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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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Serbis A, Polyzos SA, Paschou SA, Siomou E, Kiortsis DN. Diet, exercise, and supplements: what is their role in the management of the metabolic dysfunction-associated steatotic liver disease in children? Endocrine 2024:10.1007/s12020-024-03783-7. [PMID: 38519764 DOI: 10.1007/s12020-024-03783-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/13/2024] [Indexed: 03/25/2024]
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease (NAFLD), is the main cause of chronic liver disease in children and adolescents. Indeed, epidemiological studies have shown that MASLD affects up to 40% of children with obesity. Despite the recent approval of medications that target weight loss in adolescents that could have benefits on pediatric MASLD, lifestyle interventions, such as diet and exercise, remain the mainstay of our therapeutic approach. More specifically, studies on diet alone have focused on the possible role of carbohydrate or fat restriction, albeit without a definite answer on the best approach. Weight loss after dietary intervention in children with obesity and MASLD has a beneficial effect, regardless of the diet used. In relation to the role of exercise in MASLD reversal, indirect evidence comes from studies showing that a sedentary lifestyle leading to poor fitness, and low muscle mass is associated with MASLD. However, research on the direct effect of exercise on MASLD in children is scarce. A combination of diet and exercise seems to be beneficial with several studies showing improvement in surrogate markers of MASLD, such as serum alanine aminotransferase and hepatic fat fraction, the latter evaluated with imaging studies. Several dietary supplements, such as vitamin E, probiotics, and omega-3 fatty acid supplements have also been studied in children and adolescents with MASLD, but with equivocal results. This review aims to critically present available data on the effects of lifestyle interventions, including diet, exercise, and dietary supplements, on pediatric MASLD, thus suggesting a frame for future research that could enhance our knowledge on pediatric MASLD management and optimize clinicians' approach to this vexing medical condition.
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Affiliation(s)
- Anastasios Serbis
- Department of Pediatrics, School of Medicine, University of Ioannina, Ioannina, Greece.
| | - Stergios A Polyzos
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavroula A Paschou
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ekaterini Siomou
- Department of Pediatrics, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Dimitrios N Kiortsis
- Laboratory of Physiology, Medical School, University of Ioannina, Ioannina, Greece
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Capra ME, Biasucci G, Banderali G, Vania A, Pederiva C. Diet and Lipid-Lowering Nutraceuticals in Pediatric Patients with Familial Hypercholesterolemia. CHILDREN (BASEL, SWITZERLAND) 2024; 11:250. [PMID: 38397362 PMCID: PMC10887291 DOI: 10.3390/children11020250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/02/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024]
Abstract
Familial hypercholesterolemia is a genetically determined disease characterized by elevated plasma total and LDL cholesterol levels from the very first years of life, leading to early atherosclerosis. Nutritional intervention is the first-line treatment, complemented with nutraceuticals and drug therapy when necessary. Nutraceuticals with a lipid-lowering effect have been extensively studied in the past few decades, and have been recently included in international guidelines as a complement to nutritional and pharmacological treatment in subjects with dyslipidemia. In this review, we explore current nutritional interventions for dyslipidemia in childhood, with a specific focus on the main nutraceuticals studied for treating severe dyslipidemia in pediatric patients. Additionally, we briefly describe their primary mechanisms of action and highlight the advantages and risks associated with the use of lipid-lowering nutraceuticals in childhood.
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Affiliation(s)
- Maria Elena Capra
- Centre for Pediatric Dyslipidemias, Pediatrics and Neonatology Unit, University of Parma, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy; (M.E.C.); (G.B.)
- Department of Translational Medical and Surgical Sciences, University of Parma, 43126 Parma, Italy
| | - Giacomo Biasucci
- Centre for Pediatric Dyslipidemias, Pediatrics and Neonatology Unit, University of Parma, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy; (M.E.C.); (G.B.)
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Giuseppe Banderali
- Clinical Service for Dyslipidemias, Study and Prevention of Atherosclerosis in Childhood, Pediatrics Unit, ASST-Santi Paolo e Carlo, 20142 Milan, Italy; (G.B.); (C.P.)
| | - Andrea Vania
- Independent Researcher, Member of SINUPE (Italian Society of Pediatric Nutrition) Directory Board, 00162 Rome, Italy
| | - Cristina Pederiva
- Clinical Service for Dyslipidemias, Study and Prevention of Atherosclerosis in Childhood, Pediatrics Unit, ASST-Santi Paolo e Carlo, 20142 Milan, Italy; (G.B.); (C.P.)
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Dedhia K, Li Y, Stallings VA, Germiller J, Giordano T, Dailey J, Kong M, Durkin A, Legg-Jack I, Nessen S, Schapira MM. Association of Diet Patterns and Post-Operative Tympanostomy Tube Otorrhea: A Pilot Study. Laryngoscope 2023; 133:3575-3581. [PMID: 36960887 DOI: 10.1002/lary.30672] [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: 11/15/2022] [Revised: 02/21/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVE The objective of this study was to explore diet patterns in children with tympanostomy tube placement (TTP) complicated by postoperative tympanostomy tube otorrhea. STUDY DESIGN Cross-sectional survey and retrospective cohort study. METHODS Caregivers of children (0-12 years old), at a tertiary-care pediatric hospital who underwent TTP within 6 months to 2 years prior to enrollment were included. Children with a history of Down syndrome, cleft palate, craniofacial syndromes, known immunodeficiency, or a non-English-speaking family were excluded. Our primary outcome variable was the number of otorrhea episodes. The primary predictor was diet patterns, particularly dessert intake, which was captured through a short food questionnaire. RESULTS A total of 286 participants were included in this study. The median age was 1.8 years (IQR, 1.3, 2.9). A total of 174 (61%) participants reported at least one episode of otorrhea. Children who consumed dessert at least two times per week had a higher risk of otorrhea compared to children who consumed one time per week or less (odds ratio [OR], 3.22, 95% Confidence Interval [CI]: 1.69, 6.12). The odds ratio increase continued when considering more stringent criteria for otorrhea (multiple episodes or one episode occurring 4 weeks after surgery), with a 2.33 (95% CI: 1.24, 4.39) higher odds of otorrhea in children with dessert intake at least 2 times per week. CONCLUSIONS Our pilot data suggest that episodes of otorrhea among children with TTP were associated with more frequent dessert intake. Future studies using prospectively administered diet questionnaires are necessary to confirm these findings. LEVEL OF EVIDENCE 4 Laryngoscope, 133:3575-3581, 2023.
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Affiliation(s)
- Kavita Dedhia
- Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A
- Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Yun Li
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
- Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
- University of Pennsylvania Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Virginia A Stallings
- Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
| | - John Germiller
- Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A
- Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Terri Giordano
- Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A
| | - Julia Dailey
- Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A
| | - Maria Kong
- Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A
| | - Alexandra Durkin
- Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A
| | - Ibikari Legg-Jack
- University of Pennsylvania Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Sarah Nessen
- University of Pennsylvania Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Marilyn M Schapira
- Department of Internal Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
- Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, Pennsylvania, U.S.A
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Zuo C, Ma X, Yang Y, Cui Y, Ye C. School-based high-intensity interval exercise program in children with overweight induce a greater improvements in body composition and physical fitness than moderate-intensity continuous exercise. BMC Public Health 2023; 23:2210. [PMID: 37946224 PMCID: PMC10633982 DOI: 10.1186/s12889-023-17149-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND High-intensity interval running exercise (HIIE) is emerging as a time-efficient exercise modality for improving body composition and fitness in comparison with moderate-intensity continuous aerobic exercise (MICE); however, existing evidence is still unclear in children with overweight and thus we compared the effects of HIIE and MICE on body composition, muscular, and cardiorespiratory fitness in children with overweight. METHODS In this randomized study, 40 male children with overweight aged 7-10 years were divided into an 8-week exercise regime: (1) HIIE group [n = 20; 2 sets of 15 × 20s at 85-95% maximal aerobic speed (MAS) separated by 15 × 20s recovery at 50% MAS, 3 days per week] and (2) MICE group [n = 20; 30 min at 60-70% MAS, 3 days per week]. Body composition, muscular and cardiorespiratory fitness were assessed before and after the 8-week intervention at similar times and conditions of the day. RESULTS Following the 8-week HIIE protocol, weight, BMI, and fat mass decreased significantly (weight: - 1.4% vs. 0.2%, p < 0.05; BMI: - 3.1% vs. - 0.7%, p < 0.05; fat mass: - 7.7% vs. - 1.6%, p < 0.01) as compared with MICE; while the VO2peak and MAS increased significantly in both groups, the increase in HIIE group was significantly greater than that of MICE group (VO2peak: 10.3% vs. 3.5%, p < 0.01; MAS:7.7% vs. 4.5%, p < 0.05). Although significant improvements in muscular fitness were observed in HIIE and MICE groups [counter movement jump (CMJ): 7.8% vs. 5.4%; sprinting ability: - 3.7% vs. - 1.7%], no significant differences were seen between them (p > 0.05). CONCLUSION Our findings suggested that school-based HIIE intervention was highly in improving body composition and cardiorespiratory fitness of children with overweight than the MICE regime; however, MICE still provided improvements over time that were just not to the same magnitude of HIIE.
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Affiliation(s)
- Chongwen Zuo
- Air Force Medical Center of Chinese PLA, Beijing, 100142, China
- School of Kinesiology and Health, Capital University of Physical Education and Sports, Beijing, 100191, China
| | - Xiaoyan Ma
- Key Laboratory of Smart Grid of Ministry of Education, Tianjin University, Tianjin, 300072, China
| | - Yuan Yang
- Beihang University, Beijing, 100191, China
| | - Yupeng Cui
- School of Kinesiology and Health, Capital University of Physical Education and Sports, Beijing, 100191, China
| | - Chaoqun Ye
- Air Force Medical Center of Chinese PLA, Beijing, 100142, China.
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Paglialonga F, Shroff R, Zagozdzon I, Bakkaloglu SA, Zaloszyc A, Jankauskiene A, Gual AC, Consolo S, Grassi MR, McAlister L, Skibiak A, Yazicioglu B, Puccio G, Edefonti A, Ariceta G, Aufricht C, Holtta T, Klaus G, Ranchin B, Schmitt CP, Snauwaert E, Stefanidis C, Walle JV, Stabouli S, Verrina E, Vidal E, Vondrak K, Zurowska A. Sodium intake and urinary losses in children on dialysis: a European multicenter prospective study. Pediatr Nephrol 2023; 38:3389-3399. [PMID: 36988689 DOI: 10.1007/s00467-023-05932-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/06/2023] [Accepted: 02/26/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Sodium (Na) balance is unexplored in dialyzed children. We assessed a simplified sodium balance (sNaB) and its correlates in pediatric patients receiving maintenance dialysis. METHODS Patients < 18 years old on hemodialysis (HD) or peritoneal dialysis (PD) in six European Pediatric Dialysis Working Group centers were recruited. sNaB was calculated from enteral Na, obtained by a 3-day diet diary, Na intake from medications, and 24-h urinary Na (uNa). Primary outcomes were systolic blood pressure and diastolic blood pressure standard deviation scores (SBP and DBP SDS), obtained by 24-h ambulatory blood pressure monitoring or office BP according to age, and interdialytic weight gain (IDWG). RESULTS Forty-one patients (31 HD), with a median age of 13.3 (IQR 5.2) years, were enrolled. Twelve patients (29.3%) received Na-containing drugs, accounting for 0.6 (0.7) mEq/kg/day. Median total Na intake was 1.5 (1.1) mEq/kg/day, corresponding to 60.6% of the maximum recommended daily intake for healthy children. Median uNa and sNaB were 0.6 (1.8) mEq/kg/day and 0.9 (1.7) mEq/kg/day, respectively. The strongest independent predictor of sNaB in the cohort was urine output. In patients receiving HD, sNaB correlated with IDWG, pre-HD DBP, and first-hour refill index, a volume index based on blood volume monitoring. sNaB was the strongest predictor of IDWG in multiple regression analysis (β = 0.63; p = 0.005). Neither SBP SDS nor DBP SDS correlated with sNaB. CONCLUSIONS Na intake is higher than uNa in children on dialysis, and medications may be an important source of Na. sNaB is best predicted by urine output in the population, and it is a significant independent predictor of IDWG in children on HD. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Fabio Paglialonga
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy.
| | - Rukshana Shroff
- University College London Great Ormond Street Hospital for Children and Institute of Child Health, London, UK
| | - Ilona Zagozdzon
- Department of Pediatrics Nephrology & Hypertension, Medical University of Gdansk, Gdansk, Poland
| | | | - Ariane Zaloszyc
- Department of Pediatric Nephrology, Hopital de Hautepierre, Strasbourg, France
| | - Augustina Jankauskiene
- Pediatric Center, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Alejandro Cruz Gual
- Department of Pediatric Nephrology, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Silvia Consolo
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy
| | - Maria Rosa Grassi
- Department of Clinical Sciences and Community Health, University of Milano, Milan, Italy
| | - Louise McAlister
- University College London Great Ormond Street Hospital for Children and Institute of Child Health, London, UK
| | - Aleksandra Skibiak
- Department of Pediatrics Nephrology & Hypertension, Medical University of Gdansk, Gdansk, Poland
| | - Burcu Yazicioglu
- Department of Pediatric Nephrology, Gazi University, Ankara, Turkey
| | - Giuseppe Puccio
- Department of Sciences for Health Promotion, University of Palermo, Palermo, Italy
| | - Alberto Edefonti
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy
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Neyman A, Hannon TS. Low-Carbohydrate Diets in Children and Adolescents With or at Risk for Diabetes. Pediatrics 2023; 152:e2023063755. [PMID: 37718964 DOI: 10.1542/peds.2023-063755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 09/19/2023] Open
Abstract
Carbohydrate restriction is increasingly popular as a weight loss strategy and for achieving better glycemic control in people with diabetes, including type 1 and type 2 diabetes. However, evidence to support low-carbohydrate diets in youth (children and adolescents 2-18 years of age) with obesity or diabetes is limited. There are no guidelines for restricting dietary carbohydrate consumption to reduce risk for diabetes or improve diabetes outcomes in youth. Thus, there is a need to provide practical recommendations for pediatricians regarding the use of low-carbohydrate diets in patients who elect to follow these diets, including those with type 1 diabetes and for patients with obesity, prediabetes, and type 2 diabetes. This clinical report will: Provide background on current dietary patterns in youth, describe how moderate-, low-, and very low-carbohydrate diets differ, and review safety concerns associated with the use of these dietary patternsReview the physiologic rationale for carbohydrate reduction in youth with type 1 diabetes and for youth with obesity, prediabetes, and type 2 diabetesReview the evidence for low-carbohydrate diets in the management of youth with type 1 diabetesReview the evidence for low-carbohydrate diets in the management of youth with obesity, prediabetes, and type 2 diabetesProvide practical information for pediatricians counseling families and youth on carbohydrate recommendations for type 1 diabetes and for obesity, prediabetes, and type 2 diabetes.
