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Kokkou S, Notara V, Kanellopoulou A, Lagiou A, Panagiotakos D. Protein Intake, Source and Effect on Children's Weight Status: An Epidemiological Study in Greece. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1606. [PMID: 37892269 PMCID: PMC10605076 DOI: 10.3390/children10101606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023]
Abstract
The development of overweight and obesity during late childhood and early adolescence is one of the most critical issues in public health. Additionally, over the past few years, the consumption of protein has tended to increase in both children and adults. The present study aimed to evaluate whether the protein type, either plant- or animal-sourced, as well as the quantity consumed, could potentially have a relationship with excess body weight in children. A total of 47 primary schools were selected, and 1728 students, aged 10-12 years, were enrolled for the purposes of this study, leading to our final sample of 712. Physical measurements, such as weight and height, were measured, and children were separated into two weight status categories according to their Body Mass Index, which was obtained through the International Obesity Task Force criteria. Students' diets were assessed through a questionnaire, and total, plant- and animal-derived protein intakes were calculated. Unadjusted analysis showed a statistically significant association between body weight and plant protein. After adjustment for overall energy intake, sex, age, and exercise, there was a statistically significant negative association between plant protein and excess body weight in children (OR: 0.964, 95% CI: 0.936; 0.992), but a lack of association for animal-sourced protein (OR: 1.002, 95% CI: 0.991; 1.013). Dietary plant-derived protein seems to have a positive effect on weight status in children, independently of total energy intake and physical activity; nevertheless, additional research is required in order to elucidate the underlying mechanisms.
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Affiliation(s)
- Stamatia Kokkou
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, School of Public Health, University of West Attica, Alexandras Avenue 196, 115 21 Athens, Greece
| | - Venetia Notara
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, School of Public Health, University of West Attica, Alexandras Avenue 196, 115 21 Athens, Greece
| | - Aikaterini Kanellopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Thiseos 70, 176 76 Athens, Greece
| | - Areti Lagiou
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, School of Public Health, University of West Attica, Alexandras Avenue 196, 115 21 Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Thiseos 70, 176 76 Athens, Greece
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Tanous DR, Ruedl G, Kirschner W, Drenowatz C, Craddock J, Rosemann T, Wirnitzer K. School health programs of physical education and/or diet among pupils of primary and secondary school levels I and II linked to body mass index: A systematic review protocol within the project From Science 2 School. PLoS One 2022; 17:e0275012. [PMID: 36201567 PMCID: PMC9536596 DOI: 10.1371/journal.pone.0275012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/08/2022] [Indexed: 11/13/2022] Open
Abstract
The most common causes of death in Western countries today are preventable diseases mainly attributed to daily behavior. It has been well documented that genetics are influential but not the deciding factor for developing non-communicable diseases. Ideally, the public should be educated to perform methods of optimal health and wellbeing independently, meaning that individuals should be in control of their health without relying on others. As behavior is known to be consistent over time, good or poor health behavior will track from childhood into adulthood. Physical activity and diet are permanently linked to the individual's state of health, and when properly balanced, the effects on personal health summate, resulting in greater benefits from this dual-approach for public health. The objective is to highlight the different approaches (physical intervention, nutritional intervention, and dual-approach of diet and exercise) and identify effective interventions for sustainable body weight and healthy body mass index in school children. A systematic review will be conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The review will assess school-based diet and exercise interventions on children in primary and secondary school levels I and II. Overweight and obesity develop as a result of a prolonged imbalance in the energy balance model, with both physical activity and diet being influential in the fluctuation of body weight. A dual-approach including physical activity and diet could therefore be a very promising method to promote sustainable healthy body weight in school children.
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Affiliation(s)
- Derrick R. Tanous
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- * E-mail:
| | - Gerhard Ruedl
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
| | - Werner Kirschner
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
| | - Clemens Drenowatz
- Division of Physical Education, University of Education Upper Austria, Linz, Austria
| | - Joel Craddock
- Sydney School of Education and Social Work, The University of Sydney, Sydney, Australia
| | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Katharina Wirnitzer
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Health and Lifestyle Science Cluster Tirol, Subcluster Health/Medicine/Psychology, Tyrolean University Conference, Verbund West, Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
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Benefits of a plant-based diet and considerations for the athlete. Eur J Appl Physiol 2022; 122:1163-1178. [PMID: 35150294 DOI: 10.1007/s00421-022-04902-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/25/2022] [Indexed: 12/31/2022]
Abstract
Individuals may opt to follow a plant-based diet for a variety of reasons, such as religious practices, health benefits or concerns for animal or environmental welfare. Such diets offer a broad spectrum of health benefits including aiding in the prevention and management of chronic diseases. In addition to health benefits, a plant-based diet may provide performance-enhancing effects for various types of exercise due to high carbohydrate levels and the high concentration of antioxidants and phytochemicals found in a plant-based diet. However, some plant-based foods also contain anti-nutrional factors, such as phytate and tannins, which decrease the bioavailability of key nutrients, such as iron, zinc, and protein. Thus, plant-based diets must be carefully planned to ensure adequate intake and absorption of energy and all essential nutrients. The current narrative review summarizes the current state of the research concerning the implications of a plant-based diet for health and exercise performance. It also outlines strategies to enhance the bioavailability of nutrients, sources of hard-to-get nutrients, and sport supplements that could interest plant-based athletes.
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Soy Food Intake Associated with Obesity and Hypertension in Children and Adolescents in Guangzhou, Southern China. Nutrients 2022; 14:nu14030425. [PMID: 35276781 PMCID: PMC8839714 DOI: 10.3390/nu14030425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/13/2022] [Accepted: 01/16/2022] [Indexed: 11/17/2022] Open
Abstract
The associations between soy food intake and cardio-metabolic risk factors in children remain unclear due to limited evidence. We aim to explore soy food intake and its association with the risks of obesity and hypertension in Chinese children and adolescents. A total of 10,536 children and adolescents aged 7–18 years (5125 boys and 5411 girls) were enrolled in a cross-sectional study in Guangzhou City, southern China. Data on demographic characteristics and dietary consumption were collected using self-reported questionnaires, and anthropometric characteristics were measured. Obesity, abdominal obesity, and hypertension were defined using Chinese criteria for children and adolescents. A multiple logistic regression model was applied to estimate the association between soy food intake and obesity and hypertension. Roughly 39.5% of the participants consumed soy food more than three times per week. The mean amounts of liquid and solid soy food intake were 0.35 ± 0.54 cups/day and 0.46 ± 0.63 servings/day, respectively. The adjusted odds ratios (OR) of hypertension among those with high liquid soy food intake and a high frequency of all soy food intake (more than three times/week) were 0.79 (95% confidence interval (CI), 0.67–0.94), and 0.83 (95% CI, 0.70–0.97) compared to those with no intake. Additionally, the adjusted OR of obesity among those with high solid soy food intake and a high frequency of all soy food intake were 1.34 (95% CI, 1.09–1.63) and 1.30 (95% CI, 1.07–1.58), respectively. In conclusion, 39.5% of southern Chinese children and adolescents had high soy food intake (more than three times/week), which was significantly associated with a lower prevalence of hypertension and a greater prevalence of obesity.
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Makri R, Katsoulis M, Fotiou A, Kanavou E, Stavrou M, Richardson C, Kanellopoulou A, Orfanos P, Benetou V, Kokkevi A. Prevalence of Overweight and Obesity and Associated Diet-Related Behaviours and Habits in a Representative Sample of Adolescents in Greece. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9010119. [PMID: 35053743 PMCID: PMC8774704 DOI: 10.3390/children9010119] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/05/2022] [Accepted: 01/11/2022] [Indexed: 01/22/2023]
Abstract
Excessive body weight during adolescence represents a significant public health problem worldwide. Identifying factors associated with its development is crucial. We estimated the prevalence of overweight and obesity in a representative sample of 11, 13 and, 15-year-olds living in Greece and explored the association with diet-related behaviours and habits. Self-reported data on weight, height, diet-related behaviours and habits were used from 3816 students (1898 boys, 1918 girls) participants in the Greek arm of the international Health Behaviour in School-Aged Children (HBSC) study during 2018. Overweight and obesity were defined using the 2007 WHO growth charts classification. Prevalence of overweight was 19.4% in the total sample, 24.1% for boys and 14.7% for girls, and prevalence of obesity was 5.3% in the total sample, 7.3% for boys and 3.4% for girls, respectively. In the total sample, overweight (including obesity) was positively associated with male gender, low family affluence, skipping breakfast, and being on a diet, and inversely associated with age and being physically active. Eating rarely with the family was positively associated with overweight only among boys and eating snacks/meals in front of screens only among girls. No association was noted for eating in fast-food restaurants, consuming vegetables, fruits, sweets, and sugar-sweetened beverages.
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Affiliation(s)
- Rafaela Makri
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 115-27 Athens, Greece; (R.M.); (P.O.)
| | - Michail Katsoulis
- Institute of Health Informatics, Faculty of Population Health Sciences, University College London, London ΝW1 2DA, UK;
- MRC Unit for Lifelong Health and Ageing, Institute of Cardiovascular Science, Faculty of Population Health Sciences, London WC1E 7HB, UK
| | - Anastasios Fotiou
- University Mental Health, Neurosciences, & Precision Medicine Research Institute “Costas Stefanis” (UMHRI), 115-27 Athens, Greece; (A.F.); (E.K.); (M.S.); (A.K.)
| | - Eleftheria Kanavou
- University Mental Health, Neurosciences, & Precision Medicine Research Institute “Costas Stefanis” (UMHRI), 115-27 Athens, Greece; (A.F.); (E.K.); (M.S.); (A.K.)
| | - Myrto Stavrou
- University Mental Health, Neurosciences, & Precision Medicine Research Institute “Costas Stefanis” (UMHRI), 115-27 Athens, Greece; (A.F.); (E.K.); (M.S.); (A.K.)
| | - Clive Richardson
- Department of Economic and Regional Development, Panteion University of Social and Political Sciences, 176-71 Athens, Greece;
| | - Afroditi Kanellopoulou
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, 451-10 Ioannina, Greece;
| | - Philippos Orfanos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 115-27 Athens, Greece; (R.M.); (P.O.)
| | - Vassiliki Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 115-27 Athens, Greece; (R.M.); (P.O.)
- Correspondence: ; Tel.: +30-210-7462074
| | - Anna Kokkevi
- University Mental Health, Neurosciences, & Precision Medicine Research Institute “Costas Stefanis” (UMHRI), 115-27 Athens, Greece; (A.F.); (E.K.); (M.S.); (A.K.)
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Abstract
Acculturation may influence diet pattern, a risk factor for cardiometabolic disease. We assessed whether strength of traditional cultural beliefs and practices, a robust measure of acculturation, affects diet pattern among South Asians in America. With data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) cohort, we used ordinal logistic regression to assess the association between strength of traditional cultural beliefs, 6 cultural practices and diet pattern. Of 892 participants, 47% were women. Weaker traditional cultural beliefs [OR(95%CI) 1.07(1.04,1.10)] and cultural practices (p < 0.05) were associated with consuming more of the Animal Protein dietary pattern and less [0.95(0.93,0.97)] of the Fried snacks, Sweets, High-fat dairy (FSHD) pattern (P < 0.05). South Asians in America with stronger traditional cultural beliefs and practices were more likely to consume the FSHD pattern. Prevention programs may consider dietary pattern modification as part of comprehensive risk reduction in South Asians.
