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Arora A, Rahaman KS, Parmar JS, Gupta A, Evans N, Chandio N, Selvaratnam N, Manohar N. Trajectories of Sugar-Sweetened Beverage Intake in Early Life: Evidence from a Birth Cohort Study. Nutrients 2024; 16:2336. [PMID: 39064778 PMCID: PMC11279875 DOI: 10.3390/nu16142336] [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: 06/14/2024] [Revised: 07/08/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Infancy and early childhood are periods of dietary transition. Early exposure to specific foods and the establishment of dietary habits during this period can shape long-term food preferences and have lasting effects on health. This study aimed to examine the longitudinal trajectories of sugar-sweetened beverage (SSB) intake in Australian children from birth to age 3 years and identify early-life and socioeconomic factors influencing those trajectories. Mother-infant dyads (n = 934) from the Healthy Smiles Healthy Kids birth cohort study were interviewed on their weekly frequency of SSB intake at 4-month, 8-month, 1-year, 2-year, and 3-year age points. Group-based trajectory modelling analysis was performed to identify trajectories for SSB intake among Australian children. A multivariable logistic regression was performed to identify the maternal and child-related predictors of resulting trajectories. The intake of SSBs showed two distinct quadratic trajectories (high and low) with age. While the two trajectories remained distinctive throughout, the SSB consumption for both groups consistently increased between 4 months and 2 years of age and subsequently stabilised. Compared to low SSB consumers (75%), the high SSB consumers (25%) were significantly more likely to be living in households with three or more children (relative risk (RR): 1.59, 95%CI: 1.02-2.48), had low maternal education (left school < year 12-RR: 1.75, 95%CI: 1.09-2.81; completed year 12-RR: 1.57, 95%CI: 1.02-2.81), and resided in highly/the most socioeconomically disadvantaged areas (highly disadvantaged-RR: 1.89, 95%CI: 1.13-3.18; most disadvantaged-RR: 2.06, 95%CI: 1.25-3.38). Children's SSB intake patterns are established early in life as they transition from infancy to preschool age, and the trajectories of intake established during early childhood are strongly influenced by socioeconomic factors. Hence, interventions targeted to limit SSB intake and improve nutrition amongst children should occur in early life.
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Affiliation(s)
- Amit Arora
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (K.S.R.); (J.S.P.); (N.E.); (N.S.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia; (N.C.); (N.M.)
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW 2010, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Kh. Shafiur Rahaman
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (K.S.R.); (J.S.P.); (N.E.); (N.S.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia; (N.C.); (N.M.)
| | - Jinal Shashin Parmar
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (K.S.R.); (J.S.P.); (N.E.); (N.S.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia; (N.C.); (N.M.)
| | - Adyya Gupta
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC 3220, Australia;
| | - Nicole Evans
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (K.S.R.); (J.S.P.); (N.E.); (N.S.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia; (N.C.); (N.M.)
| | - Navira Chandio
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia; (N.C.); (N.M.)
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Navodya Selvaratnam
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (K.S.R.); (J.S.P.); (N.E.); (N.S.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia; (N.C.); (N.M.)
| | - Narendar Manohar
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia; (N.C.); (N.M.)
