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Apergi K, Malisova O, Vlassopoulos A, Fidanoglou P, Kandyliari A, Kapsokefalou M. Investigating the Sociodemographic and Health Characteristics of Non-Sugar Sweeteners Consumption in Greek School-Aged Children: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:813. [PMID: 39062262 PMCID: PMC11274966 DOI: 10.3390/children11070813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 06/28/2024] [Accepted: 06/28/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND/OBJECTIVES The childhood consumption of non-sugar-sweetened (NSS) soft drinks is a growing concern due to its potential health implications. This study investigated demographic, anthropometric, and lifestyle factors influencing NSS soft drink consumption among children. METHODS A sample of 1304 children and their parents were surveyed. RESULTS Analysis revealed that nearly 60% reported consuming NSS soft drinks at least once a week. Also, positive associations were found between NSS soft drink consumption and lower socioeconomic status, increased total beverage consumption, higher maternal BMI, and parental soft drink habits. However, upon employing multivariable models, only the association between total and NSS soft drinks consumption remained statistically significant (OR = 18.925, p < 0.05 for children; OR = 3.801, p < 0.05 for parents), highlighting the pivotal role of parental behavior in shaping children's consumption patterns. CONCLUSIONS These findings emphasize the importance of tracking parental habits, revealing a strong correlation between parental behavior and children's soft drink consumption patterns. Understanding these factors is crucial for developing effective public health strategies for children, which should prioritize not only individual behaviors but also parental modeling and household dynamics.
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Affiliation(s)
- Kyriaki Apergi
- Department of Food Science and Technology, University of Patras, 30100 Agrinio, Greece; (K.A.); (O.M.)
| | - Olga Malisova
- Department of Food Science and Technology, University of Patras, 30100 Agrinio, Greece; (K.A.); (O.M.)
| | - Antonis Vlassopoulos
- Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece; (A.V.); (A.K.)
| | - Philippa Fidanoglou
- Department of Food Science and Technology, University of Patras, 30100 Agrinio, Greece; (K.A.); (O.M.)
| | - Aikaterini Kandyliari
- Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece; (A.V.); (A.K.)
| | - Maria Kapsokefalou
- Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece; (A.V.); (A.K.)
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Ivaturi A, Do LG, Giles L, Devenish G, Scott JA, Ha DH, Golley R, Bell LK, Moynihan PJ. Sources and determinants of free sugars intake by 5-year-old Australian children in the SMILE cohort. MATERNAL & CHILD NUTRITION 2024:e13671. [PMID: 38804267 DOI: 10.1111/mcn.13671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/02/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024]
Abstract
Reducing free sugars intake is important for the prevention of dental caries and obesity in children. The study aimed to determine the amount and sources of free sugars known to contribute to dental caries, and identify sociodemographic determinants of intake by children aged 5 years in Australia. Cross-sectional analysis of dietary data from a cohort study, collected using a customized food frequency questionnaire were used to calculate free sugars intake as grams/day and percentage contribution to Estimated Energy Requirement (EER). The percent contribution of food sources to free sugars intake was derived. Sociodemographic determinants of achieving intakes within WHO thresholds (i.e., <5% and <10% Energy were explored with multinomial logistic regression. Complete data were available for 641 children (347 boys, 294 girls). Median (IQR) free sugars intake (g/day) was 31.6 (21.3-47.6) in boys and 28.1 (19.6-47.9) in girls. The median (IQR) percentage contribution to EER was 7.9 (5.4-12.7); 21% and 42% of children had intakes <5% EER and between 5% and <10%, respectively. The main sources of free sugars were: (1) Cakes, Biscuits and Cereal Bars; (2) Sweetened Milk Products (predominantly yoghurts) and (3) Desserts. Maternal university education, single-parent household, and maternal place of birth being Australia or New Zealand were associated with free sugars intake <5% EER. In conclusion, less than a quarter of 5-year-old children in the SMILE cohort achieved the WHO recommendations to limit free sugars to <5% EER. Strategies to lower free sugars intake could target priority populations such migrants, populations with lower levels of education or health literacy and identify areas for intervention in the wider food environments that children are exposed to.
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Affiliation(s)
- Anupama Ivaturi
- Adelaide Dental School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Loc Giang Do
- School of Dentistry, University of Queensland, Herston, Queensland, Australia
| | - Lynne Giles
- School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Gemma Devenish
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Jane A Scott
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Diep H Ha
- School of Dentistry, University of Queensland, Herston, Queensland, Australia
| | - Rebecca Golley
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Lucy K Bell
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Paula J Moynihan
- Adelaide Dental School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
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Mumena WA, Kutbi HA. Sources of free sugar in the diet of Saudi children. Front Public Health 2024; 12:1305364. [PMID: 38660353 PMCID: PMC11041394 DOI: 10.3389/fpubh.2024.1305364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 02/19/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Data concerning sources of free sugar (FS) in the diet of Saudi children are limited. Identification of the top sources of FS would permit to develop tailored interventions that aid in meeting the recommendations of the World Health Organization for FS (≤ 25 g/day). This study aimed to investigate sources of FS in children's diet. Methods A cross-sectional data of healthy children ages between 6 and 12 years who reside in Saudi Arabia were gathered from their mothers using online platforms (WhatsApp, Facebook, and X) (n = 424; 210 boys and 214 girls). An interview was conducted through the phone with the mother and her child to collect data pertaining FS intake using a validated food frequency questionnaire. Results The primary sources of FS were Sweetened Beverages, followed by Sugars, Sweet Bakery Products, Other Desserts, and Candies, of which the added sugar consisted mostly of its total sugar. The consumption of FS coming from solid food sources for the highest quartile of children almost doubled the amount of FS coming from liquid food sources. Compared to boys, girls in the top quartile of FS intake consumed significantly higher amounts of solid sugars (p = 0.030). Only the intake of FS coming from Sweetened Beverages was associated negatively with age of children (p = 0.032). Discussion Public health interventions should emphasize the necessity of reducing the consumption of the top sources of FS to practically achieve the recommendations of FS intake.
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Affiliation(s)
- Walaa Abdullah Mumena
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Hebah Alawi Kutbi
- , Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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Reppas K, Papamichael MM, Moschonis G, Cardon G, Iotova V, Bazdarska Y, Chakarova N, Rurik I, Antal E, Valve P, Liatis S, Makrilakis K, Moreno L, Manios Y. Role of parenting practices and digital media on beverage intake in European schoolchildren of different weight status. Feel4Diabetes-study. Nutrition 2023; 115:112142. [PMID: 37541142 DOI: 10.1016/j.nut.2023.112142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVES Halting the rise in childhood obesity is an ongoing challenge in Europe. Sugar-sweetened beverage (SSB) and artificially sweetened beverage (ASB) consumption has become common practice at home and during family meals. The objective of this study was to investigate associations of parenting practices and home digital media availability with beverage intake in European schoolchildren of different weight groups. METHODS Cross-sectional data were derived from six countries taking part in the multicentered Feel4Diabetes-study. Anthropometric data were measured for 12 030 schoolchildren (n = 6097 girls; median age = 8.1 y). Details on sociodemographic characteristics, beverage intake, food parenting practices, and home availability of digital media were collated from questionnaires. The outcomes, daily SSB and ASB intakes, were included as dependent variables in multivariable regression models that provided odds ratios reflecting their association with parenting practices and digital media (exposures), after stratifying for children's weight status (underweight or normal versus overweight or obese). RESULTS After controlling for children's sex, region, maternal body mass index, and education, the multivariate model found that in both body mass index groups, permissive parenting practices, such as rewarding and allowing consumption of unhealthy foods "very often or often," as compared with "rarely or never," were associated with a high daily intake of SSBs and ASBs in children, while parents "watching television together with their child," rewarding with screen time, and availability of television in children's rooms increased the likelihood of both beverages in the underweight or normal-weight group. CONCLUSIONS Modification of permissive parenting practices and removal of television from children's rooms could effectively reduce SSB intake and curb the ongoing threat of child obesity in Europe.
