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Tugault-Lafleur CN, Polsky JY. Temporal snacking patterns among Canadian children and adolescents. Appl Physiol Nutr Metab 2024. [PMID: 38981135 DOI: 10.1139/apnm-2024-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
Snacking is nearly universal among children but there is growing concern around snacking patterns and energy contribution. This study aimed to characterize temporal snacking patterns among Canadian children and adolescents. A cross-sectional analysis drew on data from 5209 respondents aged 4-18 years from the 2015 Canadian Community Health Survey Nutrition, using one 24 h dietary recall. Descriptive statistics estimated proportions of morning, afternoon, and evening snackers, the mean caloric contribution of each snacking period to total daily energy intake, and the top food categories consumed as snacks (kcal per capita). Snacking was nearly universal and accounted for one of every four calories consumed. Morning snacks were more popular among children vs. adolescents and contributed significantly less energy than afternoon or evening snacking periods for both age groups (P < 0.001). The top food groups consumed as snacks were the same for children and adolescents, although the ranking order varied. Fruits were the leading food group in terms of per capita energy for children and second for adolescents. Aside from fruits and milks, all other top per capita energy contributors were generally more energy-dense, nutrient-poor foods such as cookies, biscuits and cereal bars, and other breads. Among children, morning snacks were higher in desirable nutrients compared with afternoon snacks. Not all snacking periods are equal in terms of energy and nutrients. A better understanding of how time of day may influence the quality of snack foods can inform meal-based guidance and help children achieve the recommended daily amounts of foods and nutrients.
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Affiliation(s)
| | - Jane Y Polsky
- Health Analysis Division, Statistics Canada, Ottawa, ON, Canada
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2
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Choudhary D, Rideout TC, Millen AE, Wen X. Bean Consumption during Childhood Is Associated with Improved Nutritional Outcomes in the First Two Years of Life. Nutrients 2024; 16:1120. [PMID: 38674811 PMCID: PMC11053677 DOI: 10.3390/nu16081120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
Bean consumption during childhood may play a role in promoting early-life health given their high nutritional quality. To examine the associations of children's bean consumption with the socio-demographic characteristics of the child and mother and the child's nutrient intake, we analyzed data from the WIC-ITFPS-2, which followed children and their mothers at 1, 3, 5, 7, 9, 11, 13, 15, 18, and 24 months (m) following birth. Caregivers (mostly mothers) responded to an interview-administered 24 h recall on their child's dietary intake at each time point. The intake of dried beans, chili, yellow beans, and lima beans was quantified. Correlate measures included socio-demographic characteristics. Outcome measures of interest focused on the intake of macronutrients (grams and % kcals) and micronutrients at 11 (infancy) and 24 m (toddler) only. To ensure statistical power, we only examined the associations of dried beans and chili with socio-demographics (Chi-square tests) and nutritional outcomes (ANOVA) at 11 and 24 m. The proportion of children who consumed dried beans or chili was very low in the first 6 m of age, started to increase at 7 m (1.2% and 0.4%) and 11 m (4.9% and 2.3%), and reached a high level at 18 m (10.5%) and 24 m (5.9%), respectively. Consumption of yellow or lima beans was rare (<0.1%). At 11 and 24 m, dried bean consumption was higher in children who were White (vs. Black). Dried bean and chili consumption was higher in children who were of Hispanic or Latino ethnicity (vs. non-Hispanic or non-Latino ethnicity). Children who consumed dried beans and chili at 11 or 24 m had a higher intake of total energy, protein, total fiber, potassium, folate, and magnesium compared with non-consumers. The bean consumption was low amongst children, differed by race and ethnicity, and was associated with improved macro- and micronutrient intake in children at 11 and 24 m.
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Affiliation(s)
- Divya Choudhary
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14214, USA;
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY 14214, USA;
| | - Todd C. Rideout
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY 14214, USA;
| | - Amy E. Millen
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY 14214, USA;
| | - Xiaozhong Wen
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14214, USA;
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3
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Brown KJ, Beck KL, von Hurst P, Heath AL, Taylor R, Haszard J, Daniels L, Te Morenga L, McArthur J, Paul R, Jones E, Katiforis I, Rowan M, Casale M, McLean N, Cox A, Fleming E, Bruckner B, Jupiterwala R, Wei A, Conlon C. Adherence to Infant Feeding Guidelines in the First Foods New Zealand Study. Nutrients 2023; 15:4650. [PMID: 37960303 PMCID: PMC10647304 DOI: 10.3390/nu15214650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
Infant feeding guidelines provide evidence-based recommendations to support optimal infant health, growth, and development, and exploring adherence to guidelines is a useful way of assessing diet quality. The aim of this study was to determine adherence to the recently updated Ministry of Health "Healthy Eating Guidelines for New Zealand Babies and Toddlers (0-2 years old)". Data were obtained from First Foods New Zealand, a multicentre observational study of 625 infants aged 7.0-10.0 months. Caregivers completed two 24-h diet recalls and a demographic and feeding questionnaire. Nearly all caregivers (97.9%) initiated breastfeeding, 37.8% exclusively breastfed to around six months of age, and 66.2% were currently breastfeeding (mean age 8.4 months). Most caregivers met recommendations for solid food introduction, including appropriate age (75.4%), iron-rich foods (88.3%), puréed textures (80.3%), and spoon-feeding (74.1%). Infants consumed vegetables (63.2%) and fruit (53.9%) more frequently than grain foods (49.5%), milk and milk products (38.6%), and meat and protein-rich foods (31.8%). Most caregivers avoided inappropriate beverages (93.9%) and adding salt (76.5%) and sugar (90.6%). Our findings indicated that while most infants met the recommendations for the introduction of appropriate solid foods, the prevalence of exclusive breastfeeding could be improved, indicating that New Zealand families may need more support.
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Affiliation(s)
- Kimberley J. Brown
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Kathryn L. Beck
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Pamela von Hurst
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Anne-Louise Heath
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Rachael Taylor
- Department of Medicine, University of Otago, Dunedin 9016, New Zealand; (R.T.); (L.D.); (A.C.)
| | - Jillian Haszard
- Biostatistics Centre, University of Otago, Dunedin 9016, New Zealand;
| | - Lisa Daniels
- Department of Medicine, University of Otago, Dunedin 9016, New Zealand; (R.T.); (L.D.); (A.C.)
| | - Lisa Te Morenga
- Research Centre for Hauora and Health, Massey University, Wellington 6140, New Zealand;
| | - Jenny McArthur
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Rebecca Paul
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Emily Jones
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Ioanna Katiforis
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Madeleine Rowan
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Maria Casale
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Neve McLean
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Alice Cox
- Department of Medicine, University of Otago, Dunedin 9016, New Zealand; (R.T.); (L.D.); (A.C.)
| | - Elizabeth Fleming
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Bailey Bruckner
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Rosario Jupiterwala
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Andrea Wei
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Cathryn Conlon
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
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4
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Bragg MG, Westlake M, Alshawabkeh AN, Bekelman TA, Camargo CA, Catellier DJ, Comstock SS, Dabelea D, Dunlop AL, Hedderson MM, Hockett CW, Karagas MR, Keenan K, Kelly NR, Kerver JM, MacKenzie D, Mahabir S, Maldonado LE, McCormack LA, Melough MM, Mueller NT, Nelson ME, O’Connor TG, Oken E, O’Shea TM, Switkowski KM, Sauder KA, Wright RJ, Wright RO, Zhang X, Zhu Y, Lyall K. Opportunities for Examining Child Health Impacts of Early-Life Nutrition in the ECHO Program: Maternal and Child Dietary Intake Data from Pregnancy to Adolescence. Curr Dev Nutr 2023; 7:102019. [PMID: 38035205 PMCID: PMC10681943 DOI: 10.1016/j.cdnut.2023.102019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 12/02/2023] Open
Abstract
Background Longitudinal measures of diet spanning pregnancy through adolescence are needed from a large, diverse sample to advance research on the effect of early-life nutrition on child health. The Environmental influences on Child Health Outcomes (ECHO) Program, which includes 69 cohorts, >33,000 pregnancies, and >31,000 children in its first 7-y cycle, provides such data, now publicly available. Objectives This study aimed to describe dietary intake data available in the ECHO Program as of 31 August, 2022 (end of year 6 of Cycle 1) from pregnancy through adolescence, including estimated sample sizes, and to highlight the potential for future analyses of nutrition and child health. Methods We identified and categorized ECHO Program dietary intake data, by assessment method, participant (pregnant person or child), and life stage of data collection. We calculated the number of maternal-child dyads with dietary data and the number of participants with repeated measures. We identified diet-related variables derived from raw dietary intake data and nutrient biomarkers measured from biospecimens. Results Overall, 66 cohorts (26,941 pregnancies, 27,103 children, including 22,712 dyads) across 34 US states/territories provided dietary intake data. Dietary intake assessments included 24-h recalls (1548 pregnancies and 1457 children), food frequency questionnaires (4902 and 4117), dietary screeners (8816 and 23,626), and dietary supplement use questionnaires (24,798 and 26,513). Repeated measures were available for ∼70%, ∼30%, and ∼15% of participants with 24-h recalls, food frequency questionnaires, and dietary screeners, respectively. The available diet-related variables describe nutrient and food intake, diet patterns, and breastfeeding practices. Overall, 17% of participants with dietary intake data had measured nutrient biomarkers. Conclusions ECHO cohorts have collected longitudinal dietary intake data spanning pregnancy through adolescence from a geographically, socioeconomically, and ethnically diverse US sample. As data collection continues in Cycle 2, these data present an opportunity to advance the field of nutrition and child health.
