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Song S, Shim JE. Increasing trends in dietary total fat and fatty acid intake among Korean children: using the 2007–2017 national data. Nutr Res Pract 2022; 16:260-271. [PMID: 35392526 PMCID: PMC8971817 DOI: 10.4162/nrp.2022.16.2.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/11/2021] [Accepted: 08/25/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- SuJin Song
- Department of Food and Nutrition, Hannam University, Daejeon 34054, Korea
| | - Jae Eun Shim
- Department of Food and Nutrition, Daejeon University, Daejeon 34520, Korea
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Monnard C, Fleith M. Total Fat and Fatty Acid Intake among 1-7-Year-Old Children from 33 Countries: Comparison with International Recommendations. Nutrients 2021; 13:3547. [PMID: 34684548 PMCID: PMC8537778 DOI: 10.3390/nu13103547] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/30/2021] [Accepted: 10/02/2021] [Indexed: 12/27/2022] Open
Abstract
This work reviews available data on dietary intakes of total fat, saturated fatty acids (SFA) and individual polyunsaturated fatty acids (PUFA) in children in different countries worldwide and for the first time, compares them with recent international recommendations. Studies published before June 2021 reporting total fat, total SFA and individual PUFA intakes in children aged 1-7 y were included. Observed intakes were evaluated against FAO/WHO and EFSA recommendations. 65 studies from 33 countries were included. Fat intake was too low in 88% of studies in young children (1-3 y). SFA intake was >10%E in 69-73% of children, especially in Europe. Linoleic acid intake was <3%E in 24% of studies in 1-2 y olds and within FAO/WHO recommendations among all other ages. Alpha-linolenic acid intake was <0.5%E in almost half of studies. Docosahexaenoic acid (DHA) or eicosapentaenoic acid + DHA intakes were below recommendations in most studies. In summary, while total fat intake was too low among younger children, SFA intake was above, especially in Europe and n-3 PUFA intake, especially DHA, were below recommendations for all ages. Intake of n-3 PUFA, especially DHA, is generally suboptimal. More data, particularly from developing countries, are required to refine these findings and guide implementation of adapted nutrition policies.
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Affiliation(s)
- Cathriona Monnard
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., 1015 Lausanne, Switzerland;
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Zhao J, Zuo L, Sun J, Su C, Wang H. Trends and Urban-Rural Disparities of Energy Intake and Macronutrient Composition among Chinese Children: Findings from the China Health and Nutrition Survey (1991 to 2015). Nutrients 2021; 13:nu13061933. [PMID: 34199924 PMCID: PMC8229111 DOI: 10.3390/nu13061933] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 11/25/2022] Open
Abstract
The nutrition status of children is gaining more attention with a rapid nutrition transition. This study aimed to investigate trends and urban-rural differences in dietary energy and macronutrient composition among Chinese children. A total of 7565 participants aged 6 to 17 years were obtained from three rounds (1991, 2004 and 2015) of the Chinese Health and Nutrition Survey (CHNS). The individual diet was evaluated via three consecutive 24-hour dietary recalls and compared with the Chinese Dietary Reference Intakes (DRIs). From 1991 to 2015, there was a significant increase in children’s fat intake, the proportion of energy intake from fat, and the proportion of children with more than 30% of energy from fat and less than 50% of energy from carbohydrates (p < 0.001). Compared with the DRI, the proportion with higher fat and lower carbohydrate intakes were, respectively, 64.7% and 46.8% in 2015. The urban-rural disparities in fat and carbohydrate intake gradually narrowed, while the gap in protein intake increased notably over time (p < 0.001). Chinese children experienced a rapid transformation to a low-carbohydrate and high-fat diet. Urban-rural disparities persistently existed; further nutritional interventions and education were of great significance, so as to ensure a more balanced diet for Chinese children.
