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Bradley J, Rowland MK, Matthews JNS, Adamson AJ, Spence S. A comparison of food portion size estimation methods among 11-12 year olds: 3D food models vs an online tool using food portion photos (Intake24). BMC Nutr 2021; 7:10. [PMID: 33952349 PMCID: PMC8101205 DOI: 10.1186/s40795-021-00415-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/08/2021] [Indexed: 11/10/2022] Open
Abstract
Background Technology has advanced bringing new cost-effective methods to measure food intake. The aim of the study was to compare food and drink portion estimates from a traditional portion estimation method using 3D food models with portion estimates using an online dietary recall tool, Intake24. Methods 11-12 year old children were recruited from secondary schools in Newcastle upon Tyne. Each pupil completed a two-day food diary followed by an interview during which pupils estimated food portion sizes using a range of 3D food models. They also completed Intake24 for the same 2 days. Bland Altman analyses were used to compare mean intake for each method. Results Seventy pupils completed both portion estimation methods. There was good agreement in food weight estimations between the two methods (geometric mean ratio 1.00), with limits of agreement ranging from minus 35% to plus 53%. Intake24 provided estimates of energy intake that were 1% lower on average than estimates of energy intake using the food models. Mean intakes of all macro and micronutrients using Intake24 were within 6% of the food model estimates. Conclusions The findings suggest that there was little difference in portion estimations from the two methods, allowing comparisons to be made between Intake24 data and food diary data collected from same age pupils using 3D food models in previous years.
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Affiliation(s)
- Jennifer Bradley
- Human Nutrition Research Centre, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK.
| | - Maisie K Rowland
- Human Nutrition Research Centre, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - John N S Matthews
- School of Mathematics, Statistics and Physics, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - Ashley J Adamson
- Human Nutrition Research Centre, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Suzanne Spence
- Human Nutrition Research Centre, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
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Rosi A, Mena P, Castello F, Del Rio D, Scazzina F. Comprehensive dietary evaluation of Italian primary school children: food consumption and intake of energy, nutrients and phenolic compounds. Int J Food Sci Nutr 2020; 72:70-81. [PMID: 32316789 DOI: 10.1080/09637486.2020.1754768] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Information on children's diet including bioactive compounds is quite scarce. This observational study investigated the composition of the diet of children living in Parma (Italy; n = 172, 8-10 years) using 3-day food records completed in winter and spring. Mean daily intakes of food groups, energy and nutrients were obtained using the national food database, while (poly)phenol contents were estimated from Phenol-Explorer or by specific literature searches. Food consumption, energy and nutrient intakes decreased in spring and were partially in line with national data. Adherence to the nutritional recommendations was not satisfied for the majority of nutrients. Main contributors to the phenolic intake were flavonoids (flavan-3-ols) and phenolic acids (hydroxycinnamic acids), while main dietary sources were fruit, chocolate-based products, vegetables, and tea & coffee (decaffeinated). This study provided the first comprehensive analysis of the nutritional composition of children's diet. Future research should look at the health implications of dietary choices in children.
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Affiliation(s)
- Alice Rosi
- Human Nutrition Unit, Department of Food and Drugs, University of Parma, Parma, Italy
| | - Pedro Mena
- Human Nutrition Unit, Department of Food and Drugs, University of Parma, Parma, Italy
| | - Fabio Castello
- Human Nutrition Unit, Department of Food and Drugs, University of Parma, Parma, Italy
| | - Daniele Del Rio
- Human Nutrition Unit, Department of Veterinary Science, University of Parma, Parma, Italy.,Giocampus Scientific Committee, Parma, Italy
| | - Francesca Scazzina
- Human Nutrition Unit, Department of Food and Drugs, University of Parma, Parma, Italy.,Giocampus Scientific Committee, Parma, Italy
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Spence S, White M, Adamson AJ, Matthews JNS. Does the use of passive or active consent affect consent or completion rates, or dietary data quality? Repeat cross-sectional survey among school children aged 11-12 years. BMJ Open 2015; 5:e006457. [PMID: 25586368 PMCID: PMC4298110 DOI: 10.1136/bmjopen-2014-006457] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES An expectation of research is that participants should give fully informed consent. However, there is also a need to maximise recruitment to ensure representativeness. We explored the impact of passive or active parental consent on consent, completion rates and on dietary data quality in a survey among children aged 11-12 years. SETTING Six middle schools in North-East England. PARTICIPANTS All children aged 11-12 years attending the six middle schools were eligible to participate (n=1141). PRIMARY OUTCOMES whether or not each eligible child's parent gave consent and provided a complete dietary diary; whether or not a child completed their dietary diary but only among children who agreed to participate, and whether or not children providing diaries were classified as an under-reporter or not. RESULTS Parents were more likely to consent passively than actively. This difference was greater among the more deprived: OR 16.9 (95% CI 5.7 to 50.2) in the least and 129.6 (95% CI 39.9 to 420.6) in the most deprived quintile (test for interaction: method of consent by level of deprivation, p=0.02). For all children eligible, completion was more likely if passive consent was used (OR 2.8, 95% CI 2.2 to 3.7). When only children who gave consent are considered, completion was less likely when passive rather than active consent was used (OR 0.6, 95% CI 0.4 to 0.9). Completion rate decreased as level of deprivation increased; we found no evidence that the OR for the method of consent varied by level of deprivation. There was no evidence that the quality of dietary data, as measured by an assessment of under-reporting, differed by method of consent (OR 0.8, 95% CI 0.5 to 1.2). CONCLUSIONS Passive consent led to a higher participation rate and a more representative sample without compromising data quality.
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Affiliation(s)
- Suzanne Spence
- Institute of Health & Society, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Martin White
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK (Visiting Professor) Fuse, UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Ashley J Adamson
- Institute of Health & Society, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK Fuse, UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - John N S Matthews
- School of Mathematics and Statistics, Newcastle University, Newcastle upon Tyne, UK
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Spence S, Delve J, Stamp E, Matthews JNS, White M, Adamson AJ. Did school food and nutrient-based standards in England impact on 11-12Y olds nutrient intake at lunchtime and in total diet? Repeat cross-sectional study. PLoS One 2014; 9:e112648. [PMID: 25409298 PMCID: PMC4237353 DOI: 10.1371/journal.pone.0112648] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 10/10/2014] [Indexed: 11/20/2022] Open
Abstract
Introduction In September 2009, middle and secondary schools in England were required to comply with food and nutrient-based standards for school food. We examined the impact of this policy change on children’s lunchtime and total dietary intake. Methods We undertook repeat cross-sectional surveys in six Northumberland middle schools in 1999–2000 and 2009–10. Dietary data were collected from 11–12 y olds (n = 298 in 1999–2000; n = 215 in 2009–10). Children completed two consecutive 3-day food diaries, each followed by an interview. Linear mixed effect models examined the effect of year, lunch type and level of socio-economic deprivation on children’s mean total dietary intake. Results We found both before and after the introduction of the food and nutrient-based standards children consuming a school lunch, had a lower per cent energy from saturated fat (−0.5%; p = 0.02), and a lower intake of sodium (−143 mg; p = 0.02), and calcium (−81 mg; p = 0.001) in their total diet, compared with children consuming a home-packed lunch. We found no evidence that lunch type was associated with mean energy, or absolute amounts of NSP, vitamin C and iron intake. There was marginal evidence of an association between lunch type and per cent energy NMES (p = 0.06). In 1999–2000, children consuming a school lunch had a higher per cent energy from fat in their total diet compared with children consuming a home-packed lunch (2.8%), whereas by 2009–10, they had slightly less (−0.2%) (year by lunch type interaction p<0.001; change in mean differences −3%). Conclusions We found limited evidence of an impact of the school food and nutrient-based standards on total diet among 11–12 year olds. Such policies may need to be supported by additional measures, including guidance on individual food choice, and the development of wider supportive environments in school and beyond the school gates.
