Metabolic markers in relation to nutrition and growth in healthy 4-y-old children in Sweden

Serum phospholipid fatty acids are associated with bone mass in healthy 4-years-old children

BACKGROUND

Fatty acids are involved in bone development but knowledge in children is limited. The aim of this study was to investigate bone mass and mineral density in healthy preschool children in relation to fatty acids.

MATERIAL AND METHODS

In 111 healthy 4-yrs-old children (20 % overweight) bone was analysed by dual X-ray absorptiometry and serum phospholipid fatty acid by gas chromatography. Fat intake was calculated from 7 days self-reported dietary records and food frequency questionnaire.

RESULTS

Total bone mass content (BMC) and mineral density (BMD) differed by sex in normal weight, but not in overweight children showing generally higher bone mass density than children with normal weight. Linoleic acid intake was strongly correlated to BMC and femoral BMD in normal weight children. Serum concentration of docosahexaenoic acid correlated positively to BMD in all children (p = 0.01), but linoleic and arachidonic acids, and monounsaturated fatty acids showed diverging associations with bone in normal weight and overweight children.

CONCLUSION

Serum phospholipid DHA was associated with bone density. Other fatty acids associations to bone sites differed in overweight children, analogue to the pattern in healthy 8-yrs-old.The finding need to be confirmed longitudinally and in a larger group of overweight individuals.

The effect of different adiposity factors on insulin resistance in obese children and adolescents

CONTEXT

Insulin resistance (IR) has been common in obese children, but the effect of different adiposity factors on IR is still unclear.

OBJECTIVE

To evaluate the associations between IR with body mass index (BMI), waist circumference (WC), body fat mass (BFM), and body fat percentage (BFP) in obese children and adolescents.

METHODS

A total of 224 simple obese children were included in this study, including 150 boys and 74 girls, aged 3-18 who were seen in the clinical nutrition outpatient of Xinhua Hospital from September 2012 to December 2019. Basic information, body composition and laboratory tests were collected.

RESULTS

Compared with girls, boys had higher height, weight, BMI, WC, and BFM (P < 0.05), but on the contrary, boys' FINS and HOMA- IR were lower than girls' (P > 0.05). With the age increasing, height, weight, BMI, BFM, WC, HC, WHtR, FINS and HOMA-IR increased accordingly (P < 0.05). The results from univariate analysis and multiple linear regression analysis showed that the impact of BMI on IR was slightly lower than BFM, WC and HC, but higher than BFP, with adjusting for the effects of age, sex and lipid metabolism (P < 0.01).

CONCLUSION

Overall adipose tissue, especially abdominal adipose tissue, is a powerful marker in inducing IR in obese children and adolescents. In addition, more attention should be paid to WC and BFM than BMI in obese people with IR.

Greater Nutritional Risk Scores in 2-Year-Old Children Exposed to Gestational Diabetes Mellitus In Utero and Their Relationship to Homeostasis Model Assessment for Insulin Resistance at Age 5 Years

OBJECTIVES

Exposure to gestational diabetes mellitus (GDM) in utero may impact nutritional intake and lifestyle habits in early childhood. However, it is unclear whether nutritional status predicts greater risk for metabolic disturbances, such as insulin resistance (IR). The primary objectives were: 1) to determine parent-reported nutritional risk scores in 2-year-old children born to women with and without GDM and 2) to assess whether these scores predict IR in 5-year-old children.

METHODS

Children exposed (n=34) and unexposed (n=46) to GDM were screened at 2 years of age using the Toddler version of the Nutrition Screening Tool for Every Preschooler (NutriSTEP). At a 5-year follow up, IR was assessed using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR).

RESULTS

Total NutriSTEP scores ranged from 6 to 33, with higher scores indicating greater risk. After controlling for infant birthweight, sex of the child, child ethnicity, maternal age at time of pregnancy, breastfeeding status and maternal prepregnancy body mass index, average NutriSTEP scores were higher in children exposed to GDM compared with those unexposed (13.8±1.1 vs 11.2±1.1, p=0.03). NutriSTEP scores at 2 years emerged as a positive independent predictor of HOMA-IR at 5 years. For each unit increase in NutriSTEP score, suggesting greater nutritional risk, we saw a 0.48 (95% confidence interval, 0.17 to 0.80; p=0.003) increase in score on the HOMA-IR.