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Affiliation(s)
- Jian Zhao
- Department of Epidemiology and Health Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing 100005, China;
| | - Lijun Zuo
- Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100101, China;
| | - Jian Sun
- School of Public Health and Management, Ningxia Medical University, Yinchuan 750004, China;
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China;
- Correspondence: ; Tel.: +86-010-66237086
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China;
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Abstract
OBJECTIVE To examine current dietary fat intakes and compliance in Irish children and to examine changes in intakes from 2005 to 2019. DESIGN Analyses were based on data from the Irish National Children's Food Survey (NCFS) and the NSFS II, two cross-sectional studies that collected detailed food and beverage intake data through 7-day and 4-day weighed food diaries, respectively. SETTING NCFS and NCFS II, Republic of Ireland. PARTICIPANTS A nationally representative sample of 594 (NCFS) and 600 (NCFS II) children aged 5-12 years. Current intakes from the NCFS II were compared with those previously reported in the NCFS (www.iuna.net). RESULTS Current intakes of total fat, SFA, MUFA, PUFA and trans fat as a percentage of total energy are 33·3, 14·0, 13·6, 5·6 and 0·5 %, respectively. Total fat, SFA and trans fat intakes since 2005 remained largely stable over time with all displaying minor decreases of <1 %. Adherence to SFA recommendations remains inadequate, with only 7 % of the population complying. Insufficient compliance with PUFA (71 %) and EPA and DHA (DHA; 16 %) recommendations was also noted. CONCLUSION Children in Ireland continue to meet the total fat and trans fat target goals. Adherence to MUFA and PUFA recommendations has also significantly improved. However, deviations for some fats remain, in particular SFA. These findings are useful for the development of dietary strategies to improve compliance with current recommendations.
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Sugar intake among German adolescents: trends from 1990 to 2016 based on biomarker excretion in 24-h urine samples. Br J Nutr 2020; 124:164-172. [PMID: 32102699 DOI: 10.1017/s0007114520000665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Trend analyses based on dietary records suggest decreases in the intakes of total sugar (TS), added and free sugar since 2005 among children and adolescents in Germany. In terms of age trends, TS intake decreased with increasing age. However, self-reported sugar intake in epidemiological studies is criticised, as it may be prone to bias due to selective underreporting. Furthermore, adolescents are more susceptible to underreporting than children. We thus analysed time and age trends in urinary fructose excretion (FE), sucrose excretion (SE) and the sum of both (FE + SE) as biomarkers for sugar intake among 8·5-16·5-year-old adolescents. Urinary sugar excretion was measured by UPLC-MS/MS in 997 24-h urine samples collected from 239 boys and 253 girls participating in the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study cohort between 1990 and 2016. Time and age trends of log-transformed FE, SE and FE + SE were analysed using polynomial mixed-effects regression models. Between 1990 and 2016, FE as well as FE + SE decreased (linear time trend: P = 0·0272 and P < 0·0001, respectively). A minor increase in excretion during adolescence was confined to FE (linear age trend: P = 0·0017). The present 24-h excretion measurements support a previously reported dietary record-based decline in sugar intake since 2005. However, the previously seen dietary record-based decrease in TS from childhood to late adolescence was not confirmed by our biomarker analysis, suggesting a constant sugar intake for the period of adolescence.
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Perrar I, Schadow AM, Schmitting S, Buyken AE, Alexy U. Time and Age Trends in Free Sugar Intake from Food Groups among Children and Adolescents between 1985 and 2016. Nutrients 2019; 12:nu12010020. [PMID: 31861789 PMCID: PMC7019792 DOI: 10.3390/nu12010020] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/30/2022] Open
Abstract
Trend analyses suggest that free sugar (FS) intake—while still exceeding 10%E—has decreased among German children and adolescents since 2005, yet that intakes may shift from sugars naturally occurring in foods to added sugars as children age. Thus, we analysed time and age trends in FS intake (%E) from food groups among 3–18 year-olds (1985–2016) using 10,761 3-day dietary records from 1312 DONALD participants (660 boys, 652 girls) by use of polynomial mixed-effects regression models. Among girls, FS from sugar & sweets decreased from 1985 to 2016 (linear trend p < 0.0001), but not among boys (p > 0.05). In the total sample, FS intake from juices increased until 2000 and decreased since 2005 (linear, quadratic trend p < 0.0001). FS from sugar sweetened beverages (SSB) decreased non-linearly from 1985 to 2016 (girls: linear, quadratic, cubic trend p < 0.0001; boys: linear, quadratic, cubic trend p < 0.02). Younger children consumed more FS from juices than older ones, who had a higher FS intake from SSB. FS intake from sugar & sweets increased until early adolescence and decreased afterwards. Since sugar & sweets represent the main source of FS intake and the source with the least pronounced decline in intake, public health measures should focus on these products.
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Affiliation(s)
- Ines Perrar
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Donald Study Dortmund, Heinstück 11, 44225 Dortmund, Germany; (I.P.); (A.M.S.); (S.S.)
| | - Alena M. Schadow
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Donald Study Dortmund, Heinstück 11, 44225 Dortmund, Germany; (I.P.); (A.M.S.); (S.S.)
| | - Sarah Schmitting
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Donald Study Dortmund, Heinstück 11, 44225 Dortmund, Germany; (I.P.); (A.M.S.); (S.S.)
