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Alruwaili BF, Bayyumi DF, Alruwaili OS, Alsadun RS, Alanazi AS, Hadi A, Alruwaili NKS, Thirunavukkarasu A, Aldaghmani NF, Alrayes AA. Prevalence and Determinants of Obesity and Overweight Among Children and Adolescents in the Middle East and North African Countries: An Updated Systematic Review. Diabetes Metab Syndr Obes 2024; 17:2095-2103. [PMID: 38799280 PMCID: PMC11127655 DOI: 10.2147/dmso.s458003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024] Open
Abstract
In recent years, the countries of the Middle East and North Africa (MENA) region have experienced alarming increases in the prevalence of childhood overweight and obesity. This updated systematic review sought to measure the prevalence and determinants of obesity and overweight among children and adolescents in MENA countries. A literature search for relevant observational studies published in English was conducted using PubMed, Web of Science, Google Scholar, and Saudi Digital Library. The risk of bias was evaluated using the Newcastle-Ottawa Scale. Twenty-one published articles during the past five years were included in the systematic review. Varied approaches were used to diagnose childhood overweight and obesity, including the International Obesity Taskforce (IOTF), Centre for Disease Control (CDC), World Health Organization (WHO), and Saudi Growth Pattern Curves. We found that the combined prevalence of childhood overweight and obesity in the Middle East is up to 49.4%, depending on the methods applied in their studies. Risk factors identified were age, male gender, lack of sufficient physical activity, consumption of fried food, perceived stress level, number of family members, family size, mother's occupation, education level, family history of obesity, high energy consumption from carbohydrates, ≥2 hours spent on watching television on weekend days with overweight, and always eating breakfast while watching television with obesity. The results of this review indicate that the issue of childhood and adolescent overweight and obesity in the Middle East is substantial and concerning. Most of the risk factors identified are modifiable and, if given appropriate attention, could significantly reduce the burden of associated chronic complications.
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Affiliation(s)
- Bashayer Farhan Alruwaili
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | - Duaa Fahad Bayyumi
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | - Ohud Saud Alruwaili
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | - Razan Saud Alsadun
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | | | - Amal Hadi
- Department of Family Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Nada Kareem S Alruwaili
- Department of Primary Healthcare, Ministry of Health, Aljouf Health Cluster, Sakaka, Saudi Arabia
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Huang Z, Ma K, Yin X, Li Z, Chen M, Duan Y, Li L, Hu Y. The associations of fatty acids related dietary patterns with overweight and obesity among Chinese children. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:54. [PMID: 38654346 PMCID: PMC11036597 DOI: 10.1186/s41043-024-00549-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Childhood overweight and obesity is becoming an emerging face of malnutrition. The aims of this study were to develop fatty acid (FAs) related dietary patterns and explored the associations of FAs related dietary patterns with overweight and obesity among Chinese children. METHODS An observational study was conducted on 435 children aged 4 to 7 years old in South Central China. Erythrocyte FAs composition was analyzed by gas chromatography-mass spectrometry. Diet was collected by food frequency questionnaires and dietary patterns were evaluated by reduced rank regression. The logistic regression analysis was used to exploring the association of dietary patterns with overweight and obesity. RESULTS The prevalence of overweight, obesity, and overweight or obesity were 6.52, 4.59, and 11.11% in Chinese children, respectively. Twenty five types of FAs were detected in erythrocyte of children and four FAs related dietary patterns were identified. The dietary pattern positively correlated with n-3 PUFAs, but negatively with SFAs,was characterized by high intake of fish, shrimp, crab and shellfish, leaf-off vegetable, nuts, and tubers, which have a significantly decreased overweight risk (OR = 0.580, 95%CI: 0.375 ∼ 0.895, P = 0.014).The pattern positively strong associated with n-6 PUFAs, but negatively strong with n-3 PUFAs, had high intake of snacks, leaf-off vegetable, fresh beans, and coarse cereals, which have a significantly decreased obesity risk (OR = 0.518, 95%CI: 0.325 ∼ 0.827, P = 0.006). CONCLUSION Four FAs related dietary patterns were identified. The dietary pattern with high intake of fish, shrimp, crab and shellfish decreased overweight risk by increasing n-3 PUFAs, and decreasing SFAs. The dietary pattern with high intake of plant food, decreased obesity risk by providing an balanced n-6/n-3 PUFAs ratio.
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Affiliation(s)
- Zhi Huang
- School of Public Health and Laboratory, Hunan University of Medicine, Jinxi Road No.492, 418000, Huaihua, China
| | - Keyu Ma
- School of Public Health, University of South China, Changsheng West Road No.28, 421001, Hengyang, China
- The department of Toxicology, Hunan Provincial Center for Disease Control and Prevention, Furong Road No.450, 410005, Changsha, China
| | - Xiaochen Yin
- The department of Toxicology, Hunan Provincial Center for Disease Control and Prevention, Furong Road No.450, 410005, Changsha, China
| | - Ziming Li
- The department of Toxicology, Hunan Provincial Center for Disease Control and Prevention, Furong Road No.450, 410005, Changsha, China
| | - Ming Chen
- The department of Toxicology, Hunan Provincial Center for Disease Control and Prevention, Furong Road No.450, 410005, Changsha, China
| | - Yujie Duan
- The department of Toxicology, Hunan Provincial Center for Disease Control and Prevention, Furong Road No.450, 410005, Changsha, China
| | - Li Li
- The department of Toxicology, Hunan Provincial Center for Disease Control and Prevention, Furong Road No.450, 410005, Changsha, China
| | - Yuming Hu
- The department of Toxicology, Hunan Provincial Center for Disease Control and Prevention, Furong Road No.450, 410005, Changsha, China.
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Al Khatib A. COVID-19, economic crisis, and food insecurity worsen the double burden of malnutrition in Lebanon. Front Public Health 2024; 12:1333565. [PMID: 38504679 PMCID: PMC10948441 DOI: 10.3389/fpubh.2024.1333565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/12/2024] [Indexed: 03/21/2024] Open
Affiliation(s)
- Alissar Al Khatib
- Department of Nursing, Almoosa College of Health Sciences, Al Ahsaa, Saudi Arabia
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Chokor FAZ, Hwalla N, Naja F, Nasreddine L. Food sources of fiber and micronutrients of concern among infants and young children in Lebanon: a national cross-sectional study. BMC Pediatr 2024; 24:57. [PMID: 38243229 PMCID: PMC10797939 DOI: 10.1186/s12887-024-04535-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/03/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Intakes of fiber, iron, zinc, calcium, vitamin D, vitamin A, and folate were shown to be low in a substantial proportion of infants and children in Lebanon. The study aims to identify the top food sources of fiber, iron, zinc, calcium, vitamin D, vitamin A, and folate amongst infants and young children in Lebanon and to evaluate the evolution of food sources of these nutrients from the beginning of the complementary feeding journey up until the age of 47.9 months. METHODS A national cross-sectional survey was conducted in 2012 as part of the "Early Life Nutrition and Health in Lebanon" project using stratified cluster sampling. Dietary intakes for infants and young children aged 6-47.9 months (n = 763) were assessed using 24- Hour Dietary Recall. Food items were categorized into food groups and the percent contribution of each food group to nutrient intakes was determined to identify the top food sources of fiber and selected micronutrients for three age groups: 6-11.9 m (infants), 12-23.9 m (toddlers), and 24-47.9 m (preschoolers). RESULTS The top food source of fiber was vegetables among children aged 6-47.9 months. Among infants and toddlers, infant/young child formula was the main contributor to iron, zinc, calcium, vitamin D, vitamin A, and folate intakes. Baby cereals also contributed to around 14% of iron intakes among infants. Among preschoolers, meat and fish contributed to 13% of iron intakes and 29% of zinc intakes, while cow's milk was the major contributor of calcium (41%), vitamin D (81%) and vitamin A (25%) intakes. Sweetened beverages and sweet bakery were also ranked among the major food sources contributing to substantial intakes of key nutrients, including fiber, iron, zinc, calcium, vitamin A, and folate among infants, toddlers, and preschoolers. CONCLUSIONS In addition to milk sources, vegetables, beans and legumes, breads, meats, and rice and pasta, sweet bakery and sweetened beverages have contributed to intakes of key nutrients from early ages. This calls for implementing initiatives and designing approaches to support nutrition education and improve nutrient intakes in infancy and early childhood.
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Affiliation(s)
- Fatima Al Zahraa Chokor
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon
| | - Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon
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Shafto K, Vandenburgh N, Wang Q, Breen J. Experiential Culinary, Nutrition and Food Systems Education Improves Knowledge and Confidence in Future Health Professionals. Nutrients 2023; 15:3994. [PMID: 37764777 PMCID: PMC10535872 DOI: 10.3390/nu15183994] [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: 08/26/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
The food system plays a crucial role in the relationship between environmental, population and individual health. While leading healthcare and environmental organizations call for urgent action to address climate-planetary-human health crises, it is often challenging for healthcare organizations to respond at a systems level to these concerns. Additionally, there is little consensus and limited research exploring how future health professionals should be trained in order to work at both the individual and systems level to address or prevent the negative health impacts related to the current food system. The intervention of a 6-week, hands-on cooking and nutrition course for graduate health professional students which examines these intersections and equips students with clinically applicable skills was examined using matched pre- and post-course surveys and thematic analysis of reflective assignments. Results indicate improved knowledge and confidence in areas including understanding the food system, guiding patients through dietary change, working interprofessionally, and applying basic nutrition concepts to clinical practice.