CONCLUSIONS

Parent-reported nutritional risk is greater in GDM-exposed children, and these nutritional behaviours developed during the first years of life may predispose to metabolic disturbance in early childhood.

A feasibility study with process evaluation of a teacher led resource to improve measures of child health

Previous school-based interventions have produced positive effects upon measures of children’s health and wellbeing but such interventions are often delivered by external experts which result in short-term effects. Thus, upskilling and expanding the resources available to classroom teachers could provide longer-term solutions. This paper presents a feasibility study of an online health resource (Healthy Schools Resource: HSR) developed to assist primary school teachers in the delivery of health-related education. Four schools (n = 2 intervention) participated in this study. Study feasibility was assessed by recruitment, retention and completion rates of several outcomes including height, weight, waist circumference, blood pressure and several metabolic markers including HDL-cholesterol, triglycerides, glucose and dietary knowledge following a 10-12-week intervention period. The process evaluation involved fidelity checks of teachers’ use of the HSR and post-intervention teacher interviews. A total of 614 consent forms were issued and 267 were returned (43%), of which, 201 confirmed consent for blood sampling (75%). Retention of children participating in the study was also high (96%). Of the 13 teachers who delivered the intervention to the children, four teachers were excluded from further analyses as they did not participate in the fidelity checks. Overall, teachers found the online resource facilitative of teaching health and wellbeing and several recommendations regarding the resource were provided to inform further evaluations. Recruitment and retention rates suggest that the teacher led intervention is feasible and acceptable to both teachers, parents and children. Initial findings provide promising evidence that given a greater sample size, a longer intervention exposure period and changes made to the resource, teachers’ use of HSR could enhance measures of health and wellbeing in children.

Anthropometric indicators as predictors of total body fat and cardiometabolic risk factors in Chilean children at 4, 7 and 10 years of age

BACKGROUND/OBJECTIVE

To compare the association between anthropometric indicators of global and central obesity as predictors of total body fat (TBF) and cardiometabolic risk factors in children.

SUBJECTS/METHODS

A total of 1044 children were evaluated at 4 years (n=320), 7 years (n=1044) and 10 years (n=483). The following anthropometric indices were determined: body mass index (BMI) for age (BAZ, WHO), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR). To estimate TBF we used validated predictive equations. We measured blood sample concentrations of glucose, insulin, triglycerides, total cholesterol, Low-density lipoprotein (LDL) and High-density lipoprotein (HDL), adiponectin, C-reactive protein (CRP) and Insulin-like growth factor-1 (IGF-1).

RESULTS

Adiposity and cardiometabolic markers, particularly those related to glucose metabolism increased from 4 years to 10 years. BAZ and WC were highly correlated to body fat at all ages (all r>0.8) but at 10 years WC was more strongly correlated than BAZ (r=0.94 WC vs r=0.88 BAZ, P<0.05); conversely, WHtR was significantly associated with body fat from 7 years (r=0.85) and 10 years (r=0.88). WHR was unrelated all over the period studied at all ages. Anthropometrical adiposity indicators became associated to cardiometabolic markers only from 7 years on with associations being slightly higher at 10 years, particularly for adiponectin and lipid markers. At all ages, BAZ, WC and WHtR performed similarly as cardiometabolic markers (P<0.05) while WHR was a slightly weaker marker.

CONCLUSIONS

Relationship between anthropometrical indicators of adiposity and cardiometabolic markers becomes stronger from 7 years onwards; BAZ, WC and WHtR perform similarly as markers of cardiometabolic risk at least until 10 years of age.

Subcutaneous fat mass in infancy and cardiovascular risk factors at school-age: The generation R study

OBJECTIVE

To examine the associations of infant subcutaneous fat with cardiovascular risk factors at school-age.

