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Jalanko P, Bond B, Laukkanen JA, Brage S, Ekelund U, Laitinen T, Määttä S, Kähönen M, Haapala EA, Lakka TA. Association between arterial health and cognition in adolescents: The PANIC study. Physiol Rep 2024; 12:e16024. [PMID: 38697946 PMCID: PMC11065692 DOI: 10.14814/phy2.16024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/11/2024] [Accepted: 04/11/2024] [Indexed: 05/05/2024] Open
Abstract
We investigated the associations of the measures of arterial health with cognition in adolescents and whether physical activity (PA) or sedentary time (ST) confounds these associations. One hundred sixteen adolescents (71 boys) aged 15.9 ± 0.4 participated in the study. PA and ST were assessed using a combined accelerometer/heart rate monitor. Overall cognition was computed from the results of psychomotor function, attention, working memory, and paired-associate learning tests. Pulse wave velocity was measured by impedance cardiography, carotid intima-media thickness, and carotid artery distensibility by carotid ultrasonography. Systolic and diastolic blood pressure (SBP and DBP) were measured using an aneroid sphygmomanometer. SBP was inversely associated with overall cognition (standardized regression coefficient [β] = -0.216, 95% confidence interval (CI) -0.406 to -0.027, p = 0.025). Pulse wave velocity (β = -0.199, 95% CI -0.382 to -0.017, p = 0.033) was inversely associated with working memory task accuracy. SBP was directly associated with reaction time in the attention (β = 0.256, 95% CI 0.069 to 0.443, p = 0.008) and errors in the paired-associate learning tasks (β = 0.308, 95% CI 0.126 to 0.489, p = 0.001). Blood pressure was inversely associated with overall cognition. PA or ST did not confound the associations. Results suggest that preventing high blood pressure is important for promoting cognition in adolescents.
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Affiliation(s)
- Petri Jalanko
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Helsinki Clinic for Sports and Exercise MedicineFoundation for Sports and Exercise MedicineHelsinkiFinland
| | - Bert Bond
- Children's Health and Exercise Research Centre, Sport and Health Science, College of Life and Environmental SciencesUniversity of ExeterExeterUK
| | - Jari A. Laukkanen
- Department of Medicine, Institute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland
- Department of MedicineCentral Finland Health Care District Hospital DistrictJyväskyläFinland
| | - Soren Brage
- MRC Epidemiology UnitUniversity of Cambridge School of Clinical MedicineCambridgeUK
| | - Ulf Ekelund
- Department of Sports MedicineNorwegian School of Sport SciencesOsloNorway
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear ImagingUniversity of Eastern Finland and Kuopio University HospitalKuopioFinland
| | - Sara Määttä
- Department of Clinical NeurophysiologyKuopio University HospitalKuopioFinland
| | - Mika Kähönen
- Department of Clinical PhysiologyTampere University Hospital and Faculty of Medicine and Health Technology, Tampere UniversityTampereFinland
| | - Eero A. Haapala
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Institute of Biomedicine, School of MedicineUniversity of Eastern FinlandKuopioFinland
| | - Timo A. Lakka
- Department of Clinical Physiology and Nuclear ImagingUniversity of Eastern Finland and Kuopio University HospitalKuopioFinland
- Institute of Biomedicine, School of MedicineUniversity of Eastern FinlandKuopioFinland
- Foundation for Research in Health Exercise and NutritionKuopio Research Institute of Exercise MedicineKuopioFinland
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Skaffari E, Vepsäläinen H, Nissinen K, Lehto E, Lehto R, Roos E, Erkkola M, Korkalo L. Food consumption and nutrient intake of Finnish preschool children according to parental educational level. Br J Nutr 2024; 131:113-122. [PMID: 37424281 DOI: 10.1017/s0007114523001460] [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] [Indexed: 07/11/2023]
Abstract
We examined the association between parental educational level (PEL) and children's food consumption and nutrient intake in a sample of Finnish 3- to 6-year-old preschoolers (n 811). The data were obtained from the cross-sectional DAGIS project, conducted in eight municipalities in Finland during 2015-2016. The food consumption and nutrient intake were assessed using food records. The highest educational level of the family was used as the indicator of socio-economic status. Differences in diet by PEL were analysed using a hierarchical linear model adjusted for energy intake. Compared with high PEL, low PEL was associated with a child's lower consumption of fresh vegetables and salads, vegetarian dishes, berries, white bread, blended spread, skimmed milk and ice cream but higher consumption of milk with 1-1·5 % fat content, dairy-based desserts and sugar-sweetened soft drinks. Food consumption was also examined after disaggregating dishes into their ingredients. Low PEL was associated with lower consumption of vegetables, nuts and seeds, berries and fish but higher consumption of red meat. Children in the low PEL, compared with the high PEL group, had a lower intake of protein, fibre, EPA, DHA, vitamin D, riboflavin, vitamin B6, folate, vitamin B12, vitamin C, potassium, phosphorous, Ca, Mg, Zn and iodine but a higher intake of fat and saturated, trans and MUFA. The observed diet-related disparities highlight the need for policy actions and interventions supporting healthy eating patterns such as high consumption of vegetables, nuts and berries in childhood, paying special attention to those with low PEL.
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Affiliation(s)
- Essi Skaffari
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Kaija Nissinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- School of Food and Agriculture, Seinäjoki University of Applied Sciences, Seinäjoki, Finland
| | - Elviira Lehto
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Department of Sociology, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | | | - Eva Roos
- Folkhälsan Research Center, Helsinki, Finland
- Department of Food Studies, Nutrition and Dietetics, Uppsala Universitet, Uppsala, Sweden
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Liisa Korkalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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Naveed S, Sallinen T, Eloranta AM, Skog H, Jalkanen H, Brage S, Ekelund U, Pentikäinen H, Savonen K, Lakka TA, Haapala EA. Effects of 2-year dietary and physical activity intervention on cognition in children-a nonrandomized controlled trial. Scand J Med Sci Sports 2023; 33:2340-2350. [PMID: 37555467 DOI: 10.1111/sms.14464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND AND OBJECTIVE We investigated the effects of a combined dietary and PA intervention on cognition in children and whether changes in diet quality, PA, sedentary behavior (SB), and sedentary time (ST) are associated with changes in cognition. METHODS We conducted a 2-year nonrandomized controlled trial in 504 children aged 6-9 years at baseline. The children were allocated to a combined dietary and PA intervention group (n = 237) or a control group (n = 160) without blinding. INTERVENTIONS The children and their parents allocated to the intervention group had six dietary counseling sessions of 30-45 min and six PA counseling sessions of 30-45 min during the 2-year intervention period. The children were also encouraged to participate in after-school exercise clubs. Cognition was assessed by the Raven's Colored Progressive Matrices. We assessed dietary factors by 4 days food records and computed the Baltic Sea Diet Score (BSDS) as a measure of diet quality. PA and ST were assessed by a combined heart rate and body movement monitor, types of PA and SB by a questionnaire. RESULTS The intervention had no effect on cognition. Increased BSDS and consumption of low-fat milk and decreased consumption of red meat and sausages were associated with improved cognition over 2 years. Increased organized sports, ST, and reading were positively, while unsupervised PA, computer use, and writing were negatively associated with cognition. CONCLUSION Combined dietary and PA intervention had no effect on cognition. Improved diet quality and increased organized sports and reading were associated with improved cognition.
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Affiliation(s)
- Sehrish Naveed
- Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Taisa Sallinen
- Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- University of Eastern Finland Library Kuopio, Kuopio, Finland
| | - Aino-Maija Eloranta
- Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Hannamari Skog
- Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Henna Jalkanen
- Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences (NIH), Oslo, Norway
| | | | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Timo A Lakka
- Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Eero A Haapala
- Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Viljakainen H, Sorlí JV, Dahlström E, Agrawal N, Portolés O, Corella D. Interaction between genetic susceptibility to obesity and food intake on BMI in Finnish school-aged children. Sci Rep 2023; 13:15265. [PMID: 37709841 PMCID: PMC10502078 DOI: 10.1038/s41598-023-42430-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/10/2023] [Indexed: 09/16/2023] Open
Abstract
Diet modulates the genetic risk of obesity, but the modulation has been rarely studied using genetic risk scores (GRSs) in children. Our objectives were to identify single nucleotide polymorphisms (SNPs) that drive the interaction of specific foods with obesity and combine these into GRSs. Genetic and food frequency data from Finnish Health in Teens study was utilized. In total, 1142 11-year-old subjects were genotyped on the Metabochip array. BMI-GRS with 30 well-known SNPs was computed and the interaction of individual SNPs with food items and their summary dietary scores were examined in relation to age- and sex-specific BMI z-score (BMIz). The whole BMI-GRS interacted with several foods on BMIz. We identified 7-11 SNPs responsible for each interaction and these were combined into food-specific GRS. The most predominant interaction was witnessed for pizza (p < 0.001): the effect on BMIz was b - 0.130 (95% CI - 0.23; - 0.031) in those with low-risk, and 0.153 (95% CI 0.072; 0.234) in high-risk. Corresponding, but weaker interactions were verified for sweets and chocolate, sugary juice drink, and hamburger and hotdog. In total 5 SNPs close to genes NEGR1, SEC16B, TMEM18, GNPDA2, and FTO were shared between these interactions. Our results suggested that children genetically prone to obesity showed a stronger association of unhealthy foods with BMIz than those with lower genetic susceptibility. Shared SNPs of the interactions suggest common differences in metabolic gene-diet interactions, which warrants further investigation.
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Affiliation(s)
- Heli Viljakainen
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland.
- Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Jose V Sorlí
- Department of Preventive Medicine and Public Health, University of Valencia, Valencia, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Madrid, Spain
| | - Emma Dahlström
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, 00290, Helsinki, Finland
- Department of Nephrology, University of Helsinki and Helsinki University Hospital, 00290, Helsinki, Finland
| | - Nitin Agrawal
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Olga Portolés
- Department of Preventive Medicine and Public Health, University of Valencia, Valencia, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Madrid, Spain
| | - Dolores Corella
- Department of Preventive Medicine and Public Health, University of Valencia, Valencia, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Madrid, Spain
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Haapala EA, Widlund A, Poikkeus AM, Lima RA, Brage S, Aunio P, Lakka TA. Cross-Lagged Associations between Physical Activity, Motor Performance, and Academic Skills in Primary School Children. Med Sci Sports Exerc 2023; 55:1465-1470. [PMID: 36897825 DOI: 10.1249/mss.0000000000003163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
PURPOSE Few longitudinal studies have investigated the interwoven longitudinal dynamics between physical activity (PA), motor performance, and academic skills in middle childhood. Therefore, we investigated the cross-lagged associations between PA, motor performance, and academic skills from grade 1 to grade 3 in Finnish primary school children. METHODS A total of 189 children 6-9 yr old at baseline comprised the study sample. Total PA was assessed using a questionnaire filled out by parents, moderate-to-vigorous PA by combined heart rate and body movement monitor, motor performance by 10 × 5-m shuttle run test, and academic skills by arithmetic fluency and reading comprehension tests in grade 1 and grade 3. Data were analyzed using structural equation modeling adjusted for gender, parental education, and household income. RESULTS The final model fitted the data very well ( χ237 = 68.516, P = 0.0012, root-mean-square error of approximation = 0.067, comparative fit index = 0.95, Tucker-Lewis Index = 0.89) and explained 91% of variance in the latent academic skills variable, 41% of the variance in the latent PA variable, and 32% of variance in motor performance in grade 3. Better motor performance in grade 1 was associated with higher academic skills in grade 3, but it did not predict PA. PA was not directly or indirectly associated with academic skills. However, higher levels of PA in grade 1 predicted better motor performance in grade 3. Academic skills did not predict PA or motor performance. CONCLUSIONS These results suggest that better motor performance, but not PA, predicts later academic skills. Academic skills in grade 1 do not contribute to PA or motor performance in the early school years.
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Affiliation(s)
| | | | - Anna-Maija Poikkeus
- Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, FINLAND
| | | | - Soren Brage
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, UNITED KINGDOM
| | - Pirjo Aunio
- Faculty of Educational Sciences, University of Helsinki, Helsinki, FINLAND
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O'Kane N, Watson S, Kehoe L, O'Sullivan E, Muldoon A, Woodside J, Walton J, Nugent A. The patterns and position of snacking in children in aged 2-12 years: A scoping review. Appetite 2023:106974. [PMID: 37421978 DOI: 10.1016/j.appet.2023.106974] [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: 04/10/2023] [Revised: 06/12/2023] [Accepted: 07/05/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Childhood obesity is associated with serious comorbidities during childhood and into adulthood. One potential risk factor for childhood obesity is consumption of unhealthy, energy-dense foods. This scoping review examines evidence on snacking in children aged 2-12years of age and presents the patterns and position of snacking in children's diets. METHODS A search of electronic databases (MEDLINE, Web of Science, PubMed, Embase) for articles published from March 2011 to November 2022 was conducted. Articles providing insight into the position of snacking (e.g., energy contribution), or patterns (e.g., location, timing), in children aged 2-12years were included. A quality assessment was conducted and data was synthesised according to data source (nationally representative or other). RESULTS Twenty-one articles were included, most (n = 13) reporting nationally representative data. The average number of daily snacks was 3, with 92.9-100.0% of children consuming snacks. Most were consumed in the afternoon (75.2-84.0%) and at home (46.5-67.3%). Snacks frequently consumed were 'fruits and vegetables', 'baked desserts', 'sweets, candy and confectionery', and 'dairy products'. Snacks contributed 231-565 kcal daily, up to a third of daily carbohydrate intake, a quarter of fat intake, and a fifth of protein intake. Snacks provided up to one third of vitamin C intake, one quarter of vitamin E, potassium and magnesium intake, and a fifth of calcium, folic acid, vitamins D and B12, iron and sodium intake. DISCUSSION This scoping review provides insight into patterns and position of snacking within children's diets. Snacking plays a significant role in children's diets with multiple snacking occasions occurring throughout a child's day, the overconsumption of which has the potential to increase risk of childhood obesity. Further research is required into the role of snacking, particularly specific foods playing a role in micronutrient intake, and clear guidance for snacking intake in children.
