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Adise S, Ottino-Gonzalez J, Hayati Rezvan P, Kan E, Rhee KE, Goran MI, Sowell ER. Smaller subcortical volume relates to greater weight gain in girls with initially healthy weight. Obesity (Silver Spring) 2024. [PMID: 38710591 DOI: 10.1002/oby.24028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVE Among 3614 youth who were 9 to 12 years old and initially did not have overweight or obesity (12% [n = 385] developed overweight or obesity), we examined the natural progression of weight gain and brain structure development during a 2-year period with a high risk for obesity (e.g., pre- and early adolescence) to determine the following: 1) whether variation in maturational trajectories of the brain regions contributes to weight gain; and/or 2) whether weight gain contributes to altered brain development. METHODS Data were gathered from the Adolescent Brain Cognitive Development (ABCD) Study. Linear mixed-effects regression models controlled for puberty, caregiver education, handedness, and intracranial volume (random effects: magnetic resonance scanner [MRI] scanner and participant). Because pubertal development occurs earlier in girls, analyses were stratified by sex. RESULTS For girls, but not boys, independent of puberty, greater increases in BMI were driven by smaller volumes over time in the bilateral accumbens, amygdala, hippocampus, and thalamus, right caudate and ventral diencephalon, and left pallidum (all p < 0.05). CONCLUSIONS The results suggest a potential phenotype for identifying obesity risk because underlying differences among regions involved in food intake were related to greater weight gain in girls, but not in boys. Importantly, 2 years of weight gain may not be sufficient to alter brain development, highlighting early puberty as a critical time to prevent negative neurological outcomes.
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Affiliation(s)
- Shana Adise
- Division of Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Jonatan Ottino-Gonzalez
- Division of Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Panteha Hayati Rezvan
- Biostatistics and Data Management Core, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Eric Kan
- Division of Pediatric Research Administration, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Kyung E Rhee
- Department of Pediatrics, University of California, San Diego, California, USA
| | - Michael I Goran
- Division of Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Elizabeth R Sowell
- Division of Neurology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California, USA
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Krijger A, Schiphof-Godart L, Lanting C, Elstgeest L, Raat H, Joosten K. A lifestyle screening tool for young children in the community: needs and wishes of parents and youth healthcare professionals. BMC Health Serv Res 2024; 24:584. [PMID: 38702743 PMCID: PMC11069244 DOI: 10.1186/s12913-024-10997-y] [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: 04/28/2023] [Accepted: 04/16/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Youth healthcare has an important role in promoting a healthy lifestyle in young children in order to prevent lifestyle-related health problems. To aid youth healthcare in this task, a new lifestyle screening tool will be developed. The aim of this study was to explore how youth healthcare professionals (YHCP) could best support parents in improving their children's lifestyle using a new lifestyle screening tool for young children. METHODS We conducted four and seven focus groups among parents (N = 25) and YHCP (N = 25), respectively. Two main topics were addressed: the experiences with current practice of youth healthcare regarding lifestyle in young children, and the requirements for the lifestyle screening tool to be developed. The focus groups were recorded, transcribed verbatim and analysed using an inductive approach. RESULTS Both parents and YHCP indicated that young children's lifestyles are often discussed during youth healthcare appointments. While parents felt that this discussion could be more in-depth, YHCP mainly needed clues to continue the discussion. According to parents and YHCP, a new lifestyle screening tool for young children should be easy to use, take little time and provide courses of action. Moreover, it should be attractive to complete and align with the family concerned. CONCLUSIONS According to parents and YHCP, a new lifestyle screening tool for young children could be useful to discuss specific lifestyle topics in more detail and to provide targeted advice.
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Affiliation(s)
- Anne Krijger
- Department of Neonatal and Paediatric Intensive Care, Division of Paediatric Intensive Care, Erasmus MC - Sophia Children's Hospital, PO box 2060, Rotterdam, 3000 CB, the Netherlands
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Lieke Schiphof-Godart
- Department of Medical Informatics, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Caren Lanting
- Netherlands Organisation for Applied Scientific Research TNO, unit Healthy Living, Child Health expertise group, Leiden, the Netherlands
| | - Liset Elstgeest
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
- Reinier Academy, Reinier de Graaf Hospital, Delft, the Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Koen Joosten
- Department of Neonatal and Paediatric Intensive Care, Division of Paediatric Intensive Care, Erasmus MC - Sophia Children's Hospital, PO box 2060, Rotterdam, 3000 CB, the Netherlands.
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Choudhary D, Rideout TC, Millen AE, Wen X. Bean Consumption during Childhood Is Associated with Improved Nutritional Outcomes in the First Two Years of Life. Nutrients 2024; 16:1120. [PMID: 38674811 PMCID: PMC11053677 DOI: 10.3390/nu16081120] [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: 02/28/2024] [Revised: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
Bean consumption during childhood may play a role in promoting early-life health given their high nutritional quality. To examine the associations of children's bean consumption with the socio-demographic characteristics of the child and mother and the child's nutrient intake, we analyzed data from the WIC-ITFPS-2, which followed children and their mothers at 1, 3, 5, 7, 9, 11, 13, 15, 18, and 24 months (m) following birth. Caregivers (mostly mothers) responded to an interview-administered 24 h recall on their child's dietary intake at each time point. The intake of dried beans, chili, yellow beans, and lima beans was quantified. Correlate measures included socio-demographic characteristics. Outcome measures of interest focused on the intake of macronutrients (grams and % kcals) and micronutrients at 11 (infancy) and 24 m (toddler) only. To ensure statistical power, we only examined the associations of dried beans and chili with socio-demographics (Chi-square tests) and nutritional outcomes (ANOVA) at 11 and 24 m. The proportion of children who consumed dried beans or chili was very low in the first 6 m of age, started to increase at 7 m (1.2% and 0.4%) and 11 m (4.9% and 2.3%), and reached a high level at 18 m (10.5%) and 24 m (5.9%), respectively. Consumption of yellow or lima beans was rare (<0.1%). At 11 and 24 m, dried bean consumption was higher in children who were White (vs. Black). Dried bean and chili consumption was higher in children who were of Hispanic or Latino ethnicity (vs. non-Hispanic or non-Latino ethnicity). Children who consumed dried beans and chili at 11 or 24 m had a higher intake of total energy, protein, total fiber, potassium, folate, and magnesium compared with non-consumers. The bean consumption was low amongst children, differed by race and ethnicity, and was associated with improved macro- and micronutrient intake in children at 11 and 24 m.