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Affiliation(s)
- Anna Neyman
- Indiana University School of Medicine, Riley Children's Hospital, Indianapolis, Indiana
| | - Tamara S Hannon
- Indiana University School of Medicine, Riley Children's Hospital, Indianapolis, Indiana
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Reynolds LAF, McCaffery H, Appugliese D, Kaciroti NA, Miller AL, Rosenblum KL, Gearhardt AN, Lumeng JC. Capacity for Regulation of Energy Intake in Infancy. JAMA Pediatr 2023; 177:590-598. [PMID: 37067796 PMCID: PMC10111233 DOI: 10.1001/jamapediatrics.2023.0688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 02/24/2023] [Indexed: 04/18/2023]
Abstract
Importance The capacity for regulation of energy intake (REI) to match energy needs is thought to contribute to differences in weight gain, and preventing excess infant weight gain is a priority. Objective To determine capacity for REI across infancy. Design, Setting, and Participants For this cohort study, a convenience sample of mother-infant dyads was recruited from the community in Michigan between 2015 and 2019. Inclusion criteria were healthy, full-term infants with weight appropriate for gestational age; biological mothers who were 18 years or older, English speaking, and a legal and custodial guardian; and infant having had consumed 2 oz or more in 1 feeding from an artificial nipple at least once per week. Infants were followed in the home setting with staff support for up to 12 months. Interventions Mother-infant dyads participated at infant age 1, 2.5, 5, 7, 10, and 12 months. In the intervention condition, mothers offered a feeding every hour for 6 hours. In the control condition, mothers fed infants as they typically would for 6 hours. Intake was recorded and kilocalories calculated. Main Outcomes and Measures Capacity for REI was indexed as the difference in intake in kilocalories per kilogram of body weight (intervention minus control condition); a value of 0 indicated perfect REI. Maternal and infant characteristics were obtained by questionnaire, and anthropometry was measured. Using multiple imputation, the intercept and slope for difference in kilocalories per kilogram across the 6 age points were estimated using mixed models accounting for repeated measures within participants. Statistical analyses were conducted between September 2021 and February 2023. Results The sample included 175 infants (87 [49.71%] female, 88 [50.29%] male; 494 pairs of intervention and control conditions and 4630 feedings). The mean (SD) 12-month weight-for-age z score was 0.1 (0.8). Mean (SD) gestational age as 39.55 (1.05) weeks, and mean (SD) birth weight was 3.43 (0.41) kg. Mean (SD) breastfeeding duration for those who reported stopping by 12 months was 17.83 (12.03) weeks. As designed, the intervention (compared with control) condition included more feedings at shorter intervals. After collapsing the data across age points in a mixed model accounting for repeated measures within participants, the REI estimate at 1 month differed from 0. On average, infants ate 5.21 kcal/kg (95% CI, 2.89-7.54 kcal/kg) more in the frequent feeding intervention condition than in the ad lib feeding control condition. This difference did not significantly change over 12 months of infancy (REI slope = -0.01 kcal/kg per month; 95% CI, -0.02 to 0.03 kcal/kg per month). Conclusions and Relevance The study's findings suggested that, on average, when offered more frequent feedings, healthy, full-term infants may overeat. The results provide support for responsive feeding as a strategy for preventing excess infant weight gain.
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Affiliation(s)
- Lyndsey A. F. Reynolds
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | - Harlan McCaffery
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | | | - Niko A. Kaciroti
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Alison L. Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
| | | | | | - Julie C. Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
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Herrera-Ramos E, Tomaino L, Sánchez-Villegas A, Ribas-Barba L, Gómez SF, Wärnberg J, Osés M, González-Gross M, Gusi N, Aznar S, Marín-Cascales E, González-Valeiro MÁ, Terrados N, Tur JA, Segú M, Fitó M, Homs C, Benavente-Marín JC, Labayen I, Zapico AG, Sánchez-Gómez J, Jiménez-Zazo F, Alcaraz-Ramón PE, Sevilla-Sanchez M, Pulgar-Muñoz S, Bouzas C, Sistac-Sorigué C, Schröder H, Serra-Majem L. Trends in Adherence to the Mediterranean Diet in Spanish Children and Adolescents across Two Decades. Nutrients 2023; 15:nu15102348. [PMID: 37242233 DOI: 10.3390/nu15102348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/28/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
Unhealthy dietary habits determined during childhood may represent a risk factor to many of the chronic non-communicable diseases (NCDs) in adulthood. Mediterranean Diet (MD) adherence in children and adolescents (8-16 years) living in Spain was investigated using the KIDMED questionnaire in a comparative analysis of two cross-sectional nationwide representative studies: enKid (1998-2000, n = 1001) and PASOS (2019-2020, n = 3540). Taking into account the educational level of pupils, as well as the characteristics of the place of living, a significant association was found between a KIDMED score ≥ 8 (optimal MD adherence) and primary education as well as residency in an area of <50,000 inhabitants, while living in the southern regions was associated with non-optimal MD adherence (p < 0.001). Participants of the 2019-2020 study showed an increase in the consumption of dairy products (31.1% increase), pasta/rice (15.4% increase), olive oil (16.9% increase), and nuts (9.7% increase), as well as a decreased sweets and candies intake (12.6% reduction). In contrast, a significantly lower MD adherence was found when comparing the 2019-2020 (mean ± SE: 6.9 ± 0.04) and the 1998-2000 study (7.37 ± 0.08); p < 0.001), due to less consumption of fish (20.3% reduction), pulse (19.4% reduction), and fruits (14.9% reduction), and an increased intake of commercial goods/pastries or fast-food intake (both 19.4% increase). The lowest adherence was recorded for adolescents also in the most recent study, where 10.9% of them presented a KIDMED score ≤ 3. This study shows that eating habits are deteriorating among Spanish children and adolescents. Such findings point out the urgency of undertaking strong measures to promote the consumption of healthy, sustainable, and non-ultra-processed food, such as those available in an MD, not only at a scientific and academic level, but also at a governmental one.
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Affiliation(s)
- Estefanía Herrera-Ramos
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
| | - Laura Tomaino
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
| | - Almudena Sánchez-Villegas
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- IS-FOOD-Institute for Sustainability & Food Chain Innovation, Universidad Pública de Navarra (UPNA), IDISNA, 31006 Pamplona, Spain
| | - Lourdes Ribas-Barba
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- Fundación para la Investigación Nutricional (FIN), Barcelona Science Park, 08028 Barcelona, Spain
| | - Santiago F Gómez
- Gasol Foundation, Sant Boi de Llobregat, 08830 Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, 28029 Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
- GREpS, Health Education Research Group, Nursing and Physiotherapy Department, University of Lleida, 25008 Lleida, Spain
| | - Julia Wärnberg
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- EpiPHAAN Research Group, School of Health Sciences, Instituto de Investigación Biomédica en Málaga (IBIMA), University of Málaga, 29590 Málaga, Spain
| | - Maddi Osés
- IS-FOOD-Institute for Sustainability & Food Chain Innovation, Universidad Pública de Navarra (UPNA), IDISNA, 31006 Pamplona, Spain
| | - Marcela González-Gross
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politecnica de Madrid, 28003 Madrid, Spain
| | - Narcis Gusi
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Susana Aznar
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha-Toledo Campus, 45071 Toledo, Spain
- Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain
| | - Elena Marín-Cascales
- Research Center for High Performance Sport, Catholic University of Murcia, 30107 Murcia, Spain
- Facultad de Deporte, UCAM Universidad Católica de Murcia, 30107 Murcia, Spain
| | | | - Nicolás Terrados
- Regional Unit of Sports Medicine-Municipal Sports Foundation of Avilés, 33402 Avilés, Spain
- Health Research Institute of the Principality of Asturias (ISPA), 33011 Oviedo, Spain
| | - Josep A Tur
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- Research Group of Community Nutrition & Oxidative Stress, IUNICS, University of the Balearic Islands, 07122 Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IDISBA), 07122 Palma de Mallorca, Spain
| | - Marta Segú
- Probitas Foundation, 08022 Barcelona, Spain
| | - Montserrat Fitó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Clara Homs
- Gasol Foundation, Sant Boi de Llobregat, 08830 Barcelona, Spain
- Global Research on Wellbeing (GroW), Faculty of Health Sciences, Blanquerna Ramon Llull University, 08025 Barcelona, Spain
| | - Juan Carlos Benavente-Marín
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- EpiPHAAN Research Group, School of Health Sciences, Instituto de Investigación Biomédica en Málaga (IBIMA), University of Málaga, 29590 Málaga, Spain
| | - Idoia Labayen
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- IS-FOOD-Institute for Sustainability & Food Chain Innovation, Universidad Pública de Navarra (UPNA), IDISNA, 31006 Pamplona, Spain
| | - Augusto G Zapico
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politecnica de Madrid, 28003 Madrid, Spain
- Department of Language, Arts and Physical Education, Universidad Computense de Madrid, 28040 Madrid, Spain
| | - Jesús Sánchez-Gómez
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Fabio Jiménez-Zazo
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha-Toledo Campus, 45071 Toledo, Spain
| | - Pedro Emilio Alcaraz-Ramón
- Research Center for High Performance Sport, Catholic University of Murcia, 30107 Murcia, Spain
- Facultad de Deporte, UCAM Universidad Católica de Murcia, 30107 Murcia, Spain
| | - Marta Sevilla-Sanchez
- Faculty of Sports Sciences and Physical Education, Universida de da Coruña, 15001 A Coruña, Spain
| | - Susana Pulgar-Muñoz
- Regional Unit of Sports Medicine-Municipal Sports Foundation of Avilés, 33402 Avilés, Spain
- Health Research Institute of the Principality of Asturias (ISPA), 33011 Oviedo, Spain
| | - Cristina Bouzas
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- Research Group of Community Nutrition & Oxidative Stress, IUNICS, University of the Balearic Islands, 07122 Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IDISBA), 07122 Palma de Mallorca, Spain
| | | | - Helmut Schröder
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, 28029 Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Lluis Serra-Majem
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- Preventive Medicine Service, Canarian Health Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), 35016 Las Palmas de Gran Canaria, Spain
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10
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Leed A, Sheridan E, Baker B, Bamford S, Emmanouilidis E, Stewart F, Ostafe K, Sarwari M, Lim K, Zheng M, Islam SMS, Bolton KA, Grimes CA. Dietary Intake and Arterial Stiffness in Children and Adolescents: A Systematic Review. Nutrients 2023; 15:2092. [PMID: 37432233 DOI: 10.3390/nu15092092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 07/12/2023] Open
Abstract
Arterial stiffness is a risk factor for cardiovascular disease that is affected by diet. However, research understanding how these dietary risk factors are related to arterial stiffness during childhood is limited. The purpose of this review was to determine whether various dietary factors were associated with arterial stiffness in the pediatric population. Five databases were systematically searched. Intervention studies, cross-sectional and cohort studies were included that investigated nutrient or food intake and outcomes of arterial stiffness, primarily measured by pulse wave velocity (PWV) and augmentation index (AIx), in the pediatric population (aged 0-18 years). A final 19 studies (six intervention and 13 observational) were included. Only two intervention studies, including a vitamin D and omega-3 supplementation trial, found protective effects on PWV and AIx in adolescents. Findings from observational studies were overall inconsistent and varied. There was limited evidence to indicate a protective effect of a healthy dietary pattern on arterial stiffness and an adverse effect of total fat intake, sodium intake and fast-food consumption. Overall, results indicated that some dietary factors may be associated with arterial stiffness in pediatric populations; however, inconsistencies were observed across all study designs. Further longitudinal and intervention studies are warranted to confirm the potential associations found in this review.