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Affiliation(s)
- Kyriakos Reppas
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University of Athens, Kallithea, Greece
| | - Maria Michelle Papamichael
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University of Athens, Kallithea, Greece; Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Yuliya Bazdarska
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Nevena Chakarova
- Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary; Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Emese Antal
- Hungarian Society of Nutrition, Budapest, Hungary
| | - Päivi Valve
- Public Health and Welfare Department, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Stavros Liatis
- First Department of Propaedeutic Medicine, Laiko General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Medicine, Laiko General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Luis Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Yannis Manios
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University of Athens, Kallithea, Greece; Agri-Food and Life Sciences Institute, Hellenic Mediterranean University Research Center, Heraklion, Greece.
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Mata JDS, Freitas JV, Crispim SP, Interlenghi GS, Magno MB, Ferreira DMTP, Araujo MC. Technological tools for assessing children's food intake: a scoping review. J Nutr Sci 2023; 12:e43. [PMID: 37123397 PMCID: PMC10131056 DOI: 10.1017/jns.2023.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 05/02/2023] Open
Abstract
Technological innovations can standardise and minimise reporting errors in dietary assessment. This scoping review aimed to summarise the characteristics of technological tools used to assess children's food intake. The review followed the Joanna Briggs Institute's manual. The main inclusion criterion was studied that assessed the dietary intake of children 0-9 years of age using technology. We also considered articles on validation and calibration of technologies. We retrieved 15 119 studies and 279 articles were read in full, after which we selected 93 works that met the eligibility criteria. Forty-six technologies were identified, 37 % of which had been developed in Europe and 32⋅6 % in North America; 65⋅2 % were self-administered; 27 % were used exclusively at home; 37 % involved web-based software and more than 80 % were in children over 6 years of age. 24HR was the most widely used traditional method in the technologies (56⋅5 %), and 47⋅8 % of the tools were validated. The review summarised helpful information for studies on using existing tools or that intend to develop or validate tools with various innovations. It focused on places with a shortage of such technologies.
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Affiliation(s)
- Jonas de Souza Mata
- Emília de Jesus Ferreiro School of Nutrition, Federal Fluminense University, Niterói, RJ, Brazil
| | - Jade Veloso Freitas
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rua São Francisco Xavier, 524, 7° andar, bloco E, sala 6004, Maracanã, Rio de Janeiro, RJ CEP 20550-900, Brazil
| | | | | | - Marcela Baraúna Magno
- Associate Professor of Graduate Studies in Dentistry, Veiga de Almeida University, Rio de Janeiro, RJ, Brazil
| | | | - Marina Campos Araujo
- Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Ministry of Health, Rio de Janeiro, RJ, Brazil
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Charneca S, Gomes AI, Branco D, Guerreiro T, Barros L, Sousa J. Intake of added sugar, fruits, vegetables, and legumes of Portuguese preschool children: Baseline data from SmartFeeding4Kids randomized controlled trial participants. Front Nutr 2023; 10:1150627. [PMID: 37063316 PMCID: PMC10090424 DOI: 10.3389/fnut.2023.1150627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/10/2023] [Indexed: 03/31/2023] Open
Abstract
IntroductionThe SmartFeeding4Kids (SF4K) program is an online self-guided intervention for parents with the propose of changing parental feeding practices and children’s dietary intake, focusing on the intake of added sugars, fruit, vegetables, and legumes. This paper aims to describe children’s dietary pattern at baseline through a 24-h food recall, the SmartKidsDiet24.MethodsOverall, 89 participants recorded at least one meal of the 3-day food recall. Mean age was 36.22 ± 6.05 years and 53.09 ± 15.42 months old for parents and children, respectively. Of these, 22 participants were considered to have 2 days of near complete 24-h food recalls. Children’s dietary intake are reported for these 22 participants based on parents reports and, thus, represent estimations only, as it remains unknown whether children consumed other non-reported foods.ResultsFruit was the group with the highest daily intake among children (mean 1.77 ± 1.10 portions/day), followed by added sugar foods (mean 1.48 ± 0.89 portions/day), vegetables [median 1.27 (1.64) portions/day] and legumes [median 0.12 (0.39) portions/day]. Fruit intake was positively correlated with vegetable intake (p = 0.008). Regarding Dietary Reference Values accomplishment, 13.6% of children exceeded the daily safe and adequate intake of sodium, 77.3% did not meet potassium and fiber recommendations, and 31.8% did not meet vitamin C recommendations.DiscussionAll children did not meet calcium, vitamin B12 and vitamin D intake recommendations. Our findings further justify the need for dietary interventions in this field, to improve young children’s diets.Clinical trial registrationClinicalTrials.gov, identifier NCT04591496.
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Affiliation(s)
- Sofia Charneca
- Laboratório de Nutrição, Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisbon, Portugal
| | - Ana Isabel Gomes
- Research Center for Psychological Science (CICPSI), Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
| | - Diogo Branco
- LASIGE, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Tiago Guerreiro
- LASIGE, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Luísa Barros
- Research Center for Psychological Science (CICPSI), Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
| | - Joana Sousa
- Laboratório de Nutrição, Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisbon, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisbon, Portugal
- *Correspondence: Joana Sousa,
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Development and validation of a quantitative food frequency questionnaire to assess free sugar intake among Sri Lankan preschool children. J Nutr Sci 2023; 12:e14. [PMID: 36843966 PMCID: PMC9947589 DOI: 10.1017/jns.2023.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 02/09/2023] Open
Abstract
The present study aims to develop a quantitative food frequency questionnaire (FFQ) to assess free sugar intake as a whole and at the food group levels, retrospectively, over the past 3 months among 4 to 5-year-old preschool children in the Colombo district, Sri Lanka. Then, to assess its reliability and relative validity. In the development phase, three 24-hour dietary recalls (24 hDRs) of 518 preschool children were collected from caregivers. Based on that, a 67-item FFQ was developed, including commonly consumed free sugar-containing food items. The validation study was conducted among another 108 preschool children. The relative validity of the FFQ was assessed by comparing it with the 24 hDRs. The test-retest reliability was assessed by repeated application of the FFQ to the same population after 6 weeks. Wilcoxon sign rank test, cross-classification with weighted Kappa statistic, Spearman rank correlation and Bland-Altman plots were used for comparison. Comparing the free sugar intake calculated by the two methods showed no difference (P = 0⋅13), a good correlation (0⋅89), good agreement in cross-classifying participants (78⋅4 % correctly classified) and a good agreement in Bland-Altman plots. Repeated application of the FFQ yielded; no differences in free sugar intake values (P = 0⋅45) a good correlation (0⋅71), acceptable agreement in cross-classifying participants (52⋅3 % correctly classified) and acceptable agreement in the Bland-Altman plot. Results were the same for all food groups. According to the results, the newly developed quantitative FFQ provides a relatively valid and reliable measure for quantifying free sugar intake among preschool children as a whole or by food group.
