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Burgard L, Jansen S, Spiegler C, Brettschneider AK, Straßburg A, Alexy U, Storcksdieck genannt Bonsmann S, Ensenauer R, Heuer T. Unfavorable nutrient intakes in children up to school entry age: results from the nationwide German KiESEL study. Front Nutr 2024; 10:1302323. [PMID: 38323223 PMCID: PMC10844530 DOI: 10.3389/fnut.2023.1302323] [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: 09/26/2023] [Accepted: 12/13/2023] [Indexed: 02/08/2024] Open
Abstract
Background Nutrition in the first years of life is a cornerstone for child development and long-term health, yet there is a lack of current data on energy and nutrient intake among toddlers and preschoolers in Germany. Objective To analyze energy and nutrient intake in toddlers (1- to 2-year-olds) and preschoolers (3- to 5-year-olds) in Germany and compare the results with the Dietary Reference Values (DRVs) by the European Food Safety Authority. Design Dietary intake was assessed by weighed food record data (3 + 1 day) of 890 children from the representative cross-sectional Children's Nutrition Survey to Record Food Consumption (KiESEL), carried out in 2014-2017 as a module of the German Health Interview and Examination Survey for Children and Adolescents Wave 2. For the calculation of energy and nutrient intake, the German Nutrient Database BLS 3.02, LEBTAB, and a supplement database were used. Results Median intakes of energy and most nutrients met or exceeded the DRVs in both toddlers and preschoolers. However, low intakes relative to DRVs were found for vitamin D (6-9% of DRV, including supplements) and iodine (57-65% of DRV). Age specific downward deviations were observed for iron intake in toddlers (75% of DRV) and for calcium intake in preschoolers (67-77% of DRV). In contrast, intakes were high for saturated fatty acids (SFA) (14-16 E%), mono-/disaccharides (60-87 g/day), and protein [2.1-2.6 g/(kg body weight*day)]. Conclusion Nutrient imbalances in toddlers and preschoolers in Germany, which are partly age-related, give rise to concern. Research is needed to determine if routine vitamin D supplementation should be extended beyond infancy. Public health efforts to increase the rate of use of iodized salt and to reduce the intake of SFA and mono-/disaccharides in children's diets are to be strengthened.
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Affiliation(s)
- Leonie Burgard
- 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
| | - Clarissa Spiegler
- 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 Straßburg
- Department of Nutritional Behaviour, Max Rubner-Institut (MRI) – Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Ute Alexy
- Department of Nutritional Epidemiology, Institute of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | | | - Regina Ensenauer
- 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
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Fabios E, Martínez-González MÁ, García-Blanco L, de la O V, Santiago S, Zazpe I, Martín-Calvo N. Association between the Carbohydrate Quality Index (CQI) and Nutritional Adequacy in a Pediatric Cohort: The SENDO Project. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1711. [PMID: 37892374 PMCID: PMC10605036 DOI: 10.3390/children10101711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
Suboptimal micronutrient intake in children remains a public health concern around the world. This study examined the relationship between a previously defined dietary carbohydrate quality index (CQI) and the risk of micronutrient intake inadequacy in a pediatric cohort of Spanish preschoolers. Children aged 4-5 years old were recruited at their medical center or at school, and information on sociodemographic, dietary, and lifestyle variables were collected through a self-administered online questionnaire. Dietary information was obtained from a validated 147-item semi-quantitative food frequency questionnaire. We calculated the CQI and categorized participants into quartiles according to their scores. We assessed the intakes of 20 micronutrients and evaluated the probability of intake inadequacy by using the estimated average requirement cut-off point. Generalized estimating equations were used to adjust for potential confounders and account for the intra-cluster correlations between siblings. The adjusted proportions of children with an inadequate intake of ≥three micronutrients were 23%, 12%, 11%, and 9% in the first, second, third, and fourth quartiles of the CQI, respectively. Children in the highest quartile of the CQI had 0.22-fold lower odds (95% CI 0.10-0.48) of having ≥three inadequate micronutrient intakes than their peers in the lowest quartile. These findings reinforce the relevance of carbohydrate quality in children's diets.
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Affiliation(s)
- Elise Fabios
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (E.F.); (V.d.l.O.); (I.Z.); (N.M.-C.)
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (E.F.); (V.d.l.O.); (I.Z.); (N.M.-C.)
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain;
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, 28029 Madrid, Spain
| | - Lorena García-Blanco
- San Juan Primary Care Health Center, Servicio Navarro de Salud-Osasunbidea, 31011 Pamplona, Spain;
| | - Víctor de la O
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (E.F.); (V.d.l.O.); (I.Z.); (N.M.-C.)
- Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, 28049 Madrid, Spain
| | - Susana Santiago
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain;
- Department of Nutrition, Food Science and Physiology, School of Pharmacy, University of Navarra, 31008 Pamplona, Spain
| | - Itziar Zazpe
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (E.F.); (V.d.l.O.); (I.Z.); (N.M.-C.)
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain;
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, 28029 Madrid, Spain
- Department of Nutrition, Food Science and Physiology, School of Pharmacy, University of Navarra, 31008 Pamplona, Spain
| | - Nerea Martín-Calvo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (E.F.); (V.d.l.O.); (I.Z.); (N.M.-C.)