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Affiliation(s)
- Katherine Shafto
- Department of Medicine, Hennepin Healthcare, 701 Park Avenue, Minneapolis, MN 55415, USA
- Department of Internal Medicine and Pediatrics, University of Minnesota Medical School, 420 Delaware Street SE, Minneapolis, MN 55455, USA
| | - Natalie Vandenburgh
- University of Minnesota School of Public Health, and University of Minnesota Medical School, Minneapolis, MN 55455, USA
- Chef Ann Foundation, Boulder, CO 80301, USA
| | - Qi Wang
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN 55455, USA;
| | - Jenny Breen
- Faculty in Culinary Nutrition, Bakken Center for Spirituality and Healing, University of Minnesota, Minneapolis, MN 55455, USA
- Faculty, College of Food Science and Nutrition, University of Minnesota, St. Paul, MN 55108, USA
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Hennessy Á, McCarthy EK, Ní Chaoimh C, Murray DM, Kiely ME. Poor Quality Diets Characterized by Low-Nutrient Density Foods Observed in One-Quarter of 2-Year-Olds in a High Resource Setting. J Nutr 2023; 153:2678-2688. [PMID: 37356499 DOI: 10.1016/j.tjnut.2023.06.029] [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] [Received: 02/10/2023] [Revised: 04/17/2023] [Accepted: 06/22/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Young children have high nutritional requirements relative to their body size, making healthy diets critical for normal growth and development. OBJECTIVE We aimed to integrate analysis of dietary patterns among 2-y-old children with indicators of dietary quality, micronutrient status, and body weight status. METHODS Data from the 2-y follow-up of the Cork BASELINE Birth Cohort included dietary assessment using a 2-d weighed food diary, vitamin D and iron status biomarkers, and anthropometry (n = 468). K-means cluster analysis identified predominant dietary patterns based on energy contributions and associations with nutrient intakes and status and body weight were investigated. RESULTS Four dietary patterns emerged: "Cows' milk" (unmodified cows' milk: 32% of total energy (TE)); "Traditional" (wholemeal breads, butter, fresh meat, fruit); "Low Nutrient Density (LND) foods" (confectionary, processed meat, convenience foods) and "Formula" (young child formula: 23%TE). The LND pattern was associated with excessive free sugar intake (14%TE) and salt intake (153% of daily limit). No differences in patterns of overweight were observed between the 4 groups; however, the LND group had 3-fold higher odds of being underweight [aOR (95% CI): 3.2 (1.2, 8.5)]. Children consuming >400ml/d of cows' milk or formula exhibited lower dietary variety, fewer family-type meals, and continued use of feeding bottles (75% and 81%, respectively, vs. 35-37% in the other groups). CONCLUSIONS Unhealthy eating habits are common among young children. Dietary guidance to support families to provide healthy diets needs to maintain currency with eating habits and focus on food choices for meals, snacks, and beverages.
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Affiliation(s)
- Áine Hennessy
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, College of Science, Engineering and Food Science, University College Cork, Cork, Ireland; The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland
| | - Elaine K McCarthy
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, College of Science, Engineering and Food Science, University College Cork, Cork, Ireland; The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland
| | - Carol Ní Chaoimh
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, College of Science, Engineering and Food Science, University College Cork, Cork, Ireland; The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland
| | - Deirdre M Murray
- The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland; Department of Paediatrics and Child Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Mairead E Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, College of Science, Engineering and Food Science, University College Cork, Cork, Ireland; The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland.
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Kumma WP, Loha E. Dietary patterns and their association with cardiovascular risk factors in Ethiopia: A community-based cross-sectional study. Front Nutr 2023; 10:1074296. [PMID: 37032774 PMCID: PMC10076605 DOI: 10.3389/fnut.2023.1074296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/09/2023] [Indexed: 04/11/2023] Open
Abstract
Purpose To identify the dietary patterns and their association with cardiovascular risk factors among adult people in urban and rural areas of Wolaita, southern Ethiopia. Methods A total of 2,483 participants aged 25-64 years were selected using a three-stage random sampling. Data for this study were collected using structured questionnaires, the previous 24-h dietary intake assessment, anthropometric, blood pressure, and biochemical measurements. We used factor analysis to identify dietary patterns. Factors associated with dietary patterns were analyzed using multiple linear regression models. The adjusted regression coefficients with their 95% CI were used to ascertain the association. Result We identified three major dietary patterns that explained 51% of the variance in food consumption. The western dietary pattern was characterized by the consumption of meat/organ meat, biscuits/sweets, chicken stew, pasta-macaroni recipes, butter, white wheat bread, egg recipe, and Ethiopian dish shiro-wet, and was positively associated with urban residence, obesity, hypertension, blood glucose, and total cholesterol levels. Adherence to the consumption of tubers, whole-grain maize products, coffee leaves-and-herbs beverage, legumes, and sweet potatoes featured the traditional dietary pattern. The traditional dietary pattern showed a positive relationship with rural residence, physical activity, and obesity, and it had a negative relationship with hypertension. The healthy dietary pattern was characterized by the intake of green leafy vegetables, green pepper, and whole-grain maize products, and negatively related to obesity, and hypertension, while positively related to urban residence. Conclusion The coexistence of western, traditional, and healthy dietary patterns in the present study indicates the transition to a new dietary pattern in the study area. All dietary patterns were associated with one or more cardiovascular risk factors, but the western dietary pattern was associated with most of these, while the traditional diet showed fewer such associations. Therefore, it might be useful to promote healthy and traditional dietary patterns along with physical activity. Interventions related to the current findings, if initiated early in life, may benefit the public in preventing cardiovascular risk factors such as obesity, hypertension, and type 2-diabetes.
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Affiliation(s)
- Wondimagegn Paulos Kumma
- School of Public Health, Hawassa University, Hawassa, Ethiopia
- Centre for International Health, University of Bergen, Bergen, Norway
- School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Eskindir Loha
- School of Public Health, Hawassa University, Hawassa, Ethiopia
- Centre for International Health, University of Bergen, Bergen, Norway
- Chr. Michelsen Institute, Bergen, Norway
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The relationship between nutrition literacy and nutrition information seeking attitudes and healthy eating patterns among a group of palestinians. BMC Public Health 2023; 23:165. [PMID: 36694185 PMCID: PMC9875392 DOI: 10.1186/s12889-023-15121-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/28/2022] [Accepted: 01/23/2023] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Nutrition literacy is crucial because it gives people information and drives them to take responsibility for their eating habits. Prior research on three categories of nutrition literacy among Palestinians was lacking: functional literacy (FNL), interactive literacy (INL), and critical literacy (CNL). AIMS (1) Describe three types of nutrition literacy-FNL, INL, and CNL-among a group of Palestinians was one of the study's primary objectives. (2) To investigate the connections between various nutrition literacy levels, eating habits, and the habit of seeking out nutrition-related information. METHODS 149 Palestinians were chosen at random to take part in the study in the fall of 2020. Data on sociodemographic variables were gathered through an online survey that was disseminated across social and educational internet sites. Nutrition literacy data was gathered using a translated questionnaire, while diet behavior data was gathered using the Short Format of the Diet Health and Knowledge Survey (SFDHKS). The data were examined using SPSS 21. RESULTS This study included young people (20.4 ± 4.9 years old), 78% of whom were female. The majorities of participants had bachelor's degrees or were already enrolled in school to obtain them. FNL had a mean of 2.8 ± 0.5, INL of 3.3 ± 0.5, and CNL of 3.6 ± 0.5. The connection between CNL and INL was significant (p 0.05). Significant correlations were found between many aspects of diet behavior, the usage of food labels, and nutrition literacy. CONCLUSION Participants from the Palestinian community are willing to learn about and comprehend nutrition facts and how it relates to diet behavior in 2021.
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López-Gil JF, Smith L, Abellán-Huerta J, Abellán-Alemán J, Panisello Royo JM, Gutiérrez-Espinoza H, López-Bueno R, Tárraga-López PJ. Food consumption patterns related to excess weight and obesity in Spanish preschoolers. Pediatr Res 2023:10.1038/s41390-022-02442-9. [PMID: 36599946 DOI: 10.1038/s41390-022-02442-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/28/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE The aims of this study were (1) to identify the different food consumption patterns among Spanish preschoolers and (2) to examine the association between having a different food consumption pattern and the odds of having excess weight (i.e., overweight or obesity) or obesity among this population. METHODS This was a nationwide cross-sectional study with data from the Spanish National Health Survey-2017. All preschoolers (aged 3-5 years) with complete information on all the variables analyzed were selected. The frequency of consumption of the fourteen food groups was evaluated by a food frequency questionnaire. Excess weight/obesity were computed following the World Health Organization criteria. A hierarchical cluster analysis using Ward's method (i.e., based on squared Euclidean distances) and k-means were performed including all food group consumption. A total sample of 663 was included in the cluster analysis. RESULTS Three different clusters were established. Compared to the healthiest food consumption pattern (Cluster 1), higher odds of excess weight (OR = 1.51; CI: 95%, 1.02-2.25) and obesity (OR = 1.59; CI: 95%, 1.01-2.51) were found for participants with the unhealthiest food consumption pattern (Cluster 3). CONCLUSION Having a food consumption pattern considered unhealthy (i.e., low intake of vegetables/fruits, high consumption of confectionery products, sugar-sweetened beverages, fast-food, and snacks) was associated with presenting excess weight/obesity among Spanish preschoolers. IMPACT No studies have examined the specific food consumption patterns associated with excess weight or obesity among Spanish preschoolers. The unhealthiest food consumption pattern was characterized by a food consumption pattern that included a lower intake of vegetables and fruits and a higher consumption of confectionery products, sugar-sweetened beverages, fast-food, and snacks. Having a food consumption pattern considered unhealthy was associated with a higher prevalence of excess weight and obesity in comparison with other healthier food consumption patterns.
