Dairy product intake in children and adolescents in developed countries: trends, nutritional contribution, and a review of association with health outcomes

Dietary Intake of Adolescents and Alignment with Recommendations for Healthy and Sustainable Diets: Results of the SI.Menu Study

BACKGROUND

The SI.Menu study offers the latest data on the dietary intake of Slovenian adolescents aged 10 to 17. The purpose of this study is to comprehensively assess their dietary intake (energy and nutrients) and compare their food intakes with dietary recommendations for healthy and sustainable diets.

METHODS

The cross-sectional epidemiological dietary study SI.Menu (March 2017-April 2018) was conducted on a representative sample of Slovenian adolescents aged 10 to 17 years (n = 468) (230 males and 238 females). Data on dietary intake were gathered through two non-consecutive 24 h recalls, in line with the European Food Safety Authority (EFSA) EU Menu methodology. The repeated 24 h Dietary Recall (HDR) and Food Propensity Questionnaire (FPQ) data were combined to determine the usual intakes of nutrients and food groups, using the Multiple Source Method (MSM) program.

RESULTS

Adolescents' diets significantly deviate from dietary recommendations, lacking vegetables, milk and dairy products, nuts and seeds, legumes, and water, while containing excessive meat (especially red meat) and high-sugar foods. This results in insufficient intake of dietary fibre, and nutrients such as vitamin D, folate, and calcium.

CONCLUSIONS

The dietary intake of Slovenian adolescents does not meet healthy and sustainable diet recommendations. This study provides an important insight into the dietary habits of Slovenian adolescents that could be useful for future public health strategies.

Chilean children's adherence to sustainable healthy diets and its associations with sociodemographic and anthropometric factors: a cross-sectional study

PURPOSE

To describe adherence to sustainable healthy diets among a sample of 958 Chilean pre-schoolers (3-6 years) and explore associations between adherence and child and maternal sociodemographic and anthropometric characteristics.

METHODS

Children's adherence to sustainable healthy diets was calculated from single multiple-pass 24-h dietary recalls using the Planetary Health Diet Index for children and adolescents (PHDI-C). Higher PHDI-C scores (max score = 150 points) represent greater adherence. Adjusted linear regression models were fitted to explore associations between PHDI-C scores and child and maternal characteristics.

RESULTS

Children obtained low total PHDI-C scores (median 50.0 [IQR 39.5-59.8] points). This resulted from low consumption of nuts & peanuts, legumes, vegetables, whole cereals, and vegetable oils; a lack of balance between dark green and red & orange vegetables, inadequate consumption of tubers & potatoes and eggs & white meats, and excess consumption of dairy products, palm oil, red meats, and added sugars. Mean PHDI-C total score was significantly higher (50.6 [95%CI 49.6, 51.7] vs 47.3 [95%CI 45.0, 49.5]) among children whose mothers were ≥ 25 years compared to those with younger mothers. Positive associations were observed between scores for fruits and maternal education, vegetables and maternal age, added sugars and child weight status, while negative associations were observed between fruits and child age, and vegetable oils and maternal education. Scores for dairy products PHDI-C component were lower among girls.

CONCLUSION

Adherence to sustainable healthy diets was low among this sample of Chilean children and was significantly associated with maternal age, being lower among children whose mothers were younger.

Beverage Consumption and Factors Influencing the Choice of Beverages among Polish Children Aged 11-13 Years in 2018-2023

Adequate hydration is essential for good health, and an individual's hydration status is determined by the quantity and type of ingested fluids. The aim of the present study was to determine the hydration status of school-age children and evaluate changes in the type and quantity of consumed beverages between 2018 and 2023. The study was conducted in two stages between 2018 and 2023, and a total of 1030 fully completed questionnaires were returned by the children and their parents. A comparison of the parents' responses regarding factors that affect beverage choices revealed that beverage composition was more significant for the parents in 2023 than in 2018, whereas health-promoting properties were significant for only less than 30% of the respondents. Taste preferences were important for both the parents and the children, and they were the main criterion in the choice of beverages in both 2018 and 2023. In turn, advertising was an important factor for children, and the percentage of children who were guided by advertising in their choice of beverages increased from 52.1% in 2018 to 58.5% in 2023 (p < 0.05). Daily fluid intake from beverages in children aged 11-13 years generally does not meet recommended intakes. Low fluid intake can negatively affect children's hydration status and bodily functions. Taste preferences and advertising were correlated with a higher intake of carbonated and non-carbonated sugar-sweetened beverages (SSBs) and dairy beverages. The percentage of children who bought drinks independently and had access to SSBs increased significantly during the analyzed period. Obtain results indicate that nutrition education programs are needed to teach adolescents to make healthy drink choices, limit their consumption of SSBs and EDs, and promote regular intake of natural mineral water and non-sweetened dairy beverages.

Lead, Cadmium, and Arsenic in Raw Milk Produced in the Vicinity of a Mini Mineral Concentrator in the Central Andes and Health Risk

The bovine milk quality, safety, and security are of great concern mainly due to the dispersion of toxic substances from various anthropogenic activities and poor practices for organophosphates in agriculture use. This study evaluated the potential risk to human health from lead (Pb), cadmium (Cd), and arsenic (As) from the consumption of milk produced in an area of the Central Andes valley near a mini mineral concentrator by estimating the weekly intake (WI), dietary risk quotient (DRC), hazard quotient (THQ), and hazard index (HI) for the Peruvian population aged 2 to 85 years, in three scenarios of milk consumption by age (minimum, average, and maximum). Toxic element quantification was performed by flame atomic absorption spectrometry following standardized procedures. The mean amount ± standard deviation of Pb, Cd, and As in soils was 292±60.90, 3.54±1.58, and 5.60±2.20 mg/kg, the order of importance being Pb>As>Cd. The contents of Pb, Cd, and As in pastures were 23.17±10.02, 0.25±0.57, and 0.06±0.09 mg/kg, being from highest to lowest Pb>Cd>As. The means of Pb, Cd, and As content in 19 milk samples were 0.029±0.022, 0.007±0.006, and 0.010±0.004 mg/kg. Pb and Cd exceeded the maximum permissible limits (MPL), and the As was below the MPL. At all ages and milk consumption levels, the WI for Pb and Cd were below the estimated tolerable intake (TWI). The WI for As in < 19 years was higher than the TWI. The DRC for Pb and Cd at all three milk intake levels and all ages was < 1, and for As, it was > 1 in < 19 years, being the risk group. The TQH and HI for Pb and Cd were also > 1, signifying no health risk, and for As, the values were > 1 in < 11 years. Our results are valuable for preventing adverse health impacts from safe and innocuous milk consumption.

Assessing the Health Risk and Trophic Transfer of Lead and Cadmium in Dairy Farming Systems in the Mantaro Catchment, Central Andes of Peru

This study investigated lead (Pb) and cadmium (Cd) transfer in three dairy farming areas in the Mantaro river headwaters in the central Peruvian Andes and at varying distances from the mining complex at La Oroya. At each of these sites, the transfer of trace metals from the soil to raw milk was estimated, and a hazard assessment for lead and cadmium was carried out in scenarios of minimum, average, and maximum milk consumption in a Peruvian population aged 2-85. Pb and Cd were quantified by flame atomic absorption spectrometry. Significantly, the concentrations of lead and cadmium were found to exceed the maximum limits recommended by the World Health Organization, with a positive geospatial trend correlated with the distance from mining activity. Both Pb and Cd were found to be transferred through the soil-pasture-milk pathway, with the primary source of Cd being phosphate-based fertilizers used in pasture improvement. Pb was found to be the most significant contributor to the Hazard Index (HI) with those under 19 years of age and over 60 recording an HI of >1, with infants being the most vulnerable group due to their greater milk consumption in relation to their body weight. A marginal increase in contamination was observed in the dry season, indicating the need for studies to be expanded over several annual cycles.

