Dietary fibre and health in children and adolescents

Cholesterol-Lowering Bioactive Foods and Nutraceuticals in Pediatrics: Clinical Evidence of Efficacy and Safety

Long-term exposure to even slightly elevated plasma cholesterol levels significantly increases the risk of developing cardiovascular disease. The latest evidence recommends an improvement in plasma lipid levels, even in children who are not affected by severe hypercholesterolemia. The risk-benefit profile of pharmacological treatments in pediatric patients with moderate dyslipidemia is uncertain, and several cholesterol-lowering nutraceuticals have been recently tested. In this context, the available randomized clinical trials are small, short-term and mainly tested different types of fibers, plant sterols/stanols, standardized extracts of red yeast rice, polyunsaturated fatty acids, soy derivatives, and some probiotics. In children with dyslipidemia, nutraceuticals can improve lipid profile in the context of an adequate, well-balanced diet combined with regular physical activity. Of course, they should not be considered an alternative to conventional lipid-lowering drugs when necessary.

Dichotomous effect of dietary fiber in pediatrics: a narrative review of the health benefits and tolerance of fiber

Dietary fibers are associated with favorable gastrointestinal, immune, and metabolic health outcomes when consumed at sufficient levels. Despite the well-described benefits of dietary fibers, children and adolescents continue to fall short of daily recommended levels. This gap in fiber intake (i.e., "fiber gap") might increase the risk of developing early-onset pediatric obesity and obesity-related comorbidities such as type 2 diabetes mellitus into adulthood. The structure-dependent physicochemical properties of dietary fiber are diverse. Differences in solubility, viscosity, water-holding capacity, binding capability, bulking effect, and fermentability influence the physiological effects of dietary fibers that aid in regulating appetite, glycemic and lipidemic responses, and inflammation. Of growing interest is the fermentation of fibers by the gut microbiota, which yields both beneficial and less favorable end-products such as short-chain fatty acids (e.g., acetate, propionate, and butyrate) that impart metabolic and immunomodulatory properties, and gases (e.g., hydrogen, carbon dioxide, and methane) that cause gastrointestinal symptoms, respectively. This narrative review summarizes (1) the implications of fibers on the gut microbiota and the pathophysiology of pediatric obesity, (2) some factors that potentially contribute to the fiber gap with an emphasis on undesirable gastrointestinal symptoms, (3) some methods to alleviate fiber-induced symptoms, and (4) the therapeutic potential of whole foods and commonly marketed fiber supplements for improved health in pediatric obesity.

More than a small adult brain: Lessons from chemotherapy-induced cognitive impairment for modelling paediatric brain disorders

Childhood is recognised as a period of immense physical and emotional development, and this, in part, is driven by underlying neurophysiological transformations. These neurodevelopmental processes are unique to the paediatric brain and are facilitated by augmented rates of neuroplasticity and expanded neural stem cell populations within neurogenic niches. However, given the immaturity of the developing central nervous system, innate protective mechanisms such as neuroimmune and antioxidant responses are functionally naïve which results in periods of heightened sensitivity to neurotoxic insult. This is highly relevant in the context of paediatric cancer, and in particular, the neurocognitive symptoms associated with treatment, such as surgery, radio- and chemotherapy. The vulnerability of the developing brain may increase susceptibility to damage and persistent symptomology, aligning with reports of more severe neurocognitive dysfunction in children compared to adults. It is therefore surprising, given this intensified neurocognitive burden, that most of the pre-clinical, mechanistic research focuses exclusively on adult populations and extrapolates findings to paediatric cohorts. Given this dearth of age-specific research, throughout this review we will draw comparisons with neurodevelopmental disorders which share comparable pathways to cancer treatment related side-effects. Furthermore, we will examine the unique nuances of the paediatric brain along with the somatic systems which influence neurological function. In doing so, we will highlight the importance of developing in vitro and in vivo paediatric disease models to produce age-specific discovery and clinically translatable research.