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Affiliation(s)
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - José Abellán-Huerta
- Departamento de Cardiología, Hospital General Universitario Santa Lucía, Cartagena, Spain
| | - José Abellán-Alemán
- Cátedra de Riesgo Cardiovascular, Universidad Católica de Murcia, Murcia, Spain
| | | | | | - Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Pedro J Tárraga-López
- Departamento de Ciencias Médicas, Facultad de Medicina, Universidad de Castilla-La Mancha, Albacete, Spain
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Naja F, Hwalla N, Chokor FAZ, Zgheib R, Nasreddine L. Infant and young child feeding practices in Lebanon: a cross-sectional national study. Public Health Nutr 2023; 26:143-159. [PMID: 35369892 PMCID: PMC11077449 DOI: 10.1017/s1368980022000842] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 03/15/2022] [Accepted: 03/28/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To assess infant and young child feeding (IYCF) practices in Lebanon and investigate their associations with socio-demographic and lifestyle factors. DESIGN A cross-sectional national survey was conducted in 2012-2013. In addition to a socio-demographic and lifestyle questionnaire, a 24-h dietary recall for the children was collected, with mothers as proxies. IYCF practices were assessed based on the 2021 indicators of the WHO. SETTING Lebanon. PARTICIPANTS Children aged 0-23 months and their mothers (n 469). RESULTS While the majority of infants were ever breastfed (87·6 %), the prevalence of exclusive breast-feeding (BF) in those under 6 months of age was 11·0 %. Early initiation of BF was 28 %. A greater child's birth order, partner's support for BF, higher parental education, maternal BF knowledge and non-smoking were associated with higher odds of meeting BF recommendations. As for complementary feeding, 92·8 % of children (6-23 months) met the minimum meal frequency indicator, 37·5 % met the minimum dietary diversity (MDD) and 34·4 % met the minimum adequate diet (MAD). The consumption of unhealthy food was observed amongst 48·9 % of children, with nearly 37 % consuming sweet beverages. Older maternal age and maternal overweight/obesity were associated with lower odds of meeting MDD and MAD, while child's age and partner's support for BF were associated with higher odds. CONCLUSIONS The results documented suboptimal IYCF practices amongst Lebanese children and identified a number of factors associated with these practices. Findings from this study will help guide the development of culture-specific programmes aimed at improving IYCF practices in Lebanon.
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Affiliation(s)
- Farah Naja
- Department of Nutrition and Food Sciences, American
University of Beirut, P.O. Box 11-0236, Riad El-Solh, Beirut1107 2020, Lebanon
- Department of Clinical Nutrition and Dietetics, Research
Institute of Medical & Health Sciences (RIMHS), College of Health Sciences,
University of Sharjah, Sharjah, United
Arab Emirates
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, American
University of Beirut, P.O. Box 11-0236, Riad El-Solh, Beirut1107 2020, Lebanon
| | - Fatima Al Zahraa Chokor
- Department of Nutrition and Food Sciences, American
University of Beirut, P.O. Box 11-0236, Riad El-Solh, Beirut1107 2020, Lebanon
| | | | - Lara Nasreddine
- Department of Nutrition and Food Sciences, American
University of Beirut, P.O. Box 11-0236, Riad El-Solh, Beirut1107 2020, Lebanon
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何 苗, 蔡 晓, 彭 文, 宋 杰, 周 洪, 李 星, 吴 晓. [Cross-Sectional Study of Nutritional Status and Dietary Nutrient Intake in Children with Duchenne Muscular Dystrophy (DMD) in China]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2022; 53:1068-1073. [PMID: 36443054 PMCID: PMC10408977 DOI: 10.12182/20221160207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Indexed: 06/16/2023]
Abstract
Objective To investigate the dietary nutrient intake and the nutritional status of children with Duchenne muscular dystrophy (DMD), and to explore the correlation between them, so as to provide theoretical basis for the formulation of proper nutritional treatment for children with DMD. Methods A total of 223 children aged 2 to 14 years who came to West China Second University Hospital, Sichuan University from July 2017 to April 2021, and who were diagnosed with DMD by genetic testing were enrolled as the subjects of the study. Dietary assessment was conducted with a 3-day 24-hour dietary recall, and serum vitamin D level was measured by chemiluminescence method. Results Only 33.2% of the children with DMD were found to be of normal nutritional status. The incidences of stunted growth, underweight, overweight and obesity were 13.5%, 14.4%, 14.3% and 8.1%, respectively. Among the children with DMD, those with serum vitamin D deficiency and insufficiency accounted for 9.0% and 89.7%, respectively. According to the dietary recall of the children with MDM, the daily energy ratio of carbohydrate, protein and fat were (47.40±6.64)%, (14.46±2.22)%, and (38.17±5.30)%, respectively. The daily intake of dietary calcium and vitamin D were (433.32±164.39) mg per day and (155.73±89.30) IU per day, respectively. The ratio of daily protein intake to the estimated average requirement for protein ( P=0.003) and ratio of daily energy intake to the estimated energy requirement ( P=0.007) were lower in children with stunted growth than those of DMD children of normal nutritional status. Conclusion The dietary structure of children with DMD is obviously not suited to their condition and nutritional deficiency coexists with overnutrition among them. Further research needs to be done for developing appropriate nutritional guidance programs and standardized nutritional management measures for children with DMD.
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Affiliation(s)
- 苗 何
- 四川大学华西第二医院 (成都 610041)Department of Clinical Nutrition, West China Second University Hospital, Sichuan University, Chengdu 610041, China
- 出生缺陷与相关妇儿疾病教育部重点实验室(四川大学) (成都 610041)Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, Sichuan University, Chengdu 610041, China
| | - 晓唐 蔡
- 四川大学华西第二医院 (成都 610041)Department of Clinical Nutrition, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - 文涛 彭
- 四川大学华西第二医院 (成都 610041)Department of Clinical Nutrition, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - 杰 宋
- 四川大学华西第二医院 (成都 610041)Department of Clinical Nutrition, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - 洪敏 周
- 四川大学华西第二医院 (成都 610041)Department of Clinical Nutrition, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - 星蓉 李
- 四川大学华西第二医院 (成都 610041)Department of Clinical Nutrition, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - 晓娜 吴
- 四川大学华西第二医院 (成都 610041)Department of Clinical Nutrition, West China Second University Hospital, Sichuan University, Chengdu 610041, China
- 出生缺陷与相关妇儿疾病教育部重点实验室(四川大学) (成都 610041)Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, Sichuan University, Chengdu 610041, China
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Jomaa L, Hwalla N, Chokor FAZ, Naja F, O'Neill L, Nasreddine L. Food consumption patterns and nutrient intakes of infants and young children amidst the nutrition transition: the case of Lebanon. Nutr J 2022; 21:34. [PMID: 35599326 PMCID: PMC9125916 DOI: 10.1186/s12937-022-00779-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 04/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This is the first study on dietary intakes of infants and young children in the Eastern Mediterranean Region, a region that is currently witnessing the nutrition transition. It aims at characterizing food consumption patterns amongst 0-4 year old children in Lebanon, evaluating their macro- and micronutrient intakes and assessing adherence to dietary recommendations. METHODS Based on a national cross-sectional survey in 2012 (n = 866), the study collected data on sociodemographic and anthropometric characteristics, and one 24-hour dietary recall was administered. Nutrient intakes were compared with reference values: Estimated Average Requirement (EAR), Adequate Intake (AI) and Acceptable Macronutrient Distribution Range (AMDR). RESULTS Milk was the highest contributor to energy intake (EI) in infants (95.8 and 56.5% in 0-5.9 months and 6-11.9 months old infants, respectively), while its intake was lower among toddlers and preschoolers (35.4 and 15.1%, respectively). In contrast, intakes of sweets and sweetened beverages were the highest in preschoolers compared to younger children, contributing 18.5% EI in preschoolers. Compared to dietary guidelines, the lowest dietary adherence was found for vegetables (17.8-20.7%) and fruits (14.4-34.3%). Protein intake was within the recommendations for the vast majority of children. Although total fat intake was lower in toddlers and preschoolers compared to infants, more than 40% of toddlers and preschoolers exceeded the AMDR for fat and 87.3% of preschoolers exceeded the upper limit for saturated fat. Only 3.6% of toddlers and 11.5% of preschoolers exceeded the AI level for dietary fiber. Micronutrient intake assessment showed that mean intakes in infants exceeded the AI for all micronutrients, except for vitamin D and magnesium. In toddlers, vitamin D and calcium were below the EAR among 84.7, and 44.6%, respectively. In preschoolers, most of the children (91.9%) had inadequate intakes of vitamin D, and a third had inadequate intakes of folate, calcium and vitamin A. CONCLUSIONS This study identified priority issues for nutrition intervention in infants and young children in Lebanon. Concerted multi-stakeholder efforts are needed to instill heathier food consumption and nutrient intake patterns early in life.
