Influence of Maternal Education on Food Consumption and Energy and Nutrient Intake in a Group of Pre-School Children from Madrid

A study was conducted on the influence of maternal education level on food consumption, energy and nutrient intake, and dietary adequacy in 110 pre-school children from Madrid, Spain. With increasing maternal education, children consumed more sugar (p < 0.05), fruit (p < 0.05), and fish (p < 0.05). Snacking was more frequent with decreasing maternal education (p < 0.05). Though statistical significance was not reached, the consumption of pre-cooked foods was greater among children of mothers educated to a higher level, a phenomenon probably related to the work situation of these women. With respect to dietary composition, no significant differences were found between groups for macronutrient, fiber and energy intakes, except for energy supplied by polyunsaturated fatty acids (PUFA), which was greater in the children of less educated women (p < 0.01). This is probably due to their greater consumption of sunflower seed oil. The diets of children belonging to well-educated mothers came closer to meeting the recommended intakes for folate, vitamin C, and iodine. It would seem that maternal educational level influences the food habits of children. Mothers with less education may require special advice in this area.

Influence of the desire to lose weight on food habits, and knowledge of the characteristics of a balanced diet, in a group of Madrid university students

OBJECTIVE

The aim of this study was to determine the desire to lose weight in a group of university students, and to analyse the influence of this desire on declared food habits. The degree of knowledge on what constitutes a balanced diet was also determined.

DESIGN

Cross-sectional population survey.

SUBJECTS

The study subjects were 234 university students (48 males and 186 females) aged 22.3+/-1.5 y. The weight and height of each were recorded. All subjects were questioned on their desire to lose weight, habitual food intake frequencies, and about what they considered to constitute a balanced diet.

RESULTS

Approximately half the population (47.9%), both male (47.8%) and female (47.9%), expressed a desire to lose weight, even though the percentage of overweight students was low (11.1% overall, although much greater among male students [39.6%] than female students [3.8]). The body mass index (BMI) of those who wanted to lose weight was greater than that of those who did not. Nonetheless, the majority of subjects (especially females) showed BMIs within the normal range (18-25 kg/m(2)). Among those who wished to lose weight, the consumption of sweet foods was lower - although these subjects believed they ought to consume even less. It was also thought necessary that egg consumption be reduced, although no differences were recorded in declared consumption between those who wished to lose weight and those who did not.

CONCLUSIONS

The results show that there is great concern over body weight, although no great differences were seen in the food habits and nutrition knowledge of those who wished to lose weight and those who did not.

Influence of dietetic and anthropometric factors and of the type of sport practised on bone density in different groups of women

OBJECTIVE

The aim of this work was to analyse the influence of dietetic and anthropometric data, as well as the sport practised, on the bone density of different groups of sportswomen.

SUBJECTS AND METHODS

Dietetic, anthropometric and bone density data were collected from 74 women who practised different sports (15 skiers, 26 basketball players and 33 ballet dancers), and compared to those of 90 women who led sedentary lifestyles.

RESULTS

The sportswomen had higher bone mineral contents and bone densities than controls. However, the dancers showed similar spinal and hip values as those of controls, and lower forearm values. Low body weight and body mass index, and insufficient energy intake-characteristic of the dancers-were associated with poorer bone mineralisation status. Increased energy, protein, vitamin D, calcium, zinc and magnesium intakes were associated with greater bone density and mineral content at different sites.

CONCLUSIONS

The worst bone density status was that of the dancers, who, as a group, displayed characteristics that have negative impacts in this respect (low energy intakes and low body weight). Dancers should therefore take steps to avoid suffering fractures and skeleto-muscular lesions which could negatively influence their health and physical performance. The greater consumption of milk products and calcium and better Ca/P ratio seen in the dancers could help this group to avoid bone deterioration.

Influence of nutrition on cognitive function in a group of elderly, independently living people

OBJECTIVE

To study the differences in cognitive status with respect to food habits and energy and nutrient intake in a group of non institutionalised, elderly people.

DESIGN

Prospective study.

SETTING

The study subjects were independently living, elderly people who spent some of their time at day centres in the Comunidad de Madrid (the Madrid region). The study centres were selected by the Madrid City Hall.

SUBJECTS

The study included 168 elderly people aged 65-90 y. All accepted the invitation to participate, met all inclusion criteria, and were free of significant cognitive impairment.

INTERVENTIONS

Dietary intake was monitored using a 'food record' for 7 consecutive days including a Sunday. In addition, the 'precise individual weighing' method was used for 5 days in order to monitor the meals taken by the subjects at the centres' canteens. Cognitive capacity was measured using Folstein's mini-mental state examination (MMSE), validated for the Spanish population.

RESULTS

Subjects with an adequate cognitive capacity (MMSE>/=28) showed a greater intake of total foods, fish, and alcoholic drinks, but took less foods from the 'various' group (chocolates, cakes, etc). These subjects had a more adequate intake of fatty acids and cholesterol, and a greater intake of vitamins implicated in correct brain function (thiamine, folic acid, vitamin C).

CONCLUSIONS

Subjects with satisfactory intellectual function generally had a better diet. This shows the importance of correct nutrition in its maintenance.

Relationship between habitual breakfast and intellectual performance (logical reasoning) in well-nourished schoolchildren of Madrid (Spain)

OBJECTIVE

To determine the relationships between habitual breakfast habits and performance in verbal aptitude, logical reasoning and mathematical tests in a group of well-nourished scholars from Madrid.

DESIGN

The study subjects were 180 children between 9 and 13 y of age. A dietetic study was undertaken using a 7-day food record. Scholastic aptitude was examined using the scholastic aptitude test (SAT-1) test.

