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Conway RE, Heuchan GN, Heggie L, Rauber F, Lowry N, Hallen H, Llewellyn CH. Ultra-processed food intake in toddlerhood and mid-childhood in the UK: cross sectional and longitudinal perspectives. Eur J Nutr 2024:10.1007/s00394-024-03496-7. [PMID: 39363048 DOI: 10.1007/s00394-024-03496-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 08/29/2024] [Indexed: 10/05/2024]
Abstract
PURPOSE (i) Characterize ultra-processed food (UPF) intakes in toddlerhood and mid-childhood, including identifying principal UPF sub-groups and associations with nutrient profile; (ii) explore stability and change in UPF intake between toddlerhood and mid-childhood. METHODS Data were from children in the UK Gemini twin cohort at 21 months (n = 2,591) and 7 years (n = 592) of age. UPF intakes were estimated using diet diaries and Nova classification. Complex samples general linear or logistic regression models were used to explore associations between UPF intake, UPF sub-groups and nutrients, and changes in intake over time. RESULTS The contribution of UPF to total energy was 46.9% (± 14.7) at 21 months and 59.4% (± 12.5) at 7 years. Principal UPF sub-groups were yogurts, higher-fiber breakfast cereals, and wholegrain breads in toddlerhood, and puddings and sweet cereal products and white breads in mid-childhood. At both ages, mean free sugar and sodium intakes exceeded recommended maximums and higher UPF consumption was associated with consuming more of each nutrient (P < 0.001). UPF intake was negatively associated with fat, saturated fat and protein intake in toddlerhood, and fiber intake in mid-childhood (P < 0.001). Being in the highest UPF intake quintile in toddlerhood was predictive of being in the highest quintile in mid-childhood (OR 9.40, 95%CI 3.94-22.46). CONCLUSIONS UPF accounted for nearly half of toddlers' energy, increasing to 59% in mid-childhood. Higher UPF consumers had higher intakes of free sugar and sodium. UPF intake in toddlerhood was predictive of mid-childhood intake. Effective policies are needed to reduce UPF intakes in the early years.
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Affiliation(s)
- Rana E Conway
- Research Department of Behavioral Science and Health, University College London, London, UK.
| | - Gabriella N Heuchan
- Research Department of Behavioral Science and Health, University College London, London, UK
| | - Lisa Heggie
- Research Department of Behavioral Science and Health, University College London, London, UK
| | - Fernanda Rauber
- Centre for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Natalie Lowry
- Research Department of Behavioral Science and Health, University College London, London, UK
| | - Hannah Hallen
- Research Department of Behavioral Science and Health, University College London, London, UK
| | - Clare H Llewellyn
- Research Department of Behavioral Science and Health, University College London, London, UK
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2
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Edwards KL, Blissett J, Croker H, Farrow C, Herle M, Kininmonth A, Llewellyn C, Pickard A, Haycraft E. Examining parents' experiences and challenges of feeding preschool children with avid eating behaviour. Appetite 2024; 198:107372. [PMID: 38657683 DOI: 10.1016/j.appet.2024.107372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 04/10/2024] [Accepted: 04/21/2024] [Indexed: 04/26/2024]
Abstract
Avid eating behaviours, including greater responsiveness to food cues and emotional over-eating, have been linked to child overweight and obesity. Parental feeding practices are modifiable components of a child's food environment and may be key levers for behaviour change in tailored interventions to support parents of children with avid eating behaviour. However, there is a lack of research examining parents' experiences in this context. This study aimed to explore parents' experiences of feeding children with avid eating behaviour and to understand any challenges experienced in this context. Semi-structured interviews with parents (N = 15) of a preschool child (3-5 years) identified as having an avid eating behaviour profile explored how children's avid eating manifests, the parental feeding practices used to manage avid eating, and the perceived effectiveness of these strategies. Data were analysed using reflexive thematic analysis. Four core themes were generated. Theme one, 'Have they got worms? Children's insatiable hunger', captures parents' interpretation of the complex ways in which avid eating behaviour manifests. Theme two, 'Parenthood as a duty', illustrates how parents' perceived responsibilities shape their feeding practices. Theme three, 'Lifelong habits', captures parents' use of responsive feeding practices to support children's healthy relationship with food. Theme four, 'Picking battles', captures the structure- and coercive-based feeding strategies commonly used to manage children's avid eating. This novel study provides an in-depth understanding of the complex ways that children's avid eating behaviour manifests, and the strategic and creative parental feeding practices used to manage these behaviours. Such findings are valuable for informing the development of future support resources for parents/caregivers to help their children with avid eating behaviours to develop a healthy relationship with food.
