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Ko A, O’Brien D, Rivera P, Mancl L, Hopkins S, Randall C, Nguyen DP, Chi DL. Identifying sources of variation in added sugar intake for Alaska Native children using a hair biomarker. Int J Circumpolar Health 2024; 83:2336286. [PMID: 38560896 PMCID: PMC10986438 DOI: 10.1080/22423982.2024.2336286] [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: 09/16/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024] Open
Abstract
Sugars from sugar-sweetened beverages (SSBs) are an important risk factor for tooth decay. The study goal was to determine if there was variation in added sugar intake across communities and between and within households. In this cross-sectional study, intakes of total sugar, added sugar, and sugar-sweetened beverages (SSBs) were estimated for 282 Alaska Native children ages 0-10 years from 131 households in three Yukon-Kuskokwim (YK) Delta communities using biomarker equations based on hair carbon and nitrogen isotope ratios previously developed for the Yup'ik population. ANOVA was used to assess associations between each predictor (community and household) and outcome (estimated total sugars, added sugars, and SSB intake). Between- and within-household variation was estimated using a linear mixed-effects model with a random intercept for households with three or more children. There was no significant difference in mean estimated total sugar (p = 0.29), added sugar (p = 0.24), or SSB intake (p = 0.40) across communities. Significant variations were observed between and within households, with within-household variation amounting to 59% of the between-household variation. Added sugar intake in Alaska Native children from the three study communities is higher than the recommended maximum, and the variation is greater within households than between households.
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Affiliation(s)
- Alice Ko
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Diane O’Brien
- Center for Alaska Native Health Research, Institute of Arctic Biology, Department of Biology and Wildlife, University of Alaska, Fairbanks, AK, USA
| | - Patricia Rivera
- Center for Alaska Native Health Research, Institute of Arctic Biology, Department of Biology and Wildlife, University of Alaska, Fairbanks, AK, USA
| | - Lloyd Mancl
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Scarlett Hopkins
- Departments of Medicine and Obstetrics & Gynecology, Oregon Health & Science University, Portland, OR, USA
| | - Cameron Randall
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Daisy Patiño Nguyen
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Donald L. Chi
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
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Queral J, Wargers A, Tarro L, Llauradó E, Solà R, Jansen W. Changes over time of fruit, vegetable and sweets consumption among European adolescents and associations with sociodemographic characteristics: an HBSC study. J Public Health (Oxf) 2024; 46:392-402. [PMID: 38614469 PMCID: PMC11358633 DOI: 10.1093/pubmed/fdae033] [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: 09/22/2023] [Revised: 12/21/2023] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND European adolescents do not eat enough fruits and vegetables and have a high sweets consumption. This study aims to analyse the changes in time of dietary behaviours related to sociodemographic characteristics, among European adolescents. METHODS Health Behaviour in School Age Children data (2013/14 to 2017/18), of European adolescents, aged 11- to15-year-old, were used. Family Affluence Scale identified socioeconomic status (SES). Changes in time of dietary behaviours and associations with sociodemographic characteristics were estimated by binary and multilevel logistic regression. RESULTS 182 719 adolescents were included, and 10/36 European countries showed a significant increase in daily fruit and vegetable consumption and 12/36 countries a significant decrease in sweets consumption over 4 years. The multilevel analysis showed that 13- and 15-year-old adolescents consumed fewer daily fruits and vegetables (P < 0.001) and more daily sweets (P < 0.001) than 11-year-old adolescents. Also, 15-year-old adolescents' sweets consumption change over time was less favourable (P = 0.006). Girls consumed more daily fruits, vegetables and sweets than boys (P < 0.001).Low SES adolescents consumed fewer daily fruits and vegetables than medium/high SES adolescents. Additionally, the low SES adolescents' vegetable consumption change over time was less favourable (P < 0.001). CONCLUSIONS Dietary behaviour policy recommendations should be adapted for the sex, age and SES of the population.
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Affiliation(s)
- Judit Queral
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Avda. Josep Laporte 2, 43204 Reus, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Spain
| | - Annemieke Wargers
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40,3015 GD, Rotterdam, The Netherlands
| | - Lucia Tarro
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Avda. Josep Laporte 2, 43204 Reus, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Spain
| | - Elisabet Llauradó
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Avda. Josep Laporte 2, 43204 Reus, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Spain
| | - Rosa Solà
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Avda. Josep Laporte 2, 43204 Reus, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Spain
- Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain
| | - Wilma Jansen
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40,3015 GD, Rotterdam, The Netherlands
- Department of Social Development, City of Rotterdam, Coolsingel 40, 3011 AD Rotterdam, The Netherlands
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Perrar I, Alexy U, Nöthlings U. Intake of free sugar among children and adolescents in Germany declines - current results of the DONALD study. Eur J Nutr 2024:10.1007/s00394-024-03456-1. [PMID: 38967673 DOI: 10.1007/s00394-024-03456-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 06/17/2024] [Indexed: 07/06/2024]
Abstract
PURPOSE Our recent analysis reported decreasing trends in intake of free sugar in children and adolescents in Germany. Here we set out to update this analysis with current dietary intake (until 2023) because of the strong public health nutrition interest in sugar intake. METHODS In total, 4,218 dietary records kept between 2010 and 2023 by 751 participants (46.0% females, 3-18 years) from the German Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) cohort were examined. Age and time trends in free sugar intake (%E/d) were analysed using polynomial mixed-effects regression models. RESULTS Median intake data indicate a decline in the intake of free sugar between 2010/2011 (16.7%E) and 2022/2023 (11.7%E). Trend analyses confirmed, that intake of free sugars decreased continuously between 2017 and 2023 (Linear trend: β = -0.4126, p < 0.0001). In addition, free sugar intake changed significantly with age (Linear trend: β = 1.2922, p < 0.0001; quadratic trend: β = -0.08613, p = 0.0094; cubic trend: β = 0.001442, p = 0.1725), i.e. the intake of free sugars increases continuously up to early adolescence (9/10 years) and decreases again thereafter. CONCLUSION The intake of free sugar among children and adolescents continued to decline, but still exceeded the WHO recommendations in 2023. Further measures to reduce free sugar intake would therefore be desirable, as well as continuous monitoring of sugar intake levels among this age groups.
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Affiliation(s)
- Ines Perrar
- Institute of Nutritional and Food Sciences -Nutritional Epidemiology, University of Bonn, Friedrich-Hirzebruch- Allee 7, 53115, Bonn, Germany.
| | - Ute Alexy
- Institute of Nutritional and Food Sciences -Nutritional Epidemiology, University of Bonn, Friedrich-Hirzebruch- Allee 7, 53115, Bonn, Germany
| | - Ute Nöthlings
- Institute of Nutritional and Food Sciences -Nutritional Epidemiology, University of Bonn, Friedrich-Hirzebruch- Allee 7, 53115, Bonn, Germany
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Spiegler C, Jansen S, Burgard L, Wittig F, Brettschneider AK, Schlune A, Heuer T, Straßburg A, Roser S, Storcksdieck Genannt Bonsmann S, Ensenauer R. Unfavorable food consumption in children up to school entry age: results from the nationwide German KiESEL study. Front Nutr 2024; 11:1335934. [PMID: 39010856 PMCID: PMC11246898 DOI: 10.3389/fnut.2024.1335934] [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: 11/09/2023] [Accepted: 06/13/2024] [Indexed: 07/17/2024] Open
Abstract
Introduction Evidence points toward the early life being crucial for preventing nutrition-related diseases. As promotion of healthier food preferences in toddlerhood and preschool age might still modulate the trajectories of disease risk, understanding diet in these age groups is necessary. The objective was to analyze food consumption and diet quality of 1-5-year-old children living in Germany in relation to age and sex. Methods Data from 890 children, a subsample of the representative, cross-sectional Children's Nutrition Survey to Record Food Consumption (KiESEL) conducted by the German Federal Institute for Risk Assessment in 2014-2017, were analyzed. Dietary data were collected using food records (3 consecutive plus 1 independent day). Diet quality was evaluated against the German food-based dietary guidelines (FBDG). Results Consumption of unfavorable foods (e.g., sweets, soft drinks) exceeded the recommended maximum of 10% of energy intake (E%) by a multiple in all age and sex groups (medians: 24.8-35.8 E%). Preschoolers consumed more unfavorable foods than toddlers and boys more than girls. More than half of the children exceeded the recommendation for meat intake (medians: 2.3-3.2% of the total food consumption (%TFC) vs. 2 %TFC), especially preschoolers. In nearly all children, vegetable consumption was too low (medians: 4.2-4.5 %TFC vs. 12 %TFC). Also, milk/milk product consumption was below recommendations, more so in preschoolers (median: 12.0 %TFC ♂, 11.9 %TFC ♀ vs. 18 %TFC) than in toddlers (median: 16.1 %TFC ♂, 19.6 %TFC ♀). In toddlers and preschoolers with overweight or obesity, adherence to dietary recommendations of these food groups was largely similar to that of the total sample. Overall, 5-year-olds showed an unhealthier dietary pattern than 1-year-olds, which already emerged at age 2 years and became more evident at age 3 years. Discussion An adverse dietary pattern arises and even deteriorates at a very young age, showing sex-specific aspects. High attention from public health and research needs to be given to toddlerhood and even earlier life phases, e.g., to develop more age-specific FBDGs, aiming at reducing unhealthy food consumption.