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Affiliation(s)
- Suzanne Spence
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, England
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, England
| | - Jennifer Delve
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, England
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, England
| | - Elaine Stamp
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, England
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, England
| | - John N. S. Matthews
- School of Mathematics and Statistics, Newcastle University, Newcastle upon Tyne, England
| | - Martin White
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, England
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, England
- Fuse, UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, England
| | - Ashley J. Adamson
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, England
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, England
- Fuse, UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, England
- * E-mail:
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A repeat cross-sectional study examining the equitable impact of nutritional standards for school lunches in England in 2008 on the diets of 4-7y olds across the socio-economic spectrum. Int J Behav Nutr Phys Act 2014; 11:128. [PMID: 25342153 PMCID: PMC4228190 DOI: 10.1186/s12966-014-0128-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 10/03/2014] [Indexed: 12/04/2022] Open
Abstract
Background The 2008 nutritional standards for primary school lunch in England improved nutritional content. The impact on socio-economic inequalities is unknown. We examine the impact of the nutritional standards on children’s nutrient intake at lunchtime and in total diet by level of deprivation. Methods We conducted cross-sectional studies in 12 English primary schools before and after legislation. Dietary intake was recorded for 4-7y olds using a validated, prospective four-day food diary. Socio-economic status was estimated using the Index of Multiple Deprivation; three groups of approximately equal sizes were created. Linear, mixed-effect models explored the effect of year, lunch type (school or home-packed lunch), level of deprivation and the interaction(s) between these factors on children’s diets. Results 368 and 624 children participated in 2003–4 and 2008–9 respectively. At lunchtime, between 2003–4 and 2008–9, the increase in non-starch polysaccharide (NSP) intake was larger in the least compared to the most deprived group (difference in mean change 0.8 mg; 95% CI 0.4, 1.3). There were similar differences in mean changes for iron (0.3 mg; 0.2, 0.4) and zinc (0.3 mg; 0.1, 0.5). In total diet, differential effects were observed for NSP, iron and zinc; we found no evidence these changes were associated with lunch type. Lunch type was associated with changes in per cent energy from non-milk-extrinsic sugars (NMES) and vitamin C. Per cent energy from NMES was lower and vitamin C intake higher in school lunches in 2008–9 compared with 2003–4. The corresponding differences in home-packed lunches were not as marked and there were subtle but statistically significant effects of the level of deprivation. Conclusions By 2008–9, NMES at lunchtime and in total diet was lower for children consuming a school lunch; this change was equitable across the deprivation groups. Vitamin C intake increased more for children in the most deprived group, narrowing the socio-economic inequality. A range of significant differential effects of the nutritional standards were observed and important socio-economic inequalities in dietary intake remain. Additional interventions to promote equitable nutrition in children are needed to support legislative measures and maximise their impact.
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Huew R, Maguire A, Waterhouse P, Moynihan P. Nutrient intake and dietary patterns of relevance to dental health of 12-year-old Libyan children. Public Health Nutr 2014; 17:1107-13. [PMID: 23552503 PMCID: PMC10282245 DOI: 10.1017/s1368980013000645] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 01/28/2013] [Accepted: 01/30/2013] [Indexed: 11/05/2022]
Abstract
OBJECTIVE There are few data on the dietary intake of children in Libya, and none on free sugars intake. The present study aimed to report the intake of macronutrients and eating habits of relevance to dental health in a group of Libyan schoolchildren and to investigate any gender differences for these variables. DESIGN Dietary information was obtained from a randomly selected sample using an estimated 3 d food diary. Dietary data were coded using food composition tables and entered into a Microsoft® Access database. Intakes of energy, macronutrients, sugars and the amount of acidic items consumed were determined using purpose-written programs. SETTING Benghazi, Libya. SUBJECTS Schoolchildren aged 12 years. RESULTS One hundred and eighty children (ninety-two boys and eighty-eight girls) completed the study. Their mean age was 12·3 (sd 0·29) years. The average daily energy intake was 7·01 (sd 1·54) MJ/d. The percentage contributions to energy intake from protein, fat and carbohydrate were 16 %, 30 % and 54 %, respectively. Total sugars contributed 20·4 % of the daily energy intake, and free sugars 12·6 %. The median daily intake of acidic items was 203 g/d, and of acidic drinks was 146 g/d. There were no statistically significant differences in nutrient intakes between genders. Intake of acidic items was higher in girls (P < 0·001). CONCLUSIONS The contribution to energy intake from macronutrients was in accordance with global nutrition guidelines. The acidic drinks intake was low compared with other populations, while free sugars intake was above the recommended threshold of 10 % of energy intake.
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Affiliation(s)
- Rasmia Huew
- Centre for Oral Health Research, Newcastle University, Newcastle upon Tyne, UK
| | - Anne Maguire
- Centre for Oral Health Research, Newcastle University, Newcastle upon Tyne, UK
| | - Paula Waterhouse
- Centre for Oral Health Research, Newcastle University, Newcastle upon Tyne, UK
| | - Paula Moynihan
- Centre for Oral Health Research, Newcastle University, Newcastle upon Tyne, UK
- Institute for Ageing and Health, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4BW, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
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Spence S, Delve J, Stamp E, Matthews JNS, White M, Adamson AJ. The impact of food and nutrient-based standards on primary school children's lunch and total dietary intake: a natural experimental evaluation of government policy in England. PLoS One 2013; 8:e78298. [PMID: 24205190 PMCID: PMC3813573 DOI: 10.1371/journal.pone.0078298] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 09/19/2013] [Indexed: 12/21/2022] Open
Abstract
In 2005, the nutritional content of children's school lunches in England was widely criticised, leading to a major policy change in 2006. Food and nutrient-based standards were reintroduced requiring primary schools to comply by September 2008. We aimed to determine the effect of the policy on the nutritional content at lunchtime and in children's total diet. We undertook a natural experimental evaluation, analysing data from cross-sectional surveys in 12 primary schools in North East England, pre and post policy. Dietary data were collected on four consecutive days from children aged 4-7 years (n = 385 in 2003-4; n = 632 in 2008-9). We used linear mixed effect models to analyse the effects of gender, year, and lunch type on children's mean total daily intake. Both pre- and post-implementation, children who ate a school lunch consumed less sodium (mean change -128 mg, 95% CI: -183 to -73 mg) in their total diet than children eating home-packed lunches. Post-implementation, children eating school lunches consumed a lower % energy from fat (-1.8%, -2.8 to -0.9) and saturated fat (-1.0%; -1.6 to -0.5) than children eating packed lunches. Children eating school lunches post implementation consumed significantly more carbohydrate (16.4 g, 5.3 to 27.6), protein (3.6 g, 1.1 to 6.0), non-starch polysaccharides (1.5 g, 0.5 to 1.9), vitamin C (0.7 mg, 0.6 to 0.8), and folate (12.3 µg, 9.7 to 20.4) in their total diet than children eating packed lunches. Implementation of school food policy standards was associated with significant improvements in the nutritional content of school lunches; this was reflected in children's total diet. School food- and nutrient-based standards can play an important role in promoting dietary health and may contribute to tackling childhood obesity. Similar policy measures should be considered for other environments influencing children's diet.