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain;
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, 28029 Madrid, Spain
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Weker H, Friedrich M, Zabłocka-Słowińska K, Sadowska J, Długosz A, Hamułka J, Charzewska J, Socha P, Wądołowska L. Position Statement of the Polish Academy of Sciences' Committee of Human Nutrition Science on the Principles for the Nutrition of Preschool Children (4-6 Years of Age) and Early School-Age Children (7-9 Years of Age). JOURNAL OF MOTHER AND CHILD 2023; 27:222-245. [PMID: 38369720 PMCID: PMC10875211 DOI: 10.34763/jmotherandchild.20232701.d-23-00094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/01/2023] [Indexed: 02/20/2024]
Affiliation(s)
- Halina Weker
- Department of Nutrition, Institute of Mother and Child, Warsaw, Poland
| | - Mariola Friedrich
- Department of Applied Microbiology and Human Nutrition Physiology, Faculty of Food Sciences and Fisheries, West Pomeranianu University of Technology, Szczecin, Poland
| | | | - Joanna Sadowska
- Department of Applied Microbiology and Human Nutrition Physiology, Faculty of Food Sciences and Fisheries, West Pomeranianu University of Technology, Szczecin, Poland
| | - Anna Długosz
- Faculty of Chemical Technology and Engineering, University of Science and Technology, Bydgoszcz, Poland
| | - Jadwiga Hamułka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Warsaw, Poland
| | - Jadwiga Charzewska
- National Institute of Public Health NIH – National Research Institute, Warsaw, Poland
| | - Piotr Socha
- Department of Gastroenterology, Hepatology, Eating Disorders and Paediatrics, Institute ‘Monument - Children’s Health Center’, Warsaw, Poland
| | - Lidia Wądołowska
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Poland
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Verma M, Aditi A, Kapoor N, Sharma P, Kakkar M, Kakkar R, Kalra S. Childhood Obesity and Essential Micronutrients: Insights from India's Comprehensive National Nutrition Survey (2016-18). Diabetes Ther 2023:10.1007/s13300-023-01424-2. [PMID: 37264296 PMCID: PMC10299976 DOI: 10.1007/s13300-023-01424-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/11/2023] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Based on the long-term impact of childhood obesity, there is a compelling need to assess the burden of obesity and micronutrient deficiency and the interactions between the two. Thus, the aims of the study were to estimate the prevalence of overweight and obese children and adolescents to compare micro-nutrient levels in these children with normal and underweight categories and explore the factors affecting overweight and obesity in the presence of micronutrient deficiencies. METHODS Secondary data analysis of the Comprehensive National Nutrition Survey-India (2017-2018) was done. The survey recorded information from 112,245 preschool children (6-60 months), school age children (5-9 years), and adolescents (10-19 years). Half of these participants were invited for biochemical testing and were included in our analysis. The presence of overweight or obesity and micronutrient (serum erythrocyte folate; vitamin B12, A, and D; ferritin; zinc; and urinary iodine) deficiencies were the primary outcomes. The secondary outcome included the mean serum levels and predictors of overweight and obesity in the presence of micronutrient deficiencies. RESULTS Of the 38,060, 38,355, and 35,830 preschool, school-age, and adolescent study participants, about 2.69, 4.18, and 4.99% were overweight or obese. We observed significant variations in the mean folate and vitamin B12 levels among the overweight and obese preschool and school-age children compared to the normal weight group. School-age children exhibited significant differences in all micronutrient levels. In contrast, adolescents only showed substantial differences in vitamin D and A and serum ferritin levels. The predictors of overweight and obesity included geographical locations, wealth quintiles, and societal castes. Iron, folate, vitamin D, and zinc levels significantly affect the odds of developing childhood overweight and obesity. CONCLUSIONS It is vital to halt the growing burden of childhood overweight and obesity. Addressing micronutrient deficiencies can help us bring a sustainable and feasible approach to managing this menace.
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Affiliation(s)
- Madhur Verma
- Department of Community and Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India.
| | - Aditi Aditi
- International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, 400088, India
| | - Nitin Kapoor
- Department of Endocrine, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, 632004, India
- Non-Communicable Disease Unit, The Baker Heart and Diabetes Institute, Melbourne, VIC, 3004, Australia
| | - Priyanka Sharma
- Department of Preventive Oncology, MPMMCC, and HBCH, TMC, Varanasi, Uttar Pradesh, India
| | - Monica Kakkar
- Department of Biochemistry, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, 151001, India
| | - Rakesh Kakkar
- Department of Community and Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India.
- University Centre for Research and Development, Chandigarh University, Mohali, Punjab, India.