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Affiliation(s)
- Megan G. Bragg
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Matt Westlake
- RTI International, Research Triangle Park, NC, United States
| | | | - Traci A. Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Carlos A. Camargo
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | | | - Sarah S. Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Anne L. Dunlop
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Monique M. Hedderson
- Kaiser Permanente Northern California Division of Research, Oakland, CA, United States
| | - Christine W. Hockett
- Avera Research Institute, Sioux Falls, SD, United States
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, United States
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Kate Keenan
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, United States
| | - Nichole R. Kelly
- Department of Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR, United States
| | - Jean M. Kerver
- Departments of Epidemiology & Biostatistics and Pediatrics & Human Development, College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Debra MacKenzie
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Somdat Mahabir
- National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Luis E. Maldonado
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Lacey A. McCormack
- Avera Research Institute, Sioux Falls, SD, United States
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, United States
| | - Melissa M. Melough
- Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE, United States
- Department of Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Noel T. Mueller
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | | | - Thomas G. O’Connor
- Departments of Psychiatry, Neuroscience, Obstetrics and Gynecology, University of Rochester, Rochester, NY, United States
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - T Michael O’Shea
- Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States
| | - Karen M. Switkowski
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Katherine A. Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Rosalind J. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Robert O. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Xueying Zhang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Yeyi Zhu
- Kaiser Permanente Northern California Division of Research, Oakland, CA, United States
| | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
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5
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Shelton CD, Sing E, Mo J, Shealy NG, Yoo W, Thomas J, Fitz GN, Castro PR, Hickman TT, Torres TP, Foegeding NJ, Zieba JK, Calcutt MW, Codreanu SG, Sherrod SD, McLean JA, Peck SH, Yang F, Markham NO, Liu M, Byndloss MX. An early-life microbiota metabolite protects against obesity by regulating intestinal lipid metabolism. Cell Host Microbe 2023; 31:1604-1619.e10. [PMID: 37794592 PMCID: PMC10593428 DOI: 10.1016/j.chom.2023.09.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/07/2023] [Accepted: 09/06/2023] [Indexed: 10/06/2023]
Abstract
The mechanisms by which the early-life microbiota protects against environmental factors that promote childhood obesity remain largely unknown. Using a mouse model in which young mice are simultaneously exposed to antibiotics and a high-fat (HF) diet, we show that Lactobacillus species, predominant members of the small intestine (SI) microbiota, regulate intestinal epithelial cells (IECs) to limit diet-induced obesity during early life. A Lactobacillus-derived metabolite, phenyllactic acid (PLA), protects against metabolic dysfunction caused by early-life exposure to antibiotics and a HF diet by increasing the abundance of peroxisome proliferator-activated receptor γ (PPAR-γ) in SI IECs. Therefore, PLA is a microbiota-derived metabolite that activates protective pathways in the small intestinal epithelium to regulate intestinal lipid metabolism and prevent antibiotic-associated obesity during early life.
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Affiliation(s)
- Catherine D Shelton
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Elizabeth Sing
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Jessica Mo
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Nicolas G Shealy
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Woongjae Yoo
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Department of Life Sciences, Pohang University of Science and Technology (POSTECH), Pohang 37673, Republic of Korea
| | - Julia Thomas
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Gillian N Fitz
- Department of Cell and Developmental Biology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Pollyana R Castro
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Laboratory of Immunoinflammation, Department of Genetics, Evolution, Microbiology, and Immunology, Institute of Biology, University of Campinas, Campinas, São Paulo 12083-862, Brazil
| | - Tara T Hickman
- Department of Biochemistry, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Teresa P Torres
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Nora J Foegeding
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Jacob K Zieba
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - M Wade Calcutt
- Mass Spectrometry Research Center and Department of Biochemistry, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Simona G Codreanu
- Center for Innovative Technology and Department of Chemistry, Vanderbilt University, Nashville, TN 37232, USA
| | - Stacy D Sherrod
- Center for Innovative Technology and Department of Chemistry, Vanderbilt University, Nashville, TN 37232, USA
| | - John A McLean
- Center for Innovative Technology and Department of Chemistry, Vanderbilt University, Nashville, TN 37232, USA
| | - Sun H Peck
- Department of Biochemistry, Vanderbilt University School of Medicine, Nashville, TN 37232, USA; Department of Biomedical Engineering, Vanderbilt University School of Engineering, Nashville, TN 37232, USA; Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, USA; Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Fan Yang
- Department of Cell and Developmental Biology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Nicholas O Markham
- Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, USA; Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Epithelial Biology Center, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Institute of Infection, Immunology, and Inflammation, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Min Liu
- Department of Pathology and Molecular Medicine, Metabolic Diseases Institute, University of Cincinnati College of Medicine, Cincinnati, OH 45237, USA
| | - Mariana X Byndloss
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Institute of Infection, Immunology, and Inflammation, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Digestive Disease Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Microbiome Innovation Center, Vanderbilt University, Nashville, TN 37235, USA; Howard Hughes Medical Institute, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
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6
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Singleton CR, Wright LA, McDonald M, Archer IG, Bell CN, McLoughlin GM, Houghtaling B, Cooksey Stowers K, Anderson Steeves E. Structural racism and geographic access to food retailers in the United States: A scoping review. Health Place 2023; 83:103089. [PMID: 37557002 DOI: 10.1016/j.healthplace.2023.103089] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/16/2023] [Accepted: 07/17/2023] [Indexed: 08/11/2023]
Abstract
This scoping review summarized findings and key measures from U.S.-based studies that 1) examined associations between geographic indicators of structural racism (e.g., redlining, racial segregation) and access to food retailers (e.g., supermarkets, convenience stores) or 2) documented disparities in access by neighborhood racial/ethnic composition. In 2022, relevant scientific literature was reviewed using Covidence software. Independent reviewers examined 13,069 citations; 163 citations advanced to the full-text review stage and 70 were selected for inclusion. Twenty-one studies (30%) linked one or more indicator of structural racism to food retailer access while 49 (70%) solely examined differences in access by neighborhood racial/ethnic composition. All studies featuring indicators of structural racism reported significant findings; however, indicators varied across studies making it difficult to make direct comparisons. Key indicators of structural racism in the food access literature included redlining (n = 3), gentrification (n = 3), and racial segregation (n = 4). Many U.S.-based studies have evaluated food retailer access by neighborhood racial/ethnic composition. Moving forward, studies should model indicators of structural racism and determine their influence on geographic access to large and small food retailers.
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Affiliation(s)
- Chelsea R Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health & Tropical Medicine, New Orleans, LA, USA.
| | - Laura A Wright
- Rudolph Matas Library of the Health Sciences, Tulane University, New Orleans, LA, USA
| | - Meredith McDonald
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health & Tropical Medicine, New Orleans, LA, USA
| | - Isabel G Archer
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health & Tropical Medicine, New Orleans, LA, USA
| | - Caryn N Bell
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health & Tropical Medicine, New Orleans, LA, USA
| | - Gabriella M McLoughlin
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA; Implementation Science Center for Cancer Control, Washington University in St. Louis, St. Louis, MO, USA
| | - Bailey Houghtaling
- Gretchen Swanson Center for Nutrition, Omaha, NE, USA; Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
| | - Kristen Cooksey Stowers
- Department of Allied Health Sciences, College of Agriculture, Health, And Natural Resources, University of Connecticut, Storrs, CT, USA
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7
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Dötsch-Klerk M, Bruins MJ, Detzel P, Martikainen J, Nergiz-Unal R, Roodenburg AJC, Pekcan AG. Modelling health and economic impact of nutrition interventions: a systematic review. Eur J Clin Nutr 2023; 77:413-426. [PMID: 36195747 PMCID: PMC10115624 DOI: 10.1038/s41430-022-01199-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/17/2022] [Accepted: 08/12/2022] [Indexed: 11/08/2022]
Abstract
Diet related non-communicable diseases (NCDs), as well as micronutrient deficiencies, are of widespread and growing importance to public health. Authorities are developing programs to improve nutrient intakes via foods. To estimate the potential health and economic impact of these programs there is a wide variety of models. The aim of this review is to evaluate existing models to estimate the health and/or economic impact of nutrition interventions with a focus on reducing salt and sugar intake and increasing vitamin D, iron, and folate/folic acid intake. The protocol of this systematic review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42016050873). The final search was conducted on PubMed and Scopus electronic databases and search strings were developed for salt/sodium, sugar, vitamin D, iron, and folic acid intake. Predefined criteria related to scientific quality, applicability, and funding/interest were used to evaluate the publications. In total 122 publications were included for a critical appraisal: 45 for salt/sodium, 61 for sugar, 4 for vitamin D, 9 for folic acid, and 3 for iron. The complexity of modelling the health and economic impact of nutrition interventions is dependent on the purpose and data availability. Although most of the models have the potential to provide projections of future impact, the methodological challenges are considerable. There is a substantial need for more guidance and standardization for future modelling, to compare results of different studies and draw conclusions about the health and economic impact of nutrition interventions.