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Affiliation(s)
- Clarissa Spiegler
- Department of Nutritional Behaviour, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Sara Jansen
- Department of Child Nutrition, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Leonie Burgard
- Department of Nutritional Behaviour, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Friederike Wittig
- Department of Nutritional Behaviour, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Anna-Kristin Brettschneider
- Department of Child Nutrition, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Andrea Schlune
- Department of Child Nutrition, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Thorsten Heuer
- Department of Nutritional Behaviour, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Andrea Straßburg
- Department of Nutritional Behaviour, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Silvia Roser
- Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Presidential Office, Karlsruhe, Germany
| | | | - Regina Ensenauer
- Department of Child Nutrition, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
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Kühnel L, Schneider J, Perrar I, Adams T, Moazemi S, Prasser F, Nöthlings U, Fröhlich H, Fluck J. Synthetic data generation for a longitudinal cohort study - evaluation, method extension and reproduction of published data analysis results. Sci Rep 2024; 14:14412. [PMID: 38909025 PMCID: PMC11193715 DOI: 10.1038/s41598-024-62102-2] [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: 06/23/2023] [Accepted: 05/13/2024] [Indexed: 06/24/2024] Open
Abstract
Access to individual-level health data is essential for gaining new insights and advancing science. In particular, modern methods based on artificial intelligence rely on the availability of and access to large datasets. In the health sector, access to individual-level data is often challenging due to privacy concerns. A promising alternative is the generation of fully synthetic data, i.e., data generated through a randomised process that have similar statistical properties as the original data, but do not have a one-to-one correspondence with the original individual-level records. In this study, we use a state-of-the-art synthetic data generation method and perform in-depth quality analyses of the generated data for a specific use case in the field of nutrition. We demonstrate the need for careful analyses of synthetic data that go beyond descriptive statistics and provide valuable insights into how to realise the full potential of synthetic datasets. By extending the methods, but also by thoroughly analysing the effects of sampling from a trained model, we are able to largely reproduce significant real-world analysis results in the chosen use case.
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Affiliation(s)
- Lisa Kühnel
- Knowledge Management, ZB MED - Information Centre for Life Sciences, 50931, Cologne, Germany.
- Faculty of Technology, Graduate School DILS, Bielefeld Institute for Bioinformatics Infrastructure (BIBI), Bielefeld University, 33615, Bielefeld, Germany.
| | - Julian Schneider
- Knowledge Management, ZB MED - Information Centre for Life Sciences, 50931, Cologne, Germany
| | - Ines Perrar
- Institute of Nutritional and Food Sciences - Nutritional Epidemiology, University of Bonn, 53115, Bonn, Germany
| | - Tim Adams
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing SCAI, 53757, Sankt Augustin, Germany
| | - Sobhan Moazemi
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing SCAI, 53757, Sankt Augustin, Germany
| | - Fabian Prasser
- Medical Informatics Group, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Ute Nöthlings
- Institute of Nutritional and Food Sciences - Nutritional Epidemiology, University of Bonn, 53115, Bonn, Germany
| | - Holger Fröhlich
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing SCAI, 53757, Sankt Augustin, Germany
- Bonn-Aachen International Center for IT, University of Bonn, Friedrich Hirzebruch-Allee 6, 53115, Bonn, Germany
| | - Juliane Fluck
- Knowledge Management, ZB MED - Information Centre for Life Sciences, 50931, Cologne, Germany
- The Agricultural Faculty, University of Bonn, 53115, Bonn, Germany
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Perrar I, Alexy U, Nöthlings U. Cohort profile update-overview of over 35 years of research in the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study. Eur J Nutr 2024; 63:727-740. [PMID: 38151532 PMCID: PMC10948456 DOI: 10.1007/s00394-023-03290-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/28/2023] [Indexed: 12/29/2023]
Abstract
PURPOSE To provide an update on the cohort profile of the DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study, including objectives, study design, methods and description of the comprehensive data pool, as well as to summarize the most important research findings of recent years. METHODS In 1985, the open (dynamic) cohort started to collect information on diet, growth, development, and metabolism of healthy children and adolescents in Dortmund, Germany. Detailed data are collected annually during infancy, childhood, and adolescence of the participants, including a 3-day weighed dietary record, a 24-h urine sample, anthropometric and medical examinations as well as interviews on lifestyle. RESULTS Even if the basic examination modules have not changed since the start over 35 years ago, the DONALD study has been continuously further developed by introducing new modules. As such, participants are also invited for follow-up examinations during adulthood since 2005, including an additional fasting blood withdrawal. Overall, 2375 (♂: 1177; ♀: 1198) participants were recruited in the DONALD study between 1985 and 2022. Data from ~ 30,700 anthropometric measurements, ~ 19,200 dietary records, ~ 10,600 24-h urine and ~ 1300 blood samples are available from an observation period of over 35 years. CONCLUSION The DONALD study provides a large data pool for longitudinal studies on nutrition, growth, and health in childhood and adolescence, its impact on the development of diseases in early adult life as well as dietary intake trends over more than three decades.
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Affiliation(s)
- Ines Perrar
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Friedrich-Hirzebruch-Allee 7, 53115, Bonn, Germany
| | - Ute Alexy
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Friedrich-Hirzebruch-Allee 7, 53115, Bonn, Germany
| | - Ute Nöthlings
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Friedrich-Hirzebruch-Allee 7, 53115, Bonn, Germany.
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Velázquez AL, Vidal L, Antúnez L, Alcaire F, Varela P, Ares G. Children's reaction to sugar reduced dairy desserts in the context of the implementation of nutritional warning labels: An exploratory study. Food Res Int 2023; 170:113001. [PMID: 37316071 DOI: 10.1016/j.foodres.2023.113001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/16/2023]
Abstract
The aim of the present work was to explore children's reaction to sugar reduction in the context of the implementation of nutritional warnings in Uruguay. The study was composed of two sessions involving three evaluation conditions: tasting without package information, package evaluation without tasting, and tasting with package information. A total of 122 children, ages ranging between 6 and 13 years old (47% girls) were involved in the study. In the first session, children's hedonic and emotional response to a regular and a sugar-reduced chocolate dairy dessert (without other sweeteners) was evaluated. In the second session, children first evaluated their expected liking, emotional associations and choice of packages differing in the presence of warning labels for excessive sugar content and cartoon character (2x2 design). Finally, they tasted the selected sample in the presence of the package and evaluated their liking, emotional associations, and intention to re-taste it. Although sugar reduction led to a significant reduction in overall liking, the dessert with 40% sugar reduction showed a mean overall score of 6.5 in a 9-point hedonic scale and was described using positive emoji (, , ). When the desserts were tasted with package information, no significant differences in the expected overall liking of the regular and sugar-reduced dessert were found. Regarding the effect of packaging elements, the presence of a warning label highlighting excessive content of sugar did not have a significant effect on children's choice. Instead, children's choices were defined by the presence of a cartoon character. Results from the present work provide additional evidence about the feasibility of reducing the sugar content and sweetness of dairy products targeted at children and stress the need to regulate the use of cartoon characters on products with an unfavorable nutritional profile. Methodological recommendations for sensory and consumer research with children are also discussed.