Association between Dietary Intake and Faecal Microbiota in Children with Cystic Fibrosis

A "high-fat, high-energy diet" is commonly recommended for children with cystic fibrosis (CF), leading to negative consequences on dietary patterns that could contribute to altered colonic microbiota. The aim of this study was to assess dietary intake and to identify possible associations with the composition of faecal microbiota in a cohort of children with CF. A cross-sectional observational study was conducted, including a 3-day food record simultaneously with the collection of faecal samples. The results showed a high fat intake (43.9% of total energy intake) and a mean dietary fibre intake of 10.6 g/day. The faecal microbiota was characterised at the phylum level as 54.5% Firmicutes and revealed an altered proportion between Proteobacteria (32%) and Bacteroidota (2.2%). Significant associations were found, including a negative association between protein, meat, and fish intake and Bifidobacterium, a positive association between lipids and Escherichia/Shigella and Streptococcus, a negative association between carbohydrates and Veillonella and Klebsiella, and a positive association between total dietary fibre and Bacteroides and Roseburia. The results reveal that a "high-fat, high-energy" diet does not satisfy dietary fibre intake from healthy food sources in children with CF. Further interventional studies are encouraged to explore the potential of shifting to a high-fibre or standard healthy diet to improve colonic microbiota.

Intake and sources of dietary fibre and dietary fibre fractions in Finnish children

The current definition of dietary fibre was adopted by the Codex Alimentarius Commission in 2009, but implementation requires updating food composition databases with values based on appropriate analysis methods. Previous data on population intakes of dietary fibre fractions are sparse. We studied the intake and sources of total dietary fibre (TDF) and dietary fibre fractions insoluble dietary fibre (IDF), dietary fibre soluble in water but insoluble in 76 % aqueous ethanol (SDFP) and dietary fibre soluble in water and soluble in 76 % aqueous ethanol (SDFS) in Finnish children based on new CODEX-compliant values of the Finnish National Food Composition Database Fineli. Our sample included 5193 children at increased genetic risk of type 1 diabetes from the Type 1 Diabetes Prediction and Prevention birth cohort, born between 1996 and 2004. We assessed the intake and sources based on 3-day food records collected at the ages of 6 months, 1, 3 and 6 years. Both absolute and energy-adjusted intakes of TDF were associated with age, sex and breast-feeding status of the child. Children of older parents, parents with a higher level of education, non-smoking mothers and children with no older siblings had higher energy-adjusted TDF intake. IDF was the major dietary fibre fraction in non-breastfed children, followed by SDFP and SDFS. Cereal products, fruits and berries, potatoes and vegetables were major food sources of dietary fibre. Breast milk was a major source of dietary fibre in 6-month-olds due to its human milk oligosaccharide content and resulted in high SDFS intakes in breastfed children.

Dietary fiber - a scoping review for Nordic Nutrition Recommendations 2023

Dietary fiber is a term crudely defined as carbohydrates (CHOs) that escape digestion and uptake in the small intestine. Lignin, which is not a CHO, is also a part of the dietary fiber definition. Dietary fibers come in different sizes and forms, with a variety of combinations of monomeric units. Health authorities worldwide have for many years recommended a diet rich in dietary fibers based on consistent findings that dietary fibers are associated with reduced incidences of major non-communicable diseases, including obesity, type 2 diabetes, cardiovascular disease, and colorectal cancer. Most fibers come from common edible foods from the plant kingdom, but fibers are also found in food additives, supplements, and breast milk. The recommended intake in Nordic Nutrition Recommendations 2012 (NNR2012) is 25 g/d for women and 35 g/d for men, whereas the actual intake is significantly lower, ranging from 16 g/d to 22 g/d in women and 18 g/d to 26 g/d in men. New studies since NNR2012 confirm the current view that dietary fiber is beneficial for health, advocating intakes of at least 25 g/day.

The Association between Dietary Fiber Intake and Serum Klotho Levels in Americans: A Cross-Sectional Study from the National Health and Nutrition Examination Survey

BACKGROUND

Klotho is an aging-related marker closely associated with a number of diseases. A growing body of evidence suggests that dietary factors and lifestyle habits can impact serum Klotho levels. The effect of dietary fiber, a key component of a healthy diet, on the body's serum Klotho levels has not been fully elucidated.

OBJECTIVE

The aim of this study was to explore the relationship between dietary fiber intake and serum Klotho levels in people aged 40-79 years in the United States.

METHODS

A total of 11,282 participants were included in this study, all from the National Health and Nutrition Examination Survey from 2007 to 2016. Dietary fiber intake was assessed by uniformly trained interviewers using the 24 h dietary recall method. Serum Klotho was quantified using commercially available ELISA kits manufactured by IBL International, Japan. The relationship between dietary fiber intake and serum Klotho levels was analyzed using a multiple linear regression model. Subsequently, the non-linear dose-response relationship between the two was further explored using a restricted cubic spline (RCS) model.