- Institute of General Practice and Family Medicine, Faculty of Medicine, Ruhr-University Bochum, Universitätsstraße 150, 44801 Bochum, Germany
| | - Anette E. Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, Warburger Straße 100, 33098 Paderborn, Germany;
| | - Ute Alexy
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Donald Study Dortmund, Heinstück 11, 44225 Dortmund, Germany; (I.P.); (A.M.S.); (S.S.)
- Correspondence: ; Tel.: +49-231-7922-1016
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Song S, Shim JE. Trends in Dietary Intake of Total Fat and Fatty Acids Among Korean Adolescents from 2007 to 2017. Nutrients 2019; 11:E3073. [PMID: 31888278 PMCID: PMC6950604 DOI: 10.3390/nu11123073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 02/04/2023] Open
Abstract
We analyzed the trends in dietary intake of total fat and fatty acids among Korean adolescents during 2007-2017. A total of 6406 adolescents from the 2007-2017 Korea National Health and Examination Surveys were selected. Total fat and fatty acids intakes were calculated based on single 24-hour recall data and presented as grams (g) and percentage of energy intake (% kcal) across the survey period. Linear trends in intake across the survey period were compared using the multiple regression model. Total fat intake increased during the 11-year period from 54.3 g (21.7% kcal) to 61.8 g (25.2% kcal). Saturated fatty acids (SFA) and monounsaturated fatty acids (MUFA) intakes changed from 17.8 g (7.1% kcal) and 17.2 g (6.8% kcal) to 20.6 g (8.4% kcal) and 20.7 g (8.4% kcal) over time, respectively. For polyunsaturated fatty acids (PUFA), n-3 fatty acid intake did not change during the survey period. The proportions of individuals who had total fat and SFA above the recommendations increased across the survey period: 13.7% to 27.5% for total fat and 36.0% to 49.7% for SFA. Among Korean adolescents, dietary fat intake increased over time and the increases in SFA and MUFA intake were prominent. Monitoring dietary fat intake is helpful to suggest dietary guidelines and health policies.
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Affiliation(s)
- SuJin Song
- Department of Food and Nutrition, Hannam University, Daejeon 34054, Korea;
| | - Jae Eun Shim
- Department of Food and Nutrition, Daejeon University, Daejeon 34520, Korea
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Perrar I, Schmitting S, Della Corte KW, Buyken AE, Alexy U. Age and time trends in sugar intake among children and adolescents: results from the DONALD study. Eur J Nutr 2019; 59:1043-1054. [PMID: 30976903 DOI: 10.1007/s00394-019-01965-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/03/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe age and time trends in added sugar, free sugar and total sugar intake among German 3-18-year-olds. METHODS Overall, 10,761 3-day dietary records kept between 1985 and 2016 by 1312 DONALD participants (660 boys, 652 girls) were analysed (%E) using polynomial mixed-effects regression models. RESULTS TS intake decreased with age (♂: linear, quadratic and cubic trend all p < 0.0098; ♀: linear trend p < 0.0001). While the oldest children had the lowest FS intake (linear, quadratic trend: p < 0.0001), the youngest children had the lowest AS intake (linear, quadratic trend p < 0.0001, cubic trend p = 0.0004). In terms of time trends, TS (♂: cubic trend p = 0.0052; ♀: quadratic trend p = 0.0608, cubic trend p = 0.0014) and FS (quadratic trend p = 0.0163, cubic trend p < 0.0001) intake increased between 1985 and 2005 and decreased thereafter, most notably since 2010. AS intake decreased between 1985 and 1995, increased slightly until 2005 and decreased thereafter, most notably since 2010 (linear, quadratic, cubic trend p < 0.0001). FS intake exceeded 10%E/day throughout the 30-year study period. CONCLUSION Our results do not support the common assumptions that sugar intake is on the rise and generally higher among adolescents than among younger children. Of note, TS, AS and FS intakes have decreased in the last decade among all age groups. Nevertheless, FS intake still exceeds the intake level recommended by the WHO.