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Affiliation(s)
- Mariska Dötsch-Klerk
- Unilever Foods Innovation Centre, Wageningen, The Netherlands.
- Unilever Foods Innovation Centre, Wageningen, Bronland 14, 6708 WH, The Netherlands.
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Ullevig SL, Parra-Medina D, Liang Y, Howard J, Sosa E, Estrada-Coats VM, Errisuriz V, Li S, Yin Z. Impact of ¡Míranos! on parent-reported home-based healthy energy balance-related behaviors in low-income Latino preschool children: a clustered randomized controlled trial. Int J Behav Nutr Phys Act 2023; 20:33. [PMID: 36944986 PMCID: PMC10029790 DOI: 10.1186/s12966-023-01427-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 02/19/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Widespread establishment of home-based healthy energy balance-related behaviors (EBRBs), like diet, physical activity, sedentary behavior, screen time, and sleep, among low-income preschool-aged children could curb the childhood obesity epidemic. We examined the effect of an 8-month multicomponent intervention on changes in EBRBs among preschool children enrolled in 12 Head Start centers. METHODS The Head Start (HS) centers were randomly assigned to one of three treatment arms: center-based intervention group (CBI), center-based plus home-based intervention group (CBI + HBI), or control. Before and following the intervention, parents of 3-year-olds enrolled in participating HS centers completed questionnaires about their child's at-home EBRBs. Adult-facilitated physical activity (PA) was measured by an index based on questions assessing the child's level of PA participation at home, with or facilitated by an adult. Fruit, vegetable, and added sugar intake were measured via a short food frequency questionnaire, and sleep time and screen time were measured using 7-day logs. A linear mixed effects model examined the intervention's effect on post-intervention changes in PA, intake of fruit, vegetable, and added sugar, sleep time, and screen time from baseline to post-intervention. RESULTS A total of 325 parents participated in the study (CBI n = 101; CBI + HBI n = 101; and control n = 123). Compared to control children, CBI and CBI + HBI parents reported decreases in children's intake of added sugar from sugar-sweetened beverages. Both CBI and CBI + HBI parents also reported smaller increases in children's average weekday screen time relative to controls. In addition, CBI + HBI parents reported CBI + HBI parents reported increases in children's adult-facilitated PA, fruit and vegetable intake, and daily sleep time during weekdays (excluding weekends) and the total week from baseline to post-intervention, while children in the CBI increased sleep time over the total week compared to the children in the control group. CONCLUSIONS Parent engagement strengthened the improvement in parent-reported EBRBs at home in young children participating in an evidence-based obesity prevention program in a childcare setting. Future studies should investigate equity-related contextual factors that influence the impact of obesity prevention in health-disparity populations. TRIAL REGISTRATION ClinicalTrials.gov, NCT03590834. Registered July 18, 2018, https://clinicaltrials.gov/ct2/show/NCT03590834.
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Affiliation(s)
- Sarah L Ullevig
- College for Health, Community and Policy, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, USA
| | - Deborah Parra-Medina
- Latino Research Institute, University of Texas at Austin, 210 W. 24th Street, GWB 1.102, Austin, TX, 78712, USA.
| | - Yuanyuan Liang
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 W. Redwood Street, Baltimore, MD, USA
| | - Jeffrey Howard
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, USA
| | - Erica Sosa
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, USA
| | - Vanessa M Estrada-Coats
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, USA
| | - Vanessa Errisuriz
- Latino Research Institute, University of Texas at Austin, 210 W. 24th Street, GWB 1.102, Austin, TX, 78712, USA
| | - Shiyu Li
- School of Nursing, UT Health San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, USA
| | - Zenong Yin
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, USA
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Tsan L, Sun S, Hayes AMR, Bridi L, Chirala LS, Noble EE, Fodor AA, Kanoski SE. Early life Western diet-induced memory impairments and gut microbiome changes in female rats are long-lasting despite healthy dietary intervention. Nutr Neurosci 2022; 25:2490-2506. [PMID: 34565305 PMCID: PMC8957635 DOI: 10.1080/1028415x.2021.1980697] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Western diet consumption during adolescence results in hippocampus (HPC)-dependent memory impairments and gut microbiome dysbiosis. Whether these adverse outcomes persist in adulthood following healthy dietary intervention is unknown. Here we assessed the short- and long-term effects of adolescent consumption of a Western diet enriched with either sugar or both sugar and fat on metabolic outcomes, HPC function, and gut microbiota. METHODS Adolescent female rats (PN 26) were fed a standard chow diet (CHOW), chow with access to 11% sugar solution (SUG), or a junk food cafeteria-style diet (CAF) containing various foods high in fat and/or sugar. During adulthood (PN 65+), metabolic outcomes, HPC-dependent memory, and gut microbial populations were evaluated. In a subsequent experiment, these outcomes were evaluated following a 5-week dietary intervention where CAF and SUG groups were maintained on standard chow alone. RESULTS Both CAF and SUG groups demonstrated impaired HPC-dependent memory, increased adiposity, and altered gut microbial populations relative to the CHOW group. However, impaired peripheral glucose regulation was only observed in the SUG group. When examined following a healthy dietary intervention in a separate experiment, metabolic dysfunction was not observed in either the CAF or SUG group, whereas HPC-dependent memory impairments were observed in the CAF but not the SUG group. In both groups the composition of the gut microbiota remained distinct from CHOW rats after the dietary intervention. CONCLUSIONS While the metabolic impairments associated with adolescent junk food diet consumption are not present in adulthood following dietary intervention, the HPC-dependent memory impairments and the gut microbiome dysbiosis persist.
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Affiliation(s)
- Linda Tsan
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, USA
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, CA, USA
| | - Shan Sun
- Department of Bioinformatics and Genomics at the University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Anna M. R. Hayes
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, CA, USA
| | - Lana Bridi
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, CA, USA
| | - Lekha S. Chirala
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, CA, USA
| | - Emily E. Noble
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
| | - Anthony A. Fodor
- Department of Bioinformatics and Genomics at the University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Scott E. Kanoski
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, USA
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, CA, USA
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Griebel-Thompson AK, Murray A, Morris KS, Paluch RA, Jacobson L, Kong KL. The Association between Maternal Sugar-Sweetened Beverage Consumption and Infant/Toddler Added Sugar Intakes. Nutrients 2022; 14:4359. [PMID: 36297043 PMCID: PMC9607505 DOI: 10.3390/nu14204359] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 11/17/2022] Open
Abstract
Intake of added sugars during early life is associated with poor health outcomes. Maternal dietary intake influences the intake of their children, but little research investigates the relationship between maternal sugar sweetened beverage (SSB) and infant/toddler added sugar intakes. Our objective was to explore the relationship between maternal total sugars and SSB intakes and infant/toddler added sugar intakes. This cross-sectional study (n = 101) of mother-infant dyads measured maternal dietary intake by food frequency questionnaire and infant intake by three 24-h dietary recalls. Pearson’s correlations explored the relations between maternal total sugars and SSB intakes and infant added sugar intakes. Hierarchical stepwise regressions determined if maternal total sugars and SSB intakes explained the variation in infant added sugar intakes after accounting for known risk factors for early introduction of added sugars. Maternal total sugars (r = 0.202, p = 0.043) and SSB (r = 0.352, p < 0.001) intakes were positively correlated with infant/toddler added sugar intakes. In the hierarchical models, maternal total sugar intakes did not account for more variance in infant added sugar intakes (β = 0.046, p = 0.060), but maternal SSB intake was a significant contributor of infant added sugar intakes (β = 0.010, p = 0.006) after accounting for confounders. Interventions to reduced maternal SSB consumption may help reduce infant/toddler added sugar intakes.