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Affiliation(s)
- Suzanne Spence
- Institute of Health and Society, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Jennifer Delve
- Institute of Health and Society, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Elaine Stamp
- Institute of Health and Society, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - John N. S. Matthews
- School of Mathematics and Statistics, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Martin White
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
- Fuse, UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, United Kingdom
| | - Ashley J. Adamson
- Institute of Health and Society, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom
- Fuse, UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, United Kingdom
- * E-mail:
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Smpokos EA, Linardakis M, Papadaki A, Theodorou AS, Havenetidis K, Kafatos A. Differences in energy and nutrient-intake among Greek children between 1992/93 and 2006/07. J Hum Nutr Diet 2013; 27 Suppl 2:230-8. [DOI: 10.1111/jhn.12122] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- E. A. Smpokos
- Department of Social Medicine, Preventive Medicine & Nutrition Clinic; Faculty of Medicine; University of Crete; Heraklion Greece
| | - M. Linardakis
- Department of Social Medicine, Preventive Medicine & Nutrition Clinic; Faculty of Medicine; University of Crete; Heraklion Greece
| | - A. Papadaki
- Department of Social Medicine, Preventive Medicine & Nutrition Clinic; Faculty of Medicine; University of Crete; Heraklion Greece
- Centre For Exercise, Nutrition and Health Sciences; School for Policy Studies; University of Bristol; Bristol UK
| | - A. S. Theodorou
- Faculty of Physical Education & Sport Science; Kapodistrian University of Athens; Athens Greece
| | - K. Havenetidis
- Human Performance - Rehabilitation Laboratory; Faculty of Physical and Cultural Education; Hellenic Army Academy; Vari Greece
| | - A. Kafatos
- Department of Social Medicine, Preventive Medicine & Nutrition Clinic; Faculty of Medicine; University of Crete; Heraklion Greece
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Changes in food and nutrient intake of 6- to 17-year-old Germans between the 1980s and 2006. Public Health Nutr 2009; 12:1912-23. [PMID: 19232152 DOI: 10.1017/s1368980009004844] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To compare the food consumption and nutrient intakes of German children and adolescents in the 1980s with present dietary habits. DESIGN Two cross-sectional representative surveys, the German National Food Consumption Study (Nationale Verzehrsstudie, NVS) from 1985-8 and the nutrition module 'EsKiMo' of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) from 2006, were analysed for differences in food and nutrient intakes stratified by age and sex groups. SETTING Secondary analyses of data from representative observational studies. SUBJECTS Children and adolescents aged 6-17 years living in Germany in the 1980s (n 2265) and in 2006 (n 2506). RESULTS Food consumption was characterised by higher amounts of vegetables/pulses, fruits/nuts and beverages and less meat products/sausages, butter, fats/oils, potatoes/potato products and bread/pastries in 2006 than in 1985-8. The overall changes in food intake were reflected in improvements of macronutrient composition, increased water intake and lower energy density of the diet. Intake of most vitamins and minerals increased in relation to energy intake, but the nutrient density of the diet for vitamins B12 and D decreased. The most critical nutrients observed in NVS and EsKiMo were folate, vitamin D, vitamin A, vitamin E, Ca and Fe. In addition, dietary fibre intake was relatively low and fatty acid and carbohydrate compositions were not favourable. CONCLUSIONS Further efforts will be necessary to improve dietary habits among children and adolescents.
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Rugg-Gunn AJ, Fletcher ES, Matthews JNS, Hackett AF, Moynihan PJ, Kelly S, Adams J, Mathers JC, Adamson A. Changes in consumption of sugars by English adolescents over 20 years. Public Health Nutr 2007; 10:354-63. [PMID: 17362531 DOI: 10.1017/s1368980007249729] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Dietary surveys of 11- to 12-year-old Northumbrian children in 1980 and 1990 revealed that consumption of non-milk extrinsic sugars (NMES) was 16-17% of energy intake. This study reports dietary sugars consumption in 2000 and compares it with data collected in 1980 and 1990, using identical methods. DESIGN A repeat cross-sectional dietary survey of children aged 1-12 years attending the same schools as in the 1980 and 1990 surveys. SETTING Seven middle schools in south Northumberland. SUBJECTS All children aged 11-12 years old attending the seven schools. METHOD Food consumption was recorded using two 3-day diet diaries. Food composition tables were used to calculate energy and nutrient intakes. NMES, and milk and intrinsic sugars were calculated using previously described methods. RESULTS The numbers of children completing the surveys in 1980, 1990 and 2000 were 405, 379 and 424, respectively; approximately 60-70% of eligible children. Total sugars provided 22% of energy consistently over the three surveys. NMES consumption in 2000 provided 16% of energy compared with 16% in 1980 and 17% in 1990. Sources of NMES changed over the three surveys. NMES from soft drinks doubled from 15 to 31 g day(-1), and from breakfast cereals increased from 2 to 7 g day(-1) over the 20 years. Confectionery and soft drinks provided 61% of NMES. Over 20 years, the proportion of energy from fat decreased by 5% and from starch increased by 4%, creating a welcome tilt in the fat-starch see-saw, without an adverse effect on sugars intake. CONCLUSIONS Consumption of NMES in 2000 was substantially higher than recommended, and there has been little change over 20 years. Continued and coordinated efforts are required at a national, community and individual level to reduce the intake of NMES.
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Affiliation(s)
- A J Rugg-Gunn
- Human Nutrition Research Centre, School of Clinical Medical Sciences, Newcastle University, Newcastle upon Tyne NE1 4LP, UK
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Alexy U, Sichert-Hellert W, Kersting M. Fifteen-year time trends in energy and macronutrient intake in German children and adolescents: results of the DONALD study. Br J Nutr 2007. [DOI: 10.1079/bjn/2002572] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The DONALD study (Dortmund Nutritional and Anthropometric Longitudinally Designed study) gives the opportunity to evaluate long-term food and nutrient intake data on the basis of 3 d weighed dietary records of infants, children and adolescents since 1985. In this paper, we examine changes in energy and macronutrient intakes (protein, fat, saturated, mono- and polyunsaturated fatty acids, carbohydrates and added sugars) of 795 2–18-year-old subjects between 1985 and 2000 (4483 records). No significant changes in intakes of energy and of protein, polyunsaturated fatty acids and added sugars (as % energy intake, E %) were found. Fat intake decreased significantly in all age groups (between -0·20 and -0·26 E %/year), as well as intake of saturated fatty acids (between -0·11 and -0·14 E %/year) and monounsaturated fatty acids (between -0·07 and -0·014 E %/year). This decline was compensated for by a significant increase in carbohydrate intake (between +0·18 and +0·27 E %/year). The changes in macronutrient intake were mainly due to a decreased consumption of fats–oils (between -0·29 and -1·26 g/year) and meat–fish–eggs (between -0·21 and -2·92 g/year), whereas consumption of bread–cereals (between +0·12 and +2·42 g/year) and potatoes–pasta–rice (between +0·15 and +2·26 g/year) increased slightly. However, since recommended fat intake and fatty acid composition was not reached at the end of the study period by far, further efforts will be necessary to improve macronutrient composition and to stabilize favourable dietary habits.
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Lambert J, Agostoni C, Elmadfa I, Hulshof K, Krause E, Livingstone B, Socha P, Pannemans D, Samartín S. Dietary intake and nutritional status of children and adolescents in Europe. Br J Nutr 2007; 92 Suppl 2:S147-211. [PMID: 15522158 DOI: 10.1079/bjn20041160] [Citation(s) in RCA: 125] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The objective of this project was to collect and evaluate data on nutrient intake and status across Europe and to ascertain whether any trends could be identified. Surveys of dietary intake and status were collected from across Europe by literature search and personal contact with country experts. Surveys that satisfied a defined set of criteria – published, based on individual intakes, post-1987, adequate information provided to enable its quality to be assessed, small age bands, data for sexes separated above 12 years, sample size over 25 and subjects representative of the population – were selected for further analysis. In a small number of cases, where no other data for a country were available or where status data were given, exceptions were made. Seventy-nine surveys from 23 countries were included, and from them data on energy, protein, fats, carbohydrates, alcohol, vitamins, minerals and trace elements were collected and tabulated. Data on energy, protein, total fat and carbohydrate were given in a large number of surveys, but information was very limited for some micronutrients. No surveys gave information on fluid intake and insufficient gave data on food patterns to be of value to this project. A variety of collection methods were used, there was no consistency in the ages of children surveyed or the age cut-off points, but most surveys gave data for males and females separately at all ages. Just under half of the surveys were nationally representative and most of the remainder were regional. Only a small number of local surveys could be included. Apart from anthropometric measurements, status data were collected in only seven countries. Males had higher energy intakes than females, energy intake increased with age but levelled off in adolescent girls. Intakes of other nutrients generally related to energy intakes. Some north–south geographical trends were noted in fat and carbohydrate intakes, but these were not apparent for other nutrients. Some other trends between countries were noted, but there were also wide variations within countries. A number of validation studies have shown that misreporting is a major problem in dietary surveys of children and adolescents and so all the dietary data collected for this project should be interpreted and evaluated with caution In addition, dietary studies rely on food composition tables for the conversion of food intake data to estimated nutrient intakes and each country uses a different set of food composition data which differ in definitions, analytical methods, units and modes of expression. This can make comparisons between countries difficult and inaccurate. Methods of measuring food intake are not standardised across Europe and intake data are generally poor, so there are uncertainties over the true nutrient intakes of children and adolescents across Europe. There are insufficient data on status to be able to be able to draw any conclusions about the nutritional quality of the diets of European children and adolescents.
