Food sources of nutrients in the diet of Spanish children: the Four Provinces Study

North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper: Plant-based Milks

Parents and caretakers are increasingly feeding infants and young children plant-based "milk" (PBM) alternatives to cow milk (CM). The US Food and Drug Administration currently defines "milk" and related milk products by the product source and the inherent nutrients provided by bovine milk. Substitution of a milk that does not provide a similar nutritional profile to CM can be deleterious to a child's nutritional status, growth, and development. Milk's contribution to the protein intake of young children is especially important. For almond or rice milk, an 8 oz serving provides only about 2% or 8%, respectively, of the protein equivalent found in a serving of CM. Adverse effects from the misuse of certain plant-based beverages have been well-documented and include failure to gain weight, decreased stature, kwashiorkor, electrolyte disorders, kidney stones, and severe nutrient deficiencies including iron deficiency anemia, rickets, and scurvy. Such adverse nutritional outcomes are largely preventable. It is the position of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) Nutrition Committee, on behalf of the society, that only appropriate commercial infant formulas be used as alternatives to human milk in the first year of life. In young children beyond the first year of life requiring a dairy-free diet, commercial formula may be a preferable alternative to cow's milk, when such formula constitutes a substantial source of otherwise absent or reduced nutrients (eg, protein, calcium, vitamin D) in the child's restricted diet. Consumer education is required to clarify that PBMs do not represent an equivalent source of such nutrients. In this position paper, we provide specific recommendations for clinical care, labelling, and needed research relative to PBMs.

Targeted genotyping to identify potential functional variants associated with cholesterol content in bovine milk

High blood cholesterol concentration, mainly caused by high dietary cholesterol, is a potential risk factor for human health. Dairy products are important sources of human dietary cholesterol intake. Therefore, monitoring bovine milk cholesterol concentration is important for human health benefit. Genetic selection for improvement of cow milk cholesterol content requires understanding of the genetics of milk cholesterol. For this purpose, we performed analyses of additive and dominance effects of 126 potentially functional SNPs within 43 candidate genes with milk cholesterol content [expressed as mg of cholesterol in 100 g of fat (CHL_fat) or in 100 mg of milk (CHL_milk)]. The additive and dominance effects of SNPs rs380643365 in AGPAT1 (P = 0.04) and rs134357240 in SOAT1 (P = 0.035) genes associated significantly with CHL_fat. Moreover, five (rs109326954 and rs523413537 in DGAT1, rs109376747 in LDLR, rs42781651 in FAM198B and rs109967779 in ACAT2) and four (rs137347384 in RBM19, rs109376747 in LDLR, rs42016945 in PPARG and rs110862179 in SCAP) SNPs were significantly associated with CHL_milk (P < 0.05) based on additive and dominance effect analyses respectively. Rs109326954 and rs523413537 in DGAT1 explained a considerable portion of the phenotypic variance of CHL_milk (7.54 and 6.84% respectively), and might be useful in selection programs for reduced milk cholesterol content. Several significantly associated SNPs were in genes (such as ACAT2 and LDLR) involved in cholesterol metabolism in the liver or cholesterol transport, suggesting multiple mechanisms regulating milk cholesterol content. Nine and seven SNPs identified by additive or dominance effect analyses associated significantly with milk yield and fat yield respectively. Further analyses are required to better understand the consequences of these variants and their potential use in genomic selection of the studied traits.

Genetic parameters of milk cholesterol content in Holstein cattle

This study aimed to estimate heritability for milk cholesterol (CHL) and genetic correlations between milk CHL and other production traits (test-day milk, fat, and protein yields, fat and protein percentages, and somatic cell score). Milk CHL content was determined by gas chromatography and expressed as mg of CHL in 100 g of fat (CHL_fat) or in 100 mg of milk (CHL_milk). Univariate models were used to estimate variances and heritability, whereas bivariate models were used to compute correlations using data from 1793 cows. The average concentrations (standard deviation) of CHL_fat and CHL_milk were 275.63 (75) mg and 11.16 (3.63) mg, respectively. Milk CHL content was significantly affected by days in milk and herd (P < 0.05), but not by parity, regardless of the scale of expression. Heritability estimates for CHL_fat and CHL_milk were 0.06 ± 0.04 and 0.17 ± 0.06, respectively. Phenotypic and genetic correlations between CHL_fat and CHL_milk were 0.82 and 0.44 ± 0.24, respectively. CHL_fat had nonsignificant genetic correlations with all production traits, whereas CHL_milk had significant (P < 0.05) genetic correlations with milk yield (−0.47), fat yield (0.51), protein percentage (0.56), and fat percentage (0.88). This is the first study to estimate genetic parameters for milk CHL content. Further studies are required to assess the possibility of genetically selecting cows with lower milk CHL content.