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Affiliation(s)
- Adrianne K Griebel-Thompson
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children's Mercy Research Institute, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA
| | - Abigail Murray
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children's Mercy Research Institute, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA
| | - Katherine S Morris
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Rocco A Paluch
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Lisette Jacobson
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS 67214, USA
| | - Kai Ling Kong
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children's Mercy Research Institute, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA
- Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO 64108, USA
- Center for Children's Healthy Lifestyles and Nutrition, University of Kansas Medical Center, Kansas City, KS 66103, USA
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Food group intake of children and adolescents (6-18 years) on a vegetarian, vegan or omnivore diet: results of the VeChi Youth Study. Br J Nutr 2022; 128:851-862. [PMID: 34511141 DOI: 10.1017/s0007114521003603] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Plant-based, i.e. vegetarian (without meat and fish) or vegan (exclusively plant-based foods) diets are in trend also among children and adolescents, but data on food intake in this group are lacking. Here, we compare the consumption of food groups of vegetarian (n 145), vegan (n 110) and omnivore (n 135) children and adolescents (6-18 years) in Germany using data of the VeChi Youth Study. Each food item reported in 3 d weighed dietary records was assigned to one of eighteen food groups and individual mean intake per day (g/MJ) was calculated. Group differences were assessed using covariance analyses adjusted for age, sex and other covariates. For food groups with a high number of non-consumers, non-parametric Kruskal-Wallis tests were run. Pairwise comparison of vegetarian and vegan groups indicated significantly higher intakes of legumes, nuts, milk alternatives (all P = 0·0003) and meat alternatives (P = 0·0065) among vegan subjects. Intake of these food groups of omnivore participants was low (Q3:0·0 g/MJ for legumes, milk alternatives and meat alternatives, 0·5 g/MJ for nuts). Dairy intake of vegetarians (11·6 g/MJ) was significantly lower than of omnivore subjects (24·7 g/MJ) (P = 0·0003). Intake of fats/oils and sweet foods was lowest in vegan compared with vegetarian and omnivore participants (P< 0·05). Whole grain intake was higher in vegan participants (14·5 g/MJ) than of vegetarian (9·1 g/MJ) and omnivore (6·5 g/MJ) participants (P = 0·0003). Longitudinal studies are necessary to evaluate the long-term health consequences of vegetarian, vegan and omnivore food patterns, especially in childhood and adolescence.
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Belury MA, Raatz S, Conrad Z. Modeled Substitution of Traditional Oils with High-Oleic Acid Oils Decreases Essential Fatty Acid Intake in Children. Am J Clin Nutr 2022; 115:1180-1188. [PMID: 34910115 DOI: 10.1093/ajcn/nqab407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/07/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND High-oleic acid (OA) vegetable oils are replacing some traditional vegetable oils in the US food supply. This may lead to reduced intake of the essential fatty acids (EFAs) linoleic acid (18:2n-6) and α-linolenic acid (18:3n-3) in children, who need EFAs for growth and development and reduced risk for cardiometabolic disease into adulthood. OBJECTIVES The objectives of this study were the following: 1) to estimate trends in daily intake of EFAs among children aged 1-8 y, 2) identify top food sources of EFAs, and 3) evaluate the effects of replacing traditional oils with high-OA oils on meeting daily recommended intakes of EFAs. METHODS Dietary data from 7814 children aged 1-8 y were acquired from the NHANES (2007-2016). Using a diet model, we evaluated the effect of replacing 20%, 40%, 60%, and 80% of traditional oils with high-OA oils on meeting adequate intakes (AIs) for EFAs. RESULTS Major food sources of EFAs among all age-sex groups were grain dishes (35-40% of daily intake), meat and seafood dishes (17-21%), and fruit and vegetable dishes (12-14%). Replacing 40% or more of traditional oils with high-OA oil varieties will lead to inadequate daily intakes of EFAs. CONCLUSION Replacement of traditional vegetable oils with high-OA varieties will place children at risk of not meeting the AI levels for EFAs. A balanced approach of including traditional oils and high-OA oils in the US food supply is needed to prevent inadequate intakes of EFAs in children.
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Affiliation(s)
- Martha A Belury
- Program of Human Nutrition, The Ohio State University, Columbus, OH
| | - Susan Raatz
- Department of Food Science and Nutrition, University of Minnesota, St Paul, MN
| | - Zach Conrad
- Department of Health Sciences, William & Mary, Williamsburg, VA.,Department of Kinesiology, William & Mary, Williamsburg, VA
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Cheikh Ismail L, Al Dhaheri AS, Ibrahim S, Ali HI, Chokor FAZ, O’Neill LM, Mohamad MN, Kassis A, Ayesh W, Kharroubi S, Hwalla N. Nutritional status and adequacy of feeding Practices in Infants and Toddlers 0-23.9 months living in the United Arab Emirates (UAE): findings from the feeding Infants and Toddlers Study (FITS) 2020. BMC Public Health 2022; 22:319. [PMID: 35168591 PMCID: PMC8848814 DOI: 10.1186/s12889-022-12616-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/20/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Infant and young child feeding practices (IYCF) impact the early and later health status of the population. Limited data is available regarding IYCF in the United Arab Emirates (UAE). This study aimed to evaluate the nutritional status and adequacy of feeding practices, energy, food, and nutrient intakes of UAE infants and toddlers ages 0-23.9 months. METHODS This study is a population-based cross-sectional survey of 276 infants and toddlers aged 0-23.9 months of which 180 were nationals and 96 were Arab non-nationals living in the UAE. Data were collected from the three major emirates: Abu Dhabi, Dubai, and Sharjah. Anthropometry was collected and assessed using WHO Anthro-Survey Analyzer, and a multicomponent age-specific questionnaire was used to evaluate IYCF and sociodemographic characteristics. Usual intake of energy, micronutrients, and macronutrients, including supplements, were collected using multiple-pass 24-h dietary recall and analyzed using the PC-side software. IYCF practices were assessed using the WHO indicators. RESULTS Overall, 4% of children were malnourished, 8% wasted, 15% stunted, 18% at risk of overweight, and 7% overweight and obese. 95% of infants were ever breastfed and 37% exclusively breastfed at 6 months. Around 98% of infants had a timely introduction of complementary food. Macronutrient intake exceeded AMDR for fat, carbohydrates, and protein for 27%, 8% and 2% of toddlers respectively. As for the percentage of those exceeding the ESPGHAN cut-off for free sugars set at 5% of energy intake, 28.6% had excessive intakes overall, 10% in 0-5.9, 21.9% in 6-11.9 and 56.7% in 12-23.9 month. Usual iron intake was below the Estimated Average Requirement (EAR) in 47% of infants 6-11.9 months. Above 12 months, the usual intake of iron and vitamin D were below EAR in 11% and 49% of toddlers respectively. Usual intake exceeded the tolerable upper intake levels (UL) for vitamin A (14 to 18%) and zinc (11 to 22%) across all ages. Approximately 93% of toddlers ages 12-23.9 months did not meet food groups' recommendations for vegetables, 87% for fruits, 48% for milk/dairy, 54% for lean meat and beans, and 33% for grains. CONCLUSIONS This study revealed that a high percentage of infants and toddlers aged 0-23.9 m suffer from a double burden of malnutrition, which is the coexistence of both undernutrition, and overweight and obesity in the same population. In addition to suboptimal feeding practices and inadequate/overconsumption of various nutrients. The findings highlight the need for the development of culturally specific programs aiming to improve the nutritional status of infants and toddlers in the UAE.
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Affiliation(s)
- Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, 27272 United Arab Emirates
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, OX1 2JD UK
| | - Ayesha S. Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, 15551 United Arab Emirates
| | - Sarah Ibrahim
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut, Lebanon
| | - Habiba I. Ali
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, 15551 United Arab Emirates
| | - Fatima Al Zahraa Chokor
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut, Lebanon
| | - Lynda M. O’Neill
- Nestlé Institute of Health Sciences, Nestlé Research Center, Société des Produits Nestlé S.A., Vers-chez-les-Blanc, 1000, 26 Lausanne, Switzerland
| | - Maysm N. Mohamad
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, 15551 United Arab Emirates
| | - Amira Kassis
- Whiteboard Nutrition Science, Beaconsfield, Quebec, Canada
| | - Wafaa Ayesh
- Public Health Protection Department, Dubai Health Authority, Dubai, United Arab Emirates
| | - Samer Kharroubi
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut, Lebanon
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut, Lebanon
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Ultra-Processed Foods Are the Major Sources of Total Fat, Saturated and Trans-Fatty Acids among Tunisian Preschool and School Children: A Cross-Sectional Study. CHILDREN 2022; 9:children9020126. [PMID: 35204847 PMCID: PMC8869835 DOI: 10.3390/children9020126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 12/03/2022]
Abstract
Excessive fat and fatty acids intake are associated with significant health hazards such as obesity or chronic diseases. This study aimed to provide the first data on total fat, saturated fatty acids (SFA) and trans fatty acids (TFA) intakes and their major food sources in Tunisian children. A total of 1200 children, aged 3 to 9 years old, were randomly selected from primary schools and kindergartens under a cross-sectional design. The 24-h dietary recall method and diet history for the month preceding the survey were used to assess dietary intake. The energy percentages of total fat, SFA and TFA in Tunisian children were 29.6%, 11.4% and 0.15%, respectively. No sex differences were found. The WHO recommendations for total fat, SFA and TFA were adopted by 58%, 39% and 89% of the study population, respectively. The leading food groups of fat and fatty acids were ultra-processed foods, breakfast cereals and dairy products. The meat, fish, eggs, and fish alternatives were the fifth main contributors to Tunisian children’s total fat and SFA intakes. The implementation of a relevant strategy for fat reduction, especially from ultra-processed foods, considered as low nutrient energy-dense products, is needed to promote health among children and prevent diet-related chronic diseases.