Dairy Matrix Effects: Physicochemical Properties Underlying a Multifaceted Paradigm

When food products are often considered only as a source of individual nutrients or a collection of nutrients, this overlooks the importance of interactions between nutrients, but also interactions between nutrients and other constituents of food, i.e., the product matrix. This product matrix, which can be defined as 'The components of the product, their interactions, their structural organization within the product and the resultant physicochemical properties of the product', plays a critical role in determining important product properties, such as product stability, sensory properties and nutritional and health outcomes. Such matrix effects can be defined as 'the functional outcome of specific component(s) as part of a specific product matrix'. In this article, dairy matrix effects are reviewed, with particular emphasis on the nutrition and health impact of dairy products. Such matrix effects are critical in explaining many effects of milk and dairy products on human nutrition and health that cannot be explained solely based on nutrient composition. Examples hereof include the low glycemic responses of milk and dairy products, the positive impact on dental health, the controlled amino acid absorption and the absence of CVD risk despite the presence of saturated fatty acids. Particularly, the changes occurring in the stomach, including, e.g., coagulation of casein micelles and creaming of aggregated fat globules, play a critical role in determining the kinetics of nutrient release and absorption.

Non-targeted metabolomics identifies biomarkers in milk with high and low milk fat percentage

Milk is widely recognized as an important food source with health benefits. Different consumer groups have different requirements for the content and proportion of milk fat; therefore, it is necessary to investigate the differential metabolites and their regulatory mechanisms in milk with high and low milk fat percentages (MFP). In this study, untargeted metabolomics was performed on milk samples from 13 cows with high milk fat percentage (HF) and 13 cows with low milk fat percentage (LF) using ultra-high performance liquid chromatography coupled with mass spectrometry (UHPLC-MS/MS). Forty-eight potential differentially labeled compounds were screened using the orthogonal partial least squares-discriminant analysis (OPLS-DA) combined with the weighted gene co-expression network analysis (WGCNA) method. Amino acid metabolism was the key metabolic pathway with significant enrichment of L-histidine, 5-oxoproline, L-aspartic acid, and L-glutamic acid. The negative correlation with MFP differentiated the HF and LF groups. To further determine the potential regulatory role of these amino acids on milk fat metabolism, the expression levels of marker genes in the milk fat synthesis pathway were explored. It was noticed that L-histidine reduced milk fat concentration primarily by inhibiting the triglycerides (TAG) synthesis pathway. L-aspartic acid and L-glutamic acid inhibited milk fat synthesis through the fatty acid de novo and TAG synthesis pathways. This study provides new insights into the mechanism underlying milk fat synthesis and milk quality improvement.

Effects of the COVID-19 Pandemic on Dairy Consumption Trends: An Empirical Investigation of Accounting Data in China

The COVID-19 pandemic may have had a negative impact on dairy consumption trends. Many dairy products are perishable and have relatively high income elasticity, causing their susceptibility to market fluctuations in general, including those specifically caused by the pandemic. However, the pandemic has also brought some other prospective possibilities. For example, during the pandemic, people paid more attention to nutrition and health issues and increased the number of meals prepared and eaten at home. In consideration of the particular circumstances during the pandemic, the Chinese government issued several policies to promote the population's dairy consumption, and the Chinese dairy cattle sector actively implemented the policy of "guarantee price, quality, and supply". These factors may have caused the Chinese population to increase their consumption of dairy products during the pandemic. Before the pandemic, the consumption of dairy products in the Chinese population showed an overall upward trend. The question addressed in this study is how has COVID-19 affected dairy consumption trends during the pandemic? This study uses accounting data from the Chinese dairy cattle sector to empirically analyze the impact of the COVID-19 pandemic on dairy consumption trends through economic theories and translog revenue function. Our study found that COVID-19 increased consumers' consumption of dairy products in China, but those people experiencing poverty may still have experienced inadequate dairy intake. This study has contributed to the body of work in this area in the literature and provides response strategies for the dairy cattle sector and the authorities.

Theory of Food: Unravelling the Lifelong Impact of Childhood Dietary Habits on Adult Food Preferences across Different Diet Groups

The study investigates the behavioral manifestations of the "Theory of Food" (ToF), a novel theoretical framework centered on the early development of food perceptions. The ToF posits that childhood experiences with food shape cognitive networks influencing adult dietary choices. Stemming from the "Theory of Mind," the ToF hypothesizes that individuals construct an associative world of food images and representations mirroring the socio-cognitive world shaped by proper theory of mind development. The study, involving 249 healthy adults, employs the Cognitive Food Preference Questionnaire (CFPQ) and the Adult Food Preference Profile (AFPP) to explore the correlation between childhood and adult food preferences across diet groups (omnivores, vegetarians, and vegans). Results reveal robust correlations in omnivores, varied patterns in vegetarians, and mixed outcomes in vegans. Notably, omnivores show correlations in grains, fast food, dairy products, vegetables, meat, soft drinks, and snack consumption. Vegetarians exhibit correlations in grains, fast food, dairy products, vegetables, snacks, and, surprisingly, meat consumption. Vegans display correlations in grains, fast food, vegetables, and snacks. The study suggests that childhood dietary habits tend to influence adult food choices, offering insights for future research in the field of theory of food (ToF).

Non-Cariogenic Effect of Milk and Dairy Products on Oral Health in Children and Adolescents: A Scoping Review

Diet plays an important role in the etiopathology of dental caries. Milk and dairy products (DPs), especially in children and adolescents, are important sources of protein, calcium and phosphorus and could have an effect on dental and oral health. The aim of this scoping review was to analyze the scientific literature on the non-cariogenic effect of milk and DPs, with a focus on their potential to prevent dental caries in children and adolescents. PubMed, EMBASE, and Web of Science were searched for publications relevant to our topic from January 2013 to 30 September 2023. Thirty-eight studies were included in the qualitative analysis. The included studies highlight the properties of milk and DPs that contribute to enamel remineralization, exhibit antibacterial action, inhibit the growth of cariogenic bacteria, and promote a balanced oral microbiome. With regard to the addition of probiotics (PBs) and fluoride (F) to DPs, the mixed results of the studies analyzed did not allow a clear statement to be made about their non-cariogenic effects. However, several studies show that the addition of PBs can reduce cariogenic bacteria, create a protective barrier against pathogens and support the host's natural defense mechanisms. Further long-term and high-quality studies are needed to understand the impact of milk and its constituents on oral health in order to promote effective caries prevention strategies in children and adolescents.

Food patterns associated with overweight in 7-11-year old children: machine-learning approach

Longitudinal study, whose objective was to present a better strategy and statistical methods, and demonstrate its use with the data across the 2013-2015 period in schoolchildren aged 7 to 11 years, covered with the same food questionnaire (WebCAAFE) survey in Florianopolis, southern Brazil. Six meals/snacks and 32 foods/beverages yielded 192 possible combinations denominated meal/snack-Specific Food/beverage item (MSFIs). LASSO algorithm (LASSO-logistic regression) was used to determine the MSFIs predictive of overweight/obesity, and then binary (logistic) regression was used to further analyze a subset of these variables. Late breakfast, lunch and dinner were all associated with increased overweight/obesity risk, as was an anticipated lunch. Time-of-day or meal-tagged food/beverage intake result in large number of variables whose predictive patterns regarding weight status can be analyzed by machine learning such as LASSO, which in turn may identify the patterns not amenable to other popular statistical methods such as binary logistic regression.

Association between milk and dairy consumption and executive functioning: A cross-sectional survey based on rural Chinese adolescents

BACKGROUND

Milk and dairy product consumption continue to increase in developing countries, with positive effects on adolescent physical and mental health. However, the effect of milk and dairy product consumption on executive function of adolescents has been less reported. This study aimed to analyze the status of milk and dairy product consumption and its association with executive function among adolescents in rural areas of China. The study aims to contribute to the healthy development of adolescents in rural areas of China.

METHODS

A three-stage stratified whole-group sampling method was used to investigate the milk and dairy product consumption status and executive function of 1360 adolescents in rural areas of China. One-way analysis of variance (ANOVA) and chi-square test was used to compare the milk and dairy product consumption of different categories of adolescents. Linear regression analysis and logistic regression analysis were used to analyze the association between milk and dairy product consumption and executive function.

