Position statement of the Polish Academy of Sciences Committee Human Nutrition Science on the principles for the nutrition of children aged 1-3 years

The Position Statement on the principles of nutrition for children aged 1-3 years emphasizes that proper nutrition of children at this age determines their optimal psychometric development and has beneficial effects on the process nutritional programming, which reduces the risk of diet-related diseases in adulthood. Continued breastfeeding in the post-infancy period, together with the proper introduction of complementary foods, supplies all the nutritional needs of the child. A varied selection of food products is important to balance out the diet of a child in the context of energy and nutrient needs. Attention should be paid to products not recommended for frequent consumption, due to the possibility of the early development of improper eating habits that can lead to undesirable health consequences. Due to the potential risk of deficiency, adequate intake of iron, iodine, calcium and vitamin D, as well as of n-3 PUFAs (which is often insufficient) should be provided. Adequate dietary energy and protein intake protects children against protein-energy undernutrition and is crucial for their proper growth and development. An important element in the assessment of the development of children involves monitoring their nutritional status and physical development by systematically measuring their body weight and length/height and analyzing their weight gain. It is necessary to diagnose the causes of being underweight/overweight in children. Physical activity (such as outdoor walks, plays, and games) and healthy sleep hygiene are recommended. Physical activity, an adequate number of hours of sleep, and the quality of sleep in early childhood may improve immunity, reduce the risk of excessive weight gain, and consequently reduce the risk of obesity later in life. Other issues discussed include the functioning of the digestive system as one of the determinants of the nutrition of young children, basics of proper nutrition, risk of nutrient deficiencies and development of proper eating habits in early childhood.

Statement of the Committee of Human Nutrition Science of the Polish Academy of Sciences on the use of dietary supplements containing vitamins and minerals by adults

The use of dietary supplements (supplementation) is the individual enrichment of the diet with ingredients naturally occurring in food. As a rule, dietary supplements should be used periodically. In nutritional practice, there are many indications for dietary supplementation, but the decision to take dietary supplements should be made by consumers wisely and only in justified situations, when there is a risk that the usual diet does not provide vitamins and minerals in an amount adequate to meet dietary recommendations. However, we should remember about the real dangers of taking too large doses of vitamins and minerals. Many people using dietary supplements, especially several types at the same time, may experience undesirable side effects and deterioration of health, and in addition, people taking medicines may seriously disrupt or weaken the effect of the drug, or even lack the therapeutic effect of the drug. The document presents 10 steps and rules for the use of dietary supplements available on the market, which are addressed to the general population.

Dietary recommendations during the Covid-19 pandemic. Statement of the Committee of Human Nutrition Science of the Polish Academy of Sciences

During the COVID-19 pandemic, care for an adequate diet, well adapted to the body's needs and the current level of physical activity, becomes of particular importance. Many dietary compounds participate in the functioning of the immune system, while vitamins D, C, A (including beta-carotene), E, B6, B12, folic acid, zinc, copper, selenium, iron, amino acids, n-3 and n-6 polyunsaturated fatty acids and intestinal microbiota are crucial in various types of defence processes. There has been no evidence that consumed food and its compounds, including those with pro-/prebiotic properties, play a significant role in preventing SARS-CoV-2 infection or alleviating its course. However, in terms of the nutritional value of food and the prevention of dysbiosis, recommending a varied diet with a high proportion of plant-based foods and an adequate amount of animal-based foods has a sound scientific basis. Malnutrition, underweight and obesity are considered independent and prognostic risk factors of severe SARS-CoV-2 infection, which reduce a patient's chances of survival. Therefore, ensuring good nutritional status, including healthy body weight, is a reasonable approach in the prevention of viral infection SARS-CoV-2 or alleviating its course. The document is accompanied by two catalogues of practical nutritional recommendations during the COVID-19 pandemic, addressed to the general population and children.

Metabolically healthy obese and metabolic syndrome of the lean: the importance of diet quality. Analysis of MAGNETIC cohort

Background

Obesity is considered as an indispensable component of metabolic health assessment and metabolic syndrome diagnosis. The associations between diet quality and metabolic health in lean, young adults have not been yet established whilst data addressing this issue in overweight and obese subjects is scarce. Our analysis aimed to establish the link between diet quality (measured with data-driven dietary patterns and diet quality scores) and metabolic syndrome (MS) in young adults, regardless of their adiposity status.