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Affiliation(s)
- Niamh O'Kane
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Ireland; Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Ireland.
| | - Sinead Watson
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Ireland
| | - Laura Kehoe
- Department of Biological Sciences, Munster Technological University, Cork, Ireland; School of Food & Nutritional Sciences, University College Cork, Cork, Ireland
| | - Emma O'Sullivan
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
| | - Aine Muldoon
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
| | - Jayne Woodside
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Ireland; Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Ireland
| | - Janette Walton
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
| | - Anne Nugent
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Ireland; Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Ireland
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Greene E, Murrin C. Parental influences on children's dairy products consumption: a narrative review. Public Health Nutr 2023; 26:976-993. [PMID: 36459073 PMCID: PMC10346067 DOI: 10.1017/s1368980022002555] [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: 09/21/2021] [Revised: 10/05/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To review research on the influence of parent-related factors on children's dairy products consumption. DESIGN A search of electronic databases and a narrative synthesis of the literature were conducted. English-language articles were included if they reported data relating to parental influences on children's consumption of dairy products and if statistical significance was reported. SETTING Studies were carried out in the USA (n 8) and in a range of countries across Europe (n 12) and Asia (n 5). PARTICIPANTS The subjects of this research were children aged between 2 and 12 years of age, from a range of geographical locations. RESULTS Twenty-five studies met the inclusion criteria. The studies examined children's dairy products consumption in relation to parental socio-economic status (education level and income) (n 12), home availability (n 2), home food environment (n 3), parental dairy products consumption (n 4), parent feeding practices (n 3), parents' beliefs and attitudes (n 3) and parental nutrition knowledge (n 3). Results on the association between socio-economic status and children's dairy products consumption varied; however, studies reporting a significant association generally observed a positive relationship. Fifteen studies reported children's total dairy products intake as an outcome measure, with the remaining studies reporting intake of milk or other dairy products as individual foods. CONCLUSIONS This review identified literature exploring a range of parental factors in relation to children's dairy products intake. However, there were limited numbers of studies published within each category of modifiable factors. Further research on the parent-related determinants of dairy products consumption in children is required in order to identify potential intervention targets in this age group.
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Affiliation(s)
- Ellen Greene
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Celine Murrin
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
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Haapala EA, Kuronen E, Ihalainen JK, Lintu N, Leppänen MH, Tompuri T, Atalay M, Schwab U, Lakka TA. Cross-sectional associations between physical fitness and biomarkers of inflammation in children-The PANIC study. Scand J Med Sci Sports 2023; 33:1000-1009. [PMID: 36779507 DOI: 10.1111/sms.14337] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 01/25/2023] [Accepted: 02/06/2023] [Indexed: 02/14/2023]
Abstract
BACKGROUND Systemic low-grade inflammation has been proposed as an underlying pathophysiological mechanism for cardiometabolic diseases. We investigated the associations of physical fitness with a systemic low-grade inflammatory state in a population sample of children. METHODS Altogether 391 children aged 6-9 years were examined. Cardiorespiratory fitness (maximal power output, Wmax ) was assessed by a maximal cycle ergometer test and neuromuscular fitness by hand grip strength, sit-up, standing long jump, 50-meter shuttle run, static balance, sit-and-reach, and box and block tests. Body fat percentage (BF%) and lean mass (LM) were assessed by dual-energy X-ray absorptiometry (DXA). High sensitivity C-reactive protein (hs-CRP), leptin, leptin receptor, high molecular weight adiponectin (HMW-adiponectin), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and glycoprotein acetyls (GlycA) were assessed from fasting blood samples. The modified inflammatory score (IS) was calculated using the population-specific z-scores and formula (z hs-CRP + z leptin + z IL-6 + z TNF-α + z GlycA)-z leptin receptor-z HMW-adiponectin. The data were analyzed using linear regression analyses. RESULTS Higher Wmax /kg of body mass (β = -0.416, 95% CI = -0.514 to -0.318), higher number of completed sit-ups (β = -0.147, 95% CI = -0.244 to -0.049), a longer distance jumped in the standing long jump test (β = -0.270, 95% CI = -0.371 to -0.169), and a shorter time in the 50-meter shuttle run test (β = 0.123, 95% CI = 0.022 to 0.223) were associated with lower IS. None of these associations remained statistically significant after adjustment for BF%. CONCLUSIONS Higher physical fitness is associated with a more favorable inflammatory biomarker profile in children. However, the associations were explained by BF%.
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Affiliation(s)
- Eero A Haapala
- Sports & Exercise Medicine, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Emmi Kuronen
- Sports & Exercise Medicine, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Johanna K Ihalainen
- Sports & Exercise Medicine, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Niina Lintu
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Marja H Leppänen
- Sports & Exercise Medicine, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Tuomo Tompuri
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Mustafa Atalay
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, 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
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Laitinen AL, Antikainen A, Mikkonen S, Kähkönen K, Talvia S, Varjonen S, Paavola S, Karhunen L, Tilles-Tirkkonen T. Implementation of food education in school environments improves pupils' eating patterns and social participation in school dining. Public Health Nutr 2022; 25:1-11. [PMID: 36210798 PMCID: PMC9991779 DOI: 10.1017/s1368980022002154] [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: 05/20/2022] [Revised: 08/19/2022] [Accepted: 09/22/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Schools can be an effective arena for food education. The Tasty School is a tailored teacher-driven food education model that provides tools for implementing food education in primary schools. This study aimed to investigate the effects of the Tasty School model on pupils' eating patterns and experiences. We also aimed to assess the implementation strength of the Tasty School. DESIGN A quasi-experimental study was conducted during one school year 2019-2020 in fifteen intervention and ten control schools. The intervention schools implemented the Tasty School food education model. The pupils completed web-based baseline and follow-up questionnaires in class during a school day. The principals were interviewed after the intervention. The data were analysed using a mixed-effects model for repeated measures, accounting for the implementation strength and selected standardisation effects. SETTING A total of twenty-five general Finnish primary schools. PARTICIPANTS 1480 pupils from grades 3-6 (age 8-12 years) from five municipalities in Finland. RESULTS Percentages of pupils eating a balanced school meal increased in schools where food education was actively implemented (P = 0·027). In addition, pupils' experience of social participation in school dining strengthened in schools where the Tasty School model was implemented (5-point scale mean from 2·41 to 2·61; P = 0·017). CONCLUSIONS Healthy eating patterns can be promoted by the active implementation of food education in primary schools. The Tasty School model offers a promising tool for developing healthy eating patterns and increasing social participation among pupils not only in Finland, but also potentially in other countries as well.
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Affiliation(s)
- Aija L Laitinen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, Kuopio70211, Finland
| | - Amma Antikainen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, Kuopio70211, Finland
| | - Santtu Mikkonen
- Department of Applied Physics and Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Kaisa Kähkönen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, Kuopio70211, Finland
| | - Sanna Talvia
- School of Applied Educational Science and Teacher Education, University of Eastern Finland, Joensuu, Finland
| | - Silja Varjonen
- Finnish Society for Food Education Ruukku, Helsinki, Finland
| | - Saila Paavola
- Finnish Society for Food Education Ruukku, Helsinki, Finland
| | - Leila Karhunen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, Kuopio70211, Finland
| | - Tanja Tilles-Tirkkonen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, Kuopio70211, Finland
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Haapala EA, Väistö J, Ihalainen JK, González CT, Leppänen MH, Veijalainen A, Sallinen T, Eloranta AM, Ekelund U, Schwab U, Brage S, Atalay M, Lakka TA. Associations of physical activity, sedentary time, and diet quality with biomarkers of inflammation in children. Eur J Sport Sci 2022; 22:906-915. [PMID: 33599556 DOI: 10.1080/17461391.2021.1892830] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We investigated the associations of physical activity (PA), sedentary time (ST), and diet quality with biomarkers of inflammation in 390 children (192 girls, 198 boys) aged 6-8 years. PA energy expenditure (PAEE), light PA, moderate PA (MPA), vigorous PA (VPA), moderate-to-vigorous PA (MVPA), and ST were assessed by combined movement and heart rate sensor. Finnish Children Healthy Eating Index was calculated using data from 4 d food records. Body fat percentage (BF%) was measured by dual-energy X-ray absorptiometry. High-sensitivity C-reactive protein (Hs-CRP), leptin, interleukin-6 (IL-6), adiponectin, tumour necrosis factor-α, and glycoprotein acetyls were measured from fasting blood samples. PAEE, MPA, VPA, and MVPA were inversely associated with hs-CRP (β=-191 to -139, 95% CI=-0.294 to -0.024), leptin (β=-0.409 to -0.301, 95% CI=-0.499 to -0.107), IL-6 (β=-0.136 to -0.104, 95% CI=-0.240 to -0.001) and PAEE, MPA, and MVPA were inversely associated with glycoprotein acetyls (β=-0.117 to -0.103, 95% CI=-0.213 to -0.001). ST was directly associated with hs-CRP (β=0.170, 95% CI=0.070-0.269), leptin (β=0.355, 95% CI=0.265-0.445), and IL-6 (β=0.105, 95% CI=0.005-0.205). VPA was inversely associated with hs-CRP, leptin, and IL-6 in children with higher BF% (β=-0.344 to -0.181, 95% CI=-0.477 to -0.033) but not among children with lower BF% (β=-0.007-0.033, 95% CI=-0.183-0.184). In conclusion, PA was inversely and ST directly associated with circulating levels of biomarkers of inflammation among children. Furthermore, we observed that PA was inversely associated with these biomarkers for inflammation in children with a higher BF%. HighlightsSystemic inflammation, as indicated by increased circulating concentrations of biomarkers for inflammation, may be important in causal pathways leading to insulin resistance, sub-clinical atherosclerosis, and eventually clinical manifestations of cardiovascular diseases.Higher levels of physical activity and lower levels of sedentary time were associated with more favourable inflammatory profile.Body fat percentage modified these associations and especially vigorous intensity physical activity was inversely associated with biomarkers of inflammation on children with higher body fat percentage but not in children with lower body fat percentage.
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Affiliation(s)
- Eero A Haapala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Juuso Väistö
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Johanna K Ihalainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Swedish Winter Sports Research Centre, Mid Sweden University, Sweden
| | | | - Marja H Leppänen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Aapo Veijalainen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Taisa Sallinen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Aino-Maija Eloranta
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Ulf Ekelund
- Norwegian School of Sports Science, Oslo, Norway
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Mustafa Atalay
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, 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
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11
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Vepsäläinen H, Skaffari E, Wojtkowska K, Barlińska J, Kinnunen S, Makkonen R, Heikkilä M, Lehtovirta M, Ray C, Suhonen E, Nevalainen J, Sajaniemi N, Erkkola M. A Mobile App to Increase Fruit and Vegetable Acceptance Among Finnish and Polish Preschoolers: Randomized Trial. JMIR Mhealth Uhealth 2022; 10:e30352. [PMID: 34982718 PMCID: PMC8767468 DOI: 10.2196/30352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/08/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background Early childhood education and care (ECEC) centers are ideal venues for food education. As smartphones and tablets are becoming increasingly popular in ECEC centers, technology can be used to deliver such pedagogical content. Evidence suggests that video games can affect fruit and vegetable (FV) consumption among 9- to 12-year-old children, but studies among preschoolers are scarce. Objective This paper describes the development of the Mole’s Veggie Adventures app and its effectiveness in increasing FV acceptance among Finnish and Polish preschoolers aged 3 to 6 years. Methods A multiprofessional team created an app to be used in ECEC centers in groups of 3 to 10 children. The app aimed to increase vegetable acceptance, and it was built using elements that support the development of self-regulation and social skills. Altogether, 7 Finnish and 4 Polish ECEC centers participated in the study. Before randomization, parents reported background factors and their children’s willingness to taste different FVs. The ECEC professionals in the intervention arm were instructed to use the app at least once a week during the 3- to 4-week intervention period. The main outcomes in this unblinded, cluster-randomized study were FV acceptance and relative FV acceptance. The first was calculated as a sum variable describing the children’s willingness to taste 25 different FVs, the second as FV acceptance divided by the number of FVs served. We used analysis of covariance to compare the FV acceptance and relative FV acceptance scores between the intervention and control groups at follow-up. Results A total of 221 children were included in the analysis. At follow-up, the intervention group (115/221, 52%) had higher FV acceptance scores (baseline adjusted difference of mean 7.22; 95% CI 1.41-13.03) than the control group (106/221, 48%). The intervention effect was parallel for relative FV acceptance scores (baseline adjusted difference of mean 0.28; 95% CI 0.05-0.52). Conclusions The Mole’s Veggie Adventures app has the potential to increase FV acceptance among preschoolers and can be a valuable tool in supporting food education in ECEC centers. Furthermore, the app can be feasibly incorporated into preschool routines in countries with different educational environments. Trial Registration ClinicalTrials.gov NCT05173311; https://tinyurl.com/4vfbh283
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Affiliation(s)
- Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Essi Skaffari
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | | | | | - Satu Kinnunen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Riikka Makkonen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- School of Applied Educational Science and Teacher Education, University of Eastern Finland, Joensuu, Finland
| | - Maria Heikkilä
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Mikko Lehtovirta
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Carola Ray
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Eira Suhonen
- Department of Education, University of Helsinki, Helsinki, Finland
| | | | - Nina Sajaniemi
- School of Applied Educational Science and Teacher Education, University of Eastern Finland, Joensuu, Finland
- Department of Education, University of Helsinki, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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12
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Haapala EA, Leppänen MH, Lehti M, Lintu N, Tompuri T, Viitasalo A, Schwab U, Lakka TA. Cross-sectional associations between cardiorespiratory fitness and NMR-derived metabolic biomarkers in children - the PANIC study. Front Endocrinol (Lausanne) 2022; 13:954418. [PMID: 36213296 PMCID: PMC9538338 DOI: 10.3389/fendo.2022.954418] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Cardiorespiratory fitness has been inversely associated with cardiovascular risk across the lifespan. Some studies in adults suggest that higher cardiorespiratory fitness is associated with cardioprotective metabolite profile, but the evidence in children is lacking. Therefore, we investigated the cross-sectional association of cardiorespiratory fitness with serum nuclear magnetic resonance derived metabolic biomarkers in children. METHODS A population sample of 450 children aged 6-8 years was examined. Cardiorespiratory fitness was assessed by a maximal exercise test on a cycle ergometer and quantified as maximal power output normalised for lean body mass assessed by dual-energy X-ray absorbtiometry. Serum metabolites were assessed using a high throughput nuclear magnetic resonance platform. The data were analysed using linear regression analyses adjusted for age and sex and subsequently for body fat percentage (BF%) assessed by DXA. RESULTS Cardiorespiratory fitness was directly associated with high density lipoprotein (HDL) cholesterol (β=0.138, 95% CI=0.042 to 0.135, p=0.005), average HDL particle diameter (β=0.102, 95% CI=0.004 to 0.199, p=0.041), and the concentrations of extra-large HDL particles (β=0.103, 95% CI=0.006 to 0.201, p=0.038), large HDL particles (β=0.122, 95% CI=0.025 to 0.220, p=0.014), and medium HDL particles (β=0.143, 95% CI=0.047 to 0.239, p=0.004) after adjustment for age and sex. Higher cardiorespiratory fitness was also associated with higher concentrations of ApoA1 (β=0.145, 95% CI=0.047 to 0.242, p=0.003), glutamine (β=0.161, 95% CI=0.064 to 0.257, p=0.001), and phenylalanine (β=0.187, 95% CI=0.091 to 0.283, p<0.001). However, only the direct associations of cardiorespiratory fitness with the concentrations of HDL cholesterol (β=0.114, 95% CI=0.018 to 0.210, p=0.021), medium HDL particles (β=0.126, 95% CI=0.030 to 0.223, p=0.010), ApoA1 (β=0.126, 95% CI=0.030 to 0.223, p=0.011), glutamine (β=0.147, 95% CI=0.050 to 0.224, p=0.003), and phenylalanine (β=0.217, 95% CI=0.122 to 0.311, p<0.001) remained statistically significant after further adjustment for BF%. CONCLUSIONS Higher cardiorespiratory fitness was associated with a cardioprotective biomarker profile in children. Most associations were independent of BF% suggesting that the differences in serum metabolites between children are driven by cardiorespiratory fitness and not adiposity.
