Convenience food in the diet of children and adolescents: consumption and composition

Association between Short Stature at Grade 1 and Permanent Teeth Caries at Grade 6 in Elementary School Children in Japan: A Population-Based Cohort Study

Short stature in children is a marker of low nutritional status and has been suggested to be associated with dental caries. However, longitudinal studies on this topic are scarce. Data from a longitudinal study of elementary school children in Adachi City, Tokyo, Japan, were analyzed. In 2015, caregivers of children at grade 1 answered questionnaires, and information on dental caries and height measured at school health checkups was merged and followed to grade 6 (N = 3576; follow up rate = 83.3%). The association between short stature at grade 1 (-2.01 standard deviation (SD)--3.00 SD, or <-3.00 SD in height-for-age according to the World Health Organization criteria) and the number of decayed, missing, or filled permanent teeth (DMFT) at grade 6 was examined using multivariable Poisson regression with robust standard error. After adjusting for confounders, children with a short stature at grade 1 had a higher DMFT number at grade 6: the mean ratios (95% confidence interval) were 1.17 (0.89-1.54) and 2.18 (1.03-4.64) for children with a height-for-age -2.01 SD--3.00 SD, and those with a height-for-age < -3.00, respectively. Short stature at grade 1 could be a marker of future dental caries in the permanent teeth at grade 6.

Nutritional Value of Meals Designed for a School-Based Food Aid Program and Comparison with Similar Commercial Products: An Example of Good Practice from the DIATROFI Program

Providing meals of high nutritional value should be the principal objective of large-scale school-based food aid programs. This study aimed at highlighting the nutritional value of meals distributed in the school-based food assistance DIATROFI Program by comparing them to their commercially available counterparts. For the purpose of this study, n = 13 DIATROFI meals and n = 50 commercial products from the 2016-2017 school year, and n = 12 DIATROFI meals and n = 40 commercial products from the 2022-2023 school year were selected. The protein, carbohydrate, total sugar, dietary fiber, total fat, sodium/salt content, and fatty acid methyl ester profile of DIATROFI meals were estimated through recipe simulation and national/international food databases, and verified through laboratory analyses while the relevant information was extracted from the label for commercial products. As verified by laboratory analyses and in comparison with food labels, most DIATROFI meals had lower total fat, saturated fatty acid, and sugar content, and most had higher dietary fiber content during both years. Many recipes' nutrient profiles also improved over time. DIATROFI meals present significant advantages over available commercial products. Such tailored-made school meals can prove to be advantageous in terms of nutrition profile compared to commercially available, which have yet to be impacted by food reformulation.

Do types of snacks, sleep hours, and eating places affect nutritional intakes and its adequacy in adolescents?

BACKGROUND/OBJECTIVES

High-quality meal intake, including snacks, is necessary for optimal development during adolescence. The purpose of this study was to evaluate the nutritional intake of adolescents and the quality of their diet according to snack type, eating location, and sleep hours.

SUBJECTS/METHODS

A survey of middle school students living in Seoul and Gyeonggi province was conducted using questionnaires and the 24-h recall method to collect data on the 1-day dietary intake of the students from March to May, 2018. The data were analyzed using SPSS 23.0 and the CAN program.

RESULTS

The average nutritional intake status among the respondents showed that the energy intake was lower than the recommended, showing 1,914.8 kcal for middle school boys and 1,752.7 kcal for girls. In terms of the nutritional intake status by gender, only the consumption of protein and niacin were significantly higher in boys than girls (P < 0.05). According to the sleep amounts, vitamin C intake was significantly higher in the sleep-deprived group than in the sleep-moderate or sleep-recommended group (P < 0.05), but the intake did not meet the recommendation in any group. The lower density nutrients found in the index of nutritional quality according to eating places were vitamin C, calcium, iron, and folic acid. School meals showed a higher nutritional density in protein, vitamin B₁, and niacin compared to convenience store meals (P < 0.05).

CONCLUSIONS

This study suggested that sleep amount, and eating place affected the dietary quality of adolescents.

