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PubMed1999

Physical activity and diet in 5 to 7 years old children.

OBJECTIVE: To assess the possible associations between physical activity, diet, social state and overweight in children. DESIGN: Cross-sectional study on 1468 children aged between 5 and 7 years old in Kiel, northwest Germany. METHODS: Assessment of physical activity and social factors by a questionnaire, food frequency record, body composition analysis by anthropometrics and bioelectrical impedance analysis. RESULTS: 23% of our children were overweight or obese. Low levels of physical activity (as assessed by TV viewing time) were associated with increased body mass index and a higher prevalence of overweight. TV-viewing of more than 1 h per day was associated with a high consumption fast food, sweets, chips and pizza whereas fruits and vegetables were less frequently consumed. Overweight, inactivity and unhealthy eating habits were seen more frequently in families with a low social status. CONCLUSIONS: In 5 to 7 years old children, overweight is associated with physical inactivity, unhealthy eating habits and a low social status. Primary prevention efforts should be directed to low income families.

Child↗

PubMed1979

Nutrition imbalance and angiotoxins as dietary risk factors in coronary heart disease.

Imbalancing nutritionally adequate diets with an excessive amount of fat calories and cholesterol has obscured the fact that intimal thickening occurs spontaneously in time on low-fat cholesterol-free diets during the aging process, and that intimal thickening can be accelerated by dietary angiotoxic "risk factors." Electron microscopy of arterial tissue from animal models identified degenerated smooth muscle cells in the fetus from sows kept on low-fat cholesterol-free diets. After birth, the degenerated smooth muscle cells increased in number with age. The presence of angiotoxic "risk factors" such as oxidized cholesterol and vitamin D3 (cholecalciferol) in the diet of such animal models increased the frequency of smooth muscle cell death in their arteries. Two types of pathology could be developed in the thoracic aorta by continuous or short term feeding of 12.5 times more vitamin D than normally present in commercial rations: 1) a diffuse fibroelastic intimal thickening in the thoracic aorta (arteriosclerosis) with no evidence of lipid deposition by continuous feeding of vitamin D or 2) an initimal thickening in the thoracic aorta and intimal thickening with foam cells and extracellular lipid deposits (atherosclerosis) in the coronary arteries after a short period of supplemental vitamin D followed by 3 to 4 months of supplement-free diets. These two types of arterial damage were identical to that in the plugs of thoracic aorta obtained as a by-product of elective coronary bypass surgery. Although all of the possible sources of oxidized cholesterol in the diet have as yet not been identified, laboratory studies have identified oxidized cholesterol as an angiotoxic factor. Since population groups that consume less vitamin D-supplemented foods, less deep fat fried cholesterol-containing foods, and less hydrogenated fats have a lower incidence of coronary heart disease than Americans, it seems judicious for food processors to reduce these previously unconsidered risk factors to a minimum. This could be done by eliminating vitamin D2 and D3 from all vitamin supplements, from all food and cereal products and from the diet of livestock 1 month before they were killed so that the intake of vitamin D is no larger than the 400 IU/quart in milk which is necessary to prevent rickets in children. Deep fat fryers, which are kept at almost 200 C for 24 hr/day, could perhaps be replaced with microwave ovens in fast food chain outlets. Processors could hydrogenate vegetable oils to a minimum trans fatty acid content and rearrange this fat with polyunsaturated fats to produce high polyunsaturated fats trans-free margarines and shortenings.

Aging↗

PubMed1987

Food intake at age 8. 2. Frequency, company and place of meals.

In a sample of 141 healthy 8 year old children, over 95% had three main meals on each of the 4 days of the food record. Two-thirds had an afternoon snack and nearly one-half a morning snack on each of the 4 days, but only one-quarter had supper on each day. Seventy-one per cent of all meals were eaten at home with the family, 20% at school with friends, and less than 1% of meals were eaten at a restaurant or fast food outlet. These data show that amongst children of primary school age, take away sources of food make a very small contribution to the diet, and that eating habits at home are of greatest importance to the child's diet.

Child↗

PubMed2004

Postprandial hyperlipidemia after a fat loading test in minority adolescents with type 2 diabetes mellitus and obesity.