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Mututanthri S, Thoradeniya T, Samaranayake A, Harris R. Free sugar intake and associated factors among Sri Lankan preschool children. BMC Nutr 2022; 8:137. [PMID: 36411465 PMCID: PMC9677688 DOI: 10.1186/s40795-022-00638-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Excessive free sugar intake tends to be associated with unpleasant health consequences, such as dental caries and unhealthy weight gain in children, as well as a number of noncommunicable diseases in adults. The WHO suggests that the best method for addressing these issues is to reduce free sugar consumption throughout life, in order to be successful, these measures should be implemented as early as possible. This makes the early formative years of preschool an important point for possible intervention. To confirm this, baseline information on current sugar intake levels is needed, as well as identification of factors associated with high levels of consumption. METHODS This cross-sectional study was conducted in the district of Colombo, Sri Lanka. The probability proportionate to size technique combined with cluster sampling was used to select a representative sample of 813 children aged 4-5-years from 82 preschools. We developed, and validated a quantitative food frequency questionnaire (FFQ) to assess free sugar consumption. Data on correlated factors were collected from caregivers using a pre-tested self-administered questionnaire. RESULTS Based on the data, the daily median (IQR) free sugar intake of preschool children was 57.9 (33.2-95.8) grams/day (approximately to 14.5 (8.3-23.9) teaspoons/day) or 21.1% (12.5-34.9%) of their daily energy requirements. The WHO recommends limiting sugar intake to less than 5% of total energy intake; however, the current level is fourfold, and 96% of children consume higher percentage of energy from free sugar than recommended. In terms of total daily sugar consumption, bakery products accounted for 27%, followed by biscuits (15%), and table sugar (15%). Increasing maternal education level significantly reduced sugar intake (p = 0.04). Children of other ethnicities ate more sugar than the Sinhala children (p = 0.01). There was higher sugar intake among those who ate while returning from preschool (p < 0.001), while watching television (p < 0.001), and those who had school-going siblings (p = 0.02). CONCLUSION Among preschool children, free sugar consumption levels were very high and most of the children consumed more sugar than is recommended; which warranted urgent actions to curb sugar intake among them.
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Affiliation(s)
- Shanika Mututanthri
- Ministry of Health, No. 385, Rev. Baddegama Wimalawansa Thero Mawatha, Colombo, 10 Sri Lanka
| | - Tharanga Thoradeniya
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Anil Samaranayake
- Ministry of Health, No. 385, Rev. Baddegama Wimalawansa Thero Mawatha, Colombo, 10 Sri Lanka
| | - Rebecca Harris
- Department of Public Health, Policy and Systems, University of Liverpool, Whelan Building, Quadrangle, Liverpool, L69 3GB UK
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Kobel S, Wartha O, Dreyhaupt J, Feather KE, Steinacker JM. Intervention effects of a school-based health promotion programme on children’s nutrition behaviour. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01726-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Abstract
Aim
The programme “Join the Healthy Boat” promotes amongst other things a healthy diet in primary school children. In order to evaluate the programme’s effectiveness, this study longitudinally investigated children’s nutrition behaviour.
Subject and methods
A total of 1564 children (7.1 ± 0.6 years) participated in a cluster-randomised study. Teachers delivered lessons including behavioural contracting and budgeting. Nutritional behaviours of parents and child were assessed via parental report. Anthropometrics were measured on site.
Results
After one year, children in the intervention group (IG) showed a significant reduction in the consumption of pure juices (p ≤ 0.001). Soft drink consumption reduced in both groups, although with a trend towards a slightly greater reduction in the IG. Children with fathers of normal weight as well as first graders showed a significant reduction of soft drink consumption in the IG (p = 0.025 and p = 0.022 respectively). Fruit and vegetable intake increased significantly for first graders (p = 0.050), children from families with a high parental education level (p = 0.023), and for children with an overweight father (p = 0.034). Significant group differences were found for fruit and vegetable intake of children with migration background (p = 0.01) and children of parents with a high school degree could be observed (p = 0.019).
Conclusion
This shows that the programme appeals to a wider range of children, and is therefore more likely to compensate for differences due to origin or other social inequalities, which also shows that active parental involvement is vital for successful interventions.
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Fujiwara A, Omura Y, Oono F, Sugimoto M, Sasaki S, Takimoto H. A Scoping Review of Epidemiological Studies on Intake of Sugars in Geographically Dispersed Asian Countries: Comparison of Dietary Assessment Methodology. Adv Nutr 2022; 13:1947-1973. [PMID: 35641021 PMCID: PMC9526866 DOI: 10.1093/advances/nmac061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/10/2022] [Accepted: 05/26/2022] [Indexed: 01/28/2023] Open
Abstract
Previous systematic reviews, which focused on sugar intake and its relation with health issues, were mainly conducted in Western countries, not Asian countries characterized by differences in dietary habits and disease prevalence. The scarcity of Asian studies may be attributed to the lack of assessment tools for estimating sugar intake. To provide an overview of the epidemiological studies on sugar intake in Asian countries, with a primary focus on dietary assessment methodology for estimating sugar intake, we conducted a scoping review of the epidemiological studies estimating sugar intake in Asian countries (the United Nations' definition) and Taiwan using PubMed and Web of Science. Study quality was evaluated based on its assessment of sugar intake in the whole diet, dietary assessment methods, and data sources used for estimating sugar content. We identified 143 studies from 136 publications from Eastern (n = 63), Southern (n = 30), South-Eastern (n = 26), and Western (n = 24) Asia. Total sugars were investigated in 95 studies, while 23-30 studies investigated sucrose, fructose, added sugars, and free sugars. The main aim of the selected studies was assessment of diet-disease relations (n = 85) and estimation of dietary intake (n = 40), and 62 studies assessed sugars as the primary exposure/outcome. A total of 120 studies assessed sugar intake in the whole diet, and 62 studies used validated FFQs or multiple-day dietary assessment methods. Only 41 studies used country-specific comprehensive food-composition databases or directly measured sugar content. Only 17 studies reported high-quality data. This review elucidated a sufficient number of epidemiological studies estimating sugar intake across Asian countries; however, most studies reported low-quality data. The results from our review showed that both feasible and validated dietary assessment methods, as well as comprehensive country-specific sugar-composition databases, are essential for producing high-quality studies with accurate sugar intake to examine its association with health outcomes.
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Affiliation(s)
- Aya Fujiwara
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan,Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Yuka Omura
- Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Fumi Oono
- Department of Social and Preventive Epidemiology, Division of Health Sciences and Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Minami Sugimoto
- Institute for Future Initiatives, University of Tokyo, Tokyo, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo, Japan
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Lommi S, Manzoor M, Engberg E, Agrawal N, Lakka TA, Leinonen J, Kolho KL, Viljakainen H. The Composition and Functional Capacities of Saliva Microbiota Differ Between Children With Low and High Sweet Treat Consumption. Front Nutr 2022; 9:864687. [PMID: 35558746 PMCID: PMC9085455 DOI: 10.3389/fnut.2022.864687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/04/2022] [Indexed: 01/17/2023] Open
Abstract
Excess sugar consumption—common in youth—is associated with poor health. Evidence on the relationship between sugar consumption and the oral microbiome, however, remains scarce and inconclusive. We explored whether the diversity, composition, and functional capacities of saliva microbiota differ based on the consumption of select sugary foods and drinks (“sweet treats”). Using 16S rRNA gene sequencing, we characterized saliva microbiota from 11 to 13-year-old children who participated in the Finnish Health in Teens (Fin-HIT) cohort study. The sample comprised children in the lowest (n = 227) and highest (n = 226) tertiles of sweet treat consumption. We compared differences in the alpha diversity (Shannon, inverse Simpson, and Chao1 indices), beta diversity (principal coordinates analysis based on Bray–Curtis dissimilarity), and abundance (differentially abundant operational taxonomic units (OTUs) at the genus level) between these low and high consumption groups. We performed PICRUSt2 to predict the metabolic pathways of microbial communities. No differences emerged in the alpha diversity between low and high sweet treat consumption, whereas the beta diversity differed between groups (p = 0.001). The abundance of several genera such as Streptococcus, Prevotella, Veillonella, and Selenomonas was higher in the high consumption group compared with the low consumption group following false discovery rate correction (p < 0.05). Children with high sweet treat consumption exhibited higher proportions of nitrate reduction IV and gondoate biosynthesis pathways compared with the low consumption group (p < 0.05). To conclude, sweet treat consumption shapes saliva microbiota. Children who consume a high level of sweet treats exhibited different compositions and metabolic pathways compared with children who consume low levels of sweet treats. Our findings reveal novel insights into the relationship between sugary diets and oral microbiota.
