Association of Yogurt Consumption with Nutrient Intakes, Nutrient Adequacy, and Diet Quality in American Children and Adults

Cross-sectional associations of WIC benefit redemption and diet among children ages 1-4 years in California

BACKGROUND

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental healthy foods to children under age 5 years in low-income households.

OBJECTIVE

To characterize WIC benefit redemption, identify associations between benefit redemption with child dietary intake, and whether child age modifies these associations.

DESIGN

The cross-sectional 2023 California Statewide WIC Survey, conducted with caregivers of WIC-participating children ages 1-4 years, was analyzed for this study. Included children had complete benefit redemption data, a complete National Health and Nutrition Examination Survey Dietary Screener Questionnaire (DSQ), and complete covariate data (weighted n=2,244). Monthly household category-specific benefit redemption percentage was averaged across 6 and 3 months preceding survey completion. Associations between household redemption and child dietary intake (servings or amount/day) were assessed with multivariable linear regression and expressed as estimates and 95% confidence intervals (CI).

RESULTS

Twenty-five percent higher redemption of breakfast cereal, whole grain bread, yogurt and whole milk in the 6 months prior to the survey were associated with higher child intake frequency for cereal (0.02 servings/day, 95% CI [0.00, 0.04]), whole grain bread (0.02 [0.00, 0.03]), yogurt (0.04 [0.02, 0.06]), and whole milk (0.09 [0.01, 0.16]). Significant effect modification by child age (12 to <24 months, 24 to 59 months) was found for redemption of cheese/tofu and 100% juice (interaction p-values 0.02 and 0.001, respectively), and 25% higher redemption of these benefits were associated with lower intake frequency for cheese (-0.05 servings/day, 95% CI [-0.09, -0.02]) and higher intake frequency for juice (0.12 [0.06, 0.18]), but only among children ages 12 to <24 months.

CONCLUSIONS

Higher redemption was associated with higher child intake of select WIC foods. Pairing the promotion of benefit redemption among program participants with nutrition education efforts may enhance dietary impacts of WIC participation.

A comparison of the quality of plain yogurt and its analog made from coconut flesh extract

The aim of this study was to compare the quality of plain yogurt made from cow milk (n = 10) and its plant-based analog made from coconut flesh extract (n = 14). Coconut yogurt alternatives were divided into 2 experimental groups based on differences in their color, which were noted after the packages had been opened. The first group included products with a typical white color (n = 8), and the second group comprised products with a grayish pink color (n = 6) that developed as a result of oxidative processes. In comparison with its plant-based analog, plain yogurt was characterized by higher values of lightness (L*), yellowness (b*) and chroma (C*), higher titratable acidity, a higher content of retinol and α-tocopherol, higher nutritional value of fat, and lower values of water-holding capacity (WHC) and redness (a*). Plain yogurt had lower volatile acidity than its plant-based analog with a grayish pink color. A comparison of yogurt analogs with different colors revealed that the product with a grayish pink color was characterized by a lower value of L*, and higher values of a*, b*, C*, and pH. An analysis of its fatty acid profile demonstrated that it also had a higher proportion of C14:0 and C18:1 cis-9; higher total monounsaturated fatty acids content; a lower proportion of C10:0, C12:0, and C18:2; a lower total content of polyunsaturated fatty acids (PUFA) and essential fatty acids; and a lower ratio of PUFA to saturated fatty acids. The yogurt analog with a grayish pink color had a lower total content of tocopherol isoforms than the remaining products. The yogurt analog with a white color had the highest WHC and γ-tocopherol content. Consumers should be aware of the fact that coconut yogurt alternatives may have nonstandard quality attributes. The differences between such products and yogurt made from cow milk should be explicitly communicated to consumers so that they could make informed purchasing decisions.

Probiotic consumption and hepatic steatosis: results from the NHANES 2011-2016 and Mendelian randomization study

Background

Recent research showed that probiotics treatment may reduce insulin resistance, regulate lipid metabolism, raise liver enzyme levels, and ameliorate inflammation in individuals with metabolic associated fatty liver disease (MAFLD). However, the possible effects of probiotic use on the progression of hepatic steatosis (HS) have not been identified. The purpose of this study was to investigate this in a large population database.