RESULTS

After adjusting for potential confounders, serum Klotho levels increased by 1.9% (95% confidence interval [CI]: 0.8%, 3.0%) for each interquartile range increase in dietary fiber intake in all participants. Considering dietary fiber intake as a categorical variable, serum Klotho levels were found to be 4.7% higher in participants in the highest quartile of dietary fiber intake than in those in the lowest quartile (95% CI: 1.8%, 7.6%). RCS plots depicted a non-linear positive correlation between dietary fiber intake and serum Klotho levels. Subgroup analysis revealed that the relationship between dietary fiber intake and serum Klotho levels was more pronounced in older (percentage change: 7.0%; 95% CI: 2.5%, 11.7%) and overweight and obese participants (percentage change: 4.9%; 95% CI: 1.5%, 8.4%).

CONCLUSIONS

The results of this study showed that dietary fiber intake was significantly associated with serum Klotho levels in participants. This finding is yet to be further confirmed by prospective studies.

The Nutritional Quality of Food Provision at UK Government-Funded Holiday Clubs: A Cross-Sectional Analysis of Energy and Nutrient Content

A large proportion of children are at risk of food insecurity during school holidays in the UK. The government-funded Holiday Activities and Food (HAF) programme provides free holiday clubs offering at least one healthy meal/day to eligible children and adolescents. This study aims at evaluating the nutritional quality of food provision at HAF holiday clubs, particularly hot/cold and vegetarian/non-vegetarian meals. Menu variants (n = 2759) from 49 HAF holiday clubs were assessed for adherence to School Food Standards (SFS) and their notional compositional quality, which was scored utilising a novel nutrient-based meal quality index. The median adherence to SFS across all available menus was 70% (IQR 59-79%). Overall, hot variants scored statistically higher menu quality scores than cold variants for both 5-11y (92.3 (80.7-102.7) vs. 80.4 (69.3-90.6)) and 11-18y (73.5 (62.5-85.8) vs. 58.9 (50.0-70.7)) criteria. Cold and hot menu variants tended to score differentially for quality sub-components. These findings highlight areas for potential future improvement in HAF holiday club provision with a tendency for food provision to appear less ideal for attendees for those aged 11-18. Ensuring that children from low-income households have access to a healthy diet is crucial to reduce UK health inequalities.

Intake of added sugar, fruits, vegetables, and legumes of Portuguese preschool children: Baseline data from SmartFeeding4Kids randomized controlled trial participants

Introduction

The SmartFeeding4Kids (SF4K) program is an online self-guided intervention for parents with the propose of changing parental feeding practices and children’s dietary intake, focusing on the intake of added sugars, fruit, vegetables, and legumes. This paper aims to describe children’s dietary pattern at baseline through a 24-h food recall, the SmartKidsDiet24.

Methods

Overall, 89 participants recorded at least one meal of the 3-day food recall. Mean age was 36.22 ± 6.05 years and 53.09 ± 15.42 months old for parents and children, respectively. Of these, 22 participants were considered to have 2 days of near complete 24-h food recalls. Children’s dietary intake are reported for these 22 participants based on parents reports and, thus, represent estimations only, as it remains unknown whether children consumed other non-reported foods.

Results

Fruit was the group with the highest daily intake among children (mean 1.77 ± 1.10 portions/day), followed by added sugar foods (mean 1.48 ± 0.89 portions/day), vegetables [median 1.27 (1.64) portions/day] and legumes [median 0.12 (0.39) portions/day]. Fruit intake was positively correlated with vegetable intake (p = 0.008). Regarding Dietary Reference Values accomplishment, 13.6% of children exceeded the daily safe and adequate intake of sodium, 77.3% did not meet potassium and fiber recommendations, and 31.8% did not meet vitamin C recommendations.

Discussion

All children did not meet calcium, vitamin B12 and vitamin D intake recommendations. Our findings further justify the need for dietary interventions in this field, to improve young children’s diets.

Clinical trial registration

ClinicalTrials.gov, identifier NCT04591496.

Dietary fibre in relation to asthma, allergic rhinitis and sensitization from childhood up to adulthood

Background

Dietary fibre may reduce the risk of allergy. Our aim was to investigate the association between fibre intake in childhood, asthma, allergic rhinitis and IgE sensitization up to adulthood.