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Affiliation(s)
- Lamis Jomaa
- Department of Human Sciences, College of Health and Sciences, North Carolina Central University, Durham, NC, 27707, USA
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, 11-0236, Lebanon
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, 11-0236, Lebanon
| | - Fatima Al Zahraa Chokor
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, 11-0236, Lebanon
| | - Farah Naja
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, 11-0236, Lebanon
- Department of Nutrition and Dietetics, College of Health Sciences, University of Sharjah, 27272, Sharjah, UAE
| | - Lynda O'Neill
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., 1015, Lausanne, Switzerland
| | - Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, 11-0236, Lebanon.
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Nasreddine L, Hwalla N, Al Zahraa Chokor F, Naja F, O'Neill L, Jomaa L. Food and nutrient intake of school-aged children in Lebanon and their adherence to dietary guidelines and recommendations. BMC Public Health 2022; 22:922. [PMID: 35534814 PMCID: PMC9088130 DOI: 10.1186/s12889-022-13186-w] [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: 10/14/2021] [Accepted: 04/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lebanon, an Eastern Mediterranean country, is witnessing a remarkable nutrition transition, and the diets of school-aged children may be amongst those most affected. However, limited studies have examined the food consumption patterns and nutrient adequacy in this age group. OBJECTIVES The present study aimed to evaluate the dietary intakes of school-aged children in Lebanon and assess their adherence to nutrition guidelines and recommendations. METHODS This study used data for 4-13 y-old children (n = 711) from a national cross-sectional survey conducted in 2014-2015 on a representative sample of Lebanese households with children. Dietary intake was assessed using single 24-h recall method. Estimated food group and nutrient intakes were compared to dietary recommendations and age-specific dietary reference intakes (DRI), including Estimated Average Requirements (EAR) and Acceptable Macronutrient Distribution Range (AMDR). Food group, energy, macro- and micro-nutrient intakes were presented for all children in the sample and stratified by age (4-8 y and 9-13 y) and sex. RESULTS Mean energy intake of 4-13-year-old children was 1804 kcal/d. Almost half of the energy was provided by carbohydrates while 12% of children had protein intakes below EAR. Approximately three-quarters of children (4-13 y) exceeded the AMDR for total fat and saturated fats, and a similar proportion over consumed added sugars. The main sources of energy intake (EI) among children were the sweets, sweetened beverages and desserts followed by grains and mixed dishes. No significant differences were noted in %EI from different food groups, by sex, in either age groups. The highest adherence of children to food group recommendations was observed for the grains' food group (47.2-54.4%EI), while the lowest adherence was found for vegetables (3.1-14.1%EI). A high prevalence of vitamin and mineral inadequacies was noted amongst 4-13 y old children for key micronutrients, including vitamin D (99%), calcium (81%), and vitamin A (69.5%). Risk of inadequate micronutrient intakes was significantly increased among the older age group (p-value < 0.05). CONCLUSION Nutrient intakes of school-aged children in Lebanon reflect suboptimal nutrition. Educational and public health interventions are needed to promote healthier diets among children and prevent micronutrient deficiencies during this critical phase.
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Affiliation(s)
- Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, 11-0236, Lebanon
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, 11-0236, Lebanon
| | - Fatima Al Zahraa Chokor
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, 11-0236, Lebanon
| | - Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, 27272, Sharjah, United Arab Emirates.,Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107-2020, Lebanon
| | - Lynda O'Neill
- Nestlé Institute of Health Sciences, Nestlé Research, Société Des Produits Nestlé S.A, Vers-Chez-Les-Blancs, 1000 Lausanne 26, Lausanne, Switzerland
| | - Lamis Jomaa
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, 11-0236, Lebanon. .,Department of Human Sciences, College of Health and Sciences, North Carolina Central University, Durham, NC, 27707, USA.
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Jarman M, Edwards K, Blissett J. Influences on the dietary intakes of preschool children: a systematic scoping review. Int J Behav Nutr Phys Act 2022; 19:20. [PMID: 35193587 PMCID: PMC8862251 DOI: 10.1186/s12966-022-01254-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/17/2022] [Indexed: 12/16/2022] Open
Abstract
Background Better diet quality of preschool children is associated with many important health outcomes, but there is significant room for improvement in many children’s dietary intakes. The determinants of children’s dietary intakes are complex and whole systems approaches may be effective tools for changing dietary intake. Collation of all the evidence available on determinants of preschool children’s dietary intake is necessary to ‘map’ the whole system of influence. Therefore, this systematic scoping review of available literature on determinants of dietary intakes in preschool children was undertaken. Methods The Joanna Briggs Institute methods for conducting a systematic scoping review were followed. Articles published since 2000 which assessed influences on the dietary intakes of preschool children were identified, yielding a total of 246 papers. Studies of children with clinical conditions (excluding obesity), or those conducted in middle and low-income countries were excluded, due to the different systems of influence in these populations. Data were extracted and information synthesised based on ecological level (child, parent, household, childcare, or wider determinants). Results Most articles focused on influences at the parental level (n = 118, 48%), followed by those at the child level (n = 73, 30%). Most of the studies were of cross-sectional design (n = 109, 44%). Whilst many studies considered influences at multiple ecological levels (n = 63, 26%) few analyses determined interactions between factors in their relationship with children’s dietary intakes, which is needed going forward using systems methods. Conclusion A wealth of evidence exists examining influences on the dietary intakes of preschool children and this information would benefit from analysis using a systems thinking approach in order to assess effective levers for intervention and what works, for whom, under what circumstances. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01254-8.
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Affiliation(s)
- M Jarman
- School of Psychology, College of Health and Life Sciences, and Institute of Health and Neurodevelopment, Aston University, Birmingham, UK.
| | - K Edwards
- School of Psychology, College of Health and Life Sciences, and Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
| | - J Blissett
- School of Psychology, College of Health and Life Sciences, and Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
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Aoun R, Chokor FAZ, Taktouk M, Nasrallah M, Ismaeel H, Tamim H, Nasreddine L. Dietary fructose and its association with the metabolic syndrome in Lebanese healthy adults: a cross-sectional study. Diabetol Metab Syndr 2022; 14:29. [PMID: 35139893 PMCID: PMC8827166 DOI: 10.1186/s13098-022-00800-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Epidemiological studies investigating the association between dietary fructose intake and the metabolic syndrome (MetS) are scarce and have produced controversial findings. This study aimed at (1) assessing total dietary fructose intake in a sample of Lebanese healthy adults, and determining the intake levels of natural vs. added fructose; (2) investigating the association of dietary fructose with MetS; and (3) identifying the socioeconomic and lifestyle factors associated with high fructose intake. METHODS A cross-sectional survey was conducted on a representative sample of adults living in Beirut, Lebanon (n = 283). Anthropometric and biochemical data were collected, and dietary intake was assessed using a food frequency questionnaire. Intakes of naturally-occurring fructose from fructose-containing food sources, such as fruits, vegetables, honey, were considered as "natural fructose". Acknowledging that the most common form of added sugar in commodities is sucrose or High Fructose Corn Syrup (HFCS), 50% of added sugar in food products was considered as added fructose. Total dietary fructose intake was calculated by summing up natural and added fructose intakes. Logistic regression analyses were conducted to investigate the association of total, added and natural fructose intakes with the MetS and to identify the socioeconomic predictors of high fructose intake. RESULTS Mean intake of total fructose was estimated at 51.42 ± 35.54 g/day, representing 6.58 ± 3.71% of energy intakes (EI). Natural and added fructose intakes were estimated at 12.29 ± 8.57 and 39.12 ± 34.10 g/day (1.78 ± 1.41% EI and 4.80 ± 3.56% EI), respectively. Participants in the highest quartile of total and added fructose intakes had higher odds of MetS (OR = 2.84, 95%CI: 1.01, 7.94 and OR = 3.18, 95%CI: 1.06, 9.49, respectively). In contrast, natural fructose intake was not associated with MetS. Age, gender and crowding index were identified as factors that may modulate dietary fructose intakes. CONCLUSIONS The observed association between high added fructose intake and the MetS highlights the need for public health strategies aimed at limiting sugar intake from industrialized foods and promoting healthier dietary patterns in Lebanon.
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Affiliation(s)
- Rita Aoun
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Fatima Al Zahraa Chokor
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Mandy Taktouk
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Mona Nasrallah
- Department of Internal Medicine, Division of Endocrinology, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Vascular Medicine Program, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hussain Ismaeel
- Vascular Medicine Program, American University of Beirut Medical Center, Beirut, Lebanon
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
- Clinical Research Institute, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
| | - Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon.
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Nutrition literacy is associated with income and place of residence but not with diet behavior and food security in the Palestinian society. BMC Nutr 2021; 7:78. [PMID: 34789324 PMCID: PMC8600769 DOI: 10.1186/s40795-021-00479-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 10/25/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Palestinian society is going through health transition that is associated with increase in chronic diseases due to poor dietary habits so adequate integration of nutrition information is important. AIMS The aim of this study is to find the association between nutrition literacy and diet behavior among a group of Palestinian participants. METHODS A sample of 101 Palestinian participants were recruited to participate in the study. An online survey was used to collect study data. Newest Vital Sign quiz was used to collect information on nutrition literacy and Short Format of the Diet Health and Knowledge Survey (SFDHKS) was used to collect information on diet behavior and USDA food security questionnaire was used to collect data on food security. Data was analyzed utilizing SPSS 21. RESULTS This study included 101 participants, mean age 22.7 y ± 8.7 y, mainly females (females were 83.2% and males were 16.8%). 5.7% of the study participants were obese, 13.8% overweight and 10.3% were underweight. The prevalence of adequate nutrition literacy was 29%. There was minimal association between diet behavior and nutrition literacy, food security and BMI categories, but significant association with income and living in city relative to village (p < 0.05). Only 11 participants had some form of food insecurity. CONCLUSION There is low prevalence of adequate nutrition literacy. Nutrition literacy depends on social and economic aspects but further research is need to understand its relationship to diet behavior.