METHODS

In a population-based prospective cohort study among 808 children, total subcutaneous fat (sum of biceps, triceps, suprailiacal, and subscapular skinfold thicknesses) and central-to-total subcutaneous fat ratio (sum of suprailiacal and subscapular skinfold thicknesses/total subcutaneous fat) at 1.5 and 24 months were estimated. At 6 years, body mass index, blood pressure, cholesterol, triglycerides, and insulin levels were measured.

RESULTS

Infant subcutaneous fat measures were not associated with childhood blood pressure, triglycerides, or insulin levels. A 1-standard-deviation score (SDS) higher total subcutaneous fat at 1.5 months was, independently of body mass index, associated with lower low-density lipoprotein (LDL)-cholesterol levels at 6 years. In contrast, a 1-SDS higher total subcutaneous fat at 24 months was associated with higher total-cholesterol [difference 0.13 (95% confidence interval (CI) 0.03, 0.23) SDS] and LDL-cholesterol levels [difference 0.12 (95% CI 0.02, 0.21) SDS] at 6 years. There were no associations of central-to-total subcutaneous fat ratio with childhood cholesterol levels.

CONCLUSIONS

These results suggest that infant total subcutaneous fat is weakly associated with cholesterol levels at school-age. Further studies are needed to assess the long-term cardiometabolic consequences of infant body fat.

Association between anthropometric indices and cardiometabolic risk factors in pre-school children

BACKGROUND

The world health organization (WHO) and the Identification and prevention of dietary- and lifestyle-induced health effects in children and infants- study (IDEFICS), released anthropometric reference values obtained from normal body weight children. This study examined the relationship between WHO [body mass index (BMI) and triceps- and subscapular-skinfolds], and IDEFICS (waist circumference, waist to height ratio and fat mass index) anthropometric indices with cardiometabolic risk factors in pre-school children ranging from normal body weight to obesity.

METHODS

A cross-sectional study with 232 children (aged 4.1 ± 0.05 years) was performed. Anthropometric measurements were collected and BMI, waist circumference, waist to height ratio, triceps- and subscapular-skinfolds sum and fat mass index were calculated. Fasting glucose, fasting insulin, homeostasis model analysis insulin resistance (HOMA-IR), blood lipids and apolipoprotein (Apo) B-100 (Apo B) and Apo A-I were determined. Pearson's correlation coefficient, multiple regression analysis and the receiver-operating characteristic (ROC) curve analysis were run.

RESULTS

51% (n = 73) of the boys and 52% (n = 47) of the girls were of normal body weight, 49% (n = 69) of the boys and 48% (n = 43) of the girls were overweight or obese. Anthropometric indices correlated (p < 0.001) with insulin: [BMI (r = 0.514), waist circumference (r = 0.524), waist to height ratio (r = 0.304), triceps- and subscapular-skinfolds sum (r = 0.514) and fat mass index (r = 0.500)], and HOMA-IR: [BMI (r = 0.509), waist circumference (r = 0.521), waist to height ratio (r = 0.296), triceps- and subscapular-skinfolds sum (r = 0.483) and fat mass index (r = 0.492)]. Similar results were obtained after adjusting by age and sex. The areas under the curve (AUC) to identify children with insulin resistance were significant (p < 0.001) and similar among anthropometric indices (AUC > 0.68 to AUC < 0.76).

CONCLUSIONS

WHO and IDEFICS anthropometric indices correlated similarly with fasting insulin and HOMA-IR. The diagnostic accuracy of the anthropometric indices as a proxy to identify children with insulin resistance was similar. These data do not support the use of waist circumference, waist to height ratio, triceps- and subscapular- skinfolds sum or fat mass index, instead of the BMI as a proxy to identify pre-school children with insulin resistance, the most frequent alteration found in children ranging from normal body weight to obesity.