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Affiliation(s)
- Divya Choudhary
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14214, USA;
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY 14214, USA;
| | - Todd C. Rideout
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY 14214, USA;
| | - Amy E. Millen
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY 14214, USA;
| | - Xiaozhong Wen
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14214, USA;
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Wang C, Chen Y, Xu H, Wang W, Zhou H, Sun Q, Hong X, Zhao J. Sustaining Healthy Habits: The Enduring Impact of Combined School-Family Interventions on Consuming Sugar-Sweetened Beverages among Pilot Chinese Schoolchildren. Nutrients 2024; 16:953. [PMID: 38612987 PMCID: PMC11013720 DOI: 10.3390/nu16070953] [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: 02/05/2024] [Revised: 03/14/2024] [Accepted: 03/16/2024] [Indexed: 04/14/2024] Open
Abstract
This study assesses the enduring impact of combined school- and family-based interventions on reducing the consumption of sugar-sweetened beverages (SSBs) among schoolchildren in China. Two primary schools were assigned at random to either the Intervention Group or the Control Group, in Nanjing, eastern China. All students were in grade three and received an invitation to participate. In the first year, students in the Intervention Group received one-year intervention measures, including monthly monitoring, aiming to decrease the consumption of SSBs. Students in the Control Group only received regular monitoring without interventions. In the second year, both groups received only regular monitoring, without active interventions. A generalized estimating equations model (GEE) was used to assess the intervention effects. After two years, relative to the Control Group, the Intervention Group had a significantly improved knowledge of SSBs and an improved family environment with parents. In the Intervention Group, 477 students (97.3%) had adequate knowledge about SSBs, compared to 302 students (83.2%) in the Control Group (X2 = 52.708, p < 0.001). Two years later, the number of students who stated 'my home always has SSBs' in the Intervention Group (7.8%) was fewer than that in the Control Group (12.4%), which was a statistically significant finding (p < 0.05). One year later, both the frequency and the quantity of SSB consumption in the Intervention Group were less than those in the Control Group; such differences between the groups remained statistically significant for the quantity but not for the frequency of SSB consumption two years later. In the Intervention Group, the frequency of SSB consumption was significantly reduced by 1.0 times per week, compared to a reduction of 0.1 times per week in the Control Group in the first year (p < 0.05). In the second year, the frequency of SSB consumption was reduced by 0.8 times per week in the Intervention Group, compared to 0.5 times per week in the Control Group (p > 0.05). In the first year, the volume of SSB consumption was significantly reduced by 233 mL per week in the Intervention Group, compared to an increase of 107 mL per week in the Control Group (p < 0.05). In the second year, the volume of SSB consumption was reduced by 122 mL per week in the Intervention Group compared to an increase of 31 mL per week in the Control Group (p > 0.05). The combined school-based and family-based interventions had a positive effect on the students' knowledge of SSBs and their family dynamics during the first and second year. Relative to the Control Group, the Intervention Group had a statistically significant reduction in SSB consumption after 1 year, but not after 2 years.
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Affiliation(s)
- Chenchen Wang
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Yijia Chen
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Hao Xu
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Weiwei Wang
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Hairong Zhou
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Qiannan Sun
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Xin Hong
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Jinkou Zhao
- Department of Non-Communicable Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
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Grap ME, Hamner HC, Dooyema C, Noiman A, Park S. Factors Associated with Sugar-Sweetened Beverage Intake Among Young Children - United States, 2021. Prev Chronic Dis 2024; 21:E17. [PMID: 38512779 PMCID: PMC10962274 DOI: 10.5888/pcd21.230354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
Introduction Because limited data exist about factors related to sugar-sweetened beverage (SSB) intake among younger children, we investigated factors associated with SSB intake among US children aged 1 to 5 years. Methods We examined SSB intake (0, 1-3, or ≥4 times/week) by using data from the 2021 National Survey of Children's Health. We performed a multinomial logistic regression to calculate adjusted odds ratios (aORs) for select sociodemographic and household factors associated with moderate (1-3 times/week) and high (≥4 times/week) SSB intake. Results Overall, 36% of children consumed SSBs 1 to 3 times/week and 21% consumed 4 or more times/week. Both moderate and high SSB intake were associated with child's age, child's race and ethnicity, highest caregiver education level, household income, primary household language, and frequency of family meals. For example, children who lived in households with caregiver education level of high school graduate or less were significantly more likely to have moderate (aOR, 2.06) and high (aOR, 2.81) SSB intake than those who lived in households with caregiver education level of college degree or higher. High SSB intake was also associated with marginal household food sufficiency, nonmetropolitan statistical area status, and receipt of government food benefits. Conclusion Several sociodemographic and household factors were significantly associated with SSB intake among children aged 1 to 5 years. Public health initiatives designed to address SSB intake among young children in various settings including pediatric health care, early care and education, and the child's home could consider key associated factors.
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Affiliation(s)
- Mary Ellen Grap
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
- Division of Nutrition, Physical Activity, and Obesity, CDC, 4770 Buford Highway NE, MS S107-5, Atlanta GA, 30341
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Heather C Hamner
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carrie Dooyema
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Adi Noiman
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sohyun Park
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Regalo IH, Palinkas M, Gonçalves LMN, de Vasconcelos PB, Cappella A, Solazzo R, Ferreira CLP, Dolci C, Regalo SCH, Sforza C, Siessere S. Impact of obesity on the structures and functions of the stomatognathic system: A morphofunctional approach. Arch Oral Biol 2024; 159:105877. [PMID: 38183935 DOI: 10.1016/j.archoralbio.2023.105877] [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: 08/30/2023] [Revised: 11/27/2023] [Accepted: 12/24/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVE The prevalence of obesity is increasing significantly worldwide, raising great concern among health professionals. This observational study evaluated the electromyographic activity and thickness of the masseter and temporalis muscles, in addition to the maximum molar bite force, in obese and eutrophic subjects. METHODS Sixty subjects were divided into three groups: I (7-12 years), II (13-20 years), III (21-40 years) and sex: with 10 men and 10 women for each group. Electromyographic recordings of the masticatory muscles were obtained during mandibular tasks. The masticatory muscles thicknesses were obtained at rest and during dental clenching. The maximum molar bite forces were measured on the right and left sides. The difference in outcome measures between the groups and sex was analyzed using Mann-Whitney U test (p < 0.05) and analysis of covariance (ANCOVA). RESULTS Electromyographic activity in the masseter and temporal muscles consistently displayed lower levels in obese subjects of both sexes across all three age groups during mandibular tasks. Additionally, greater thickness of the masticatory muscles was observed in obese subjects of both sexes across all three age groups. Obese women in Group II displayed higher values of molar bite force, both on the right and left sides, compared to eutrophic women. On the other hand, women in Group III exhibited higher values of molar bite force on the right side in comparison to eutrophic women. CONCLUSIONS This study underscores the potential impact of obesity on the morphofunctional aspects of the stomatognathic system in subjects aged 7 to 40 years.
