1
|
El Sharkawy M, Felix JF, Grote V, Voortman T, Jaddoe VWV, Koletzko B, Küpers LK. Animal and plant protein intake during infancy and childhood DNA methylation: a meta-analysis in the NutriPROGRAM consortium. Epigenetics 2024; 19:2299045. [PMID: 38198623 PMCID: PMC10793674 DOI: 10.1080/15592294.2023.2299045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Higher early-life animal protein intake is associated with a higher childhood obesity risk compared to plant protein intake. Differential DNA methylation may represent an underlying mechanism. METHODS We analysed associations of infant animal and plant protein intakes with DNA methylation in early (2-6 years, N = 579) and late (7̄-12 years, N = 604) childhood in two studies. Study-specific robust linear regression models adjusted for relevant confounders were run, and then meta-analysed using a fixed-effects model. We also performed sex-stratified meta-analyses. Follow-up analyses included pathway analysis and eQTM look-up. RESULTS Infant animal protein intake was not associated with DNA methylation in early childhood, but was associated with late-childhood DNA methylation at cg21300373 (P = 4.27 × 10¯8, MARCHF1) and cg10633363 (P = 1.09 × 10¯7, HOXB9) after FDR correction. Infant plant protein intake was associated with early-childhood DNA methylation at cg25973293 (P = 2.26 × 10-7, C1orf159) and cg15407373 (P = 2.13 × 10-7, MBP) after FDR correction. There was no overlap between the findings from the animal and plant protein analyses. We did not find enriched functional pathways at either time point using CpGs associated with animal and plant protein. These CpGs were not previously associated with childhood gene expression. Sex-stratified meta-analyses showed sex-specific DNA methylation associations for both animal and plant protein intake. CONCLUSION Infant animal protein intake was associated with DNA methylation at two CpGs in late childhood. Infant plant protein intake was associated with DNA methylation in early childhood at two CpGs. A potential mediating role of DNA methylation at these CpGs between infant protein intake and health outcomes requires further investigation.
Collapse
Affiliation(s)
- Mohammed El Sharkawy
- Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital Munich, Munich, Germany
- Munich Medical Research School, Faculty of Medicine, LMU - Ludwig-Maximilians Universität Munich, Munich, Germany
| | - Janine F. Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Veit Grote
- Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital Munich, Munich, Germany
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. Von Hauner Children’s Hospital, LMU University Hospital Munich, Munich, Germany
| | - Leanne K. Küpers
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
2
|
Kohansal A, Zangene A, Turki Jalil A, Hooshang H, Leilami K, Gerami S, Najafi M, Nouri M, Faghih S. Association between plant and animal proteins intake with lipid profile and anthropometric indices: A cross-sectional study. Nutr Health 2024; 30:129-137. [PMID: 35656771 DOI: 10.1177/02601060221104311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Results of studies on the effects of plant and animal proteins on lipid profile are controversial. So we aimed to assess the relationship between plant and animal protein intake with lipid profile and novel anthropometric indices in healthy individuals. METHOD In this cross-sectional study, 236 participants have selected from Shiraz medical centers (Iran) through random cluster sampling. Food intakes were assessed using a 168-items food frequency questionnaire (FFQ). Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) were measured. Anthropometric indices including a body shape index (ABSI), abdominal volume index (AVI), buddy roundness index (BRI), and conicity index (CI) were calculated. RESULTS In the crude and fully adjusted models, more consumption of plant proteins was associated with TG levels (OR = 2.31; 95% CI: 1.08, 4.95; P = 0.03 and OR = 2.39; 95% CI: 1.03, 5.15; P = 0.04). Also, there was a significant direct association between plant proteins and BRI in the curd model (OR = 3.55; 95% CI: 1.32, 9.54; P = 0.01), and after adjusting for age and energy intake (OR = 3.32; 95% CI: 1.21, 9.14; P = 0.01). More consumption of plant proteins was related to higher CI in the crude model (OR = 3.06; 95% CI: 1.12, 8.31; P = 0.03), but not in the fully adjusted model. CONCLUSION We found that a higher intake of plant proteins was associated with a higher TG level, BRI, and CI index. However, more research is needed to confirm these relations and provide the evidence needed to exert these findings into clinical practice.
Collapse
Affiliation(s)
- Atefeh Kohansal
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Zangene
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abduladheem Turki Jalil
- Medical Laboratories Techniques Department, Al-Mustaqbal University College, Babylon, Hilla, 51001, Iraq
| | - Hamed Hooshang
- Department of Persian Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Kimia Leilami
- Student Research Committee, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shirin Gerami
- Student Research Committee, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Najafi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehran Nouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shiva Faghih
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
3
|
Defina S, Woofenden T, Baltramonaityte V, Pariante CM, Lekadir K, Jaddoe VWV, Serdarevic F, Tiemeier H, Walton E, Felix JF, Cecil CAM. Effects of Pre- and Postnatal Early-Life Stress on Internalizing, Adiposity, and Their Comorbidity. J Am Acad Child Adolesc Psychiatry 2024; 63:255-265. [PMID: 37453606 DOI: 10.1016/j.jaac.2023.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/26/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Depression and obesity are 2 highly prevalent and often comorbid conditions. Exposure to early-life stress (ELS) has been associated with both depression and obesity in adulthood, as well as their preclinical manifestations during development. However, it remains unclear whether (1) associations differ depending on the timing of stress exposure (prenatal vs postnatal), and whether (2) ELS is a shared risk factor underlying the comorbidity between the 2 conditions. METHOD Leveraging data from 2 large population-based birth cohorts (ALSPAC: n = 8,428 [52% male participants]; Generation R: n = 4,268 [48% male participants]), we constructed comprehensive cumulative measures of prenatal (in utero) and postnatal (from birth to 10 years) ELS. At age 13.5 years, we assessed the following: internalizing symptoms (using maternal reports); fat mass percentage (using dual-energy X-ray absorptiometry); and their comorbidity, defined as the co-occurrence of high internalizing and high adiposity. RESULTS Both prenatal (total effect [95% CI] = 0.20 [0.16; 0.22]) and postnatal stress (β [95%CI] = 0.22 [0.17; 0.25]) were associated with higher internalizing symptoms, with evidence of a more prominent role of postnatal stress. A weaker association (driven primarily by prenatal stress) was observed between stress and adiposity (prenatal: 0.07 [0.05; 0.09]; postnatal: 0.04 [0.01; 0.07]). Both prenatal (odds ratio [95%CI] = 1.70 [1.47; 1.97]) and postnatal (1.87 [1.61; 2.17]) stress were associated with an increased risk of developing comorbidity. CONCLUSION We found evidence of timing and shared causal effects of ELS on psycho-cardiometabolic health in adolescence; however, future research is warranted to clarify how these associations may unfold over time. DIVERSITY & INCLUSION STATEMENT We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group.
Collapse
Affiliation(s)
- Serena Defina
- Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | | | | | | | - Vincent W V Jaddoe
- Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Fadila Serdarevic
- Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | | | - Janine F Felix
- Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Charlotte A M Cecil
- Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Leiden University Medical Center, Leiden, the Netherlands.
| |
Collapse
|
4
|
Lee GO, Caulfield LE, Paredes-Olortegui M, Penataro-Yori P, Salas MS, Kosek MN. Nutrient intakes from complementary foods are associated with cardiometabolic biomarkers among undernourished Peruvian children. J Nutr Sci 2023; 12:e80. [PMID: 37528831 PMCID: PMC10388437 DOI: 10.1017/jns.2023.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 08/03/2023] Open
Abstract
Relatively little is known about how the diet of chronically undernourished children may impact cardiometabolic biomarkers. The objective of this exploratory study was to characterise relationships between dietary patterns and the cardiometabolic profile of 153 3-5-year-old Peruvian children with a high prevalence of chronic undernutrition. We collected monthly dietary recalls from children when they were 9-24 months old. At 3-5 years, additional dietary recalls were collected, and blood pressure, height, weight, subscapular skinfolds and fasting plasma glucose, insulin and lipid profiles were assessed. Nutrient intakes were expressed as average density per 100 kcals (i) from 9 to 24 months and (ii) at follow-up. The treelet transform and sparse reduced rank regress'ion (RRR) were used to summarize nutrient intake data. Linear regression models were then used to compare these factors to cardiometabolic outcomes and anthropometry. Linear regression models adjusting for subscapular skinfold-for-age Z-scores (SSFZ) were then used to test whether observed relationships were mediated by body composition. 26 % of children were stunted at 3-5 years old. Both treelet transform and sparse RRR-derived child dietary factors are related to protein intake and associated with total cholesterol and SSFZ. Associations between dietary factors and insulin were attenuated after adjusting for SSFZ, suggesting that body composition mediated these relationships. Dietary factors in early childhood, influenced by protein intake, are associated with cholesterol profiles, fasting glucose and body fat in a chronically undernourished population.
