Biomedical subjects

U Alexy

Publications and source records attributed to U Alexy.

At least 19 recordsLinked to original sources

PubMed2005

Ghrelin levels before and after reduction of overweight due to a low-fat high-carbohydrate diet in obese children and adolescents.

BACKGROUND: There are conflicting results for ghrelin changes in reduction of overweight. Increasing ghrelin levels in weight reduction are considered to be responsible for compensatory mechanisms that make the reduction of overweight unlikely to be sustained. METHODS: We have analyzed fasting serum ghrelin levels, weighed dietary record and, as biochemical markers of clinically relevant reduction of overweight, leptin, adiponectin and insulin levels and insulin resistance measured by homeostasis model assessment (HOMA) at baseline and after a 1-y outpatient weight reduction program based on a high-carbohydrate and low-fat diet in 37 obese children (median age 10 y). We divided these children into two subgroups according to their degree of weight loss (substantial reduction of overweight: decrease in SDS-BMI > or = 0.5). Furthermore, we analyzed ghrelin levels in 16 normal-weight children. RESULTS: Obese children demonstrated significant (P<0.001) lower ghrelin levels compared to normal-weight children. Daily caloric intake (P = 0.004) and percentage fat content decreased significantly (P<0.001), while percentage carbohydrate content increased significantly (P = 0.003) between baseline and 1-y follow-up in the obese children. The substantial reduction of overweight in 16 children (median SDS-BMI = -0.7) was associated with significant changes in insulin resistance (median decrease of HOMA 27%; P = 0.013), insulin (median decrease 25%, P = 0.036), adiponectin (median increase 15%; P = 0.003), and leptin levels (median decrease 19%; P = 0.023), while there were no significant changes in ghrelin levels (median increase 4%; P = 0.326). In the 21 children without substantial reduction of overweight (median SDS-BMI = -0.3), there were no significant changes in insulin resistance and in insulin, adiponectin, leptin and ghrelin levels. CONCLUSIONS: We conclude that in obese children, low-fat high-carbohydrate diet-induced weight loss does not change ghrelin secretion, but significantly decreases leptin levels, increases adiponectin levels and improves insulin resistance determined by significantly decreased insulin resistance indices as well as lowered serum insulin levels.

Adiponectin↗

PubMed2004

[Nutrition of children and adolescents. Results of the DONALD Study].

In this paper, the actual diet of children and adolescents is characterized by food group intake. Age-dependent dietary patterns and long-term dietary trends are described and commented on against the background of the optimized mixed diet, a preventive total diet concept for German children and adolescents. Dietary intake data come from 3-day dietary records obtained in the DONALD Study (Dortmund Nutritional and Anthropometrical Longitudinally Designed Study), an ongoing mixed longitudinal cohort study conducted at the Research Institute of Child Nutrition since 1985. The actual diet of the observed children and adolescents differed to some extent from the optimized mixed diet. For example, the intake of vegetables was lower and the intake of meat/sausage and confectionary was higher than recommended. The three rules for food selection of the optimized mixed diet (consume plant foods and beverages liberally, animal foods moderately, and high-fat, high-sugar foods occasionally) show a practical way to improve unfavorable dietary habits of children and adolescents without fundamental changes of food intake patterns and taste properties of the actual diet. The partly favorable and partly unfavorable dietary trends observed in the DONALD Study should continue to be critically considered.

Adolescent↗

PubMed2004

Letter.

Explore the source record for details and available documents.

Energy Intake↗

PubMed2004

Pattern of long-term fat intake and BMI during childhood and adolescence--results of the DONALD Study.

OBJECTIVE: Adverse dietary habits have been discussed as being conducive to the increased prevalence of obesity in children and adolescents. No single dietary factor has been clearly identified so far. We analyzed long-term fat intake patterns during childhood and adolescence and their influence on body fatness. METHODS: Four clusters with different patterns of percent energy from fat were found in 228 individuals from the age of 2-18 y participating in the DONALD Study (Dortmund Nutritional Anthropometric Longitudinally Designed Study) with at least 10 yearly weighed dietary records between 1985 and 2002. Clusters were evaluated with regard to macronutrient and food group intakes and body mass index (BMI). RESULTS: The mean energy density and the ratio of energy intake to estimated basal metabolic rate per subject differed significantly between clusters. All calculated macronutrients (per energy intake) with the exception of dietary fiber differed significantly as well as intakes of Meat/Fish/Eggs, Fats/Oils and Fruit/Vegetables. Although these differences in dietary characteristics persisted during the study period, no differences of BMI (calculated as standard deviation score) were found either at the first or last examination per subject. The mean BMI during the study period differed significantly, with the highest BMI in the low fat intake cluster. CONCLUSION: BMI could not be explained by different dietary patterns during childhood and adolescence in this long-term evaluation of dietary records. Underreporting especially in obese subjects, the problem of detecting minor overconsumption of energy intake that favors the development of obesity over long periods, and the small study sample may explain these conflicting results.