Improved Diet Quality and Nutrient Adequacy in Children and Adolescents with Abdominal Obesity after a Lifestyle Intervention

High rates of childhood obesity require integral treatment with lifestyle modifications that achieve weight loss. We evaluated a lifestyle intervention on nutrient adequacy and diet quality in children and adolescents with abdominal obesity. A randomized controlled trial was performed on 107 participants, assigned either to a usual care group or to an intensive care group that followed a moderate hypocaloric Mediterranean diet and received nutritional education. Intake adequacy was evaluated using Dietary Reference Intakes and diet quality through the Diet Quality Index for Adolescents (DQI-A), the Healthy Lifestyle Diet-Index (HLD-I) and the Mediterranean Diet Quality Index (KIDMED). Both groups achieved a significant reduction in BMI standard deviation score (BMI-SDS), glucose and total cholesterol levels. Intake of Calcium, Iodine and vitamin D were higher in the intensive care group, with enhanced compliance with recommendations. Higher dietary scores were associated with lower micronutrient inadequacy. DQI-A and HLD-I were significantly higher in the intensive care group vs. usual care group after the treatment. In conclusion, we observed that an intensive lifestyle intervention was able to reduce BMI-SDS in children with abdominal obesity. Furthermore, participants significantly improved dietary indices getting closer to the nutritional recommendations. Therefore, these diet quality indices could be a valid indicator to evaluate micronutrient adequacy.

Genome wide association study identifies novel potential candidate genes for bovine milk cholesterol content

This study aimed to identify single nucleotide polymorphisms (SNPs) associated with milk cholesterol (CHL) content via a genome wide association study (GWAS). Milk CHL content was determined by gas chromatography and expressed as mg of CHL in 100 g of fat (CHL_fat) or in 100 mg of milk (CHL_milk). GWAS was performed with 1,183 cows and 40,196 SNPs using a univariate linear mixed model. Two and 20 SNPs were significantly associated with CHL_fat and CHL_milk, respectively. The important regions for CHL_fat and CHL_milk were at 41.9 Mb on chromosome (BTA) 17 and 1.6-3.2 Mb on BTA 14, respectively. DGAT1, PTPN1, INSIG1, HEXIM1, SDS, and HTR5A genes, also known to be associated with human plasma CHL phenotypes, were identified as potential candidate genes for bovine milk CHL. Additional new potential candidate genes for milk CHL were RXFP1, FAM198B, TMEM144, CXXC4, MAML2 and CDH13. Enrichment analyses suggested that identified candidate genes participated in cell-cell signaling processes and are key members in tight junction, focal adhesion, Notch signaling and glycerolipid metabolism pathways. Furthermore, identified transcription factors such as PPARD, LXR, and NOTCH1 might be important in the regulation of bovine milk CHL content. The expression of several positional candidate genes (such as DGAT1, INSIG1 and FAM198B) and their correlation with milk CHL content were further confirmed with RNA sequence data from mammary gland tissues. This is the first GWAS on bovine milk CHL. The identified markers and candidate genes need further validation in a larger cohort for use in the selection of cows with desired milk CHL content.

Dietary fibre in Europe: current state of knowledge on definitions, sources, recommendations, intakes and relationships to health

Research into the analysis, physical properties and health effects of dietary fibre has continued steadily over the last 40–50 years. From the knowledge gained, countries have developed guidelines for their populations on the optimal amount of fibre to be consumed each day. Food composition tables from many countries now contain values for the dietary fibre content of foods, and, from these, combined with dietary surveys, population intakes have been determined. The present review assessed the uniformity of the analytical methods used, health claims permitted, recommendations and intakes, particularly from national surveys across Europe and around the world. It also assessed current knowledge on health effects of dietary fibre and related the impact of different fibre types on health. The overall intent was to be able to provide more detailed guidance on the types of fibre which should be consumed for good health, rather than simply a total intake figure, the current situation. Analysis of data indicated a fair degree of uniformity in the definition of dietary fibre, the method used for analysis, the recommended amount to be consumed and a growing literature on effects on digestive health and disease risk. However, national dietary survey data showed that intakes do not reach recommendations and very few countries provide guidance on the types of fibre that are preferable to achieve recommended intakes. Research gaps were identified and ideas suggested to provide information for more detailed advice to the public about specific food sources that should be consumed to achieve health benefits.

Dietary sources and sociodemographic and lifestyle factors affecting vitamin D and calcium intakes in European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study

Objective

To investigate dietary sources of Ca and vitamin D (VitD) intakes, and the associated sociodemographic and lifestyle factors, among European adolescents.

Design

Linear regression mixed models were used to examine sex-specific associations of Ca and VitD intakes with parental education, family affluence (FAS), physical activity and television (TV) watching while controlling for age, Tanner stage, energy intake and diet quality.

Setting

The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA)Cross-Sectional Study.

Subjects

Adolescents aged 12·5–17·5 years (n 1804).

Results

Milk and cheese were the main sources of Ca (23 and 19 % contribution to overall Ca intake, respectively). Fish products were the main VitD source (30 % contribution to overall VitD intake). Ca intake was positively associated with maternal education (β=56·41; 95 % CI 1·98, 110·82) and negatively associated with TV viewing in boys (β=–0·43; 95 % CI −0·79, −0·07); however, the significance of these associations disappeared when adjusting for diet quality. In girls, Ca intake was positively associated with mother’s (β=73·08; 95 % CI 34·41, 111·74) and father’s education (β=43·29; 95 % CI 5·44, 81·14) and FAS (β=37·45; 95 % CI 2·25, 72·65). This association between Ca intake and mother’s education remained significant after further adjustment for diet quality (β=41·66; 95 % CI 0·94, 82·38). Girls with high-educated mothers had higher Ca intake.