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Affiliation(s)
- Allanah Leed
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Emma Sheridan
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Brooke Baker
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Sara Bamford
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Elana Emmanouilidis
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Fletcher Stewart
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Kristen Ostafe
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Mustafa Sarwari
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Karen Lim
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Kristy A Bolton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Carley A Grimes
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
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11
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Bae SR, Bicki A, Coufal S, Jin E, Ku E. Cardiovascular disease risk factors and lifestyle modification strategies after pediatric kidney transplantation: what are we dealing with, and what can we target? Pediatr Nephrol 2023; 38:663-671. [PMID: 35552523 PMCID: PMC10799690 DOI: 10.1007/s00467-022-05589-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 01/19/2023]
Abstract
Kidney transplantation in pediatric patients can lead to partial improvement of some of the cardiometabolic parameters that increase the risk for cardiovascular disease (CVD) in patients with chronic kidney disease. However, even after restoration of kidney function, transplant recipients remain at risk for CVD due to the continual presence of traditional and non-traditional risk factors, including the side effects of immunosuppression and chronic inflammation. This educational review describes the prevalence of CVD risk factors in pediatric kidney transplant recipients and presents available evidence for therapeutic lifestyle changes and other non-pharmacologic strategies that can be used to improve traditional and modifiable CVD risk factors. Although trial-grade evidence for interventions that improve CVD in pediatric kidney transplant recipients is limited, potential strategies include lowering dietary sodium and saturated fat intake and increasing physical activity levels. Intensive follow-up may help patients achieve guideline-recommended goals for reducing their overall CVD risk.
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Affiliation(s)
- Se Ri Bae
- University of California, Davis, School of Medicine, Sacramento, CA, USA
| | - Alexandra Bicki
- Division of Pediatric Nephrology, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
| | - Sarah Coufal
- Division of Nephrology, Department of Medicine and Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Ethan Jin
- College of Osteopathic Medicine, Touro University, Vallejo, CA, USA
| | - Elaine Ku
- Division of Pediatric Nephrology, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
- Division of Nephrology, Department of Medicine and Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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12
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McConnell-Nzunga J, Gabel L, Macdonald HM, Rhodes RE, Hofer SM, Naylor PJ, McKay HA. A 4-Yr Mixed Longitudinal Study of Health Behaviors and Fat Mass Accrual during Adolescence and Early Adulthood. Med Sci Sports Exerc 2022; 54:2178-2187. [PMID: 35868009 DOI: 10.1249/mss.0000000000003003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Physical activity (PA), sedentary time (SED), and energy intake (EI) are associated with fat mass accrual in children and youth. Previous studies relied primarily on cross-sectional designs and proxy measures of body composition such as body mass index. We aimed to prospectively investigate associations between PA, SED, EI, and total body fat mass accrual using dual-energy x-ray absorptiometry. METHODS This analysis of the mixed longitudinal Healthy Bones III Study included data from 312 participants (138 boys age 9 to 21 yr at baseline). For each participant, we acquired a maximum of four annual total body dual-energy x-ray absorptiometry scans from which we determined fat mass (in kilograms; n = 748 observations). We assessed total PA, moderate-to-vigorous PA (MVPA) and SED with accelerometers (ActiGraph GT1M) and measured EI via 24-h dietary recall. We fit sex-specific multilevel models adjusting for maturity (years from age at peak height velocity (APHV)), weight status, ethnicity, total PA, MVPA, SED, and EI. RESULTS Boys and girls demonstrated divergent trajectories of fat mass accrual; rate of fat mass accrual in girls was four times greater than boys at APHV and increased across adolescence, whereas boys' fat mass plateaued after APHV. In boys, within-person change in MVPA negatively predicted fat mass independent of SED; each annual increase in MVPA of 6 min·d -1 was associated with a 0.21-kg lower fat mass. In girls, between-person average MVPA negatively predicted fat mass accrual independent of SED; greater MVPA of 4 min·d -1 across adolescence was associated with a 0.31-kg lower fat mass. CONCLUSIONS MVPA demonstrates an independent and negative effect on fat mass in boys and girls. Given different trajectories of fat mass accrual and movement behaviors between boys and girls, PA interventions aimed at preventing obesity in youth may benefit from a sex and gendered approach.
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Affiliation(s)
- Jennifer McConnell-Nzunga
- Social Dimensions of Health, University of Victoria, Interdisciplinary Programs, Victoria, BC, CANADA
| | - Leigh Gabel
- Faculty of Kinesiology, University of Calgary, Calgary, AB, CANADA
| | | | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, CANADA
| | - Scott M Hofer
- Department of Psychology, University of Victoria, Victoria, BC, CANADA
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, CANADA
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13
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Rossi L, Martone D, Piccinelli R, Buonocore P, Ghiselli A. Considerations for the translation of nutrient recommendations as dietary plans for infants, children, and adolescents as reported in Italian Guidelines for healthy eating. Front Nutr 2022; 9:935963. [PMID: 36091229 PMCID: PMC9452650 DOI: 10.3389/fnut.2022.935963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/29/2022] [Indexed: 11/30/2022] Open
Abstract
Healthy eating in childhood and adolescence is important for proper growth and development and to establish a healthy foundation for future dietary habits. This paper aims to describe the elaboration of dietary plans for pediatric ages highlighting critical points related to the application of the Italian nutrient recommendations. National databases on food composition data were used to compile the dietary plans. Starting from the definition of serving size for adults, the suggested portion size for pediatric ages was shaped to produce appropriate dietary plans according to the different classes of age. Items from “cereals and derivatives,” “milk,” “fruit,” “vegetables,” “olive oil,” and “water” groups were included daily. Pizza was included once a week. Sweets and snacks were gradually introduced, once a week in infants and up to five times a week in adolescents. Legumes were provided three times a week, as a source of vegetable and sustainable proteins. The main critical aspect of the dietary plans was related to the monotony, especially for snacks and breakfasts. This work demonstrated the limits of the translation of Italian nutrient recommendations into dietary plans for pediatric age groups. Keeping the protein intake in the recommended range of 8–12% of daily energy resulted in inadequate provision of calcium and iron. Other critical points were the reference values for body weight and physical activity. The proposed dietary plans are adequate with regard to food composition, the intake of energy and several nutrients, and in terms of food selection. However, their implementations require action, information, and advocacy.
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14
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Tong J, An X, Zhao L, Qu P, Tang X, Chen M, Liang X. Combining multiaspect factors to predict the risk of childhood hypertension incidence. J Clin Hypertens (Greenwich) 2022; 24:1015-1025. [PMID: 35866196 PMCID: PMC9380136 DOI: 10.1111/jch.14544] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/07/2022] [Accepted: 06/23/2022] [Indexed: 12/03/2022]
Abstract
Childhood hypertension has become a global public health issue due to its increasing prevalence and association with cerebral‐cardiovascular disease in adults. In this study, we developed a predictive model for childhood hypertension based on environmental and genetic factors to identify at‐risk individuals. Eighty children diagnosed with childhood hypertension and 84 children in the control group matched by sex and age from an established cohort were included in a nested case–control study. We constructed a multiple logistic regression model to analyze the factors associated with hypertension and applied the 10‐fold cross‐validation method to verify the prediction stability of the model. Childhood hypertension was found positively correlated with triglyceride level ≥150 mg/dL; low‐density lipoprotein cholesterol level ≥110 mg/dL; body mass index Z score; waist‐to‐height ratio Z score; and red blood cell count (all P < .01) and negatively correlated with the relative expression level of retinol acyltransferase; relative expression level of vitamin D receptor; and dietary intake of fiber, vitamin C and copper (all P < .05) in this study. BMI Z score, triglyceride ≥150 mg/dL, RBC count, VDR/β‐actin and LRAT/β‐actin ratios were used to construct the predictive model. The area under the receiver operating characteristic curve was 94.45% (95% CI = 89.35%∼98.65%, P < .001). The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were all above 80% in both the training and validation sets. In conclusion, this model can predict the risk of childhood hypertension and could provide a theoretical basis for early prevention and intervention to improve the cardiovascular health of children.
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Affiliation(s)
- Jishuang Tong
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Xizhou An
- Hematology and Oncology Department, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Li Zhao
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Ping Qu
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Xian Tang
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Min Chen
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Xiaohua Liang
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
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15
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Nutritional Treatment in a Cohort of Pediatric Patients with Familial Hypercholesterolaemia: Effect on Lipid Profile. Nutrients 2022; 14:nu14142817. [PMID: 35889775 PMCID: PMC9322083 DOI: 10.3390/nu14142817] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 02/01/2023] Open
Abstract
Background and aims: Familial Hypercholesterolaemia (FH) is characterised by a genetic alteration in the transport and metabolism of cholesterol that leads to elevated levels of total cholesterol (CT) and low-density lipoprotein cholesterol (LDL-C) and early onset of atherosclerosis. According to the current guidelines, diet and promotion of healthy habits are first-line treatments. Little is known about the effectiveness of cholesterol-lowering diet and healthy lifestyle habits on plasma cholesterol and lipid profile in children and adolescents with FH. The aim of the study is to investigate the effect of the nutritional counseling on plasma lipid profile in FH children at the first step of treatment. Methods: 115 FH children (2−17 years) were included in the study; dietary habits were evaluated through a Food Frequency Questionnaire (FFQ) and blood samples for lipid profile were collected at the enrollment (T0) and six months later (T1). Results: the lipid profile at T0 and T1, expressed as mean ± standard deviation in mg/dL, was, respectively: total cholesterol 285.9 ± 51.1 and 276.6 ± 46.8 (paired test difference p value < 0.01), LDL-cholesterol 214.9 ± 47.7 and 206.4 ± 46.6 (p value < 0.01), HDL-cholesterol 52.9 ± 13 and 54.4 ± 11.5 (p value 0.07), triglycerides 87 ± 46.7 and 82.2 ± 38.4 (p value 0.4), non-HDL cholesterol 233 ± 51.4 and 222.2 ± 47.4 (p < 0.01). In the dietary habits (weekly portions) we observed an improvement (p ≤ 001) for fruit and vegetables, fish, pulses, whole foods, and a reduction (p < 0.01) for meat, sausages, cheese, junk foods consumption. Conclusions: In FH children we have highlighted an improvement of the plasma lipid profile and in healthy dietary habits after nutritional counseling.
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16
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The Knockout of the ASIP Gene Altered the Lipid Composition in Bovine Mammary Epithelial Cells via the Expression of Genes in the Lipid Metabolism Pathway. Animals (Basel) 2022; 12:ani12111389. [PMID: 35681853 PMCID: PMC9179457 DOI: 10.3390/ani12111389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/21/2022] [Accepted: 05/25/2022] [Indexed: 02/04/2023] Open
Abstract
Agouti signalling protein (ASIP) is a coat colour-related protein and also is a protein-related to lipid metabolism, which had first been found in agoutis. According to our previous study, ASIP is a candidate gene that affects the lipid metabolism in bovine adipocytes. However, its effect on milk lipid has not been reported yet. This study focused on the effect of the ASIP gene on the lipid metabolism of mammary epithelial cells in cattle. The ASIP gene was knocked out in bMECs by using CRISPR/Cas9 technology. The result of transcriptome sequencing showed that the differentially expressed genes associated with lipid metabolism were mainly enriched in the fatty acids metabolism pathways. Furthermore, the contents of intracellular triglycerides were significantly increased (p < 0.05), and cholesterol tended to rise (p > 0.05) in bMECs with the knockout of the ASIP gene. Fatty acid assays showed a significant alteration in medium and long-chain fatty acid content. Saturated and polyunsaturated fatty acids were significantly up-regulated (p < 0.05), and monounsaturated fatty acids were significantly decreased in the ASIP knockout bMECs (p < 0.05). The Q-PCR analysis showed that knockout of ASIP resulted in a significant reduction of gene expressions like PPARγ, FASN, SCD, and a significant up-regulation of genes like FABP4, ELOVL6, ACSL1, HACD4 prompted increased mid-to long-chain fatty acid synthesis. Overall, ASIP plays a pivotal role in regulating lipid metabolism in bMECs, which could further influence the component of lipid in milk.