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Berlic M, Jug U, Battelino T, Levart A, Dimitrovska I, Albreht A, Korošec M. Antioxidant-rich foods and nutritional value in daily kindergarten menu: A randomized controlled evaluation executed in Slovenia. Food Chem 2023; 404:134566. [DOI: 10.1016/j.foodchem.2022.134566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/16/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022]
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Total Usual Nutrient Intakes and Nutritional Status of United Arab Emirates Children (4 Years-12.9 Years): Findings from the Kids Nutrition and Health Survey (KNHS) 2021. Nutrients 2023; 15:nu15010234. [PMID: 36615891 PMCID: PMC9824044 DOI: 10.3390/nu15010234] [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: 12/01/2022] [Revised: 12/27/2022] [Accepted: 12/30/2022] [Indexed: 01/04/2023] Open
Abstract
This study aims at investigating the anthropometric status and food consumption patterns of children in the United Arab Emirates (UAE) and assessing their adherence to nutrient and dietary recommendations. It is a population-based cross-sectional survey of 690 children (4-12.9 years), from 3 major Emirates. Socio-demographic and anthropometric characteristics were collected. Dietary intakes were assessed using the 24-hour recall approach. Of the total sample, 4% were stunted, 8% were wasted and 28% were overweight/obese. A third of participating children consumed above the Estimated Energy Requirement, while the majority's intakes carbohydrate, total fat, and protein were within the recommendations; whereas over 70% and 90% of participants consumed above the WHO daily limits of free sugars and saturated fats, respectively. Inadequate intakes of linoleic acid (36% of children), alpha-linolenic acid (91%) and dietary fiber (100%) were observed. All children failed to meet the recommendation for vitamin D and considerable proportions had inadequate intakes of vitamin A, calcium, zinc, folate, and magnesium. Compared with the American Heart Association/American Academy of Pediatrics recommendations, low dietary adherence was noted for fruits (9%), vegetables (4%), and milk/dairy (14%). These findings may be used in the development of nutritional policies aimed at improving the diets of children in the UAE.
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Yang S, Ratteree K, Turner SA, Tuason RT, Brooks A, Wallen GR, Barb JJ. Dietary Intakes of Patients with Alcohol Use Disorder During a 4-Week Protocol on an Inpatient Treatment Unit Found to Meet Dietary Reference Intakes for Macronutrients, but Have Variability in Energy Balance and Adequacy of Micronutrient Intake. J Acad Nutr Diet 2022; 122:2311-2319. [PMID: 35659642 PMCID: PMC9691517 DOI: 10.1016/j.jand.2022.05.022] [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: 09/17/2021] [Revised: 05/19/2022] [Accepted: 05/29/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Despite literature supporting the importance of diet during rehabilitation, minimal research quantifies dietary intake during treatment for alcohol use disorder (AUD). OBJECTIVE The aim was to quantify dietary intake and energy balance of patients with AUD during inpatient treatment. DESIGN This was a secondary analysis of data from a 4-week observational protocol. Participants self-selected food from a room service menu. Dietary intake was recorded by patients and reviewed by nutrition staff. To quantify nutrient and food group intake, data were coded into Nutrition Data Systems for Research software, versions 2016 and 2017. Daily average intake was calculated for all dietary variables. PARTICIPANTS/SETTING Participants (n = 22) were adults seeking treatment for AUD at the National Institutes of Health Clinical Center (Bethesda, MD) between September 2016 and September 2017 and who were enrolled in a study examining the microbiome during AUD rehabilitation. Four participants discontinued protocol participation before study week 4 and were not included in analyses examining change over time. MAIN OUTCOME MEASURES Weight change, daily energy, and macronutrient and select micronutrient intakes were the main outcome measures included. STATISTICAL ANALYSES PERFORMED Mean differences in intake and weight were assessed using nonparametric tests. RESULTS Sixty-four percent of participants were male; mean ± SD age was 46.3 ± 13.0 years, mean ± SD body mass index (calculated as kg/m2) was 23.9 ± 2.5, and mean intake was 2,665 kcal/d (consisting of 45.9% carbohydrate, 34.9% fat, and 19.1% protein). Eighty percent or more of this sample met the Estimated Average Requirement for 10 of 16 micronutrients assessed. Male participants consumed more energy than estimated needs (P = .003) and gained a mean ± SD of 2.67 ± 1.84 kg (P = .006) when an outlier with weight loss and acute pancreatitis was removed from analysis. Female participants did not gain weight or consume more than estimated energy needs. CONCLUSIONS Overall macronutrient intake was within recommended ranges, but intake of other dietary components and weight gain were variable, supporting the need for individualized nutrition care during AUD treatment.
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Affiliation(s)
- Shanna Yang
- Nutrition Department, Clinical Center, National Institutes of Health, Bethesda, MD
| | - Kelly Ratteree
- Nutrition Department, Clinical Center, National Institutes of Health, Bethesda, MD
| | - Sara A Turner
- Nutrition Department, Clinical Center, National Institutes of Health, Bethesda, MD.