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Affiliation(s)
- Isabela Hallak Regalo
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, Brazil
| | - Marcelo Palinkas
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, Brazil; National Institute and Technology - Translational Medicine (INCT.TM), Brazil.
| | | | | | - Annalisa Cappella
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; U.O. Laboratory of Applied Morphology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Riccardo Solazzo
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | | | - Claudia Dolci
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Simone Cecilio Hallak Regalo
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, Brazil; National Institute and Technology - Translational Medicine (INCT.TM), Brazil
| | - Chiarella Sforza
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Selma Siessere
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, Brazil; National Institute and Technology - Translational Medicine (INCT.TM), Brazil
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Neri D, Martínez Steele E, Rauber F, Santos Costa CD, D'Aquino Benicio MH, Bertazzi Levy R. Infants' Dietary Pattern Characterized by Ultraprocessed Foods Is Associated With Rapid Weight Gain and Overweight/Obesity Risk: National Health and Nutrition Examination Survey 2009-2018. J Acad Nutr Diet 2024:S2212-2672(24)00053-4. [PMID: 38331189 DOI: 10.1016/j.jand.2024.02.003] [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: 03/17/2023] [Revised: 01/28/2024] [Accepted: 02/01/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Global trends toward childhood obesity have been associated with several factors, including suboptimal infant feeding practices, the increasing availability of ultraprocessed foods in the world's food supply, and the corresponding changes in children's dietary patterns. OBJECTIVE To describe infants' dietary patterns and assess their associations with weight status outcomes in a nationally representative sample of US infants. DESIGN Cross-sectional analyses were performed on data collected from infants participating in the 2009-2018 National Health and Nutrition Examination Survey. PARTICIPANTS/SETTING Participants included 744 infants aged 6 to 12 months who had data from at least 1 day of valid 24-hour dietary recall data. MAIN OUTCOME MEASURES Rapid weight gain and overweight/obesity risk. STATISTICAL ANALYSES PERFORMED Principal component analysis was used to identify dietary patterns considering the energy intake of 39 Nova food subgroups (expressed in calories per day), including breast milk. Associations were evaluated using logistic regression adjusted for potential confounders. RESULTS A total of 42% infants experienced rapid weight gain, and 33% were at risk of overweight/obesity. Most infants (65.5%) were started on solid foods early. Three main dietary patterns were derived. The first pattern, labeled Natural or Minimally Processed Foods, had positive loadings for a variety of natural or minimally processed foods, some processed culinary ingredients, and a few processed and ultraprocessed foods. The second pattern, labeled Infant Formula, had high negative loading for breast milk, and high positive loading for infant formula and breakfast cereal. The third pattern, labeled Ultraprocessed Foods, had negative loadings for natural or minimally processed foods and processed culinary ingredients, positive loadings for other processed foods and for a variety of ultraprocessed foods, and negative loading for infant formula. Infants who adhere to the Ultraprocessed Foods dietary pattern were more likely to present rapid weight gain (adjusted odds ratio 1.3, 95% CI 1.1 to 1.5) and overweight/obesity risk (adjusted odds ratio 1.2, 95% CI 1.0 to 1.4). CONCLUSIONS Higher adherence to a dietary pattern characterized by ultraprocessed foods was associated with a greater likelihood of both rapid weight gain and overweight/obesity risk early in life. Promoting breastfeeding and increasing consumption of unprocessed/minimally processed foods during early infancy while restricting ultraprocessed foods are key components to reducing the growing burden of childhood obesity.
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Affiliation(s)
- Daniela Neri
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil; Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, Brazil.
| | - Eurídice Martínez Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil; Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Fernanda Rauber
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, Brazil; Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Caroline Dos Santos Costa
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Maria Helena D'Aquino Benicio
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil; Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Renata Bertazzi Levy
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, Brazil; Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
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Giontella A, Tagetti A, Bonafini S, Marcon D, Cattazzo F, Bresadola I, Antoniazzi F, Gaudino R, Cavarzere P, Montagnana M, Pietrobelli A, Maffeis C, Minuz P, Fava C. Comparison of Performance in the Six-Minute Walk Test (6MWT) between Overweight/Obese and Normal-Weight Children and Association with Haemodynamic Parameters: A Cross-Sectional Study in Four Primary Schools. Nutrients 2024; 16:356. [PMID: 38337641 PMCID: PMC10857357 DOI: 10.3390/nu16030356] [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: 01/01/2024] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Physical activity plays a pivotal role in preventing obesity and cardiovascular risks. The six-minute walk test (6MWT) is a tool to assess functional capacity and predict cardiovascular events. The aim of this cross-sectional study was to compare the performance and haemodynamic parameters before and after a 6MWT between obese/overweight vs. normal-weight children (average age 8.7 ± 0.7 years) participating in a project involving four primary schools in South Verona (Italy). Validated questionnaires for physical activity and diet, as well as blood drops, were collected. Overweight or obese children (OW&OB; n = 100) covered a shorter 6MWT distance compared to normal-weight children (NW, n = 194). At the test's conclusion, the OW&OB group exhibited a higher Rate Pulse Product (RPP = Systolic Blood Pressure × Heart Rate) as compared to the NW. Body Mass Index, waist-to-height ratio, fat mass by electrical impedance, and trans fatty acids showed direct correlations with pre and post-test haemodynamic parameters, such as RPP, and inverse correlations with oxygen saturation. OW&OB children demonstrated lower performance in this low-intensity exercise test, along with an elevated haemodynamic response. Excess fat in childhood can be considered a risk factor for haemodynamic stress, with potential deleterious consequences later in life. Efforts should be initiated early to break this cycle.