RESULTS

The proportions of adolescents in rural China with milk and dairy product consumption ≤1 t/w, 2-4 t/w, and ≥5 t/w were 39.26%, 45.07%, and 15.66%, respectively. After adjusting for relevant confounding variables, logistic regression analysis showed that compared to adolescents with milk and dairy product consumption ≥5 t/w, milk and dairy product consumption 2-4 t/w (OR = 2.115,95% CI: 1.265, 3.533) and ≤1 t/w (OR = 5.929,95% CI: 3.552,9.895) had a higher risk of inhibit control dysfunction (p < 0.05). Compared to adolescents with milk and dairy product consumption ≥5 t/w, adolescents with milk and dairy product consumption ≤1 t/w (OR = 2.141,95% CI: 1.110,4.129) had a higher risk of conversion the risk of flexibility dysfunction was also higher in adolescents with milk and dairy product consumption ≤1 t/w (OR = 2.141,95% CI: 1.110,4.129).

CONCLUSION

Milk and dairy product consumption among adolescents in rural areas of China is inadequate and has a positive association with executive function. In the future, we should increase milk and dairy product consumption and improve executive function of adolescents in rural areas of China in order to promote healthy physical and mental development.

Vegetarian diets and diets which restrict animal-source foods during childhood in high-income countries

Increasing numbers of populations in the West are restricting their intake of meat and other animal products for reasons relating to health or ethics; in many countries, these restrictions are already common for cultural, religious, or socio-economic reasons. By following their parent's diet, children are exposed in parallel. This narrative review aims at assessing current data regarding vegetarian diets in children from birth to 18 years of age, which include, by increasing degree of restriction, flexitarian, lacto-ovo-vegetarian, lacto-vegetarian, pescatarian, vegan and macrobiotic diets. The 202 references include 45 studies in children. The more restrictive the diet and the younger the child, the greater the risk of nutritional deficiency. Of particular concern are vitamin B12, iron, zinc, calcium, n-3 long-chain polyunsaturated fatty acids, and protein and energy intake, especially in pregnant and nursing women, infants and young children. Providing an adequate lacto-ovo-vegetarian diet is relatively easy, whereas the maintenance of more restrictive diets may be challenging. The benefits and risks of vegetarian diets in adults are relatively well documented, but data for children are scarce. Vegan and macrobiotic diets should be discouraged in pregnant and lactating mothers as well as in young children, who, otherwise, should pay careful attention to ensuring nutritional adequacy, blood testing and appropriate supplementation. The health consequences of a chosen diet should be discussed with parents and adolescents to ensure the best possible adherence to advice and prescriptions. There is a need for well conducted studies in children but also for better knowledge of nutrition in healthcare professionals.Abbreviations: ALA: α-linolenic acid; ARA: arachidonic acid; ASF: animal source foods; BMC: bone mineral content; BMD: bone mineral density; DHA: docosahexaenoic acid; DRV: dietary reference value; EPA: eicosapentaenoic acid; FLD: flexitarian diet; LA: linoleic acid; LC-PUFA: long-chain polyunsaturated fatty acids; LOVD: lacto-ovo-vegetarian diet; LVD: lacto-vegetarian diet; MAD: macrobiotic diet; OMD: omnivorous diet; PSF: plant-source foods; SFA: saturated fatty acids; VGD: vegetarian diets; VND: vegan diet.

Plant-Based Dietary Indices in Relation to Nutrient and Food Group Intakes in Preschool-Aged Children

Dietary guidance promotes plant-based foods, yet minimal research has examined intake in children. This study examined plant-based food intake in preschool-aged children using plant-based dietary index (PDI) metrics and related these metrics to nutrient and food group intakes. Dietary data were collected from preschool-aged children (n = 283, 3.45 ± 1.22 years) from the Guelph Family Health Study at baseline using the Automated Self-Administered 24-Hour Dietary Assessment Tool. Food intake servings were assigned to 16 food groups for calculation of overall PDI (oPDI), healthful PDI (hPDI), and less healthful (lhPDI) scores and summarized into tertiles for energy-adjusted comparisons. For oPDI, participants in the highest vs. lowest tertile had higher intakes of nutrients and food groups to encourage (e.g., dietary fiber, fruits) as well as lower intakes of nutrients to encourage (e.g., calcium, vitamin D). For hPDI, participants in the highest vs. lowest tertile had higher intakes of nutrients and food groups to encourage and lower intakes of those to limit (e.g., saturated fat, sweets and desserts). For lhPDI, participants in the highest vs. lowest tertile had higher intakes of nutrients and food groups to limit and lower intakes of those to encourage. These results can inform dietetic practice for dietary guidance that promotes plant-based foods in children.

Analysis of public food procurement in relation to dairy products and their quality criteria

Introduction

Public procurement of food is key to ensuring proper nutrition with high-quality products in public institutions such as schools and kindergartens. However, it should not be considered a mandatory expenditure from public finances but rather an investment in health promotion.

Materials and methods

A total of 1,126 public procurement orders processed by schools and kindergartens in Poland during the period from November 2022 to March 2023 were analyzed. Ultimately, 197 public procurement orders meeting the inclusion criteria were considered for analysis. Based on these orders, 2,753 food products classified as dairy and its derivatives were extracted. The ordered quantities of individual products were analyzed, as well as their descriptions (quality characteristics).

Results

Criteria related to composition were most commonly described, the most common criterion was the fat content and the absence of preservatives. On the second places were organoleptic characteristics, where taste and consistency expectations were most frequently specified. Sustainable public procurement criteria were the least frequently mentioned and were treated as highly marginal.

Conclusion

Introducing minimum standards for the descriptions of dairy products in terms of organoleptic characteristics, composition features, and sustainability criteria will improve the quality of dairy products supplied to public institutions, particularly schools and kindergartens.

Lead, Cadmium, and Arsenic in Raw Cow's Milk in a Central Andean Area and Risks for the Peruvian Populations

Milk and its derivatives are basic foods in Peru, especially for children. The Junín region, in the central Andes, is one of the leading dairy basins. However, the safety of milk is affected by mining-metallurgical activities, wastewater dumping, organic residues, and inappropriate use of organophosphate fertilizers in agriculture whose contaminants reach the food chain, putting human health at risk. The purpose of this study was to evaluate the bioaccumulation of lead (Pb), cadmium (Cd), and arsenic (As) in milk produced on a representative farm in central Peru, which uses phosphorous agrochemicals and is adjacent to a small mineral concentrator and a municipal solid waste dump, and to evaluate the potential risk for the Peruvian population of 2-85 years considering three levels of daily intake by age, which constitutes the innovative contribution of the study. These three elements were quantified by flame atomic absorption spectrometry following standardized procedures. The mean contents of Pb (0.062 mg/kg), Cd (0.014 mg/kg), and As (0.030 mg/kg) in milk exceeded the maximum limits allowed by international standards. At all ages, the target quotient hazard followed a descending order of As > Pb > Cd, being > 1 in the case of As. The hazard index was >1 for children under 7, 9, and 11 years of age in the scenarios of low, medium, and high milk intake. The information is valid for formulating policies to prevent adverse health effects and develop standards and awareness programs, monitoring, and control of heavy metals in milk in Peru.

Dairy and Plant-Based Milks: Implications for Nutrition and Planetary Health

PURPOSE OF REVIEW

Dairy milk products are dominant in the market; however, plant-based milks are gaining prominence among USA consumers. Many questions remain about how plant-based milk products compare to dairy milk from a nutrition, public health, and planetary health perspective. Here, we compare the retail sales, nutrient profiles, and known health and environmental impacts of the production and consumption of dairy and plant-based milks and identify knowledge gaps for future studies. For our plant-based milk comparisons, we reviewed almond, soy, oat, coconut, rice, pea, cashew, and other plant-based milks as data were available.