Collapse
Key Words
- Cardiometabolic biomarkers
- Complementary foods
- HAZ, height-for-age Z-score, based on the WHO reference standard
- HDL-c, high-density lipoprotein cholesterol
- HDLZ, sd of mean HDL-c, based on the distribution of the sample
- HOMA-IR, homeostatic model assessment-insulin resistance
- INZ, sd of insulin, based on the distribution of the sample
- LDC-c, low-density lipoprotein cholesterol
- MAPZ, sd of mean arterial blood pressure, based on the distribution of the sample
- MFP, meat, fish or poultry
- Nutrient intake
- PCA, principal components analysis
- Peru
- RRR, reduced rank regression
- Stunting
- TC, total cholesterol
- TG, triglycerides
- TGZ, sd of triglycerides, based on the distribution of the sample
- WAZ, weight-for-age Z-score, based on the WHO reference standard
- WHZ, weight-for-height Z-score, based on the WHO reference standard
- vLDL-c, very low-density lipoprotein cholesterol
Collapse
Affiliation(s)
- Gwenyth O. Lee
- Rutgers Global Health Institute and Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, New Brunswick, NJ, USA
| | - Laura E. Caulfield
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Pablo Penataro-Yori
- University of Virginia Division of Infectious Diseases and International Health, Charlottesville, VA, USA
| | | | - Margaret N. Kosek
- University of Virginia Division of Infectious Diseases and International Health, Charlottesville, VA, USA
| |
Collapse
|
5
|
Arnesen EK, Thorisdottir B, Lamberg-Allardt C, Bärebring L, Nwaru B, Dierkes J, Ramel A, Åkesson A. Protein intake in children and growth and risk of overweight or obesity: A systematic review and meta-analysis. Food Nutr Res 2022; 66:8242. [PMID: 35261578 PMCID: PMC8861858 DOI: 10.29219/fnr.v66.8242] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 12/20/2021] [Accepted: 01/05/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives The aim of this study was to examine the evidence for an association between the dietary protein intake in children and the growth and risk of overweight or obesity up to 18 years of age in settings relevant for the Nordic countries. Methods We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus up to February 26, 2021 for randomized controlled trials (RCTs) or prospective cohort studies assessing for protein intake from foods (total and from different sources) in children. The outcomes include weight, height/length, adiposity indices, and/or risk of overweight and/or obesity. The risk of bias was evaluated with instruments for each respective design (Cochrane's Risk of Bias 2.0 and RoB-NObS). A meta-analysis of five cohort studies was performed. The evidence was classified according to the criteria of the World Cancer Research Fund. Results The literature search resulted in 9,132 abstracts, of which 55 papers were identified as potentially relevant. In total, 21 studies from 27 publications were included, of which five were RCTs and 16 were cohort studies. The RCTs found generally null effects of high-protein intake in infants on weight gain, nor that lower protein diets negatively affected growth. All included RCTs had some concern regarding the risk of bias and were limited by small sample sizes. Total protein intake and BMI were assessed in 12 cohorts, of which 11 found positive associations. The meta-analysis revealed a pooled effect estimate of 0.06 (95% CI 0.03, 0.1) kg/m2 BMI per one E% increment in total protein (I 2 = 15.5). Therefore, the evidence for a positive relationship between total protein intake and BMI was considered probable. Furthermore, there was probable evidence for an association between higher intake of animal protein and increased BMI. There was limited, suggestive evidence for an effect of total protein intake and higher risk of overweight and/or obesity, while no conclusions could be made on the associations between animal vs. plant protein intake and risk of overweight and/or obesity. Discussion In healthy, well-nourished children of Western populations, there is probably a causal relationship between a high-protein intake in early childhood (≤ 18 months) - particularly protein of animal origin - and higher BMI later in childhood, with consistent findings across cohort studies. A lack of RCTs precluded a stronger grading of the evidence.
Collapse
Affiliation(s)
- Erik Kristoffer Arnesen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Birna Thorisdottir
- Faculty of Sociology, Anthropology and Folkloristics and Health Science Institute, University of Iceland, Reykjavik, Iceland
| | | | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Bright Nwaru
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Sweden
| | - Jutta Dierkes
- Centre for Nutrition, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Alfons Ramel
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Agneta Åkesson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
6
|
Stokes A, Campbell KJ, Yu HJ, Szymlek-Gay EA, Abbott G, He QQ, Zheng M. Protein Intake from Birth to 2 Years and Obesity Outcomes in Later Childhood and Adolescence: A Systematic Review of Prospective Cohort Studies. Adv Nutr 2021; 12:1863-1876. [PMID: 33903896 PMCID: PMC8483959 DOI: 10.1093/advances/nmab034] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 12/18/2022] Open
Abstract
Emerging evidence shows an association between protein intake during infancy and later obesity risk, and that association may differ by protein sources. This systematic review summarized and evaluated prospective cohort studies assessing the long-term association of total protein intake and protein sources during infancy (from birth to 2 y) with subsequent obesity outcomes in childhood or adolescence. Literature searches were conducted in Embase, Medline, Scopus, and Web of Science. Sixteen studies that reported associations between total protein intake and/or protein intake from different sources from birth to 2 y and ≥1 obesity outcomes in childhood or adolescence from 9 cohorts were identified. Most studies (11/16) were rated as high quality. The most frequently reported association was total protein intake and BMI (up to 10 y) with 6 out of 7 cohorts showing significant positive associations. Similar associations were found for animal protein, but not for plant protein. Limited studies examined the association between protein intake (both total and sources) and body composition (body fat, fat mass, and fat-free mass) and revealed inconsistent findings. Overall, higher intakes of total and animal protein during infancy were associated with higher BMI in childhood and adolescence. Future studies investigating the contribution of protein sources in long-term obesity development are needed. This review was registered at PROSPERO as CRD42020166540.
Collapse
Affiliation(s)
- Alexandra Stokes
- School of Exercise and Nutrition eSciences, Deakin University, Geelong, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Hong-Jie Yu
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Ewa A Szymlek-Gay
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Qi-Qiang He
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| |
Collapse
|
7
|
Siddiqui NZ, Nguyen AN, Santos S, Voortman T. Diet quality and cardiometabolic health in childhood: the Generation R Study. Eur J Nutr 2021; 61:729-736. [PMID: 34528119 PMCID: PMC8854322 DOI: 10.1007/s00394-021-02673-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 08/31/2021] [Indexed: 11/24/2022]
Abstract
Purpose Diet is an important determinant of cardiometabolic disease risk in adults. We aimed to study associations of diet quality with cardiometabolic health in school-age children. Methods This study was embedded in the Generation R Study a prospective population-based cohort in Rotterdam, the Netherlands and included 3991 children. Food intake was assessed with a Food-Frequency Questionnaire at age 8 years. A diet quality score (0–10) was calculated reflecting adherence to age-specific dietary guidelines. The following outcome variables were measured at age 10 years and used to create a continuous cardiometabolic risk factor score: body fat percentage, insulin, triglycerides, HDL cholesterol, and systolic and diastolic blood pressure. Outcomes were expressed in age- and sex-specific standard deviation scores (SDS). Multivariable linear regression models were used to assess associations between the diet quality score and the cardiometabolic risk factor score and with the individual cardiometabolic risk factors. Results In models adjusted for socioeconomic and lifestyle factors and BMI, a higher diet quality was associated with a lower cardiometabolic risk factor score [− 0.08 per point higher diet score, (95% CI − 0.15, − 0.001)]. This association was mainly driven by associations of higher diet quality with lower systolic [− 0.04 SD (95% CI − 0.06, − 0.01)] and diastolic blood pressure [− 0.05 SD, (95% CI − 0.07, − 0.02)]. No statistically significant associations were found for insulin, triglycerides, HDL cholesterol, or body fat percentage as individual factors. Conclusions We found an association between higher diet quality and better cardiometabolic health in childhood, mainly driven by a lower blood pressure. Further research is needed to explore associations of diet quality in childhood with long-term cardiometabolic health. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02673-2.