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Motswagole B, Jackson J, Kobue-Lekalake R, Maruapula S, Mongwaketse T, Kwape L, Thomas T, Swaminathan S, Kurpad AV, Jackson M. The Association of General and Central Obesity with Dietary Patterns and Socioeconomic Status in Adult Women in Botswana. J Obes 2020; 2020:4959272. [PMID: 32963826 PMCID: PMC7491446 DOI: 10.1155/2020/4959272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 03/31/2020] [Accepted: 08/05/2020] [Indexed: 11/17/2022] Open
Abstract
Dietary patterns and their association with general and central obesity among adult women were studied using a cross-sectional survey with multistage cluster sampling in urban and rural areas nationwide in Botswana. The participants in the study were adult women (N = 1019), 18-75 years old. The dietary patterns were identified using principal component analysis, and their associations with the body mass index and the weight-for-height ratio were examined. Factor analysis with varimax rotation was used to identify six dietary patterns (fast foods, refined carbohydrates, vegetables and fruits, fish and nuts, Botswana traditional foods, and organ and red meat dietary pattern). Overall, 24.5% of the women were overweight (BMI 25.0-29.99 kg/m2) and 24.5% were obese (BMI > 30 kg/m2). A waist-to-height ratio greater than 0.5 was observed for 42.2% of the women. With adjustment for age and education, individuals in the highest tertile of the Botswana traditional food pattern had a significantly higher risk of general obesity (RR = 1.40, 95% CI: 1.07-1.84) and central obesity (RR = 1.20, 95% CI: 0.97-1.48). With respect to the fish and nut pattern, a significant association was observed with central obesity only (RR = 1.43, 95% CI: 1.18-1.72). The Botswana traditional food pattern, characterised by a high carbohydrate intake, was found to be associated with a high risk of obesity in this study. However, more research is required to assess other factors contributing to obesity in women so that appropriate intervention programs can be put in place to help control this epidemic.
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Affiliation(s)
- Boitumelo Motswagole
- National Food Technology Research Centre, Department of Nutrition and Dietetics, Private Bag 8, Kanye, Botswana
| | - Jose Jackson
- Michigan State University, Alliance for African Partnership, 427 N Shaw Lane, East Lansing, Michigan 48824, USA
| | - Rosemary Kobue-Lekalake
- Botswana University of Agriculture and Natural Resources, Department of Food Science and Technology, Private Bag, 0027 Gaborone, Botswana
| | - Segametsi Maruapula
- University of Botswana, Department of Family and Consumer Sciences, Private Bag, 0022 Gaborone, Botswana
| | - Tiyapo Mongwaketse
- National Food Technology Research Centre, Department of Nutrition and Dietetics, Private Bag 8, Kanye, Botswana
| | - Lemogang Kwape
- National Food Technology Research Centre, Department of Nutrition and Dietetics, Private Bag 8, Kanye, Botswana
- Ministry of Health & Wellness, Private Bag, 0038 Gaborone, Botswana
| | - Tinku Thomas
- St Johns Research Institute, Koramangala, Bengaluru, Karnataka, India
| | | | - Anura V. Kurpad
- St Johns Research Institute, Koramangala, Bengaluru, Karnataka, India
| | - Maria Jackson
- University of the West Indies, Department of Community Health and Psychiatry, Kingston, Jamaica
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Cai Z, Xian J, Xu X, Zhang Z, Araujo C, Sharma M, Zhao Y. Dietary Behaviours Among Han, Tujia and Miao Primary School Students: A Cross-Sectional Survey in Chongqing, China. Risk Manag Healthc Policy 2020; 13:1309-1318. [PMID: 32922099 PMCID: PMC7457872 DOI: 10.2147/rmhp.s249101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 07/31/2020] [Indexed: 11/23/2022] Open
Abstract
Background and Purpose Exploring the differences of children's dietary behaviours from different nationalities could provide a reference for targeted nutritional interventions. This study aims to assess the dietary behaviours among Han, Tujia and Miao primary school students and the differences among the ethnic groups. Materials and Methods This cross-sectional survey included 556 primary school students (249 Han, 76 Tujia and 231 Miao students) aged 6-13 years from the representative minority areas of Chongqing, China. Data were collected with a self-administered or one-on-one interview-based questionnaire encompassing questions on sociodemographics, eating habits and dietary intake. Eating habits and dietary intake were categorized into health-protective and health-risk dietary behaviours. χ2 tests were conducted to examine the differences in eating habits and dietary intake among the three ethnic groups. Forward stepwise logistic regression models were performed to check the factors affecting dietary intake. Results Fewer than half of the students had health-protective dietary behaviours in terms of rice, fruit, fish, eggs and milk intake. Compared with Han students, Tujia students were more likely to meet the recommended intake of vegetables (OR = 2.13, 95% CI [1.22-3.69]), less likely to meet the recommended intake of meat (OR = 0.58, 95% CI [0.35-0.94]) and fish (OR = 0.55, 95% CI [0.32-0.94]); Miao students were more likely to meet the recommended intake of vegetables (OR = 1.73, 95% CI [1.20-2.51]), fruits (OR = 1.62, 95% CI [1.16-2.28]) and water (OR = 1.59, 95% CI [1.12-2.26]) than those of Han students. Conclusion The low proportion of health-protective dietary behaviours among primary school students from Han, Tujia and Miao ethnicities was found in this study. There were differences in dietary behaviours among the three ethnic groups. This study could provide a reference for implementing national dietary guidelines in consideration of socioeconomic status, ways of preparing and consuming foods, traditional foods and customs of different ethnic groups.
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Affiliation(s)
- Zhengjie Cai
- School of Public Health and Management, Chongqing Medical University, Chongqing, People's Republic of China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, People's Republic of China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Jinli Xian
- School of Public Health and Management, Chongqing Medical University, Chongqing, People's Republic of China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, People's Republic of China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Xianglong Xu
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia.,China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health, Science Center, Xi'an, Shanxi, People's Republic of China
| | - Ziwei Zhang
- The Second Clinical College, Chongqing Medical University, Chongqing, People's Republic of China
| | - Camila Araujo
- Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Manoj Sharma
- Environmental and Occupational Health, School of Public Health, University of Nevada , Las Vegas, NV, USA
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Chongqing, People's Republic of China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, People's Republic of China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, People's Republic of China.,Chongqing Key Laboratory of Child Nutrition and Health, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
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Jafari M, Izadi A, Dehghan P, Mojtahedi SY. Dietary diversities score and anthropometric characteristics in Iranian elementary school children. Eur J Transl Myol 2019; 29:8339. [PMID: 31579479 PMCID: PMC6767834 DOI: 10.4081/ejtm.2019.8339] [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: 06/09/2019] [Accepted: 07/05/2019] [Indexed: 11/23/2022] Open
Abstract
Dietary diversity scoring is a good method to assess quality of individual's diet. The study aimed to investigate the association between dietary diversity and body mass index among elementary school students in the south of Tehran, Iran. This cross-sectional study was conducted on elementary school students, age range of 7-12 years old, in 2015. Data were collected using a personal information questionnaire and three 24-h recall questionnaires. Dietary diversity score was calculated from the number of food groups in these questionnaires. A total of 536 students, 258 (48.1%) female and 278 (51.9%) male, were recruited in the study. The mean age of the students was 9.43 ± 1.73 years. Seafood consumption was more frequent and beans was lower frequent in students at higher BMI (≥95th percentile) than the other children (34% vs 25% and 71% vs 83%, respectively, p<0.05). However, the statistical analysis failed to find significant relationships between children’s body mass index (BMI) with consumption of diary, vegetable, fruits, protein, fat, and junk food intake. The association between children's BMI with seafood and beans consumption confirmed in multivariate analysis (OR= 1.50 and 0.52, respectively, p<0.05). The study finding showed that seafood and beans consumption may influence on elementary student BMI.
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Affiliation(s)
- Mohsen Jafari
- Department of pediatric infectious diseases, Bahrami children Hospital, Tehran University of Medical sciences, Tehran, Iran
| | - Anahita Izadi
- Department of pediatric infectious diseases, Tehran University of Medical sciences, Tehran, Iran
| | - Paniz Dehghan
- School of Medicine, Ziyaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sayed Yousef Mojtahedi
- Department of pediatric nephrology, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Nga VT, Dung VNT, Chu DT, Tien NLB, Van Thanh V, Ngoc VTN, Hoan LN, Phuong NT, Pham VH, Tao Y, Linh NP, Show PL, Do DL. School education and childhood obesity: A systemic review. Diabetes Metab Syndr 2019; 13:2495-2501. [PMID: 31405667 DOI: 10.1016/j.dsx.2019.07.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 07/08/2019] [Indexed: 01/24/2023]
Abstract
Childhood obesity prevalence is shooting up at a phenomenal rate worldwide, leading to long-term devastating consequences. A great number of studies have investigated factors contributing to the increase in BMI of children and adolescents. School-based, home-based and clinic-based solutions have been suggested as possible viable strategies, among which school-based interventions is believed to produce a noticeable effect on a massive scale. However, the question of whether school interventions, especially school education exert significant impact on childhood obesity or not, is left with mixing results. This article aims to holistically review the relationship between school education and childhood obesity. Various factors are covered, including health education, nutrition education, school nutrition, physical education, teachers' awareness, teaching practice and school stress, In all, school education is not the answer to childhood obesity but just part of it. More attempts from other stakeholders (parents, community, policy makers, researchers, etc.) should be made in order to solve this complicated puzzle.