RESULTS

Breakfast made up 19.1% of total daily intake. No differences were found between subjects in terms of personal data or total diet with respect to whether they habitually took adequate breakfasts (AB) (ie, more than 20% of daily energy being provided by this meal) or inadequate breakfasts (IB) (less than 20%). However, AB subjects achieved better reasoning scores in the SAT-1 test.

CONCLUSIONS

The normal breakfast habits of schoolchildren should be taken into account when studying diet-mental function relationships, even when studying well-nourished populations.

The influence of vitamin B2 intake on the activation coefficient of erythrocyte glutation reductase in the elderly

OBJECTIVE

To evaluate the influence of dietetic vitamin B2 on the activation coefficient of erythrocyte glutation reductase (alpha-EGR) of a group of elderly people.

DESIGN

The study subjects were 133, independently-living elderly people, between 65 and 90 years of age. A dietetic study was performed using a 7-day food record. Riboflavin status was measured by determining the alpha-EGR.

RESULTS

Some 23.9% of subjects had riboflavin intakes lower than those recommended. At the biochemical level, 9.8% of subjects (7.7% of men and of 10.6% women) showed alpha-EGR>1.2. Those subjects with riboflavin intakes below 90% of those recommended showed significantly higher alpha-EGR levels (1.15+/-0.16), an indication of a poorer riboflavin status at the biochemical level. Those with greater intakes showed lower alpha-EGR values (1.05+/-0.10). Furthermore, the mean consumption of dairy products (an important source of this vitamin) by subjects is insuficiente (341.1+/-159.8 g/day, 2.1+/-1 servings/day). The data show that those with riboflavin intakes below those recommended took 204.7+/-89.4 g/day of milk products (1.3+/-0.5 servings/day) compared to the 384+/-153.1 g/day (2.4+/-1 servings/day) (p<0.001) consumed by those with higher riboflavin intakes.

CONCLUSION

Although the mean riboflavin intake is acceptable, there remain some insufficiencies that require attention. It would seem advisable to recommend the elderly increase their intake of milk products. This would be especially important for subjects who take less than two rations per day.

Homocysteine levels in elderly Spanish people: influence of pyridoxine, vitamin B12 and folic acid intakes

BACKGROUND

Serum homocysteine levels are a risk factor in cardiovascular disease. Knowledge on how dietary factors might affect these levels is therefore of interest.

OBJECTIVE

To evaluate serum homocysteine levels in a group of elderly people and analyse the effect of pyridoxine, vitamin B12 and folic acid intakes on these levels.

DESIGN

The study subjects were 130 independently-living elderly people over the age of 65. A dietetic study was performed using a 7-day food record. Serum homocysteine levels were determined by HPLC.

RESULTS

Mean pyridoxine, vitamin B12 and folate intakes were 67.2+/-16.8%, 392.8+/-549.2% and 84.5+/-28.3% of recommended values respectively. With regard to sex, differences were seen only for vitamin B12 intake (9.1+/-12.7 microg/day in men, and 6.5+/-8.8 microg/day in women). Some 93.6% of subjects showed pyridoxine intakes below those recommended, as did 17.6% with respect to vitamin B12 and 72.8% with respect to folic acid. Homocysteine levels were 12.4 micromol/l (12.6+/-3.7 micromol/l in men and 12.2+/-7.9 micromol/l in women) (P<0.05). No significant differences were seen in homocysteine levels between subjects with lower than recommended intakes of pyridoxine or vitamin B12 and those with better intakes. However, subjects with folic acid intakes below 200 microg/day showed higher homocysteine levels (13.0+/-6.7 micromol/l) than did subjects with more adequate intakes (10.9+/-4.1 micromol/l) (P<0.05).

CONCLUSION

The diet of the study subjects might be improved, especially with respect to pyridoxine and folic acid. Raising the intake of the latter might be especially useful in controlling homocysteine levels and the risk of cardiovascular disease.

Vitamin E status in a group of elderly people from Madrid

BACKGROUND

Given that vitamin E plays an important role in the prevention of pathological processes frequently observed in older age, it is of special interest to evaluate the nutritional situation of this population with respect to this vitamin.

OBJECTIVE

To evaluate the nutritional situation with respect to vitamin E in a group of elderly individuals from Madrid, Spain.

DESIGN

The vitamin E status of a group of 120, independently-living elderly people was investigated. All included subjects (i.e., those for whom it was possible to determine vitamin E status) belonged to a sample of 158 elderly volunteers, subjects of a larger nutritional study. A 5-day food record (including a Sunday) was kept in order to monitor food intake. Serum levels of alpha-tocopherol were determined by HPLC.

RESULTS

Some 95.2% of subjects showed intakes below those recommended; 86.7% did not even meet 66% of the recommended values. At serum level, subjects showed alpha-tocopherol values of 8.3+/-3.6 mg/L, with no differences between men and women (8.5+/-3.6 mg/l in men and 8.2+/-3.6 mg/L in women). Some 51.7% (52.4% of men and 51.3% of women) showed levels below 7.8 mg/L; 17.5% (14.3% of men and 19.2% of women) showed values of 5 mg/L. The influence of the diet at the biochemical level can be seen in that those subjects with intakes lower than 50% of the recommended who showed significantly lower serum levels (7.8+/-3.4 mg/L) that those with greater intakes (9.3+/-4.2 mg/L). This difference was independent of serum triglyceride and cholesterol levels. Subjects with coefficients of vitamin E (mg)/polyunsaturated fatty acids (g) (E/AGP) below the 5 th percentile (0.32) had significantly lower serum alpha-tocopherol levels (5.3+/-1.1 mg/L) than did subjects with E/AGP>or= 0.32 (8.5+/-3.7 mg/L).

