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Objective: The present study describes the energy content of primary-school children's lunchboxes and the proportion of lunchbox foods considered discretionary. Subgroup analyses by sex, socio-economic status, age and weight status were undertaken.Design: A cross-sectional study was conducted. Mean kilojoule content, number of items and categorisation of foods and drinks in lunchboxes as 'everyday' (healthy) or discretionary (sometimes) foods were assessed via a valid and reliable lunchbox observational audit.Setting: Twelve Catholic primary schools (Kindergarten-Grade 6) located in the Hunter region of New South Wales, Australia.Participants: Kindergarten to Grade 6 primary-school students.Results: In total, 2143 children (57 %) had parental consent to have their lunchboxes observed. School lunchboxes contained a mean of 2748 kJ, of which 61·2 % of energy was from foods consistent with the Australian Dietary Guidelines and 38·8 % of energy was discretionary foods. The proportion of lunchboxes containing only healthy foods was 12 %. Children in Kindergarten-Grade 2 packed more servings of 'everyday' foods (3·32 v. 2·98, P < 0·01) compared with children in Grades 3-6. Children in Grades 3-6 had a higher percentage of energy from discretionary foods (39·1 v. 33·8 %, P < 0·01) compared with children in Kindergarten-Grade 2 and children from the most socio-economically disadvantaged areas had significantly higher total kilojoules in the school lunchbox compared with the least disadvantaged students (2842 v. 2544 kJ, P = 0·03).Conclusions: Foods packed within school lunchboxes may contribute to energy imbalance. The development of school policies and population-based strategies to support parents overcome barriers to packing healthy lunchboxes are warranted. [ABSTRACT FROM AUTHOR]

Objective: We aimed to profile vegetable consumption and its association with dietary and sociodemographic factors.Design: Secondary analysis of a nationally representative nutrition survey. 'Vegetables' refers to non-discretionary 'vegetables and legumes/beans' as defined by the Australian Dietary Guidelines (ADG). Prevalence of vegetable consumption, frequency of intake, proportion meeting ADG recommendations, most popular food groups, intake at each reported eating occasion, and the profile of high and low vegetable consumers (based on the median servings) were determined.Setting: Australian 2011-2012 National Nutrition and Physical Activity Survey.Participants: Children and adolescents aged 2 to 18 years (n 2812).Results: Vegetables were consumed by 83·0% (95% CI 81·6, 84·4%) of participants, but the median vegetable servings was less than a third of the ADG recommendations. 'Leaf and stalk vegetables' and 'potatoes' were the most popular vegetable-dense food groups at lunch and dinner, respectively. Sixty-four percent had vegetables once a day, and predominantly at dinner. Vegetable frequency was positively associated with daily vegetable servings and variety. Participants who consumed vegetables twice a day generally had vegetables at both lunch and dinner and had nearly double the servings (2·6, sd 1·9) of those who consumed them once (1·5, sd 1·5). High vegetable consumers were older, had higher total energy, but lower discretionary energy intake and were less likely to be at risk of metabolic complications.Conclusion: Increasing the frequency of vegetable consumption may assist with increasing daily vegetable servings. A focus on consuming vegetables at lunch may assist with increasing both total servings and variety. [ABSTRACT FROM AUTHOR]

Saliva and urine are the two main body fluids sampled when breast milk intake is measured with the 2H oxide dose-to-mother technique. However, these two body fluids may generate different estimates of breast milk intake due to differences in isotope enrichment. Therefore, we aimed to assess how the estimated amount of breast milk intake differs when based on saliva and urine samples and to explore whether the total energy expenditure of the mothers is related to breast milk output. We used a convenience sample of thirteen pairs of mothers and babies aged 2–4 months, who were exclusively breastfed and apparently healthy. To assess breast milk intake, we administered doubly labelled water to the mothers and collected saliva samples from them, while simultaneously collecting both saliva and urine from their babies over a 14-d period. Isotope ratio MS was used to analyse the samples for 2H and 18O enrichments. Mean breast milk intake based on saliva samples was significantly higher than that based on urine samples (854·5 v. 812·8 g/d, P = 0·029). This can be attributed to slightly higher isotope enrichments in saliva and to a poorer model fit for urine samples as indicated by a higher square root of the mean square error (14·6 v. 10·4 mg/kg, P = 0·001). Maternal energy expenditure was not correlated with breast milk output. Our study suggests that saliva sampling generates slightly higher estimates of breast milk intake and is more precise as compared with urine and that maternal energy expenditure does not influence breast milk output. [ABSTRACT FROM AUTHOR]

A high-fat (H) diet increases metabolic disorders in offspring. However, there is great variability in the literature regarding the time of exposure, composition of the H diets offered to the genitors and/or offspring and parameters evaluated. Here, we investigated the effect of a H diet subjected to the genitors on different cardio-metabolic parameters on first (F1)- and second (F2)-generation offspring. Female Fischer rats, during mating, gestation and breast-feeding, were subjected to the H diet (G0HF) or control (G0CF) diets. Part of F1 offspring becomes G1 genitors for generating the F2 offspring. After weaning, F1 and F2 rats consumed only the C diet. Nutritional, biometric, biochemical and haemodynamic parameters were evaluated. G0HF genitors had a reduction in food intake but energy intake was similar to the control group. Compared with the control group, the F1H and F2H offspring presented increased plasma leptin, insulin and fasting glucose levels, dietary intake, energy intake, adiposity index, mean arterial pressure, sympathetic drive evidenced by the hexamethonium and insulin resistance. Our data showed that only during mating, gestation and breast-feeding, maternal H diet induced cardio-metabolic disorders characteristic of human metabolic syndrome that were transferred to both females and males of F1 and F2 offspring, even if they were fed control diet after weaning. This process probably occurs due to the disturbance in mechanisms related to leptin that increases energy intake in F1H and F2H offspring. The present data reinforce the importance of balanced diet during pregnancy and breast-feeding for the health of the F1 and F2 offspring. [ABSTRACT FROM AUTHOR]

Objective: To estimate the changes in the prevalence of underweight among girls and boys living in Kraków that occurred between 1983 and 2010.Design: The study was based on two cross-sectional surveys conducted in 1983 and 2010. The prevalence of underweight was estimated based on the International Obesity Task Force (IOTF) and Centers for Disease Control and Prevention (CDC) cut-off points.Setting: The study was conducted in Kraków, Poland.Participants: Children aged 3-18 years (n 5245).Results: Between 1983 and 2010 the prevalence of underweight decreased in both sexes. Using the IOTF criteria, the prevalence of underweight decreased from 10·5 to 10·3 % in girls and from 8·9 to 7·5 % in boys, but it was still higher in girls than in boys. According to the CDC criteria, this prevalence decreased from 5·1 to 4·4 % and from 5·9 to 4·6 %, respectively, and was slightly lower in girls. According to the IOTF criteria, underweight prevalence increased slightly during childhood in both sexes while according to the CDC criteria it decreased in boys and did not change in girls. Among juveniles and adolescents, it decreased regardless of the method used.Conclusions: The frequency of underweight in the population of children and adolescents from Kraków changed slightly in 1983 and 2010 despite economic and social changes. Depending on the cut-off points used, not only the magnitude but also the direction of changes between series could be different. In order to aid global monitoring, the prevalence of underweight as well as overweight should always be evaluated by several methods. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between maternal autonomy and various indices of child undernutrition among children aged <2 years in Nigeria, considering the cultural context and sociodemographic factors.Design: Population-based, cross-sectional study. Associations between various indices of maternal autonomy and child undernutrition (specifically stunting, underweight and wasting) were determined using weighted bivariate and multivariable logistic regression modelling.Setting: 2013 Nigerian Demographic Health Survey.Participants: Children aged between 3 and 24 months (n 7532).Results: Overall, 31·4 % (n 2270), 29·8 % (n 2060) and 25·0 % (n 1755) of children in the sample were stunted, underweight and wasted, respectively. Women with acceptance of domestic violence (low autonomy) were approximately 18 and 14 % less likely to have stunted (OR = 0·82; 95 % CI 0·71, 0·94) and underweight children (OR = 0·86; 95 % CI 0·75, 0·99), respectively. Similarly, women with low power in their couple relations were 17 % less likely to have children who were wasted (OR = 0·83; 95 % CI 0·72, 0·97). Sociodemographic predictors of all indices of undernutrition included maternal education and Hausa ethnicity. Additionally, stunting was predicted by lack of exclusive breast-feeding, low income and being of Fulani ethnicity; wasting by having mothers with low BMI; and underweight by breast-feeding initiation within 1 h hour of birth, polygamous homes, mothers with low BMI and being of Fulani ethnicity.Conclusions: Women with acceptance of domestic violence and low power in couple relations were found to be less likely to have children with indices of undernutrition. This unexpected finding calls for future exploratory research, and policies and interventions that target at-risk subgroups. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between social deprivation and the food environment. Furthermore, to evaluate if the food environment is associated with the prevalence of obesity among students in Brazilian public schools.Design: Cross-sectional. For the classification of obesity, weight and height were measured, and the cut-off point of BMI-for-age Z-score >+2 was adopted. Social deprivation level was determined from the Health Vulnerability Index (HVI). To assess the food environment, the density of food establishments in urban residential areas was calculated. Associations between the food environment and the presence of obesity were estimated by binary logistic regression through a generalized estimating equations model.Setting: Juiz de Fora, Minas Gerais, Brazil.Subjects: Children and adolescents (n 661) aged 7-14 years.Results: The lowest social deprivation level showed a higher density of all types of establishments that sold predominantly unhealthy foods. An inverse association was found between the density of supermarkets and hypermarkets and the presence of obesity (OR=0·58; 95 % CI 0·36, 0·93). For the other categories of food retailers, no significant differences were found.Conclusions: The findings reinforce the need for public policies that promote equality in the food environments of the city. Also, further investigations into the influence of the presence of supermarkets on the nutritional status of children and adolescents are required. [ABSTRACT FROM AUTHOR]