RECENT FINDINGS

The retail unit price of plant-based milks was generally higher than that of cow's milk, making it less accessible to lower-income groups. Many plant-based milks are fortified to match the micronutrient profile of dairy milk more closely. Notable differences remained, especially in protein, zinc, and potassium, depending on the base ingredient and individual product. Some plant-based milks contain added sugar to improve flavor. Plant-based milks were generally associated with lower environmental impacts (e.g., greenhouse gas emissions, water use) than cow's milk, with the notable exception of the higher water footprint of almond milk. This review of recent studies and consumer purchases confirmed that retail sales of plant-based milks are increasing and shifting among products. Further research is needed to better characterize the environmental impacts of newer plant-based milks, such as cashew, hemp, and pea milks; consumer attitudes and behavior towards plant-based milks; and the safety and potential health effects related to their long-term and more frequent consumption.

Plasma Fatty Acid Biomarkers of Dairy Consumption Are Associated with Sex-Dependent Effects on Metabolic Syndrome Components in Mexican Adolescents

INTRODUCTION

During adolescence, dairy product intake has shown conflicting associations with metabolic syndrome (MetS) components, which are risk factors for cardiovascular disease (CVD). This study aims to investigate the association between plasma fatty acids (FAs) C15:0, C17:0, and t-C16:1n-7, as biomarkers of dairy intake, with MetS and its components in Mexican adolescents.

METHODS

A sample of 311 participants from the Early Life Exposure in Mexico City to Environmental Toxicants (ELEMENT) cohort was included in this cross-sectional analysis. FA concentrations were measured in plasma as a percentage of total FA. We used quantile regression models stratified by sex to evaluate the association between FA quantiles and MetS components, adjusting for age, socioeconomic status (SES), sedentary behavior, BMI z-score, pubertal status, and energy intake.

RESULTS

We found significant associations between dairy biomarkers and the median of MetS variables. In females, t-C16:1n-7 was associated with a decrease of 2.97 cm in WC (Q4 vs. Q1; 95% CI: -5.79, -0.16). In males, C15:0 was associated with an increase of 5.84 mm/Hg in SBP (Q4 vs. Q1; CI: 1.82, 9.85). For HDL-C, we observed opposite associations by sex. C15:0 in males was associated with decreased HDL-C (Q3 vs. Q1: β = -4.23; 95% CI: -7.98, -0.48), while in females, C15:0 and t-C16:1n-7 were associated with increased HDL-C (Q3 vs. Q1: β = 4.75; 95% CI: 0.68, 8.82 and Q4 vs. Q1: β = 6.54; 95% CI: 2.01, 11.07), respectively. Additionally, in both sexes, different levels of C15:0, C17:0, and t-C16:1n-7 were associated with increased triglycerides (TG).

CONCLUSION

Our results suggest that adolescent dairy intake may be associated in different directions with MetS components and that associations are sex-dependent.

Health risk assessment of dietary cadmium intake in children aged 2-17 years in East China

Food is the main way for people to be exposed to heavy metal cadmium (Cd), and Cd pollution will affect human health. In this paper, exposure and health risk assessment of dietary Cd intake were conducted in children aged 2, 3, 4, 5, 6-8, 9-11, 12-14 and 15-17 years in East China. The results showed that the total exposure of dietary Cd intake in children exceeded the standard limits. The total exposure of all age groups were 1.11 × 10-3, 1.15 × 10-3, 9.67 × 10-4, 8.75 × 10-4, 9.18 × 10-4, 7.75 × 10-4, 8.24 × 10-4, 7.11 × 10-4 mg kg-1 d-1, respectively, and the highest was the children aged 3 years. The hazard quotients of children aged 2 and 3 years were 1.11 and 1.15, respectively, at an unacceptable health risk level. The hazard quotients of dietary Cd intake in children of other ages were less than 1, at an acceptable health risk level. Staple foods were the most significant contributor to the dietary Cd intake in children, and the contribution ratio of non-carcinogenic risk of dietary Cd intake in all age groups were more than 35%, the proportion of non-carcinogenic risk in children aged 6-8 and 9-11 years were as high as 50%. This study provides scientific basis for the health of children in East China.

Growth in milk consumption and reductions in child stunting: Historical evidence from cross-country panel data

Agricultural and food policies are increasingly being tasked with doing more to improve the nutritional status of low-income populations, especially reductions in child stunting. Which specific food sectors warrant additional policy attention is less clear, although a growing body of research argues that increased animal-sourced food consumption in general, and increased dairy consumption specifically, can significantly reduce the risks of stunting, as well as deficiencies in micronutrients and high quality protein. However, experimental research on dairy's impacts on child growth in developing countries is very limited, and non-experimental evidence is confined to cross-sectional surveys. In this study we adopt a more macro lens by using a cross-country panel to show that increases in milk consumption over time are associated with large reductions in child stunting even after controlling for important confounding factors. Countries with high rates of stunting should therefore consider nutrition-sensitive strategies to increase dairy consumption among young children through both supply- and demand-side interventions.

A comprehensive review on infant formula: nutritional and functional constituents, recent trends in processing and its impact on infants' gut microbiota

Human milk is considered the most valuable form of nutrition for infants for their growth, development and function. So far, there are still some cases where feeding human milk is not feasible. As a result, the market for infant formula is widely increasing, and formula feeding become an alternative or substitute for breastfeeding. The nutritional value of the formula can be improved by adding functional bioactive compounds like probiotics, prebiotics, human milk oligosaccharides, vitamins, minerals, taurine, inositol, osteopontin, lactoferrin, gangliosides, carnitine etc. For processing of infant formula, diverse thermal and non-thermal technologies have been employed. Infant formula can be either in powdered form, which requires reconstitution with water or in ready-to-feed liquid form, among which powder form is readily available, shelf-stable and vastly marketed. Infants' gut microbiota is a complex ecosystem and the nutrient composition of infant formula is recognized to have a lasting effect on it. Likewise, the gut microbiota establishment closely parallels with host immune development and growth. Therefore, it must be contemplated as an important factor for consideration while developing formulas. In this review, we have focused on the formulation and manufacturing of safe and nutritious infant formula equivalent to human milk or aligning with the infant's needs and its ultimate impact on infants' gut microbiota.

Parental influences on children's dairy products consumption: a narrative review

OBJECTIVE

To review research on the influence of parent-related factors on children's dairy products consumption.

DESIGN

A search of electronic databases and a narrative synthesis of the literature were conducted. English-language articles were included if they reported data relating to parental influences on children's consumption of dairy products and if statistical significance was reported.

SETTING

Studies were carried out in the USA (n 8) and in a range of countries across Europe (n 12) and Asia (n 5).

PARTICIPANTS

The subjects of this research were children aged between 2 and 12 years of age, from a range of geographical locations.

RESULTS

Twenty-five studies met the inclusion criteria. The studies examined children's dairy products consumption in relation to parental socio-economic status (education level and income) (n 12), home availability (n 2), home food environment (n 3), parental dairy products consumption (n 4), parent feeding practices (n 3), parents' beliefs and attitudes (n 3) and parental nutrition knowledge (n 3). Results on the association between socio-economic status and children's dairy products consumption varied; however, studies reporting a significant association generally observed a positive relationship. Fifteen studies reported children's total dairy products intake as an outcome measure, with the remaining studies reporting intake of milk or other dairy products as individual foods.

CONCLUSIONS

This review identified literature exploring a range of parental factors in relation to children's dairy products intake. However, there were limited numbers of studies published within each category of modifiable factors. Further research on the parent-related determinants of dairy products consumption in children is required in order to identify potential intervention targets in this age group.

Evaluation and Management of Reduced Dietary Diversity in Children with Pediatric Feeding Disorder

Pediatric Feeding Disorder, a common problem in children, is commoner in children with various developmental disorders. Children with pediatric feeding disorder can have food selectivity and lack dietary diversity (DD). In this paper, an understanding of DD in these children is provided along with a dietary diversity index that can be helpful in measuring and understanding the risks posed by this lack of DD. An overview of a management strategy to address decreased DD is proposed. In these children, improving DD can improve growth, micronutrient status, long-term metabolic health, and potentially quality of life.

Determinants of the attitudes of proinnovative dairy consumers and a model simulating consumer behavior regarding increasing calcium intake

OBJECTIVE

A study was carried out to identify characteristics of consumers of dairy products.