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Affiliation(s)
- Vu Thi Nga
- Institute for Research and Development, Duy Tan University, 03 QuangTrung, Danang, Viet Nam
| | | | - Dinh-Toi Chu
- Faculty of Biology, Hanoi National University of Education, Hanoi, Viet Nam; School of Odonto Stomatology, Hanoi Medical University, Hanoi, Viet Nam.
| | - Nguyen Le Bao Tien
- Institute of Orthopaedics and Trauma Surgery, Viet Duc Hospital, Hanoi, Viet Nam
| | - Vo Van Thanh
- Institute of Orthopaedics and Trauma Surgery, Viet Duc Hospital, Hanoi, Viet Nam; Department of Surgery, Hanoi Medical University, Hanoi, Viet Nam
| | | | - Le Ngoc Hoan
- Faculty of Biology, Hanoi National University of Education, Hanoi, Viet Nam
| | - Nguyen Thi Phuong
- NTT Hi-tech Institute, Nguyen Tat Thanh University, 300A Nguyen Tat Thanh St, Ward 13, District 4, Ho Chi Minh City, Viet Nam
| | - Van-Huy Pham
- AI Lab, Faculty of Information Technology, Ton Duc Thang University, Ho Chi Minh City, Viet Nam.
| | - Yang Tao
- College of Food Science and Technology, Nanjing Agricultural University, Nanjing 8, 210095, China
| | | | - Pau Loke Show
- Department of Chemical and Environmental Engineering, Faculty of Engineering, University of Nottingham Malaysia Campus, JalanBroga, 43500, Semenyih, Selangor Darul Ehsan, Malaysia
| | - Duc-Lan Do
- National Centre for Sustainable Development of General Education Quality, Vietnam National Institute of Educational Sciences, Hanoi, Viet Nam
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11
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Weder S, Hoffmann M, Becker K, Alexy U, Keller M. Energy, Macronutrient Intake, and Anthropometrics of Vegetarian, Vegan, and Omnivorous Children (1⁻3 Years) in Germany (VeChi Diet Study). Nutrients 2019; 11:nu11040832. [PMID: 31013738 PMCID: PMC6521189 DOI: 10.3390/nu11040832] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 04/08/2019] [Accepted: 04/10/2019] [Indexed: 12/16/2022] Open
Abstract
Due to the lack of current, large-scale studies examining their dietary intake and health, there are concerns about vegetarian (VG) and vegan (VN) diets in childhood. Therefore, the Vegetarian and Vegan Children Study (VeChi Diet Study) examined the energy and macronutrient intake as well as the anthropometrics of 430 VG, VN, and omnivorous (OM) children (1⁻3 years) in Germany. A 3-day weighed dietary record assessed dietary intake, and an online questionnaire assessed lifestyle, body weight (BW), and height. Average dietary intakes and anthropometrics were compared between groups using ANCOVA. There were no significant differences in energy intake or density and anthropometrics between the study groups. OM children had the highest adjusted median intakes of protein (OM: 2.7, VG: 2.3, VN: 2.4 g/kg BW, p < 0.0001), fat (OM: 36.0, VG: 33.5, VN: 31.2%E, p < 0.0001), and added sugars (OM: 5.3, VG: 4.5, VN: 3.8%E, p = 0.002), whereas VN children had the highest adjusted intakes of carbohydrates (OM: 50.1, VG: 54.1, VN: 56.2%E, p < 0.0001) and fiber (OM: 12.2, VG: 16.5, VN: 21.8 g/1,000 kcal, p < 0.0001). Therefore, a VG and VN diet in early childhood can provide the same amount of energy and macronutrients, leading to a normal growth in comparison to OM children.
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Affiliation(s)
- Stine Weder
- Fachhochschule des Mittelstands (FHM), University of Applied Sciences, 33602 Bielefeld, Germany.
- Biochemistry and Molecular Biology, Interdisciplinary Research Center, Justus Liebig University Giessen, 35392 Giessen, Germany.
| | - Morwenna Hoffmann
- Fachhochschule des Mittelstands (FHM), University of Applied Sciences, 33602 Bielefeld, Germany.
| | - Katja Becker
- Biochemistry and Molecular Biology, Interdisciplinary Research Center, Justus Liebig University Giessen, 35392 Giessen, Germany.
| | - Ute Alexy
- IEL-Nutritional Epidemiology, DONALD Study, University of Bonn, 44225 Dortmund, Germany.
| | - Markus Keller
- Fachhochschule des Mittelstands (FHM), University of Applied Sciences, 33602 Bielefeld, Germany.
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12
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Verdaguer S, Mateo KF, Wyka K, Dennis-Tiwary TA, Leung MM. A Web-Based Interactive Tool to Reduce Childhood Obesity Risk in Urban Minority Youth: Usability Testing Study. JMIR Form Res 2018; 2:e21. [PMID: 30684417 PMCID: PMC6334715 DOI: 10.2196/formative.9747] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 05/25/2018] [Accepted: 07/06/2018] [Indexed: 11/13/2022] Open
Abstract
Background Childhood obesity is a serious public health issue among minority youth in the United States. Technology-enhanced approaches can be effective for promoting healthy behavior change. Objective The purpose of this study was to test the usability of prototypes of a Web-based interactive tool promoting healthy dietary behaviors to reduce childhood obesity risk in urban minority youth. The Web-based tool comprised a manga-style comic with interactive features (eg, sound effects, clickable pop-ups), tailored messaging, and goal setting, and was optimized for use on tablet devices. Methods Latino and black/African American children ages 9 to 13 years were recruited to participate in two rounds of usability testing. A modified think-aloud method was utilized. Self-reported surveys and field notes were collected. Audio recordings and field notes from usability testing sessions were systematically reviewed by extracting and coding user feedback as either positive comments or usability or negative issues. The quantitative data from self-reported questionnaires were analyzed using descriptive statistics. Results Twelve children (four female; eight black/African American) with a mean age of 10.92 (SD 1.16) years participated. Testing highlighted overall positive experiences with the Web-based interactive tool, especially related to storyline, sound effects, and color schemes. Specific usability issues were classified into six themes: appearance, content, special effects, storyline, terminology, and navigation. Changes to the Web-based tool after round 1 included adding a navigation guide, making clickable icons more visible, improving graphic designs, and fixing programming errors. In round 2 of testing (after modifications to the Web-based tool were incorporated), many of the usability issues that were identified in round 1 did not emerge. Conclusions Results of testing will inform further development and finalization of the tool, which will be tested using a two-group pilot randomized study, with the goal of reducing childhood obesity risk in minority, low-income youth.
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Affiliation(s)
- Sandra Verdaguer
- School of Urban Public Health, Hunter College, The City University of New York, New York, NY, United States.,Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, United States
| | - Katrina F Mateo
- School of Urban Public Health, Hunter College, The City University of New York, New York, NY, United States.,Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, United States
| | - Katarzyna Wyka
- Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, United States
| | - Tracy A Dennis-Tiwary
- School of Arts and Sciences, Hunter College, The City University of New York, New York, NY, United States.,The Graduate Center, The City University of New York, New York, NY, United States
| | - May May Leung
- School of Urban Public Health, Hunter College, The City University of New York, New York, NY, United States
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13
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Stea TH, Tveter ET, te Velde SJ, Vik FN, Klepp KI, Bere E. The effect of an extra piece of fruit or vegetables at school on weight status in two generations - 14 years follow-up of the Fruit and Vegetables Makes the Marks study. PLoS One 2018; 13:e0205498. [PMID: 30321202 PMCID: PMC6188749 DOI: 10.1371/journal.pone.0205498] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 09/26/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The obesity epidemic presents a major public health challenge, and a poor diet quality has been identified as one of the most important contributing factors. Whereas a sufficient fruit and vegetable consumption has been associated with several positive health outcomes, the long-term effect on overweight and obesity is unclear. Thus, the aims of this study were to investigate if one year with free school fruit had any effect on weight status 14 years later, and if it affected the birth weight of the participants' children. METHODS In 2001, 10 -12-year old Norwegian children, received one year of free school fruit in the intervention study "Fruits and Vegetables Make the Marks" (FVMM) and in 2016, a total of 1081 participants of 2049 eligible responded to a follow-up survey. Multilevel logistic regression was used to investigate if one year of free school fruit was associated with weight status and with birthweight status of the offspring. The analyses were adjusted for gender, educational level, and the offspring analysis also for parents' weight status, and the nested design (child/parent). RESULTS The odds ratios of being overweight (OR: 0.93, 95% CI: 0.70, 1.24) or having a child with high or low birth weight (OR: 0.52, 95% CI: 0.21, 1.30) in the intervention group compared to the control group were not statistically significant, 14 years after the intervention period. CONCLUSIONS One year of free school fruit did not have an effect on weight status on the participants or birth weight of their offspring, 14 years after the intervention period. Although, results from the present study contribute to fill the knowledge gaps concerning long-term effects of public health efforts on weight status, more follow-up studies with larger samples are warranted.
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Affiliation(s)
- Tonje Holte Stea
- University of Agder, Department of Public Health, Sport and Nutrition, Kristiansand, Norway
| | - Eline Tønnesson Tveter
- University of Agder, Department of Public Health, Sport and Nutrition, Kristiansand, Norway
| | - Saskia J. te Velde
- University of Agder, Department of Public Health, Sport and Nutrition, Kristiansand, Norway
| | - Frøydis Nordgård Vik
- University of Agder, Department of Public Health, Sport and Nutrition, Kristiansand, Norway
| | | | - Elling Bere
- University of Agder, Department of Public Health, Sport and Nutrition, Kristiansand, Norway
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14
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Madden GJ, Price J, Wengreen H. Change and Maintaining Change in School Cafeterias: Economic and Behavioral-Economic Approaches to Increasing Fruit and Vegetable Consumption. NEBRASKA SYMPOSIUM ON MOTIVATION 2018. [DOI: 10.1007/978-3-319-96920-6_4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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15
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Chong KH, Lee ST, Ng SA, Khouw I, Poh BK. Fruit and Vegetable Intake Patterns and Their Associations with Sociodemographic Characteristics, Anthropometric Status and Nutrient Intake Profiles among Malaysian Children Aged 1-6 Years. Nutrients 2017; 9:E723. [PMID: 28758956 PMCID: PMC5579587 DOI: 10.3390/nu9080723] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 06/29/2017] [Accepted: 07/03/2017] [Indexed: 11/17/2022] Open
Abstract
This study aimed to assess fruit and vegetable intake patterns and their associations with sociodemographic characteristics, anthropometric status and nutrient intake profiles among Malaysian children aged 1-6 years. Using the Malaysian dataset of South East Asian Nutrition Surveys (SEANUTS Malaysia), a total of 1307 children aged 1-6 years with complete datasets were included in this analysis. Dietary intake was assessed using age-specific, validated food frequency questionnaires. On average, Malaysian children consumed 0.91 and 1.07 servings of fruits and vegetables per day, respectively. Less than one-fifth of the children achieved the daily recommended servings of fruits (11.7%) and vegetables (15.8%). Fruit intake was associated with age, parental educational level and geographical region, and vegetable intake was associated with ethnicity and geographical region. There was little evidence of an association between fruit and vegetable intake and children's anthropometric status, but an adequate intake of fruits and vegetables contributed significantly and differently to children's micronutrient intake. Future nutrition interventions should focus on addressing the sociodemographic determinants and be tailored to the needs of the low consumers to more effectively promote and encourage the adequate intake of fruit and vegetables among young children.
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Affiliation(s)
- Kar Hau Chong
- Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia.
| | - Shoo Thien Lee
- Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia.
| | - Swee Ai Ng
- FrieslandCampina, Stationsplein 4, 3818 LE Amersfoort, The Netherlands.
| | - Ilse Khouw
- FrieslandCampina, Stationsplein 4, 3818 LE Amersfoort, The Netherlands.
| | - Bee Koon Poh
- Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia.
- National Co-Ordinator, the SEANUTS Study Group, Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia.