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Affiliation(s)
- Ana Laura Velázquez
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000 Pando, Canelones, Uruguay; Graduate Program in Chemistry, Facultad de Química, Universidad de la República, Uruguay
| | - Leticia Vidal
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000 Pando, Canelones, Uruguay
| | - Lucía Antúnez
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000 Pando, Canelones, Uruguay
| | - Florencia Alcaire
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000 Pando, Canelones, Uruguay
| | | | - Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000 Pando, Canelones, Uruguay.
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Adeoye I. Sugar-sweetened beverage consumption among pregnant women attending general and teaching hospitals in Ibadan, Nigeria : SSB consumption during pregnancy. BMC Public Health 2023; 23:980. [PMID: 37237281 DOI: 10.1186/s12889-023-15828-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Sugar-sweetened beverages (SSBs) have become a global health concern because of their adverse health effects and their association with the obesity pandemic. It has not received much attention in sub-Saharan Africa, including Nigeria, especially among pregnant women. The pattern, frequency and factors associated with SSBs among pregnant women in Ibadan, Nigeria, were investigated. DESIGN Data were from the Ibadan Pregnancy Cohort Study - a prospective cohort study investigating 1745 pregnant women from four comprehensive obstetric facilities in Ibadan. A qualitative food frequency questionnaire (FFQ) was used to assess the pregnant women's intake of food and drinks over the previous months. Sugar-sweetened beverage variable and scores were also generated using the principal component analysis with varimax rotation. Factors associated with high SSB scores were examined using multivariate logistics regression analyses at a 5% significance level. RESULTS The most commonly consumed SSBs were cocoa-sweetened beverages, soft drinks, malt drinks, and fruit juice. A quarter of the women (75th percentile) consumed SSB more than once weekly. The factors associated with high SSB on multivariate analysis were; being employed (AOR: 1.52, 95% CI 1.02-2.26), maternal obesity (AOR: 0.065, 95% CI 0.47-0.89), high fruit intake (AOR:3.62, 95% CI 2.62-4.99), high green vegetable consumption (AOR:1.99, 95% CI 1.06-3.74), high milk intake (AOR: 2.13, 95% CI 1.65- 2.74), frequent fast food outlet visit (AOR: 2.19, 95% CI 1.53-1.70), all of these remained significant after adjusting for confounding variables. CONCLUSION SSBs were common among our study population. Factors associated with high SSBs intake are crucial for implementing locally relevant public health interventions.
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Affiliation(s)
- Ikeola Adeoye
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
- Consortium for Advanced Research Training in Africa (CARTA), Nairobi, Kenya.
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Vinoy S, Goletzke J, Rakhshandehroo M, Schweitzer L, Flourakis M, Körner A, Alexy U, van Schothorst EM, Ceriello A, Zakrzewski-Fruer JK, Buyken A. Health relevance of lowering postprandial glycaemia in the paediatric population through diet': results from a multistakeholder workshop. Eur J Nutr 2023; 62:1093-1107. [PMID: 36534178 PMCID: PMC10030539 DOI: 10.1007/s00394-022-03047-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 10/20/2022] [Indexed: 12/23/2022]
Abstract
To summarize current knowledge and gaps regarding the role of postprandial glycaemic response in the paediatric population, a workshop was organized in June 2021 by the European branch of the International Life Science Institute (ILSI). This virtual event comprised of talks given by experts followed by in-depth discussions in breakout sessions with workshop participants. The main pre-specified topics addressed by the workshop organizing committee to the invited speakers and the workshop participants were: (1) the role of glycaemic responses for paediatric health, based on mechanistic insights from animal and human data, and long-term evidence from observational and intervention studies in paediatric populations, and (2) changes in metabolism and changes in dietary needs from infancy to adolescence. Each talk as well as the discussions were summarised, including the main identified research gaps. The workshop led to the consensus on the crucial role on health of postprandial glycaemic response in paediatric population. However, a lack of scientific data has been identified regarding detailed glucose and insulin profiles in response to foods commonly consumed by paediatric populations, as well as a lack of long-term evidence including the need for suitable predictors during childhood and adolescence to anticipate health effects during adulthood.
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Affiliation(s)
- Sophie Vinoy
- Mondelēz International, Nutrition Research, Clamart, France
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Spagnuolo MS, Mazzoli A, Nazzaro M, Troise AD, Gatto C, Tonini C, Colardo M, Segatto M, Scaloni A, Pallottini V, Iossa S, Cigliano L. Long-Lasting Impact of Sugar Intake on Neurotrophins and Neurotransmitters from Adolescence to Young Adulthood in Rat Frontal Cortex. Mol Neurobiol 2023; 60:1004-1020. [PMID: 36394711 PMCID: PMC9849314 DOI: 10.1007/s12035-022-03115-8] [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: 05/05/2022] [Accepted: 11/01/2022] [Indexed: 11/18/2022]
Abstract
The detrimental impact of fructose, a widely used sweetener in industrial foods, was previously evidenced on various brain regions. Although adolescents are among the highest consumers of sweet foods, whether brain alterations induced by the sugar intake during this age persist until young adulthood or are rescued returning to a healthy diet remains largely unexplored. To shed light on this issue, just weaned rats were fed with a fructose-rich or control diet for 3 weeks. At the end of the treatment, fructose-fed rats underwent a control diet for a further 3 weeks until young adulthood phase and compared with animals that received from the beginning the healthy control diet. We focused on the consequences induced by the sugar on the main neurotrophins and neurotransmitters in the frontal cortex, as its maturation continues until late adolescence, thus being the last brain region to achieve a full maturity. We observed that fructose intake induces inflammation and oxidative stress, alteration of mitochondrial function, and changes of brain-derived neurotrophic factor (BDNF) and neurotrophin receptors, synaptic proteins, acetylcholine, dopamine, and glutamate levels, as well as increased formation of the glycation end-products Nε-carboxymethyllysine (CML) and Nε-carboxyethyllysine (CEL). Importantly, many of these alterations (BDNF, CML, CEL, acetylcholinesterase activity, dysregulation of neurotransmitters levels) persisted after switching to the control diet, thus pointing out to the adolescence as a critical phase, in which extreme attention should be devoted to limit an excessive consumption of sweet foods that can affect brain physiology also in the long term.