Collapse
Affiliation(s)
- Noreen Z Siddiqui
- Department of Epidemiology, Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Anh N Nguyen
- Department of Epidemiology, Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Susana Santos
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Sophia Children's Hospital, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. .,Division of Human Nutrition & Health, Wageningen University & Research, Wageningen, The Netherlands.
| |
Collapse
|
8
|
Newton-Tanzer E, Demmelmair H, Horak J, Holdt L, Koletzko B, Grote V. Acute Metabolic Response in Adults to Toddler Milk Formulas with Alternating Higher and Lower Protein and Fat Contents, a Randomized Cross-Over Trial. Nutrients 2021; 13:nu13093022. [PMID: 34578900 PMCID: PMC8472683 DOI: 10.3390/nu13093022] [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: 07/31/2021] [Revised: 08/24/2021] [Accepted: 08/27/2021] [Indexed: 01/23/2023] Open
Abstract
Protein intake in early life influences metabolism, weight gain, and later obesity risk. As such, a better understanding of the effects of protein intake on the postprandial metabolism and its dynamics over time may elucidate underlying mechanisms. In a randomized crossover study, we observed fasted adults who consumed two isocaloric toddler milk formulas concentrated as meals of 480 kcal with 67 g of carbohydrates 30 g (HP) or 7 g (LP) protein, and 10 g or 20 g fat, respectively. Anthropometry and body plethysmography were assessed, and blood samples collected at baseline and over five hours. Time-specific concentrations, areas under concentration curves (AUC), and maximum values of metabolites were compared by paired t-tests to examine the effects of protein content of toddler milks on postprandial plasma concentrations of insulin, glucose, branched-chain amino acids (BCAA), urea and triglycerides. Twenty-seven men and women aged 26.7 ± 5.0 years (BMI: 22.2 ± 2.5 kg/m2) (mean ± SD) participated. BCAA AUC, and Cmax values were significantly higher with HP than LP (144,765 ± 21,221 vs. 97,089 ± 14,650 µmol·min/L, p < 0.001; 656 ± 120 vs. 407 ± 66 µmol/L, p < 0.001), as were insulin AUC and Cmax values (6674 ± 3013 vs. 5600 ± 2423 µmol·min/L, p = 0.005; 71 ± 37 vs. 55 ± 28 µmol/L, p = 0.001). Higher glucose, urea, and triglyceride concentrations occurred in the late postprandial phase (≥180 min) with HP. In conclusion, we noted that higher milk protein intake induces increased postprandial BCAA concentrations for at least 5 h and led to higher initial insulin secretion. Gluconeogenesis due to an influx of amino acids and their degradation after HP meal might explain the late effects of protein intake on glucose and insulin.
Collapse
Affiliation(s)
- Emily Newton-Tanzer
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, LMU University Hospital Munich, 80337 Munich, Germany; (E.N.-T.); (H.D.); (J.H.); (V.G.)
| | - Hans Demmelmair
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, LMU University Hospital Munich, 80337 Munich, Germany; (E.N.-T.); (H.D.); (J.H.); (V.G.)
| | - Jeannie Horak
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, LMU University Hospital Munich, 80337 Munich, Germany; (E.N.-T.); (H.D.); (J.H.); (V.G.)
| | - Lesca Holdt
- Institute of Laboratory Medicine, LMU University Hospital Munich, 81377 Munich, Germany;
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, LMU University Hospital Munich, 80337 Munich, Germany; (E.N.-T.); (H.D.); (J.H.); (V.G.)
- Correspondence: ; Tel.: +49-(0)89-4400-52826
| | - Veit Grote
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, LMU University Hospital Munich, 80337 Munich, Germany; (E.N.-T.); (H.D.); (J.H.); (V.G.)
| |
Collapse
|
9
|
Larrosa S, Luque V, Grote V, Closa-Monasterolo R, Ferré N, Koletzko B, Verduci E, Gruszfeld D, Xhonneux A, Escribano J. Fibre Intake Is Associated with Cardiovascular Health in European Children. Nutrients 2020; 13:E12. [PMID: 33374515 PMCID: PMC7822117 DOI: 10.3390/nu13010012] [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: 12/01/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND We aimed at analysing the association between dietary fibre intake during childhood and cardiovascular health markers. METHODS We used observational longitudinal analysis and recorded diet using 3-day diaries at the ages of 3, 4, 5, 6, and 8 years in children from the EU Childhood Obesity Project Trial. At the age of 8, waist circumference, systolic and diastolic blood pressure (SBP and DBP) and biochemical analyses (lipoproteins, triglycerides and homeostasis model for insulin resistance (HOMA-IR)) were evaluated. Those parameters were combined into a cardiometabolic risk score through the sum of their internal z-scores. RESULTS Four-hundred children (51.8% girls) attended to the 8-year visit with a 3-day diary. Adjusted linear regression models showed that children who repeatedly stayed in the lowest tertile of fibre intake during childhood had higher HOMA-IR (p = 0.004), higher cardiometabolic risk score (p = 0.02) and a nonsignificant trend toward a higher SBP at 8 years. The higher the dietary intake of soluble fibre (from fruits and vegetables) at 8 years, the lower the HOMA-IR and the cardiometabolic risk score (p = 0.002; p = 0.004). SBP was directly associated with fibre from potatoes and inversely with fibre from nuts and pulses. CONCLUSION A diet rich in dietary fibre from fruits, vegetables, pulses and nuts from early childhood was associated to a healthier cardiovascular profile, regardless of children's weight.
Collapse
Affiliation(s)
- Susana Larrosa
- Paediatrics, Nutrition and Development Research Unit, Universitat Rovira i Virgili, IISPV, 43204 Reus, Spain; (S.L.); (R.C.-M.); (N.F.)
| | - Veronica Luque
- Paediatrics, Nutrition and Development Research Unit, Universitat Rovira i Virgili, IISPV, 43204 Reus, Spain; (S.L.); (R.C.-M.); (N.F.)
- Serra Hunter Fellow, Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Veit Grote
- Department Paediatrics, Dr. von Hauner Children’s Hospital, University Hospital, LMU Ludwig-Maximilians-Universität, 80337 Munich, Germany; (V.G.); (B.K.)
| | - Ricardo Closa-Monasterolo
- Paediatrics, Nutrition and Development Research Unit, Universitat Rovira i Virgili, IISPV, 43204 Reus, Spain; (S.L.); (R.C.-M.); (N.F.)
| | - Natalia Ferré
- Paediatrics, Nutrition and Development Research Unit, Universitat Rovira i Virgili, IISPV, 43204 Reus, Spain; (S.L.); (R.C.-M.); (N.F.)
| | - Berthold Koletzko
- Department Paediatrics, Dr. von Hauner Children’s Hospital, University Hospital, LMU Ludwig-Maximilians-Universität, 80337 Munich, Germany; (V.G.); (B.K.)
- Else Kröner-Seniorprofessor of Paediatrics, LMU Ludwig-Maximilians-Universität, 80337 Munich, Germany
| | - Elvira Verduci
- Department of Health Sciences, University of Milan, 20146 Milano, Italy;
- Department of Pediatrics Ospedale Vittore Buzzi, University of Milan, 20154 Milano, Italy
| | - Dariusz Gruszfeld
- Neonatal Department, Children’s Memorial Health Institute, 04-730 Warsaw, Poland;
| | | | - Joaquin Escribano
- Paediatrics, Nutrition and Development Research Unit, Universitat Rovira i Virgili, IISPV, 43204 Reus, Spain; (S.L.); (R.C.-M.); (N.F.)