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16
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Leung MM, Green MC, Tate DF, Cai J, Wyka K, Ammerman AS. Fight for Your Right to Fruit: Psychosocial Outcomes of a Manga Comic Promoting Fruit Consumption in Middle-School Youth. HEALTH COMMUNICATION 2017; 32:533-540. [PMID: 27540773 DOI: 10.1080/10410236.2016.1211074] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The purpose of this study was to determine whether exposure to a manga comic (Japanese comic art) with messages promoting fruit consumption influenced psychosocial variables associated with increased fruit intake in middle-school youth. A three-group, randomized, single-session study was conducted in two public middle schools in central North Carolina. Participants were randomly assigned to one of three groups: (a) comic (manga comic promoting fruit consumption, (b) newsletter (newsletter about fruit), or (c) attention-control (newsletter about ancient Greece). Participants included N = 263 youth, with a mean age of 13.18 years (SD = 1.12). Outcome expectations, self-efficacy, and knowledge related to fruit intake were measured at baseline and immediately after reading. Secondary outcomes included transportation (degree to which participants are immersed in their media) and enjoyment, measured at posttest. Data were analyzed using regression analyses. Comic group participants tended to have greater change in outcome expectations related to fruit intake compared to the attention-control group and greater transportation and enjoyment than the newsletter and attention-control groups. Study results are promising and suggest that manga comics may be a useful format to promote positive health beliefs in youth.
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Affiliation(s)
| | - Melanie C Green
- b Department of Communication , University at Buffalo, The State University of New York
| | - Deborah F Tate
- c Department of Health Behavior , University of North Carolina at Chapel Hill
- d Department of Nutrition , University of North Carolina at Chapel Hill
| | - Jianwen Cai
- e Department of Biostatistics , University of North Carolina at Chapel Hill
| | - Katarzyna Wyka
- f Department of Epidemiology and Biostatistics , City University of New York
| | - Alice S Ammerman
- d Department of Nutrition , University of North Carolina at Chapel Hill
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17
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Hall C, Hillen C, Garden Robinson J. Composition, Nutritional Value, and Health Benefits of Pulses. Cereal Chem 2017. [DOI: 10.1094/cchem-03-16-0069-fi] [Citation(s) in RCA: 159] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Clifford Hall
- Department of Plant Science, North Dakota State University, Fargo, ND 58108-6050, U.S.A
| | - Cassandra Hillen
- Department of Plant Science, North Dakota State University, Fargo, ND 58108-6050, U.S.A
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18
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Madden GJ, Price J, Sosa FA. Behavioral Economic Approaches to Influencing Children’s Dietary Decision Making at School. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/2372732216683517] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The health benefits of consuming fruits and vegetables (FVs) are clear, but most children do not eat them regularly. At school, FVs are available, but children often refuse them or throw them away. This review article illustrates the evidence for and against behavioral–economic approaches to increasing FV consumption in schools. Simple but effective interventions include prompting children to take FVs and serving vegetables before other foods are available. Also effective is reducing their handling costs (e.g., serving sliced fruit) and opportunity costs (e.g., scheduling lunch after recess). Still larger improvements can be achieved by improving the taste of FVs, or by incentivizing consumption. Although controversial, even small incentives can produce immediate and lasting effects. Game-based virtual incentives can reduce the costs of incentive systems, while minimizing concerns that children are being bribed into healthy habit formation.
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19
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Strategies Low-Income Parents Use to Overcome Their Children’s Food Refusal. Matern Child Health J 2016; 21:68-76. [DOI: 10.1007/s10995-016-2094-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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20
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Elsamanoudy AZ, Mohamed Neamat-Allah MA, Hisham Mohammad FA, Hassanien M, Nada HA. The role of nutrition related genes and nutrigenetics in understanding the pathogenesis of cancer. J Microsc Ultrastruct 2016; 4:115-122. [PMID: 30023217 PMCID: PMC6014201 DOI: 10.1016/j.jmau.2016.02.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 02/22/2016] [Indexed: 12/23/2022] Open
Abstract
Nutrition has a predominant and recognizable role in health management. Nutrigenetics is the science that identifies and characterizes gene variants associated with differential response to nutrients and relating this variation to variable disease states especially cancer. This arises from the epidemiological fact that cancer accounts for a high proportion of total morbidity and mortality in adults throughout the world. There is much evidence to support that genetic factors play a key role in the development of cancer; these genetic factors such as DNA instability and gene alterations are affected by nutrition. Nutrition may also lead to aberrant DNA methylation, which in turn contributes to carcinogenesis. The aim of this work is to clarify the basic knowledge about the vital role of nutrition-related genes in various disease states, especially cancer, and to identify nutrigenetics as a new concept that could highlight the relation between nutrition and gene expression. This may help to understand the mechanism and pathogenesis of cancer. The cause of cancer is a complex interplay mechanism of genetic and environmental factors. Dietary nutrient intake is an essential environmental factor and there is a marked variation in cancer development with the same dietary intake between individuals. This could be explained by the variation in their genetic polymorphisms, which leads to emergence of the concept of nutrigenomics and nutrigenetics.
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Affiliation(s)
- Ayman Zaky Elsamanoudy
- Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Medical Biochemistry and Molecular Biology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | | | - Mohammed Hassanien
- Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Medical Biochemistry Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Hoda Ahmed Nada
- Medical Biochemistry and Molecular Biology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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21
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Shashaj B, Graziani MP, Contoli B, Ciuffo C, Cives C, Facciolini S, Rigoni ML, Spaterna S, Taucci M, Raponi M, Manco M. Energy Balance-Related Behaviors, Perinatal, Sociodemographic, and Parental Risk Factors Associated with Obesity in Italian Preschoolers. J Am Coll Nutr 2016; 35:362-71. [PMID: 26933953 DOI: 10.1080/07315724.2015.1070699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The obesity epidemic stems from the complex interplay between genetics and environmental factors. Identifying age-specific risk factors in preschoolers may allow implementing more effective intervention strategies. The aim of the present investigation was to examine the association of overweight/obesity with several perinatal, parental, socioeconomic status (SES), and lifestyle-related risk factors in a large sample of Italian preschoolers. METHODS One thousand eleven children (age 2.0 to 5.7 years) were included in the study. Family pediatricians measured weight and height and collected information on obesity risk factors by means of questionnaires. Perinatal risk factors were recalled from electronic medical records. Weight status was defined according to cutoffs of the International Obesity Task Force (IOTF). RESULTS Seven hundred sixty-four children (75.6%) were normal weight, and 247 (24.4%) were overweight/obese. Multivariate analysis showed that skipping breakfast (odds ratio [OR] = 3.7; 95% confidence interval [CI], 1.32-10.51), daily drinking of sugar-sweetened beverages (OR = 2.0; 95% CI, 1.02-4.03), meat consumption <5 times/week (OR = 2.2; 95% CI, 1.11-4.57), and formula feeding (OR = 2.1; 95% CI, 0.8-4.5) were significantly (p < 0.05) associated with increased risk of obesity. CONCLUSIONS Though exclusive formula or mixed feeding represents an age-specific risk factor for overweight/obesity, lifestyle factors associated with increased risk in Italian preschoolers include habits that are common to school-age children, such as skipping breakfast and consumption of sugar-sweetened beverages. The reduced consumption of meat emerged as a risk factor for overweight/obesity, but future research is required to better understand this relationship. Our data suggest, on the whole, that prevention of such unhealthy behaviors must be pursued in preschoolers by means of age-specific interventions.
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Affiliation(s)
| | | | | | | | - Claudia Cives
- b Federazione Italiana Medici Pediatri, FIMP , Rome , ITALY
| | | | - Maria L Rigoni
- b Federazione Italiana Medici Pediatri, FIMP , Rome , ITALY
| | | | - Mauro Taucci
- b Federazione Italiana Medici Pediatri, FIMP , Rome , ITALY
| | | | - Melania Manco
- a Bambino Gesù Children's Hospital, IRCCS , Rome , ITALY
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22
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Fisher JO, Dwyer JT. Next Steps for Science and Policy on Promoting Vegetable Consumption among US Infants and Young Children. Adv Nutr 2016; 7:261S-271S. [PMID: 26773035 PMCID: PMC4717881 DOI: 10.3945/an.115.009332] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Vegetables are an important part of a healthy diet for infants and young children, but they are poorly accepted and underconsumed. This paper highlights major themes and research needs for understanding how to raise children to consume and enjoy vegetables as part of a healthful diet. A range of factors impedes US infants and young children from eating as many vegetables as experts consider optimal for child nutrition, health, and development. Barriers include biological and behavioral issues relating to infant and child development, household- and family-related barriers, obstacles in the larger community, economic limitations, and some government policies and programs. These barriers must be removed to encourage children to eat more vegetables. Research gaps also must be filled. We summarize the basic and applied research that is needed to craft more effective messages, devise strategies for parents and other child caretakers to take within households, develop action in the larger community, and modify some government policies and programs.
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Affiliation(s)
- Jennifer O Fisher
- Department of Social and Behavioral Sciences, College of Public Health, Center for Obesity Research and Education, Temple University, Philadelphia, PA; and
| | - Johanna T Dwyer
- School of Medicine, Friedman School of Nutrition Science and Policy, and Jean Mayer/USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
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23
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Baranowski T, Lytle L. Should the IDEFICS outcomes have been expected? Obes Rev 2015; 16 Suppl 2:162-72. [PMID: 26707025 DOI: 10.1111/obr.12359] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 10/27/2015] [Indexed: 01/16/2023]
Abstract
The Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study evaluated with a large sample a comprehensive carefully planned obesity prevention intervention targeting multiple levels of influence that were culturally adapted to the situations in eight European countries. Despite the great effort and attention to detail, the IDEFICS study did not achieve its targeted adiposity or behaviour change objectives. Should we be surprised that the IDEFICS trial did not have its intended effects? We think not, and would have been surprised if it did. Recent research has revealed the lack of consistent meaningful relationships between several apparently obesogenic behaviours and adiposity, weak or no relationships among behavioural change procedures, mediating variables and targeted behaviours and inadequate attention to moderating effects. Future obesity prevention interventions would benefit from a more thorough understanding of the complex relationships that have been hypothesized and the interrelationships with biological factors. While systems modelling has been proposed as providing the solution, important less complex identification of new constructs, new relationships and community interventions are still needed, both to find innovative solutions and to provide input into the systems models. We should question results from cross-sectional studies and be satisfied only with longitudinal or experimental tests of relationships.
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Affiliation(s)
- T Baranowski
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - L Lytle
- Department of Health Behavior, School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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24
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Funtikova AN, Navarro E, Bawaked RA, Fíto M, Schröder H. Impact of diet on cardiometabolic health in children and adolescents. Nutr J 2015; 14:118. [PMID: 26574072 PMCID: PMC4647337 DOI: 10.1186/s12937-015-0107-z] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 11/05/2015] [Indexed: 01/10/2023] Open
Abstract
The manifestation of cardiovascular risk factors, such as hypertension, diabetes, and particularly obesity begins in children and adolescents, with deleterious effects for cardiometabolic health at adulthood. Although the impact of diet on cardiovascular risk factors has been studied extensively in adults, showing that their cardiometabolic health is strongly lifestyle-dependent, less is known about this impact in children and adolescents. In particular, little is known about the relationship between their dietary patterns, especially when derived a posteriori, and cardiovascular risk. An adverse association of cardiovascular health and increased intake of sodium, saturated fat, meat, fast food and soft drinks has been reported in this population. In contrast, vitamin D, fiber, mono-and poly-unsaturated fatty acids, dairy, fruits and vegetables were positively linked to cardiovascular health. The aim of this review was to summarize current epidemiological and experimental evidence on the impact of nutrients, foods, and dietary pattern on cardiometabolic health in children and adolescents. A comprehensive review of the literature available in English and related to diet and cardiometabolic health in this population was undertaken via the electronic databases PubMed, Cochrane Library, and Medline.