Conclusions

Low-educated families with poor diet quality may be targeted when strategizing health promotion programmes to enhance dietary Ca.

Adequacy of Usual Vitamin and Mineral Intake in Spanish Children and Adolescents: ENALIA Study

Background: The National Dietary Survey on the Child and Adolescent Population in Spain (ENALIA) provides data to assess the usual micronutrient intake among Spanish infants, children, and adolescents. Methods: Cross-sectional survey (November 2012-July 2014) of a representative sample of Spanish children and adolescents (six months-17 years) (n = 1862). Dietary information was collected using two non-consecutive one-day food diaries (six months-10 years old) or two 24 h dietary recalls (11 years and older) separated by at least 14 days. Estimates were calculated using the Iowa State University method and PC-SIDE software (version 1.0, department of statistics, center for agricultural and rural development, Ames, IA, USA) to account for within- and between-person variation. Results: Usual intake of vitamin D was insufficient in practically all individuals. Vitamin E, folate, and calcium were insufficient, especially from nine years of age, and magnesium and iodine from 14 years of age. The percentage of subjects with insufficient intakes was higher among females. Sodium intake was excessive in a considerable percentage of the population, especially in males, and it increased with age. Finally, over half of children under four years of age had zinc usual intakes that exceeded the Tolerable Upper Level. Conclusion: Vitamin and mineral intake in Spain should be improved, especially in late childhood and adolescence. Nutritional intervention and educational strategies are needed to promote healthy eating habits and correct micronutrient inadequacies in Spanish children and adolescents.

Food sources of energy and nutrients in Finnish girls and boys 6-8 years of age - the PANIC study

Background

Data on food sources of nutrients are needed to improve strategies to enhance nutrient intake among girls and boys in Western countries.

Objective

To identify major food sources of energy, energy nutrients, dietary fibre, and micronutrients, and to study gender differences in these food sources among children.

Design

We assessed food consumption and nutrient intake using 4-day food records in a population sample of Finnish girls (n=213) and boys (n=217) aged 6–8 years from the Physical Activity and Nutrition in Children Study. We calculated the percentual contribution of 55 food groups for energy and nutrient intake using the population proportion method.

Results

Low-fibre grain products, skimmed milk, and high-fibre bread provided almost 23% of total energy intake. Skimmed milk was the top source of protein (18% of total intake), vitamin D (32%), potassium (20%), calcium (39%), magnesium (17%), and zinc (16%). Vegetable oils (15%) and high-fat vegetable oil–based spreads (14%) were the top sources of polyunsaturated fat. High-fibre bread was the top source of fibre (27%) and iron (12%). Non-root vegetables were the top source of folate (14%) and vitamin C (22%). Sugar-sweetened beverages provided 21% of sucrose intake. Pork was a more important source of protein and sausage was a more important source of total fat and monounsaturated fat in boys than in girls. Vegetable oils provided a higher proportion of unsaturated fat and vitamin E among boys, whereas high-fat vegetable oil–based spreads provided a higher proportion of these nutrients among girls.

Conclusion

Commonly recommended foods, such as skimmed milk, high-fibre grain products, vegetables, vegetable oil, and vegetable oil–based spreads, were important sources of several nutrients, whereas sugar-sweetened beverages provided the majority of sucrose intake among children. This knowledge can be used in improving health among children by dietary interventions, nutrition education, and health policy decision making.

Differences in milk fat composition from four old sheep breeds

Abstract. The present short communication presents a comparison between the milk fat composition of four old sheep breeds. All animals were fed the same diet and a milk sample was obtained at the same lactation day and analyzed for its major components, cholesterol concentration and a complete fatty acid profile. From all studied candidates, the Walachian breed (also when compared with modern breeds employed in the dairy industry) was determined to have the most suitable milk composition for human health.

Effects of rapeseed and soybean oil dietary supplementation on bovine fat metabolism, fatty acid composition and cholesterol levels in milk

The main goal of this experiment was to study the effect of milk fat depression, induced by supplementing diet with plant oils, on the bovine fat metabolism, with special interest in cholesterol levels. For this purpose 39 cows were divided in three groups and fed different rations: a control group (C) without any oil supplementation and two groups with soybean oil (SO) or rapeseed oil (RO) added to the partial mixed ration (PMR). A decrease in milk fat percentage was observed in both oil feedings with a higher decrease of -1·14 % with SO than RO with -0·98 % compared with the physiological (-0·15 %) decline in the C group. There was no significant change in protein and lactose yield. The daily milk cholesterol yield was lower in both oil rations than in control ration, while the blood cholesterol level showed an opposite variation. The milk fatty acid pattern showed a highly significant decrease of over 10 % in the amount of saturated fatty acids (SFA) in both oil feedings and a highly significant increase in mono (MUFA) and poly (PUFA) unsaturated fatty acids, conjugated linoleic acids (CLA) included. The results of this experiment suggest that the feeding of oil supplements has a high impact on milk fat composition and its significance for human health, by decreasing fats with a potentially negative effect (SFA and cholesterol) while simultaneously increasing others with positive (MUFA, PUFA, CLA).