Adolescent↗

PubMed2003

Time trends in the consumption of dairy foods in German children and adolescents.

OBJECTIVE: Examination of time trends in the consumption of dairy food and their impact on fat and calcium intakes in German children and adolescents. DESIGN: Dietary records from the DONALD Study (DOrtmund Nutritional and Anthropometric Longitudinally Designed Study). METHODS: A total of 5068 3-day weighed dietary records from 914 1 to 13-y-old children and adolescents collected between 1986 and 2001 were analysed using a mixed linear model, in which the means of the data and the covariance structure specific to the DONALD Study were modelled. RESULTS: During the study period, the consumption of 'milk products' in children and adolescents >/=4 y remained stable, since the reduced consumption of 'fluid milk' (between -2.8 and -7.4 g/day/study year) was compensated for by an increased consumption of 'yoghurt' (between +2.4 and +3.3 g/day/study year). The consumption of 'cheese' increased in subjects >/=4 y (between +0.2 and +0.7 g/day/study year). In 1 to 3-y-old children, the decreased intake of 'fluid milk' (-6.5 g/day/study year) was not compensated for by the increased intake of 'formula' (+3.5 g/day/study year). The percentage of 'low-fat milk products' significantly increased (although not significant in 9-13-y-old boys) to nearly 25% of milk products. The impact of dairy food on fat intake (as percentage of energy intake) remained stable with the exception of a slight reduction in 4-8 y olds, the impact of dairy on calcium (as percentage of US adequate intake) decreased only in 1-3 y olds. CONCLUSIONS: The consumption of dairy food remained widely stable over time in >/=4-y-old children and adolescents, but decreased in 1-3 y olds. A further decline in this age group would be undesirable as is the shift from common milk to formula. The intake of 'low-fat milk products' increased and should be continuously promoted.

Adolescent↗

PubMed2003

Predictors to success in outpatient training in obese children and adolescents.

OBJECTIVE: The treatment of obese children and adolescents is not yet satisfactorily effective. It is not clear which participants can profit by a long-time outpatient therapy. DESIGN: Longitudinal, clinical intervention study based on a 1-y outpatient training programme consisting of physical exercise, nutrition course and behaviour therapy for children and their parents. SUBJECTS: A total of 75 obese children (age 7-15 y; standard duration scores of body mass index(SDS-BMI)+1.9-+3.8). MEASUREMENTS: We characterised the participants as to their willingness to change their behaviour (changes in weight status, number of attempts at therapy, participation in exercise groups), somatic characteristics (BMI of children and family members, gender, age), socioeconomic status (level of education of the children and their parents, working mother), exercise and dietary habits, dietary intake as well as the quality of dietary records. These factors were related to the success of the treatment using a multiple logistic regression. RESULTS: A total of 27 (37%) of the children were unsuccessful after treatment. For 48 (63%) of the children, there was a median weight loss of about 0.4 SDS-BMI (range -0.2 to -1.1). The only significant difference (P<0.0001) between these successful children and the unsuccessful ones was that they had taken part in the exercise groups before training began. CONCLUSION: A training for the obese children and their parents enables the majority of the participants to reduce weight. Previous participation in exercise groups can be considered as a predictor to success of the treatment.

Adolescent↗

PubMed2001

The foods most consumed by German children and adolescents: results of the DONALD Study. Dortmund Nutritional and Anthropometric Longitudinally Design.

BACKGROUND: For a successful nutrition counseling of children and adolescents, knowledge of dietary habits is mandatory. This report describes food group intake and gives details of the customary food selection of healthy German children and adolescents. Main foods which are consumed in large amounts were identified as those on which health promotion should be concentrated. METHODS: 3-day weighed dietary records of 344 children (age range 4-6 years) and 92 adolescents (age range 13-14 years) concerning the period 1990-1997 of the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study) were evaluated. RESULTS: The number of different foods recorded during the 3-day observation period ranged from 21 to 70 and was independent of age or sex. In contrast to dietary guidelines, the consumption of animal foods and 'fats/oils' exceeded the consumption of plant foods with the exception of adolescent girls. Food selection was very similar in age and sex groups. CONCLUSION: Our study shows that under preventive aspects the current food selection could be improved without disturbing the prevailing dietary habits and food preferences.