- Serra Hunter Fellow, Universitat Rovira i Virgili, 43201 Reus, Spain
| |
Collapse
|
10
|
Segovia-Siapco G, Khayef G, Pribis P, Oda K, Haddad E, Sabaté J. Animal Protein Intake Is Associated with General Adiposity in Adolescents: The Teen Food and Development Study. Nutrients 2019; 12:E110. [PMID: 31906138 PMCID: PMC7019331 DOI: 10.3390/nu12010110] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/21/2019] [Accepted: 12/26/2019] [Indexed: 12/12/2022] Open
Abstract
Protein plays a crucial role in the growth and development of adolescents. However, being a secondary energy source, protein's role in obesity has been sidelined. We examined whether intake of protein (total, animal, plant), branched-chain (BCAAs), and sulfur-containing (SCAAs) amino acids are associated with general body and central obesity and body composition in a cross-sectional study among healthy adolescents. Students aged 12-18 years old (n = 601) in schools near two major Adventist universities in California and Michigan provided dietary data via a validated web-based food frequency questionnaire (FFQ) and anthropometric data during school visits. Intakes of total, animal, and plant proteins, and BCAAs and SCAAs were derived from FFQ data. We defined general body obesity with body-mass-index-for-age (BMIz) z-scores and central obesity with waist-to-height ratios (WHtR). After full adjustment for covariates, multiple regression analyses showed significant positive associations between intakes of total protein (β = 0.101, 95% CI: 0.041, 0.161), animal protein (β = 0.118, 95% CI: 0.057, 0.178), BCAAs (β = 0.056, 95% CI: 0.025, 0.087), and SCAAs (β = 0.025, 95% CI: 0.012, 0.038) with general body adiposity. Animal protein (β = 0.017, 95% CI: 0.001, 0.033) and SCAAs (β = 0.004, 95% CI: 0.000, 0.008) were also associated with central obesity. Total and animal protein and BCAA and SCAA were also significantly associated with fat mass. Our findings suggest that high protein intake may pose a possible detriment to adolescent health. Longitudinal and safety evaluation studies are recommended.
Collapse
Affiliation(s)
- Gina Segovia-Siapco
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; (K.O.); (E.H.); (J.S.)
| | - Golandam Khayef
- Don B. Huntley College of Agriculture, California State Polytechnic University, 3801 West Temple Avenue, Pomona, CA 91768, USA
| | - Peter Pribis
- Department of Individual, Family & Community Education, Nutrition and Dietetics Program, College of Education, University of New Mexico, Albuquerque, NM 87131, USA;
| | - Keiji Oda
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; (K.O.); (E.H.); (J.S.)
| | - Ella Haddad
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; (K.O.); (E.H.); (J.S.)
| | - Joan Sabaté
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; (K.O.); (E.H.); (J.S.)
| |
Collapse
|
11
|
Abstract
High protein intake in young children is associated with excess gains in weight and body fat, but the specific role of different protein sources has yet to be described. The study aimed to investigate the role of different types of protein in the post-weaning stage on weight, BMI and overweight/obesity at 60 months. Intakes of animal, dairy and plant protein and a dietary pattern characterising variation in protein types at 21 months of age were estimated using a 3-d diet diary in a cohort of 2154 twins; weight and height were recorded every 3 months from birth to 60 months. Longitudinal mixed-effect models investigated the associations between sources of protein intake or dietary pattern scores and BMI, weight and overweight/obesity from 21 months up to 60 months. Adjusting for confounders, dairy protein intake at 21 months was positively associated with greater weight (46 (95 % CI 21, 71) g and BMI up to 60 months (0·04 (95 % CI 0·004, 0·070) kg/m2) and the odds of overweight/obesity at 3 years (OR 1·12; 95 % CI 1·00, 1·24). Milk showed associations of similar magnitude. A dietary pattern low in dairy protein and high in plant protein was associated with lower weight gain up to 60 months, but not overweight/obesity. Intake of dairy products in early childhood is most strongly associated with weight gain, compared with other protein sources. A dietary pattern characterised by lower protein intake and greater protein source diversity at 2 years may confer a lower risk of excess weight gain.
Collapse
|
12
|
Effect of early postnatal nutrition on chronic kidney disease and arterial hypertension in adulthood: a narrative review. J Dev Orig Health Dis 2018; 9:598-614. [PMID: 30078383 DOI: 10.1017/s2040174418000454] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Intrauterine growth restriction (IUGR) has been identified as a risk factor for adult chronic kidney disease (CKD), including hypertension (HTN). Accelerated postnatal catch-up growth superimposed to IUGR has been shown to further increase the risk of CKD and HTN. Although the impact of excessive postnatal growth without previous IUGR is less clear, excessive postnatal overfeeding in experimental animals shows a strong impact on the risk of CKD and HTN in adulthood. On the other hand, food restriction in the postnatal period seems to have a protective effect on CKD programming. All these effects are mediated at least partially by the activation of the renin-angiotensin system, leptin and neuropeptide Y (NPY) signaling and profibrotic pathways. Early nutrition, especially in the postnatal period has a significant impact on the risk of CKD and HTN at adulthood and should receive specific attention in the prevention of CKD and HTN.
Collapse
|
13
|
Naude CE, Visser ME, Nguyen KA, Durao S, Schoonees A. Effects of total fat intake on bodyweight in children. Cochrane Database Syst Rev 2018; 7:CD012960. [PMID: 29974953 PMCID: PMC6513603 DOI: 10.1002/14651858.cd012960.pub2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND As part of efforts to prevent childhood overweight and obesity, we need to understand the relationship between total fat intake and body fatness in generally healthy children. OBJECTIVES To assess the effects and associations of total fat intake on measures of weight and body fatness in children and young people not aiming to lose weight. SEARCH METHODS For this update we revised the previous search strategy and ran it over all years in the Cochrane Library, MEDLINE (Ovid), MEDLINE (PubMed), and Embase (Ovid) (current to 23 May 2017). No language and publication status limits were applied. We searched the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov for ongoing and unpublished studies (5 June 2017). SELECTION CRITERIA We included randomised controlled trials (RCTs) in children aged 24 months to 18 years, with or without risk factors for cardiovascular disease, randomised to a lower fat (30% or less of total energy (TE)) versus usual or moderate-fat diet (greater than 30%TE), without the intention to reduce weight, and assessed a measure of weight or body fatness after at least six months. We included prospective cohort studies if they related baseline total fat intake to weight or body fatness at least 12 months later. DATA COLLECTION AND ANALYSIS We extracted data on participants, interventions or exposures, controls and outcomes, and trial or cohort quality characteristics, as well as data on potential effect modifiers, and assessed risk of bias for all included studies. We extracted body weight and blood lipid levels outcomes at six months, six to 12 months, one to two years, two to five years and more than five years for RCTs; and for cohort studies, at baseline to one year, one to two years, two to five years, five to 10 years and more than 10 years. We planned to perform random-effects meta-analyses with relevant subgrouping, and sensitivity and funnel plot analyses where data allowed. MAIN RESULTS We included 24 studies comprising three parallel-group RCTs (n = 1054 randomised) and 21 prospective analytical cohort studies (about 25,059 children completed). Twenty-three studies were conducted in high-income countries. No meta-analyses were possible, since only one RCT reported the same outcome at each time point range for all outcomes, and cohort studies were too heterogeneous to combine.Effects of dietary counselling to reduce total fat intake from RCTsTwo studies recruited children aged between 4 and 11 years and a third recruited children aged 12 to 13 years. Interventions were combinations of individual and group counselling, and education sessions in clinics, schools and homes, delivered by dieticians, nutritionists, behaviourists or trained, supervised teachers. Concerns about imprecision and poor reporting limited our confidence in our findings. In addition, the inclusion of hypercholesteraemic children in two trials raised concerns about applicability.One study of dietary counselling to lower total fat intake found that the intervention may make little or no difference to weight compared with usual diet at 12 months (mean difference (MD) -0.50 kg, 95% confidence interval (CI) -1.78 to 0.78; n = 620; low-quality evidence) and at three years (MD -0.60 kg, 95% CI -2.39 to 1.19; n = 612; low-quality evidence). Education delivered as a classroom curriculum probably decreased BMI in children at 17 months (MD -1.5 kg/m2, 95% CI -2.45 to -0.55; 1 RCT; n = 191; moderate-quality evidence). The effects were smaller at longer term follow-up (five years: MD 0 kg/m2, 95% CI -0.63 to 0.63; n = 541; seven years; MD -0.10 kg/m2, 95% CI -0.75 to 0.55; n = 576; low-quality evidence).Dietary counselling probably slightly reduced total cholesterol