Children's dairy intake in the United States: too little, too fat?

Combined full-length transcriptomic and metabolomic analysis reveals the molecular mechanisms underlying nutrients and taste components development in Primulina juliae

BACKGROUND

Primulina juliae has recently emerged as a novel functional vegetable, boasting a significant biomass and high calcium content. Various breeding strategies have been employed to the domestication of P. juliae. However, the absence of genome and transcriptome information has hindered the research of mechanisms governing the taste and nutrients in this plant. In this study, we conducted a comprehensive analysis, combining the full-length transcriptomics and metabolomics, to unveil the molecular mechanisms responsible for the development of nutrients and taste components in P. juliae.

RESULTS

We obtain a high-quality reference transcriptome of P. juliae by combing the PacBio Iso-seq and Illumina sequencing technologies. A total of 58,536 cluster consensus sequences were obtained, including 28,168 complete protein coding transcripts and 8,021 Long Non-coding RNAs. Significant differences were observed in the composition and content of compounds related to nutrients and taste, particularly flavonoids, during the leaf development. Our results showed a decrease in the content of most flavonoids as leaves develop. Malate and succinate accumulated with leaf development, while some sugar metabolites were decreased. Furthermore, we identified the different accumulation of amino acids and fatty acids, which are associated with taste traits. Moreover, our transcriptomic analysis provided a molecular basis for understanding the metabolic variations during leaf development. We identified 4,689 differentially expressed genes in the two developmental stages, and through a comprehensive transcriptome and metabolome analysis, we discovered the key structure genes and transcription factors involved in the pathways.

CONCLUSIONS

This study provides a high-quality reference transcriptome and reveals molecular mechanisms associated with the development of nutrients and taste components in P. juliae. These findings will enhance our understanding of the breeding and utilization of P. juliae as a vegetable.

Genome-wide association study reveals the genetic variation and candidate gene for grain calcium content in bread wheat

KEY MESSAGE

This study provides important information on the genetic basis of GCaC in wheat, thus contributing to breeding efforts to improve the nutrient quality of wheat. Calcium (Ca) plays important roles in the human body. Wheat grain provides the main diet for billions of people worldwide but is low in Ca content. Here, grain Ca content (GCaC) of 471 wheat accessions was determined in four field environments. A genome-wide association study (GWAS) was performed to reveal the genetic basis of GCaC using the phenotypic data form four environments and a wheat 660 K single nucleotide polymorphism (SNP) array. Twelve quantitative trait locus (QTLs) for GCaC were identified on chromosomes 1A, 1D, 2A, 3B, 6A, 6D, 7A, and 7D, which was significant in at least two environments. Haplotype analysis revealed that the phenotypic difference between the haplotypes of TraesCS6D01G399100 was significant (P ≤ 0.05) across four environments, suggesting it as an important candidate gene for GCaC. This research enhances our understanding of the genetic architecture of GCaC for further improving the nutrient quality of wheat.

Stages of dairy product consumption among Iranian female high school students based on transtheoretical model: The case of osteoporosis prevention

Background: As nutritional needs increase in adolescence, dairy consumption can play a key role in health and disease prevention; however, unfortunately, inadequate consumption of milk and dairy products has often been reported in adolescents. Aim: The purpose of this study was to investigate the relation between decisional balance, self-efficacy, and the processes of change with the stages of change for dairy consumption in female high school students in Shaft county located in the west of Gilan Province, Iran. Methods: A total of 385 female high school students in Shaft County were studied through the census method in 2019. The data collection instrument was a valid and reliable questionnaire consisting of demographic information, stages of change and items of transtheoretical model constructs including the processes of change (cognitive process: consciousness-raising, dramatic relief, self-reevaluation, environmental reevaluation, and social liberation; behavioral process: self-liberation, counter conditioning, reinforcement management, stimulus control and helping relationships), decisional balance and self-efficacy. Data were analyzed using SPSS 21 software. Results: A total of 208 (54%), 53 (13.8%), 56 (14.5%), 32 (8.3%) and 36 (9.4%) students were in the pre-contemplate, contemplation, preparation, action and maintenance stages, respectively. As the subjects progressed through the stage of change for dairy consumption, an increase in the mean score of self-efficacy, decisional balance, and processes of change was observed (P < 0.01). Conclusion: The constructs of the transtheoretical model should be considered in designing educational interventions to promote dairy consumption with regard to the stage of change for dairy consumption in the subjects.

Calcium Biofortification of Crops-Challenges and Projected Benefits

Despite Calcium (Ca) being an essential nutrient for humans, deficiency of Ca is becoming an ensuing public health problem worldwide. Breeding staple crops with higher Ca concentrations is a sustainable long-term strategy for alleviating Ca deficiency, and particular criteria for a successful breeding initiative need to be in place. This paper discusses current challenges and projected benefits of Ca-biofortified crops. The most important features of Ca nutrition in plants are presented along with explicit recommendations for additional exploration of this important issue. In order for Ca-biofortified crops to be successfully developed, tested, and effectively implemented in most vulnerable populations, further research is required.

Community-based interventions to increase dairy intake in healthy populations: a systematic review

Background

Considering the low frequency of dairy intake in the population, interventions aiming to increase its consumption can be a priority for any health system.

Objective

This study aims to summarize community-based interventions for improving dairy consumption and their effectiveness to help policy-makers in designing coherent public health strategies.

Methods

This study was conducted in 2019, using PubMed/MEDLINE, Scopus, EMBASE, Cochrane Library, Web of Science, ProQuest, and Google Scholar. Two independent reviewers selected the eligible studies, and the outcomes of interest were extracted. The quality of eligible studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for randomized controlled trials and quasi-experimental studies.

Results

Out of 521 initially identified articles, 25 studies were included. Interventions reported in 19 studies were effective in increasing dairy consumption. Interventions in high-income countries were more effective than those in middle- and low-income countries. Interventions in health centers and supermarkets were more effective than the community and school-level interventions. Interventions in supermarkets and adolescents as target groups were more effective than children, middle-aged people, and the elderly. Also, educational interventions and changing buying/selling pattern were more effective than multiple interventions. Interventions longer than 24 and 48 weeks were more effective than shorter interventions.