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Affiliation(s)
- Sohvi Lommi
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Muhammed Manzoor
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Elina Engberg
- Folkhälsan Research Center, Helsinki, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Nitin Agrawal
- Folkhälsan Research Center, Helsinki, Finland.,Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.,Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Jukka Leinonen
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kaija-Leena Kolho
- Children's Hospital, University of Helsinki and Helsinki University Hospital (HUS), Helsinki, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Heli Viljakainen
- Folkhälsan Research Center, Helsinki, Finland.,Faculty of Medicine, University of Helsinki, Helsinki, Finland
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12
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Dietary Intake of Individual (Intrinsic and Added) Sugars and Food Sources from Spanish Children Aged One to <10 Years—Results from the EsNuPI Study. Nutrients 2022; 14:nu14081667. [PMID: 35458229 PMCID: PMC9024444 DOI: 10.3390/nu14081667] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 02/01/2023] Open
Abstract
Currently, in Spain there are no studies assessing the intakes and sources of intrinsic and added sugars by both children consuming standard milks and children regularly consuming adapted milk formulas. Our goal was to evaluate current sugar intake levels (intrinsic and added) and their major dietary sources within the EsNuPI study participants by applying two 24-h dietary recalls that were completed by 1448 children (1 to <10 years) divided into two subsamples: One “Spanish Reference Sample” (SRS) of the general population (n = 707) and another sample which included children consuming adapted milks including follow-on milk, toddler’s or growing up milk and fortified and enriched milks, here called “Adapted Milk Consumers Sample” (AMS) (n = 741). Estimates of intrinsic and added sugar intakes from the Spanish EsNuPI population as well as the adherence to recommendations varied notably according to age segment, but no major differences between subsamples were found. Younger children (1 to <3 years) showed the highest added sugar contribution to total energy intake (TEI) (SRS: 12.5% for boys and 11.7% for girls; AMS: 12.2% for boys and 11.3% for girls) and the lowest adherence to recommendations set at <10% TEI (SRS: 27.4% for boys and 37.2% for girls; AMS: 31.3% for boys and 34.7% for girls). Adherence increased with age but remains inadequate, with approximately one in two children from the older age segment (6 to <10 years) exceeding the recommendations. Main food sources of intrinsic sugars for both subsamples were milk and dairy products, fruits, vegetables and cereals, while for added sugars, these were milk and dairy products (mainly yogurts), sugars and sweets (mainly sugary cocoa and nougat), bakery products (mainly cookies) and cereals (mainly bread and wheat flour). However, for the AMS, the groups milk and dairy products and cereals showed a significantly lower contribution to intrinsic sugar intake but a significantly higher contribution to that of added sugars. These results demonstrate that sugar intake and the adherence to recommendations in the studied population varied notably according to age but not to the type of milk consumed. In addition, our results highlight the need to monitor the consumption of added sugars by the infant population, as well as the need to make efforts to facilitate this task, such as harmonizing the recommendations regarding free/added sugars and the inclusion of information on their content on the nutritional labeling of products in order to incorporate them into food composition databases.
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13
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Hohoff E, Perrar I, Jankovic N, Alexy U. Dairy intake and long-term body weight status in German children and adolescents: results from the DONALD study. Eur J Nutr 2022; 61:1087-1096. [PMID: 34718860 PMCID: PMC8854286 DOI: 10.1007/s00394-021-02715-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/18/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To analyse the association between intake of total dairy (TD) and types of dairy [liquid dairy (LD), solid dairy (SD), low-fat dairy (LFD), high-fat dairy (HFD), high sugar dairy (HSD), low-sugar dairy (LSD), not fermented dairy (NFD), as well as fermented dairy (FD)] and long-term changes in body weight status and composition among children and adolescents in Germany. METHODS In total, 9999 3-day dietary records collected between 1985 and 2019 by 1126 participants (3.5-18.5 years; boys: 50.8%) of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study were analysed. Polynomial mixed-effects regression models were used to examine whether changes (median follow-up: 9 years) in the intake of TD and dairy types (in 100 g/1000 kcal total energy intake) were associated with changes in body-mass-index-standard-deviation-score (BMI-SDS); fat mass index (FMI); fat-free mass index (FFMI) over time. RESULTS An individual increase in TD intake was slightly but significantly associated with an increase in BMI-SDS (β = 0.0092; p = 0.0371), FMI (β = 0.022; p = 0.0162), and FFMI (β = 0.0156; p = 0.0417) after adjustment for potential confounder. Analyses for LD (BMI-SDS: β = 0.0139; p = 0.0052; FMI: β = 0.0258; p = 0.0125; FFMI: β = 0.0239; p = 0.0052) and LSD intake (BMI-SDS: β = 0.0132; p = 0.0041, FMI: β = 0.02; p = 0.0316, FFMI: β = 0.0183; p = 0.0189) showed similar results to TD. Both processing method and fat content showed no association with body composition in our analyses. CONCLUSION Increases in TD, LD, and LSD intake showed small but significant increases in BMI and concomitant increases in fat mass and lean mass. However, the observed changes were too small to expect biological or physiological meaningful effects. Overall, our results showed that policies to promote dairy intake in childhood are to be welcomed, as no negative effects on body composition are expected, while the intake of important nutrients for growth is ensured. The type of dairy does not seem to matter.
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Affiliation(s)
- Eva Hohoff
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
| | - Ines Perrar
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
| | - Nicole Jankovic
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
| | - Ute Alexy
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
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14
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Hafner E, Lavriša Ž, Hribar M, Krušič S, Kušar A, Žmitek K, Skrt M, Poklar Ulrih N, Pravst I. Verifying the Use of Food Labeling Data for Compiling Branded Food Databases: A Case Study of Sugars in Beverages. Front Nutr 2022; 9:794468. [PMID: 35187031 PMCID: PMC8850951 DOI: 10.3389/fnut.2022.794468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/10/2022] [Indexed: 11/18/2022] Open
Abstract
Branded food composition databases are an important tool for research, education, healthcare, and policy making, amongst others. Such databases are typically compiled using food labeling data without chemical analyses of specific products. This study aimed to verify whether the labeled sugar content in sugar-sweetened beverages (SSBs) corresponds to the actual sugar content in these products, thus enabling food monitoring studies to be conducted. A secondary objective was to determine the specific types of sugars in these SSBs. A case study was conducted using market share-driven sampling of these beverages from the Slovenian food supply. On the basis of nationwide yearly sales data, 51 best-selling products were sampled in 2020 and analyzed using high-performance liquid chromatography. This sales-driven approach to sampling has been shown to be very useful for conducting food monitoring studies. With the careful selection of a small proportion of available products, we finished with a manageable sample size, reflecting the composition of a majority (69%) of the national market share volume. The analyzed total sugar content was compared with labeled data, within the context of the European Union's regulatory labeling tolerances. In all samples, the sugar content was within the tolerance levels. The most common (N = 41) deviation was within ±10% of the labeled sugar content. In the subcategories, the differences between the analyzed and labeled median sugar contents were not statistically significant. Sucrose was most commonly (N = 36; 71%) used for sweetening, suggesting that the proportion of fructose in most SSBs was around 50%. A higher fructose content was only observed in beverages with fructose–glucose syrup or a higher content of fruit juice. The study results show that the labeled sugar content information in SSBs is reliable and can be used to compile branded food databases and monitor the nutritional quality of foods in the food supply.