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Affiliation(s)
- Janet Lambert
- Lambert Nutrition Consultancy Ltd, 5 Britwell Road, Watlington, OX49 5JS, UK
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Energy and nutrient intakes in a sample of 136 Edinburgh 7–8 year olds: a comparison with United Kingdom dietary reference values. Br J Nutr 2007. [DOI: 10.1017/bjn19960121] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractEnergy and nutrient intakes were assessed in 136 children, aged 7–8 years and living in and around Edinburgh, using the 7 d weighed inventory technique. The results were compared with UK dietary reference values (DRV) for energy, macronutrients and micronutrients. NSP intakes were compared with a calculated reference value (CRV). Mean energy intakes were close to the estimated average requirement for both boys and girls. Mean percentages of food energy derived from fat and saturated fat were high in relation to DRV (37 and 14 compared with 35 and 11 respectively). Mean percentage of food energy derived from total carbohydrate was close to the DRV of 50 but intakes of starch appeared to be low and intakes of total sugars high (23 and 26% food energy respectively). Superficially, this suggests that there is a need to alter the balance of carbohydrate in favour of increasing starch and lowering total sugar. There was, however, a clear ‘fat-sugar seesaw’, i.e. children with a high percentage energy from total sugars had a low percentage energy from fat, and vice versa. In view of this finding, it is possible that efforts to reduce total sugar intake in children may result in a further increase in percentage energy from fat. Mean intakes of NSP were only 50% of the CRV, but this guideline may be set too high. Mean intakes of most micronutrients were above reference nutrient intakes. Reported low intakes of Zn and Se were treated with caution due to the perceived incompleteness of the data for these in the nutrient database. The authors concluded that targeting high intakes of total fat and saturated fat should be the health priorities in this age-group.
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Tracking of nutrient intakes in adolescence: the experiences of the Young Hearts Project, Northern Ireland. Br J Nutr 2007. [DOI: 10.1017/s0007114500001859] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study evaluated the tracking of energy and nutrient intakes, assessed by diet history, in a random sample of adolescents (boys n 225, girls n 230) at baseline (age 12 years), and subsequently at age 15 years. Median energy (MJ/d) and macronutrient (g/d) intakes increased significantly (all P<0·001) with increasing age in the boys. The girls' reported energy intake (MJ/d) remained stable over time, despite significant increases in BMI, weight and % body fat. Age-related changes in the girls' macronutrient intakes were inconsistent. When expressed in terms of nutrient density, the diets of both sexes became significantly richer, over time, in total folate (both sexes, P<0·01), but poorer in Ca (boys P<0·01, girls P<0·001) and riboflavin (both sexes P<0·001). Vitamin B6 (P<0·001) and Fe (P<0·05) densities increased in the boys, while the thiamin density of the girls' diets decreased (P<0·001). Tracking, defined as maintenance of rank over time, was summarised using weighted kappa statistics (κ). There were some significant changes in intakes at the group level; however, tracking of energy and nutrients in both sexes was only poor to fair (κ<0·40), indicating substantial drift of individuals between classes of intake over time. Particularly poor tracking was evident for % energy from sugars (κ 0·09) and total fat (κ 0·09) in the girls' diets. In conclusion, the poor to fair tracking observed in this cohort suggests that individual dietary patterns exhibited at 12 years of age are unlikely to be predictive of energy and nutrient intake at age 15 years.
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Hackett AF, Gibbon M, Sratton G, Hamill L. Dietary intake of 9–10-year-old and 11–12-year-old children in Liverpool. Public Health Nutr 2007. [DOI: 10.1079/phn2001266] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AbstractObjective:To describe the eating habits of children in Liverpool and compare two age groups that bridge the transition from primary to secondary school.Design:Two cross-sectional studies carried out one year apart using a food intake questionnaire that records whether or not each child claims to have eaten specific marker foods on the previous day.Setting:Primary and secondary schools in Liverpool.Subjects:Six hundred and forty-nine children aged 11 or 12 years and 3556 children aged 9 or 10 years.Results:Fewer older children ate breakfast (68–82%), especially the girls, and not eating breakfast was associated with eating on the way to school in the younger children. More of the older girls ate nothing at breakfast or on the way to school. Overall, the less desirable foods were reported to have been eaten by more children, of both ages, than the more desirable foods. Fruit, however, was mentioned by most children (69–77%) but the next 10 foods mentioned by most children were all less desirable ones. Only 31% of primary and 21% of secondary children ate both fruit and vegetables but 23% of primary and 26% of secondary children ate neither fruit nor vegetables. Overall, more of the girls of both age groups claimed to have eaten foods that would normally be encouraged.Conclusions:Food choice changes appreciably between primary and secondary school and, in some key respects, for the worse. In particular, far more children of both age groups need to be eating fruit and vegetables every day.
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Watkins DC, Murray LJ, McCarron P, Boreham CAG, Cran GW, Young IS, McGartland C, Robson PJ, Savage JM. Ten-year trends for fatness in Northern Irish adolescents: the Young Hearts Projects—repeat cross-sectional study. Int J Obes (Lond) 2005; 29:579-85. [PMID: 15889116 DOI: 10.1038/sj.ijo.0802945] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine secular trends in measures of fatness over a 10-y period (the 1990s) in Northern Irish schoolchildren. DESIGN Repeat cross-sectional surveys. SUBJECTS In total, 12- and 15-y-old children randomly selected from post-primary schools. A total of 1015 children studied between 1989 and 1990, and 2017 studied between 1999 and 2001. MEASUREMENTS The same study methods were applied in both surveys. Body mass index (BMI) was calculated from height and weight, and percentage body fat (%BF) was derived from skinfold measurements at four sites. Dietary intake was assessed using a diet history method and habitual physical activity (PA) was estimated from a self-report questionnaire. RESULTS Increases were seen in both height and weight in all age-sex groups. The overall prevalence of overweight/obesity increased from 15.0 to 19.6%, but 12-y-old girls contributed most to this increase (15.9-26.3%), with a modest increase observed also in 15-y-old boys. Increases in mean BMI (19.2-20.3 kg/m2) and mean %BF (25.8-27.1%) were seen in 12-y-old girls, with no significant changes in any of the other subgroups. Mean energy intake increased in girls but not in boys, while mean PA score decreased in 12-y-old girls, but was unchanged in the other three groups. All age-sex groups showed substantial increases in the sugar intake while fat intake increased in girls and decreased in boys. CONCLUSION Increases in indices of fatness were seen among school-age children in Northern Ireland during the 1990s. Trends differed between age-sex groups with the largest changes seen in 12-y-old girls. It remains to be seen whether the large increase in overweight/obesity in this group tracks into adulthood, with consequences for chronic disease incidence in women.
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Affiliation(s)
- D C Watkins
- Department of Paediatrics, Antrim Hospital, Northern Ireland, UK.