| | | | - Alyssa Brooks
- Center for Scientific Review, National Institutes of Health, Bethesda, MD
| | - Gwenyth R Wallen
- Center for Scientific Review, National Institutes of Health, Bethesda, MD
| | - Jennifer J Barb
- Center for Scientific Review, National Institutes of Health, Bethesda, MD
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Madrigal C, Soto-Méndez MJ, Hernández-Ruiz Á, Ruiz-López MD, Samaniego-Vaesken MDL, Partearroyo T, Varela-Moreiras G, Gil Á. Dietary Intake, Nutritional Adequacy, and Food Sources of Selected Antioxidant Minerals and Vitamins; and Their Relationship with Personal and Family Factors in Spanish Children Aged 1 to <10 Years: Results from the EsNuPI Study. Nutrients 2022; 14:nu14194132. [PMID: 36235784 PMCID: PMC9573671 DOI: 10.3390/nu14194132] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/28/2022] [Accepted: 10/01/2022] [Indexed: 11/23/2022] Open
Abstract
Minerals and vitamins involved in the antioxidant defense system are essential for healthy growth and proper development during infancy. Milk and dairy products are of particular importance for improving the supply of these nutrients to children. Indeed, the present study aimed to evaluate the nutrient intake and food sources of zinc (Zn), selenium (Se), retinol and carotenoids (sources of vitamin A), and vitamins C and E, and to analyze their relationships with personal and familiar factors in Spanish children from the EsNuPI study. One subpopulation representative of the Spanish population from 1 to <10 years old (n = 707) (reference group, REF) who reported consuming all types of milk over the last year, and another subpopulation of the same age who reported consuming fortified milk formulas (FMFs) (including follow-on formula, young child formula, growing up milk, toddler’s milk, and enriched and fortified milk) (n = 741) (fortified milk consumers, FMCs) completed two 24 h dietary recalls used to estimate their nutrient intakes and to compare them to the European Food Safety Authority (EFSA) Dietary Reference Values (DRVs). The REF reported higher median intakes than FMCs for Se (61 µg/kg vs. 51 µg/kg) and carotenoids (1079 µg/day vs. 998 µg/day). Oppositely, FMCs reported higher intakes than REF for Zn (7.9 mg/day vs. 6.9 mg/day), vitamin A (636 µg/day vs. 481 µg/day), vitamin E (8.9 mg/day vs. 4.5 mg/day), vitamin C (113 mg/day vs. 71 mg/day), and retinol (376 µg/day vs. 233 µg/day). In the REF group, more than 50% of the children met the EFSA recommendations for Zn (79.6%), Se (87.1%), vitamin A (71.3%), and vitamin C (96.7%), respectively. On the other hand, 92.2% were below the EFSA recommendations for vitamin E. In the FMC group, more than 50% of the children met the EFSA recommendations for Zn (55.2%), Se (90.8%), vitamin A (75.7%), vitamin E (66.7%), and vitamin C (100%). We found statistically significant differences between subpopulations for all cases except for Se. In both subpopulations, the main sources of all antioxidant nutrients were milk and dairy products. For carotenoids, the main sources were vegetables and fruits followed by milk and dairy products. A high percentage of children had vitamins A and E intakes below the recommendations, information of great importance to stakeholders. More studies using intakes and biomarkers are needed, however, to determine an association with diverse factors of oxidative damage.
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Affiliation(s)
- Casandra Madrigal
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
- Iberoamerican Nutrition Foundation (FINUT), 18016 Granada, Spain
| | | | | | - María Dolores Ruiz-López
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
- Iberoamerican Nutrition Foundation (FINUT), 18016 Granada, Spain
- Biomedical Research Center, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, 18011 Granada, Spain
- Correspondence:
| | - María de Lourdes Samaniego-Vaesken
- Grupo USP-CEU de Excelencia “Nutrición Para la Vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28660 Boadilla del Monte, Spain
| | - Teresa Partearroyo
- Grupo USP-CEU de Excelencia “Nutrición Para la Vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28660 Boadilla del Monte, Spain
| | - Gregorio Varela-Moreiras
- Grupo USP-CEU de Excelencia “Nutrición Para la Vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28660 Boadilla del Monte, Spain
| | - Ángel Gil
- Iberoamerican Nutrition Foundation (FINUT), 18016 Granada, Spain
- Biomedical Research Center, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, 18011 Granada, Spain
- Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071 Granada, Spain
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Abstract
Sex differences are an important consideration when researching and establishing policies for nutrition and optimal health. For women's health, there are important physiologic, neurologic, and hormonal distinctions throughout the lifecycle that impact nutritional needs. Distinct from those for men, these nutritional needs must be translated into appropriate nutrition policy that aims to not only avoid overt nutritional deficiency, but also to promote health and minimize risk for chronic disease. Through a series of webinars, scientific experts discussed the advances in the understanding of the unique nutritional needs, challenges and opportunities of the various life stages for women across the life course and identified emerging nutritional interventions that may be beneficial for women. Nevertheless, there is concern that existing nutrition policy intended for women's health is falling short with examples of programs that are focused more on delivering calories than achieving optimal nutrition. To be locally effective, targeted nutrition needs to offer different proposals for different cultural, socio-economic, and geographic communities, and needs to be applicable at all stages of growth and development. There must be adequate access to nutritious foods, and the information to understand and implement proven nutritional opportunities. Experts provided recommendations for improvement of current entitlement programs that will address accessibility and other social and environmental issues to support women properly throughout the lifecycle.
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Adherence to Dietary Recommendations of 7-Year-Old Children from a Birth Cohort in Friuli Venezia Giulia, Italy. Nutrients 2022; 14:nu14030515. [PMID: 35276874 PMCID: PMC8838727 DOI: 10.3390/nu14030515] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 01/20/2022] [Indexed: 12/16/2022] Open
Abstract
Few Italian and European studies have assessed adherence to dietary recommendations in primary school children using dietary records. No Italian studies have provided an index-based nutritional adequacy assessment. We provided a comprehensive overview of dietary intake in 381 7-year-old children from NAC-II cohort study, Friuli Venezia Giulia (Italy). Energy, macro-, and micronutrient intakes were derived from 3-day dietary records. Standard (median and percentage) and index-based (Nutrient Adequacy Ratio (NAR) and Mean Adequacy Ratio (MAR)) approaches were used to evaluate adequacy to Italian dietary reference values at nutrient- and overall-diet-level. Percentage contribution of macronutrients to energy intake (%En) was unbalanced towards total fats and protein. In 25% of children, total fats intake exceeded the reference intake upper limit. In ~63% of children, protein intake was at least doubled in their child-specific population reference intake. Median intakes of sodium (1.7 g/day), saturated fatty acids (12.2 %En), and soluble carbohydrates (19.4 %En) exceeded the suggested dietary target in most (65–84%) children. Inadequacy was also observed for micronutrients, with median NARs ranging from 0.11 (vitamin D) to 0.90 (zinc). The median MAR was 0.75 (0.69–0.79), with 1 indicating optimal overall dietary intake. In conclusion, the enrolled children showed suboptimal intakes of several macro- and micronutrients, in line with Italian and European studies on primary school children. Based on the current findings, public health interventions may be targeted to specific nutrients or subpopulations.