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Affiliation(s)
- Alice Giontella
- Department of Medicine, University of Verona, 37100 Verona, Italy; (A.G.); (A.T.); (D.M.); (F.C.); (I.B.); (P.M.); (C.F.)
| | - Angela Tagetti
- Department of Medicine, University of Verona, 37100 Verona, Italy; (A.G.); (A.T.); (D.M.); (F.C.); (I.B.); (P.M.); (C.F.)
| | - Sara Bonafini
- Department of Medicine, University of Verona, 37100 Verona, Italy; (A.G.); (A.T.); (D.M.); (F.C.); (I.B.); (P.M.); (C.F.)
| | - Denise Marcon
- Department of Medicine, University of Verona, 37100 Verona, Italy; (A.G.); (A.T.); (D.M.); (F.C.); (I.B.); (P.M.); (C.F.)
| | - Filippo Cattazzo
- Department of Medicine, University of Verona, 37100 Verona, Italy; (A.G.); (A.T.); (D.M.); (F.C.); (I.B.); (P.M.); (C.F.)
| | - Irene Bresadola
- Department of Medicine, University of Verona, 37100 Verona, Italy; (A.G.); (A.T.); (D.M.); (F.C.); (I.B.); (P.M.); (C.F.)
| | - Franco Antoniazzi
- Department of Surgical, Odontostomatological and Maternal-Infantile Sciences, University of Verona, 37129 Verona, Italy; (F.A.); (R.G.); (P.C.); (A.P.); (C.M.)
| | - Rossella Gaudino
- Department of Surgical, Odontostomatological and Maternal-Infantile Sciences, University of Verona, 37129 Verona, Italy; (F.A.); (R.G.); (P.C.); (A.P.); (C.M.)
| | - Paolo Cavarzere
- Department of Surgical, Odontostomatological and Maternal-Infantile Sciences, University of Verona, 37129 Verona, Italy; (F.A.); (R.G.); (P.C.); (A.P.); (C.M.)
| | - Martina Montagnana
- Department of Engineering for Innovative Medicine, University of Verona, 37100 Verona, Italy;
| | - Angelo Pietrobelli
- Department of Surgical, Odontostomatological and Maternal-Infantile Sciences, University of Verona, 37129 Verona, Italy; (F.A.); (R.G.); (P.C.); (A.P.); (C.M.)
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Claudio Maffeis
- Department of Surgical, Odontostomatological and Maternal-Infantile Sciences, University of Verona, 37129 Verona, Italy; (F.A.); (R.G.); (P.C.); (A.P.); (C.M.)
| | - Pietro Minuz
- Department of Medicine, University of Verona, 37100 Verona, Italy; (A.G.); (A.T.); (D.M.); (F.C.); (I.B.); (P.M.); (C.F.)
| | - Cristiano Fava
- Department of Medicine, University of Verona, 37100 Verona, Italy; (A.G.); (A.T.); (D.M.); (F.C.); (I.B.); (P.M.); (C.F.)
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Torres I, Villalba JJ, López-Cevallos DF, Galea S. Governmental institutionalization of corporate influence on national nutrition policy and health: a case study of Ecuador. LANCET REGIONAL HEALTH. AMERICAS 2024; 29:100645. [PMID: 38298501 PMCID: PMC10829353 DOI: 10.1016/j.lana.2023.100645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 02/02/2024]
Abstract
Corporate influence in policy and decision-making is an important public health concern. This Health Policy paper reviews Ecuador's child malnutrition strategy instruments, approved between 2020 and 2023, to identify how private interests are becoming legally integrated into the public sector. Evidence indicates that recent changes are enabling corporations to promote their brands, gain tax deductions, oversee public policy and set priorities, allocate resources, and decide on implementation of the country's child malnutrition strategy. Further, corporate representatives are active members of an advisory council, free from scrutiny or accountability, while being privy to undisclosed government information. Moreover, a UN agency (the World Food Program) engaged in corporate promotion of highly processed foods, illustrating the breadth of Ecuador's corporate influence scheme. Improved regulations should set clear limits to the influence of food and beverage industries in national nutrition policy, while following transparency laws in the composition and operation of Ecuador's child malnutrition strategy and related efforts.
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Affiliation(s)
- Irene Torres
- Fundacion Octaedro, El Zurriago E8-28 y Ave. De los Shyris, Quito, Ecuador
| | - José Julio Villalba
- School of Nursing, Pontifical Catholic University of Ecuador, Ave. 12 de Octubre 1076, Quito 170143, Ecuador
| | - Daniel F. López-Cevallos
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA 01003, United States
| | - Sandro Galea
- Boston University School of Public Health, Boston, MA 02118, United States
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10
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Rousham E, Pareja RG, Creed-Kanashiro HM, Bartolini R, Pradeilles R, Ortega-Roman D, Holdsworth M, Griffiths P, Verdezoto N. Designing intervention prototypes to improve infant and young child nutrition in Peru: a participatory design study protocol. BMJ Open 2023; 13:e071280. [PMID: 38070935 PMCID: PMC10729018 DOI: 10.1136/bmjopen-2022-071280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Nutrition during the complementary feeding period (6-23 months) is critical to ensure optimal growth and reduce the risk of diet-related disease across the life course. Strategies to reduce multiple forms of malnutrition (stunting, overweight/obesity and anaemia) in infants and young children (IYC) are a key priority in low-income and middle-income countries, including Peru. This study aims to co-design and develop prototypes for interventions to address the multiple forms of malnutrition in IYC in urban Peru, using a participatory design approach. METHODS AND ANALYSIS The study will be based within peri-urban communities in two areas of Peru (Lima and Huánuco city). Following the identification of key nutritional challenges for IYC aged 6-23 months through formative research (phase I), we will conduct a series of workshops bringing together healthcare professionals from government health centres and caregivers of IYC aged 6-23 months. Workshops (on idea generation; creating future scenarios; storyboarding and early implementation and feedback) will take place in parallel in the two study areas. Through these workshops, we will engage with community participants to explore, experiment, co-design and iteratively validate new design ideas to address the challenges around IYC complementary feeding from phase I. Workshop outputs and transcripts will be analysed qualitatively using affinity diagramming and thematic analyses. The intervention prototypes will be evaluated qualitatively and piloted with the participating communities. ETHICS AND DISSEMINATION Ethical approval for this study was obtained from the Ethical Review Committee of the Instituto de Investigación Nutricional (IIN) Peru (388-2019/CIEI-IIN), Loughborough University (C19-87) and confirmed by Cardiff University. Findings of the participatory design process will be disseminated through a deliberative workshop in Lima, Peru with national and regional government stakeholders, as well as participants and researchers involved in the design process. Further dissemination will take place through policy briefs, conferences and academic publications.