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Almaamary S, Al Shammakhi S, Alghamari I, Jabbour J, Al-Jawaldeh A. Preschoolers' and Mothers Dietary Practices and Compliance with the 24-h Movement Guidelines: Results of Oman's National Nutrition Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168867. [PMID: 34444616 PMCID: PMC8395034 DOI: 10.3390/ijerph18168867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/02/2021] [Accepted: 08/08/2021] [Indexed: 12/14/2022]
Abstract
Introduction: Little is known on the nutritional and lifestyle variables of preschool children in Oman. This study analyzed data of the 2017 Oman National Nutrition Survey to assess the prevalence and interrelationships between dietary and movement variables among preschool children, aged 2–5 years. Methods: Household visits of a nationally representative sample evaluated mothers and children’s dietary, sleep and physical activity practices; media exposure; and anthropometric and sociodemographic variables. Results: Dyads of mothers and pre-school children aged 2–5 years (n = 1771) were assessed. Childhood overweight/obesity was prevalent in 2% of the sample. Over 54% of children consumed sweetened items and/or French fries or chips at least once daily. Over 65% of children had fruits and/or vegetables once daily or less. Mothers had healthier dietary and movement habits compared to their offspring. Compliance with media exposure was the lowest among mothers and children. Multivariate regression revealed children’s increased sweet intake was the only significant predictor of excess weight in children. Conclusion: This study revealed a low prevalence of overweight/obesity among preschool children in Oman. Children had an acceptable compliance with sleeping recommendations, yet limited adherence to media exposure, activity, added sugar and fruits and vegetables guidelines.
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Affiliation(s)
- Salima Almaamary
- Nutrition Department, Ministry of Health, Muscat 393, Oman; (S.A.); (S.A.S.); (I.A.)
| | - Saleh Al Shammakhi
- Nutrition Department, Ministry of Health, Muscat 393, Oman; (S.A.); (S.A.S.); (I.A.)
| | - Ibtisam Alghamari
- Nutrition Department, Ministry of Health, Muscat 393, Oman; (S.A.); (S.A.S.); (I.A.)
| | - Jana Jabbour
- Nutrition Department, School of Health Sciences, Modern University of Business and Sciences, Beirut 113-7501, Lebanon
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo 11371, Egypt;
- Correspondence:
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo 11371, Egypt;
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Flores ME, Rivera-Pasquel M, Macías N, Sánchez-Zamorano LM, Rodríguez-Ramírez S, Contreras-Manzano A, Denova-Gutiérrez E. Dietary patterns in Mexican preschool children are associated with stunting and overweight. Rev Saude Publica 2021; 55:53. [PMID: 34406279 PMCID: PMC8352562 DOI: 10.11606/s1518-8787.2021055002350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 12/20/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the association between dietary patterns, stunting, and overweight among Mexican preschoolers. METHODS This study was conducted with anthropometric (weight, height/length), sociodemographic (age, gender, education level of household head, socioeconomic status, country region and area, ethnicity, and beneficiary of social programs), and dietary data (Semiquantitative-food frequency questionnaire) on children aged from 1 to 4 years collected from the Mexican National Health and Nutrition Survey-2012. Dietary patterns were derived by principal components analysis. The association between dietary patterns, stunting, and overweight was assessed by prevalence ratios (PR), estimated by Poisson regression. RESULTS In total, 1,112 preschoolers (mean age 3.06 years, SD = 1.08 years; 48.8% females) were included in the study; 11.9% of whom presented stunting, and 6.7% overweight. We identified four dietary patterns: Fruits and Vegetables [F&V], Western [W], Traditional [T], and Milk and Liquids [M&L]. Considering the lowest tertile of each dietary pattern as reference, the prevalence of stunting was 2.04 times higher [95%CI: 1.17–3.56] among children in the highest tertile of the “F&V” pattern. The prevalence of stunting was lower among children in the highest tertile of the “W” pattern [PR = 0.48; 95%CI: 0.27–0.85]. Overweight was negatively associated with the “F&V” dietary pattern [PR = 0.37; 95%CI: 0.16–0.85 for its highest tertile], and children whose consumption was mostly equivalent to the “T” pattern showed higher prevalence of stunting [PR = 1.74; 95%CI: 1.01–3.00]. CONCLUSIONS The prevalence of stunting and overweight in a nationwide sample of Mexican preschoolers was associated with dietary patterns.
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Affiliation(s)
- Mario E Flores
- Nutrition and Health Research Center. National Institute of Public Health. Cuernavaca, México
| | - Marta Rivera-Pasquel
- Nutrition and Health Research Center. National Institute of Public Health. Cuernavaca, México
| | - Nayeli Macías
- Nutrition and Health Research Center. National Institute of Public Health. Cuernavaca, México
| | | | - Sonia Rodríguez-Ramírez
- Nutrition and Health Research Center. National Institute of Public Health. Cuernavaca, México
| | | | - Edgar Denova-Gutiérrez
- Nutrition and Health Research Center. National Institute of Public Health. Cuernavaca, México
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Jomaa L, Hamamji S, Kharroubi S, Diab-El-Harakeh M, Al Zahraa Chokor F, Nasreddine L. Dietary intakes, sources, and determinants of free sugars amongst Lebanese children and adolescents: findings from two national surveys. Eur J Nutr 2021; 60:2655-2669. [PMID: 33389083 DOI: 10.1007/s00394-020-02444-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/12/2020] [Indexed: 01/28/2023]
Abstract
PURPOSE To determine the intake levels, dietary sources, and determinants of free sugars (FS) consumption amongst Lebanese children and adolescents. METHODS This study is based on data collected by two national cross-sectional surveys conducted on representative samples of Lebanese children: survey 1 (under-five years (U5) children) (n = 899) and survey 2 (5-18 years-old children) (n = 1133). Multi-component questionnaires were used for data collection. Dietary intakes were assessed using one 24 h dietary recall. Median daily intakes of FS, and percent contribution of various food groups to FS intake were compared between sex and age groups. Logistic regressions were conducted to explore the determinants of high FS intake (> 10% energy intake/d), as per the WHO recommendations. RESULTS Median contribution of FS to daily energy intake was 8.5% in U5 children and 11.9% amongst those aged 5-18 years old. The top contributors to FS in both surveys were sugar-sweetened beverages and biscuits and chocolates. The proportion of children and adolescents exceeding WHO upper limits for FS was estimated at 43 and 62% in survey 1 and survey 2, respectively. Regression models showed females, higher household monthly incomes and higher parental educational levels were associated with significantly lower odds of exceeding the WHO upper limit for FS. CONCLUSION The study showed that a high proportion of Lebanese children and adolescents exceeded the WHO upper limit for FS intake, while also documenting a socioeconomic gradient in FS intake. Findings call for devising food system-based interventions to help reduce FS intake in this nutritionally vulnerable age group.
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Affiliation(s)
- Lamis Jomaa
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon
| | - Samer Hamamji
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon
| | - Samer Kharroubi
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon
| | - Marwa Diab-El-Harakeh
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon
| | - Fatima Al Zahraa Chokor
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon
| | - Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon.
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Hoteit M, Zoghbi E, Rady A, Shankiti I, Al-Jawaldeh A. Fatty Acids Quality in Middle Eastern Traditional Dishes, Arabic Sweets and Market Foods Frequently Consumed in Lebanon. Nutrients 2021; 13:2462. [PMID: 34371969 PMCID: PMC8308895 DOI: 10.3390/nu13072462] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/04/2021] [Accepted: 07/09/2021] [Indexed: 01/06/2023] Open
Abstract
The prevalence of diet-related non-communicable diseases is on the rise in the countries of the Eastern Mediterranean, including Lebanon. This study aimed to provide data on fatty acid profiles and ratios of Lebanese composite dishes, Arabic sweets, and market foods. Methods: Thirty types of traditional dishes, collected from five different Lebanese governorates, thirty-seven types of Arabic sweets and forty-six market food products were considered for analysis. Food samples were chemically analyzed for total, unsaturated and saturated fatty acids. The range of total fatty acids in composite dishes, Arabic sweets, and market food products was between 1.2-11.7 g/100 g, 5.3-25.8 g/100 g, and 0.5-100 g/100 g, respectively. Additionally, the range of saturated fatty acids in composite dishes, Arabic sweets, and market food products was between 0.5-4.9 g/100 g, 2.5-23.6 g/100 g and 0.1-56.4 g/100 g, respectively. Furthermore, about 75% of these foods were poor in unsaturated fatty acids. Regarding saturated fatty acid, the polyunsaturated to monounsaturated (P.M.S) ratio was lower than the recommended ratio of 1:1:1 in 96% of samples. To conclude, there is a need to prioritize fat content in foods and consider processing modifications in the food production system with the aim of achieving a higher P:M:S ratio intake among the population.