Methods

The cross-sectional research was conducted among adults with complete data on probiotic yogurt consumption and HS in the 2011-2016 National Health and Nutrition Examination Survey (NHANES). Probiotic yogurt consumption was assessed using a dietary supplement questionnaire, while HS was evaluated with HS index (HSI). To explore their relationship, weighted univariate regression analysis, subgroup analysis, and interaction analysis were conducted. To evaluate the causal association between yogurt consumption and NAFLD, mendelian randomization analysis (MR) were performed. A restricted cubic spline (RCS) was used to analyze the relationship curve between the leves of yogurt consumption and hepatic steatosis.

Results

A total of 7,891 participants were included in the study represented 146.7 million non-institutionalized residents of the United States, of whom 4,322 (54.77%) were diagnosed with HS. Multivariable logistic regression showed probiotic yogurt consumption had significantly inverse relationship for HS (OR = 0.84, 95% CI: 0.72-0.97, p = 0.02) after adjusting for all covariates. Once more, the independent relationship between probiotic yogurt consumption and HS was verified by subgroup analysis and interaction analysis. The MR analysis results indicate that there is no causal relationship between yogurt consumption and NAFLD. The RCS model demonstrated a robust J-shaped link between yogurt consumption and HS, revealing a significant decrease in risk within the lower range of yogurt consumption, which attained the lowest risk close to 0.4 cup.

Conclusion

According to the NHANES data, the consumption of probiotics and yogurt has a beneficial effect on HS, whereas the MR results indicated it was not related to NAFLD. The RCS analysis indicates a J-shaped relationship between yogurt consumption and HS, which may account for the inconsistency in the results. Based on these findings, we recommend that adults take half a cup of yogurt daily.

A new era for food in health? The FDA announces a qualified health claim for yogurt intake and type 2 diabetes mellitus risk reduction

INTRODUCTION

Over the last two decades research has grown regarding dairy intake and health. It has been reported by many that yogurt intake may be associated with reduced risk of type 2 diabetes mellitus (T2D). In this report, the United States Food and Drug Administration (FDA) decision to announce a qualified health claim for yogurt products regarding reduced risk of T2D in response to a Danone North America petition is discussed.

METHODS

Relevant literature cited in the petition along with supporting evidence from PubMed and Google Scholar databases until April 1st, 2024 were used. Literature was found using relevant keywords.

RESULTS

On March 1st, 2024, the United States Food and Drug Administration (FDA) announced the first ever qualified health claim, stating that eating yogurt regularly may reduce the risk of T2D according to limited scientific evidence. The enforcement discretion letter was critically reviewed and discussed regarding its future implications for people with T2M and public health.

CONCLUSIONS

It is unclear how this FDA decision will affect public health and nutrition in the long-term. Limited scientific evidence suggests that at least 3 servings of yogurt per week may reduce the risk of T2D incidence for the general population. Yogurt will not cure or treat people with T2D.

Lactobacillus paracasei ZFM54 alters the metabolomic profiles of yogurt and the co-fermented yogurt improves the gut microecology of human adults

Gut microbiota imbalance could lead to various diseases, making it important to optimize the structure of flora in adults. Lactobacillus paracasei ZFM54 is a bacteriocin and folic acid producing Lactobacillus strain. Herein ZFM54 was used as the potentialy probiotic bacterium to ferment milk together with a yogurt starter. We optimized the fermentation conditions and the obtained yogurts were then subjected to volatile and non-volatile metabolome analysis, showing that ZFM54 cannot only improve the acidity, water holding capacity and live lactic acid bacteria counts, but also improve many volatile acid contents and increase some beneficial non-volatile metabolites such as N-ethyl glycine and L-Lysine, endowing the yogurt with more flavor and better function. The regulatory effects of the co-fermented yogurt on intestinal microecology of volunteers were investigated by 16S rRNA sequencing and short-chain fatty acids (SCFAs) analysis after a continuous consuming the yogurt of 2-week, showing better effect to increase the relative abundance of beneficial bacteria such as Ruminococcus and Alistipes, decrease harmful bacteria (Escherichia-Shigella and Enterobacter), and enhance the production of SCFAs (acetate, propionate and butyric acid) than the control yogurt. In conclusion, L. paracasei ZFM54 can significantly improve the health benefits of yogurt, laying the foundation for its commercial application in improving gut microbiota.