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Affiliation(s)
- Katie L Edwards
- School of Psychology and Institute of Health and Neurodevelopment, Aston University, Birmingham, UK.
| | - Jacqueline Blissett
- School of Psychology and Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
| | - Helen Croker
- World Cancer Research Fund International, London, UK
| | - Claire Farrow
- School of Psychology and Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
| | - Moritz Herle
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alice Kininmonth
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Clare Llewellyn
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Abigail Pickard
- School of Psychology and Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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3
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Jachimowicz-Rogowska K, Winiarska-Mieczan A. Initiatives to Reduce the Content of Sodium in Food Products and Meals and Improve the Population's Health. Nutrients 2023; 15:nu15102393. [PMID: 37242276 DOI: 10.3390/nu15102393] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
Table salt is the main source of sodium (Na) in the human diet. Excessive supply of Na in a diet is strongly linked to many non-communicable human diseases, such as hypertension, obesity and stomach cancer. The World Health Organization recommends that daily intake of salt in adult diets should be kept below 5 g/person/day, which corresponds to 2 g Na/person/day. However, on average, adults consume about 9-10 g/person/day, and children and young people about 7-8 g/person/day. Initiatives to reduce salt intake include modifications of food composition in collaboration with the food industry, education of consumers, salt marking on foodstuff labels and taxation of salt. A need also exists to educate society so that they choose low-sodium products. In view of the food technology and amount of salt intake, the most important and the easiest change to make is to reduce the content of salt in baked goods. This paper analyses the results of surveys regarding strategies to reduce salt content in food products and considers multifaceted initiatives to reduce salt intake as a possible efficient method of improving the population's health status.
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Affiliation(s)
- Karolina Jachimowicz-Rogowska
- Department of Bromatology and Food Physiology, Institute of Animal Nutrition and Bromatology, University of Life Sciences in Lublin, Akademicka 13 St., 20-950 Lublin, Poland
| | - Anna Winiarska-Mieczan
- Department of Bromatology and Food Physiology, Institute of Animal Nutrition and Bromatology, University of Life Sciences in Lublin, Akademicka 13 St., 20-950 Lublin, Poland
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4
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Nazareth M, Pinto E, Severo M, Graça P, Lopes C, Rêgo C. Prevalence of nutritional inadequacy in children aged 12-36 months: EPACI Portugal 2012. NUTR BULL 2023; 48:101-114. [PMID: 36722373 DOI: 10.1111/nbu.12603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 12/20/2022] [Accepted: 01/03/2023] [Indexed: 02/02/2023]
Abstract
Adequate nutritional intake in the first years of life is crucial for future health. The purpose of this study is to assess the adequacy of nutritional intake in Portuguese toddlers. The EPACI Portugal 2012 is a cross-sectional study of a representative sample of toddlers (n = 2230), aged between 12 and 36 months. Data on diets were collected by trained interviewers. The current analysis included 853 children with full data from 3-day food diaries completed by parents/caregivers. Intakes of energy, macro- and micronutrients were estimated through Statistical Program to Assess Dietary Exposure (SPADE). Nutritional adequacy was evaluated using Dietary Reference Values established by the European Food Safety Authority. A large proportion of children exceeded the recommended energy intake. The median daily protein intake was 4.7 g/kg/day, five times more than that recommended. About 9% and 90% of the children consumed a lower proportion of energy than the lower limit of the Reference Intake range for carbohydrates and fat, respectively. Around a third consumed less fibre and magnesium and 100% less vitamin D than the recommended Adequate Intake (AI). Almost a third consumed less vitamin A than the recommended Average Requirement (AR) and 86% of the children showed excessive sodium consumption. Portuguese toddlers consumed a low proportion of energy from fat, had energy and protein intakes above the recommendations and excessive intakes of sodium, and inadequate intakes of vitamin A. Every child consumed less than the recommended AI for vitamin D.