The continuing increase in the incidence of type 2 diabetes mellitus (DM2) and obesity in children and adolescents is attributable to excessive caloric intake. Abnormal lipid metabolism in the postprandial state leads to long exposure of the vasculature to hyperlipidemia. Most children and adolescents with DM2 are obese, and many have fasting hypertriglyceridemia. Clustering of hyperlipidemia, DM2 and obesity increases the risk for cardiovascular disease. We therefore studied lipids, insulin, C-peptide, and glucose in response to an oral fat load simulating the fat content of a high-fat, fast-food meal in 12 type 2 diabetic obese, 15 non-diabetic obese, and 12 non-diabetic non-obese (control) adolescents (aged 10-19 yr; 87% African-Americans). All three groups were age-, sex-, and sexual maturation-matched. Mean body mass indices were similar in the diabetes and obese groups (32.7 +/- 1.1 vs 35.8 +/- 1.6 kg/m2). All patients with DM2 had fasting C-peptide > 0.2 nmol/l (0.7 ng/ml) and negative diabetes-associated autoantibodies. Serum total cholesterol, triglyceride, high- and low-density lipoprotein cholesterol, insulin, C-peptide, and plasma glucose levels were measured at 0, 2, 4, and 6 h after the fat load. The area under the curve (AUC) was calculated by trapezoidal estimation. Triglyceride AUC was significantly greater in the diabetes group than in the other two groups (15.7 +/- 2.9 vs 9.2 +/- 0.7 and 7.5 +/- 0.7 mmol x h/l [1389 +/- 258 vs 819 +/- 60 and 663 +/- 62 mg x h/dl]; p < 0.02 and <0.004, respectively), as were insulin, C-peptide, and glucose AUCs. Incremental triglyceride response (delta triglyceride = peak - fasting) in the diabetes group was significantly higher than that in the control group (2.1 +/- 0.7 vs 0.8 +/- 0.1 mmol/l 189.7 +/- 58.4 vs 71.2 +/- 11.1 mg/dl]; p < 0.04). Insulin resistance was estimated using the homeostasis model assessment (HOMA), which was greater in the diabetes group than in the obese and control groups (14.4 +/- 2.8 vs 5.2 +/- 0.8 and 3.2 +/- 0.4; p < 0.001 and < 0.0001, respectively). The diabetes group was divided into subgroups of high and normal fasting triglycerides on the basis of triglyceride levels above and below the 95th percentile. The delta triglyceride in the subgroup with high fasting triglycerides was substantially greater than in the subgroup with normal fasting triglycerides (3.4 +/- 1.1 vs 0.8 +/- 0.2 mmol/l [305.2 +/- 96.8 vs 74.2 +/- 18.0 mg/dl]; p < 0.001). Total cholesterol and triglyceride AUCs were much greater in the high vs normal fasting triglycerides subgroup (33.0 +/- 2.9 vs 24.2 +/- 1.9 and 23.6 +/- 3.5 vs 7.8 +/- 0.6 mmol x h/l [1274 +/- 113 vs 934 +/- 72 and 2085 +/- 309 vs 692 +/- 49 mg x h/dl]; p < 0.02 and <0.0001, respectively), as were insulin and C-peptide AUCs. HOMA was greater in the high vs normal fasting triglycerides subgroup (20.8 +/- 4.0 vs 8.0 +/- 1.6; p < 0.0001). In addition to elevated plasma glucose levels, there were no significant differences in either insulin or lipid parameters among the diabetes subgroup with normal fasting triglycerides, the obese group, and controls. Our data suggest that postprandial hyperlipidemia in response to a fat loading test is present in adolescents with DM2 who already have fasting hypertriglyceridemia. The degree of insulin resistance as an underlying abnormality--not DM per se--determines the degree of postprandial lipemia.

Adolescent↗

PubMed2003

Expanding portion sizes in the US marketplace: implications for nutrition counseling.