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Affiliation(s)
- Edvina Hafner
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Živa Lavriša
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
| | - Maša Hribar
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
| | - Sanja Krušič
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
| | - Anita Kušar
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
| | - Katja Žmitek
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
- VIST–Faculty of Applied Sciences, Ljubljana, Slovenia
| | - Mihaela Skrt
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | | | - Igor Pravst
- Nutrition and Public Health Research Group, Nutrition Institute, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
- VIST–Faculty of Applied Sciences, Ljubljana, Slovenia
- *Correspondence: Igor Pravst
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15
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Calvo-Lerma J, Boon M, Hulst J, Colombo C, Asseiceira I, Garriga M, Masip E, Claes I, Bulfamante A, Janssens HM, Roca M, Vicente S, Fornés V, Zazzeron L, van Schijndel B, Woodcock S, Pereira L, de Boeck K, Ribes-Koninckx C. Change in Nutrient and Dietary Intake in European Children with Cystic Fibrosis after a 6-Month Intervention with a Self-Management mHealth Tool. Nutrients 2021; 13:nu13061801. [PMID: 34073260 PMCID: PMC8229611 DOI: 10.3390/nu13061801] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/22/2021] [Accepted: 05/22/2021] [Indexed: 01/04/2023] Open
Abstract
Cystic Fibrosis (CF) is a life-long genetic disease, causing increased energy needs and a healthy diet with a specific nutrient distribution. Nutritional status is an indicator of disease prognosis and survival. This study aimed at assessing the effectiveness of a self-management mobile app in supporting patients with CF to achieve the dietary goals set by the CF nutrition guidelines. A clinical trial was conducted in pancreatic insufficient children with CF, followed in six European CF centres, where the self-management app developed within the MyCyFAPP project was used for six months. To assess secondary outcomes, three-day food records were compiled in the app at baseline and after 3 and 6 months of use. Eighty-four subjects (mean 7.8 years old) were enrolled. Compared to baseline, macronutrient distribution better approximated the guidelines, with protein and lipid increasing by 1.0 and 2.1% of the total energy intake, respectively, by the end of the study. Consequently, carbohydrate intake of the total energy intake decreased significantly (-2.9%), along with simple carbohydrate intake (-2.4%). Regarding food groups, a decrease in ultra-processed foods was documented, with a concomitant increase in meat and dairy. The use of a self-management mobile app to self-monitor dietary intake could become a useful tool to achieve adherence to guideline recommendations, if validated during a longer period of time or against a control group.
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Affiliation(s)
- Joaquim Calvo-Lerma
- Instituto de Investigación Sanitaria La Fe—Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (E.M.); (M.R.); (C.R.-K.)
- Correspondence: ; Tel.: +34-961-246-712
| | - Mieke Boon
- Center for Cystic Fibrosis, Department of Pediatrics, University Hospital Leuven, 3000 Leuven, Belgium; (M.B.); (I.C.); (K.d.B.)
| | - Jessie Hulst
- Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada;
| | - Carla Colombo
- Cystic Fibrosis Center, University of Milan, IRCCS Ca ‘Granda, Maggiore Policlinico Hospital, 20122 Milan, Italy; (C.C.); (A.B.); (L.Z.)
| | - Inês Asseiceira
- Centro de Fibrose Quística, Hospital de Santa Maria, 1649-028 Lisbon, Portugal; (I.A.); (L.P.)
| | - María Garriga
- Unidad de Fibrosis Quística, Hospital Universitario Ramón y Cajal, 28010 Madrid, Spain; (M.G.); (S.V.)
| | - Etna Masip
- Instituto de Investigación Sanitaria La Fe—Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (E.M.); (M.R.); (C.R.-K.)
| | - Ine Claes
- Center for Cystic Fibrosis, Department of Pediatrics, University Hospital Leuven, 3000 Leuven, Belgium; (M.B.); (I.C.); (K.d.B.)
| | - Anna Bulfamante
- Cystic Fibrosis Center, University of Milan, IRCCS Ca ‘Granda, Maggiore Policlinico Hospital, 20122 Milan, Italy; (C.C.); (A.B.); (L.Z.)
| | - Hettie M. Janssens
- Department of Pediatrics, Division of Gastro-Enterology, Erasmus MC-Sophia Children’s Hospital, University Hospital Rotterdam, 14010 Rotterdam, The Netherlands; (H.M.J.); (B.v.S.); (S.W.)
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC-Sophia Children’s Hospital, University Hospital Rotterdam, 14010 Rotterdam, The Netherlands
| | - Maria Roca
- Instituto de Investigación Sanitaria La Fe—Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (E.M.); (M.R.); (C.R.-K.)
| | - Saioa Vicente
- Unidad de Fibrosis Quística, Hospital Universitario Ramón y Cajal, 28010 Madrid, Spain; (M.G.); (S.V.)
| | | | - Laura Zazzeron
- Cystic Fibrosis Center, University of Milan, IRCCS Ca ‘Granda, Maggiore Policlinico Hospital, 20122 Milan, Italy; (C.C.); (A.B.); (L.Z.)
| | - Bo van Schijndel
- Department of Pediatrics, Division of Gastro-Enterology, Erasmus MC-Sophia Children’s Hospital, University Hospital Rotterdam, 14010 Rotterdam, The Netherlands; (H.M.J.); (B.v.S.); (S.W.)
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC-Sophia Children’s Hospital, University Hospital Rotterdam, 14010 Rotterdam, The Netherlands
| | - Sandra Woodcock
- Department of Pediatrics, Division of Gastro-Enterology, Erasmus MC-Sophia Children’s Hospital, University Hospital Rotterdam, 14010 Rotterdam, The Netherlands; (H.M.J.); (B.v.S.); (S.W.)
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC-Sophia Children’s Hospital, University Hospital Rotterdam, 14010 Rotterdam, The Netherlands
| | - Luisa Pereira
- Centro de Fibrose Quística, Hospital de Santa Maria, 1649-028 Lisbon, Portugal; (I.A.); (L.P.)
| | - Kris de Boeck
- Center for Cystic Fibrosis, Department of Pediatrics, University Hospital Leuven, 3000 Leuven, Belgium; (M.B.); (I.C.); (K.d.B.)
| | - Carmen Ribes-Koninckx
- Instituto de Investigación Sanitaria La Fe—Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (E.M.); (M.R.); (C.R.-K.)
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16
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Diani L, Forchielli ML. Sugar Intake: Are All Children Made of Sugar? Life (Basel) 2021; 11:life11050444. [PMID: 34069163 PMCID: PMC8156357 DOI: 10.3390/life11050444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/09/2021] [Accepted: 05/11/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction: A healthy diet is characterized by a variety of food and a balanced energy intake, which should accompany every human being since early childhood. Unfortunately, excessive consumption of protein, fat, and lately sugar are very common in developed countries. Sugar intakes are not easily quantifiable and comparable among subjects. Therefore, we decide to analyze dietary patterns in children of different ages and diets (with and without gluten) using a food and nutrient database and a new application called the “Zuccherometro”. Patients and methods: This is a descriptive observational study conducted among children that are recruited consecutively either during a pediatric evaluation or through a school survey. Sociodemographic, nutritional and anthropometric data, degree of physical activity, and presence of medical conditions are collected. Dietary intake data are obtained by a 24 h recall diet. Results: The study analyzes 400 children: 213 girls and 187 boys. The majority of children (70.7%) are in normal weight range with similar extreme values (6.5% obese and 6.7% underweight). Celiac disease is diagnosed in 186 children. Caloric intakes are in line with the recommendations in all age-distributed groups with the exception of adolescents (11–17 years old), whose caloric intake is lower than recommendations. Protein intakes, on the contrary, are always exceeding recommendations and are significantly elevated in preschool children, (more than three times the population reference intakes). As for sugar intakes, all the children except the 11–17 years adolescents exceed the recommended cut off of 15% of daily calories. The same trend is obtained using the “Zuccherometro” that shows different percentages of age-stratified children exceeding the reference values: 1–3 years, 59% of children; 4–6 years, 68%; 7–10 years, 39.8%; 11–14 years, 25.5%; 15–17 years, 24.5%. The sugar load consists of both natural or added sugars (fructose and lactose) in food or beverages. Sugar intakes are more generously consumed by all age-stratified controls than by celiac children with the exception of the youngest ones (1–3 years old) and male adolescents. Conclusion: Since high sugar intakes are constantly accompanying children during their growth, important dietary education and coordination between families and institutions are mandatory.