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Affiliation(s)
- Margarida Nazareth
- Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina- Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
| | - Elisabete Pinto
- Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina- Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal.,EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit/ ITR - Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto, Porto, Portugal.,ICBAS - School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Pedro Graça
- EPIUnit/ ITR - Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto, Porto, Portugal.,Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Carla Lopes
- EPIUnit/ ITR - Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto, Porto, Portugal.,Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Carla Rêgo
- Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina- Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal.,Child and Adolescent Centre, CUF Hospital Porto, Porto, Portugal.,Center for Health Technology and Services Research (CINTESIS), Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
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5
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Warren E, Williams L, Knai C. The "Cinderella sector": The challenges of promoting food and nutrition for young children in early years' settings in England. Ecol Food Nutr 2022; 61:576-594. [PMID: 35579381 DOI: 10.1080/03670244.2022.2073353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The quality of food that children eat in early childhood has profound impacts on their future wellbeing. In England, many children eat the majority of meals in early years' settings including nurseries and childminders. We conducted 16 interviews with 18 stakeholders exploring food provision, the use of voluntary nutrition guidelines, and the effects of government support on the early years' sector. Key themes emerging from our thematic analysis included feeling insufficiently consulted, undervalued, support being unequally distributed, needing to fill multiple support roles for families, disagreement about the role and effect of voluntary nutrition standards, and being chronically underfunded.
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Affiliation(s)
- Emily Warren
- , Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London
| | - Lorraine Williams
- , Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London
| | - Cécile Knai
- , Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London
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Abstract
OBJECTIVE To analyse nutritional and packaging characteristics of toddler-specific foods and milks in the Australian retail food environment to identify how such products fit within the Australian Dietary Guidelines (ADG) and the NOVA classification. DESIGN Cross-sectional retail audit of toddler foods and milks. On-pack product attributes were recorded. Products were categorised as (1) food or milk; (2) snack food or meal and (3) snacks sub-categorised depending on main ingredients. Products were classified as a discretionary or core food as per the ADG and level of processing according to NOVA classification. SETTING Supermarkets and pharmacies in Australia. RESULTS A total of 154 foods and thirty-two milks were identified. Eighty percentage of foods were snacks, and 60 % of foods were classified as core foods, while 85 % were ultraprocessed (UP). Per 100 g, discretionary foods provided significantly more energy, protein, total and saturated fat, carbohydrate, total sugar and Na (P < 0·001) than core foods. Total sugars were significantly higher (P < 0·001) and Na significantly lower (P < 0·001) in minimally processed foods than in UP foods. All toddler milks (n 32) were found to have higher energy, carbohydrate and total sugar levels than full-fat cow's milk per 100 ml. Claims and messages were present on 99 % of foods and all milks. CONCLUSIONS The majority of toddler foods available in Australia are UP snack foods and do not align with the ADG. Toddler milks, despite being UP, do align with the ADG. A strengthened regulatory approach may address this issue.
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7
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Batzios SP, Provatidou M, Christoforidis A, Sidiropoulos H, Cassimos DC. Adolescent obesity: Confessions of the young mind. Metabol Open 2020; 7:100044. [PMID: 32812940 PMCID: PMC7424820 DOI: 10.1016/j.metop.2020.100044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/14/2020] [Accepted: 07/09/2020] [Indexed: 11/24/2022] Open
Abstract
Background Obesity represents a worldwide leading health problem. Although the proportion of adolescent obesity is continuously rising, yet little is known considering adolescent's opinions regarding this condition. Aim To investigate adolescent's perceptions in relation to various aspects of obesity in a prospective cohort study. Subjects and methods The study population included primary school adolescents, 11-12 years of age. Anthropometric measurements of participants included height and weight. Overweight and obese participants were classified using the International Obesity Task Force criteria. A structured questionnaire assessing physical activity, dietary habits, parental guidance regarding dietary intake and psychological aspects in relation to social functioning, body weight and image was completed by each adolescent. Results Three hundred and thirty-five adolescents (181 boys) formed the study group. Obese participants were found to have significantly fewer friends (p = .050) and preferred indoor sedentary activities (p = .041). No differences were observed within the groups when questioned about their eating habits in terms of appetite and hunger. The majority of participants reported frequent consumption of homemade snacks in school resulting in no significant difference within the groups. Finally, body weight satisfaction was recorded for only 5.66% of the obese children, 25.66% and 68.64% of overweight and normal-weight participants respectively. Conclusions Our findings support the notion that adolescents are perfectly capable of expressing their opinions. When planning interventional programs for the management of adolescent obesity their views should be strongly considered.