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Affiliation(s)
- Maria Stefania Spagnuolo
- grid.419162.90000 0004 1781 6305Institute for the Animal Production System in the Mediterranean Environment, National Research Council, P.le E.Fermi 1, 80055 Portici, Italy
| | - Arianna Mazzoli
- grid.4691.a0000 0001 0790 385XDepartment of Biology, University of Naples Federico II, Complesso Universitario Monte S. Angelo, Edificio 7, Via Cintia - I-80126, Naples, Italy
| | - Martina Nazzaro
- grid.4691.a0000 0001 0790 385XDepartment of Biology, University of Naples Federico II, Complesso Universitario Monte S. Angelo, Edificio 7, Via Cintia - I-80126, Naples, Italy
| | - Antonio Dario Troise
- grid.419162.90000 0004 1781 6305Institute for the Animal Production System in the Mediterranean Environment, National Research Council, P.le E.Fermi 1, 80055 Portici, Italy
| | - Cristina Gatto
- grid.4691.a0000 0001 0790 385XDepartment of Biology, University of Naples Federico II, Complesso Universitario Monte S. Angelo, Edificio 7, Via Cintia - I-80126, Naples, Italy
| | - Claudia Tonini
- grid.8509.40000000121622106Department of Science, Biomedical and Technology Science Section, University Roma Tre, Rome, Italy
| | - Mayra Colardo
- grid.10373.360000000122055422Department of Biosciences and Territory, University of Molise, Pesche, Italy
| | - Marco Segatto
- grid.10373.360000000122055422Department of Biosciences and Territory, University of Molise, Pesche, Italy
| | - Andrea Scaloni
- grid.419162.90000 0004 1781 6305Institute for the Animal Production System in the Mediterranean Environment, National Research Council, P.le E.Fermi 1, 80055 Portici, Italy
| | - Valentina Pallottini
- grid.8509.40000000121622106Department of Science, Biomedical and Technology Science Section, University Roma Tre, Rome, Italy ,grid.417778.a0000 0001 0692 3437Neuroendocrinology Metabolism and Neuropharmacology Unit, IRCSS Fondazione Santa Lucia, Rome, Italy
| | - Susanna Iossa
- grid.4691.a0000 0001 0790 385XDepartment of Biology, University of Naples Federico II, Complesso Universitario Monte S. Angelo, Edificio 7, Via Cintia - I-80126, Naples, Italy
| | - Luisa Cigliano
- grid.4691.a0000 0001 0790 385XDepartment of Biology, University of Naples Federico II, Complesso Universitario Monte S. Angelo, Edificio 7, Via Cintia - I-80126, Naples, Italy
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11
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The Assessment of School Lunches in the Form of Food Packs during the COVID-19 Pandemic in Latvia. CHILDREN 2022; 9:children9101459. [PMID: 36291394 PMCID: PMC9600045 DOI: 10.3390/children9101459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022]
Abstract
During the pandemic, Latvian schools switched to remote learning which required looking for solutions to provide state-funded school lunches for pupils at home. The aim of study was to analyse the type of support received by pupils for provision of school lunches, the compliance of the composition of food packs with Latvian healthy diet recommendations and parental assessment of the food packs received. With the help of the questionnaire data on the composition of food packs, parental assessment was obtained by interviewing 1495 parents of pupils in grades 1–4 (age 6–11 years). The composition of food packs was evaluated in accordance with the recommendations for a healthy diet. Food packs were the main choice for the provision of school lunches in all regions (90.70%). The emphasis in the food packs was on protein-rich products like canned meat and meat products (93.36%) and milk (91.37%). 81.71% of food packs contained both vegetables and fruits. Food packs covered basic needs but improvements would be needed. The parents appreciated the support received, 90% of them rated it as positive/partially positive. In the event of a pandemic recurrence, the state would need to work with food producers to provide smaller packaging of products for food packs to ensure food diversity.
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Food group intake of children and adolescents (6-18 years) on a vegetarian, vegan or omnivore diet: results of the VeChi Youth Study. Br J Nutr 2022; 128:851-862. [PMID: 34511141 DOI: 10.1017/s0007114521003603] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Plant-based, i.e. vegetarian (without meat and fish) or vegan (exclusively plant-based foods) diets are in trend also among children and adolescents, but data on food intake in this group are lacking. Here, we compare the consumption of food groups of vegetarian (n 145), vegan (n 110) and omnivore (n 135) children and adolescents (6-18 years) in Germany using data of the VeChi Youth Study. Each food item reported in 3 d weighed dietary records was assigned to one of eighteen food groups and individual mean intake per day (g/MJ) was calculated. Group differences were assessed using covariance analyses adjusted for age, sex and other covariates. For food groups with a high number of non-consumers, non-parametric Kruskal-Wallis tests were run. Pairwise comparison of vegetarian and vegan groups indicated significantly higher intakes of legumes, nuts, milk alternatives (all P = 0·0003) and meat alternatives (P = 0·0065) among vegan subjects. Intake of these food groups of omnivore participants was low (Q3:0·0 g/MJ for legumes, milk alternatives and meat alternatives, 0·5 g/MJ for nuts). Dairy intake of vegetarians (11·6 g/MJ) was significantly lower than of omnivore subjects (24·7 g/MJ) (P = 0·0003). Intake of fats/oils and sweet foods was lowest in vegan compared with vegetarian and omnivore participants (P< 0·05). Whole grain intake was higher in vegan participants (14·5 g/MJ) than of vegetarian (9·1 g/MJ) and omnivore (6·5 g/MJ) participants (P = 0·0003). Longitudinal studies are necessary to evaluate the long-term health consequences of vegetarian, vegan and omnivore food patterns, especially in childhood and adolescence.
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13
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Total and Added Sugar Intakes Are Increasing among Children and Adolescents in China: Findings from CHNS 1997-2011. Nutrients 2022; 14:nu14163340. [PMID: 36014849 PMCID: PMC9416199 DOI: 10.3390/nu14163340] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 02/02/2023] Open
Abstract
A high level of sugar intake has been linked to poor dietary quality and a wide range of chronic diseases. However, data on sugar intake are still scarce in China. This study aimed to provide time trends in the total and added sugar intakes among Chinese children and adolescents from 1997 to 2011. A nationwide ongoing open prospective cohort study of Chinese children and adolescents aged 3−17 years (n = 13,212) was conducted by using data from the China Health and Nutrition Survey (CHNS) 1997−2011 (six 1-year cycles). An individual dietary intake was collected from three consecutive 24-h recalls during randomly allocated home visits. Data for total and added sugar contents were determined based on the U.S. Department of Agriculture (USDA) National Nutrient Database for Standard Reference, Release 28 (SR28), the Food Patterns Equivalents Database (FPED) 2015−2016, and the labeled ingredients and nutrient contents. General linear regression was used to estimate time trends. Over the 15-year period, total sugar and added sugar intakes increased among all age groups studied (3−17 years: total sugar increased from 11.2 ± 0.3 g/d to 28.1 ± 0.5 g/d, added sugar increased from 1.0 ± 0.1 g/d to 7.2 ± 0.3 g/d; 3−6 years: 9.5 ± 0.6 g/d to 25.1 ± 0.9 g/d, 1.3 ± 0.2 g/d to 6.9 ± 0.4 g/d; 7−12 years: 11.4 ± 0.5 g/d to 28.1 ± 0.8 g/d, 0.9 ± 0.1 g/d to 7.1 ± 0.5 g/d; 13−17 years: 11.8 ± 0.4 g/d to 31.4 ± 1.1 g/d, 1.0 ± 0.2 g/d to 7.6 ± 0.6 g/d) (all p for trend < 0.001). Adolescents aged 13−17 years had the highest total sugar intake, and children aged 3−6 years had the highest added sugar intake, except for 2011. Children and adolescents living in urban areas and who were overweight had much higher total and added sugar intakes than those residing in rural areas and of non-overweight/obesity. Furthermore, the dietary sources of total and added sugars have become more diverse over the study period. In conclusion, we observed a notable rise in total and added sugar intakes among children and adolescents across all age groups, both genders, both urban and rural areas, and all BMI categories, with dietary sources of total and added sugars becoming more diverse in China over 15 years.
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14
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Kobel S, Wartha O, Dreyhaupt J, Feather KE, Steinacker JM. Intervention effects of a school-based health promotion programme on children’s nutrition behaviour. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01726-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Abstract
Aim
The programme “Join the Healthy Boat” promotes amongst other things a healthy diet in primary school children. In order to evaluate the programme’s effectiveness, this study longitudinally investigated children’s nutrition behaviour.
Subject and methods
A total of 1564 children (7.1 ± 0.6 years) participated in a cluster-randomised study. Teachers delivered lessons including behavioural contracting and budgeting. Nutritional behaviours of parents and child were assessed via parental report. Anthropometrics were measured on site.