Objective: We aimed to study the correlation between neck circumference (NC) and anthropometric adiposity indicators, and to determine cut-off points of NC for both sexes to identify elevated central adiposity in schoolchildren in western Mexico.Design: Cross-sectional study.Setting: Rural settings in western México.ParticipantsChildren from a convenience sample of six schools in Acatlán, Jalisco, Mexico (n 1802).Results: NC showed a strong positive correlation with all anthropometric adiposity indicators in both sexes, which were notably higher in boys regardless of age. Noteworthy, waist circumference displayed the highest significant correlation when analysed by both age and sex. As age increased, NC cut-off points to identify elevated central adiposity ranged from 25·7 to 30·1 cm for girls and from 27·5 to 31·7 cm for boys.Conclusions: NC could be used as a simple, inexpensive and non-invasive indicator for central obesity assessment in Mexican schoolchildren. [ABSTRACT FROM AUTHOR]

Objective: To describe infant feeding practices and predictors of exclusive breast-feeding among women attending a local Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) programme.Design: Cross-sectional survey. Outcomes included reported infant feeding practices at 3 and 6 months, timing and reasons for introduction of formula. Descriptive statistics, χ 2 tests and logistic regression were used describe the sample and explore relationships between variables.Setting: Loudoun County, VA, USA.Subjects: A sample of 190 predominantly Hispanic women attending local WIC clinics.Results: Overall, 84 % of women reported ever breast-feeding and 61 % of infants received formula in the first few days of life. Mothers who reported on infant feeding practices were less likely to exclusively breast-feed (34 v. 45 %) and more likely to provide mixed feeding (50 v. 20 %) at 3 months compared with 6 months, respectively. Significant (P<0·05) predictors of exclusive breast-feeding at 3 months included setting an exclusive breast-feeding goal and completing some high school (compared with completing high school or more). Only education remained a significant predictor of exclusive breast-feeding at 6 months.Conclusions: A high proportion of women reported giving formula in the first few days of life and many changed from mixed to exclusive breast-feeding or formula by 6 months, suggesting possibly modifiable factors. Further investigation can help drive direct service- as well as policy and systems-based interventions to improve exclusive breast-feeding. [ABSTRACT FROM AUTHOR]

Objective: We aimed to examine associations between early educators' feeding practices and opinions and children's dietary intake at pre-school, in a context where uniform meals are served and pre-schools are highly regulated.Design: Cross-sectional study. Food consumption data of the children consisted of two-day food records from pre-school kept by early educators. Early educators also reported their feeding practices and opinions on pre-school food. Serving style was observed.Setting: Municipal pre-schools in Southern and Western Finland.ParticipantsPre-schoolers (n 586) aged 3-6 years and early educators (n 378).Results: Early educators' positive opinion of the food served at pre-school and the opinion that sufficient vegetables were available for the children were positively associated with children's vegetable consumption. Early educators' role modelling and a positive opinion of the food were negatively associated with children's energy intake. Encouragement to eat fruit and vegetables was associated with higher fibre intake. Intake of added sugar was low (4·4 % of energy).Conclusions: Some of the feeding practices and opinions of early educators were related to healthier dietary intake (higher vegetable consumption and fibre intake) among the children. However, in some respects, the results contradicted previous findings. Overall, early educators' feeding practices and opinions contribute to children's dietary intake and should be taken into account when promoting healthy food intake among pre-school children. [ABSTRACT FROM AUTHOR]

Preterm infants whose mothers are unable to produce sufficient breast milk are increasingly being supplemented with pasteurised donor human milk (PDHM) instead of commercial preterm infant formula. Concerns have been raised that this practice can result in reduced growth. This retrospective clinical audit collected data from the medical records of a cohort of preterm infants (≤30 weeks gestational age) receiving either ≥28 d of PDHM (n 53) or ≥28 d of their mother's own milk (MOM, n 43) with standard fortification supplied to both groups during admission. Weight growth velocity was assessed from regained birth weight to 34+1 weeks' postmenstrual age (PMA); and weight, length and head circumference were compared at discharge and 12 months (corrected age). At 34+1 weeks' PMA, the weight growth velocity (g/kg per d) was significantly lower in the PDHM group (15·4 g/kg per d, 95 % CI 14·6, 16·1) compared with the MOM group (16·9 g/kg per d, 95 % CI 16·1, 17·7, P =0·007). However, the increase was still within clinically acceptable limits (>15 g/kg per d) and no significant difference was observed in the weight between the two groups. There was no significant difference in weight between the groups at discharge or at the 12-month corrected gestational age review. Although we demonstrated a significant reduction in the weight growth velocity of preterm infants receiving PDHM at 34 weeks' PMA, this difference is not present at discharge, suggesting that the growth deficit is reduced by supplementation before discharge. [ABSTRACT FROM AUTHOR]

Objective: To examine the prevalence of fast-food consumption and the association between fast food and lifestyle factors in a representative sample of children and adolescents.Design: Cross-sectional, observational study. Fast-food consumption and dietary habits were evaluated using questionnaires (KIDMED index). Anthropometric and physical fitness measurements were obtained by trained investigators. Physical activity (PA) status, sedentary activities and sleeping habits were assessed through self-completed questionnaires.Setting: Greece.Subjects: Population data derived from a school-based health survey (EYZHN programme) carried out in 2015 on 177 091 (51 % boys) children aged 8-17 years.Results: A greater proportion of boys v. girls (23·3 v. 15·7 %, P1 time/week. Frequent fast-food consumption was strongly correlated with unhealthy dietary habits such as skipping breakfast and consuming sweets/candy regularly. Adjusting for several covariates, insufficient dietary habits, insufficient (<8-9 h/d) sleep, inadequate PA levels and increased screen time increased the odds (95 % CI) of being a frequent fast-food consumer by 77 % (0·218, 0·234), 30 % (1·270, 1·338), 94 % (1·887, 1·995) and 32 % (1·287, 1·357), respectively. Being overweight/obese or centrally obese did not correlate with frequency of fast-food consumption.Conclusions: Frequent fast-food consumption was associated with an unhealthy lifestyle profile among children and adolescents. The findings support the development of interventions to help children adopt healthier dietary habits. [ABSTRACT FROM AUTHOR]