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17
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Murni IK, Sulistyoningrum DC, Susilowati R, Julia M, Dickinson KM. The association between dietary intake and cardiometabolic risk factors among obese adolescents in Indonesia. BMC Pediatr 2022; 22:273. [PMID: 35549677 PMCID: PMC9097319 DOI: 10.1186/s12887-022-03341-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 05/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Poor diets, characterized by excess fat, sugar and sodium intakes, are considered to be one of the most important modifiable risk factors for cardiovascular disease. Diet patterns and intakes during adolescence may persist into adulthood and impact on risk for chronic disease later in life. We aimed to evaluate the dietary intake of obese adolescents and its relationship to cardiometabolic health including lipid status and glycemic control. METHODS AND STUDY DESIGN This was a cross-sectional study of obese children aged 15 to < 18 years in Yogyakarta, Indonesia. All children had a medical history performed including a physical examination and fasting blood sample. Dietary intake was assessed using a semi-quantitative recall food frequency questionnaire. Multivariable linear regression model was performed to determine the relationship between dietary intakes and cardiovascular disease risks and to adjust for potential confounders. RESULTS Of 179 adolescents, 101 (57.4%) were male and median age was 16.4 (15.0-17.9) years. The majority of adolescents (98%) had inadequate intake of fibre and exceeded intakes of total fat (65%) and total sugar (36%). There was statistically significant correlation found in the multivariable linear regression analysis between fibre intake and HDL cholesterol after adjusting for potential confounders (β = 0.165; p = 0.033). CONCLUSIONS This study demonstrates that there is a high proportion of obese Indonesian adolescents with poor dietary intakes. There was relationship observed between intake of nutrients of concern (fibre) and cardiometabolic risk factor among this sample of obese adolescents. Future research should examine overall dietary patterns in more detail among this population to elucidate the role of poor diet intakes in development of cardiovascular disease risk factors in young people transitioning into adulthood.
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Affiliation(s)
- Indah K. Murni
- Department of Child Health, DR. Sardjito Hospital/Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, 55284 Indonesia
| | - Dian C. Sulistyoningrum
- Department of Nutrition and Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Rina Susilowati
- Department of Histology and Cell Biology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Madarina Julia
- Department of Child Health, DR. Sardjito Hospital/Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, 55284 Indonesia
| | - Kacie M. Dickinson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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18
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Fioravanti M, Di Giorgio G, Amato R, Bossù M, Luzzi V, Ierardo G, Polimeni A, Vozza I. Baby Food and Oral Health: Knowledge of the Existing Interaction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5799. [PMID: 35627333 PMCID: PMC9140504 DOI: 10.3390/ijerph19105799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/06/2022] [Accepted: 05/06/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The purpose of this study is to verify parents' knowledge of child nutrition and their awareness of the interaction between unhealthy sugars in their child's diet and caries formation. METHODS a questionnaire was proposed using Instagram to analyze type of breastfeeding; type of weaning and diet; home oral hygiene maneuvers; bad habits (use of pacifiers, bottles, and sugary substances); knowledge on the usefulness of fluoride; and first dental visit. A total of 200 parents from different regions of Italy with children aged 2 months to 6 years were contacted. Results showed that 66% parents preferred breastfeeding, while the remaining 34% chose artificial breastfeeding. Fifty percent (100 babies) started weaning at six months, 20% (40 babies) at the fifth month, 13.5% (27 babies) at the fourth month, and only 11.5% (23 babies) in a range from the seventh to ninth month of life. Oral hygiene practices were performed only by 25% of parents before eruption of the first tooth. After eruption of the first tooth, there is greater attention to home oral hygiene practices: 59% of parents carry out and teach their children daily home oral hygiene maneuvers. CONCLUSIONS it is possible to raise awareness among parents and caregivers on the importance of food education.
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Affiliation(s)
- Miriam Fioravanti
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy; (G.D.G.); (R.A.); (M.B.); (V.L.); (G.I.); (A.P.); (I.V.)
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Said L, Gubbels JS, Kremers SPJ. Effect Evaluation of Sahtak bi Sahnak, a Lebanese Secondary School-Based Nutrition Intervention: A Cluster Randomised Trial. Front Nutr 2022; 9:824020. [PMID: 35369051 PMCID: PMC8966668 DOI: 10.3389/fnut.2022.824020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To evaluate the effectiveness of Sahtak bi Sahnak on dietary knowledge and adherence to dietary guidelines in Lebanese adolescents. Design/setting A cluster randomised controlled trial was conducted in public and private secondary schools located in urban and rural regions in Lebanon. Participants Sixteen secondary schools including 1,572 adolescents were randomly assigned to the intervention (n = 739) or control group (n = 833). Intervention Sahtak bi Sahnak is an educational school-based intervention dedicated to improving dietary adherence to nutritional guidelines, increasing the level of dietary knowledge, and preventing the development of obesity during adolescence. It was systematically designed based on the Intervention Mapping framework. The total length of the intervention was around seven educational sessions, until all of the 11 lessons were covered. Each education session lasted 20-40 min. Main Outcome Measures Dietary knowledge and adherence levels were measured at baseline and post-intervention using validated questionnaires. Statistical Analysis Multivariate multilevel regression models were used to examine intervention effects on outcomes, controlled for background characteristics (i.e., age, gender, location, type of school, grade, BMI z-score). Results The intervention group showed significant improvements in total dietary knowledge (B = 12.74, p < 0.001) and intake of healthy items (B = 1.89, p < 0.001), compared to the control group. Intake of unhealthy items decreased significantly (B = -1.43, p < 0.001), compared to the control group. These results were adjusted for age, gender, type of school, location, BMI z-score, study group, and score at baseline. Conclusion and Implications Sahtak bi Sahnak is an effective and culturally appropriate school-based intervention for targeting diet among a variety of Lebanese adolescents.
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Affiliation(s)
- Liliane Said
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, Netherlands
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Lebanese International University, Bekaa, Lebanon
| | - Jessica S. Gubbels
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Stef P. J. Kremers
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, Netherlands
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Meng C, Yucheng T, Shu L, Yu Z. Effects of school-based high-intensity interval training on body composition, cardiorespiratory fitness and cardiometabolic markers in adolescent boys with obesity: a randomized controlled trial. BMC Pediatr 2022; 22:112. [PMID: 35232402 PMCID: PMC8886768 DOI: 10.1186/s12887-021-03079-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 12/17/2021] [Indexed: 12/31/2022] Open
Abstract
Background With accumulating evidence suggesting that CVD has its origins in childhood obesity. The purpose of this study was to determine the effect of a real-world school-based high-intensity interval training intervention on body composition, cardiorespiratory fitness and cardiometabolic markers in obese boys aged 10 to 13 years. Methods Forty-five adolescent boys with obesity (age = 11.2 ± 0.7 years, BMI = 24.2 ± 1.0 kg/m2), were randomized to high-intensity interval training group (HIIT, n = 15), moderate-intensity continuous training group (MICT, n = 15), or a control group (CON, n = 15). The intervention groups performed three weekly exercise sessions over 12 weeks. HIIT group performed two sets of eight bouts of 15 s run at high-intensity [90 ~ 100% maximal aerobic speed (MAS)] separated by eight bouts of 15 s recovery run at low-intensity (50% MAS), MICT group performed 30 min run at moderate intensity (60 ~ 70% MAS) and CON group were instructed to continue their normal behaviors. All participants had indices of body composition, cardiorespiratory fitness (CRF) and cardiometabolic markers measured at baseline and post-intervention. Statistical differences between and within groups were determined by use of two-way analysis of variance (ANOVA) with repeated measures. Results Following the school-based training program, BMI and body fat mass decreased (BMI: − 1.8 kg/m2 vs. – 1.2 kg/m2, P < 0.01; FM: − 1.6 kg, P < 0.05 vs. -3.7 kg, P < 0.01) in HIIT and MICT group, but there was no significant difference between the two interventions; \documentclass[12pt]{minimal}
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\begin{document}$$\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}}$$\end{document}V˙O2peak both increased significantly in two intervention groups, and the increment of HIIT group was significantly greater than that of MICT (6.1 mL/kg/min vs. 3.8 mL/kg/min, P < 0.01), Visceral adipose tissue was significant decrease in HIIT group (− 53 g vs. -17 g, P < 0.01) whilst the MICT group experienced a significant decrease in body fat percentage (− 3.1 ± 1.0 kg, P < 0.01), but there were no significant difference between the two interventions. Low-density lipoprotein cholesterol decreased only in HIIT group (− 17.2%, P < 0.05). Significant decrease in the usual index of insulin resistance (HOMA-IR) occurred in HIIT and MICT groups (− 27.3 and − 28.6%, respectively; P < 0.05). Conclusions Our results demonstrated that high-intensity interval training based on running can be used to improve the physical health of obese adolescents in school. Further investigations involving a larger cohort of participants, taken from different schools, is recommended. Trial registration title Effect of High Intensity Interval Training on Obese Children and Adolescents, time 16/12/2017, IDChiCTR-IOR-17013992, websitehttp://www.chictr.org.cn
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Affiliation(s)
- Cao Meng
- Institute of Physical Education, Normal College, Shenzhen University, 3688 Nan Hai Road, Nan Shan district, Shenzhen, 518061, China. .,Institute of KEEP Collaborative Innovation, Shenzhen, 518061, China.
| | - Tang Yucheng
- Institute of Physical Education, Normal College, Shenzhen University, 3688 Nan Hai Road, Nan Shan district, Shenzhen, 518061, China.,Institute of KEEP Collaborative Innovation, Shenzhen, 518061, China
| | - Li Shu
- Institute of Physical Education, Normal College, Shenzhen University, 3688 Nan Hai Road, Nan Shan district, Shenzhen, 518061, China.,Institute of KEEP Collaborative Innovation, Shenzhen, 518061, China
| | - Zou Yu
- College of Education, Zhejiang University, Zhejiang, 310058, China
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21
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Eidson-Ton WS. Health Care of the Adolescent. Fam Med 2022. [DOI: 10.1007/978-3-030-54441-6_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Saxe-Custack A, LaChance J, Hanna-Attisha M, Goldsworthy M, Ceja T. Household Supplemental Nutrition Assistance Program Participation is Associated With Higher Fruit and Vegetable Consumption. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:1060-1065. [PMID: 34479817 DOI: 10.1016/j.jneb.2021.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/23/2021] [Accepted: 06/27/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Examine whether differences were present by Supplemental Nutrition Assistance Program (SNAP) participation in dietary patterns, achievement of dietary recommendations, and food security for children (aged 7-18 years) receiving free/reduced-price school meals. METHODS Cross-sectional study. Caregiver-child dyads at a pediatric clinic completed validated surveys. Food security, dietary patterns, and achievement of dietary recommendations were compared between child SNAP participants/nonparticipants. RESULTS Among 205 caregivers, 128 (62.4%) reported SNAP participation. Percentages of child SNAP participants/nonparticipants meeting recommendations were largely nonsignificantly different and overwhelmingly low. Supplemental Nutrition Assistance Program participants reported higher mean daily servings of vegetables (P = 0.01) and fruits (P = 0.01) than nonparticipants. Caregiver-reported household food security was not significantly different between SNAP participants and nonparticipants (P = 0.44). CONCLUSIONS AND IMPLICATIONS In this study, child-reported fruit/vegetable intakes were significantly higher among SNAP participants than nonparticipants, suggesting child SNAP participants may experience small but noteworthy benefits related to fruit/vegetable consumption. Additional supports are needed to achieve dietary recommendations.
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Affiliation(s)
- Amy Saxe-Custack
- Department of Food Science and Human Nutrition, Division of Public Health, Michigan State University-Hurley Children's Hospital Pediatric Public Health Initiative, Flint, MI.
| | - Jenny LaChance
- Division of Public Health, Michigan State University-Hurley Children's Hospital Pediatric Public Health Initiative, Flint, MI
| | - Mona Hanna-Attisha
- Department of Pediatrics and Human Development, Division of Public Health, Michigan State University-Hurley Children's Hospital Pediatric Public Health Initiative, Flint, MI
| | - Mallory Goldsworthy
- Division of Public Health, Michigan State University-Hurley Children's Hospital Pediatric Public Health Initiative, Flint, MI
| | - Tiffany Ceja
- Division of Public Health, Michigan State University-Hurley Children's Hospital Pediatric Public Health Initiative, Flint, MI
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Kris-Etherton PM, Petersen KS, Després JP, Braun L, de Ferranti SD, Furie KL, Lear SA, Lobelo F, Morris PB, Sacks FM. Special Considerations for Healthy Lifestyle Promotion Across the Life Span in Clinical Settings: A Science Advisory From the American Heart Association. Circulation 2021; 144:e515-e532. [PMID: 34689570 DOI: 10.1161/cir.0000000000001014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
At a population level, engagement in healthy lifestyle behaviors is suboptimal in the United States. Moreover, marked disparities exist in healthy lifestyle behaviors and cardiovascular risk factors as a result of social determinants of health. In addition, there are specific challenges to engaging in healthy lifestyle behaviors related to age, developmental stage, or major life circumstances. Key components of a healthy lifestyle are consuming a healthy dietary pattern, engaging in regular physical activity, avoiding use of tobacco products, habitually attaining adequate sleep, and managing stress. For these health behaviors, there are guidelines and recommendations; however, promotion in clinical settings can be challenging, particularly in certain population groups. These challenges must be overcome to facilitate greater promotion of healthy lifestyle practices in clinical settings. The 5A Model (assess, advise, agree, assist, and arrange) was developed to provide a framework for clinical counseling with consideration for the demands of clinical settings. In this science advisory, we summarize specific considerations for lifestyle-related behavior change counseling using the 5A Model for patients across the life span. In all life stages, social determinants of health and unmet social-related health needs, as well as overweight and obesity, are associated with increased risk of cardiovascular disease, and there is the potential to modify this risk with lifestyle-related behavior changes. In addition, specific considerations for lifestyle-related behavior change counseling in life stages in which lifestyle behaviors significantly affect cardiovascular disease risk are outlined. Greater attention to healthy lifestyle behaviors during every clinician visit will contribute to improved cardiovascular health.