Home Cooking Is Related to Potential Reduction in Cardiovascular Disease Risk among Adolescents: Results from the A-CHILD Study

This study aimed to investigate the association between the frequency of home cooking and cardiovascular disease risk among Japanese adolescents. We used cross-sectional data on adolescents from the 2018 Adachi Child Health Impact of Living Difficulty study, which targeted junior high school students aged 13–14 years in Adachi, Tokyo, Japan. Frequency of home cooking by 553 caregivers was assessed via questionnaire and classified as high (almost daily), medium (4–5 days/week), or low (≤3 days/week). Cardiovascular disease risk factors included blood pressure, serum cholesterol (total, LDL, and HDL), hemoglobin A1c, and body mass index. Multiple linear regression analysis revealed that adolescents exposed to a low frequency of home cooking showed higher diastolic blood pressure (β = 3.59, 95% confidence interval [CI]: 0.42 to 6.75) and lower HDL cholesterol (β = −6.15, 95% CI: −11.2 to −1.07) than those exposed to a high frequency of home cooking, adjusting for adolescents’ sex, household income, and parental comorbidity. Future studies are needed to clarify the causal relationship and mechanisms through which home cooking influences adolescents’ cardiovascular health.

Ultra-processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers

Understanding the drivers and dynamics of global ultra-processed food (UPF) consumption is essential, given the evidence linking these foods with adverse health outcomes. In this synthesis review, we take two steps. First, we quantify per capita volumes and trends in UPF sales, and ingredients (sweeteners, fats, sodium and cosmetic additives) supplied by these foods, in countries classified by income and region. Second, we review the literature on food systems and political economy factors that likely explain the observed changes. We find evidence for a substantial expansion in the types and quantities of UPFs sold worldwide, representing a transition towards a more processed global diet but with wide variations between regions and countries. As countries grow richer, higher volumes and a wider variety of UPFs are sold. Sales are highest in Australasia, North America, Europe and Latin America but growing rapidly in Asia, the Middle East and Africa. These developments are closely linked with the industrialization of food systems, technological change and globalization, including growth in the market and political activities of transnational food corporations and inadequate policies to protect nutrition in these new contexts. The scale of dietary change underway, especially in highly populated middle-income countries, raises serious concern for global health.

Ultra-Processed Foods and Health Outcomes: A Narrative Review

The nutrition literature and authoritative reports increasingly recognise the concept of ultra-processed foods (UPF), as a descriptor of unhealthy diets. UPFs are now prevalent in diets worldwide. This review aims to identify and appraise the studies on healthy participants that investigated associations between levels of UPF consumption and health outcomes. This involved a systematic search for extant literature; integration and interpretation of findings from diverse study types, populations, health outcomes and dietary assessments; and quality appraisal. Of 43 studies reviewed, 37 found dietary UPF exposure associated with at least one adverse health outcome. Among adults, these included overweight, obesity and cardio-metabolic risks; cancer, type-2 diabetes and cardiovascular diseases; irritable bowel syndrome, depression and frailty conditions; and all-cause mortality. Among children and adolescents, these included cardio-metabolic risks and asthma. No study reported an association between UPF and beneficial health outcomes. Most findings were derived from observational studies and evidence of plausible biological mechanisms to increase confidence in the veracity of these observed associations is steadily evolving. There is now a considerable body of evidence supporting the use of UPFs as a scientific concept to assess the 'healthiness' of foods within the context of dietary patterns and to help inform the development of dietary guidelines and nutrition policy actions.

The nutritional quality of supermarket own brand chilled convenience foods: an Australian cross-sectional study reveals limitations of the Health Star Rating

OBJECTIVE

To assess the nutritional quality of Australian supermarket own brand chilled convenience foods (SOBCCF), for example, ready meals, pizza, pies and desserts.

DESIGN

Cross-sectional.

SETTING

Two large supermarkets (Coles and Woolworths) in Perth, Western Australia were audited in February 2017.

PARTICIPANTS

Data were extracted from photographic images of 291 SOBCCF, including front-of-pack information (i.e. product name, description and nutrition labels including Health Star Rating (HSR)) and back-of-pack information (i.e. nutrition information panel and ingredients list). SOBCCF were classified as healthy or unhealthy consistent with principles of the Australian Guide to Healthy Eating (AGTHE), NOVA classification of level of food processing and HSR score.

RESULTS

Fifty-four percentage of SOBCCF were classified as unhealthy according to AGTHE principles, 94 % were ultra-processed foods using NOVA and 81 % scored a HSR of ≥2·5, implying that they were a healthy choice. Some convenience food groups comprised more healthy choices overall including prepared vegetables, salad kits and bowls, soups and vegetarian food. A significantly larger proportion of SOBCCF from Coles were classified as unhealthy compared with Woolworths (70 v. 44 %, P < 0·05) using the AGTHE.