Objective: With the intention to inform future public health initiatives, we aimed to determine the extent to which typical childhood dietary trajectories predict adolescent cardiovascular phenotypes.Design: Longitudinal study. Exposure was determined by a 4 d food diary repeated over eight waves (ages 4-15 years), coded by Australian Dietary Guidelines and summed into a continuous diet score (0-14). Outcomes were adolescent (Wave 8, age 15 years) blood pressure, resting heart rate, pulse wave velocity, carotid intima-media thickness, retinal arteriole-to-venule ratio. Latent class analysis identified 'typical' dietary trajectories from childhood to adolescence. Adjusted linear regression models assessed relationships between trajectories and cardiovascular outcomes, adjusted for a priori potential confounders.Setting: Community sample, Melbourne, Australia.Subjects: Children (n 188) followed from age 4 to 15 years.Results: Four dietary trajectories were identified: unhealthy (8 %); moderately unhealthy (25 %); moderately healthy (46 %); healthy (21 %). There was little evidence that vascular phenotypes associated with the trajectories. However, resting heart rate (beats/min) increased (β; 95 % CI) across the healthy (reference), moderately healthy (4·1; -0·6, 8·9; P=0·08), moderately unhealthy (4·5; -0·7, 9·7; P=0·09) and unhealthy (10·5; 2·9, 18·0; P=0·01) trajectories.Conclusions: Decade-long dietary trajectories did not appear to influence macro- or microvascular structure or stiffness by mid-adolescence, but were associated with resting heart rate, suggesting an early-life window for prevention. Larger studies are needed to confirm these findings, the threshold of diet quality associated with these physiological changes and whether functional changes in heart rate are followed by phenotypic change. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the process of implementation of a national nutritional programme for improving the nutritional status of children in Iran.Design: A cross-sectional process evaluation was carried out using field observations, document reviews, semi-structured interviews and focus group discussions.Setting: Data were collected across urban and rural areas of Qazvin and Semnan provinces of Iran, March-September 2014.Subjects: Mothers (n 362) of children under programme coverage were chosen for the survey. Senior nutrition officers, the head of Hygiene, Remedy and Insurance Affairs at Imam Khomeini Relief Foundation and community health workers were selected purposively for interviews. Mothers with at least one child under 6 years of age covered by the programme were selected to participate in focus group discussions.Results: Five steps of programme implementation were identified: supplementary food basket content, food basket distribution methods, selection of eligible children, distributed food consumption, and child growth monitoring and nutrition training sessions for mothers. The distributed food baskets did not have enough milk/dairy products, vegetables and fruits. Nearly 50 % of children consumed 75-100 % of the distributed milk and cake/biscuit, while staple foods were shared with other family members. When electronic cards were offered instead of food baskets, attendance for child growth monitoring and the food items participants chose with the cards tended to differ from what was originally designed.Conclusions: Focusing on food items that are mostly being used for child feeding (e.g. eggs or milk in food baskets) may be beneficial to assure the target child is receiving the distributed foods. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to examine the effectiveness of two different implementation forms of the EU School Fruit and Vegetable Scheme (SFVS).Design: A quasi-experimental design was applied including a thrice as well as a twice weekly intervention group. Repeated 24 h dietary recalls were used to measure children's fruit and vegetable (F&V) intake. Effects were analysed on days with and without F&V deliveries using hierarchical linear regression models.Setting: Twelve primary schools in North Rhine-Westphalia, Germany.Subjects: Third and fourth graders (n 664).Results: Average daily F&V intake at pre-intervention was 0·84 frequencies in the thrice weekly intervention group, 0·90 frequencies in the twice weekly intervention group and 1·25 frequencies in the control group. Providing children thrice weekly with F&V increased children's F&V intake on average by 0·96 (P<0·001) frequencies/d. The effects were higher on days with (1·07; P<0·001) than on days without (0·75; P<0·001) F&V deliveries. Distributing F&V twice weekly resulted in an increase of 0·75 (P<0·001) frequencies/d on average, again with higher effects on days with (1·30; P<0·001) than without (0·48; P<0·003) F&V deliveries. Subgroup analysis revealed some indications for differential effectiveness only in the twice weekly intervention group.Conclusions: The SFVS with thrice or twice weekly deliveries of F&V led to a significant increase in children's F&V intake on days with and without deliveries. The latter might provide an indication of positive long-term effects of the scheme. The scheme shows equal efficiency for almost all subgroups. [ABSTRACT FROM AUTHOR]

Objective: Sufficient vitamin D status during infancy is important for child health and development. Several initiatives for improving vitamin D status among immigrant children have been implemented in Norway. The present study aimed to evaluate the vitamin D status and its determinants in children of immigrant background in Oslo.Design: Cross-sectional study.Setting: Child health clinics in Oslo.Subjects: Healthy children with immigrant background (n 102) aged 9-16 months were recruited at the routine one-year check-up from two child health clinics with high proportions of immigrant clients. Blood samples were collected using the dried blood spot technique and analysed for serum 25-hydroxyvitamin D (s-25(OH)D) concentration using LC-MS/MS.Results: Mean s-25(OH)D was 52·3 (sd 16·7) nmol/l, with only three children below 25 nmol/l and none below 12·5 nmol/l. There was no significant gender, ethnic or seasonal variation in s-25(OH)D. However, compared with breast-fed children, s-25(OH)D concentration was significantly higher among children who were about 1 year of age and not breast-fed. About 38 % of the children were anaemic, but there was no significant correlation between s-25(OH)D and Hb (Pearson correlation, r=0·1, P=0·33).Conclusions: Few children in the study had vitamin D deficiency, but about 47 % of the children in the study population were under the recommended s-25(OH)D sufficiency level of ≥50 nmol/l. [ABSTRACT FROM AUTHOR]

Objective: To determine the effect of a fish protein isolate (FPi), administered over 6 months, on the growth of children aged 6-36 months, measured by Z-scores of height-for-age (HAZ) and weight-for-height (WHZ), compared with the standard meal without FPi; and to determine the safety and acceptability of FPi daily consumption.Design: Cluster-randomized community-based controlled trial. For 6 months, the centres received either FPi replacing 50 % of total proteins in the diet or standard protein. HAZ and WHZ were used to determine the effect on growth. Acceptability was determined by daily consumption, measured by weighing the servings before and after consumption.Setting: Day care centres and community nutritional centres in northern Lima, Peru.Subjects: Children (n 441) aged 6-36 months.Results: Four centres were randomized to the intervention with FPi, five centres were randomized to the standard control diet. More than 36 900 meals were prepared and administered in a supervised manner. Both groups received the same amounts of energy and proteins daily (proteins about 12-15 % of total energy). Growth of children who received the FPi diet was similar to that of children with the standard diet. Consumption was similar in the FPi and control groups (70 v. 80 % of amount offered, respectively). The protein was safe and well tolerated. No adverse events were reported. However, the cost of the intervention with FPi was 20-40 % lower v. the standard diet with animal protein derived from beef, chicken, eggs or liver.Conclusions: The FPi was well accepted and there was no significant difference in growth between both groups. FPi is a potential source of animal protein at lower cost. [ABSTRACT FROM AUTHOR]

Although breakfast consumption is widely considered to be an important component of a healthy lifestyle, few UK studies have examined differences in nutrient intakes between breakfast consumers and breakfast skippers among children and adolescents. We investigated associations between breakfast skipping in 4-18-year-olds and their nutrient intakes using data from the UK's National Diet and Nutrition Survey Rolling Programme. Dietary data were derived from 4-d estimated food diaries of 802 children aged 4-10 years and 884 children aged 11-18 years (1686 in total). Daily nutrient intakes of children with different breakfast habits were compared by one-way ANCOVA adjusting for relevant covariates (sex, age, ethnicity, equivalised household income and BMI). Within-person analysis was carried out on children with an irregular breakfast habit (n 879) comparing nutrient intakes on breakfast days with those on non-breakfast days using repeated measures ANCOVA. We observed that the overall nutritional profile of the children in terms of fibre and micronutrient intake was superior in frequent breakfast consumers (micronutrients: folate, Ca, Fe and I (P<0⋅01)) and, for the 4-10 years age group, on breakfast days (micronutrients: folate, vitamin C, Ca and I (P<00⋅01)). Also, significantly higher proportions of breakfast-consuming children met their reference nutrient intakes of folate, vitamin C, Ca, Fe and I compared with breakfast skippers (χ² analysis, P<0⋅001). Our study adds to the body of data linking breakfast consumption with higher quality dietary intake in school-age children, supporting the promotion of breakfast as an important element of a healthy dietary pattern in children. [ABSTRACT FROM AUTHOR]

Objective: To examine the feasibility of implementing nine behavioural economics-informed strategies, or 'nudges', that aimed to encourage home dinner vegetable intake among low-income children.Design: Caregivers were assigned six of nine strategies and implemented one new strategy per week (i.e. 6 weeks) during three dinner meals. Caregivers recorded child dinner vegetable intake on the nights of strategy implementation and rated the level of difficulty for assigned strategies. Baseline data on home vegetable availability and child vegetable liking were collected to assess overall strategy feasibility.Setting: Participants' homes in a large Midwestern metropolitan area, USA.Subjects: Low-income caregiver/child (aged 9-12 years) dyads (n 39).Results: Pairwise comparisons showed that child dinner vegetable intake for the strategy 'Serve at least two vegetables with dinner meals' was greater than intake for each of two other strategies: 'Pair vegetables with other foods the child likes' and 'Eat dinner together with an adult(s) modelling vegetable consumption'. Overall, caregivers' mean rating of difficulty for implementing strategies was 2·6 (1='not difficult', 10='very difficult'). Households had a mean of ten different types of vegetables available. Children reported a rating ≥5 for seventeen types of vegetable on a labelled hedonic scale (1='hate it', 5-6='it's okay', 10='like it a lot').Conclusions: Behavioural economics-informed strategies are feasible to implement during dinner meals, with some strategies differing by how much they influence vegetable intake among low-income children in the home. [ABSTRACT FROM AUTHOR]