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The Effects of a Science-Based Community Intervention on Health Outcomes in Minority Children: The Translational Health in Nutrition and Kinesiology Program. J Phys Act Health 2021; 18:1074-1081. [PMID: 34172591 DOI: 10.1123/jpah.2020-0622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND This study evaluated the effects of a novel nutrition and movement science after-school program integrating laboratory experiences for minority children. Laboratory experiences demonstrated how the body moves, functions, and performs in response to exercise and healthy nutrition. METHODS A total of 76 children from 4 after-school programs that were primarily Latino and black were randomly assigned to either an experimental translational health in nutrition and kinesiology (THINK; n = 46) or standard curriculum that served as the control group (CON; n = 30). An analysis of covariance controlling for baseline values was used to compare differences between THINK and CON after the 4-month intervention. RESULTS Following the program, THINK participants evidenced lower triceps and subscapular skinfold thickness (P < .01 and <.05, respectively). THINK students showed greater improvements in aerobic fitness, grip strength, and agility than CON (P < .01, <.01, and <.05, respectively). Participants in THINK also demonstrated higher scores on their nutrition habits/behaviors questionnaire (P < .01), nutrition science (P < .05), and exercise fitness tests (P < .001) than CON. CONCLUSION An innovative curriculum featuring nutrition and kinesiology education interfaced with hands-on laboratory experiences and physical activities can improve physical outcomes and health-related behaviors in after-school programs serving minority children.
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Fiorentino R, Chiarelli F. Treatment of Dyslipidaemia in Children. Biomedicines 2021; 9:biomedicines9091078. [PMID: 34572264 PMCID: PMC8470054 DOI: 10.3390/biomedicines9091078] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/07/2021] [Accepted: 08/21/2021] [Indexed: 01/14/2023] Open
Abstract
Childhood dyslipidaemia is one of the main traditional cardiovascular risk factors that initiate and exacerbate the atherosclerotic process. Healthcare providers may play a key role in the management of children with lipid abnormalities; however, they have to properly evaluate the normal lipid values and know the available treatment options in children and adolescents. Current guidelines recommend healthy behaviours as the first-line treatment for childhood dyslipidaemia. The therapeutic lifestyle changes should focus on dietary modifications, daily physical activity, reduction in body weight and tobacco smoking cessation. Parents play a key role in promoting their children’s healthy habits. In children with more severe forms of lipid abnormalities and in those who do not benefit from healthy behaviours, pharmacological therapy should be considered. Safe and effective medications are already available for children and adolescents. Statins represent the first-line pharmacological option, while ezetimibe and bile acid sequestrants are usually used as second-line drugs. Despite their limited use in children, other lipid-lowering agents (already approved for adults) are currently available or under study for certain categories of paediatric patients (e.g., familial hypercholesterolemia). Further studies are needed to evaluate the long-term efficacy, safety and tolerability of novel lipid-lowering drugs, especially in children.
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Močnik M, Marčun Varda N. Cardiovascular Risk Factors in Children with Obesity, Preventive Diagnostics and Possible Interventions. Metabolites 2021; 11:metabo11080551. [PMID: 34436493 PMCID: PMC8398426 DOI: 10.3390/metabo11080551] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/30/2021] [Accepted: 08/10/2021] [Indexed: 12/16/2022] Open
Abstract
The increasing burden of obesity plays an essential role in increased cardiovascular morbidity and mortality. The effects of obesity on the cardiovascular system have also been demonstrated in childhood, where prevention is even more important. Obesity is associated with hormonal changes and vascular dysfunction, which eventually lead to hypertension, hyperinsulinemia, chronic kidney disease, dyslipidemia and cardiac dysfunction—all associated with increased cardiovascular risk, leading to potential cardiovascular events in early adulthood. Several preventive strategies are being implemented to reduce the cardiovascular burden in children. This paper presents a comprehensive review of obesity-associated cardiovascular morbidity with the preventive diagnostic workup at our hospital and possible interventions in children.
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Affiliation(s)
- Mirjam Močnik
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia;
- Correspondence: ; Tel.: +386-40323726
| | - Nataša Marčun Varda
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia;
- Medical Faculty, University of Maribor, Taborska 8, 2000 Maribor, Slovenia
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Wang L, Martínez Steele E, Du M, Pomeranz JL, O’Connor LE, Herrick KA, Luo H, Zhang X, Mozaffarian D, Zhang FF. Trends in Consumption of Ultraprocessed Foods Among US Youths Aged 2-19 Years, 1999-2018. JAMA 2021; 326:519-530. [PMID: 34374722 PMCID: PMC8356071 DOI: 10.1001/jama.2021.10238] [Citation(s) in RCA: 140] [Impact Index Per Article: 46.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE The childhood obesity rate has been steadily rising among US youths during the past 2 decades. Increasing evidence links consumption of ultraprocessed foods to excessive calorie consumption and weight gain, but trends in the consumption of ultraprocessed foods among US youths have not been well characterized. OBJECTIVE To characterize trends in the consumption of ultraprocessed foods among US youths. DESIGN, SETTING, AND PARTICIPANTS Serial cross-sectional analysis using 24-hour dietary recall data from a nationally representative sample of US youths aged 2-19 years (n = 33 795) from 10 cycles of the National Health and Nutrition Examination Survey (NHANES) from 1999-2000 to 2017-2018. EXPOSURES Secular time. MAIN OUTCOMES AND MEASURES Percentage of total energy consumed from ultraprocessed foods as defined by NOVA, an established food classification system that categorizes food according to the degree of food processing. RESULTS Dietary intake from youths were analyzed (weighted mean age, 10.7 years; 49.1% were girls). From 1999 to 2018, the estimated percentage of total energy from consumption of ultraprocessed foods increased from 61.4% to 67.0% (difference, 5.6% [95% CI, 3.5% to 7.7%]; P < .001 for trend), whereas the percentage of total energy from consumption of unprocessed or minimally processed foods decreased from 28.8% to 23.5% (difference, -5.3% [95% CI, -7.5% to -3.2%]; P < .001 for trend). Among the subgroups of ultraprocessed foods, the estimated percentage of energy from consumption of ready-to-heat and -eat mixed dishes increased from 2.2% to 11.2% (difference, 8.9% [95% CI, 7.7% to 10.2%]) and from consumption of sweet snacks and sweets increased from 10.7% to 12.9% (difference, 2.3% [95% CI, 1.0% to 3.6%]), but the estimated percentage of energy decreased for sugar-sweetened beverages from 10.8% to 5.3% (difference, -5.5% [95% CI, -6.5% to -4.5%]) and for processed fats and oils, condiments, and sauces from 7.1% to 4.0% (difference, -3.1% [95% CI, -3.7% to -2.6%]) (all P < .05 for trend). There was a significantly larger increase in the estimated percentage of energy from consumption of ultraprocessed foods among non-Hispanic Black youths (from 62.2% to 72.5%; difference, 10.3% [95% CI, 6.8% to 13.8%]) and Mexican American youths (from 55.8% to 63.5%; difference, 7.6% [95% CI, 4.4% to 10.9%]) than the increase among non-Hispanic White youths (from 63.4% to 68.6%; difference, 5.2% [95% CI, 2.1% to 8.3%]) (P = .04 for trends). CONCLUSIONS AND RELEVANCE Based on the NHANES cycles from 1999 to 2018, the estimated proportion of energy intake from consumption of ultraprocessed foods has increased among youths in the US and has consistently comprised the majority of their total energy intake.
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Affiliation(s)
- Lu Wang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Euridice Martínez Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Mengxi Du
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Jennifer L. Pomeranz
- Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, New York
| | - Lauren E. O’Connor
- Division of Cancer Control and Population Science, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Kirsten A. Herrick
- Division of Cancer Control and Population Science, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Hanqi Luo
- Department of Nutrition and Institute for Global Nutrition, University of California, Davis
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
- Tufts Institute for Global Obesity Research, Tufts University, Boston, Massachusetts
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Nutritional Approach to Prevention and Treatment of Cardiovascular Disease in Childhood. Nutrients 2021; 13:nu13072359. [PMID: 34371871 PMCID: PMC8308497 DOI: 10.3390/nu13072359] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/05/2021] [Accepted: 07/08/2021] [Indexed: 12/19/2022] Open
Abstract
Coronary Heart Disease (CHD) is a major mortality and morbidity cause in adulthood worldwide. The atherosclerotic process starts even before birth, progresses through childhood and, if not stopped, eventually leads to CHD. Therefore, it is important to start prevention from the earliest stages of life. CHD prevention can be performed at different interventional stages: primordial prevention is aimed at preventing risk factors, primary prevention is aimed at early identification and treatment of risk factors, secondary prevention is aimed at reducing the risk of further events in those patients who have already experienced a CHD event. In this context, CHD risk stratification is of utmost importance, in order to tailor the preventive and therapeutic approach. Nutritional intervention is the milestone treatment in pediatric patients at increased CHD risk. According to the Developmental Origin of Health and Disease theory, the origins of lifestyle-related disease is formed in the so called “first thousand days” from conception, when an insult, either positive or negative, can cause life-lasting consequences. Nutrition is a positive epigenetic factor: an adequate nutritional intervention in a developmental critical period can change the outcome from childhood into adulthood.
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Vidmar AP, Jones RB, Wee CP, Berger PK, Plows JF, Rios RDC, Raymond JK, Goran MI. Timing of food consumption in Hispanic adolescents with obesity. Pediatr Obes 2021; 16:e12764. [PMID: 33370849 PMCID: PMC8178160 DOI: 10.1111/ijpo.12764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/01/2020] [Accepted: 12/04/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Little is known about the normal eating time periods in adolescents with obesity and how these patterns change throughout development. As the obesity epidemic continues to rise in adolescence, it becomes imperative to understand developmentally appropriate eating behaviours and to create weight management strategies that build on those innate patterns and preferences. The purpose of this study was to determine the most common habitual eating windows observed in adolescents with obesity. METHODS Participants were 101 Hispanic adolescents (mean age 14.8 ± 2.1 years; 48 male/53 female) with obesity (BMI ≥95th percentile) who were recruited as part of a larger clinical trial. Dietary intake and meal timing was determined using multiple pass 24-hours recalls. Histograms were utilized to determine the natural distribution of percent consumption of total kilocalories, carbohydrates and added sugar per hour. RESULTS The majority of total kilocalories (65.4%), carbohydrates (65.3%) and added sugar (59.1%) occurred between 11:00 and 19:00. Adolescents were 2.5 to 2.9 times more likely to consume kilocalories, carbohydrates, and added sugar during the 8-hour window between 11:00 am and 19:00 pm than other time windows examined (all P < .001). The consumption of these calories did not differ between weekdays and weekend (P > .05) or by sex. CONCLUSIONS In this cohort, more than 60% of calories, carbohydrates and added sugar were consumed between 11:00 am and 19:00 pm, which is concordant with an afternoon/evening chronotype that is common in adolescents. Our findings support this 8-hour period as a practical window for weight loss interventions that target pre-specified eating periods in this population.
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Affiliation(s)
- Alaina P. Vidmar
- Diabetes & Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
- Keck School of Medicine of USC, Los Angeles, California
| | - Roshonda B. Jones
- Diabetes & Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
- Keck School of Medicine of USC, Los Angeles, California
| | - Choo Phei Wee
- CTSI Biostatics Core, The Saban Research Institute, Los Angeles, California
| | - Paige K. Berger
- Diabetes & Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
- Keck School of Medicine of USC, Los Angeles, California
| | - Jasmine F. Plows
- Diabetes & Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
- Keck School of Medicine of USC, Los Angeles, California
| | - R. D. Claudia Rios
- Diabetes & Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
- Keck School of Medicine of USC, Los Angeles, California
| | - Jennifer K. Raymond
- Diabetes & Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
- Keck School of Medicine of USC, Los Angeles, California
| | - Michael I. Goran
- Diabetes & Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
- Keck School of Medicine of USC, Los Angeles, California
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Heller RL, Chiero JD, Trout N, Mobley AR. A qualitative study of providers' perceptions of parental feeding practices of infants and toddlers to prevent childhood obesity. BMC Public Health 2021; 21:1276. [PMID: 34193104 PMCID: PMC8243475 DOI: 10.1186/s12889-021-11305-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background With a recent focus on establishing US Dietary Guidance for children ages 0 to 2 years old, the objective of this qualitative study was to determine misconceptions and barriers that prevent parents from implementing early childhood feeding and obesity prevention practices as reported by healthcare, community-based, and education providers. Methods Trained researchers conducted one-on-one qualitative phone interviews, using a semi-structured script, with early childhood health and education providers working with families of young children. Interviews were audiotaped, transcribed verbatim, and analyzed using the classic analysis approach. Transcripts were coded by researchers and analyzed for themes. Results Providers (n = 21) reported commonly observed obesogenic practices including overfeeding tendencies, early initiation of solids or less optimal feeding practices, lack of autonomy and self-regulation by child, and suboptimal dietary patterns. Sources of parental misconceptions about feeding were often related to cultural, familial, and media influences, or lack of knowledge about optimal feeding practices for infants or toddlers. Conclusions Providers indicated a need for engaging and consistent child feeding and obesity prevention education materials appropriate for diverse cultural and literacy levels of parents, with detailed information on transitioning to solid foods. Early education and community-based providers reported limited access to evidence-based educational materials more so than healthcare providers. It is an opportune time to develop reputable and evidence-based child feeding guidance that is readily available and accessible for parents of infants and toddlers to prevent early childhood obesity.