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Affiliation(s)
- Ines Perrar
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225, Dortmund, Germany
| | - Sarah Schmitting
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225, Dortmund, Germany
- Institute of General Practice and Family Medicine, Faculty of Medicine, Ruhr-University Bochum, Universitätsstraße 150, 44801, Bochum, Germany
| | - Karen W Della Corte
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Warburger Straße 100, 33098, Paderborn, Germany
| | - Anette E Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Warburger Straße 100, 33098, Paderborn, Germany
| | - Ute Alexy
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225, Dortmund, Germany.
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Naude CE, Visser ME, Nguyen KA, Durao S, Schoonees A. Effects of total fat intake on bodyweight in children. Cochrane Database Syst Rev 2018; 7:CD012960. [PMID: 29974953 PMCID: PMC6513603 DOI: 10.1002/14651858.cd012960.pub2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND As part of efforts to prevent childhood overweight and obesity, we need to understand the relationship between total fat intake and body fatness in generally healthy children. OBJECTIVES To assess the effects and associations of total fat intake on measures of weight and body fatness in children and young people not aiming to lose weight. SEARCH METHODS For this update we revised the previous search strategy and ran it over all years in the Cochrane Library, MEDLINE (Ovid), MEDLINE (PubMed), and Embase (Ovid) (current to 23 May 2017). No language and publication status limits were applied. We searched the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov for ongoing and unpublished studies (5 June 2017). SELECTION CRITERIA We included randomised controlled trials (RCTs) in children aged 24 months to 18 years, with or without risk factors for cardiovascular disease, randomised to a lower fat (30% or less of total energy (TE)) versus usual or moderate-fat diet (greater than 30%TE), without the intention to reduce weight, and assessed a measure of weight or body fatness after at least six months. We included prospective cohort studies if they related baseline total fat intake to weight or body fatness at least 12 months later. DATA COLLECTION AND ANALYSIS We extracted data on participants, interventions or exposures, controls and outcomes, and trial or cohort quality characteristics, as well as data on potential effect modifiers, and assessed risk of bias for all included studies. We extracted body weight and blood lipid levels outcomes at six months, six to 12 months, one to two years, two to five years and more than five years for RCTs; and for cohort studies, at baseline to one year, one to two years, two to five years, five to 10 years and more than 10 years. We planned to perform random-effects meta-analyses with relevant subgrouping, and sensitivity and funnel plot analyses where data allowed. MAIN RESULTS We included 24 studies comprising three parallel-group RCTs (n = 1054 randomised) and 21 prospective analytical cohort studies (about 25,059 children completed). Twenty-three studies were conducted in high-income countries. No meta-analyses were possible, since only one RCT reported the same outcome at each time point range for all outcomes, and cohort studies were too heterogeneous to combine.Effects of dietary counselling to reduce total fat intake from RCTsTwo studies recruited children aged between 4 and 11 years and a third recruited children aged 12 to 13 years. Interventions were combinations of individual and group counselling, and education sessions in clinics, schools and homes, delivered by dieticians, nutritionists, behaviourists or trained, supervised teachers. Concerns about imprecision and poor reporting limited our confidence in our findings. In addition, the inclusion of hypercholesteraemic children in two trials raised concerns about applicability.One study of dietary counselling to lower total fat intake found that the intervention may make little or no difference to weight compared with usual diet at 12 months (mean difference (MD) -0.50 kg, 95% confidence interval (CI) -1.78 to 0.78; n = 620; low-quality evidence) and at three years (MD -0.60 kg, 95% CI -2.39 to 1.19; n = 612; low-quality evidence). Education delivered as a classroom curriculum probably decreased BMI in children at 17 months (MD -1.5 kg/m2, 95% CI -2.45 to -0.55; 1 RCT; n = 191; moderate-quality evidence). The effects were smaller at longer term follow-up (five years: MD 0 kg/m2, 95% CI -0.63 to 0.63; n = 541; seven years; MD -0.10 kg/m2, 95% CI -0.75 to 0.55; n = 576; low-quality evidence).Dietary counselling probably slightly reduced total cholesterol at 12 months compared to controls (MD -0.15 mmol/L, 95% CI -0.24 to -0.06; 1 RCT; n = 618; moderate-quality evidence), but may make little or no difference over longer time periods. Dietary counselling probably slightly decreased low-density lipoprotein (LDL) cholesterol at 12 months (MD -0.12 mmol/L, 95% CI -0.20 to -0.04; 1 RCT; n = 618, moderate-quality evidence) and at five years (MD -0.09, 95% CI -0.17 to -0.01; 1 RCT; n = 623; moderate-quality evidence), compared to controls. Dietary counselling probably made little or no difference to HDL-C at 12 