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Affiliation(s)
- Eero A. Haapala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- *Correspondence: Eero A. Haapala,
| | - Marja H. Leppänen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Maarit Lehti
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Niina Lintu
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Tuomo Tompuri
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Anna Viitasalo
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, 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
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13
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da Costa MP, Severo M, Oliveira A, Lopes C, Hetherington M, Vilela S. Longitudinal bidirectional relationship between children's appetite and diet quality: A prospective cohort study. Appetite 2021; 169:105801. [PMID: 34774668 DOI: 10.1016/j.appet.2021.105801] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 10/21/2021] [Accepted: 11/09/2021] [Indexed: 11/02/2022]
Abstract
This study explored the relationship between eating behaviours and diet quality, from 7 to 10y. The sample included 3879 children evaluated, from the Portuguese birth cohort Generation XXI, with complete information on Food Frequency Questionnaire (FFQ) and the Children Eating Behaviour Questionnaire (CEBQ). A healthy eating index (HEI) (range: 9-31) was developed to evaluate the child's diet quality. The eight CEBQ's eating behaviours were included in the analysis. Generalised linear models were used to estimate the associations. Adjusted structural equation modelling was performed to study the direction of the associations. Eating behaviours measured at age 7y tracked to age 10y. A bidirectional inverse association between the food fussiness trait and diet quality was found, with a similar magnitude (p < 0.001), thus a higher score on food fussiness predicted a lower quality of the diet. A higher HEI score at 7y was associated with lower satiety responsiveness at 10y (βstandardized = -0.039), and a higher HEI score at age 10y was associated with higher enjoyment of food at 7y (βstandardized = 0.046). Eating behaviours were linked to diet quality in children with high enjoyment of food and low food fussiness at age 7y linked to a high-quality diet at 10y. In addition, children with high-quality diets at 7y were more likely to have lower food fussiness and satiety responsiveness at 10y. Given the stability of eating behaviours and the bidirectional nature of effects between eating behaviours and dietary quality in the long term, tailored interventions may be needed to encourage the acquisition of healthy eating behaviours and habits in early life.
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Affiliation(s)
- Marta Pinto da Costa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Carla Lopes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | | | - Sofia Vilela
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.
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14
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Leppänen MH, Haapala EA, Väistö J, Ekelund U, Brage S, Kilpeläinen TO, Lakka TA. Longitudinal and cross-sectional associations of adherence to 24-hour movement guidelines with cardiometabolic risk. Scand J Med Sci Sports 2021; 32:255-266. [PMID: 34644434 DOI: 10.1111/sms.14081] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 09/03/2021] [Accepted: 09/08/2021] [Indexed: 12/11/2022]
Abstract
This study aimed to examine (1) adherence to 24 h movement guidelines over a 2 years follow-up in children aged 6-8 years and (2) association of this adherence with cardiometabolic risk factors. Physical activity and sleep were assessed by a monitor combining heart rate and accelerometry measurements. Screen time was reported by the parents. Body fat percentage, waist circumference, blood glucose, serum insulin, plasma lipids, and blood pressure were assessed, and a cardiometabolic risk score was calculated using z-scores. Children were classified as meeting the guidelines if they had on average ≥60 min/day of moderate-to-vigorous physical activity during the valid days; ≤120 min/day of screen time; and 9-11 h/day of sleep. In total, 485 children had valid data at baseline or at 2 years follow-up. Analyses were conducted using adjusted logistic and linear regression models. Most children adhered to the 24 h movement guidelines at baseline, but the adherence decreased over the 2 years follow-up. Meeting physical activity guidelines individually, or in combination with screen time and/or sleep, was longitudinally associated with a lower cardiometabolic risk score, insulin and waist circumference, and cross-sectionally additionally with lower diastolic blood pressure and higher high-density lipoprotein cholesterol. However, these associations became statistically non-significant after adjustment for body fat. In conclusion, meeting 24 h movement guidelines at baseline increases the odds of meeting them at 2 years follow-up in school-aged children. Furthermore, meeting 24 h movement guidelines is associated with lower levels of cardiometabolic risk factors, but these associations are partly explained by lower body fat. Thus, promoting movement behaviors, especially physical activity, and healthy weight in early childhood is important in supporting cardiometabolic health in children.
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Affiliation(s)
- Marja H Leppänen
- Folkhälsan Research Center, Helsinki, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Eero A Haapala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Juuso Väistö
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ulf Ekelund
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.,Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Søren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Tuomas O Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - 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, University of Eastern Finland, Kuopio, Finland.,Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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15
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Development of a stand-alone index for the assessment of diet quality in elementary school-aged children. Public Health Nutr 2021; 24:5629-5640. [PMID: 34420540 DOI: 10.1017/s1368980021003657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To develop and evaluate a stand-alone Elementary School-aged Children's Index of Diet Quality (ES-CIDQ). DESIGN In this cross-sectional study, children filled in a food frequency questionnaire (FFQ) with twenty-nine multiple-item questions on the consumption of foods, portion sizes and eating frequency and a 5-d food diary. Nutrient intakes were calculated with nutrient analysis software. FFQ questions best reflecting a health-promoting diet with reference to dietary recommendations were identified by correlations, logistic regression modelling and receiver-operating characteristics curve analysis. SETTING Southwest and Eastern Finland. PARTICIPANTS Healthy elementary school-aged volunteers [n 266, mean (sd) age 9·7 (1·7) years] were recruited between March 2017 and February 2018. RESULTS A set of questions was identified from the FFQ that best depicted the children's diet quality as defined in the dietary recommendations. These fifteen questions were scored and formulated into a stand-alone index as a continuous index score (range 0-16·5 points) and a two-category score: good and poor diet quality. The cut-off score of six points for a good diet quality had a sensitivity of 0·60 and a specificity of 0·78. Children with a good diet quality (49·8 % of the children) had higher intakes of protein, dietary fibre, and several vitamins and minerals, and lower intakes of sucrose, total fat, SFA and cholesterol compared to children with a poor diet quality. CONCLUSIONS The developed short stand-alone index depicted diet quality as defined in the dietary recommendations. Thus, ES-CIDQ may be used for assessing diet quality in Finnish elementary school-aged children in school health care and nutrition research.
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16
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Parental and Child Factors Associated With 2- to 6-Year-Old Children's Diet Quality in Finland. J Acad Nutr Diet 2021; 122:129-138.e4. [PMID: 34378535 DOI: 10.1016/j.jand.2021.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/26/2021] [Accepted: 06/15/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND There is limited evidence about diet quality and associated factors in a representative population-based sample of preschool-aged children in Finland. OBJECTIVE The aims of this study were to investigate (1) the extent to which child diet quality and the consumption of health indicator foods (vegetables, fruits, berries, vegetable oil-based spread, nonfat milk) are in accordance with Finnish recommendations for preschool-aged children, (2) whether diet quality differs between children with underweight or normal weight compared with children with overweight or obesity, and (3) whether parental or child factors are related to children's diet quality. DESIGN This was a cross-sectional study. PARTICIPANTS/SETTING Healthy children aged 2 to 6 years (n = 766) were recruited from child health clinics across Finland from February to June 2016. MAIN OUTCOME MEASURES Diet quality and consumption of the health indicator foods were assessed by the Children's Index of Diet Quality (CIDQ, score 0-21, values < 10 indicate poor; 10-13.5, moderate; and ≥14, good diet quality). Parental information was collected with a self-administered questionnaire. Child weight and height were measured by child health clinic nurses. STATISTICAL ANALYSES The overweight/obesity status and diet quality of the children were compared with 1-way analysis of variance. One-way analysis of variance was used as the preliminary analysis between child and parental factors and CIDQ scores, and linear mixed model analysis to further analyze the relationship between child and parental factors and CIDQ data. RESULTS Only a small minority (13.7%) of the children had a good diet quality, 55.4% had a moderate diet quality, and 30.9% had a poor diet quality. Only 1% of the children consumed the key health indicator foods, namely vegetables, fruits, and berries, as recommended. Diet quality did not differ between children with underweight/normal weight and overweight/obesity. Instead, the child's younger age, parents' higher education, and parents' self-perceived healthy diet were related to good diet quality in the child. CONCLUSIONS The diet quality was moderate or poor in the majority of the children. Parental characteristics were the main factors related to the child's diet quality. The results suggest that future efforts to improve preschool-aged children's diet quality are needed including efforts to counsel families in pediatric care. Whether the findings from the current study also apply to Finnish school-aged children should be investigated further.
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17
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Savinainen SE, Viitasalo A, Sallinen TM, Jääskeläinen JES, Lakka TA. Child-related and parental predictors for thelarche in a general population of girls: the PANIC study. Pediatr Res 2020; 88:676-680. [PMID: 32050255 DOI: 10.1038/s41390-020-0802-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/04/2019] [Accepted: 12/25/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Obesity has been associated with earlier thelarche, whereas other predictors for it remain unclear. METHODS We studied child-related and parental predictors for earlier thelarche in 195 girls aged 6-8 years followed up for 2 years. A physician evaluated breast development by inspection and palpation. Body fat percentage (BF%) was measured by dual-energy X-ray absorptiometry, diet by food records, and physical activity and sedentary time by body movement and heart rate monitors. Parental education, smoking, and alcohol consumption and household income were assessed by questionnaires. Gestational age, birth weight, and maternal prepregnancy BMI were obtained from hospital registers. Predictors for thelarche were examined using logistic regression analysis adjusted for age and follow-up time. RESULTS The incidence of thelarche during 2 years increased by 11% (OR 1.11, CI 1.06-1.17, p < 0.001) for 1 unit increase in baseline BF%. Girls with a smoking parent had a 2.64 (95% CI 1.21-5.77, p = 0.015) times higher incidence of thelarche than other girls. The associations of lower parental education and higher maternal prepregnancy BMI with the higher incidence of thelarche were largely explained by BF%. Other possible predictors were not associated with thelarche. CONCLUSIONS Higher BF% and exposure to tobacco smoke are independent predictors for earlier thelarche.
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Affiliation(s)
- Saija E Savinainen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland. .,Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.
| | - Anna Viitasalo
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Taisa M Sallinen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jarmo E S Jääskeläinen
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.,Department of Pediatrics, University of Eastern Finland, Kuopio, 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.,Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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18
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Lommi S, Figueiredo RADO, Tuorila H, Viljakainen H. Frequent use of selected sugary products associates with thinness, but not overweight during preadolescence: a cross-sectional study. Br J Nutr 2020; 124:631-640. [PMID: 32312332 PMCID: PMC7525105 DOI: 10.1017/s0007114520001361] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 04/06/2020] [Accepted: 04/15/2020] [Indexed: 12/20/2022]
Abstract
Convincing evidence suggests that diets laden with added sugar, specifically sugar-sweetened beverages, associate with excess weight in children. The relationships between sugar consumption frequency and BMI remain less well studied. We, therefore, evaluated children's consumption frequency of selected sugary products (n 8461; mean age 11·1 (sd 0·9) years) selected from the Finnish Health in Teens cohort study. Using a sixteen-item FFQ including six sugary products (chocolate/sweets, biscuits/cookies, ice cream, sweet pastry, sugary juice drinks and sugary soft drinks), we calculated a Sweet Treat Index (STI) for the frequency of weekly sugary product consumption and categorised children based on quartiles (Q) into low (Q1, cut-off < 4·0), medium (Q2 + Q3, range 4·0-10·5) and high STI (Q4, cut-off > 10·5), and as thin, normal and overweight/obese based on the measured BMI. Through multinomial logistic regression analyses, we found that subjects with a high STI exhibited a higher risk of being thin (OR 1·20, 95 % CI 1·02, 1·41) and lower risk of being overweight (OR 0·79, 95 % CI 0·67, 0·92), while subjects with a low STI were at higher risk of being overweight (OR 1·32, 95 % CI 1·14, 1·53). High consumption frequencies of salty snacks, pizza and hamburgers most closely were associated with a high STI. Our findings suggest that consuming sugary products at a high frequency does not associate with being overweight. The relationship between a low consumption frequency and being overweight suggests that overweight children's consumption frequency of sugary products may be controlled, restricted or underreported.