Conclusion

Three policy options including educational interventions, multiple interventions, and changing the purchase pattern are suggested. It seems that applying all of the interventions together can be more effective. Also, long-term and well-designed future studies in different settings are recommended to confirm these results.

DEFINITION OF VITAMIN D DEFICIENCY IN SCHOOLCHILDREN: SYSTEMATIC REVIEW WITH META-ANALYSIS

BACKGROUND

Vitamin D deficiency is being recognized as a pandemic due to the volume of people affected by the deficiency and the number of illnesses generated or stimulated by the deficiency. There is a lack of consensus in the literature on what is considered vitamin D deficiency [25(OH)D].

OBJECTIVE

This review brings together the most common levels of 25(OH)D found in healthy schoolchildren and what is considered deficient.

METHODS

This systematic review was based on the literature accessed from the electronic databases: MEDLINE, EMBASE, LILACS, SCOPUS and WEB OF SCIENCE. The following descriptors were used in English, Portuguese and Spanish: "Vitamin D"; "Vitamin D deficiency"; "Nutritional Supplements" as well as all their synonyms. The meta-analysis was performed considering the random model. Inclusion criteria: healthy children aged 6 to 12 years, studies that had vitamin D levels, defined vitamin D deficiency.

RESULTS

Of the 191 potentially eligible articles, only six articles were included, with 2618 students in total. The mean value of 25(OH)D was estimated at 18.11 ng/mL with 95% confidence interval. Among the articles found, three were considered deficiency levels below 20 ng/mL, one considered below 18 ng/mL, another below 15 ng/mL, and the latter below 11 ng/ mL. The prevalence of vitamin D deficiency among the articles was 48.6%, 7%, 98%, 64.63%, 19.5%, 28.4%, according to each classification used by the same.

CONCLUSION

The most common definition in the literature of 25(OH)D deficiency in schoolchildren was at levels below 20 ng/mL. No side effects have been reported in studies that used fortification and/or vitamin D supplementation. Daily supplementation is more effective than seasonal supplementation. However, more studies are needed to define what can be considered as optimal levels of 25(OH)D in children.

Foods served at faith community events for children - Is there room for improvements in this unexplored child nutrition site?

OBJECTIVE

To describe food and beverage provisions by Faith Communities from one denomination in association with events for children.

DESIGN, SAMPLE AND MEASURES

Foods and beverages provided at 32 child-focused activities were documented using direct observation methodology and analyzed for contribution to food groups and per serving energy, fat, saturated fat, sugar, and sodium contents.

RESULTS

Main dishes were mostly (71%) convenience/casserole-type foods, and averaged 962 mg sodium and 436 kcal, with 36% of energy from fat and 14% as saturated fat. Cheese was the main source of dairy products. Grain-based side dishes, provided at 29% of meals, included white rice, pasta, and bread. Non-starchy vegetables were provided at three (29%) meals. Fruits were served at six events. Desserts, served at 75% of events, contained 41% of energy from fat, with 17% as saturated fat, and 22 g of added sugar. Snack chips, provided at 31% of events, contributed 165 kcal mostly from fat and 243 mg of sodium. Sugar-sweetened beverages, served at 71% of events, contributed 28 g of added sugar.

CONCLUSIONS

This pilot investigation identified areas for improvements in the nutritional quality of foods/beverages served at faith community child-focused events and aligns with expanding public health efforts to improve child nutrition beyond traditional settings.

Acyl-carnitine, C5DC, and C26 as potential biomarkers for diagnosis of autism spectrum disorder in children

Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders that shown a close association with impaired lipid metabolism. The acyl-carnitine spectrum status in Chinese children with ASD has not been reported. In this study, we assessed the levels of blood acyl-carnitines in Chinese children with ASD and examined the relation between acyl-carnitine profiles and the intelligence levels. Blood levels of acyl-carnitines were determined by tandem mass spectrometry in 60 children with ASD and 30 typically developing children. Chinese Wechsler Young Children Scale of Intelligence (C-WYCSI) was used in ASD group. Blood levels of free carnitine, glutaricyl carnitine, octyl carnitine, twenty four carbonyl carnitine and carnosyl carnitine in the ASD group were significantly lower than those in the control group. Glutaryl carnitine and carnosyl carnitine might be potential biomarkers for diagnosis of ASD. The changes in the acyl-carnitine spectrum indicate potential mitochondrial dysfunction and abnormal fatty acid metabolism in preschool ASD children.

Consommation des produits lactés chez l’enfant et l’adolescent marocain de 2 à 16 ans: une étude monocentrique

Introduction

Evaluer la consommation quotidienne des produits laitiers dans une population d’enfants marocains et déterminer les facteurs associés pouvant influencer cette consommation.

Méthodes

Etude prospective du 1^er octobre 2013 au 31 avril 2014. Les enfants âgés entre 2 et 16 ans ont été inclus. Le recrutement a eu lieu dans la ville de Fès. Le recueil des données s’est fait à l’aide d’un questionnaire fréquentiel. Les parents et les enfants inclus ont été interrogés sur la consommation des produits laitiers et les facteurs socio-démographiques avec une évaluation anthropométrique des enfants. L’association des variables à la consommation des produits laitiers a été analysée en analyse univariée et multivariée par un modèle de régression logistique.

Résultats

L’enquête alimentaire avait intéressé 286 enfants dont 151 filles (52,8 %) et 131 garçons (45,8%). Les enfants âgés de 2 à 3 ans représentaient 26,4 %, ceux âgés de 4 à 7 ans 28,9 %, ceux âgés de 7 à 9 ans 18,3 % et les adolescents âgés de 10 à 16 ans 26,4 %. Les enfants consommaient en moyenne 2.5±1 produits laitiers par jour. Les enfants consommaient au moins 3 produits laitiers par jour dans 57,8% chez les enfants âgés de 2 à 3 ans, 53,6% chez les enfants âgés de 4 à 6 ans, 40% chez les enfants âgés de 7 à 9 ans et 41.2% chez les enfants âgés de 10 à 16 ans. Les facteurs associés à la consommation de trois produits laitiers minimum par jour en analyse univariée étaient le niveau d’instruction maternel analphabète p < 0.001 OR = 0.1 et primaire p = 0.002 OR = 0.1, le niveau socioéconomique familial moyen p < 0.001 OR = 3, l’âge p= 0.01 OR = 0.9 et l’indice de masse corporelle normal p = 0.01 OR = 2.5 et > 90° percentiles p < 0.001 OR = 6. Il existe un lien positif entre l’indice de masse corporelle > 90° percentiles p = 0.01 OR = 3.9 est et la quantité consommée des produits laitiers et négatif avec le faible niveau de scolarité maternel analphabète p = 0.008 OR = 0.1 et primaire p = 0.009 OR = 0.1.