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Carroll JE, Price G, Longacre MR, Hendricks KM, Langeloh G, Beach P, Dalton MA, Emond JA. Associations between advertisement-supported media exposure and dietary quality among preschool-age children. Appetite 2021; 166:105465. [PMID: 34146648 PMCID: PMC10549928 DOI: 10.1016/j.appet.2021.105465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/24/2021] [Accepted: 06/09/2021] [Indexed: 11/23/2022]
Abstract
Foods of low nutritional quality are heavily marketed to children, and exposure to food ads shapes children's preferences and intake towards advertised foods. Whether food ad exposure independently relates to an overall lower diet quality among children remains unclear. We examined the association between ad-supported media use, a proxy for food ad exposure, and diet quality using the baseline data (2014-2015) from 535 3-5-year-olds in a community-based cohort study. Parents reported their child's dietary intake over 3 days via a diary, and diet quality was assessed with the Healthy Eating Index (HEI-2015) where higher scores reflect greater adherence to USDA dietary guidelines. Children's media exposure was measured through online parent surveys. Mean HEI score was 54.5 (SD = 9.4). In models adjusted for sociodemographic characteristics and metrics of parent diet quality, children's HEI scores were 0.5 points lower (adjusted beta = -0.5 [95% CI: 0.8, -0.1]; P < 0.01) for each 1-h increment in weekly viewing of ad-supported children's TV networks. Children's use of media that may have food ads (e.g., apps, online games) also related to a lower diet quality yet to a lesser extent (adjusted beta -0.2 [-0.2, -0.1]; P < 0.01). In contrast, children's ad-free media use was not associated with diet quality (P = 0.21). Findings support the premise that exposure to food advertisements via media may result in a lower quality diet among children independently of other risk factors.
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Affiliation(s)
- Jennifer E Carroll
- Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth College, One Medical Center Drive, Lebanon, NH, 03766-0001, USA; Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, 415 Arnold House, 715 North Pleasant Street Amherst, MA, 01003-9304, USA
| | - George Price
- Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth College, One Medical Center Drive, Lebanon, NH, 03766-0001, USA
| | - Meghan R Longacre
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth College, Williamson Translational Research Building, Level 5, One Medical Center Drive, Lebanon, NH 03756-0001, USA; Department of Pediatrics, Geisel School of Medicine at Dartmouth College, One Medical Center Drive, Lebanon, NH, 03766-0001, USA
| | - Kristy M Hendricks
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth College, Williamson Translational Research Building, Level 5, One Medical Center Drive, Lebanon, NH 03756-0001, USA
| | - Gail Langeloh
- Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth College, One Medical Center Drive, Lebanon, NH, 03766-0001, USA
| | - Paul Beach
- Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth College, One Medical Center Drive, Lebanon, NH, 03766-0001, USA
| | - Madeline A Dalton
- Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth College, One Medical Center Drive, Lebanon, NH, 03766-0001, USA; Department of Pediatrics, Geisel School of Medicine at Dartmouth College, One Medical Center Drive, Lebanon, NH, 03766-0001, USA
| | - Jennifer A Emond
- Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth College, One Medical Center Drive, Lebanon, NH, 03766-0001, USA; Department of Pediatrics, Geisel School of Medicine at Dartmouth College, One Medical Center Drive, Lebanon, NH, 03766-0001, USA.
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Bably MB, Paul R, Laditka SB, Racine EF. Factors Associated with the Initiation of Added Sugar among Low-Income Young Children Participating in the Special Supplemental Nutrition Program for Women, Infants, and Children in the US. Nutrients 2021; 13:3888. [PMID: 34836143 PMCID: PMC8624134 DOI: 10.3390/nu13113888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 11/24/2022] Open
Abstract
Added sugar intake at a young age is associated with chronic diseases including cardiovascular diseases, asthma, elevated blood pressure, and overweight. The Dietary Guidelines for Americans 2020-2025 and the American Heart Association recommend delaying the introduction of added sugar until age 2. The aims of this study were to identify the timing of added sugar initiation; factors associated with added sugar initiation; and the top five added sugar foods and beverages consumed by infants and children at three age ranges (<7 months, 8-13 months, and 14-24 months). Data were from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2, a longitudinal, national population of WIC participants enrolled in WIC eligible clinics (n = 3835). The Cox proportional hazards model was used to examine the factors associated with introducing added sugar. About 25% of children were given added sugar at or before 7 months. Contributing factors were caregivers' race/ethnicity, education, employment, weight status, parity, child sex, and premature birth (all p < 0.05). The top added sugar foods consumed between 1-24 months were cereal, crackers, apple sauce, dessert, yogurt, sweetened beverages, syrup and preserves, and cookies. Further research to examine the impact of early initiation of added sugar on health outcomes and taste preferences is warranted.
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Affiliation(s)
- Morium B. Bably
- Department of Public Health Sciences, The University of North Carolina at Charlotte, University City Blvd 9201, Charlotte, NC 28223, USA; (R.P.); (S.B.L.); (E.F.R.)
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Lyons OC, Kerr MA, McNulty H, Ward F, Walton J, Livingstone MBE, McNulty BA, Kehoe L, Byrne PA, Saul I, Flynn MAT. Addressing nutrient shortfalls in 1- to 5-year-old Irish children using diet modeling: development of a protocol for use in country-specific population health. Am J Clin Nutr 2021; 115:105-117. [PMID: 34718385 PMCID: PMC8755081 DOI: 10.1093/ajcn/nqab311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 09/10/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Dietary habits formed in early childhood can track into later life with important impacts on health. Food-based dietary guidelines (FBDGs) may have a role in improving population health but are lacking for young children. OBJECTIVES We aimed to establish a protocol for addressing nutrient shortfalls in 1- to 5-y-old children (12-60 mo) using diet modeling in a population-based sample. METHODS Secondary analysis of 2010-2011 Irish National Pre-School Nutrition Survey data (n = 500) was conducted to identify typical food consumption patterns in 1- to 5-y-olds. Nutrient intakes were assessed against dietary reference values [European Food Safety Authority (EFSA) and Institute of Medicine (IOM)]. To address nutrient shortfalls using diet modeling, 4-d food patterns were developed to assess different milk-feeding scenarios (human milk, whole or low-fat cow milk, and fortified milks) within energy requirement ranges aligned with the WHO growth standards. FBDGs to address nutrient shortfalls were established based on 120 food patterns. RESULTS Current mean dietary intakes for the majority of 1- to 5-y-olds failed to meet reference values (EFSA) for vitamin D (≤100%), vitamin E (≤88%), DHA (22:6n-3) + EPA (20:5n-3) (IOM; ≤82%), and fiber (≤63%), whereas free sugars intakes exceeded recommendations of <10% energy (E) for 48% of 1- to 3-y-olds and 75% of 4- to 5-y-olds. "Human milk + Cow milk" was the only milk-feeding scenario modeled that predicted sufficient DHA + EPA among 1- to 3-y-olds. Vitamin D shortfalls were not correctable in any milk-feeding scenario, even with supplementation (5 µg/d), apart from the "Follow-up Formula + Fortified drink" scenario in 1- to 3-y-olds (albeit free sugars intakes were estimated at 12%E compared with ≤5%E as provided by other scenarios). Iron and vitamin E shortfalls were most prevalent in scenarios for 1- to 3-y-olds at ≤25th growth percentile. CONCLUSIONS Using WHO growth standards and international reference values, this study provides a protocol for addressing nutrient shortfalls among 1- to 5-y-olds, which could be applied in country-specific population health.