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Krijger A, Schiphof-Godart L, Elstgeest L, van Rossum C, Verkaik-Kloosterman J, Steenbergen E, Ter Borg S, Lanting C, van Drongelen K, Engelse O, Kindermann A, Detmar S, Frenkel C, Raat H, Joosten K. Development and evaluation study of FLY-Kids: a new lifestyle screening tool for young children. Eur J Pediatr 2023; 182:4749-4757. [PMID: 37580556 PMCID: PMC10587277 DOI: 10.1007/s00431-023-05126-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/09/2023] [Accepted: 07/18/2023] [Indexed: 08/16/2023]
Abstract
Evaluating, discussing, and advising on young children's lifestyles may contribute to timely modification of unhealthy behaviour and prevention of adverse health consequences. We aimed to develop and evaluate a new lifestyle screening tool for children aged 1-3 years. The lifestyle screening tool "FLY-Kids" was developed using data from lifestyle behaviour patterns of Dutch toddlers, age-specific lifestyle recommendations, target group analyses, and a Delphi process. Through 10 items, FLY-Kids generates a dashboard with an overview of the child's lifestyle that can be used as conversation aid. FLY-Kids was completed by parents of children aged 1-3 years attending a regular youth healthcare appointment. Youth healthcare professionals (YHCP) then used the FLY-Kids dashboard to discuss lifestyle with the parents and provided tailored advice. Parents as well as YHCP evaluated the tool after use. Descriptive and correlation statistics were used to determine the usability, feasibility, and preliminary effect of FLY-Kids. Parents (N = 201) scored an average of 3.2 (out of 9, SD 1.6) unfavourable lifestyle behaviours in their children, while 3.0% complied with all recommendations. Most unfavourable behaviours were reported in unhealthy food intake and electronic screen time behaviour. Parents and YHCP regarded FLY-Kids as usable and feasible. The number of items identified by FLY-Kids as requiring attention was associated with the number of items discussed during the appointment (r = 0.47, p < 0.001). Conclusion: FLY-Kids can be used to identify unhealthy lifestyle behaviour in young children and guide the conversation about lifestyle in preventive healthcare settings. End-users rated FLY-Kids as helpful and user-friendly. What is Known: • A healthy lifestyle is important for optimal growth, development and overall health of young children (1-3 years). • Evaluating, discussing and advising on young children's lifestyles may contribute to timely modification of unhealthy behaviour and prevention of adverse health consequences. What is New: • The new lifestyle screening tool FLY-Kids generates a dashboard with an overview of young children's lifestyle that can be used as conversation aid between parents and youth healthcare professionals. • As parents and youth healthcare professionals rated FLY-Kids as helpful and user-friendly, and the number of items identified by FLY-Kids as requiring attention was associated with the number of items discussed during the appointment, FLY-Kids can be considered guiding the lifestyle discussion in preventive healthcare settings.
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Affiliation(s)
- Anne Krijger
- Department of Pediatrics and Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, PO Box 2060, 3000 CB, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Lieke Schiphof-Godart
- Department of Medical Informatics, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Liset Elstgeest
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Reinier Academy, Reinier de Graaf Hospital, Delft, The Netherlands
| | - Caroline van Rossum
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | | | - Elly Steenbergen
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Sovianne Ter Borg
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Caren Lanting
- Netherlands Organisation for Applied Scientific Research TNO, Unit Healthy Living, Child Health Expertise Group, Leiden, The Netherlands
| | | | - Ondine Engelse
- Dutch Knowledge Centre for Youth Health, Utrecht, The Netherlands
| | - Angelika Kindermann
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands
| | - Symone Detmar
- Netherlands Organisation for Applied Scientific Research TNO, Unit Healthy Living, Child Health Expertise Group, Leiden, The Netherlands
| | - Carolien Frenkel
- Association of Dutch Infant and Dietetic Foods Industries, The Hague, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Koen Joosten
- Department of Pediatrics and Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, PO Box 2060, 3000 CB, Rotterdam, The Netherlands.
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de Souza GR, Ribeiro-Silva RDC, Felisbino-Mendes MS, Silva NDJ, de Andrade RDCS, Pedroso J, Spaniol AM, Bortolini GA, Nilson EAF, da Silva SA, Lourenço BH, Rocha ADS, Falcão IR, Ichihara MYT, Farias DR, Barreto ML. Time trends and social inequalities in infant and young child feeding practices: national estimates from Brazil's Food and Nutrition Surveillance System, 2008-2019. Public Health Nutr 2023; 26:1731-1742. [PMID: 37231823 PMCID: PMC10478053 DOI: 10.1017/s1368980023001039] [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: 08/10/2022] [Revised: 04/26/2023] [Accepted: 05/12/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To describe the time trends and socio-economic inequalities in infant and young child feeding practices in accordance with the Brazilian deprivation index (BDI). DESIGN This time-series study analysed the prevalence of multiple breast-feeding and complementary feeding indicators based on data from the Brazilian Food and Nutrition Surveillance System, 2008-2019. Prais-Winsten regression models were used to analyse time trends. Annual percent change (APC) and 95 % CI were calculated. SETTING Primary health care services, Brazil. PARTICIPANTS Totally, 911 735 Brazilian children under 2 years old. RESULTS Breast-feeding and complementary feeding practices differed between the extreme BDI quintiles. Overall, the results were more favourable in the municipalities with less deprivation (Q1). Improvements in some complementary feeding indicators were observed over time and evidenced such disparities: minimum dietary diversity (Q1: Δ 47·8-52·2 %, APC + 1·44, P = 0·006), minimum acceptable diet (Q1: Δ 34·5-40·5 %, APC + 5·17, P = 0·004) and consumption of meat and/or eggs (Q1: Δ 59·7-80·3 %, APC + 6·26, P < 0·001; and Q5: Δ 65·7-70·7 %, APC + 2·20, P = 0·041). Stable trends in exclusive breast-feeding and decreasing trends in the consumption of sweetened drinks and ultra-processed foods were also observed regardless the level of the deprivation. CONCLUSIONS Improvements in some complementary food indicators were observed over time. However, the improvements were not equally distributed among the BDI quintiles, with children from the municipalities with less deprivation benefiting the most.