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Thomas M. Post‐16 students’ perceptions to health and healthy eating in Welsh secondary schools. HEALTH EDUCATION 2005. [DOI: 10.1108/09654280510584544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe aim of this study was to assess how post‐16 students in Wales conceptualized health and healthy eating.Design/methodology/approachA health survey questionnaire was completed by 297 post‐16 students who were pursuing Biology at A level in year 12. The questionnaire was issued towards the end of the summer term in year 12 which ensured that at that stage in their A level studies, all students had received teaching on the nutritional and biochemical component of the syllabus they were taking.FindingsFor the majority of respondents, and particularly males, being healthy was seen as the absence of illness and having the capacity to function as expected whereas female students significantly reported the importance of positive health behaviours, such as the need for exercising regularly and eating a balanced diet. Of concern, only a small percentage of the respondents reported the importance of eating fruit and vegetables as part of a healthy diet. Despite an increased emphasis on health issues within the school curriculum, it was apparent that female students possessed a more positive view of health as well as demonstrating a better understanding of what healthy eating means.Originality/valueIt is recommended that greater attention needs to be devoted to how health and nutritional education is taught in secondary schools.
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Oogarah‐Pratap B, Heerah‐Booluck B. Children’s consumption of snacks at school in Mauritius. ACTA ACUST UNITED AC 2005. [DOI: 10.1108/00346650510579117] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Sichert-Hellert W, Kersting M. Vitamin and mineral supplements use in German children and adolescents between 1986 and 2003: results of the DONALD Study. ANNALS OF NUTRITION AND METABOLISM 2005; 48:414-9. [PMID: 15665507 DOI: 10.1159/000083574] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2003] [Accepted: 07/12/2004] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Dietary supplements may contribute to a considerable proportion to micronutrient intake. However, little is known about the consumption of supplements in children and adolescents, especially in Germany. We therefore examined patterns and time trends in supplement consumption in healthy children and adolescents. METHODS A total of 5,990 3-day records from 931 subjects 2-18 years of age from the DONALD Study between 1986 and 2003 were examined. RESULTS (a) Supplement type: A total of 166 different supplements were reported: 49% vitamin-mineral combinations, 31% vitamin, 13% mineral, 7% fluorine supplements. 12% (vitamin) and 13% (mineral) were single nutrient supplements. Vitamin C (72%), B(1) (57%), B(2) (54%), calcium (44%), magnesium (31%) and phosphorus (20%) were the most frequent added nutrients. (b) Users: In 25.8% (males 13.2%, females 12.6%) of the records, supplement usage was documented. Fluorine supplements were by far the most often consumed items (18.1%) followed by vitamins (4.5%), vitamin-mineral combinations (3.6%), minerals (2.4%), and multiple usage (2.6%). (c) Time trend: We found a marked time trend in supplement consumption in the past 18 years with a peak between 1994 and 1996 and lower usage before and after that time (independent of age and gender). (d) Associated factors: Supplement usage was influenced by age, year of study, season, smoking and number of persons in families, education level and employment of mothers, whereas gender or the number of children per family failed to have any effect. CONCLUSION Supplement usage is a common behaviour in German children and adolescents and changing with time. Type and frequency of supplement usage is age dependent. Those nutrients found mostly in supplements are not the critical ones. In evaluations of children's diet it is mandatory to separate fluorine from other supplements.
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McCarthy HD, Jarrett KV, Emmett PM, Rogers I. Trends in waist circumferences in young British children: a comparative study. Int J Obes (Lond) 2004; 29:157-62. [PMID: 15570313 DOI: 10.1038/sj.ijo.0802849] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To compare waist circumference (a measure of central fatness) and body mass index (BMI, a measure of general fatness) between a contemporary cohort and similar aged British children measured in 1987. DESIGN : Comparative study of two cohorts. The first was a cross-sectional survey and the second an ongoing longitudinal survey. SETTING : The cross-sectional study was conducted throughout Great Britain during 1987. The ongoing longitudinal study was conducted in the Avon region between 1995 and 1998. PARTICIPANTS A total of 1821 children were measured in the cross-sectional study, and around 1000 children were measured in the longitudinal study. Ages ranged between 2 and 5 y. MAIN OUTCOME MEASURES Waist circumference, height, weight and BMI. Values were expressed as mean+/-s.d. Age-related measures were compared. RESULTS At equivalent ages, mean waist circumference values were greater in the contemporary children, compared with children measured in the earlier cross-sectional study in 1987 (P<0.05). Although boys from the contemporary cohort had the larger absolute waist circumference measurements, the absolute and percentage differences in waist circumference between the cohorts were greater for the girls. Mean BMI values were slightly but significantly higher in the contemporary children compared with children measured in the earlier cross-sectional study (P<0.05). The proportional increase in waist circumference for each age-sex group generally exceeded the proportional increase in BMI. CONCLUSION These results suggest that central fatness in young British children has increased over the period of 1987-97 to a greater extent than general fatness. This should be of concern since evidence associates greater central adiposity with adverse levels of cardiovascular risk factors in children. Furthermore, the study highlights important shortcomings of the BMI measurement, in that it provides no information on body fat distribution and can mask true obesity-related risk in children.
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Affiliation(s)
- H D McCarthy
- Institute of Health Research & Policy, London Metropolitan University, London, UK.
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Fletcher ES, Rugg-Gunn AJ, Matthews JNS, Hackett A, Moynihan PJ, Mathers JC, Adamson AJ. Changes over 20 years in macronutrient intake and body mass index in 11- to 12-year-old adolescents living in Northumberland. Br J Nutr 2004; 92:321-33. [PMID: 15333164 DOI: 10.1079/bjn20041199] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Monitoring adolescent diets over time enables the assessment of the effectiveness of public health messages which are particularly important in vulnerable groups such as adolescents. In 2000, 424 children aged 11-12 years old completed two 3 d estimated dietary records. On the fourth day one nutritionist interviewed each child to clarify the information in the diary and foods were quantified with the aid of food models. Nutrient intake was calculated using computerised food tables. These children attended the same seven schools in the same Northumberland area as the 11- to 12-year-old children who recorded their diet using the same method in 1980 (n 405) and 1990 (n 379), respectively. Height and weight, and parental occupation were recorded in all three surveys for each child. Height and weight were used to calculate BMI, weight was used to estimate BMR and parental occupation was used to determine social class. Comparing the macronutrient intakes in 2000 with 1980 and 1990, energy intakes (EI) fell in boys (to 8.45 MJ) and girls (to 7.60 MJ). This fall may, at least in part, be due to an increase in low energy reporting. For 1980, 1990 and 2000 the percentage of boys with EI:BMR below 1.1 was 6, 15 and 23 %, respectively; for girls, 3, 14 and 18 %, respectively. Percentage energy from fat was unchanged between 1980 and 1990 but fell to 35 % (about 76 g/d) in 2000, alongside a 3 % increase in percentage energy from starch (30 %). Percentage energy from non-milk extrinsic sugars remained above recommendations (16 %; about 82 g/d). The number of overweight and obese children increased from 11 % to 30 % between 1980 and 2000. Positive changes have occurred in the Northumbrian adolescent diet but social inequalities, reported in previous surveys, remain.
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Affiliation(s)
- E S Fletcher
- Human Nutrition Research Centre, University of Newcastle upon Tyne, NE1 4LP, UK
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Thane CW, Bates CJ, Prentice A. Risk factors for low iron intake and poor iron status in a national sample of British young people aged 4-18 years. Public Health Nutr 2003; 6:485-96. [PMID: 12943565 DOI: 10.1079/phn2002455] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To examine the prevalence and dietary, sociodemographic and lifestyle risk factors of low iron intake and poor iron status in British young people. DESIGN National Diet and Nutrition Survey of young people aged 4-18 years. SETTING Great Britain, 1997. SUBJECTS In total, 1699 young people provided 7-day weighed dietary records, of which 11% were excluded because the participant reported being unwell with eating habits affected. Blood was obtained from 1193 participants, with iron status indicated by haemoglobin, serum ferritin and transferrin saturation. RESULTS Iron intakes were generally adequate in most young people aged 4-18 years. However, low iron intakes (below the Lower Reference Nutrient Intake) occurred in 44% of adolescent girls (11-18 years), being less prevalent with high consumption of breakfast cereals. Low haemoglobin concentration (<115 g l-1, 4-12 years; <120 or <130 g l-1, 13+ years for girls and boys, respectively) was observed in 9% of children aged 4-6 years, pubertal boys (11-14 years) and older girls (15-18 years). Adolescent girls who were non-Caucasians or vegetarians had significantly poorer iron status than Caucasians or meat eaters, independent of other risk factors. The three iron status indices were correlated significantly with haem, but not non-haem, iron intake. CONCLUSIONS Adolescent girls showed the highest prevalence of low iron intake and poor iron status, with the latter independently associated with non-Caucasian ethnicity and vegetarianism. Risk of poor iron status may be reduced by consuming (particularly lean red) meat or enhancers of non-haem iron absorption (e.g. fruit or fruit juice) in vegetarians.