Association between the Healthy Eating Index-2015 and Developmental Disabilities in Children: A Cross-Sectional Analysis

Few studies have examined the association between dietary quality and the risk of developmental disabilities (DDs). This study aimed to investigate the association between dietary quality and the risk of DDs in US children aged 5 to 15. We employed data from the National Health and Nutrition Examination Survey (NHANES) 2003-2018. Multivariable logistic regression was used to evaluate the association between HEI-2015 score, HEI component score, and the likelihood of DDs. Restricted cubic splines (RCS) were utilized to investigate nonlinear links between HEI-2015 score and the likelihood of DDs. Interaction analysis was utilized to explore differences between subgroups. HEI-2015 score was negatively linked with the risk of DDs after adjusting covariates [odds ratio (OR) = 0.99; 95% confidence interval (CI) = (0.98, 1.00)]. HEI-2015 score was separated by quartile into Q1, Q2, Q3, and Q4. Q1 represents the lowest HEI scores, while Q4 represents the highest HEI scores. Children in the fourth quartile of the HEI-2015 exhibited a decreased prevalence of DDs compared to those in the first quartile [(OR = 0.69; 95% CI = (0.53, 0.89)]. The association between HEI-2015 score and the risk of DDs was modified by race/ethnicity. The higher HEI-2015 score was associated with a lower risk of DDs, suggesting that better dietary quality may reduce the risk of DDs in children.

Dietary Guidelines Meet NOVA: Developing a Menu for A Healthy Dietary Pattern Using Ultra-Processed Foods

BACKGROUND

A proposed topic for the 2025 Dietary Guidelines for Americans (DGA) Scientific Advisory Committee to address is the relationship between dietary patterns with ultra-processed foods (UPF) and body composition and weight status. Implementing the NOVA system, the most commonly applied framework for determining whether a food is "ultra-processed," in dietary guidance could omit several nutrient-dense foods from recommended healthy diets in the DGA.

OBJECTIVE

The purpose of this proof-of-concept study was to determine the feasibility of building a menu that aligns with recommendations for a healthy dietary pattern from the 2020 DGA and includes ≥80% kcal from UPF as defined by NOVA.

DESIGN

To accomplish this objective, we first developed a list of foods that fit NOVA criteria for UPF, fit within dietary patterns in the 2020 DGA, and are commonly consumed by Americans. We then used these foods to develop a 7-d, 2000 kcal menu modeled on MyPyramid sample menus and assessed this menu for nutrient content as well as for diet quality using the Healthy Eating Index-2015 (HEI-2015).

RESULTS

In the ultra-processed DGA menu that was created, 91% of kcal were from UPF, or NOVA category 4. The HEI-2015 score was 86 out of a possible 100 points. This sample menu did not achieve a perfect score due primarily to excess sodium and an insufficient amount of whole grains. This menu provided adequate amounts of all macro- and micronutrients except vitamin D, vitamin E, and choline.

CONCLUSIONS

Healthy dietary patterns can include most of their energy from UPF, still receive a high diet quality score, and contain adequate amounts of most macro- and micronutrients.