Faster eating rates are associated with increased energy intake, but little is known about the relationship between children’s eating rate, food intake and adiposity. We examined whether children who eat faster consume more energy and whether this is associated with higher weight status and adiposity. We hypothesised that eating rate mediates the relationship between child weight and ad libitum energy intake. Children (n 386) from the Growing Up in Singapore Towards Healthy Outcomes cohort participated in a video-recorded ad libitum lunch at 4·5 years to measure acute energy intake. Videos were coded for three eating-behaviours (bites, chews and swallows) to derive a measure of eating rate (g/min). BMI and anthropometric indices of adiposity were measured. A subset of children underwent MRI scanning (n 153) to measure abdominal subcutaneous and visceral adiposity. Children above/below the median eating rate were categorised as slower and faster eaters, and compared across body composition measures. There was a strong positive relationship between eating rate and energy intake (r 0·61, P<0·001) and a positive linear relationship between eating rate and children’s BMI status. Faster eaters consumed 75 % more energy content than slower eating children (Δ548 kJ (Δ131 kcal); 95 % CI 107·6, 154·4, P<0·001), and had higher whole-body (P<0·05) and subcutaneous abdominal adiposity (Δ118·3 cc; 95 % CI 24·0, 212·7, P=0·014). Mediation analysis showed that eating rate mediates the link between child weight and energy intake during a meal (b 13·59; 95 % CI 7·48, 21·83). Children who ate faster had higher energy intake, and this was associated with increased BMI z-score and adiposity. [ABSTRACT FROM PUBLISHER]

In a longitudinal study including 642 healthy 8–11-year-old Danish children, we investigated associations between vitamin D dependent SNP and serum 25-hydroxyvitamin D (25(OH)D) concentrations across a school year (August–June). Serum 25(OH)D was measured three times for every child, which approximated measurements in three seasons (autumn, winter, spring). Dietary and supplement intake, physical activity, BMI and parathyroid hormone were likewise measured at each time point. In all, eleven SNP in four vitamin D-related genes: Cytochrome P450 subfamily IIR1 (CYP2R1); 7-dehydrocholesterol reductase/nicotinamide adenine dinucleotide synthetase-1(DHCR7/NADSYN1); group-specific complement (GC); and vitamin D receptor were genotyped. We found minor alleles of CYP2R1 rs10500804, and of GC rs4588 and rs7041 to be associated with lower serum 25(OH)D concentrations across the three seasons (all P<0·01), with estimated 25(OH)D differences of −5·8 to −10·6 nmol/l from major to minor alleles homozygosity. In contrast, minor alleles homozygosity of rs10741657 and rs1562902 in CYP2R1 was associated with higher serum 25(OH)D concentrations compared with major alleles homozygosity (all P<0·001). Interestingly, the association between season and serum 25(OH)D concentrations was modified by GC rs7041 (Pinteraction=0·044), observed as absence of increase in serum 25(OH)D from winter to spring among children with minor alleles homozygous genotypes compared with the two other genotypes of rs7041 (P<0·001). Our results suggest that common genetic variants are associated with lower serum 25(OH)D concentrations across a school year. Potentially due to modified serum 25(OH)D response to UVB sunlight exposure. Further confirmation and paediatric studies investigating vitamin D-related health outcomes of these genotypic differences are needed. [ABSTRACT FROM AUTHOR]

Anaemia in children is a public health concern in Mexico; Federal food assistance programmes are being implemented to prevent it. We undertook this research to investigate the indirect association between food assistance programmes (FAP) and anaemia through dietary and socio-economic conditions of beneficiary children. A structural equation model (SEM) was constructed to assess associations among FAP, dietary and socio-economic conditions, as well as anaemia. A cross-sectional comparative study was conducted based on a sample of 1214 households with children <5 years old, beneficiaries of two FAP: Prospera and rescue from malnutrition with amaranth (RMA) and a comparison group in San Luis Potosí, Mexico. The SEM and a decomposition effect analysis revealed the existence of a significant indirect association of FAP on the prevalence of anaemia via dietary and socio-economic conditions in children under 5 years old. The Prospera assistance programme showed a significant indirect positive association with the prevalence of anaemia (standard coefficient=0·027, P<0·031), and the RMA programme showed a significant indirect negative association with the prevalence of anaemia (standard coefficient=−0·029, P=0·047). There was a direct association between FAP and dietary and socio-economic conditions. FAP could indirectly modify the prevalence of anaemia in young children with a direct improvement on dietary and socio-economic conditions. The unexpected finding of the association between RMA, dietary and socio-economic conditions and the prevalence of anaemia reflects differences in the focus of the programmes. [ABSTRACT FROM PUBLISHER]

Oxidative stress and nitric oxide (NO) appear to represent important links between obesity and cardiovascular, metabolic and/or renal disease. We investigated whether oxidative stress and NO production/metabolism are increased in overweight and obese prepubertal children and correlate with cardiometabolic risk and renal function. We performed a cross-sectional evaluation of 313 children aged 8–9 years. Anthropometrics, 24-h ambulatory blood pressure, pulse wave velocity (PWV), insulin resistance (homoeostasis model assessment index (HOMA-IR)), inflammatory/metabolic biomarkers, estimated glomerular filtration rate (eGFR), plasma total antioxidant status (TAS), plasma and urinary isoprostanes (P-Isop, U-Isop), urinary hydrogen peroxide (U-H2O2), and plasma and urinary nitrates and nitrites (P-NOx, U-NOx) were compared among normal weight, overweight and obese groups, according to WHO BMI z-score reference. U-Isop were increased in the obese group, whereas U-NOx were increased in both overweight and obese children. U-Isop were positively correlated with U-H2O2, myeloperoxidase (MPO), high-sensitivity C-reactive protein, HOMA-IR and TAG. TAS correlated negatively with U-Isop and MPO and positively with PWV. HOMA-IR and U-H2O2 were associated with higher U-Isop, independently of BMI and eGFR, and total cholesterol and U-H2O2 were associated with U-NOx, independently of BMI, eGFR values and P-NOx concentration. In overweight and obese children, eGFR decreased across P-NOx tertiles (median: 139·3 (25th, 75th percentile 128·0, 146·5), 128·0 (25th, 75th percentile 121·5, 140·4), 129·5 (25th, 75th percentile 119·4, 138·3), Pfor linear trend=0·003). We conclude that oxidant status and NO are increased in relation to fat accumulation and, even in young children, they translate into higher values of cardiometabolic risk markers and affect renal function. [ABSTRACT FROM PUBLISHER]

Objective: Safety of home fortificants in children is uncertain in areas where infections are common. We tested the hypothesis that provision of lipid-based nutrient supplements (LNS) containing Fe does not increase infectious morbidity in children.Design: Randomized controlled trial. Infants were randomised to receive 10, 20 or 40 g LNS/d; or no supplement until age 18 months. All LNS contained 6 mg Fe/d. Morbidity outcomes (serious adverse events, non-scheduled visits and guardian-reported morbidity episodes) were compared between control and intervention groups using a non-inferiority margin of 20 %.Setting: Namwera and Mangochi catchment areas in rural Malawi.Subjects: Infants aged 6 months (n 1932).Results: The enrolled 1932 infants contributed 1306 child-years of follow-up. Baseline characteristics were similar across groups. Compared with the control group, the relative risk (95 % CI) of serious adverse events was 0·71 (0·48, 1·07), 0·67 (0·48, 0·95) and 0·91 (0·66, 1·25) in 10, 20 and 40 g LNS/d groups, respectively. The incidence rate ratio (95 % CI) of non-scheduled visits due to malaria was 1·10 (0·88, 1·37), 1·08 (0·89, 1·31) and 1·21 (1·00, 1·46), and of guardian-reported morbidity episodes was 1·04 (0·96, 1·11), 1·03 (0·97, 1·10) and 1·04 (0·97, 1·10), in the respective LNS groups.Conclusions: Provision of 10 and 20 g LNS/d containing 6 mg Fe/d did not increase morbidity in the children. Provision of 40 g LNS/d did not affect guardian-reported illness episodes but may have increased malaria-related non-scheduled visits. [ABSTRACT FROM AUTHOR]

Objective: Height is required for the assessment of growth and nutritional status, as well as for predictions and standardization of physiological parameters. To determine whether arm span, mid-upper arm and waist circumferences and sum of four skinfolds can be used to predict height, the relationships between these anthropometric variables were assessed among Ellisras rural children aged 8-18 years.Design: The following parameters were measured according to the International Society for the Advancement of Kinathropometry: height, arm span, mid-upper arm circumference, waist circumference and four skinfolds (suprailiac, subscapular, triceps and biceps). Associations between the variables were assessed using Pearson correlation coefficients and linear regression models.Setting: Ellisras Longitudinal Study (ELS), Limpopo Province, South Africa.Subjects: Boys (n 911) and girls (n 858) aged 8-18 years.Results: Mean height was higher than arm span, with differences ranging from 4 cm to 11·5 cm between boys and girls. The correlation between height and arm span was high (ranging from 0·74 to 0·91) with P<0·001. The correlation between height and mid-upper arm circumference, waist circumference and sum of four skinfolds was low (ranging from 0·15 to 0·47) with P<0·00 among girls in the 15-18 years age group.Conclusions: Arm span was found to be a good predictor of height. The sum of four skinfolds was significantly associated with height in the older age groups for girls, while waist circumference showed a negative significant association in the same groups. [ABSTRACT FROM AUTHOR]