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Affiliation(s)
- C W Thane
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, CB1 9NL, UK.
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Zohouri FV, Rugg-Gunn AJ. Sources of dietary iron in urban and provincial 4-year-old children in Iran. Asia Pac J Clin Nutr 2003; 11:128-32. [PMID: 12074179 DOI: 10.1046/j.1440-6047.2002.00278.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Iron-deficiency anaemia is prevalent in childhood, especially in developing countries. Nutritional deficiency is one of the main causes of iron-deficiency anaemia, although absorption varies considerably between different dietary items. Information on the sources of iron in young children is limited. A study was therefore undertaken to investigate the different dietary sources of iron in 151 healthy children aged 4 years who were selected from two districts of Fars province, Iran. Two 3-day dietary diaries with pre- and post-interview were used to record the dietary intake of the children. Food and drinks were categorised into four groups (animal, plant, drinks and other) to measure the relative importance of different sources of iron. Sixty-eight percent of the children completed the 3-day dietary diaries in both summer and winter. The results showed no statistically significant differences in total daily iron intake between the two seasons or between genders. However, the difference in the total daily iron intake between children in the city and the provincial district was significant: 7.73+/-1.75 mg/day and 10.33+/-2.9 mg/day, respectively (P < 0.001). About 75 and 60% of iron intake came from plant sources in the provincial district and city, respectively. The three most important sources of iron for children of the provincial district were bread (51%), fruit and vegetables (12%) and meat (7%). This pattern was also observed for children living in the city, but with different percentages: 27%, 16% and 16%, respectively. In conclusion, total iron intakes were similar to those recorded in European countries, but little of the intake came from animal sources and substantial differences between city and provincial children were recorded.
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Affiliation(s)
- Fatemeh V Zohouri
- Department of Child Dental Health and Human Nutrition Research Centre, WHO Collaborating Centre for Nutrition and Oral Health, Newcastle University, Newcastle upon Tyne, UK.
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Moynihan PJ, Rugg-Gunn AJ, Butler TJ, Adamson AJ. Dietary intake of folate by adolescents and the potential effect of flour fortification with folic acid. Br J Nutr 2001; 86:529-34. [PMID: 11591241 DOI: 10.1079/bjn2001425] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The UK Department of Health recently recommended that flour be fortified with folic acid, at 2400 microg/kg. The objectives of the present paper were: to determine the consequence of this on folic acid intake of adolescents; to determine the level of fortification necessary to achieve an intake of 400 microg/d in adolescent girls (the amount recommended periconceptionally); to estimate the consequence of fortification on folic acid intake of high flour consumers; and to report on folate intake of adolescents. Dietary intake of folate and flour were determined by analysis of an existing database of the diets of 379 English adolescents. The folic acid intake that would result from white flour fortification with folic acid at 2400 microg/kg was determined and the level of folic acid fortification necessary to achieve an intake of 400 microg/d in girls from this source was also calculated. Without flour fortification, 6.9 % of girls failed to reach the UK lower reference nutrient intake for total folate. Fortification of white flour with folic acid at 2400 microg/kg would result in an additional folic acid intake of 191(sem 6) microg/d in girls. To ensure 97 % of girls received 400 microg/d from white flour, white flour would need to be fortified at a level of 10 430 microg/kg, resulting in intakes of 1260 microg/d from flour in the highest (97.5 centile) female white flour consumers and 1422 microg/d from flour in the highest (97.5 centile) male white flour consumers.
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Affiliation(s)
- P J Moynihan
- The Dental School, and the Human Nutrition Research Centre, University of Newcastle, Newcastle upon Tyne, UK.
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Rozen GS, Rennert G, Rennert HS, Diab G, Daud D, Ish-Shalom S. Calcium intake and bone mass development among Israeli adolescent girls. J Am Coll Nutr 2001; 20:219-24. [PMID: 11444417 DOI: 10.1080/07315724.2001.10719035] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To determine the possible relationship between food and life style habits and bone health in adolescent Israeli females. METHODS 2,000 adolescent Israeli Jewish and Arab high-school girls (mean age 14.5) completed a semi-quantitative food frequency questionnaire and a personal history questionnaire. 27 food components were calculated for each subject. Bone mineral content and density were determined for 112 subjects with calcium intake below 800 mg/day. RESULTS Average calcium intake was found to be 1,260 mg/day, but 20% of all girls had a calcium intake below 800 mg/day. All low-energy diets were very low in calcium, as mean calcium intake per 1,000 calories was 411 128 grams. A large percentage of diets with less than 800 mg calcium were also deficient in phosphorus (95.2%), magnesium (84.8%). iron (90.5%) and zinc (100%). Due to differences in food sources. Jewish girls had more phosphorus in their diet, but less magnesium and iron compared to Arab girls. Calcium and zinc deficiencies in Jewish and Arab diets were similar. A negative correlation was found between body mass index (BMI) and age at menarche for all girls in the study. Bone mineral density (BMD) measured for girls with calcium intake below 800 mg/day distributed normally around the average when compared to age matched controls despite their low calcium intake. There was a strong positive correlation between BMD and bone mineral content (BMC) at all sites and body weights. CONCLUSIONS Low calcium intake, other nutritional deficiencies and delayed menarche due to low-energy diet in the growing period and in adolescence may prevent the formation of healthy bones. There is no evidence of lower bone mass among the low calcium intake group in the study population at this stage. It remains to be documented if the window of opportunity for optimal bone accretion for this group will be missed in the future. possibly leading to increased risk of osteoporosis.
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Affiliation(s)
- G S Rozen
- Department of Diet and Nutrition, Rambam Medical Center, Haifa, Israel.
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Abstracts of Original Communications. Proc Nutr Soc 2001. [DOI: 10.1017/s0029665101000623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Iuliano-Burns S, Whiting SJ, Faulkner RA, Bailey DA. Levels, sources, and seasonality of dietary calcium intake in children and adolescents enrolled in the University of Saskatchewan Pediatric Bone Mineral Accrual Study. Nutr Res 1999. [DOI: 10.1016/s0271-5317(99)00104-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Douglas L. Contribution of “packed lunches” to the dietary intake of 11‐12‐year‐old children. ACTA ACUST UNITED AC 1999. [DOI: 10.1108/00346659910270936] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Johnson-Down L, O'Loughlin J, Koski KG, Gray-Donald K. High prevalence of obesity in low income and multiethnic schoolchildren: a diet and physical activity assessment. J Nutr 1997; 127:2310-5. [PMID: 9405579 DOI: 10.1093/jn/127.12.2310] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The objective of the study was to assess the prevalence of obesity and/or undernutrition and evaluate diet and activity patterns among schoolchildren from an ethnically diverse low income urban population. A cross-sectional survey of 498 children aged 9-12 y from 24 schools in low income multiethnic neighborhoods in Montreal, Canada was undertaken. Height, weight, dietary intake, physical activity record, and lifestyle and demographic characteristics were measured. There was no evidence of undernutrition because linear growth was appropriate for age, but 39.4% of children were overweight (>85th percentile NHANES II). Dietary fat intake was higher in children from single-parent families (P < 0.001) and those with mothers born in Canada. Intake of vitamins A, C, iron and folate was directly related to income sufficiency. Children who did more physical activity had significantly higher intakes of energy, calcium, iron, zinc and fiber but were not heavier. Dietary intake was systematically underreported among overweight children, i.e., their reported intakes did not meet calculated energy needs. This underreporting makes it difficult to attribute the accumulated energy imbalance to either energy intake or expenditure.
