Comprehensive assessment of food and nutrient intake of children and adolescents in Germany: EsKiMo II - the eating study as a KiGGS module

[Eating Habits with Climate Impact: At Which Meals and How Often Do 6- to 11-year-olds Eat Meat and Meat Products?]

BACKGROUND

Climate change presents one of the greatest public health challenges. Regarding diet, the production of animal-based foods contributes significantly to greenhouse gas emissions. In Germany, even children often eat more meat and meat products than is recommended for a healthy diet. To plan, implement, and tailor interventions to the needs of different target groups, it is crucial to better understand people's eating habits.

METHODS

Using data from 4-day eating records of 1,190 participants of the EsKiMo II study (Nutrition study as KiGGS module, 2nd survey), which was carried out nationwide in Germany from 2015 to 2017, a detailed analysis of the consumption of meat and meat products of children aged 6-11 years, including consumption quantities and frequencies with regard to different meals, was conducted.

RESULTS

On average, children ate 71 g of meat and meat products per day, 2/3 of the amount during lunch and dinner. More red meat (pork, beef, and lamb) were chosen than poultry. Almost half of the children ate these food items twice a day, another 40% once a day. Only five percent consumed meat or meat products less than once a day.

CONCLUSIONS

Meat and meat products are therefore part of the daily diet of almost all children at this age with a general high intake among both boys and girls. Consumption could be reduced by replacing meat and meat products with vegetarian dishes or plant-based sandwich fillings, particularly for lunch and dinner. While school lunch can considerably contribute to a healthy and climate-friendly diet, families should also reduce meat servings at dinner.

Proteomic Analysis of Liver from Finishing Beef Cattle Supplemented with a Rumen-Protected B-Vitamin Blend and Hydroxy Trace Minerals

Simple Summary

Greater metabolic needs in high-producing beef cattle might lead to mineral and vitamin deficiency. Previous studies have shown the benefits of B-vitamin and trace mineral supplementation in animal performance of ruminants; however, little is known about the effects of supplementing finishing beef cattle with rumen-protected forms on the liver metabolism. Therefore, the aim of the present study was to determinate the impact of rumen-protected B-vitamin blend and hydroxy trace mineral supplementation on the hepatic proteome of finishing steers. This study reports the first evidence indicating that the supplementation of these micronutrients induces protein changes concerning oxidative metabolism and responses to oxidative stress in the liver tissue.

Abstract

Vitamin B and trace minerals are crucial molecular signals involved in many biological pathways; however, their bioavailability is compromised in high-producing ruminant animals. So far, studies have mainly focused on the effects of these micronutrients on animal performance, but their use in a rumen-protected form and their impact on liver metabolism in finishing beef cattle is poorly known. We used a shotgun proteomic approach combined with biological network analyses to assess the effects of a rumen-protected B-vitamin blend, as well as those of hydroxy trace minerals, on the hepatic proteome. A total of 20 non-castrated Nellore males with 353 ± 43 kg of initial body weight were randomly assigned to one of the following treatments: CTRL—inorganic trace minerals without supplementation of a protected vitamin B blend, or SUP—supplementation of hydroxy trace minerals and a protected vitamin B blend. All animals were fed the same amount of the experimental diet for 106 days, and liver biopsies were performed at the end of the experimental period. Supplemented animals showed 37 up-regulated proteins (p < 0.10), and the enrichment analysis revealed that these proteins were involved in protein folding (p = 0.04), mitochondrial respiratory chain complex I (p = 0.01) and IV (p = 0.01), chaperonin-containing T-complex 2 (p = 0.01), glutathione metabolism (p < 0.01), and other aspects linked to oxidative-stress responses. These results indicate that rumen-protected vitamin B and hydroxy trace mineral supplementation during the finishing phase alters the abundance of proteins associated with the electron transport chain and other oxidation–reduction pathways, boosting the production of reactive oxygen species, which appear to modulate proteins linked to oxidative-damage responses to maintain cellular homeostasis.

Adherence to food-based dietary guidelines among adolescents in Germany according to socio-economic status and region: results from Eating Study as a KiGGS Module (EsKiMo) II

OBJECTIVE

Dietary habits developed during childhood and adolescence are likely to continue into adulthood. An unbalanced diet may cause nutrient deficiencies and excessive energy intake; these enhance the risk for developing overweight and obesity and their co-morbidities. In the present analysis, food consumption of adolescents is described and evaluated against German food-based dietary guidelines with special focus on socio-economic status (SES) and region of residence.

DESIGN

Within the 'German Health Interview and Examination Survey for Children and Adolescents' (KiGGS Wave 2), the cross-sectional 'Eating Study as a KiGGS Module' (EsKiMo II) was conducted from 2015 until 2017 to provide data about dietary behaviour.

SETTING

Germany.

PARTICIPANTS

1353 adolescents aged 12-17 years from a nationwide representative sample with food consumption data from computer-assisted dietary history interviews.

RESULTS

The median consumption of fruits, vegetables, starchy foods and milk/dairy products among adolescents in Germany was below the recommendation. The median consumption of both meat/meat products and unfavourable foods, like confectionery, which should be consumed sparingly, was about 1·5 times the recommended amount. The total amount of beverages consumed by most adolescents was above the minimum amount recommended. Soft drink consumption of adolescents with a low SES was three to five times higher than soft drink consumption of adolescents with a high SES.

CONCLUSIONS

The results indicate the need for an improvement of dietary habits among adolescents in Germany. Further approaches to promote healthy diets in Germany should be continued, and the focus on social inequalities should be strengthened.