- Black Dog Institute, Hospital Road, Randwick, NSW 2031, Australia
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Manohar N, Hayen A, Do L, Scott J, Bhole S, Arora A. Early life and socio-economic determinants of dietary trajectories in infancy and early childhood - results from the HSHK birth cohort study. Nutr J 2021; 20:76. [PMID: 34493286 PMCID: PMC8424821 DOI: 10.1186/s12937-021-00731-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/09/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Early childhood is a period when dietary behaviours are established. This study aimed to examine the longitudinal intake of core and discretionary foods and identify early life and socio-economic factors influencing those intakes. METHODS Mother-infant dyads (n = 934) from the Healthy Smiles Healthy Kids study, an ongoing birth cohort study, were interviewed. The information on 'weekly frequency of core and discretionary foods intake' using a food frequency questionnaire was collected at 4 months, 8 months, 1 year, 2 years and 3 years age points. Group-based trajectory modelling analyses were performed to identify diet trajectories for 'core' and 'discretionary' foods respectively. A multinomial logistic regression was performed to identify the maternal and child-related predictors of resulting trajectories. RESULTS The intake of core and discretionary foods each showed distinct quadratic (n = 3) trajectories with age. Overall, core foods intake increased rapidly in the first year of life, followed by a decline after age two, whereas discretionary foods intake increased steadily across the five age points. Multiparity (Relative Risk (RR): 0.46, 95%CI: 0.27-0.77), non-English speaking ethnicity of mother (RR: 0.66, 95%CI: 0.47-0.91) and having a single mother (RR: 0.40, 95%CI: 0.18-0.85) were associated with low trajectories of core foods intake whereas older maternal age (RR: 1.05, 95%CI: 1.01-1.08) and longer breastfeeding duration (RR: 1.02, 95%CI: 1.00-1.03) were associated with higher trajectories of core foods intake. Also, multiparity (RR 2.63, 95%CI: 1.47-4.70), low maternal education (RR 3.01, 95%CI: 1.61-5.65), and socio-economic disadvantage (RR 2.69, 95%CI: 1.31-5.55) were associated with high trajectories of discretionary foods intake. Conversely, longer duration of breastfeeding (RR 0.99, 95%CI: 0.97-0.99), and timely introduction of complementary foods (RR 0.30, 95%CI: 0.15-0.61) had a protective effect against high discretionary foods consumption in infancy and early childhood. CONCLUSION Children's frequency of discretionary foods intake increases markedly as they transition from infancy to preschool age, and the trajectories of intake established during early childhood are strongly influenced by socio-demographic factors and infant feeding choices. Hence, there is a need for targeted strategies to improve nutrition in early childhood and ultimately prevent the incidence of chronic diseases in children.
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Affiliation(s)
- Narendar Manohar
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia
- Australian College of Physical Education, Sydney Olympic Park, NSW, 2127, Australia
| | - Andrew Hayen
- Faculty of Health, School of Public Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Loc Do
- Faculty of Health and Behavioural Sciences, School of Dentistry, University of Queensland, Brisbane, QLD, 4072, Australia
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Jane Scott
- Discipline of Nutrition and Dietetics, School of Population Health, Curtin University, Perth, WA, 6102, Australia
| | - Sameer Bhole
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW, 2010, Australia
- Faculty of Medicine and Health, Sydney Dental School, The University of Sydney, Surry Hills, NSW, 2010, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia.
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia.
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW, 2010, Australia.
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2560, Australia.
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, Westmead, NSW, 2145, Australia.
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Impact of Dietary Trajectories on Obesity and Dental Caries in Preschool Children: Findings from the Healthy Smiles Healthy Kids Study. Nutrients 2021; 13:nu13072240. [PMID: 34209914 PMCID: PMC8308427 DOI: 10.3390/nu13072240] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/25/2021] [Accepted: 06/25/2021] [Indexed: 12/15/2022] Open
Abstract
This study examines the impact of longitudinal dietary trajectories on obesity and early childhood caries (ECC) in preschool children in Australia. Mother–infant dyads from the Healthy Smiles Healthy Kids study were interviewed at 4 and 8 months, and 1, 2, and 3 years of age. Children underwent anthropometric and oral health assessments between 3 and 4 years of age. Multivariable logistic regression and negative binomial regression analysis were performed for the prevalence of overweight and obesity, and the number of tooth surfaces with dental caries, respectively. The intake of core, discretionary, and sugary foods showed distinct quadratic (n = 3) trajectories with age. The prevalence of overweight or obesity was 10% (n = 72) and that of early childhood caries (ECC) was 33% (mean decayed, missing, and filled tooth surfaces (dmfs) score: 1.96). Children with the highest trajectories of discretionary foods intake were more likely to be overweight or obese (adjusted OR: 2.51, 95 %CI: 1.16–5.42). Continued breastfeeding beyond 12 months was associated with higher dmfs scores (adjusted IRR: 2.17, 95 %CI: 1.27–3.73). Highest socioeconomic disadvantage was the most significant determinant for overweight or obesity (adjusted OR: 2.86, 95 %CI: 1.11–7.34) and ECC (adjusted IRR: 2.71, 95 %CI: 1.48–4.97). Targeted health promotion interventions should be designed to prevent the incidence of two highly prevalent conditions in preschool children.