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Affiliation(s)
- L Johnson-Down
- School of Dietetics and Human Nutrition, McGill University, Ste. Anne de Bellevue, QC H9X 3V9, Canada
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Hurson M, Corish C. Evaluation of lifestyle, food consumption and nutrient intake patterns among Irish teenagers. Ir J Med Sci 1997; 166:225-30. [PMID: 9394071 DOI: 10.1007/bf02944239] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Lifestyle, food consumption and nutrient intake patterns from a randomly selected group of 390 secondary pupils aged between 12-18 were evaluated. Demographic information and anthropometric measurements included weight, height, and skinfold thickness were taken. Nutrient intake was assessed using the 7-day dietary history method, using a photographic atlas as an aid. Mean energy intakes for boys and girls aged 12-15 and 15-18 were 11.3MJ and 14MJ and 9.1MJ and 8.9MJ respectively. As percentage energy, protein fat and carbohydrate intakes varied little between the different age-sex groupings and were approximately 13.7-14.5, 35.4-37 and 46.8-50 per cent respectively. For boys micronutrient intake for iron and folate achieving only 83 and 78 per cent and 98 and 90 per cent of the recommended nutrient intake (R.N.I.) for ages 12-15 and 15-18 respectively. Mean dietary fibre intakes were approximately 19.6-25g/day for boys aged 12-18 and 17g/day for girls of a similar age. The main sources of energy were bread, meat and meat products, potatoes/chips, confectionery and preserves. Fruit and vegetable consumption was low for all groups. The majority of those surveyed consumed the traditional main meals. Snacking was also common practice. The snack foods consumed were generally of a high fat/high sugar content. 1.1 per cent boys and 2.6 per cent of girls aged 12-15 and 5.5 per cent and 8.2 per cent of boys and girls aged 15-18 respectively had a BMI greater than 26 indicating a risk of overweight. Greater than 68 per cent of girls and 79.5 per cent of boys surveyed participated in some form of sport. Boys were more physically active than girls and older girls less active than younger. In conclusion, changes from present day practices would be beneficial to reduce incidence of chronic disease for present day teenagers.
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Affiliation(s)
- M Hurson
- Irish Nutrition and Dietetic Institute, Dublin, Ireland
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McNulty H, Eaton-Evans J, Cran G, Woulahan G, Boreham C, Savage JM, Fletcher R, Strain JJ. Nutrient intakes and impact of fortified breakfast cereals in schoolchildren. Arch Dis Child 1996; 75:474-81. [PMID: 9014598 PMCID: PMC1511814 DOI: 10.1136/adc.75.6.474] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To report micronutrient intakes in Northern Ireland schoolchildren, and to establish the contribution of fortified breakfast cereal to overall nutrient intakes and achievement of current dietary recommendations. DESIGN Analysis of dietary intakes and physical characteristics of participants in a randomly selected 2% population sample of 1015 schoolchildren aged 12 and 15 years in Northern Ireland during the 1990/1 school year. MAIN OUTCOME MEASURES Dietary intakes, physical characteristics, and their association with consumption of fortified breakfast cereal. RESULTS Mean micronutrient intakes were generally adequate with the exception of low intakes of folate (boys and girls) and iron (girls). Fortified breakfast cereals, consumed by a high proportion (94% boys; 83% girls) of the sample, were associated with higher daily intakes of most micronutrients and fibre and with a macronutrient profile consistent with current nutritional recommendations. Appreciable proportions of subjects who did not consume fortified breakfast cereals had daily intakes that fell below the lower reference nutrient intake for riboflavin, niacin, folate, vitamin B-12, and iron (girls). CONCLUSIONS The results demonstrate the potential of fortification in contributing to micronutrient intakes of schoolchildren, particularly where requirements are high, or for those on marginal diets of low nutritional quality.
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Affiliation(s)
- H McNulty
- Human Nutrition Research Group, University of Ulster at Coleraine
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Nathan I, Hackett AF, Kirby S. The dietary intake of a group of vegetarian children aged 7-11 years compared with matched omnivores. Br J Nutr 1996; 75:533-44. [PMID: 8672406 DOI: 10.1079/bjn19960157] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
There is a lack of information concerning the diet of vegetarian children. The present study compared the dietary intake of fifty vegetarian children, aged 7-11 years, with fifty matched omnivores. Three 3 d food records were completed by each child at intervals of 6 months. The day after completing the record each child was interviewed to clarify food items and assess portion sizes. Food records were analysed using Microdiet (University of Salford). Finger-prick cholesterol and haemoglobin measurements were taken from a subsample of the group. Only one child's family was a member of the Vegetarian Society and almost one-third of vegetarian children had omnivorous parents (seventeen of fifty subjects). The energy intake (MJ) of the vegetarians was significantly lower than that of the omnivores, 7.6 (SD 1.05) and 8.0 (SD 1.36) respectively; there were no significant differences in Fe or fat intakes. For the vegetarians polyunsaturated:saturated fat ratio (P:S 0.7 (SD 0.04)) and NSP intake (13.8 (SD 0.7) g/d) were significantly higher than those of the omnivores (P:S 0.5 (SD 0.02), NSP 10.3 (SD 0.4) g/d). There was no significant difference in cholesterol measurements (mmol/l) between the two groups: vegetarian 3.5 (SD 0.12), omnivores 3.7 (SD 0.15). The haemoglobin level (g/l) of the vegetarians (11.8 (SD 0.2)) was significantly below that of the omnivores (12.4 (SD 0.2)); 47.5% of the vegetarian children fell below the third percentile of the Dallman reference curves (Dallman & Siimes, 1979). The intake of the vegetarians more closely resembled current recommendations (Department of Health, 1991), although they need to be as aware as omnivores of the need to reduce fat intake. The haemoglobin levels of vegetarian children suggest that they need dietary advice to ensure optimal absorption of Fe.
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Affiliation(s)
- I Nathan
- School of Education and Community Studies, Liverpool John Moores University
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Affiliation(s)
- M Nelson
- Department of Nutrition and Dietetics, King's College London
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Moynihan P, Adamson A, Rugg-Gunn A, Appleton D, Butler T. Dietary sources of calcium and the contribution of flour fortification to total calcium intake in the diets of Northumbrian adolescents. Br J Nutr 1996; 75:495-505. [PMID: 8785221 DOI: 10.1079/bjn19960150] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Increased Ca intake by adolescents is desirable. In order to achieve this, information on the current dietary sources of Ca by this age group is essential to enable change to build on existing habits. This paper addresses two issues: first, the dietary sources of Ca for adolescents are reported and, second, the importance of fortification of flour with Ca to present-day Ca intakes was determined. In 1990 the diets of 379 children aged 12 years were assessed using the 3 d dietary diary and interview method. Computerized food tables were used to calculate the contributions of different food groups to total Ca intake. The Ca content of each food was subdivided into naturally occurring Ca and Ca from fortification, and data were analysed to give the daily intake of each. The four most important sources of Ca were milk (25%), beverages (12%), puddings (10%) and bread (9%). Fortification of flour accounted for 13% of total Ca intake. When the contribution of fortification was removed, the proportion of subjects with intakes of Ca below the lower reference nutrient intake (Department of Health, 1991) increased more than fourfold, to 10% of girls and 12% of boys. Milk is contributing less to Ca intake than in the past and increased consumption should be encouraged. Ca fortification of flour remains an important source of Ca. Therefore, unless dietary habits are modified to ensure adequate Ca from other sources, increased consumption of unfortified products from outside the UK will lead to a further reduction in Ca intake.