Conclusion

La consommation du lait et des autres produits laitiers était inappropriée en particulier chez l’enfant âgé de 7 à 9 ans et l’adolescent de 10 à 16 ans. Le faible niveau d’éducation maternel et un indice de masse corporelle supérieur au 90° percentiles était des facteurs indépendamment associés à la consommation de moins de 3 produits laitiers par jour. La sensibilisation des parents et des enfants sur l’intérêt du lait et de ses dérivés dans l’alimentation de l’enfant est indispensable.

Genome-Wide Association Study of Calcium Accumulation in Grains of European Wheat Cultivars

Mineral concentrations in cereals are important for human health, especially for people who depend mainly on consuming cereal diet. In this study, we carried out a genome-wide association study (GWAS) of calcium concentrations in wheat (Triticum aestivum L.) grains using a European wheat diversity panel of 353 varieties [339 winter wheat (WW) plus 14 of spring wheat (SW)] and phenotypic data based on two field seasons. High genotyping densities of single-nucleotide polymorphism (SNP) markers were obtained from the application of the 90k iSELECT ILLUMINA chip and a 35k Affymetrix chip. Inductively coupled plasma optical emission spectrometry (ICP-OES) was used to measure the calcium concentrations of the wheat grains. Best linear unbiased estimates (BLUEs) for calcium were calculated across the seasons and ranged from 288.20 to 647.50 among the varieties (μg g-1 DW) with a mean equaling 438.102 (μg g-1 DW), and the heritability was 0.73. A total of 485 SNP marker-trait associations (MTAs) were detected in data obtained from grains cultivated in both of the two seasons and BLUE values by considering associations with a -log10 (P-value) ≥3.0. Among these SNP markers, we detected 276 markers with a positive allele effect and 209 markers with a negative allele effect. These MTAs were found on all chromosomes except chromosomes 3D, 4B, and 4D. The most significant association was located on chromosome 5A (114.5 cM) and was linked to a gene encoding cation/sugar symporter activity as a potential candidate gene. Additionally, a number of candidate genes for the uptake or transport of calcium were located near significantly associated SNPs. This analysis highlights a number of genomic regions and candidate genes for further analysis as well as the challenges faced when mapping environmentally variable traits in genetically highly diverse variety panels. The research demonstrates the feasibility of the GWAS approach for illuminating the genetic architecture of calcium-concentration in wheat grains and for identifying putative candidate genes underlying this trait.

Patterns of dairy food intake, body composition and markers of metabolic health in Ireland: results from the National Adult Nutrition Survey

Background:

Studies examining the association between dairy consumption and metabolic health have shown mixed results. This may be due, in part, to the use of different definitions of dairy, and to single types of dairy foods examined in isolation.

Objective:

The objective of the study was to examine associations between dairy food intake and metabolic health, identify patterns of dairy food consumption and determine whether dairy dietary patterns are associated with outcomes of metabolic health, in a cross-sectional survey.

Design:

A 4-day food diary was used to assess food and beverage consumption, including dairy (defined as milk, cheese, yogurt, cream and butter) in free-living, healthy Irish adults aged 18–90 years (n=1500). Fasting blood samples (n=897) were collected, and anthropometric measurements taken. Differences in metabolic health markers across patterns and tertiles of dairy consumption were tested via analysis of covariance. Patterns of dairy food consumption, of different fat contents, were identified using cluster analysis.

Results:

Higher (total) dairy was associated with lower body mass index, %body fat, waist circumference and waist-to-hip ratio (P<0.001), and lower systolic (P=0.02) and diastolic (P<0.001) blood pressure. Similar trends were observed when milk and yogurt intakes were considered separately. Higher cheese consumption was associated with higher C-peptide (P<0.001). Dietary pattern analysis identified three patterns (clusters) of dairy consumption; 'Whole milk', 'Reduced fat milks and yogurt' and 'Butter and cream'. The 'Reduced fat milks and yogurt' cluster had the highest scores on a Healthy Eating Index, and lower-fat and saturated fat intakes, but greater triglyceride levels (P=0.028) and total cholesterol (P=0.015). conclusion: Overall, these results suggest that while milk and yogurt consumption is associated with a favourable body phenotype, the blood lipid profiles are less favourable when eaten as part of a low-fat high-carbohydrate dietary pattern. More research is needed to better understand this association.

Conclusion:

Overall, these results suggest that although milk and yogurt consumption is associated with a favourable body phenotype, the blood lipid profiles are less favourable when eaten as part of a low-fat high-carbohydrate dietary pattern. More research is needed to better understand this association.

Calcium Biofortification: Three Pronged Molecular Approaches for Dissecting Complex Trait of Calcium Nutrition in Finger Millet (Eleusine coracana) for Devising Strategies of Enrichment of Food Crops

Calcium is an essential macronutrient for plants and animals and plays an indispensable role in structure and signaling. Low dietary intake of calcium in humans has been epidemiologically linked to various diseases which can have serious health consequences over time. Major staple food-grains are poor source of calcium, however, finger millet [Eleusine coracana (L.) Gaertn.], an orphan crop has an immense potential as a nutritional security crop due to its exceptionally high calcium content. Understanding the existing genetic variation as well as molecular mechanisms underlying the uptake, transport, accumulation of calcium ions (Ca2+) in grains is of utmost importance for development of calcium bio-fortified crops. In this review, we have discussed molecular mechanisms involved in calcium accumulation and transport thoroughly, emphasized the role of molecular breeding, functional genomics and transgenic approaches to understand the intricate mechanism of calcium nutrition in finger millet. The objective is to provide a comprehensive up to date account of molecular mechanisms regulating calcium nutrition and highlight the significance of bio-fortification through identification of potential candidate genes and regulatory elements from finger millet to alleviate calcium malnutrition. Hence, finger millet could be used as a model system for explaining the mechanism of elevated calcium (Ca2+) accumulation in its grains and could pave way for development of nutraceuticals or designer crops.