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Affiliation(s)
- Sohvi Lommi
- Department of Public Health, University of Helsinki, 00014 Helsinki, Finland
- Folkhälsan Research Center, 00250Helsinki, Finland
| | | | - Hely Tuorila
- Department of Food and Nutrition, University of Helsinki, 00014Helsinki, Finland
| | - Heli Viljakainen
- Folkhälsan Research Center, 00250Helsinki, Finland
- Department of Food and Nutrition, University of Helsinki, 00014Helsinki, Finland
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19
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Haapala EA, Gao Y, Lintu N, Väistö J, Vanhala A, Tompuri T, Lakka TA, Finni T. Associations between cardiorespiratory fitness, motor competence, and adiposity in children. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Eero A. Haapala
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
- Institute of Biomedicine School of Medicine University of Eastern Finland Kuopio Finland
| | - Ying Gao
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
- Department of Sports Science College of Education Zhejiang University Hangzhou China
| | - Niina Lintu
- Institute of Biomedicine School of Medicine University of Eastern Finland Kuopio Finland
| | - Juuso Väistö
- Institute of Biomedicine School of Medicine University of Eastern Finland Kuopio Finland
| | - Anssi Vanhala
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
- Department of Education Faculty of Educational Sciences University of Helsinki Helsinki Finland
| | - Tuomo Tompuri
- Institute of Biomedicine School of Medicine University of Eastern Finland Kuopio Finland
- Department of Clinical Physiology and Nuclear Medicine Kuopio University Hospital Kuopio 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
- Kuopio Research Institute of Exercise Medicine Kuopio Finland
| | - Taija Finni
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
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20
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Haapala EA, Wiklund P, Lintu N, Tompuri T, Väistö J, Finni T, Tarkka IM, Kemppainen T, Barker AR, Ekelund U, Brage S, Lakka TA. Cardiorespiratory Fitness, Physical Activity, and Insulin Resistance in Children. Med Sci Sports Exerc 2020; 52:1144-1152. [PMID: 31764464 PMCID: PMC7358077 DOI: 10.1249/mss.0000000000002216] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE Few studies have investigated the independent and joint associations of cardiorespiratory fitness (CRF) and body fat percentage (BF%) with insulin resistance in children. We investigated the independent and combined associations of CRF and BF% with fasting glycemia and insulin resistance and their interactions with physical activity (PA) and sedentary time among 452 children age 6 to 8 yr. METHODS We assessed CRF with a maximal cycle ergometer exercise test and used allometrically scaled maximal power output (Wmax) for lean body mass (LM) and body mass (BM) as measures of CRF. The BF% and LM were measured by dual-energy X-ray absorptiometry, fasting glycemia by fasting plasma glucose, and insulin resistance by fasting serum insulin and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). The PA energy expenditure, moderate-to-vigorous PA (MVPA), and sedentary time were assessed by combined movement and heart rate sensor. RESULTS Wmax/LM was not associated with glucose (β = 0.065, 95% confidence interval [CI] = -0.031 to 0.161), insulin (β = -0.079, 95% CI = -0.172 to 0.015), or HOMA-IR (β = -0.065, 95% CI = -0.161 to 0.030). Wmax/BM was inversely associated with insulin (β = -0.289, 95% CI = -0.377 to -0.200) and HOMA-IR (β = -0.269, 95% CI = -0.359 to -0.180). The BF% was directly associated with insulin (β = 0.409, 95% CI = 0.325 to 0.494) and HOMA-IR (β = 0.390, 95% CI = 0.304 to 0.475). Higher Wmax/BM, but not Wmax/LM, was associated with lower insulin and HOMA-IR in children with higher BF%. Children with higher BF% and who had lower levels of MVPA or higher levels of sedentary time had the highest insulin and HOMA-IR. CONCLUSIONS Children with higher BF% together with less MVPA or higher levels of sedentary time had the highest insulin and HOMA-IR. Cardiorespiratory fitness appropriately controlled for body size and composition using LM was not related to insulin resistance among children.
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Affiliation(s)
| | | | - Niina Lintu
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, FINLAND
| | | | - Juuso Väistö
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, FINLAND
| | - Taija Finni
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - Ina M Tarkka
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - Titta Kemppainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - Alan R Barker
- Children's Health and Exercise Research Centre, University of Exeter, Exeter, UNITED KINGDOM
| | - Ulf Ekelund
- Norwegian School of Sports Science, Oslo, NORWAY
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UNITED KINGDOM
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21
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Haapala EA, Haapala HL, Syväoja H, Tammelin TH, Finni T, Kiuru N. Longitudinal associations of physical activity and pubertal development with academic achievement in adolescents. JOURNAL OF SPORT AND HEALTH SCIENCE 2020; 9:265-273. [PMID: 32444151 PMCID: PMC7242213 DOI: 10.1016/j.jshs.2019.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 04/25/2019] [Accepted: 05/22/2019] [Indexed: 06/11/2023]
Abstract
OBJECTIVE We sought to investigate the longitudinal associations of moderate-to-vigorous physical activity (MVPA) and pubertal development with academic achievement in adolescents. METHODS A total of 635 adolescents (283 boys, 352 girls) aged 11-13 years participated in the study. MVPA was assessed by the Health Behaviour in School-aged Children study questionnaire, and pubertal development was assessed by the Pubertal Development Scale at beginning of the 6th grade (baseline) and end of the 7th grade (follow-up). Grade point average (GPA) at the end of Grades 5 and 7 was computed from data acquired from the school registers. The data were analyzed using linear regression and analyses of covariance. RESULTS In boys, MVPA was positively associated with GPA at baseline after adjustment for age (β = 0.144, 95% confidence interval (CI): 0.028-0.260, p = 0.028). In girls, the Pubertal Development Scale was positively associated with GPA at baseline (β = 0.104, 95%CI: -0.004 to 0.211, p = 0.058) and follow-up (β = 0.104, 95%CI: -0.002 to 0.211, p = 0.055) after adjustment for age, and these associations strengthened after further adjustment for MVPA (p < 0.05). Adolescents who were inactive at baseline or at baseline and follow-up had lower GPA during follow-up than their continuously highly active peers (mean difference = -0.301, 95%CI: -0.543 to -0.058, p = 0.009) and all other adolescents (mean difference = -0.247, 95%CI: -0.475 to -0.019, p = 0.029). These differences were greater in girls than in boys. CONCLUSION Lower levels of MVPA were associated with lower GPA in boys at baseline. Girls who were continuously inactive had lower GPA over the follow-up period than those who were continuously active. Finally, earlier pubertal development was associated with better academic achievement in girls.
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Affiliation(s)
- Eero A Haapala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FI-40014, Finland; Department of Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, FI-70211, Finland.
| | - Henna L Haapala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FI-40014, Finland
| | - Heidi Syväoja
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, FI-40700, Finland
| | - Tuija H Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, FI-40700, Finland
| | - Taija Finni
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FI-40014, Finland
| | - Noona Kiuru
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, FI-40014, Finland
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22
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Laitinen TT, Nuotio J, Rovio SP, Niinikoski H, Juonala M, Magnussen CG, Jokinen E, Lagström H, Jula A, Viikari JSA, Rönnemaa T, Simell O, Raitakari OT, Pahkala K. Dietary Fats and Atherosclerosis From Childhood to Adulthood. Pediatrics 2020; 145:peds.2019-2786. [PMID: 32209700 DOI: 10.1542/peds.2019-2786] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/02/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The association of dietary fat distribution with markers of subclinical atherosclerosis during early life is unknown. We examined whether success in achieving the main target of an infancy-onset dietary intervention based on the distribution of dietary fat was associated with aortic and carotid intima-media thickness (IMT) and distensibility from childhood to young adulthood. METHODS In the prospective randomized controlled Special Turku Coronary Risk Factor Intervention Project trial, personalized dietary counseling was given biannually to healthy children from infancy to young adulthood. The counseling was based on Nordic Nutrition Recommendations, with the main aim of improving the distribution of dietary fat in children's diets. IMT and distensibility of the abdominal aorta and common carotid artery were measured repeatedly at ages 11 (n = 439), 13 (n = 499), 15 (n = 506), 17 (n = 477), and 19 years (n = 429). The targeted distribution of dietary fat was defined as a ratio of saturated fatty acids to monounsaturated and polyunsaturated fatty acids of <1:2 and as an intake of saturated fatty acids of <10% of energy intake. Participants who met ≥1 of these 2 criteria were defined to achieve the main intervention target. RESULTS Individuals who achieved the main intervention target had lower aortic IMT (age- and sex-adjusted mean difference 10.4 µm; 95% confidence interval: 0.3 to 20.5 µm) and better aortic distensibility (0.13% per 10 mm Hg; 95% confidence interval: 0.00% to 0.26% per10 mm Hg) compared with their peers who did not meet the target. CONCLUSIONS Achieving the main target of an infancy-onset dietary intervention, reflecting dietary guidelines, was favorably associated with aortic IMT and distensibility during the early life course. These data support the recommendation of favoring unsaturated fat to enhance arterial health.
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Affiliation(s)
- Tomi T Laitinen
- Research Centre of Applied and Preventive Cardiovascular Medicine and Centre for Population Health Research and .,Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Departments of Physical Activity and Health and
| | - Joel Nuotio
- Research Centre of Applied and Preventive Cardiovascular Medicine and Centre for Population Health Research and
| | - Suvi P Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine and Centre for Population Health Research and
| | | | | | - Costan G Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine and Centre for Population Health Research and.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Eero Jokinen
- Department of Pediatric Cardiology, University of Helsinki and Hospital for Children and Adolescents, Helsinki, Finland; and
| | | | - Antti Jula
- Department of Chronic Disease Prevention, Institute for Health and Welfare, Turku, Finland
| | | | | | - Olli Simell
- Research Centre of Applied and Preventive Cardiovascular Medicine and Centre for Population Health Research and
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine and Centre for Population Health Research and.,Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine and Centre for Population Health Research and.,Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Departments of Physical Activity and Health and
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23
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Naveed S, Lakka T, Haapala EA. An Overview on the Associations between Health Behaviors and Brain Health in Children and Adolescents with Special Reference to Diet Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E953. [PMID: 32033054 PMCID: PMC7037721 DOI: 10.3390/ijerph17030953] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 01/29/2020] [Accepted: 01/30/2020] [Indexed: 01/14/2023]
Abstract
Unhealthy diet has been associated with overweight, obesity, increased cardiometabolic risk, and recently, to impaired cognition and academic performance. The aim of this review is to provide an overview of the associations between health behaviors and cognition and academic achievement in children and adolescents under 18 years of age with a special reference to diet quality. Dietary patterns with a low consumption of fish, fruits, and vegetables, and high in fast food, sausages, and soft drinks have been linked to poor cognition and academic achievement. The studies on the associations between the high intake of saturated fat and red meat and low intake of fiber and high-fiber grain products with cognition are limited. The available evidence and physiological mechanisms suggest that diet may have direct, indirect, and synergistic effects on brain and cognition with physical activity, sedentary behaviors, cardiometabolic health, and sleep, but the associations have been modest. Therefore, integrating a healthy diet, physically active lifestyle, and adequate sleep may provide optimal circumstances for brain development and learning. We conclude that most of the existing literature is contained in cross-sectional studies, which therefore highlights the need for longitudinal and intervention studies on the effects of diet, physical activity, sedentary behavior, and sleep on cognition and academic performance.
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Affiliation(s)
- Sehrish Naveed
- Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, 70211 Kuopio, Finland; (T.L.); (E.A.H.)
| | - Timo Lakka
- Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, 70211 Kuopio, Finland; (T.L.); (E.A.H.)
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, 70211 Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, 70100 Kuopio, Finland
| | - Eero A. Haapala
- Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, 70211 Kuopio, Finland; (T.L.); (E.A.H.)
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland
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24
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Adolphus K, Lawton CL, Dye L. Associations Between Habitual School-Day Breakfast Consumption Frequency and Academic Performance in British Adolescents. Front Public Health 2019; 7:283. [PMID: 31824903 PMCID: PMC6879673 DOI: 10.3389/fpubh.2019.00283] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 09/18/2019] [Indexed: 11/13/2022] Open
Abstract
Studies indicate that breakfast positively affects learning in children. The present study aimed to examine associations between habitual school-day breakfast consumption frequency and academic performance, as measured by the General Certificate of Secondary Education (GCSE). The GCSE is a national academic qualification obtained by most British children during secondary education. Adolescents aged 16-18 years (n = 294; females: 77.2%) completed a retrospective 7-day food diary to report breakfast intake and a questionnaire to report GCSE grades. Breakfast was defined as any food or drink containing ≥5% of total energy expenditure (TEE) consumed up to 10:00 a.m. on school days. Habitual weekly school-day breakfast consumption frequency was categorized as rare (0-1 school days), occasional (2-3 school days), or frequent (4-5 school days). GCSE grades were aggregated into point scores and linear regression models were applied. Participants' GCSE grades in Mathematics and English were analyzed using ordinal logistic regression. Adolescents who rarely consumed breakfast on school days had a significantly lower capped point score (β = -0.13, p < 0.05) and mean point score (β = -0.14, p < 0.05) compared with frequent consumers. Low/middle socio-economic status (SES) adolescents who rarely consumed breakfast were significantly less likely to achieve higher Mathematics grades compared to low/middle SES adolescents who frequently consumed breakfast [adjusted cumulative odds ratio (OR): 0.35 95% confidence interval (CI): 0.17-0.72]. This cross-sectional study demonstrates that habitual school-day breakfast consumption amongst adolescents is a significant correlate of GCSE attainment. The results offer promising associative evidence which warrants further exploration in well controlled studies.