months (MD -0.03 mmol/L, 95% CI -0.08 to 0.02; 1 RCT; n = 618; moderate-quality evidence), and at five years (MD -0.01 mmol/L, 95% CI -0.06 to 0.04; 1 RCT; n = 522; moderate-quality evidence). Likewise, counselling probably made little or no difference to triglycerides in children at 12 months (MD -0.01 mmol/L, 95% CI -0.08 to 0.06; 1 RCT; n = 618; moderate-quality evidence). Lower versus usual or modified fat intake may make little or no difference to height at seven years (MD -0.60 cm, 95% CI -2.06 to 0.86; 1 RCT; n = 577; low-quality evidence).Associations between total fat intake, weight and body fatness from cohort studiesOver half the cohort analyses that reported on primary outcomes suggested that as total fat intake increases, body fatness measures may move in the same direction. However, heterogeneous methods and reporting across cohort studies, and predominantly very low-quality evidence, made it difficult to draw firm conclusions and true relationships may be substantially different. AUTHORS' CONCLUSIONS We were unable to reach firm conclusions. Limited evidence from three trials that randomised children to dietary counselling or education to lower total fat intake (30% or less TE) versus usual or modified fat intake, but with no intention to reduce weight, showed small reductions in body mass index, total- and LDL-cholesterol at some time points with lower fat intake compared to controls. There were no consistent effects on weight, high-density lipoprotein (HDL) cholesterol or height. Associations in cohort studies that related total fat intake to later measures of body fatness in children were inconsistent and the quality of this evidence was mostly very low. Most studies were conducted in high-income countries, and may not be applicable in low- and middle-income settings. High-quality, longer-term studies are needed, that include low- and middle-income settings to look at both possible benefits and harms.
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Affiliation(s)
- Celeste E Naude
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health SciencesFrancie van Zijl DriveCape TownSouth Africa
| | - Marianne E Visser
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health SciencesFrancie van Zijl DriveCape TownSouth Africa
- South African Medical Research CouncilCochrane South AfricaCape TownSouth Africa
| | - Kim A Nguyen
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health SciencesFrancie van Zijl DriveCape TownSouth Africa
| | - Solange Durao
- South African Medical Research CouncilCochrane South AfricaCape TownSouth Africa
| | - Anel Schoonees
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health SciencesFrancie van Zijl DriveCape TownSouth Africa
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Koch SAJ, Alexy U, Diederichs T, Buyken AE, Roßbach S. The relevance of restrained eating behavior for circadian eating patterns in adolescents. PLoS One 2018; 13:e0197131. [PMID: 29791516 PMCID: PMC5965828 DOI: 10.1371/journal.pone.0197131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 04/26/2018] [Indexed: 01/10/2023] Open
Abstract
Background Restrained Eating, i.e. the tendency to restrict dietary intake to control body-weight, often emerges during adolescence and may result in changes in circadian eating patterns. Objective The objective of the present investigation was to determine the cross-sectional relevance of restrained eating for characteristics of circadian eating pattern in adolescents and whether changes in restrained eating are accompanied by concurrent changes in circadian eating pattern over the course of adolescence. Methods Two questionnaires assessing restrained eating (Score 0–30) with parallel 3-day weighed dietary records from two different time points were available from 209 (♂:101, ♀:108) 11–18 year old adolescents of the DONALD study. Mixed linear regression models were used to analyze whether restrained eating was associated with eating occasion frequency, snack frequency and morning and evening energy intake [in % of daily energy intake, %E]. Linear regression models were used to examine whether changes in restrained eating were associated with changes in the mentioned variables. Results Among girls, greater restrained eating was cross-sectionally associated with higher morning energy intake (p = 0.03). Further, there was a tendency towards lower evening energy intake with higher levels of restrained eating for the whole sample (p = 0.06). No cross-sectional associations were found with eating occasion or snack frequency. Each one-point increase in restrained eating during adolescence was related to a concurrent decrease in eating occasion frequency by 0.04 (95% CI -0.08; -0.01, p = 0.02) and in evening energy intake by 0.36%E (95% CI -0.70; -0.03, p = 0.04). A tendency towards decreasing snack frequency with increasing restrained eating was observed (β = -0.03, 95% CI -0.07; 0.00, p = 0.07). No association was found between changes in restrained eating and concurrent changes in morning energy intake. Conclusion We found indications for cross-sectional and prospective associations between restrained eating and chronobiological aspects of food intake in adolescents. Our results suggest that restrained eating should be considered a relevant determinant of circadian eating patterns.