CONCLUSIONS

The findings suggest there is potential for Australian supermarkets to improve the nutritional quality of their SOBCCF and highlights the differences between supermarkets in applying their corporate social responsibility policies. Policies to assist consumers to select healthier foods should address difficulties in identifying healthy convenience foods. The findings reveal misclassification of unhealthy SOBCCF as healthy by the HSR suggesting that its algorithm should be reformed to align with recommendations of the AGTHE.

Association of frequent intake of fast foods, energy drinks, or convenience food with atopic dermatitis in adolescents

PURPOSE

Specific food consumption, besides food allergy, may aggravate atopic dermatitis (AD). However, previous reports on the association between AD and food intake in adolescents are scarce. The aim of this study was to determine the relationship between AD and specific food consumption frequency in adolescents.

METHODS

A cross-sectional analysis using data from the Korea Youth Risk Behavior Web-based Survey 2017 was performed. The frequency of food consumption in the recent-diagnosed AD group (AD diagnosed within 12 months) compared to those in the previous-diagnosed AD (AD diagnosed more than 12 months ago) or control group were investigated.

RESULTS

A total of 53,373 participants were eligible for this study. The weighted prevalence of the recent-diagnosed AD and the previous-diagnosed AD was 7.39% and 18.00%, respectively. When compared with subjects with the previous-diagnosed AD, those with the recent-diagnosed AD were significantly more likely to frequently consume fast foods (odds ratio OR 1.405; 95% CI 1.150-1.717), energy drinks (OR 1.457; 95% CI 1.175-1.807), or convenience food (OR 1.304; 95% CI 1.138-1.495). Patients of the recent-diagnosed AD were significantly more likely to frequently consume fast foods (OR 1.374; 95% CI 1.155-1.634) than the control group. The differences in the frequency of specific food consumption among groups were more pronounced in high school students than in middle school students.

CONCLUSIONS

Frequent intake of fast foods, energy drinks, and convenience food was related to the recent-diagnosed AD in adolescents. Prospective cohort and interventional studies are needed to identify causal relationships.

Home Cooking and Child Obesity in Japan: Results from the A-CHILD Study

This study aimed to investigate the association between the frequency of home cooking and obesity among children in Japan. We used cross-sectional data from the Adachi Child Health Impact of Living Difficulty study, a population-based sample targeting all fourth-grade students aged 9 to 10 in Adachi City, Tokyo, Japan. Frequency of home cooking was assessed by a questionnaire for 4258 caregivers and classified as high (almost every day), medium (4-5 days/week), or low (≤3 days/week). School health checkup data on height and weight were used to calculate body mass index z-scores. Overall, 2.4% and 10.8% of children were exposed to low and medium frequencies of home cooking, respectively. After adjusting for confounding factors, children with a low frequency of home cooking were 2.27 times (95% confidence interval: 1.16-4.45) more likely to be obese, compared with those with a high frequency of home cooking. After adjustment for children's obesity-related eating behaviors (frequency of vegetable and breakfast intake and snacking habits) as potential mediating factors, the relative risk ratio of obesity became statistically non-significant (1.90; 95% confidence interval: 0.95-3.82). A low frequency of home cooking is associated with obesity among children in Japan, and this link may be explained by unhealthy eating behaviors.

Perceived Barriers to Adherence to Hemodialysis Dietary Recommendations

Barriers to following dietary recommendations have been described; however, they remain poorly understood. The purpose of this qualitative study was to explore perceived barriers to adherence to dietary recommendations in a diverse hemodialysis patient population. Participants were eligible to participate in a semi-structured qualitative telephone interview prior to randomization for an ongoing clinical trial to evaluate the efficacy of an intervention designed to reduce dietary sodium intake. Interviews were digitally recorded, transcribed verbatim and coded using an iterative qualitative process. In total, 30 (37% females, 53% Caucasians) participants, 63.2 ± 13.3 years, were interviewed. Time, convenience, and financial constraints hindered dietary adherence. Dietary counseling efforts were rated positively but require individualization. Ability to follow recommended guidelines was challenging. Suggestions for addressing barriers include technology-based interventions that allow patients to improve food choices and real-time decision-making, and permit tailoring to individual barriers and preferences.