at 12 months compared to controls (MD -0.15 mmol/L, 95% CI -0.24 to -0.06; 1 RCT; n = 618; moderate-quality evidence), but may make little or no difference over longer time periods. Dietary counselling probably slightly decreased low-density lipoprotein (LDL) cholesterol at 12 months (MD -0.12 mmol/L, 95% CI -0.20 to -0.04; 1 RCT; n = 618, moderate-quality evidence) and at five years (MD -0.09, 95% CI -0.17 to -0.01; 1 RCT; n = 623; moderate-quality evidence), compared to controls. Dietary counselling probably made little or no difference to HDL-C at 12 months (MD -0.03 mmol/L, 95% CI -0.08 to 0.02; 1 RCT; n = 618; moderate-quality evidence), and at five years (MD -0.01 mmol/L, 95% CI -0.06 to 0.04; 1 RCT; n = 522; moderate-quality evidence). Likewise, counselling probably made little or no difference to triglycerides in children at 12 months (MD -0.01 mmol/L, 95% CI -0.08 to 0.06; 1 RCT; n = 618; moderate-quality evidence). Lower versus usual or modified fat intake may make little or no difference to height at seven years (MD -0.60 cm, 95% CI -2.06 to 0.86; 1 RCT; n = 577; low-quality evidence).Associations between total fat intake, weight and body fatness from cohort studiesOver half the cohort analyses that reported on primary outcomes suggested that as total fat intake increases, body fatness measures may move in the same direction. However, heterogeneous methods and reporting across cohort studies, and predominantly very low-quality evidence, made it difficult to draw firm conclusions and true relationships may be substantially different. AUTHORS' CONCLUSIONS We were unable to reach firm conclusions. Limited evidence from three trials that randomised children to dietary counselling or education to lower total fat intake (30% or less TE) versus usual or modified fat intake, but with no intention to reduce weight, showed small reductions in body mass index, total- and LDL-cholesterol at some time points with lower fat intake compared to controls. There were no consistent effects on weight, high-density lipoprotein (HDL) cholesterol or height. Associations in cohort studies that related total fat intake to later measures of body fatness in children were inconsistent and the quality of this evidence was mostly very low. Most studies were conducted in high-income countries, and may not be applicable in low- and middle-income settings. High-quality, longer-term studies are needed, that include low- and middle-income settings to look at both possible benefits and harms.
Collapse
Affiliation(s)
- Celeste E Naude
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health SciencesFrancie van Zijl DriveCape TownSouth Africa
| | - Marianne E Visser
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health SciencesFrancie van Zijl DriveCape TownSouth Africa
- South African Medical Research CouncilCochrane South AfricaCape TownSouth Africa
| | - Kim A Nguyen
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health SciencesFrancie van Zijl DriveCape TownSouth Africa
| | - Solange Durao
- South African Medical Research CouncilCochrane South AfricaCape TownSouth Africa
| | - Anel Schoonees
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health SciencesFrancie van Zijl DriveCape TownSouth Africa
| | | |
Collapse
|
14
|
Naude CE, Visser ME, Nguyen KA, Durao S, Schoonees A. Effects of total fat intake on bodyweight in children. Cochrane Database Syst Rev 2018; 2:CD012960. [PMID: 29446437 PMCID: PMC6491333 DOI: 10.1002/14651858.cd012960] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND As part of efforts to prevent childhood overweight and obesity, we need to understand the relationship between total fat intake and body fatness in generally healthy children. OBJECTIVES To assess the effects of total fat intake on measures of weight and body fatness in children and young people not aiming to lose weight. SEARCH METHODS For this update we revised the previous search strategy and ran it over all years in the Cochrane Library, MEDLINE (Ovid), MEDLINE (PubMed), and Embase (Ovid) (current to 23 May 2017). No language and publication status limits were applied. We searched the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov for ongoing and unpublished studies (5 June 2017). SELECTION CRITERIA We included randomised controlled trials (RCTs) in children aged 24 months to 18 years, with or without risk factors for cardiovascular disease, randomised to a lower fat (30% or less of total energy (TE)) versus usual or moderate-fat diet (greater than 30%TE), without the intention to reduce weight, and assessed a measure of weight or body fatness after at least six months. We included prospective analytical cohort studies in these children if they related baseline total fat intake to weight or body fatness at least 12 months later. We duplicated inclusion decisions and resolved disagreement by discussion with other authors. DATA COLLECTION AND ANALYSIS We extracted data on participants, interventions or exposures, controls and outcomes, and trial or cohort quality characteristics, as well as data on potential effect modifiers, and assessed risk of bias for all included studies. We extracted outcome data using the following time point ranges, when available: RCTs: baseline to six months, six to 12 months, one to two years, two to five years and more than five years; cohort studies: baseline to one year, one to two years, two to five years, five to 10 years and more than 10 years. We planned to perform random-effects meta-analyses with relevant subgrouping, and sensitivity and funnel plot analyses where data allowed. MAIN RESULTS We included 24 studies comprising three parallel-group RCTs (n = 1054 randomised) and 21 prospective analytical cohort studies (about 25,059 children completed). Twenty-three were conducted in high-income countries. No meta-analyses were possible, since only one RCT reported the same outcome at each time point range for all outcomes, and cohort studies were too heterogeneous.For the RCTs, concerns about imprecision and poor reporting limited our confidence in our findings. In addition, the inclusion of hypercholesteraemic children in two trials raised concerns about applicability. Lower versus usual or modified total fat intake may have made little or no difference to weight over a six- to twelve month period (mean difference (MD) -0.50 kg, 95% confidence interval (CI) -1.78 to 0.78; 1 RCT; n = 620; low-quality evidence), nor a two- to five-year period (MD -0.60 kg, 95% CI -2.39 to 1.19; 1 RCT; n = 612; low-quality evidence). Compared to controls, lower total fat intake (30% or less TE) probably decreased BMI in children over a one- to two-year period (MD -1.5 kg/m2, 95% CI -2.45 to -0.55; 1 RCT; n = 191; moderate-quality evidence), with no other differences evident across the other time points (two to five years: MD 0.00 kg/m2, 95% CI -0.63 to 0.63; 1 RCT; n = 541; greater than five years; MD -0.10 kg/m2, 95% CI -0.75 to 0.55; 1 RCT; n = 576; low-quality evidence). Lower fat intake probably slightly reduced total cholesterol over six to 12 months compared to controls (MD -0.15 mmol/L, 95% CI -0.24 to -0.06; 1 RCT; n = 618; moderate-quality evidence), but may make little or no difference over longer time periods. Lower fat intake probably slightly decreased low-density lipoprotein (LDL) cholesterol over six to 12 months (MD -0.12 mmol/L, 95% CI -0.20 to -0.04; 1 RCT; n = 618, moderate-quality evidence) and over two to five years (MD -0.09, 95% CI -0.17 to -0.01; 1 RCT; n = 623; moderate-quality evidence), compared to controls. However, lower total fat intake probably made little or no difference to HDL-C over a six- to 12-month period (MD -0.03 mmol/L, 95% CI -0.08 to 0.02; 1 RCT; n = 618; moderate-quality evidence), nor a two- to five-year period (MD -0.01 mmol/L, 95% CI -0.06 to 0.04; 1 RCT; n = 522; moderate-quality evidence). Likewise, lower total fat intake probably made little or no difference to triglycerides in children over a six- to 12-month period (MD -0.01 mmol/L, 95% CI -0.08 to 0.06; 1 RCT; n = 618; moderate-quality evidence). Lower versus usual or modified fat intake may make little or no difference to height over more than five years (MD -0.60 cm, 95% CI -2.06 to 0.86; 1 RCT; n = 577; low-quality evidence).Over half the cohort analyses that reported on primary outcomes suggested that as total fat intake increases, body fatness measures may move in the same direction. However, heterogeneous methods and reporting across cohort studies, and predominantly very low-quality evidence, made it difficult to draw firm conclusions and true relationships may be substantially different. AUTHORS' CONCLUSIONS We were unable to reach firm conclusions. Limited evidence from three trials that randomised children to a lower total fat intake (30% or less TE) versus usual or modified fat intake, but with no intention to reduce weight, showed small reductions in body mass index, total- and LDL-cholesterol at some time points with lower fat intake compared to controls, and no consistent differences in effects on weight, high-density lipoprotein (HDL) cholesterol or height. Associations in cohort studies that related total fat intake to later measures of body fatness in children were inconsistent and the quality of this evidence was mostly very low. Twenty-three out of 24 included studies were conducted in high-income countries, and may not be applicable in low- and middle-income settings. High-quality, longer-term studies are needed, that include low- and middle-income settings and look at both possible benefits and risks.