CONCLUSION

Given the importance of vitamin E as an antioxidant, and its role in the prevention of a range of pathological processes, insufficient intakes (frequently detected in the group studied) should be corrected.

Effect of saturated fatty acid consumption on energy and nutrient intake and blood lipid levels in preschool children

In this article the effects of saturated fatty acid (SFA) consumption on energy and nutrient intake, and on a range of serum lipid parameters (indicators of cardiovascular risk) are reported in a group of 110 preschool children. Subjects were divided into 2 groups: high consumption (HC), in which > or =13% (20th percentile) of total energy came from SFAs, and low consumption (LC), in which SFAs provided <13% of energy intake. Food intake was monitored for 7 consecutive days. At participating day care centers, a 'precise individual weighing' method was used, while a 'food intake record' was kept for foods taken at home. At the blood level it was found that HC subjects showed higher HDL-cholesterol levels and better HDL-cholesterol/LDL-cholesterol ratios than did LC subjects. The greater intakes of riboflavin, iodine, zinc, magnesium and calcium seen in HC subjects suggest that these may have a better nutritive status (with respect to certain nutrients) than LC subjects. The development of criteria for providing the greatest protection against cardiovascular disease, while maintaining good nutritive condition, should be the subject of future studies. This is especially important in children of preschool age since nutritional deficiencies at this stage in life can have important effects on growth and health.

[Dietary and biochemical riboflavin status in a cohort of young people in the community of Madrid]

Riboflavin status was measured in 228 young people (101 women and 127 men) between 18 and 35 years of age, resident in the Comunidad Autónoma de Madrid. A dietetic study was undertaken using a three day food record (which included one non-working day). Also, biochemical levels of riboflavin were investigated via the determination of the activation coefficient of erythrocyte glutathione reductase (alpha-EGR). Although the mean intake of riboflavin was acceptable (107.1 +/- 29.1 of recommended intakes), 46.9 of subjects showed intakes below recommended. At the biochemical level, 14.9% of subjects showed a moderate risk of vitamin B2 deficiency (alpha-EGR: 1.2-1.4) whilst 1.3% were at high risk (alpha-EGR > 1.4). Male subjects showed higher alpha-EGR levels than did females, which coincides with their greater intake of vitamin B2. Milk products provided some 40.4% of the vitamin, meats 19.9%, cereals 8%, vegetables 7.2%, eggs 6.3%. Other foods provided lesser amounts. Therefore, although riboflavin is available across the food groups, it Would seem that milk products are its most important source. Indeed, subjects with high milk product intakes (more than one ration per day) showed the highest riboflavin levels and the most adequate alpha-EGR levels. This study shows that riboflavin status can be improved, especially amongst those with low milk product intakes. An increase in the consumption of these foods to recommended levels (2-3 rations per day) might improve this situation at both dietetic and biochemical levels.

Riboflavin levels in maternal milk: the influence of vitamin B2 status during the third trimester of pregnancy

OBJECTIVE

The aim of the present investigation was to study the relationship between riboflavin status during the third trimester of pregnancy and levels of this vitamin in transition milk (days 13 to 14 of lactation) and mature milk (day 40 of lactation).

METHODS

The pregnancies and lactation periods of 57 healthy women between 18 and 35 years of age (27+/-3.7 years) were monitored, vitamin intake during the third trimester was determined by recording the consumption of foods over five days and by registering the quantities provided by dietary supplements. Riboflavin status during this stage of pregnancy was determined via the measurement of the activation of erythrocyte glutathione reductase (EGR) by flavine adenine dinucleotide (FAD). Milk riboflavin levels were determined by fluorometry.

RESULTS

Those subjects with riboflavin intakes below recommended (1.6 mg/day) (Group L) showed lower consumption of milk products (305.2+/-88.5 g/day) than did those with greater intakes (Group H) (507.9+/-137.2 g/day). The consumption of riboflavin containing supplements was very low and was seen only in two H subjects. Transition and mature milk riboflavin levels were significantly higher in H subjects (948.1+/-700.1 nmol/L for transition milk and 993.8+/-436.6 nmol/L for mature milk) than L subjects (574.9+/-258.7 nmol/L for transition milk and 725.4+/-254.3 nmol/L for mature milk). Subjects with alpha-EGR coefficients over 1.2 in the third trimester showed significantly lower mature milk riboflavin levels (704.1+/-241.8 nmol/L) than did subjects with more satisfactory alpha-EGR coefficients (996.4+/-302.9 nmol/L).

CONCLUSION

The influence of maternal vitamin B2 status during pregnancy on breast milk riboflavin levels was confirmed.

[Maternal age as conditioning factor of vitamin E levels in the third trimester of pregnancy and in breast milk]

BACKGROUND

Since pregnancy in older women is becoming more common, the aim of this work was to determine the influence of maternal age on third trimester maternal vitamin E status, and on vitamin E levels in maternal milk.

SUBJECTS AND METHODS

The pregnancies and lactation periods of 57 women were examined. The intake of vitamin E during the third trimester of pregnancy was determined using a 5 days food record. Vitamin E concentrations in serum, transition milk (days 13 and 14 of lactation) and mature milk (day 40 of lactation) were determined by high performance liquid chromatography (HPLC).

RESULTS

Pregnant women < 32 years of age (90th percentile) showed significantly higher serum vitamin E levels (1.46 [0.38] mg/dl) than older pregnant women (1.19 [0.24] mg/dl). Transition milk vitamin E levels were significantly lower in pregnant women > or = 29 years of age (75th percentile) than did younger pregnant women (1.7 [0.4] mg/l compared to 2.0 [0.7] mg/l).