Intake and dietary sources of haem and non-haem iron in Flemish preschoolers

BACKGROUND/OBJECTIVES

In the absence of biochemical data on iron status in preschoolers, data on the adequacy of iron intake may be used to assess the possible risk of iron deficiency in this population group. Therefore, this study aims to investigate iron intake and its food sources in Flemish preschoolers.

SUBJECTS/METHODS

A total of 661 Flemish preschoolers 2.5-6.5 years old were recruited via a random cluster sampling design, using schools as primary sampling units. Three-day estimated diet records were used to assess dietary intakes. The contribution to iron intake (haem and non-haem) of 57 food groups was computed by summing the amount provided by the food group for all individuals divided by the total intake for all individuals.

RESULTS

Mean total iron intake (s.d.) was 7.4 (±2.3) and 6.7 (±2.8) mg/day for boys and girls, respectively. In all 65% of the children <4 years old and 45% of those 4-6.5 years old presented adequate iron intakes. The food groups with the highest mean proportional contribution to total iron intake were bread, meat and meat products, breakfast cereals and sweet snacks (in that order). Children from small families whose mother had a low educational level had higher iron intakes.

CONCLUSION

Iron intakes were similar for boys and girls and almost half of the Flemish preschoolers do not comply with the dietary iron recommendations.

Simulation of total dietary iodine intake in Flemish preschool children

The aim of the present study was to calculate the distribution of total iodine intake among Flemish preschoolers and to identify the major sources contributing to iodine intake. A simulation model using a combination of deterministic and probabilistic techniques was utilised. Scenario analyses were performed to assess iodine intake via dairy products, industrially added iodised salt in bread and discretionarily added iodised household salt. Relevant data from 3-d estimated dietary records of 696 preschoolers 2·5–6·5 years old were used. Usual iodine intakes were calculated using the Iowa State University method. With a more generalised utilisation of iodised salt in bread (44 % of the bakers in 2011 instead of 12 % in 2002), mean iodine intake increased from 159 to 164 μg/d using the McCance and Widdowson's food composition table and from 104 to 109 μg/d using the German food composition table. The percentage of preschoolers with an iodine intake below the estimated average requirement (65 μg/d) decreased from 5–12 to 4–9 %, while the percentage of preschoolers with an iodine intake above the tolerable upper intake level (300 μg/d) remained constant (0·3–4 %). Mean iodine intake via food supplements was 4·2 μg/d (total population) and 16·9 μg/d (consumers only). Both in 2002 and 2011, sugared dairy products, milk and iodised salt (21·4, 13·1, and 8·7 %, respectively in 2011) were the main contributors to total iodine intake. In conclusion, dietary iodine intake could still be improved in Flemish preschoolers. The use of adequately iodised household salt and the more generalised use of iodised salt by bakers should be further encouraged.

Dietary sources of energy and macronutrient intakes among Flemish preschoolers

This study aims to identify major food sources of energy and macronutrients among Flemish preschoolers as a basis for evaluating dietary guidelines. Three-day estimated diet records were collected from a representative sample of 696 Flemish preschoolers (2.5-6.5 years old; participation response rate: 50%). For 11 dietary constituents, the contribution of 57 food groups was computed by summing the amount provided by the food group for all individuals divided by the total intake of the respective nutrient for all individuals. Bread (12%), sweet snacks (12%), milk (6%), flavoured milk drinks (9%), and meat products (6%) were the top five energy contributors. Sweet snacks were among the top contributors to energy, total fat, all fatty acids, cholesterol, and complex and simple carbohydrates. Fruit juices and flavoured milk drinks are the main contributors to simple carbohydrates (respectively 14% and 18%). All principal food groups like water, bread and cereals, vegetables, fruit, milk and spreadable fats were under-consumed by more than 30% of the population, while the food groups that were over-consumed consisted only of low nutritious and high energy dense foods (sweet snacks, sugared drinks, fried potatoes, sauces and sweet spreads). From the major food sources and gaps in nutrient and food intakes, some recommendations to pursue the nutritional goals could be drawn: the intake of sweet snacks and sugar-rich drinks (incl. fruit juices) should be discouraged, while consumption of fruits, vegetables, water, bread and margarine on bread should be encouraged.

Dietary sources of animal and plant protein intake among Flemish preschool children and the association with socio-economic and lifestyle-related factors

Background

The aims of this study were to assess the intake of animal, plant and food group-specific protein, and to investigate their associations with socio-economic and lifestyle-related factors in Flemish preschoolers.