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Chen S, Yang M, Wang R, Fan X, Tang T, Li P, Zhou X, Qi K. Suppression of high-fat-diet-induced obesity in mice by dietary folic acid supplementation is linked to changes in gut microbiota. Eur J Nutr 2022; 61:2015-2031. [PMID: 34993642 DOI: 10.1007/s00394-021-02769-9] [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] [Received: 03/22/2021] [Accepted: 12/03/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE To investigate whether the effects of dietary folic acid supplementation on body weight gain are mediated by gut microbiota in obesity. METHODS Male C57 BL/6J conventional (CV) and germ-free (GF) mice both aged three to four weeks were fed a high-fat diet (HD), folic acid-deficient HD (FD-HD), folic acid-supplement HD (FS-HD) and a normal-fat diet (ND) for 25 weeks. Faecal microbiota were analyzed by 16S rRNA high-throughput sequencing, and the mRNA expression of genes was determined by the real-time RT-PCR. Short-chain fatty acids (SCFAs) in faeces and plasma were measured using gas chromatography-mass spectrometry. RESULTS In CV mice, HD-induced body weight gain was inhibited by FS-HD, accompanied by declined energy intake, smaller white adipocyte size, and less whitening of brown adipose tissue. Meanwhile, the HD-induced disturbance in the expression of fat and energy metabolism-associated genes (Fas, Atgl, Hsl, Ppar-α, adiponectin, resistin, Ucp2, etc.) in epididymal fat was diminished, and the dysbiosis in faecal microbiota was lessened, by FS-HD. However, in GF mice with HD feeding, dietary folic acid supplementation had almost no effect on body weight gain and the expression of fat- and energy-associated genes. Faecal or plasma SCFA concentrations in CV and GF mice were not altered by either FD-HD or FS-HD feeding. CONCLUSION Dietary folic acid supplementation differently affected body weight gain and associated genes' expression under HD feeding between CV and GF mice, suggesting that gut bacteria might partially share the responsibility for beneficial effects of dietary folate on obesity.
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Affiliation(s)
- Si Chen
- Laboratory of Nutrition and Development, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Pediatric Research Institutue, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nan-li-shi Road, Beijing, 100045, China
| | - Mengyi Yang
- Laboratory of Nutrition and Development, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Pediatric Research Institutue, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nan-li-shi Road, Beijing, 100045, China
| | - Rui Wang
- Laboratory of Nutrition and Development, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Pediatric Research Institutue, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nan-li-shi Road, Beijing, 100045, China
| | - Xiuqin Fan
- Laboratory of Nutrition and Development, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Pediatric Research Institutue, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nan-li-shi Road, Beijing, 100045, China
| | - Tiantian Tang
- Laboratory of Nutrition and Development, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Pediatric Research Institutue, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nan-li-shi Road, Beijing, 100045, China
| | - Ping Li
- Laboratory of Nutrition and Development, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Pediatric Research Institutue, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nan-li-shi Road, Beijing, 100045, China
| | - Xinhui Zhou
- Laboratory of Nutrition and Development, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Pediatric Research Institutue, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nan-li-shi Road, Beijing, 100045, China
| | - Kemin Qi
- Laboratory of Nutrition and Development, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Pediatric Research Institutue, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nan-li-shi Road, Beijing, 100045, China.
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12
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Zang XD, Hu QH, Liu XX, Da M, Yang ZC, Qi JR, Mo XM. Serum vitamin E concentration is negatively associated with body mass index change in girls not boys during adolescence. World J Pediatr 2021; 17:517-526. [PMID: 34468958 DOI: 10.1007/s12519-021-00454-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/11/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Vitamin E is the most abundant lipid-soluble antioxidants present in plasma; however, the relationship between serum vitamin E and change in body mass index (BMI)-for-age Z scores in adolescents has not been well described. METHODS This study is a cross-sectional study. Data were analyzed from 4014 adolescents who participated in the National Health and Nutrition Examination Survey. The nutritional status was calculated by BMI Z scores and was classified into normal weight, overweight, and obese. Multivariable-adjusted logistic regression was used to examine the association between serum vitamin E levels with overweight/obesity. Besides, the interaction effects between potential confounders and vitamin E on obesity were further evaluated. RESULTS After adjusting potential confounders, serum vitamin E levels were negatively associated with overweight/obesity in girls but not in boys. Per standard deviation increment in vitamin E concentrations was associated with a 92% decreased risk of obesity in females. Besides, lower quartiles of serum vitamin E were associated with a higher risk of overweight/obesity in girls. Moreover, the inverse association between serum vitamin E levels and obesity was also found in most subgroups through subgroup analysis. CONCLUSIONS Our study supports the negative association between serum vitamin E levels and overweight/obesity in adolescents. A higher serum vitamin E level may be associated with a reduced probability of obesity in girls, but not in boys.