CONCLUSIONS

Given that serum vitamin E levels were seen to fall in pregnancy and in transition milk, when maternal age increase, the monitoring of maternal nutritional status is highly recommendable. Antioxidant supplements, especially vitamin E, might be prescribed for older, pregnant women.

The age at which meat is first included in the diet affects the incidence of iron deficiency and ferropenic anaemia in a group of pre-school children from Madrid

A study was made into the effect of the age at which meat was first included in the diet on a series of haematological parameters and biochemical indicators of iron status in 94 pre-school children (aged 2-6 years) from Madrid (Spain). Those children who first took meat during their eighth month of life or earlier (Group A) showed better iron status that did those who were introduced to meat later (Group B). Significant differences were found in hemoglobin levels (P < 0.01), mean corpuscular haemoglobin (MCH) (P < 0.05), serum ferritin (P < 0.05), transferrin levels (P < 0.05) and total iron binding capacity (TIBC) (P < 0.001). Some 13.8% of all subjects showed iron deficiency and 5.3% showed ferropenic anaemia. These latter subjects were the last to have meat included in their diets (9.3 +/- 1.2 months compared to 7.4 +/- 2.0 months in those without ferropenic anaemia) (P < 0.05). It would appear that the age at which meat is included in the diet has an important effect on iron status in pre-school children. Delaying its inclusion beyond the age of eight months seems to be associated with an impairment of later iron status.

[Implication of calcium deficiency in the progress of periodontal diseases and osteoporosis]

Several authors have established a relationship between osteoporosis and periodontal disease. The ageing process is associated with a loss of both oral and total bone mass. It has been shown that a reduction of bone mineralization aggravates pathological periodontal changes, resulting in less support for the teeth. The present study investigates the nutritional influences that may condition the appearance of both pathological process. Insufficient dietary calcium and a reduction in the calcium: phosphorous ratio may favour the appearance of both these conditions by promoting bone reabsorption. Bone loss affects the following in descending order: jaw bones (especially alveolar bone), cranial bones, ribs, vertebrae and long bones. Alveolar bone which has the highest rate of renewal, is affected first and consequently is the most severely affected in the long term. The role of calcium in the etiology of osteoporosis is a controversial issue. Nevertheless, its implication has been proven in numerous investigations. The effect of adequate calcium intake on dental health has formed the basis of several recent studies. These investigations have demonstrated that increased calcium intake improves the suffering of inflammatory processes and tooth mobility in patients suffering from gingivitis with haemorrhaging. Based on the results of studies which link dietary calcium and phosphorous to the risk of osteoporosis and periodontal disease, and bearing in mind that in a large proportion of the Spanish population calcium intake is below that recommended, there is a need for a general improvement of the diet. It may be of special interest to increase the calcium intake of patients suffering periodontal disease. It may also help in the prevention of osteoporosis.

[Dietary cholesterol as a conditioner of ingestion of other nutrients and various blood parameters in young women]

The aim of the study was to determine the effects of cholesterol intakes of greater (HC) or less than 300 mg/day (LC) (the upper advisable limit for the control of cholesterolaemia and the risk of cardiovascular disease) on a range of blood parameters, and to determine any influence such intakes might have on the consumption of food, energy and nutrients. The study subjects we one hundred and thirty young women. Food intake was determined using a 7-day dietary record (including a Sunday). A range of serum lipid parameters, and haematological and biochemical indicators of iron status were also determined. The percentage discrepancy between observed energy intake and theoretical energy expenditure was greater amongst LC subjects (9.7 +/- 18.8% compared to 5.5 +/- 24.4% in HC subjects) (P < 0.05). Analysis of covariance was therefore performed with respect to the degree of underestimation/overestimation of intake. The comparison of the adjusted means showed that HC subjects consumed greater quantities of eggs and meat and less alcohol, than did LC subjects. HC subjects also showed greater intakes of protein, carbohydrates, total fats, monounsaturated fatty acids, polyunsaturated fatty acids, saturated fatty acids, cholesterol, riboflavin, niacin, folic acid, vitamin E, zinc and iron. At blood level, HC subjects showed greater quantities of red blood cells, haemoglobin and HDL cholesterol. No significant differences were seen between LC and HC subjects for the remaining blood and biochemical parameters investigated. The development of criteria for the greatest protection against cardiovascular disease whilst maintaining good nutritive condition, is the subject of studies soon to be commenced. Women may need different advice to men, owing to their greater need of iron. Greater quantities of foods rich in haem iron, such as meat and fish, might be appropriate for the female population.

The influence of meat consumption on dietary data, iron status and serum lipid parameters in young women

In a group of 130 women of fertile age (24.5 +/- 2.7 years), the consumption of meat and meat products was evaluated in order to determine the effect of this food group on blood and biochemical parameters that act as indicators of iron status, and on a range of serum lipid parameters that indicate cardiovascular risk. Food intake was monitored using a "Food Record" for seven days, including a Sunday. Subjects were divided into two groups: those who took > or = 100 g/day of meat (25th percentile) (high consumption--HC) (n = 102), and those with lesser intakes (low consumption--LC) (n = 28). Dietary data were adjusted to take into account differences in discrepancies in reporting between the two groups. The greater consumption of meat observed in HC subjects, despite its association with greater intakes of lipids (both in g/day and % of energy) and cholesterol (in mg/day and mg/1000 Kcal), did not seem to be related to any impairment of blood lipid profiles. Neither was it seen to be related to increased bodyweight nor raised blood pressure. It should not, therefore, bring about any increased risk of cardiovascular disease. However, the greater intake of thiamine, niacin, zinc and iron (total and haem) in HC subjects suggests that these may have a better nutritive status (with respect to certain nutrients) than do LC subjects. In relation to iron status. HC subjects showed higher levels of haemoglobin, haematocrit and mean corpuscular haemoglobin concentration (MCHC). These results show that restrictive criteria, with respect to the consumption of meat and meat products, could have negative repercussions on the nutritive status and health of certain groups within the population. In the female population, such criteria may be associated with impairment of iron status, without affording any greater level of protection against cardiovascular disease, or be of any help in the control of bodyweight.