Low prevalence of inadequate micronutrient intake in young children in the south of Brazil: a new perspective

In Brazil, children's eating patterns have been characterised by an increased consumption of ultra-processed foods that are fortified. Our aims were to (1) estimate the prevalence of inadequate micronutrient intake among children from low-income families and (2) to assess micronutrient intake from fortified foods. We carried out a cross-sectional study from a randomised field trial conducted at healthcare centres in Porto Alegre, Brazil, with 446 mother-child pairs, with the children aged 2-3 years. Dietary data were assessed using two 24-h recalls. The prevalence of inadequacy for six micronutrients was estimated using the proportion of individuals with intakes below the estimated average requirement (EAR). Micronutrient intakes from fortified foods were evaluated using EAR and upper tolerable level (UL). Healthy foods consumption was below the recommendations, except for beans, and 88·1 % of the children consumed ultra-processed foods. A low prevalence of inadequate micronutrient intake was observed for Fe (1·2 %), vitamin C (4·7 %), vitamin A (5·2 %), Ca (11·4 %) and folate (15·2 %). None of the children had intakes less than the EAR for Zn. Fortified foods contributed between 11·3 and 38·3 % to micronutrient intakes, and 43·0 % of the children met the EAR for Fe, 13·9 % for vitamin C and 12·3 % for Zn using fortified foods only. In addition, 4·0 % of the children exceeded the UL for vitamin A, 3·1 % for Zn, 1·1 % for folic acid and 0·2 % for Fe. These results highlight a low prevalence of inadequate micronutrient intakes among children and suggest that such a group could be at risk of excessive micronutrient intakes provided by ultra-processed foods.

Involvement in home meal preparation is associated with food preference and self-efficacy among Canadian children

Objective

To examine the association between frequency of assisting with home meal preparation and fruit and vegetable preference and self-efficacy for making healthier food choices among grade 5 children in Alberta, Canada.

Design

A cross-sectional survey design was used. Children were asked how often they helped prepare food at home and rated their preference for twelve fruits and vegetables on a 3-point Likert-type scale. Self-efficacy was measured with six items on a 4-point Likert-type scale asking children their level of confidence in selecting and eating healthy foods at home and at school.

Setting

Schools (n151) located in Alberta, Canada.

Subjects

Grade 5 students (n3398).

Results

A large majority (83–93 %) of the study children reported helping in home meal preparation at least once monthly. Higher frequency of helping prepare and cook food at home was associated with higher fruit and vegetable preference and with higher self-efficacy for selecting and eating healthy foods.

Conclusions

Encouraging children to be more involved in home meal preparation could be an effective health promotion strategy. These findings suggest that the incorporation of activities teaching children how to prepare simple and healthy meals in health promotion programmes could potentially lead to improvement in dietary habits.

Time spent in home meal preparation affects energy and food group intakes among midlife women

Time spent in meal preparation may be indicative of the healthfulness of meals and therefore with weight status. The purpose of this study was to examine the association between amount of time spent preparing meals and meal food group and nutrient content by meal occasion (breakfast, lunch, and dinner) among 1036 midlife women. Participants completed a 1-day food record and eating occasion questionnaires for each meal occasion. ANCOVA was used to identify possible associations. Approximately half of the participants reported spending <5 min preparing breakfast and lunch, and <20 min preparing dinner. Less time spent preparing breakfast was associated with lower energy and fat intakes (p<0.0001), while less time spent preparing lunch and dinner was associated with lower vegetable and sodium intakes (p<0.0001). There were no apparent differences in the association between time spent preparing meals and meal content by weight status. Nutrition education should encourage home meal preparation while stressing the selection of healthier options. The differing associations by meal occasion suggest that interventions should be tailored according to meal type.

Consumption of dietary salt measured by urinary sodium excretion and its association with body weight status in healthy children and adolescents

OBJECTIVE

Highly processed foods such as convenience foods usually have a high salt content and therefore might indirectly act as adipogenic due to an increasing consumption of sugar-containing beverages (SCB). We examined the association between dietary salt and body weight status.

DESIGN

We used data on urinary Na excretion as an indicator of dietary salt and BMI standard deviation score (BMI-SDS) and percentage body fat (%BF) of children and adolescents participating in the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) Study.

SETTING

Dortmund, Germany.

SUBJECTS

Children and adolescents (n 364) who had at least two 24 h urine samples and two dietary records in the observational period between 2003 and 2009 were considered in our data analysis.

RESULTS

Repeated-measures regression models revealed that urinary Na was positively associated with BMI-SDS (+0·202 SDS/g Na excretion at baseline; P < 0·001) and %BF (+1·303 %BF/g Na excretion at baseline; P < 0·01) at baseline in boys and girls. These associations remained significant after adjustment for SCB consumption and total energy intake. Furthermore, there was a positive trend between baseline Na excretion and the individual change in %BF in the study period (+0·364 increase in %BF/g Na excretion at baseline), which was confirmed after inclusion of SCB consumption or total energy intake. There was no significant association between the change in Na excretion and the concurrent change of either BMI-SDS or %BF in any model.