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Affiliation(s)
- Xiao-Dong Zang
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China.,The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China
| | - Qing-Hui Hu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China
| | - Xiao-Xu Liu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China
| | - Min Da
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China
| | - Zhao-Cong Yang
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China
| | - Ji-Rong Qi
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China
| | - Xu-Ming Mo
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China.
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13
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Tsakoumaki F, Kyrkou C, Athanasiadis AP, Menexes G, Michaelidou AM. Nutritional Inadequacy: Unraveling the Methodological Challenges for the Application of the Probability Approach or the EAR Cut-Point Method-A Pregnancy Perspective. Nutrients 2021; 13:3473. [PMID: 34684473 PMCID: PMC8538604 DOI: 10.3390/nu13103473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/20/2021] [Accepted: 09/28/2021] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to unravel the methodological challenges when exploring nutritional inadequacy, involving 608 healthy pregnant women. The usual intake of twenty-one nutrients was recorded by employing a validated FFQ. Simulated datasets of usual intake were generated, with randomly imposed uncertainty. The comparison between the usual intake and the EAR was accomplished with the probability approach and the EAR cut-point method. Point estimates were accompanied by bootstrap confidence intervals. Bootstrap intervals applied on the risk of inadequacy for raw and simulated data tended in most cases to overlap. A detailed statistical analysis, aiming to predict the level of inadequacy, as well as the application of the EAR cut-point method, along with bootstrap intervals, could effectively be used to assess nutrient inadequacy. However, the final decision for the method used depends on the distribution of nutrient-intake under evaluation. Irrespective of the applied methodology, moderate to high levels of inadequacy, calculated from FFQ were identified for certain nutrients (e.g., vitamins C, B6, magnesium, vitamin A), while the highest were recorded for folate and iron. Considering that micronutrient-poor, obesogenic diets are becoming more common, the underlying rationale may help towards unraveling the complexity characterizing nutritional inadequacies, especially in vulnerable populations.
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Affiliation(s)
- Foteini Tsakoumaki
- Department of Food Science and Technology, School of Agriculture, Faculty of Agriculture, Forestry and Natural Environment, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (F.T.); (C.K.)
| | - Charikleia Kyrkou
- Department of Food Science and Technology, School of Agriculture, Faculty of Agriculture, Forestry and Natural Environment, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (F.T.); (C.K.)
| | - Apostolos P. Athanasiadis
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece;
| | - Georgios Menexes
- Department of Field Crops and Ecology, School of Agriculture, Faculty of Agriculture, Forestry and Natural Environment, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece;
| | - Alexandra-Maria Michaelidou
- Department of Food Science and Technology, School of Agriculture, Faculty of Agriculture, Forestry and Natural Environment, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (F.T.); (C.K.)
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14
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Berglund SK, Domellöf M. Iron deficiency in infancy: current insights. Curr Opin Clin Nutr Metab Care 2021; 24:240-245. [PMID: 33656466 DOI: 10.1097/mco.0000000000000749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE OF REVIEW Iron deficiency is the most common micronutrient deficiency and infants are at particular risk. The purpose of this review is to summarize recent studies that explored the metabolism of iron in infants as well as the risks and benefits of iron supplementation in different populations. RECENT FINDINGS The ability of infants to regulate iron homeostasis is not fully known but most likely different from adults. Reducing iron deficiency has beneficial effects on neurodevelopment but iron overload may have adverse functional effects including diarrhea and even poor neurodevelopment. Recent studies have confirmed benefits of delayed cord clamping and supplementation of infants in risk groups while iron supplementation to pregnant women has shown limited effect in the offspring with regard to iron status and neurodevelopment. Further support is given to the recommendation that exclusive breast feeding, without supplementation, is safe for normal birth weight infants until 6 months whereafter an iron-rich diet should be given. SUMMARY Iron deficiency negatively impacts global health but efforts to identify optimal interventions are progressing. Yet, questions remain, particularly regarding long-term risks, benefits and optimal interventions for low birth weight infants as well as the level of iron fortification in infant formula.
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Affiliation(s)
- Staffan K Berglund
- Department of Clinical Sciences, Pediatrics
- Wallenberg Centre for Molecular Medicine (WCMM), Umeå University, Umeå, Sweden
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15
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Romero-Marco P, Pérez-Gallardo LL. Adequacy of calcium intake in Spanish population according age groups. Arch Osteoporos 2020; 15:161. [PMID: 33044638 DOI: 10.1007/s11657-020-00831-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/28/2020] [Indexed: 02/03/2023]
Abstract
This review shows the estimated calcium intake in Spain in recent years. Our results indicate that adolescents and the elderly are at risk of insufficient calcium intake. By using the national and the European recommendations, this work contributes to map and compare population's dietary calcium intake in the European countries. PURPOSE AND METHODS : The present work aims to examine calcium intake in the healthy Spanish population of any age and analyze its adequacy to the calcium Recommended Dietary Intake (RDI) for different groups in Spanish population, as well to the Adequate Intake (AI) or Population Reference Intake (PRI) estimated by European Food Safety Authority (EFSA). Forty-three studies published in the last 5 years were eligible for review. RESULTS AND CONCLUSIONS: The results show that infants and children exceed Spanish and EFSA dietary recommendations, adults meet more that 80% of the RDI and EFSA recommendations, and the estimated average calcium intake in the adolescent and elderly groups does not reach 75% of the recommended intake. Representative national studies with a common methodology to estimate calcium intake are needed.