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Affiliation(s)
- Oonagh C Lyons
- Food Safety Authority of Ireland, Dublin, Ireland,Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - Maeve A Kerr
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - Fiona Ward
- Clinical Nutrition and Dietetics, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Janette Walton
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
| | - M Barbara E Livingstone
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - Breige A McNulty
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Laura Kehoe
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | | | - Ita Saul
- Clinical Nutrition and Dietetics, Children's Health Ireland at Crumlin, Dublin, Ireland
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18
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Feldens CA, Dos Santos IF, Kramer PF, Vítolo MR, Braga VS, Chaffee BW. Early-Life Patterns of Sugar Consumption and Dental Caries in the Permanent Teeth: A Birth Cohort Study. Caries Res 2021; 55:505-514. [PMID: 34428768 DOI: 10.1159/000518890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 08/02/2021] [Indexed: 12/27/2022] Open
Abstract
Early-life family conditions may presage caries development in childhood. The aim of this study was to evaluate associations between patterns of sugar consumption in early childhood and permanent dentition caries at age 6 years. A cohort enrolled women accessing prenatal care at public health clinics in Porto Alegre, Brazil. Sociodemographic, anthropometric, and dietary data were collected during pregnancy and 6-month, 12-month, and 3-year follow-ups. Calibrated dental examinations occurred at ages 3 and 6 years. Multivariable logistic regression analysis was performed in series to quantify associations between early-life variables and permanent dentition caries. At age 6 years, 7.9% of children (21/266) had ≥1 caries lesion on permanent teeth (first molars). In unadjusted models, gestational weight gain, sweet food introduction (age 6 months), household sugar purchases (age 3 years), and caries (age 3 years) were positively associated with permanent dentition caries (age 6 years). In multivariable models, each 1-kg increase in gestational weight gain (odds ratio [OR]: 1.08; 95% confidence interval [CI]: 1.01, 1.16) and each 1-item increase in sweet food consumption at age 6 months (OR: 1.27; 95% CI: 1.02, 1.59) remained statistically significantly associated with permanent molar caries. Findings from this cohort study suggest family and child factors that long predate the permanent dentition, including sugar-related behaviors, predict future dental status, and may inform prevention strategies.
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Affiliation(s)
| | | | - Paulo Floriani Kramer
- Department of Pediatric Dentistry, Universidade Luterana do Brasil, Canoas, Brazil.,Department of Pediatric Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Márcia Regina Vítolo
- Graduate Program in Pediatrics: Child and Adolescent Health Care, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Vanessa Simas Braga
- Department of Pediatric Dentistry, Universidade Luterana do Brasil, Canoas, Brazil
| | - Benjamin W Chaffee
- Division of Oral Epidemiology and Dental Public Health, University of California, San Francisco, California, USA
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19
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Feldens CA, Vítolo MR, Maciel RR, Baratto PS, Rodrigues PH, Kramer PF. Exploring the risk factors for early-life sugar consumption: A birth cohort study. Int J Paediatr Dent 2021; 31:223-230. [PMID: 32815208 DOI: 10.1111/ipd.12713] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/26/2020] [Accepted: 08/10/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Sugar consumption in early childhood is the primary cause of negative health outcomes, including early childhood caries. AIM To investigate risk factors associated with early-life sugar consumption. DESIGN Explanatory variables were collected at baseline of a birth cohort in Porto Alegre, Southern Brazil. At six months of age, data were collected on child feeding practices, including the number of foods and beverages containing sugar. Multivariate Poisson regression analysis with robust variance was performed. RESULTS Virtually all children (98.3%) had consumed sugar by the age of 6 months. Multivariable analysis showed that the number of sweet items was significantly larger in children whose mothers were less than 20 years of age (MR = 1.19; 95% CI: 1.05-1.36), those from non-nuclear families (MR = 1.12; 95% CI: 1.04-1.20), those whose mothers had less than eight years of schooling (MR = 1.34; 95% CI: 1.20-1.50) and those whose mothers smoked (MR = 1.23; 95% CI: 1.13-1.35). Moreover, the number of sweet items was significantly lower among children who breastfed in the first hour of life (MR = 0.85; 95% CI: 0.76-0.95). CONCLUSION Sugar consumption begins very early, especially in children with no access to breastfeeding in the first hours of life and those from younger, less educated, and smoking mothers.
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Affiliation(s)
| | - Márcia Regina Vítolo
- Graduate Program in Pediatrics: Child and Adolescent Health Care, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Renata Rocha Maciel
- Graduate Program in Dentistry, Universidade Luterana do Brasil, Canoas, Brazil
| | - Paola Seffrin Baratto
- Graduate Program in Pediatrics: Child and Adolescent Health Care, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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20
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Madrigal C, Soto-Méndez MJ, Leis R, Hernández-Ruiz Á, Valero T, Lara Villoslada F, Martínez de Victoria E, Moreno JM, Ortega RM, Ruiz-López MD, Varela-Moreiras G, Gil Á. Dietary Intake, Nutritional Adequacy and Food Sources of Total Fat and Fatty Acids, and Relationships with Personal and Family Factors in Spanish Children Aged One to <10 Years: Results of the EsNuPI Study. Nutrients 2020; 12:E2467. [PMID: 32824377 PMCID: PMC7468841 DOI: 10.3390/nu12082467] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/10/2020] [Accepted: 08/14/2020] [Indexed: 12/14/2022] Open
Abstract
We aimed to determine the usual intake of total fat, fatty acids (FAs), and their main food sources in a representative cohort of the Spanish pediatric population aged 1 to <10 years (n = 707) who consumed all types of milk and an age-matched cohort who consumed adapted milk over the last year (including follow-on formula, toddler's milk, growing-up milk, and fortified and enriched milks) (n = 741) who were participants in the EsNuPI study (in English, Nutritional Study in the Spanish Pediatric Population). Dietary intake, measured through two 24 h dietary recalls, was compared to the European Food Safety Authority (EFSA) and the Food and Agriculture Organization of the United Nations (UN-FAO) recommendations. Both cohorts showed a high intake of saturated fatty acids (SFAs), according to FAO recommendations, as there are no numerical recommendations for SFAs at EFSA. Also, low intake of essential fatty acids (EFAs; linoleic acid (LA) and α-linolenic acid (ALA)) and long-chain polyunsaturated fatty acids (LC-PUFA) of the n-3 series, mainly docosahexaenoic acid (DHA) were observed according to EFSA and FAO recommendations. The three main sources of total fat and different FAs were milk and dairy products, oils and fats, and meat and meat products. The consumption of adapted milk was one of the main factors associated with better adherence to the nutritional recommendations of total fat, SFAs, EFAs, PUFAs; and resulted as the main factor associated with better adherence to n-3 fatty acids intake recommendations. Knowledge of the dietary intake and food sources of total fat and FAs in children could help in designing and promoting effective and practical age-targeted guidelines to promote the consumption of EFA- and n-3 PUFA-rich foods in this stage of life.
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Affiliation(s)
- Casandra Madrigal
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain; (C.M.); (M.D.R.-L.)
- Iberoamerican Nutrition Foundation (FINUT), Av. del Conocimiento 12, 3 ª pta, Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
| | - María José Soto-Méndez
- Iberoamerican Nutrition Foundation (FINUT), Av. del Conocimiento 12, 3 ª pta, Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
| | - Rosaura Leis
- Department of Pediatrics, Unit of Pediatric Gastroenterology, Hepatology and Nutrition University Clinical Hospital of Santiago, 15706 Santiago de Compostela, Spain;
- Instituto de Investigación Sanitaria de Santiago, IDIS, Santiago de Compostela, University Clinical Hospital of Santiago, 15706 Santiago de Compostela, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Ángela Hernández-Ruiz
- Iberoamerican Nutrition Foundation (FINUT), Av. del Conocimiento 12, 3 ª pta, Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
| | - Teresa Valero
- Spanish Nutrition Foundation (FEN), c/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain;
| | | | - Emilio Martínez de Victoria
- Department of Physiology, Faculty of Pharmacy, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain;
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100 Granada, Spain
| | - José Manuel Moreno
- Pediatric Department, University of Navarra Clinic, Calle Marquesado de Sta. Marta, 1, 28027 Madrid, Spain;
| | - Rosa M. Ortega
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain;
| | - María Dolores Ruiz-López
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain; (C.M.); (M.D.R.-L.)