Fast food consumption among 12- to 17-year-olds in Germany - Results of EsKiMo II

Consuming high amounts of fast food can lead to an excessive intake of energy and subsequently promote obesity. Obesity increases a person's risk for diabetes and cardiovascular diseases. The second wave of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017) included the Eating study as a KiGGS Module (EsKiMo II, 2015-2017) which assessed the self-reported dietary habits of children and adolescents in Germany. The analysis of the data permits an overview of the fast food consumption of 12- to 17-year-olds (n=1,353). Girls consume 57.5 grams and boys 86.3 grams of fast food per day on average (around 400 grams and 600 grams per week, respectively). Pizza is the most consumed fast food product, followed by filled pita and sausage/meat products such as curry sausage. Adolescent girls on average get 6.5% and boys 7.8% of total daily energy intake from fast food. 23% of 12- to 17-year-olds get at least 10% of their daily energy intake from fast food (high consumers). Significant differences between the proportion of high consumers exist regarding sex, age, socioeconomic status, community size, type of school and media consumption. Compared to EsKiMo I (2006), girls' daily energy intake from fast food has remained nearly constant, whereas that of boys has dropped substantially. From a nutrition physiology perspective, the aim should be to further reduce fast food consumption.

Energy drink consumption among 12- to 17-year-olds in Germany - Results of EsKiMo II

Energy drinks are soft drinks that usually contain a large content of caffeine and sugar. Excessive caffeine intake can lead to side effects such as nausea and anxiety. Up to three milligrams of caffeine per kilogram of body weight per day is considered safe for children and young people. The second Eating study as a KiGGS Module (EsKiMo II, 2015-2017) collected nationwide representative data about children's and adolescents' dietary behaviour. To collect food intake data from 12- to 17-year-olds (n=1,353), a dietary history interview was used. 8.9% of the girls and boys stated that they had consumed energy drinks during the four-week reference period, with nearly a quarter of these individuals (n=99) exceeding the limit of safe caffeine intake solely through their consumption of energy drinks. This corresponds to 2.2% of the 12- to 17-year-olds in Germany. In addition to a general warning about the high levels of sugar present in sugary drinks, awareness also needs to be raised among young people about the dangers of excessive caffeine intake resulting from the consumption of energy drinks. Regulations governing sales and advertising should also be considered.

Consumption of organic food by children in Germany - Results of EsKiMo II

Data from the second Eating study as a KiGGS module (EsKiMo II, 2015-2017), are used to determine the contribution of food produced by organic farming (organic food) to the diet of children aged between six and eleven years (n=1,190) in Germany. Dietary intake was assessed by food records during a total of four days. Information on the proportion of organic food intake relative to daily food intake was used to differentiate between three groups: children who did not consume organic food; children whose diet contains 8.0% or less of organic food; and children whose diet comprises more than 8.0% of organic food. The 8.0% threshold represents the mean proportion of organic food eaten by children whose diet includes any amount of organic produce. In total, 63.2% of children eat organic food. The diet of 43.0% of children contains 8.0% or less of organic food, with the diet of 20.2% comprising more than 8.0% of organic food. Vegetables and fruit are among the most commonly consumed organic products. While consumption frequency of organic food does not differ by sex or age, consumption frequency increases with higher socioeconomic status. The large proportion of children (63.2%) who eat organic food suggests that health, environmental and ethical motives play a role in the food choices made by families with children.

Use of vitamin and mineral supplements among adolescents living in Germany-Results from EsKiMo II

Dietary supplements may contribute to nutrient intake; however, actual data on dietary supplement use among adolescents living in Germany are rare. The aim of this analysis was to describe the current use of dietary supplements, its determinants, and reasons of use. Changes in supplement use over time were evaluated by comparing the results with those from EsKiMo I (2006). Data from the Eating Study as a KiGGS Module EsKiMo II (2015-2017) were used to analyze supplement intake according to sociodemographic, health characteristics, and physical exercise behavior of 12-17-year-olds (n = 1356). Supplement use during the past four weeks was assessed by a standardized computer assisted personal interview. Multivariable logistic regression was used to identify the association between supplement use and its determinants. Between 2015-2017, 16.4% (95%-CI: 13.0-19.7%) of the adolescents used dietary supplements, and its use decreased with lower levels of physical exercise and overweight. Most supplement users used only one supplement, often containing both vitamins and minerals. The most frequently supplemented nutrients were vitamin C and magnesium. The main reported reason to use supplements was 'to improve health'. Prevalence of supplement use was slightly lower in 2015-2017 than in 2006 (18.5%; 95%-CI: 15.8-21.2%). The results underline the importance of including nutrient intake through dietary supplements in nutrition surveys.

EsKiMo II - the Eating study as a KiGGS Module in KiGGS Wave 2

Nutrition plays an important role for health, in particular of children and adolescents. In addition to the baseline German Health Interview and Examination Survey for Children and Adolescents (KiGGS, 2003-2006), the nutrition survey EsKiMo (Eating study as a KiGGS Module) assessed the dietary habits of children and adolescents aged 6 to 17 in detail. In KiGGS Wave 2 (2014-2017) the corresponding module is EsKiMo II. Between June 2015 and September 2017, specially trained nutritionists will visit EsKiMo II participants at their homes. The parents of 6-to 11-year-olds are instructed on how to complete food records on four randomly chosen days - three consecutive days, followed later by an additional day. Participants aged 12 to 17 are interviewed personally on their food intake during the past four weeks with the dietary interview programme DISHES. Further information, for example, regarding dietary supplements is also recorded. EsKiMo II will provide an up-to-date and representative overview of the current nutrition status of 6-to 17-year-olds living in Germany, and it allows analysing changes in dietary behaviour over time. EsKiMo II can identify shortcomings in the nutrition of children and adolescents and thus may contribute with important information to nutrition and health policy.