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Affiliation(s)
- Katie Adolphus
- Human Appetite Research Unit, School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Clare L Lawton
- Human Appetite Research Unit, School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Louise Dye
- Human Appetite Research Unit, School of Psychology, University of Leeds, Leeds, United Kingdom
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25
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Viitasalo A, Schnurr TM, Pitkänen N, Hollensted M, Nielsen TRH, Pahkala K, Atalay M, Lind MV, Heikkinen S, Frithioff-Bøjsøe C, Fonvig CE, Grarup N, Kähönen M, Carrasquilla GD, Larnkjaer A, Pedersen O, Michaelsen KF, Lakka TA, Holm JC, Lehtimäki T, Raitakari O, Hansen T, Kilpeläinen TO. Abdominal adiposity and cardiometabolic risk factors in children and adolescents: a Mendelian randomization analysis. Am J Clin Nutr 2019; 110:1079-1087. [PMID: 31504107 PMCID: PMC6904295 DOI: 10.1093/ajcn/nqz187] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 07/18/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Mendelian randomization studies in adults suggest that abdominal adiposity is causally associated with increased risk of type 2 diabetes and coronary artery disease in adults, but its causal effect on cardiometabolic risk in children remains unclear. OBJECTIVE We aimed to study the causal relation of abdominal adiposity with cardiometabolic risk factors in children by applying Mendelian randomization. METHODS We constructed a genetic risk score (GRS) using variants previously associated with waist-to-hip ratio adjusted for BMI (WHRadjBMI) and examined its associations with cardiometabolic factors by linear regression and Mendelian randomization in a meta-analysis of 6 cohorts, including 9895 European children and adolescents aged 3-17 y. RESULTS WHRadjBMI GRS was associated with higher WHRadjBMI (β = 0.021 SD/allele; 95% CI: 0.016, 0.026 SD/allele; P = 3 × 10-15) and with unfavorable concentrations of blood lipids (higher LDL cholesterol: β = 0.006 SD/allele; 95% CI: 0.001, 0.011 SD/allele; P = 0.025; lower HDL cholesterol: β = -0.007 SD/allele; 95% CI: -0.012, -0.002 SD/allele; P = 0.009; higher triglycerides: β = 0.007 SD/allele; 95% CI: 0.002, 0.012 SD/allele; P = 0.006). No differences were detected between prepubertal and pubertal/postpubertal children. The WHRadjBMI GRS had a stronger association with fasting insulin in children and adolescents with overweight/obesity (β = 0.016 SD/allele; 95% CI: 0.001, 0.032 SD/allele; P = 0.037) than in those with normal weight (β = -0.002 SD/allele; 95% CI: -0.010, 0.006 SD/allele; P = 0.605) (P for difference = 0.034). In a 2-stage least-squares regression analysis, each genetically instrumented 1-SD increase in WHRadjBMI increased circulating triglycerides by 0.17 mmol/L (0.35 SD, P = 0.040), suggesting that the relation between abdominal adiposity and circulating triglycerides may be causal. CONCLUSIONS Abdominal adiposity may have a causal, unfavorable effect on plasma triglycerides and potentially other cardiometabolic risk factors starting in childhood. The results highlight the importance of early weight management through healthy dietary habits and physically active lifestyle among children with a tendency for abdominal adiposity.
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Affiliation(s)
- Anna Viitasalo
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,Address correspondence to AV (e-mail: )
| | - Theresia M Schnurr
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niina Pitkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Mette Hollensted
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tenna R H Nielsen
- The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark,Department of Pediatrics, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland,Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Mustafa Atalay
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Mads V Lind
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Sami Heikkinen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Christine Frithioff-Bøjsøe
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark
| | - Cilius E Fonvig
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark,The Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland,Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center, Tampere University, Tampere, Finland
| | - Germán D Carrasquilla
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anni Larnkjaer
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kim F Michaelsen
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Timo A Lakka
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland,Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Jens-Christian Holm
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Terho Lehtimäki
- Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center, Tampere University, Tampere, Finland,Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tuomas O Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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26
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Genetic predisposition to higher body fat yet lower cardiometabolic risk in children and adolescents. Int J Obes (Lond) 2019; 43:2007-2016. [PMID: 31332278 DOI: 10.1038/s41366-019-0414-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 06/06/2019] [Accepted: 06/08/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Most obese children show cardiometabolic impairments, such as insulin resistance, dyslipidemia, and hypertension. Yet some obese children retain a normal cardiometabolic profile. The mechanisms underlying this variability remain largely unknown. We examined whether genetic loci associated with increased insulin sensitivity and relatively higher fat storage on the hip than on the waist in adults are associated with a normal cardiometabolic profile despite higher adiposity in children. METHODS We constructed a genetic score using variants previously linked to increased insulin sensitivity and/or decreased waist-hip ratio adjusted for body mass index (BMI), and examined the associations of this genetic score with adiposity and cardiometabolic impairments in a meta-analysis of six cohorts, including 7391 European children aged 3-18 years. RESULTS The genetic score was significantly associated with increased degree of obesity (higher BMI-SDS beta = 0.009 SD/allele, SE = 0.003, P = 0.003; higher body fat mass beta = 0.009, SE = 0.004, P = 0.031), yet improved body fat distribution (lower WHRadjBMI beta = -0.014 SD/allele, SE = 0.006, P = 0.016), and favorable concentrations of blood lipids (higher HDL cholesterol: beta = 0.010 SD/allele, SE = 0.003, P = 0.002; lower triglycerides: beta = -0.011 SD/allele, SE = 0.003, P = 0.001) adjusted for age, sex, and puberty. No differences were detected between prepubertal and pubertal/postpubertal children. The genetic score predicted a normal cardiometabolic profile, defined by the presence of normal glucose and lipid concentrations, among obese children (OR = 1.07 CI 95% 1.01-1.13, P = 0.012, n = 536). CONCLUSIONS Genetic predisposition to higher body fat yet lower cardiometabolic risk exerts its influence before puberty.
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Identifying eating habits in Finnish children: a cross-sectional study. BMC Public Health 2019; 19:312. [PMID: 30876472 PMCID: PMC6420733 DOI: 10.1186/s12889-019-6603-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 02/27/2019] [Indexed: 11/10/2022] Open
Abstract
Background We aimed to identify different eating habits among Finnish children and to evaluate their association with meal patterns, breakfast consumption, and socio-demographic characteristics in a large, nationwide cohort of children. Methods We evaluated 10,569 children aged 9–14 years into the Finnish Health in Teens cohort in a cross-sectional design. The hierarchical K-means method was used to identify groups of children with different eating habits, based on five factors obtained through factor analysis of 10 food items. Multiple correspondence analysis was used to show associations between groups with different eating habits and meal patterns, breakfast patterns, gender, age, and language spoken at home. Results Analyses identified three groups: unhealthy eaters (12.3%), fruit and vegetable avoiders (43.3%), and healthy eaters (44.1%). Most children had regular meal and breakfast patterns. The proportion of boys was higher among unhealthy eaters. Unhealthy eaters also showed irregular meal and breakfast patterns, and had parents with low education level. There was a higher proportion of girls among healthy eaters. Healthy eaters also showed regular meal and breakfast patterns, and had parents with high education level. Conclusions Although the number of unhealthy eaters was small, special attention should be still paid to these, mostly male children, as they have poor eating habits and they lack regular eating routine. Skipping breakfast was more common among older children and girls, although girls had healthier eating habits overall. Our results can contribute to public health efforts to improve eating behaviours, especially among children with poor eating habits and those skipping healthy food items.
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Viljakainen HT, Figueiredo RAO, Rounge TB, Weiderpass E. Picky eating - A risk factor for underweight in Finnish preadolescents. Appetite 2018; 133:107-114. [PMID: 30393153 DOI: 10.1016/j.appet.2018.10.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 08/22/2018] [Accepted: 10/22/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Picky eating (PE) is the most common cause of early-life feeding problems. However, the consequences of PE on food intake and weight development in general populations have not been established. OBJECTIVES This study aims to investigate the associations of PE and food neophobia (FN) with weight status in 5700 Finnish preadolescents. In addition, we described food consumption by PE/FN status. MATERIAL AND METHODS We utilised the Finnish Health in Teens (Fin-HIT) cohort of 9-12-year-old preadolescents, who were categorised as having PE and FN based on answers from parental questionnaires. Weight was categorised as underweight, normal weight, and overweight/obesity based on body mass index (BMI) according to IOTF age- and sex-specific cut-offs. Eating patterns were obtained with a 16-item food frequency questionnaire. Multinomial logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CIs). RESULTS The overall prevalence of PE and FN were 34% and 14%, respectively. PE was inversely associated with overweight/obesity (OR = 0.7; 95% CI 0.6-0.8) and led to a higher risk of underweight (OR = 2.0; 95% CI 1.7-2.4), while this was not observed with FN. Compared with preadolescents without PE/FN, those with PE/FN reported consuming unhealthy foods such as pizza, hamburgers/hot dogs, and salty snacks more frequently (p < 0.0038). By the same token, these preadolescents reported consuming healthy foods such as cooked vegetables, fresh vegetables/salad, fruit/berries, milk/soured milk, and dark bread less frequently. CONCLUSIONS Among Finnish preadolescents, only PE was associated with a higher risk for underweight and inversely with overweight/obesity. PE and FN were accompanied with unhealthy eating patterns. Management of PE in children may be explored as a potential strategy for improving healthy eating and avoiding underweight in preadolescents.
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Affiliation(s)
- Heli T Viljakainen
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland.
| | - Rejane A O Figueiredo
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Trine B Rounge
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Research, Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
| | - Elisabete Weiderpass
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Research, Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
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Lehto E, Ray C, Vepsäläinen H, Korkalo L, Lehto R, Kaukonen R, Suhonen E, Nislin M, Nissinen K, Skaffari E, Koivusilta L, Sajaniemi N, Erkkola M, Roos E. Increased Health and Wellbeing in Preschools (DAGIS) Study-Differences in Children's Energy Balance-Related Behaviors (EBRBs) and in Long-Term Stress by Parental Educational Level. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2313. [PMID: 30347875 PMCID: PMC6210204 DOI: 10.3390/ijerph15102313] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/16/2018] [Accepted: 10/18/2018] [Indexed: 01/01/2023]
Abstract
This paper describes the Increased Health and Wellbeing in Preschools (DAGIS) survey process and socioeconomic status (SES) differences in children's energy balance-related behaviors (EBRBs), meaning physical activity, sedentary and dietary behaviors, and long-term stress that serve as the basis for the intervention development. A cross-sectional survey was conducted during 2015⁻2016 in 66 Finnish preschools in eight municipalities involving 864 children (3⁻6 years old). Parents, preschool personnel, and principals assessed environmental factors at home and preschool with questionnaires. Measurement of children's EBRBs involved three-day food records, food frequency questionnaires (FFQ), seven-day accelerometer data, and seven-day sedentary behavior diaries. Children's long-term stress was measured by hair cortisol concentration. Parental educational level (PEL) served as an indicator of SES. Children with low PEL had more screen time, more frequent consumption of sugary beverages and lower consumption of vegetables, fruit, and berries (VFB) than those with high PEL. Children with middle PEL had a higher risk of consuming sugary everyday foods than children with high PEL. No PEL differences were found in children's physical activity, sedentary time, or long-term stress. The DAGIS intervention, aiming to diminish SES differences in preschool children's EBRBs, needs to have a special focus on screen time and consumption of sugary foods and beverages, and VFB.
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Affiliation(s)
- Elviira Lehto
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland.
- Faculty of Educational Sciences, University of Helsinki, P.O. Box 9, 00100 Helsinki, Finland.
| | - Carola Ray
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland.
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00100 Helsinki, Finland.
| | - Liisa Korkalo
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00100 Helsinki, Finland.
| | - Reetta Lehto
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland.
| | - Riikka Kaukonen
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland.
| | - Eira Suhonen
- Faculty of Educational Sciences, University of Helsinki, P.O. Box 9, 00100 Helsinki, Finland.
| | - Mari Nislin
- Department of Early Childhood Education, The Education University of Hong Kong, 10 Lo Ping Road, New Territories, Hong Kong.
| | - Kaija Nissinen
- School of Food and Agriculture, Seinäjoki University of Applied Sciences, P.O. Box 412, 60320 Seinäjoki, Finland.
| | - Essi Skaffari
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00100 Helsinki, Finland.
| | - Leena Koivusilta
- Department of Social Research, Faculty of Social Sciences, University of Turku, Assistentinkatu 7, 20500 Turku, Finland.
| | - Nina Sajaniemi
- Faculty of Educational Sciences, University of Helsinki, P.O. Box 9, 00100 Helsinki, Finland.
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00100 Helsinki, Finland.
| | - Eva Roos
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland.
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00100 Helsinki, Finland.
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Laitinen TT, Nuotio J, Juonala M, Niinikoski H, Rovio S, Viikari JSA, Rönnemaa T, Magnussen CG, Jokinen E, Lagström H, Jula A, Simell O, Raitakari OT, Pahkala K. Success in Achieving the Targets of the 20-Year Infancy-Onset Dietary Intervention: Association With Insulin Sensitivity and Serum Lipids. Diabetes Care 2018; 41:2236-2244. [PMID: 30072407 DOI: 10.2337/dc18-0869] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/14/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We examined whether success in achieving the key targets of an infancy-onset 20-year dietary intervention associated with insulin sensitivity and serum lipids from early childhood to young adulthood. RESEARCH DESIGN AND METHODS The sample comprised 941 children participating in the prospective, randomized Special Turku Coronary Risk Factor Intervention Project (STRIP). Dietary counseling was given biannually based on the Nordic Nutrition Recommendations with the main aim to improve the quality of dietary fat in children's diets and the secondary aim to promote intake of vegetables, fruits, and whole-grain products. Food records and serum lipid profile were studied annually from 1 to 20 years of age, and HOMA of insulin resistance (HOMA-IR) was assessed between 7 and 20 years of age. Meeting the intervention targets for quality of dietary fat was defined as the ratio of saturated fatty acids (SAFA) to monounsaturated and polyunsaturated fatty acids (MUFA + PUFA) <1:2 and intake of SAFA <10% of total energy intake (E%). Meeting the target for intake of whole-grain products, fruits, and vegetables was indicated by a fiber intake ≥3 g/MJ. RESULTS Participants in the intervention group had a higher probability of meeting the targets of SAFA/(PUFA + MUFA) <1:2 (risk ratio [RR] 3.91 [95% CI 3.33-4.61]), intake of SAFA <10 E% (RR 3.33 [95% CI 2.99-3.96]), and intake of fiber >3 g/MJ (RR 1.37 [95% CI 1.04-1.80]). Participants who achieved more targets had lower HOMA-IR, lower concentrations of fasting serum glucose, insulin, LDL cholesterol, and non-HDL cholesterol, and a lower ratio of apolipoprotein (Apo) B/ApoA1 (P values all ≤0.003). CONCLUSIONS Achieving the key targets of an infancy-onset 20-year dietary intervention was associated with better insulin sensitivity and serum lipid profile throughout the early life course.