Results
After one year, children in the intervention group (IG) showed a significant reduction in the consumption of pure juices (p ≤ 0.001). Soft drink consumption reduced in both groups, although with a trend towards a slightly greater reduction in the IG. Children with fathers of normal weight as well as first graders showed a significant reduction of soft drink consumption in the IG (p = 0.025 and p = 0.022 respectively). Fruit and vegetable intake increased significantly for first graders (p = 0.050), children from families with a high parental education level (p = 0.023), and for children with an overweight father (p = 0.034). Significant group differences were found for fruit and vegetable intake of children with migration background (p = 0.01) and children of parents with a high school degree could be observed (p = 0.019).
Conclusion
This shows that the programme appeals to a wider range of children, and is therefore more likely to compensate for differences due to origin or other social inequalities, which also shows that active parental involvement is vital for successful interventions.
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15
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Malik VS, Hu FB. The role of sugar-sweetened beverages in the global epidemics of obesity and chronic diseases. Nat Rev Endocrinol 2022; 18:205-218. [PMID: 35064240 PMCID: PMC8778490 DOI: 10.1038/s41574-021-00627-6] [Citation(s) in RCA: 235] [Impact Index Per Article: 117.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/20/2021] [Indexed: 02/08/2023]
Abstract
Sugar-sweetened beverages (SSBs) are a major source of added sugars in the diet. A robust body of evidence has linked habitual intake of SSBs with weight gain and a higher risk (compared with infrequent SSB consumption) of type 2 diabetes mellitus, cardiovascular diseases and some cancers, which makes these beverages a clear target for policy and regulatory actions. This Review provides an update on the evidence linking SSBs to obesity, cardiometabolic outcomes and related cancers, as well as methods to grade the strength of nutritional research. We discuss potential biological mechanisms by which constituent sugars can contribute to these outcomes. We also consider global trends in intake, alternative beverages (including artificially-sweetened beverages) and policy strategies targeting SSBs that have been implemented in different settings. Strong evidence from cohort studies on clinical outcomes and clinical trials assessing cardiometabolic risk factors supports an aetiological role of SSBs in relation to weight gain and cardiometabolic diseases. Many populations show high levels of SSB consumption and in low-income and middle-income countries, increased consumption patterns are associated with urbanization and economic growth. As such, more intensified policy efforts are needed to reduce intake of SSBs and the global burden of obesity and chronic diseases.
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Affiliation(s)
- Vasanti S Malik
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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16
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Chiavaroli L, Wang YF, Ahmed M, Ng AP, DiAngelo C, Marsden S, Sievenpiper JL. Intakes of nutrients and food categories in Canadian children and adolescents across levels of sugars intake: cross-sectional analyses of the Canadian Community Health Survey 2015 Public Use Microdata File. Appl Physiol Nutr Metab 2022; 47:415-428. [PMID: 35007181 DOI: 10.1139/apnm-2021-0517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Dietary recommendations to reduce sugars consumption may influence choices of sugars-containing foods and affect the intake of key micronutrients. We compared intakes of nutrients and food sources stratified by quintiles of total sugars in Canadian children (2-8 y) and adolescents (9-13 y, 14-18 y) using 24-hour dietary recalls from the 2015 Canadian Community Health Survey-Nutrition. Energy intakes did not differ across quintiles of sugars intake. Those with lower sugars intakes (Q1/Q3) generally had higher protein, fat, sodium, niacin, folate, and zinc and lower vitamin C compared with those with the highest sugars intakes (Q5). Q1 also had lower potassium but higher saturated fat compared with Q5. Further, Q1 generally had higher protein, fats, and niacin compared with Q3, while children in Q3 had higher potassium and riboflavin and older adolescents had higher calcium and fibre. Q5 had highest intakes of multiple sugar-containing food categories (e.g., fruit, confectionary, milks, cakes/pies/pastries), with higher sugars-sweetened beverages in adolescents. Q3 had higher fruit, milks, and fruit juice compared with Q1 and lower sugars/syrups/preserves, confectionary, and fruit juices compared with Q5. Certain nutrient-dense food sources of sugars (fruit, milks) may help increase key nutrients (potassium, calcium, fibre) in older adolescents with low sugars intakes. However, in those with the highest sugars intakes, nutrient-poor foods may displace nutrient-dense foods. Novelty: Canadian children and adolescents with lower sugars intake have better intakes of some nutrients. Energy intakes did not differ across sugars intake. Older adolescents with mean intakes of total sugars had better intakes of some key nutrients (potassium, calcium, fibre).
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Affiliation(s)
- Laura Chiavaroli
- Departments of Nutritional Sciences and Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5B 1W8, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON M5B 1W8, Canada
| | - Ye Flora Wang
- Nutrition Information Service, Canadian Sugar Institute, Toronto, ON M5V 3E4, Canada
| | - Mavra Ahmed
- Departments of Nutritional Sciences and Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5B 1W8, Canada.,Joannah and Brian Lawson Centre for Child Nutrition, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Alena Praneet Ng
- Departments of Nutritional Sciences and Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5B 1W8, Canada
| | - Chiara DiAngelo
- Nutrition Information Service, Canadian Sugar Institute, Toronto, ON M5V 3E4, Canada
| | - Sandra Marsden
- Nutrition Information Service, Canadian Sugar Institute, Toronto, ON M5V 3E4, Canada
| | - John L Sievenpiper
- Departments of Nutritional Sciences and Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5B 1W8, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON M5B 1W8, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON M5B 1W8, Canada.,Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON M5B 1W8, Canada
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17
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Perrar I, Alexy U, Jankovic N. Changes in Total Energy, Nutrients and Food Group Intake among Children and Adolescents during the COVID-19 Pandemic-Results of the DONALD Study. Nutrients 2022; 14:nu14020297. [PMID: 35057478 PMCID: PMC8778042 DOI: 10.3390/nu14020297] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 02/01/2023] Open
Abstract
The COVID-19 pandemic may have changed the habitual lifestyles of children and adolescents, in particular, due to the closure of kindergartens and schools. To investigate the impact of the pandemic on nutrients and food intake of children and adolescents in Germany, we analyzed repeated 3-day weighed dietary records from 108 participants (3–18 years; females: n = 45, males: n = 63) of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study. Polynomial mixed-effects regression models were used to identify prospective changes in dietary intake (total energy (TEI), carbohydrates, fat, protein, free sugar, ultra-processed foods, fruits and vegetables, sugar sweetened beverages and juices) before and during the first months of the COVID-19 pandemic. For the current analysis, we have chosen the first months of the pandemic (March 2020–August 2020), as this was the period with the most restrictions in Germany so far (kindergarten, school and restaurant closures; contact and outdoor activity restrictions). No significant changes in either the selected nutrients or food groups were observed. However, children and adolescents recorded a significantly lower TEI during the pandemic (β = −109.65, p = 0.0062). Results remained significant after the exclusion of participants with under-reported records (β = −95.77, p = 0.0063). While macronutrient intake did not change, descriptive data indicate a non-significant decrease in sugar sweetened beverages and ultra-processed foods intake. We suggest that children and adolescents from high socioeconomic families may have adapted lifestyle changes during the pandemic.
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Affiliation(s)
- Ines Perrar
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Friedrich-Hirzebruch-Allee 7, 53115 Bonn, Germany
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany; (U.A.); (N.J.)
- Correspondence:
| | - Ute Alexy
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany; (U.A.); (N.J.)
| | - Nicole Jankovic
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany; (U.A.); (N.J.)
