Of the individual nutrients, particular attention has been paid to Ca, vitamin D, protein and P. There has also been interest in several food groups, particularly dairy products, fruit and vegetables and foods contributing to acid-base balance. However, it is not possible at the present time to define dietary reference values using bone health as a criterion, and the question of what type of diet constitutes the best support for optimal bone growth and development remains open. Prudent recommendations (Department of Health, 1998; World Health Organization/Food and Agriculture Organization, 2003) are the same as those for adults, i.e. to consume a Ca intake close to the reference nutrient intake, optimise vitamin D status through adequate summer sunshine exposure (and diet supplementation where appropriate), be physically active, have a body weight in the healthy range, restrict salt intake and consume plenty of fruit and vegetables.

Child overweight in France and its relationship with physical activity, sedentary behaviour and socioeconomic status

OBJECTIVE

(1) To assess the prevalence of childhood overweight (OW) and obesity in France; (2) to examine how physical activity and sedentary behaviour are involved in the association between socioeconomic status (SES) and OW, while taking into account total energy intake.

DESIGN AND SUBJECTS

Representative sample of French children aged 3-14 years (n=1016) taken from the 1998-1999 cross-sectional French INCA (Enquête Individuelle et Nationale sur les Consommations Alimentaires) food consumption survey.

MEASUREMENTS

Weight and height, leisure-time physical activity (LTPA), sedentary behaviour (TV viewing and video-game use), and SES were reported by parents or children by answering questionnaires; total energy intake was assessed using a 7-day food record.

RESULTS

In total, 15.2% (95% CI: 13.0-17.6) of the children are OW (including obese), according to the IOTF (International Obesity Task Force) definition. OW is inversely associated with SES in children over 6 years of age. LTPA is negatively correlated to OW among the 3 to 5-year-old children only, whereas sedentary behaviour is positively related to OW in childhood and adolescence. From 6 years old on, SES is inversely associated with sedentary behaviour, which consequently may partly mediate the relationship between SES and OW.

CONCLUSION

This study confirms the association between SES, sedentary behaviour and childhood OW in France. It was performed before the launching of the French Program of Nutrition and Health (PNNS) in 2001 and will be repeated in 2006. This will contribute to monitoring both childhood OW and its main determinants at the population scale.

Food Intake and Serum Selenium Concentration in Elderly People

BACKGROUND/AIMS

It is becoming apparent that the essential trace element selenium plays a critical role in the maintenance of optimal health status. The objective of this study was to identify the food groups that most contributed to selenium intake and its serum levels in elderly people.

METHODS

Dietary intake was assessed in 205 institutionalized elderly by means of a 1-year food frequency questionnaire (FFQ). Intake of macronutrients and minerals of the diet were estimated. Selenium was determined in serum and analyzed by graphite-furnace atomic absorption spectrometry.

RESULTS

Selenium intake and serum concentration were both within the normal range. The major contributors to selenium intake were cereals and bakery, fish and shellfish, meat and meat products and dairy products. All of them except cereals were also associated to serum selenium. Intake of animal protein, but not the vegetable one, contributed to serum selenium.

CONCLUSION

An adequate intake of fish and meat would be of importance to improve selenium status and health principally in elderly people who are at high risk of mineral deficiency.

How to measure dietary intake and food habits in adolescence: the European perspective

AIM

This paper deals with some methodological aspects of data collection in the context of measuring dietary intake in individuals in their adolescence life stage.

METHOD

Experiences from three partners of the HELENA project in dietary intake measurement in children and adolescents are presented in this paper with emphasis on characteristics of under-reporting, long-term diet measurement and food patterns (Dortmund DONALD group), influences of survey duration on under-reporting (Ghent group) and meal habits (Spanish AVENA group).

RESULTS

Under-reporters in the DONALD Study, particularly female adolescents, had a significantly higher body mass index (BMI) than non-under-reporters; BMI could not be explained by different long-term dietary patterns during childhood and adolescence clustered according to fat consumption; consumers of fast food had higher BMI values than nonconsumers. In the Ghent experience, the decline in population mean energy intake as calculated over selected clusters of days is 184 kcal (6.5%) in boys and 116 (5.6%) in girls; the cluster of 1 recording day and the cluster of 3 recording days were not significantly different but they were both significantly different from the 7-day cluster; no significant interaction was observed between the effect of time and BMI. In the AVENA Study, the percentage of adolescents skipping breakfast was higher in females (8.6%) than in males (3.5%, P<0.001); higher BMI values were observed in those skipping breakfast than in those notskipping breakfast, but differences were statistically significant in males at 15 y and in females at 14 and 17 y; adolescents avoiding some food groups for breakfast had higher BMI values (carbohydrates, fruits and pastries in males and milk, fruits and pastries in females).

CONCLUSION

Dietary and nutrient intake data in the HELENA project will be obtained by means of repeated 24-h dietary recalls. Data from HELENA might be a basis for developing complex approaches like Healthy Eating Indices.