Reformulation of Processed Yogurt and Breakfast Cereals over Time: A Scoping Review

Poor diet is responsible for a quarter of European non-communicable disease (NCD)-related deaths. The reformulation of sugar, salt, and saturated fat in processed packaged foods offers an opportunity to reduce consumption of nutrients of concern and also support a reduction in energy intake. To date, there have been no publications measuring progress in food reformulation by compiling published evidence for a food category. The aim of this scoping review was to identify, characterize and summarise the findings of studies analysing the reformulation of processed yogurt and breakfast cereals. The review answered the research question: "What is the impact of food reformulation on the nutrient quality of yogurt and breakfast cereals available in the retail environment?" The research protocol was defined based on PRISMA-ScR guidelines. Five databases were searched in May 2022. Thirteen studies, published between 2010 and 2021 and completed across seven countries were eligible for inclusion. There were sufficient eligible studies to identify trends in sodium, salt, and sugar reduction in breakfast cereals. However, there was minimal or no reduction in energy, which may bring into question the use of food reformulation as part of an overall health strategy for obesity reduction.

Added Sugar Consumption in Spanish Children (7-12 y) and Nutrient Density of Foods Contributing to Such Consumption: An Observational Study

BACKGROUND

Diets rich in free sugars are associated with an increased risk of obesity. The aim of the present study is to estimate the intake of added sugars in the population of Spanish children and analyze the quality of the foods that contribute to this intake.

METHODS

An observational study was conducted to collect self-reported information on weekly food consumption in 1775 Spanish children (7-12 years). Nutrient contents were obtained from different databases. Two nutritional density indices were constructed taking into account all nutrients provided and compared with two previously described indices.

RESULTS

The average consumption of added sugars in Spanish children was 55.7 ± 1.0 g/day. The products that most contributed to added sugar intake were biscuits (13.3%), cocoa powder (11.1%), sweetened yogurts (9.9%), and dairy desserts (8.6%). Among these, dairy products had considerable nutritional value. Parents' perception of nutritional value was not aligned with the actual nutritional value.

CONCLUSION

The consumption of added sugars was higher than recommended. Public awareness efforts should focus on: (1) the reduction of consumption of low-nutritional quality products containing high amounts of added sugars; (2) the industrial reformulation of most consumed products to reduce sugar content and increase valuable nutrients; and (3) nutritional education.

Dairy fortification as a good option for dietary nutrition status improvement of 676 preschool children in China: A simulation study based on a cross-sectional diet survey (2018-2019)

Background

Chinese children are deficient in several essential nutrients due to poor dietary choices. Dairy products are a source of many under-consumed nutrients, but preschool children in China consume dairy products significantly less than the recommended level.

Methods

From the cross-sectional dietary intake survey of infants and young children aged 0-6 years in China (2018-2019), preschool children (age: 3-6 years) (n = 676) were selected. The four-day dietary data (including 2 working days and 2 weekends) collected through an online diary with reference to the food atlas were used for analysis and simulation. In scenario 1, individual intake of liquid milk equivalents was substituted at a corresponding volume by soymilk, cow's milk, or formulated milk powder for preschool children (FMP-PSC). In scenario 2, the amount of cow's milk or FMP-PSC increased to ensure each child's dairy intake reached the recommended amount (350 g/day). In both scenarios, the simulated nutrient intakes and nutritional inadequacy or surplus were compared to the survey's actual baseline data.

Results

It was suggested suggested that replacing dairy foods with FMP-PSC at matching volume is better than replacing them with soymilk or cow's milk to increase the intake of DHA, calcium, iron, zinc, iodine, vitamin A, vitamin B₁, vitamin B₃, vitamin B₁₂, vitamin C and vitamin D. Moreover, our results suggested that adding FMP-PSC to bring each child's dairy intake to the recommended amount can bring the intakes of dietary fiber, DHA, calcium, iron, zinc, iodine, vitamin A, vitamin B₁, vitamin B₃, vitamin B₉, vitamin B₁₂, vitamin C and vitamin D more in line with the recommendations when compared with cow's milk.

Conclusion

Accurate nutrition information should be provided to the parents of preschool children so as to guide their scientific consumption of dairy products and the usage and addition of fortified dairy products can be encouraged as needed.