Adolescent↗

PubMed2000

Vitamin intake of 1- to 18-year-old German children and adolescents in the light of various recommendations.

Data on the vitamin intake during childhood and adolescence are rare in Europe. Here, age and sex specific percentiles of the absolute intakes and relative densities (per MJ) of retinol, carotenoids, vitamins A, E, C, B1, B2, B6, niacin and folate in a sample of 627 subjects between the age of 1 and 18 years are reported and compared to the actual recommendations from Germany, the EC and the USA. The evaluation of the intakes clearly depends on the reference value chosen. In total, the vitamin intake can be assessed to range between satisfactory and generous with the exception of folate which ranged consistently below the references.

Adolescent↗

PubMed2000

Ten-year trends in vitamin and mineral intake from fortified food in German children and adolescents.

OBJECTIVE: We investigated time trends in consumption patterns, and energy and nutrient intakes (protein, fat, carbohydrates, added sugars, vitamins A, E, C, B1, B2 and B6, niacin, folate, calcium and iron) from fortified food in children and adolescents between 1987 and 1996 in Germany. DESIGN: Mixed longitudinal survey (DONALD study) with 3 d weighed dietary records (n=2062 from 594 subjects), one subject per family per year chosen by random. SETTING: Dortmund (Western Germany) district cohort. SUBJECTS: 285 males, 309 females; mean age 6 y (2-13 y). RESULTS: Almost all children and adolescents consumed fortified food irrespective of the year studied. With the exception of vitamin E, significant time trends in the proportions of nutrient intakes from fortification were observed. The fortification of food with vitamins A, C, B1, B2 and B6 and niacin raised the already adequate intakes from non-fortified food (100% to 150% of reference intake values) by 20-50%. The fortification of food with vitamin E and folate raised the low intakes from non-fortified food (about 50% of reference intake values) to about 80% (folate) and 100% (vitamin E) of the references. Fortification of food with calcium and iron was not significant (<10%), but while total intake of calcium was adequate, total intake of iron remained critical. CONCLUSIONS: Since the nutrient intake of the population of children and adolescents studied is adequate with respect to vitamins A, C, B1, B2 and B6, niacin and calcium, fortification seems inefficient, while fortification of food with vitamin E and folate, but not iron, improves an inadequate intake. SPONSORSHIP: The DONALD study is supported by the German Federal Ministry of Health and the North-Rhine-Westphalian Ministry of Science and Research. European Journal of Clinical Nutrition (2000) 54, 81-86

Adolescent↗

PubMed2000

Vitamin and mineral supplements for the use of children on the German market: products, nutrients, dosages.

A market survey of vitamin and mineral supplements was carried out considering various points of purchase. 37 of 146 producers offered a total of 110 supplements marketed 'directly' (42%) or 'indirectly' (58%) for the use of children. These products contained 31 different nutrients, vitamins more frequently than minerals. The number of nutrients per product ranged from 1 (23%) to over 10 (13%), maximum 26. In most cases, the daily dosage recommended by producers reached from 100 to 200% of the reference doses for nutrition labelling for vitamins and from 50 to 100% for minerals. In total, the findings point to an abundance of products, nutrients and dosages in the German market supply of vitamin and mineral supplements for the use of children.

Adolescent↗

PubMed1999

Development of scores to measure the effects of nutrition counselling on the overall diet: A pilot study in children and adolescents.

An intervention study by documented dietary counselling was carried out in a sample of 9 children and adolescents (12-15 years) living in a full-time institution in Dortmund. Three weighed dietary records were collected over 3-7 days, one before and one after each of two individual nutrition counselling sessions, which were based on the recommended intake of food groups defined by the Optimized Mixed Diet (OMD), a quantitative preventive dietary conception for children and adolescents. As univariate dietary parameters (e.g., cholesterol intake), which are often used to show the effectiveness of nutrition counselling, do not take into account the multivariate complexitiy of nutrition, we developed 3 multivariate scores to measure the effectiveness of nutrition counselling. They are defined as: Recommended Food group change Score (RFS): Average change in the amounts of the deviations (%) from the reference food groups values (OMD = 100 %) before and after counselling taking into account the aim (eat mor/less) of the counselling session, exclusively based on the food groups addressed during counselling. Total Food group change Score (TFS): Average change in the amounts of the deviations (%) from the reference food group values (OMD = 100 %) before and after counselling based on all food groups consumed. Nutrient Improvement Score (NIS): Average change in the negative deviations (%) of 8 vitamins and 8 minerals from the German reference values for nutrient intake (Deutsche Gesellschaft für Ernährung (DGE) = 100 %) before and after counselling. On average, the intakes of the food groups mentioned during the first counselling session improved considerably (RFS = +36 %), the change in the intake of all food groups was small (TFS = +6 %) and the nutrient intakes did not improve (NIS = 0 %). From the second counselling session the values of the RFS was +10 %, of the TFS was +6% and of the NIS +3 %. This means that the success of counselling on one dietary criterion does not guarantee success on others. Our food and nutrient based scores together with a detailed food intake assessment give an example of multivariate measurements of nutrition counselling outcomes.