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Factors Influencing the Early Introduction of Sugar Sweetened Beverages among Infants: Findings from the HSHK Birth Cohort Study. Nutrients 2020; 12:nu12113343. [PMID: 33143073 PMCID: PMC7693806 DOI: 10.3390/nu12113343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/25/2020] [Accepted: 10/27/2020] [Indexed: 12/27/2022] Open
Abstract
Understanding the determinants of early introduction of sugar sweetened beverages (SSBs) may assist in designing effective public health interventions to prevent childhood weight related conditions (obesity). This study explores the relationship between family/infant characteristics and the early introduction of SSBs among infants in Sydney, Australia. Mothers (n = 934) from an ongoing birth cohort study were interviewed at 8, 17, 34, and 52 weeks postpartum. Multivariable logistic regression analysis was used to identify family/infant factors independently associated with the likelihood of early introduction of SSBs (<52 weeks of age). Of the 934 mothers interviewed, 42.7% (n = 399) of infants were introduced to SSBs before 52 weeks. Mothers who were born in Vietnam (adjusted Odds Ratio (AOR) = 2.14; 95% confidence interval (CI) 1.33, 3.47), other Asian countries (AOR = 1.62; 95% CI 1.02, 2.58) as well as single mothers (AOR = 3.72; 95% CI 2.46, 5.62) had higher odds of introducing SSBs early to their infants. Mothers from highly advantaged socioeconomic background (AOR = 0.43; 95% CI 0.28, 0.68), those who breastfed their baby for 17–25 weeks (AOR = 0.60; 95% CI 0.37, 0.99), 26–51 weeks (AOR = 0.65; 95% CI 0.45, 0.94), and 52 weeks or more (AOR = 0.62; 95% CI 0.43, 0.90); and those who introduced solids between 17–25 weeks (AOR = 0.58; 95% CI 0.36, 0.91) and 26 weeks or more (AOR = 0.55; 95% CI 0.34, 0.91) had reduced odds of introducing SSBs early. Tailoring health promotion programs for these vulnerable groups may delay the introduction of SSBs.
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Validation and calibration of the Eating Assessment in Toddlers FFQ (EAT FFQ) for children, used in the Growing Up Milk - Lite (GUMLi) randomised controlled trial. Br J Nutr 2020; 125:183-193. [PMID: 32799967 DOI: 10.1017/s0007114520002664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The Eating Assessment in Toddlers FFQ (EAT FFQ) has been shown to have good reliability and comparative validity for ranking nutrient intakes in young children. With the addition of food items (n 4), we aimed to re-assess the validity of the EAT FFQ and estimate calibration factors in a sub-sample of children (n 97) participating in the Growing Up Milk - Lite (GUMLi) randomised control trial (2015-2017). Participants completed the ninety-nine-item GUMLi EAT FFQ and record-assisted 24-h recalls (24HR) on two occasions. Energy and nutrient intakes were assessed at months 9 and 12 post-randomisation and calibration factors calculated to determine predicted estimates from the GUMLi EAT FFQ. Validity was assessed using Pearson correlation coefficients, weighted kappa (κ) and exact quartile categorisation. Calibration was calculated using linear regression models on 24HR, adjusted for sex and treatment group. Nutrient intakes were significantly correlated between the GUMLi EAT FFQ and 24HR at both time points. Energy-adjusted, de-attenuated Pearson correlations ranged from 0·3 (fibre) to 0·8 (Fe) at 9 months and from 0·3 (Ca) to 0·7 (Fe) at 12 months. Weighted κ for the quartiles ranged from 0·2 (Zn) to 0·6 (Fe) at 9 months and from 0·1 (total fat) to 0·5 (Fe) at 12 months. Exact agreement ranged from 30 to 74 %. Calibration factors predicted up to 56 % of the variation in the 24HR at 9 months and 44 % at 12 months. The GUMLi EAT FFQ remained a useful tool for ranking nutrient intakes with similar estimated validity compared with other FFQ used in children under 2 years.