The greater energy content of larger food portions could be contributing to the increasing prevalence of overweight. Prevention guidelines recommend "sensible" portion sizes but do not define them. The US Department of Agriculture (USDA) defines standard serving sizes for dietary guidance, and the Food and Drug Administration (FDA) defines standard servings for food labels. To use these standards in counseling, nutritionists must know the sizes of portions available in the marketplace. We determined marketplace portion sizes, identified changes in these sizes with time, and compared current marketplace portions with federal standards. Most marketplace portions exceed standard serving sizes by at least a factor of 2 and sometimes 8-fold. Portions have increased over time; those offered by fast-food chains, for example, often are 2 to 5 times larger than the original size. The discrepancy between marketplace portions and standard servings suggests the need for greater emphasis on the relationship of portion size to energy intake as a factor in weight maintenance.

Counseling↗

PubMed2001

Impact of aging on eating behaviors, food choices, nutrition, and health status.

People eat less and make different food choices as they get older. It is unclear what impact these dietary changes may have on health status. However, lower food intake among the elderly has been associated with lower intakes of calcium, iron, zinc, B vitamins and vitamin E. Low energy intakes or low nutrient density of the diet may increase the risk of diet-related illnesses and so pose a health problem. Several factors may influence this observed decline in energy intake. Older adults tend to consume less energy-dense sweets and fast foods, and consume more energy-dilute grains, vegetables and fruits. Daily volume of foods and beverages also declines as a function of age. Physiological changes associated with age, including slower gastric emptying, altered hormonal responses, decreased basal metabolic rate, and altered taste and smell may also contribute to lowered energy intake. Other factors such as marital status, income, education, socioeconomic status, diet-related attitudes and beliefs, and convenience likely play a role as well. Many age-related nutritional problems may be remedied to some extent by providing nutrient-dense meals through home delivery or meal congregate programs. Management of medical and dental problems and the provision of vitamin and mineral supplements may also be effective. More studies that integrate nutrition research, public health intervention, and outcomes research are needed to determine the impact of diet on nutrition, health, and overall quality of life.

Aged↗

PubMed2005

How to measure dietary intake and food habits in adolescence: the European perspective.

AIM: This paper deals with some methodological aspects of data collection in the context of measuring dietary intake in individuals in their adolescence life stage. METHOD: Experiences from three partners of the HELENA project in dietary intake measurement in children and adolescents are presented in this paper with emphasis on characteristics of under-reporting, long-term diet measurement and food patterns (Dortmund DONALD group), influences of survey duration on under-reporting (Ghent group) and meal habits (Spanish AVENA group). RESULTS: Under-reporters in the DONALD Study, particularly female adolescents, had a significantly higher body mass index (BMI) than non-under-reporters; BMI could not be explained by different long-term dietary patterns during childhood and adolescence clustered according to fat consumption; consumers of fast food had higher BMI values than nonconsumers. In the Ghent experience, the decline in population mean energy intake as calculated over selected clusters of days is 184 kcal (6.5%) in boys and 116 (5.6%) in girls; the cluster of 1 recording day and the cluster of 3 recording days were not significantly different but they were both significantly different from the 7-day cluster; no significant interaction was observed between the effect of time and BMI. In the AVENA Study, the percentage of adolescents skipping breakfast was higher in females (8.6%) than in males (3.5%, P<0.001); higher BMI values were observed in those skipping breakfast than in those notskipping breakfast, but differences were statistically significant in males at 15 y and in females at 14 and 17 y; adolescents avoiding some food groups for breakfast had higher BMI values (carbohydrates, fruits and pastries in males and milk, fruits and pastries in females). CONCLUSION: Dietary and nutrient intake data in the HELENA project will be obtained by means of repeated 24-h dietary recalls. Data from HELENA might be a basis for developing complex approaches like Healthy Eating Indices.

Adolescent↗

PubMed2003

The sweetening of the world's diet.