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Affiliation(s)
- Maha Hoteit
- Faculty of Public Health, Lebanese University, Beirut 6573, Lebanon;
| | - Edwina Zoghbi
- Country Office for Lebanon, World Health Organization, Beirut 5391, Lebanon; (E.Z.); (A.R.); (I.S.)
| | - Alissar Rady
- Country Office for Lebanon, World Health Organization, Beirut 5391, Lebanon; (E.Z.); (A.R.); (I.S.)
| | - Iman Shankiti
- Country Office for Lebanon, World Health Organization, Beirut 5391, Lebanon; (E.Z.); (A.R.); (I.S.)
| | - Ayoub Al-Jawaldeh
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo 11371, Egypt
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Low adherence to traditional dietary pattern and food preferences of low-income preschool children with food neophobia. Public Health Nutr 2021; 24:2859-2866. [PMID: 33023714 PMCID: PMC9884771 DOI: 10.1017/s1368980020003912] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To associate dietary patterns and food neophobia in low-income preschoolers. DESIGN This was a cross-sectional study using a semi-structured questionnaire for socio-demographic data, birth conditions and breast-feeding history. Food neophobia was assessed using an adapted version of the Child Food Neophobia Scale. Children's nutritional status was assessed using BMI-for-age and height-for-age Z-scores. Dietary patterns were estimated using a semi-quantitative FFQ through exploratory factor analysis. Multiple linear regression was used to test for an association between food neophobia and dietary pattern adherence. SETTING Philanthropic childhood education schools in Aracaju, an urban community in northeastern Brazil, between July and December 2017. PARTICIPANTS Two hundred fourteen children aged 3-6 years and their parents. RESULTS The percentages of low/medium and high food neophobia among preschoolers were 85·9 % and 11·2 %, respectively. Children with high food neophobia more frequently consumed ultra-processed foods rich in sugars (snacks, filled and unfilled cookies and sweets), as well as protein-rich foods (white meat, cheese and yogurt). Three dietary patterns were identified (traditional, snacks and school snacks). Children with a high level of neophobia had lower adherence to traditional dietary patterns. CONCLUSIONS A high level of food neophobia among socially vulnerable preschoolers is an eating behaviour related to unhealthy eating and is associated with the poorest diet in typical foods.
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Dietary Patterns in Early Childhood and the Risk of Childhood Overweight: The GECKO Drenthe Birth Cohort. Nutrients 2021; 13:nu13062046. [PMID: 34203797 PMCID: PMC8232591 DOI: 10.3390/nu13062046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 11/17/2022] Open
Abstract
Limited and inconsistent evidence exists on the associations between dietary patterns and overweight during childhood. The present study describes dietary patterns of three-year-old Dutch children and associations between childhood overweight and body mass index (BMI) development between 3 and 10 years. In the GECKO Drenthe birth cohort (N = 1306), body height and weight were measured around the age of 3, 4, 5, and 10 years, and overweight was defined according to Cole and Lobstein. A validated food frequency questionnaire (FFQ) was used to measure diet at 3 years. Dietary patterns were derived using principal components analysis (PCA). Using logistic regression analyses, pattern scores were related to overweight at 3 and 10 years. A linear mixed-effect model was used to estimate BMI-SDS development between 3 to 10 years according to quartiles of adherence to the pattern scores. Two dietary patterns were identified: (1) 'minimally processed foods', indicating high intakes of vegetables/sauces/savory dishes, and (2) 'ultra-processed foods', indicating high intakes of white bread/crisps/sugary drinks. A 1 SD increase in the 'ultra-processed foods' pattern score increased the odds of overweight at 10 years (adjusted OR: 1.30; 95%CI: 1.08, 1.57; p = 0.006). The 'minimally processed foods' pattern was not associated with overweight. Although a high adherence to both dietary patterns was associated with a higher BMI-SDS up to 10 years of age, a stronger association for the 'ultra-processed foods' pattern was observed (p < 0.001). A dietary pattern high in energy-dense and low-fiber ultra-processed foods at 3 years is associated with overweight and a high BMI-SDS later in childhood.
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Naja F, Itani L, Hammoudeh S, Manzoor S, Abbas N, Radwan H, Saber-Ayad M. Dietary Patterns and Their Associations With the FTO and FGF21 Gene Variants Among Emirati Adults. Front Nutr 2021; 8:668901. [PMID: 34095191 PMCID: PMC8171665 DOI: 10.3389/fnut.2021.668901] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/12/2021] [Indexed: 01/03/2023] Open
Abstract
Purpose: To examine the dietary patterns and their associations with the FTO and FGF21 gene variants among Emirati adults. Methods: Using a cross-sectional design, healthy adult male and female Emiratis (n = 194) were recruited from primary health care centers in Sharjah, UAE. Participants completed a 61-item semi-quantitative food frequency questionnaire. In addition, a saliva sample was obtained for the genetic analysis. Genotyping was performed for FTOrs9939609(A>T), FTOrs9930506(A>G), FGF21 rs838133 (A > G), and FGF21 rs838145 (A > G). Dietary patterns were derived using the principal component analysis. Logistic regression analyses were used to examine the association of dietary patterns with genetic variants. Results: Three dietary patterns were identified: "Western": consisting of fast food, sweets, and processed meat; "Traditional Emirati" rich in vegetables, traditional Emirati-mixed-dishes and whole dairy; while whole grains, low-fat dairy, and bulgur were components of the "Prudent" pattern. Subjects carrying the A allele of the FTO rs9939609 were 2.41 times more likely to adhere to the Western pattern compared to subjects with genotype TT (OR:2.41; 95%CI:1.05-5.50). Compared with subjects with A/A, those carrying the G allele of the FTO rs9930506 were more likely to follow a Western diet (OR: 2.19; 95%CI: 1.00-4.97). Participants carrying the risk allele (A) of the FGF21 rs838133 were twice more likely to adhere to the Traditional pattern as compared to subjects with genotype GG (OR: 1.9, 95%CI: 1.01-3.57). Conclusions: The findings of this study suggested associations among specific FTO and FGF21 gene variants with dietary patterns among Emirati adults. These findings could be used to inform evidence-based targeted nutrition preventive recommendations, especially those aiming to limit intake of western type foods.
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Affiliation(s)
- Farah Naja
- Clinical Nutrition and Dietetics Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Nutrition and Food Sciences Department, American University of Beirut, Beirut, Lebanon
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Sarah Hammoudeh
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Shaista Manzoor
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nada Abbas
- Nutrition and Food Sciences Department, American University of Beirut, Beirut, Lebanon
| | - Hadia Radwan
- Clinical Nutrition and Dietetics Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Maha Saber-Ayad
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Min K, Wang J, Liao W, Astell-Burt T, Feng X, Cai S, Liu Y, Zhang P, Su F, Yang K, Sun L, Zhang J, Wang L, Liu Z, Jiang Y. Dietary patterns and their associations with overweight/obesity among preschool children in Dongcheng District of Beijing: a cross-sectional study. BMC Public Health 2021; 21:223. [PMID: 33504346 PMCID: PMC7839210 DOI: 10.1186/s12889-021-10240-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/14/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Few studies investigated the associations between dietary patterns and overweight/obesity among Chinese preschool children. Thus, the study aims to explore dietary patterns and their associations with overweight/obesity among preschool children in the Dongcheng District of Beijing. METHODS With a stratified proportionate cluster sampling, the study included 3373 pairs of preschool children and their guardians. Children's weight and height were measured by school nurses, and their food and beverage consumption frequencies were reported by guardians via a food frequency questionnaire. Children's age, gender, physical activity time, and sedentary time, as well as their parents' highest level of educational attainment, occupation, weight, and height were also collected. Dietary patterns were identified through exploratory factor analysis. Among these identified dietary patterns, the one with the largest factor score was defined as the predominant dietary pattern for each child. The associations between predominant dietary patterns and overweight/obesity were tested by two-level random-intercept logistic models with cluster-robust standard errors. RESULTS Four dietary patterns, i.e., a "Sugar-sweetened beverage (SSB) and snack" pattern, a "Chinese traditional" pattern, a "Health conscious" pattern, and a "Snack" pattern, were identified. Among the children, 21.02% (95% CI: 19.68 to 22.43%) were predominated by the "SSB and snack" pattern, 27.78% (95% CI: 26.29 to 29.32%) by the "Chinese traditional" pattern, 24.90% (95% CI: 23.47 to 26.39%) by the "Health conscious" pattern, and 26.30% (95% CI: 24.84 to 27.81%) by the "Snack" pattern. After controlling for potential confounders, the "SSB and snack" pattern characterized by fresh fruit/vegetable juice, flavored milk drinks, carbonated drinks, flavored fruit/vegetable drinks, tea drinks, plant-protein drinks, puffed foods, fried foods, and Western fast foods was associated with a higher risk of overweight/obesity (OR: 1.61, 95% CI:1.09 to 2.38), compared with the "Chinese traditional" pattern. CONCLUSIONS The preference for dietary patterns with high energy density but low nutritional value was prevalent among preschool children in the Dongcheng District of Beijing. Comprehensive measures to simultaneously reduce consumption of SSBs and unhealthy snacks among preschool children should be taken urgently to address the childhood obesity problem in China, particularly in metropolises.