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Manohar N, Hayen A, Bhole S, Arora A. Predictors of Early Introduction of Core and Discretionary Foods in Australian Infants-Results from HSHK Birth Cohort Study. Nutrients 2020; 12:E258. [PMID: 31963864 PMCID: PMC7019241 DOI: 10.3390/nu12010258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 11/21/2022] Open
Abstract
Early introduction of complementary foods can have a detrimental impact on children's long-term health. This study examined the timing and determinants of early introduction of core and discretionary foods among infants in Sydney, Australia. Mothers (n = 1035) from an ongoing population-based birth cohort study were interviewed at 8, 17, 34 and 52 weeks postpartum. The outcome was 'age at which particular core and discretionary food items were first introduced'. Multivariable logistic regression models were used to investigate family and infant-related determinants of early introduction of core (<17 weeks of age) and discretionary foods (<52 weeks of age). Of the 934 mother-infant dyads interviewed, 12% (n = 113) of infants were introduced core foods before 17 weeks of age (median: 22). Mothers working part-time (adjusted odds ratio (OR): 3.42, 95% confidence interval (CI): 1.54-7.62) and those exclusively formula-feeding their babies at four-weeks postpartum (adjusted OR 3.26, 95% CI: 1.99-5.33) were most likely to introduce core foods early. Ninety-five percent (n = 858) of infants were introduced discretionary foods before 52 weeks of age (median: 28). Low socio-economic status was significantly associated with early introduction of discretionary foods (adjusted OR: 3.72, 95% CI: 1.17-11.78). Compliance with infant feeding guidelines related to core foods was better; however, discretionary foods were introduced early in most infants.
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Affiliation(s)
- Narendar Manohar
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia;
| | - Andrew Hayen
- Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia;
| | - Sameer Bhole
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW 2010, Australia;
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW 2010, Australia
- Oral Health Alliance, Oral Health Centre, University of Queensland, Brisbane, QLD 4072, Australia
- Metro North Oral Health Services, Stafford, QLD 4053, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia;
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW 2010, Australia;
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney Faculty of Medicine and Health, Westmead, NSW 2050, Australia
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Allan C, Abdul Kader UH, Ang JYY, Muhardi L, Nambiar S. Relative validity of a semi-quantitative food frequency questionnaire for Singaporean toddlers aged 15-36 months. BMC Nutr 2018; 4:42. [PMID: 32153903 PMCID: PMC7050816 DOI: 10.1186/s40795-018-0252-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 10/03/2018] [Indexed: 02/07/2023] Open
Abstract
Background There is presently no simple tool for use in large epidemiological studies to understand the food and nutrient intakes of Asian toddlers. This study aimed to assess the relative validity of a semi-quantitative food frequency questionnaire (sqFFQ) developed for multi-ethnic Singaporean toddlers aged 15–36 months. Methods Ninety-one parents completed the sqFFQ and a 2-day weighed food record as the reference method. Intake of energy and 25 nutrients were determined for each method and compared using Pearson correlations corrected for attenuation, Bland-Altman plots, and weighted kappa according to quartiles; sqFFQ calibration was performed using multivariable linear regression. Results Deattenuated correlations for energy and all nutrients were acceptable (r = ≥0.30, p < 0.001). The sqFFQ was highly reproducible, but significantly overestimated intake of energy and all nutrients except vitamin A. Bland-Altman plots showed wide limits of agreement for energy and all nutrients. Weighted kappa ranged from 0.12 (slight) to 0.53 (moderate). After calibration, deattenuated correlations improved for energy and 10/25 nutrients, with no change or a slight decline for the remainder, including one falling to r = 0.27. Limits of agreement narrowed for energy and all nutrients, and except for DHA, median intakes were not significantly different except for vitamin A, enabling population estimates of absolute intakes. Weighted kappa improved overall; energy and 16 nutrients now had moderate agreement (0.41–0.60), while 9 nutrients had fair agreement (0.21–0.40). Conclusions The Singaporean toddler semi-quantitative food frequency questionnaire is suitable for ranking nutrient intakes of Singaporean toddlers in larger epidemiological studies. However, for population estimates of absolute nutrient intakes, it is recommended that a subsample within a cohort complete weighed food records for calibration purposes. Trial registration This study was registered retrospectively on clinicaltrials.gov on 3rd May 2017 (identifier code: NCT03138330).