METHODS

Based on a questionnaire with 127 participants, aged 22 to 52, a simulation model was developed, taking into account factors influencing the development of health-seeking behavior.

RESULTS

A relationship was found between consumer proinnovative attitude, actual prohealth behavior, and characteristics of the consumer influencing the consumption of calcium. Prohealth behavior (knowledge and application of the principles of healthy eating) is mainly influenced by material situation, age, and gender of the consumer. It has been reported that only 25% of parents talk to their children about the principles of healthy eating. No relationship was found between prohealth and proinnovation behaviors and level of education, sports activity, or number of children in the family.

CONCLUSIONS

Among young people, as many as 39% do not follow the principles of healthy eating, and these are mainly women. Respondents' proinnovative attitudes and social status were conducive to increasing calcium intake and correlate with greater diversity in the consumption of dairy products. The Pearson correlation coefficient between body mass index and calcium intake was not significant (r = -0.03; P = 0.76).

Food Group, Macronutrient Intake, and Metabolic Status in the US-Affiliated Pacific's Children's Healthy Living (CHL) Program

BACKGROUND

The Children's Healthy Living study provided dietary intake information for understudied Native Hawaiian and Other Pacific Islander (NHOPI) young children.

OBJECTIVES

Our objective was to describe food group and macronutrient intakes of NHOPI children in the US-Affiliated Pacific region (USAP), overall and by jurisdiction, income level, and metabolic status.

METHODS

We evaluated 2-8-y-olds (n = 3520) in a cross-sectional cluster sampled study using 2 d of dietary records completed by caregivers using provided tools, quantified by a specially developed food composition table and compared with US dietary recommendations. Overweight and obesity (OWOB) and acanthosis nigricans (AN) assessment (metabolic status) was completed by trained evaluators using standard tools. Demographic data were collected by questionnaire. Regression analysis identified differences in dietary component means by jurisdiction, World Bank income groups (WBIGs), and metabolic status, adjusted for age and sex.

RESULTS

Few children met US recommendations for vegetable (2.4%) and milk (4.1%) food groups. US macronutrient recommendations were generally met. Food group and macronutrient intakes were significantly different by jurisdiction and WBIG. Means for food groups, except meats, and macronutrients, except protein, were higher in overweight/obese (OWOB) compared with healthy-weight children. Grain intake of 7.25 (SE: 0.08) oz was higher (P < 0.05) and milk intake of 0.90 (SE: 0.05) cups was lower (P < 0.05) in children with OWOB compared with those without OWOB [grains: 7.17 (SE: 0.07) oz; and milk: 0.96 (SE: 0.04) cups]. Monounsaturated fat intake of 11.68 (SE: 0.10) % energy was higher in those with OWOB, compared with healthy-weight children [11.56 (SE: 0.08) % energy, P < 0.05].

CONCLUSIONS

Young children's diets in the USAP did not meet milk, vegetable, or fruit intake recommendations. There was variability in dietary patterns across the USAP and by WBIG. Grain intake and monounsaturated fat intake were lower and milk intake was higher in children with better metabolic status.

Assessment of Dietary Intake of Iodine and Risk of Iodine Deficiency in Children with Classical Galactosaemia on Dietary Treatment

Iodine is an essential mineral required for the synthesis of thyroid hormones. Iodine plays a critical role in growth and neurocognitive development. Classical galactosaemia is a disorder resulting from an inborn error in galactose metabolism. Its current management consists of life-long lactose and galactose dietary restriction. This study estimated dietary intakes of iodine in infants and children with classical galactosaemia in the Republic of Ireland. The diets of 43 participants (aged 7 months-18 years) with classical galactosaemia were assessed for iodine intake using an iodine-specific food frequency questionnaire. Intakes were compared to the European Food Safety Authority (EFSA) dietary recommendations for iodine intake. The potential role of iodine fortification of dairy alternative products was also examined. There were no significant differences observed between sex, ethnicity and parental education and meeting dietary iodine recommendations. Differences, however, were seen between age groups, causing the p value to approach statistical significance (p = 0.06). Infants consuming infant formula were likely to meet iodine recommendations. However, over half (53%) of children aged 1-18 years had average intakes below the recommendations for age. For these children, consumption of iodine-fortified dairy alternative milk was the leading source of iodine in the diets, followed by fish/shellfish and eggs. An assessment of iodine intake should be undertaken during dietetic reviews for those with classical galactosaemia. Mandatory iodine fortification of all dairy alternative products would result in 92% of the total population cohort meeting iodine recommendations based on their current consumption.

Dietary calcium intake in Brazilian preschoolers and schoolchhildren: review of the literature

Objective:

The objective of this study was to map and synthesize evidence on the adequacy of dietary calcium intake and dairy products in Brazilian preschoolers and schoolchildren.

Data source:

Evidence searches were performed in the MEDLINE (via PubMed) and Latin American and Caribbean Health Sciences Literature (LILACS; via BVS) databases, with no restriction on date or language of publication. Experimental or observational studies that evaluated healthy Brazilian children between 2 and 12 incomplete years old were included.

Data synthesis:

A total of 18 studies were included. Seven of 11 studies of 11 studies (63.6%) identified mean values of dietary calcium intake below the age recommendation, especially in schoolchildren, with the progression of the age group. Among preschoolers, studies with direct weighing of food showed higher mean values of dietary calcium ingested compared to those with dietary recall. Children attending public daycare centers on a part-time basis tended to have inadequate calcium intake. The consumption of milk and dairy products was lower among older children, especially schoolchildren.

Conclusions:

Inadequate dietary calcium intake seems to be prevalent in Brazil during childhood, especially among schoolchildren. Therefore, the evaluation of milk and dairy products intake must be considered in order to desgn appropriate corrective actions.

Recommended dairy intake is associated with healthy dietary habits, better physical fitness, less obesity and a healthier lifestyle profile in school age children

This study aimed to identify the association of recommended dairy intake with several dietary habits, obesity, physical fitness (PF), physical activity (PA), screen time and sleep. Population data were derived from a health survey on a representative sample of 177 091 children aged 8-17 years. Dairy intake and dietary habits were evaluated using questionnaires (KIDMED index). Participants were characterised as 'dairy products consumers' based on whether they met current recommendations for milk or dairy consumption (e.g. if they consumed two yogurts and/or 40 g cheese and a cup of milk daily). Participants who did not consume the above-mentioned quantities were characterised as 'non-consumers.' Anthropometric and PF data were obtained by trained investigators. PA status, screen time and sleeping habits were assessed through self-completed questionnaires. Boys and girls consuming recommended dairy products were 25 % (95 % CI: 0·71, 0·79) and 43 % (95 % CI: 0·51, 0·64) less likely to have low performances in cardiorespiratory fitness tests, Participants from both sexes classified as dairy products consumers had lower odds of central obesity by 10 % (95 % CI: 0·86, 0·95), as compared with non-consumers. Moreover, recommended dairy products consumers had lower odds for insufficient sleep by 8 % (95 % CI: 0·89, 0·96) in boys and 14 % (95 % CI: 0·83-0·90) in girls, for inadequate PA levels by 15 % (95 % CI: 0·77, 0·93) in boys and 16 % (95 % CI: 0·76, 0·90) in girls and for increased screen time by 11 % (95 % CI: 0·83, 0·95) in boys and 9 % (95 % CI: 0·85, 0·97) in girls than no-consumers. In conclusion, recommended dairy intake is associated with less obesity, better PF and a healthier lifestyle profile.