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Affiliation(s)
- Kaiyuan Min
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Dongcheng District, Beijing, China.,Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences/Peking Union Medical College, Dongcheng District, Beijing, China
| | - Jing Wang
- Dongcheng Center for Disease Control and Prevention, Dongcheng District, Beijing, China
| | - Wei Liao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences/Peking Union Medical College, Dongcheng District, Beijing, China
| | - Thomas Astell-Burt
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Dongcheng District, Beijing, China.,Population Wellbeing and Environment Research Lab, School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, Australia.,National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.,Menzies Centre for Health Policy, University of Sydney, Sydney, Australia
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab, School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, Australia.,National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.,Menzies Centre for Health Policy, University of Sydney, Sydney, Australia.,School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Shuya Cai
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Dongcheng District, Beijing, China
| | - Yang Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences/Peking Union Medical College, Dongcheng District, Beijing, China
| | - Peiwen Zhang
- School of Health Policy and Management, Chinese Academy of Medical Sciences/Peking Union Medical College, Dongcheng District, Beijing, China
| | - Fenghua Su
- Dongcheng Center for Disease Control and Prevention, Dongcheng District, Beijing, China
| | - Kexin Yang
- Dongcheng Center for Disease Control and Prevention, Dongcheng District, Beijing, China
| | - Liang Sun
- Dongcheng Center for Disease Control and Prevention, Dongcheng District, Beijing, China
| | - Juan Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Dongcheng District, Beijing, China.
| | - Lianjun Wang
- Dongcheng Center for Disease Control and Prevention, Dongcheng District, Beijing, China.
| | - Zechen Liu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yu Jiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Dongcheng District, Beijing, China
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DUARTE JUNIOR MADS, GAYA ACA, LEMES VB, FOCHESATTO CF, BRAND C, GAYA AR. Association between eating habits, body mass index, cardiorespiratory fitness, and cardiometabolic risk factors in children. REV NUTR 2021. [DOI: 10.1590/1678-9865202134e200116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Objective To verify the multivariate relationships between eating habits, cardiorespiratory fitness, body mass index, and cardiometabolic risk factors in children. Methods This is a cross-sectional study developed in a public elementary school with 60 first- to sixth-graders. Their eating habits were assessed using the Food Frequency Survey, weight, height, and cardiorespiratory fitness, assessed according to the Projeto Esporte Brasil protocol. Moreover, the variables, high-density lipoprotein, low-density lipoprotein, glucose, insulin, C-reactive protein, adiponectin, leptin, diastolic and systolic blood pressure were evaluated. Descriptive statistics were used for data analysis and generalized estimation equations were used for the analysis of direct and indirect relations, in a multivariate analysis model with several simultaneous outcomes. Results It appears that the eating habits and cardiorespiratory fitness explain 20% of the body mass index. Cardiometabolic risk factors are explained by the relationship between eating habits, cardiorespiratory fitness, and body mass index, according to the following percentages: 29% (systolic blood pressure), 18% (diastolic blood pressure), 63% (leptin), 4% (adiponectin), 14% (C-reactive protein), 17% (insulin), 10% (high-density lipoprotein), 1% (low-density lipoprotein), 4% (glucose). It is also observed that the effects of the eating habits on cardiometabolic risk factors are indirect, that is, they are dependent on changes in the body mass index and cardiorespiratory fitness levels. Conclusions The relationship between eating habits and cardiometabolic risk factors in children is dependent on cardiorespiratory fitness and body mass index. Thus, our findings suggest a multivariate relationship between these factors.
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Plaza-Díaz J, Molina-Montes E, Soto-Méndez MJ, Madrigal C, Hernández-Ruiz Á, Valero T, Lara Villoslada F, Leis R, Martínez de Victoria E, Moreno JM, Ortega RM, Ruiz-López MD, Varela-Moreiras G, Gil Á. Clustering of Dietary Patterns and Lifestyles Among Spanish Children in the EsNuPI Study †. Nutrients 2020; 12:nu12092536. [PMID: 32825604 PMCID: PMC7551863 DOI: 10.3390/nu12092536] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 12/21/2022] Open
Abstract
Dietary patterns (DPs) are known to be tied to lifestyle behaviors. Understanding DPs and their relationships with lifestyle factors can help to prevent children from engaging in unhealthy dietary practices. We aimed to describe DPs in Spanish children aged 1 to <10 years and to examine their associations with sociodemographic and lifestyle variables. The consumption of toddler and young children milk formulas, enriched and fortified milk within the Spanish pediatric population is increasing, and there is a lack of evidence whether the consumption of this type of milk is causing an impact on nutrient intakes and if they are helping to reach the nutrient recommendations. Within the Nutritional Study in the Spanish Pediatric Population (EsNuPI), we considered two study cohorts and three different age groups in three year-intervals in each of them. The study cohort included 740 children in a representative sample of the urban non-vegan Spanish population and 772 children in a convenience cohort of adapted milk consumers (AMS) (including follow-on formula, toddler’s milk, growing up milk, and fortified and enriched milks) who provided information about sociodemographics, lifestyle, and dietary habits; a food frequency questionnaire was used for the latter. Principal component analysis was performed to identify DPs from 18 food groups. Food groups and sociodemographic/lifestyle variables were combined through a hierarchical cluster algorithm. Three DPs predominated in every age group and study sample: a palatable energy-dense food dietary pattern, and two Mediterranean-like DPs. However, children from the AMS showed a predominant dietary pattern markedly related to the Mediterranean diet, with high consumption of cereals, fruits and vegetables, as well as milk and dairy products. The age of children and certain lifestyle factors, namely level of physical activity, parental education, and household income, correlated closely with the dietary clusters. Thus, the findings provide insight into designing lifestyle interventions that could reverse the appearance of unhealthy DPs in the Spanish child population.
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Affiliation(s)
- Julio Plaza-Díaz
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain;
- Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n, 18016 Granada, Spain; (E.M.-M.); (E.M.d.V.); (M.D.R.-L.)
- Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
| | - Esther Molina-Montes
- Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n, 18016 Granada, Spain; (E.M.-M.); (E.M.d.V.); (M.D.R.-L.)
- Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
- Department of Nutrition and Food Sciences, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain;
| | - María José Soto-Méndez
- Iberoamerican Nutrition Foundation (FINUT), Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.)
| | - Casandra Madrigal
- Department of Nutrition and Food Sciences, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain;
- Iberoamerican Nutrition Foundation (FINUT), Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.)
| | - Ángela Hernández-Ruiz
- Iberoamerican Nutrition Foundation (FINUT), Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.)
| | - Teresa Valero
- Spanish Nutrition Foundation (FEN), 28010 Madrid, Spain; (T.V.); (G.V.-M.)
| | | | - Rosaura Leis
- Department of Pediatrics, Unit of Pediatric Gastroenterology, Hepatology and Nutrition University Clinical Hospital of Santiago, 15706 Santiago de Compostela, Spain;
- Instituto de Investigación Sanitaria de Santiago, IDIS, Santiago de Compostela, University Clinical Hospital of Santiago, 15706 Santiago de Compostela, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Emilio Martínez de Victoria
- Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n, 18016 Granada, Spain; (E.M.-M.); (E.M.d.V.); (M.D.R.-L.)
- Department of Physiology, University of Granada, 18071 Granada, Spain
| | - José Manuel Moreno
- Department of Pediatrics, University of Navarra Clinic, 28027 Madrid, Spain;
| | - Rosa M. Ortega
- Department of Nutrition and Food Sciences, Faculty of Pharmacy, Complutense University, 28040 Madrid, Spain;
| | - María Dolores Ruiz-López
- Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n, 18016 Granada, Spain; (E.M.-M.); (E.M.d.V.); (M.D.R.-L.)
- Department of Nutrition and Food Sciences, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain;
- Iberoamerican Nutrition Foundation (FINUT), Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.)
| | - Gregorio Varela-Moreiras
- Spanish Nutrition Foundation (FEN), 28010 Madrid, Spain; (T.V.); (G.V.-M.)
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, 28668 Madrid, Spain
| | - Ángel Gil
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain;
- Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada, Avda. del Conocimiento s/n, 18016 Granada, Spain; (E.M.-M.); (E.M.d.V.); (M.D.R.-L.)
- Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
- Iberoamerican Nutrition Foundation (FINUT), Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-695466922
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Wu WC, Lin CI, Li YF, Chang LY, Chiang TL. The mediating effect of dietary patterns on the association between mother's education level and the physical aggression of five-year-old children: a population-based cohort study. BMC Pediatr 2020; 20:221. [PMID: 32414349 PMCID: PMC7227108 DOI: 10.1186/s12887-020-02126-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Relatively few studies have investigated the effects of diet on behavior problems among preschoolers, particularly, physical aggression. In addition, children raised by poorly educated mothers usually have a higher probability of developing negative outcomes. Additionally, highly educated mothers have a higher probability of providing more healthy foods for their children. Thus, mothers providing healthy foods might mitigate children's behavior problems. The study aims to examine whether preschoolers' dietary pattern, as a manipulable factor, mediates the association between maternal education level and physical aggression. METHODS Data came from the Taiwan Birth Cohort Study (TBCS), a nationally representative population-based cohort study, which included 18,513 five-year-old Taiwanese children. Mothers and primary caregivers reported the information on preschoolers' physical aggression and food consumption at age 5 and maternal education level at age 6 months. Two dietary patterns, namely a healthy diet and a high-fat-sugar-salt (HFSS) diet, were retrieved by exploratory factor analysis. Mediation hypotheses were tested by a series of multiple regression models conducted using the PROCESS macro of SAS 9.4. All models were adjusted for children's sex, parental marital status, household income, mental distress at age 5 and children's physical aggression at age 3. RESULTS Maternal education positively linked to healthy dietary patterns (B = 0.014, p = 0.002) which was negatively associated with preschoolers' physical aggression (B = -0.096, p = 0.013), and it is negatively related to the HFSS dietary pattern (B = -0.042, p = 0.002) which was directly positively associated with preschoolers' physical aggression (B = 0.123, p = 0.008). The association between maternal education and preschoolers' physical aggression was partially mediated by preschoolers' healthy (B = -0.001, p < .001) and HFSS (B = -0.005, p = <.001) dietary patterns, respectively. The R-square of the mediation model is 0.178. CONCLUSIONS Preschoolers' dietary patterns directly associate with their physical aggression. In addition, mothers with poor education may provide less healthy foods and more unhealthy foods to their children, which may increase the level of physical aggression. The results imply partial mediating effects of dietary patterns between maternal education and physical aggression. It is suggested that a parent-based nutritional education program focusing on healthy meal preparation for poor educated mothers might be beneficial for preschoolers' healthy development.