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Affiliation(s)
- Giesy Ribeiro de Souza
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Rita de Cássia Ribeiro-Silva
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Mariana Santos Felisbino-Mendes
- School of Nursing, Department of Mother-Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Natanael de Jesus Silva
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- Barcelona Institute for Global Health, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | | | - Jéssica Pedroso
- General Coordination of Food and Nutrition, Ministry of Health, Federal District, Brasília, Brazil
| | - Ana Maria Spaniol
- General Coordination of Food and Nutrition, Ministry of Health, Federal District, Brasília, Brazil
| | - Gisele Ane Bortolini
- General Coordination of Food and Nutrition, Ministry of Health, Federal District, Brasília, Brazil
| | - Eduardo Augusto Fernandes Nilson
- Food, Nutrition and Culture Program (PALIN), Brasília Regional Management, Oswaldo Cruz Foundation, Federal District, Brasília, Brazil
| | - Sara Araújo da Silva
- General Coordination of Food and Nutrition, Ministry of Health, Federal District, Brasília, Brazil
| | | | - Aline dos Santos Rocha
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Ila Rocha Falcão
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
| | - Maria Yury Travassos Ichihara
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
| | - Dayana Rodrigues Farias
- Nutritional Epidemiology Observatory, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maurício Lima Barreto
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
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Park S, Lee SH, Merlo C, Blanck HM. Associations between Knowledge of Health Risks and Sugar-Sweetened Beverage Intake among US Adolescents. Nutrients 2023; 15:nu15102408. [PMID: 37242294 DOI: 10.3390/nu15102408] [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: 04/27/2023] [Revised: 05/13/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Sugar-sweetened beverage (SSB) intake is associated with adverse health outcomes. OBJECTIVE We examined associations between the knowledge of health risks related to SSB and SSB intake among adolescents. DESIGN A cross-sectional study using 2021 YouthStyles survey data. PARTICIPANTS/SETTINGS 831 US adolescents (12-17 years old). MAIN OUTCOME MEASURES The outcome variable was SSB intake (none, 1-6 times/week, and ≥1 time/day). Exposure variables were knowledge of seven SSB-related health risks. STATISTICAL ANALYSES PERFORMED Seven multinomial regressions were used to estimate adjusted odds ratios (AOR) for drinking SSB, according to knowledge of SSB-related health risks and after controlling for sociodemographics. RESULTS Overall, 29% of adolescents consumed SSB ≥1 time/day. Although most adolescents identified cavities (75.4%), weight gain (74.6%), and diabetes (69.7%) as being related to drinking SSB, fewer adolescents identified related conditions such as high blood pressure (31.7%), high cholesterol (25.8%), heart disease (24.6%), and some cancers (18.0%). Compared to non-SSB consumers, drinking SSB ≥1 time/day was significantly higher among adolescents who lacked knowledge of associations between SSB intake and weight gain (AOR = 2.0), heart disease (AOR = 1.9), or some cancers (AOR = 2.3) after controlling for covariates. CONCLUSIONS Among US adolescents, knowledge of SSB-related health risks varied by condition, ranging from 18% (some cancers) to 75% (cavities and weight gain). There were increased odds of drinking SSB among those unaware that weight gain, heart disease, and some cancers are associated with SSB intake. Intervention could evaluate whether increasing certain types of knowledge may influence youth SSB intake.
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Affiliation(s)
- Sohyun Park
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Seung Hee Lee
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Caitlin Merlo
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Heidi M Blanck
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
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Calcaterra V, Cena H, Rossi V, Santero S, Bianchi A, Zuccotti G. Ultra-Processed Food, Reward System and Childhood Obesity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050804. [PMID: 37238352 DOI: 10.3390/children10050804] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/19/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023]
Abstract
Obesity and overweight are a major public health problem globally. Diet quality is critical for proper child development, and an unhealthy diet is a preventable risk factor for noncommunicable diseases (NCDs), such as obesity. Consumption of sugar-sweetened beverages and ultra-processed foods (UPFs) in childhood may increase the BMI/BMI z-score, body fat percentage, or likelihood of overweight. A strict feeding regulation system allows for sufficient food to be consumed to meet ongoing metabolic demands while avoiding overconsumption. This narrative review explores the issues of obesity and the regulation of food intake related to reward systems and UPF consumption. Nutrient composition alone cannot explain the influence of UPFs on the risk of obesity. Furthermore, the non-nutritional properties of UPFs may explain the mechanisms underlying the relationship with obesity and NCDs. UPFs are designed to be highly palatable, appealing, and energy dense with a unique combination of the main taste enhancer ingredients to generate a strong rewarding stimulus and influence the circuits related to feeding facilitation. How individual UPF ingredients influence eating behavior and reward processes remains not fully elucidated. To increase the knowledge on the relationship between UPFs and pediatric obesity, it may be useful to limit the rapid growth in the prevalence of obesity and subsequent related complications, and to develop new strategies for appropriate food and nutrition policies.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
- Clinical Nutrition Unit, General Medicine, Istituti Clinici Salvatore Maugeri Istituto di Ricovero e Cura a Carattere Sscientifico, 27100 Pavia, Italy
| | - Virginia Rossi
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Sara Santero
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Alice Bianchi
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milano, Italy
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15
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Piórecka B, Jamka-Kasprzyk M, Niedźwiadek A, Jagielski P, Jurczak A. Fluid Intake and the Occurrence of Erosive Tooth Wear in a Group of Healthy and Disabled Children from the Małopolska Region (Poland). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4585. [PMID: 36901595 PMCID: PMC10001795 DOI: 10.3390/ijerph20054585] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
Background: The aim of this study was to analyse the relationship between the type and amount of fluid intake and the incidence of erosive tooth wear in a group of healthy children and children with disabilities. Methods: This study was conducted among children aged 6-17 years, patients of the Dental Clinic in Kraków. The research included 86 children: 44 healthy children and 42 children with disabilities. The prevalence of erosive tooth wear using the Basic Erosive Wear Examination (BEWE) index was assessed by the dentist, who also determined the prevalence of dry mouth using a mirror test. A qualitative-quantitative questionnaire on the frequency of consumption of specific liquids and foods related to the occurrence of erosive tooth wear, completed by the children's parents, was used to assess dietary habits. Results: The occurrence of erosive tooth wear was determined for 26% of the total number of children studied, and these were mostly lesions of minor severity. The mean value of the sum of the BEWE index was significantly higher (p = 0.0003) in the group of children with disabilities. In contrast, the risk of erosive tooth wear was non-significantly higher in children with disabilities (31.0%) than in healthy children (20.5%). Dry mouth was significantly more frequently identified among children with disabilities (57.1%). Erosive tooth wear was also significantly more common (p = 0.02) in children whose parents declared the presence of eating disorders. Children with disabilities consumed flavoured water or water with added syrup/juice and fruit teas with significantly higher frequency, while there were no differences in quantitative fluid intake between groups. The frequency and quantity of drinking flavoured waters or water with added syrup/juice, sweetened carbonated, and non-carbonated drinks were associated with the occurrence of erosive tooth wear for all children studied. Conclusions: The group of studied children presents inappropriate drinking behaviours regarding the frequency and amount of beverages consumed, which, especially in a group of children with disabilities, may contribute to the formation of erosive cavities.