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Affiliation(s)
- Lucia Diani
- Dietetics, Morgagni Pierantoni Hospital, 47121 Forli, Italy;
| | - Maria Luisa Forchielli
- DIMEC, University of Bologna, 40138 Bologna, Italy
- Health Science and Technologies Interdepartmental Center for Industrial Research (CIRI-SDV), University of Bologna, 40100 Bologna, Italy
- Correspondence:
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17
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Fernández-Iglesias R, Álvarez-Pereira S, Tardón A, Fernández-García B, Iglesias-Gutiérrez E. Adherence to the Mediterranean Diet in a School Population in the Principality of Asturias (Spain): Relationship with Physical Activity and Body Weight. Nutrients 2021; 13:1507. [PMID: 33946967 PMCID: PMC8145401 DOI: 10.3390/nu13051507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/22/2021] [Accepted: 04/27/2021] [Indexed: 01/13/2023] Open
Abstract
The Mediterranean diet (MD), despite its multiple benefits, presents low levels of adherence among children. Moreover, childhood is a key stage in the acquisition of healthy habits. The aim of this study was to describe adherence to MD in school-age children from Asturias, Spain, and to evaluate the association with weight status and several lifestyle behaviors. A cross-sectional study was conducted on 309 children aged between 8 and 13 years old. The level of adherence to MD was evaluated through the KIDMED questionnaire. Descriptive analysis and logistic regression models were used to analyze the association between adherence to MD and weight status, frequency of out-of-school exercise, frequency of school canteen attendance, and sleep habits. We found that 54.4% of children had optimal adherence to MD and 29.9% of the sample was overweight or obese. Frequency of exercise practice was positively associated with optimal adherence to MD (95% CI: 1.02, 1.33). A positive association was found between some KIDMED items and frequency of out-of-school exercise practice and attendance at the school canteen. This study shows the need for an improvement in the adherence to MD in youth considering the concomitant occurrence of other related healthy behaviors.
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Affiliation(s)
- Rocío Fernández-Iglesias
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029 Madrid, Spain;
- Department of Medicine, Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IOUPA), University of Oviedo, Julian Clavería Street s/n, 33006 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n, 33001 Oviedo, Spain; (B.F.-G.); (E.I.-G.)
| | - Sonia Álvarez-Pereira
- Department of Morphology and Cell Biology, University of Oviedo, Julian Clavería Street s/n, 33006 Oviedo, Spain;
| | - Adonina Tardón
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029 Madrid, Spain;
- Department of Medicine, Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IOUPA), University of Oviedo, Julian Clavería Street s/n, 33006 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n, 33001 Oviedo, Spain; (B.F.-G.); (E.I.-G.)
| | - Benjamín Fernández-García
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n, 33001 Oviedo, Spain; (B.F.-G.); (E.I.-G.)
- Department of Morphology and Cell Biology, University of Oviedo, Julian Clavería Street s/n, 33006 Oviedo, Spain;
| | - Eduardo Iglesias-Gutiérrez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n, 33001 Oviedo, Spain; (B.F.-G.); (E.I.-G.)
- Department of Functional Biology, University of Oviedo, Julian Clavería Street s/n, 33006 Oviedo, Spain
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18
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Age and time trends of dairy intake among children and adolescents of the DONALD study. Eur J Nutr 2021; 60:3861-3872. [PMID: 33881583 PMCID: PMC8437911 DOI: 10.1007/s00394-021-02555-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 04/03/2021] [Indexed: 12/03/2022]
Abstract
Purpose To describe age and time trends in dietary intake of Total Dairy (TD) (g/1000 kcal Total Energy Intake) and types of dairy (weight percent of total dairy intake, w%TD) represented as Low Fat Dairy (LFD), High Sugar Dairy (HSD), Fermented Dairy (FD) and Liquid Dairy (LD) among children and adolescents in Germany. Methods Overall, 10,333 3-day dietary records kept between 1985 and 2019 by 1275 DONALD participants (3.5–18.5 years; boys: 50.8%) were analyzed using polynomial mixed-effects regression models. Results TD intake decreased with age (♂: linear trend p < 0.0001; ♀: linear and quadratic trend p < 0.0001), whereas FD (♀: linear, quadratic, cubic trend p ≤ 0.02) increased slightly in girls. HSD (♂: linear, quadratic, cubic trend p ≤ 0.004; ♀: linear, quadratic, cubic trend p ≤ 0.005) and LD (linear, quadratic trend p ≤ 0.0002) decreased with age. In terms of time trends, TD intake decreased in the last three decades, especially since 1995 (quadratic trend for ♂ 0.0007 and ♀ p = 0.004). LFD intake increased until 2010 and decreased thereafter (linear, quadratic, cubic trend p < 0.0001). HSD decreased until 1995, then increased until 2010 and decreased again afterwards (♂: linear, quadratic, cubic trend p ≤ 0.001; ♀: linear, quadratic, cubic trend p ≤ 0.003). While FD intake increased linear (in both ♂ and ♀: p < 0.0001), LD intake decreased (linear, quadratic trend p ≤ 0.03). Conclusion Our results showed changes in dairy consumption patterns among children and adolescents over the past three decades, demonstrating a decrease in TD intake with age and time, and a shift from liquid to solid dairy products with a simultaneous increase in fermented dairy products, while LFD and HSD fluctuated over time. Further evaluations will examine the health significance of these consumption patterns. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02555-7.
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Longitudinal Associations between Food Parenting Practices and Dietary Intake in Children: The Feel4Diabetes Study. Nutrients 2021; 13:nu13041298. [PMID: 33920052 PMCID: PMC8071003 DOI: 10.3390/nu13041298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 12/19/2022] Open
Abstract
Food parenting practices (FPPs) have an important role in shaping children’s dietary behaviors. This study aimed to investigate cross-sectional and longitudinal associations over a two-year follow-up between FPP and dietary intake and compliance with current recommendations in 6- to 11-year-old European children. A total of 2967 parent-child dyads from the Feel4Diabetes study, a randomized controlled trial of a school and community-based intervention, (50.4% girls and 93.5% mothers) were included. FPPs assessed were: (1) home food availability; (2) parental role modeling of fruit intake; (3) permissiveness; (4) using food as a reward. Children’s dietary intake was assessed through a parent-reported food frequency questionnaire. In regression analyses, the strongest cross-sectional associations were observed between home availability of 100% fruit juice and corresponding intake (β = 0.492 in girls and β = 0.506 in boys, p < 0.001), and between parental role modeling of fruit intake and children’s fruit intake (β = 0.431 in girls and β = 0.448 in boys, p < 0.001). In multilevel logistic regression models, results indicated that improvements in positive FPPs over time were mainly associated with higher odds of compliance with healthy food recommendations, whereas a decrease in negative FPP over time was associated with higher odds of complying with energy-dense/nutrient-poor food recommendations. Improving FPPs could be an effective way to improve children’s dietary intake.