Methods

Three-day estimated dietary records were collected from 661 preschoolers aged 2.5-6.5 y (338 boys and 323 girls). Multiple linear regression analysis was used to investigate the association between animal, plant, and food group-specific protein intake and socio-economic and lifestyle factors.

Results

Animal proteins (mean 38 g/d) were the main source of total protein (mean 56 g/d), while mean plant protein intake amounted to 18 g/d. The group of meat, poultry, fish and eggs was the main contributor (51%) to animal protein intake, followed by milk and milk products (35%). Bread and cereals (41%) contributed most to the plant protein intake, followed by low-nutritious, energy-dense foods (21%). With higher educated fathers and mothers as reference, respectively, preschoolers with lower secondary and secondary paternal education had lower animal, dairy-, and meat-derived protein intakes, and those with lower secondary and secondary maternal education consumed less plant, and bread and cereal-derived proteins. Compared to children with high physical activity levels, preschoolers with low and moderate physical activity had lower animal and plant protein intakes. Significantly higher potatoes and grains-, and fish- derived proteins were reported for children of smoking mothers and fathers, respectively, compared to those of non-smoking mothers and fathers.

Conclusions

The total protein intake of Flemish preschoolers was sufficient according to the recommendations of the Belgian Superior Health Council. Parental level of education and smoking status might play a role in the sources of children's dietary proteins.

Western and Mediterranean dietary patterns among Balearic Islands' adolescents: socio-economic and lifestyle determinants

OBJECTIVE

To assess prevailing food patterns among Balearic Islands' adolescents, and socio-economic and lifestyle determinants.

DESIGN

Cross-sectional nutritional survey carried out (2007-2008) in the Balearic Islands, a Mediterranean region. Dietary assessment was based on a 145-item semi-quantitative FFQ and two non-consecutive 24 h recalls. Anthropometric measurements and questions related to socio-economic, lifestyle, physical activity and body image were assessed.

SETTING

Data obtained from a representative sample of all inhabitants living in the Balearic Islands aged 12-17 years.

SUBJECTS

A random sample (n 1231) of the adolescent population (12-17 years old) was interviewed.

RESULTS

Factor analysis identified two major dietary food patterns: 'Western' and 'Mediterranean'. The 'Western' dietary pattern was higher among boys than girls, associated with spending ≥4 h/d on media screen time, but less prevalent among those adolescents who desired a thinner body and those girls who desired to remain the same weight. The 'Mediterranean' dietary pattern was mainly followed by girls, and also boys who spent < 2 h/d on media screen time and girls with high parental socio-economic status.

CONCLUSIONS

The present study shows the existence of two major dietary patterns among Balearic Islands' adolescents: 'Western' and 'Mediterranean', but girls are more 'Mediterranean' than boys. This evidence supports that the food pattern of Balearic Islands' adolescents is in a transitional state characterised by the loss of the traditional Mediterranean dietary pattern towards a Western dietary pattern. Low parental socio-economic status, much leisure-time on sedentary behaviours such as media screen time and body image are factors associated with the 'Western' dietary pattern.

Dietary sources and sociodemographic and economic factors affecting vitamin D and calcium intakes in Flemish preschoolers

BACKGROUND/OBJECTIVES

Low calcium and vitamin D intakes have been associated with health risks in childhood and adulthood. This study aims to investigate dietary sources of calcium and vitamin D intake, and its associated sociodemographic, economic and lifestyle factors among preschoolers.

SUBJECTS/METHODS

Three-day estimated diet records from 696 Flemish preschoolers 2.5-6.5 years old (51% boys) were used (66% of 1052 collected diaries). Contribution of 58 food groups to calcium and vitamin D intake were computed. Multiple linear regression was used to examine associations of intakes with sociodemographic, economic and lifestyle factors.

RESULTS

Mean calcium intake (844 mg per day) was above, and mean vitamin D intake (2.0 μg per day) largely below the Belgian recommendations. Milk, sweetened milk drinks and cheese were the main sources of calcium intakes (26, 25 and 11%, respectively). Butter and margarine were the main vitamin D sources (26%), followed by growth milk (=fortified milk) (20%) and fish (15%). Calcium and vitamin D intake were negatively associated with participants' age, and calcium positively with parental education and family size. The child's gender, supplement use and physical activity level, and the employment status and smoking behaviour of the parents were not associated with calcium or vitamin D intake.

CONCLUSIONS

Flemish preschoolers had too low vitamin D intakes while most had adequate calcium intakes. Milk (including sweetened, fortified/growth milk) was the main food source of calcium intake and the second important source of vitamin D intake after butter and margarine. Calcium intake was positively associated with parental education, while vitamin D intake was not.