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Affiliation(s)
- Patricia Romero-Marco
- Deparment of Anatomical Pathology, Microbiology, Preventive Medicine and Public Health, Forensic and Legal Medicine, University of Valladolid, Soria Campus, C/ Universidad s/n, 42005, Soria, Spain.
| | - Lucía Luisa Pérez-Gallardo
- Department of Biochemistry and Molecular Biology and Physiology, University of Valladolid, Soria Campus, Soria, Spain
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16
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Theurich MA, Grote V, Koletzko B. Complementary feeding and long-term health implications. Nutr Rev 2020; 78:6-12. [PMID: 33196095 DOI: 10.1093/nutrit/nuaa059] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Melissa A Theurich
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universitaet, Munich, Germany
| | - Veit Grote
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universitaet, Munich, Germany
| | - Berthold Koletzko
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universitaet, Munich, Germany
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17
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Nutritional Adequacy of Commercial Complementary Cereals in Germany. Nutrients 2020; 12:nu12061590. [PMID: 32485833 PMCID: PMC7352855 DOI: 10.3390/nu12061590] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 12/17/2022] Open
Abstract
Commercial cereals are among the first complementary foods fed to infants in Germany and elsewhere. The purpose of this national survey is to describe the nutritional adequacy of commercial complementary cereals. A comprehensive, cross-sectional survey of cereal manufacturer websites (n = 15) was conducted from March to April 2019. Food labels were analyzed for iron, zinc, iodine, sodium, and sugar contents in commercial complementary cereals, and ingredient lists were evaluated for whole grains and added sugars. Preparation instructions were evaluated for the type of liquid recommended for reconstitution. Among 164 commercial complementary cereals, few contain iron (n = 43, 26%), zinc (n = 23, 14%) or iodine (n = 43, 26%). Sodium contents fall within EU thresholds. Most cereals were single grain, containing only wheat (n = 54), with half of the products (n = 86, 52%) containing whole grains. The average carbohydrate content of dry cereals is 69 g/100 g ± 9 g of which 14 ± 15 g is sugar. Preparation instructions for breakfast porridges and cereals recommend formula or toddler milk, while few recommend human milk (n = 13, 18%). Few commercial complementary cereals contain appreciable amounts (at least 15% of daily reference values) of zinc, iron, or iodine. A quarter of cereal carbohydrates are sugar and one-third of the products contain added sugars. Future directives should stipulate minimum micronutrient levels, strictly regulate sugar contents, and include human milk among preparation instructions.
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18
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O'Neill LM, Dwyer JT, Bailey RL, Reidy KC, Saavedra JM. Harmonizing Micronutrient Intake Reference Ranges for Dietary Guidance and Menu Planning in Complementary Feeding. Curr Dev Nutr 2020; 4:nzaa017. [PMID: 32161844 PMCID: PMC7059853 DOI: 10.1093/cdn/nzaa017] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 01/29/2020] [Accepted: 01/31/2020] [Indexed: 01/21/2023] Open
Abstract
There are no published harmonized nutrient reference values for the complementary feeding period. The aim of the study was to develop proposals on adequate and safe intake ranges of micronutrients that can be applied to dietary guidance and menu planning. Dietary intake surveys from 6 populous countries were selected as pertinent to the study and reviewed for data on micronutrients. The most frequently underconsumed micronutrients were identified as iron, zinc, calcium, magnesium, phosphorus, potassium, and vitamins A, B6, B12, C, D, E, and folate. Key published reference values for these micronutrients were identified, compared, and reconciled. WHO/FAO values were generally identified as initial nutrient targets and reconciled with nutrient reference values from the Institute of Medicine and the European Food Standards Authority. A final set of harmonized reference nutrient intake ranges for the complementary feeding period is proposed.
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Affiliation(s)
| | - Johanna T Dwyer
- Tufts University School of Medicine and Friedman School of Nutrition Science and Policy, Boston, MA, USA
| | - Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | | | - Jose M Saavedra
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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19
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Childhood Dietary Intake in Italy: The Epidemiological "MY FOOD DIARY" Survey. Nutrients 2019; 11:nu11051129. [PMID: 31117214 PMCID: PMC6567114 DOI: 10.3390/nu11051129] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/05/2019] [Accepted: 05/17/2019] [Indexed: 11/17/2022] Open
Abstract
Promoting a healthy lifestyle during the first years of life is a key strategy for controlling obesity risk in later life; having good-quality epidemiological data on eating habits of infants and toddlers can improve awareness and possibly the education given by pediatricians to parents and children. With this aim, we performed a survey about the dietary pattern of Italian children in early childhood. We described the intake of energy, macronutrients and fiber, minerals, and vitamins of 443 Italian children (range 6.4–131 months), through a three-day food record filled out by their parents and assessed by family pediatricians. The results were compared with the Italian Dietary Reference Values. The median protein intake, in g/kg per body weight, exceeded the average requirement in all age groups, and in the 12–36 month period, the intake as % of energy was outside the reference range (>15%). The majority of the children consumed quantities of simple carbohydrates (consisting of both natural sugars and free or added sugars, 82.3% of the children in the study) and saturated fats (69% of the children in the study) above the limits of the Italian Dietary Reference Values, with low intake of fiber and polyunsaturated fats. Median mineral intake, in our study, was different depending on age, while vitamin D intake was very low in all age groups. This is one of the few studies reporting on the nutrient intake of Italian children with reference to nutrition recommendations in order to identify the principal nutritional errors. The present results underline the need for healthcare policies starting from the first years of life in order to ameliorate nutrient intake during childhood, possibly impacting long-term health outcomes.