Effects of protein intake on blood pressure, insulin sensitivity and blood lipids in children: a systematic review

High protein intake in early childhood is associated with obesity, suggesting possible adverse effects on other cardiometabolic outcomes. However, studies in adults have suggested beneficial effects of protein intake on blood pressure (BP) and lipid profile. Whether dietary protein intake is associated with cardiovascular and metabolic health in children is unclear. Therefore, we aimed to systematically review the evidence on the associations of protein intake with BP, insulin sensitivity and blood lipids in children. We searched the databases Medline, Embase, Cochrane Central and PubMed for interventional and observational studies in healthy children up to the age of 18 years, in which associations of total, animal and/or vegetable protein intake with one or more of the following outcomes were reported: BP; measures of insulin sensitivity; cholesterol levels; or TAG levels. In the search, we identified 6636 abstracts, of which fifty-six studies met all selection criteria. In general, the quality of the included studies was low. Most studies were cross-sectional, and many did not control for potential confounders. No overall associations were observed between protein intake and insulin sensitivity or blood lipids. A few studies suggested an inverse association between dietary protein intake and BP, but evidence was inconclusive. Only four studies examined the effects of vegetable or animal protein intake, but with inconsistent results. In conclusion, the literature, to date provides insufficient evidence for effects of protein intake on BP, insulin sensitivity or blood lipids in children. Future studies could be improved by adequately adjusting for key confounders such as energy intake and obesity.

Dietary Habits and Cardiometabolic Health in Obese Children

BACKGROUND

Prevalence rates of cardiometabolic risk factors vary largely among overweight children. This study investigated the relationships between dietary habits and cardiometabolic health among obese children living in a city of Northern Italy.

METHODS

Dietary habits were collected in 448 obese subjects aged 6-18 years, attending an obesity outpatient center in Milan. Anthropometry, blood pressure (BP), lipids, fasting and post-load glucose, and insulin were measured. Physical activity was assessed in adolescents using a questionnaire.

RESULTS

Frequency of glucose intolerance, hypertension and dyslipidemia was 0.7%, 13% and 27.2%, respectively. Plausible reporters consumed more animal protein and sodium and less legumes than recommended in nutritional recommendations and adequate amounts of fiber mainly derived from whole grains. Subjects skipping breakfast had unhealthy diets and greater body fatness. After adjustment for confounders, waist/height and fasting glucose were associated with sodium intake (r =0.149 and r = 0.142, respectively; p < 0.05), 2-hour glucose with fiber (r = -0.172; p < 0.01), and BP with vegetable protein intake (systolic r = -0.120 (p < 0.05); diastolic r = -0.267 (p < 0.01)). Hypertensive children consumed less vegetable protein than normotensive children.

CONCLUSIONS

The cardiometabolic health of obese children improves with vegetable protein and whole grain intake, whereas dysglycemia and adiposity increase with sodium intake.

Retarded tempo of physiological development in childhood delays the onset of the metabolic syndrome in adulthood

Using serial data from the Fels Longitudinal Study, we investigated the effects of early and late attainment of the peak height velocity (PHV) in childhood on the timing of the appearance of the metabolic syndrome later in life. We aimed to show if early attainment of PHV engenders greater risks for chronic diseases in boys than in girls. Therefore, we defined those boys and girls in sex-specific quartiles of the study population that were slowest to attain PHV as having a slow tempo of development, and those in the growth that most rapidly attained PHV as having a rapid tempo of development. Boys who experienced an early onset of PHV tended to have a higher risk for the metabolic syndrome, dyslipidemia and impaired fasting glucose than those who had late onset of PHV. Girls who had an early onset of PHV tended to develop more abdominal obesity than females who had a late onset of PHV.

Is carbohydrate intake in the first years of life related to future risk of NCDs?

Studies on children's carbohydrate intake, especially fibre intake, and its associations with later health are rare. The current recommendations for fibre intake in children are based on average assumptions and data extrapolated from intakes in adults. Generally, increase in whole-grain consumption and decrease in sucrose intake are considered healthy. Due to fibre's high bulk volume however, excessive dietary fibre has been feared to decrease energy density have effects on growth, at least in developing countries and in children consuming very restricted diets. Furthermore, it has been speculated that if fats are reduced from the diet, it may become high in sucrose. In STRIP study, which is a long-term, randomized controlled trial designed to decrease the exposure of children to known risk factors of atherosclerosis, carbohydrate intakes have been investigated in detail in children aged 13 months to 9 years. The intervention was successful in decreasing saturated fat intake and cholesterol concentrations throughout childhood and adolescence. The study results also show that a higher than average fibre intake does not displace energy or disturb growth in children and that children with high fibre intake have better dietary quality than those with low fibre intake. Dietary fibre intake associated with lower serum total cholesterol concentrations whereas increases in total carbohydrate, sucrose and fructose intakes associated with increases in serum triglyceride concentrations. In conclusion, from the point of view of CHD risk factor prevention, efforts aiming at increasing the fibre intake while restricting that of refined sugar seem justified in the child population in developed countries.