[Relationship between the number of daily meals and the energy and nutrient intake in the elderly. Effect on various cardiovascular risk factors]

The metabolic consequences of the consumption of a diet depend, in part, on the frequency and distribution of meals. The aim of the present study was to examine the number of meals taken per day by elderly persons, and to analyse the relationship between the number of meals per day on the intake of energy and nutrients, the incidence of obesity/overweight, and different cardiovascular risk factors. Food intake was monitored for five consecutive days using 'precise individual weighing' for institutionalised subjects (n = 58), and by means of a 'food intake record' for independent subjects (n = 92). The number of meals taken per day was recorded, along with anthropometric data, blood pressure and serum lipid and lipoprotein levels. No subject took only one meal per day, 7.3% took two, 56.7% took three, 33.3% took four and 2.7% took five. Only 10% of subjects took a mid-morning meal. Breakfast and merienda (a light evening snack) were the meals most frequently omitted. A positive, significant relationship was found to exist between the number of meals taken per day and the intake of fibre (r = 0.2737), thiamin (r = 0.1671), pyridoxine (r = 0.2060), magnesium (r = 0.2423) and the percentage of energy provided by carbohydrates (r = 0.2144). Women subjects who took 2-3 meals per day showed greater body mass indices and a greater proportion were overweight/obese compared to those who took 4-5 meals per day. Subjects who took 4-5 meals per day showed higher levels of HDL-cholesterol and lower levels of LDL-cholesterol/HDL-cholesterol and cholesterol/HDL-cholesterol than did those who took fewer meals per day. Inverse, significant relationships were also found between the number of meals per day and serum cholesterol (r = 0.2297) and LDL-cholesterol levels (r = 0.1984). Taking into account energy and nutrient intakes, the incidence of obesity/overweight and serum lipid and lipoprotein levels, the consumption of 4-5 meals per day would seem more advisable for the elderly than the taking of fewer meals.

Difference in the breakfast habits of overweight/obese and normal weight schoolchildren

The aim of the present study was to analyse the differences between the breakfast habits of obese/overweight (O) (those with body mass index [BMI] above the 75th percentile) and normal weight schoolchildren (N) (those with BMI equal to or below the 75th percentile). A seven consecutive days "food record" was used to record the intake of foods at breakfast and throughout the rest of the day. O subjects, and in particular female O subjects, omitted breakfast more frequently and took significantly smaller quantities of cereals than did N subjects. The energy supplied by breakfast, measured as a percentage of energy expenditure, was significantly lower in O subjects (17.0 +/- 8.5% in males and 14.6 +/- 6.1% in females) than in N subjects (20.9 +/- 9.4% in males and 17.6 +/- 6.5% in females). With respect to the energy and nutrients supplied by breakfast, O subjects took lower quantities of carbohydrates, thiamin, niacin, pyridoxine, vitamin D and iron than did N subjects. The energy profiles of O subjects breakfasts were more imbalanced than those of N subjects. A significant difference was seen between the amounts of energy supplied by carbohydrates. Without doubt, O subjects have less satisfactory breakfast habits than N subjects. This might be a reflection of whole diet that is less adequate, however, it is possible that an inadequate breakfast contributes to the making of poor food choices over the rest of the day, and, in the long term, to an increased risk of obesity.

The importance of breakfast in meeting daily recommended calcium intake in a group of schoolchildren

OBJECTIVE

To evaluate the breakfast intake of calcium and milk products and to determine whether these correlate with total intake of both calcium and milk products.

METHODS

Food taken at breakfast and throughout the day was recorded using a 7 consecutive day food record in 200 schoolchildren aged between 9 and 13 years.

RESULTS

65.3% of boys and 80.5% of girls showed intakes of calcium which were lower than recommended. Milk products were the foods most frequently included in breakfast (95.5% of subjects included them in this meal). A relationship was seen between energy provided by breakfast and the quantities of milk products (r = 0.5735) and calcium (r = 0.6908) taken at this meal. A relationship was also seen between energy provided by breakfast and daily intake of milk products (r = 0.4633) and calcium (r = 0.4954). The percentage of intakes of calcium lower than those recommended decreased when breakfast provided > or = 20% of total energy intake, and when the consumption of milk products at breakfast was greater than the 50th percentile (200 ml). Subjects with breakfast milk product intakes > or = 200 ml showed higher intakes of the same over the rest of the day (233.3 +/-140.4 g) than did those who took lesser quantities of these foods at breakfast (161.5 +/- 100.6 g). Further, those who took > or = 25% of the recommended intake of calcium at breakfast showed greater intakes of the same over the rest of the day (600.4 +/- 213.8 mg compared to 510.8 +/- 200.7 mg in subjects with lower calcium intakes).

CONCLUSIONS

The intake of milk products (r = 0.7587) and calcium (r = 0.7223) at breakfast correlates with the consumption of these foods in the whole diet. However, the total daily intake of milk products and calcium does not depend solely on breakfast intake. Subjects with the greatest intakes at breakfast also showed greater intakes over the rest of the day (r = 0.3953 for milk products and r = 0.4122 for calcium).