Long-term association between dairy consumption and risk of childhood obesity: a systematic review and meta-analysis of prospective cohort studies

BACKGROUND/OBJECTIVES

Data from small-scale, short-term, clinical trials suggest a beneficial effect of dairy consumption on the risk of childhood obesity; however, the long-term association is unclear. Therefore, we aim to examine the longitudinal association between dairy consumption and the risk of overweight/obesity in children and adolescents by conducting a systematic review and meta-analysis of prospective cohort studies.

SUBJECTS/METHODS

Eligible studies were identified by searching PubMed and EMBASE through March 2015. Additional studies were retrieved via Google Scholar or a hand review of the reference lists from relevant articles. Pooled associations of interest were estimated by using a random-effects model. The heterogeneity for each pooled analysis was evaluated by I(2) statistic as well as by Cochran's Q test. Publication bias was assessed by using both Egger's and Begg's tests.

RESULTS

Ten studies comprising 46,011 children and adolescents with an average 3-year follow-up were included. As compared with those who were in the lowest group of dairy consumption, children in the highest intake group were 38% less likely to have childhood overweight/obesity (pooled odds ratio (OR)=0.62; 95% confidence interval (CI): 0.49, 0.80). With each 1 serving/day increment in dairy consumption, the percentage of body fat was reduced by 0.65% (β=0.65; 95% CI: -1.35, 0.06; P=0.07), and the risk of overweight/obesity was 13% lower (OR=0.87; 95% CI: 0.74, 0.98).

CONCLUSIONS

Accumulated evidence from prospective cohort studies suggests that dairy consumption is inversely and longitudinally associated with the risk of childhood overweight/obesity. Further studies are warranted to examine the types of dairy products in relation to the risk of childhood overweight/obesity.

Potential population-level nutritional impact of replacing whole and reduced-fat milk with low-fat and skim milk among US children aged 2-19 years

OBJECTIVE

Dietary guidance emphasizes plain low-fat and skim milk over whole, reduced-fat, and flavored milk (milk eligible for replacement [MER]). The objective of this study was to evaluate the population-level impact of such a change on energy, macronutrient and nutrient intakes, and diet cost.

DESIGN

Cross-sectional modeling study.

SETTING

Data from the 2001-2002 and 2003-2004 National Health and Nutrition Examination Survey.

PARTICIPANTS

A total of 8,112 children aged 2-19 years.

MAIN OUTCOME MEASURES

Energy, macronutrient, and micronutrient intake before and after replacement of MER with low-fat or skim milk.

ANALYSIS

Survey-weighted linear regression models.

RESULTS

Milk eligible for replacement accounted for 46% of dairy servings. Among MER consumers, replacement with skim or low-fat milk would lead to a projected reduction in energy of 113 (95% confidence interval [CI], 107-119) and 77 (95% CI, 73-82) kcal/d and percent energy from saturated fat by an absolute value of 2.5% of total energy (95% CI, 2.4-2.6) and 1.4% (95% CI, 1.3-1.5), respectively. Replacement of MER does not change diet costs or calcium and potassium intake.

CONCLUSIONS

Substitution of MER has the potential to reduce energy and total and saturated fat intake with no impact on diet costs or micronutrient density. The feasibility of such replacement has not been examined and there may be negative consequences if replacement is done with non-nutrient-rich beverages.

Evaluating the Impact of Six Supplemental Nutrition Assistance Program Education Interventions on Children’s At-Home Diets

Background. Nutrition education in the Supplemental Nutrition Assistance Program Education (SNAP-Ed) is designed to promote healthy eating behaviors in a low-income target population. Purpose. To evaluate the effectiveness of six SNAP-Ed interventions delivered in child care centers or elementary school settings in increasing participating children’s at-home fruit and vegetable (F/V) consumption by 0.3 cups per day and use of fat-free or low-fat milk instead of whole or reduced-fat milk during the prior week. Method. Clustered randomized or quasi-experimental clustered trials took place in child care centers or elementary schools between 2010 and 2012. Parents of children at intervention and control sites completed baseline and follow-up surveys about their child’s at home F/V consumption and other dietary behaviors. Results. One of the six interventions was successful in meeting the objective of increasing children’s F/V consumption by 0.3 cups per day. For three of the six interventions, there was a small but statistically significant increase in F/V consumption and/or use of low-fat or fat-free milk. Conclusion. Although not all interventions were effective, these findings suggest that it is possible for some SNAP-Ed interventions to improve dietary habits among low-income children among some families. The effective interventions appear to have benefited from implementation experience and sustained efforts at intervention refinement and improvement.

The nutritional role of flavored and white milk in the diets of children

BACKGROUND

Some schools are removing flavored milk from lunchrooms based on the perception that consumption has a negative impact on the overall dietary quality. The goal of this study was to assess the contribution of flavored and white milk in the diets of children.

METHODS

Intake data from children 2 to 18 years (N = 7332) participating in the National Health and Nutrition Examination Survey (NHANES) 2003-2006 were obtained from in-person 24-hour dietary recalls. Mean ± standard error of energy and nutrients were determined.

RESULTS

Flavored and white milk contributed, respectively, 2-6% of total energy consumed, 3-12% of saturated fats, 1-3% of sodium, and 4-0% of added sugars. The percent contribution of white milk to intakes of vitamin A (21%), vitamin D (54%), calcium (29%), potassium (17%), magnesium (12%), and phosphorus (19%) exceeded 10% of total intake. Consumption of flavored milk contributed a smaller percentage to total intake. For total dairy consumed the percent contribution to intake of vitamins A and D, calcium, potassium, magnesium, and phosphorus ranged from 19% to 68%.

CONCLUSIONS

Milk has an important nutritional role in the diets of children. More research is needed to understand the barriers to consuming milk and potential unintended nutrition consequences of removing flavored milk from the lunchrooms.