Collapse
Affiliation(s)
- Celeste E Naude
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health SciencesFrancie van Zijl DriveCape TownSouth Africa
| | | | - Kim A Nguyen
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health SciencesFrancie van Zijl DriveCape TownSouth Africa
| | - Solange Durao
- South African Medical Research CouncilCochrane South AfricaCape TownSouth Africa
| | - Anel Schoonees
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health SciencesFrancie van Zijl DriveCape TownSouth Africa
| |
Collapse
|
15
|
Hauta-Alus HH, Korkalo L, Holmlund-Suila EM, Rosendahl J, Valkama SM, Enlund-Cerullo M, Helve OM, Hytinantti TK, Mäkitie OM, Andersson S, Viljakainen HT. Food and Nutrient Intake and Nutrient Sources in 1-Year-Old Infants in Finland: A Cross-Sectional Analysis. Nutrients 2017; 9:E1309. [PMID: 29194422 PMCID: PMC5748759 DOI: 10.3390/nu9121309] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/22/2017] [Accepted: 11/28/2017] [Indexed: 02/07/2023] Open
Abstract
The infant diet has short- and long-term health consequences. Updated data regarding the dietary intake of Finnish infants are lacking. The objectives of this study were to describe infant food and nutrient intake and to identify food sources of the nutrients. Altogether, 739 healthy infants were studied. Dietary intake and breastfeeding frequency were assessed with a three-day food record at 1 year of age. Dietary intake was calculated separately for non-breastfed and breastfed infants. One-third (36%) of the infants were partially breastfed and 95% consumed mass-produced baby foods. The infants' diet consisted mainly of infant formula, dairy milk, porridges, fruit and berry foods, and meat dishes. The mean vegetable, fruit and berry consumption was 199 g/day. Most nutrient intakes were adequate except for fat, linoleic acid, vitamin D and iron from food. Mean sucrose intake, as a percentage of total energy intake (E%), was 5-6 E%. High protein intake (>20 E%) was observed in 19% of non-breastfed infants. Overall, the infants' diet was favorable since vegetable and fruit consumption was reasonably high and nutrient intake was mostly adequate. However, the fat intake was lower, and protein intake higher than recommended. Increasing the consumption of vegetable oils and reducing the intake of red meat and dairy milk may further improve the diet of 1-year-olds.
Collapse
Affiliation(s)
- Helena H Hauta-Alus
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Liisa Korkalo
- Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland.
| | - Elisa M Holmlund-Suila
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Jenni Rosendahl
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Saara M Valkama
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Maria Enlund-Cerullo
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Otto M Helve
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Timo K Hytinantti
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Outi M Mäkitie
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
- Folkhälsan Research Center, Haartmaninkatu 8, P.O. Box 63, 00014 Helsinki, Finland.
- Center for Molecular Medicine, Karolinska Institute and Clinical Genetics, Karolinska University Hospital, Solna, 171 76 Stockholm, Sweden.
| | - Sture Andersson
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Heli T Viljakainen
- Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland.
- Folkhälsan Research Center, Haartmaninkatu 8, P.O. Box 63, 00014 Helsinki, Finland.
| |
Collapse
|
16
|
Looman KIM, Jansen MAE, Voortman T, van den Heuvel D, Jaddoe VWV, Franco OH, van Zelm MC, Moll HA. The role of vitamin D on circulating memory T cells in children: The Generation R study. Pediatr Allergy Immunol 2017; 28:579-587. [PMID: 28686349 DOI: 10.1111/pai.12754] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/04/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND Previous studies have demonstrated that vitamin D affects T-cell function and maturation via the vitamin D receptor. However, no studies in children have been performed on this topic. Because most of the T-cell memory is formed in the first 5 years of life, we aimed to determine the association between serum 25-hydroxyvitamin D (25(OH)D) levels and numbers of circulatory naive, central memory (Tcm), and effector memory (Tem) T lymphocytes in a large population of healthy children. METHODS Among 3189 children participating in a population-based prospective cohort, we measured 25(OH)D levels and performed detailed immunophenotyping of naive and memory T lymphocytes at a median age of 6.0 years (95% range 5.7-7.9). Detailed lymphocyte subsets were available in 986 children. Multivariable linear regression analyses were performed to determine the association between 25(OH)D and the maturation of T lymphocytes in children adjusted for cord blood 25(OH)D levels, herpes seropositivity, sociodemographic and lifestyle confounders. Furthermore, multivariable logistic regression analyses were performed to determine associations between 25(OH)D and childhood infections. RESULTS Higher 25(OH)D levels were associated with higher numbers of Tem lymphocytes. Every 10 nmol/L higher 25(OH)D was associated with 2.20% (95% CI 0.54-3.89; P=.009) higher CD4TemRA, 1.50% (95% CI 0.38-2.62; P=.008) higher CD4TemRO, and 1.82% (95% CI 0.11-3.56; P=.037) higher CD8TemRA cell numbers. Generally, stronger associations were observed among boys. 25(OH)D levels were not significantly associated with naive, Tcm cell numbers, herpes seropositivity, or URTIs. CONCLUSIONS Our results suggest that vitamin D enhances cellular immunity in young children.
Collapse
Affiliation(s)
- Kirsten I M Looman
- Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Sophia Children's Hospital, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Michelle A E Jansen
- Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Sophia Children's Hospital, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Trudy Voortman
- Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Diana van den Heuvel
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Vincent W V Jaddoe
- Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Sophia Children's Hospital, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Menno C van Zelm
- Department of Immunology and Pathology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, VIC, Australia
| | - Henriëtte A Moll
- Department of Pediatrics, Sophia Children's Hospital, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
17
|
Leermakers ETM, van den Hooven EH, Franco OH, Jaddoe VWV, Moll HA, Kiefte-de Jong JC, Voortman T. A priori and a posteriori derived dietary patterns in infancy and cardiometabolic health in childhood: The role of body composition. Clin Nutr 2017; 37:1589-1595. [PMID: 28830701 DOI: 10.1016/j.clnu.2017.08.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/01/2017] [Accepted: 08/08/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND & AIMS Cardiometabolic risk has its origins in early life. However, it is unclear whether diet during early childhood is associated with cardiometabolic health, and what the role is of obesity. We aimed to study whether overall diet during early childhood is associated with cardiometabolic health and to examine if difference in body composition explain this association. METHODS We examined associations of different types of dietary patterns in infancy with cardiometabolic health at school age among 2026 Dutch children participating in a population-based cohort in the Netherlands. Food intake at the age of 1 year was assessed with a food-frequency questionnaire. Three dietary pattern approaches were used: 1) An a priori-defined diet quality score; 2) dietary patterns based on variation in food intake, derived from principal component analysis (PCA); and 3) dietary patterns based on variations in fat and fat-free mass index, derived with reduced-rank regression (RRR). At the children's age of 6 years, we measured their body composition, systolic and diastolic blood pressure, and serum concentrations of insulin, triglycerides, and HDL-cholesterol, which we combined in a cardiometabolic risk-factor score. RESULTS We observed that, after adjustment for confounders, children with higher adherence to a 'Health-conscious' PCA-derived pattern had a lower cardiometabolic risk-factor score (-0.07 SD (95%CI -0.12; -0.02) per SD). This association did not change after adjustment for fat and fat-free mass index. The RRR-derived dietary patterns based on variations in body composition were not associated with the cardiometabolic risk-factor score. CONCLUSIONS Our results suggest that diet in early childhood may affect cardiometabolic health independent of differences in body composition.