Methods

The individual fibre intake of 2285 participants from the Swedish population‐based birth cohort BAMSE was estimated between 98‐ and 107‐item food frequency questionnaires at ages 8 and 16 years, respectively. At 8, 16 and 24 years, asthma and allergic rhinitis symptoms were assessed by questionnaires, and sensitization to common allergens by serum IgE. Longitudinal associations were analysed by generalized estimating equations, adjusting for potential confounders.

Results

An inverse overall association was indicated between fibre intake at 8 years and allergic rhinitis symptoms up to 24 years (OR per 5 g/d 0.86; 95% CI 0.77–0.96), particularly in combination with airborne (0.74; 0.62–0.89) and food (0.69; 0.54–0.88) allergen sensitization. Higher fibre intake was also associated with specific allergen sensitization, for example, birch (0.77; 0.67–0.88) and soy (0.68; 0.53–0.87). No association was observed with asthma. Regarding sources, fruit (0.79; 0.67–0.94) and other (potatoes, chips/popcorn, legumes, and nuts, 0.71; 0.50–0.99), but not cereal or vegetable fibre were associated with allergic rhinitis. In additional analyses, including long‐term fibre intake at 8 and 16 years, excluding participants with food‐related allergic symptoms to examine reverse causation, as well as adjusting for antioxidant intake, associations were attenuated and became non‐significant.

Conclusion

Higher fibre intake in mid‐childhood may be inversely associated with allergic rhinitis and sensitization to specific allergens up to adulthood. However, avoidance of food triggers of allergic symptoms in allergic rhinitis patients may contribute to the protective associations.

Food Insecurity, Dietary Intakes, and Eating Behaviors in a Convenience Sample of Toronto Youth

BACKGROUND

Food insecurity has been shown to be associated with poor dietary quality and eating behaviors, which can have both short- and long-term adverse health outcomes in children. The objective was to investigate the food security status, dietary intakes, and eating behaviors in a convenience sample of youth participating in the Maple Leaf Sports Entertainment LaunchPad programming in downtown Toronto, Ontario.

METHODS

Youth aged 9-18 years were recruited to participate in the study. Food security status, dietary intakes, and eating behaviors were collected using parent- or self-reported questionnaires online.

RESULTS

Sixty-six youth (mean ± SD: 11.7 ± 1.9 years) participated in the study. The prevalence of household food insecurity was higher than the national average with at least one child under 18 years of age (27.7% vs. 16.2%). Dietary intake patterns were similar to the national trends with low intakes of fiber, inadequate intakes of calcium and vitamin D; and excess intakes of sodium, added sugar, and saturated fat. Despite a low prevalence of poor eating habits, distracted eating was the most frequently reported poor eating habit.

CONCLUSIONS

Although youth were at high risk for experiencing household food insecurity, inadequate dietary intake patterns were similar to the national trends. Our findings can be used to develop future programming to facilitate healthy dietary behaviors appropriate for the target community.

Evaluation of Dietary Intake and Anthropometric Status in 1–9-Year-old Children Living in Serbia: National Food Consumption Survey According to the EU Menu Methodology

The Serbian Food Consumption Survey among 1–9-year-old-children was conceptualized and conducted in compliance with the principles, established protocols, and guidelines of the EU Menu project between 2017 and 2021. Valid data were collected for 576 individuals (290 1–3-year-old toddlers and 276 3–9-year-old children). Regardless of age and gender category, the majority (68.80%) of children had normal weights according to the Body Mass Index-for-age classification system. The median daily energy intake was 1406.71 kcal with no differences between the settlement types. The overall median contributions of carbohydrates, protein, and fat to the total energy intake were 47.54%, 14.06%, and 37.88%, respectively. The proportions of the macronutrient intake deviated from the dietary reference values with compliance to the recommendations being particularly poor for fat and fiber. The consumption of energy-dense food groups such as meat and meat products, fat and oil, sugar, and confections was more pronounced among older children. The survey results provide a valuable insight into the nutritional status and dietary habits of toddlers and children 1–9 years old living in Serbia. They may serve as an evidence platform for public health programs, a valuable asset for decision-makers, and a reliable reference to guide nutritional policies, diet monitoring, and interventions targeting this population group in the future.

Association between dietary fiber intake and atherosclerotic cardiovascular disease risk in adults: a cross-sectional study of 14,947 population based on the National Health and Nutrition Examination Surveys

Background

This study aimed to investigate the association between dietary fiber intake and long-term cardiovascular disease (CVD) risk based on the National Health and Nutrition Examination Survey (NHANES) database.