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Affiliation(s)
- Spyros P Batzios
- 1st Pediatric Department, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Athanasios Christoforidis
- 1st Pediatric Department, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Dimitrios C Cassimos
- Pediatric Department, University Hospital of Alexandroupolis, Dimokritio University of Thrace, Alexandroupolis, Greece
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8
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Jabri L, Rosenthal DM, Benton L, Lakhanpaul M. Complementary feeding practices and nutrient intakes of children aged 6-24 months from Bangladeshi background living in Tower Hamlets, East London: a feasibility study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2020; 39:4. [PMID: 32111257 PMCID: PMC7048146 DOI: 10.1186/s41043-020-0213-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 02/05/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND The aim of this study was to assess dietary intakes and complementary feeding practices of children aged 6-24 months who are from Bangladeshi ancestry and living in Tower Hamlets, London, and determine the feasibility of a larger, population-representative study. METHODS Questionnaires for demographic variables and feeding practices, and 24-h dietary recalls were administered to 25 mothers to determine whether it would be feasible to conduct a similar study on a representative sample size of the same population. Data from both tools were used to determine adequacy of complementary feeding practices through the WHO indicators and an infant and child feeding index score as well as overall macronutrient and micronutrient intake. RESULTS Four children had varying suboptimal complementary feeding practices: two children failed to achieve the minimum dietary diversity, one child was being fed cow's milk before the age of 1 year, and one scored 'poor' on the infant and child feeding index. Most notably, the mean protein intake (39.7 g/day, SD 18.2) was higher than RNIs for all age groups (P = 0.001). Vitamin D intake was below recommendations (P = 0.006) for the 12-24-month age group. For the 10-12-month age group, zinc intake fell below recommendations (P = 0.028). For the 6-9-month combined age group, iron and zinc intakes were below recommendations (P = 0.021 and P = 0.002, respectively). CONCLUSIONS Given the feasibility of this study, the results obtained require a large-scale study to be conducted to confirm findings. Our initial results indicated that children from Bangladeshi heritage may not be meeting nutritional requirements; thus, a future intervention tailored to the needs of the Bangladeshi population may be required to improve aspects of complementary feeding practices and nutrient intakes of those children.
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Affiliation(s)
- Laura Jabri
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London, WC1N 1EH UK
- University College London, London, WC1E 6BT UK
| | - Diana Margot Rosenthal
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London, WC1N 1EH UK
- University College London, London, WC1E 6BT UK
- UCL Collaborative Centre for Inclusion Health, Department of Epidemiology and Public Health, London, WC1E 7HB UK
| | - Lorna Benton
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London, WC1N 1EH UK
- University College London, London, WC1E 6BT UK
| | - Monica Lakhanpaul
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London, WC1N 1EH UK
- University College London, London, WC1E 6BT UK
- UCL Collaborative Centre for Inclusion Health, Department of Epidemiology and Public Health, London, WC1E 7HB UK
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9
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Industrialized foods in early infancy: a growing need of nutritional research. Porto Biomed J 2019; 4:e47. [PMID: 31930180 PMCID: PMC6924974 DOI: 10.1097/j.pbj.0000000000000047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 07/04/2019] [Indexed: 12/29/2022] Open
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Abstract
High protein intake in young children is associated with excess gains in weight and body fat, but the specific role of different protein sources has yet to be described. The study aimed to investigate the role of different types of protein in the post-weaning stage on weight, BMI and overweight/obesity at 60 months. Intakes of animal, dairy and plant protein and a dietary pattern characterising variation in protein types at 21 months of age were estimated using a 3-d diet diary in a cohort of 2154 twins; weight and height were recorded every 3 months from birth to 60 months. Longitudinal mixed-effect models investigated the associations between sources of protein intake or dietary pattern scores and BMI, weight and overweight/obesity from 21 months up to 60 months. Adjusting for confounders, dairy protein intake at 21 months was positively associated with greater weight (46 (95 % CI 21, 71) g and BMI up to 60 months (0·04 (95 % CI 0·004, 0·070) kg/m2) and the odds of overweight/obesity at 3 years (OR 1·12; 95 % CI 1·00, 1·24). Milk showed associations of similar magnitude. A dietary pattern low in dairy protein and high in plant protein was associated with lower weight gain up to 60 months, but not overweight/obesity. Intake of dairy products in early childhood is most strongly associated with weight gain, compared with other protein sources. A dietary pattern characterised by lower protein intake and greater protein source diversity at 2 years may confer a lower risk of excess weight gain.