Food Costs of Children and Adolescents Consuming Vegetarian, Vegan or Omnivore Diets: Results of the Cross-Sectional VeChi Youth Study

The aim was to analyse the total food costs and the impact of food groups on total food costs among vegetarian, vegan and omnivore children and adolescents in Germany. Based on three-day weighed dietary records of 6–18-year-old children and adolescents of the VeChi Youth Study, the total daily food costs and food group costs (both EUR/day, EUR/1000 kcal) of a vegetarian (n = 145 records), vegan (n = 110) and omnivore (n = 135) diet were calculated. Minimum retail prices of 1000 empirically selected foods reported in the dietary records were linked to individual food intakes. The group differences were analysed using ANCOVA or Kruskal-Wallis tests. Vegans had the highest energy adjusted total food costs at 2.98 EUR/1000 kcal, vegetarians the lowest at 2.52 EUR/1000 kcal. Omnivores also had significantly higher costs than vegetarians with 2.83 EUR/1000 kcal/1000 kcal (p = 0.01), but the total costs did not differ significantly between omnivores and vegans (EUR/d and EUR/1000 kcal). Compared to vegetarians, vegans had significantly higher expenditures (EUR/day) on fruit (p = 0.0003), vegetables (p = 0.006), dairy alternatives (p = 0.0003) and legumes/nuts/seeds (p = 0.0003). Expenditure on starchy foods was significantly higher in the vegetarian or vegan than in the omnivore diet (p = 0.0003). Omnivores spent a quarter of their total food costs on animal source foods (25%), which is equivalent to the sum of food costs for legumes/nuts/seeds, dairy alternatives and meat alternatives in vegans and additionally dairy in vegetarians. The VeChi Youth Study indicated that financial constraints are not necessarily a barrier to switching to a more plant-based diet.

Human Milk Lipid Profiles around the World: A Systematic Review and Meta-Analysis

Reported breast milk lipid concentrations may vary with geographical region, postnatal age, and year of sample collection. In this review, we summarized data on the concentrations of total fat, total phospholipids, cholesterol, and fatty acids in human milk worldwide and their variation according to lactation stage, study area, and sample collection year. A systematic literature search was performed using the PubMed, Embase, Web of Science, and Medline databases for English-language papers and Wanfang and China National Knowledge Infrastructure databases for Chinese-language papers. A total of 186 studies evaluating the human milk lipid profiles were included. According to random-effects models based on worldwide data, the summarized means (95% CIs) as percentages of total fat were 42.2% (41.1%, 43.3%) for SFAs, 36.6% (35.6%, 37.5%) for MUFAs, and 21.0% (19.3%, 22.7%) for PUFAs. However, the study heterogeneity was high for most types of fatty acids (I2 > 99%). Human milk from Western countries had higher concentrations of MUFAs and 18:1n-9 (ω-9), but lower concentrations of PUFAs, 18:2n-6, 20:4n-6, 18:3n-3, 20:5n-3, 22:6n-3, and total n-6 PUFA compared with those from non-Western countries (P < 0.001-0.011). Significant lactation stage differences were observed for total fat and some individual fatty acids. The concentrations of SFAs and 16:0 were significantly negatively correlated with sampling year (P < 0.001-0.028). In contrast, a significant positive correlation between the concentrations of 18:2n-6 and 18:3n-3 and sampling year was observed (P < 0.001-0.035). Our results suggest that the pooling of data on human milk lipid profiles in different studies should be done with caution due to the high between-study heterogeneity. The concentration of lipids, including total fat, cholesterol, and specific fatty acids, differs in human milk according to lactation stage, geographical region, and year of sample collection.

Association between early childhood caries and diet quality among Chinese children aged 2-5 years

Background

Early childhood caries (ECC) is a major oral problem affecting the health and wellbeing of children worldwide. Diet quality is a better predictor of ECC risk than single foods or specific nutrients. The purposes of this study were to assess the associations between ECC and diet quality among 2- to 5-year-old Chinese children.

Methods

A total of 150 eligible children were included in this study. The decayed, missing, or filled surface (dmfs) score was recorded for each child by dental examination. All participants were divided into three groups based on their age and dmfs score [the caries-free group, the ECC group, and the severe early childhood caries (S-ECC) group]. Parents were invited to complete a questionnaire on the general characteristics and oral health behaviors of the participants. The information of 24-h dietary intake from each child was captured via a mobile APP. The Chinese diet balance index for preschool children (DBI_C) indicators score, high bound score (HBS), low bound score (LBS), and diet quality distance (DQD) score were calculated to assess the diet quality of study subjects. The associations of ECC with HBS, LBS, DQD score, and DBI_C indicators score were analyzed by Mann-Whitney U test and multivariable logistic regression analysis.

Results

In this study, 21, 31, and 98 children were diagnosed with caries-free, ECC, and S-ECC, respectively. Statistical analysis revealed that the risk of ECC and S-ECC were significantly increased with the DQD score (OR = 1.283 and 1.287, respectively), but both were not associated with HBS and LBS (P > 0.05). In the meantime, the risk of ECC and S-ECC were significantly increased with the Grains score (OR = 1.623 and 1.777, respectively), and significantly decreased with the Food diversity score (OR = 0.271 and 0.315, respectively). Moreover, the risk of S-ECC also significantly decreased with the Vegetables score (OR = 0.137).

Conclusion

Both ECC and S-ECC were associated with a high degree of dietary imbalance and grains intake as well as a low degree of food diversity among Chinese children aged 2-5 years. In addition, S-ECC was also associated with a low degree of vegetable intake.

The association between sugar-sweetened beverages and milk intake with emotional and behavioral problems in children with autism spectrum disorder

Background

Emotional and behavioral problems are common in children with autism spectrum disorder (ASD). It's still unclear whether children with ASD have abnormal sugar-sweetened beverages (SSBs) and milk intake and whether this abnormality will affect their emotions and behavior remains unclear. The current study aims to investigate the association of SSBs and milk intake with emotional and behavioral problems in children with autism spectrum disorder (ASD).

Methods

107 children with ASD and 207 typical developing (TD) children aged 6-12 years old were recruited for the study. The frequency of SSBs and milk intake was assessed by a self-designed questionnaire. Emotional and behavioral problems were assessed by Strength and Difficulties Questionnaire (SDQ). Then, the linear regression model was produced to evaluate the association of SSBs and milk intake with emotional and behavioral problems.

Results

In the current study, there was no difference in frequency of SSBs intake between children with ASD and TD children (p > 0.05), and children with ASD consumed less milk compared to TD children (p < 0.05). After adjusting sex, age, maternal and paternal education, and monthly family income, we found a significant difference in each subscale score of SDQ in the two groups (p < 0.05). In children with ASD, higher frequent SSBs intake was positively associated with the scores of the emotional problem (p for trend <0.05), and lower frequent milk intake was inversely associated with the scores of prosocial behavior (p for trend <0.05). No interactive effects were found on SSBs and milk intake with emotional and behavioral problems (p for trend > 0.05).

Conclusion

In children with ASD, frequency of SSBs and milk intake was associated with the emotional problem and prosocial behavior, respectively. Children with ASD should increase the frequency of milk intake and decrease the frequency of SSBs intake.

Retail Cost and Energy Adjusted Cost Are Associated with Dietary Diversity and Nutrient Adequacy for Diets of 6–24 Months Children

Poor nutrition during the first two years of life has long term consequences, but resource-poor households often do not have the means to access nutrient-dense and diverse diets. Pooled data of 24-h dietary recalls (n = 3336) and 2019 retail food prices were analyzed to determine associations of retail cost and energy cost (per 100 kcal) with diet quality indicators for diets of 6–24-month-old South African children who were breastfed (BF-diet) and not breastfed (NBF-diet) during the 24-h recall period. Compared to the BF-diet, retail cost for the NBF-diet was three times higher for age 6–11 months, and double for age 12–17 months. Higher retail cost and energy cost were both associated with higher mean adequacy ratios and dietary diversity scores for BF and NBF diets, except energy cost for the NBF-diet for age 6–11 months. Overall, inclusion of flesh foods, vitamin A-rich fruits and vegetables, and other fruit and vegetables increased from the lowest to the highest retail cost tertile. The higher cost of more nutritious diets highlights the importance of the affordability of diets in interventions aimed at improving diet quality. Possible strategies include: identifying the most-affordable foods within each food group, focusing on foods that provide multiple key micronutrients, and the inclusion of locally available indigenous foods.