OBJECTIVE: Using data from many countries in the world combined with in-depth U.S. dietary data, we explored trends in caloric sweetener intake, the role of urbanization and income changes in explaining these trends, and the contribution of specific foods to these changes. RESEARCH METHODS AND PROCEDURES: Food disappearance data from 103 countries in 1962 and 127 in 2000 were coupled with urbanization and gross national income per capita data in pooled regression analysis to examine associations between these factors and caloric sweetener intake. Three nationally representative surveys from 1977 to 1978, 1989 to 1991, and 1994 to 1996 plus 1998 are used to examine caloric sweetener intake trends in the United States and the foods responsible for these changes. RESULTS: Increased consumption of caloric sweetener is one element in the world's dietary changes, represented by a 74-kcal/d increase between 1962 and 2000. Urbanization and income growth represent 82% of the change. U.S. data show an 83-kcal/d increase of caloric sweetener consumed-a 22% increase in the proportion of energy from caloric sweetener. Of this increase, 80% comes from sugared beverages; restaurant and fast food sources are represented in greater proportions. DISCUSSION: Caloric sweetener use has increased considerably around the world. Beverage intake seems to be a major contributor.

Adolescent↗

PubMed2003

Nutritive value of meals, dietary habits and nutritive status in Croatian university students according to gender.

The aim of this study was to evaluate daily menus at students' restaurants and to report dietary habits and other health-related behaviour of Croatian university students (n=2075) according to gender. A specially designed self-administered questionnaire was used. One hundred and twenty daily menus were chosen by random sampling, and the nutritive value was calculated using food composition tables. Daily menus on average provide an adequate amount of energy, protein and most micronutrients: 88.2% of daily menus provide a balanced intake of protein, fat and carbohydrates, 22.5% of daily menus provide more than 300 mg of cholesterol, and 58.8% have more than 25 g dietary fibre. On average, students had 2.4 meals and 1.3 snacks per day. Breakfast was the most often skipped meal. Red meat, cereals and fast food were consumed more often by males (P<0.05). Low-fat dairy products, whole grain products and breakfast cereals were consumed more often by females (P<0.05). The most common choice for snacks was fruit. Males exercised more than females (4.4 h/week versus 1.6 h/week; P<0.05). A higher percentage of females (29.8%) than males (17.2%) smoked cigarettes. For alcohol consumption it was vice versa: 88.9 and 84.8% of males and females, respectively. A total of 80.4% of students were well nourished. This study showed that meals offered at students' restaurants are adequate. Dietary and other health-related behaviour differed according to gender. Clustering of some behaviours was observed.

Adult↗

PubMed1997

[Nutrition in the etiopathogenesis of chronic inflammatory bowel diseases].

It is currently held that the pathogenesis of inflammatory bowel disease (IBD) involves a complex interaction of host responses, some immunologic and genetically determined, and external influences including microbial and dietary factors. Nutritional surveys and studies testing stepwise exclusion dietary compounds have suggested that dietary factors might be linked to the occurrence of IBD. Food allergy was suggested early as a possible trigger for the inflammatory response; however, no firm evidence has been gathered over the years to substantiate this possibility. The possibility that patients with Crohn's disease may have an unusual premorbid pattern of dietary intake has also been examined since the early seventies. Several groups of investigators report a high intake of refined sugars (i.e. sucrose), recycled cooking oil, a more frequent consumption of fast foods in patients with Crohn's disease and ulcerative colitis respectively. However, a critical comparison of incidence and prevalence studies published from 1976 until 1994 clearly showed no pre-existing nutritional abnormality that has been identified consistently in patients who develop inflammatory bowel disease.

Adolescent↗

PubMed1995

Anaphylaxis to mustard as a masked allergen in "chicken dips".

BACKGROUND: Masked allergens in processed foods are sometimes responsible for "idiopathic" anaphylaxis because of the lack of full ingredient labeling. Patients, even if they are aware of a specific hypersensitivity, may be unaware of trace amounts of the offending allergen(s) that are present in these products. METHODS: We report a case of severe anaphylaxis to mustard masked in "chicken dips." A 38-year-old woman had an anaphylactic reaction beginning 20 minutes after eating "chicken dips" in a fast food restaurant. She was treated successfully in an emergency room and then referred to us for evaluation. We performed skin prick tests, IgE antibody, and inhibition assays to identify allergens in foods eaten just prior to the anaphylactic reaction. RESULTS: She had a history of allergy to mustard. Skin prick tests revealed sensitivity to mustard, coriander, and curry powder, which contains mustard. She had 56.3 KU/L mustard-specific serum IgE antibody in a Phadebas CAP RAST assay (Pharmacia, Sweden). The mustard RAST was inhibited with an extract of "chicken dips," confirming the presence of mustard in "chicken dips." CONCLUSIONS: This case points out the risk of masked allergens in modern food products and the value of the RAST inhibition assay for the identification of such hidden allergens.