Methods

A total of 14,947 participants aged 20–79 from the NHANES database were included in this study between 2009 and 2018. The atherosclerotic cardiovascular disease (ASCVD) score was utilized to predict the 10-year risk of CVD in individuals (low, borderline, intermediate, and high risk). Weighted univariate and multinomial multivariate logistic regression analyses were used to analyze the association between dietary fiber intake and long-term CVD risk.

Results

Higher dietary fiber density may be associated with a reduced ASCVD risk in participants with intermediate risk [odds ratio (OR) = 0.76; 95% confidence interval (CI), 0.61–0.94] and high risk (OR = 0.60; 95%CI, 0.45–0.81) compared with those in the group with low risk. Higher total dietary fiber intake may also reduce ASCVD risk in participants with high risk (OR = 0.84; 95%CI, 0.75–0.95). Subgroup analyses showed that higher dietary fiber density may be related to reduced ASCVD risk in intermediate-risk participants aged 20–39 (OR = 0.62; 95%CI, 0.43–0.89) and 40–59 (OR = 0.67; 95%CI, 0.49–0.94). In high-risk participants, higher dietary fiber density may reduce ASCVD risk in 20–39-year-old (OR = 0.38; 95%CI, 0.19–0.77), 40–59-year-old (OR = 0.37; 95%CI, 0.20–0.70), male (OR = 0.47; 95%CI, 0.23–0.97) and female (OR = 0.57; 95%CI, 0.38–0.86) participants.

Conclusion

Higher dietary fiber density and total dietary fiber intake were associated with a lower long-term CVD risk, especially in the 20–39 and 40–59 age groups, where the reduction was most significant.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13419-y.

Dietary Fibre Intake in Relation to Asthma, Rhinitis and Lung Function Impairment-A Systematic Review of Observational Studies

A high intake of dietary fibre has been associated with a reduced risk of several chronic diseases. This study aimed to review the current evidence on dietary fibre in relation to asthma, rhinitis and lung function impairment. Electronic databases were searched in June 2021 for studies on the association between dietary fibre and asthma, rhinitis, chronic obstructive pulmonary disease (COPD) and lung function. Observational studies with cross-sectional, case–control or prospective designs were included. Studies on animals, case studies and intervention studies were excluded. The quality of the evidence from individual studies was evaluated using the RoB-NObs tool. The World Cancer Research Fund criteria were used to grade the strength of the evidence. Twenty studies were included in this systematic review, of which ten were cohort studies, eight cross-sectional and two case–control studies. Fibre intake during pregnancy or childhood was examined in three studies, while seventeen studies examined the intake during adulthood. There was probable evidence for an inverse association between dietary fibre and COPD and suggestive evidence for a positive association with lung function. However, the evidence regarding asthma and rhinitis was limited and inconsistent. Further research is needed on dietary fibre intake and asthma, rhinitis and lung function among adults and children.

Calcium, fiber, iron, and sodium intake in adolescents with intellectual and developmental disabilities and overweight and obesity

BACKGROUND

Adolescents with intellectual and developmental disabilities (IDD) and overweight or obesity (OW/OB) are a nutritionally vulnerable group with increased risk of nutritional deficiencies. However, there are limited data examining micronutrient intake in adolescents with IDD and OW/OB.

OBJECTIVE

The purpose of this study was to assess the adequacy of calcium, iron, fiber, and sodium intake referenced against the United States Dietary Reference Intakes in adolescents with IDD and OW/OB.

METHODS

Three-day image-assisted food records were used to assess dietary intake of 64 adolescents with IDD and OW/OB. A mean ± standard deviation was calculated for mean intake of calcium (mg), fiber (g/1000 kcals energy), iron (mg), and sodium (mg).

RESULTS

A total of 157 nutrient intake observations were completed by 64 participants (56% female, 16.3 ± 2.3 years). Calcium intake for participants ages 14-18 years (n = 57) was 1027.4 ± 607.5 mg, which is below the EAR of 1050 mg. Calcium intake for participants ages ≥19 years (n = 7) was 921.1 ± 596.4 mg, which is greater than the EAR of 840 mg. Fiber intake was 8.4 ± 3.6 g/1000 kcals, which is below the AI of 14 g/1000 kcals. Iron intake for all participants exceeded their respective EARs. Sodium intake was 3180.9 ± 975.9 mg, which above the AI of 2300 mg.

CONCLUSION

Calcium intake was adequate for participants ≥19 years of age, but inadequate for participants 14-18 years. For all participants, iron and sodium intake exceeded the DRI while fiber intake was below the DRI.