Objectives: Fe-deficiency anaemia (IDA) occurs in 1-2 % of infants in developed countries, peaks at 1-3 years of age and is associated with later cognitive deficits. The objectives of the present study were to describe the characteristics of young children with severe IDA and examine modifiable risk factors in a developed-country setting.Design: Two prospective samples: a national surveillance programme sample and a regional longitudinal study sample.Setting: Canada, 2009-2011.Subjects: Two samples of young children recruited from community-based health-care practices: a national sample with severe anaemia (Hb<80 g/l) due to Fe deficiency and a regional sample with non-anaemic Fe sufficiency.Results: Children with severe IDA (n 201, mean Hb 55·1 g/l) experienced substantial morbidity (including developmental delay, heart failure, cerebral thrombosis) and health-care utilization (including a 42 % hospitalization rate). Compared with children with Fe sufficiency (n 597, mean Hb 122·4 g/l), children with severe IDA consumed a larger volume of cow's milk daily (median 1065 ml v. 500 ml, P<0·001) and were more likely to be using a bottle during the day (78 % v. 43 %, OR=6·0; 95 % CI 4·0, 8·9) and also in bed (60 % v. 21 %, OR=6·5; 95 % CI 4·4, 9·5).Conclusions: Severe IDA is associated with substantial morbidity and may be preventable. Three potentially modifiable feeding practices are associated with IDA: (i) cow's milk consumption greater than 500 ml/d; (ii) daytime bottle use beyond 12 months of age; and (iii) bottle use in bed. These feeding practices should be highlighted in future recommendations for public health and primary-care practitioners. [ABSTRACT FROM AUTHOR]

Few children consume the recommended portions of fruit or vegetables. This study examined the effects of parental physical prompting and parental modelling in children’s acceptance of a novel fruit (NF) and examined the role of children’s food-approach and food-avoidance traits on NF engagement and consumption. A total of 120 caregiver–child dyads (fifty-four girls, sixty-six boys) participated in this study. Dyads were allocated to one of the following three conditions: physical prompting but no modelling, physical prompting and modelling or a modelling only control condition. Dyads ate a standardised meal containing a portion of a fruit new to the child. Parents completed measures of children’s food approach and avoidance. Willingness to try the NF was observed, and the amount of the NF consumed was measured. Physical prompting but no modelling resulted in greater physical refusal of the NF. There were main effects of enjoyment of food and food fussiness on acceptance. Food responsiveness interacted with condition such that children who were more food responsive had greater NF acceptance in the prompting and modelling conditions in comparison with the modelling only condition. In contrast, children with low food responsiveness had greater acceptance in the modelling control condition than in the prompting but no modelling condition. Physical prompting in the absence of modelling is likely to be detrimental to NF acceptance. Parental use of physical prompting strategies, in combination with modelling of NF intake, may facilitate acceptance of NF, but only in food-responsive children. Modelling consumption best promotes acceptance in children with low food responsiveness. [ABSTRACT FROM PUBLISHER]

The present study examined the acute effects of active gaming on energy intake (EI) and appetite responses in 8–11-year-old boys in a school-based setting. Using a randomised cross-over design, twenty-one boys completed four individual 90-min gaming bouts, each separated by 1 week. The gaming bouts were (1) seated gaming, no food or drink; (2) active gaming, no food or drink; (3) seated gaming with food and drink offered ad libitum; and (4) active gaming with food and drink offered ad libitum. In the two gaming bouts during which foods and drinks were offered, EI was measured. Appetite sensations – hunger, prospective food consumption and fullness – were recorded using visual analogue scales during all gaming bouts at 30-min intervals and at two 15-min intervals post gaming. In the two bouts with food and drink, no significant differences were found in acute EI (MJ) (P=0·238). Significant differences were detected in appetite sensations for hunger, prospective food consumption and fullness between the four gaming bouts at various time points. The relative EI calculated for the two gaming bouts with food and drink (active gaming 1·42 (sem 0·28) MJ; seated gaming 2·12 (sem 0·25) MJ) was not statistically different. Acute EI in response to active gaming was no different from seated gaming, and appetite sensations were influenced by whether food was made available during the 90-min gaming bouts. [ABSTRACT FROM AUTHOR]

Objective: Supply of essential n-3 PUFA is limited worldwide. While fish-oil supplementation effectively improves n-3 PUFA status, it may not be a sustainable intervention. The use of α-linolenic acid (ALA)-rich cooking oils in the household may be a suitable alternative but its effect on PUFA status is unclear. We aimed to compare the effect of providing families with soyabean oil, an ALA-rich cooking oil, v. sunflower oil on whole-blood PUFA levels of children aged 11-18 years.Design: In a randomized, masked, parallel trial, we assigned families to receive a one-month supply of either soyabean or sunflower oil. Fatty acid concentrations were quantified in whole-blood samples obtained from the children before and at the end of the intervention. Changes in fatty acids were compared between treatment arms with use of linear regression for repeated measures.Subjects: Sixty low- and middle-income families.Setting: Bogotá, Colombia.Results: Soyabean oil significantly increased ALA concentrations by 0.05 percentage points of total serum fatty acids whereas sunflower oil decreased them by 0.12 percentage points (soyabean v. sunflower oil effect=0.17; 95% CI 0.11, 0.24). Concentrations of both n-3 and n-6 very-long-chain PUFA, including docosapentaenoic acid, DHA, dihomo-γ-linolenic acid and arachidonic acid, increased significantly in both intervention arms. Levels of oleic acid and palmitic acid decreased, irrespective of oil assignment. Total energy or energy intake from saturated fat did not change.Conclusions: Replacing cooking oils at the household level is an effective intervention to improve essential PUFA status of children. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of a new government-subsidized supermarket in a high-need area on household food availability and dietary habits in children.Design: A difference-in-difference study design was utilized.Setting: Two neighbourhoods in the Bronx, New York City. Outcomes were collected in Morrisania, the target community where the new supermarket was opened, and Highbridge, the comparison community.Subjects: Parents/caregivers of a child aged 3-10 years residing in Morrisania or Highbridge. Participants were recruited via street intercept at baseline (pre-supermarket opening) and at two follow-up periods (five weeks and one year post-supermarket opening).Results: Analysis is based on 2172 street-intercept surveys and 363 dietary recalls from a sample of predominantly low-income minorities. While there were small, inconsistent changes over the time periods, there were no appreciable differences in availability of healthful or unhealthful foods at home, or in children's dietary intake as a result of the supermarket.Conclusions: The introduction of a government-subsidized supermarket into an underserved neighbourhood in the Bronx did not result in significant changes in household food availability or children's dietary intake. Given the lack of healthful food options in underserved neighbourhoods and need for programmes that promote access, further research is needed to determine whether healthy food retail expansion, alone or with other strategies, can improve food choices of children and their families. [ABSTRACT FROM AUTHOR]

ObjectiveRecently, school meal composition regulations have been implemented in France in order to improve the nutritional status of children. The present study investigated the link between school lunch attendance and the food intakes of schoolchildren aged 3–17 years.DesignSecond French cross-sectional dietary survey (2006–2007). Eating frequencies were assessed for twenty-four food groups with a 7 d food record. Eating locations were recorded for main meals. Food group intakes at weekday lunches were compared for the school canteen and for other locations. The children’s overall dietary intake was compared based on school lunch attendance.SettingMainland France.SubjectsSchoolchildren aged 3–17 years (n 1068).ResultsLunchtime food intake differed between the school canteen and other locations. Some intakes at school canteens were more in accordance with the regulations (more fruit and vegetables, fish and dairy products, and less sandwiches, soft drinks, chocolate and confectionery), whereas others highlighted needs for improvement (more sweet biscuits and pastries, ice cream and dairy desserts, pizzas and salty pastries). Many of these differences were also observed in the children’s overall diet: children regularly attending school lunches ate more mashed fruit, fish and sweet biscuits or pastries, and less sandwiches and soft drinks. The link between school lunch attendance and overall diet was less pronounced in secondary-school children.ConclusionsSchool canteen attendance is associated with both potentially beneficial and deleterious differences in the lunchtime and overall diets of French children. These findings are important to consider when setting national regulations for school meal composition. [ABSTRACT FROM AUTHOR]