Adult↗

PubMed2007

Partner effects on food consumption in brown capuchin monkeys.

It has been claimed that capuchin monkeys (Cebus apella) show inequity aversion in relation to food rewards for a simple exchange task. However, other factors may affect the willingness of a monkey to consume foods of high or low value in the presence of a conspecific. In this study, pairs of monkeys were presented with unequally valued foods, but without any task-performance: they simply received the food under four experimental conditions. By looking at the rate of collection and consumption of low-valued cucumber slices we expected to see variation dependent on whether the partner either had 1) cucumber (equity), 2) grape (inequity), 3) inaccessible cucumber or 4) inaccessible grape. Testing 12 adult capuchin monkeys, our findings differed from those of other authors in that the monkeys failed to show negative reactions to inequity, but rather responded with scramble competition (i.e., fast food collection) in the presence of a conspecific without access to food. They also showed facilitated consumption in the presence of a conspecific consuming high-valued food. Possibly, (in)equity plays a different role if food serves as a reward for a task rather than if it is simply made available for consumption.

Analysis of Variance↗

PubMed2002

The 'carnivore connection'--evolutionary aspects of insulin resistance.

Insulin resistance is common and is determined by physiological (aging, physical fitness), pathological (obesity) and genetic factors. The metabolic compensatory response to insulin resistance is hyperinsulinaemia, the primary purpose of which is to maintain normal glucose tolerance. The 'carnivore connection' postulates a critical role for the quantity of dietary protein and carbohydrate and the change in the glycaemic index of dietary carbohydrate in the evolution of insulin resistance and hyperinsulinaemia. Insulin resistance offered survival and reproductive advantages during the Ice Ages which dominated human evolution, during which a high-protein low-carbohydrate diet was consumed. Following the end of the last Ice Age and the advent of agriculture, dietary carbohydrate increased. Although this resulted in a sharp increase in the quantity of carbohydrate consumed, these traditional carbohydrate foods had a low glycaemic index and produced only modest increases in plasma insulin. The industrial revolution changed the quality of dietary carbohydrate. The milling of cereals made starch more digestible and postprandial glycaemic and insulin responses increased 2-3 fold compared with coarsely ground flour or whole grains. This combination of insulin resistance and hyperinsulinaemia is a common feature of many modern day diseases. Over the last 50 y the explosion of convenience and takeaway 'fast foods' has exposed most populations to caloric intakes far in excess of daily energy requirements and the resulting obesity has been a major factor in increasing the prevalence of insulin resistance.

Biological Evolution↗

PubMed2006

The relationship between the neighbourhood environment and adverse birth outcomes.

Intrauterine growth retardation and preterm birth are more frequent in African-American women and women of lower socio-economic status, but the reasons for these disparities are not fully understood. The physical and social environments in which these women live may contribute to these disparities. We conducted a multilevel study to explore whether conditions of mothers' neighbourhood of residence contribute to adverse birth outcomes independent of individual-level determinants. We analysed data from 105 111 births in 1015 census tracts in Louisiana during 1997-98, merging it with data from other existing sources on neighbourhood socio-economic status, neighbourhood physical deterioration, and neighbourhood density of retail outlets selling tobacco, alcohol and foods. After controlling for individual-level sociodemographic factors, tract-level median household income was positively associated with both birthweight-for-gestational-age and gestational age at birth. Neighbourhood physical deterioration was associated with these birth outcomes in ecological analyses but only inconsistently associated with them after controlling for individual-level factors. Neither gestational age nor birthweight-for-gestational-age was associated with the neighbourhood density of alcohol outlets, tobacco outlets, fast-food restaurants or grocery supermarkets. We conclude that measures of neighbourhood economic conditions are associated with both fetal growth and the length of gestation independent of individual-level factors, but that readily available measures of neighbourhood retail outlets are not. Additional studies are needed to better understand the nature of environmental influences on birth outcomes.