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Jardi C, Aranda N, Bedmar C, Arija V. Excess nutritional risk in infants and toddlers in a Spanish city. INT J VITAM NUTR RES 2019; 89:210-220. [PMID: 30747605 DOI: 10.1024/0300-9831/a000530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Adequate dietary intake is vital for infants' growth and development. The aim was to analyse food consumption and energy and nutrient intakes in a group of healthy Spanish infants and toddlers. Cross-sectional study. 154 infants were assessed at 6 months, and followed at 12 and 30 months. Clinical history, anthropometry, type of feeding, food consumption and energy and nutrient intakes (24-hours recall) were estimated. Advice about food consumed, estimated average requirements, the prevalence of inadequate intakes and percentage of adequacy of the recommended dietary allowance were applied. Toddlers had an excessive daily consumption of meat (>51.3g/day), milk (>545g/day), fish (>20.8g/day) and free-sugar foods (>30.5g/day). This consumption was related to a very high intake of proteins (>18%) and free sugars (>10%), at 12 and 30 months, as a percentage of daily energy intake. The mean prevalence of inadequacy intakes was above 48% for iron at 6 months, and 68% and 87% for vitamin D at 12 and 30 months, respectively. At 6 months, infants who were breastfed had greater adequacy in energy and nutrients to recommended dietary, while infants fed infant formula had a higher intake (>120% compared with RDA) in vitamins E, C, B1, B2, pantothenic acid, B6, B12 and folic acid. The contribution of micronutrients in infant formula should be reviewed, appropriate protein and free sugars should be provided during complementary feeding, as well as strategies to avoid vitamin D deficiency since childhood; and continue with the promotion of breastfeeding.
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Affiliation(s)
| | - Núria Aranda
- Universitat Rovira i Virgili, Reus, Tarragona, Spain
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21
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Romanos-Nanclares A, Zazpe I, Santiago S, Marín L, Rico-Campà A, Martín-Calvo N. Influence of Parental Healthy-Eating Attitudes and Nutritional Knowledge on Nutritional Adequacy and Diet Quality among Preschoolers: The SENDO Project. Nutrients 2018; 10:nu10121875. [PMID: 30513857 PMCID: PMC6316633 DOI: 10.3390/nu10121875] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/31/2018] [Accepted: 11/27/2018] [Indexed: 12/24/2022] Open
Abstract
Parental nutrition knowledge and attitudes play a fundamental role in their children’s food knowledge. However, little is known about their influence on their children’s diet quality and micronutrient intake. Thus, we aimed to assess the association of parental nutrition knowledge and healthy-eating attitudes with their children’s adherence to the Mediterranean dietary pattern and micronutrient adequacy. Parental healthy-eating attitudes and knowledge of the quality of their child’s diet as well as anthropometric, lifestyle, and nutrient intake characteristics were recorded with a basal questionnaire that included a 140-item-food frequency-questionnaire. A total of 287 pre-school children were included in the analyses. Intake adequacy was defined using the Estimated Average Requirements (EAR) cut-off point method. We developed a parental nutrition knowledge and healthy-eating attitudes scores and evaluated whether they were independently associated with 1) children’s inadequate intake (probability of failing to meet ≥3 EAR) of micronutrients, using logistic regression analyses, and 2) children’s diet quality (adherence to the Mediterranean Diet according to a Mediterranean Diet Quality Index for children and adolescents, the KIDMED index), using multiple linear regression models. A higher score in the parental healthy-eating attitudes score was associated with lower risk of failing to meet ≥3 EAR compared with the reference category (odds ratio (OR): 0.3; 95% confidence interval (CI) 0.12–0.95; p for trend: 0.037) and a higher adherence to the Mediterranean diet in the most adjusted model (β coefficient: 0.34; 95% CI 0.01–0.67; p for trend: 0.045). Our results suggest a positive association of parental healthy-eating attitudes with nutritional adequacy and diet quality in a sample of Spanish preschoolers. Public health strategies should focus on encouraging parental healthy-eating attitudes rather than simply educating parents on what to feed their children, recognizing the important influence of parental behavior on children’s practices.
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Affiliation(s)
- Andrea Romanos-Nanclares
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain.
| | - Itziar Zazpe
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain.
- Department of Nutrition, Food science and Physiology, School of Pharmacy, University of Navarra, 31008 Pamplona, Spain.
- Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, 28029 Madrid, Spain.
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Navarra, Spain.
| | - Susana Santiago
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain.
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Navarra, Spain.
| | - Lucía Marín
- San Jorge Primary Care Health Center, Servicio Navarro de Salud-Osasunbidea, 31008 Pamplona, Spain.
| | - Anaïs Rico-Campà
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain.
- Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, 28029 Madrid, Spain.
| | - Nerea Martín-Calvo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain.
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