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Affiliation(s)
- Stefanie A. J. Koch
- DONALD Study, Nutritional Epidemiology, Department of Nutrition and Food Sciences, Faculty of Agriculture, University of Bonn, Bonn, North Rhine-Westphalia, Germany
| | - Ute Alexy
- DONALD Study, Nutritional Epidemiology, Department of Nutrition and Food Sciences, Faculty of Agriculture, University of Bonn, Bonn, North Rhine-Westphalia, Germany
- * E-mail:
| | - Tanja Diederichs
- DONALD Study, Nutritional Epidemiology, Department of Nutrition and Food Sciences, Faculty of Agriculture, University of Bonn, Bonn, North Rhine-Westphalia, Germany
- Public Health Nutrition, Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Paderborn, North Rhine-Westphalia, Germany
| | - Anette E. Buyken
- DONALD Study, Nutritional Epidemiology, Department of Nutrition and Food Sciences, Faculty of Agriculture, University of Bonn, Bonn, North Rhine-Westphalia, Germany
- Public Health Nutrition, Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, University Paderborn, Paderborn, North Rhine-Westphalia, Germany
| | - Sarah Roßbach
- DONALD Study, Nutritional Epidemiology, Department of Nutrition and Food Sciences, Faculty of Agriculture, University of Bonn, Bonn, North Rhine-Westphalia, Germany
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Inadequate daily intakes of n-3 polyunsaturated fatty acids (PUFA) in the general French population of children (3-10 years) and adolescents (11-17 years): the INCA2 survey. Eur J Nutr 2018; 58:895-903. [PMID: 29687265 DOI: 10.1007/s00394-018-1694-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 04/19/2018] [Indexed: 01/25/2023]
Abstract
PURPOSE This paper deals with the dietary daily intakes of main polyunsaturated fatty acids (PUFA) in French children and adolescents. METHODS Dietary intakes of main PUFA were determined from a general French population of 1500 children (3-10 years) and adolescents (11-17 years) by using the most recent set of national robust data on food (National Survey INCA 2 performed in 2006 and 2007). RESULTS Main results showed that mean daily intakes of total fat and n-6 PUFA linoleic acid (LA, 18:2n-6) were close to current recommended values for children and adolescent populations. However, 80% (children) to 90% (adolescents) of our French populations not only ingested low quantities of n-3 long-chain PUFA (docosahexaenoic (22:6n-3) and eicosapentaenoic (20:5n-3) acids) but also very low quantities of alpha-linolenic acid (ALA, 18:3n-3) at the origin of a non-balanced n-6/n-3 ratio. Inadequate consumption of EPA + DHA was also observed in subgroups of infants and adolescent who consumed more than two servings/week of fish. CONCLUSIONS Such disequilibrium in PUFA dietary intakes in favor of n-6 PUFA could have adverse impact on cell membrane incorporation of long-chain n-3 PUFA and deleterious impacts on the health of children and adolescents. Promoting the consumption of both vegetable oils and margarines rich in ALA, and oily fish rich in long-chain n-3 PUFA might improve such PUFA disequilibrium.
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Time and age trends in morning and evening protein intakes of German children and adolescents. J Nutr Sci 2018; 7:e9. [PMID: 29599971 PMCID: PMC5869278 DOI: 10.1017/jns.2018.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 12/20/2017] [Accepted: 01/23/2018] [Indexed: 11/16/2022] Open
Abstract
The present study describes time and age trends in morning and evening protein intakes and sources among German children and adolescents from 1985 to 2014. A total of 9757 three-day weighed dietary records of 1246 3- to 18-year-old participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study were analysed using polynomial mixed-effects regression models. Morning protein intake increased over the study period by approximately 1 % of morning energy intake (linear trend P < 0·0001), with the youngest and the oldest children having the highest protein intake (linear, quadratic trend P < 0·0001). Evening protein intake increased over time by approximately 2 % of evening energy intake in girls (linear trend P < 0·0001) and 1 % of evening energy intake in boys (quadratic trend P = 0·0313), with decreasing intake with age (girls: linear trend P < 0·0001; boys: linear trend P = 0·0963). Time trends were largely due to increases in protein from ‘starchy foods’. In conclusion, morning and evening protein intakes increased modestly between 1985 and 2014; these increases were, however, not accompanied by increases in traditional protein sources (i.e. meat or dairy products).