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Affiliation(s)
- P Moynihan
- Dental School, University of Newcastle upon Tyne
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Beighton D, Adamson A, Rugg-Gunn A. Associations between dietary intake, dental caries experience and salivary bacterial levels in 12-year-old English schoolchildren. Arch Oral Biol 1996; 41:271-80. [PMID: 8735013 DOI: 10.1016/0003-9969(96)84555-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
A population of 328 12-yr-old English schoolchildren, consuming their normal diets, was investigated in a cross-sectional study to determine the interactions between caries experience, oral hygiene status as gingival index (GI), dietary intake (as number of eating events per day and the number of eating events per day at which sugar-containing foodstuffs, confectionery or starch-containing foods were consumed) and salivary levels of caries-associated micro-organisms (mutants streptococci, lactobacilli and yeasts). The mean (+/- SD) decayed, missing and filled surfaces (DMFS) (excluding precavitation lesions) score was 3.05 +/- 3.85 and 5.72 +/- 5.00 (including precavitation lesions). The DMFS scores were significantly related to the salivary levels of caries-associated micro-organisms and to the number of eating events per day for total number of eating events and the number of eating events at which sugar-containing foods or confectionery were consumed. These associations were apparent in both bivariate and partial correlation coefficients with the caries-associated micro-organisms and GI controlled. The total daily intakes of food types, except for starch, were not associated with caries experience. No significant correlations were found between intake of food types and salivary levels of caries-associated micro-organisms except that the mean number of confectionery-eating events was correlated with lactobacillus levels (r = 0.136, p < 0.01). The salivary levels of mutans streptococci, lactobacilli and yeasts were significantly correlated with GI scores. These data do not indicate simple associations between dietary intake, caries and levels of caries-associated micro-organisms. Poor oral hygiene, in children consuming unrestricted diets, may influence the salivary levels of mutans streptococci, lactobacilli and yeasts irrespective of the frequency or amount of sugar consumed. Multiple regression analyses revealed that three variables--GI (probably an indicator of toothbrushing behaviour with a fluoride-containing toothpaste), salivary concentration of lactobacilli and frequency of ingestion of confectionery/sugary foods--were independently and positively related to caries experience.
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Affiliation(s)
- D Beighton
- Joint Microbiology Research Unit, Faculty of Clinical Dentistry, King's College School of Medicine and Dentistry, Denmark Hill, London, U.K
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Laitinen S, Räsänen L, Viikari J, Akerblom HK. Diet of Finnish children in relation to the family's socio-economic status. SCANDINAVIAN JOURNAL OF SOCIAL MEDICINE 1995; 23:88-94. [PMID: 7676224 DOI: 10.1177/140349489502300203] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The differences between higher and lower socio-economic groups in food consumption, energy intake and nutrient density of the diet of Finnish 9- to 15-year-old children were examined in a study performed within the project entitled Cardiovascular Risk in Young Finns. Data on food consumption were collected using the 48-hour recall method. Family's socio-economic status was defined according to the father's educational level, his occupation, and family income. Children of families with higher socio-economic status used more fruit, low-fat milk, soft vegetable margarine and less high-fat milk, butter, rye products and coffee than did the children of families with lower socioeconomic status. Consequently, the main differences appeared in the fat, vitamin D, vitamin C and fatty acid content of the diet. Differences in energy intake and in mineral density of the diet were minor. If these childhood dietary differences remain in adulthood, it is possible that the present disparity between socio-economic groups in mortality from coronary heart disease will not disappear.
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Affiliation(s)
- S Laitinen
- Department of Applied Chemistry and Microbiology, University of Helsinki
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Dennison CM, Shepherd R. Adolescent food choice: an application of the Theory of Planned Behaviour. J Hum Nutr Diet 1995. [DOI: 10.1111/j.1365-277x.1995.tb00292.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstracts of Communications. Proc Nutr Soc 1994. [DOI: 10.1079/pns19940077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Strain JJ, Robson PJ, Livingstone MB, Primrose ED, Savage JM, Cran GW, Boreham CA. Estimates of food and macronutrient intake in a random sample of Northern Ireland adolescents. Br J Nutr 1994; 72:343-52. [PMID: 7947651 DOI: 10.1079/bjn19940038] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Estimates of food consumption and macronutrient intake were obtained from a randomly selected population sample (2%) of 1015 adolescents aged 12 and 15 years in Northern Ireland during the 1990/1991 school year. Dietary intake was assessed by diet history with photographic album to estimate portion size. Reported median energy intakes were 11.0 and 13.1 MJ/d for boys aged 12 and 15 years respectively and 9.2 and 9.1 MJ/d for girls of these ages. Protein, carbohydrate and total sugars intakes as a percentage of total energy varied little between the age and sex groups and were approximately 11, 49 and 20% respectively of daily total energy intakes. Median dietary fibre intakes were approximately 20 and 24 g/d for boys aged 12 and 15 years respectively and 18 and 19 g/d for girls of these ages. Major food sources of energy (as a percentage of total energy intakes) were bread and cereals (15-18%), cakes and biscuits (12-14%), chips and crisps (13-14%), dairy products (9-11%), meat and meat products (9-11%) and confectionery (9%). Fruit and vegetable intakes were low at about 2.5% and 1.5% respectively of total energy intakes. Median fat intakes were high at 39% of total daily energy intakes. Major food sources of fat as a percentage of total fat intakes were from the food groupings: chips and crisps (16-19%), meat and meat products (14-17%), fats and oils (14-16%), cakes and biscuits (13-16%) and dairy products (12-15%). Median intakes of saturated fatty acids were also high at approximately 15% of daily total energy intake while intakes of monounsaturated fatty acids averaged 12% of daily total energy intake. Median polyunsaturated fatty acid (PUFA) intakes were low, comprising 5.2 and 5.5% of daily total energy intake for boys aged 12 and 15 years respectively and were lower than the PUFA intakes (5.9 and 6.3% of daily total energy intake) for girls of these ages. About 1.3% for boys and 1.4% for girls of daily total energy intake was in the form of n-3 PUFA. Ca and Mg intakes were adequate for both sexes. Based on these results, some concern about the dietary habits and related health consequences in Northern Ireland adolescents appears justified.
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Affiliation(s)
- J J Strain
- Human Nutrition Research Group, University of Ulster, Coleraine
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Nelson M, Bakaliou F, Trivedi A. Iron-deficiency anaemia and physical performance in adolescent girls from different ethnic backgrounds. Br J Nutr 1994; 72:427-33. [PMID: 7947657 DOI: 10.1079/bjn19940044] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
One hundred and fourteen 11-14-year-old schoolgirls from Wembley, Middlesex, were assessed for Fe status (haemoglobin (Hb), packed cell volume and mean corpuscular Hb concentration, height, weight, eating habits, and ethnic origin, and undertook a step test to assess physical performance. Overall, 20% of girls had Hb less than 120 g/l, ranging from 11% in White girls to 22-25% in girls of Asian origin. Prevalence of low Hb was 20% in vegetarians, higher in White vegetarians compared with non-vegetarians (23 v. 4%), but lower in the Indian vegetarians compared with non-vegetarians (17 v. 32%). Low Hb was present in 25% of girls who had tried to lose weight in the previous year, and was more common in girls from manual social class backgrounds than non-manual (24 v. 10%). At the start of the step test the twenty-three girls with low Hb had heart rates similar to those with normal Hb, but heart rates in the low Hb group were significantly elevated immediately after the step test, and still significantly elevated 1 min later. The present results confirm the findings of a previous study in White girls, and suggest that physical performance may be compromised at mild levels of anaemia.
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Affiliation(s)
- M Nelson
- Department of Nutrition and Dietetics, King's College London
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Moynihan PJ, Anderson C, Adamson AJ, Rugg-Gunn AJ, Appleton DR, Butler TJ. Dietary sources of iron in English adolescents. J Hum Nutr Diet 1994. [DOI: 10.1111/j.1365-277x.1994.tb00434.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rugg-Gunn AJ, Adamson AJ, Appleton DR, Butler TJ, Hackett AF. Sugars consumption by 379 11–12-year-old English children in 1990 compared with results in 1980. J Hum Nutr Diet 1993. [DOI: 10.1111/j.1365-277x.1993.tb00387.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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