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Sex- and weight-specific changes in the frequency of sweet treat consumption during early adolescence: a longitudinal study. Br J Nutr 2021; 126:1592-1600. [PMID: 33787473 PMCID: PMC8524426 DOI: 10.1017/s0007114521001112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The transition from childhood to adolescence is a sensitive period, triggering changes in health- and weight-related behaviours including eating habits which likely vary between girls and boys. We aimed to characterise the changes in the frequency of consumption of select sugary foods and drinks ('sweet treats') among 4237 Finnish girls and boys during a 2-year follow-up period. Additionally, we examined four subgroups: children whose weight or waist normalised as well as children whose weight or waist circumference increased during follow-up. An FFQ was completed at 11·1 (sd 0·9) and again at 13·4 (sd 1·1) years of age. A sum variable sweet treat index (STI, range 0-84) captured the weekly consumption frequencies of sweet treats. From baseline to follow-up, the mean STI decreased among girls from 7·1 (95 % CI 6·9, 7·3) to 6·0 (95 % CI 5·9, 6·2) (P < 0·001) and boys from 8·5 (95 % CI 8·3, 8·8) to 7·8 (95 % CI 7·6, 7·8) (P < 0·001), although both sexes increased their chocolate/sweets consumption: girls from 1·3 (95 % CI 1·3, 1·4) to 1·6 (95 % CI 1·5, 1·6) (P < 0·001) and boys from 1·4 (95 % CI 1·3, 1·4) to 1·6 (95 % CI 1·6, 1·7) (P < 0·001), and boys increased their soft drink consumption from 1·4 (95 % CI 1·3, 1·4) to 1·5 (95 % CI 1·4, 1·5) (P = 0·020). We found similar decreases in both the weight and waist subgroups. To conclude, the total frequency of consumption of sweet treats decreased during early adolescence. A similar trend across subgroups suggests that the frequency of consumption of sweet treats is unrelated to becoming overweight.
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Free Sugars Intake among Chinese Adolescents and Its Association with Dental Caries: A Cross-Sectional Study. Nutrients 2021; 13:nu13030765. [PMID: 33652968 PMCID: PMC7996778 DOI: 10.3390/nu13030765] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 02/07/2023] Open
Abstract
This study aims to estimate the free sugars intake, identify the primary food sources of free sugars, and explore the relationship between free sugars intake and dental caries among Chinese adolescents. This cross-sectional study included 1517 middle-school students aged 12–14 years in Changsha city, China. Adolescents completed a 12-item Food Frequency Questionnaire (FFQ) and oral health assessment. The students’ dental caries experience was available as DMFT score (number of decayed, missing, and filled permanent teeth). Statistical analyses included the Mann–Whitney test, Kruskal–Wallis test, Chi-square test, and binary logistic regression model. The average intake of free sugars was 53.1 g/d in adolescents, and 43.2% of the students consumed more than 50 g of free sugars daily. The primary contributor to free sugars was sugar-sweetened beverages (SSBs). Age, boarders, and high family income were risk factors for excessive free sugars intake (p < 0.05), and increased free sugars intake was a risk factor for dental caries (odds ratio, OR = 1.446, 95% confidence interval: 1.138–1.839). Both the free sugars intake and dental caries prevalence in Chinese adolescents were high. Targeted interventions are urgently needed to address the excessive consumption of free sugars and improve Chinese adolescents’ oral health.
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Flieh SM, Moreno LA, Miguel-Berges ML, Stehle P, Marcos A, Molnár D, Widhalm K, Béghin L, De Henauw S, Kafatos A, Leclercq C, Gonzalez-Gross M, Dallongeville J, Molina-Hidalgo C, González-Gil EM. Free Sugar Consumption and Obesity in European Adolescents: The HELENA Study. Nutrients 2020; 12:nu12123747. [PMID: 33291491 PMCID: PMC7762126 DOI: 10.3390/nu12123747] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/27/2020] [Accepted: 12/02/2020] [Indexed: 12/22/2022] Open
Abstract
Few studies have evaluated the association between dietary free sugars intake (FSI) and obesity in adolescents. We examined the relation between FSI and their contributors from the main food groups and obesity in European adolescents. We included 843 adolescents (51.6% male) from the cross-sectional HELENA study with two completed 24 h recalls and anthropometric data. Linear mixed models were applied to investigate the relation between FSI and different anthropometric indices. Odds ratios for having a high body mass index (BMI) were also estimated by multilevel ordinal regression. Total FSI was higher in males than females (102.60 g and 87.58 g, respectively, p < 0.001). No effect was observed between free sugar from the main food groups and BMI. Consumers of FSI from "cakes, pies and biscuits" in males (odd ratio (OR) = 0.455; 95% Confidence interval (CI) 0.251, 0.824) and from "breakfast cereals" in females had a lower probability of having obesity (OR = 0.423; 95%CI 0.204, 0.878), whereas females consuming FSI from 'fruit and vegetables juices' had a higher probability of obesity (OR= 2.733; 95% CI 1.286, 5.810). This study provides no evidence that increased FSI is associated with obesity in adolescents. Further studies are needed to assess the longitudinal exposure to FSI and their effect on obesity development.
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Affiliation(s)
- Sondos M. Flieh
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (E.M.G.-G.)
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (E.M.G.-G.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Correspondence:
| | - María L. Miguel-Berges
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (E.M.G.-G.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
| | - Peter Stehle
- Department of Nutrition and Food Sciences, University of Bonn, D-53115 Bonn, Germany;
| | - Ascensión Marcos
- Inmunonutrition Research Group, Department of Metabolism and Nutrition, Instituto del Frío, Institute of Food Science and Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), 28040 Madrid, Spain;
| | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, H-7624 Pécs, Hungary;
| | - Kurt Widhalm
- Division of Clinical Nutrition and Prevention, Department of Pediatrics, Medical University of Vienna, 1090 Vienna, Austria;
| | - Laurent Béghin
- Inserm, U1286—INFINITE—Clinical Investigation Center—Institute for Translational Research in Inflammation and CIC 1403, University Lille, CHU Lille, F-59000 Lille, France;
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Anthony Kafatos
- Faculty of Medicine, University of Crete, GR-71003 Crete, Greece;
| | - Catherine Leclercq
- Food and Nutrition Research Centre—Council for Agricultural Research and Economics, 00198 Rome, Italy;
| | - Marcela Gonzalez-Gross
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Jean Dallongeville
- Department of Epidemiology and Public Health, Institut Pasteur de Lille, 59000 Lille, France;
| | - Cristina Molina-Hidalgo
- EFFECTS 262, Department of Physiology, Faculty of Medicine, University of Granada, 18016 Granada, Spain;
| | - Esther M. González-Gil
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (E.M.G.-G.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Center of Biomedical Research (CIBM), Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, University of Granada, 18071 Granada, Spain
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Rosi A, Mena P, Castello F, Del Rio D, Scazzina F. Comprehensive dietary evaluation of Italian primary school children: food consumption and intake of energy, nutrients and phenolic compounds. Int J Food Sci Nutr 2020; 72:70-81. [PMID: 32316789 DOI: 10.1080/09637486.2020.1754768] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Information on children's diet including bioactive compounds is quite scarce. This observational study investigated the composition of the diet of children living in Parma (Italy; n = 172, 8-10 years) using 3-day food records completed in winter and spring. Mean daily intakes of food groups, energy and nutrients were obtained using the national food database, while (poly)phenol contents were estimated from Phenol-Explorer or by specific literature searches. Food consumption, energy and nutrient intakes decreased in spring and were partially in line with national data. Adherence to the nutritional recommendations was not satisfied for the majority of nutrients. Main contributors to the phenolic intake were flavonoids (flavan-3-ols) and phenolic acids (hydroxycinnamic acids), while main dietary sources were fruit, chocolate-based products, vegetables, and tea & coffee (decaffeinated). This study provided the first comprehensive analysis of the nutritional composition of children's diet. Future research should look at the health implications of dietary choices in children.