Dietary sources of fiber intake and its association with socio-economic factors among Flemish preschool children

The objectives were to assess total dietary fiber intake, identify the major sources of dietary fiber, and examine its association with socio-economic factors among Flemish preschoolers. Three-day estimated dietary records were collected from a representative sample of preschoolers 2.5-6.5 years old (n = 661; 338 boys, 323 girls). The mean dietary fiber intake (13.4 g/d) was lower than the intake level recommended by the Belgian Superior Health Council (70% boys and 81% girls below the guidelines). The most important contributor was the group of bread and cereals (29.5%), followed by fruits (17.8%), potatoes and grains (16.0%), energy-dense, low-nutritious foods (12.4%), and vegetables (11.8%). Multiple linear regression analyses showed that total fiber intake was associated with maternal education and parents' employment. Overall, fiber intakes from high-nutritious foods (vegetables and fruits) were higher in preschoolers of higher educated mothers and those with one or both parents being employed. In conclusion, the majority of the preschoolers had dietary fiber intakes below the recommended level. Hence, dietary fiber should be promoted among parents of preschoolers and low socio-economic status families should be addressed in particular.

Adherence to the Mediterranean dietary pattern among Balearic Islands adolescents

The aim of the present work was to assess the prevalence of the Mediterranean dietary pattern (MDP) in Balearic Islands adolescents, and socio-demographic and lifestyle factors that might determine adherence to the MDP. A cross-sectional nutritional survey was carried out in the Balearic Islands between 2007 and 2008. A random sample (n 1231) of the adolescent population (12-17 years old) was interviewed. Dietary questionnaires and a general questionnaire incorporating questions related to socio-economic status, parental education level and lifestyle factors were used. Dietary habits were assessed by means of two 24 h recalls and a quantitative FFQ. Adherence to the MDP was defined according to a score constructed considering the consumption of nine MDP characteristic components: high MUFA:SFA ratio, moderate ethanol consumption, high legumes, cereals and roots, fruits, vegetables and fish consumption, and low consumption of meat and milk. Then, socio-demographic, lifestyle and health status variables that could determine a higher or ower adherence were assessed. The mean adherence was 57.9 (sd 8.9) % and the median adherence was 57.3 %. Half of the Balearic Islands adolescents (50.5 %) showed an adherence to the MDP comprised between 52.7 and 62.8 %. By multivariate analyses, a high maternal level of education, increased physical activity, reduced alcohol intake and abstinence from smoking were independent associations of better adherence to the MDP. The promotion of not only the MDP but also the Mediterranean lifestyle, including greater physical activity, should be reinforced among the Balearic younger generations.

Rapid method for cholesterol analysis in bovine milk and options for applications

The adaptation of a colorimetric technique for the analysis of cholesterol in raw milk is presented. Performance quality was satisfying (mean intra-assay coefficient of variation (CV) 4·8, inter-assay CV 9·1%, linearity between 0 and 7 mm, recovery of spiked cholesterol into raw milk 98·1 and 106·3%). However, the milk fat extraction must be carried out within the 48 hours following milk sampling. When performing sampling, the significant variation of milk cholesterol composition during the milking process has to be taken into account.

Dietary habits and related psychological and social factors: Influence on the body weight of elementary school children

This article studies the alimentary habits of children in relation to their body mass index (BMI) and food preferences, and to underline the influences of cultural and social aspects. The investigation tested 198 children (90 male and 108 female) from Cento (Ferrara), using food frequency questionnaires that were completed by the children. Subjects were subdivided into three groups based on their BMI--normal weight, overweight and underweight--taking into consideration their food frequency and preferences. The correlations between the BMI of children, mother's geographic origin and cultural level revealed differences between boys and girls. The variability of results does not allow precise correlations to be made between food frequency and children's weight, psychological and social aspects. Some incorrect dietary habits were revealed in the overweight and underweight groups. These could be controlled for and corrected by an alimentary education programme.

How to find information on national food and nutrient consumption surveys across Europe: systematic literature review and questionnaires to selected country experts are both good strategies

The present research was conducted within the framework of the EURopean micronutrient RECommendations Aligned project. In order to identify the best practice in assessing nutrient intakes, a search strategy for collecting data from national food consumption surveys/studies in Europe was developed. Systematic literature searches were carried out on twenty-eight European and the four European Free Trade Association countries. A questionnaire was also sent to two to five experts in each country. Systematic reviews using PubMed yielded 12 703 abstracts that were reduced to 200 studies using inclusion and exclusion criteria. Similarly, a search of ministry web sites yielded 3033 hits, and subsequently reduced to nine surveys. Belgium, France, Germany, Ireland, Sweden, Spain and the United Kingdom were the countries with most data and Slovenia and Liechtenstein were those with the least. Seventy-eight expert questionnaires were obtained from all countries except for Liechtenstein, Luxembourg and Slovakia. Detailed results and references are given. A systematic search and questionnaires are equally good at identifying national surveys across countries. Literature searching provides globally accessible and objective information albeit limited, whereas the questionnaire provides information that, depending upon responders, can be more complete. A combination of both strategies is recommended.