Methods

A total of 797 participants aged 18–35 years old were included in the study. Participants were assigned into metabolic syndrome (MS) group if at least two abnormalities within the following parameters were present: blood pressure, triglycerides, total cholesterol, HDL cholesterol, blood glucose. Participants with one or none abnormalities were considered as metabolically healthy subjects (MH), Diet quality was assessed with two approaches: 1) a posteriori by drawing dietary patterns (DPs) with principal component analysis (PCA) and 2) a priori by establishing diet quality scores and the adherence to pro-Healthy-Diet-Index (pHDI) and non-Healthy-Diet-Index (nHDI). Logistic regression with backward selection based on Akaike information criterion was carried out, to identify factors independently associated with metabolic health.

Results

Within the MS group, 31% were of normal weight. Three PCA-driven DPs were identified, in total explaining 30.0% of the variance: “Western” (11.8%), “Prudent” (11.2%) and “Dairy, breakfast cereals & treats” (7.0%). In the multivariate models which included PCA-driven DPs, higher adherence to middle and upper tertiles of “Western” DP (Odds Ratios [OR] and 95% Confidence Intervals [95% CI]: 1.72, 1.07–2.79 and 1.74, 1.07–2.84, respectively), was associated with MS independently of clinical characteristics including BMI and waist-hip ratio (WHR). Similar results were obtained in the multivariate model with diet quality scores - MS was independently associated with higher scores within nHDI (2.2, 0.92–5.28).

Conclusions

Individuals with MS were more likely to adhere to the western dietary pattern and have a poor diet quality in comparison to metabolically healthy peers, independently of BMI and WHR. It may imply that diet composition, as independent factor, plays a pivotal role in increasing metabolic risk. Professional dietary advice should be offered to all metabolically unhealthy patients, regardless of their body mass status.

Family History of Premature Coronary Artery Disease (P-CAD)-A Non-Modifiable Risk Factor? Dietary Patterns of Young Healthy Offspring of P-CAD Patients: A Case-Control Study (MAGNETIC Project)

Dietary habits of healthy offspring with a positive family history of premature coronary artery disease (P-CAD) have not been studied so far. The aim of this study was twofold: (1) to identify dietary patterns in a sample of young healthy adults with (cases) and without (controls) family history of P-CAD, and (2) to study the association between dietary patterns and family history of P-CAD. The data came from the MAGNETIC case-control study. The participants were healthy adults aged 18⁻35 years old, with (n = 351) and without a family history of P-CAD (n = 338). Dietary data were collected with food frequency questionnaire FFQ-6. Dietary patterns (DP) were derived using principal component analysis (PCA). The associations between the adherence to DPs and family history of P-CAD were investigated using logistic regression. Two models were created: crude and adjusted for age, sex, smoking status, place of residence, financial situation, education, and physical activity at leisure time. Three DPs were identified: 'prudent', 'westernized traditional' and 'dairy, breakfast cereals, and treats'. In both crude and adjusted models, subjects with family history of P-CAD showed higher adherence by 31% and 25% to 'westernized traditional' DP (odds ratio (OR) 1.31, 95% confidence interval (95% CI): 1.12⁻1.53; p < 0.005; per 1 unit of standard deviation (SD) of DP score and adjOR 1.25, 95% CI: 1.06⁻1.48; p = 0.007; per 1 unit of SD of DP score, respectively). Young healthy adults with family history of P-CAD present unfavorable dietary patterns and are potentially a target group for CAD primary prevention programs.

Dietary patterns and breast or lung cancer risk: A pooled analysis of 2 case-control studies in north-eastern Poland

BACKGROUND

Breast cancer in women and lung cancer in men are the most prevalent cancers in Poland and worldwide. Evidence of the impact of food groups and nutrients on the risk of breast and lung cancer is limited and lacking conclusions. Studies on food consumption and breast or lung cancer are limited.

OBJECTIVES

Assessment of the association between dietary patterns and the prevalence of breast and lung cancers in adult Poles.

MATERIAL AND METHODS

The study involved a pooled analysis of 2 case-control studies on 320 subjects aged 50-70 years from north-eastern Poland (160 women, 160 men). Breast cancer cases in 80 women and lung cancer cases in 80 men were diagnosed. The food consumption frequency for 21 selected foods was collected using the Questionnaire of Eating Behaviors (QEB). Principal component analysis and multiple logistic regression analysis were used. The odds ratio (OR) and 95% confidence interval (95% CI) were calculated.