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Valkama S, Holmlund-Suila E, Enlund-Cerullo M, Rosendahl J, Hauta-Alus H, Helve O, Hytinantti T, Viljakainen H, Andersson S, Mäkitie O. No Severe Hypercalcemia with Daily Vitamin D3 Supplementation of up to 30 µg during the First Year of Life. Horm Res Paediatr 2018. [PMID: 28647736 DOI: 10.1159/000477298] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Vitamin D supplementation is widely recommended for infants, but the optimal dose remains unclear. High intake may result in hypercalcemia. METHODS We evaluated the incidence of hypercalcemia during the first year of life in a cohort of 987 healthy children who received 10 or 30 μg of vitamin D3 supplementation daily. Ionized calcium (Ca-ion) was analyzed at 6 and 12 months, and serum 25-hydroxyvitamin D (25-OHD) and parathyroid hormone (PTH) concentration at 12 months. Severe hypercalcemia was defined as Ca-ion exceeding the reference limit (1.16-1.39 mmol/L) by 10%. RESULTS No severe hypercalcemia occurred. Mild hypercalcemia (1.40-1.52 mmol/L) was present at 6 months in 28% and at 12 months in 2% of infants. At 12 months, 25-OHD ranged between 23 and 241 nmol/L (median 97), and PTH was between undetectable and 104 pg/mL (median 24) and was below the reference range (11.5-78.4 pg/mL) in 11%. 25-OHD and Ca-ion correlated positively (r = 0.149), and 25-OHD was slightly higher in the 12 infants with mild hypercalcemia (median 97 vs. 110 nmol/L, p = 0.046). CONCLUSIONS Vitamin D3 supplementation of 10 or 30 µg did not cause severe hypercalcemia. Mild hypercalcemia was more prevalent at 6 months than at 12 months, and was associated weakly with 25-OHD at 12 months.
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Affiliation(s)
- Saara Valkama
- Children's Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Elisa Holmlund-Suila
- Children's Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Maria Enlund-Cerullo
- Children's Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Jenni Rosendahl
- Children's Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Helena Hauta-Alus
- Children's Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Otto Helve
- Children's Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Timo Hytinantti
- Children's Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Heli Viljakainen
- Children's Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Sture Andersson
- Children's Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Outi Mäkitie
- Children's Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland.,Center for Molecular Medicine, Karolinska Institutet, and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
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12
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Hauta-Alus HH, Korkalo L, Holmlund-Suila EM, Rosendahl J, Valkama SM, Enlund-Cerullo M, Helve OM, Hytinantti TK, Mäkitie OM, Andersson S, Viljakainen HT. Food and Nutrient Intake and Nutrient Sources in 1-Year-Old Infants in Finland: A Cross-Sectional Analysis. Nutrients 2017; 9:E1309. [PMID: 29194422 PMCID: PMC5748759 DOI: 10.3390/nu9121309] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/22/2017] [Accepted: 11/28/2017] [Indexed: 02/07/2023] Open
Abstract
The infant diet has short- and long-term health consequences. Updated data regarding the dietary intake of Finnish infants are lacking. The objectives of this study were to describe infant food and nutrient intake and to identify food sources of the nutrients. Altogether, 739 healthy infants were studied. Dietary intake and breastfeeding frequency were assessed with a three-day food record at 1 year of age. Dietary intake was calculated separately for non-breastfed and breastfed infants. One-third (36%) of the infants were partially breastfed and 95% consumed mass-produced baby foods. The infants' diet consisted mainly of infant formula, dairy milk, porridges, fruit and berry foods, and meat dishes. The mean vegetable, fruit and berry consumption was 199 g/day. Most nutrient intakes were adequate except for fat, linoleic acid, vitamin D and iron from food. Mean sucrose intake, as a percentage of total energy intake (E%), was 5-6 E%. High protein intake (>20 E%) was observed in 19% of non-breastfed infants. Overall, the infants' diet was favorable since vegetable and fruit consumption was reasonably high and nutrient intake was mostly adequate. However, the fat intake was lower, and protein intake higher than recommended. Increasing the consumption of vegetable oils and reducing the intake of red meat and dairy milk may further improve the diet of 1-year-olds.