CLINICAL TRIAL REGISTRATION INFORMATION

NCT00223600.

The role and requirements of digestible dietary carbohydrates in infants and toddlers

Digestible carbohydrates are one of the main sources of dietary energy in infancy and childhood and are essential for growth and development. The aim of this narrative review is to outline the intakes of digestible carbohydrates and their role in health and disease, including the development of food preferences, as well the consequences of excess carbohydrate. Key experts in these fields provided up-to-date reviews of the literature. A search of available information on dietary intakes of children below the age of 4 years was conducted from 1985 up to 2010. Articles and reports including information about sugars and/or starch intakes were selected. A number of factors limit the ability to obtain an overall picture of carbohydrate intakes and food sources in this age group. These include small numbers of intake studies, differing approaches to analysing carbohydrate, a variety of terms used to describe sugars intakes and a dearth of information about starch intakes. Data suggest that sweet taste is preferred in infancy and later food choices. There are few established adverse consequences of high intakes of digestible carbohydrate for young children. The greatest evidence is for dental caries, although this is influenced by high intake frequency and poor oral hygiene. Evidence for detrimental effects on nutrient dilution, obesity, diabetes or cognition is limited. In infants, minimum carbohydrate (mainly lactose) intake should be 40% of total energy, gradually increasing to 55% energy by the age of 2 years.

Obesity indicators and cardiometabolic status in 4-y-old children

BACKGROUND

In adults and adolescents, obesity is positively associated with cardiovascular disease risk factors; however, evidence in preschool children is scarce.

OBJECTIVE

The objective was to assess the relations between obesity indicators and cardiometabolic risk factors in 324 Chilean children 4 y of age.

DESIGN

We collected anthropometric measurements and calculated general indicators of obesity [weight, body mass index (BMI), sum of 4 skinfold thicknesses, percentage fat, and body fat index] and central obesity (waist circumference, waist-to-hip ratio, waist-to-height ratio, and truncal fatness based on skinfold thickness). We measured blood sample concentrations of C-reactive protein, interleukin-6, homeostasis model assessment of insulin resistance, triglycerides, and total, LDL, and HDL cholesterol. We used correlation and multiple linear regression analyses.

RESULTS

The prevalence of obesity (BMI-for-age z score >2, World Health Organization 2006), central obesity (> or = 90th percentile, third National Health and Nutrition Examination Survey), and lipid disorders was high (13%, 11%, and > or = 20%, respectively), and 70% of the children had at least one cardiometabolic risk factor. Most correlations between obesity and central obesity indicators were moderate to strong (0.40 < r < 0.96). Obesity was positively but weakly associated with C-reactive protein in both sexes and with homeostasis model assessment of insulin resistance only in girls (all r < 0.3, P < 0.05). Obesity indicators were unrelated to interleukin-6 and lipid concentrations (P > 0.05). Overall, obesity indicators explained, at most, 8% of the variability in cardiometabolic risk factors.

CONCLUSIONS

Obesity and central obesity were common, and most of the children had at least one cardiometabolic risk factor, particularly lipid disorders. Obesity and central obesity indicators were highly intercorrelated and, overall, were weakly related to cardiometabolic status. At this age, body mass index and waist circumference were poor predictors of cardiometabolic status.

Metabolic profiles of fat and glucose differ by gender in healthy 8-year-olds

OBJECTIVE

The aim was to investigate if metabolic markers were associated with anthropometry and weight increase in healthy 8-year-olds.