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18
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Ricciuto L, Fulgoni VL, Gaine PC, Scott MO, DiFrancesco L. Trends in Added Sugars Intake and Sources Among US Children, Adolescents, and Teens Using NHANES 2001-2018. J Nutr 2021; 152:568-578. [PMID: 34850066 PMCID: PMC8826875 DOI: 10.1093/jn/nxab395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/01/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Over the past 2 decades, there has been an increased emphasis on added sugars intake in the Dietary Guidelines for Americans (DGA), which has been accompanied by policies and interventions aimed at reducing intake, particularly among children, adolescents, and teens. OBJECTIVES The present study provides a comprehensive time-trends analysis of added sugars intakes and contributing sources in the diets of US children, adolescents, and teens (2-18 years) from 2001-2018, focusing on variations according to sociodemographic factors (age, sex, race and ethnicity, income), food assistance, and health-related factors (physical activity level, body weight status). METHODS Data from 9 consecutive 2-year cycles of the NHANES were combined and regression analyses were conducted to test for trends in added sugars intake and sources from 2001-2018 for the overall age group (2-18 years) and for 2 age subgroups (2-8 and 9-18 years). Trends were also examined on subsamples stratified by sex, race and ethnicity (Hispanic, non-Hispanic Asian, non-Hispanic Black, non-Hispanic White), income (household poverty income ratio), food assistance, physical activity level, and body weight status. RESULTS From 2001-2018, added sugars intakes decreased significantly (P < 0.01), from 15.6% to 12.6% kcal among children (2-8 years) and from 18.4% to 14.3% kcal among adolescents and teens (9-18 years), mainly due to significant declines in added sugars from sweetened beverages, which remained the top source. Declines in added sugars intakes were observed for all strata, albeit to varying degrees. CONCLUSIONS Declines in added sugars intakes were observed among children, adolescents, and teens from 2001-2018, regardless of sociodemographic factors, food assistance, physical activity level, or body weight status, but variations in the magnitudes of decline suggest persistent disparities related to race and ethnicity and to income. Despite these declines, intakes remain above the DGA recommendation; thus, continued monitoring is warranted.
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Affiliation(s)
- Laurie Ricciuto
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
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19
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Perrar I, Buyken AE, Penczynski KJ, Remer T, Kuhnle GG, Herder C, Roden M, Della Corte K, Nöthlings U, Alexy U. Relevance of fructose intake in adolescence for fatty liver indices in young adulthood. Eur J Nutr 2021; 60:3029-3041. [PMID: 33464363 PMCID: PMC8354997 DOI: 10.1007/s00394-020-02463-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 12/11/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To examine the association between fructose intake in adolescence and fatty liver indices (hepatic steatosis index (HSI), fatty liver index (FLI)) in young adulthood. METHODS Overall, 246 participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study who had a fasting blood sample in adulthood (18-36 years), at least two 3-day weighed dietary records for calculating fructose intakes and other fructose-containing sugars (total (TS), free (FS), added sugar (AS)) as well as two complete 24-h urine samples for calculating sugar excretion (fructose excretion (FE), fructose + sucrose excretion (FE + SE)) in adolescence (males: 9.5-16.5 years; females: 8.5-15.5 years) were analysed using multivariable linear regression analyses. RESULTS On the level of dietary intake, no prospective associations were observed between adolescent fructose intake and both adult fatty liver indices, whereas higher FS intakes were associated with lower levels of HSI (Ptrend = 0.02) and FLI (Ptrend = 0.03). On the urinary excretion level, however, a higher FE (Ptrend = 0.03) and FE + SE (Ptrend = 0.01) in adolescence were prospectively related to higher adult FLI values. No associations were observed between adolescent sugar excretion and adult HSI. CONCLUSION The present study does not provide unambiguous support for a detrimental impact of adolescent fructose intake on adult liver health. Nonetheless, further examinations estimating exposure by means of urinary excretion as well as dietary intake levels appear warranted.
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Affiliation(s)
- Ines Perrar
- Institute of Nutritional and Food Sciences , Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
| | - Anette E. Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Warburger Straße 100, 33098 Paderborn, Germany
| | - Katharina J. Penczynski
- Institute of Nutritional and Food Sciences , Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Warburger Straße 100, 33098 Paderborn, Germany
- Department Food Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Thomas Remer
- Institute of Nutritional and Food Sciences , Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
| | - Gunter G. Kuhnle
- Department of Food and Nutritional Sciences, University of Reading, Whiteknights, RG6 6UR UK
| | - Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764 München-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764 München-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Karen Della Corte
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Warburger Straße 100, 33098 Paderborn, Germany
| | - Ute Nöthlings
- Institute of Nutritional and Food Sciences , Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
- Institute of Nutritional and Food Sciences, Nutritional Epidemiology, University of Bonn, Endenicher Allee 19 B, 53115 Bonn, Germany
| | - Ute Alexy
- Institute of Nutritional and Food Sciences , Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
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20
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A Systematic Review of Metabolomic Biomarkers for the Intake of Sugar-Sweetened and Low-Calorie Sweetened Beverages. Metabolites 2021; 11:metabo11080546. [PMID: 34436487 PMCID: PMC8401376 DOI: 10.3390/metabo11080546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/13/2021] [Accepted: 08/14/2021] [Indexed: 11/16/2022] Open
Abstract
Intake of added sugars (AS) is challenging to assess compared with total dietary sugar because of the lack of reliable assessment methods. The reliance on self-reported dietary data in observational studies is often cited as biased, with evidence of AS intake in relation to health outcomes rated as low to moderate quality. Sugar-sweetened beverages (SSBs) are a major source of AS. A regular and high intake of SSBs is associated with an overall poor diet, weight gain, and cardiometabolic risks. An elevated intake of low-calorie sweetened beverages (LCSBs), often regarded as healthier alternatives to SSBs, is also increasingly associated with increased risk for metabolic dysfunction. In this review, we systematically collate evidence and provide perspectives on the use of metabolomics for the discovery of candidate biomarkers associated with the intake of SSBs and LCSBs. We searched the Medline, Embase, Scopus, and Web of Science databases until the end of December 2020. Seventeen articles fulfilled our inclusion criteria. We evaluated specificity and validity of the identified biomarkers following Guidelines for Biomarker of Food Intake Reviews (BFIRev). We report that the 13C:12C carbon isotope ratio (δ13C), particularly, the δ13C of alanine is the most robust, sensitive, and specific biomarker of SSBs intake. Acesulfame-K, saccharin, sucralose, cyclamate, and steviol glucuronide showed moderate validity for predicting the short-term intake of LCSBs. More evidence is required to evaluate the validity of other panels of metabolites associated with the intake of SSBs.
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21
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Heilmann A, Ziller S. [Reducing sugar consumption to improve oral health-which strategies are effective?]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:838-846. [PMID: 34014353 PMCID: PMC8241649 DOI: 10.1007/s00103-021-03349-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/06/2021] [Indexed: 12/02/2022]
Abstract
Strategien zur Gesundheitsförderung können einen wesentlichen Beitrag leisten, um nichtübertragbare chronische Krankheiten zu verhindern. Die wesentlichen nichtübertragbaren Erkrankungen in der Zahnmedizin sind Zahnkaries und Parodontalerkrankungen. Zucker spielt sowohl bei der Entstehung von Zahnkaries als auch von Übergewicht und dessen Folgen für die Allgemeingesundheit eine ursächliche Rolle und ist daher als wichtige kommerzielle Gesundheitsdeterminante mehr und mehr ins Blickfeld von Wissenschaft und Gesundheitspolitik gerückt. Existierende Strategien zur Reduktion des Zuckerkonsums zielen jedoch häufig auf Maßnahmen zur individuellen Verhaltensänderung ab und lassen dabei die Rolle von gesellschaftlichen und kommerziellen Einflüssen außer Acht. In diesem Artikel beschreiben wir die aktuellen Empfehlungen der Weltgesundheitsorganisation (WHO) zum Zuckerkonsum, Daten zum Zuckerverzehr in Deutschland sowie die sozialen und kommerziellen Faktoren, welche den Zuckerkonsum beeinflussen. Grundlegende Prinzipien der Gesundheitsförderung werden dargelegt und sich daraus ergebende Strategien zur Zuckerreduzierung diskutiert. Dabei werden konkrete Beispiele für Upstream- und Downstream-Ansätze benannt und Möglichkeiten der Einflussnahme durch die zahnmedizinische Community in Politik und Praxis aufgezeigt.