Collapse
Affiliation(s)
- Elisabeth T M Leermakers
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Edith H van den Hooven
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Henriëtte A Moll
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Leiden University College, The Hague, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| |
Collapse
|
18
|
Voortman T, Tielemans MJ, Stroobant W, Schoufour JD, Kiefte-de Jong JC, Steenweg-de Graaff J, van den Hooven EH, Tiemeier H, Jaddoe VWV, Franco OH. Plasma fatty acid patterns during pregnancy and child's growth, body composition, and cardiometabolic health: The Generation R Study. Clin Nutr 2017; 37:984-992. [PMID: 28456538 DOI: 10.1016/j.clnu.2017.04.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 01/27/2017] [Accepted: 04/07/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Exposure to different concentrations of fatty acids during fetal life may affect growth and metabolism. However, most studies examined individual fatty acids, whereas concentrations highly correlate and may interact with each other. We aimed to evaluate patterns of plasma fatty acids during pregnancy and their associations with growth, body composition, and cardiometabolic health of the 6-year-old offspring. METHODS This study was performed in 4830 mother-child pairs participating in a population-based cohort in the Netherlands. Around 20 weeks of gestation, we measured plasma phospholipid concentrations of 22 fatty acids, in which we identified three fatty acid patterns using principal component analysis: a 'high n-6 polyunsaturated fatty acid (PUFA)' pattern, a 'monounsaturated and saturated fatty acid (MUFA and SFA)' pattern, and a 'high n-3 PUFA' pattern. When the children were 6 years old, we measured their anthropometrics and detailed body composition (using dual-energy X-ray absorptiometry), and we calculated their body mass index (BMI), fat mass index (FMI), fat-free mass index (FFMI). At the same age, children's blood pressure, and serum insulin, HDL-cholesterol, and triacylglycerol were measured. RESULTS After adjustment for confounders and the other patterns, a higher score for the 'high n-6 PUFA' pattern during pregnancy was associated with a higher height, BMI, and FFMI in the offspring at 6 years, but not independently with cardiometabolic outcomes. The 'MUFA and SFA' pattern was not consistently associated with child body composition or cardiometabolic health. A higher score for the 'high n-3 PUFA' pattern was associated with a lower FMI, higher FFMI, higher HDL-cholesterol, and lower triacylglycerol. CONCLUSIONS Our results suggest that plasma fatty acid patterns during pregnancy may affect offspring's body composition and cardiometabolic health. Specifically, a pattern characterized by high n-3 PUFA levels was associated with a more favorable body composition and blood lipid profile.
Collapse
Affiliation(s)
- Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - Myrte J Tielemans
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Wendy Stroobant
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Josje D Schoufour
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Leiden University College, The Hague, The Netherlands
| | | | - Edith H van den Hooven
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
19
|
Jen V, Erler NS, Tielemans MJ, Braun KV, Jaddoe VW, Franco OH, Voortman T. Mothers' intake of sugar-containing beverages during pregnancy and body composition of their children during childhood: the Generation R Study. Am J Clin Nutr 2017; 105:834-841. [PMID: 28275130 DOI: 10.3945/ajcn.116.147934] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 02/03/2017] [Indexed: 11/14/2022] Open
Abstract
Background: High intake of sugar-containing beverages (SCBs) has been linked to increased risk of obesity. However, associations of SCB intake during pregnancy with child body composition have been unclear.Objectives: We explored whether SCB intake during pregnancy was associated with children's body mass index (BMI) and detailed measures of body composition. In addition, we examined different types of SCBs (i.e., fruit juice, soda, and concentrate).Design: We included 3312 mother-child pairs of the Generation R Study, a prospective cohort from fetal life onward in the Netherlands. Energy-adjusted SCB intake was assessed in the first trimester with a food-frequency questionnaire. Anthropometric data of the children were collected repeatedly ≤6 y of age, and BMI was calculated. At 6 y of age, we further measured fat mass index (FMI) and fat-free mass index with dual-energy X-ray absorptiometry. All outcomes were sex- and age-standardized. Associations of SCB intake with children's BMI trajectories and body composition were analyzed with multivariable linear mixed and regression models.Results: Results from linear mixed models showed that, after adjustment for confounders including the SCB intake of the child itself, mothers' total SCB intake was positively associated with children's BMI ≤6 y of age [per serving per day: 0.04 SD score (SDS); 95% CI: 0.00, 0.07 SDS]. In addition, intakes of total SCBs and fruit juice, but not of soda or concentrate, were associated with a higher FMI [total SCBs: 0.05 SDS (95% CI: 0.01, 0.08 SDS); fruit juice: 0.04 SDS (95% CI: 0.01, 0.06 SDS)] of the 6-y-old children. These associations remained significant (P < 0.05) after additional adjustment for gestational weight gain, birth weight, and children's insulin concentrations.Conclusion: Our study suggests that maternal SCB intake during pregnancy is positively associated with children's BMI during early childhood and particularly with higher fat mass.
Collapse
Affiliation(s)
- Vincent Jen
- Generation R Study Group and.,Departments of Epidemiology
| | | | | | | | - Vincent Wv Jaddoe
- Generation R Study Group and.,Departments of Epidemiology.,Pediatrics, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Trudy Voortman
- Generation R Study Group and .,Departments of Epidemiology
| |
Collapse
|
20
|
Greater adherence to the dietary approaches to stop hypertension (DASH) dietary pattern is associated with lower blood pressure in healthy Iranian primary school children. Eur J Nutr 2017; 57:1449-1458. [PMID: 28321547 DOI: 10.1007/s00394-017-1423-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 02/28/2017] [Indexed: 02/06/2023]
Abstract
PURPOSE The dietary determinants of children blood pressure (BP) are poorly understood. We examined the association between adherence to the dietary approaches to stop hypertension (DASH) dietary pattern and BP in healthy Iranian primary school children. METHODS This cross-sectional study was conducted among a representative sample (n = 407) of healthy Shirazi students aged 6-12 years. Subjects' systolic and diastolic BP were measured by a validated oscillometric BP monitor. Usual dietary intakes over the past 12 months were assessed using a valid and reproducible 168-item semi-quantitative food frequency questionnaire via face-to-face interviews. A DASH score was calculated for each subject based on his/her energy-adjusted intakes of 8 major dietary components emphasized or minimized in the DASH dietary pattern. The higher the DASH score of a subject, the more his/her adherence to the DASH dietary pattern. RESULTS After controlling for several potential confounders in the analysis of covariance models, multivariable-adjusted means of systolic and mean BP of subjects in the highest tertile of DASH score were significantly lower than those in the lowest tertile (for systolic BP: mean difference -6.2 mmHg, P = 0.010; and for mean BP: mean difference -5.4 mmHg, P = 0.013). Furthermore, a similar but statistically insignificant difference was found in terms of multivariable-adjusted means of diastolic BP (mean difference -3.9 mmHg, P = 0.146). CONCLUSIONS The findings suggest that greater adherence to the DASH dietary pattern is associated with lower BP in healthy Iranian primary school children. However, future prospective studies of adequate methodological quality are warranted to confirm these findings.