METHODS

Ninety-seven healthy children, 66 of whom had been examined at the age of 4 years, were investigated. Dual energy X-ray absorptiometry was performed to determine fat (FM) and lean body mass (LBM). Plasma glucose and serum levels of insulin, cholesterol, triglycerides, adiponectin and leptin were analysed and HOMA-indices were calculated.

RESULTS

Despite similar anthropometry, metabolic markers differed by gender. Sixteen % of the children were overweight or obese. Body mass index (BMI) was strongly correlated to FM. Anthropometric measures except LBM correlated to metabolic markers in the girls. Boys had higher concentrations of plasma glucose than girls. In overweight children, insulin was negatively associated with LBM. Leptin and the ratio between leptin and adiponectin, but not adiponectin, were significantly associated with HOMA-IR and body composition.

CONCLUSION

The metabolic profile of plasma glucose, serum leptin, fasting insulin and related HOMA indices differed by gender, despite no difference in BMI or FM. LBM, but not FM correlated to the insulin concentration in the overweight children. Leptin was the best marker of overweight.

BMI at 4 years of age is associated with previous and current protein intake and with paternal BMI

OBJECTIVES

To evaluate possible associations between body mass index (BMI) at 4 years of age, current and previous dietary intakes and parental BMI.

METHODS

A follow-up of dietary intake and anthropometry in 127 4-year-old children corresponding to 54% of children who completed an initial intervention study at 18 months of age.

RESULTS

Fourteen percent of the girls and 13% of the boys were overweight (age-adjusted BMI> or =25) and 2% of the girls and 3% of the boys were obese (age-adjusted BMI> or =30). Thirty-four percent and 9% of the fathers and 19 and 7% of the mothers were overweight and obese, respectively. BMI at 6-18 months was a strong predictor of BMI at 4 years. Univariate regression analyses revealed that intake of protein in particular, and also of total energy and carbohydrates at 17/18 months and at 4 years, was positively associated with BMI at 4 years. Although BMI at 6-18 months was the strongest predictor of BMI at 4 years, in the final multivariate models of the child's BMI, protein intake at 17-18 months and at 4 years, energy intake at 4 years and the father's-but not the mother's-BMI were also independent contributing factors.

CONCLUSIONS

Among these healthy children, BMI at 4 years of age tracked from 6 to 18 months of age and were associated with previous and current protein intake as well as parental BMI, particularly that of the father.

Effect of growth on cardiometabolic status at 4 y of age

BACKGROUND

Cardiovascular disease (CVD) risks are increasingly being diagnosed in children and track into adulthood. Growth is associated with CVD risk in adulthood; however, its contribution to CVD risks in children facing the obesity epidemic is unclear.

OBJECTIVE

The objective was to assess relations between growth from age 0 to 4 y and CVD status at 4 y in 323 Chilean children with normal birth weight.

DESIGN

From health records we obtained weight and height every 6 mo from age 0 to 3 y and calculated body mass index (BMI; weight/height(2)). At age 4 y, we measured height, waist circumference, insulin, glucose, and plasma lipids; infant feeding information was provided by the mothers. Outcomes were metabolic score (waist-to-height ratio + glucose + insulin + triglycerides - HDL-cholesterol z scores/5), total cholesterol (TC):HDL cholesterol, and homeostasis model of assessment of insulin resistance.

RESULTS

At 4 y, the prevalence of obesity was 13%. Changes in BMI, particularly from 6 to 24 mo, predicted a higher metabolic score (standardized regression coefficient = 0.29; 95% CI: 0.16, 0.42) but were unrelated to homeostasis model of assessment of insulin resistance and TC:HDL cholesterol. Height changes were not associated with CVD risks at the age of 4 y. Mode of infant feeding was unrelated to CVD status at 4 y; however, in children who were exclusively breastfed at 4 mo, an increase in BMI from 0 to 6 mo was positively associated with TC:HDL cholesterol at 4 y (standardized regression coefficient = 0.24; 95% CI: -0.02, 0.50), whereas in children who were partially or nonbreastfed at 4 mo, it was negatively associated with TC:HDL cholesterol at 4 y (standardized regression coefficient = -0.30; 95% CI: -0.52, -0.08).

