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BACKGROUND/OBJECTIVES: Bioimpedance analysis (BIA) is a simple, convenient and widely used tool for the measurement of body composition in population surveys and surveillance. Prediction equations based on BIA applicable to preschool children are available but are based on total body water estimation and have not been developed across multiple ethnic groups. Our aim was to develop a BIA-based equation in a multi-ethnic sample of 2-year old using fat-free mass (FFM) from dual-energy X-ray absorptiometry (DXA) as criterion measure. SUBJECTS/METHODS: Single-frequency hand-to-foot BIA (model BIM4, Impedimed) and whole-body DXA measurements were carried out in 77 (35 boys, 42 girls;27 European, 20 Polynesian, 30 Asian and other) healthy preschool children (age range 22-38 months). Body mass index s.d. scores were 0.41 [+ or -] 1.23 for boys and 0.61 ± 1.09 for girls. The performance of published equations applicable to this age group was assessed. The predicted residual sum of squares method was used to develop and cross-validate a multiple regression equation relating FFM to BIA measures. RESULTS: Published equations performed poorly for estimating FFM in this group of children. The prediction equation developed in all 77 children was: FFM (kg) = 0.367 height(cm)2/resistance + 0.188 weight (kg) + 0.077 height (cm) + 0.273 sex (male = 1, female = 0)-2.490, [R.sup.2] = 0.89, standard error of estimate = 0.50 kg. Ethnicity and age did not add significantly to the model. CONCLUSIONS: We have developed an equation that may have application for prediction of FFM in 2-3-year-old children, which does not require determination of hydration factors. Further work should be carried out using DXA scanning to extend the applicable age range. doi:10.1038/ejcn.2012.182; published online 12 December 2012 Keywords: bioimpedance analysis; dual-energy X-ray absorptiometry; fat-free mass; children, INTRODUCTION The most rapid postnatal growth takes place in the first 3 years of a child's life. An early understanding of changes in the differential accumulation of fat and fat-free [...]

BACKGROUND/OBJECTIVES: Considering the large number of children worldwide attending all-day schools, information on the effects of lunch on short-term cognitive performance is of public health relevance. However, only adult studies investigated this issue yet. Therefore, this study examined the impact of skipping lunch vs having lunch on children's cognitive functioning in the early afternoon. SUBJECTS/METHODS: Participants in this randomized crossover study with two groups were healthy 6th grade students of an all-day school in Gelsenkirchen, Germany. Group 1 skipped lunch on study day 1 and received an ad libitum lunch 1 week later on study day 2. The order for group 2 was vice versa. In the afternoon tonic alertness, visuospatial memory and selective attention were determined using a computerized test battery of the Vienna Test System. For continuous and discrete interval-scaled variables, treatment effect was estimated using the two sample t-test or the Wilcoxon rank-sum test, for discrete ordinal-scaled variables using generalized linear models. RESULTS: Data on 105 children (48% male;12.6±0.6 years) were analyzed. Except for tonic alertness there were no significant differences in cognitive functioning between the skipping lunch day and the having lunch day. The higher number of omission errors on the skipping lunch day lost significance when adjusting for multiple testing. CONCLUSIONS: In the first study on this topic lunch did not have relevant effects on children's cognitive functioning in the early afternoon. Future research needs to be done to figure out potential methodical and physiological explanations. doi: 10.1038/ejcn.2012.209 Keywords: child; attention; memory; diet; food services; schools, INTRODUCTION The long-standing National School Lunch Program of the US (1) and its nutrition standards (2) set an example for a well-organized provision of school meals with the objective of [...]

OBJECTIVES: Body mass index (BMI) percentiles have been routinely and historically used to identify elevated adiposity. The aim of this study was to investigate the optimal Centers for Disease Control and Prevention (CDC) BMI percentile that predicts elevated visceral adipose tissue (VAT), fat mass and cardiometabolic risk in a biracial sample of children and adolescents. PARTICIPANTS AND METHODS: This cross-sectional analysis included 369 white and African-American children (5-18 years). BMI was calculated using height and weight and converted to BMI percentiles based on CDC growth charts. Receiver operating characteristic curve analysis identified the optimal (balance of sensitivity and specificity) BMI percentile to predict the upper quartile of age-adjusted VAT (measured by magnetic resonance imaging), age-adjusted fat mass (measured by dual-energy X-ray absorptiometry) and elevated cardiometabolic risk (≥ 2 of high glucose, triglycerides and blood pressure, and low high-density lipoprotein cholesterol) for each race-by-sex group. RESULTS: The optimal CDC BMI percentile to predict those in the top quartile of age-adjusted VAT, age-adjusted fat mass and elevated cardiometabolic risk were the 96th, the 96th and the 94th percentiles, respectively, for the sample as a whole. Sensitivity and specificity was satisfactory (>0.70) for VAT and fat mass. Compared to VAT and fat mass, there was a lower overall accuracy of the optimal percentile in identifying those with elevated cardiometabolic risk. CONCLUSIONS: The present findings support the utility of the 95th CDC BMI percentile as a useful threshold for the prediction of elevated levels of VAT, fat mass and cardiometabolic risk in children and adolescents. doi: 10.1038/ejcn.2012.203; published online 12 December 2012 Keywords: body mass index; visceral adipose tissue; children; adolescents; Centers for Disease Control and Prevention; body fat, INTRODUCTION Body mass index (BMI) is routinely used in surveillance and as a screening tool to identify those with excess adiposity. (1) In children, the absolute BMI is typically not [...]

Background/Objectives: Children with celiac disease (CD) are at risk for decreased bone mineral density (BMD) because of fat-soluble vitamin malabsorption, inflammation and/or under-nutrition. The study objective was to determine the interrelationships between vitamin K/D status and lifestyle variables on BMD in children and adolescents with CD at diagnosis and after 1 year on the gluten-free diet (GFD). Subjects/Methods: Children and adolescents aged 3-17 years with biopsy proven CD at diagnosis and after 1 year on the GFD were studied. BMD was measured using dual-energy X-ray absorptiometry. Relevant variables included: anthropometrics, vitamin D/K status, diet, physical activity and sunlight exposure. Results: Whole-body and lumbar-spine BMD-z scores were low ([less than or equal to] -1) at diagnosis (10-20%) and after 1 year (30-32%) in the children, independent of symptoms. Whole-body BMD-z scores (-0.55 ± 0.7 versus 0.72 ± 1.5) and serum levels of 25(OH) vitamin D (90.3 [+ or -] 24.8 versus 70.5 ± 19.8 nmol/l) were significantly lower in older children (> 10 years) when compared with younger children ([less than or equal to] 10 years) (P < 0.001). Forty-three percent had suboptimal vitamin D status (25(OH)-vitamin D < 75 nmol/l) at diagnosis; resolving in nearly half after 1 year on the GFD. Twenty-five percent had suboptimal vitamin K status at diagnosis; all resolved after 1 year. Conclusions: Children and adolescents with CD are at risk for suboptimal bone health at time of diagnosis and after 1 year on GFD; likely due in part to suboptimal vitamin D/K status. Therapeutic strategies aimed at optimizing vitamin K/D intake may contribute to improved BMD in children with CD. European Journal of Clinical Nutrition (2012) 66, 488-495; doi: 10.1038/ejcn.2011.176; published online 5 October 2011 Keywords: vitamin K and D; bone health; children; celiac disease, Introduction Celiac disease (CD) is the most common autoimmune-mediated gastrointestinal (GI) disorder; occurring in approximately 1/100 individuals (Fasano and Catassi, 2001). Genetically susceptible individuals exposed to gluten peptides have an [...]