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Affiliation(s)
- Beata Piórecka
- Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Science, Jagiellonian University Medical College, Skawińska 8, 31-066 Krakow, Poland
| | - Małgorzata Jamka-Kasprzyk
- Department of Paediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, Montelupich 4, 31-155 Krakow, Poland
| | - Anna Niedźwiadek
- Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Science, Jagiellonian University Medical College, Skawińska 8, 31-066 Krakow, Poland
| | - Paweł Jagielski
- Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Science, Jagiellonian University Medical College, Skawińska 8, 31-066 Krakow, Poland
| | - Anna Jurczak
- Department of Paediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, Montelupich 4, 31-155 Krakow, Poland
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Abstract
PURPOSE OF REVIEW To discuss recent evidence on the influence of complementary feeding (CF) timing, content and feeding methods on childhood obesity risk. RECENT FINDINGS The evidence-base is limited by heterogeneity, risk of bias and the predominance of observational studies. The content of the diet and feeding practices are more influential than timing for obesity risk. There is limited evidence that CF introduction before 4 months may be associated with increased risk. Intake of animal protein, particularly dairy protein, may contribute to rapid weight gain; protein from infant/follow-on formula shows the most robust association with later obesity risk. Evidence linking sugar intake to obesity risk is limited, but intake should be as low as possible given there is no nutritional requirement. Responsive feeding (RF) practices may promote appropriate infant growth and reduce risk. The effect of baby-led weaning (BLW) is inconclusive. SUMMARY Recent evidence supports current recommendations to avoid high protein intakes, especially from infant/follow-on formula, for infants in high income countries; and to promote RF practices for all infants. Studies in low- and middle-income countries are required to define optimal CF practices given increasing rates of child obesity alongside double-burden malnutrition.
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Affiliation(s)
- Kulnipa Kittisakmontri
- Nutrition Research Group, Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
- Division of Nutrition, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Mary Fewtrell
- Nutrition Research Group, Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
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Markey O, Pradeilles R, Goudet S, Griffiths PL, Boxer B, Carroll C, Rousham EK. Unhealthy Food and Beverage Consumption during Childhood and Risk of Cardiometabolic Disease: A Systematic Review of Prospective Cohort Studies. J Nutr 2023; 153:176-189. [PMID: 36913452 PMCID: PMC10127523 DOI: 10.1016/j.tjnut.2022.11.013] [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: 09/05/2022] [Revised: 11/04/2022] [Accepted: 11/15/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Global consumption of unhealthy foods, including ultra-processed foods (UPFs) and sugar-sweetened beverages (SSBs), has increased substantially among pediatric populations. Suboptimal diet during early life can track into adulthood, alongside risk factors for cardiometabolic disease. OBJECTIVE To inform the development of updated WHO guiding principles for complementary feeding of infants and young children, this systematic review sought to examine the association between unhealthy food consumption during childhood and cardiometabolic risk biomarkers. METHODS PubMed (Medline), EMBASE, and Cochrane CENTRAL were systematically searched, with no language restriction, up to 10 March 2022. Inclusion criteria were randomized controlled trials (RCTs), non-RCTs, and longitudinal cohort studies; children aged ≤10.9 y at exposure; studies reporting greater consumption of unhealthy foods and beverages (defined using nutrient- and food-based approaches) than no or low consumption; studies assessing critical nonanthropometric cardiometabolic disease risk outcomes (blood lipid profile, glycemic control, or blood pressure). RESULTS Of 30,021 identified citations, 11 articles from 8 longitudinal cohort studies were included. Six studies focused on exposure to unhealthy foods or UPF, and 4 focused on SSB only. Methodological heterogeneity was too high across studies to meta-analyze effect estimates. A narrative synthesis of quantitative data revealed that exposure to unhealthy foods and beverages, specifically NOVA-defined UPF, in children of preschool age may be associated with a worse blood lipid and blood pressure profile in later childhood (Grading of Recommendations Assessment, Development, and Evaluation [GRADE]: low and very low certainty, respectively). No associations were evident between SSB consumption and blood lipids, glycemic control, or blood pressure (GRADE: all low certainty). CONCLUSIONS No definitive conclusion can be made because of quality of the data. More high-quality studies that purposefully assess the effects of unhealthy food and beverage exposure during childhood on cardiometabolic risk outcomes are needed. This protocol was registered at https://www.crd.york.ac.uk/PROSPERO/ as CRD42020218109.