The relationship between breakfast and whole diet energy profiles in a group of preschool children

The energy profile of the diet of the Spanish population is imbalanced, showing excessive intake of fats and protein and insufficient intake of carbohydrates. The aim of the present study was to investigate whether this imbalance also existed in 110 preschool children between 2 and 6 years of age, and to examine the relationship between their breakfast and whole diet energy profiles. The results obtained show that subjects who consumed less carbohydrate (< 50% of energy intake) or more fat (> 35% of total intake) at breakfast showed poorer energy profiles and poorer fat quality over their whole diet. Significant and positive correlations were found between energy supplied at breakfast by protein, fats, carbohydrates, saturated, monounsaturated and polyunsaturated fatty acids, and the same parameters measured for the whole diet.

Dietary intake and cognitive function in a group of elderly people

Associations between dietary intake and cognitive performance were examined in 260 elderly people aged 65-90 y who were free of significant cognitive impairment. Dietary intake was monitored with a weighed-food record for 7 consecutive days. The subjects' cognitive capacity was tested by using Folstein et al's Mini-Mental State Examination (MMSE) and Pfeiffer's Mental Status Questionnaire (PMSQ). Subjects with adequate MMSE results (> or = 28 points) had lower intakes of monounsaturated fatty acids, saturated fatty acids, and cholesterol, and higher intakes of total food, fruit, carbohydrate, thiamine, folate, and vitamin C compared with those with less satisfactory results. Subjects who made no errors on the PMSQ had greater intakes of total food, vegetables, fruit, carbohydrate, fiber, folate, vitamin C, beta-carotene, iron, and zinc, and lower intakes of saturated fatty acids compared with those who made errors. Our results agree with those of other authors indicating that intakes of different nutrients or the consumption of a more satisfactory global diet is associated with better cognitive function in the elderly. However, more research is required to determine whether differences in intake of a particular nutrient are the result of or a conditioning factor for incipient impaired cognition. Unmeasured confounding factors may also affect both dietary intake and risk of cognitive impairment. A diet with less fat, saturated fat, and cholesterol, and more carbohydrate, fiber, vitamins (especially folate, vitamins C and E, and beta-carotenes), and minerals (iron and zinc) may be advisable not only to improve the general health of the elderly but also to improve cognitive function.

Effects of human immunodeficiency virus infection and detoxification time on anthropometric measurements and dietary intake of male drug addicts

Anthropometric measurements and dietary intakes of male drug addicts (n = 62), infected (n = 23) or not infected (n = 39) with human immunodeficiency virus (HIV), who underwent two phases of detoxification (P1:15 d to 1 mo and P2: 5-6 mo) were assessed. Body weight, weight gain during detoxification, height, body mass index, and ideal body weight were measured. A prospective food-record questionnaire was compiled and energy and nutrient contents of ingested food were determined. Food intakes were compared with dietary recommendations for the Spanish population. At the time of the study, all patients had substantial weight gains, mostly in P1. Nutrient consumption was lower in P2 (energy, protein, and lipids) and in groups not infected with HIV. In P2, lipid intake was higher in the HIV-positive than in the HIV-negative group (P < 0.05, Student's t test). Moreover, an interactive effect of HIV by phase was shown for lipid intake (P = 0.04, two-way analysis of variance). Magnesium, folate, and vitamin E intakes were lower than recommended in nearly all patients. Energy, zinc, riboflavin, and vitamin B-6 intakes were lower than recommended or were borderline. HIV infection did not have a negative effect on anthropometric measurements or on nutrient intakes. The anthropometric assessment may suggest an adequate recovery of the indexes measured in all patients, which principally took place during P1. Measurement of nutrient intakes showed certain imbalances and deficits that should be corrected.

Human immunodeficiency virus infection and nutritional status in female drug addicts undergoing detoxification: anthropometric and immunologic assessments

To clarify the interrelations among drug abuse, malnutrition, and immunosuppression, the effects of human immunodeficiency virus (HIV) infection on the nutritional status of 17 noninfected and 19 HIV-infected asymptomatic female drug addicts undergoing detoxification were evaluated by measuring anthropometric and immunologic indexes. Anthropometric measurements were normal in both groups as a result of weight gain (approximately 10 kg) in every patient after the detoxification period. Leukocyte and lymphocyte values and CD2 lymphocyte subset counts were also similar in both groups. CD4 counts (P = 0.04) and the ratio of CD4 to CD8 cells (P = 0.6 x 10(-4)) were lower whereas CD8 counts (P = 0.003) were higher in the HIV-infected than in the noninfected group. Responses to a delayed-hypersensitivity skin test were below normal in both groups but significantly more so in the HIV-positive group (P = 0.05). CD19 counts were lower (P = 0.02) and values for serum immunoglobulins G and M were higher (51% and 37%, respectively) in the HIV-infected females than in the noninfected women. These results may suggest that despite anthropometric recovery, the HIV-infected women had depleted immune function, resulting not only from HIV infection but also from the subclinical malnutrition triggered by previous drug addiction.

The female Spanish population: a group at risk of nutritional iron deficiency

Iron deficiency is one of the most common nutritional problems in the world. It is frequent in both developed and developing countries and mainly affects women of childbearing age. The aim of the present study was to investigate the prevalence of iron deficiency in a group of young women from Madrid, Spain. The study subjects were a group of 130 women aged between 19 and 35 (24.53 +/- 0.24 years). Measurements were made of iron intake and also of the haematological and biochemical indicators of iron status. 10.7% of subjects showed iron deficiency (defined as the recording of at least two indicator parameters with values below normal). The high incidence of iron deficiency at blood level (10.7%) coincided with the low iron intake of these subjects (11.08 +/- 2.98 mg/day). 98.3% of subjects showed intakes below recommended. Observed intake covered only 61.6% of recommended intake. 3.9% of subjects presented ferropenic anaemia, i.e. they showed both iron deficiency and low haemoglobin levels.