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Naude CE, Visser ME, Nguyen KA, Durao S, Schoonees A. Effects of total fat intake on bodyweight in children. Cochrane Database Syst Rev 2018; 2:CD012960. [PMID: 29446437 PMCID: PMC6491333 DOI: 10.1002/14651858.cd012960] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND As part of efforts to prevent childhood overweight and obesity, we need to understand the relationship between total fat intake and body fatness in generally healthy children. OBJECTIVES To assess the effects of total fat intake on measures of weight and body fatness in children and young people not aiming to lose weight. SEARCH METHODS For this update we revised the previous search strategy and ran it over all years in the Cochrane Library, MEDLINE (Ovid), MEDLINE (PubMed), and Embase (Ovid) (current to 23 May 2017). No language and publication status limits were applied. We searched the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov for ongoing and unpublished studies (5 June 2017). SELECTION CRITERIA We included randomised controlled trials (RCTs) in children aged 24 months to 18 years, with or without risk factors for cardiovascular disease, randomised to a lower fat (30% or less of total energy (TE)) versus usual or moderate-fat diet (greater than 30%TE), without the intention to reduce weight, and assessed a measure of weight or body fatness after at least six months. We included prospective analytical cohort studies in these children if they related baseline total fat intake to weight or body fatness at least 12 months later. We duplicated inclusion decisions and resolved disagreement by discussion with other authors. DATA COLLECTION AND ANALYSIS We extracted data on participants, interventions or exposures, controls and outcomes, and trial or cohort quality characteristics, as well as data on potential effect modifiers, and assessed risk of bias for all included studies. We extracted outcome data using the following time point ranges, when available: RCTs: baseline to six months, six to 12 months, one to two years, two to five years and more than five years; cohort studies: baseline to one year, one to two years, two to five years, five to 10 years and more than 10 years. We planned to perform random-effects meta-analyses with relevant subgrouping, and sensitivity and funnel plot analyses where data allowed. MAIN RESULTS We included 24 studies comprising three parallel-group RCTs (n = 1054 randomised) and 21 prospective analytical cohort studies (about 25,059 children completed). Twenty-three were conducted in high-income countries. No meta-analyses were possible, since only one RCT reported the same outcome at each time point range for all outcomes, and cohort studies were too heterogeneous.For the RCTs, concerns about imprecision and poor reporting limited our confidence in our findings. In addition, the inclusion of hypercholesteraemic children in two trials raised concerns about applicability. Lower versus usual or modified total fat intake may have made little or no difference to weight over a six- to twelve month period (mean difference (MD) -0.50 kg, 95% confidence interval (CI) -1.78 to 0.78; 1 RCT; n = 620; low-quality evidence), nor a two- to five-year period (MD -0.60 kg, 95% CI -2.39 to 1.19; 1 RCT; n = 612; low-quality evidence). Compared to controls, lower total fat intake (30% or less TE) probably decreased BMI in children over a one- to two-year period (MD -1.5 kg/m2, 95% CI -2.45 to -0.55; 1 RCT; n = 191; moderate-quality evidence), with no other differences evident across the other time points (two to five years: MD 0.00 kg/m2, 95% CI -0.63 to 0.63; 1 RCT; n = 541; greater than five years; MD -0.10 kg/m2, 95% CI -0.75 to 0.55; 1 RCT; n = 576; low-quality evidence). Lower fat intake probably slightly reduced total cholesterol over six to 12 months compared to controls (MD -0.15 mmol/L, 95% CI -0.24 to -0.06; 1 RCT; n = 618; moderate-quality evidence), but may make little or no difference over longer time periods. Lower fat intake probably slightly decreased low-density lipoprotein (LDL) cholesterol over six to 12 months (MD -0.12 mmol/L, 95% CI -0.20 to -0.04; 1 RCT; n = 618, moderate-quality evidence) and over two to five years (MD -0.09, 95% CI -0.17 to -0.01; 1 RCT; n = 623; moderate-quality evidence), compared to controls. However, lower total fat intake probably made little or no difference to HDL-C over a six- to 12-month period (MD -0.03 mmol/L, 95% CI -0.08 to 0.02; 1 RCT; n = 618; moderate-quality evidence), nor a two- to five-year period (MD -0.01 mmol/L, 95% CI -0.06 to 0.04; 1 RCT; n = 522; moderate-quality evidence). Likewise, lower total fat intake probably made little or no difference to triglycerides in children over a six- to 12-month period (MD -0.01 mmol/L, 95% CI -0.08 to 0.06; 1 RCT; n = 618; moderate-quality evidence). Lower versus usual or modified fat intake may make little or no difference to height over more than five years (MD -0.60 cm, 95% CI -2.06 to 0.86; 1 RCT; n = 577; low-quality evidence).Over half the cohort analyses that reported on primary outcomes suggested that as total