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Affiliation(s)
- Tomi T Laitinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland .,Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Joel Nuotio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Markus Juonala
- Division of Medicine, Department of Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Harri Niinikoski
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Suvi Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Jorma S A Viikari
- Division of Medicine, Department of Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Tapani Rönnemaa
- Division of Medicine, Department of Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Costan G Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Eero Jokinen
- Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
| | - Hanna Lagström
- Department of Public Health, University of Turku, Turku, Finland
| | - Antti Jula
- Department of Chronic Disease Prevention, Institute for Health and Welfare, Turku, Finland
| | - Olli Simell
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
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Mäntyselkä A, Lindi V, Viitasalo A, Eloranta AM, Ågren J, Väisänen S, Voutilainen R, Laitinen T, Lakka TA, Jääskeläinen J. Associations of Dehydroepiandrosterone Sulfate With Cardiometabolic Risk Factors in Prepubertal Children. J Clin Endocrinol Metab 2018; 103:2592-2600. [PMID: 29757399 DOI: 10.1210/jc.2018-00184] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/07/2018] [Indexed: 02/13/2023]
Abstract
CONTEXT Premature adrenarche (PA) has been associated with overweight and insulin resistance, but the associations of serum dehydroepiandrosterone sulfate (DHEAS) concentration with other cardiometabolic risk factors are uncertain. OBJECTIVE To examine the associations of serum DHEAS concentration with several cardiometabolic risk factors in children. DESIGN Cross-sectional data from the Physical Activity and Nutrition in Children Study. PARTICIPANTS Population sample of 207 girls and 225 boys aged 7.6 ± 0.4 years. MAIN OUTCOME MEASURES Cardiometabolic risk factors by serum DHEAS concentration. RESULTS DHEAS correlated positively with body mass index standard deviation score, body fat percentage, lean body mass, high-sensitivity C-reactive protein (hs-CRP), and alanine aminotransferase (ALT) when adjusted for age and sex. The associations of DHEAS with hs-CRP and ALT disappeared when adjusted also for body fat percentage. When further adjusted for birth weight SD score, DHEAS correlated negatively with low-density lipoprotein (LDL) cholesterol and LDL/high-density lipoprotein (HDL) cholesterol ratio. LDL cholesterol was lower in children with DHEAS ≥40 µg/dL than in those with DHEAS <40 µg/dL, adjusted for age, sex, and body fat percentage (86.5 vs 92.3 mg/dL, P = 0.029). This association strengthened after further adjustment for birth weight SD score (85.3 vs 92.3 mg/dL, P = 0.012). CONCLUSION Higher DHEAS is not associated with an increased cardiometabolic risk in prepubertal children. Instead, it may be protective, evidenced by an association with lower LDL cholesterol and LDL/HDL cholesterol ratio. The increased cardiometabolic risk in PA shown in many studies may be due to low birth weight and childhood overweight associated with PA.
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Affiliation(s)
- Aino Mäntyselkä
- Department of Pediatrics, School of Medicine, Kuopio University Hospital, and University of Eastern Finland Kuopio, Finland
| | - Virpi Lindi
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Anna Viitasalo
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Aino-Maija Eloranta
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jyrki Ågren
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Sari Väisänen
- Department of Clinical Chemistry, University of Eastern Finland and Eastern Finland Laboratory Centre, Kuopio Finland
| | - Raimo Voutilainen
- Department of Pediatrics, School of Medicine, Kuopio University Hospital, and University of Eastern Finland Kuopio, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, School of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Timo A Lakka
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, School of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Jarmo Jääskeläinen
- Department of Pediatrics, School of Medicine, Kuopio University Hospital, and University of Eastern Finland Kuopio, Finland
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Mäntyselkä A, Jääskeläinen J, Eloranta AM, Väistö J, Voutilainen R, Ong K, Brage S, Lakka TA, Lindi V. Associations of lifestyle factors with serum dehydroepiandrosterone sulphate and insulin-like growth factor-1 concentration in prepubertal children. Clin Endocrinol (Oxf) 2018; 88:234-242. [PMID: 29112780 PMCID: PMC6195184 DOI: 10.1111/cen.13511] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/07/2017] [Accepted: 10/31/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Little is known about the relationships of dietary factors, physical activity and sedentary behaviour to dehydroepiandrosterone sulphate (DHEAS) and insulin-like growth factor-1 (IGF-1) concentrations among prepubertal children. Therefore, we studied the associations of these lifestyle factors with serum DHEAS and IGF-1 in children. DESIGN AND SUBJECTS Cross-sectional analysis of a population sample of 431 prepubertal children aged 6-9 years. MEASUREMENTS Assessment of dietary factors by food records and physical activity and sedentary behaviour by a combined heart rate and movement monitor and a questionnaire. Measurement of serum DHEAS and IGF-1. RESULTS Consumption of low-fibre grain products (standardized regression coefficient β = .118, P = .017) and intake of vegetable protein (β = .100, P = .045) was positively and consumption of sugar-sweetened beverages (β = -.117, P = .018) was inversely associated with DHEAS after adjustment for sex, age and body fat percentage. Energy intake (β = .160, P = .001) was positively associated with IGF-1 adjusting for sex, age and body fat percentage. Vigorous physical activity was inversely associated with DHEAS after adjustment for sex and age (β = -.120, P = .027), and total (β = -.137, P = .007), moderate (β = -.130, P = .012), vigorous (β = -.136, P = .011) and moderate to vigorous physical activity (β = -.160, P = .003) were inversely and total sedentary behaviour (β = .151, P = .003) was positively associated with IGF-1 adjusting for sex and age. None of physical activity measures was associated with DHEAS or IGF-1 after additional adjustment for body fat percentage. CONCLUSIONS Lifestyle factors have weak and moderate associations with biochemical markers of adrenarche in prepubertal children. These associations indicate body fat independent and dependent influences of diet and physical activity, respectively.
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Affiliation(s)
- Aino Mäntyselkä
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Jarmo Jääskeläinen
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Aino-Maija Eloranta
- Department of Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Juuso Väistö
- Department of Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Institute of Dentistry, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Raimo Voutilainen
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Ken Ong
- MRC Epidemiology Unit, University of Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, UK
| | - Timo A. Lakka
- Department of Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Virpi Lindi
- Department of Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
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Hauta-Alus HH, Korkalo L, Holmlund-Suila EM, Rosendahl J, Valkama SM, Enlund-Cerullo M, Helve OM, Hytinantti TK, Mäkitie OM, Andersson S, Viljakainen HT. Food and Nutrient Intake and Nutrient Sources in 1-Year-Old Infants in Finland: A Cross-Sectional Analysis. Nutrients 2017; 9:E1309. [PMID: 29194422 PMCID: PMC5748759 DOI: 10.3390/nu9121309] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/22/2017] [Accepted: 11/28/2017] [Indexed: 02/07/2023] Open
Abstract
The infant diet has short- and long-term health consequences. Updated data regarding the dietary intake of Finnish infants are lacking. The objectives of this study were to describe infant food and nutrient intake and to identify food sources of the nutrients. Altogether, 739 healthy infants were studied. Dietary intake and breastfeeding frequency were assessed with a three-day food record at 1 year of age. Dietary intake was calculated separately for non-breastfed and breastfed infants. One-third (36%) of the infants were partially breastfed and 95% consumed mass-produced baby foods. The infants' diet consisted mainly of infant formula, dairy milk, porridges, fruit and berry foods, and meat dishes. The mean vegetable, fruit and berry consumption was 199 g/day. Most nutrient intakes were adequate except for fat, linoleic acid, vitamin D and iron from food. Mean sucrose intake, as a percentage of total energy intake (E%), was 5-6 E%. High protein intake (>20 E%) was observed in 19% of non-breastfed infants. Overall, the infants' diet was favorable since vegetable and fruit consumption was reasonably high and nutrient intake was mostly adequate. However, the fat intake was lower, and protein intake higher than recommended. Increasing the consumption of vegetable oils and reducing the intake of red meat and dairy milk may further improve the diet of 1-year-olds.
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Affiliation(s)
- Helena H Hauta-Alus
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Liisa Korkalo
- Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland.
| | - Elisa M Holmlund-Suila
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Jenni Rosendahl
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Saara M Valkama
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Maria Enlund-Cerullo
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Otto M Helve
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Timo K Hytinantti
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Outi M Mäkitie
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
- Folkhälsan Research Center, Haartmaninkatu 8, P.O. Box 63, 00014 Helsinki, Finland.
- Center for Molecular Medicine, Karolinska Institute and Clinical Genetics, Karolinska University Hospital, Solna, 171 76 Stockholm, Sweden.
| | - Sture Andersson
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Heli T Viljakainen
- Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland.
- Folkhälsan Research Center, Haartmaninkatu 8, P.O. Box 63, 00014 Helsinki, Finland.
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Household income is associated with food and nutrient intake in Japanese schoolchildren, especially on days without school lunch. Public Health Nutr 2017; 20:2946-2958. [DOI: 10.1017/s1368980017001100] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveThe present study aimed to examine the association between household income and the intake of foods and nutrients by Japanese schoolchildren, and any differences between days with and without school lunch.DesignThis was a cross-sectional study. Children, with the support of their parents, kept dietary records with photographs for 4 d (2 d with school lunch and 2 d without). The socio-economic status of each family was obtained from a questionnaire completed by the parents.SettingJapan.SubjectsAll students in 5th grade (10–11 years old) at nineteen schools in four prefectures and their parents (1447 pairs of students and parents) were invited to take part in the study; 836 pairs of complete data sets were analysed.ResultsThe average results of four days of dietary records showed that lower income level was associated with a lower intake of fish/shellfish, green vegetables and sugar at the food group level, a lower intake of protein and several micronutrients, and a higher energy intake from carbohydrates at the nutrient level among the children. These associations between income and food/nutrient intake were not significant on days with school lunches, but were significant on days without school lunch.ConclusionsOur study confirmed an association between household income and the amount of foods and nutrients consumed by Japanese schoolchildren, and suggested that school lunches play a role in reducing disparities in the diets of children from households with various incomes.
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Vierola A, Suominen AL, Eloranta AM, Lintu N, Ikävalko T, Närhi M, Lakka TA. Determinants for craniofacial pains in children 6-8 years of age: the PANIC study. Acta Odontol Scand 2017. [PMID: 28622039 DOI: 10.1080/00016357.2017.1339908] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Determinants for orofacial pain, headache, morning headache and painful signs of temporomandibular disorders (TMD) were investigated in prepubertal children. MATERIAL AND METHODS The participants were a population sample of 439 children aged 6-8 years. Craniofacial pains, eating meals and snacks, sleep bruxism, sleep quality, sleep-disordered breathing (SDB), psychological well-being, parental education and household income were assessed by questionnaires filled out by the parents. Sleep duration was assessed using a combined heart rate and movement sensor and clinical signs of TMD and dental occlusion by a dentist. The determinants of pain conditions were analyzed using logistic regression. RESULTS Of all 439 children, 26% had experienced orofacial pain and 31% headache during the past 3 months, 17% had suffered morning headache weekly and 13% had painful signs of TMD in a clinical examination. Restless sleep was associated with increased risk of orofacial pain, the painful signs of TMD and restless sleep with increased risk of headache and restless sleep, sleep bruxism and skipping meals with increased risk of morning headache after adjustment for other independent determinants of these pain conditions. Headache was associated with increased risk for painful signs of TMD. CONCLUSIONS Craniofacial pains are common among prepubertal children. Prepubertal children with sleep bruxism, restless sleep and skipping meals have increased likelihood of craniofacial pains.
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Affiliation(s)
- Anu Vierola
- Department of Dentistry, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
- Department of Biomedicine/Physiology, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Anna Liisa Suominen
- Department of Dentistry, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Aino-Maija Eloranta
- Department of Biomedicine/Physiology, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Niina Lintu
- Department of Biomedicine/Physiology, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Tiina Ikävalko
- Department of Dentistry, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Matti Närhi
- Department of Dentistry, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
- Department of Biomedicine/Physiology, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Timo A. Lakka
- Department of Biomedicine/Physiology, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
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Jalkanen H, Lindi V, Schwab U, Kiiskinen S, Venäläinen T, Karhunen L, Lakka T, Eloranta A. Eating behaviour is associated with eating frequency and food consumption in 6–8 year-old children: The Physical Activity and Nutrition in Children (PANIC) study. Appetite 2017; 114:28-37. [DOI: 10.1016/j.appet.2017.03.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 01/13/2017] [Accepted: 03/09/2017] [Indexed: 01/28/2023]
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Haapala EA, Viitasalo A, Venäläinen T, Eloranta AM, Ågren J, Lindi V, Lakka TA. Plasma polyunsaturated fatty acids are directly associated with cognition in overweight children but not in normal weight children. Acta Paediatr 2016; 105:1502-1507. [PMID: 27644481 DOI: 10.1111/apa.13596] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 07/08/2016] [Accepted: 09/15/2016] [Indexed: 12/14/2022]
Abstract
AIM Polyunsaturated fatty acids are essential nutrients for the normal development of the brain. We investigated the associations between plasma polyunsaturated fatty acids and cognition in normal weight and overweight children. METHODS The study recruited 386 normal weight children and 58 overweight children aged six to eight years and blood samples were drawn after a 12-hour fast. We assessed plasma polyunsaturated fatty acids using gas chromatography, cognition using Raven's Coloured Progressive Matrices, and overweight and obesity using the age-specific and sex-specific cut-offs from the International Obesity Task Force. The data were analysed by linear regression analyses adjusted for age and sex. RESULTS Higher proportions of eicosapentaenoic acid in plasma triacylglycerols (β = 0.311, p = 0.020, p = 0.029 for interaction) and docosahexaenoic acid in plasma triacylglycerols (β = 0.281, p = 0.038, p = 0.049 for interaction) were both associated with higher Raven's scores in overweight children but not in normal weight children. Higher eicosapentaenoic acid to arachidonic acid ratios in triacylglycerols (β = 0.317, p = 0.019) and phospholipids (β = 0.273, p = 0.046) were directly associated with the Raven's score in overweight children but not in normal weight children. CONCLUSION These findings suggest that increasing the consumption of fish and other sources of eicosapentaenoic acid and docosahexaenoic acid may improve cognition among overweight children.