- Iberoamerican Nutrition Foundation (FINUT), Av. del Conocimiento 12, 3 ª pta, Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100 Granada, Spain
| | - Gregorio Varela-Moreiras
- Department of Pediatrics, Unit of Pediatric Gastroenterology, Hepatology and Nutrition University Clinical Hospital of Santiago, 15706 Santiago de Compostela, Spain;
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, Urb. Montepríncipe, crta. Boadilla km. 5.3, Boadilla del Monte, 28668 Madrid, Spain
| | - Ángel Gil
- Iberoamerican Nutrition Foundation (FINUT), Av. del Conocimiento 12, 3 ª pta, Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100 Granada, Spain
- Department of Biochemistry and Molecular Biology II University of Granada, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain
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Masztalerz-Kozubek D, Zielinska MA, Rust P, Majchrzak D, Hamulka J. The Use of Added Salt and Sugar in the Diet of Polish and Austrian Toddlers. Associated Factors and Dietary Patterns, Feeding and Maternal Practices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145025. [PMID: 32668675 PMCID: PMC7400520 DOI: 10.3390/ijerph17145025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 12/31/2022]
Abstract
Children aged <2 years should not be given meals with the addition of salt and sugar due to health risks and to promote healthier dietary habits. The aims of this study were: to assess the prevalence of the use of added salt (AS), sugar (ASu) and both salt and sugar (AS&Su) in the diets of Polish and Austrian toddlers aged 12-24 and 25-36 months; to explore the sociodemographic and early nutritional factors associated with the use of AS and ASu; to investigate the difference in dietary habits and maternal concerns about toddlers' eating regarding the use of AS and ASu in toddlers' diet. This cross-sectional anonymous study was conducted in 5893 mothers of children aged 12-36 months, recruited through social media in 2017-2019. The questionnaire consisted of questions about sociodemographics, early feeding practices and current children's nutrition (e.g., use of AS and ASu, food frequency questionnaire). Multivariate logistic regression and cluster analyses were applied. Austrian mothers more often used AS than mothers from Poland (at 2 years old: 74.8% vs. 52.8%; at 3 years old 87.4% vs. 74.4%, p ≤ 0.001), however Polish mothers were more prone to use ASu (at 2 years old: 34.7% vs. 27.7%; at 3 years old: 59.0% vs. 45.8%, p ≤ 0.001). In younger toddlers (12-24 months), the odds of using of AS, ASu, and AS&Su increased with toddlers' age, when the mother was a multipara, was not currently breastfeeding, or had exclusively breastfed for 4-5 months. This risk decreased when older toddlers (25-36 months) were introduced to solids by baby-led weaning (BLW). Toddlers from both countries who consumed meals with AS or ASu more often a followed Western-like dietary pattern. Our study emphasizes the need for parental nutritional education when beginning to introduce solid foods.
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Affiliation(s)
- Daria Masztalerz-Kozubek
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 02-787 Warsaw, Poland; (D.M.-K.); (M.A.Z.)
| | - Monika A. Zielinska
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 02-787 Warsaw, Poland; (D.M.-K.); (M.A.Z.)
| | - Petra Rust
- Department of Nutritional Sciences, University of Vienna, 1090 Vienna, Austria; (P.R.); (D.M.)
| | - Dorota Majchrzak
- Department of Nutritional Sciences, University of Vienna, 1090 Vienna, Austria; (P.R.); (D.M.)
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 02-787 Warsaw, Poland; (D.M.-K.); (M.A.Z.)
- Correspondence: ; Tel.: +48-22-593-71-12
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22
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Nutritional problems in childhood and adolescence: a narrative review of identified disparities. Nutr Res Rev 2020; 34:17-47. [PMID: 32329426 DOI: 10.1017/s095442242000013x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
To inform programmes and policies that promote health equity, it is essential to monitor the distribution of nutritional problems among young individuals. Common nutritional problems include overall low diet quality, the underconsumption and overconsumption of certain dietary components, unhealthy meal and snack patterns, problematic feeding practices and disordered eating. The objective of the present narrative review was to summarise recent evidence of disparities among US children (2-19 years) according to age, sex, socio-economic status, ethnicity/race and rural-urban location. Searches in PubMed® and MEDLINE® were completed to identify peer-reviewed research studies published between January 2009 and January 2019. Findings from the ninety-nine reviewed studies indicate adolescent females, young individuals from lower socio-economic households and individuals who identify as non-Hispanic Black race are particularly vulnerable populations for whom targeted strategies should be developed to address evidence of increased risk with regards to multiple aspects of nutritional wellbeing. Limitations of the existing evidence relate to the accuracy of self-reported dietary data; the need for consistent definitions of disordered eating; the focus on individual dietary components v. patterns; the complexities of categorising socio-economic status, ethnicity/race, and rural and urban areas; and the cross-sectional, observational nature of most research designs. There is an urgent need for research to address these limitations and fill a large gap in evidence on rural-urban differences in nutritional problems. It will further be important for future studies to build greater understanding of how nutritional problems cluster among population groups.
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23
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Herrick KA, Fryar CD, Hamner HC, Park S, Ogden CL. Added Sugars Intake among US Infants and Toddlers. J Acad Nutr Diet 2020; 120:23-32. [PMID: 31735600 PMCID: PMC7512119 DOI: 10.1016/j.jand.2019.09.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/05/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Limited information is available on added sugars consumption in US infants and toddlers. OBJECTIVES To present national estimates of added sugars intake among US infants and toddlers by sociodemographic characteristics, to identify top sources of added sugars, and to examine trends in added sugars intake. DESIGN Cross-sectional analysis of 1 day of 24-hour dietary recall data. PARTICIPANTS/SETTING A nationally representative sample of US infants aged 0 to 11 months and toddlers aged 12 to 23 months (n=1,211) during the period from 2011 through 2016 from the National Health and Nutrition Examination Survey. Trends were assessed from 2005-2006 through 2015-2016 (n=2,795). MAIN OUTCOME MEASURES Among infants and toddlers, the proportion consuming any added sugars, the average amount of added sugars consumed, percent of total energy from added sugars, and top sources of added sugars intake. STATISTICAL ANALYSIS Paired t tests were used to compare differences by age, sex, race/Hispanic origin, family income level, and head of household education level. Trends were tested using orthogonal polynomials. Significance was set at P<0.05. RESULTS During 2011 to 2016, 84.4% of infants and toddlers consumed added sugars on a given day. A greater proportion of toddlers (98.3%) consumed added sugars than infants (60.6%). The mean amount of added sugars toddlers consumed was also more compared with infants (5.8 vs 0.9 tsp). Non-Hispanic black toddlers (8.2 tsp) consumed more added sugars than non-Hispanic Asian (3.7 tsp), non-Hispanic white (5.3 tsp), and Hispanic (5.9 tsp) toddlers. A similar pattern was observed for percent energy from added sugars. For infants, top sources of added sugars were yogurt, baby food snacks/sweets, and sweet bakery products; top sources among toddlers were fruit drinks, sugars/sweets, and sweet bakery products. The mean amount of added sugars decreased from 2005-2006 through 2015-2016 for both age groups; however, percent energy from added sugars only decreased among infants. CONCLUSION Added sugars intake was observed among infants/toddlers and varied by age and race and Hispanic origin. Added sugars intake, as a percent of energy, decreased only among infants from 2005 to 2016.
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24
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Ahluwalia N. Nutrition Monitoring of Children Aged Birth to 24 Mo (B-24): Data Collection and Findings from the NHANES. Adv Nutr 2020; 11:113-127. [PMID: 31390469 PMCID: PMC7442347 DOI: 10.1093/advances/nmz077] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The first 2 y of life are characterized by several transitions that can affect growth, development, and eating patterns long term. These include a shift from a primarily milk-based eating pattern to introduction of complementary foods at ∼4-6 mo of age, and passage to family-meal patterns in toddler years. Recognizing the importance of this critical period, the Dietary Guidelines for Americans from 2020 onwards will include guidance for children aged birth to 24 mo (B-24). Few large-scale surveys provide comprehensive, nationally representative, quantitative, recent data on infant and toddler nutrition in the United States. The continuous NHANES has collected data relevant to this initiative since 1999 using standardized interview and examination protocols. These include data on infant feeding practices, dietary intakes (foods, beverages, and supplements), anthropometry, and blood-based nutritional status on nationally representative samples of infants and toddlers. NHANES data can be used to describe large group-level consumption patterns, as well as trends over time for B-24 children overall, and by demographic groups (e.g., race-ethnic and income groups). In addition, NHANES data can be analyzed to examine adherence to nutrition-related recommendations, such as those from the American Academy of Pediatrics (AAP), and to track Healthy People 2020 objectives. This paper provides an update on NHANES nutrition monitoring in B-24 children since our previous publication (which provided details through NHANES 2009-2010) and describes data collection since 2010 and plans for upcoming cycles. It also describes key NHANES-based findings published in the last 5 y on infant feeding practices, dietary intakes and supplement use, and nutritional status of US children aged <2 y. Findings related to existing recommendations, such as from the AAP, are presented when available. This information can inform researchers and policymakers on the state of nutrition in the US B-24 population and its subgroups of interest.
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Affiliation(s)
- Namanjeet Ahluwalia
- Division of Health and Nutrition Examination Surveys (DHANES), National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
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25
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Neri D, Martinez-Steele E, Monteiro CA, Levy RB. Consumption of ultra-processed foods and its association with added sugar content in the diets of US children, NHANES 2009-2014. Pediatr Obes 2019; 14:e12563. [PMID: 31364315 DOI: 10.1111/ijpo.12563] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 06/11/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is cumulative recognition that increases in the dietary share of ultra-processed foods result in deterioration of the nutritional quality of the overall diet and adverse health outcomes. OBJECTIVE The purpose of this study was to assess the consumption of ultra-processed foods and to examine its association with added sugar content in the diet of US children aged 2 to 19 years. METHODS We classified all food items according to the NOVA food classification system and looked at the consumption of ultra-processed foods, measured as percentage of total energy intake. We assessed dietary added sugar content by estimating its contribution to total energy intake and the proportion of individuals with diets exceeding the recommended limit of 10% of total energy intake from added sugars. We also examined the proportion of those who surpassed twice that limit. Gaussian and Poisson regressions estimated the association between consumption of ultra-processed foods and estimates of added sugar content. RESULTS Ultra-processed foods contributed to 65% of total energy intake and to 92% of energy from added sugars in the diet of US children. The mean percent energy provided by added sugars in the observed period was 14.3%. Most individuals (70.9%) had diets exceeding the recommended limit of added sugar (<10% of total energy intake), and 18.4% of the population had diets surpassing twice the recommended level (20% of total energy intake). A 5.5% point increase in the dietary share of ultra-processed foods determined a 1 percentage point increase in the dietary content of added sugars, with stronger adjusted associations among younger children. CONCLUSIONS Public health efforts to reduce added sugars in the diet of US children must put greater emphasis on decreasing the consumption of ultra-processed foods.