Trajectories of beverage consumption during adolescence

Beverages contribute substantially to daily energy and nutrient intakes. However, little is known about the co-development of beverage consumption throughout adolescence. This study aimed to investigate the presence of naturally occurring sub-groups of girls and boys following distinct trajectories of various types of beverage consumption (i.e. sugary beverages, tea and coffee, water, and milk) throughout adolescence. During the Monitoring Activities for Teenagers to Comprehend their Habits study, data were collected from 744 Canadian youths followed for six years (2013-2019). The participants were asked yearly (start-age 10-11 years old) to report how many times they consumed sugary beverages, tea and coffee, water, and milk in a week. Trajectories of beverage consumption were identified from age 11 to 18 using a person-centred approach, namely group-based multi-trajectory modelling. For girls, three different groups were identified: 'Water consumers' (62.7%), 'High beverage consumers' (20.9%), and 'Water and milk consumers' (16.4%). For boys, four different groups were identified: 'Water consumers' (39.1%), 'Water and milk consumers' (30.5%), 'Sugary drinks, coffee and tea consumers' (20.1%), and 'High beverage consumers' (10.4%). This study illustrates the complexity of beverage consumption patterns in adolescence. Various types of public health messaging and interventions may be required to promote healthier beverage consumption patterns among all adolescents.

The Role of Milk on Children's Weight Status: An Epidemiological Study among Preadolescents in Greece

Milk consumption contributes greatly to children's diet, playing a pivotal role in the development and structure of bones and the functioning of the musculoskeletal system and the heart. This study investigated the association between the type of milk and childhood overweight/obesity. In the school period 2014-2016, 1728 students aged 10-12 years and their parents participated. The measurement and classification of their weight status were performed through the criteria of the International Obesity Task Force. Among others, the type of milk consumption was recorded. Four categories of the type of milk children consumed were classified (white milk, chocolate milk, both types of milk, and no milk at all). Children consuming only white milk were 33.1% less likely to be overweight/obese in comparison with children who were not consuming milk at all [OR (95% CI): 0.669 (0.516, 0.867), p = 0.002]. The consumption of chocolate milk showed a protective role against childhood overweight/obesity although its association was not consistently significant. This study highlights the significant contribution of milk (and particularly of white milk) consumption to weight management, and thus its promotion should be consistently encouraged. More studies are needed to shed light on the effects of different dairy foods on weight status in childhood.

Lead and Cadmium Bioaccumulation in Fresh Cow's Milk in an Intermediate Area of the Central Andes of Peru and Risk to Human Health

The dairy basin of the Mantaro River located in the centre of Peru faces serious anthropogenic disturbances as it receives emissions and discharges from the metallurgical mining activity located in the headwaters of the basin and milk contaminated with lead (Pb) and cadmium (Cd) endangers the environmental and human health, especially children. To measure the concentrations of Pb and Cd in milk and the dangers of their consumption in the Peruvian population, 40 milk samples were collected and quantified by atomic absorption spectrometry. The mean concentration of Pb in milk was 15 ± 2.6 µg/kg, which represented 75% of the Maximum Limit (ML), and that of Cd was 505 ± 123 µg/kg, which exceeded the ML by more than 194 times. The estimated weekly intake of Pb for people aged 2−85 years was below the Provisional Tolerable Weekly Intake (PTWI) references, determining risk coefficients (CRD) < 1. Weekly Cd intake was much higher than the PTWIs and CRDs were between 14 and 34, indicating that consumers would experience carcinogenic health effects, with children being at higher risk than adults, therefore, milk from the area is not safe for consumption. Cd would be transferred mainly through the soil (water)-grass-milk pathway, due to its presence in irrigation water and in fertilizers that contain Cd. The main pathway for Pb entry would be air-soil (water)-milk grass, from the fine particles emitted into the air by the mining-metallurgical activity, developed approximately 90 km from the study area.

Food consumption patterns and nutrient intakes of infants and young children amidst the nutrition transition: the case of Lebanon

Background

This is the first study on dietary intakes of infants and young children in the Eastern Mediterranean Region, a region that is currently witnessing the nutrition transition. It aims at characterizing food consumption patterns amongst 0–4 year old children in Lebanon, evaluating their macro- and micronutrient intakes and assessing adherence to dietary recommendations.

Methods

Based on a national cross-sectional survey in 2012 (n = 866), the study collected data on sociodemographic and anthropometric characteristics, and one 24-hour dietary recall was administered. Nutrient intakes were compared with reference values: Estimated Average Requirement (EAR), Adequate Intake (AI) and Acceptable Macronutrient Distribution Range (AMDR).

Results

Milk was the highest contributor to energy intake (EI) in infants (95.8 and 56.5% in 0–5.9 months and 6–11.9 months old infants, respectively), while its intake was lower among toddlers and preschoolers (35.4 and 15.1%, respectively). In contrast, intakes of sweets and sweetened beverages were the highest in preschoolers compared to younger children, contributing 18.5% EI in preschoolers. Compared to dietary guidelines, the lowest dietary adherence was found for vegetables (17.8–20.7%) and fruits (14.4–34.3%). Protein intake was within the recommendations for the vast majority of children. Although total fat intake was lower in toddlers and preschoolers compared to infants, more than 40% of toddlers and preschoolers exceeded the AMDR for fat and 87.3% of preschoolers exceeded the upper limit for saturated fat. Only 3.6% of toddlers and 11.5% of preschoolers exceeded the AI level for dietary fiber. Micronutrient intake assessment showed that mean intakes in infants exceeded the AI for all micronutrients, except for vitamin D and magnesium. In toddlers, vitamin D and calcium were below the EAR among 84.7, and 44.6%, respectively. In preschoolers, most of the children (91.9%) had inadequate intakes of vitamin D, and a third had inadequate intakes of folate, calcium and vitamin A.

Conclusions

This study identified priority issues for nutrition intervention in infants and young children in Lebanon. Concerted multi-stakeholder efforts are needed to instill heathier food consumption and nutrient intake patterns early in life.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12937-022-00779-9.

Cheese Intake is Inversely Associated with LDL Cholesterol in Young Children

Purpose: To determine if intake (servings/day) of total dairy and/or dairy subtypes (milk, cheese, and yogurt) were associated with biomarkers related to dyslipidemia, insulin sensitivity and inflammation in a sample of cardio-metabolically healthy young children from the Guelph Family Health Study at the University of Guelph, Guelph, Ontario, Canada.Methods: Baseline data from 42 children (aged 2.0-6.2 years) from 33 families who provided a dietary assessment and a fasted blood sample were included in this cross-sectional analysis. Linear and logistic regressions using generalized estimating equations were used for analysis and models were adjusted for age, gender, and household income.Results: In total, 42 children (3.74 ± 1.23 years old; mean (± SD)) consumed median (25th percentile, 75th percentile) servings/day of 1.70 (1.16, 2.81) for total dairy, 0.74 (0.50, 1.70) for milk, 0.63 (0.00, 1.16) for cheese, and 0.00 (0.00, 0.38) for yogurt. Cheese intake was significantly inversely associated with LDL cholesterol (-0.16 (95% CI: -0.29, -0.03) mmol/L per serving; P = 0.02)). No other associations between dairy intake and biomarkers were significant.Conclusions: Cheese intake was inversely associated with LDL cholesterol in this preliminary study of cardio-metabolically healthy young children, thereby warranting further research on dairy intake and cardiometabolic risk factors.

Assessing the Nutrient Status of Low Carbohydrate, High-Fat (LCHF) Meal Plans in Children: A Hypothetical Case Study Design

There is well-established evidence for low-carbohydrate, high-fat (LCHF) diets in the management of chronic health conditions in adults. The natural next step is to understand the potential risks and benefits of LCHF diets for children, where they may have useful applications for general health and a variety of chronic health conditions. It is vital that any diet delivers sufficient micronutrients and energy to ensure health, wellbeing, and growth. This descriptive study assesses the nutrient and energy status of LCHF sample meal plans for children. We designed four meal plans for hypothetical weight-stable male and female children (11 years) and adolescents (16 years). Carbohydrates were limited to ≤80 g, protein was set at 15–25% of the total energy, and fat supplied the remaining calories. Using FoodWorks dietary analysis software, data were assessed against the national Australian/New Zealand nutrient reference value (NRV) thresholds for children and adolescents. All meal plans exceeded the minimum NRV thresholds for all micronutrients; protein slightly exceeded the AMDR recommendations by up to three percentage points. This study demonstrates that LCHF meal plans can be energy-, protein-, and micronutrient-replete for children and adolescents. As with any dietary approach, well-formulated meals and careful planning are key to achieving the optimal nutrient status.