RESULTS

Three dietary patterns (DPs) were identified: 'Prudent', 'Processed & fast food', and 'Traditional Polish'. In the pooled analysis for both cancers, the ORs were from 0.35 (95% CI: 0.20-0.61; p < 0.05 with adjustment for age) to 0.48 (95% CI: 0.26-0.88; p < 0.05 with adjustment for age, socioeconomic status index, physical activity, smoking, and abuse of alcohol) in the upper tertile of the 'Prudent' DP in comparison to the absence of cancers (OR = 1.00). The ORs of both cancers were 1.83 (95% CI: 1.06-3.16; p < 0.05 with adjustment for age) in the upper tertile of the 'Processed & fast food' DP. The ORs of both cancers for the 'Traditional Polish' DP were insignificant.

CONCLUSIONS

In the pooled analysis, a strong inverse relation was found between the 'Prudent' dietary pattern, characterized by higher frequency of dairy, fruit, vegetables, wholemeal bread, fish and juices consumption, and breast or lung cancer prevalence, irrespective of age, socioeconomic status, physical activity, smoking, alcohol abuse, and type of cancer in Polish adults from north-eastern Poland.

Intake of Dietary Fibre and Its Sources Related to Adolescents' Age and Gender, but Not to Their Weight

AIM

The aim of this observational study was to investigate the intake of dietary fibre and its sources among Polish adolescents according to prevalence of overweight after adjustment for age and gender.

METHODS

The study sample consisted of 1,565 students, including 48% boys and 52% girls aged 13-18 with normal weight, overweight and obesity. Dietary information was reported using the Block Screening Questionnaire for Fruit/Vegetable/Fibre Intake. The nutritional status was assessed on the basis of body mass and height measurements. The statistical analysis used one-factor logistic regression, multiple linear regression, trend estimation and a comparison of mean values.

RESULTS

Adolescents consuming white bread and rolls with a frequency ≥4 times/week had OR=0.74 (95% CI 0.56-0.97) for overweight and obesity compared to adolescents with less frequent consumption. For other fibre sources and overall dietary fibre no significant differences were noted in consumption frequency between adolescents with normal weight and overweight/obesity. Overall, boys were more often overweight and obese than girls. Girls had a higher intake of dietary fibre, fruit, fresh vegetables, dark bread and rolls, and lower intake of potatoes, beans and white bread and rolls than boys. Older age was associated with a decrease in the consumption of fruit juices, fruit, potatoes, white bread and rolls, and dietary fibre in girls and a decrease in fruit and fresh vegetable consumption in boys.

CONCLUSION

The intake of dietary fibre was not associated with the prevalence of overweight. As to the fibre sources, only a higher consumption of white bread and rolls decreased the chance of the occurrence of adolescent overweight. The consumption of dietary fibre and its sources was related to the age and gender of adolescents.

Nutritional knowledge, diet quality and breast or lung cancer risk: a case-control study of adults from Warmia and Mazury region in Poland

BACKGROUND

Knowledge on proper nutrition favours the creation of pro-healthy nutritional behaviours of people. Studies related to the nutritional knowledge of adults, diet quality and incidence of breast or lung cancers are limited.

OBJECTIVE

Analysis of the relationship between the level of nutritional knowledge, diet quality and risk of breast cancer in women or lung cancer in men from the Warmia and Mazury region in Poland.

MATERIAL AND METHODS

The study was carried out in 202 subjects aged 23-80 years, including 107 women (17 cases of breast cancer) and 95 men (54 cases of lung cancer) from the Warmia and Mazury region in Poland. Nutritional knowledge was evaluated with the Questionnaire of Eating Behaviours (QEB), including 25 statements. Based on the frequency of the consumption of 16 food items, two diet quality indices were created: the pro-Healthy-Diet-Index-8 (pHDI-8) and the non-Healthy-Diet-Index-8 (nHDI-8). The values of pHDI-8 and nHDI-8 were calculated on the basis of the sum of the daily frequency of consumption of the selected food items and expressed as times/day. The Odds Ratio (OR) of both breast cancer or lung cancer in relation to the level of nutritional knowledge was calculated based on a logistic regression analysis.