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Affiliation(s)
- Anja Heilmann
- Department of Epidemiology and Public Health, University College London, WC1E 6BT, London, Großbritannien.
| | - Sebastian Ziller
- Abteilung Prävention und Gesundheitsförderung, Bundeszahnärztekammer (BZÄK), Berlin, Deutschland
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22
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Velázquez AL, Vidal L, Varela P, Ares G. Sugar reduction in products targeted at children: Why are we not there yet? J SENS STUD 2021. [DOI: 10.1111/joss.12666] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Ana Laura Velázquez
- Sensometrics & Consumer Science Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República Pando Uruguay
- Graduate Program in Chemistry Facultad de Química, Universidad de la República Pando Uruguay
| | - Leticia Vidal
- Sensometrics & Consumer Science Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República Pando Uruguay
| | | | - Gastón Ares
- Sensometrics & Consumer Science Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República Pando Uruguay
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23
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Nutrient Intake and Status of German Children and Adolescents Consuming Vegetarian, Vegan or Omnivore Diets: Results of the VeChi Youth Study. Nutrients 2021; 13:nu13051707. [PMID: 34069944 PMCID: PMC8157583 DOI: 10.3390/nu13051707] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/12/2021] [Accepted: 05/14/2021] [Indexed: 02/06/2023] Open
Abstract
There is a lack of data on associations between modern vegetarian and vegan diets and health among children and adolescents. The aim of the Vechi Youth Study was to cross-sectionally examine anthropometry, dietary intakes and nutritional status in a sample of 149 vegetarian, 115 vegan and 137 omnivore children and adolescents (6-18 years old, mean age: 12.7 ± 3.9 years). Group differences of dietary intake (calculated from three-day dietary records), nutrient biomarker and blood lipid concentrations were assessed using an analysis of covariance, adjusted for sex, age and other covariates. The total energy intake did not differ significantly between groups, but intake of carbohydrates was higher among vegetarians and vegans than among omnivores (p = 0.0002, respectively). The median protein intake exceeded 0.9 g/kg body weight/day in all diet groups and was lowest among vegetarians (p < 0.02). There was no significant difference of haemoglobin, vitamin B2, 25-OH vitamin D3, HDL-C and triglycerides blood concentrations between diet groups. Vegan participants had higher folate concentrations than vegetarian participants (p = 0.0053). Ferritin concentration was significantly higher in omnivores than in vegetarians (p = 0.0134) and vegans (p = 0.0404). Vegetarians had lower concentrations of holotranscobalamin (p = 0.0042) and higher concentrations of methylmalonic acid (p = 0.0253) than omnivores. Vegans had the lowest non-HDL-C and LDL-C concentrations in comparison to vegetarians (p = 0.0053 and p = 0.0041) and omnivores (p = 0.0010 and p = 0.0010). A high prevalence (>30%) of 25-OH vitamin D3 and vitamin B2 concentrations below reference values were found irrespective of the diet group. In conclusion, the Vechi Youth Study did not indicate specific nutritional risks among vegetarian and vegan children and adolescents compared to omnivores.
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24
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Sex- and weight-specific changes in the frequency of sweet treat consumption during early adolescence: a longitudinal study. Br J Nutr 2021; 126:1592-1600. [PMID: 33787473 PMCID: PMC8524426 DOI: 10.1017/s0007114521001112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The transition from childhood to adolescence is a sensitive period, triggering changes in health- and weight-related behaviours including eating habits which likely vary between girls and boys. We aimed to characterise the changes in the frequency of consumption of select sugary foods and drinks ('sweet treats') among 4237 Finnish girls and boys during a 2-year follow-up period. Additionally, we examined four subgroups: children whose weight or waist normalised as well as children whose weight or waist circumference increased during follow-up. An FFQ was completed at 11·1 (sd 0·9) and again at 13·4 (sd 1·1) years of age. A sum variable sweet treat index (STI, range 0-84) captured the weekly consumption frequencies of sweet treats. From baseline to follow-up, the mean STI decreased among girls from 7·1 (95 % CI 6·9, 7·3) to 6·0 (95 % CI 5·9, 6·2) (P < 0·001) and boys from 8·5 (95 % CI 8·3, 8·8) to 7·8 (95 % CI 7·6, 7·8) (P < 0·001), although both sexes increased their chocolate/sweets consumption: girls from 1·3 (95 % CI 1·3, 1·4) to 1·6 (95 % CI 1·5, 1·6) (P < 0·001) and boys from 1·4 (95 % CI 1·3, 1·4) to 1·6 (95 % CI 1·6, 1·7) (P < 0·001), and boys increased their soft drink consumption from 1·4 (95 % CI 1·3, 1·4) to 1·5 (95 % CI 1·4, 1·5) (P = 0·020). We found similar decreases in both the weight and waist subgroups. To conclude, the total frequency of consumption of sweet treats decreased during early adolescence. A similar trend across subgroups suggests that the frequency of consumption of sweet treats is unrelated to becoming overweight.
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Masztalerz-Kozubek D, Zielinska MA, Rust P, Majchrzak D, Hamulka J. The Use of Added Salt and Sugar in the Diet of Polish and Austrian Toddlers. Associated Factors and Dietary Patterns, Feeding and Maternal Practices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145025. [PMID: 32668675 PMCID: PMC7400520 DOI: 10.3390/ijerph17145025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 12/31/2022]
Abstract
Children aged <2 years should not be given meals with the addition of salt and sugar due to health risks and to promote healthier dietary habits. The aims of this study were: to assess the prevalence of the use of added salt (AS), sugar (ASu) and both salt and sugar (AS&Su) in the diets of Polish and Austrian toddlers aged 12-24 and 25-36 months; to explore the sociodemographic and early nutritional factors associated with the use of AS and ASu; to investigate the difference in dietary habits and maternal concerns about toddlers' eating regarding the use of AS and ASu in toddlers' diet. This cross-sectional anonymous study was conducted in 5893 mothers of children aged 12-36 months, recruited through social media in 2017-2019. The questionnaire consisted of questions about sociodemographics, early feeding practices and current children's nutrition (e.g., use of AS and ASu, food frequency questionnaire). Multivariate logistic regression and cluster analyses were applied. Austrian mothers more often used AS than mothers from Poland (at 2 years old: 74.8% vs. 52.8%; at 3 years old 87.4% vs. 74.4%, p ≤ 0.001), however Polish mothers were more prone to use ASu (at 2 years old: 34.7% vs. 27.7%; at 3 years old: 59.0% vs. 45.8%, p ≤ 0.001). In younger toddlers (12-24 months), the odds of using of AS, ASu, and AS&Su increased with toddlers' age, when the mother was a multipara, was not currently breastfeeding, or had exclusively breastfed for 4-5 months. This risk decreased when older toddlers (25-36 months) were introduced to solids by baby-led weaning (BLW). Toddlers from both countries who consumed meals with AS or ASu more often a followed Western-like dietary pattern. Our study emphasizes the need for parental nutritional education when beginning to introduce solid foods.
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Affiliation(s)
- Daria Masztalerz-Kozubek
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 02-787 Warsaw, Poland; (D.M.-K.); (M.A.Z.)
| | - Monika A. Zielinska
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 02-787 Warsaw, Poland; (D.M.-K.); (M.A.Z.)
| | - Petra Rust
- Department of Nutritional Sciences, University of Vienna, 1090 Vienna, Austria; (P.R.); (D.M.)
| | - Dorota Majchrzak
- Department of Nutritional Sciences, University of Vienna, 1090 Vienna, Austria; (P.R.); (D.M.)
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 02-787 Warsaw, Poland; (D.M.-K.); (M.A.Z.)