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Affiliation(s)
- Anna N Funtikova
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Barcelona, Spain.,Food and Nutrition PhD program, University of Barcelona, Barcelona, Spain
| | - Estanislau Navarro
- Molecular Oncology Laboratory, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Rowaedh Ahmed Bawaked
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Biomedicine PhD program, University of Pompeu Fabra, Barcelona, Spain
| | - Montserrat Fíto
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Barcelona, Spain
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. .,CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Barcelona, Spain.
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25
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Gadgil MD, Anderson CAM, Kandula NR, Kanaya AM. Dietary patterns are associated with metabolic risk factors in South Asians living in the United States. J Nutr 2015; 145:1211-7. [PMID: 25904730 PMCID: PMC4442115 DOI: 10.3945/jn.114.207753] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 03/23/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND South Asians are at high risk of metabolic syndrome, and dietary patterns may influence this risk. OBJECTIVES We aimed to determine prevalent dietary patterns for South Asians in the United States and their associations with risk factors for metabolic syndrome. METHODS South Asians aged 40-84 y without known cardiovascular disease were enrolled in a community-based cohort called Mediators of Atherosclerosis in South Asians Living in America. A validated food frequency questionnaire and serum samples for fasting and 2-h glucose, insulin, glycated hemoglobin, triglycerides, and total and HDL cholesterol were collected cross-sectionally. We used principal component analysis with varimax rotation to determine dietary patterns, and sequential linear and logistic regression models for associations with metabolic factors. RESULTS A total of 892 participants were included (47% women). We identified 3 major dietary patterns: animal protein; fried snacks, sweets, and high-fat dairy; and fruits, vegetables, nuts, and legumes. These were analyzed by tertile of factor score. The highest vs. the lowest tertile of the fried snacks, sweets, and high-fat dairy pattern was associated with higher homeostasis model assessment of insulin resistance (HOMA-IR) (β: 1.88 mmol/L ⋅ uIU/L) and lower HDL cholesterol (β: -4.48 mg/dL) in a model adjusted for age, sex, study site, and caloric intake (P < 0.05). The animal protein pattern was associated with higher body mass index (β: 0.73 m/kg(2)), waist circumference (β: 0.84 cm), total cholesterol (β: 8.16 mg/dL), and LDL cholesterol (β: 5.69 mg/dL) (all P < 0.05). The fruits, vegetables, nuts, and legumes pattern was associated with lower odds of hypertension (OR: 0.63) and metabolic syndrome (OR: 0.53), and lower HOMA-IR (β: 1.95 mmol/L ⋅ uIU/L) (P < 0.05). CONCLUSIONS The animal protein and the fried snacks, sweets, and high-fat dairy patterns were associated with adverse metabolic risk factors in South Asians in the United States, whereas the fruits, vegetables, nuts, and legumes pattern was linked with a decreased prevalence of hypertension and metabolic syndrome.
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Affiliation(s)
- Meghana D Gadgil
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA;
| | - Cheryl AM Anderson
- Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA; and
| | - Namratha R Kandula
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Alka M Kanaya
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
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Adams MA, Bruening M, Ohri-Vachaspati P. Use of Salad Bars in Schools to Increase Fruit and Vegetable Consumption: Where's the Evidence? J Acad Nutr Diet 2015; 115:1233-6. [PMID: 25828564 DOI: 10.1016/j.jand.2015.02.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 02/04/2015] [Indexed: 11/26/2022]
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Bjelland M, Hausken SES, Bergh IH, Grydeland M, Klepp KI, Andersen LF, Totland TH, Lien N. Changes in adolescents' and parents' intakes of sugar-sweetened beverages, fruit and vegetables after 20 months: results from the HEIA study - a comprehensive, multi-component school-based randomized trial. Food Nutr Res 2015; 59:25932. [PMID: 25797051 PMCID: PMC4369556 DOI: 10.3402/fnr.v59.25932] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 02/09/2015] [Accepted: 03/02/2015] [Indexed: 11/24/2022] Open
Abstract
Background Interventions conducted in school-aged children often involve parents, but few studies have reported effects on parents’ own behaviour as a result of these interventions. Objective To determine if a multi-component, cluster randomized controlled trial targeting 11–13 year olds influenced their consumption of fruit, vegetables, sugar-sweetened soft drinks and fruit drinks, and to explore whether the results varied by gender, adolescent weight status or parental educational level. A final aim was to assess whether the parents’ intakes were affected by the intervention. Design Participants were 1,418 adolescents, 849 mothers and 680 fathers. Baseline and post-intervention data from the 20 months intervention study HEIA (HEalth In Adolescents) were included. Data were collected assessing frequency (and amounts; beverages only). Results No significant differences were found at baseline between the intervention and control groups, except for the parental groups (educational level and intakes). At post-intervention, the adolescents in the intervention group consumed fruit more frequently (P<0.001) and had a lower intake of sugar-sweetened fruit drinks compared to the control group (P=0.02). The parental educational level moderated the effect on intake of sugar-sweetened fruit drinks in adolescents. The intake was less frequent in the intervention groups compared to the control groups (P=0.02) for those who had parents with low and medium educational level. Furthermore, the intervention may have affected mothers’ fruit intake and the vegetable intake in higher educated fathers. Conclusion Favourable effects in favour of the intervention group were found for intake of fruit and sugar-sweetened fruit drinks among the adolescents in the HEIA study. Our results indicate that it is possible to reduce adolescents’ intake of sugar-sweetened fruit drinks across parental education, and potentially affect sub-groups of parents.
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Affiliation(s)
- Mona Bjelland
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway;
| | - Solveig E S Hausken
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingunn H Bergh
- Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
| | - May Grydeland
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Knut-Inge Klepp
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lene F Andersen
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Torunn H Totland
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
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BORIČIĆ K, SIMIĆ S, VASILJEVIĆ N, MARINKOVIĆ J. Risk Factors Associated with Overweight among Adolescents in Serbia. Zdr Varst 2014; 53:283-93. [PMID: 27669514 PMCID: PMC4820196 DOI: 10.2478/sjph-2014-0031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Accepted: 06/19/2014] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION The pandemic of obesity in adolescents is one of the challenges of public health. AIM The aim of this study was to examine the association of overweight with demographic, socioeconomic and lifestyle factors among Serbian adolescents. METHOD A cross-sectional study of 2139 adolescents aged 10 to 19 years was carried out. Data used in this study were from the 2006 Health Survey. In accordance with the international sex- and age-specific Body Mass Index cut-off points, all participants were classified as being normal weight or overweight, including obese. The association between the risk factors and overweight were examined using a multivariate logistic regression model. RESULTS The study showed that 28.9% of boys and 17.0% of girls were overweight, while 14.5% of boys and 8.1% of girls were obese. Boys were more likely to be overweight/obese, compared with girls. Being younger (p< 0.01 for 14 to 15 years) and (p< 0.01, for 16 to 19 years), engaging in physical activities that last less than 7 hours a week, in such a manner that they breathe quickly and become sweaty, (p< 0.01) and skipping breakfast (p< 0.05) were risk factors significantly associated with overweight among adolescents. No significant association was found with wealth index. CONCLUSION These findings should be an integral part of further preventive interventions, especially oriented towards younger adolescents, who are physically inactive, have a habit of skipping breakfast and are boys.
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Affiliation(s)
- Katarina BORIČIĆ
- Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”, Department for Health Promotion for Special Groups, Dr Subotic Street 5, 11000 Belgrade, Serbia
| | - Snežana SIMIĆ
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Nađa VASILJEVIĆ
- Dietetic Unit, Institute of Hygiene and Medical Ecology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Jelena MARINKOVIĆ
- Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
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Diep CS, Chen TA, Davies VF, Baranowski JC, Baranowski T. Influence of behavioral theory on fruit and vegetable intervention effectiveness among children: a meta-analysis. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2014; 46:506-546. [PMID: 25457730 DOI: 10.1016/j.jneb.2014.05.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 05/12/2014] [Accepted: 05/19/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To test the hypotheses that interventions clearly based on theory, multiple theories, or a formal intervention planning process will be more effective in changing fruit and vegetable consumption among children than interventions with no behavioral theoretical foundation. DESIGN Systematic review and meta-analysis. SETTING Identification of articles in PubMed, PsycInfo, Medline, Cochrane Collaborative database, and existing literature reviews and meta-analyses. PARTICIPANTS Children aged 2-18 years. INTERVENTIONS Change in fruit and/or vegetable consumption in dietary change interventions. METHODS Meta-analysis, meta-regression analysis, and summary reporting for articles. CONCLUSIONS AND IMPLICATIONS Predicating an intervention on behavioral theory had a small to moderate enhancement (P < .001) of outcome effectiveness. Differences in mean Hedges' g effect sizes between theory and non-theory interventions were 0.232 for fruit, 0.043 for vegetables, and 0.333 for fruit and vegetables combined. There was mixed support, however, for enhanced dietary change with multiple theories or a formal planning process. After controlling for study quality, theory use was related only to vegetable consumption (β = 0.373; P < .001). More research is needed on theory's influences on dietary behaviors to guide future interventions among children. More research is also needed to identify what may be effective practical- or experience-based procedures that complement theory, to incorporate into interventions.
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Affiliation(s)
- Cassandra S Diep
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX; Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX.
| | - Tzu-An Chen
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Vanessa F Davies
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX; Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Janice C Baranowski
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Tom Baranowski
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
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Kaiser KA, Brown AW, Bohan Brown MM, Shikany JM, Mattes RD, Allison DB. Increased fruit and vegetable intake has no discernible effect on weight loss: a systematic review and meta-analysis. Am J Clin Nutr 2014; 100:567-76. [PMID: 24965308 PMCID: PMC4095660 DOI: 10.3945/ajcn.114.090548] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND A common dietary recommendation for weight loss, especially in lay public outlets, is to eat more fruit and vegetables (F/Vs). Without a compensatory reduction in total energy intake, significant weight loss would be unlikely. OBJECTIVE We aimed to synthesize the best available evidence on the effectiveness of the general recommendation to eat more F/Vs for weight loss or the prevention of weight gain. DESIGN We searched multiple databases for human randomized controlled trials that evaluated the effect of increased F/V intake on body weight. Inclusion criteria were as follows: ≥15 subjects/ treatment arm, ≥8-wk intervention, a stated primary or secondary outcome of body weight, the stated goal of the intervention was weight or fat loss or the prevention of weight or fat gain, and food intake provided or prescribed was of a variety of F/Vs that remained minimally processed. RESULTS Two studies met all criteria; 5 other studies met all criteria but one. The primary analysis indicated an effect size of weight change (outcome of interest) from baseline [standardized mean difference (SMD) for studies that met all criteria] of -0.16 (95% CI: -0.78, 0.46) (P = 0.60). The SMD for 7 studies that met all or most criteria was 0.04 (95% CI: -0.10, 0.17) (P = 0.62). CONCLUSIONS Studies to date do not support the proposition that recommendations to increase F/V intake or the home delivery or provision of F/Vs will cause weight loss. On the basis of the current evidence, recommending increased F/V consumption to treat or prevent obesity without explicitly combining this approach with efforts to reduce intake of other energy sources is unwarranted. This systematic review and meta-analysis was registered at http://www.crd.york.ac.uk/PROSPERO/ as CRD42013004688.