RESULTS

The incidence of breast or lung cancer in the bottom, middle and upper tertile of nutritional knowledge was 57.6%, 32.6% and 15.8%, respectively. As nutritional knowledge grew in the subsequent tertiles, pHDI-8 was on the increase (2.63 vs. 3.78 vs. 4.22 times/day) and n-HDI-8 was on the decrease (1.32 vs. 1.21 vs. 0.94 times/day). In the upper tertile of nutritional knowledge, the Odds Ratio for the incidence of breast or lung cancers varied from 0.06 (95% CI: 0.02; 0.17; p<0.05, with adjustment for cancer type and age) to 0.17 (95% CI: 0.04; 0.69; p<0.05, with adjustment for age and sex) when compared to the bottom tertile (OR=1.00). In the middle tertile of nutritional knowledge, the Odds Ratio of both cancers varied from 0.27 (95% CI: 0.12; 0.62, p<0.05, with adjustment for cancer type and age) to 0.35 (95% CI: 0.18; 0.71, p<0.05, variables without adjustment) when compared to the bottom tertile.

CONCLUSIONS

A higher level of nutritional knowledge was associated with the higher quality of a pro-healthy diet and lower risk of breast cancer in women or lung cancer in men. In contrast, a lower level of nutritional knowledge was associated with a lower diet quality and a higher risk of both types of cancers.

Habitual eating of breakfast, consumption frequency of selected food and overweight prevalence in adolescents from various age groups

AIM

To assess the influence of eating breakfast on the consumption of selected food and overweight prevalence among adolescents from different age groups.

MATERIAL AND METHODS

The study group consisted of students aged 13-18.9 (n=1700). Their height and weight measurements were used to calculate their body mass index and interpreted according to international standards for adolescents. Food consumption was assessed via the frequency method and involved the consumption of breakfast, dietary "bre and sweetened beverages. We used Block's validated questionnaire to assess the intake of dietary "bre and its sources. Analysis of the results was carried out in three age groups: 13-14.9, 15-16.9 and 17-18.9 years old. We used one-factor logistic regression adjusted by gender.

RESULTS

The percentage of adolescents with a regular habit of eating breakfast dropped by 5.7 percentage points when compared to adolescents aged 13-14.9 and 17-18.9 (from 54.2% to 48.5%), which was a phenomenon accompanied by an increase in the percentage of adolescents who ate breakfast irregularly or hardly ever (by 3.7 and 1.9 percentage points, respectively). Eating breakfast infrequently was related to a more frequent consumption of sweetened beverages (the odds ratio: from 2.32 to 2.67 depending on the age group) and a higher prevalence of a "bre-poor diet (from 1.49 to 2.23). Among adolescents aged 13-14.9 who hardly ever ate breakfast, the chance of being overweight increased by 83% in comparison to adolescents with regular habits of eating breakfast.

CONCLUSIONS

The frequency of eating breakfast decreased with the adolescents' age, especially among girls. Eating breakfast infrequently was associated with unhealthy nutrition, typical examples of which are lower intake of dietary "bre and more frequent consumption of sweetened beverages, and in the youngest group of adolescents caused a higher prevalence of overweight.

The effect of girls attitudes towards the health benefits of food on selected dietary characteristics. The GEBahealth Project

BACKGROUND

Dietary habits are formed at an early age and to a large extent they affect such nutritional behaviour in adulthood. Mothers in particular, influence family nutrition. In this respect, their knowledge, attitudes and behaviour about nutrition are responsible for the schooling of future generations. Many aspects of the link between food and health with nutritional behaviour in girls remain, however, unknown.

OBJECTIVES

To determine the effect of girls attitudes towards the health benefits of food on selected dietary characteristics.

MATERIAL AND METHODS

Study included 186 girls aged 13-21 years. Using a food frequency method the three dietary characteristics were obtained; food intake variety, fibre intake and fat intake, all of them expressed by a graded scale. Three validated questionnaires were used; FIVeQ, BSQFVF and BSQF. The girls attitudes towards the health benefits of food were rated from one of the survey's six parts, comprising of 8 statements from the Health and Taste Attitude Scale (HTAS) accordingly graded. Statistical analyses used logistic regression.

RESULTS

The mean index of food intake variety was 28.7 foods/week (ranging 0-60), whilst the mean dietary intakes of fibre and fat were 16.7 points (0-36 range) and 18.2 points (0-52 range), respectively. Girls from the upper tertile with favourable attitudes on food health benefits had an odds ratio (OR) for adequate fat intake (<22 points) of 3.1 (95% CI: 1.28, 7.52; p<0.05), as compared to those from the middle-neutral attitudes tertile, with an OR = 1.00. The ORs for the relatively high food intake variety and acceptable fibre intake were 1.05 in girls from the positive-upper tertiles, which were not significant.