- Correspondence: ; Tel.: +48-22-593-71-12
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26
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Aumueller N, Gruszfeld D, Gradowska K, Escribano J, Ferré N, Martin F, Poncelet P, Verduci E, ReDionigi A, Koletzko B, Grote V. Influence of total sugar intake on metabolic blood markers at 8 years of age in the Childhood Obesity Project. Eur J Nutr 2020; 60:435-442. [PMID: 32377804 PMCID: PMC7867537 DOI: 10.1007/s00394-020-02229-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 03/12/2020] [Indexed: 11/10/2022]
Abstract
Purpose We aimed to characterize the association of dietary sugar intake with blood lipids and glucose-related markers in childhood. Methods Data from the multicentric European Childhood Obesity Project Trial were used. Three-day weighed dietary records were obtained at 8 years of age along with serum concentrations of triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), glucose, and insulin. Total sugar intake comprised all mono- and disaccharides; different sugar sources were defined. Linear regression models were applied to investigate the cross-sectional association of total sugar intake with blood lipids and glucose-related markers with adjustment for total energy intake using the residual method. Results Data were available for 325 children. Children consumed on average 332 kcal (SD 110) and 21% (SD 6) of energy from total sugar. In an energy-adjusted model, an increase of 100 kcal from total sugar per day was significantly associated with a z score HDL-C decrease (− 0.14; 95% CI − 0.01, − 0.27; p value = 0.031). Concerning different food groups of total sugar intake, 100 kcal total sugar from sweetened beverages was negatively associated with z score HDL-C (− 1.67; 95% CI − 0.42, − 2.91; p value = 0.009), while total sugar from milk products was positively related to z score HDL-C (1.38, 95% CI 0.03, 2.72; p value = 0.045). None of the other blood lipids or glucose-related markers showed a significant relationship with total sugar intake. Conclusion Increasing dietary total sugar intake in children, especially from sweetened beverages, was associated with unfavorable effects on HDL-C, which might increase the long-term risk for dyslipidemia and cardiovascular disease. Clinical trial registry ClinicalTrials.gov Identifier: NCT00338689; Registered: June 19, 2006. URL: https://clinicaltrials.gov/ct2/show/NCT00338689?term=NCT00338689&rank=1. Electronic supplementary material The online version of this article (10.1007/s00394-020-02229-w) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nicole Aumueller
- Division of Metabolic and Nutritional Medicine, Department of Paediatrics, Dr. von Hauner Children's Hospital, LMU-Ludwig-Maximilians-Universität Munich, Lindwurmstr. 4, 80337, Munich, Germany
| | - Dariusz Gruszfeld
- Neonatal Intensive Care Unit, Children's Memorial Health Institute, Warsaw, Poland
| | - Kinga Gradowska
- Neonatal Intensive Care Unit, Children's Memorial Health Institute, Warsaw, Poland
| | - Joaquín Escribano
- Hospital Universitari Sant Joan de Reus, Reus, Spain.,Paediatrics Research Unit, Universitat Rovira I Virgili, IISPV, Reus, Spain
| | - Natalia Ferré
- Paediatrics Research Unit, Universitat Rovira I Virgili, IISPV, Reus, Spain
| | | | | | - Elvira Verduci
- Department of Peadiatrics, San Paolo Hospital, University of Milan, Milan, Italy
| | - Alice ReDionigi
- Department of Peadiatrics, San Paolo Hospital, University of Milan, Milan, Italy
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Department of Paediatrics, Dr. von Hauner Children's Hospital, LMU-Ludwig-Maximilians-Universität Munich, Lindwurmstr. 4, 80337, Munich, Germany.
| | - Veit Grote
- Division of Metabolic and Nutritional Medicine, Department of Paediatrics, Dr. von Hauner Children's Hospital, LMU-Ludwig-Maximilians-Universität Munich, Lindwurmstr. 4, 80337, Munich, Germany
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Perrar I, Schadow AM, Schmitting S, Buyken AE, Alexy U. Time and Age Trends in Free Sugar Intake from Food Groups among Children and Adolescents between 1985 and 2016. Nutrients 2019; 12:nu12010020. [PMID: 31861789 PMCID: PMC7019792 DOI: 10.3390/nu12010020] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/30/2022] Open
Abstract
Trend analyses suggest that free sugar (FS) intake—while still exceeding 10%E—has decreased among German children and adolescents since 2005, yet that intakes may shift from sugars naturally occurring in foods to added sugars as children age. Thus, we analysed time and age trends in FS intake (%E) from food groups among 3–18 year-olds (1985–2016) using 10,761 3-day dietary records from 1312 DONALD participants (660 boys, 652 girls) by use of polynomial mixed-effects regression models. Among girls, FS from sugar & sweets decreased from 1985 to 2016 (linear trend p < 0.0001), but not among boys (p > 0.05). In the total sample, FS intake from juices increased until 2000 and decreased since 2005 (linear, quadratic trend p < 0.0001). FS from sugar sweetened beverages (SSB) decreased non-linearly from 1985 to 2016 (girls: linear, quadratic, cubic trend p < 0.0001; boys: linear, quadratic, cubic trend p < 0.02). Younger children consumed more FS from juices than older ones, who had a higher FS intake from SSB. FS intake from sugar & sweets increased until early adolescence and decreased afterwards. Since sugar & sweets represent the main source of FS intake and the source with the least pronounced decline in intake, public health measures should focus on these products.
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Affiliation(s)
- Ines Perrar
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Donald Study Dortmund, Heinstück 11, 44225 Dortmund, Germany; (I.P.); (A.M.S.); (S.S.)
| | - Alena M. Schadow
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Donald Study Dortmund, Heinstück 11, 44225 Dortmund, Germany; (I.P.); (A.M.S.); (S.S.)
| | - Sarah Schmitting
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Donald Study Dortmund, Heinstück 11, 44225 Dortmund, Germany; (I.P.); (A.M.S.); (S.S.)
- Institute of General Practice and Family Medicine, Faculty of Medicine, Ruhr-University Bochum, Universitätsstraße 150, 44801 Bochum, Germany
| | - Anette E. Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, Warburger Straße 100, 33098 Paderborn, Germany;
| | - Ute Alexy
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Donald Study Dortmund, Heinstück 11, 44225 Dortmund, Germany; (I.P.); (A.M.S.); (S.S.)
- Correspondence: ; Tel.: +49-231-7922-1016
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28
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Associations of sugar intake with anthropometrics in children from ages 2 until 8 years in the EU Childhood Obesity Project. Eur J Nutr 2019; 59:2593-2601. [PMID: 31642983 DOI: 10.1007/s00394-019-02107-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/04/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE We determined the association of total sugar intake with body weight and fat mass in children on an energy-equivalent basis and potential changes in the association from 2 to 8 years of age. METHODS Data were available from the Childhood Obesity Project Trial initiated in 2002. Sugar intake was measured by 3-day weighed food protocols at 2, 3, 4, 5, 6, and 8 years of age. Body mass index (BMI) and fat mass index (FMI) were available at the same time points. To investigate the association of sugar intake with anthropometrics over time, linear mixed models were applied. Odds ratios for having a high BMI or FMI (above one standard deviation) were estimated by logistic random-effects models. To control for total energy intake, the residual method was chosen and models were additionally adjusted for total energy intake. RESULTS Data were available for 809 children with in total 2846 observations. In an isocaloric model, an increase of 100 kcal from sugar per day was significantly associated with lower zBMI (- 0.033; 95% CI -0.061, - 0.005) and zFMI (- 0.050; 95% CI - 0.089, - 0.011). In addition, a 100 kcal higher sugar intake was related to lower odds of having a high zBMI (OR 0.743; 95% CI 0.611, 0.903). CONCLUSION This study provides no indication that increased total sugar intake positively affects BMI on an energy-equivalent basis. Whether the negative association of sugar is due to physiological effects or points more to macronutrient preferences or a reporting bias (lower sugar intake) in children with higher BMI can be debated. CLINICAL TRIAL REGISTRY ClinicalTrials.gov Identifier: NCT00338689; Registered: June 19, 2006. URL: http://clinicaltrials.gov/ct2/show/NCT00338689?term=NCT00338689&rank=1 .
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