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Affiliation(s)
- Kathryn A Kaiser
- From the Office of Energetics, School of Public Health (KAK, AWB, and DBA), the Nutrition Obesity Research Center (KAK, AWB, MMBB, JMS, and DBA), the Department of Nutrition, School of Health Professions (MMBB), and the Division of Preventive Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL, and the Department of Nutrition Science, Purdue University, West Lafayette, IN (RDM)
| | - Andrew W Brown
- From the Office of Energetics, School of Public Health (KAK, AWB, and DBA), the Nutrition Obesity Research Center (KAK, AWB, MMBB, JMS, and DBA), the Department of Nutrition, School of Health Professions (MMBB), and the Division of Preventive Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL, and the Department of Nutrition Science, Purdue University, West Lafayette, IN (RDM)
| | - Michelle M Bohan Brown
- From the Office of Energetics, School of Public Health (KAK, AWB, and DBA), the Nutrition Obesity Research Center (KAK, AWB, MMBB, JMS, and DBA), the Department of Nutrition, School of Health Professions (MMBB), and the Division of Preventive Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL, and the Department of Nutrition Science, Purdue University, West Lafayette, IN (RDM)
| | - James M Shikany
- From the Office of Energetics, School of Public Health (KAK, AWB, and DBA), the Nutrition Obesity Research Center (KAK, AWB, MMBB, JMS, and DBA), the Department of Nutrition, School of Health Professions (MMBB), and the Division of Preventive Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL, and the Department of Nutrition Science, Purdue University, West Lafayette, IN (RDM)
| | - Richard D Mattes
- From the Office of Energetics, School of Public Health (KAK, AWB, and DBA), the Nutrition Obesity Research Center (KAK, AWB, MMBB, JMS, and DBA), the Department of Nutrition, School of Health Professions (MMBB), and the Division of Preventive Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL, and the Department of Nutrition Science, Purdue University, West Lafayette, IN (RDM)
| | - David B Allison
- From the Office of Energetics, School of Public Health (KAK, AWB, and DBA), the Nutrition Obesity Research Center (KAK, AWB, MMBB, JMS, and DBA), the Department of Nutrition, School of Health Professions (MMBB), and the Division of Preventive Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL, and the Department of Nutrition Science, Purdue University, West Lafayette, IN (RDM)
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Rebello CJ, Greenway FL, Finley JW. Whole grains and pulses: a comparison of the nutritional and health benefits. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2014; 62:7029-7049. [PMID: 24992700 DOI: 10.1021/jf500932z] [Citation(s) in RCA: 137] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Nutrition plays an important role in the prevention and management of disease. Whole grain cereals contain a host of nutrients and bioactive substances that have health-promoting effects. Epidemiological evidence shows a consistent inverse association between whole grain intake and the risk of chronic disease. Despite a concerted effort by scientists, educators, and policy makers to promote the consumption of whole grains, it remains dismally short of the recommended intakes. Pulses (dried beans and peas) differ from whole grains in their structural and physicochemical properties and have varying amounts of fiber, resistant starch, vitamins, minerals, and other bioactive components; nevertheless, these food groups complement each other. Observational as well as intervention trials show that pulse consumption has beneficial effects on the prevention and management of chronic disease. The nutritional and phytochemical components of pulses coupled with those of whole grains suggest a potential synergistic effect that could provide significant health benefits.
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Affiliation(s)
- Candida J Rebello
- School of Nutrition and Food Sciences, Louisiana State University , Baton Rouge, Louisiana 70803, United States
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Rebello CJ, Greenway FL, Finley JW. A review of the nutritional value of legumes and their effects on obesity and its related co-morbidities. Obes Rev 2014; 15:392-407. [PMID: 24433379 DOI: 10.1111/obr.12144] [Citation(s) in RCA: 137] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 12/12/2013] [Accepted: 12/13/2013] [Indexed: 01/11/2023]
Abstract
Since the 1970s, the proportion of overweight and obese people in the United States has grown at an alarming rate. An awareness of the consequences of obesity on the health and well-being of individuals is evident in the plethora of strategic plans at the local and national levels, most of which have largely fallen short of their goals. If interventions continue to be unsuccessful, it is estimated that approximately three of four Americans will be overweight or obese by 2020. Prevention of excess weight gain can be accomplished with relatively small changes in lifestyle behaviours to control body weight. Small sustainable changes are perhaps better than efforts to achieve larger changes that cannot be sustained. Legumes can be a valuable food by which the needs of the undernourished or under-served populations could be met. They can be incorporated into meat products, such as sausages and burgers, to lower the energy density of these foods while providing important nutrients. Replacing energy-dense foods with legumes has been shown to have beneficial effects on the prevention and management of obesity and related disorders, such as cardiovascular disease, diabetes and the metabolic syndrome. This review explores the nutritional value and obesity-related health benefits of legume consumption while focusing on pulses.
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Affiliation(s)
- C J Rebello
- School of Nutrition and Food Sciences, Louisiana State University, Baton Rouge, LA, USA; Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
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Papier K, Williams GM, Luceres-Catubig R, Ahmed F, Olveda RM, McManus DP, Chy D, Chau TNP, Gray DJ, Ross AGP. Childhood malnutrition and parasitic helminth interactions. Clin Infect Dis 2014; 59:234-43. [PMID: 24704723 DOI: 10.1093/cid/ciu211] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is evidence to support that nutritional deficiency can reduce the body's immune function, thereby decreasing resistance to disease and increasing susceptibility to intestinal parasites. METHODS A cross-sectional survey was carried out on 693 school-aged children from 5 schistosomiasis-endemic villages in Northern Samar, the Philippines. Data on dietary intake, nutritional status, and intestinal parasitic infection were collected. RESULTS The prevalence of stunting, thinness, and wasting was 49.2%, 27.8%, and 59.7% of all children. The proportion of children infected with Schistosoma japonicum (15.6%, P = .03) and hookworm (22.0%, P = .05) were significantly lower among children who met the recommended energy and nutrient intake (RENI) for total calories. The percentage of children infected with Trichuris trichiura was highest among children who did not meet the RENI for energy (74.1%, P = .04), iron (73.4%, P = .01), thiamine (74.0%, P = .00), and riboflavin (73.3%, P = .01). Susceptibility to having 1 or more parasitic infections was significantly associated with poor intake of energy (P = .04), thiamine (P = .02), and riboflavin (P = .01).The proportion of stunted children was significantly higher among children who did not meet the RENI for energy (68.9%, P = .002), protein (54.0%, P = .004), or niacin (30.8%, P = .02) and for those infected with hookworm (31.8%, P = .0002). After adjusting for potential confounders, protein intake less than the RENI (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.03-2.14), and hookworm infection (OR, 1.77; 95% CI, 1.22-2.55) were the major predictors of stunting. CONCLUSIONS The results support the hypothesis that poor nutrient intake may increase susceptibility to parasitic diseases and together they negatively affect childhood nutritional status.
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Affiliation(s)
- Keren Papier
- Department of Public Health, School of Medicine, Griffith University, Gold Coast Campus and
| | - Gail M Williams
- School of Population Health, University of Queensland, Brisbane, Australia
| | - Ruby Luceres-Catubig
- Department of Health, Research Institute for Tropical Medicine, Muntinlupa City, the Philippines
| | - Faruk Ahmed
- Department of Public Health, School of Medicine, Griffith University, Gold Coast Campus and
| | - Remigio M Olveda
- Department of Health, Research Institute for Tropical Medicine, Muntinlupa City, the Philippines
| | | | - Delia Chy
- Municipal Office of Health, Palapag, Northern Samar, the Philippines
| | - Thao N P Chau
- Discipline of Public Health, Flinders University, Adelaide
| | - Darren J Gray
- School of Population Health, University of Queensland, Brisbane, Australia
| | - Allen G P Ross
- Griffith Health Institute, Griffith University, Gold Coast Campus, Australia
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Wilson DK, Alia KA, Kitzman-Ulrich H, Resnicow K. A pilot study of the effects of a tailored web-based intervention on promoting fruit and vegetable intake in African American families. Child Obes 2014; 10:77-84. [PMID: 24299118 PMCID: PMC3922140 DOI: 10.1089/chi.2013.0070] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The current study examined the effects of a Web-based tailored parenting intervention on increasing fruit and vegetable intake in African American families. METHODS Forty-seven African American parents (mean age, 41.32 ± 7.30; 93.6% female) with an adolescent (mean age, 13.32 ± 1.46; 59.6% female) participated in a Web-based autonomy-support parenting tailored intervention session to increase both parent and youth fruit and vegetable (F&V) intake. The session lasted 45-60 minutes and included three phases: a feedback phase; a Web-based information phase, and a goal-setting and action plan phase. Self-reported measures of parenting skills [based on autonomy (choice), support, and communication] and F&V intake (assessed as average daily intake) were assessed at baseline and at a 1-week follow-up session. RESULTS There was a significant increase in parents' self-reports of daily fruit intake from pretest to the 1-week follow-up. Parent and adolescent combined F&V intake also significantly increased from pretest to 1-week follow-up. Overall, parents reported that the program was easy to navigate and that they enjoyed participating in the Web-based online program. CONCLUSIONS Current findings provide preliminary support for an autonomy-support parent tailored Web-based program for improving dietary intake in African American families.
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Affiliation(s)
- Dawn K. Wilson
- Department of Psychology, University of South Carolina, Columbia, SC
| | - Kassandra A. Alia
- Department of Psychology, University of South Carolina, Columbia, SC
| | - Heather Kitzman-Ulrich
- Department of Behavioral and Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX
| | - Ken Resnicow
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI
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Majumdar D, Koch PA, Lee H, Contento IR, Islas-Ramos ADL, Fu D. "Creature-101": A Serious Game to Promote Energy Balance-Related Behaviors Among Middle School Adolescents. Games Health J 2013; 2:280-290. [PMID: 24761326 DOI: 10.1089/g4h.2013.0045] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Considering adolescents' heavy use of media, serious videogames may provide an engaging and innovative way to achieve positive impact on adolescents' diet and physical activity. The objective of this study was to evaluate the efficacy of playing a serious game, "Creature-101" (developed by Teachers College, Columbia University [New York, NY] and Stottler Henke Inc. [San Mateo, CA]), at promoting energy balance-related behaviors (EBRBs) such as increasing fruits and vegetables intake, water intake, and physical activity and decreasing processed snacks intake, sweetened beverages intake, and recreational screen time. SUBJECTS AND METHODS This pre-post intervention-control study (n=590) was conducted in New York City low-income public middle schools. The students (11-13 years of age, 51.6 percent male) played "Creature-101" online in science/health education classes (seven sessions, 30 minutes each session for 1 month). "Creature-101" used behavioral theories as the framework for "creature care" in a world "Tween." Students were provided with scientific evidence that promoted energy balance through minigames, educational videos, and slideshows and were motivated with interactive dialogues with game characters. Students also assessed their own behaviors, created their own "real life" food and activity goals, and reported their progress. A self-reported, validated, online instrument that measured frequency and amount of targeted behaviors was administered at baseline and post-intervention. RESULTS Analysis of covariance compared post-test means between groups with pretest scores as covariates. Intervention students reported significant decreases in frequency and amount of consumption of sweetened beverages and processed snacks compared with the controls. No changes were observed for the other behaviors. CONCLUSIONS "Creature-101" was effective at reducing consumption of sweetened beverages and processed snacks, which are related to obesity risks, indicating that the game shows promise at promoting EBRBs.