CONCLUSION

In children with normal birth weight and a high prevalence of obesity at 4 y, changes in BMI after 6 mo predicted a higher overall CVD risk at 4 y.

Physical activity and dietary behaviour in a population-based sample of British 10-year old children: the SPEEDY study (Sport, Physical activity and Eating behaviour: environmental Determinants in Young people)

Background

The SPEEDY study was set up to quantify levels of physical activity (PA) and dietary habits and the association with potential correlates in 9–10 year old British school children. We present here the analyses of the PA, dietary and anthropometry data.

Methods

In a cross-sectional study of 2064 children (926 boys, 1138 girls) in Norfolk, England, we collected anthropometry data at school using standardised procedures. Body mass index (BMI) was used to define obesity status. PA was assessed with the Actigraph accelerometer over 7 days. A cut-off of ≥ 2000 activity counts was used to define minutes of moderate-to-vigorous PA (MVPA). Dietary habits were assessed using the Health Behaviour in School Children food questionnaire. Weight status was defined using published international cut-offs (Cole, 2000). Differences between groups were assessed using independent t-tests for continuous data and chi-squared tests for categorical data.

Results

Valid PA data (>500 minutes per day on ≥ 3 days) was available for 1888 children. Mean (± SD) activity counts per minute among boys and girls were 716.5 ± 220.2 and 635.6 ± 210.6, respectively (p < 0.001). Boys spent an average of 84.1 ± 25.9 minutes in MVPA per day compared to 66.1 ± 20.8 among girls (p < 0.001), with an average of 69.1% of children accumulating 60 minutes each day. The proportion of children classified as overweight and obese was 15.0% and 4.1% for boys and 19.3% and 6.6% for girls, respectively (p = 0.001). Daily consumption of at least one portion of fruit and of vegetables was 56.8% and 49.9% respectively, with higher daily consumption in girls than boys and in children from higher socioeconomic backgrounds.

Conclusion

Results indicate that almost 70% of children meet national PA guidelines, indicating that a prevention of decline, rather than increasing physical activity levels, might be an appropriate intervention target. Promotion of daily fruit and vegetable intake in this age group is also warranted, possibly focussing on children from lower socioeconomic backgrounds.

High sucrose intake is associated with poor quality of diet and growth between 13 months and 9 years of age: the special Turku Coronary Risk Factor Intervention Project

BACKGROUND

Previous studies have suggested that interventions to lower dietary fat content and improved fat quality lead to a compensatory increase in sucrose content.

OBJECTIVE

The purpose of this work was to determine what associations exist between sucrose intake and intake of nutrients, intake of specific foods, and growth in children aged 13 months to 9 years of age in the prospective, randomized Special Turku Coronary Risk Factor Intervention Project.

SUBJECTS AND METHODS

Nutrient intake and food consumption were evaluated annually at ages 13 months through 9 years by using food records. Altogether, 543 children were divided into 3 groups according to mean sucrose intake: constantly high sucrose intake (highest 10%), constantly low sucrose intake (lowest 10%), and average sucrose intake (80%). Absolute and relative weights and heights were recorded at 7, 13, and 24 months of age and annually thereafter until 9 years old.

RESULTS

The high sucrose-intake group exceeded the recommended sucrose intake (<10% of energy intake, World Health Organization) already at the age of 2 years. Energy and total fat intake did not differ between the sucrose-intake groups. Children with low and average sucrose intake consumed more protein and had a better dietary fat quality than children with high sucrose intake. They also tended to receive more vitamin E, niacin, calcium, iron, zinc, and dietary fiber than children who consumed a high sucrose diet. Children in the low sucrose-intake group consumed more grains, vegetables, and dairy products than the other children. Sugar intake had no direct association with obesity, but weight, height, and BMI of children differed between the sucrose-intake groups between 7 months and 9 years of age.

CONCLUSIONS

In children aged 13 months to 9 years, long-term low sucrose intake is associated with better nutrient intake and growth than high sucrose intake.