fat intake increases, body fatness measures may move in the same direction. However, heterogeneous methods and reporting across cohort studies, and predominantly very low-quality evidence, made it difficult to draw firm conclusions and true relationships may be substantially different. AUTHORS' CONCLUSIONS We were unable to reach firm conclusions. Limited evidence from three trials that randomised children to a lower total fat intake (30% or less TE) versus usual or modified fat intake, but with no intention to reduce weight, showed small reductions in body mass index, total- and LDL-cholesterol at some time points with lower fat intake compared to controls, and no consistent differences in effects on weight, high-density lipoprotein (HDL) cholesterol or height. Associations in cohort studies that related total fat intake to later measures of body fatness in children were inconsistent and the quality of this evidence was mostly very low. Twenty-three out of 24 included studies were conducted in high-income countries, and may not be applicable in low- and middle-income settings. High-quality, longer-term studies are needed, that include low- and middle-income settings and look at both possible benefits and risks.
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Affiliation(s)
- Celeste E Naude
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health SciencesFrancie van Zijl DriveCape TownSouth Africa
| | | | - Kim A Nguyen
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health SciencesFrancie van Zijl DriveCape TownSouth Africa
| | - Solange Durao
- South African Medical Research CouncilCochrane South AfricaCape TownSouth Africa
| | - Anel Schoonees
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health SciencesFrancie van Zijl DriveCape TownSouth Africa
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Age and time trends in eating frequency and duration of nightly fasting of German children and adolescents. Eur J Nutr 2016; 56:2507-2517. [DOI: 10.1007/s00394-016-1286-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 07/27/2016] [Indexed: 11/26/2022]
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Truthmann J, Schienkiewitz A, Busch MA, Mensink GBM, Du Y, Bosy-Westphal A, Knopf H, Scheidt-Nave C. Changes in mean serum lipids among adults in Germany: results from National Health Surveys 1997-99 and 2008-11. BMC Public Health 2016; 16:240. [PMID: 26956524 PMCID: PMC4784325 DOI: 10.1186/s12889-016-2826-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 02/04/2016] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Monitoring of serum lipid concentrations at the population level is an important public health tool to describe progress in cardiovascular disease risk control and prevention. Using data from two nationally representative health surveys of adults 18-79 years, this study identified changes in mean serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) in relation to changes in potential determinants of serum lipids between 1997-99 and 2008-11 in Germany. METHODS Sex-specific multivariable linear regression analyses were performed with serum lipids as dependent variables and survey wave as independent variable and adjusted for the following covariables: age, fasting duration, educational status, lifestyle, and use of medication. RESULTS Mean TC declined between the two survey periods by 13 % (5.97 mmol/l vs. 5.19 mmol/l) among men and by 12 % (6.03 mmol/l vs. 5.30 mmol/l) among women. Geometric mean TG decreased by 14 % (1.66 mmol/l vs. 1.42 mmol/l) among men and by 8 % (1.20 mmol/l vs. 1.10 mmol/l) among women. Mean HDL-C remained unchanged among men (1.29 mmol/l vs. 1.27 mmol/l), but decreased by 5 % among women (1.66 mmol/l vs. 1.58 mmol/l). Sports activity and coffee consumption increased, while smoking and high alcohol consumption decreased only in men. Processed food consumption increased and wholegrain bread consumption decreased in both sexes, and obesity increased among men. The use of lipid-lowering medication, in particular statins nearly doubled over time in both sexes. Among women, hormonal contraceptive use increased and postmenopausal hormone therapy halved over time. The changes in lipid levels between surveys remained significant after adjusting for covariables. CONCLUSION Serum TC and TG considerably declined over one decade in Germany, which can be partly explained by increased use of lipid-lowering medication and improved lifestyle among men. The decline in serum lipids among women, however, remains unexplained.
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Affiliation(s)
- Julia Truthmann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Anja Schienkiewitz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Markus A Busch
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Gert B M Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Yong Du
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Anja Bosy-Westphal
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
| | - Hildtraud Knopf
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
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