Cholesterol synthesis in the lactating cow: Induced expression of candidate genes

Despite the extensive knowledge for other species, cholesterol metabolism in ruminants is nowadays still not clear. Huge differences in milk cholesterol concentration are observed between breeds, managing strategies, individuals and moment of the lactating cycle, but the genetic actors working in the process of cholesterol secretion into milk have not been identified. As ruminant diet contains no cholesterol, understanding the mechanisms and regulation of synthesis, transport and secretion into milk is crucial when trying to reduce the amount of this metabolite in dairy products. The present work aims to study the expression of candidate genes for these processes in the liver of Bos taurus during the lactating cycle. Liver biopsies were obtained from 16 adult brown Swiss cows at different time points (2 weeks pre-partum and 0, 2, 4 and 8 weeks post-partum). After RNA extraction and reverse transcription, gene expression of candidate genes was studied using quantitative RT-PCR. Key enzymes of the cholesterol synthesis (3-hydroxy-methyglutaryl-coenzyme-A (HMG-CoA) synthase, HMG-CoA reductase and farnesyldiphosphat-farnesyltransferase (FDFT)) and gene expression feed-back regulators involved in lipid metabolism (sterol regulatory element binding proteins (SREBP1and 2) SREBP-cleavage activating protein (Scap) were selected as candidate genes. HMG-CoA-reductase and FDFT showed a huge expression increase until week 2 post-partum (p<0.01), most probably in response to the new requirements in the mammary gland. As well, and as a possible explanation for such modifications, an increase in the expression of the regulators SREBP1 and Scap was observed (p<0.01 and p<0.05 respectively). Most important, the whole synthesis machinery showed a coordinated regulation, as highly significant positive correlations were found between the expression levels of the above mentioned enzymes (p<0.01). The increase of milk and blood cholesterol levels in B. taurus after parturition might be the result of a coordinated induction in the expression of key liver enzymes and their regulating factors.

Dietary sources and determinants of soy isoflavone intake among midlife Chinese Women in Hong Kong

The dietary sources, intake levels, and determinants of soy isoflavone intake were examined using 3217 dietary recalls (DR) collected from 141 Hong Kong Chinese women aged 50-61 y. Multiple-pass 24-h DR were administered by phone by trained interviewers on 23 random, nonconsecutive days to participants over a 12-mo period from 2001 to 2002. We calculated isoflavone intake using analytical values in the Chinese University of Hong Kong Soy Isoflavone Database. Results indicated that the daily intake of total isoflavones was 7.8 +/- 5.6 mg in the study population. Non-Cantonese women had a higher intake of 10.7 +/- 7.6 mg compared with 7.3 +/- 5.0 mg in Cantonese women (P = 0.04). Altogether, 22 foods contributed approximately 90% of the total isoflavone intake. Soft tofu alone accounted for approximately 21% of the isoflavone intake, followed by bean curd skin (7.1%), name-brand soybean milk (6.3%), homemade soybean milk (6.2%), and generic soybean milk (5.8%). Combined, these 5 food items contributed 46% of the total dietary isoflavones. Multiple linear regression analysis indicated dialect group, self-reported health, and age group were significant independent predictors of soy isoflavone consumption. The data provide the basis for elucidating the patterns, determinants, and assessment of dietary soy isoflavone intake in Asian women.

Nutrition risk in the child and adolescent population of the Basque country: the enKid Study

Cross-sectional population studies provide valuable information for nutrition surveillance and planning intervention strategies. The enKid Study is the largest nutrition survey on the child and adolescent Spanish population to date. In the present paper, nutrition risks in children and young people of the Basque country based on the enKid Study subsample for the Basque region are presented. Dietary assessment was completed by means of a 24 h recall and a food frequency questionnaire completed in an interview with the mother or caregiver for children under 13 years. A second 24 h recall was completed on 25 % of the sample. Body weight, height and circumference were measured on each individual. Overweight and obesity were defined using Coleet al.cut-offs. Fat intake supplied 40 % of energy intake and saturated fats 13·8 %. Overall, 80 % of the sample had intakes of fat above 35 %. Main food sources of fats were added fats (32 %), meat (20 %) and milk products (20 %). Buns, cakes and pastry supplied 11 % of total fat intake. The nutrients showing the highest proportion of people who did not reach one third (33 %) of the Spanish dietary reference intake levels were vitamin D, vitamin E, vitamin A and folate. Prevailing food pattern showed a high consumption of meat and meat products, milk, dairy products and cereals. Conversely, consumption of fruit, vegetables and fish was low; in fact, 89 % of the sample had a normal consumption of fruit and vegetables below five portions a day. Prevalence of obesity was estimated at 3·94 %, and 17·85 % of the sample was classified as overweight.

Saturated fat in the diet of Spanish children: relationship with anthropometric, alimentary, nutritional and lipid profiles

Objective

To compare the anthropometric, alimentary, nutritional and lipid profiles and global diet quality of Spanish children according to saturated fat intake.

Design

This was a cross-sectional study. Food data were collected using a food-frequency questionnaire.

Subjects and methods

The sample included 1112 children of both sexes, aged between 6 and 7 years, selected by means of random cluster sampling in schools. The plasma lipid profile included measurements of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, apolipoprotein A1 (apoA1) and apolipoprotein B (apoB). Global diet quality was evaluated by the Dietary Variety Index (DVI) and the Healthy Eating Index (HEI).