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Affiliation(s)
- EA Haapala
- Institute of Biomedicine; School of Medicine; University of Eastern Finland; Kuopio Finland
- Childhood Health and Active Living Research Group; Department of Biology of Physical Activity; University of Jyväskylä; Jyväskylä Finland
| | - A Viitasalo
- Institute of Biomedicine; School of Medicine; University of Eastern Finland; Kuopio Finland
| | - T Venäläinen
- Institute of Biomedicine; School of Medicine; University of Eastern Finland; Kuopio Finland
| | - A-M Eloranta
- Institute of Biomedicine; School of Medicine; University of Eastern Finland; Kuopio Finland
| | - J Ågren
- Institute of Biomedicine; School of Medicine; University of Eastern Finland; Kuopio Finland
| | - V Lindi
- Institute of Biomedicine; School of Medicine; University of Eastern Finland; Kuopio Finland
| | - TA Lakka
- Institute of Biomedicine; School of Medicine; University of Eastern Finland; Kuopio Finland
- Department of Clinical Physiology and Nuclear Medicine; Kuopio University Hospital and University of Eastern Finland; Kuopio Finland
- Kuopio Research Institute of Exercise Medicine; Kuopio Finland
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Socio-economic disparities in the diet of French children and adolescents: a multidimensional issue. Public Health Nutr 2016; 20:870-882. [PMID: 27846923 DOI: 10.1017/s1368980016002895] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The present research aimed to study the multidimensionality of the link between dietary intake and socio-economic position (SEP) in a representative sample of French children and adolescents, using a variety of SEP indicators. DESIGN Data from the second French national food consumption survey (INCA2) were used. Information on food consumption was collected using a 7d food record and SEP data (occupation, education, income, household wealth indices) using questionnaires. Multivariable linear regression analyses were performed separately in children and adolescents to assess the relationships between dietary components (food groups and macronutrients) and each dimension of SEP. SETTING The INCA2 survey, France. SUBJECTS A representative sample of French children (3-10 years of age; n 574) and adolescents (11-17 years of age; n 881). RESULTS Compared with children from a higher SEP, those from a lower SEP had lower intakes of fruit and vegetables, yoghurts and confectionery and higher intakes of starchy foods, meat, milk, sugar-sweetened beverages and pizzas/sandwiches. Similar results were observed in adolescents for fruit and vegetables, yoghurts and sugar-sweetened beverages. Adolescents also had lower intakes of cakes/pastries and higher intakes of processed meat and dairy desserts. Neither energy nor protein intake was associated with SEP. Adolescents from a lower SEP had higher carbohydrate and lower lipid intakes. Overall, these findings were consistent across the various dimensions of SEP, but the gradient was steeper depending on the caregiver's educational level. CONCLUSIONS This research highlights the need for specific messages to help poorly educated families adopt good eating habits.
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Eloranta AM, Venäläinen T, Soininen S, Jalkanen H, Kiiskinen S, Schwab U, Lakka TA, Lindi V. Food sources of energy and nutrients in Finnish girls and boys 6-8 years of age - the PANIC study. Food Nutr Res 2016; 60:32444. [PMID: 27702428 PMCID: PMC5045967 DOI: 10.3402/fnr.v60.32444] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/16/2016] [Accepted: 08/16/2016] [Indexed: 11/30/2022] Open
Abstract
Background Data on food sources of nutrients are needed to improve strategies to enhance nutrient intake among girls and boys in Western countries. Objective To identify major food sources of energy, energy nutrients, dietary fibre, and micronutrients, and to study gender differences in these food sources among children. Design We assessed food consumption and nutrient intake using 4-day food records in a population sample of Finnish girls (n=213) and boys (n=217) aged 6–8 years from the Physical Activity and Nutrition in Children Study. We calculated the percentual contribution of 55 food groups for energy and nutrient intake using the population proportion method. Results Low-fibre grain products, skimmed milk, and high-fibre bread provided almost 23% of total energy intake. Skimmed milk was the top source of protein (18% of total intake), vitamin D (32%), potassium (20%), calcium (39%), magnesium (17%), and zinc (16%). Vegetable oils (15%) and high-fat vegetable oil–based spreads (14%) were the top sources of polyunsaturated fat. High-fibre bread was the top source of fibre (27%) and iron (12%). Non-root vegetables were the top source of folate (14%) and vitamin C (22%). Sugar-sweetened beverages provided 21% of sucrose intake. Pork was a more important source of protein and sausage was a more important source of total fat and monounsaturated fat in boys than in girls. Vegetable oils provided a higher proportion of unsaturated fat and vitamin E among boys, whereas high-fat vegetable oil–based spreads provided a higher proportion of these nutrients among girls. Conclusion Commonly recommended foods, such as skimmed milk, high-fibre grain products, vegetables, vegetable oil, and vegetable oil–based spreads, were important sources of several nutrients, whereas sugar-sweetened beverages provided the majority of sucrose intake among children. This knowledge can be used in improving health among children by dietary interventions, nutrition education, and health policy decision making.
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Affiliation(s)
- Aino-Maija Eloranta
- Department of Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland;
| | - Taisa Venäläinen
- Department of Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Sonja Soininen
- Department of Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Social and Health Center, City of Varkaus, Finland.,Institute of Dentistry, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Henna Jalkanen
- Department of Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Sanna Kiiskinen
- Department of Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ursula Schwab
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Internal Medicine, Institute of Clinical Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Timo A Lakka
- Department of Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Virpi Lindi
- Department of Physiology, Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
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Haapala EA, Eloranta AM, Venäläinen T, Jalkanen H, Poikkeus AM, Ahonen T, Lindi V, Lakka TA. Diet quality and academic achievement: a prospective study among primary school children. Eur J Nutr 2016; 56:2299-2308. [DOI: 10.1007/s00394-016-1270-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 07/11/2016] [Indexed: 12/19/2022]
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Viitasalo A, Pihlajamäki J, Paananen J, Atalay M, Lindi V, Lakka TA. Associations of TM6SF2 167K allele with liver enzymes and lipid profile in children: the PANIC Study. Pediatr Res 2016; 79:684-8. [PMID: 26756786 DOI: 10.1038/pr.2016.3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 10/28/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND The 167K allele in the TM6SF2 gene has been suggested to protect against cardiovascular disease at the cost of developing nonalcoholic fatty liver disease in adults. METHODS We performed a cross-sectional study in a population sample of 462 Caucasian children aged 6-9 y, genotyped the polymorphism using HumanCoreExome BeadChip, and assessed several cardiometabolic risk factors. RESULTS The 51 (11%) carriers of the 167K allele had higher plasma alanine aminotransferase (ALT) (20.8 vs. 18.4 U/l, P = 0.011) but lower plasma triglycerides (0.54 vs. 0.61 mmol/l, P = 0.024), total cholesterol (4.08 vs. 4.30 mmol/l, P = 0.016), and low-density lipoprotein (LDL) cholesterol (2.22 vs. 2.38 mmol/l, P = 0.012) than the 411 noncarriers. In factor analysis, the first factor was heavily loaded by plasma ALT (factor loading 0.63), triglycerides (-0.82), LDL cholesterol (-0.71), and waist circumference (0.61) in the carriers but not in the noncarriers. CONCLUSIONS The carriers of the 167K allele have higher plasma ALT but lower plasma triglycerides and total and LDL cholesterol than the noncarriers already in childhood.
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Affiliation(s)
- Anna Viitasalo
- Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Jussi Pihlajamäki
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Nutrition and Obesity Center, Kuopio University Hospital, Kuopio, Finland
| | - Jussi Paananen
- Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland.,Institute of Biomedicine, Bioinformatics Center, University of Eastern Finland, Kuopio, Finland
| | - Mustafa Atalay
- Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Virpi Lindi
- Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Timo A Lakka
- Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland.,Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
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Determinants of serum 25-hydroxyvitamin D concentration in Finnish children: the Physical Activity and Nutrition in Children (PANIC) study. Br J Nutr 2016; 115:1080-91. [PMID: 26836317 DOI: 10.1017/s0007114515005292] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We studied vitamin D intake, serum 25-hydroxyvitamin D (S-25(OH)D) concentration, determinants of S-25(OH)D and risk factors for S-25(OH)D <50 nmol/l in a population sample of Finnish children. We studied 184 girls and 190 boys aged 6-8 years, analysed S-25(OH)D by chemiluminescence immunoassay and assessed diet quality using 4-d food records and other lifestyle factors by questionnaires. We analysed the determinants of S-25(OH)D using linear regression and risk factors for S-25(OH)D <50 nmol/l using logistic regression. Mean dietary intake of vitamin D was 5·9 (sd 2·1) µg/d. Altogether, 40·8 % of children used no vitamin D supplements. Of all children, 82·4 % did not meet the recommended total vitamin D intake of 10 µg/d. Milk fortified with vitamin D was the main dietary source of vitamin D, providing 48·7 % of daily intake. S-25(OH)D was <50 nmol/l in 19·5 % of children. Consumption of milk products was the main determinant of S-25(OH)D in all children (standardised regression coefficient β=0·262; P<0·001), girls (β=0·214; P=0·009) and boys (β=0·257; P=0·003) in multivariable models. Vitamin D intake from supplements (β=0·171; P=0·035) and age (β=-0·198; P=0·015) were associated with S-25(OH)D in girls. Children who drank ≥450 g/d of milk, spent ≥2·2 h/d in physical activity, had ≥13·1 h/d of daylight time or were examined in autumn had reduced risk for S-25(OH)D <50 nmol/l. Insufficient vitamin D intake was common among Finnish children, one-fifth of whom had S-25(OH)D <50 nmol/l. More attention should be paid to the sufficient intake of vitamin D from food and supplements, especially among children who do not use fortified milk products.
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Qi Q, Downer MK, Kilpeläinen TO, Taal HR, Barton SJ, Ntalla I, Standl M, Boraska V, Huikari V, Kiefte-de Jong JC, Körner A, Lakka TA, Liu G, Magnusson J, Okuda M, Raitakari O, Richmond R, Scott RA, Bailey MES, Scheuermann K, Holloway JW, Inskip H, Isasi CR, Mossavar-Rahmani Y, Jaddoe VWV, Laitinen J, Lindi V, Melén E, Pitsiladis Y, Pitkänen N, Snieder H, Heinrich J, Timpson NJ, Wang T, Yuji H, Zeggini E, Dedoussis GV, Kaplan RC, Wylie-Rosett J, Loos RJF, Hu FB, Qi L. Dietary Intake, FTO Genetic Variants, and Adiposity: A Combined Analysis of Over 16,000 Children and Adolescents. Diabetes 2015; 64:2467-76. [PMID: 25720386 PMCID: PMC4876751 DOI: 10.2337/db14-1629] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 02/12/2015] [Indexed: 12/26/2022]
Abstract
The FTO gene harbors variation with the strongest effect on adiposity and obesity risk. Previous data support a role for FTO variation in influencing food intake. We conducted a combined analysis of 16,094 boys and girls aged 1-18 years from 14 studies to examine the following: 1) the association between the FTO rs9939609 variant (or a proxy) and total energy and macronutrient intake; and 2) the interaction between the FTO variant and dietary intake, and the effect on BMI. We found that the BMI-increasing allele (minor allele) of the FTO variant was associated with increased total energy intake (effect per allele = 14.3 kcal/day [95% CI 5.9, 22.7 kcal/day], P = 6.5 × 10(-4)), but not with protein, carbohydrate, or fat intake. We also found that protein intake modified the association between the FTO variant and BMI (interactive effect per allele = 0.08 SD [0.03, 0.12 SD], P for interaction = 7.2 × 10(-4)): the association between FTO genotype and BMI was much stronger in individuals with high protein intake (effect per allele = 0.10 SD [0.07, 0.13 SD], P = 8.2 × 10(-10)) than in those with low intake (effect per allele = 0.04 SD [0.01, 0.07 SD], P = 0.02). Our results suggest that the FTO variant that confers a predisposition to higher BMI is associated with higher total energy intake, and that lower dietary protein intake attenuates the association between FTO genotype and adiposity in children and adolescents.