Dairy food intake of Australian children and adolescents 2-16 years of age: 2007 Australian National Children's Nutrition and Physical Activity Survey

OBJECTIVE

Dairy food consumption is important for Australian children as it contributes key nutrients such as protein and Ca. The aim of the present paper is to describe dietary intake from dairy foods for Australian children aged 2-16 years in 2007.

DESIGN

Secondary analysis of a quota-sampled survey using population-weighted, 1 d (24 h) dietary recall data.

SETTING

Australian national survey conducted from February to August 2007.

SUBJECTS

Children (n 4487) aged 2-16 years.

RESULTS

Most Australian children consumed dairy foods (84-98 %), with the proportion consuming tending to decrease with age and males consuming significantly more than females from the age of 4 years. Milk was the most commonly consumed dairy food (58-88 %) and consumed in the greatest amount (243-384 g/d). Most children consumed regular-fat dairy products. The contribution of dairy foods to total energy intake decreased with age; from 22 % of total energy at age 2-3 years to 11 % at age 14-16 years. This trend was similar for all nutrients analysed. Dairy food intake peaked between 06.00 and 10.00 hours (typical breakfast hours) corresponding with the peak in dairy Ca intake. Australian children (older than 4 years) did not reach recommendations for dairy food intake, consuming ≤2 servings/d.

CONCLUSIONS

The under-consumption of dairy foods by Australian children has important implications for intake of key nutrients and should be addressed by multiple strategies.

Fresh Fruit and Vegetable Program participation in elementary schools in the United States and availability of fruits and vegetables in school lunch meals

Dietary intake among children in the United States falls short of national recommendations. Schools can play an important role in improving children's preferences and food consumption patterns. The US Department of Agriculture's Fresh Fruit and Vegetable Program (FFVP) aims to improve children's nutrient intake patterns by offering fresh fruits and vegetables as snacks outside the reimbursable meals programs in elementary schools that serve large numbers of low-income children. Using a nationally representative sample of public elementary schools, this cross-sectional study investigated FFVP participation patterns among schools by demographic and school characteristics. Further, the study investigated the association between FFVP participation and availability of fresh fruits, salads, and vegetables at lunch as reported by school administrators and foodservice staff. Data collected via a mail-back survey from 620 public elementary schools participating in the National School Lunch Program during 2009-2010 were analyzed. Almost 70% of the FFVP-participating schools had a majority of students (>50%) eligible for free and reduced-cost meals. Participating in US Department of Agriculture Team Nutrition Program and having a registered dietitian or a nutritionist on staff were significantly associated with FFVP participation. Based on the results from logistic regression analyses schools participating in the FFVP were significantly more likely (odds ratio 2.07; 95% CI 1.12 to 3.53) to serve fresh fruit during lunch meals. Slightly >25% of public elementary schools across the United States participated in the FFVP, and participation was associated with healthier food availability in school lunches.

Caregiver food behaviours are associated with dietary intakes of children outside the child-care setting

Objective

To evaluate whether food behaviours of parents are associated with children's dietary intakes outside the child-care setting, and to compare children's dietary intakes at home with foods and beverages consumed when they are at child-care centres.

Design

In 2005–2006, a survey was completed by parents of at least one child between 3 and 5 years old who attended group child-care centres. Surveys about nutrition practices were completed by centre directors. Research assistants observed foods and beverages consumed by children at lunchtime at the centres.

Setting

Sixteen licensed group child-care centres in three underserved New York City communities (South Bronx, East/Central Harlem, Central Brooklyn) and the Lower East Side of Manhattan.

Subjects

Two hundred parents.

Results

Children were more likely to consume healthful foods including fruits or vegetables if parents reported purchasing food from produce stands/farmers’ markets, shopped for frozen or canned fruits frequently and ate family meals or meals prepared at home daily. Children were more likely to consume less healthful foods such as French fries, or fruit drinks, more frequently if parents reported eating meals from fast-food or other restaurants at least once weekly, or if children ate while watching television. Types of foods and beverages offered to children at home (e.g. higher-fat milk, soft drinks and desserts) were less healthful than those offered at child-care centres.

Conclusions

Children's dietary intakes at home need to be improved. Parents need to understand the importance of providing home environments that support healthful food behaviours in children.

The calcium-sensing receptor affects fat accumulation via effects on antilipolytic pathways in adipose tissue of rats fed low-calcium diets

Low-calcium intake is associated with increased risk of obesity, but the mechanism underlying this is not clear. We previously reported that the calcium-sensing receptor (CaSR) plays an important role in modulating the expression of rate-limiting lipolysis enzymes in human adipocytes. In the present study, rats were fed diets containing normal [0.50% (NC)], low [0.30% (LC)], or very low [0.15% (VLC)] calcium for 15 wk. Ten rats of each group were killed at wk 5, 10, and 15 of the intervention. The LC-fed rats had greater visceral fat mass, lower serum FFA and glycerol concentrations, and greater CaSR expression in white adipose tissue than did those fed the NC diet at wk 10 and 15. Hormone-sensitive lipase (HSL) and adipose TG lipase (ATGL) protein levels were lower, whereas fatty acid synthase mRNA in white adipose tissue was greater in the LC-fed rats compared with the NC-fed rats. These differences from the NC group were greater in the VLC group than in the LC group at wk 15. In vitro experiments showed that 1,25-dihydroxycholecalciferol stimulated the expression of CaSR through the nuclear vitamin D receptor (nVDR). This resulted in an antilipolytic effect by increasing intracellular calcium, decreasing the intracellular cAMP level, and downregulating HSL and ATGL protein expression in adipocytes. These effects were suppressed by either nVDR or CaSR small-interfering RNA. These results suggest that CaSR affects fat accumulation by mediating antilipolytic pathways in adipose tissue of rats fed low-calcium diets.