The Influence of Increased Dairy Product Consumption, as Part of a Lifestyle Modification Intervention, on Diet Quality and Eating Patterns in Female Adolescents with Overweight/Obesity

Our study examined how increased dairy consumption versus habitually low dairy consumption, against a background of healthy eating (and exercise), influenced diet quality, nutrient intake, and snacking in Canadian female adolescents (14.8 ± 2.2 years) with overweight/obesity (OW/OB). We also explored dairy consumption patterns in the group consuming dairy products. Participants were randomized into two groups: higher/recommended dairy (RDa; 4 svg/d; n = 24) or low dairy (LDa; 0−2 svg/d; n = 23). Both groups participated in a 12-week, eucaloric, lifestyle modification intervention consisting of exercise training and nutritional counseling. The intervention increased the total Canadian Healthy Eating Index score (p < 0.001) with no differences between groups. The “other food” sub-score improved more in RDa than LDa (p = 0.02), and the “saturated fat” sub-score increased more in LDa than RDa (p = 0.02). The intervention significantly increased the consumption of dairy-related nutrients more in RDa than LDa (p < 0.05). The intervention also decreased snack size in both groups (p = 0.01) and improved percentage of healthy snack energy intake more in RDa than LDa (p = 0.04). More servings of dairy products were consumed as snacks than at breakfast, lunch, or dinner (p < 0.05). Thus, our study improved diet quality, and dairy product consumption improved intakes of key related nutrients and snack consumption in adolescents with OW/OB.

Understanding supply chain resilience through conceptual modelling techniques

Purpose

This paper aims to propose a conceptualization of the supply chain resilience domain using conceptual modelling techniques formalized through a metamodel and illustrated through an example.

Design/methodology/approach

This research uses conceptual modelling techniques to build and modularize the metamodel, the latter to manage complexity. The metamodel was built iteratively and subsequently instantiated with an example of a yogurt factory to analyse its usefulness and theoretical relevance, and thus its contributions to the domain.

Findings

Conceptual modelling techniques can represent a complex domain such as supply chain resilience simply, and the proposed metamodel makes it possible to create models that become valuable decision support tools.

Originality/value

Consolidation and structuring of concepts in the supply chain resilience domain through conceptual modelling techniques.

Probiotic dairy products and consumption preferences in terms of sweetness sensitivity and the occurrence of childhood obesity

Fermented dairy products such as yogurt contain many bioactive compounds. In addition, probiotic yogurts are an invaluable source of probiotic bacteria and are a group of probiotic products best accepted by children. There is plenty of research indicating an interdependence between yogurt consumption, body mass index, and adipose tissue percentage, which suggests that yogurt consumption may contribute to reducing the risk of becoming overweight or obese. In turn, the occurrence of overweight and obesity may be accompanied by a reduced sensitivity to sweetness, which modifies food preference selection and acceptance, including with yogurt. This study aimed to assess the preferences and consumption of yogurt in terms of sensitivity to recognize sweetness and obesity in a group of 7–9-year-old children. Body mass index and adipose tissue percentage obesity indicators were determined, and the frequency of fermented milk product consumption was assessed about the results of the sweetness recognition test as well as yogurt preferences. There was no significant relationship between body weight and the frequency of fermented milk product consumption. Correlations were found between the values of body mass index and the ability to recognize sweetness, which was significantly better recognized by underweight children or at normal body weight, moreover, those children with a higher ability to recognize sweetness significantly more frequently preferred plain unsweetened yogurt.

Study of the consistency of defrosted aerated fermented milk desserts by rheological methods

The aim of the research was to quantify the consistency of defrosted aerated fermented milk desserts. The objects of research were samples of desserts with a mass fraction of fat of 2.5%, in one of the samples whey protein concentrate was used (WPC). Rotational viscometry, penetrometric and thermostatic methods were used. It has been established that the use of WPC allows increasing dynamic viscosity by 4.5 times, mixture overrun by 1.4 times, dimensional stability (less shrinkage degree) by 1.26 times, adhesion by 1.65 times and stickiness by 1.93 times. Also, the hardness decreases by 1.6 times and the elastic modulus by 1.65 times. The results obtained are of practical importance in substantiating the composition, parameters of the production process and the sale of defrosted aerated fermented milk desserts.