Interactions between dietary fibre and the gut microbiota

Research characterising the gut microbiota in different populations and diseases has mushroomed since the advent of next-generation sequencing techniques. However, there has been less emphasis on the impact of dietary fibres and other dietary components that influence gut microbial metabolic activities. Dietary fibres are the main energy source for gut bacteria. However, fibres differ in their physicochemical properties, their effects on the gut and their fermentation characteristics. The diversity of carbohydrates and associated molecules in fibre-rich foods can have a major influence on microbiota composition and production of bioactive molecules, for example SCFAs and phenolic acids. Several of these microbial metabolites may influence the functions of body systems including the gut, liver, adipose tissues and brain. Dietary fibre intake recommendations have recently been increased (to 30 g daily) in response to growing obesity and other health concerns. Increasing intakes of specific fibre and plant food sources may differentially influence the bacteria and their metabolism. However, in vitro studies show great individual variability in the response of the gut microbiota to different fibres and fibre combinations, making it difficult to predict which foods or food components will have the greatest impact on levels of bioactive molecules produced in the colon of individuals. Greater understanding of individual responses to manipulation of the diet, in relation to microbiome composition and production of metabolites with proven beneficial impact on body systems, would allow the personalised approach needed to best promote good health.

The effect of sodium carboxymethyl starch with high degree of substitution on defecation

Sodium carboxymethyl starch (CMS-Na), a kind of food additive with high degree of substitution, is also known as a prebiotic. The aim of this study was to determine the effect of CMS-Na on defecation. Constipated mouse model was prepared by loperamide. Normal rats were also used in the study. Short-chain fatty acids in rat feces were detected by gas chromatography. The bacterial communities in rat feces were identified by 16S rDNA gene sequencing. 5-hydroxytryptamine (5-HT) and tryptophan hydroxylase 1 (Tph1) were measured by ELISA. The results showed that CMS-Na increased the fecal granule counts and intestinal propulsion rate in constipated mice. The contents of water, acetic acid, propionic acid and n-butyrate in feces, Tph1 in colon and 5-HT in serum of rats were increased. In addition, CMS-Na shortened the colonic transport time in rats. The 16S rDNA gene sequencing results indicated that CMS-Na increased the relative abundance of Alloprevotella and decreased the proportion of Lactobacillus. However, the biodiversity of the normal intestinal flora was not altered. In conclusion, CMS-Na can promote defecation in constipated mice. The mechanism may be related to the regulation of Alloprevotella and Lactobacillus in colon, the increase of short-chain fatty acids, and the promotion of the synthesis of Tph1 and 5-HT.

Breakfast Cereals Intended for Children: Opportunities for Reformulation and Potential Impact on Nutrient Intake

Ready-to-eat cereals (RTECs) have become a popular breakfast option claiming to provide important nutrients to children's diets, despite being a source of excess sugar and, therefore, a health concern. Thus, food reformulation constitutes an important public health strategy that could benefit from inputs provided by nutrient profiling. This study aimed to assess the adequacy of the RTECs for children available in Portuguese supermarkets, applying three nutrient profile models (NPMs)-the nutrient profile model of the World Health Organization's Regional Office for Europe (WHO-EURO), the profile of the private-sector EU Pledge (EU-Pledge), and the national model developed by the Directorate-General of Health (NPM-PT)-in order to explore the potential for reformulation of the RTECs identified as not adequate and evaluate the impact of RTECs' reformulation on the nutritional quality of Portuguese children's diets. In total, 78 RTECs intended for children were assessed and two scenarios-current (not considering reformulation) and alternative (considering reformulation to accomplish the nutrient profile requirements)-were considered to assess the impact of reformulation on nutritional quality. Across all RTECs, only 5.1% could be promoted to children according to the considered NPMs. The most common nutrients requiring reformulation were sugar, saturated fatty acids (SFA), salt, and dietary fiber. The scenarios of reformulation considered could reduce the RTECs average content of total sugars, SFA, and salt by 43%, 8.7%, and 1.1%, respectively, and dietary fiber intake could be increased by 34%. Thus, these results support policies to implement reformulation strategies for developing healthier food products to be promoted to children.

Low intake of dietary fibre among Brazilian adolescents and association with nutritional status: cross-sectional analysis of Study of Cardiovascular Risks in Adolescents data

OBJECTIVE

To evaluate dietary fibre intake in Brazilian adolescents and its association with nutritional status.