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Affiliation(s)
- Rebecca L Heller
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA.,Rhythm Pharmaceuticals, Boston, MA, USA
| | - Jesse D Chiero
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA
| | - Nancy Trout
- Division of Primary Care, Connecticut Children's Medical Center, Department of Pediatrics, University of Connecticut School of Medicine, Hartford, CT, USA
| | - Amy R Mobley
- Department of Nutritional Sciences, Storrs, CT, USA. .,Department of Health Education and Behavior, University of Florida, PO Box 118210, Gainesville, FL, 32611-8210, USA.
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Weigensberg MJ, Àvila Q, Spruijt-Metz D, Davis JN, Wen CKF, Goodman K, Perdomo M, Wadé NB, Ding L, Lane CJ. Imagine HEALTH: Randomized Controlled Trial of a Guided Imagery Lifestyle Intervention to Improve Obesity-Related Lifestyle Behaviors in Predominantly Latinx Adolescents. J Altern Complement Med 2021; 27:738-749. [PMID: 34037459 DOI: 10.1089/acm.2020.0515] [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] [Indexed: 12/20/2022] Open
Abstract
Introduction: To determine the effects of a novel lifestyle intervention combining lifestyle behavioral education with the complementary-integrative health modality of guided imagery (GI) on dietary and physical activity behaviors in adolescents. The primary aim of this study was to determine the incremental effects of the lifestyle education, stress reduction GI (SRGI), and lifestyle behavior GI (LBGI) components of the intervention on the primary outcome of physical activity lifestyle behaviors (sedentary behavior, light, moderate, and vigorous physical activity), as well as dietary intake behaviors, at the completion of the 12-week intervention. The authors hypothesized that the intervention would improve obesity-related lifestyle behaviors. Materials and Methods: Two hundred and thirty-two adolescent participants (aged 14-17 years, sophomore or junior year of high school) were cluster randomized by school into one of four intervention arms: nonintervention Control (C), Lifestyle education (LS), SRGI, and LBGI. After-school intervention sessions were held two (LS) or three (SRGI, LBGI) times weekly for 12 weeks. Physical activity (accelerometry) and dietary intake (multiple diet recalls) outcomes were assessed pre- and postintervention. Primary analysis: intention-to-treat (ITT) mixed-effects modeling with diagonal covariance matrices; secondary analysis: ad hoc subgroup sensitivity analysis using only those participants adherent to protocol. Results: ITT analysis showed that the Healthy Eating Index (HEI) increased in the LS group compared with C (p = 0.02), but there was no additional effect of GI. Among adherent participants, sedentary behavior was decreased stepwise relative to C in SRGI (d = -0.73, p = 0.004) > LBGI (d = -0.59, p = 0.04) > LS (d = -0.41, p = 0.07), and moderate + vigorous physical activity was increased in SRGI (d = 0.58, p = 0.001). Among adherent participants, the HEI was increased in LS and SRGI, and glycemic index reduced in LBGI. Conclusions: While ITT analysis was negative, among adherent participants, the Imagine HEALTH lifestyle intervention improved eating habits, reduced sedentary activity, and increased physical activity, suggesting that GI may amplify the role of lifestyle education alone for some key outcomes. CTR #NCT02088294.
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Affiliation(s)
- Marc J Weigensberg
- Department of Pediatrics, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Quintila Àvila
- Department of Pediatrics, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Donna Spruijt-Metz
- Department of Psychology, USC Dornsife Center for Economic and Social Research, Los Angeles, CA, USA
| | - Jaimie N Davis
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, USA
| | - Cheng K F Wen
- USC Center for Self-Report Science, Los Angeles, CA, USA
| | - Kim Goodman
- Department of Adult Mental Health and Wellness, USC Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA
| | - Marisa Perdomo
- Division of Biokinesiology and Physical Therapy, USC Ostrow School of Dentistry, Los Angeles, CA, USA
| | - Niquelle Brown Wadé
- Division of Biostatistics, Department of Preventive Medicine, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Li Ding
- Division of Biostatistics, Department of Preventive Medicine, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Christianne J Lane
- Division of Biostatistics, Department of Preventive Medicine, USC Keck School of Medicine, Los Angeles, CA, USA
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Cholesterol at ages 6, 12 and 24 months: Tracking and associations with diet and maternal cholesterol in the Infant Cholesterol Study. Atherosclerosis 2021; 326:11-16. [PMID: 33990045 DOI: 10.1016/j.atherosclerosis.2021.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/17/2021] [Accepted: 04/28/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS There are indications for tracking of circulating total cholesterol concentration (TC) from childhood to later in life. An increased lifelong TC exposure increases the risk of developing atherosclerosis, however little is known about the determinants of TC early in life. We aimed to describe TC in Norwegian offspring aged 6, 12 and 24 months, and to explore if maternal TC, breastfeeding and offspring diet are associated with offspring TC. METHODS In this cross-sectional study, mothers of offspring aged 6 (n = 629), 12 (n = 258) and 24 (n = 263) months completed a questionnaire of the offspring's diet and took home-based dried blood spot samples from themselves and their offspring. The mothers and offspring participating at age 12 months also participated at age 6 months of the offspring. RESULTS Offspring TC showed a wide range in all three age groups. Twenty one percent of the offspring had TC ≥ 5.1 mmol/l. There was significant tracking of offspring TC from 6 to 12 months of age (r = 0.42, p < 0.001). Maternal and offspring TC was positively associated in all age groups (0.20 ≤ β ≤ 0.40, p < 0.001 for all). Breastfeeding was positively associated with offspring TC at ages 6 and 12 months (0.05 ≤ β ≤ 0.26, 0.001 ≤ p ≤ 0.03), but not at age 24 months. CONCLUSIONS The wide range in TC and probable tracking of TC from infancy to later in life highlights the importance of early identification of children with elevated TC who can benefit from preventive measures.
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Scapaticci S, D’Adamo E, Mohn A, Chiarelli F, Giannini C. Non-Alcoholic Fatty Liver Disease in Obese Youth With Insulin Resistance and Type 2 Diabetes. Front Endocrinol (Lausanne) 2021; 12:639548. [PMID: 33889132 PMCID: PMC8056131 DOI: 10.3389/fendo.2021.639548] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/28/2021] [Indexed: 02/06/2023] Open
Abstract
Currently, Non-Alcoholic Fatty Liver Disease (NAFLD) is the most prevalent form of chronic liver disease in children and adolescents worldwide. Simultaneously to the epidemic spreading of childhood obesity, the rate of affected young has dramatically increased in the last decades with an estimated prevalence of NAFLD of 3%-10% in pediatric subjects in the world. The continuous improvement in NAFLD knowledge has significantly defined several risk factors associated to the natural history of this complex liver alteration. Among them, Insulin Resistance (IR) is certainly one of the main features. As well, not surprisingly, abnormal glucose tolerance (prediabetes and diabetes) is highly prevalent among children/adolescents with biopsy-proven NAFLD. In addition, other factors such as genetic, ethnicity, gender, age, puberty and lifestyle might affect the development and progression of hepatic alterations. However, available data are still lacking to confirm whether IR is a risk factor or a consequence of hepatic steatosis. There is also evidence that NAFLD is the hepatic manifestation of Metabolic Syndrome (MetS). In fact, NAFLD often coexist with central obesity, impaired glucose tolerance, dyslipidemia, and hypertension, which represent the main features of MetS. In this Review, main aspects of the natural history and risk factors of the disease are summarized in children and adolescents. In addition, the most relevant scientific evidence about the association between NAFLD and metabolic dysregulation, focusing on clinical, pathogenetic, and histological implication will be provided with some focuses on the main treatment options.
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Affiliation(s)
| | | | | | | | - Cosimo Giannini
- Department of Pediatrics, University of Chieti, Chieti, Italy
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Sawh MC, Wallace M, Shapiro E, Goyal NP, Newton KP, Yu EL, Bross C, Durelle J, Knott C, Gangoiti JA, Barshop BA, Gengatharan JM, Meurs N, Schlein A, Middleton MS, Sirlin CB, Metallo CM, Schwimmer JB. Dairy Fat Intake, Plasma Pentadecanoic Acid, and Plasma Iso-heptadecanoic Acid Are Inversely Associated With Liver Fat in Children. J Pediatr Gastroenterol Nutr 2021; 72:e90-e96. [PMID: 33399331 PMCID: PMC8842839 DOI: 10.1097/mpg.0000000000003040] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES We sought to evaluate the relevance of pediatric dairy fat recommendations for children at risk for nonalcoholic fatty liver disease (NAFLD) by studying the association between dairy fat intake and the amount of liver fat. The effects of dairy fat may be mediated by odd chain fatty acids (OCFA), such as pentadecanoic acid (C15:0), and monomethyl branched chain fatty acids (BCFA), such as iso-heptadecanoic acid (iso-C17:0). Therefore, we also evaluated the association between plasma levels of OCFA and BCFA with the amount of liver fat. METHODS Observational, cross-sectional, community-based sample of 237 children ages 8 to 17. Dairy fat intake was assessed by 3 24-hour dietary recalls. Plasma fatty acids were measured by gas chromatography-mass spectrometry. Main outcome was hepatic steatosis measured by whole liver magnetic resonance imaging proton density fat fraction (MRI-PDFF). RESULTS Median dairy fat intake was 10.6 grams/day (range 0.0--44.5 g/day). Median liver MRI-PDFF was 4.5% (range 0.9%-45.1%). Dairy fat intake was inversely correlated with liver MRI-PDFF (r = -0.162; P = .012). In multivariable log linear regression, plasma C15:0 and iso-C17:0 were inverse predictors of liver MRI-PDFF (B = -0.247, P = 0.048; and B = -0.234, P = 0.009). CONCLUSIONS Dairy fat intake, plasma C15:0, and plasma iso-C17:0 were inversely correlated with hepatic steatosis in children. These hypothesis-generating findings should be tested through clinical trials to better inform dietary guidelines.
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Affiliation(s)
- Mary Catherine Sawh
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
| | - Martina Wallace
- Department of Bioengineering, University of California, San Diego, La Jolla, California
| | - Emma Shapiro
- Boston University College of Health & Rehabilitation Sciences: Sargent College, Boston, Massachusetts
| | - Nidhi P. Goyal
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
- Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California
| | - Kimberly P. Newton
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
- Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California
| | - Elizabeth L. Yu
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
- Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California
| | - Craig Bross
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
| | - Janis Durelle
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
| | - Cynthia Knott
- Altman Clinical and Translational Research Institute, School of Medicine, University of California, San Diego, La Jolla
| | - Jon A. Gangoiti
- Division of Genetics, Biochemical Genetics and Metabolomics Laboratory, Department of Pediatrics; University of California San Diego; La Jolla, California
| | - Bruce A. Barshop
- Division of Genetics, Biochemical Genetics and Metabolomics Laboratory, Department of Pediatrics; University of California San Diego; La Jolla, California
| | - Jivani M. Gengatharan
- Department of Bioengineering, University of California, San Diego, La Jolla, California
| | - Noah Meurs
- Department of Bioengineering, University of California, San Diego, La Jolla, California
| | - Alexandra Schlein
- Liver Imaging Group, Department of Radiology, University of California San Diego, La Jolla, California
| | - Michael S. Middleton
- Liver Imaging Group, Department of Radiology, University of California San Diego, La Jolla, California
| | - Claude B. Sirlin
- Liver Imaging Group, Department of Radiology, University of California San Diego, La Jolla, California
| | - Christian M. Metallo
- Department of Bioengineering, University of California, San Diego, La Jolla, California
| | - Jeffrey B. Schwimmer
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
- Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California
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Khoshbakht Y, Moghtaderi F, Bidaki R, Hosseinzadeh M, Salehi-Abargouei A. The effect of dietary approaches to stop hypertension (DASH) diet on attention-deficit hyperactivity disorder (ADHD) symptoms: a randomized controlled clinical trial. Eur J Nutr 2021; 60:3647-3658. [PMID: 33715085 DOI: 10.1007/s00394-021-02527-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 02/23/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The dietary approaches to stop hypertension (DASH) diet have several components like high amounts of fruits, vegetables, low-fat dairy products, and vitamin C and low amounts of simple sugars that might improve attention-deficit hyperactivity disorder (ADHD) symptoms. We aimed to investigate the effect of a DASH diet on children (aged 6-12 years) with ADHD, for the first time. METHODS Participants were randomized to receive a DASH or a control diet for 12 weeks. The severity of ADHD symptoms [determined by abbreviated 10-item Conner's scale (ACS), 18-item Swanson, Nolan and Pelham (SNAP-IV) scale and strengths and difficulties questionnaire (SDQ)] were assessed every four weeks. RESULTS Eighty children completed the study. After adjustment for confounders, parent (- 4.71 for the DASH group vs. - 3 for the control group) and teacher-reported (- 5.35 vs. - 1.87) ACS scores, parent-, teacher-, child-reported hyperactivity (- 1.40 vs. - 0.66, - 1.95 vs. -0.63, - 1.60 vs. - 0.43, respectively), emotional symptoms (- 1.50 vs. - 0.45, - 1.42 vs. - 0.63, and - 1.09 vs. - 0.61, respectively), and total SDQ scores (- 3.81 vs. - 1.65, - 4.11 vs. - 1.23, - 4.44 vs. - 1.26, respectively), teacher-reported of conduct problems (- 1.42 vs. - 0.63), peer relationship problems (- 0.87 vs. - 0.07), and prosocial behaviors (1.36 vs. 0.08) assessed by the SDQ were significantly improved in the DASH group compared with the control group (P < 0.05). CONCLUSION Adherence to a DASH-style diet might improve ADHD symptoms. Further RCTs which include participants from both sexes and with longer follow-up periods are needed to warrant current findings (The trial registration code: IRCT20130223012571N6; http://irct.ir/trial/12623 ). Trial registration Trial registration number: The trial was registered in the Iranian registry of clinical trials (registration code: IRCT20130223012571N6), URL: http://irct.ir/trial/12623 .