CONCLUSIONS

Our results suggest that a high intake of processed salty foods could have a negative impact on body weight status in children and adolescents independently from their consumption of SCB.

School and workplace meals promote healthy food habits

Objective

The present study is to describe, on the basis of recent Finnish population surveys, (i) the frequencies of school and worksite canteen use, (ii) the determinants of having a hot lunch during school or working hours and (iii) the associations of lunch eating patterns with food habits.

Setting

The study summarises mainly basic reports and studies concerning catering services conducted in Finland based on nationally representative population surveys.

Design and subjects

Cross-sectional study. The most important surveys cited in this paper are the School Health Promotion Study, the Work and the Working Conditions survey, the National FINDIET 2002 Study, and the Health Behavior and Health among Finnish Adult Population survey.

Results

School lunch is eaten by on average 70–90 % of children aged 9–18 years. Of all employees, 30 % eat at a worksite canteen daily, whereas 30 % of men and 45 % of women eat packed lunches. Nationally representative cross-sectional population surveys show that the use of catering services is associated with more healthy food habits; schoolchildren eating school meals and employees eating lunch at a worksite canteen tend to make food choices closer to nutritional recommendations as compared to those not using catering services to the same degree.

Conclusions

Some evidence exists that catering services in schools and worksites contribute to healthy eating habits in the population. In order to verify the positive role of catering services more scientific research with prospective and intervention design studies will be needed.

Patterns of free amino acids in German convenience food products: marked mismatch between label information and composition

BACKGROUND/OBJECTIVES

Free amino acids affect food palatability. As information on amino acids in frequently purchased pre-packaged food is virtually absent, we analyzed free amino acid patterns of 17 frequently purchased ready-to-serve convenience food products, and compared them with the information obtained from the respective food labels.

SUBJECTS/METHODS

Quantitative amino acid analysis was performed using ion-exchange chromatography. gamma-Aminobutyric acid (GABA) concentrations were verified using a stable isotope dilution gas chromatography/mass spectrometry (GC-MS) method. The patterns of free amino acids were compared with information obtained from food labels.

RESULTS

An obvious mismatch between free amino acid patterns and food label information was detected. Even on considering that tomatoes and cereal proteins are naturally rich in glutamate, the concentrations of free glutamate outranged the natural concentration of this amino acid in several products, and strongly suggested artificial enrichment. Free glutamate was found to be elevated even in dishes that explicitly state 'no glutamate added'. Arginine was markedly elevated in lentils. Free cysteine was generally low, possibly reflecting thermal destruction of this amino acid during food processing. The meat and brain-specific dipeptide carnosine (CARN) was present in most meat-containing products. Some products did not contain detectable amounts of CARN in spite of meat content being claimed on the food labels. We detected GABA at concentrations that contribute significantly to the taste sensation.

CONCLUSION

This investigation highlights a marked mismatch between food label information and food composition.

Some similarities in dietary clusters of pre-school children and their mothers

The diet of pre-school children is determined by the parents and carers. The aim of the present study was to describe dietary clusters of pre-school children and their mothers in Finland, and analyse the similarity of dietary clusters within child–mother pairs. The present study comprised the mothers (n 4862) whose child was recruited in the Type 1 Diabetes Prediction and Prevention Nutrition Study and the children belonging to selected, cross-sectional age groups of 1 year (n 719), 3 years (n 708) and 6 years (n 841). The dietary data were collected from children by 3-d food records and from mothers by a FFQ validated for pregnant women. The food consumption data were analysed for patterns by hierarchical cluster analysis. Three main dietary clusters were identified in children: ‘healthy’ and ‘traditional’ in all three age groups, and ‘ready-to-eat baby foods’ in 1-year-olds and ‘fast foods, sweet’ in the older children. Six main clusters were identified among the mothers who completed a FFQ for their diet during pregnancy. Some familial dependence between dietary clusters of mother–child pairs was observed in 6-year-old children but not in younger children. Younger age and lower educational level of the mother were associated with the cluster ‘fast food, sweet’ only at the age of 3 years. The diets of pre-school children vary by age and only a slight similarity within dietary clusters of mother–child pairs was observed.