Collapse
|
21
|
Lind MV, Larnkjær A, Mølgaard C, Michaelsen KF. Dietary protein intake and quality in early life: impact on growth and obesity. Curr Opin Clin Nutr Metab Care 2017; 20:71-76. [PMID: 27749711 DOI: 10.1097/mco.0000000000000338] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE OF REVIEW Obesity is an increasing problem and high-protein intake early in life seems to increase later risk of obesity. This review summarizes recent publications in the area including observational and intervention studies and publications on underlying mechanisms. RECENT FINDINGS Recent observational and randomized controlled trials confirmed that high-protein intake in early life seems to increase early weight gain and the risk of later overweight and obesity. Recent studies have looked at the effect of different sources of protein, and especially high-animal protein intake seems to have an effect on obesity. Specific amino acids, such as leucine, have also been implicated in increasing later obesity risk maybe via specific actions on insulin-like growth factor I. Furthermore, additional underlying mechanisms including epigenetics have been linked to long-term obesogenic programming. Finally, infants with catch-up growth or specific genotypes might be particularly vulnerable to high-protein intake. SUMMARY Recent studies confirm the associations between high-protein intake during the first 2 years and later obesity. Furthermore, knowledge of the mechanisms involved and the role of different dietary protein sources and amino acids has increased, but intervention studies are needed to confirm the mechanisms. Avoiding high-protein intake in early life holds promise as a preventive strategy for childhood obesity.
Collapse
Affiliation(s)
- Mads V Lind
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | | | | | | |
Collapse
|
22
|
Associations between Dietary Fiber Intake in Infancy and Cardiometabolic Health at School Age: The Generation R Study. Nutrients 2016; 8:nu8090531. [PMID: 27589791 PMCID: PMC5037518 DOI: 10.3390/nu8090531] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/09/2016] [Accepted: 08/23/2016] [Indexed: 02/06/2023] Open
Abstract
Dietary fiber (DF) intake may be beneficial for cardiometabolic health. However, whether this already occurs in early childhood is unclear. We investigated associations between DF intake in infancy and cardiometabolic health in childhood among 2032 children participating in a population-based cohort in The Netherlands. Information on DF intake at a median age of 12.9 months was collected using a food-frequency questionnaire. DF was adjusted for energy intake using the residual method. At age 6 years, body fat percentage, high-density lipoprotein (HDL)-cholesterol, insulin, triglycerides, and blood pressure were assessed and expressed in age- and sex-specific standard deviation scores (SDS). These five factors were combined into a cardiometabolic risk factor score. In models adjusted for several parental and child covariates, a higher DF intake was associated with a lower cardiometabolic risk factor score. When we examined individual cardiometabolic factors, we observed that a 1 g/day higher energy-adjusted DF intake was associated with 0.026 SDS higher HDL-cholesterol (95% CI 0.009, 0.042), and 0.020 SDS lower triglycerides (95% CI −0.037, −0.003), but not with body fat, insulin, or blood pressure. Results were similar for DF with and without adjustment for energy intake. Our findings suggest that higher DF intake in infancy may be associated with better cardiometabolic health in later childhood.
Collapse
|
23
|
Kocevska D, Voortman T, Dashti HS, van den Hooven EH, Ghassabian A, Rijlaarsdam J, Schneider N, Feskens EJ, Jaddoe VW, Tiemeier H, Franco OH. Macronutrient Intakes in Infancy Are Associated with Sleep Duration in Toddlerhood. J Nutr 2016; 146:1250-6. [PMID: 27146923 DOI: 10.3945/jn.115.225847] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 03/23/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Dietary composition has been associated with sleep indexes. However, most of the evidence is based on cross-sectional data, and studies in young children are lacking. OBJECTIVE The aim of this study was to explore the longitudinal associations of macronutrient composition of the diet with sleep duration and consolidation (number of awakenings) in infancy and early childhood. METHODS The study was performed in 3465 children from the Generation R Study, a population-based cohort study in the Netherlands. Mothers reported their child's food intake at 13 mo of age by using a validated food-frequency questionnaire and their child's sleep patterns at 2 and 3 y of age. We used nutrient substitution models to assess the associations of relative macronutrient intakes with sleep indexes and adjusted the models for sociodemographic and lifestyle factors. RESULTS Isocaloric substitution of fat intake by protein or carbohydrate in infancy was associated with longer total sleep duration at 2 but not 3 y of age. For each 5% increase in energy intake of either protein or carbohydrate at the expense of fat, sleep duration at 2 y of age was longer by 6 min (95% CI: 0.4, 12 min) and 4 min (95% CI: 2, 6 min), respectively. Further exploration of macronutrient subtypes indicated no consistent differences between saturated or unsaturated fat and that intake of plant compared with animal protein or Trp did not explain the association of higher total protein intake with longer sleep duration at 2 y of age. Replacing unsaturated with saturated fat was associated with 7 min (95% CI: -13, -1 min) shorter total sleep duration at 3 y of age. Macronutrient intakes were not associated with sleep consolidation. CONCLUSIONS Our results suggest that the macronutrient composition of the diet is associated with sleep duration in young children. Future research should further study the causality of this association and explore the underlying mechanisms.
Collapse
Affiliation(s)
| | | | - Hassan S Dashti
- Nutrition and Genomics Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | | | | | | | - Nora Schneider
- Nestec Ltd., Nestlé Research Center, Lausanne, Switzerland; and
| | - Edith Jm Feskens
- Department of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Vincent Wv Jaddoe
- Generation R Study Group, Departments of Epidemiology, Pediatrics, Sophia Children's Hospital, Erasmus Medical Center, University Medical Center, Rotterdam, Netherlands
| | - Henning Tiemeier
- Departments of Epidemiology, Child and Adolescent Psychiatry, Psychiatry, and
| | | |
Collapse
|
24
|
Voortman T, Braun KVE, Kiefte-de Jong JC, Jaddoe VWV, Franco OH, van den Hooven EH. Protein intake in early childhood and body composition at the age of 6 years: The Generation R Study. Int J Obes (Lond) 2016; 40:1018-25. [PMID: 26975442 DOI: 10.1038/ijo.2016.29] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 01/06/2016] [Accepted: 01/13/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND Previous studies suggest that high protein intake in infancy leads to a higher body mass index (BMI) in later childhood. We examined the associations of total, animal and vegetable protein intake in early childhood with detailed measures of body composition at the age of 6 years. METHODS This study was performed in 2911 children participating in a population-based cohort study. Protein intake at the age of 1 year was assessed with a validated food-frequency questionnaire and was adjusted for total energy intake. At the children's age of 6 years, we measured their anthropometrics and body fat (with dual-energy X-ray absorptiometry). We calculated age- and sex-specific s.d. scores for BMI, fat mass index (FMI) and fat-free mass index (FFMI). RESULTS After adjustment for confounders, a 10 g per day higher total protein intake at 1 year of age was associated with a 0.05 s.d. (95% confidence interval (CI) 0.00, 0.09) higher BMI at age 6. This association was fully driven by a higher FMI (0.06 s.d. (95%CI 0.01, 0.11)) and not FFMI (-0.01 s.d. (95%CI -0.06, 0.05)). The associations of protein intake with FMI at 6 years remained significant after adjustment for BMI at the age of 1 year. Additional analyses showed that the associations of protein intake with FMI were stronger in girls than in boys (P for interaction=0.03), stronger among children who had catch-up growth in the first year of life (P for interaction<0.01) and stronger for intake of animal protein (both dairy and non-dairy protein) than protein from vegetable sources. CONCLUSIONS Our results suggest that high protein intake in early childhood is associated with higher body fat mass, but not fat-free mass. Future studies are needed to investigate whether these changes persist into adulthood and to examine the optimal range of protein intake for infants and young children.
Collapse
Affiliation(s)
- T Voortman
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - K V E Braun
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - J C Kiefte-de Jong
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Leiden University College, The Hague, The Netherlands
| | - V W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - E H van den Hooven
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|