Food and beverage offerings by parents of preschoolers: A daily survey study of dinner offerings during COVID-19

The COVID-19 pandemic is likely to have altered parents' daily feeding practices, including what and how much they feed their children, which may have negative implications for children's weight. The primary aim of this study was to examine patterns of and variation in parents' daily food and beverage offerings at dinner across 10 days during the COVID-19 pandemic using descriptive analysis and non-parametric tests. Ninety-nine parents (M_age = 32.90, SD_age = 5.60) of children ages 2–4 years (M = 2.82, SD = 0.78) completed an online baseline survey and 10 daily surveys (929 completed surveys) assessing their daily food and beverage offerings at dinner. On average, parents did not offer recommended foods and beverages on a daily basis; parents offered vegetables and protein most often across the 10 days, however, less than 50% of parents offered the recommended serving size for each group. The intraclass correlations and random sampling plots revealed considerable within-parent variation in food and beverage offerings. Eating dinner as a family, planning dinner in advance, and preparing a homemade dinner were associated with more vegetable and protein offerings, while processed, fast, or fried foods were offered less often when dinner was planned or homemade. Dairy, water, and refined grains were offered more often when dinner was homemade, while whole grains, processed, fast, or fried foods, and sugar-sweetened beverages were offered less often when dinner was homemade. The results provide documentation of parents' daily food and beverage offerings at dinner within the context of COVID-19 and point towards the importance of examining predictors and consequences of parents' daily feeding practices.

β-Galactosidase therapy can mitigate blood galactose elevation after an oral lactose load in galactose mutarotase deficiency

Galactose mutarotase (GALM) deficiency (MIM# 618881), also known as type IV galactosemia, is caused by biallelic pathogenic variants of GALM. Cataracts are observed in patients with GALM deficiency as well as in other conditions associated with high levels of blood galactose and can be prevented by consuming a galactose-restricted diet or formula. Galactose restriction is the only known treatment for GALM deficiency and other types of galactosemia. We incidentally found that β-galactosidase might reduce blood galactose levels caused by lactose loading in GALM deficiency. Consequently, we investigated the effectiveness of β-galactosidase in decreasing the level of blood galactose in three patients with GALM deficiency. We performed two lactose loading tests per case: one with and one without β-galactosidase. The add-on administration of β-galactosidase significantly mitigated blood galactose elevations after lactose loading. Although urine galactitol was mildly elevated in all patients with GALM deficiency, β-galactosidase did not prevent increased levels of urine galactitol during the loading tests. No adverse events, including cataracts, were observed during or after the tests. Therefore, β-galactosidase could be a potential novel treatment agent for blood galactose elevation caused by lactose in patients with GALM deficiency. The effectiveness of β-galactosidase could possibly result in loosening of the galactose dietary restrictions or treatment for patients with GALM deficiency.

Types and Aspects of Front-of-Package Labeling Preferred by Parents: Insights for Policy Making in China

The WHO recommends front-of-package labeling (FOPL) to help parents make healthier food choices for their children. But which type of FOPL resonates with parents in China? We performed a cross-sectional study to investigate parental preferences for five widely used formats of FOPL. A multi-stage cluster sampling method was applied to selected parents of students in primary and secondary schools in six provinces and municipalities from July 2020 to March 2021. A close-ended questionnaire was used to collect demographic information, parents’ preferences for five FOPL in three dimensions, perceptions of the importance of nutrients labeled on FOPL, and prepackaged foods that need FOPL most. Chi-square tests were used to examine the characteristics among five groups. The results showed that multiple traffic lights (MTL) was preferred by parents, followed by warning labels. Parents thought the most needed nutrients to label were sugar, salt, and total fat. The top three prepackaged foods to label were “baked food”, “milk and dairy products” and “sugar-sweetened beverages”. Our findings indicate that nutrient-specific FOPL formats with interpretive aids were preferred by Chinese parents. These new findings can help inform the planning and implementation of FOPL in China and help Chinese parents make healthier food choices.

Time trend estimation of food consumption in repeated studies with different versions of food questionnaire among Brazilian schoolchildren aged 7 to 11 years

Abstract Longitudinal study, whose objective was to evaluate of the time trend in food consumption across the 2002-2015 period in schoolchildren aged 7 to 11 years, covered five food surveys in Florianopolis, southern Brazil. Methodological differences across the surveys (typical vs. previous day food consumption, pen-and-paper versus computer screen presentation) and some known risk factors, were adjusted for statistically. Offset by maximum food/beverage consumption per day allowed comparability of a varying number of food components in a food group over survey years. Significant reduction in some healthy (fruits and animal proteins) and unhealthy diet markers (sodas, sugary drinks, sweets) was observed over the 2013-2015 period compared with the 2002 and 2007 data. Computer screen presentation of the food questionnaire systematically reduced the reporting frequency compared to the pen-and-paper presentation. Converting frequency reports into rates and using contrast analysis allowed time trend estimation based on food questionnaires with different presentation modes, varying number of items within food group over survey years, and variations in probabilistic sampling procedures.

The Diet of Children Attending a Holiday Programme in the UK: Adherence to UK Food-Based Dietary Guidelines and School Food Standards

Child poverty rates are rising, particularly in London, putting more children at risk of experiencing food insecurity. Holiday programmes in the UK provide children who receive free schools meals during term time with access to free/low-cost holiday clubs offering nutritious food and enriching activities during the school holidays. This study aimed to investigate whether children’s dietary intake was more adherent to the UK Eatwell Guide throughout the day and meets School Food Standards (SFS) for the lunchtime meal on a club attendance versus a non-attendance day. A repeated measures design was used to assess data on the food and drink intake of children (n = 57) aged 7–16 years old using a 24 h recall method on two separate occasions: once based on an attending club day and once based on a non-attending club day. The results showed children’s diet quality improved (p = 0.007) on an attending club day (mean: 58.0 ± SD 12.6) versus a non-attending club day (51.8 ± 15.0). Children also more closely adhered to the SFS (p = 0.001) on an attending club day (median = 9, interquartile range = 8–9) versus a non-attending club day (median = 7, interquartile range = 6–8). This suggests that holiday programmes targeting children who receive free school meals during term time have the potential to improve children’s dietary behaviours during the school holidays, underlining the importance of holiday programmes to support food security.

Nutrition in Patients with Lactose Malabsorption, Celiac Disease, and Related Disorders

Lactose malabsorption (LM), celiac disease (CD), non-celiac gluten sensitivity (NCGS), and irritable bowel syndrome (IBS) are conditions associated with food triggers, improvement after withdrawal, treatment with dietary restriction, and subsequent nutritional detriments. LM occurs when there is incomplete hydrolysis of lactose due to lactase deficiency and frequently produces abdominal symptoms; therefore, it can cause lactose intolerance (LI). A lactose-restricted diet is frequently recommended, although it can potentially lead to nutrient deficiencies. Furthermore, lactose is an essential component of fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) and is subsequently associated with intolerance to these compounds, especially in IBS. LM commonly presents in CD. Nutritional deficits are common in CD and can continue even on a gluten-free diet (GFD). Conditions triggered by gluten are known as gluten-related disorders (GRDs), including CD, wheat allergy, and NCGS. IBS can also be associated with a gluten sensitivity. A GFD is the treatment for CD, GRDs, and gluten sensitive IBS, although compliance with this restricted diet can be difficult. Strict dietary therapies can have a negative effect on quality of life. This review aims to provide an overview of the difficult nutritional elements of these disorders, which are critical for medical providers to recognize when managing these patients.