Salivary α-amylase (sAA) is responsible for the ‘pre-digestion’ of starch in the oral cavity and accounts for up to 50 % of salivary protein in human saliva. An accumulating body of literature suggests that sAA is of nutritional importance; however, it is still not clear how sAA is related to individual's nutritional status. Although copy number variations (CNV) of the salivary amylase gene (AMY1) are associated with variation in sAA levels, a significant amount of sAA variation is not explained by AMY1 CNV. To measure sAA responses to gustatory stimulation with citric acid, we used sAA ratio (the ratio of stimulated sAA levels to those of resting sAA) and investigated acute sAA responses to citric acid in children with normal (Normal-BMI, n 22) and low (Low-BMI, n 21) BMI. The AMY1 gene copy number was determined by quantitative PCR. We, for the first time, demonstrated attenuated acute sAA responses (decreased sAA ratio) to gustatory stimulation in Low-BMI (thinness grade 3) children compared with the Normal-BMI children, which suggest that sAA responses to gustatory stimulation may be of nutritional importance. However, child's nutritional status was not directly related to their resting or stimulated sAA levels, and it was not associated with AMY1 gene copy number. Finally, AMY1 CNV might influence, but did not eventually determine, sAA levels in children. [ABSTRACT FROM PUBLISHER]

ObjectiveTo compare energy (calories), total and saturated fats, and Na levels for ‘kids’ menu’ food items offered by four leading multinational fast-food chains across five countries.DesignA content analysis was used to create a profile of the nutritional content of food items on kids’ menus available for lunch and dinner in four leading fast-food chains in Australia, Canada, New Zealand, the UK and the USA.SettingFood items from kids’ menus were included from four fast-food companies: Burger King, Kentucky Fried Chicken (KFC), McDonald's and Subway. These fast-food chains were selected because they are among the top ten largest multinational fast-food chains for sales in 2010, operate in high-income English-speaking countries, and have a specific section of their restaurant menus labelled ‘kids’ menus’.ResultsThe results by country indicate that kids’ menu foods contain less energy (fewer calories) in restaurants in the USA and lower Na in restaurants in the UK. The results across companies suggest that kids’ menu foods offered at Subway restaurants are lower in total fat than food items offered at Burger King and KFC, and food items offered at KFC are lower in saturated fat than items offered at Burger King.ConclusionsAlthough the reasons for the variation in the nutritional quality of foods on kids’ menus are not clear, it is likely that fast-food companies could substantially improve the nutritional quality of their kids’ menu food products, translating to large gains for population health. [ABSTRACT FROM AUTHOR]

Intra-uterine growth restriction (IUGR) may induce significant metabolic and inflammatory anomalies, increasing the risk of obesity and CVD later in life. Similarly, alterations in the adipose tissue may lead to metabolic changes in children with a history of extra-uterine growth restriction (EUGR). These mechanisms may induce alterations in immune response during early life. The aim of the present study was to compare pro-inflammatory markers in prepubertal EUGR children with those in a reference population. A total of thirty-eight prepubertal children with a history of EUGR and a reference group including 123 healthy age- and sex-matched children were selected. Perinatal data were examined. In the prepubertal stage, the concentrations of inflammatory biomarkers were measured in both groups. The serum concentrations of C-reactive protein (CRP) and plasma concentrations of hepatocyte growth factor (HGF), IL-6, IL-8, monocyte chemotactic protein type 1 (MCP-1), neural growth factor, TNF-α and plasminogen activator inhibitor type 1 were determined. The plasma concentrations of inflammatory biomarkers CRP, HGF, IL-8, MCP-1 and TNF-α were higher in the EUGR group than in the reference group (P< 0·001). After adjustment for gestational age, birth weight and length, blood pressure values and TNF-α concentrations remained higher in the EUGR group than in the reference group. Therefore, further investigations should be conducted in EUGR children to evaluate the potential negative impact of metabolic, nutritional and pro-inflammatory changes induced by the EUGR condition. [ABSTRACT FROM PUBLISHER]

Few studies have investigated the relative validity of FFQ in young children and no study has investigated the relative validity of changes in children's food intake in a longitudinal context. The aim of the present study was to compare the FFQ of the longitudinal Family Influences on Food Intake study, assessing children's food intake in the previous 3 months, with a 3 d online food record when children were 3 and 7 years old, as well as to investigate the relative validity of changes in food group intake over a 4-year period. Parents (n 89) completed the FFQ and an online food record over three non-consecutive days on two separate occasions (January–April 2008 and 2012). Wilcoxon signed-rank tests and Spearman's correlations were used to compare food group intake and changes in intake assessed using both methods. In 2008, the intake of eleven of the twenty-two food groups was overestimated and that of four food groups underestimated in the FFQ in comparison with the online tool; in 2012, the intake of four food groups was overestimated and that of seven food groups underestimated. Nevertheless, changes in intake did not differ significantly between the two methods for eighteen food groups. Correlations in 2008 and 2012 were, on average, 0·47; correlations between the changes in dietary intake were, on average, 0·26. The results suggest that despite the significant differences between the two methods for a number of food groups at both baseline and/or follow-up, the FFQ can be used to monitor changes in dietary intake for groups of young children. [ABSTRACT FROM PUBLISHER]

Maternal consumption of a high-fat diet (HFD) during pregnancy and lactation is closely related to hepatic lipid accumulation, insulin resistance and increased serum cytokine levels in offspring and into their adulthood. MicroRNA (miRNA) have been implicated in cholesterol biosynthesis and fatty acid metabolism. We evaluated the modulation of hepatic fatty acid synthesis (de novo), β-oxidation pathways, and miRNA-122 (miR-122) and miRNA-370 (miR-370) expression in recently weaned offspring (day 28) of mouse dams fed a HFD (HFD-O) or a standard chow (SC-O) during pregnancy and lactation. Compared with SC-O mice, HFD-O mice weighed more, had a larger adipose tissue mass and were more intolerant to glucose and insulin (P< 0·05). HFD-O mice also presented more levels of serum cholesterol, TAG, NEFA and hepatic IκB kinase and c-Jun N-terminal kinase phosphorylation compared with SC-O mice (P< 0·05). Protein levels of fatty acid synthase, acetyl-CoA carboxylase and 3-hydroxy-3-methylglutaryl-CoA reductase were similar in HFD-O and SC-O mice, whereas expression levels of SCD1 mRNA and protein were more abundant in HFD-O mice than in SC-O mice (P< 0·05). Interestingly, mRNA expression levels of the β-oxidation-related genes ACADVL and CPT1 were decreased in HFD-O mice (P< 0·05). Furthermore, the expression of miR-122 was reduced but that of miR-370 was increased in HFD-O mice compared with that in SC-O mice (P< 0·05). Changes in hepatic lipid metabolism were accompanied by increased mRNA content of AGPAT1 and TAG deposition in HFD-O mice (P< 0·05). Taken together, the present results strongly suggest that maternal consumption of a HFD affects the early lipid metabolism of offspring by modulating the expression of hepatic β-oxidation-related genes and miRNA that can contribute to metabolic disturbances in adult life. [ABSTRACT FROM PUBLISHER]

ObjectiveTo assess the efficacy of two school-based programmes to promote students’ willingness to engage in lifestyle changes related to eating habits and physical activity behaviours.DesignElementary school-based health promotion intervention, designed as a multicomponent experimental study, based on a behavioural epidemiological model.SettingNine intervention and eight comparative public and private elementary schools.SubjectsThe goal was to determine the impact on the longitudinally assessed outcomes of two programmes that addressed healthy nutrition and active living in a cohort of 2038 children. The evaluations used pre-intervention and follow-up student surveys that were based on the Transtheoretical Model of the stages of behaviour change.ResultsIn the intervention group, there were significant (P < 0·001) differences between the pre- and post-intervention times in the stages of change, with a reduction in the percentage of children at the pre-contemplation and contemplation stages and increased percentages at the preparation, action and maintenance stages, leading to healthier behaviours in fatty food consumption, fruit and vegetable consumption, physical activity and time spent in sedentary activities. The determinants of the behaviour stage were the intervention programme, the type of school and the presence of motivated teachers. The comparison group did not show significant differences between the pre- and post-intervention times for any of the stages of behaviour.ConclusionsThe intervention programme encouraged the students to make healthy lifestyle choices related to eating habits and physical activity behaviours. [ABSTRACT FROM AUTHOR]

ObjectiveTo evaluate general knowledge about nutrition in an Italian population of children, pre-adolescents and adolescents.DesignKnowledge about nutrition-related items such as healthy eating, breakfast, snacks, fast food, beverages, fruits and vegetables, cereals and tubers, meat/fish/legumes/eggs, milk and dairy products, fats and dressings, and sweets was analysed by means of a self-administered questionnaire (QuesCA IT) containing thirty-one questions, that was translated and adapted from a Swiss version (QuesCA) previously used in Geneva and Vaud.SettingNorth of Italy (Bergamo, Milan).SubjectsStudents (n 614) belonging to two different age groups: 9–11 years (GR1) and 12–16 years (GR2).ResultsData analysis showed that nutritional knowledge varied in relation to the age of the participants, increasing in particular in the older group, although this difference was not statistically significant for all the considered items. Nutritional knowledge also varied in relation to the gender of the participants, with females in particular seeming to possess better cognition. For each age group there was poor knowledge about the items healthy diet, snacks, milk and dairy products, meat/fish/legumes/eggs, and fats and dressings. Moreover, the percentage of participants who declared own knowledge as insufficient was higher in GR2 compared with GR1.ConclusionsThe present research demonstrates a lack of knowledge about the main concepts of healthy nutrition both in the youngest and oldest participants of the survey. This evidence, together with the presence of higher self-consciousness in GR2, should be taken into account in specific educational interventions during the school period. [ABSTRACT FROM AUTHOR]