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Affiliation(s)
- Helena H Hauta-Alus
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Liisa Korkalo
- Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland.
| | - Elisa M Holmlund-Suila
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Jenni Rosendahl
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Saara M Valkama
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Maria Enlund-Cerullo
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Otto M Helve
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Timo K Hytinantti
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Outi M Mäkitie
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
- Folkhälsan Research Center, Haartmaninkatu 8, P.O. Box 63, 00014 Helsinki, Finland.
- Center for Molecular Medicine, Karolinska Institute and Clinical Genetics, Karolinska University Hospital, Solna, 171 76 Stockholm, Sweden.
| | - Sture Andersson
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Heli T Viljakainen
- Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland.
- Folkhälsan Research Center, Haartmaninkatu 8, P.O. Box 63, 00014 Helsinki, Finland.
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Preschool and School Meal Policies: An Overview of What We Know about Regulation, Implementation, and Impact on Diet in the UK, Sweden, and Australia. Nutrients 2017; 9:nu9070736. [PMID: 28696403 PMCID: PMC5537850 DOI: 10.3390/nu9070736] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 06/29/2017] [Accepted: 07/03/2017] [Indexed: 01/08/2023] Open
Abstract
School meals make significant contributions to healthy dietary behaviour, at a time when eating habits and food preferences are being formed. We provide an overview of the approaches to the provision, regulation, and improvement of preschool and primary school meals in the UK, Sweden, and Australia, three countries which vary in their degree of centralisation and regulation of school meals. Sweden has a centralised approach; all children receive free meals, and a pedagogical approach to meals is encouraged. Legislation demands that meals are nutritious. The UK system is varied and decentralised. Meals in most primary schools are regulated by food-based standards, but preschool-specific meal standards only exist in Scotland. The UK uses food groups (starchy foods, fruit and vegetables, proteins and dairy) in a healthy plate approach. Australian States and Territories all employ guidelines for school canteen food, predominantly using a "traffic light" approach outlining recommended and discouraged foods; however, most children bring food from home and are not covered by this guidance. The preschool standards state that food provided should be nutritious. We find that action is often lacking in the preschool years, and suggest that consistent policies, strong incentives for compliance, systematic monitoring, and an acknowledgement of the broader school eating environment (including home provided food) would be beneficial.
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Abstract
PURPOSE OF REVIEW There is considerable variability in human body weight, despite the ubiquity of the 'obesogenic' environment. Human body weight has a strong genetic basis and it has been hypothesised that genetic susceptibility to the environment explains variation in human body weight, with differences in appetite being implicated as the mediating mechanism; so-called 'behavioural susceptibility theory' (BST), first described by Professor Jane Wardle. This review summarises the evidence for the role of appetite as a mediator of genetic risk of obesity. RECENT FINDINGS Variation in appetitive traits is observable from infancy, drives early weight gain and is highly heritable in infancy and childhood. Obesity-related common genetic variants identified through genome-wide association studies show associations with appetitive traits, and appetite mediates part of the observed association between genetic risk and adiposity. Obesity results from an interaction between genetic susceptibility to overeating and exposure to an 'obesogenic' food environment.
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Affiliation(s)
- Clare H Llewellyn
- Department of Behavioural Science and Health, University College London, London, UK.