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Affiliation(s)
- Yadollah Khoshbakht
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, 8915173160, Yazd, Iran
| | - Fatemeh Moghtaderi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, 8915173160, Yazd, Iran
| | - Reza Bidaki
- Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahdieh Hosseinzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, 8915173160, Yazd, Iran
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, 8915173160, Yazd, Iran.
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Application of the Intervention Mapping Protocol to Develop Sahtak bi Sahnak, a School-Based Intervention to Prevent Pediatric Obesity among Lebanese Adolescents. HEALTH PSYCHOLOGY BULLETIN 2021. [DOI: 10.5334/hpb.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Life-Course Implications of Pediatric Risk Factors for Cardiovascular Disease. Can J Cardiol 2021; 37:766-775. [PMID: 33581191 DOI: 10.1016/j.cjca.2021.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 12/19/2022] Open
Abstract
The concept that origins of cardiovascular disease (CVD) begin in childhood is supported by substantial evidence. Prospective studies beginning in childhood report associations of childhood obesity, abnormal blood pressure (BP), dyslipidemia, diabetes, and tobacco use with intermediate CVD markers, including left ventricular hypertrophy and vascular stiffness in young adulthood. Trajectory analyses from longitudinal studies describe discrete BP pathways from childhood to young adult status of hypertension and prehypertension. Among individuals with familial hypercholesterolemia, abnormal low-density lipoprotein cholesterol levels are present in childhood. Some children are at risk for future CVD owing to hereditary factors, psychosocial stress, race, low birth weight, or other nonmodifiable exposures. Behavioural factors, including suboptimal diet, sedentary activity, and tobacco use, in childhood augment risk and can be modified to reduce risk. Pharmacologic treatments are reserved for those at high levels of the BP and cholesterol distributions and for those with diabetes and additional risk factors.
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Makkawy E, Alrakha AM, Al-Mubarak AF, Alotaibi HT, Alotaibi NT, Alasmari AA, Altamimi T. Prevalence of overweight and obesity and their associated factors among health sciences college students, Saudi Arabia. J Family Med Prim Care 2021; 10:961-967. [PMID: 34041105 PMCID: PMC8138400 DOI: 10.4103/jfmpc.jfmpc_1749_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/27/2020] [Accepted: 10/27/2020] [Indexed: 11/08/2022] Open
Abstract
CONTEXT The healthcare sciences college students have a lifestyle with low physical activity and disordered eating habits, which exposes them to a higher risk of obesity. Health science college students were the target group of particular interest in this study as they are future physicians. If they are overweight or obese, they will carry the wrong impression to the general population. AIM To assess the prevalence of overweight and obesity among healthcare science college students at private university in Saudi Arabia. Also, it assesses the relationship between the sociodemographic characteristics and risk of overweight and obesity in this population. METHODS A cross-sectional study was conducted among healthcare science college students. A validated, structured, closed-ended questionnaire was self-administered through the Monkey survey. All data were analyzed using SPSS. RESULTS 401 students participated, in which 33.4% were male and 66.6% were female students; and the mean age was 22 years. The study showed that 23.7% of participants were overweight, and 11% were obese. The prevalence of obesity was higher among males. Family history of obesity and fatigue were risk factors for obesity. CONCLUSION The healthcare Science College students showed a high prevalence of obesity and overweight. This is strengthening the need to encourage a healthy lifestyle, healthy food habits, and physical activities to avoid obesity-related complications.
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Affiliation(s)
- Eyad Makkawy
- Department of Medicine, Gastroenterology Division, Prince Mohammed bin Abdulaziz Hospital, Riyadh, Saudi Arabia
| | - Almaali M. Alrakha
- Medical Students, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Amena F. Al-Mubarak
- Medical Students, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Hanouf T. Alotaibi
- Medical Students, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Nour T. Alotaibi
- Medical Students, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Aeshah A. Alasmari
- Medical Students, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Tahani Altamimi
- Department of Family and Community Medicine, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
- Department of Family Medicine and Community Medicine, College of Medicine, University of Hail, Hail, Saudi Arabia
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More JA, Lanigan J, Emmett P. The development of food portion sizes suitable for 4-18-year-old children used in a theoretical meal plan meeting energy and nutrient requirements. J Hum Nutr Diet 2021; 34:534-549. [PMID: 33492716 DOI: 10.1111/jhn.12852] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/17/2020] [Accepted: 12/01/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Healthy eating guidelines for school-aged children are available but without advice on portion sizes. This is a concern because consuming large portions is associated with an increased risk of overweight/obesity. The present study aimed to calculate recommended portion sizes for school-aged children based on weight for age and use them to develop a meal plan to meet nutritional needs within energy requirements. METHODS Portion size data on foods consumed by school-aged children (4-18 years) were extracted from two sources: (i) British National Diet and Nutrition Survey (1997) and (ii) Avon Longitudinal Study of Parents and Children (1997-2006). Foods were allocated to groups based on the UK Eatwell Guide and the US My Plate Model. Portion sizes were developed for a variety of foods. A meal plan that included portion size guidance and met healthy eating guidelines was developed based on the number of portions of each food group needed to meet dietary requirements. RESULTS Portion sizes were developed for 131 foods that were commonly eaten by children in age groups 4-6, 7-10, 11-14 and 15-18 years. The meal plan met requirements for energy and nutrients as specified by UK dietary reference values, except for vitamin D for which there are few dietary sources. CONCLUSIONS Food portion sizes informed by usual intake in UK children can help inform dietary advice for a range of childhood settings and for parents. The meal plan included a wide variety of foods to encourage dietary diversity and meet energy and nutrient needs for school-aged children.
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Affiliation(s)
- J A More
- Child-Nutrition.co.uk Ltd, London, UK
| | - J Lanigan
- Childhood Nutrition Research, Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
| | - P Emmett
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Health Care of the Adolescent. Fam Med 2021. [DOI: 10.1007/978-1-4939-0779-3_22-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Complementary feeding practices and their association with adiposity indicators at 12 months of age. J Dev Orig Health Dis 2020; 12:780-787. [PMID: 33222718 DOI: 10.1017/s2040174420001038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Nutrition during the first 1000 days of life represents a window of opportunity to reduce the risk of metabolic dysfunctions later in life. Exclusive breastfeeding (EBF) and adequate introduction of solid foods are essential to promote metabolic and nutritional benefits. We evaluated the association of infant feeding practices from birth to 6 months (M) with adiposity indicators at 12 M. We performed a secondary analysis of 106 healthy term infants born from a cohort of healthy pregnant women. Type of breastfeeding (exclusive or nonexclusive), the start of complementary feeding (CF) (before (<4 M) or after (≥4 M)), and adiposity (body mass index - BMI, body mass index-for-age - BMI/A, waist circumference - WC, and waist circumference-length ratio - WLR) were evaluated at 12 M using descriptive statistics, mean differences, X2, and linear regression models. During the first 6 M, 28.3% (n = 30) of the infants received EBF. Early CF (<4 M) was present in 26.4% (n = 28) of the infants. Children who started CF < 4 M were less breastfed, received added sugars as the most frequently introduced food category, and showed higher BMI, BMI/A, WC, and WLR; those who consumed added sugars early (<4 M) had a higher WC. Starting CF < 4 M was the main factor associated with a higher WC at 12 M. Unhealthy infant feeding practices, such as lack of EBF, early CF, and early introduction of sugars, may be associated with higher adiposity at 12 M.
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Al-Jawaldeh A, Taktouk M, Nasreddine L. Food Consumption Patterns and Nutrient Intakes of Children and Adolescents in the Eastern Mediterranean Region: A Call for Policy Action. Nutrients 2020; 12:E3345. [PMID: 33143163 PMCID: PMC7693485 DOI: 10.3390/nu12113345] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 10/23/2020] [Accepted: 10/29/2020] [Indexed: 11/17/2022] Open
Abstract
The Eastern Mediterranean Region (EMR) has witnessed significant social and economic changes that may have influenced the diet of children and adolescents, and increased the risk for obesity and malnutrition in this age group. This review aims to characterize and assess food consumption patterns and nutrient intakes amongst school-aged children (5-10 years) and adolescents (10-19 years) in countries of the EMR. Electronic databases (MedLine, PubMed, Scopus, and Google Scholar) were searched for relevant articles published between 2005 and 2020; international organizations and governmental websites were also searched. Available studies documented low intakes of fruits, vegetables and fiber, inadequate consumption of water, milk and dairy products, coupled with high intakes of fat, saturated fat, and sugar sweetened beverages, as well as a frequent consumption of energy-dense, nutrient poor foods such as sweet and savory snacks. Micronutrient inadequacies were also observed, particularly for calcium, iron, zinc and vitamins A, D, C, and folate. Acknowledging the impact that nutrition may have on building societies and transforming the lives of children, adolescents and their families, there is a crucial need for a food system approach in developing and implementing national and regional policies and interventions aimed at improving the diet of children and adolescents.
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Affiliation(s)
- Ayoub Al-Jawaldeh
- World Health Organization (WHO), Regional Office for the Eastern Mediterranean (EMRO), Cairo 7608, Egypt;
| | - Mandy Taktouk
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 11-0236, Lebanon;
| | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 11-0236, Lebanon;
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Collins J, Maughan RJ, Gleeson M, Bilsborough J, Jeukendrup A, Morton JP, Phillips SM, Armstrong L, Burke LM, Close GL, Duffield R, Larson-Meyer E, Louis J, Medina D, Meyer F, Rollo I, Sundgot-Borgen J, Wall BT, Boullosa B, Dupont G, Lizarraga A, Res P, Bizzini M, Castagna C, Cowie CM, D'Hooghe M, Geyer H, Meyer T, Papadimitriou N, Vouillamoz M, McCall A. UEFA expert group statement on nutrition in elite football. Current evidence to inform practical recommendations and guide future research. Br J Sports Med 2020; 55:416. [PMID: 33097528 DOI: 10.1136/bjsports-2019-101961] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2020] [Indexed: 01/09/2023]
Abstract
Football is a global game which is constantly evolving, showing substantial increases in physical and technical demands. Nutrition plays a valuable integrated role in optimising performance of elite players during training and match-play, and maintaining their overall health throughout the season. An evidence-based approach to nutrition emphasising, a 'food first' philosophy (ie, food over supplements), is fundamental to ensure effective player support. This requires relevant scientific evidence to be applied according to the constraints of what is practical and feasible in the football setting. The science underpinning sports nutrition is evolving fast, and practitioners must be alert to new developments. In response to these developments, the Union of European Football Associations (UEFA) has gathered experts in applied sports nutrition research as well as practitioners working with elite football clubs and national associations/federations to issue an expert statement on a range of topics relevant to elite football nutrition: (1) match day nutrition, (2) training day nutrition, (3) body composition, (4) stressful environments and travel, (5) cultural diversity and dietary considerations, (6) dietary supplements, (7) rehabilitation, (8) referees and (9) junior high-level players. The expert group provide a narrative synthesis of the scientific background relating to these topics based on their knowledge and experience of the scientific research literature, as well as practical experience of applying knowledge within an elite sports setting. Our intention is to provide readers with content to help drive their own practical recommendations. In addition, to provide guidance to applied researchers where to focus future efforts.