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Affiliation(s)
- Cameron Allan
- 1School of Exercise & Nutrition Sciences, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059 Australia
| | - Ummi Hani Abdul Kader
- Early Life Nutrition, Danone Nutricia Research, 30 Biopolis St, Matrix Building #05-01B, Singapore, 138671 Singapore
| | - Jowynn Yu Ying Ang
- 1School of Exercise & Nutrition Sciences, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059 Australia
| | - Leilani Muhardi
- Early Life Nutrition, Danone Nutricia Research, 30 Biopolis St, Matrix Building #05-01B, Singapore, 138671 Singapore.,Healthcare Nutrition Science, Danone Nutricia Sari Husada, 15th Fl, Cyber 2 Building, Jl. HR Rasuna Said no. 13, Jakarta, Indonesia
| | - Smita Nambiar
- Early Life Nutrition, Danone Nutricia Research, 30 Biopolis St, Matrix Building #05-01B, Singapore, 138671 Singapore
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Ibiyemi O, Zohoori FV, Valentine RA, Maguire A. Fluoride intake and urinary fluoride excretion in 4- and 8-year-old children living in urban and rural areas of Southwest Nigeria. Community Dent Oral Epidemiol 2018; 46:482-491. [PMID: 29971814 DOI: 10.1111/cdoe.12396] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 05/30/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To estimate and compare total daily fluoride intake (TDFI), daily urinary fluoride excretion (DUFE), daily fluoride retention (DFR), fractional urinary fluoride excretion (FUFE) and fractional fluoride retention (FFR) in 4- and 8 year-old Nigerians and explore associations between these outcomes to improve understanding of fluoride metabolism. METHODS Using a cross-sectional observational study, 72 four-year-olds and 72 eight-year-olds were recruited from nursery and primary schools (respectively) in lower and higher water F areas of urban and rural localities in Oyo State, southwest Nigeria. TDFI from diet and toothpaste ingestion was assessed using a validated Food Frequency Questionnaire and visual scale of toothpaste used during toothbrushing. DUFE was measured by collecting a 24-hour urine sample, FUFE estimated as the ratio between DUFE and TDFI, DFR estimated as TDFI-TDFE (where TDFE = DUFE + estimated faecal F excretion (ie TDFI × 10%), and FFR was estimated as [(TDFI-DFR)/TDFI] × 100. Data were analysed using ANOVA with post hoc tests and Student's t tests and strengths of associations between key variables measured. RESULTS Mean (SD) TDFI, DUFE, DFR, FUFE and FFR were 0.137 (0.169) mg/kg bw/d, 0.032 (0.027) mg/kg bw/d, 0.091 (0.147) mg/kg bw/d, 44% (44%) and 46% (44%), respectively, for 4-year-olds. Corresponding values for 8-year-olds (n = 63) were 0.106 (0.130) mg/kg bw/d, 0.022 (0.017) mg/kg bw/d, 0.073 (0.107) mg/kg bw/d, 36% (30%) and 54% (30%), respectively. Dietary contribution to TDFI was 79% and 75% (respectively), for 4- and 8-year-olds. Mean (SD) TDFI from toothpaste ingestion was 0.021 (0.013) mg/kg bw/d in 4-year-olds, 0.014 (0.010) mg/kg bw/d in 8-year-olds (P = .002) but with no differences between areas. Differences in dietary F intake determined the main differences in F exposure between areas. The positive correlation between TDFI and DUFE was weak for 4-year-olds (r = +.29) and strong for 8-year-olds (r = +.64). A strong positive correlation was observed between TDFI and DFR for both age groups: (r) = +.98 for 4-year-olds and (r) = +.99 for 8-year-olds. CONCLUSION Fluoride intake in these 4- and 8-year-old Nigerians was much higher than the "optimal range" of 0.05-0.07 mg/kg bw/d in rural, higher F water areas, with diet as the main contributor. F retention was similar in both age groups, with almost half of TDFI retained in the body. In terms of risk vs benefit for fluorosis and dental caries, this finding should be considered when mitigating against excessive fluoride exposure and planning F-based prevention.