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Affiliation(s)
- Wen-Chi Wu
- Department of Health Promotion and Health Education, National Taiwan Normal University, 17 Xuzhou Road, Taipei, 100, Taiwan
| | - Ching-I Lin
- Department of Nutrition and Health Sciences, Kainan University, No. 1, Kainan Road, Luzhu District, Taoyuan City, 338, Taiwan.
| | - Yi-Fan Li
- Division of Clinical Chinese Medicine, National Research Institute of Chinese Medicine, Ministry of Health and Welfare, 11221 Room, No. 155-1, Section 2, Linong St, Beitou District, Taipei City, 112, Taiwan
| | - Ling-Yin Chang
- Institute of Health Behaviors and Community Sciences, School of Public Health, National Taiwan University, 17 Xuzhou Road, Taipei, 100, Taiwan
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, School of Public Health, National Taiwan University, 17 Xuzhou Road, Taipei, 100, Taiwan
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Nasreddine L, Chamieh MC, Ayoub J, Hwalla N, Sibai AM, Naja F. Sex disparities in dietary intake across the lifespan: the case of Lebanon. Nutr J 2020; 19:24. [PMID: 32216804 PMCID: PMC7098147 DOI: 10.1186/s12937-020-00543-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 03/11/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Little is known about sex-based dietary differences in middle-income countries, particularly those undergoing the nutrition transition. This study aims at examining sex disparities in energy and macronutrients' intakes, food consumption patterns, and micronutrients' adequacy in Lebanon, while adopting a life course approach. METHODS Data were derived from a national cross-sectional survey conducted in Lebanon in 2008/2009. The study sample consisted of 3636 subjects: 956 children and adolescents aged 6-19.9 years; 2239 adults aged 20-59.9 years and 441 older adults aged above 60 years. At the households, trained nutritionists conducted face-to-face interviews with participants to complete a sociodemographic questionnaire and one 24-h diet recall. Food items were categorized into 25 food groups. The Nutritionist Pro software was used for the analysis of dietary intake data and the estimation of energy, macronutrients', and micronutrients' intakes. RESULTS In all age groups, males had significantly higher energy intakes, while females had significantly higher fiber intakes. In addition, in adolescents aged 12-19.9 years, females had higher fat intakes as compared to males (37.02 ± 0.6% vs 35.03 ± 0.61%), and in adults aged 20-59.9 years, females had significantly higher total fat (37.73 ± 0.33% vs 36.45 ± 0.38%) and saturated fat intakes (11.24 ± 0.15% vs 10.45 ± 0.18%). These differences in macronutrient intakes were not observed in younger children nor in older adults. Sex-based differences in food groups' intakes were also observed: men and boys had significantly higher intakes of red and processed meat, bread, fast food, soft drinks, and alcohol, while girls and women had higher intakes of fruits, vegetables, milk, and sweets. In all age groups, females had lower micronutrient intakes compared to males, including calcium, iron, and zinc. CONCLUSIONS This study identified sex-specific priorities that ought to be tackled by context-specific interventions to promote healthier diets in Lebanon. The fact that sex-based differences in nutrient intakes and food consumption patterns were the most noticeable in the adolescent and adult years, hence women's reproductive years call for concerted efforts to improve nutrition for women and girls as this would lay the foundation not only for their future education, productivity, and economic empowerment, but also for the health of future generations.
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Affiliation(s)
- Lara Nasreddine
- Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Marie Claire Chamieh
- Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Jennifer Ayoub
- Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Nahla Hwalla
- Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Abla-Mehio Sibai
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Farah Naja
- Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon.
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Naja F, Itani L, Hwalla N, Sibai AM, Kharroubi SA. Identification of dietary patterns associated with elevated blood pressure among Lebanese men: A comparison of principal component analysis with reduced rank regression and partial least square methods. PLoS One 2019; 14:e0220942. [PMID: 31419246 PMCID: PMC6697315 DOI: 10.1371/journal.pone.0220942] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 07/27/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To examine the associations of dietary patterns with odds of elevated Blood Pressure (BP) among Lebanese adult males using principal component analysis (PCA), and compare the results to two other data reduction methods, including reduced rank regression (RRR) and partial least-squares (PLS) regression. METHODS Data from the National Nutrition and Non-Communicable Disease Risk Factor Survey conducted in Lebanon between years 2008 and 2009 were used. Dietary intake data were collected by a 61-item food frequency questionnaire (FFQ). In addition, anthropometric and blood pressure measurements were obtained following standard techniques. For the purpose of this study, data of males older than 20 years with no history of chronic diseases were selected (n = 673). Elevated BP was indicated if the systolic blood pressure was > = 130mm Hg and/or the diastolic blood pressure > = 85 mm Hg. Dietary patterns were constructed using PCA, PLS and RRR and compared based on the performance to identify plausible patterns associated with elevated BP. For PLS and RR, the response variables were BMI, waist circumference and percent body fat. Multiple logistic regression was used to evaluate the associations between the dietary pattern scores of each method and risk of elevated BP. RESULTS Three dietary patterns were identified using PCA: Western, Traditional Lebanese, and Fish and alcohol. Both the Western and the Traditional Lebanese patterns were associated with higher odds of elevated BP in the study population (OR = 1.23, CI 1.03, 1.46; OR = 1.29, CI 1.09, 1.52 respectively). The comparison among the three methods for dietary patterns derivation showed that PLS and RRR derived patterns explained greater variance in the outcome (PCA: 1.2%; PLS: 14.1%; RRR: 15.36%) and were significantly associated with elevated BP, while the PCA dietary patterns were descriptive of the study population's real dietary habits (PCA: 23.6%; PLS: 19.8%; RRR: 11.3%). CONCLUSIONS The Western and Traditional Lebanese dietary patterns were associated with higher odds of elevated BP among Lebanese males. The findings of this study showed that, compared to PCA, the use of RRR method resulted in more significant associations with the outcome while the PCA-derived patterns were more related to the real habits in the study population.
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Affiliation(s)
- Farah Naja
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Laila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University Beirut, Lebanon
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Abla M Sibai
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Samer A Kharroubi
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
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Hinnig PDF, Monteiro JS, de Assis MAA, Levy RB, Peres MA, Perazi FM, Porporatti AL, Canto GDL. Dietary Patterns of Children and Adolescents from High, Medium and Low Human Development Countries and Associated Socioeconomic Factors: A Systematic Review. Nutrients 2018; 10:E436. [PMID: 29601553 PMCID: PMC5946221 DOI: 10.3390/nu10040436] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 03/14/2018] [Accepted: 03/28/2018] [Indexed: 01/07/2023] Open
Abstract
The purpose of this systematic review is to assess the associations among education, income and dietary pattern (DP) in children and adolescents from high, medium and low human development countries (HHDC, MHDC and LHDC, respectively). Observational studies that evaluated the association between family income or education with the DP are obtained through electronic database searches. Forty articles are selected for review. In HHDC, education is inversely associated with "unhealthy" DP and positively associated with "healthy" DP. In cross-sectional studies from HHDC, higher income is negatively associated with "unhealthy" DP. In MHDC, there is no association between the socioeconomic variables (SE) and the DPs, although, in some studies, the unhealthy diet is positively associated with SE. Only one study conducted in LHDC showed an inverse association between income/education with "unhealthy" DP and there is no association between the SE and "healthy" DP. In conclusion, children and adolescents living in HHDC with high parental education tend to have a healthier diet. In MHDC, although an unhealthy diet is found among the high-income and educated population, the associations are not clear. Additional research is needed to clarify the associations between income and education with "unhealthy" and "healthy" DPs in MHDC and LHDC.
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Affiliation(s)
- Patrícia de Fragas Hinnig
- Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, CCS/UFSC, Campus Trindade, Florianopolis 88040-900, Brazil.
| | - Jordanna Santos Monteiro
- Postgraduate Program in Human Nutrition, Faculty of Health Sciences, University of Brasília (UnB), Brasilia-DF 70910-900, Brazil.
| | - Maria Alice Altenburg de Assis
- Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, CCS/UFSC, Campus Trindade, Florianopolis 88040-900, Brazil.
| | - Renata Bertazzi Levy
- Preventive Medicine Department, University of São Paulo (FMUSP), São Paulo 01246-903, Brazil.
| | - Marco Aurélio Peres
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - Fernanda Machado Perazi
- Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, CCS/UFSC, Campus Trindade, Florianopolis 88040-900, Brazil.
| | - André Luís Porporatti
- Brazilian Centre for Evidence-Based Research Department of Dentistry, Federal University of Santa Catarina CCS/UFSC, Campus Trindade, Florianopolis 88040-900, Brazil.
| | - Graziela De Luca Canto
- Brazilian Centre for Evidence-Based Research Department of Dentistry, Federal University of Santa Catarina CCS/UFSC, Campus Trindade, Florianopolis 88040-900, Brazil.
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