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Affiliation(s)
- Oonagh Markey
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom.
| | - Rebecca Pradeilles
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Sophie Goudet
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Paula L Griffiths
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Benjamin Boxer
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Christopher Carroll
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Emily K Rousham
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
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18
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Becker PC, Neves RO, Silva CHD, Goldani MZ, Bernardi JR. Does early fruit juice introduction influence anthropometric outcomes and food consumption at preschool age? CIENCIA & SAUDE COLETIVA 2023. [DOI: 10.1590/1413-81232023281.09992022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Abstract The aim of this study was to evaluate the impact of fruit juice consumption before 6 months of age on Body Mass Index-for-age (BMI-for-age) and food consumption in preschoolers. We conducted a longitudinal study with mothers and their children (n=103) at 6 months and 3-6 years. Weight and height were measured and converted into BMI-for-age z-scores. Food consumption was analyzed using the Food Frequency Questionnaire for Children. Groups were compared using the chi-squared and Student’s t-tests. No differences in anthropometric measurements were found at preschool age between children who had been given fruit juice before 6 months and those who had not. Consumption of artificial juice (≥once/day) and sandwich cookies at preschool age was higher in children with early introduction of fruit juice (≤150 days of life) (63.8% versus 35.7%; p=0.028 and 21.3% versus 14.3%; p=0.001, respectively). The prevalence of the consumption of soda (1 to 4 times/week) and chocolate milk (at least once/day) was higher in children who had been given artificial juice before 6 months (69.2% versus 27.4%; p=0.014 and 38.5% versus 69.4%; p=0.027, respectively). It can be concluded that the consumption of sweet foods and sugary beverages was higher in children with early introduction of fruit juice.
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Tiered dietary exposure assessment of steviol glycosides in the Belgian population. J Nutr Sci 2023; 12:e28. [PMID: 36843978 PMCID: PMC9947756 DOI: 10.1017/jns.2023.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 02/25/2023] Open
Abstract
The objective of the present study was to assess the dietary intake of steviol glycosides in the Belgian population and to conduct a risk assessment by comparing the estimated intakes to the acceptable daily intake (ADI). A tiered approach was adopted in this study. First, a Tier 2 assessment was performed using maximum permitted levels. Next, the calculations were refined because market share data were used (refined Tier 2). Finally, the actual concentration data of 198 samples purchased from the Belgian market were used for Tier 3 exposure assessment. Based on a Tier 2 assessment, the ADI was exceeded for the high-consumer children population. However, the results of a more refined exposure assessment (Tier 3) of high consumers (P95) within the child, adolescent and adult populations were 13·75, 10 and 6·25 % of the ADI, respectively, using mean analytical results. Even with more conservative refined approaches, the estimated daily intake remained below 20 % of ADI. Flavoured drinks, flavoured fermented milk products and jams, jellies, and marmalades were the top three contributing food groups to steviol intake at 26–49 %, 12–27 % and 5–13 %, respectively. Despite the high concentrations (up to 94 000 mg/kg) of steviol glycosides in tabletop sweeteners, their contribution to the total intake remains low. The impact of the use of food supplements on the total intake was also considered to be limited. It was concluded that there was no risk for the Belgian population related to dietary exposure to steviol glycoside.
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Becker PC, Neves RO, Silva CHD, Goldani MZ, Bernardi JR. Does early fruit juice introduction influence anthropometric outcomes and food consumption at preschool age? CIENCIA & SAUDE COLETIVA 2023; 28:269-280. [PMID: 36629571 DOI: 10.1590/1413-81232023281.09992022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/12/2022] [Indexed: 01/11/2023] Open
Abstract
The aim of this study was to evaluate the impact of fruit juice consumption before 6 months of age on Body Mass Index-for-age (BMI-for-age) and food consumption in preschoolers. We conducted a longitudinal study with mothers and their children (n=103) at 6 months and 3-6 years. Weight and height were measured and converted into BMI-for-age z-scores. Food consumption was analyzed using the Food Frequency Questionnaire for Children. Groups were compared using the chi-squared and Student's t-tests. No differences in anthropometric measurements were found at preschool age between children who had been given fruit juice before 6 months and those who had not. Consumption of artificial juice (≥once/day) and sandwich cookies at preschool age was higher in children with early introduction of fruit juice (≤150 days of life) (63.8% versus 35.7%; p=0.028 and 21.3% versus 14.3%; p=0.001, respectively). The prevalence of the consumption of soda (1 to 4 times/week) and chocolate milk (at least once/day) was higher in children who had been given artificial juice before 6 months (69.2% versus 27.4%; p=0.014 and 38.5% versus 69.4%; p=0.027, respectively). It can be concluded that the consumption of sweet foods and sugary beverages was higher in children with early introduction of fruit juice.
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Affiliation(s)
- Patrícia Cemin Becker
- Departamento de Nutrição, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS). R. Ramiro Barcelos 2400, Santa Cecília. 90035-003 Porto Alegre RS Brasil.
| | - Renata Oliveira Neves
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, UFRGS. Porto Alegre RS Brasil
| | | | | | - Juliana Rombaldi Bernardi
- Departamento de Nutrição, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS). R. Ramiro Barcelos 2400, Santa Cecília. 90035-003 Porto Alegre RS Brasil.
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Estimating Unhealthy Food Effects on Childhood Overweight in Malawi Using an Observational Study. Matern Child Health J 2022; 26:2346-2354. [PMID: 35947273 DOI: 10.1007/s10995-022-03462-x] [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: 02/18/2021] [Revised: 07/04/2022] [Accepted: 07/18/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION Consumption of unhealthy foods in children contributes to high levels of childhood obesity globally. In developing countries there is paucity of empirical studies on the association. This study employed propensity-score methods to evaluate the effect of unhealthy foods on overweight among children in Malawi using observational data. METHODS Data on 4625 children aged 6 to 59 months from the 2015-16 Malawi Demographic and Health Survey (MDHS) were analyzed. A multivariable logistic regression model of unhealthy foods (yes or no) on purported confounders of childhood overweight was used to obtain a child's unhealthy food propensity score. The propensity scores were then used to form matched sets of healthy and unhealthy fed children. The association between unhealthy foods and childhood overweight was assessed using the conditional logistic regression model. RESULTS The prevalence of overweight (body mass index (BMI) z-score > 2 standard deviations) was estimated at 4.5% (3.8%, 5.3%). The proportion of children who consumed unhealthy foods was estimated at 14.6% (95% CI: 13.1%, 16.2%). Our propensity score matching achieved a balance in the distribution of the confounders between children in the healthy and unhealthy food groups. Children fed unhealthy foods were significantly more likely to be overweight than those fed healthy foods (OR = 2.5, 95% CI: (1.2, 5.2)). CONCLUSION The findings suggest the adverse effects of unhealthy foods on childhood overweight in Malawi. Thus, efforts to reduce unhealthy food consumption among children should be implemented and supported to address the problem of childhood overweight in Malawi and the sub-Saharan African region.
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