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Affiliation(s)
- Dalia Majumdar
- Department of Health and Behavior Studies, Teachers College, Columbia University , New York, New York
| | - Pamela A Koch
- Department of Health and Behavior Studies, Teachers College, Columbia University , New York, New York
| | - Heewon Lee
- Department of Health and Behavior Studies, Teachers College, Columbia University , New York, New York
| | - Isobel R Contento
- Department of Health and Behavior Studies, Teachers College, Columbia University , New York, New York
| | | | - Daniel Fu
- Stottler Henke Associates, Inc. , San Mateo, California
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Bjelland M, Brantsæter AL, Haugen M, Meltzer HM, Nystad W, Andersen LF. Changes and tracking of fruit, vegetables and sugar-sweetened beverages intake from 18 months to 7 years in the Norwegian Mother and Child Cohort Study. BMC Public Health 2013; 13:793. [PMID: 24103398 PMCID: PMC3765981 DOI: 10.1186/1471-2458-13-793] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 08/28/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A few studies have investigated tracking of dietary patterns or nutrient intake in pre-school children, but no studies have been identified examining tracking of sugar-sweetened beverages (SSB), fruit and vegetable intakes in early childhood (1-7 year olds). The purpose of this study was to investigate changes and tracking of intakes of fruit, vegetables and SSB, and association between maternal education and dietary tracking, from 18 months to 7 years of age. METHODS Longitudinal data from the nation-wide Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health were used, including 9025 children participating at three time points (18 months, 36 months and 7 years). Frequencies of fruit, vegetables and SSB were assessed by questionnaire. Slightly different questions were used at each time point to collect information about intake. Maternal education was categorized into ≤ 12 years, 13-16 years, ≥ 17 years. Cross-tabulation, Spearman's rho and multinomial logistic regression were used for assessing change, tracking and differences by maternal education. RESULTS Analyses by gender indicated largest changes for intake of fruit and SSB from age 18 months to 7 years. Fair to moderate tracking coefficients (Spearman's rho = 0.23-0.46) for intake of fruit, vegetables and SSB were found and children assigned to low, medium and high frequency of consumption at 18 months continued to be in the same group at age 36 months and 7 years. Children of mothers with low education consumed fruit and vegetables less often and SSB more often compared to children of mothers with high education at 18 months of age. Children with higher educated mothers had lower odds for increasing fruit intake or decreasing SSB intake, compared to children with lower educated mothers showing a stable intake. CONCLUSIONS The tracking coefficients for intakes were fair to moderate and differences in intakes according to maternal education were found already at age 18 months. This suggests that promotion of healthy dietary behaviours at an early age is important to prevent unfavourable dietary behaviours later in childhood. Moreover, it seems important to target mothers in nutrition interventions for improving dietary habits among children.
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Affiliation(s)
- Mona Bjelland
- Department of Nutrition, University of Oslo, P,O, Box 1046 Blindern, NO-0316 Oslo, Norway.
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Baranowski T, Diep C, Baranowski J. Influences on Children's Dietary Behavior, and Innovative Attempts to Change It. ANNALS OF NUTRITION AND METABOLISM 2013; 62 Suppl 3:38-46. [DOI: 10.1159/000351539] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Which foods are the strongest predictors of dietary fibre consumption in children aged 6 to 7 years? Proc Nutr Soc 2013. [DOI: 10.1017/s0029665113001468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Greene GW, White AA, Hoerr SL, Lohse B, Schembre SM, Riebe D, Patterson J, Kattelmann KK, Shoff S, Horacek T, Blissmer B, Phillips BW. Impact of an Online Healthful Eating and Physical Activity Program for College Students. Am J Health Promot 2012; 27:e47-58. [DOI: 10.4278/ajhp.110606-quan-239] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To identify impact of an online nutrition and physical activity program for college students. Design. Randomized, controlled trial using online questionnaires and on-site physical and fitness assessments with measurement intervals of 0 (baseline), 3 (postintervention), and 15 months (follow-up). Setting. Online intervention delivered to college students; a centralized Web site was used for recruitment, data collection, data management, and intervention delivery. Subjects. College students (18–24 years old, n = 1689), from eight universities (Michigan State University, South Dakota State University, Syracuse University, The Pennsylvania State University, Tuskegee University, University of Rhode Island, University of Maine, and University of Wisconsin). Intervention. A 10-lesson curriculum focusing on healthful eating and physical activity, stressing nondieting principles such as size acceptance and eating competence (software developer: Rainstorm, Inc, Orono, Maine). Measures. Measurements included anthropometrics, cardiorespiratory fitness, fruit/vegetable (FV) intake, eating competence, physical activity, and psychosocial stress. Analysis. Repeated measures analysis of variance for outcome variables. Results. Most subjects were white, undergraduate females (63%), with 25% either overweight or obese. Treatment group completion rate for the curriculum was 84%. Over 15 months, the treatment group had significantly higher FV intake (+.5 cups/d) and physical activity participation (+270 metabolic equivalent minutes per week) than controls. For both groups, anthropometric values and stress increased, and fitness levels decreased. Gender differences were present for most variables. First-year males and females gained more weight than participants in other school years. Conclusion. A 10-week online nutrition and physical activity intervention to encourage competence in making healthful food and eating decisions had a positive, lasting effect on FV intake and maintained baseline levels of physical activity in a population that otherwise experiences significant declines in these healthful behaviors.
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Evans CEL, Christian MS, Cleghorn CL, Greenwood DC, Cade JE. Systematic review and meta-analysis of school-based interventions to improve daily fruit and vegetable intake in children aged 5 to 12 y. Am J Clin Nutr 2012; 96:889-901. [PMID: 22952187 DOI: 10.3945/ajcn.111.030270] [Citation(s) in RCA: 313] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To our knowledge, no reviews have assessed the impact of a range of multi- and single-component school-based programs on daily fruit and vegetable intake by using a meta-analysis. OBJECTIVE The aim of this study was to quantify the impact of school-based interventions on fruit and vegetable intake in children aged 5-12 y. DESIGN A systematic literature review was carried out to identify randomized and nonrandomized controlled trials that were based in primary schools and designed to increase portions of daily fruit and vegetable intake. MEDLINE, Cochrane libraries, EMBASE, PsycINFO, and Educational Information Centre were searched from 1985 to 2009. Data were extracted, and mean effect sizes were calculated by using random effects models. RESULTS A total of 27 school-based programs involving 26,361 children were identified that met the inclusion criteria and assessed the daily weight of fruit and vegetable intake combined, fruit intake only, or vegetable intake only, and 21 studies were used in meta-analyses. The results of the meta-analyses indicated an improvement of 0.25 portions (95% CI: 0.06, 0.43 portions) of fruit and vegetable daily intake if fruit juice was excluded and an improvement of 0.32 portions (95% CI: 0.14, 0.50 portions) if fruit juice was included. Improvement was mainly due to increases in fruit consumption but not in vegetable consumption. The results of the meta-analyses for fruit (excluding juice) and vegetables separately indicated an improvement of 0.24 portions (95% CI: 0.05, 0.43 portions) and 0.07 portions (95% CI: -0.03, 0.16 portions), respectively. CONCLUSIONS School-based interventions moderately improve fruit intake but have minimal impact on vegetable intake. Additional studies are needed to address the barriers for success in changing dietary behavior, particularly in relation to vegetables.
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Affiliation(s)
- Charlotte E L Evans
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom.
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Ohri-Vachaspati P, Turner L, Chaloupka FJ. Fresh Fruit and Vegetable Program participation in elementary schools in the United States and availability of fruits and vegetables in school lunch meals. J Acad Nutr Diet 2012; 112:921-6. [PMID: 22709817 DOI: 10.1016/j.jand.2012.02.025] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 02/22/2012] [Indexed: 11/17/2022]
Abstract
Dietary intake among children in the United States falls short of national recommendations. Schools can play an important role in improving children's preferences and food consumption patterns. The US Department of Agriculture's Fresh Fruit and Vegetable Program (FFVP) aims to improve children's nutrient intake patterns by offering fresh fruits and vegetables as snacks outside the reimbursable meals programs in elementary schools that serve large numbers of low-income children. Using a nationally representative sample of public elementary schools, this cross-sectional study investigated FFVP participation patterns among schools by demographic and school characteristics. Further, the study investigated the association between FFVP participation and availability of fresh fruits, salads, and vegetables at lunch as reported by school administrators and foodservice staff. Data collected via a mail-back survey from 620 public elementary schools participating in the National School Lunch Program during 2009-2010 were analyzed. Almost 70% of the FFVP-participating schools had a majority of students (>50%) eligible for free and reduced-cost meals. Participating in US Department of Agriculture Team Nutrition Program and having a registered dietitian or a nutritionist on staff were significantly associated with FFVP participation. Based on the results from logistic regression analyses schools participating in the FFVP were significantly more likely (odds ratio 2.07; 95% CI 1.12 to 3.53) to serve fresh fruit during lunch meals. Slightly >25% of public elementary schools across the United States participated in the FFVP, and participation was associated with healthier food availability in school lunches.
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Affiliation(s)
- Punam Ohri-Vachaspati
- School of Nutrition and Health Promotion, Arizona State University, 500 N 3rd St, Phoenix, AZ 85004, USA.
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Whole grain consumption is inversely associated with BMI Z-score in rural school-aged children. Public Health Nutr 2012; 16:212-8. [PMID: 22894825 DOI: 10.1017/s1368980012003527] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine the relationship between intake of whole grains and BMI Z-score in rural children. DESIGN General linear models and logistic regression were used to examine the cross-sectional associations between whole grain intake and BMI Z-score, prevalence and odds ratios of overweight and obesity. Dietary intake was assessed using the Block Food Screener for ages 2-17 years. Children were classified into three categories according to servings of whole grain intake: <1·0 serving/d, 1·0-1·5 servings/d and >1·5 servings/d. SETTING The CHANGE (Creating Healthy, Active and Nurturing Growing-up Environments) study, an obesity prevention intervention in elementary schools in eight rural US communities in California, Mississippi, Kentucky and South Carolina. SUBJECTS Seven hundred and ninety-two children attending 3rd-6th grade. RESULTS After adjusting for age, sex, race/ethnicity, physical activity and state of residence, whole grain intake was inversely associated with BMI Z-score (0·90 v. 0·61 in the lowest v. the highest whole grain intake category; P trend = 0·01). Children who consumed >1·5 servings of whole grains/d had a 40 % lower risk of being obese (OR = 0·60; 95 % CI 0·38, 0·95, P = 0·02) compared with children who consumed <1·0 serving/d. Further adjustment for potential dietary predictors of body weight (fruit, vegetable and dairy intakes) did not change the observed associations. CONCLUSIONS Increasing the intake of whole grains as part of an overall healthy lifestyle may be beneficial for children to achieve and maintain a healthy weight.