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Affiliation(s)
- James Collins
- Intra Performance Group, London, UK.,Performance and Research Team, Arsenal Football Club, London, UK
| | | | - Michael Gleeson
- School of Sports Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Johann Bilsborough
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia.,New England Patriots, Foxboro, MA, USA
| | - Asker Jeukendrup
- School of Sports Exercise and Health Sciences, Loughborough University, Loughborough, UK.,MySport Science, Birmingham, UK
| | - James P Morton
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - S M Phillips
- Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Lawrence Armstrong
- Human Performance Laboratory, University of Connecticut, Storrs, CT, USA
| | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Graeme L Close
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Rob Duffield
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia.,Medical Department, Football Federation Australia, Sydney, New South Wales, Australia
| | - Enette Larson-Meyer
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
| | - Julien Louis
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Daniel Medina
- Athlete Care and Performance, Monumental Sports & Entertainment, Washington, DC, USA
| | - Flavia Meyer
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ian Rollo
- School of Sports Exercise and Health Sciences, Loughborough University, Loughborough, UK.,PepsiCo Life Sciences, Global R&D, Gatorade Sports Science Institute, Birmingham, UK
| | | | - Benjamin T Wall
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | | | - Gregory Dupont
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | | | - Peter Res
- Dutch Olympic Team, Amsterdam, Netherlands
| | - Mario Bizzini
- Research and Human Performance Lab, Schulthess Clinic, Zurich, Switzerland
| | - Carlo Castagna
- University of Rome Tor Vergata, Rome, Italy.,Technical Department, Italian Football Federation (FIGC), Florence, Italy.,Italian Football Referees Association, Bologna, Italy
| | - Charlotte M Cowie
- Technical Directorate, Football Association, Burton upon Trent, UK.,Medical Committee, UEFA, Nyon, Switzerland
| | - Michel D'Hooghe
- Medical Committee, UEFA, Nyon, Switzerland.,Medical Centre of Excelence, Schulthess Clinic, Zurich, Switzerland
| | - Hans Geyer
- Center for Preventive Doping Research, German Sport University Cologne, Cologne, Germany
| | - Tim Meyer
- Medical Committee, UEFA, Nyon, Switzerland.,Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | | | | | - Alan McCall
- Performance and Research Team, Arsenal Football Club, London, UK .,Medical Department, Football Federation Australia, Sydney, New South Wales, Australia.,Sport, Exercise and Health Sciences, School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
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45
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A scoping review of literature describing the nutritional status and diets of adolescents in Côte d'Ivoire. Public Health Nutr 2020; 24:5261-5276. [PMID: 32883396 DOI: 10.1017/s1368980020002621] [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: 11/06/2022]
Abstract
OBJECTIVE Adolescents living in resource-limited settings remain a neglected population regarding their nutritional health. We reviewed what studies on nutrition have been conducted for adolescents living in Côte d'Ivoire. DESIGN A scoping literature review, searching for any quantitative studies published from 1 January 2000 to 1 May 2019, referenced in PubMed and grey literature, related to adolescent nutritional status and diet, written in English or French. SETTING Côte d'Ivoire, West Africa. SUBJECTS Adolescent girls and boys (aged 10-19 years). RESULTS We used three search strategies to explore studies related to (1) diet and nutritional practices, (2) anthropometry and (3) micronutrient intakes/status. Each identified 285, 108 and 84 titles and abstracts, respectively, resulting in 384 full-text articles to review. Finally, after adding five relevant studies from the grey literature, thirty articles were included. Two-thirds were cross-sectional observation studies. The main topics were anaemia and parasitic diseases. Among seven intervention studies, most focused on micronutrient supplementation or deworming. No studies on macronutrients or food supplementation were found. Overall, studies showed a high prevalence of undernutrition, along with emerging overweight and obesity. Anaemia and Fe deficiency were highly prevalent, with Fe supplementation showing modest improvements. Malaria and gut parasite infections remain a major burden, affecting adolescents' nutritional status. CONCLUSIONS Few specific relevant studies have been published regarding adolescent nutrition in Côte d'Ivoire, and most studies being focused on younger children. There are knowledge gaps about many nutritional aspects in this population, which urgently need to be addressed.
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Hernandez RG, Garcia JT, Amankwah EK. A Look Back at Healthy Lifestyle Behavioral Patterns among School-Age Children: Are We Neglecting Healthy Weight for Overweight Kids? Child Obes 2020; 15:271-279. [PMID: 30920296 DOI: 10.1089/chi.2018.0334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: To describe prevalence of healthy lifestyle behaviors (HLBs) between two school-age cohorts of racial-ethnically diverse children. Methods: Using two Early Childhood Longitudinal Study cohorts (ECLS-K 1999 and 2010), we compared percentage change in HLBs (sleep, physical activity, screen time, and family meals) by child weight groups and within racial-ethnic groups. Weight groups of interest included healthy weight (HW; BMI 5th-84th percentile), overweight (OW; ≥ 85th-94th), obese (OB; ≥ 95th-99th percentile), and severely obese (SO; ≥ 99th percentile). Results: OW children within the 2010 cohort reported greater percentage change (range: 2.0%-15.1% increase) in HLBs, whereas HW children demonstrated lower percentage change (range: -6.2% to 8.7% increase). OB and SO children showed significant lower percentage change in reducing screen time (range: -11.0% and -12.7%, respectively). HW Latino children demonstrated the least favorable trends with overall declines noted for 4/5 HLBs. Screen time was noted to have the greatest degree of favorable change (2%-14%) across weight groups, whereas adequate sleep duration demonstrated the lowest favorable percentage change (2%-2.8%). Conclusion: Fewer HW and OB children were participating in recommended HLBs compared with OW children in 2010. Recent health campaigns may have helped providers prioritize the identification and counseling of OW children, yet our data suggest that we may be neglecting the role of HLB counseling in OB and HW children. Continued analysis on the social determinants that impact HLBs in school-age and HW/OB minority children should inform how we can best tailor counseling and messages in the coming decades.
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Affiliation(s)
- Raquel G Hernandez
- 1 Department of Pediatrics Johns Hopkins University School of Medicine, Baltimore, MD.,2 Johns Hopkins All Children's Hospital, St. Petersburg, FL
| | | | - Ernest K Amankwah
- 1 Department of Pediatrics Johns Hopkins University School of Medicine, Baltimore, MD.,2 Johns Hopkins All Children's Hospital, St. Petersburg, FL
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47
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Rice J, Ramtekkar U. Integrative Management of Metabolic Syndrome in Youth Prescribed Second-Generation Antipsychotics. Med Sci (Basel) 2020; 8:medsci8030034. [PMID: 32824428 PMCID: PMC7564042 DOI: 10.3390/medsci8030034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/20/2020] [Accepted: 07/30/2020] [Indexed: 02/07/2023] Open
Abstract
Weight gain and metabolic syndrome are common side effects of second-generation antipsychotics and carry significant health consequences both in childhood and into adulthood. This review highlights evidence-based, non-pharmacologic interventions to assist in the management of these side effects. Such intervention categories include dietary, physical activity, sleep, stress management, and nutritional supplementation. Interventions with the highest quality evidence include increasing the consumption of fruits, vegetables, and whole grains, increasing physical activity, improving sleep, and fish oil supplementation. We suggest that clinicians work with patients on managing metabolic side effects in a patient-centered way, incorporating principles of motivational interviewing, to reduce the risk of metabolic syndrome.
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Affiliation(s)
- Jessie Rice
- Department of Psychiatry, University of Arizona, Tucson, AZ 85721, USA;
| | - Ujjwal Ramtekkar
- Partners for Kids, Columbus, OH 43215, USA
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH 43210, USA
- Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH 43210, USA
- Correspondence:
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48
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Said L, Gubbels JS, Kremers SPJ. Dietary Knowledge, Dietary Adherence, and BMI of Lebanese Adolescents and Their Parents. Nutrients 2020; 12:nu12082398. [PMID: 32796513 PMCID: PMC7468749 DOI: 10.3390/nu12082398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/04/2020] [Accepted: 08/06/2020] [Indexed: 12/28/2022] Open
Abstract
Paediatric obesity is a severe public health problem accompanied by several physical and mental complications, mainly due to an imbalance between energy input and output. Dietary behaviours are influenced by many demographic factors and determinants, such as the place of residence and the level of dietary knowledge of the children and their parents. The aim of the current paper is to assess the levels of dietary knowledge, dietary adherence (in relation to recommendations), and the body mass index (BMI) of Lebanese adolescents in association with demographic variables, their parents’ dietary knowledge and adherence levels, and with other lifestyle behaviours. This cross-sectional study included 1535 Lebanese adolescents aged 15 to 18 years, from 16 public and private high schools located in urban and rural regions, and 317 of their parents. Our results showed that 30.2% of the adolescents were overweight or obese. Participants enrolled in private schools and those living in urban regions had a significantly higher BMI z-score compared to those enrolled in public schools and living in rural regions, respectively. In addition, Lebanese adolescents generally had low levels of dietary knowledge and 32.4% had low levels of dietary adherence. Their dietary adherence was significantly associated with their parents’ dietary adherence. The findings underline the significant role of the parents in shaping their children’s eating behaviours, in addition to the other determinants and factors affecting the diet of Lebanese adolescents. As the prevalence of paediatric overweight and obesity has reached alarming rates, the results of the current study have important implications for both public health policies and obesity prevention interventions in the Middle East and worldwide.
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Affiliation(s)
- Liliane Said
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine, and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands; (J.S.G.); (S.P.J.K.)
- Department of Nutrition and Food Sciences, Faculty of Arts and Sciences, Lebanese International University, Bekaa, Lebanon
- Correspondence:
| | - Jessica S. Gubbels
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine, and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands; (J.S.G.); (S.P.J.K.)
| | - Stef P. J. Kremers
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine, and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands; (J.S.G.); (S.P.J.K.)
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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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50
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Vizzuso S, Amatruda M, Del Torto A, D’Auria E, Ippolito G, Zuccotti GV, Verduci E. Is Macronutrients Intake a Challenge for Cardiometabolic Risk in Obese Adolescents? Nutrients 2020; 12:nu12061785. [PMID: 32560039 PMCID: PMC7353408 DOI: 10.3390/nu12061785] [Citation(s) in RCA: 4] [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: 05/03/2020] [Revised: 06/07/2020] [Accepted: 06/15/2020] [Indexed: 12/29/2022] Open
Abstract
(1) Background: Pediatric obesity is an emerging public health issue, mainly related to western diet. A cross-sectional study was conducted to explore the association between macronutrients intake and cardiometabolic risk factors in obese adolescents. (2) Methods: Ninety-three Italian obese adolescents were recruited; anthropometric parameters, body composition, glucose and lipid metabolism profiles were measured. Macronutrients intake was estimated by a software-assisted analysis of a 120-item frequency questionnaire. The association between macronutrients and cardiometabolic risk factors was assessed by bivariate correlation, and multiple regression analysis was used to adjust for confounders such as age and sex. (3) Results: By multiple regression analysis, we found that higher energy and lower carbohydrate intakes predicted higher body mass index (BMI) z-score, p = 0.005, and higher saturated fats intake and higher age predicted higher HOmeostasis Model Assessment of insulin resistance (HOMA-IR) and lower QUantitative Insulin-sensitivity ChecK (QUICK) index, p = 0.001. In addition, a saturated fats intake <7% was associated with normal HOMA-IR, and a higher total fats intake predicted a higher HOMA of percent β-cell function (HOMA-β), p = 0.011. (4) Conclusions: Higher energy intake and lower carbohydrate dietary intake predicted higher BMI z-score after adjustment for age and sex. Higher total and saturated fats dietary intakes predicted insulin resistance, even after adjustment for confounding factors. A dietary pattern including appropriate high-quality carbohydrate and reduced saturated fat intakes could result in reduced cardiometabolic risk in obese adolescents.
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Affiliation(s)
- Sara Vizzuso
- Department of Health Sciences, University of Milan, 20133 Milan, Italy; (S.V.); (M.A.); (G.I.)
| | - Matilde Amatruda
- Department of Health Sciences, University of Milan, 20133 Milan, Italy; (S.V.); (M.A.); (G.I.)
| | | | - Enza D’Auria
- Department of Pediatrics, Vittore Buzzi Children’s Hospital University of Milan, 20154 Milan, Italy; (E.D.); (G.V.Z.)
| | - Giulio Ippolito
- Department of Health Sciences, University of Milan, 20133 Milan, Italy; (S.V.); (M.A.); (G.I.)
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children’s Hospital University of Milan, 20154 Milan, Italy; (E.D.); (G.V.Z.)
| | - Elvira Verduci
- Department of Health Sciences, University of Milan, 20133 Milan, Italy; (S.V.); (M.A.); (G.I.)
- Department of Pediatrics, Vittore Buzzi Children’s Hospital University of Milan, 20154 Milan, Italy; (E.D.); (G.V.Z.)
- Correspondence:
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