Adolescent↗

PubMed1999

Vitamin intake of 3- to 36-month-old German infants and children--results of the DONALD-Study.

Infants and young children are a vulnerable group with regard to nutrition. However, there is a lack of information about the dietary composition of healthy German infants and children. Therefore, the intake of vitamins (A, C, E, B1, B2, B6, folate, niacin) was assessed in 354 healthy German infants and children aged 3 to 36 months from 3-day-weighed diet records and compared with German, European and US reference values. Intake of all B-vitamins (B1, B2, B6, folate, niacin) increased during the first 3 years of life, whereas intake of vitamin E decreased. Intake of vitamin A and C varied between age groups. The highest levels of the nutrient densities of most vitamins were found at the end of the first year of life. Depending on the reference values chosen, the vitamin supply of the study population ranged between sufficient and very good. The reported satisfactory intake of vitamins in infants and young children in this study gives rise to the question of whether the current extent of fortification of commercial infant food in Germany is necessary.

Breast Feeding↗

PubMed1999

Fruit juice consumption and the prevalence of obesity and short stature in german preschool children: results of the DONALD Study. Dortmund Nutritional and Anthropometrical Longitudinally Designed.

BACKGROUND: In recent years, a possible association between excessive consumption of fruit juice (> or =12 fl oz per day) and short stature and/or obesity has been discussed. The association among the consumption of fruit juice, anthropometric indices, and the overall diet was examined during a 3-year period in a sample of healthy preschool children participating in the Dortmund Nutritional and Anthropometrical Longitudinally Designed (DONALD) Study. METHODS: Two hundred five children were examined annually at the ages of 3, 4, and 5 years. Dietary intake was calculated from 3-day weighed diet records. Height was measured using a stadiometer. Weight was measured using an electronic scale. RESULTS: Five children consumed excessive fruit juice continually in all three records, 10 children in two records, and 23 children in one record. None of the five children with repeatedly excessive fruit juice consumption was obese or short. Growth velocity, body mass index, and height standard deviation score were not correlated with fruit juice consumption. Consumption of fruit juice was inversely correlated with the consumption of all other beverages and the total consumption of all other food. The intake of protein, fat, and carbohydrates of children consuming excessive fruit juice was closer to the international dietary preventive guidelines than the intake of children consuming low amounts of fruit juice. CONCLUSIONS: In the study sample, even repeatedly excessive fruit juice consumption had no influence on anthropometric indices. The results do not justify a general warning or a general promotion regarding high fruit juice consumption in preschool children's diets.

Animals↗

PubMed1999

Macronutrient intake of 3- to 36-month-old German infants and children: results of the DONALD Study. Dortmund Nutritional and Anthropometric Longitudinally Designed Study.

The intake of macronutrients (protein, fat, fatty acids, carbohydrates, added sugars, fiber) was assessed in 354 healthy German infants and children aged 3-36 months from 3-day weighed diet records. The intake of protein ranged between 7 and 14% of energy intake. Fat intake decreased from 3 months (breast-fed boys and girls, 48%; formula-fed boys/girls, 41/44%) to 12 months (boys/girls, 33/36%) due to the increasing consumption of commercial weaning foods, and then increased again up to 36 months (boys/girls, 40/43%). Intake of added sugars decreased during the first 12 months and then increased again, but only slightly exceeded the limit of 10%. Intake of dietary fiber was highest at the age of 1 year (boys/girls, 2.7/2.3 g/MJ). The macronutrient intake was in accordance with other German and European surveys, but deviated considerably from the respective recommendations.

Age Factors↗

PubMed1998

Energy intake of 1 to 18 year old German children and adolescents.