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Baranowski T. School-based obesity-prevention interventions in low- and middle-income countries: do they really work? Am J Clin Nutr 2012; 96:227-8. [PMID: 22760569 PMCID: PMC3396438 DOI: 10.3945/ajcn.112.043349] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Prelip M, Kinsler J, Thai CL, Erausquin JT, Slusser W. Evaluation of a school-based multicomponent nutrition education program to improve young children's fruit and vegetable consumption. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2012; 44:310-318. [PMID: 22578965 DOI: 10.1016/j.jneb.2011.10.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 10/11/2011] [Accepted: 10/13/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To assess the impact of a multicomponent nutrition education program on student knowledge, attitudes, and behaviors related to consumption of fruits and vegetables (FVs). DESIGN Quasi-experimental pretest/posttest research design; 3 study conditions (Intervention+, Intervention, Comparison). SETTING Six schools from the Los Angeles Unified School District (LAUSD). PARTICIPANTS Three hundred ninety-nine low-income third-, fourth-, and fifth-grade students. INTERVENTION The Intervention+ condition included 4 components: traditional Network-LAUSD program, new standardized nutrition curriculum, teacher training workshops, and parent nutrition education workshops. The Intervention condition included 2 components: traditional Network-LAUSD program and teacher training workshops. MAIN OUTCOME MEASURES Fruit and vegetable consumption, knowledge of food groups, attitudes and beliefs toward FVs, and parent/teacher influence on students' attitudes toward FVs. ANALYSIS Linear mixed models. RESULTS The Intervention+ resulted in a positive change in knowledge (P < .05), attitudes and beliefs toward vegetables (P < .01), and teacher influence on students' FV attitudes (P < .05). CONCLUSIONS AND IMPLICATIONS Although this study influenced knowledge and attitudes regarding FVs, a significant increase in students' FV consumption was not observed. Given the ultimate aim of the LAUSD nutrition efforts is to increase FV consumption, future studies should consider adopting new intervention strategies, such as focusing on changing the school food environment.
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Affiliation(s)
- Michael Prelip
- Department of Community Health Sciences, School of Public Health, University of California-Los Angeles, CA 90095, USA.
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Ledoux TA, Watson K, Barnett A, Nguyen NT, Baranowski JC, Baranowski T. Components of the diet associated with child adiposity: a cross-sectional study. J Am Coll Nutr 2012; 30:536-46. [PMID: 22331689 DOI: 10.1080/07315724.2011.10720000] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study sought to determine which components of youths' diets were related to adiposity while controlling for potential often-neglected confounders such as moderate to vigorous physical activity (MVPA) and dietary reporting error. Secondary goals of this study were to determine the extent to which MVPA confounded the associations between diet and adiposity and whether associations between diet and adiposity would differ depending on reporting error. METHODS An ethnically diverse urban sample of 342 children aged 9-10 years and 323 adolescents aged 17-18 years were recruited for this cross-sectional study. Body mass index (BMI) and waist circumference (WC) were measured in the school; dietary assessment included three 24-hour recalls via telephone in the evenings, and MVPA assessment included 5 days of accelerometry. Over (n = 68), under (n = 250), or plausible (n = 347) dietary intake reporters were identified with the Huang calculation method. Linear regression assessed the relationship between adiposity indicators (BMI z-score and WC) and components of the diet (energy intake, food groups, macronutrients) after controlling for reporting error, demographic variables, and MVPA. RESULTS When dietary reporting error and potential confounders such as MVPA and demographic variables were controlled, energy intake (EI), vegetables, refined grains, total fat, total protein, and total carbohydrate were positively related to BMI z-score and WC and artificially sweetened beverages to WC. MVPA was a significant confounder. For BMI z-score, but not WC, relationships and strength of these relationships differed depending on dietary reporting error group (plausible, underreporter, overreporter). CONCLUSIONS Among plausible reporters, as expected, EI, refined grains, and all macronutrients were positively related to adiposity; however, artificially sweetened beverages and vegetables, which are low-energy-dense foods, were also positively related to adiposity. Reporting error interfered with associations between diet and BMI z-score but not WC, suggesting WC is a more robust measure of adiposity in relation to diet.
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Affiliation(s)
- Tracey A Ledoux
- Children's Nutrition Research Center USDA/ARS, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
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Meinen A, Friese B, Wright W, Carrel A. Youth Gardens Increase Healthy Behaviors in Young Children. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2012. [DOI: 10.1080/19320248.2012.704662] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Childhood obesity is a profoundly complex problem and serves as an example of a biospsychosocial issue. Scientific inquiry has provided incredible insight into the complex etiology of weight gain but must be viewed as an interaction between a human's propensity to conserve calories for survival in a world with an abundance of it. This article provides a brief overview divided between biological (nature) and psychosocial and behavioral (nurture) factors.
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Affiliation(s)
- Joseph A Skelton
- Department of Pediatrics, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
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Abstract
The relationship between dietary intake and obesity is complex, and dietary pattern analysis may offer new insight. We examined associations between dietary patterns identified in a diverse cohort of adolescents and weight status cross-sectionally and over a 5-year period. Project EAT (Eating Among Teens) (Time 1) collected data on 4746 middle (younger cohort) and high school (older cohort) students in 1998-9. EAT-II (Time 2) resurveyed 2516 of the original cohort in 2003-4. All analyses were run separately by age cohort and sex. The relationship between dietary patterns identified previously (vegetable, fruit, vegetable & fruit, starchy food, sweet & salty snack food, and fast food) and weight status was examined using logistic regression. All analyses were adjusted for socioeconomic status, race/ethnicity and activity level (longitudinal analyses were also adjusted for baseline weight status). In cross-sectional analyses, higher adherence to dietary patterns loading heavily on vegetables was associated with lower risk of overweight/obese weight status in older and younger girls, whereas higher adherence to a 'sweet & salty snack food' pattern was associated with lower risk in older and younger boys. These associations were found prospectively in older boys and girls, but were no longer significant in analyses adjusting for baseline weight status. We did not find consistent or intuitive associations between dietary patterns and weight status. Identified patterns may not capture the elements of diet that are truly important in determining adolescent weight, or diet may not be the primary driver in determining weight status at this age. Methodological difficulties in assessing diet must also be taken into consideration.
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Matthews VL, Wien M, Sabaté J. The risk of child and adolescent overweight is related to types of food consumed. Nutr J 2011; 10:71. [PMID: 21702912 PMCID: PMC3130644 DOI: 10.1186/1475-2891-10-71] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Accepted: 06/24/2011] [Indexed: 11/15/2022] Open
Abstract
Background/Aims To investigate the association between the risk of overweight and the consumption of food groups in children and adolescents. Methods We studied 1764 healthy children and adolescents (age 6-19y) attending 16 Seventh-Day Adventist schools and 13 public schools using a 106-item non-quantitative food frequency questionnaire from the late 1980 Child-Adolescent Blood Pressure Study. Logistic regression models were used to compute the risk of overweight according to consumption of grains, nuts, vegetables, fruits, meats/fish/eggs, dairy, and, low nutrient-dense foods (LNDF). Results The frequency of consumption of grains, nuts, vegetables and LNDF were inversely related to the risk of being overweight and dairy increased the risk. Specifically, the odds ratio (95% CI) for children in the highest quartile or tertile of consumption compared with the lowest quartile or tertile were as follows: grains 0.59(0.41-0.83); nuts 0.60(0.43-0.85); vegetables 0.67(0.48-0.94); LNDF 0.43(0.29-0.63); and, dairy 1.36(0.97, 1.92). Conclusion The regular intake of specific plant foods may prevent overweight among children and adolescents.
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Affiliation(s)
- Vichuda L Matthews
- Department of Epidemiology and Biostatistics, School of Public Health, Loma Linda University, Loma Linda, California, USA.
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Dupuy M, Godeau E, Vignes C, Ahluwalia N. Socio-demographic and lifestyle factors associated with overweight in a representative sample of 11-15 year olds in France: results from the WHO-Collaborative Health Behaviour in School-aged Children (HBSC) cross-sectional study. BMC Public Health 2011; 11:442. [PMID: 21649892 PMCID: PMC3123212 DOI: 10.1186/1471-2458-11-442] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Accepted: 06/07/2011] [Indexed: 11/16/2022] Open
Abstract
Background The prevalence of overweight in children and adolescents is high and overweight is associated with poor health outcomes over short- and long-term. Lifestyle factors can interact to influence overweight. Comprehensive studies linking overweight concomitantly with several demographic and potentially-modifiable lifestyle factors and health-risk behaviours are limited in adolescents - an age-group characterized by changes in lifestyle behaviours and high prevalence of overweight. Thus, the objective of the current study was to examine the association of overweight with several socio-demographic and lifestyle variables simultaneously in a representative sample of adolescents. Methods A nationally representative sample of 11-15 year-olds (n = 7154) in France participated as part of the WHO-Collaborative Health Behaviour in School-aged Children (HBSC) study. Students reported data on their age, height, weight, socio-demographic variables, lifestyle factors including nutrition practices, physical activity at two levels of intensity (moderate and vigorous), sedentary behaviours, as well as smoking and alcohol consumption patterns using standardized HBSC protocols. Overweight (including obesity) was defined using the IOTF reference. The multivariate association of overweight with several socio-demographic and lifestyle factors was examined with logistic regression models. Results The adjusted odds ratios for the association with overweight were: 1.80 (95% CI: 1.37-2.36) for low family affluence; 0.73 (0.60-0.88) for eating breakfast daily; 0.69 (0.56-0.84) for moderate to vigorous physical activity (MVPA); and 0.71 (0.59-0.86) for vigorous physical activity (VPA). Significant interactions between age and gender as well as television (TV) viewing and gender were noted: for boys, overweight was not associated with age or TV viewing; in contrast, for girls overweight correlated negatively with age and positively with TV viewing. Fruit and vegetable intake, computer and video-games use, smoking and alcohol consumption were not associated with overweight. Conclusions In multivariate model, family affluence, breakfast consumption and moderate to vigorous as well as vigorous physical activity were negatively associated with overweight. These findings extend previous research to a setting where multiple risk and protective factors were simultaneously examined and highlight the importance of multi-faceted approaches promoting physical activity and healthy food choices such as breakfast consumption for overweight prevention in adolescents.
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Affiliation(s)
- Marie Dupuy
- INSERM U1027, Epidémiologie et Analyses en Santé Publique, Toulouse, France
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