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Affiliation(s)
- Alice Rosi
- Human Nutrition Unit, Department of Food and Drugs, University of Parma, Parma, Italy
| | - Pedro Mena
- Human Nutrition Unit, Department of Food and Drugs, University of Parma, Parma, Italy
| | - Fabio Castello
- Human Nutrition Unit, Department of Food and Drugs, University of Parma, Parma, Italy
| | - Daniele Del Rio
- Human Nutrition Unit, Department of Veterinary Science, University of Parma, Parma, Italy.,Giocampus Scientific Committee, Parma, Italy
| | - Francesca Scazzina
- Human Nutrition Unit, Department of Food and Drugs, University of Parma, Parma, Italy.,Giocampus Scientific Committee, Parma, Italy
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Perrar I, Schadow AM, Schmitting S, Buyken AE, Alexy U. Time and Age Trends in Free Sugar Intake from Food Groups among Children and Adolescents between 1985 and 2016. Nutrients 2019; 12:nu12010020. [PMID: 31861789 PMCID: PMC7019792 DOI: 10.3390/nu12010020] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/30/2022] Open
Abstract
Trend analyses suggest that free sugar (FS) intake—while still exceeding 10%E—has decreased among German children and adolescents since 2005, yet that intakes may shift from sugars naturally occurring in foods to added sugars as children age. Thus, we analysed time and age trends in FS intake (%E) from food groups among 3–18 year-olds (1985–2016) using 10,761 3-day dietary records from 1312 DONALD participants (660 boys, 652 girls) by use of polynomial mixed-effects regression models. Among girls, FS from sugar & sweets decreased from 1985 to 2016 (linear trend p < 0.0001), but not among boys (p > 0.05). In the total sample, FS intake from juices increased until 2000 and decreased since 2005 (linear, quadratic trend p < 0.0001). FS from sugar sweetened beverages (SSB) decreased non-linearly from 1985 to 2016 (girls: linear, quadratic, cubic trend p < 0.0001; boys: linear, quadratic, cubic trend p < 0.02). Younger children consumed more FS from juices than older ones, who had a higher FS intake from SSB. FS intake from sugar & sweets increased until early adolescence and decreased afterwards. Since sugar & sweets represent the main source of FS intake and the source with the least pronounced decline in intake, public health measures should focus on these products.
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Affiliation(s)
- Ines Perrar
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Donald Study Dortmund, Heinstück 11, 44225 Dortmund, Germany; (I.P.); (A.M.S.); (S.S.)
| | - Alena M. Schadow
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Donald Study Dortmund, Heinstück 11, 44225 Dortmund, Germany; (I.P.); (A.M.S.); (S.S.)
| | - Sarah Schmitting
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Donald Study Dortmund, Heinstück 11, 44225 Dortmund, Germany; (I.P.); (A.M.S.); (S.S.)
- Institute of General Practice and Family Medicine, Faculty of Medicine, Ruhr-University Bochum, Universitätsstraße 150, 44801 Bochum, Germany
| | - Anette E. Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, Warburger Straße 100, 33098 Paderborn, Germany;
| | - Ute Alexy
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Donald Study Dortmund, Heinstück 11, 44225 Dortmund, Germany; (I.P.); (A.M.S.); (S.S.)
- Correspondence: ; Tel.: +49-231-7922-1016
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Associations of sugar intake with anthropometrics in children from ages 2 until 8 years in the EU Childhood Obesity Project. Eur J Nutr 2019; 59:2593-2601. [PMID: 31642983 DOI: 10.1007/s00394-019-02107-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/04/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE We determined the association of total sugar intake with body weight and fat mass in children on an energy-equivalent basis and potential changes in the association from 2 to 8 years of age. METHODS Data were available from the Childhood Obesity Project Trial initiated in 2002. Sugar intake was measured by 3-day weighed food protocols at 2, 3, 4, 5, 6, and 8 years of age. Body mass index (BMI) and fat mass index (FMI) were available at the same time points. To investigate the association of sugar intake with anthropometrics over time, linear mixed models were applied. Odds ratios for having a high BMI or FMI (above one standard deviation) were estimated by logistic random-effects models. To control for total energy intake, the residual method was chosen and models were additionally adjusted for total energy intake. RESULTS Data were available for 809 children with in total 2846 observations. In an isocaloric model, an increase of 100 kcal from sugar per day was significantly associated with lower zBMI (- 0.033; 95% CI -0.061, - 0.005) and zFMI (- 0.050; 95% CI - 0.089, - 0.011). In addition, a 100 kcal higher sugar intake was related to lower odds of having a high zBMI (OR 0.743; 95% CI 0.611, 0.903). CONCLUSION This study provides no indication that increased total sugar intake positively affects BMI on an energy-equivalent basis. Whether the negative association of sugar is due to physiological effects or points more to macronutrient preferences or a reporting bias (lower sugar intake) in children with higher BMI can be debated. CLINICAL TRIAL REGISTRY ClinicalTrials.gov Identifier: NCT00338689; Registered: June 19, 2006. URL: http://clinicaltrials.gov/ct2/show/NCT00338689?term=NCT00338689&rank=1 .
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Wanselius J, Axelsson C, Moraeus L, Berg C, Mattisson I, Larsson C. Procedure to Estimate Added and Free Sugars in Food Items from the Swedish Food Composition Database Used in the National Dietary Survey Riksmaten Adolescents 2016-17. Nutrients 2019; 11:E1342. [PMID: 31207923 PMCID: PMC6627866 DOI: 10.3390/nu11061342] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/11/2019] [Accepted: 06/12/2019] [Indexed: 11/16/2022] Open
Abstract
A high intake of added and free sugars is associated with poor diet quality, caries, and potentially has a role in non-communicable diseases. As a result, dietary guidelines advice limitation. However, there is no standardized method for estimation of added and free sugars in food items and consequently intake is difficult to measure. This study aimed to refine a procedure for sugars estimation and apply it to a Swedish dietary survey on adolescents (Riksmaten Adolescents 2016-17). A national sample of 3099 adolescents in school year 5, 8 and 11 participated (55% girls). Individual dietary intake data from two non-consecutive days was collected retrospectively and used for analysis. A ten-step systematic procedure for estimation of sugars in a Swedish context has been developed by combining two earlier methods, one for estimation of added sugars and one for free sugars. Sugars estimates were made for all food items comprising the survey database. Mainly objective decisions were necessary to make the estimates (92% and 93% for the sugars respectively); meaning that the procedure was largely transparent. In relation to Nordic Nutrition Recommendations, 45% of the participants had an intake that adhered to the guidelines. However, the majority of intakes was close to the recommendation. Further research on how specific food sources contribute to added and free sugars is necessary to facilitate further guidance on sugars and how to reach recommended target levels in Sweden.
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Affiliation(s)
- Julia Wanselius
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, SE-405 30 Gothenburg, Sweden.
| | - Cecilia Axelsson
- The National Food Agency, Sweden, Risk Benefit Assessment department, SE-751 26 Uppsala, Sweden.
| | - Lotta Moraeus
- The National Food Agency, Sweden, Risk Benefit Assessment department, SE-751 26 Uppsala, Sweden.
| | - Christina Berg
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, SE-405 30 Gothenburg, Sweden.
| | - Irene Mattisson
- The National Food Agency, Sweden, Risk Benefit Assessment department, SE-751 26 Uppsala, Sweden.
| | - Christel Larsson
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, SE-405 30 Gothenburg, Sweden.
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