In a sample of 695 healthy well-nourished German children and adolescents covering the total age range from 1 to 18 years, 3d weighed diet records were collected and measurements of body height and weight were taken. 10% non-plausible records (reported energy intake (EI):estimated basal metabolic rate (BMR) < Cut off 1.06) were excluded from further analysis. The rate of non-plausible records was low in the childhood age groups (2-6%), higher in the male (10%), and highest in the female adolescents (30%). Recalculation of age and sex specific cut offs based on assumed light physical activity levels (PAL) reduced the exclusion rate to 6.5% (total) and 20% (female adolescents). The reported energy intake of the total sample based on plausible records (n = 627, EI:BMR > or = 1.06) was close to the new estimations of energy requirements assuming light physical activity which are proposed for the revision of the current FAO/WHO energy requirements. The sample was of normal height and weight compared to the Netherlands growth references. For a definite interpretation of the low reported energy intake in the context of health promoting physical activity patterns of children and adolescents more scientific evidence should be available.

Adolescent↗

PubMed1998

Macronutrient intake of 1 to 18 year old German children and adolescents.

In a sample of 627 healthy German children and adolescents between the age of 1 and 18 years the intake of macronutrients (protein, fat, carbohydrates) and their specific subgroups (animal protein, saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA), cholesterol, added sugars, dietary fiber) were assessed from 3d weighed diet records. The medians of the nutrient intake (% of energy) were 13% protein (2/3 animal), 38% fat, 49% carbohydrates, 17% SFA, 16% MUFA, 5% PUFA, 12% added sugars and (per MJ) 34 mg cholesterol, 1.9 g dietary fiber. The macronutrient patterns were almost uniform across the age and sex groups with the exception of lower fat, PUFA, and sugar intakes in the 1 year olds. The findings were almost in accordance with former and current dietary surveys in Germany and neighboring countries. Several findings, particularly the high SFA and low fiber intake, differed considerably from the diet for the prevention of the chronic diseases related to nutrition in western societies which is recommended for this age range. Based on the findings of this study, a preventive dietary concept for German children and adolescents was proposed.

Adolescent↗

PubMed1998

Measured consumption of commercial infant food products in German infants: results from the DONALD study. Dortmund Nutritional and Anthropometrical Longitudinally Designed.

BACKGROUND: Commercial food products intended for infants form an important part of the diet. Such products are defined as special dietetic food by food legislation. However, quantitative consumption data in the context of the current European Community (EC) food regulations have not been available up to now. METHODS: Six hundred eighty 3-day weighed diet records from 3-, 6-, 9-, and 12-month-old infants involved in the DONALD (Dortmund Nutritional and Anthropometrical Longitudinally Designed) Study were evaluated regarding overall and individual consumption of commercial infant food (CIF). Here, CIF was allocated to the food categories of the current EC directives. RESULTS: Four hundred eighteen varieties of infant food were recorded. The total CIF (formulae; beikost [any food or drink other than breast milk or infant and follow-on formulae]) reached percentages of the total food intake (including breast milk) of 51% (47%; 4%), 62% (33%; 29%), 53% (20%; 32%), and 37% (13%; 24%) at the ages of 3, 6, 9 and 12 months, respectively. Approximately 55% (95%) of the 3-month-old infants (range, 6-12 months) consumed some sort of CIF, but the highest amounts were observed at 6 months and the highest numbers of consumers at 9 months. Depending on the definition of "high consumers" of CIF, the individual consumption quantities (in grams per kilogram per day) differed by a maximum of 60% but high consumers were always found in the 6-month-old group. CONCLUSION: The high proportions of CIF in the diet during a critical developmental period call for a guaranteed high nutritional and safety quality of CIF and for realistic data on consumption patterns.

Breast Feeding↗

PubMed1998

Energy intake and growth of 3- to 36-month-old German infants and children.

Recently, new estimations of the energy requirements of infants and children were proposed as a basis of new FAO/ WHO energy requirements. We have compared the energy intake of 354 healthy, well-nourished infants taking part in the Dortmund Nutritional and Anthropometric Longitudinal Designed Study (3-day-weighted diet records) with these new estimated energy requirements. The energy intake of breast-fed and formula-fed infants and the energy intake of the 1- to 3-year-old children in the study population corresponded well with the new estimated energy requirements, although these were considerably lower than the 1985 FAO/WHO energy requirements. Breast-feeding rates were lower and the introduction of beikost was earlier than the current recommendations. Height and weight, which were taken as global indicators of the adequacy of the energy intake, were in good accordance with The Netherlands' third nationwide survey. Our data indicate that the new estimations of energy requirement seem to be more appropriate than the 1985 FAO/WHO energy requirements.

Body Height↗