Health effects of yogurt consumption during paediatric age: a narrative review

Yogurt is a fermented milk product characterised by a peculiar nutritional composition with live and viable cultures of bacteria. Few studies have analysed the benefits of yogurt consumption on health outcomes during paediatric age. Recent epidemiological studies evaluating the nutritional impact of yogurt have demonstrated its significant contribution to nutrients intakes among children. Thus, consuming yogurt is a strategy to achieve recommended nutrient intake and healthier dietary choices, with potential impact on obesity and cardiometabolic outcome in children. Yogurt's effects on paediatric infectious diseases, gastrointestinal diseases and atopic-related disorders are ascribed to the specific probiotic strain administered. Interestingly, the benefits of yogurt consumption are most likely due to effects mediated through the gut microbiota and the enhancement of innate and adaptive immune responses. Therefore, supplementing standard yogurt cultures with probiotic strains could be useful to promote health at different paediatric ages, although more evidence is needed regarding the strain-related effects and their interplay within the paediatric immune system.

Towards a Water-Energy-Food (WEF) nexus index: A review of nutrient profile models as a fundamental pillar of food and nutrition security

The Water-Energy-Food (WEF) nexus approach should be promoted as a tool for sustainable management of resources through the interconnection of these three fundamental pillars. Particularly, food security must ensure healthy and balanced diets for everyone, but selecting individual indicators to assess all slants covered by this element is not an easy task. Hence, the objective of this paper is two-fold, to review nutrient profiling (NP) models that allow to categorize foods and evaluate diets based on their nutritional quality, and to choose the most appropriate model to be used within a WEF nexus index. To address this issue, a total of 159 documents were assessed, appraising the geographic distribution, and time evolution of the publications, as well as the characteristics and potential applications of the NP systems. The review concludes that the NRF9.3. model is the most liable option to be used in a WEF nexus index, presenting the best characteristics by means of the definition of scores and thresholds, and the use of an 'across-the-board' criteria and a reference quantity of 100 kcal, alongside offering higher ability to assess diets and foods than the other competitive model (HEI) through the evaluation of nutrients to encourage instead of foods. A secondary outcome of the review is the identification of the NP models as a useful tool to enable institutions with information to establish policies in the field of public health and facilitating the decision-making process according to the current healthy claims.

Milk and dairy consumption is positively associated with height in adolescents: results from the Israeli National Youth Health and Nutrition Survey

PURPOSE

Milk consumption is associated with increased height primarily in early childhood. However, in adolescents, data are scarce with inconsistent results. Since height is a proxy for overall health and well-being, this study evaluated the association of dairy intake with height in adolescents.

METHODS

Students in 7th-12th grades, participating in the 2015-2016 Israeli Health and Nutrition Youth Survey, a school-based cross-sectional study, completed self-administered questionnaires, including a semi-quantitative food frequency questionnaire (n = 3529, 48% males, 15.2 ± 1.6 years). Anthropometric measurements were also performed. Dairy servings were calculated as the calcium equivalent of 1 cup of milk, and consumption was divided into four categories from very low (< 1 serving/day) to high (3 + servings/day). BMI- and Height-for-age z scores (HAZs) were calculated according to WHO growth standard; relatively short stature (RSS) was defined as HAZ < - 0.7 SD (< 25th percentile). Multivariable linear and logistic regression analyses were performed to evaluate the association of dairy intake with HAZ and prevalence of RSS, respectively.

RESULTS

Median consumption of dairy products was 2 servings/day, 1.4 from unsweetened products (milk, cheese and yogurt). Controlling for age, sex, BMI-z-score and socioeconomic status, each increment of unsweetened dairy intake was associated with on average 0.04 higher HAZ (equivalent to 0.3-0.4 cm, p < 0.05), and with reduced risk for RSS: OR 0.90, 95%CI: 0.84, 0.97, p < 0.01. No such associations were found with sweetened dairy products.

CONCLUSION

Consumption of unsweetened dairy products (3-4 servings/day) appears to contribute to achieving growth potential in adolescents. Intervention studies are necessary to determine the causal relationship between dairy intake and linear growth.