Adolescent↗

PubMed1990

Hunger/craving responses and reactivity to food stimuli during fasting and dieting.

One group of fasting obese patients and one group of dieting obese patients were instructed to report their feelings of hunger and craving on a continuous basis before and during a three-week treatment period. Once a week they were also exposed to food slides to measure their reactivity to food stimuli. The frequency of hunger/craving responses and reactivity to food stimuli showed radically different changes over time in the fasting and dieting groups. During the last week of fasting, reactivity to food slides was completely abolished, and the frequency of hunger/craving responses was close to zero. Only slight changes of frequency of hunger/craving responses and reactivity to food stimuli were observed in the dieting group. The results suggest that the frequency of hunger/craving responses and reactivity to food stimuli show parallel decreases during fasting, but no changes during dieting.

Appetite↗

PubMed2001

Foods, health claims, and the law: comparisons of the United States and Europe.

Government, academia, and the food industry can play a significant role in the identification of healthy foods and ingredients important for weight management and health. The U.S. Food and Drug Administration developed regulations that define specific food categories for weight management and health. These categories include foods for special dietary uses and medical foods. Medical foods are classified for use in specific disease states and require a physician's recommendation and continuous monitoring. The European regulations specify energy-restricted foods as a subcategory of food for particular nutritional uses, which includes infant formula, medical foods, and foods for sports. European standards for energy-restricted diets have been established, leaving little flexibility for change. Three categories exist (i.e., very-low-calorie diets [450 to 800 kcal], low-calorie diets [800 to 1200 kcal], and meal replacements [200 to 400 kcal]). No claims on anticipated weight loss can be made even where significant clinical research has demonstrated long-term efficacy, thereby preventing informed choice management. Dramatic changes in lifestyle (e.g., disruption of the family unit, altered eating occasions, fast foods, and food grazing) have resulted in an epidemic of obesity and chronic disease. Regulating food selection or dietary patterns to limit the epidemic is not realistic. However, stimulating government health agencies and the food industry to increase public awareness through educational programs and regulating the definition of acceptable methods and products can provide an environment for change. A consensus is needed among academia, government, and industry for appropriate food labeling and claims. These actions are needed to help individuals make healthy food selections and maintain a healthy weight. Public health initiatives should change consumer attitudes with programs that are simple, affordable, effective, and accessible.

Diet, Reducing↗

PubMed1993

Bulimic behaviors among interscholastic wrestlers: a statewide survey.

Wrestlers are known for their extreme weight-cutting practices including fasting, food and fluid restriction, and dehydration. Using a stratified statewide survey, this investigation elucidated weight loss practices, nutritional knowledge, and bulimic behaviors among 713 high school wrestlers in Wisconsin. Results showed that 1.7% of the wrestlers answered questions consistent with all five criteria for bulimia nervosa, a rate higher than expected for adolescent males. An additional 43% exhibited weight-cutting practices similar to those of the wrestlers who met all bulimia nervosa criteria. The average wrestler lost 3.2 kg to compete, cycled 1.8 kg weekly, and fasted 20 hours prior to weigh-in. More extreme behaviors occurred among the 45% who met two or more bulimia nervosa criteria on their questionnaire; 19% frequently fasted, 25% restricted fluids, 34% used rubber suits, and 8% vomited. These results are comparable with data published over the past 20 years. Efforts to curtail these behaviors through regulations restricting weight loss coupled with sound nutritional information are warranted. Physicians and health professionals should be alert to potential eating disorders within this population.

Adolescent↗

PubMedDate not supplied

[Effect of several factors on lead absorption in the intestine].

Experiments were made on 270 rats to examine lead absorption and the effect on this process of fasting, food intake, preliminary contact of the mucosa with selenium, iron and calcium, a single enteral and parenteral administration of these elements. Lead absorption was observed in all the parts of the intestine. Lead binding to the intestinal mucosa was reduced by food intake one hour before investigation, preliminary contact of the mucosa with selenium, calcium, particularly with iron, as well as by a single administration of iron and calcium. Selenium did not produce any substantial effect on absorption. The conclusions are made about the necessity of the organization of the treatment and prophylactic nutrition for workers.

Animals↗