Concern regarding bodyweight and energy balance in a group of female university students from Madrid: differences with respect to body mass index

OBJECTIVE

There are powerful social and psychological motivators that oblige a high proportion of women to restrict their energy intake for purely aesthetic reasons. The purpose of this research was to assess the relationships between concern regarding body weight and energy balance in a group of female university students from Madrid, Spain, with respect to differences in body mass index (BMI).

DESIGN

126 subjects completed a questionnaire asking if they were happy with their body weight, if they considered themselves fat, and if they would like to lose some weight. Energy intake was measured by means of a 7-day food record. Food intake was recorded by weight, except for that consumed away from home which was recorded using traditional household quantities. A comparison of energy intake and estimated energy expenditure was performed, using equations proposed by the World Health Organization (WHO), to provide a measure of the under- or overestimation of intake.

RESULTS

All subjects with BMI > or = 25 kg/m2 (6.2% of the total) described themselves as fat. 71.4% had, at some time, followed a weight-reduction diet. However, even among subjects with BMI < 20 kg/m2 (28.4% of the total), 2.9% thought themselves fat and 17.1% had at some time followed a slimming diet. This shows excessive concern over losing weight in some women. Estimated energy expenditure was similar to energy intake in subjects with BMI < 20 kg/m2. However, as BMI rose (with a corresponding increase in theoretical energy expenditure), the reported energy intake decreased. It is therefore likely that underestimation of energy intake increased with BMI (r = 0.4498).

CONCLUSION

These results indicate that a large percentage of the women studied would like to lose weight until they reach, or indeed exceed, the lower limit of the acceptable normal range. This could be a danger to their health. Underestimation of energy intake was found to increase with BMI, a phenomenon that should be kept in mind when designing diet studies.

Concern about nutrition and its relation to the food habits of a group of young university students from Madrid (Spain)

The aim of this investigation was to study the relationship between concern about nutrition and food consumption in 533 university students (112 men and 421 women), aged 21.7 +/- 2.1 years old. Fish, dairy products and fruit were consumed in quite satisfactory quantities though cereals and vegetables were consumed less frequently than recommended. Men were found to consume greater quantities of milk, meat, bread and alcoholic drinks, while women ate more fruit and vegetables than men. 35.4% of subjects said they were especially concerned about the intake of fat and cholesterol, 24.5% expressed special interest in weight control and 18.2% recorded worries about the intake of vitamins and minerals. 21.6% of subjects expressed no worries at all. Multiple regression analysis showed no differences in concern about nutrition with respect to the sex or body mass index (BMI) of subjects. However, as age increased, the number of subjects expressing no concern fell whilst worries over the quantity of vitamins and minerals in the diet increased. Worries about bodyweight were found to rise with BMI. However, amongst those who wanted to lose weight, 42.2% of women and 7.4% of men had a BMI < 20 kg/m2. These persons, already very slim (below recommended values), still wished to lose weight and could become susceptible to nutritional imbalances. Relationships between concerns and food habits were scarce. Although fat and cholesterol were a concern in theory, the consumption of foodstuffs such as meat and eggs was quite high. However, relationships were found between concern over the vitamin and mineral content of the diet and the intake of supplements, and concern over bodyweight and intake of products that aid slimming. Nutrition educators may find this information useful in the design of their messages and educational programs.

Folate and vitamin B12 status in a group of preschool children

An adequate intake of folates and vitamin B12 is essential for the rapid growth rates characteristic of infancy. However, little information exists on the prevalence of deficiencies of these nutrients in preschool children. The status of these vitamins was therefore evaluated in a group of 79 children between 2 and 6 years of age. A 5 day dietary record (including a Sunday) was kept for all subjects. All food taken at day care centres was monitored using "Precise individual weighing" and recorded by trained personnel. Measurements were made of serum and erythrocyte folate levels, vitamin B12 levels, number of red blood cells, haemoglobin and haematocrit levels, and mean corpuscular volume. Though the mean intake of folic acid surpassed recommended levels for this age group 31.4% of the subjects showed intakes below those recommended. 7.7% of the subjects showed serum folate levels between 3 and 6 ng/mL, values which indicate a moderate deficiency of this vitamin. A correlation was found between folate intake and serum folate levels r = 0.3654 (P < 0.01). Vitamin B12 intake was 438% that recommended. Only 2.9% of the subjects showed vitamin B12 intake below recommended and none showed serum values below 150 pg/ml, the lower normal limit below which deficiency is considered to exist.

CONCLUSION

Amongst preschool children, folate deficiency is probably much more common than vitamin B12 deficiency. However, its incidence is low, and much lower than that observed in other age groups.

Estimated energy balance in female university students: differences with respect to body mass index and concern about body weight

OBJECTIVE

To assess the relationships between concern over bodyweight, anthropometric parameters (both real and ideal) and estimated energy balance.

DESIGN

Prospective study.

SUBJECTS

126 young, female university students from Madrid, Spain, between the ages of 19 and 36.

MEASUREMENTS

Energy intake was measured by means of a "seven day food record'. Anthropometric data were collected both at the beginning of the study and at 30 d to determine any change in weight. Subjects were grouped with respect to body mass index (BMI) (BMI < 30th percentile, between 30th and 60th percentiles and > or = 60th percentile). Subjects also completed a questionnaire asking if they would like to lose some weight.