CONCLUSIONS

The positive attitudes of girls towards the health benefits of food are conducive for making more favourable food choices and lowered dietary fat intake, however this did not significantly affect fibre intake nor food intake variety.

Socio-economic status as an environmental factor - incidence of underweight, overweight and obesity in adolescents from less-urbanized regions of Poland

INTRODUCTION

Under-nutrition, over-nutrition and obesity incidence in relation to environmental diversity and socio-economic influences in adolescents from less urbanized regions of Poland has not been widely studied.

OBJECTIVE

To determine the correlation between socio-economic status and incidence of underweight, overweight and obesity in adolescents located in less-urbanized regions of Poland.

MATERIAL AND METHODS

The study involved 553 adolescents aged 13-18 living in 2 less-urbanized regions of Poland (small towns and villages in the central and north-eastern regions). The sample was randomly chosen. The distinguishing determinants of socio-economic status (SES) included 6 features. The SES index (SESI) was calculated. Low, average and high SESI adolescents were distinguished. Using logistic regression, the odds ratio (OR) of underweight (BMI<18.5 kg/m(2)), overweight (BMI ≥ 25 kg/m(2)) and obesity (BMI ≥ 30 kg/m(2)) incidence was calculated after BMI conversion using the international cut-off by Cole et al. (2000, 2007). The reference group were adolescents with low SESI (OR=1.00).

RESULTS

11% of the adolescents were underweight, 14% were overweight and 3% were obese. The odds ratio of underweight incidence for the average SESI adolescent was 0.33 (95%CI: 0.15, 0.73; p<0.01) and in high SESI adolescents - 1.05 (95%CI: 0.78, 1.42; p>0.05). The odds ratio of overweight incidence in the average SESI adolescent was 1.73 (95%CI: 0.93, 3.19; p>0.05) and in high SESI adolescents - 1.14 (95%CI: 0.83, 1.57; p>0.05). The odds ratio of obesity incidence in the average SESI adolescent was 0.70 (95%CI: 0.21, 2.34; p>0.05) and in high SESI adolescents - 0.76 (95%CI: 0.40, 1.44; p>0.05). Adjustments for gender, age or region of residence did not significantly change the ORs values or their interpretation.

CONCLUSIONS

Underweight incidence in adolescents from less urbanized regions of Poland depended on socio-economic status. An adolescent with average socio-economic status was 3 times less likely to be underweight than an adolescent with low socio-economic status. The correlation between socio-economic status and overweight and obesity was not significant.

Validity of self-reported height and weight in elderly Poles

BACKGROUND/OBJECTIVES

In nutritional epidemiology, collecting self-reported respondent height and weight is a simpler procedure of data collection than taking measurements. The aim of this study was to compare self-reported and measured height and weight and to evaluate the possibility of using self-reported estimates in the assessment of nutritional status of elderly Poles aged 65 + years.

SUBJECTS/METHODS

The research was carried out in elderly Poles aged 65 + years. Respondents were chosen using a quota sampling. The total sample numbered 394 participants and the sub-sample involved 102 participants. Self-reported weight (non-corrected self-reported weight; non-cSrW) and height estimates (non-corrected self-reported height; non-cSrH) were collected. The measurements of weight (measured weight; mW) and height (measured height; mH) were taken. Using multiple regression equations, the corrected self-reported weight (cSrW) and height (cSrH) estimates were calculated.

RESULTS

Non-cSrH was higher than mH in men on average by 2.4 cm and in women on average by 2.3 cm. In comparison to mW, non-cSrW was higher in men on average by 0.7 kg, while in women no significant difference was found (mean difference of 0.4 kg). In comparison to mBMI, non-cSrBMI was lower on average by 0.6 kg/m² in men and 0.7 kg/m² in women. No differences were observed in overweight and obesity incidence when determined by mBMI (68% and 19%, respectively), non-cSrBMI (62% and 14%, respectively), cSrBMI (70% and 22%, respectively) and pcSrBMI (67% and 18%, respectively).

CONCLUSIONS

Since the results showed that the estimated self-reported heights, weights and BMI were accurate, the assessment of overweight and obesity incidence was accurate as well. The use of self-reported height and weight in the nutritional status assessment of elderly Poles on a population level is therefore recommended. On an individual level, the use of regression equations is recommended to correct self-reported height, particularly in women.