The behavioural impact of an imposed bout of prolonged sitting is yet to be investigated in the paediatric population. The objective of the present study was to determine the acute effect of prolonged sitting on ad libitum food intake and spontaneous physical activity (PA) levels in healthy children and youth. A total of twenty healthy youth (twelve males and eight females) aged 10–14 years, with a mean BMI of 18·6 (sd 4·3) kg/m2, were exposed to three experimental conditions in a random order: (1) a day of uninterrupted sitting (Sedentary); (2) a day of sitting interrupted with a 2 min light-intensity walk break every 20 min (Breaks); (3) a day of sitting interrupted with a 2 min light-intensity walk break every 20 min as well as 2 × 20 min of moderate-intensity PA (Breaks+PA). Food intake (ad libitum buffet meal) and PA (accelerometry for 24 h) were assessed following exposure to each experimental condition. Despite significant differences in sedentary behaviour and activity levels during the three in-laboratory sessions (all P< 0·01), we did not observe any differences in ad libitum food intake immediately following exposure to each experimental condition or any changes in the levels of sedentary behaviour or PA in the 24 h following exposure to each experimental condition (all P>0·25). These findings suggest that children and youth may not compensate for an imposed bout of sedentary behaviour by reducing subsequent food intake or increasing PA levels. [ABSTRACT FROM PUBLISHER]

ObjectiveAdequate assessment of energy balance-related behaviours in adolescents is essential to develop and evaluate effective obesity prevention programmes. The present study examined the test–retest reliability and construct validity of a questionnaire assessing energy balance-related behaviours in adolescents during the evaluation of the DOiT (Dutch Obesity Intervention in Teenagers) intervention.DesignTo assess test–retest reliability, adolescents filled in the questionnaire twice (n 111). To assess construct validity, the results from the first test were compared with data collected in a personal cognitive interview (n 20, independent from the reliability study). For both reliability and validity, intraclass correlation coefficients for continuous data or Cohen's kappa coefficients for categorical data were calculated as well as percentage agreement.SettingData were collected during school time from February to May 2010.SubjectsStudy participants were Dutch adolescents aged 12–14 years attending pre-vocational secondary schools.ResultsIn more than three-quarters of the ninety-five questionnaire items the test–retest reliability appeared to be good to excellent. Moderate reliability was found for all other twenty-one items. Fifty-one items (of ninety-five items) showed good to excellent construct validity. Construct validity appeared moderate in twenty-three items and poor in twenty-one items. Most items with poor construct validity concerned consumption of sugar-containing beverages and high-energy snacks/sweets.ConclusionsOur study showed good test–retest reliability and largely moderate to good construct validity for the majority of items of the DOiT questionnaire. Items with poor construct validity (most of them found for items concerning energy intake-related behaviours) should be revised and tested again to improve the questionnaire for future use. [ABSTRACT FROM AUTHOR]

ObjectiveTo compare, specifically by age group, proxy-reported food group estimates obtained from the food frequency section of the Children's Eating Habits questionnaire (CEHQ-FFQ) against the estimates of two non-consecutive 24 h dietary recalls (24-HDR).DesignEstimates of food group intakes assessed via the forty-three-food-group CEHQ-FFQ were compared with those obtained by a computerized 24-HDR. Agreement on frequencies of intakes (equal to the number of portions per recall period) between the two instruments was examined using crude and de-attenuated Pearson's correlation coefficients, cross-classification analyses, weighted kappa statistics (κw) and Bland–Altman analysis.SettingKindergartens/schools from eight European countries participating in the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) Study cross-sectional survey (2007–2008).SubjectsChildren aged 2–9 years (n 2508, 50·4 % boys).ResultsThe CEHQ-FFQ provided higher intake estimates for most of the food groups than the 24-HDR. De-attenuated Pearson correlation coefficients ranged from 0·01 (sweetened fruit) to 0·48 (sweetened milk) in children aged 2–<6 years (mean = 0·25) and from 0·01 (milled cereal) to 0·44 (water) in children aged 6–9 years (mean = 0·23). An average of 32 % and 31 % of food group intakes were assigned to the same quartile in younger and older children, respectively, and classification into extreme opposite quartiles was ≤12 % for all food groups in both age groups. Mean κw was 0·20 for 2–<6-year-olds and 0·17 for 6–9-year-olds.ConclusionsThe strength of association estimates assessed by the CEHQ-FFQ and the 24-HDR varied by food group and by age group. Observed level of agreement and CEHQ-FFQ ability to rank children according to intakes of food groups were considered to be low. [ABSTRACT FROM AUTHOR]

Project Energize, a region-wide whole-school nutrition and physical activity programme, commenced as a randomised controlled trial (RCT) in the period 2004–6 in 124 schools in Waikato, New Zealand. In 2007, sixty-two control schools were engaged in the programme, and by 2011, all but two of the 235 schools in the region were engaged. Energizers (trained nutrition and physical activity specialists) work with eight to twelve schools each to achieve the goals of the programme, which are based on healthier eating and enhanced physical activity. In 2011, indices of obesity and physical fitness of 2474 younger (7·58 (sd 0·57) years) and 2330 older (10·30 (sd 0·51) years) children attending 193 of the 235 primary schools were compared with historical measurements. After adjusting for age, sex, ethnicity, socio-economic status (SES) and school cluster effects, the combined prevalence of obesity and overweight among younger and older children in 2011 was lower by 31 and 15 %, respectively, than that among ‘unEnergized’ children in the 2004 to 2006 RCT. Similarly, BMI was lower by 3·0 % (95 % CI − 5·8, − 1·3) and 2·4 % (95 % CI − 4·3, − 0·5). Physical fitness (time taken to complete a 550 m run) was significantly higher in the Energized children (13·7 and 11·3 %, respectively) than in a group of similarly aged children from another region. These effects were observed for boys and girls, both indigenous Māori and non-Māori children, and across SES. The long-term regional commitment to the Energize programme in schools may potentially lead to a secular reduction in the prevalence of overweight and obesity and gains in physical fitness, which may reduce the risk of developing obesity and type 2 diabetes. [ABSTRACT FROM PUBLISHER]

Maternal dietary Zn deficiency during fetal development induces substantial cognitive dysfunctions in the resultant offspring. The mechanism underlying this effect is unclear. The present study evaluated whether the impairments caused by gestational and lactational Zn deficiency are mediated by the hippocampal calmodulin-dependent protein kinase II α (α-CaMKII)/brain-derived neurotrophic factor (BDNF) signalling pathway as well as whether they can be restored by postnatal Zn supplementation. Rats were randomly divided into four groups on the first day of pregnancy (n 12): control (CO) group; pair-fed (PF) group; Zn-deprived (ZD) group; orally Zn-supplemented group. The spatial memory of the offspring was tested at postnatal day 35 using the Morris water maze. Long-term potentiation (LTP) in the rat hippocampal medial perforant path–dentate gyrus pathway was evaluated simultaneously, and α-CaMKII and BDNF protein levels were examined by Western blot analysis. The results demonstrated that the ZD group exhibited a significantly longer latency period in the Morris water maze as well as a significantly decreased LTP amplitude compared with the CO and PF groups. α-CaMKII and BDNF protein expression in the hippocampus was significantly reduced in the ZD group. Postnatal Zn supplementation restored the cognitive dysfunction induced by gestational Zn deficiency but could not completely reverse the decreased LTP and α-CaMKII/BDNF protein levels. Our findings suggest that the α-CaMKII/BDNF signalling pathway may be involved in Zn deficiency-induced cognitive and synaptic impairments. [ABSTRACT FROM PUBLISHER]

Earlier studies in animals have suggested an essential role for Si in connective tissues, but such works have not been replicated per se. Nonetheless, a study conducted in 2000 has reported that Si may be essential during pregnancy for the growing fetus, since serum Si concentrations in infants were approximately 300 % higher than those in older children and adults and serum Si concentrations in pregnant women were approximately 300 % lower than those in age-matched non-pregnant controls. To reproduce these potentially important findings, in the present study, serum Si concentrations were measured in fourteen pregnant women (15–24 weeks of gestation) and compared with those of seventeen non-pregnant, non-lactating female controls. Serum Si concentrations were also measured in fourteen full-term mothers at the time of delivery and in the umbilical cord (UC) vein and artery where possible. Fasting serum Si concentrations in pregnant women were not significantly different from those of the female controls and showed little change with advancing gestation (r 0·2). Mean serum Si concentrations in the UC vein samples were 52 % higher, while those in the UC artery samples were 235 % higher than those in the maternal forearm vein samples, although data were widely spread and differences were not significant. Mean maternal forearm vein Si concentrations at delivery were 50 % lower than those of pregnant women and female controls, but, again, these were not significant. Overall, we note that there are significant analytical challenges in comparing baseline Si levels between different groups; notwithstanding, our findings cannot confirm a reduction in fasting serum Si levels during pregnancy, but, equally, we cannot rule out higher serum Si levels in newborns than in their mothers, and further work is required. [ABSTRACT FROM PUBLISHER]