Vitamin, fluoride, and iron use among US children younger than 12 years of age: results from the Slone Survey 1998-2007

Pediatric vitamin and mineral supplements are thought to be used commonly in the United States, but details of their use are lacking. Using data from the Slone Survey (a cross-sectional national random-digit-dial medication use survey), this study sought to define the prevalence and patterns of use of supplemental vitamins, fluoride, and iron among US children younger than 12 years of age. Primary statistical analyses involved descriptive statistics and calculation of weighted prevalence of use estimates with 95% confidence intervals. Between February 1998 and April 2007, there were 2,857 children 0 to 11 years of age enrolled from the 48 contiguous United States with weighted prevalence of use of vitamins, iron, and fluoride as the primary outcome. The response rate to the survey was 61%. Overall, 23.1% of children had used a vitamin, fluoride, or iron supplement in the 7 days before the interview, with use being highest among 2- to 5-year-olds. Almost all vitamins and most fluoride and iron were taken in the form of multicomponent products. The most commonly taken specific vitamins were C, D, B-12, B-6, and B-2, each by >20% of children. Overall, 3.3% of study participants took supplemental fluoride and 9.7% took supplemental iron. In conclusion, this study found that almost one-quarter of US children younger than 12 years of age, and 30% of 2-year-olds, use supplemental vitamins, fluoride, and iron in a given week. These data should be combined with what is known about the need for pediatric supplementation with vitamins, fluoride, and iron to help clinicians and policy makers counsel parents about the optimal use of these products.

High prevalence of vitamin D deficiency in school-age children in Tehran, 2008: a red alert

OBJECTIVE

To assess the vitamin D status of 9-12-year-old primary-school children in Tehran during autumn and winter 2007-2008.

DESIGN

A descriptive cross-sectional study.

SETTING

Primary schools of Tehran city, Iran.

SUBJECTS

A total of 1111 children aged 9-12 years (573 boys and 538 girls) from sixty primary schools were enrolled in the study. Weight, height, BMI and serum levels of Ca, P, Mg, 25-hydroxyvitamin D (25(OH)D), intact parathyroid hormone (iPTH), osteocalcin and bone-specific alkaline phosphatase of all the participants were assessed. Dietary Ca intake was also evaluated using a quantitative FFQ for a subsample of the study population (n 503). Vitamin D sufficiency was defined on the basis of serum levels of 25(OH)D as either ≥37 nmol/l (criterion 1) or ≥50 nmol/l (criterion 2).

RESULTS

Daily intake of Ca did not differ significantly between boys and girls (929·6 (sd 436·7) mg and 909·5 (sd 465·5) mg, respectively). However, on the basis of the first criterion, approximately 86 % of the children had vitamin D deficiency, with 38·3 % being severely deficient (25(OH)D < 12·5 nmol/l). According to the second criterion, prevalence of vitamin D deficiency rose to 91·7 %. Prevalence of vitamin D deficiency was higher in girls than in boys by either criterion. Serum levels of 25(OH)D inversely correlated with iPTH (r = -0·154, P < 0·001) and BMI (r = -0·092, P = 0·002) but directly correlated with duration of sun exposure (r = 0·115, P < 0·001).

CONCLUSIONS

The high prevalence of vitamin D deficiency among schoolchildren (especially among girls) warrants immediate interventions for proper nutritional support.

Calcium storage in plants and the implications for calcium biofortification

Calcium (Ca) is an essential nutrient for plants and animals, with key structural and signalling roles, and its deficiency in plants can result in poor biotic and abiotic stress tolerance, reduced crop quality and yield. Likewise, low Ca intake in humans has been linked to various diseases (e.g. rickets, osteoporosis, hypertension and colorectal cancer) which can threaten quality of life and have major economic costs. Biofortification of various food crops with Ca has been suggested as a good method to enhance human intake of Ca and is advocated as an economically and environmentally advantageous strategy. Efforts to enhance Ca content of crops via transgenic means have had promising results. Overall Ca content of transgenic plants has been increased but in some cases adverse affects on plant function have been observed. This suggests that a better understanding of how Ca ions (Ca(2+)) are stored and transported through plants is required to maximise the effectiveness of future approaches.

Calcium intake and body composition in African-American children and adolescents at risk for overweight and obesity

This study examined the role of calcium intake on body composition in 186 African-American adolescents at risk for overweight and obesity. The average weight of 89.8 kg ± 23.6 (SD) had a mean BMI z score of 2.2. Females with a calcium intake of <314 mg/day had higher percent fat mass compared to those with the highest calcium intakes that were ≥634 mg/day. Compared to those with a low calcium intake (<365 mg/day), those with the highest calcium intake of >701 mg/day had higher intake of thiamin, folate, cobalamin, vitamin D, phosphorus, iron, zinc.

Molecular mechanisms triggered by low-calcium diets

Ca is not only essential for bone mineralisation, but also for regulation of extracellular and intracellular processes. When the Ca2+ intake is low, the efficiency of intestinal Ca2+ absorption and renal Ca2+ reabsorption is increased. This adaptive mechanism involves calcitriol enhancement via parathyroid hormone stimulation. Bone is also highly affected. Low Ca2+ intake is considered a risk factor for osteoporosis. Patients with renal lithiasis may be at higher risk of recurrence of stone formation when they have low Ca2+ intake. The role of dietary Ca2+ on the regulation of lipid metabolism and lipogenic genes in adipocytes might explain an inverse relationship between dairy intake and BMI. Dietary Ca2+ restriction produces impairment of the adipocyte apoptosis and dysregulation of glucocorticosteroid metabolism in the adipose tissue. An inverse relationship between hypertension and a low-Ca2+ diet has been described. Ca2+ facilitates weight loss and stimulates insulin sensitivity, which contributes to the decrease in the blood pressure. There is also evidence that dietary Ca2+ is associated with colorectal cancer. Dietary Ca2+ could alter the ratio of faecal bile acids, reducing the cytotoxicity of faecal water, or it could activate Ca2+-sensing receptors, triggering intracellular signalling pathways. Also it could bind luminal antigens, transporting them into mucosal mononuclear cells as a mechanism of immunosurveillance and promotion of tolerance. Data relative to nutritional Ca2+ and incidences of other human cancers are controversial. Health professionals should be aware of these nutritional complications and reinforce the dairy intakes to ensure the recommended Ca2+ requirements and prevent diseases.