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Affiliation(s)
- Daniela Neri
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.,Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Euridice Martinez-Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.,Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Carlos Augusto Monteiro
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.,Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Renata Bertazzi Levy
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil.,Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
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Cuadrado-Soto E, Risica PM, Gans KM, Mena NZ, Ellis C, Araujo CD, Lofgren IE, Stowers KC, Tovar A. Micronutrient Adequacy in Preschool Children Attending Family Child Care Homes. Nutrients 2019; 11:nu11092134. [PMID: 31500153 PMCID: PMC6770721 DOI: 10.3390/nu11092134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/28/2019] [Accepted: 09/02/2019] [Indexed: 01/09/2023] Open
Abstract
Limited data is available on the micronutrient intake and adequacy in preschool children enrolled in family child care homes (FCCH). The goal of this paper is to describe the micronutrient adequacy relative to age-specific recommendations of preschool-aged children (aged 2-5 years) attending FCCH in Rhode Island (RI). Dietary data among younger preschoolers (aged 2-3 years), n = 245) and older preschoolers (aged 4-5 years), n = 121) in 118 RI FCCH (N = 366 children) were analyzed. Nutrient adequacy was assessed as the amount of nutrient per 1000 kcal of the diet that would meet the Institute of Medicine nutrient requirements (critical nutrient density), and it was compared to the observed nutrient densities of the children. The sodium:potassium ratio was also calculated. For most micronutrients, the observed density met or exceeded the recommendation, meaning the children's intake was adequate. However, a high proportion of children had nutrient densities under the recommendation for vitamins D, E, K, and potassium (86.1%, 89.1%, 70.8%, and 99.2% of children, respectively). The mean vitamin B12, potassium, and zinc densities were statistically higher in younger vs. older preschoolers (p < 0.05 for all). Low densities in calcium and vitamins K and B5 were more frequent in older children vs. younger children (p < 0.05). In addition, older preschoolers had a higher sodium:potassium ratio than younger children (p < 0.05). The micronutrient intake density was adequate for most nutrients. However, intake of some nutrients was of concern. Further attention to training and compliance in FCCH may improve the diet quality of those cared for in these settings.
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Affiliation(s)
- Esther Cuadrado-Soto
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
| | - Patricia Markham Risica
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA; (P.M.R.)
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI 02912, USA
| | - Kim M. Gans
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA; (P.M.R.)
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI 02912, USA
- Department of Human Development and Family Studies, University of Connecticut, Storrs, CT 06269, USA
- Institute for Collaboration in Health, Interventions and Policy, University of Connecticut, Storrs, CT 06269, USA;
| | - Noereem Z. Mena
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA; (N.Z.M.); (C.E.); (C.D.A.); (I.E.L.)
| | - Carolyn Ellis
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA; (N.Z.M.); (C.E.); (C.D.A.); (I.E.L.)
| | - Carolina D. Araujo
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA; (N.Z.M.); (C.E.); (C.D.A.); (I.E.L.)
| | - Ingrid E. Lofgren
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA; (N.Z.M.); (C.E.); (C.D.A.); (I.E.L.)
| | - Kristen Cooksey Stowers
- Institute for Collaboration in Health, Interventions and Policy, University of Connecticut, Storrs, CT 06269, USA;
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA; (N.Z.M.); (C.E.); (C.D.A.); (I.E.L.)
- Correspondence: ; Tel.: +401-874-9855
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Abstract
PURPOSE OF REVIEW To describe current findings on sugar intake in children worldwide, including sugar sources and their impact on child health focusing on cardiometabolic alterations usually associated to obesity. RECENT FINDINGS In children less than 4 years, intakes of added sugars across countries ranged from 9.8 to 11.2% of total energy; in children 4-10 years, it ranged from less than 3-18%; and in adolescents, it ranged from 13.6 to 16.6%. For most countries, intakes of added sugars were greater than the recommended upper limit of 10% of total energy for children and adolescents and less or around 10% in infants. In most studies, soft drinks and fruit-based drinks accounted for the greatest proportion of the added sugars intake, followed by milk products and sweet bakery products. High added sugar intake has been associated with increased obesity risk and fat deposition in the liver, contributing to dyslipidemia, high blood pressure, insulin resistance and cardio-metabolic risk. SUMMARY As a high added sugar intake is associated with cardio-metabolic conditions in children and adolescents, the current scenario supports the need for stronger targeted long-term policies that prevent the excessive sugar intake in young populations.
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Affiliation(s)
- Azahara Iris Rupérez
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Food and Agriculture Institute of Aragón (IA2), Health Research Institute of Aragón (ISS Aragón), Zaragoza
| | - María Isabel Mesana
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Food and Agriculture Institute of Aragón (IA2), Health Research Institute of Aragón (ISS Aragón), Zaragoza
| | - Luis Alberto Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Food and Agriculture Institute of Aragón (IA2), Health Research Institute of Aragón (ISS Aragón), Zaragoza
- CIBER Obesity and Nutrition Physiopathology (CIBEROBN). Madrid, Spain
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28
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Bournez M, Ksiazek E, Charles MA, Lioret S, Brindisi MC, de Lauzon-Guillain B, Nicklaus S. Frequency of Use of Added Sugar, Salt, and Fat in Infant Foods up to 10 Months in the Nationwide ELFE Cohort Study: Associated Infant Feeding and Caregiving Practices. Nutrients 2019; 11:E733. [PMID: 30934918 PMCID: PMC6520717 DOI: 10.3390/nu11040733] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 03/16/2019] [Accepted: 03/26/2019] [Indexed: 01/05/2023] Open
Abstract
The consumption of sugar, salt, and fat in infancy may influence later health. The objective of this study was to describe the frequency of use of added sugar, salt, and fat during the complementary feeding period and the associated infant caregiving practices. Data were obtained from a monthly questionnaire filled by parents for 10,907 infants from the French Etude Longitudinale Française depuis l'Enfance (ELFE) cohort. A score of frequency of use (SU) for added sugar, salt, and fat (oil, margarine, butter, and/or cream) was calculated from the age at complementary feeding introduction (CFI) to the 10th month. Associations between the SU of each added ingredient with infant feeding and caregiving practices were studied with multivariable linear regressions adjusted for familial characteristics. Only 28% of the parents followed the recommendation of adding fat and simultaneously not adding sugar or salt. Breastfeeding mothers were more prone to add sugar, salt, and fat than non-breastfeeding mothers. CFI before four months was positively associated with the SU of added sugar and salt and negatively associated with the SU of added fat. The use of commercial baby food was negatively related to the SU of added salt and fat. The use of these added ingredients was mainly related to breastfeeding, age at CFI, and use of commercial food, and it was independent of the household socioeconomic characteristics.
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Affiliation(s)
- Marie Bournez
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Univ. Bourgogne Franche-Comté, 21000 Dijon, France.
- Centre Hospitalier Universitaire de Dijon, Hôpital d'Enfants, Pediatrics, 21079 Dijon, France.
| | - Eléa Ksiazek
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Univ. Bourgogne Franche-Comté, 21000 Dijon, France.
| | - Marie-Aline Charles
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early life research on later health Team (EAROH), F-75014 Paris, France.
- 12 rue de l'Ecole de Médecine, Paris Descartes University, 75006 Paris, France.
| | - Sandrine Lioret
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early life research on later health Team (EAROH), F-75014 Paris, France.
- 12 rue de l'Ecole de Médecine, Paris Descartes University, 75006 Paris, France.
| | - Marie-Claude Brindisi
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Univ. Bourgogne Franche-Comté, 21000 Dijon, France.
- Centre Hospitalier Universitaire de Dijon, Hôpital d'Enfants, Endocrinology, Nutrition, 21079 Dijon, France.
| | - Blandine de Lauzon-Guillain
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early life research on later health Team (EAROH), F-75014 Paris, France.
- 12 rue de l'Ecole de Médecine, Paris Descartes University, 75006 Paris, France.
| | - Sophie Nicklaus
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Univ. Bourgogne Franche-Comté, 21000 Dijon, France.
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