ObjectiveThe predominance of marketing of products high in fat, sugar and/or salt to children has been well documented and implicated in the incidence of obesity. The present study aimed to determine whether foods marketed to children in UK supermarkets are nutritionally similar to the non-children's equivalent, focusing on food categories that may be viewed as healthier options.DesignNutritional data were collected on yoghurts (n 147), cereal bars (n 145) and ready meals (n 144) from seven major UK supermarkets and categorised as children's or non-children's products based on the characteristics, promotional nature or information on the product packaging. Fat, sugar and salt content was compared per 100 g and per recommended portion size.SettingUK.ResultsPer 100 g, children's yoghurts and cereal bars were higher in total sugars, fat and saturated fat than the non-children's; this was significant for all except sugar and total fat in cereal bars. Per portion these differences remained, except for sugars in yoghurts. Conversely children's ready meals were significantly lower in these nutrients per portion than non-children's, but not when expressed per 100 g. Children's yoghurts and ready meals had significantly lower sodium content than non-children's both per portion and per 100 g.ConclusionsSignificant differences between the nutritional composition of children's and non-children's products were observed but varied depending on the unit reference. A significant number of products marketed towards children were higher in fat, sugar and salt than those marketed to the general population. [ABSTRACT FROM AUTHOR]

A strategy is needed on how to treat the growing number of obese children with the limited resources available. We compared the long-term (24 months) effectiveness of therapist-led groups (TLG) v. self-help groups (SHG) for parents on changes in children's adiposity and dietary intake. The study included ninety-nine children (forty-eight girls) who were referred to obesity treatment (7–12 years, BMI z-scores ≥ 2, attendance of at least one parent). Parents (ninety-one mothers, fifty-four fathers) were randomised to TLG aimed at increasing parents' competence to accomplish lifestyle changes (n 47), or SHG (n 52), both with fifteen sessions. All children participated in children's groups, and all families attended individual counselling by a clinical dietitian and physiotherapist. Percentage of body fat (BF) was measured by dual-energy X-ray absorptiometry, BMI z-score was calculated by international reference values and dietary intake was calculated from 4 d estimated food records at baseline and after 6 and 24 months. No significant between-group differences were detected in the children's changes in adiposity or dietary intake after 6 and 24 months. BF, BMI z-scores and energy intake were significantly decreased after 6 months (P< 0·05) in both intervention groups, and this persisted throughout 24 months without compromising the diet macronutrient composition. In conclusion, the TLG and SHG intervention groups appear to be equally effective in improving long-term adiposity and dietary intake in obese children. Further research should be performed to clarify whether the SHG should be preferred to parental group treatment for similar children with obesity. [ABSTRACT FROM PUBLISHER]

Children are not consuming sufficient amounts of fruits and vegetables in their habitual diet. Methods derived from associative learning theories could be effective at promoting vegetable intake in pre-school children. The objective of the present study was to compare the effectiveness of different learning strategies in promoting the intake of a novel vegetable. Children aged between 9 and 38 months were recruited from UK nurseries. The children (n 72) were randomly assigned to one of three conditions (repeated exposure, flavour–flavour learning or flavour–nutrient learning). Each child was offered ten exposures to their respective version of a novel vegetable (artichoke). Pre- and post-intervention measures of artichoke purée and carrot purée (control vegetable) intake were taken. At pre-intervention, carrot intake was significantly higher than artichoke intake (P< 0·05). Intake of both vegetables increased over time (P< 0·001); however, when changes in intake were investigated, artichoke intake increased significantly more than carrot intake (P< 0·001). Artichoke intake increased to the same extent in all three conditions, and this effect was persistent up to 5 weeks post-intervention. Five exposures were sufficient to increase intake compared to the first exposure (P< 0·001). Repeated exposure to three variants of a novel vegetable was sufficient to increase intake of this vegetable, regardless of the addition of a familiar taste or energy. Repetition is therefore a critical factor for promoting novel vegetable intake in pre-school children. [ABSTRACT FROM PUBLISHER]

Little is known about changes in dietary patterns over time. The present study aims to derive dietary patterns using cluster analysis at three ages in children and track these patterns over time. In all, 3 d diet diaries were completed for children from the Avon Longitudinal Study of Parents and Children at 7, 10 and 13 years. Children were grouped based on the similarities between average weight consumed (g/d) of sixty-two food groups using k-means cluster analysis. A total of four clusters were obtained at each age, with very similar patterns being described at each time point: Processed (high consumption of processed foods, chips and soft drinks), Healthy (high consumption of high-fibre bread, fruit, vegetables and water), Traditional (high consumption of meat, potatoes and vegetables) and Packed Lunch (high consumption of white bread, sandwich fillings and snacks). The number of children remaining in the same cluster at different ages was reasonably high: 50 and 43 % of children in the Healthy and Processed clusters, respectively, at age 7 years were in the same clusters at age 13 years. Maternal education was the strongest predictor of remaining in the Healthy cluster at each time point – children whose mothers had the highest level of education were nine times more likely to remain in that cluster compared to those with the lowest. Cluster analysis provides a simple way of examining changes in dietary patterns over time, and similar underlying patterns of diet at two ages during late childhood, that persisted through to early adolescence. [ABSTRACT FROM PUBLISHER]

Vitamin A (VA) plays an important role in post-natal lung development and maturation. Previously, we have reported that a supplemental dose of VA combined with 10 % of all-trans-retinoic acid (VARA) synergistically increases retinol uptake and retinyl ester (RE) storage in neonatal rat lung, while up-regulating several retinoid homeostatic genes including lecithin:retinol acyltransferase (LRAT) and the retinol-binding protein receptor, stimulated by retinoic acid 6 (STRA6). However, whether inflammation has an impact on the expression of these genes and thus compromises the ability of VARA to increase lung RE content is not clear. Neonatal rats, 7- to 8-d-old, were treated with VARA either concurrently with lipopolysaccharide (LPS; Expt 1) or 12 h after LPS administration (Expt 2); in both studies, lung tissue was collected 6 h after VARA treatment, when RE formation is maximal. Inflammation was confirmed by increased IL-6 and chemokine (C–C motif) ligand 2 (CCL2) gene expression in lung at 6 h and C-reactive protein in plasma at 18 h. In both studies, LPS-induced inflammation only slightly reduced, but did not prevent the VARA-induced increase in lung RE. Quantitative RT-PCR showed that co-administration of LPS with VARA slightly attenuated the VARA-induced increase of LRAT mRNA, but not of STRA6 or cytochrome P450 26B1, the predominant RA hydroxylase in lung. By 18 h post-LPS, expression had subsided and none of these genes differed from the level in the control group. Overall, the present results suggest that retinoid homeostatic gene expression is reduced modestly, if at all, by acute LPS-induced inflammation and that VARA is still effective in increasing lung RE under conditions of moderate inflammation. [ABSTRACT FROM PUBLISHER]

Little is known about dietary patterns on weekdays and weekend days in children, and the aim of the present study was to investigate 4–14-year-old children's dietary patterns specifically on weekdays (Monday–Thursday) and weekend days (Saturday–Sunday). Dietary data were derived from the Danish National Survey of Dietary Habits and Physical Activity 2003–8, where a total of 784 children aged 4–14 years completed a 7 d pre-coded food record. Principal component analysis was used to identify dietary patterns in the age groups 4–6, 7–10 and 11–14 years. Consistently, two dietary patterns, labelled ‘processed’ and ‘health conscious’, emerged on both weekdays and weekend days. Factor scores from corresponding dietary patterns were significantly correlated between weekdays and weekend days with the exception of the ‘health conscious’ pattern in the 7–10-year-olds. Within each age group, children with high agreement for the ‘processed’ pattern had a significantly higher dietary energy density, which was reflected in significantly higher intakes of sugar-sweetened beverages and lower intakes of fruit and vegetables, compared with children with high agreement for the ‘health conscious’ pattern (P< 0·05). Moreover, these variables indicated less healthy dietary intakes on weekend days than on weekdays for both patterns. In conclusion, two distinct dietary patterns, labelled ‘processed’ and ‘health conscious’, were identified on both weekdays and weekend days for each age group. While overall major dietary patterns may somewhat track between weekdays and weekends, the specific foods actually eaten became less healthy during weekends. [ABSTRACT FROM PUBLISHER]