Prospective association between milk intake and adiposity in preschool-aged children

OBJECTIVE

To determine whether the quantity and type of milk (whole, reduced fat, or 1%/nonfat) consumed at age 2 years is associated with adiposity at age 3 years.

DESIGN

We assessed milk and dairy intake at age 2 years with food frequency questionnaires completed by mothers. Our primary outcomes were body mass index (BMI; calculated as kg/m(2)), z score and overweight at age 3 years, defined as BMI for age and sex >or=85th percentile.

SUBJECTS/SETTING

Eight-hundred and fifty-two preschool-aged children in the prospective US cohort Project Viva.

STATISTICAL ANALYSES

Linear and logistic regression models, adjusting for maternal BMI and education, paternal BMI, and child age, sex, race/ethnicity, intake of energy, nondairy beverages, television viewing, and BMI z score at age 2 years were used.

RESULTS

At age 2 years, mean milk intake was 2.6 (standard deviation 1.2) servings per day. Higher intake of whole milk at age 2, but not reduced-fat milk, was associated with a slightly lower BMI z score (-0.09 unit per daily serving [95% confidence interval: -0.16 to -0.01]) at age 3 years; when restricted to children with a normal BMI (5th to <85th percentile) at age 2 years, the association was null (-0.05 unit per daily serving [95% confidence interval: -0.13 to 0.02]). Intake of milk at age 2 years, whether full- or reduced-fat, was not associated with risk of incident overweight at age 3 years. Neither total milk nor total dairy intake at age 2 years was associated with BMI z score or incident overweight at age 3 years.

CONCLUSION

Neither consuming more dairy products, nor switching from whole milk to reduced-fat milk at age 2 years, appears likely to prevent overweight in early childhood.

Season-related variation in dietary recalls used in a paediatric population

BACKGROUND

The effect of seasonality in estimating population mean nutrient intake using a single dietary recall has not been fully explored. The present study aimed to evaluate variation in energy and nutrient intake using a single 24-h recall between two seasons (spring/summer and autumn/winter) in a sample of children and adolescents.

METHODS

  A randomly selected subgroup (n = 623) of a representative sample of 3-18-year-old Greek children and adolescents was used in the present analysis. Information on participants' socio-demographic characteristics, body weight/height and dietary intake were collected through telephone interviews. Dietary assessment was based on two 24-h recalls (the first during the spring/summer season and the second 6 months later, during autumn/winter season).

RESULTS

Reported daily energy intake in spring/summer was 344 ± 130 kJ (82 ± 31 kcal) higher compared to the one in autumn/winter after adjusting for potential confounders (P = 0.008). However, the contribution of the macronutrients to the total energy intake was not statistically different between the two periods and the same was also true for vitamin C and calcium. The results remained unchanged after excluding low energy reporters.

CONCLUSIONS

The use of a second 24-h recall in a different season of the year does not confer additional information with regard to a population assessment of macronutrient contribution to the total energy intake in paediatric samples; its use appears to be justified in the light of a more accurate assessment of energy intake.

Role of dairy beverages in the diet

The U.S. Dietary Guidelines for Americans recommends 3 cups of low fat milk or equivalent daily for most calorie levels [1]. Milk provides over 10% of the requirement for calcium, vitamin D, magnesium, phosphorus, potassium, riboflavin, protein, and carbohydrates for most people. Obtaining adequate intakes of calcium, potassium, and magnesium without milk in the diet requires effort. Milk has bioactive ingredients that may play unique roles in health. Benefits of dairy consumption are associated with reduced risk of low bone mass, stroke, metabolic syndrome, and some cancers. Concerns over milk consumption have focused on saturated fats historically. More research is needed to resolve potential concerns of milk consumption and risk of several disorders including ovarian cancer and soft tissue calcification.

Development and validation of a beverage and snack questionnaire for use in evaluation of school nutrition policies

School nutrition policies limiting access to sweetened beverages, candy, and salty snacks have the potential to improve the health of children. To effectively evaluate policy success, appropriate and validated dietary assessment instruments are needed. The objective of this study was to develop and validate a beverage and snack questionnaire suitable for use among young adolescents. A new 19-item Beverage and Snack Questionnaire (BSQ) was administered to middle school students on two occasions, 2 weeks apart, to measure test-retest reliability. The questionnaire inquired about frequency of consumption, both at school and away from school, of soft drinks, salty snacks, sweets, milk, and fruits and vegetables. Students also completed 4-day food records. To assess validity, food-record data were compared with BSQ data. Forty-six students of diverse backgrounds from metropolitan Seattle, WA, participated in this study. Participants answered the BSQ during class time and completed the food record at home. Pearson correlation coefficients assessed test-retest reliability and validity. Using frequency per week data, the test-retest reliability coefficients were r=0.85 for fruits and vegetables consumed at school and r=0.74 and r=0.72 for beverages and sweets/snacks, respectively, consumed at school. Correlations ranged from r=0.73 to 0.77 for foods consumed outside of school. Compared with the criterion food record, validity coefficients were very good: r=0.69 to 0.71 for foods consumed at school and r=0.63 to 0.70 for foods consumed away from school. The validity coefficients for the 19 individual food items ranged from r=0.56 to 0.87. This easy-to-administer 19-item questionnaire captures data on sugar-sweetened beverages, salty snacks, sweets, milk, and fruit and vegetables as well as a more lengthy and expensive food record does. The BSQ can be used by nutrition researchers and practitioners to accurately evaluate student consumption of foods that are the focus of school nutrition policies.

Are school employees role models of healthful eating? Dietary intake results from the ACTION worksite wellness trial

BACKGROUND

Little is known about the dietary intake of school employees, a key target group for improving school nutrition.

OBJECTIVE

To investigate selected dietary variables and weight status among elementary school personnel.

DESIGN

Cross-sectional, descriptive study.

SUBJECTS/SETTING

Elementary school employees (n=373) from 22 schools in a suburban parish (county) of southeastern Louisiana were randomly selected for evaluation at baseline of ACTION, a school-based worksite wellness trial.

METHODS

Two 24-hour dietary recalls were administered on nonconsecutive days by registered dietitians using the Nutrition Data System for Research. Height and weight were measured by trained examiners and body mass index calculated as kg/m(2).