DESIGN

This was a cross-sectional study including data from the Brazilian multicentre Study of Cardiovascular Risks in Adolescents (ERICA). Data analysed were geographic region, sex, age, nutritional status, sexual maturation stage, socioeconomic status, school type and level of physical activity. For nutritional status classification, BMI/age was used by sex. Dietary intake was assessed by 24-h recall. Dietary fibre intake was expressed in g/d, and adequacy was determined using dietary reference intake (DRI) values. Complex sample design was considered in statistical analysis, and logistic regression was used to estimate OR for fibre intake and nutritional status.

SETTING

Brazilian municipalities with more than 100 000 inhabitants.

PARTICIPANTS

A total of 71 740 adolescents aged 12-17 years were included.

RESULTS

The average total dietary fibre intake was 19·1 g/d (95 % CI 18·5, 19·7), and only 13·1 % (95 % CI 11·6, 14·7) of Brazilian adolescents reached the recommendations. The results of logistic regression analysis adjusted for geographic region, sex and type of school showed that overweight and obese adolescents were 1·6 and 1·8 times more likely, respectively, to have inadequate dietary fibre intake (P < 0·0001).

CONCLUSIONS

Brazilian adolescents had a significantly inadequate dietary fibre intake. This was particularly notable in adolescents with excess weight. Education policies on nutrition must be implemented, as dietary fibre plays an important role in the prevention and treatment of obesity and other chronic diseases.

Dietary fibre intake and its association with inflammatory markers in adolescents

A high dietary fibre intake has been associated with improvements in inflammatory conditions in adults. However, little is known on whether associations between dietary fibre and inflammation are evident during adolescence. We examined the relationship between dietary fibre intake measured by FFQ and the inflammatory marker high-sensitivity C-reactive protein (hs-CRP) and the adipokines leptin and adiponectin cross-sectionally in 17-year-olds participating in the Raine Study (n 621). In weighted analysis using tobit and linear regression, and after excluding participants with hs-CRP > 10 mg/l, higher total dietary fibre intake (per 5 g/d) was significantly associated with lower leptin (β = -0·13, 95 % CI -0·17, -0·09) and adiponectin (β = -0·28, 95 % CI -0·49, -0·07), but not hs-CRP, in unadjusted analyses. These associations were no longer significant after adjustment for sex, anthropometry and a number of lifestyle factors. However, higher cereal and grain fibre intake was significantly associated with lower leptin (β = -0·06, 95 % CI -0·10, -0·01) in fully adjusted analysis. Our findings suggest that a higher intake of cereal and grain fibre may contribute to lower leptin in adolescents. This may contribute to reductions in low-grade chronic inflammation and improved health outcomes.

The Role of Short-Chain Fatty Acids From Gut Microbiota in Gut-Brain Communication

A substantial body of evidence supports that the gut microbiota plays a pivotal role in the regulation of metabolic, endocrine and immune functions. In recent years, there has been growing recognition of the involvement of the gut microbiota in the modulation of multiple neurochemical pathways through the highly interconnected gut-brain axis. Although amazing scientific breakthroughs over the last few years have expanded our knowledge on the communication between microbes and their hosts, the underpinnings of microbiota-gut-brain crosstalk remain to be determined. Short-chain fatty acids (SCFAs), the main metabolites produced in the colon by bacterial fermentation of dietary fibers and resistant starch, are speculated to play a key role in neuro-immunoendocrine regulation. However, the underlying mechanisms through which SCFAs might influence brain physiology and behavior have not been fully elucidated. In this review, we outline the current knowledge about the involvement of SCFAs in microbiota-gut-brain interactions. We also highlight how the development of future treatments for central nervous system (CNS) disorders can take advantage of the intimate and mutual interactions of the gut microbiota with the brain by exploring the role of SCFAs in the regulation of neuro-immunoendocrine function.

Differences in dietary fibre intake and associated familial factors in a longitudinal study at two time points across adolescence

OBJECTIVE

Dietary fibre is essential for a healthy diet; however, intake is often inadequate. Understanding of sources of dietary fibre and familial factors associated with intake in adolescents is limited, hampering efforts to increase intake. We aimed to determine adequacy of dietary fibre intake in adolescents, examine how intake changes from mid to late adolescence, identify major food sources and explore associations with familial factors.

DESIGN

Dietary fibre intake measured with semi-quantitative FFQ and sources calculated with the AUSNUT database. Familial factors determined by questionnaire.