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Affiliation(s)
- O Ibiyemi
- Centre for Oral Health Research, School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK.,Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - F V Zohoori
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - R A Valentine
- Centre for Oral Health Research, School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - A Maguire
- Centre for Oral Health Research, School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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Quality of food-frequency questionnaire validation studies in the dietary assessment of children aged 12 to 36 months: a systematic literature review. J Nutr Sci 2017. [PMID: 28630693 PMCID: PMC5468742 DOI: 10.1017/jns.2017.12] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
A child's diet is an important determinant of growth and development. Because of this, the accurate assessment of dietary intake in young children remains a challenge. A systematic search of studies validating FFQ methodologies in children 12 to 36 months of age was completed. English-language articles published until March 2016 were searched using three electronic databases (MEDLINE, EMBASE and CINAHL). Quality assessment of the identified studies was carried out using The Reduced Summary Score and EURopean micronutrient RECommendations Aligned (EURRECA) scoring system. Seventeen studies were included and categorised according to whether they reflected long-term (≥7 d) or short-term (<7 d) intake, or used a biomarker. A total score for each micronutrient was calculated from the mean of the correlation coefficients weighted by the study quality score. At least three validation studies per micronutrient were required for inclusion. Fifteen studies (83 %) that considered validity of the FFQ in assessing nutrient intakes had quality scores from 2·5 to 6·0. Of those, ten (67 %) studies found FFQ to have good correlations in assessing dietary intake (>0·4). Of the nutrients with three or more studies available, FFQ validated using a reference method reflecting short-term intake had a good weighted correlation for Ca (0·51), and acceptable weighted correlations for vitamin C (0·31) and Fe (0·33). Semi-quantitative FFQ were shown to be valid and reproducible when estimating dietary intakes at a group level, and are an acceptable instruments for estimating intakes of Ca, vitamin C and Fe in children 12 to 36 months of age.
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Rankin SJ, Levy SM, Warren JJ, Gilmore JE, Broffitt B. Fluoride content of solid foods impacts daily intake. J Public Health Dent 2011; 72:128-34. [PMID: 22315974 DOI: 10.1111/j.1752-7325.2011.00292.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the amount of fluoride received from solid foods for a cohort of children. METHODS Parents were asked to complete questionnaires for the preceding week and dietary diaries for 3 days for their children. Data collected at 6, 9, 12, 16, 20, 24, 36, 48, and 60 months were analyzed cross-sectionally. RESULTS At 6 months of age, children ingested an estimated mean of 8 percent of dietary fluoride from solid foods. At 12 months of age, children ingested an estimated 39 percent of dietary fluoride from solid foods. Although the percentage of fluoride intake from solid foods stabilized from 24 to 60 months (means of 36-39 percent), some children received as much as 85-88 percent of their dietary fluoride from solid foods. CONCLUSIONS Some children receive a substantial portion of dietary fluoride from solid foods.
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Children in public health nutrition. Public Health Nutr 2011; 14:1131-2. [DOI: 10.1017/s1368980011001200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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