Results

Energy intake, DVI and HEI of children from the lower quartile of saturated fat intake (LL) were higher (P < 001) than in the remaining children (UL). However, there were no significant differences in average height or weight between groups. The UL children had lower intakes of meat, fish, vegetables, fruits and olive oil and a higher intake of dairy products (P < 0.001). The intakes of fibre, vitamins C, D, B6, E and folic acid were higher in the LL children, who had lower intakes of vitamin A and calcium. The ratios LDL-C/HDL-C and apoB/apoA1 were lower (P = 0.04) in the LL children (1.87 and 0.52, respectively) than in the UL children (2.02 and 0.54, respectively).

Conclusions

The growth rate of children does not seem to be affected by the level of saturated fat intake. Furthermore, at the levels of intake observed in this study, diets with less saturated fat are associated with better alimentary, nutritional and plasma lipid profiles.

Refrigerated fruit juices: quality and safety issues

Fruit juices are an important source of bioactive compounds, but techniques used for their processing and subsequent storage may cause alterations in their contents so they do not provide the benefits expected by the consumer. In recent years consumers have increasingly sought so-called "fresh" products (like fresh products), stored in refrigeration. This has led the food industry to develop alternative processing technologies to produce foods with a minimum of nutritional, physicochemical, or organoleptic changes induced by the technologies themselves. Attention has also focused on evaluating the microbiological or toxicological risks that may be involved in applying these processes, and their effect on food safety, in order to obtain safe products that do not present health risks. This concept of minimal processing is currently becoming a reality with conventional technologies (mild pasteurization) and nonthermal technologies, some recently introduced (pasteurization by high hydrostatic pressure) and some perhaps with a more important role in the future (pulsed electric fields). Nevertheless, processing is not the only factor that affects the quality of these products. It is also necessary to consider the conditions for refrigerated storage and to control time and temperature.

Cholesterol and saturated fat intake determine the effect of polymorphisms at ABCG5/ABCG8 genes on lipid levels in children

PURPOSE

Analysis of mutations in genes of the cholesterol metabolic pathway has not completely explained the interindividual variability of blood cholesterol concentrations attributed to gene-nutrient interactions. Thus, we analyzed polymorphisms in the ABCG5 and ABCG8 genes, involved in the regulation of intestinal cholesterol absorption, with special interest in a potential interaction with diet to determine lipid levels.

METHODS

The polymorphisms ABCG5 C1950G (Gln604Glu) and ABCG8 C1895T (Ala640Val) were determined by polymerase chain reaction and restriction analysis in 1227 healthy school children, aged 6 to 8 years.

RESULTS

No significant differences were found in blood lipid levels between subjects with different genotypes of the two analyzed polymorphisms. However, important differences appeared when separating subjects by their different lipid intake. The presence of the ABCG8 C1895T and ABCG5 C1950G polymorphisms was associated with different plasma total cholesterol, low-density lipoprotein cholesterol complex, and apolipoprotein B levels only in low-cholesterol consumers (significantly for the C1895T polymorphism), and among children within the lower tertile of saturated fat intake (significantly for the C1950G polymorphism).

CONCLUSION

Polymorphisms at the half-transporter ABCG5 and ABCG8 genes affect blood cholesterol concentrations in prepubertal children by influencing dietary responsiveness. This highly significant gene-nutrient interaction could explain the great individual differences in the plasma lipid response to cholesterol and fat intake.

Influence of apolipoprotein E genotype on fat-soluble plasma antioxidants in Spanish children

BACKGROUND

Apolipoprotein (apo) E is a major determinant of plasma lipid concentrations, which in turn influence the plasma concentrations of various fat-soluble vitamins.

OBJECTIVE

We aimed to analyze the effect of APOE genotype on fat-soluble antioxidant concentrations in children.

DESIGN

A total of 926 healthy boys and girls aged 6-8 y were selected from 4 cities in Spain. APOE genotyping was carried out, and plasma concentrations of lipids, apolipoproteins, and lipid-soluble antioxidants were measured.

RESULTS

Plasma lipid concentrations were strongly influenced by APOE genotype. The mean plasma concentration of alpha-tocopherol was 21.3 micromol/L, which is one of the highest values ever reported for a population of children. Although plasma concentrations of alpha-tocopherol, gamma-tocopherol, lycopene, and alpha-carotene varied significantly between subjects with different APOE genotypes, most of these differences disappeared after adjustment for lipoprotein-related covariates. Nevertheless, tocopherol concentrations remained elevated in individuals with the E2/2 genotype. Multivariate regression analysis showed interactions of APOE genotype with triacylglycerol and apo B in determining alpha-tocopherol concentrations. When subjects were stratified according to major apo E groups, apo B appeared to be the most important predictor of alpha-tocopherol concentrations in all groups, whereas triacylglycerol was identified only in carriers of the E2 allele.

CONCLUSIONS

The association between APOE genotype and lipophilic antioxidant concentrations is dependent mainly on the effect of the polymorphism on lipoprotein concentrations. However, triacylglycerol plays a role in determining the variability of alpha-tocopherol concentrations in E2 carriers only. This suggests that the alpha-tocopherol content in each lipoprotein class varies according to APOE genotype.