| | - Alison Fildes
- Department of Behavioural Science and Health, University College London, London, UK
- School of Psychology, University of Leeds, Leeds, UK
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Walton J, Kehoe L, McNulty BA, Nugent AP, Flynn A. Nutrient intakes and compliance with nutrient recommendations in children aged 1-4 years in Ireland. J Hum Nutr Diet 2017; 30:665-676. [DOI: 10.1111/jhn.12452] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- J. Walton
- School of Food and Nutritional Sciences; University College Cork; Cork Ireland
| | - L. Kehoe
- School of Food and Nutritional Sciences; University College Cork; Cork Ireland
| | - B. A. McNulty
- UCD Institute of Food and Health; University College Dublin; Belfield Dublin Ireland
| | - A. P. Nugent
- UCD Institute of Food and Health; University College Dublin; Belfield Dublin Ireland
| | - A. Flynn
- School of Food and Nutritional Sciences; University College Cork; Cork Ireland
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Barbalho SM, Fontana LCS, Finalli EFR, Martuchi KA, Ferreira MC, Filho MEP, Cerri SVDC, Sasaki V, Spada APM, Oshiiwa M, Santos MCBD, Pescinini-Salzedas LM, Bragante LS. Eating habits and presence of cardiovascular risks in children. Int J Adolesc Med Health 2016; 30:/j/ijamh.ahead-of-print/ijamh-2016-0045/ijamh-2016-0045.xml. [PMID: 27508956 DOI: 10.1515/ijamh-2016-0045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 07/13/2016] [Indexed: 01/20/2023]
Abstract
INTRODUCTION The changes in the eating habits associated with physical inactivity are directly related to the increase in the prevalence of obesity and associated diseases such as diabetes mellitus (DM), metabolic syndrome and cardiovascular diseases. OBJECTIVE The aim of this study was to investigate the relationship between the frequency of consumption of some food groups (snacks, fruits, vegetables and candies), physical exercise, nutritional classification and biochemical profile in children. METHODS After the approval of the Ethics Committee, we studied 882 schoolchildren ranging between 6 and 10 years of age. Biochemical and anthropometric evaluations were performed and questionnaires were used in order to check the eating habits and physical activity. RESULTS Our results showed that we may relate the consumption of snacks, fruits, vegetables or candies with modifications in the glycemia, triglycerides, total cholesterol, HDL-c, and LDL-c but we did not observe association with the nutritional classification. It is noteworthy to say that almost 50% of the studied children were overweight or obese and many presented alterations in the lipid and glucose levels. CONCLUSION Our results also show that many children have abnormal levels of lipids and glycemia and a great number of them are classified as overweight or obese. In this context, we can say that urgent approaches are needed to be carried out by a multidisciplinary team in order to improve the diet and reduces the risk factors in this population of children and prevent secondary diseases in adolescence and adulthood.
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Affiliation(s)
- Sandra Maria Barbalho
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Av. Higino Muzzi Filho 1001, Marília 15525-902, SP, Brazil.,Department of Biochemistry and Nutrition, Faculty of Food Technology of Marília (FATEC), Av. Castro Alves, 62, Marília 17506-000, SP, Brazil, Mobile: +(55 14) 99655-3190
| | | | | | | | | | | | | | | | | | - Marie Oshiiwa
- Department of Biochemistry, School of Medicine, University of Marília (UNIMAR), Marília, SP, Brazil.,Department of Biochemistry and Nutrition, Faculty of Food Technology of Marília (FATEC), Marília, SP, Brazil
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Syrad H, Llewellyn CH, Johnson L, Boniface D, Jebb SA, van Jaarsveld CHM, Wardle J. Meal size is a critical driver of weight gain in early childhood. Sci Rep 2016; 6:28368. [PMID: 27321917 PMCID: PMC4913249 DOI: 10.1038/srep28368] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 05/31/2016] [Indexed: 11/17/2022] Open
Abstract
Larger serving sizes and more frequent eating episodes have been implicated in the rising prevalence of obesity at a population level. This study examines the relative contributions of meal size and frequency to weight gain in a large sample of British children. Using 3-day diet diaries from 1939 children aged 21 months from the Gemini twin cohort, we assessed prospective associations between meal size, meal frequency and weight gain from two to five years. Separate longitudinal analyses demonstrated that every 10 kcal increase in meal size was associated with 1.5 g/wk or 4% (p = 0.005) faster growth rate, while meal frequency was not independently associated with growth (β = 0.3 g/wk p = 0.20). Including both meal parameters in the model strengthened associations (meal size: β = 2.6 g/wk, p < 0.001; meal frequency: β = 1.0 g/wk, p = 0.001). Taken together, the implication is that meal size promotes faster growth regardless of frequency, but meal frequency has a significant effect only if meal size is assumed to be held constant. Clearer advice on meal size and frequency, especially advice on appropriate meal size, may help prevent excess weight gain.
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Affiliation(s)
- Hayley Syrad
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK
| | - Clare H. Llewellyn
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Rd, Bristol BS8 1TZ
| | - David Boniface
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK
| | - Susan A. Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK
| | - Cornelia H. M. van Jaarsveld
- Department for Health Evidence & Department of Primary and Community Care, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Jane Wardle
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK
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