STATISTICAL ANALYSES PERFORMED

Descriptive analyses characterized energy, macronutrient, fiber, and MyPyramid food group consumption. Inferential statistics (t tests, analysis of variance, chi(2)) were used to examine differences in intake and compliance with recommendations by demographic and weight status categories.

RESULTS

Approximately 31% and 40% of the sample were overweight and obese, respectively, with higher obesity rates than state and national estimates. Mean daily energy intake among women was 1,862+/-492 kcal and among men was 2,668+/-796 kcal. Obese employees consumed more energy (+288 kcal, P<0.001) and more energy from fat (P<0.001) than those who were normal weight. Approximately 45% of the sample exceeded dietary fat recommendations. On average, only 9% had fiber intakes at or above their Adequate Intake, which is consistent with the finding that more than 25% of employees did not eat fruit, 58% did not eat dark-green vegetables, and 45% did not eat whole grains on the recalled days. Only 7% of employees met the MyPyramid recommendations for fruits or vegetables, and 14% of the sample met those for milk and dairy foods.

CONCLUSIONS

These results suggest that greater attention be directed to understanding and improving the diets of school employees given their high rates of overweight and obesity, poor diets, and important role in student health.

Diet- and body size-related attitudes and behaviors associated with vitamin supplement use in a representative sample of fourth-grade students in Texas

OBJECTIVE

To examine diet- and body size-related attitudes and behaviors associated with supplement use in a representative sample of fourth-grade students in Texas.

DESIGN

Cross-sectional data from the School Physical Activity and Nutrition study, a probability-based sample of schoolchildren. Children completed a questionnaire that assessed supplement use, food choices, diet-related attitudes, and physical activity; height and weight were measured.

SETTING

School classrooms.

PARTICIPANTS

Representative sample of fourth-grade students in Texas (n = 5967; mean age = 9.7 years standard error of the mean [SEM] = .03 years, 46% Hispanic, 11% African-American).

MAIN OUTCOME MEASURES

Previous day vitamin supplement consumption, diet- and body size-related attitudes, food choices, demographic factors, and physical activity.

ANALYSIS

Multivariable logistic regression models, P < .05.

RESULTS

The prevalence of supplement use was 29%. Supplement intake was associated with physical activity. Girls who used supplements were more likely to report positive body image and greater interest in trying new food. Relative to nonusers, supplement users were less likely to perceive that they always ate healthful food, although supplement use was associated with more healthful food choices in boys and girls (P < .001).

CONCLUSIONS AND IMPLICATIONS

The widespread use of supplements and clustering of supplement use with healthful diet and greater physical activity in fourth graders suggest that supplement use be closely investigated in studies of diet-disease precursor relations and lifestyle factors in children.

Opportunities for the primary prevention of obesity during infancy

Many parents, grandparents, and clinicians have associated a baby’s ability to eat and gain weight as a sign of good health, and clinicians typically only call significant attention to infant growth if a baby is failing to thrive or showing severe excesses in growth. Recent evidence, however, has suggested that pediatric healthcare providers should pay closer attention to growth patterns during infancy. Both higher weight and upward crossing of major percentile lines on the weight-for-age growth chart during infancy have long term health consequences, and are associated with overweight and obesity later in life. Clinicians should utilize the numerous available opportunities to discuss healthy growth and growth charts during health maintenance visits in the first two years after birth. Further, providers should instruct parents on strategies to promote healthy behaviors that can have long lasting obesity preventive effects.

Duarte (DG) galactosemia: a pilot study of biochemical and neurodevelopmental assessment in children detected by newborn screening

Newborn screening for galactosemia has shown a high prevalence of partial galactose uridyl transferase deficiencies such as Duarte (DG) galactosemia.

STUDY OBJECTIVE

To determine whether (a) there is any clinical impact of DG galactosemia on development (b) there is a relationship between outcome and biochemical parameters in patients who receive no treatment.

STUDY POPULATION

Twenty-eight children with DG galactosemia. Group-I-17 children had a lactose restricted diet in the first year of life. Group-II-11 children had a regular diet since birth.

METHODS

Developmental, physical, and ophthalmologic assessments were completed on both DG groups. RBC gal-1-p and urine galactitol were monitored during the follow-up visits in every child with DG galactosemia. Gal-1-p, urine galactitol, liver function tests, and FSH were tested at the time of study visit.

RESULTS

The groups had statistically significant differences on RBC gal-1-p and urine galactitol at the 2 week, 1 month, 6 month, and 1 year time points. There was no statistical difference of gal-1-p or urine galactitol in group-I and -II at the time of study. The groups had statistically significant differences on adaptive scores, but not on language or IQ. None of the DG subjects had abnormal liver function at the time of diagnosis or the study visit. The FSH levels were normal. There were no statistically significant relationships between the first year metabolic values and developmental outcomes.

CONCLUSIONS

The data presented here indicate that clinical and developmental outcomes in DG galactosemics are good regardless of any diet changes.

Effects of average childhood dairy intake on adolescent bone health

OBJECTIVE

To evaluate the effects of usual childhood dairy intake on adolescent bone health.

STUDY DESIGN

Dietary data collected in the Framingham Children's Study over 12 years were used to evaluate usual dairy consumption and adolescent bone health. Each child's average Food Pyramid servings were estimated from yearly sets of 3-day diet records. Bone mineral content (BMC) and area (BA) for total body and 6 regions (arms, legs, trunk, ribs, pelvis, and spine) at ages 15 to 17 years were the primary outcomes. Analysis of covariance was used to adjust for potential confounding by sex and physical activity, as well as age, height, body mass index and percent body fat at the time of the bone scan.

RESULTS

Consuming >or= 2 servings/day of dairy (versus less) was associated with significantly higher mean BMC and BA. Higher intakes of meats/other proteins (>or= 4 servings per/day) were also associated with higher mean BMC and BA values. Children with higher intakes of both dairy and meats/other proteins had the highest adjusted BMC (3090.1 g), and children consuming less of each had the lowest BMC (2740.2 g).

CONCLUSIONS

These prospective data provide evidence for a beneficial effect of childhood dairy consumption on adolescent bone health.