SETTING

Western Australian Pregnancy Cohort (Raine) Study.

PARTICIPANTS

Generation 2 adolescents from the 14- (n 1626) and 17-year (n 835) follow-ups.

RESULTS

Mean intake of dietary fibre did not meet national dietary guidelines other than for females aged 14 years. Mean intake of both sexes was lower at 17 years (23·0 (sd 10·0) g/d) than at 14 years (24·3 (sd 9·0) g/d, P < 0·001). The quantity of dietary fibre consumed per megajoule also decreased (2·6 (sd 0·7) g/MJ at 14 years, 2·5 (sd 0·9) g/MJ at 17 years, P = 0·007). The greatest source of dietary fibre was cereals and grains, followed by fruits, then vegetables. In multivariable mixed-model analysis, female sex, Caucasian race, age 14 years, good family functioning, high level of parental education and high energy intake were independently associated with higher dietary fibre intake.

CONCLUSIONS

Our study highlights an age range and characteristics of adolescents lacking in dietary fibre, thereby identifying target populations for interventions to improve dietary fibre intake across adolescence, which would lead to better health.

The Gut Microbiota in the First Decade of Life

Appreciation of the importance of the gut microbiome is growing, and it is becoming increasingly relevant to identify preventive or therapeutic solutions targeting it. The composition and function of the gut microbiota are relatively well described for infants (less than 3 years) and adults, but have been largely overlooked in pre-school (3-6 years) and primary school-age (6-12 years) children, as well as teenagers (12-18 years). Early reports suggested that the infant microbiota would attain an adult-like structure at the age of 3 years, but recent studies have suggested that microbiota development may take longer. This development time is of key importance because there is evidence to suggest that deviations in this development may have consequences in later life. In this review, we provide an overview of current knowledge concerning the gut microbiota, its evolution, variation, and response to dietary challenges during the first decade of life with a focus on healthy pre-school and primary school-age children (up to 12 years) from various populations around the globe. This knowledge should facilitate the identification of diet-based approaches targeting individuals of this age group, to promote the development of a healthy microbiota in later life.

Short Chain Fatty Acids Prevent High-fat-diet-induced Obesity in Mice by Regulating G Protein-coupled Receptors and Gut Microbiota

Elucidating the mechanisms by which short chain fatty acids (SCFA) reduce body weight may assist in the development of an effective weight control strategy. Dietary supplementation of acetate, propionate, butyrate or their admixture was shown to significantly inhibit the body weight gain induced by high-fat diet feeding. Supplementation of SCFAs caused significant changes in the expressions of G-protein coupled receptor 43 (GPR43) and GPR41 characterized by increases in the adipose tissue and reductions in the colon. Additionally, they influenced the bacterial community structure in feces, with a reduction in the proportion of Firmicutes and an increase in the proportion of Bacteroidetes. The effects of dietary SCFAs on the GPR expression and gut microbiota composition may further result in body weight reduction by enhancing triglyceride hydrolysis and FFA oxidation in the adipose tissue, promoting beige adipogenesis and mitochondrial biogenesis, and inhibiting chronic inflammation.

Associations between Dietary Fiber Intake in Infancy and Cardiometabolic Health at School Age: The Generation R Study

Dietary fiber (DF) intake may be beneficial for cardiometabolic health. However, whether this already occurs in early childhood is unclear. We investigated associations between DF intake in infancy and cardiometabolic health in childhood among 2032 children participating in a population-based cohort in The Netherlands. Information on DF intake at a median age of 12.9 months was collected using a food-frequency questionnaire. DF was adjusted for energy intake using the residual method. At age 6 years, body fat percentage, high-density lipoprotein (HDL)-cholesterol, insulin, triglycerides, and blood pressure were assessed and expressed in age- and sex-specific standard deviation scores (SDS). These five factors were combined into a cardiometabolic risk factor score. In models adjusted for several parental and child covariates, a higher DF intake was associated with a lower cardiometabolic risk factor score. When we examined individual cardiometabolic factors, we observed that a 1 g/day higher energy-adjusted DF intake was associated with 0.026 SDS higher HDL-cholesterol (95% CI 0.009, 0.042), and 0.020 SDS lower triglycerides (95% CI −0.037, −0.003), but not with body fat, insulin, or blood pressure. Results were similar for DF with and without adjustment for energy intake. Our findings suggest that higher DF intake in infancy may be associated with better cardiometabolic health in later childhood.