RESULTS

The concern of these young women about their body image was greater amongst those with higher BMI. However, 31.6% of subjects with BMI falling < 30th percentile (< 20.1 Kg/m2) wished to lose some weight. Though the mean discrepancy between energy intake and estimated energy expenditure was 5.7%, there were great differences with respect to BMI and concern expressed about bodyweight. The declared energy intake was 9.3% greater than estimated energy expenditure in very thin subjects (BMI < 30th percentile) who expressed no desire to lose weight. However, in subjects with BMI between the 30th and 60th percentiles and who wanted to lose weight, declared energy intake was 11.4% below estimated expenditure. Similarly in subjects with BMI > or = 60th percentile, declared energy intake was 15.7% below estimated expenditure.

CONCLUSION

In order to gain more exact knowledge of food intake in dietary studies, factors such as subject BMI and desire for a different bodyweight should be taken into account.

Influence of the intake of fortified breakfast cereals on dietary habits and nutritional status of Spanish schoolchildren

A study was performed on the breakfast habits of 200 schoolchildren between 9 and 13 years of age. The subjects were classified into two groups: group C, children who consumed fortified breakfast cereals (65 boys and 35 girls), and group NC, children who did not (64 boys and 36 girls). The different dietary habits and the nutritional status of the two groups were analyzed. Haematological, biochemical, anthropometric, and dietary data were collected, the latter involving a 5-day food record. The children of the C group were found not only to have a more complete and nutritive breakfast, but also showed better dietary patterns for the rest of the day. Their lipid intake (% kJ) was lower and the carbohydrate intake (g/d and % kJ) higher than in the NC children. The intakes of thiamine, pyridoxine, folates, and beta-carotenes were also higher in group C. Better dietary habits were reflected in higher blood levels of some important compounds. Group C children had higher retinol, serum folate, and riboflavin levels than NC children. The percentage of children with hypercholesterolaemia (serum cholesterol > 4.5 mmol/l) was higher amongst those of the NC group: 37% as compared with 18% of the C children.

Relationship between diet composition and body mass index in a group of Spanish adolescents

The dietary patterns of sixty-four adolescents (thirty-seven young men and twenty-seven young women) between 15 and 17 years of age were examined by analysis of food, energy and nutrient intakes, over a period of 5 d, including a Sunday. Adolescents were identified for inclusion in two study groups: (1) overweight and obese subjects (O) with a BMI (kg/m2) > or = 75th percentile, and (2) subjects of normal weight (NW) with BMI < 75th percentile. The study was designed to investigate the differences between the energy and nutrient intakes of NW and O adolescents. No differences were found in energy intake between NW and O adolescents. However, O subjects derived a greater proportion of their energy from proteins (19.8% v 16.4% for NW subjects) and fats (45.4% v. 38.7% for NW subjects), and less from carbohydrates (34.6% v. 44.6% for NW subjects). Also, O subjects consumed significantly larger amounts of cholesterol. In order to prevent obesity and avoid the disorders associated with this condition, it appears necessary not only to regulate energy intake, but also to control the composition of the diet. Given that it is during infancy that feeding habits are developed, it is important to ensure that correct habits are acquired. Special attention should be given to improving the dietary habits of overweight and obese children and adolescents.

[Milk and dairy products in the prevention and control of cardiovascular diseases]

Highly saturated fat and cholesterol intakes elevate serum cholesterol levels, which is a risk factor for suffering from cardiovascular disease, one of the most important death causes in developed countries. Milk and dairy products, because of their high saturated fat and cholesterol levels, are often included among the forbidden foodstuffs for people with high serum cholesterol levels. But our studies demonstrate that dairy products, including the whole cream ones, don't increase total cholesterol but increase HDL-cholesterol levels. The intake of skimmed dairy products seem to have a preventive effect on the developing of atherosclerosis, because they condition decreases in serum cholesterol levels, specially in people with hyperlipemia. Dairy products are also effective for the control of triglyceridemia, hypertension and other cardiovascular risk factors. When the dietitian introduces nutritional measurements to prevent or stop cardiovascular disease, it is important to know the nutritional status of the person, in order that the fight against cardiovascular disease does not lead to nutritional deficiencies with similar or worse sanitary repercussions than cardiovascular disease itself. Dairy products are excellent sources of proteins, vitamins and minerals. Their regular intake can prevent, whereas their restriction can lead to nutritional deficit and pathologies. The results of our study show that it is not advisable to limit the intake of dairy products, not even whole cream ones. Only if there is a pathology, as hypercholesterolemia, it can be beneficial to consume skimmed and semi-skimmed dairy products.

[Influence of iron status on attention and intellectual performance of a population of Spanish adolescents]

Dietetic, hematologic and biochemical data were used to asses the iron status of a group of 64 adolescents (37 males and 27 females), aged 15 to 18 (mean age 15.94 +/- 0.76 years), who study in a High School in the comunidad Autónoma de Madrid. All were asked to keep a dietary record during 5 days, one of which had to be a sunday. Iron intake was estimated using the Food Composition Tables of the Instituto de Nutrición (1990). The hematologic survey determined hemoglobin hematocrit mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), serum iron and serum ferritin. These data were correlated with the scores obtained in the attention and school capability test (AT), that gave information about the verbal (V), reasoning (R) and calculus (C) capabilities. There is a positive correlation between MCV (r = 0.2705), MCH (r = 0.3370) ferritin (r = 0.3383) and attention. MCV (r = 0.2995), MCH (r = 0.3998), MCHC (r = 0.3134) and ferritin (r = 0.3970) were also correlated with the speed capability shown on the attention test and the hemoglobin level was correlated with the calculus capability (r = 0.2905). The students who obtained higher scores in the school capability test had also better blood parameter values. This was statistically significant for serum ferritin in males students and for hemoglobin and MCHC in female students. 19.6% of the adolescents had ferritin levels lower than 12 ng/ml. Their intelligence test scores were lower to those who had serum ferritin > or = 12 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)