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Affiliation(s)
- Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY Department of Nutrition, Harvard School of Public Health, Boston, MA
| | - Mary K Downer
- Department of Nutrition, Harvard School of Public Health, Boston, MA
| | - Tuomas O Kilpeläinen
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital and University of Cambridge, Cambridge, U.K. The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - H Rob Taal
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands Department of Pediatrics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Sheila J Barton
- MRC Lifecourse Epidemiology Unit, Faculty of Medicine, University of Southampton, Southampton, U.K
| | - Ioanna Ntalla
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece Department of Health Sciences, University of Leicester, Leicester, U.K
| | - Marie Standl
- Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Vesna Boraska
- Wellcome Trust Sanger Institute, Hixton, Cambridge, U.K. Department of Medical Biology, University of Split School of Medicine, Split, Croatia
| | - Ville Huikari
- Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands Global Public Health, Leiden University College, Hague, the Netherlands
| | - Antje Körner
- Pediatric Research Center, Department of Women's & Child Health, University of Leipzig, Leipzig, Germany
| | - Timo A Lakka
- Institute of Biomedicine, Department of Physiology, University of Eastern Finland, Kuopio, Finland Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Gaifen Liu
- Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jessica Magnusson
- Institute of Environmental Medicine, Karolinska Institutet, and Sachs' Children and Youth Hospital, Stockholm, Sweden
| | - Masayuki Okuda
- Graduate School of Science and Engineering, Yamaguchi University, Ube, Japan
| | - Olli Raitakari
- The Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Rebecca Richmond
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, U.K
| | - Robert A Scott
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital and University of Cambridge, Cambridge, U.K
| | - Mark E S Bailey
- School of Life Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, U.K
| | - Kathrin Scheuermann
- Pediatric Research Center, Department of Women's & Child Health, University of Leipzig, Leipzig, Germany
| | - John W Holloway
- Human Genetics and Medical Genomics, Faculty of Medicine, University of Southampton, Southampton, U.K
| | - Hazel Inskip
- MRC Lifecourse Epidemiology Unit, Faculty of Medicine, University of Southampton, Southampton, U.K
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands Department of Pediatrics, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Virpi Lindi
- Institute of Biomedicine, Department of Physiology, University of Eastern Finland, Kuopio, Finland
| | - Erik Melén
- Institute of Environmental Medicine, Karolinska Institutet, and Sachs' Children and Youth Hospital, Stockholm, Sweden
| | - Yannis Pitsiladis
- School of Life Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, U.K
| | - Niina Pitkänen
- The Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands Georgia Prevention Center, Department of Pediatrics, Georgia Regents University, Augusta, GA
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | | | - Tao Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Hinoda Yuji
- Hokkaido Nursing College, Chuo-ku, Sapporo, Japan
| | | | - George V Dedoussis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Judith Wylie-Rosett
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Ruth J F Loos
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital and University of Cambridge, Cambridge, U.K. The Genetics of Obesity and Related Metabolic Traits Program, The Charles Bronfman Institute for Personalized Medicine, The Mindich Child Health and Development Institute, Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY
| | - Frank B Hu
- Department of Nutrition, Harvard School of Public Health, Boston, MA Department of Epidemiology, Harvard School of Public Health, Boston, MA Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Lu Qi
- Department of Nutrition, Harvard School of Public Health, Boston, MA Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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Viitasalo A, Pihlajamaki J, Lindi V, Atalay M, Kaminska D, Joro R, Lakka TA. Associations of I148M variant in PNPLA3 gene with plasma ALT levels during 2-year follow-up in normal weight and overweight children: the PANIC Study. Pediatr Obes 2015; 10:84-90. [PMID: 24916969 DOI: 10.1111/ijpo.234] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 03/24/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVES PNPLA3 I148M polymorphism (rs738409) has been strongly associated with liver fat content and plasma alanine aminotransferase (ALT) levels in obese adults and children, but little is known about these relationships in normal weight individuals. We studied the associations and interactions of overweight and the PNPLA3 I148M polymorphism with plasma ALT levels during 2-year follow-up in children. METHODS Subjects were a population sample of 481 Caucasian children aged 6-8 years examined at baseline and 419 children re-examined after 2-year follow-up. Altogether, 58 (12%) of 481 children at baseline and 71 (17%) of 419 children after 2-year follow-up were overweight. We assessed plasma ALT levels and other cardiometabolic risk factors and genotyped the PNPLA3 I148M polymorphism. RESULTS Being overweight and carrying PNPLA3 148M allele were associated with increased ALT levels at baseline (P = 0.002; P = 0.033) and after 2-year follow-up (P < 0.001; P = 0.001). Being overweight (P < 0.001) and carrying PNPLA3 148M allele (P = 0.001) were also associated with increase in ALT levels during 2-year follow-up. PNPLA3 148M allele carriers had increased ALT levels at baseline (P = 0.024 for interaction) and after 2-year follow-up (P = 0.002 for interaction) as well as a larger increase in ALT levels during 2-year follow-up (P = 0.002 for interaction) if they were overweight but not if they were normal weight. Further adjustment for clinical puberty, dietary factors, physical activity or sedentary behaviour had little or no effect on these associations. CONCLUSION PNPLA3 148M allele carriers had higher plasma ALT levels and larger increase in ALT levels during follow-up than non-carriers only among overweight children.
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Affiliation(s)
- A Viitasalo
- Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland; Institute of Dentistry, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
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Kyttälä P, Erkkola M, Lehtinen-Jacks S, Ovaskainen ML, Uusitalo L, Veijola R, Simell O, Knip M, Virtanen SM. Finnish Children Healthy Eating Index (FCHEI) and its associations with family and child characteristics in pre-school children. Public Health Nutr 2014; 17:2519-27. [PMID: 24152429 PMCID: PMC10284681 DOI: 10.1017/s1368980013002772] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 09/04/2013] [Accepted: 09/04/2013] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The objective was to develop a Finnish Children Healthy Eating Index (FCHEI), to determine the relative validity of the index and to examine associations between the index and familial sociodemographic and lifestyle characteristics. DESIGN Cross-sectional samples of children participating in a population-based birth cohort study in Finland. SETTING Type I Diabetes Prediction and Prevention (DIPP) Study cohort. SUBJECTS Three-day food records from 1-year-old (n 455), 3-year-old (n 471) and 6-year-old (n 713) children were completed between 2003 and 2005. RESULTS Validity of the FCHEI was assessed by studying the associations between the FCHEI and nutrient intakes of the children. Among all age groups, intakes of SFA and sugars decreased across increasing quartiles of the FCHEI while intakes of PUFA, dietary fibre, vitamin D and vitamin E increased. Among 3- and 6-year-olds, being cared for at home was associated with the lowest FCHEI quartile (diet that deviates most from the recommendations). The lowest FCHEI quartile was also associated with residence in a semi-urban area among the 3-year-olds and low maternal education and smoking during pregnancy among the 6-year-olds. CONCLUSIONS The FCHEI serves as a valid indicator of the quality of Finnish children's diet. Public health programmes aimed at improving the dietary behaviours of pre-school aged children should aim to improve the quality of food served at home. Families with history of lower parental education, maternal smoking during pregnancy or non-urban place of residence may require special attention.
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Affiliation(s)
- Pipsa Kyttälä
- School of Health Sciences, FI-33014 University of Tampere, Tampere, Finland
- Unit of Nutrition, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland
| | - Maijaliisa Erkkola
- Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Susanna Lehtinen-Jacks
- School of Health Sciences, FI-33014 University of Tampere, Tampere, Finland
- Unit of Nutrition, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland
- The Science Center of Pirkanmaa Hospital District, Tampere, Finland
| | - Marja-Leena Ovaskainen
- Unit of Nutrition, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland
| | - Liisa Uusitalo
- Unit of Nutrition, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland
| | - Riitta Veijola
- Department of Paediatrics, University of Oulu, Oulu, Finland
| | - Olli Simell
- Department of Paediatrics, University of Turku, Turku, Finland
| | - Mikael Knip
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Research Center for Child Health, Tampere University Hospital, Tampere, Finland
| | - Suvi Mirjami Virtanen
- School of Health Sciences, FI-33014 University of Tampere, Tampere, Finland
- Unit of Nutrition, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland
- The Science Center of Pirkanmaa Hospital District, Tampere, Finland
- Research Center for Child Health, Tampere University Hospital, Tampere, Finland
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Väistö J, Eloranta AM, Viitasalo A, Tompuri T, Lintu N, Karjalainen P, Lampinen EK, Ågren J, Laaksonen DE, Lakka HM, Lindi V, Lakka TA. Physical activity and sedentary behaviour in relation to cardiometabolic risk in children: cross-sectional findings from the Physical Activity and Nutrition in Children (PANIC) Study. Int J Behav Nutr Phys Act 2014; 11:55. [PMID: 24766669 PMCID: PMC4008488 DOI: 10.1186/1479-5868-11-55] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 04/16/2014] [Indexed: 12/12/2022] Open
Abstract
Background Lower levels of physical activity (PA) and sedentary behaviour (SB) have been associated with increased cardiometabolic risk among children. However, little is known about the independent and combined associations of PA and SB as well as different types of these behaviours with cardiometabolic risk in children. We therefore investigated these relationships among children. Methods The subjects were a population sample of 468 children 6–8 years of age. PA and SB were assessed by a questionnaire administered by parents and validated by a monitor combining heart rate and accelerometry measurements. We assessed body fat percentage, waist circumference, blood glucose, serum insulin, plasma lipids and lipoproteins and blood pressure and calculated a cardiometabolic risk score using population-specific Z-scores and a formula waist circumference + insulin + glucose + triglycerides - HDL cholesterol + mean of systolic and diastolic blood pressure. We analysed data using multivariate linear regression models. Results Total PA was inversely associated with the cardiometabolic risk score (β = -0.135, p = 0.004), body fat percentage (β = -0.155, p < 0.001), insulin (β = -0.099, p = 0.034), triglycerides (β = -0.166, p < 0.001), VLDL triglycerides (β = -0.230, p < 0.001), VLDL cholesterol (β = -0.168, p = 0.001), LDL cholesterol (β = -0.094, p = 0.046) and HDL triglycerides (β = -0.149, p = 0.004) and directly related to HDL cholesterol (β = 0.144, p = 0.002) adjusted for age and gender. Unstructured PA was inversely associated with the cardiometabolic risk score (β = -0.123, p = 0.010), body fat percentage (β = -0.099, p = 0.027), insulin (β = -0.108, p = 0.021), triglycerides (β = -0.144, p = 0.002), VLDL triglycerides (β = -0.233, p < 0.001) and VLDL cholesterol (β = -0.199, p < 0.001) and directly related to HDL cholesterol (β = 0.126, p = 0.008). Watching TV and videos was directly related to the cardiometabolic risk score (β = 0.135, p = 0.003), body fat percentage (β = 0.090, p = 0.039), waist circumference (β = 0.097, p = 0.033) and systolic blood pressure (β = 0.096, p = 0.039). Resting was directly associated with the cardiometabolic risk score (β = 0.092, p = 0.049), triglycerides (β = 0.131, p = 0.005), VLDL triglycerides (β = 0.134, p = 0.009), VLDL cholesterol (β = 0.147, p = 0.004) and LDL cholesterol (β = 0.105, p = 0.023). Other types of PA and SB had less consistent associations with cardiometabolic risk factors. Conclusions The results of our study emphasise increasing total and unstructured PA and decreasing watching TV and videos and other sedentary behaviours to reduce cardiometabolic risk among children. Trial registration ClinicalTrials.gov Identifier:
NCT01803776.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Timo A Lakka
- Institute of Biomedicine, Physiology, University of Eastern Finland, Kuopio, Finland.
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Dietary factors associated with metabolic risk score in Finnish children aged 6–8 years: the PANIC study. Eur J Nutr 2013; 53:1431-9. [DOI: 10.1007/s00394-013-0646-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 12/18/2013] [Indexed: 10/25/2022]
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48
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Fairclough SJ, Hackett AF, Davies IG, Gobbi R, Mackintosh KA, Warburton GL, Stratton G, van Sluijs EMF, Boddy LM. Promoting healthy weight in primary school children through physical activity and nutrition education: a pragmatic evaluation of the CHANGE! randomised intervention study. BMC Public Health 2013; 13:626. [PMID: 23819701 PMCID: PMC3733685 DOI: 10.1186/1471-2458-13-626] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 06/28/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This pragmatic evaluation investigated the effectiveness of the Children's Health, Activity and Nutrition: Get Educated! (CHANGE!) Project, a cluster randomised intervention to promote healthy weight using an educational focus on physical activity and healthy eating. METHODS Participants (n = 318, aged 10-11 years) from 6 Intervention and 6 Comparison schools took part in the 20 weeks intervention between November 2010 and March/April 2011. This consisted of a teacher-led curriculum, learning resources, and homework tasks. Primary outcome measures were waist circumference, body mass index (BMI), and BMI z-scores. Secondary outcomes were objectively-assessed physical activity and sedentary time, and food intake. Outcomes were assessed at baseline, at post-intervention (20 weeks), and at follow-up (30 weeks). Data were analysed using 2-level multi-level modelling (levels: school, student) and adjusted for baseline values of the outcomes and potential confounders. Differences in intervention effect by subgroup (sex, weight status, socio-economic status) were explored using statistical interaction. RESULTS Significant between-group effects were observed for waist circumference at post-intervention (β for intervention effect =-1.63 (95% CI = -2.20, -1.07) cm, p<0.001) and for BMI z-score at follow-up (β=-0.24 (95% CI = -0.48, -0.003), p=0.04). At follow-up there was also a significant intervention effect for light intensity physical activity (β=25.97 (95% CI = 8.04, 43.89) min, p=0.01). Interaction analyses revealed that the intervention was most effective for overweight/obese participants (waist circumference: β=-2.82 (95% CI = -4.06, -1.58) cm, p<0.001), girls (BMI: β=-0.39 (95% CI = -0.81, 0.03) kg/m2, p=0.07), and participants with higher family socioeconomic status (breakfast consumption: β=8.82 (95% CI = 6.47, 11.16), p=0.07). CONCLUSIONS The CHANGE! intervention positively influenced body size outcomes and light physical activity, and most effectively influenced body size outcomes among overweight and obese children and girls. The findings add support for the effectiveness of combined school-based physical activity and nutrition interventions. Additional work is required to test intervention fidelity and the sustained effectiveness of this intervention in the medium and long term. TRIAL REGISTRATION Current Controlled Trials ISRCTN03863885.
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Affiliation(s)
- Stuart J Fairclough
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 62, Great Crosshall Street, Liverpool, UK.
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Rauber F, da Costa Louzada ML, Feldens CA, Vitolo MR. Maternal and family characteristics associated with the Healthy Eating Index among low socioeconomic status Brazilian children. J Hum Nutr Diet 2012. [DOI: 10.1111/jhn.12005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- F. Rauber
- Federal University of Health Sciences of Porto Alegre (UFCSPA); Porto Alegre RS Brazil
| | | | - C. A. Feldens
- Lutheran University of Brazil (ULBRA); Bairro São José Canoas RS Brazil
| | - M. R. Vitolo
- Federal University of Health Sciences of Porto Alegre (UFCSPA); Porto Alegre RS Brazil
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Viitasalo A, Laaksonen DE, Lindi V, Eloranta AM, Jääskeläinen J, Tompuri T, Väisänen S, Lakka HM, Lakka TA. Clustering of Metabolic Risk Factors Is Associated with High-Normal Levels of Liver Enzymes Among 6- to 8-Year-Old Children: The PANIC Study. Metab Syndr Relat Disord 2012; 10:337-43. [DOI: 10.1089/met.2012.0015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Affiliation(s)
- Anna Viitasalo
- Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - David E. Laaksonen
- Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
- Department of Internal Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Virpi Lindi
- Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Aino-Maija Eloranta
- Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
- Department of Public Health, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | | | - Tuomo Tompuri
- Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Sari Väisänen
- Department of Clinical Chemistry, Kuopio University Hospital, Kuopio, Finland
| | - Hanna-Maaria Lakka
- Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
- Department of Public Health, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Timo A. Lakka
- Department of Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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